Best she should concentrate on work. What could she remember from her early studies about the tumour called a meningioma? Usually benign, she thought, but its growth within the outer covering of the brain—the meninges—could be causing compression on areas of vital function—in this case on the occipital region.
‘Has she had any treatment for it?’ Liz asked as Khalifa folded his phone and slipped it into his pocket.
‘Normally the patient would have been given steroids in an attempt to shrink the tumour, but with her pregnancy it was thought an immediate operation was the best option. We have cribs with radiant heaters at the hospital because we use them to fly at-risk babies to the capital. I’ve asked one be prepared for you and for staff to be available.’
He paused, turning to look directly at her.
‘Are you sure about this?’ he asked. ‘The journey—you must be tired…’
Liz had to smile.
‘When I slept for most of it? Hardly,’ she said. ‘And isn’t this the best way to tackle a new job? To leap right in and find out exactly what you do and don’t have on hand? I’m very sorry for the poor woman, but I have to admit I’m excited at the same time.’
She really was, Khalifa realised as he took in the shine in her eyes and the slight flush of colour in her cheeks. He shook his head, unable to believe he’d, just by chance, found a colleague who obviously felt as he did about their profession, felt the physical thrill of a challenge.
Though it was probably best he not think of physical thrills and this woman in the same breath…
‘Oh, it’s pink as well.’
She whispered the words but he saw wonder in her face and felt a surge of pride because his hospital was truly a beautiful building. Stretched out in a swathe of parkland, the architect had somehow managed, with the design of the multi-level building, to still hint at the shape of the tents his family had used for thousands of years, while the dark pink colour of the walls spoke of desert dunes, the gold highlights desert sunsets.
But all he’d said was, ‘We can leave our luggage in the vehicle.’
It was the most unusual hospital Liz had ever seen, arched openings leading into wide verandas that spread out from every floor, bright rugs and cushions thrown with apparent abandon across the marble tiling. Here and there black-robed women and turbaned men sat around low tables, drinking coffee from tall silver pots set over braziers that looked as if they held live coals.
In a hospital?
‘Families like to be close to their loved ones, and this seemed to me a practical way to provide accommodation for them,’ Khalifa said, making Liz realise her amazement must be showing.
‘And presumably they don’t take their cooking fires inside near the oxygen tanks,’ she remarked, following him through a self-opening door into the foyer of what looked like a six-star hotel but was obviously the hospital’s main entrance.
Voices called what she took to be greetings to Khalifa, some men bowing their heads in his direction, not, she felt, subserviently, but merely an acknowledgement that he was among them again.
He spoke briefly to a woman in loose trousers and a long tunic, a uniform not unlike the clothes Liz had brought with her. So she’d got that right, she was thinking when Khalifa took her arm and steered her towards another foyer with a bank of lifts.
This was the bit she still had to get right, she realised as her body reacted with volatile enthusiasm to his touch. She could have lit up an entire fireworks display had the fizz and sparks been visible. It had to be the hormonal shift of being pregnant. She’d put it down to that and, in the meantime, avoid opportunities that involved touch—or smiles, or laughter, or even, if possible, hearing his voice. Toes could only take so much!
‘This is the theatre floor,’ he said, preparing to lead her out of the lift, but she dodged his hand and strode ahead then realised she’d turned the wrong way. That was okay. Now she could follow him, trailing in his wake, taking in the ramrod-straight back, the sleek sheen of his hair, and the neat way his trousers hugged—
Totally not going there, Liz!
He led her into a theatre anteroom where a group of men and women were already pulling on hospital gowns over T-shirts and shorts, or were fully gowned and discussing what lay ahead of them.
‘This is Dr Elizabeth Jones,’ Khalifa announced above the rush of greetings. ‘I won’t confuse her with all your names at this stage but she’ll take care of the baby once it’s delivered.’
He beckoned to a woman at one side of the room and she came forward, her dark eyes studying Liz.
‘Laya is the head nurse in our nursery,’ he explained, and Liz held out her hand.
‘Call me Liz,’ she said. ‘And lead me somewhere I can have a shower and change. Who knows what foreign germs I could be carrying?’
Laya led her into a large bathroom with several shower stalls.
‘Theatre gowns are in these cupboards,’ she explained. ‘I’ll wait and get you kitted up.’
Liz grinned at her.
‘Kitted up? Is that a local expression?’
‘I trained in England,’ Laya said. ‘I could have chosen the USA but my family had been visiting London for years so I knew people there who were happy for me to live with them.’
She’d been stacking clean theatre gear on a bench so hadn’t noticed Liz’s baby bump until she turned back towards her.
‘Oh!’ she said.
‘Exactly,’ Liz told her, ‘though it’s not what it seems and, anyway, I’m perfectly well and quite capable of doing my job. Just get me a couple of sizes larger of everything.’
Laya looked as if she’d have liked to protest, or maybe ask more, but Liz hurried into a shower stall, stripping off her underwear then grimacing as she realised she’d have to put it back on again afterwards—or wear some of those enormous paper undies that were available throughout most hospitals. Pity they didn’t do large size paper bras.
‘Now we’re organised,’ she finally said to Laya, ‘so lead on.’
Scrub up next, then into Theatre, gowned and gloved, where the patient was already on the table, one of the men from the anteroom in place at the patient’s head, another man, obviously the obstetrician, preparing for an incision on the woman’s swollen belly. Khalifa was on the far side of the room, examining the X-rays and scans on what looked like a flat-screen television fixed to the wall.
Liz checked the preparations Laya had made in the hastily set-up newborn care corner. A trolley of fixed height with radiant warmer, drawers that would hold equipment, an oxygen bottle, a hand-operated neonate resuscitator, scale, pump suction with foot operation, IV cannulas, mucus extractors, soft towels for drying and wrapping the baby, sterile equipment for tying and cutting the cord, feeding tube, sterile gloves—everything seemed to be in place.
As the obstetrician reached into the small incision and drew out the tiny infant, Laya wheeled the trolley close and Liz took the baby—a boy. She used a fine tube to clear his mouth and nose, squeezed his little chest so he began to breathe and then to cry. She held him against his mother’s chest, only for a moment, but it felt the right thing to do for both of them, then, when the obstetrician had tied and cut the cord, she set the infant on the trolley and wheeled him to the corner of the room while the surgeons prepared the woman for the next stage of her operation.
‘He’s come through this well,’ she said to Laya, as the vital Apgar numbers added up to six at one minute. She’d used a bag and mask to give him a little extra oxygen, and by five minutes his score was up to nine.
Once dry and warm, they weighed and measured him.
‘Fifteen hundred and fifty-eight grams—it’s low for thirty-four weeks,’ she said to Laya, then glanced over at where Khalifa was preparing to open the woman’s skull. ‘She possibly hasn’t been feeling well for some time, maybe not eating properly. Would she have been seeing a doctor or midwife regularly?’
‘I don’t know her, but she’s from the desert so I doubt
it,’ Laya said. ‘It’s all very well to build hospitals and clinics but getting our people, particularly the women, to use them will take a lot longer than His Highness realises.’
‘His Highness?’ Liz echoed, and Laya nodded towards Khalifa.
‘He’s our leader—a prince, a highness,’ she explained.
Well, that settled all the fizz and sparking stuff, Liz thought, not that she’d ever had any indication that the man might be interested in her. As if he would be, pregnant as she was, and probably not even if she hadn’t been pregnant.
A highness, for heaven’s sake! And she’d been joking with him!
Though she should have twigged when he’d talked about the palace!
‘Did he not tell you?’ Laya asked as Liz wrote down the baby’s crown-heel length of forty-four centimeteres.
‘Well, yes,’ Liz admitted, ‘but somehow you don’t connect a bloke you meet in the corridor at work with royalty. I thought maybe like our prime minister—that kind of leader—an ordinary person with a tough job. Head circumference thirty-three.’
She made another note, her mind now totally on the baby, although the murmur of the surgical teams voices provided a background to all she did.
‘I’ve got a special-care crib waiting. Should we take him to the nursery?’ Laya asked when the little boy was safely swaddled and ready to be moved.
Liz glanced over at the woman on the table. The baby’s mother was unconscious, of course, but would she have some awareness? Would she know her baby had been taken? Would she need him nearby?
‘I think we’ll stay here to do the stabilisation,’ Liz responded. ‘The crib has monitors on it so we can hook him up to them to watch him, and give him anything he needs as he needs it. At this weight he’ll probably have some apnoea and will need oxygen support, caffeine to help his lungs…’
She knew she was thinking aloud, but the situation was so strange she wanted to make sure she was ready for every possible problem that could arise. CPAP, the continuous positive airway pressure, could be delivered through a nasal cannula, and if she put in a central venous catheter for drugs and measurements and a peripheral line as well, all the bases would be covered.
But without a special-care unit, where would they take the baby?
To the nursery?
No, from what Khalifa had told her, under normal circumstances they’d fly any premature baby to the capital.
Not a good idea, given what the mother was going through. Liz glanced towards the tall surgeon bent intently over the operating table.
‘Do new babies room in with their mothers here at the hospital?’ she asked Laya.
‘Some do,’ Laya told her. ‘It’s a choice the mothers are offered.’
‘And are there on-call staff rooms at the hospital—places where staff can stay over?’
Laya frowned at this question—not a big frown, more a worried grimace.
‘Of course. Why are you asking?’
Liz grinned at her.
‘I’m thinking maybe this baby can room in with his mother,’ she said. ‘Khalifa—’ should she keep calling him that now she knew about the Highness thing? ‘—said there were few financial restraints and, anyway, it would only mean maybe a couple of shifts of nursery nurses, preferably ones who’ve worked with fragile newborns, helping stablise them before they’re flown out, and we could keep him with the mother. I’d be happy to live in at the hospital to take a couple of shifts, and I’d still be able to do the preliminary work on the new unit at the same time. What do you think?’
It was Laya’s turn to glance towards the surgical team.
‘I don’t know what to think,’ she said. ‘But once she’s out of Recovery, the mother will go into Intensive Care…’
‘A very sterile environment for a newborn,’ Liz reminded her. ‘Of course, we’ll have to make sure there’s room for the crib and a nurse to watch his monitor, but if there is, wouldn’t it be best to have the baby near the mother? Wouldn’t that be more of a help to her recovery than a hindrance?’
Laya shook her head.
‘I don’t know,’ she said, glancing again at the table—or more particularly at the lead surgeon, who was still bent over the patient.
‘You think he’ll be a problem?’ Liz teased, then she realised Laya was genuinely distracted.
‘I know he lost his wife and child,’ Liz said gently, ‘but I would have thought that would make him all the more determined to achieve the best outcome for this mother and child.’
‘Of course,’ Laya told her, ‘but…’
‘But what?’
Laya hesitated, before saying, in a very quiet voice, ‘Will you ask him?’
The way she spoke reminded Liz of the fear some surgeons managed to instil in their theatre staff, roaring at the slightest mistake, swearing and cursing when things went wrong. Now she, too, looked back at this particular surgeon. She didn’t know him from Adam, but from the time she’d spent with him, she’d have put him down as the very opposite—quiet, reserved, not given to tantrums.
‘Is it because of the highness thing you don’t want to ask him?’ she said to Laya, who looked even more uncertain.
‘Not really. But I suppose it must be, because when he was just a doctor, if I did happen to run into him, it was just “Good morning, Doctor” like you do with all the staff you don’t know really well. But since he became our leader—well, it changes things, doesn’t it?’
Liz adjusted the cannula in the baby’s nose.
‘Did he change?’ she asked, and Laya gave the question some thought then shook her head.
‘He’s not here as often, of course, but when he is he’s just the same. And he always knows everyone’s name, which most of the doctors and even nurses from other departments don’t, but I don’t think he’s changed. It must be me who’s changed.’
‘I wouldn’t if I were you,’ Liz told her. ‘Just carry on as you always did. But, anyway, it was my idea we room the baby with the mother so I’ll ask him and make the arrangements, okay?’
Laya’s smile told her the nurse had relaxed, and her words delighted Liz even more.
‘Will you ask if he can arrange for me to be one of the nurses? I’ve travelled with preemie babies to the hospital in the capital so I know how to care for them, and I’ve already put my name down for training in the new unit.’
‘Then I’ll certainly ask for you,’ Liz promised as Khalifa straightened up, stepped back from the patient and pulled off his gloves.
‘Clean gown and gloves,’ he said to one of the surgical staff, then he walked over to look at the baby, tilting his head to one side as if to take the little being in more clearly.
‘You’re still here?’ He looked up at Liz as he asked the question and though she was about to make a joke about just being a mirage, the strain in his eyes told her this wasn’t the time.
‘No unit to take him to,’ she said lightly. ‘And I felt it was important to keep him close to his mother. In fact, Laya and I have just been talking about it, and we’d like him to room in with her if that can be managed. I’d be happy to live in here so I’m always on hand, and Laya and another nurse can share shifts with me. I realise the mother will be in the ICU for a while, but at least the atmosphere will be sterile and when the mother becomes conscious we’ll have the baby on hand for her to see so she doesn’t feel any anxiety or fear for him. I realise if you’re not done there, you can’t discuss it now, but we’ll wait here until you finish and maybe talk about it then.’
He probably wouldn’t understand the slang expression ‘stunned mullet’ but it described him to a T. Fortunately the scrub nurse called him for his fresh gown and gloves and one of his colleagues needed him back at the table, so any further discussion was suspended.
‘He didn’t look too happy about your idea,’ Laya ventured, and Liz grinned at her.
‘That’s probably only because he’s used to being the one with the big ideas,’ she said. ‘Once he’s had time
to think about it, he’ll see it makes sense.’
And living in at the hospital would keep her safe from fizzing and sparks—but that was a side benefit. The baby definitely came first.
CHAPTER FIVE
TWO hours later, as he stepped away from the operating table, leaving room for one of his assistants to close, Khalifa remembered the baby in the room—the baby and the woman caring for him!
She wanted the baby rooming in with his mother in the ICU?
The idea was bizarre, but even more confusing was her determination to stay at the hospital to care for the newborn. Was her own pregnancy making her ultra-sensitive?
Not that he’d noticed the slightest sensitivity on her part towards her pregnancy—the subject was not open for discussion. Yet it niggled at him, both the pregnancy and her seeming lack of interest in it.
He shoved his soiled gown and gloves into a bin, called for a fresh gown, although he’d finished at the operating table, and eventually, clean again, moved across the room to where the two women waited by the crib.
‘The mother will be in Recovery for some time,’ he said, addressing the air between Laya and the newcomer. ‘I suggest the baby goes to the nursery where Laya can keep an eye on him.’
Now he had to face his new employee. With her richly coloured hair hidden by a cap, the black-rimmed glasses dominated her face, making her skin seem creamier, her eyes a deeper blue.
‘Not a good idea,’ she said. ‘Look at him. You say he’s thirty-four weeks, but the mother may have miscalculated. Either that or he’s not been well nourished. Put him in among healthy newborns and he’ll look more like a skinned rabbit than he already does. Apart from anything else, it would be upsetting for the other mothers, with their chubby little pink-cheeked babies, to see him.’
Khalifa felt a twinge of annoyance. Dr Elizabeth Jones might have seemed the perfect person to set up the new unit at his hospital, but if she was going to argue with him every time he opened his mouth…
‘Apart from anything else?’ he queried, allowing his voice to reveal the twinge.
The Sheikh and the Surrogate Mum Page 6