Kjelland's forceps had a sliding lock and minimal pelvic curve so that rotation of the forceps would not lead to damage by the blades during the process of rotation.
Fliss nodded inwardly but then laid the forceps down again on the sterile drape covering her desk.
'You OK?' Angus queried softly.
The nod was obvious this time. 'I'm going to try a manual rotation first,' she told him. 'If it works, I'll use the forceps to complete the delivery.'
She was hoping, desperately, that it would work. Using her hand to hold and rotate the baby's head would be a lot safer than trying to cradle the tiny skull between cruel-looking metal blades.
'OK, Maria? You might feel me pushing a bit here, but it shouldn't hurt.'
'I'm fine.'
She didn't sound fine. She sounded terrified. Fliss was aware of Angus reaching out to hold the young mother's hand, and in the fleeting instant that part of her brain registered the action another part produced the clearest memory of exactly what Maria would be feeling. Fliss could feel it herself. The curl and grip of that big, strong hand. The gentle stroke of a thumb against a palm. Angus was very good at holding hands. So good that just the memory was enough for Fliss to be getting the same benefit Maria was right now. Enough to chase away any fear and insecurity that was blocking the total focus she needed for the challenging medical procedure she was on the point of undertaking.
A procedure that had a new life depending on it.
Whatever else was going on in the township of Morriston—even what could be happening to her other patients, out of sight in the waiting area—had to be temporarily forgotten.
The baby's head had to be turned to the anterior position through the shortest possible distance. Fortunately, with Maria's baby still three weeks away from its due date, it wasn't huge and Fliss actually found the procedure much easier than she had anticipated. She still couldn't afford to allow the delivery to continue naturally, however. When Angus located the foetal heartbeat with the stethoscope after its position had been corrected, the rate had dropped to just over eighty.
Way too slow. The baby was still in big trouble.
Fliss picked up the forceps again. She applied the left blade to the left side of the pelvis, then the right blade to the right side. She fixed the lock between the blades. Then she held her breath and concentrated on applying intermittent traction in the direction of the pelvic canal.
It seemed an agonisingly long time until a tiny head, plastered with dark hair, came into view. Anterior extension was required to effect delivery of the head and then, with a rush of fluid, the rest of Maria's baby came into the world.
'You were right, Maria! It is a boy!'
'Oh....Thank God! Is he all right?'
'Can you hold the desk lamp up a bit for me, please, Angus? The light's a bit low.' Fliss was amazed at how calm she sounded. She was feeling anything but calm. One crisis dealt with. Another just starting.
There was a suction bulb from the contents of the kit on the desk. Fliss used it clear the baby's airway but the tiny body was still limp and blue. There was no sound or movement that suggested an attempt to breathe for himself.
Prior to the delivery, Fliss had taken the precaution of laying out all the paediatric resuscitative equipment she had on hand. At the time she had hoped it was simply a precaution.
That hope evaporated as she reached for the tiny bag mask unit.
'What's wrong?' Maria sounded panicked. 'Why hasn't he started crying yet?'
'Give it a moment or two, love.' Angus said calmly. 'He's had a bit of a hard time getting here. He might just need a little longer to get used to things first.'
The tension was unbearable. Fliss puffed a tiny amount of air in to inflate the baby's lungs. She felt for a pulse, mentally preparing herself to start CPR and glancing towards the desk to check that the intubation gear was there. When a miniature hand suddenly jerked up a moment later and the baby screwed up his tiny features and opened its mouth to emit his first cry, Fliss found herself perilously close to tears.
Maria was sobbing aloud.
'He's alive....Oh, my God....I wish Ben was here.'
The baby's warbling cry strengthened. He was pinking up and his heart rate increasing. It was no longer possible to hold back tears of relief and joy when Fliss wrapped the baby in a soft, fluffy towel and put him into his mother's arms. Angus sounded suspiciously gruff himself.
'He's a beauty, Maria. Congratulations.'
It seemed that only Seth was aware of a cry that wasn't coming from the newborn infant.
'Angus?'
'Yeah?'
'Can you get over here? Like, now?'
'Help!' Everybody heard the cry when it came again a few seconds later. 'We need help!'
'There's two people outside,' Seth said tersely.
'Dr Slade?' The banging on the door was loud. 'Are you in there? Help...quick! Roger's bleeding to death here.'
'Who is it, Fliss?' Angus asked. 'Do you recognise the voices?'
'Roger owns the pub. That sounds like Wayne. He's an Australian who's been working at the pub for a while.' Fliss was clamping the umbilical cord.
'Shall we let them in?' Seth asked Angus.
'I think we should—'
'Of course,' Fliss interrupted. She reached for a pair of scissors to cut the cord but glanced up, hoping to catch a glance from Angus.
She needed to let him know that she was depending on him. She couldn't cope if he left. Maybe, if she pleaded hard enough, he could defy an order to go somewhere else.
A new patient was arriving. A case that sounded like it could be critical. The Apgar score on Maria's baby might have reached an acceptable level at the five-minute point but it still needed careful monitoring. His mother also needed attention to repair the perineal wound and deliver the placenta.
It was way past the time when Fliss would have preferred to have completed a thorough reassessment of her other two patients.
How had she ever thought she could manage without Angus McBride in her life?
She couldn't.
Not now.
Not ever.
CHAPTER SEVEN
The man was covered in blood.
'I need help,' his companion gasped. 'He can't stay on his feet much longer.'
Angus slipped his arm around the middle-aged man. 'Roger, is it? Come on, mate. Let's get you inside.'
He turned to the younger man who had staggered to one side as he was released from the burden of supporting his injured companion. He was now leaning forward, his hands on his thighs, trying to catch his breath.
'What's happened? Has Roger been shot?'
'No...'
Fliss appeared at the door connecting the waiting area to her surgery. 'Wayne, are you hurt?'
'No...just Rog.'
Angus was supporting virtually all of Roger's weight which was not inconsiderable. He felt the warmth of fresh blood well over his hand and was thankful he still had gloves on from assisting with the birth of Maria's baby.
'Got a torch, Fliss? I can't see where this blood is coming from.'
'It's his arm,' Wayne said.
'Let's get you sitting down.' Angus eased Roger to the floor, a task made easy by the way his patient's legs buckled at the suggestion. He propped the man against the wall only a few feet from Callum's bed.
Fliss was back with a torch.
'Watch the floor,' Angus warned. 'It's pretty slippery.'
With blood.
Wayne hadn't moved. 'It's his arm,' he said again.
'What happened?'
'We were trying to get away from the pub.' Wayne paused to take another ragged breath. 'Bob was worried sick about his kids.'
Bob was the father of the twins.
'He went one way and we went another.. .Kept ourselves hidden.'
'You didn't get challenged by the police?' Angus found the information disturbing. Two men had been moving through the township and had made it as far as the surgery without
being stopped.
If they could do it, so could the man responsible for at least some of the mayhem and injuries inflicted on Morriston tonight. They were all a long way from being safe yet.
Fliss was shining the torch on Roger's upper body. Through the ragged strips of torn woollen bush shirt covering his right arm, Angus could see the blood welling.
Spurting, in fact.
'Arterial bleed.' He clamped his hand over the wound and pressed. Hard.
'We were climbing over the Daleys' back fence.' Wayne was recovering now. 'We heard something move, which turned out to be their dog, but Rog got a fright and slipped. He caught his arm on a bent bit of the corrugated-iron fence. He's been bleeding like a stuck pig ever since.'
'Roger?' Fliss crouched beside their new patient. 'Can you hear me?'
Roger nodded.
'How are you feeling?'
'Like hell,' he said succinctly.
Fliss had her fingers on his wrist. 'Still got a good radial pulse,' she told Angus, 'but we'd better get some fluids up. He's tachycardia'
Angus nodded. He liked the way Fliss treated him as an equal when they were working together like this. Medically speaking, they made a great team, didn't they?
Hell, they would make a great team under any circumstances if only Fliss would give it a fair shot.
'I'll get the gear,' Fliss said. .'Keep the pressure on, Angus.'
He pressed harder and Roger groaned.
'Sorry, mate,' Angus said, 'but we really need to get this bleeding stopped.'
They couldn't know how much blood Roger had already lost. Having a radial pulse still present indicated that the systolic pressure was at least eighty but it could be dropping fast and they needed to keep it up to a hundred, in any case, to combat the effects of shock from lack of circulating blood volume. Silently, he willed Fliss to be speedy in getting back with the necessary equipment to start intravenous fluid replacement, but it seemed that she was going to be delayed.
'Fliss?' It was Maria calling. 'Something's happening.'
Behind him, Callum stirred and whimpered and Angus turned his head. 'It's OK, buddy,' he called softly, 'We're still here.'
'I can look after the lad.' Jack was moving from his mattress. The old man knelt beside Callum and took hold of the young boy's hand and Angus heard him start talking.
'I hear you're doing real well at school, young man. You have to get up early to catch the school bus, don't you? I can see you in the mornings when you and Cody are waiting at the bus stop with Mum.'
As Jack paused to catch his breath, the soft tones of Fliss's voice could be heard again and Angus felt a familiar curl of something pleasurable deep in his gut. He loved the sound of this woman's voice.
'It's the placenta arriving, Maria. It's all fine, hon.'
The baby's cry added to the impressions Angus was getting and Wayne was now crouched at Roger's feet.
'Is he going to be all right?'
'He's lost a fair bit of blood. I'm just trying to stop the bleeding.'
'I didn't know what to do,' Wayne confessed. 'And we were so close to the medical centre. I thought the best thing was to try and get here as fast as possible and find someone who did know what to do.'
'Mmm.' Angus kept his tone neutral. He couldn't blame Wayne for not wanting to stay put and maybe he had no idea how much blood could be lost if arterial bleeding wasn't controlled.
'Roger didn't want to stop, you know? We didn't know where that mad devil with the gun was.' Wayne dropped his voice. 'We were scared, you know?'
'I know.' It was easy to sound understanding now. Everyone was scared.
Including Angus.
Scared that he and Seth would be called to rejoin their squad and take part in some containment exercise, which would mean having to desert Fliss. What if he got injured himself? Or worse...killed? For the first time Angus felt the weight of the risk his job entailed. He'd never been afraid for himself. When adrenaline was running, it was only too easy to have the 'it won't happen to me' attitude. It had never really sunk in before how something happening to him could affect someone else.
This small medical centre was turning into a circus. How on earth would Fliss be able to cope alone? But she seemed to be doing astonishingly well and she was back by his side with a pile of intravenous supplies a very short time later.
'Placenta's arrived and appears intact,' Fliss relayed to Angus. 'I've saved it to get checked properly later.'
'How's the baby?'
'Seems fine. I've propped Maria up as much as I can with some pillows and she's managing to breastfeed him. I'm leaving the repair of the episiotomy till later when we've got more time.' Fliss handed the torch to Wayne. 'Could you hold this, please, and point it at Roger's arm, here? I'm going to put an IV line in. Is that OK, Roger?'
'Sure.'
'I've lost track of how long I've been sitting on this.' Angus looked up at Seth. 'Any idea?'
'Must be at least ten minutes.'
'That's what I thought.' Angus cautiously lifted his hand but an undiminished well of blood covered the space instantly. 'Damn!' He clamped his hand back on the wound. 'It's still bleeding, Fliss.'
'Mmm.' Fliss had her head bent, intent on inserting a wide-bore cannula in Roger's other forearm. 'We might need to try and tie off that artery.'
Her movements were swift and efficient as she taped the cannula into place, attached the giving set and the bag of fluids.
'Could you be a pole, please, Wayne? If you can squeeze the bag and get the fluids to go in a little faster to start with, that would be great.' Fliss wrapped a blood-pressure cuff where the loose tourniquet was still in place. Then she pulled the stethoscope from around her neck. 'I'll just get a quick BP and then I'd better change Callum's fluids.' She hesitated for a moment. 'I took the bag of saline from your kit, Gus. I've run out of extras now.'
Only Angus and Fliss were aware of the significance of her comment. Fluids were their main weapon in fighting to keep these patients stable until they could get them to hospital. Especially for Callum.
Jack was still having his one-sided conversation with the boy.
'That's a pretty smart bike you've got, lad. You and Cody got them for your birthday a while back, didn't you?'
The object of the old man's devoted attention stirred and they all heard the low moan.
'Cody-y...'
Roger twisted his head to look at Callum. His pale face folded into distressed lines and then he looked up at Fliss.
'He's hurt bad, isn't he?'
'I'm afraid so.'
'Where's the other one? Cody?'
'We don't know.'
Angus could hear the fear in her voice. He wanted to tell her things were going to be all right—that Callum would make it to hospital and an operating theatre in time and that they would find his twin and reunite the brothers—but he couldn't say that, could he?
He wanted to storm out into the night and end the terror for everyone, especially for Fliss. But he couldn't do that either.
Or could he?
Seth was obviously getting a message through on his radio. Angus could hear the buzz of static on his own malfunctioning equipment.
'We've got a rendezvous point,' Seth told him when the static cleared. 'We're due there in ten minutes. The guys they picked up in the pass have admitted there are other members of the gang still here. They've also revealed that the agenda was to deal with both the Barrett brothers and the younger guy that was involved in the dealing. Two people have been spotted on the move and, assuming that Darren is alone, they have to be gang members. We're closing the; cordon and clearing each house on the way in.'
'How far away is the rendezvous?'
'We should leave now.'
Angus shook his head. 'I can't leave now!'
Seth gave him a very level look but said nothing.
'For God's sake.' Angus knew where his duty lay and he wasn't about to shirk the responsibilities that came with his career, but this
was impossible. 'My hand is the only thing that's stopping this man bleeding to death.'
Seth looked at Wayne. He looked back at Angus and raised his eyebrows meaningfully. Fliss had another able-bodied man to help her, didn't she?
Angus was needed elsewhere.
'I'm going to find a clamp and some sutures.' Fliss scrambled to her feet. 'We'll have to get this artery sorted. Can you stay and help for just a few more minutes, Gus? Please?'
The plea tore at Angus. He had a duty to go with Seth and strong loyalty to his squad members, but the loyalty he felt for Fliss outweighed anything else at this moment.
'Buy us a bit of time?' he asked Seth. 'It's important, mate.'
'I'll see what I can do.' Seth didn't sound happy. He'd spent the last few hours on little more than sentry duty. Of course he wanted to get out there and in on the action. It was what they trained for. The kind of opportunity they'd curse missing if they hadn't been on duty.
He wanted to be part of the operation that would bring this incident to a close. An operation that could well involve some very serious tactics, like the use of teargas or stun grenades or firearms. The kind of action the squad trained for so assiduously and rarely got to put into practice for real.
Fliss clearly realised the significance of asking for the delay. She was moving fast. She laid out a suture kit, stripped off her gloves and donned a fresh pair. She drew up local anaesthetic and gave Wayne directions as to where they needed the strongest beam of light from the torch.
'I'm going to put in as much local as I can,' she told Roger, 'but this is going to hurt. I'm sorry.'
'Do what you need to, Dr Slade. I don't want to bleed to death.'
'You're not going to.' Angus kicked himself mentally for having scared Roger, but Seth wouldn't have been impressed by anything less than the truth. He shifted a pile of gauze swabs closer. He had to try and keep pressure on the artery and keep his fingers away from the needle as Fliss infiltrated the area with local. Then he needed to keep them away from the scalpel as she cleaned torn flesh obscuring the wound. He also had to try and swab blood fast enough for Fliss to see what she was doing.
'Right. Take the pressure off,' Fliss instructed Angus only a minute or two later.
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