Christmas on the Children's Ward

by Carol Marinelli

  Eden’s heart was in her mouth as Vince gently extended the little girl’s neck. Eden applied the necessary pressure to allow the endotracheal tube to pass more easily and with her other hand passed him a laryngoscope, which allowed him to visualise the throat as he passed in the ET tube. His fingers snapped impatiently for Eden to pass the connections to the oxygen supply, waiting for the bag to inflate. It probably only took a couple of seconds but it felt like for ever.

  ‘Has she had any acyclovir?’ Vince asked, and Eden shook her head.

  ‘We only just noticed the rash—’

  ‘It’s ready,’ Becky broke in. ‘It’s all been checked.’

  ‘Then let’s get it started,’ the anaesthetist said grimly. ‘Can you ring ICU and let them know I’m bringing her straight up?’ His foot was already kicking off the brake and Eden moved quickly, disconnecting the oxygen from the wall and attaching it to the portable cylinder, moving the monitors and dripstand onto the bed to prepare it for transfer as Becky dashed off to alert ICU.

  ‘What’s happening?’ Dr Timms’s registrar stood breathlessly at the door after a mad dash from the car park, his car keys jangling in his hand.

  ‘I’ll tell you on the way.’

  ‘ICU wants ten minutes,’ Becky called as she ran along the ward. Everywhere lights were flicking on, mothers alerted by the overhead chimes and commotion, babies abruptly woken from sleep crying for attention, but for now the sole concern was Harriet.

  ‘ICU can keep on wanting,’ Vince responded, continuing to move along the corridor and bagging Harriet as the rest of the MET staff pushed the bed, one running ahead to hold the lift doors open. ‘This child doesn’t have a spare ten minutes.’ He glanced over at Nick, whose face was seemingly impassive, but Eden knew he was lacerated with pain. ‘I’m sorry, Nick, I forgot you were here.’

  ‘Just do what you can, Vince.’ Nick’s lips were white. ‘Don’t worry about me.’

  Becky was grabbing Harriet’s notes, running to catch up with the entourage, and Rochelle was wheeling the crash trolley back to the nurses’ station. For a small slice of time, Eden and Nick were left alone, and for the first time in her life Eden truly didn’t know what to say, didn’t know how on earth to comfort him. Dragging her hair tie out, she ran a helpless hand through her hair and a tiny ghost of a smile dusted his taut lips at the familiar gesture.

  ‘You don’t have to say anything, Eden. This isn’t anyone’s fault.’

  ‘I know that,’ Eden choked. ‘I just…’ Helplessly she stood there, wanting so much to reach out and comfort him, to somehow convey that she felt his pain, but those days were long gone now. Her fists bunched at her sides as she struggled to keep her emotions in check. ‘I’d better tell Lily what’s going on.’

  ‘I already know.’ A tiny figure emerged from the darkness, fear, pain and grief etched on every feature. Nick was on the ball because just as Lily’s knees buckled he caught her. Strong arms wrapping around his sister, he guided her down the long lonely walk to ICU and all Eden could do was stand there and watch them leave.

  CHAPTER ELEVEN

  ‘BUT how?’ For what seemed the hundredth time Rochelle voiced the question that no one could really answer as Eden struggled to feed a restless Ben.

  The ward had long since been cleaned up, the crash trolley restocked. In theory Eden could probably have gone for her break, but sitting down and flicking through a magazine held no particular charm right now so instead she was attempting to settle Ben, who no doubt was picking up on Eden’s heart still thumping in her chest and refusing to take his bottle. Rochelle stood at Ben’s doorway, clearly stunned at the rapid turn of events and desperately needing to talk.

  ‘I mean, the poor kid’s only got chickenpox!’

  ‘It’s very common.’ Eden nodded. ‘Unfortunately, in some cases the side effects can be severe.’

  ‘But it all happened so quickly,’ Rochelle said.

  ‘That’s the way it is with children,’ Eden explained. ‘They can hold their vital signs for a long time, appear relatively well, but when their condition deteriorates it can be extremely rapid. That’s why we do such frequent observations on the children’s ward—they can’t always tell you themselves that they’re not feeling well.’

  ‘If I’d done Harriet’s obs, would I have picked it up? I mean, his mum’s a doctor and she didn’t seem concerned. What chance would I have had?’

  ‘I don’t know,’ Eden admitted, ‘but I can guarantee that next time you do a set of neuro obs and every time for the rest of your nursing career, you’ll remember what just happened and be on the lookout for anything that doesn’t seem quite right.’

  ‘He’s nearly asleep,’ Rochelle observed, smiling from the doorway at Ben. ‘He likes it when you’re talking.’

  ‘He does,’ Eden said fondly gazing down at a now relaxed Ben. His eyes were closed and he was sucking hard on his bottle. She took the opportunity to explain in a bit more detail what had just happened to Harriet.

  ‘As I said, chickenpox can have some quite nasty side effects, one of them being viral encephalitis, which means an inflammation of the brain. Now, in Harriet’s case, the inflammation caused the seizure that brought her to Emergency. Often, first seizures are sent home and followed up with outpatient appointments, but because Harriet was febrile it was decided to keep her in hospital for observation.’

  ‘But she didn’t even have a rash.’

  ‘She didn’t have to,’ Eden patiently explained. ‘The fact she was febrile and had had a seizure indicated there was some type of infection going on. It could have been nothing more than a mild ear infection, but until a diagnosis was made no one could be sure. At the back of the doctor’s mind would have been the possibility if not of viral encephalitis then certainly meningitis—that’s why she was kept in isolation until we knew exactly what was going on.’

  ‘But will she be OK?’

  And that was the one question, as much as she wanted to, Eden couldn’t really answer.

  ‘I don’t know, Rochelle,’ Eden admitted. ‘They’ve started her on some strong antiviral medication and they’ll probably give her some steroids to reduce the inflammation to her brain, but it really is going to be a case of wait and see.’

  ‘Could she have brain damage?’ Rochelle asked, and even though her question was merited, Eden closed her eyes in horror, scarcely able to comprehend herself that the vibrant beautiful girl she had shared Christmas with now lay in Intensive Care in a critical condition.

  ‘She might,’ Eden said softly. ‘But there’s one good thing about working with children. As quickly as they decline, they also pick up very rapidly. Let’s just hope that’s the case with Harriet.’

  But despite her confident words, despite the hope she tried to imbue, as the night progressed, as notes were written and the morning round commenced, the horror of what had taken place never left her mind. Her heart ached for Lily and what she must be going through, and even though she was loathe to admit it, even to herself, she felt desperate for Nick, for all he had been through and for all he was suffering now.

  When handover had been given and the day staff had been bought up to date with the night’s events, Eden pulled on her jacket and slipped into Ben’s room for a quick goodbye. She knew she had to go up and check on Harriet’s progress before she left the hospital.

  She knew that, despite her own pain, she couldn’t walk away without letting Nick know she was thinking of him.

  Bracing herself, Eden entered Intensive Care. Introducing herself to the nurse in charge and checking it was OK, she made her way over to Harriet’s cubicle, standing quietly outside the glass window and staring in.

  ‘How is she?’ Eden asked as Lavinia, one of the charge nurses she vaguely knew, came up beside her.

  ‘About as sick as a five-year-old can be. The mother’s just gone to ring the father. Apparently they’re separated. Imagine the poor guy when he picks up the phone and hears this news.’

  �
��How’s Nick?’ Eden asked, already knowing the answer.

  ‘Beside himself, of course. He thinks that he should somehow have worked out what was wrong sooner. He’s berating himself that the acyclovir wasn’t started down in Emergency. As if, I told him, we’re going to start acyclovir on every febrile child that comes into the hospital.’

  ‘He’s just scared, I guess,’ Eden said, staring through the glass at Nick. Draped in a white gown and even with a mask covering his face, the raw anguish was visible in his eyes and all she could do was repeat Rochelle’s words.

  ‘The poor kid’s only got chickenpox.’

  The worst thing about night shift was Eden’s total inability to sleep during the day, and that morning was no exception. Lying on her back, she stared wide-eyed at the ceiling, going over and over in her head the previous night’s events, wondering over and over if something—anything—could have been done that might somehow have changed the outcome.

  ‘Oh, Nick.’ The words shivered on her lips, the face that had haunted her for days swimming into focus every time she closed her eyes. Even though she was still reeling from his callous rejection, she was completely unable to hate him. Her mind was a horrible jumbled mess. She was furious with herself for crying over someone she didn’t mean a thing to yet unable to stop.

  Giving in, Eden padded into the kitchen. The house was impossibly quiet without Jim. She dropped two pieces of bread into the toaster and pulled some margarine and Vegemite out of the fridge, comfort food definitely the order of the day! There was something infinitely comforting about tea and toast in bed. She stared unseeing at a midmorning chat show on her faithful portable TV, watching as a relationship guru shared his wisdom, listening to the appalling mess people made of their lives and realising she’d done exactly the same.

  Becky was wrong, Eden decided, her mind finally made up. Placing her plate on the bedside table and flicking off the television, she shut down other people’s problems and for once really concentrated on her own.

  The hardest thing wasn’t walking away, it was staying to watch love die.

  Her mind made up, Eden closed her eyes.

  The first real sleep she’d had since Boxing Day finally washed over her.

  CHAPTER TWELVE

  ‘IS THIS about Ben?’ Donna stared at the sheet of paper in front of her, rereading the neat handwriting once again before looking over to where Eden sat at the other side of the desk.

  ‘In part,’ Eden admitted. ‘But there are other factors involved.’

  ‘Are you going to enlighten me?’ Donna asked, frowning as Eden shook her head. ‘You’re not giving the ward much notice, Eden.’

  ‘I’ve got a week off after tonight,’ Eden pointed out. ‘And after that I’ve still got four weeks’ annual leave owing. I know it might be difficult to fill the roster, but—’

  ‘I’m not worried about the roster,’ Donna broke in. ‘I’m worried about you, Eden. I can fill a few shifts, but I can’t replace a dedicated, knowledgeable paediatric nurse so easily. I thought you were happy here.’

  ‘I am,’ Eden answered, desperately trying to keep her voice even, to keep her emotions in check and just make it through this awkward interview. ‘Or, rather, I have been. I just think I need a change.’

  ‘And you have to leave tonight?’ Donna frowned. ‘On New Year’s Eve?’

  ‘I know it’s a lot to ask—but I just want a fresh start.’ Eden swallowed. ‘I saw a position advertised in the intensive care unit at the children’s hospital. I want a fresh challenge.’

  ‘You’re sure?’ Donna checked. ‘There’s nothing I can say to make you change your mind?’

  ‘Nothing,’ Eden gulped, and she braced for the protest, for Donna to dig deeper, to try to get to the bottom of things. Instead, she was standing up and offering her hand, which almost reluctantly Eden took.

  ‘Then I wish you well, Sister. I’ll be happy to provide a reference for you.’

  ‘I’m sorry if I’m leaving you short,’ Eden attempted, slightly taken back by the ease in which Donna had accepted the news.

  ‘We’ll manage.’ Donna smiled. ‘I need nurses who want to be here, Eden.’

  ‘I know.’ Eden nodded.

  ‘You haven’t exactly given us time to arrange a leaving do or a collection—’

  ‘I don’t want anything,’ Eden broke in. ‘I just want to slip away.’

  ‘Run away perhaps?’ Donna said, raising an eyebrow, but when Eden didn’t react instead she offered her hand. ‘Good luck, Eden.’

  And that, Eden realised, as she shakily made her way into her last handover, was that. No fanfares, no tearful goodbyes. She could walk away with her head held high.

  So why didn’t it feel good?

  ‘I don’t believe her,’ Becky huffed as Donna marched off the ward without even stopping to say goodbye. ‘It’s New Year’s Eve, for goodness’ sake, and she expects us to take the Christmas decorations down.’

  ‘Well, we’re not,’ Eden said. Becky had, no doubt, been expecting a small murmur of protest, but there was a definite note of defiance in Eden’s voice that had Nick, who was on the phone, looking up. ‘It’s still Christmas. Decorations aren’t supposed to be taken down until Twelfth Night, which isn’t until the sixth of January.’

  ‘Try telling that to Donna,’ Becky said, rolling her eyes.

  ‘I will,’ Eden responded. ‘There’s no way I’m taking them down. It’s bad luck.’

  ‘Actually,’ Nick corrected her, covering the mouthpiece with his hand ‘it’s bad luck to leave them up after the sixth.’

  ‘Same thing,’ Eden retorted.

  ‘Hey, I’m on your side,’ Nick sighed, putting down the phone. ‘Frankly, I could use all the luck I can get tonight. They’re going to extubate Harriet.’

  ‘I heard,’ Eden said. ‘She seems to be responding well to treatment.’

  Nick gave a very tentative nod. ‘We’ll know more once they take the tube out. There’s still a long way to go, but at least she’s fighting. I’ll be in Intensive Care if you need me.’

  ‘We won’t,’ Becky responded. ‘For once the ward’s just about empty and I, for one, intend to make the most of it. We deserve a quiet night after the last few we’ve had.’

  ‘Well, I’m off,’ Nick answered, clicking off his pen and placing it in his top suit pocket. For an indulgent moment Eden stared, capturing this moment, tracing his features with her eyes, trying to somehow etch them on her mind, knowing that it might be the last time she saw him. ‘And don’t you dare take down those decorations. Happy New Year, ladies.’

  ‘Happy New Year, Nick,’ Becky said. ‘We’ll ring Intensive Care later and see how Harriet is. Good luck!’

  Maybe he felt the weight of her stare, maybe he sensed there was something going on, but Nick stared at Eden for a long moment, frowning slightly at her pensive face.

  ‘Good luck with Harriet,’ Eden croaked.

  ‘Thanks, Eden…’ Still he stood there and Eden was sure there was something he was about to say, but whatever it was he chose otherwise, giving her the briefest of nods and heading off to Intensive Care.

  Ben seemed to know something was up and refused to go to sleep, giggling and waving every time Eden walked past the room. When he didn’t know she was watching he played peek-a-boo with the mirror that was attached to his cot, the absolute cutest he had ever been, as if making some last-ditch effort to win her heart.

  ‘Den,’ he squealed when she finally came into the room and pulled on her gown, going through the familiar routine of changing his nappy before feeding him, catching legs that were kicking their protest and dressing him in his new pyjamas, brushing his teeth for him. Finally, when all the chores were done, she cuddled him close and gave him his bottle.

  ‘You’re going to be fine,’ Eden said firmly, as if to convince herself. ‘Donna was telling me this evening that Lorna’s found a wonderful new home for you. There will be lots of other children there, lots of friends to play wi
th.’ Tears that couldn’t fall tonight threatened to choke her, a residential unit the very last thing she had wanted for Ben. If Eden hadn’t been sure, she knew then she was making the right decision. She couldn’t bear the thought of seeing Ben when, as was inevitable with his condition, he was readmitted, knowing that the one thing the little guy really deserved, really needed, was going to be denied.

  That he’d never have a family.

  ‘Fifteen minutes till midnight,’ Becky said as Eden came and sat down, taking a grateful drink of the coffee Becky had made her. ‘And the Christmas tree lights are still on. We’re going to be in trouble in the morning.’

  ‘We’d better take them down before the morning,’ Eden sighed.

  ‘What happened to your sudden streak of assertiveness?’ Becky grinned.

  ‘It scared the life out of me. You know how useless I am at saying no. Do you mind if I take first break?’ Eden asked. ‘I might head up to the roof and watch the fireworks over the harbour.’

  ‘Go for it,’ Becky said, then screwed up her nose. ‘Bloody fireworks. I refuse to watch them on principle. Imagine burning thousands of dollars that could be spent providing meals for some poverty-stricken country.’

  The diamond rocks in Becky’s ears would provide a whole new irrigation system, Eden felt like pointing out, but realised her bad mood wasn’t Becky’s fault. Eden didn’t say anything, just pulled on her cardigan and headed out of the ward, taking a moment to stop and stare at Ben, who was finally asleep, the sheet she had tucked around him discarded on the floor, his little bottom sticking up in the air, thumb firmly in mouth. Eden thought her heart would break.

  The roof of the hospital was a fairly open secret and Eden half expected to find a crowd gathered there to watch the New Year firework display, but clearly the other wards weren’t as quiet as the paediatric unit tonight and Eden stood alone, staring out to Sydney Harbour, seeing the elegant shape of the Opera House and the impressive sight of the Sydney Harbour Bridge. Hundreds of boats were out on the water in prime vantage points. Despite the warm night air, Eden shivered, pulling her cardigan tighter around her, jumping when she heard footsteps coming up behind her. Even before she turned Eden knew it was Nick.