The Midwife's Special Delivery

by Carol Marinelli

  ‘Will you come with me while I speak to Mark?’

  CHAPTER NINE

  THEY walked out of Theatre and into the tiny annexe.

  Rory pulled off his blood-soaked theatre gown, but his theatre trousers and top beneath were stained as well, and Ally rummaged through the linen trolley and found him a fresh pair. As Rory quickly changed, not a single word or glance was exchanged between them.

  Rory’s lips were clamped together as undoubtedly he practised the words in his mind, summoning the strength to deliver a speech that every obstetrician dreaded. Ally stood there, willing herself to be calm, trying to stop the palsied shaking that seemed to be consuming her, knowing she had to be strong here, that it wouldn’t be helpful to Mark if she was overly emotional—that was entirely his prerogative.

  Down along the polished corridors they walked in silence, and only as they arrived at the interview room door did Rory turn and look at her.

  ‘I don’t know if I can do this.’

  And she nodded, nodded because she understood, and nodded her encouragement because they both knew that Rory had to.

  ‘Jess says that there’s been a complication.’ Mark sprang to his feet the second the door opened, and Jess looked over at Rory and Ally, searching their faces for any clues as to what was to come.

  ‘Sit down, Mark.’ Rory’s voice was firm, guiding the man to his chair and then sitting down opposite him. And even if the speech could have been delivered standing, Ally guessed that it wasn’t just for Mark’s benefit they were sitting. Her own legs felt as if they were made of jelly so Rory’s must be too.

  ‘Jess is right.’ He paused for a second and Ally knew he was struggling to compose himself. ‘Almost as soon as we started the operation, the anaesthetist noticed some worrying signs in Fiona.’

  ‘Fiona?’ Mark’s bewildered voice filled the room, terrified eyes darting from Ally to Jess and then back to Rory. ‘What about the baby?’

  ‘The baby was delivered quickly,’ Rory said gently. ‘And the paediatrician was on hand and he’s doing OK.’

  ‘So the problem isn’t with the baby?’ Mark was standing again now, raking his hand through his hair, his breath coming in short rapid bursts as the news started to filter through, as a nightmare he hadn’t even contemplated started to descend. ‘You’re telling me that there are problems with Fiona?’

  ‘Fiona has suffered an extremely rare reaction to anaesthetic, Mark.’ Rory’s voice was completely even, detached almost as he walked Mark through the minefield of information. ‘It’s called malignant hyperthermia, or MH. It’s when the body reacts to the drugs used in anaesthesia.’

  ‘And is it serious? I mean, can you reverse it?’

  Rory stood now, facing Mark head on. ‘It’s extremely serious, Mark. It causes trouble in many systems in the body—her temperature and blood pressure are elevated and her heart is beating irregularly. We’ve also had trouble trying to control her bleeding…’ Ally knew he was avoiding getting too technical but at the same time attempting to let Mark know the multifaceted problem that the doctors were facing. ‘We completed the operation as quickly as we could, but Fiona is very sick indeed. The symptoms progressed extremely rapidly and right now we’re struggling to stabilise her.’

  ‘But she’ll be OK?’ Mark’s anguished eyes pleaded with Rory.

  ‘It’s way too early to say that,’ Rory said gently, holding Mark’s eyes when he must have wanted so badly to look away.

  ‘Are you trying to tell me that my wife might die?’

  ‘It’s possible, Mark.’ Somehow, Rory still looked him in the eye as he nodded. ‘We’re doing everything we possibly can to save her, but I have to tell you that things don’t look good.’

  ‘She came in to have a baby!’ Mark was shouting now, his fists clenched in rage and horror, grief literally overwhelming him, and for a flash of time Ally was worried he was going to lose it, that he might even hit Rory. But Rory didn’t flinch and Ally guessed that he was also prepared for that eventuality and would stop it before it started. ‘My wife trusted you—you never told us this could happen. I’d never have made her sign that form if I thought this was how it was going to turn out!’

  ‘No one expected this to happen,’ Rory said, and all the fight seemed to go out of Mark, his body convulsed by sobbing. Rory held onto his shoulders, literally held him up as his whole world fell apart.

  ‘She came in to have a baby,’ Mark kept repeating. ‘This isn’t how it’s supposed to be. I don’t even know what she had.’ Stunned, dazed, he looked from Ally to Rory. ‘What did she have?’

  Strange that what had once seemed so vitally important was almost immaterial now.

  ‘You had a son,’ Rory said softly, lowering Mark back onto his seat. ‘And he’s beautiful. Would you like Ally to bring him in to you?’

  It was a relief to escape for a moment, and when Mark nodded, Ally slipped out and headed over to the nursery, ignoring her colleagues who were all eager for an update, terrified that if she stopped to talk, she’d just break down.

  ‘He wants to see the baby,’ Ally said to Vivien, the nurse unit manager, who was actually out of her office and working the floor, most of the staff tied up with emergency. ‘Is it OK if I take him down to him?’

  ‘Of course.’

  ‘Have you heard how Fiona is?’

  ‘Not good.’ Vivien gave a crisp nod. ‘Though they have asked me to organise an air ambulance, which I’ve just done, so hopefully she’s stabilised a touch. I really don’t know any more than that and I don’t want to get in the way by asking for updates.’

  ‘How’s the baby doing?’Ally asked, staring down at the tiny bundle fretting in his cot.

  ‘A bit restless, but his obs are all good.’ She was filling in the babe’s chart. ‘He’s actually hungry. Maybe you could ask the dad to sign the consent form so we can give him some formula.’

  And even if it was protocol, even if it was hospital policy to obtain a parent’s permission before the baby was given formula, Ally could scarcely believe what she was hearing. Vivien might be her senior, but Ally was past caring who she offended right now.

  ‘As if I’m going to ask the dad to sign a petty consent form after what just happened,’ Ally snapped, close to tears and angry with everyone. ‘Just give him a bottle, Vivien.’

  The interview room was subdued as Ally entered. A theatre nurse was talking to Mark and explaining that the anaesthetists were still working on his wife, but one of them would be along shortly to explain about Fiona’s transfer to a major hospital with specialized intensive care facilities.

  ‘That’s good, isn’t it?’ Mark gulped. ‘I mean, if she’s made it this far.’

  ‘It’s a little bit more hopeful,’ the nurse said cautiously, ‘but there’s still an awful long way to go. We’re literally taking things minute by minute right now.’

  Only then did Mark notice that Ally was in the room. His face slipped as he stared at the small package she was holding in her arms, and Ally wasn’t the only one in the room to shed a tear as she handed the babe to his father. Jess’s face was purple as she blew into a tissue and Rory sniffed loudly a couple of times as Mark cradled his son for the first time.

  ‘He’s beautiful.’ Mark stared down at him, and Ally knelt down beside him, supporting the baby as well, as Mark was shaking so much. ‘And he’s OK, you said.’

  ‘He’s perfect,’ Ally agreed. Now was not the time to tell Mark about his son’s close call—the baby was fine and for now that was all he needed to know.

  ‘She wanted a son…’ Mark’s finger traced the tiny snub nose. ‘Fiona doesn’t even know what she’s had. She’d have been so happy to know that she’s had a little boy.’

  And Ally thought back to the conversation she’d had with Fiona just as she’d been about to be put under, but filed it and saved it for later. She decided to discuss with Jess what to do with that precious piece of information and hoped against hope that Fiona might soon be able
to tell Mark herself. She watched as a smile flickered on Mark’s face between his tears as his son sucked furiously on his tiny hands. ‘Is he hungry?’

  ‘I think so,’ Ally said gently. ‘Would you like me to bring a bottle so you can feed him?’ she offered, not in the least surprised when Mark shook his head.

  ‘I don’t think I can.’

  ‘That’s fine—we’ll take care of him for now,’ Ally said gently, glad she had stood up to Vivien, wondering what Rory’s reaction would have been if she’d produced a form now for this poor man to sign.

  ‘Can I go with Fiona—when she’s transferred?’

  ‘No, I’m sorry.’ Rory shook his head, and answered the difficult question. Sometimes relatives were allowed to travel, even with a desperately ill patient, but not in this case. Fiona’s treatment was so intensive there would barely be enough room for the equipment and staff. ‘She’ll be going by helicopter—there will be a lot of staff and a lot of activity on board.’

  ‘Do you want me to ring someone for you?’ Jess offered. ‘You shouldn’t be facing this on you own, Mark. One of your relatives could drive you into the city.’

  ‘Our families are both in Sydney.’ Mark shook his head.

  ‘What about a friend?’

  Again Mark shook his head, staring down at his son as he spoke. ‘I don’t really want to tell anyone just yet but I don’t think I can drive. I’ll call a taxi…’

  ‘I’ll take you,’ Rory cut in. ‘I’ll go and arrange cover and I’ll take you there myself.’

  As he walked out of the interview room Ally caught Jess’s worried look.

  ‘Go,’ she mouthed, telling Ally to go after him, then, talking so that everyone could hear, she added, ‘I’ll stay here with Mark and the baby.’

  ‘Rory!’ Ally had to run to catch up with him. ‘I know you want to help, but you’re needed here. We’ve got other women labouring, the ward’s fit to burst, we need patients to be discharged…’

  ‘Then Mr Davies can come in from the golf course and do it!’ Rory snapped back, staring somewhere over her shoulder, refusing to meet her eyes.

  ‘You can’t just step down. You’re an obstetrician, Rory, not a taxi driver. I know you feel awful for Mark, we all do—’

  ‘I can’t do this.’ Rory slapped his hands on his thighs and turned to go.

  ‘It’s your job,’ Ally pointed out.

  ‘Well, maybe I don’t want it any more—maybe I don’t want to be a registrar.’

  ‘Rory, you’re not making sense.’

  ‘Just leave it, Ally.’

  ‘You can’t just walk off!’

  ‘Watch me.’ Rory’s face was chalk white, a muscle pounding in his cheek as he still refused to look at her. ‘I’m not cut out for this, for any of this, Ally.’ Some sixth sense told her that he wasn’t just talking about work. ‘It’s just not me.’

  ‘We’ll talk about it tonight, Rory. We can discuss it at home when things have calmed down,’ Ally said, but as Rory shook his head Ally knew what was coming next, knew because when finally he forced himself to look at her it was as if a glass wall had been placed between them, because even though he was just a few inches away, the distance was huge. She knew as he shook his head what was coming next, and she braced herself for his second cruel rejection.

  ‘I’m not cut out for any of this, Ally.’

  ‘Does that include me?’ He gave a slow nod and somehow she stayed standing as again he broke her heart. ‘Work, relationships…it’s just not me. I can’t see myself in five years as a consultant…’

  ‘You don’t have to be one if you don’t want to—’ Ally said, but he broke her off with the cruellest line of them all, ‘And I can’t see myself with you either, Ally.’

  CHAPTER TEN

  THE rest of the day seemed interminable and Ally had to drag on every last piece of her reserves to perform one of the hardest tasks in nursing—comforting patients when you needed it yourself, smiling, carrying on, reassuring them over and over when your own heart was bleeding.

  ‘I heard a patient was sick and I saw Mark in tears in the corridor.’ Kathy was as frantic as she was inconsolable, her looming depression and friendship with Fiona making the unpalatable news worse, if that was at all possible. ‘It’s Fiona, isn’t it?’

  Ally sat down on the edge of the bed and nodded. Word had spread like wildfire, the patients had all heard the frantic overhead chimes, seen the staff running towards Theatre, witnessed the helicopter landing. To deny it would be futile.

  ‘Fiona became unwell in Theatre—she’s been transferred to one of the bigger hospitals in the city and Mark’s gone to be with her.’

  ‘And the baby?’

  ‘He’s doing well,’Ally said, glad to be able to give one piece of good news at least. ‘He’s here in the nursery.’

  ‘Why hasn’t he gone with Fiona?’ Kathy said. ‘She’ll be devastated to leave him behind. Does she even know?’

  ‘Fiona’s not well enough to look after him right now and the baby will be better off here in the nursery than on a ward with other sick people.’ Deliberately Ally dodged the latter question, also avoiding the words ‘intensive care’. She certainly had no desire to volunteer information. ‘So we’ll keep the baby here for now and hopefully Fiona will be back soon to look after him herself.’

  ‘But what happened?’ Kathy pushed. ‘What went wrong? Why did she have to have a Caesarean section?’

  ‘Kathy, I can’t discuss it with you—the same way I wouldn’t discuss your care with another patient. All I can tell you is that Fiona is receiving the best treatment possible.’

  ‘Poor Fiona,’ Kathy sobbed. ‘And poor Mark. God, I’ve been such an idiot, sitting here moaning when I should have realised at the time just how lucky I was.’

  ‘Don’t even think about that,’ Ally soothed. ‘That’s not going to help anyone, is it? Right now you need to concentrate on you and your lovely baby. I see that Rinska’s taken you off the antibiotics. You’ll be able to feed him in a couple of days once they’re all out of your system.’

  ‘I’m going home tomorrow,’ Kathy gulped. ‘Rinska rang a lactation consultant and she’s going to come to my house if I’m having trouble getting him to take the breast.’

  ‘I’m sure you’ll be fine.’ Ally gave an encouraging smile. ‘It might be a bit tricky at first, but young Toby’s got a very experienced mum.’ Her diversion tactics only worked for a couple of moments. Kathy’s questions about Fiona started again and in the end Ally was grateful when Jess poked her head around the door and reminded Ally that her shift should have ended half an hour ago.

  There was just one job to do before Ally left the ward—fill in the admission book. Ally looked at her own casual writing of that morning, listing Fiona’s name and the date of admission in smart black pen. Clicking her pen to red to show there had been a serious event, Ally filled in the rest of details with a heavy heart.

  Live male.

  Mother transferred to Royal Women’s Hospital.

  ‘Have we heard any more news from the Women’s Hospital?’ Ally asked, joining an equally weary Jess at the lockers.

  ‘“Critical”.’ Jess tutted. ‘That’s all they’ll say when we ring—as if we didn’t know that much already. I hate the way the nurses on Intensive Care just take over, and forget we were the ones looking after her. Well, they’d better have a bit more information soon. I’ve already warned the girls on the late shift that we’ll be ringing later this evening for news. I’m not going to be able to make it all night without knowing.’

  ‘Me neither,’ Ally sighed, hoping that by the time she got home Rory would be there and could bring her up to speed.

  Hoping that by the time she got home Rory would have calmed down. She was literally shaking inside. As she walked to the lift Ally felt as if she was climbing off the biggest roller-coaster ride of her life, scarcely able to believe that the shift that had started so beautifully had ended so tragically. And she couldn�
��t even begin to deal with Rory’s little bombshell about the two of them. Her mind was completely scrambled, her head spinning as she walked away from the ward.

  ‘I’ve been a midwife for twenty years and I’ve never had a mother die.’ Tears were sparkling in Jess’s eyes as she pushed the button for the lift. ‘I’ve had some become sick, of course, but normally there’s been some warning, a heart condition or something, but for a perfectly healthy woman to come in to give birth and just…’

  ‘She isn’t dead,’Ally said firmly, but her heart wasn’t really in it. Over and over images of Fiona’s pale, mottled body on the theatre table as bag after bag of blood and fluid had been pushed into her played in Ally’s mind, and not for the first time she wondered if the only person she was fooling with her forced optimism was herself.

  Seeing Rory’s hire car badly parked in her driveway, Ally let herself in the door, not knowing what to expect when she saw him, and devastated to see his bags packed and lined up in the hallway. However, it was nothing she hadn’t been expecting.

  ‘Leaving again?’ She managed a twist of sarcasm as Rory met her in the hallway. ‘Well, I can’t say it’s come as a complete surprise. After all, I’ve had enough practice.’

  ‘Don’t,’ Rory attempted. ‘Ally, it’s not you, it’s me.’

  ‘I know it’s not me with the problem, Rory,’ Ally flared. ‘I’m just the idiot who trusted you all over again. When did you decide it was a mistake, Rory?’ She watched his face stiffen. ‘Or didn’t you even care what it might do to me, just so long as you were satisfied?’ Anger rose in her, and even though she’d sworn she wouldn’t do this, Ally let him have it—just a little bit—let him glimpse some of the hell he was putting her through. ‘I believed every word you told me!’ Ally shouted. ‘I let you twist everything around until in the end I doubted even myself—really thought that perhaps I’d misjudged you all those years ago. But it turns out that the only person I misjudged was myself, because I was sure I’d never let you hurt me again.’