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‘It’s more common in women who’ve had a baby before. In pregnancy, the uterus can be tipped back, though it normally returns to its normal position again. If it stays tipped back in the second trimester, there’s a risk that the uterus will get trapped—known as incarceration—though it’s not that common.’ He shrugged. ‘About one in three thousand pregnancies, roughly. You’ll need to do a pelvic exam and check the ultrasound—retroversion sometimes mimics other problems. If you can rule out a UTI or a threatened miscarriage, it might be a malformation of the uterus.’
‘Right.’
Again, that flicker of worry in her eyes. Her instincts had been spot on in the near fortnight he’d been working with her. Why didn’t she trust herself?
Maybe he could do something about that. ‘OK. If it’s a retroverted uterus, what will you expect to find in a pelvic exam?’
Judith concentrated for a moment. ‘Her cervix will be positioned well behind the pubic symphysis, there’ll be a soft, smooth non-tender mass filling the cul-de-sac, and the uterine fundus will be in a posterior position, behind the sacral promontory.’
He nodded. ‘It’s pretty unmistakable. What management would you suggest?’
‘Give her a catheter for twenty-four hours or so, so we can decompress her bladder, and get her to do intermittent knee-chest exercises—that might put the uterus back into the right position by itself.’
‘And if that doesn’t work?’
‘Manipulation.’ She grimaced. ‘Though if you use too much force, there’s a risk of injury to her cervix, or it might distort the uterus or affect the blood flow from the uterus, so it could damage the baby.’
‘Mild to moderate force is fine. She’ll be in the knee-chest position and you’ll need a long Allis clamp—grasp the posterior lip of the cervix.’
She frowned. ‘The anterior lip, surely?’
He raised an eyebrow. Just as he’d expected, she’d picked up his deliberate mistake. ‘Exactly. It’s not a common procedure, Jude. You really know your stuff.’
Her eyes narrowed. ‘So that was a trick question?’
‘No. It was an experiment, to prove to you that you know more than you think. Trust yourself, Jude.’
She scowled. ‘I’m not a child.’
‘I know you’re not. What I’ve seen of your work is good, and your instincts are spot on. But you come across—to me, that is, not to the patients—as lacking confidence.’ Which was probably why she’d only recently been promoted to registrar.
Her chin came up. ‘I’m fine.’
‘I know,’ he said, as gently as he could. ‘Look, if you want to talk to me about anything, I’m very good at keeping things secret.’
Oh, yes. She knew that. Like his wife. And his baby. Any other proud father would be showing photographs to the midwives, the doctors and even their new mums. Swapping stories about broken nights and nappies from hell. But Kieran kept his private life so private, anyone would think he was unattached.
Thank God she hadn’t done anything stupid. Like asking him to dinner. Like giving in to the temptation to kiss him.
He didn’t smell of baby sick today. He smelled clean and fresh. All male, with a citrus tang. A scent she liked. A lot.
This really, really wasn’t good.
‘I’m fine,’ she said stiffly.
He raked a hand through his hair. ‘Jude, I don’t understand this. Since I started here, we’ve been getting on well—but today you’re snappy with me.’
If he suggested that she had PMT or something, she’d throw his coffee over him.
Then he surprised her. ‘If I’ve said or done something to upset you, I apologise. Just tell me what it is, so I don’t do it again.’
You’re looking at me, she thought. Looking at me the same way I look at you. Wanting. And knowing I can’t touch. ‘Nothing,’ she said tightly.
‘OK. Well, the offer’s there. If you want to talk, I’m here. But if it makes you feel any better, Bella has a good opinion of you.’
‘Right.’ She swallowed. ‘Well, thanks for the advice. About the retroversion,’ she emphasised.
‘Yell if you need a hand.’
Judith nodded, and left his office, feeling sick to her stomach. He was married. Married. She’d even seen him with his wife. So why, why, why did she still feel that pull towards him?
Maybe she should apply for a transfer. Not to the Hampstead Free: she wanted to get a job on her own merits, not just because her father was the obstetric director there. Or maybe this pull of attraction between Kieran and her would stop. Please, please, make it stop soon, she begged silently. Before either of us says or does something we’ll regret.
When Judith had finished examining Rhiannon and had done a second ultrasound, she was sure that it was uterine retroversion. She explained the condition. ‘Did you have anything like this with your last baby?’ she asked.
Rhiannon shook her head. ‘Not a bit of it. To be honest, because it’s my second, I wasn’t so worried about getting a dating scan done or anything. But I’ve felt so weird, this last day or so…My baby’s going to be all right, isn’t it?’
‘I’m pretty sure it’ll be fine. But I should warn you, there’s a risk of miscarriage if we don’t get your uterus back in the right place.’
‘How are you going to do that?’
‘We’re going to try and let gravity help you, first of all,’ Judith said. ‘So it means you’ll be in for a couple of days.’
Rhiannon closed her eyes. ‘I was hoping this wouldn’t happen.’ She sighed. ‘I’ll just have to ask the childminder to keep Livvy a bit longer for the next couple of days—and nag Greg to get home from work a bit earlier. What if the gravity thing doesn’t work?’
‘We can manipulate your uterus, very gently. It shouldn’t hurt, though it might feel a little bit uncomfortable. I should warn you that again there’s a small risk of miscarriage, but it’s very, very small.’
‘Leave it and I might lose the baby; fix it and I might lose the baby.’ Rhiannion sighed. ‘Not much choice, is there? I’m in your hands.’ She paused. ‘Um, is this very common?’
‘Not that common. But don’t worry, our consultant’s very experienced.’ And drop-dead gorgeous.
Judith settled Rhiannon into the ward, inserted a catheter and showed Rhiannon how to do the knee-chest positioning which would, with any luck, help her uterus move back to the right position.
Kieran was at lunch by the time Jude had finished—she wasn’t sure if she was more relieved or disappointed. It meant she didn’t have to face him—didn’t have to struggle to ignore that magnetic pull—but it also meant she didn’t have the chance to apologise. Because he was right: she had snapped at him. And he hadn’t put a foot wrong. He’d found her sore spot all right—the fear she wasn’t really good enough to do her job—but he’d encouraged her, not laughed at her or despised her for it.
True, he’d said nothing at all about his wife, but that wasn’t any of her business. And he’d been the perfect colleague. Patient with the mums, happy to spend time explaining things to the dads, good-humoured with the staff, approachable if you needed a second opinion.
On a professional level, at least, she owed him an apology. She nipped into the hospital shop, bought him a box of chocolates and had just finished scribbling a note to him when he walked into his office and saw her by his desk.
‘Hello,’ he said quietly.
Lord, his voice. The slightest trace of a posh accent. It sent ripples of longing down her spine.
But she had to stay in control. ‘I was just leaving you this.’ She screwed up the note and shoved it in her pocket, then handed him the chocolates. ‘To say thanks. You were right about the retroverted uterus.’
‘That’s very sweet of you, but there’s no need. You’d already picked most of it up,’ he said.
‘Not just that. I wanted to say thanks for the pep talk.’ She flushed. ‘And, um, sorry for snapping.’
Kieran shrugged. ‘No problem. We all have our bad days.’
‘Yes.’ She should leave. Now. But she couldn’t. She was stuck there, watching his mouth. Watching the heat in his eyes. Wishing that things were different. That he was single.
The air felt thick and static—if she reached out, she was sure an electric current would sizzle between them and light up the room.
Then he spoke. ‘Jude, are you busy tonight?’
‘What?’
‘I wondered if you’d like to come out for a drink.’
Was she hearing this right? He was asking her out? ‘With you?’
‘Yes.’
‘Just you?’ she checked.
He frowned. ‘Yes.’
Oh, God. He really was asking her out. And if he’d meant it in the platonic sense, he’d have asked some of the others, too. This was one on one. Just the two of them. How she wanted to say yes. But no way could she accept. Not when she knew he was spoken for. ‘You must be joking,’ she said through gritted teeth.
His frown deepened. ‘What?’
‘I don’t know what kind of women you normally associate with—’ apart from his wife ‘—but I don’t do affairs.’
‘I wasn’t asking for an affair.’ Though he was thinking about one right now, Jude was sure. Colour slashed across his cheekbones and his voice sounded slightly slurred. ‘I just thought we could have a drink together. Maybe dinner. Get to know each other a bit.’
She folded her arms. ‘And how would your wife see that? Forget it!’ She looked at him in utter disgust, then walked out of his office, not bothering to slam the door behind her. He wasn’t worth it.
Kieran stared after Judith in shock. Wife? What wife? He wasn’t married!
Then he remembered Margot’s comments. If the midwife had told Jude he’d bought two tickets, maybe Jude had jumped to the conclusion that he was married. But surely she’d seen Tess with him at the fundraiser? OK, Tess had a different father, her skin was paler than his and she’d inherited her father’s blue eyes while he’d inherited his father’s dark eyes, but surely there was enough of a family resemblance for Judith to have seen it?
Or maybe not. He was about to go after her and explain when the phone rang. By the time he’d sorted out the problem, Jude was nowhere to be seen. He finally caught up with her during her teabreak. Luck was with him, because she was on her own.
‘Jude, we need to talk,’ he said.
She shook her head. ‘I don’t think so.’
‘I’m not married. The woman you saw me with at your fundraiser—’
‘Don’t tell me—she’s your sister?’ Jude folded her arms. ‘That’s what they all say. Sister, best friend—there’s always some cover story.’
Kieran stared at her in disbelief. He was telling the truth! Tess was his sister. How could Jude possibly think he was the kind of man who’d cheat on his wife? Hell. He’d seen what it had done to his mother when his father had cheated on her. He’d barely started school and he’d had to listen to his mother crying, night after night, when his father was late home. By the time he was six, he’d learned to make scrambled eggs so he could coax some food down her. When his father had finally left her for good, a month or so later, he’d watched his mother collapse in on herself. And it had only been meeting Martyn Bailey that had changed her life. Changed his, too, because at last he’d had a proper father, one who had actually been there to encourage him and teach him things. And, when he was ten, he’d had the kid sister he’d always wanted, too.
Well, he wasn’t going to crawl. If Judith could misread him that much, a relationship with her would be a nightmare. One he could well do without. Given time and enough cold showers, he’d be able to snap the attraction between them.
Wouldn’t he?
‘Suit yourself,’ he said coolly, and left the room.
Unfortunately, they still had to work together. The following afternoon, not long after Kieran had signed Lisa Ford’s discharge form, Jude came to see him.
‘How can I help you, Dr Powell?’ He couldn’t bring himself to use her first name. And maybe keeping a professional distance would help him keep a personal distance.
Her chin rose. ‘As you’re the most senior doctor on the unit right now, Mr Bailey, I wondered if you might be able to help one of my mums.’
He inclined his head slightly and waited.
She glowered and folded her arms. ‘Rhiannon Morgan. The knee-chest exercises haven’t worked. I haven’t manipulated a retroverted uterus before.’
He knew what she wanted. And she was going to have to ask. Nicely. This time he wasn’t going to jump in and offer. ‘And?’
She swallowed. Kieran watched the movement of her throat and had to dig his nails into his palms to remind himself that he didn’t want to kiss her there. He didn’t want to loosen her hair. He didn’t want to kick his door shut and kiss her until neither of them could see straight.
‘And,’ she said softly, ‘I need help.’
‘You described the manoeuvre perfectly yesterday.’ Before she’d accused him of being a philanderer—and then of being a liar. That still rankled.
‘There’s a huge difference between reading a textbook and actually doing the procedure.’
‘True.’
‘Are you going to help me?’
‘Help Rhiannon Morgan, you mean.’
She swallowed. ‘Look, I…’
Five little letters. Two syllables. She really wasn’t going to say the ‘s’ word, was she? Stubborn as hell. And it wasn’t Rhiannon’s fault. It wasn’t fair to let one of the mums on his ward suffer, just because he was still absolutely furious with Judith Powell. ‘All right. I’ll do it, you assist. What’s her blood type?’
‘A positive.’
‘Good. So we don’t need to give her anti-D.’ The manipulation was one of the medical procedures which could cause a small exchange of maternal and foetal blood—and if the mum’s blood type was rhesus negative and the baby’s was rhesus positive, that could spell trouble for the foetus unless the mum was given special antibodies.
‘I need a long Allis clamp, and I want the portable ultrasound so I can check the positioning, the baby and the amniotic fluid before and after the procedure. Perhaps you could arrange it while I introduce myself to Rhiannon.’
‘Fine.’ She paused. ‘Thank you.’
He couldn’t bring himself to respond with ‘Pleasure’ or ‘That’s OK’. Because it wasn’t going to be a pleasure, working close to Jude. It was going to be sheer bloody torture—because although his mind knew that she was trouble, his body wasn’t listening. He could smell her perfume and it made him want to hold her closer. To bury his face in her hair, her skin. To lose himself in her incredible body.
The procedure was simple enough. Rhiannon was in the knee-chest position, and he grasped the anterior lip of her cervix with the clamp, slid a finger into her vagina and applied pressure to the top of the uterus. While Judith kept up a gentle constant traction to the cervix, following his instructions exactly, he gradually rotated the uterus, sliding the fundus on one side of the sacral promontory.
‘OK, we’re there. Dr Powell, you can stop now. Rhiannon, you can lower your legs again.’ He smiled at the young woman on the bed. ‘Well done.’
‘That wasn’t as bad as I thought it was going to be.’
‘Good. It really shouldn’t hurt, though you might feel a little bit sore later. Can you lift up your top for me? I just want to put some gel on your tummy and give you another scan—and I’m sure you’d feel happier if you could see your little one moving around.’
Rhiannon nodded. ‘Jude told me there was a slight risk of miscarriage. And…’
He squeezed her hand. ‘I know. Percentages always seem small until they’re personal, don’t they?’
He squeezed gel onto her abdomen, then brought the head of the scanner across the gel. ‘Here we go. One baby, kicking happily. There’s the heart—it’s beating nice and strongly. Full bladder.’ He did a few quick checks. ‘That’s absolutely fine, Rhiannon. Your uterus is in the right place and the fluid around the baby is exactly as it should be.’
‘Could my uterus slip back again?’ she asked.
He shook his head. ‘Not now. And you should find that you won’t have a problem going to the loo. I want to keep you in overnight, and if anything feels different or you’re worried about anything, ask me or one of the midwives.’
‘Thank you.’
‘That’s what I’m here for. Now, I want you to drink plenty. And I’d also advise eating half a dozen dried apricots every day—they’re a good source of iron, and they’ll also help you avoid constipation.’ He switched off the scanner. ‘Dr Powell will be looking after you, and I’m sure she’ll be able to answer any questions you have.’ He nodded at Judith without looking her in the eye. ‘Thanks for your help, Dr Powell.’
He didn’t wait to hear her reply. If she even made one.
‘He’s lovely,’ Rhiannon said to Judith when Kieran had left the room.
‘Mmm.’ A two-timing low-life, more like—just like the last man she’d dated. The man she’d met on a training course, the one who’d claimed that the woman who’d phoned him was a friend.
It had taken Jude three months to find out the truth. That he was married.
And now it was happening all over again with Kieran.
Not that Judith was going to shatter Rhiannon’s illusions. As a doctor, Kieran Bailey was fine. As a man, definitely not.
It was just a shame she couldn’t get him out of her head.
CHAPTER FOUR
HOLLY finished taping up the dressing. ‘OK, Tess. I’m pleased to tell you that Charlie’s going to be fine. His arm will feel a bit sore, and he’ll need that dressing on for a while to prevent any infection getting in—but at least Kieran’s a doctor so he can change it for you.’
‘You know my brother?’ Tess asked.
‘Your brother?’ Holly gaped. Hadn’t Judith said that Kieran was married? And the little boy looked so like him, with fine dark hair and those huge dark eyes. ‘I’m sorry. I thought he was…’
‘What?’ Tess asked suspiciously.
‘Your husband,’ Holly admitted, embarrassed.
Tess shook her head. ‘That’d be funny, if…’ She sniffed. ‘No, you don’t need to know what a mess my life is. Kieran’s my big brother. He’s letting us stay with him for a while.’
‘Right.’ Holly coughed. ‘Do you want me to ring up to the ward? Or can I ring your mum?’
‘Definitely not my mum.’ Tess shook her head. ‘I’ll be fine. I just feel so stupid. I didn’t think Charlie could even reach up the stairs. I thought it was safe. He’s crawling, but he hasn’t started pulling himself up—well, not until today. I put my coffee on the stairs while I was doing my hair, and the next thing I knew…’ She scrubbed away a tear. ‘I’m such a bad mother.’
‘Hey. Of course you’re not. Accidents happen.’ Holly stroked the little boy’s hair. ‘You wait till he gets really mobile. He’ll be into everything and you’ll need locks everywhere, he’ll empty your handbag down the loo, and he’ll end up falling over and banging himself so he gets a huge bruise about five minutes before you’re due to see the health visitor.’
Tess gave her a watery smile. ‘Have you got kids of your own?’
Holly flinched inwardly. ‘No. But one of my old school-friends is a health visitor and she’s got a fund of stories like that.’ She forced a smile to her face. ‘I’ll ring up to Maternity for you. I won’t be a minute.’
She escaped to the phone and dialled Judith’s extension.
‘Maternity, Jude Powell speaking.’
‘Hiya. It’s Holly. Is Kieran about?’
‘Sorry, Holls. He’s in Theatre, doing a section.’
‘Ah.’ Holly paused. ‘Well, you’ll do. Can you come down to ED?’
‘Sure. What have you got for me?’
‘Tess Bailey.’
Judith froze. Kieran’s wife was in the emergency department? ‘What’s wrong?’ she asked carefully.
‘Scald. To Charlie—her little boy, that is. She’s in a bit of a state.’
‘I’ll get someone to page Theatre. Kieran’ll want to know if his son’s injured.’
‘Nephew,’ Holly corrected.
‘What?’ Was she hearing this right?
‘You got it wrong, you dope. So all that ranting to me and Zo at Giovanni’s the other night…You leapt in completely the opposite direction and hit the wrong conclusion by miles. She’s his kid sister.’
‘Oh, my God.’ So Kieran wasn’t married. Tess really was his sister. But she’d been so sure.
‘Jude, you didn’t tell him he was a two-timing, low-life scumbag, did you?’
‘Sort of.’ He’d told her the truth and she’d called him a liar. And she’d been formal and even a bit prissy with him for the past week.
‘I foresee a very large humble-pie job,’ Holly teased. Then her voice sobered. ‘Actually, I’m glad he’s not here. Tess needs to talk to someone professionally and I’d rather it was you.’
Judith frowned. ‘Zo’s the paediatric specialist, not me.’
‘Charlie’s going to be fine. This is a maternity thing. Post-maternity. I can’t discuss things over the phone.’
Post-maternity? Judith thought fast. ‘How old’s the little boy?’
‘Ten months.’
So the chances were it wasn’t a post-partum haemorrhage or severe bleeding after the birth. ‘If I said PND, would I be a million miles away?’ Postnatal depression was very common, and it wasn’t always picked up.
‘About two millimetres, I’d say. Good leap this time, Jude.’
‘I’m on my way,’ Judith said. She called in at the midwives’ station on her way out of the department. ‘Lulu, if anyone needs me, I’m in ED.’ She scribbled a note on the whiteboard. ‘When Kieran comes out of Theatre, can you get him to buzz down to me, please?’
‘Sure,’ the senior midwife said. ‘Problem?’
‘Nothing major,’ Judith said carefully. He hadn’t mentioned his sister in the three weeks he’d been working there, so he must have a good reason. And she didn’t want him to panic. Holly had sounded very matter-of-fact about Charlie’s injury, and she would have told Judith if it had been really serious.
Five minutes later, Holly had introduced Judith to Tess and explained what had happened to Charlie.
‘Kieran’s in Theatre at the moment, so I’m afraid you’ve been lumbered with me,’ Judith said. ‘But you’re very welcome to come and wait in his office. I can get you a cup of coffee or something.’
Tess’s eyes filled with tears. ‘I don’t think I’ll ever drink coffee again!’
‘It wasn’t your fault. You didn’t know he’d pull himself up for the very first time this morning and grab your cup.’ Judith took a touch-and-feel book out of her pocket. ‘How about playing with this, little one, while your mummy and I have a chat?’ She opened the book. ‘Look, here’s a fluffy lamb. Can you stroke his coat?’
Charlie’s eyes brightened and he rubbed the woolly material.
‘It’s a real shock when something like that happens, isn’t it?’ Judith asked, turning back to Tess.
Tess nodded, her face blanching. ‘I panicked. My baby was hurt and it was all my fault. All I could remember was that you’re supposed to cool a burn, so I put his arm under the tap. He was screaming and screaming, and the ambulance man could hardly hear me when I rang for help.’
‘You did the right thing,’ Judith reassured her. ‘Holly says he’ll be fine—because you kept the skin cool, there’s a very good chance he’s not going to have a mark on him.’
‘I was just doing my hair, that was all.’
‘Tell me about it,’ Judith said with a grimace. ‘Why does long hair get so many knots in it? It takes ages to dry, and sometimes I think about having the whole lot cut off.’
‘But you’ve got beautiful hair!’ Tess looked at her. ‘You’re the one who was singing last week, aren’t you?’
Judith nodded. ‘I saw you with Kieran.’ And the way Tess had clung to his arm. She’d thought at the time that Tess was his wife, scared that her husband was going to start seeing someone else. And all the time, she’d been Kieran’s sister, not wanting to go out or face people she didn’t know. He’d tried to explain and Jude had refused to listen. ‘Do you manage to get out much? It must be hard, with a little one.’
‘I don’t mind. I’d rather stay with Charlie anyway.’
‘How about mum-and-baby groups?’
‘They’re a bit cliquey. I did go, but…’ Tess let the idea trail away.