by Joanna Neil
She dragged in a shaky breath. ‘My little boy’s had a cough for about a week but the antibiotics the doctor gave him don’t seem to be working. I’m on my own this weekend. I’ve been so worried. I’m new to the village and I have no transport and no one I can leave him with while I try to sort out what to do. I was going to the pharmacy to see if anyone could help, but he suddenly got worse. I knew he was ill but I didn’t think it was so bad—I think I need to call for an ambulance.’
‘Yes, that would probably be best,’ Nate said. He glanced up at Sophie but she was already dialling the number. ‘He’s feverish and not breathing properly,’ Nate went on. ‘He needs oxygen.’ He looked at Sophie once more. ‘Do you have your medical kit in your car? I have mine but I’m parked further down the road.’ He checked the boy over, feeling for a pulse. ‘His lips are a bluish colour already. I’m afraid we may need to intubate him fast.’
‘Yes, I’ll go and get it.’ Finishing the call, she hurriedly opened the boot of her car and hauled out her copious medical bag. Taking off her jacket, she rolled it up into the shape of a pillow and placed it under the boy’s head. She placed an SpO2 monitor on his finger and connected it to the portable machine that gave an oxygen read-out.
‘What’s his name?’ Nate asked the mother.
‘Shaun.’
‘Okay.’ He spoke directly to the boy. ‘Shaun, I’m going to listen to your chest.’ The boy didn’t respond but Nate reached for a stethoscope and was quiet for a moment, running the diaphragm over Shaun’s ribcage. ‘It sounds like pneumonia,’ he said after a while. He checked the SpO2 reading. ‘His blood oxygen saturation is very low,’ he told Sophie. ‘The most important thing right now is to get a tube into his windpipe and give him the oxygen he needs.’
Sophie helped him, introducing a cannula into Shaun’s hand and giving him a sedative and anaesthetic so that Nate could get easier access to insert the tube into his throat. They worked quickly, taping the tube in place on the boy’s cheek. Nate connected the tube to the bag and mask device and then attached this to an oxygen canister. He began to squeeze the bag rhythmically, getting life-saving oxygen into Shaun’s lungs.
Sophie explained the procedure to the mother and then said, ‘When he gets to the hospital he’ll most likely be given an X-ray and possibly a CT scan to take a better look at his lungs. They’ll want to do tests to see what’s causing the problem and they’ll give him a stronger broad spectrum antibiotic in the meantime.’
In the distance, they heard the sound of the ambulance siren. Nate looked up, frowning slightly as he saw that a crowd of onlookers had gathered around them. They were mostly silent, just watching, but Nate was too busy to take much notice. ‘I’m going to give him nebulised adrenaline,’ he told Sophie. ‘Will you take over here while I set it up?’
‘Of course.’ She squeezed the oxygen bag while he prepared the nebulised solution. It would help to relax the child’s airways and allow him to breathe more easily. After a while, when the boy was still unresponsive, he gave him a shot of corticosteroid, aiming to reduce any inflammation that was causing a problem. Sophie went on squeezing the oxygen bag and Nate spoke quietly to the child’s mother, trying to reassure her.
The ambulance drew up close by. ‘Hi, Doc—hi, Sophie...’ The paramedics arrived and listened carefully as Nate outlined the situation.
‘We need to have a team waiting for us at the hospital. He should go straight to Paediatric Intensive Care.’
‘Okay, we’ll let them know.’
They transferred Shaun to the ambulance and connected him to the monitors that would tell them his heart and respiratory rate, along with the level of oxygen in his blood. It was improving but it was still very low because of the infection in his lungs. Shaun’s mother sat alongside her son and Nate climbed into the vehicle to make the journey with them.
He glanced at Sophie. ‘Thanks for everything you did back there, Sophie. Maybe I’ll see you at the hospital later?’ He was looking at her packages, abandoned on the pavement.
She nodded. ‘Yes, I’ll be there most of the day, I expect.’ She watched the ambulance pull away and then went to gather up all her equipment.
The small crowd of people were still watching. ‘You and the other doctor did all right, there,’ one man said. ‘Do you think the boy will pull through?’
‘Well, we’ve done everything we can and he’ll be in the right place to get the care he needs,’ she answered carefully.
‘I never thought of Nate Branscombe working as an emergency doctor,’ another bystander said. ‘I only ever saw him coming and going from the Manor House.’ He nodded slowly, deep in thought. ‘Just goes to show, you never really know someone.’
Sophie collected her supplies and put them back into her medical bag. She stowed it away in the boot of her car, along with her shopping. A woman who Sophie recognised from around the village picked up one of the bags from the pavement and handed it to her. ‘Baby things,’ she said with a smile. ‘I guessed your sister would be due any time now. I hope things go well for her.’
‘Thanks.’ Sophie smiled and slid into the driver’s seat. She and Nate had spent a worrying half hour or so with the boy and she was almost looking forward to enjoying a more relaxed time in the maternity unit with Jessica.
* * *
Perhaps she ought to have known it wasn’t to be. Life was never that easy for her, and when she arrived on the ward Jessica was nowhere to be seen.
‘Oh, she’s been taken to the delivery suite,’ a nurse told her. ‘She’s not doing too well, poor girl. The contractions have been painful and they’ve been going on for quite a long time through the night. The doctor’s given her an epidural to give her some relief.’
‘But she didn’t tell me... Why wouldn’t she have phoned me?’
‘She said if it was going to be a long haul she didn’t want to worry you. I was about to call you, though. Things are beginning to speed up quite significantly.’
‘I’ll go and see her.’
Sophie hurried away to find Jessica. She was lying on the bed looking very pale, with a sheen of sweat on her brow. ‘Oh, Jessica, you were supposed to ring me,’ Sophie said, going over to her to give her a hug. ‘Did you change your mind about wanting me here?’
‘No! Never!’ Jessica smiled tiredly. ‘It’s just that it all started to happen in the night and I guessed you’d be asleep. I didn’t want to disturb you. And Mum was here earlier. She can be a bit exhausting when she’s in full flow. I’m not sure she’s taken her tablets.’
‘Oh, heavens! Where is she now?’
‘She’s gone to get a cup of coffee. Do you think you might be able to persuade her to swallow her meds with a bun or something?’
‘I will...but shouldn’t I be here with you?’
‘You will be. They say it will be a while yet.’ Jessica smiled, laying a hand on her abdomen as another contraction swept over her. ‘I can feel it but since I had the epidural there’s no pain. I’ll be fine. I think Ryan’s on his way to the hospital. He said he was going to catch a flight last night.’
‘That’s good. All right, I’ll go and see if I can find Mum and calm her down—though I suppose you can’t really blame her for being excited with a grandson on the way!’
Jessica smiled. ‘Yes, maybe.’
Sophie found her mother in the cafeteria, happily sending messages from her phone to all her friends. ‘I can’t believe it’s actually happening,’ she said. ‘But she’s been in labour for ages.’
‘It’s taking a while, isn’t it?’ Sophie agreed. ‘But a first grandchild is something special...worth waiting for.’
‘Oh, I can’t wait to hold him!’
‘I know. I feel the same way.’
They chatted and she persuaded her mother to eat something and swallow her tablets. Tom phoned a little
later and Sophie took the opportunity to slip away while her mother was preoccupied with the call. ‘I’ll see you in a little while,’ she mouthed as she left the cafeteria and her mother smiled.
She went back into the delivery room and saw, to her relief, that Ryan had arrived. He was holding Jessica’s hand.
She and Ryan greeted one another and then Sophie went to stand at the other side of the bed. ‘I’m so glad you made it in time,’ she told him. But, even as she said it, things started to happen all at once. Another major contraction started.
‘I can see the baby’s head,’ the midwife said. ‘Try to give a big push.’
The baby’s head appeared, but instead of being followed by the appearance of his shoulders, everything seemed to stop. They waited for Jessica’s next contraction, but even then the baby’s shoulders stayed firmly in place and when the midwife intervened it was no use.
‘The shoulder’s stuck,’ she said, looking worried. The baby’s face was turning grey and Sophie was becoming more alarmed with every minute that passed. If the baby stayed in this position for too long, the umbilical cord would be squashed and oxygen wouldn’t get through to him.
The midwife had signalled for help and the room filled with people: obstetricians, paediatricians, midwives, an anaesthetist. They all had a specific job to do but seeing them all there, trying to bring this baby into the world, was terrifying. As a doctor, Sophie knew the dangers but this was different—this was her sister at risk, along with her unborn baby.
Two midwives helped Jessica to get into a better knees-up position to facilitate the birth, the doctor made a deeper episiotomy cut and another midwife pressed down hard on Jessica’s abdomen. The baby was in distress and Jessica began to haemorrhage. It was horrifying to stand there and see it happen, and for Sophie to know that she had to keep out of the way and let the doctors and nurses do their jobs. This was her sister and her nephew who were in danger and she was frightened for both of them.
In the next minute the baby was born, but he didn’t make any sound. He was a bluish colour and floppy, and immediately the paediatrician took him and began to try to resuscitate him. A midwife wrapped him in a blanket to keep him warm and then the doctor suctioned him to clear away the secretions that were blocking his airway. They placed him in an incubator and started to give him oxygen, attaching vital monitor leads to him before wheeling him away to the Neonatal Intensive Care Unit.
Sophie wanted to rush after him and do anything she could to help, but her sister needed her too. Ryan was white with shock and looked about ready to pass out, while Jessica was clammy with exhaustion and loss of blood. She was still bleeding and the midwives were doing everything they could to stem the flow. Sophie tried to stay calm, urging Ryan to sit down and put his head between his knees for a while to restore his blood pressure, and then she went to hold Jessica’s hand once more.
Over the next hour, as the doctors and the nurses did everything they could to bring the bleeding under control, Jessica kept vomiting. All Sophie and Ryan could do was to try to make her comfortable. Sophie spoke to her mother and tried to reassure her—they’d been allowed to take it in turns to be in the delivery room.
‘I believe things have calmed down finally,’ the doctor said at last. ‘She’s stable, and the best thing to do now is to let her rest.’
Sophie and her mother left Jessica alone with Ryan from time to time over the next couple of hours, to give them some space. Her mother went to fetch coffees for everyone and Sophie went outside for a breath of fresh air.
Her phone rang. It was Nate, and relief washed over her at the sound of his voice. Everything seemed better when he was close by, even if he was only at the end of a phone line.
‘I wondered how things were going,’ he asked. ‘I’ve been thinking about all of you.’
‘She’s had a really tough time and I’m worried about the baby,’ she told him. ‘I don’t know exactly how he’s doing, yet, but I think he’s out of the woods. Jessica’s still retching. They’re giving her oxygen through nasal tubes and she’s on intravenous fluids, so she’s gradually improving.’
‘I’m sorry, Sophie. It sounds as though it’s been rough on her and the baby. Are you going to stay there through the night?’
‘No, Ryan’s the only one who can be with her then. The rest of the time they’re not allowing more than two visitors at the bedside and Mum’s going to be there for a while. Actually, I was almost expecting her to be overexcited despite her medication, but she’s been remarkably subdued.’
‘She’s probably worried, like everyone else. I guess when she takes her medication she’s fine.’
‘Yes.’ She frowned. ‘I’m glad you understand, Nate.’ Somehow, it was becoming more and more important to her that he accepted her family as they were. ‘I was afraid you might be uncomfortable around my family. They can be difficult to handle at times.’
He gave a short laugh. ‘I’m hardly likely to feel that way—there are skeletons in most family backgrounds, mine included, and my father isn’t exactly a prime example of how to behave.’
‘I suppose not.’ She wished he could be here with her right now. She yearned for his soothing presence but it wasn’t to be. He was probably going to spend time with his father.
Sophie cut the call a little later, after telling him, ‘I’ll stay with Jessica for another couple of hours and then I’m going to see Dad and Rob and let them know what’s happening. After that I’m going home. It’s been a traumatic day.’
Before going back to Maternity, Sophie looked in on the Children’s Unit and checked up on Shaun to see how he was getting on. He’d been in a bad way when the ambulance brought him to the hospital earlier that morning and she was worried about his condition.
‘He’s on powerful antibiotics,’ Tracey told her. ‘He’ll stay on the ventilator for some time, but he seems to be responding to the treatment.’
‘That’s something, anyway,’ Sophie said. ‘Thanks, Tracey.’ She checked on Josh, the five-year-old who had the head injury, but he was doing fine. He was almost well enough to be discharged home.
She went to see her sister one more time. Her mother was keeping her company, concerned for her youngest daughter and holding her hand.
‘I feel so dizzy,’ Jessica murmured, glancing at Sophie. ‘The baby—is he all right? I wish he was here. Have you been to look at him? Ryan’s gone to see him.’
‘Yes, I looked in on him in the Neonatal Unit,’ Sophie told her. ‘They’re keeping him warm and giving him oxygen. When you’re a little stronger and the baby’s more up to it, you’ll be able to hold him.’
‘I wish I didn’t feel so tired,’ Jessica said. ‘I feel so weak—the room’s spinning.’
Sophie gently squeezed her hand. ‘It’s because you haemorrhaged—you’re very short on iron, so they’re going to give you a transfusion. You should start to feel much better after that.’
Sophie’s mother left to go and meet her husband and tell him what had been happening, but Jessica asked Sophie to stay. ‘I feel better having you and Ryan with me,’ she said.
Jessica had the blood transfusion soon after that, and an hour later Ryan wheeled the baby into the side room where she was recovering. The baby was a much healthier colour now and looked none the worse for his ordeal. He was well wrapped up in a shawl and had a soft wool hat on his head to keep him warm.
Ryan carefully laid the baby on Jessica’s chest and she wrapped an arm around the sleeping infant. ‘We’re going to call him Casey,’ she said with a smile, and her husband kissed her tenderly. She was still very weak, but the three of them were together at last and Sophie breathed a sigh of relief, watching them. It looked as though mother and son were out of danger. She took some photos for posterity and then slipped out of the room to give them some privacy.
She went to see her father and
tell him about the new addition to the family. Rob was with him, getting the spare room ready while they waited for news, and he and her father were both glad to hear that disaster had been avoided. ‘I think the baby is a bit jaundiced,’ she told them, ‘so the medical team might have to deal with that, as well as making sure that Jessica recovers her strength.’
‘Maybe we could go and see her if she’s going to be staying in hospital for a few days,’ her father said and Sophie nodded.
‘Yes, I’ll take both of you. Ryan’s going to stay with her until they let her come home and then she’ll come back to live with me for a while, until he finishes this project he’s working on. As soon as that’s done, he’s going to take paternity leave to be with her and the baby.’
‘I’m glad he made it back here in time.’ Rob was proud to be an uncle and pored over the photos with his father.
She left them a little later and went home. It was late evening by then and she realised she had missed out on a meal. Her stomach was rumbling and she set about making a quick broccoli, pasta and cheese bake.
The doorbell rang as she set the table and she wondered if Rob had forgotten his key.
‘Hi, Sophie.’ Nate stood outside her front door, looking wonderful, his dark eyes glittering as he gazed at her in the evening light, his body honed and full of vitality. He was wearing smart casuals, chinos and a dark shirt.
‘Come in.’ She smiled at him and showed him along the hallway to the kitchen. ‘I wasn’t expecting you, but you must have smelled the food. There’s plenty. Would you like to eat with me?’
‘Mmm...smells good. It’ll have to be a quick bite, though,’ he said regretfully. ‘I’ve been with my father most of the day and I need to go back to the hospital in a while.’
She frowned. ‘It’s bad, then?’
He nodded. ‘I came away for a while so that the nurses could tend to him. I thought I’d check up on you—see how you’re bearing up. I guessed you’d be back by now.’ He folded her into his arms. ‘I’ve been thinking about you all day, wondering how you were getting on, missing you.’