by Amy Andrews
He missed that smell. It had dissipated quite quickly from his bed and his unit, and damn it all—he wanted it back!
* * *
A week later, Claire’s phone rang and she picked it up. It was Casualty.
‘Claire, we need you here. We have a patient of yours who’s arriving in about two minutes in premature labour.’
‘Who?’ Claire heard alarm bells ringing in her head.
‘Lex Craven.’
‘She’s twenty-eight weeks, isn’t she?’
‘That’s right. I’ve already paged Campbell.’
‘I’m coming now.’
Claire hurried down to Casualty, her mind running through all contingencies. The odds for premature babies had improved dramatically with modern drugs and supportive respiratory measures, but twenty-eight weeks … that was quite early. Where prematurity was concerned, the longer the gestation the better the baby’s chances.
A lot was going to depend on the size of the baby and the maturity of its lungs. Hopefully it wouldn’t come to that. They might be able to stop the labour if it wasn’t too far advanced, or at least delay it a little to allow the administration of steroids to help mature the baby’s lungs.
Claire was so focused on achieving a good outcome for Lex and her baby, the thought of having to work closely with Campbell was completely secondary. The most important thing was they put aside their awkwardness and act as a team. They were both professional enough for that.
She arrived slightly out of breath, adrenaline energising her blood in anticipation. The Casualty department was bedlam.
‘Claire.’ The nurse who emerged from behind the curtains of the obstetric cubicle greeted her, handing her a gown as she washed her hands. ‘Campbell’s just arrived. It’s a madhouse here. There’s an arrest in cubicle two and the neonatal team are dealing with an emergency in Theatre. They’ve been paged and will get here as soon as they can. It’s just you and Campbell for the moment.’ She gave a lewd wink and Claire rolled her eyes. ‘The minute anyone becomes available I’ll send them your way.’ She scurried away, pushing a pole laden with pumps.
When Claire entered the cubicle, Campbell was hooking Lex up to the CTG machine to monitor the baby’s heart rate. Lex was hysterical—crying, moaning and writhing around on the narrow trolley.
‘I can’t have the baby now,’ she cried. ‘It’s too early. Please, please,’ she begged them. ‘I don’t want my baby to die.’
Brian was trying his best to calm and comfort his wife, but Campbell’s relief at seeing her was palpable and Claire didn’t need to ask to assess what he needed first.
‘Lex,’ Claire said loudly, to cut through the woman’s hysteria.
‘Claire … Oh, Claire. My baby, please, my baby.’ She burst into renewed tears.
‘Lex.’ Claire gripped her hand firmly. ‘I know this is a worrying time for you, but it’s very, very important that you calm down.’
‘But my waters broke. I’m bleeding and it’s too early,’ she sobbed.
‘I know, but we won’t know anything for sure until we’ve checked you out. It’s imperative you stay still so Campbell can assess how the baby’s doing. Now, take some deep breaths and calm down. Come on,’ she encouraged, demonstrating how she wanted it done. ‘Breathe with me.’
Lex started to relax a little, which allowed Campbell to get a good trace of the baby’s heart rate.
‘One hundred,’ he said quietly, but loud enough for Claire to hear. A little slow.
‘Shall I get a speculum?’ she volunteered, swapping the hand-holding job with Campbell.
‘Lex,’ he said, ‘I need to check and see if you’re dilated at all. Your membranes have ruptured so this baby obviously wants out, whether we like it or not. The only choice now is whether to let you deliver normally or to section you, and that will depend on your dilatation.’
‘But it’s too early for the baby to be here,’ she sobbed.
‘Obviously I wish the baby was further along, but the choice is no longer ours. Don’t worry, Claire and I are here.’ He shot a reassuring smile at Lex.
Claire handed him a speculum to allow him visual access to Lex’s cervix. ‘You want me to give her this?’ she asked, holding up the empty ampoule of steroids she had already prepared in a syringe.
‘You read my mind,’ he said, his brow puckered in concentration as he removed the speculum and felt the amount of dilatation with his fingers. ‘Fully dilated.’ He grimaced as Claire injected the steroids into Lex’s leg. This would hopefully have some effect on maturing the baby’s lungs. Ideally, two doses were given before the premmie baby was born, but they obviously weren’t going to have enough time.
Lex groaned as a contraction swamped her body, and Claire noted the baby’s heart dip into the sixties. She glanced at Campbell and his eyes mirrored her concern.
‘Oh, no! I need to push!’ Lex cried, alarm causing more tears to fall.
‘Lex, you’re fully dilated.’ Campbell’s calm voice took control of the situation. ‘I want you to push, go with it. Push.’
Lex face reddened as she pushed down with all her might. When the contraction eased she said, ‘What about a Caesarean?’
‘Not enough time. This baby will be out quicker than I can section you. Now, I’m not going to lie to you. The baby does seem to be showing some signs of distress so the quicker you can push it out, the better.’
Lex started to cry again, working herself up very quickly. Claire had to get Lex to settle and focus if they were going to get the baby out quickly.
‘Lex, we’re here. Trust us. Stay calm and push on the next contraction.’
With Claire’s soothing, Lex settled again and Claire encouraged her to channel her anxiety into the pushing. Five minutes later a tiny baby girl slid safely into Claire’s waiting hands.
Thankfully another nurse arrived just at that moment to tend to Lex, which freed Claire to help Campbell resuscitate the small and as yet silent neonate.
‘Doesn’t look very big. Eight hundred grams if we’re lucky,’ Claire said in a low voice, placing the baby in the specialised resuscitation cot, complete with overhead warmer and removable sides for easy emergency access.
‘She’s barely breathing.’ Adrenaline pounded through Claire’s system as her trembling hands hooked the baby up to the monitor. ‘Heart rate fifty.’
Claire’s fingers worked rapidly administering gentle chest compressions as Campbell fitted a mask attached to a bag over the baby’s face, enabling him to give respiratory support to the baby’s feeble attempts at breathing.
‘I’ll need to intubate,’ he stated, grabbing a thin curved plastic tube handed to him by a member of the neonatal team, who had burst through the curtain seconds ago.
Campbell felt adrenaline charge into his system, kicking his heart rate up and honing his concentration. His hand shook and he took a deep breath. He would not lose another baby.
Claire continued working as he quickly passed the tube down the baby’s throat and into her lungs. Campbell exhaled the breath he’d been holding, but there was still too much to do to dwell on the success of the tricky procedure.
‘Adrenaline,’ he said, as he attached the breathing tube to the bag and puffed one hundred per cent oxygen into the little lungs.
Campbell quickly disconnected the bag again so adrenaline could be squirted down the breathing tube directly into the lungs. Claire watched the monitor as the heart rate accelerated to one hundred and eighty.
The collective sigh of relief could be heard outside the curtain as people started to relax, knowing that they had brought the tiny baby back from the brink. The first hurdle had been passed.
‘Her lungs are very stiff,’ Campbell commented to the neonatologist, who was dialling up settings on a portable ventilator. ‘She’ll need high pressure.’
Claire let the neonatal team take over and went back to her patient who was inconsolable, desperately needing to know what was happening with her baby.
‘Is she OK?’ asked Brian.
‘We’ve managed to secure her airway and get her heart to beat faster,’ Claire confirmed cautiously.
‘That’s good, right?’ asked Lex, an edge of hysteria in her voice.
Claire looked at Lex’s and Brian’s desperate faces, hungry for good news. She knew all they wanted was any scrap of positivity she could give them. It was a difficult line to walk. The compassionate nurse and human being in her wanted to help allay their fears and assure them everything would be OK.
But in reality she knew that the combined effects of their baby’s prematurity, her weight and the high pressure needed to ventilate her were not good signs. As much as she wanted to, she couldn’t give them false hope.
‘She’s over this initial hurdle. They’re taking her to the neonatal intensive care unit. Her progress from now on will all depend on how her little lungs cope. Luckily, we have some very good drugs to help her in that department.’
‘So she’s not out of the woods yet,’ Lex sniffed.
‘No. In fact, she’s quite critical.’ Claire softened her voice to ease the blow. It had to be said. There was no point trying to put a positive spin on it when Claire knew the baby’s chances were slim.
Lex began to cry again and Brian hugged her to him. Claire stood by silently, holding Lex’s hand, giving them time to express their grief.
‘But premmie babies do really well these days, right?’ asked Brian. His face begged her to agree.
‘Yes, some of them do really well,’ she confirmed gently. Claire didn’t have the heart to go into any more detail. She’d tried to prepare them for what the neonatologist would say, but she didn’t want them to give up all hope. ‘Why don’t we get you sorted and you can both go up and see her?’
‘Really? We’ll be able to see her this soon?’
‘Absolutely!’
Lex and Brian were cheered by this prospect and Claire spent the next hour dealing with routine post-delivery matters. Campbell had gone to the NICU with the baby and Claire was too busy to dwell on the heart-stopping events that had just taken place.
Brian pushed his wife in a wheelchair to see their daughter, with Claire tagging along. On their arrival at the unit they were put in a comfortable lounge area and told the doctor would come and talk to them. Claire waited with them—she couldn’t leave them now.
Campbell found them there a few minutes later. Claire’s heart sank at the grim look on his face.
‘Campbell.’ Lex’s voice lifted at his arrival, ‘What’s happening? Is she all right?’
‘It’s touch and go,’ he said quietly, pulling up a chair to sit close to them.
Lex’s face crumpled and Campbell took her hand, rubbing it soothingly.
‘The neonatologist will be here to speak to you soon. I just thought you might like an update.’
‘Claire said she’s critical. Is that right?’ Brian’s voice wobbled with emotion.
Campbell looked at Claire and smiled sadly at her worried face. He was glad she was there. Glad for Lex and Brian, who were going to need a lot of emotional support, and glad for him, too. Her presence helped make his words easier to say. Knowing she was there to support him as well as them was comforting. Giving people bad news was never easy. Having someone you knew and trusted by your side was a godsend.
‘Yes, Brian. Your baby is critical. She’s needing one hundred per cent oxygen and special drugs to support her blood pressure. Her lungs are very hard to ventilate, they’re very stiff. The machine that is breathing for her has to deliver her breaths under great pressure to even get them into her lungs. I won’t lie to you. Her outlook isn’t good.’
Claire closed her eyes, feeling dreadful for Lex and Brian and thankful that she didn’t have to deliver such devastating news herself. She looked at Campbell. His face was as grim as the news he’d just imparted.
She felt a tug in the region of her heart. He hadn’t had a very good run. He’d worked wonders today under great pressure but she wondered if he felt a sense of déjà vu. Having witnessed at first hand how affected he had been by Hillary’s baby only weeks ago, she worried how he’d be if he lost this baby, too.
‘What are her odds?’ Brian asked gruffly.
‘We’ll be doing everything in our power to get her through this, Brian. But she’s nearly on maximum support now so I’d say her chances are quite slim. I don’t like to give percentages, the neonatologist will probably go through that with you, but she’s so tiny. That’s her biggest disadvantage at the moment.’
‘How tiny?’ asked Lex, realising that she knew almost nothing about her little girl—not even how much she weighed.
‘Eight hundred and fifty grams.’
Claire’s heart went out to Campbell as his words sank heavily into the silence that followed. No further words were necessary to impart the seriousness of her size. One thousand grams was the magic number for premmie babies. Those weighing less often didn’t have good outcomes.
How could a baby so small ever survive? Even with the medical technology they had today? It would be a miracle. But, Claire reminded herself, miracles can and did occur in intensive care units all the time.
‘Maybe we should think about getting her christened,’ Brian said quietly to his wife, tears glistening in his eyes. Lex’s shoulders shrugged up and down as she sobbed into her husband’s shoulder.
Claire and Campbell sat in silence while the couple’s grief echoed around the room. Claire felt helpless. What could you say to make things better? Nothing. All she could do was be there for them.
‘Would you say a prayer with us, Campbell? Claire?’ asked Brian quietly, lifting his head.
Campbell wasn’t a religious man but he knew that people’s faith could help them through extremely traumatic situations. Who was he to argue with that? Whatever helped Lex and Brian cope was worth a try.
They all joined hands and bowed their heads.
Claire was conscious of Campbell’s hand engulfing hers and of their shoulders rubbing lightly together. The circle was intense and intimate and she felt a connection with Campbell she hadn’t felt before. It suddenly seemed right to be here by his side.
Claire felt her heart thudding in her chest as a realisation began to dawn. This feeling of intensity and connection—she knew what it was. It was love.
Suddenly it was clear. She’d been in love with him all along and hadn’t known it. Claire suppressed a groan. What a completely inappropriate time to have such an epiphany!
‘Amen,’ whispered Brian.
Amen, thought Claire.
A nurse entering the room broke the mood and startled Claire out of her introspection.
‘I’m sorry we’ve taken so long to get to you, Mr and Mrs Craven. My name’s Leah. I’m looking after your baby today. Julie MacDonald, the neonatologist, will speak to you both shortly. Would you like to come and see your daughter first?’
Leah spoke to the new parents on the way to the bedside about all the machines and tubes and monitors they would be seeing. She knew it was often devastating for parents to see their intensely monitored baby for the first time.
Claire and Campbell tagged behind slightly. It was hard for Claire to concentrate now. She was trying to come to grips with her revelation and act normally at the same time. A difficult thing to do when the man in question was so close she could feel the heat radiating from his body.
‘She’s so tiny,’ Lex whispered, a tear running down her face as they watched the fragile little girl through the clear plastic of the isolette. Tubes and lines crisscrossed her practically transparent body. There didn’t seem to be an area of skin that had escaped being covered by one thing or another.
‘What’s her name?’ Claire enquired.
‘Charlotte. After Charlotte Bronte. Jane Eyre is my favourite book,’ replied Lex, her voice flat, her hand pressed to the plastic.
‘It’s a beautiful name,’ said Claire, squeezing Lex’s shoulder.
Julie MacDonald arri
ved and Claire withdrew, knowing that Lex and Brian were in good hands. She gave assurances she’d call back later when the new parents had digested some of the information. Claire arranged with Leah to page her should the baby’s condition change for the worse.
Now all the drama was over Claire needed to be alone. She had to get away from Campbell’s presence to think. A lot had happened today. Professionally and personally.
Her hands trembled as she walked back to the birth centre. What kind of a fool had she been? She’d honestly thought she could deny love from her life. She’d thought that if she didn’t allow a man into her life and didn’t allow herself to think about it, or talk about it then it couldn’t possibly happen. She’d been wrong. Love didn’t work like that. You didn’t get to choose where love was concerned.
She realised now that those feelings and emotions that had puzzled her so much after she’d met him, the ones she’d never experienced before, had been the first stirrings of her love for him. Her feelings for Shane had been puppy love in comparison.
She sat at her desk and cradled her head in her hands. Watching Campbell in action today, his compassion and gentleness with Lex and Brian, the way he’d empathised with them—that had done it. That had been the clincher.
She’d already witnessed his brilliant professional skills in highly stressful situations. She knew he was an excellent practitioner. But to see him connect and take the time to be with grieving people—that was special.
His involvement with Hillary and Danny and their baby was a perfect example. He cared. He got involved. Too many doctors departed after bad news and left it to the nurse to do the comforting. Not Campbell, and, heaven help her, she loved him for it.
Claire groaned and gave herself a mental shake. She swivelled in her chair so she could look out the window. It didn’t matter anyway. That she loved him was immaterial. The facts of her life were still the same. Nothing could come of it.
So she’d just have to get over it. Yes, it was going to take time, but she’d acknowledged it, hadn’t she? Surely that was the first step. She couldn’t be with him, so pining was pointless. Besides, she never pined. Never. She got on with life. She did that really well.