Cinderella And The Surgeon / Miracle Baby For The Midwife

CHAPTER THREE

SHE DIDN’T SLEEP too well that night. She might as well have covered the night shift the amount of times she was back and forth to the toilet.

By the time she took the route along the Thames she’d reached that strange point where sleep now seemed like an optional extra, so she bought the biggest coffee she could from one of the street vendors with two extra shots to try and give herself the oomph that felt missing.

It was a huge relief when she walked into the NICU and Harry wasn’t there. Last thing she wanted was him calling her on how tired she looked. Apparently he’d gone back to France to see the baby he’d operated on previously.

He’d been so scrupulous about Billy’s monitoring—almost as much as she was—and she’d heard him on the phone to France yesterday on a few occasions. It was clear he kept a close eye on any baby he’d operated on.

Yesterday they seemed to have reached an uneasy truce. There hadn’t been a single word about her expertise or competence. She’d spent most of the day looking after both Billy and his mother, but Harry had constantly stayed around. Lingering doubts had hovered in her head and part of her wondered if he was keeping an eye on Billy, or if he was really keeping an eye on her. The more she’d thought about it last night, the more it seemed to amplify in her mind. Could he have hung around yesterday to assess her competence?

Once the seed was planted there she just couldn’t shake it off. She’d re-examined every conversation they’d had. The fact he’d offered to sit with Billy to let her take Jill to the canteen. The truth was Jill hadn’t eaten much at all.

But for the first time Jill had agreed to leave Billy’s bedside and have a few hours’ sleep in an actual bed. The NICU had two small rooms—just big cupboards, really—where parents could actually lie down and sleep, then have a shower if they wished. If Harry was examining her care, surely he could see how important it was to take care of mum too?

Billy’s post-op care had been unremarkable, but when she’d read the theatre notes Esther realised just how touch and go it had been for him. Even if she’d initially detested him Harry Beaumont was a skilled surgeon, and looking at the neat clean scar line on Billy’s tiny chest and the way his lungs filled with air every few moments, the scare in Theatre seemed a lifetime away.

Esther’s stomach had churned as she’d made her way to the unit that day. She’d washed her hair and made sure her scrubs were immaculate. Even applying a little more make-up to her still slightly pale face. And that annoyed her too, because she’d always been immaculate at work. So why did it seem even more important that day? In a way she’d almost been annoyed when she realised Harry Beaumont wasn’t there after all. But the annoyance had quickly given way to relief. On a day like today she wanted to be comfortable at work. All her concentration had to be on Billy and his mother. Not on some random, tall, dark and handsome arrogant fool with toffee-coloured eyes.

Heat rushed into her cheeks as she finished another set of Billy’s checks. Where had that thought come from?

Abi nudged her elbow. ‘So, anyway, I was telling you. We’ve found out what branch of royalty our new surgeon has.’ She smiled brightly as if she thought Esther might actually be interested. ‘He’s from your neck of the woods. He’s a duke. From Scotland. The Duke of Montrose.’

Esther wrinkled her nose. ‘There’s nothing Scottish about him. Have you heard that cut-glass accent?’

Abi laughed. ‘What—you don’t have posh people in Scotland?’

Esther had to smile too. ‘Sure we do. But not in my neck of the woods. Anyhow, when these people get titles, it doesn’t mean it relates to where they stay, or where they’re from. The Prince of Wales wasn’t born and brought up in Wales, was he?’

Abi frowned for a second. ‘I guess not.’ She waved her hand as she started to walk away. ‘Anyway, just thought you’d want to know.’

Esther was surprised. ‘Why on earth did you think I’d want to know?’

Abi’s eyebrows rose. ‘Just in case you were plotting a murder. Thought you’d want to know who he is before you kill him.’ She was grinning as she left, but Esther pressed her lips together.

Okay. Abi hadn’t mentioned anything about the day before. But people were clearly talking. At some point she’d expect Harry to appear again and review Billy. If she were lucky, somebody else would be on duty. If not, it was really important that she didn’t give off those vibes. The ones that said, If I was a superhero and had powers, I’d strike you down with my laser vision.

She had to maintain her professional composure. It didn’t matter they’d had a few fallouts. The patients were the most important thing in NICU. It was important that an easy ambience was kept in place. She could be civil. She might not smile, but she could certainly be civil.

‘Hey, Esther, can you take a call from Harry Beaumont? He wants a report on Billy.’

She stiffened and picked up Billy’s chart. ‘Sure.’

It seemed like she’d have to start right now. She picked up the phone from where it was lying on the nurses’ station and did actually smile as she kept things deliberately formal. ‘This is Esther McDonald, Billy’s midwife, can I help you?’

There was a pause at the end of the line. ‘This is Harry Beaumont, the neonatal cardiac surgeon who carried out Billy’s surgery yesterday. Can you give me an update on how he’s doing, please?’

Oh. It seemed that two could play that game.

The smile stayed on her face. She gave Harry a quick rundown on all of Billy’s obs, new blood results, his colour and then…she did what she always did. She told him how she felt. There was something to be said about the instinct of a health professional. She always believed it should never be ignored. Sometimes, even though there was not a single piece of scientific fact, a health professional just seemed to know if a patient was going to go ‘off.’ So many times, their instincts had been correct. Studies had even been done on the phenomenon.

So she went with her gut. ‘Billy’s good. Everything is going well. I think he’s on the road to recovery.’

‘That’s your professional opinion?’ There was something in his tone. She wasn’t quite sure if he was mocking her, or if he actually got it.

‘I have a good feeling,’ she replied.

‘Okay.’ His voice was thoughtful. He paused for a few seconds. ‘Thanks for the update. I should be back by tomorrow. I’ll review him in person then. How’s his mum doing?’

Once again, Esther was a little surprised. The surgeons she’d worked with before generally didn’t take the time to consider the parents. ‘Sleeping,’ she said. ‘For the first time in days. She’s taken a shower and washed her hair too. When she wakes up, I’m going to send her down to the hospital canteen with one of my colleagues to make sure she eats.’

‘Does she really have no supports? Does no one else come to visit Billy?’

Esther’s curiosity was piqued. Not only was he interested, he actually sounded concerned. ‘Not the whole time I’ve been here,’ she said.

‘Hmm…’ She could tell he was thinking. Her brain was whirring. Maybe he wasn’t quite as bad as she’d first thought.

‘Esther, can I just check? Your temperature yesterday, it’s resolved?’

And there it was. Just when she’d finally had a reasonable thought about this man it was like he’d just pulled the rug from under her feet.

In a way she understood the question. His issue was protecting the baby he’d operated on. But the question was intensely personal. Just as well she didn’t have anything to hide.

‘My temperature is resolved.’

‘The reason?’

She bristled. It seemed to be her permanent state when she had any contact with this man. She couldn’t remember the last time she’d felt like this about anyone. He was checking up on her—again.

She decided to put all her cards on the table. ‘Don’t worry. I don’t have a respiratory infection.’ If she had, she knew she’d have to have bailed out of the NICU for a few days. There were strict rules adhered to by all the members of staff in the NICU. ‘I have a UTI,’ she added. ‘Long-term history, and I’ve got antibiotics.’

It was too much information. But she wanted this guy off her back. As a health care professional she wasn’t embarrassed to talk about medical conditions. She really didn’t think she had anything to hide.

There was a few moments’ silence at the end of the phone, then his voice sounded deep and husky. ‘I hope you feel better soon, Esther.’

She licked her lips as she put down the phone, a strange buzz going up her arm. She was feeling a little warm again. Maybe it was time for some more paracetamol?

CHAPTER FOUR

HER PHONE BUZZED and she checked it as she walked into A&E. ‘Hi, Mum, everything okay?’

She listened for a few minutes as her mum filled her in on the last few days. Her heart always twisted in her chest when her mum’s name came up on her phone. It always made her wonder if it was going to be something she didn’t want to hear.

Her mum had fought cancer a few years ago, the worst part being she’d initially kept it a secret from Esther because she didn’t want to distract her from her studies. Esther had been absolutely devastated when she’d found out—particularly when she’d realised her mum had gone through the diagnosis and some of her treatment on her own. Guilt had overwhelmed her, that her mother had put her first in her own biggest time of need. They’d always been so close and the treatment had left her mother unable to work any more. Hence, why Esther worked every shift she could. She had to pay rent in London, which was always extortionate, plus the mortgage payment on her mum’s home in Edinburgh. But there was only two years left on the mortgage. She could do it. She just had to keep up with the extra shifts.

‘I’m glad you’re doing okay,’ said Esther, her shoulders going down a little in relief.

‘Please don’t work too hard, honey,’ came the reply. ‘I’m so sorry about all this.’ This conversation happened in every call. Her mum felt massively guilty that her daughter was helping support her now.

But what else could she do? Her dad had died a few years earlier. He’d been wonderful, if a little harum-scarum. He’d drifted from job to job. Her mother had always really been the breadwinner in the household. Her father’s jobs had always revolved around his passions. He’d been an extra for film companies, a body-double, had a go at training as a stunt man, then he’d taken jobs everywhere as a tour guide. He’d always seemed to like jumping from place to place, before coming home to his girls with a whole host of wonderful stories to tell.

Although they’d both loved and adored him, his attitude to work had put a strain on things for her mum, who’d counted every penny. It had ingrained in Esther the fact that security and a steady job were one of the most important things in life.

‘It’s fine, Mum, please don’t worry. You paid the first twenty-three years, let me pay off the rest.’ She spoke for another few minutes, then ended the call.

The board in A&E was full. It was going to be a busy night.

She walked down to where the shift handover normally happened. The first person she saw was Rob, the ANP. He groaned and grabbed her elbow. ‘I called yesterday—didn’t you get the message to call me back?’

She shook her head. He walked into one of the consulting rooms and took out a key to open a locked drawer. ‘The lab work showed that the antibiotic you’re on won’t work this time. You need something different.’

He handed over a prescription bottle with her name on it.

She nodded. ‘I wondered why I wasn’t feeling better so quickly. Okay, I’ll swap them over.’ She opened the bottle and swallowed the first tablet with some water. ‘All good.’ She smiled at him.

‘Are you sure?’

‘Yes, now let’s get to the handover.’

Thursdays were a strange day in A&E. Everyone always expected weekends to be busy, but Thursdays liked to keep staff hanging, wondering if it was going to be a lull before the storm, or a full-on tornado.

Today, the waiting room was packed.

‘Where do you want me?’ asked Esther.

‘Can you cover cubicles?’ asked the charge nurse as he tried to assign everyone to their spot.

‘No trouble.’ She picked up the charts for the cubicles nearby and scanned them. Stitches. A fractured wrist. A patient waiting for a bed in Respiratory. Another patient needing a catheter inserted due to urinary strictures, and a confused elderly patient that had been found wandering near one of the parks and was bordering on hypothermic. More than enough to keep her busy.

Six hours later she still hadn’t had a break. Esther knew she really needed to grab some more paracetamol and another dose of her new antibiotics but she literally hadn’t had a minute.

‘Where’s the nurse who works in NICU?’ she heard a harassed voice say. ‘And someone call the paed doctor?’

Esther stuck her head from behind the cubicle curtains where she’d just finished stitching up a laceration. ‘I’m here. Need a hand?’

The doctor she didn’t know that well nodded. ‘Please, I’ve got a newborn who doesn’t look great.’

Esther nodded. ‘Absolutely.’ She snapped off the gloves she was wearing and grabbed a new pair, striding quickly alongside the doctor. She could sense his panic. And she understood it. He was new to the department and relatively junior. Dealing with babies could be scary. Paediatrics wasn’t everyone’s bag.

She stepped into the cubicle and saw the baby still clutched in its mother’s arms. She sat down in the chair next to her. ‘Hi there. I’m Esther, a midwife and a nurse. Can you tell me what happened today?’

The mother was trembling. She knew it was important to get a good history from the mother, and to try and keep things calm.

She caught a waft of something and sensed someone had come in at her back. But she kept her concentration on the baby. She really needed to get a look at either he or she.

‘I h-had a home delivery last week. Everything was fine. But…he’s just gone downhill fast. He’s not feeding well, he keeps being sick. His colour is bad, and he gasps when he’s breathing.’

Esther nodded and held out her arms towards the mother. ‘Okay, sounds like I need to take a little look at him. What’s his name?’

‘Jude.’

She smiled and kept her hands outstretched. ‘Do you mind if I take a look at Jude?’

The woman hesitated and then finally handed over the little baby. Esther moved slowly and laid the little boy down on the A&E trolley.

She knew instantly that the person on her shoulder was Harry, and after one look at this baby, for once, she wasn’t too sorry he was there.

He’d walked into the cubicle just a few steps behind Esther. Paeds had received three panicked calls from A&E. He couldn’t quite understand why Esther was working down here, but he gave her space to talk to what was clearly a very anxious mother. She handled the situation well and he waited until she’d moved the baby to the trolley before moving to the other side. He gave a nod to the mother and opened his mouth to speak but Esther got there first.

‘Was Jude full term when he was born?’

The mum shook her head. ‘Thirty-eight weeks but the midwife said there was nothing to worry about.’

Harry took his stethoscope from his neck and smiled at the mum. ‘I’m Harry, I’m one of the paediatric doctors. I’m just going to check Jude over if that’s okay with you.’

The woman gave an anxious nod and Harry waited patiently as Esther unwound a finger probe from the paed monitor and attached it to Jude’s tiny finger.

Harry had learned not to introduce himself as a paediatric surgeon; it had a tendency to freak people out. Truth was, the paed doctor who was on call was dealing with a meningitis case in one of the wards upstairs. When Harry had heard there was a baby with potential breathing difficulties, he’d offered to cover the call.

And he was glad he had.

This little guy was using all his accessory muscles to breathe. It only took a few seconds to show that he was bradycardic, and his oxygen saturation was lower than he would have hoped for.

Esther didn’t say a word, just reached for the oxygen and handed him the chart. She was efficient, he’d give her that.

She slid the nasal prongs into place and picked up an ear thermometer. Harry listened carefully to Jude’s chest, hearing exactly what he expected to.

There was a definite heart defect. One he’d need to diagnose after a few more investigations. In the meantime he pulled over the sonogram without waiting for a sonographer and had a quick look for himself.

Esther was talking in a low voice to little Jude. He was responding, blinking and kicking his arms and legs. His skin was a little dusky, but not enough to cause huge concerns for Harry. He suspected this was something he could solve with surgery in the next few days. It wasn’t uncommon for heart defects not to be obvious in babies straight away. The most severe were normally picked up at prenatal scans. But the less severe could be missed.

He moved around and sat in the chair next to the mum, then paused, realising he didn’t know her name.

It was like Esther read his mind. She glanced at the chart he’d left sitting on the other side of the trolley and gave a casual smile. ‘Claire, Harry our doctor is going to explain what he thinks is going on with Jude right now.’

Harry gave her a grateful nod. ‘Is there anyone else here with you?’

Claire shook her head, her eyes bright with tears. ‘I just panicked and brought him in. I tried to phone my husband and my mum-in-law but neither of them answered. I left messages.’

Esther nodded. ‘How about I have a quick check in the waiting room to see if either of them have arrived?’

Two minutes later she returned with a breathless man and an older-looking woman with her bag clutched to her chest. Both of them immediately crowded over Jude. Harry waited for them to ease their panic. The guy came and put his arm around his wife. ‘What’s going on?’

‘He went a funny colour when he was feeding and it just didn’t get better.’

The older woman was stroking Jude’s head and whispering to him. It was clear Claire had supports in place that Jill in the NICU could badly do with. Harry introduced himself and shook hands, then took some time explaining what was wrong with Jude’s heart, drew a diagram for them explaining how surgery would fix things.

It was clear they were horrified, but Esther was smooth, finding tissues for tears, then a chair for gran, whose legs seemed to fold once she found out her precious first grandson needed surgery.

‘But who can do it?’

‘I’ll do it.’

‘You do surgery on babies’ hearts? Doesn’t that need to be a specialist?’

‘I am a specialist. I’m a visiting surgeon at the Queen Victoria. Cardiac surgery in babies is my speciality.’

Esther’s eyes locked with his, and she gave the slightest nod of her head, as if she approved of how he was talking to the mum.

‘How many times have you done this operation?’

Harry counted in his head. ‘This will be number twenty-seven.’

There was an audible sigh of relief. He understood that. Esther made a few notes and stepped outside the cubicle while he kept talking to the family.

When she came back in he had just finished explaining that they’d transfer Jude upstairs and make arrangements for admission.

‘Done,’ said Esther, handing him the paperwork. ‘Porter is just coming. Francesca will review Jude on the ward.’

Harry raised his eyebrows. ‘You don’t waste time.’

She gave him a tight smile. ‘Some people call me efficient.’

He shifted on his feet. Was she mad at him again? He thought they’d sorted things. The porter arrived quickly and Harry decided to head up to the ward with the family.

He booked the theatre time for the next day and spoke to Francesca before heading back down to A&E. It only took him a few minutes to find Esther again. She was clearing up a tray of bloody swabs.

‘Whoa.’

She looked up. ‘‘Gunshot wound. Thankfully it was just a graze.’

‘Do midwives normally treat gunshot wounds?’

She blinked. ‘I’m a nurse too. That’s why I get to work in A&E.’ She paused for a second and then added, ‘How’s your baby in France?’

He pulled a face. ‘Post-op complications. He developed a pulmonary embolism. Probably not much bigger than the head of pin. But in a twenty-five-weeker…’

He looked up and realised she was holding her breath. ‘Oh, everything’s good now. We’re back to a “wait and see.”’

‘How come you were down covering?’

‘I’d just got back from France and came in to check on Billy. I’d gone along to the ward and saw the messages about the A&E referral. The doc in Paeds was dealing with a meningitis case so I offered to cover.’

‘That was nice of you.’ Her eyebrows were raised.

‘What? You don’t think I can be nice?’

She tilted her head to the side. ‘To be honest, I don’t know what I think of you, Harry Beaumont, or should I call you the Duke of Montrose?’

He winced. His title followed him everywhere. Not that he ever really used it. Only at family occasions when he had to.

Her hand went to her mouth to cover a yawn, and he was instantly suspicious.

‘Excuse me,’ she said as she dug her hand into her pocket and pulled out some antibiotics, tipping one out and swallowing it.

‘You’re still not feeling better?’ They were under the bright lights of the treatment room and it struck him that she pretty much looked like when he’d seen her on that first day.

She gave a half-hearted shrug. ‘They’ve changed my antibiotics. I was resistant to the first lot and I didn’t get the message until today.’

‘So, you still have a temp and feel knackered?’

She spun towards him in surprise. ‘Since when did you get all Scottish?’ She let out a little laugh. ‘Have you any idea how that word sounds in an accent like yours?’

He grinned at her. ‘Does it sound any better when I say Crabbie Rabbie?’