City Surgeon, Small Town Miracle

CHAPTER THREE

THIS was crazy. Worse than crazy, it was dangerous. No, she wouldn’t leave Gran and the unknown Angus, but maybe his responsibility was to pick both women up and take them to hospital regardless.

But he’d have to chain Gran into the car, he thought ruefully. Plus he didn’t know what facilities Gosland hospital had, and the long drive to Sydney was the last thing either of them needed.

But caring for an injured, pregnant woman at home…

And for him personally to have to check her baby…

Max was out on the back veranda, supposedly on his way to fetch Maggie’s gear from the back of her wagon. He’d taken a moment to phone Anton, his anaesthetist, to tell him that their more-than-competent registrar would be needed for the woman coming in with the hysterectomy complications. Now he was staring down at the river winding down to the sea, taking a second to catch his breath. And his thoughts.

Maggie would agree to hospital if there was a real threat to her baby. He knew it. The moment he’d laid it on the line-that they were risking the baby’s death-he could tell that both women would finally agree to go. Only there was such despair in the old lady’s eyes, and such a sense of defeat and fear on Maggie’s face, that he’d agreed to help them stay.

So all he had to do now was to find Maggie’s ultrasound equipment and turn into an obstetrician again.

No. Checking one baby didn’t make an obstetrician.

He wasn’t even delivering a baby. He was simply checking it was healthy, before heading back to the city to his very successful gynaecological practice-the surgery he was good at and that he could do without the emotional investment every pregnant woman seemed to demand of him.

The need to care.

Not that he didn’t care about his patients. He did. He gave excellent service, making the lives of the women who came to him much more comfortable. He was even saving lives.

He just didn’t do babies anymore.

Except this one.

This was insane. He should refuse to have anything to do with it.

Yet…the way she looked at him…

It was the craziest of reasons and yet he couldn’t let it go. She looked as trapped as he felt. More.

He didn’t know what was at stake here. He shouldn’t want to know, he reminded himself. Do not get personally involved.

Stay professional, he told himself harshly. Find the ultrasound equipment, make sure things are okay and then leave. An ultrasound was no big deal. It wasn’t like she was expecting him to deliver the baby.

That was really when he’d run a mile.

‘Is he really a doctor?’

‘He says he is and he knows all the right words.’

The open fire was wonderful, the room was warm, but Maggie was still shivering. Reaction, she thought. Nothing more. It couldn’t be anything like internal shock-caused by a bleed, say, from a torn placenta.

She had to fight the fear. But what was keeping him?

She had a sudden vision of Max in his beautiful car, heading back to Sydney, and she felt ill. But she wasn’t running after him this time. She trusted him.

She had no choice.

‘Where are my calves?’ Gran said fretfully.

‘The crate slid off the back of the truck. The calves ended up on the beach. Bonnie’s watching over them.’

‘Are you sure they’re okay?’

‘They’re fine.’ Hopefully they were.

‘How do you know? Of all the irresponsible… You only had to bring four calves less than ten miles.’ The old lady’s voice was querulous and Maggie looked at her sharply.

‘How bad’s the pain? Scale of one to ten?’

‘Three.’

‘Betty…’

‘Eight, then,’ she said, goaded.

‘You have to let me put up a syringe driver.’ With a permanent syringe, morphine could be delivered continuously so there wasn’t this four-hourly cycle of pain, relief, sleep, pain that Betty was suffering. But so far Betty had resisted. She’d insisted on control at every stage of this illness and she wasn’t letting go now.

‘I’ll take a pill in a few minutes.’

‘Take one now. No, take two.’

‘When I see our baby’s okay,’ Betty said roughly. ‘Oh, my dear…’

‘It’ll be fine.’ Maggie hauled herself around and stretched her hand out to her. Betty’s hand was thin and cold and it trembled.

Probably hers did, too, Maggie thought. Things were going from bad to worse.

Hurry up the man with the ultrasound. Max. A doctor for her baby.

And more.

Max.

He’d carried her and he’d made her feel cared for. The remembered sensation was insidious-almost treacherous. It undermined her independence. Stupidly it made her want to cry.

Max.

He opened the back of the wagon, expecting to see a basic medical kit-or even no kit at all, because he still hardly believed she was a doctor-but what he saw was amazing. The equipment, carefully stored, sorted and readily accessible, was state of the art.

What had she said back at the crash site? She was the ambulance?

Maybe she was, for in the centre of the shelves of equipment lay a stretcher. It had been fitted to custom-built rails, with wheeled legs folded underneath. It was narrow, but otherwise there was little difference to the stretcher trolleys used at his city teaching hospital.

The ultrasound equipment was impossible to miss for it was in a red case labelled ‘Ultrasound’. Useful for a doctor in a crisis, he thought, to be able to say to an onlooker, ‘Fetch me the red case with this label.’ And the cases were stacked and fastened against the sides in such a way that in a crisis they could be pulled out fast.

He had a sudden vision of an emergency-maybe a child with breathing problems. With this set-up Maggie could haul out the side cases fast, then have someone else drive while she worked on the patient until they reached help.

Basic but effective. She was efficient, then, this Dr Maggie.

He needed to be as well. He tugged the ultrasound case, grabbed another case labelled ‘Pain/Anaesthetic’-and then, thinking of the strain on the old lady’s face and the wheeze behind her voice, he grabbed an oxygen canister as well.

Okay. Doctor with equipment.

They dropped their linked hands as he walked back into the room. Up until now he’d seen only an underlying tension, but there was now an obvious tie between the women. Emotional as well as physical?

Was the old lady really dying? He gave himself time to look at her-really look. She was dreadfully gaunt, as though eating had long ceased to be a priority, and her face was taut with pain. And her eyes… He’d seen that look before. Turning inward.

‘Betty needs a shot of morphine,’ Maggie said before he could say anything. ‘Please. Ten milligrams. You’ll find everything in my bag.’

‘The baby…’

‘One injection’s not going to take time. Betty needs it badly.’

‘Diagnosis?’ he said, watching Betty now and talking directly to the elderly woman.

‘Bone metastases,’ Betty whispered. ‘Ovarian cancer ten years back. I knew it’d get me in the end.’

‘Is Maggie your treating doctor?’

‘Now I’m not in hospital, she is,’ Betty said fretfully. ‘But look after her. I’m fine.’

But Max was already flipping open the case, drawing up the injection, aware both women were watching him like two hawks with a mouse between them. Or two mice with a hawk?’

‘You agree to this?’ he said, watching Betty’s face. Feeling Maggie’s tension behind him.

‘Yes,’ Betty whispered. ‘Please.’

He injected the morphine, feeling her pulse as he did so. Faint, irregular. If she was forty he’d be roaring for help, he thought, bullying her into hospital, pulling out all stops to help her, but her body language told him she knew exactly what was happening. He placed pressure on the injection site for a moment and her hand lifted to his and held.

‘Thank you,’ she whispered, and closed her eyes. ‘Now Maggie.’

‘Now Maggie,’ he agreed, and Maggie nodded and pointed to a power plug behind the couch.

‘We can do it here.’

‘You don’t want to be private?’

‘I doubt I’ll shock Betty by showing a bit of skin,’ Maggie said, smiling wryly. ‘And it’s warm in here.’

She shivered as she said it. He didn’t comment, though-she’d know as well as he did that shock would be causing her to shiver.

And internal bleeding?’

Please not.

‘You’ve used one of these before?’ she asked him.

‘Not a portable one.’

‘Nothing to it,’ she said.

And there wasn’t. In moments he had it organised, set up on a side table right by Maggie’s abdomen.

She was wearing jeans with an elasticised waist and a sloppy windcheater that could easily be pulled up. He rubbed the stethoscope in his hands to take away the chill, then knelt beside her. As she tugged up her windcheater, he glanced up at her and once again saw the flash of fear. He should take her blood pressure first, he thought, and check her pulse, but he had a feeling they’d be high and racing until he gave her the reassurance she needed. Was she shivering from shock or shivering from fear? Probably the latter.

So he placed the stethoscope over her tummy and listened.

And heard.

‘What is it?’ she whispered, and he glanced up and realised his emotions were showing in his face. How many years since he’d done this? And the last baby he’d heard…

‘It’s fantastic,’ he said, but he said it too fast, and saw doubt remain. Try as he may, he couldn’t get his face in order. As an alternative he put an arm around her shoulders, propped her up and handed the stethoscope to her.

She listened, and her face relaxed. As it should. And strangely he found himself relaxing as well, in a way that had nothing to do with the sound of a strong baby’s heartbeat. He was holding her, feeling the tension ease, feeling her body relax into his.

Just like…

No.

‘You looked like there was something wrong,’ Maggie whispered.

‘Nothing’s wrong.’

‘Then why-?’

‘No reason. Let’s move on with this ultrasound,’ he said, more roughly than he’d intended, and she nodded and lay back on her cushions and looked at him directly.

‘Do you need me to tell you how to work this?’

‘I’m fine.’

‘But-’

Okay, truth time. ‘Maggie, I’m not a general surgeon,’ he told her. It went against the grain to admit it but he was up to his ears in this mess already-he may as well commit the whole way. ‘I’m a gynaecologist.’

‘A gynaecologist,’ she said, stunned.

‘Yes. I’m in charge of surgical gynaecology at Sydney South.’ He smiled wryly and glanced across at Betty. ‘If Betty’s ovarian cancer had been diagnosed now rather than ten years back maybe I’d be able to help her. It’s what I’m good at.’

He was searching for gel, laying out what he needed. She was staring at him as if he’d just grown two heads.

‘A surgical gynaecologist,’ she muttered, awed. And then: ‘You don’t get to be a gynaecologist in this country without being an obstetrician as well.’

‘I’m English. But, yes, that’s right. I’ve done the training.’

‘You’re a baby doctor?’ He’d thought Betty had drifted into sleep as the morphine took effect, but now the old lady’s eyes flew open. ‘We so need a baby doctor,’ she whispered.

‘I’m not a baby doctor,’ he said, more roughly than he’d intended. ‘I work with women with gynaecological problems. Surgical problems.’

But Betty was no longer listening. Instead she was smiling. ‘That was the only thing missing,’ she said. ‘Now we have everything we need. Oh, Maggie…’

‘Don’t you dare give up,’ Maggie said, sounding fearful, and Betty tried a feeble wave but didn’t have the strength to pull it off. She closed her eyes.

‘You just concentrate on our baby,’ she said. ‘On William’s son.’

‘Okay,’ Max said, trying not to sound grim as he saw the colour drain from Betty’s face. The more he saw what was happening to Betty, the less he liked it, but he needed to focus on Maggie. ‘Let’s get some gel on you and have a look.’

He rubbed gel on her bulge. Maggie closed her eyes. Yes, she was desperately anxious about the outcome of this ultrasound but she was so tired. If she could just sink into her cushions and sleep for twenty-four hours, that’s exactly what she’d do.

There was not a snowball’s chance in a bushfire of that happening.

Where was Angus? And how was she going to cope with her patients, with the farm, with Gran, with an injured leg?

She couldn’t. She’d hoped she’d have another few weeks to work before the baby was born, but now, with her leg hurting as much as it did, and with Betty dying, and…

And as if on cue the doorbell pealed.

She tried really hard not to groan.

Max was about to place the paddle on her tummy. He paused and looked questioningly at her.

‘They’ll keep knocking till we answer,’ she said, and tried to sit up.

‘They?’

‘It’ll be a patient. The locals know where I live. I need to answer.’

‘You’re not going anywhere,’ he said, sounding appalled she could think such a thing. He placed his hands firmly on her shoulders and pushed her back on the cushions. Which, she had to admit, felt excellent.

This man was taking charge. Even if it was only for a moment, it’d do, she conceded. There were too many worries to fit in her head. He’d carried her, he’d cared for Gran, he was caring for her.

So soak it in.

She could lie back and imagine that this arrogant, bossy doctor could take all her worries away. He’d check her baby, tell her everything was fine, make sure Betty was pain free, reassure Angus, fix whoever was at the door, fix her world…

Yeah, and pigs might fly. But, meanwhile, he’d said she wasn’t going anywhere and he meant it. She let herself relax against her cushions. She didn’t quite close her eyes but she almost did. If she shut her eyes the world might disappear.

She wasn’t quite ready for that, she conceded. Not yet. Disappearing worlds were for Betty.

But she wouldn’t mind if ninety per cent of hers went away.

He was wasting time. The ultrasound was becoming urgent. He had to get to the door, tell whoever it was to wait and get back to his patient. To Maggie.

But when he tugged the door wide he found a deputation. Mother, father, a scrawny little boy clinging to the mother’s jeans, and a baby.

‘The baby’s got a cold,’ the man said quickly, as if he was worried the door might be slammed in his face. ‘We’ve all had it, but she’s been bad all day and then she went limp. She looks okay now but the missus got scared. So I said we’ll stick her in the car and bring her here. Can Doc have a look?’

This was a nightmare. He should tell them to go away.

But Maggie had said she was the ambulance. Was she also the only local doctor?

These people looked terrified. For good reason?

He glanced down and saw the tiny child was swaddled in so much wool he could barely see her.

‘How long was she limp?’ he asked.

‘Only for a moment,’ the man said. ‘Ben here and me were watching telly while Cathy was feeding her in the bedroom. Cathy screamed but by the time I got there she was okay again. But Cathy’s that scared. Said she looked awful. We wrapped her up and brought her straight to Doc Maggie.’

‘Okay, unwrap her,’ Max said tersely. ‘Fast.’ He turned back to the living room, calling to Maggie. ‘Where’s your bathroom?’

‘Shall I come?’ Maggie called.

‘Stay where you are,’ he growled. The last thing Maggie needed was cross-infection, and she had to stay still. ‘Bathroom?’ he demanded again.

‘Door on the right of the hall,’ she called, sounding bewildered.

He glanced again at the baby, touched her face lightly with the back of his hand, felt how hot she was and knew he was right. ‘You go in there,’ he told the frightened parents. ‘Strip off all her clothes and pop her into a tepid bath. Tepid. Not cold but not warm either. She’s running a fever. I’m guessing she’s had a febrile convulsion and she needs to get cool in a hurry. You’re to keep her in the bath and keep her cool until I come back. I have an emergency in the other room.’

‘But Doc,’ the man said. ‘We want Doc Maggie.’

‘Doc Maggie’s the emergency,’ he snapped. ‘I’m a doctor, too, and I’m all there is. I need to take care of her.’

‘How do we know you’re a doctor?’ the man said, fear and belligerence mixed. ‘We want Maggie.’

‘Pete,’ the woman said, and she’d peered past Max into the living room. Seen what was there. ‘Maggie’s pregnant. If anything happens to Maggie the whole community’s in trouble. Just thank God there’s another doctor. Shut up and do what he says.’

Betty was asleep. Maggie was still slumped against the cushions, looking anxious. And exhausted. And pale.

‘Febrile convulsion?’ she queried.

‘I’m assuming so,’ he told her. ‘But I’ll check her when your baby’s been checked.’ He was worrying in earnest now. She was looking too shocked, too pale. If he’d messed around this long and she was bleeding… ‘Lie back and let me see.’

So she did, and in the middle of chaos there was suddenly peace.

There was no way to rush an ultrasound. There could be no urgency about it. He smoothed the gel over her tummy, settled the paddle and started moving it with care.

The screen beside him started showing images.

She was watching, too. He didn’t need to explain it to her. He moved his hand in careful, precise rhythm, taking in the whole picture with care.

He’d seen so many. This was just one baby more. There was nothing here to make his heart clench.

Only his chest was certainly tight.

One baby more…

Be professional, he told himself, and there was no choice to be anything but. He was focussing first on the placenta, moving carefully, seeing its position, noting carefully the visuals around it. He was looking for pooled blood. Looking for evidence of damage.

Not finding it.

One tiny heart, beating, beating.

A tiny fist curled close to the wand.

A tiny, perfect hand…

A miracle. Just like…

No. He felt himself blink and thought, hell, he was hardly hiding his emotions. If Maggie was watching him…

Only of course Maggie wasn’t watching him. She had eyes only for the screen. He glanced at her and saw tears coursing down her cheeks, and a tremulous smile.

‘He’s okay,’ she whispered, fighting to get the words out.

‘Did you think he wouldn’t be?’

‘I shouldn’t think. If I wasn’t a doctor I wouldn’t think. I wouldn’t have even known about torn placentas. I’d have felt him kick and thought he was fine.’

‘He is fine.’ Involuntarily he flicked a tear from her cheek and it was just as well he was still holding the paddle for he was suddenly aware of an almost overwhelming urge to let it go and gather her into his arms. To take away the look of almost unbearable strain.

This woman was so alone.

‘When did your husband die?’ he asked gently as he moved the wand on.

‘Three years ago.’

His hand paused in mid-stroke. Three years.

‘World’s longest pregnancy,’ Maggie whispered, still watching the screen. Then she managed a wavering smile. ‘Sorry. William had non-Hodgkin’s lymphoma, and we stored sperm before he started chemotherapy. When the chemotherapy didn’t work he said if I ever wanted to have his baby he’d be honoured. At first the thought was unbearable but gradually it seemed…right. But it took me this long and Betty’s coercion to feel strong enough, and maybe that strength was an illusion anyway.’

She winced and bit her lip, fighting for composure. ‘But, hey, it’s okay,’ she said, and struggled to smile again. ‘As long as my baby’s fine.’

‘He is,’ he said. And then he paused.

They were both looking at the screen.

‘You know you called him Archibald?’ Max ventured cautiously, not sure where to take this conversation with a colleague who was seeing exactly what he was seeing. ‘That may cause problems. Not that unusual names aren’t all the rage, but…’

‘She,’ she breathed. ‘My baby’s a girl.’

‘You didn’t know?’

She was staring at the screen in stunned amazement. ‘I had my last ultrasound at three months, but Betty and I always assumed it’d be a boy.’

‘Because?’

‘Because Betty has a blue crib,’ she breathed. ‘She’s been knitting blue matinee jackets for ever. Someone should alert the share market. It’s about to be flooded with blue.’ She looked again at the screen, seeing the irrefutable evidence, and she was smiling again, this time like she meant it. ‘Don’t tell Betty,’ she whispered.

‘You think she’ll be upset?’

‘She wants a boy so much, and why tell her?’ The smile faded and her voice was suddenly bleak again. ‘Do you think Betty will live to see my baby born?’

He glanced across at Betty. She’d collapsed into sleep but it was more than sleep. The amount of morphine he’d given her couldn’t explain the look of total lack of consciousness. He shifted slightly so he could reach over and take her wrist. Her skin was parched and dry, her pulse was thready and her fingers were cold to touch.

‘She needs fluids,’ he said. ‘She’s dehydrated. And blood tests. Is she hypoxic?’

‘I’m assuming so. She hasn’t let me do anything but give her pain relief for weeks now. But it’s okay. It’s what she wants. And now…now I know my baby’s okay… If you could just check the other one before you go…’

‘The other one?’

‘The one you left in the bathroom,’ she reminded him.

He knew that. But he was moving past it in his head. Facing the inevitable.

‘Okay, here’s the plan,’ he said softly. ‘I stay here. I attend to our bathroom baby. I dress your head and your knee, I keep a check on you tonight to make sure your head injury’s not causing trouble, and in the morning I find a way to get you X-rayed. Until those things happen I’m not leaving.’

She stared up at him for a long moment-and then she closed her eyes. For a moment he thought she was going to react with anger. With denial.

Instead she opened her eyes again and the relief he saw there was stunning. Her face looked lighter, younger. Free. As if an unbearable burden had been lifted.

He’d given her a promise of one night. Her eyes said it was much more.

‘Thank you,’ she whispered softly. ‘You have no idea how much I would love you to stay.’ And she reached up and took his hand and held it.

He’d finished the ultrasound. He’d sorted Maggie’s need for the night. His next priority was the baby in the bathroom. He should move.

Instead he stayed, looking into her eyes while her hand held his. Just looking.

Feeling the touch of Maggie’s hand, and knowing it was so much more.

Feeling a web he’d taken years to break free from tighten once more inexorably around his heart.

This woman was pregnant. This woman represented everything he ran from.

Yet still he couldn’t disengage his hand.