Midwives On Call: Stealing The Surgeon's Heart

CHAPTER TWO

CIRO beat them there.

Pulling back the curtain and assessing in a split second what had happened, Ciro knelt down and swiftly examined Alyssa who lay unconscious on the floor. He checked her vital signs as Harriet pulled an oxygen mask from the wall and placed it over the young girl’s mouth, careful not to move her until Ciro gave the OK.

‘She said she felt OK,’ Mrs Harrison was sobbing. ‘I thought if I got her home to her own bed—’

‘Did she hit her head when she fell?’ Ciro’s question was direct.

‘No. She was just getting off the trolley and she went dizzy.’

‘Did you break her fall?’

‘Yes!’ Mrs Harrison’s voice was a screech. ‘What the hell’s happening? Has she fainted or something?’

That was what Harriet had been hoping when first she’d seen the young girl collapsed on the floor, but normally, with a simple faint, consciousness returned almost as soon as the patient was prone. But despite the oxygen, despite the seconds ticking past, Alyssa still lay unconscious.

‘Let’s get her over to Resus.’ Ciro’s expression was grim as he attempted to check her blood pressure, but as Harriet went to pull out the trolley Ciro impatiently shook his head. He swiftly removed the oxygen mask. Picking up the feather-light young girl in his arms, he carried her through the department to the better-equipped resuscitation room as Harriet moved like lightning ahead of him.

‘Fast-page the paediatricians,’ Ciro ordered, but thankfully Susan was already on to it. Even Charlotte was thinking ahead, pulling open a flask of IV saline to run through a drip, but though Harriet was pleased to see her acting independently, she still needed supervision.

‘Charlotte,’ Harriet called, as she attached Alyssa to a multitude of monitors, ‘run the saline through a paediatric burette. She’s extremely underweight so we have to be very careful of doses.’

‘We need to be very careful not to overload her with fluid,’ Ciro confirmed and even though he was busy, inserting an IV and connecting the drips, he still managed to find the time to explain his thought process to the eager grad nurse. ‘Her heart is beating irregularly, she may have some heart failure, so the last thing we want to do is give her more fluid than her heart can deal with. On the other hand…’ He paused as he carefully examined Alyssa’s neck, checking her jugular venous pressure. Then he whipped out his stethoscope and listened carefully to her lungs for a moment before resuming his knowledgeable lecture. ‘She is undoubtedly dehydrated. Let’s give her a stat 200 ml bolus. I want a catheter put in and her input and output strictly monitored.

‘Come on, Alyssa.’ His words were loud, the call to his patient sharp as he not-too-gently rubbed her sternum. It worked. Alyssa’s eyes flickered open as she attempted to push him away. ‘Good girl.’ Ciro’s voice was more soothing now, moving quickly to orientate his patient to her new surroundings. ‘You lost consciousness again, Alyssa, so we have moved you to a different area of Emergency where we can keep a closer eye on you…’ The frantic running of feet along the corridor outside heralded the arrival of the paediatric team, but instead of turning to greet them, Harriet noted with approval that he carried on talking to Alyssa, perhaps sensing that a full emergency team arriving at her bedside would be daunting for the young girl. Ciro took time to reassure her that, despite the apparent chaos, everything was very much in order. ‘We were concerned about you so there are going to be a lot of doctors arriving and a lot of talk that you don’t understand, but you are going to be OK.’

There certainly were a lot of doctors arriving. An emergency call always merited a rapid response, but the page had been put out as a paediatric emergency and though the difference was probably negligible, Harriet was sure that everyone had run just that bit faster to get there, from the anaesthetist to the nursing supervisor.

‘Alyssa Harrison,’ Ciro explained, ‘presented with a head injury secondary to a fall while dancing…’

Harriet listened as she worked on, listened to his heavily accented English barely faltering as he explained Alyssa’s complicated symptoms, and even though it was his first night, even though none of the doctors had met him before, he delivered his findings with a calm authority that demanded respect, explained without words to the rapidly gathering crowd that he was very much in control.

‘Can you chase up those results?’ Ciro looked over and Harriet let out a low moan.

‘I’ve left the pathologist hanging on the line.’

‘Tell him we’ll be sending some blood gases along shortly,’ Ciro called as Harriet rapidly headed back for the nurses’ station.

It took for ever to get through, the switchboard operator telling her in a rather pained voice that ‘yet again’ she was about to be connected, but suddenly those tiny white spots that had been dancing in front of her eyes earlier seemed to have returned for an encore. The nurses’ station seemed impossibly small all of a sudden. Sweat trickled between her breasts as she choked back bile, pleading with the powers that be to just let her get through the next few minutes of her life without major problems. If she could just get the blessed results down, she could hopefully escape the department for five minutes.

‘Harriet, we need those results!’ Ciro’s voice was booming at her, his impatient face swimming before her eyes as she looked up. Finally Harriet conceded to herself that she had to get to the bathroom at once. Hurling the receiver somewhere in Ciro’s direction, she stumbled off the stool.

‘The pathologist is on the line now.’

‘So, what are the results?’

‘I don’t know,’ she mumbled, backing out, her hand over her mouth. Thankfully Susan was around, and recognised potential disaster before it hit. Susan’s reflexes were like lightning, guiding Harriet to a vacant cubicle, sitting her on a chair and mercifully producing a bowl as she pulled the curtains on one of the many humiliating moments in Harriet’s life!

CHAPTER THREE

‘GIVE her the Maxalon, you meanie,’ Susan teased as Ciro stepped into the cubicle a few moments later.

Thankfully his telephone conversation with the pathologist had at least given Susan enough time to remove the offending bowl and for Harriet to rinse her mouth and at least manage a semblance of dignity.

‘I’ve already discussed this with Harriet,’ Ciro said, completely unmoved. ‘Now, will you let me examine you?’

‘There’s no need,’ Harriet insisted. ‘I went out to dinner last night, the food was really rich…’

‘Did you have a lot to drink?’

‘Apart from mineral water, no.’ Standing, attempting not to wince with the pain that small exertion caused, she attempted a brisk smile. ‘I’d better get back out there.’

‘You are in no fit state to be working.’

‘I’m much better now,’ Harriet muttered.

‘I disagree. I have already spoken with the nurse supervisor and she is arranging cover for you.’

‘You’ve what?’ Appalled, she glared at him. ‘How dare you?’

‘I dare because I am the doctor in charge tonight and I need my colleagues, especially my senior ones, to be completely on the ball. There is no room for error in Emergency.’

He was right, of course, Harriet knew that deep down, but it didn’t make her feel any better.

‘Now, are you going to let me examine you?’

‘No,’ Harriet answered tartly. ‘You should be in with Alyssa, instead of worrying about me.’

‘The paediatricians are in with Alyssa now. Everything is under control.’

‘Including me.’ Harriet bristled. ‘I’m going to wait for the nurse supervisor to arrange cover and then I’m going to take some paracetamol and lie down for an hour or so until I feel well enough to start working again.’

‘You shouldn’t take anything until you know what’s wrong with you. I’m not going to give you anything.’

‘You really are the limit, you know!’ Embarrassment was turning into anger now, furious at his control, his authoritative air—well, it might quiet his patients but it damn well wasn’t going to silence her into submission. ‘Well, Dr Delgato, as it happens, I have some painkillers in my handbag, painkillers that don’t require some over-inflated doctor’s signature to take, unless there’s a rule that’s suddenly been invented that I don’t know about, unless I’m not allowed to go into my locker without your consent, unless I’m not allowed to open my bag and take my own tablets without your permission!’

‘You are being childish,’ Ciro responded, not remotely fazed by her outburst. ‘But as you’re now off duty, that is entirely your prerogative.

‘Now, I suggest you put on a gown, lie down on the trolley and rest for a while. Then, with your consent, I will come in and examine you once I have spoken to Mrs Harrison to let her know what is going on.’

She wasn’t sure if it was deliberate, but the mention of the Harrisons made her protests about refusing to put on a gown and be examined rather feeble, childish even, and Ciro seemed to sense the change in her.

‘How do you feel now that you have vomited?’

Which wasn’t exactly the sweetest line to deliver a woman, but Harriet knew that his medical brain meant well.

‘A bit better.’

‘Good! Then rest and I’ll be back shortly.’

She gave a reluctant nod. ‘How are Alyssa’s results?’ She knew, just knew, he was about to shake his head and tell her that it was no longer her problem, so Harriet added quickly, ‘I really would like to know.’

‘Her potassium is dangerously low, as is her albumin, her renal function is decreased, she’s extremely malnourished, which is why she has the peripheral oedema. I’ve spoken with Pathology and it would seem those vitamins that Mrs Harrison’s been giving to her daughter are, in fact, diuretics, which of course are used to get rid of oedema, but that’s the trouble with self-prescribing…’ He gave her a tight smile as Harriet blushed. ‘As you know, some diuretics need to be taken with a potassium supplement. Instead, Alyssa’s potassium has dropped so low she is in danger of having a serious cardiac arrhythmia and possibly a cardiac arrest. I’ll let you know how it goes when you’re feeling a bit better.’

‘Thank you.’

It was horrible, horrible, horrible being on the other side of the curtain. Horrible lying in a flimsy gown with the ties missing, on a hard trolley. Horrible having a probe stuck in your ear and your blood pressure taken, but that didn’t even begin to compare to the humiliation of lying back and closing one’s eyes while someone as divine and toned and clearly fit as Ciro told you to stop trying to hold in your stomach so that he could examine you properly.

She didn’t even want to think about the sensible knickers she was wearing, supposedly safe in the knowledge she had been going to work.

‘Tender?’ Ciro asked as Harriet gave a stifled moan.

‘A bit.’

‘And here?’

‘No.’

‘Hmm.’

The dreaded ‘hmm’—the sound doctors worldwide made as they broached a tentative diagnosis.

‘You are tender in the right iliac fossa. I think it could be appendicitis or possibly an ectopic pregnancy.’

‘I’m not pregnant.’

‘Do you have your period?’

‘No,’ Harriet croaked.

‘So when is it due?’

‘Soon.’ Blushing to the roots of her hair, she tried to focus on dates to respond to this necessary but excruciatingly embarrassing question in as matter-of-fact a way as she could muster. ‘Actually, it was due a couple of days ago but—’

‘Hmm.’

‘I’m not pregnant.’ Meeting his doubtful eyes, Harriet shook her head firmly on the pillow. ‘I’m definitely not pregnant.’

‘You are on the Pill?’

Harriet gave a small nod, hoping that would be enough to mollify him but knowing that it was futile.

‘The Pill isn’t always a hundred per cent effective.’

‘I’m just not pregnant, OK?’ Wrenching the beastly gown down over her stomach, she prayed for her blush to fade, prayed for this interrogation to end. ‘So I haven’t got an ectopic pregnancy and neither do I have appendicitis. I just want to go home to my own bed—’

‘Harriet, I know that this is embarrassing for you.’ Perching himself on the trolley, he took her hand, the touch so unexpected, so surprisingly tender she felt tears prick her eyes, his glimpse of kindness providing no balm, more a sharp sting to her bruised emotions. ‘It is always awkward when staff are ill, but the fact is you have not looked well since you first came on duty and you are getting progressively worse. It clearly needs to be dealt with. Now, as uncomfortable as these questions are, they have to be asked. In a young woman, with abdominal tenderness, vomiting and a late period, it would be criminally negligent of me not to consider that it could be a ruptured ectopic pregnancy. So can you tell me why I should rule out that diagnosis? Are you unable to conceive, is there anything in your medical history…?’

And she didn’t want to voice it, didn’t want to admit it even to herself let alone anyone else, but knowing the truth was needed, drawing strength from the kind eyes that stared in concern, the warmth from the hand holding hers, Harriet let go of the horrible truth she had held in so tightly for so long now, admitted, perhaps for the first time, the hopelessness of her own situation.

‘I’m using the only completely reliable form of contraception.’ Swallowing hard, she forced herself to say it, to just get this the hell over with. ‘Abstinence! I can’t be pregnant because I’m not sleeping with my husband.’ She saw the flicker of confusion in his eyes, second-guessed what was coming next. ‘We haven’t slept together for months now, not since Drew got this job and we moved to Sydney. So, you see, I couldn’t possibly be…’ Tears that had been held back for so long were now finally trying to come forth and holding them in hurt her ribs almost as much as the pain in her stomach did.

‘You are allowed to cry, Harriet.’

‘No, Ciro, I’m not.’

‘You don’t have to hold it all in,’ Ciro insisted.

But she did.

Had for so long now it came as second nature.

‘When David decided his name should be changed to Drew I had to grin and bear it,’ Harriet snarled. ‘And when Drew needs a pair of designer jeans for an audition I just work an extra shift, when he misses out on a part that should have been his I’m the one who has to deliver a pep talk…’ The floodgates were opening now, years of suppressed anger bubbling to the fore, and she didn’t care. For the first time in her entire adult life, Harriet couldn’t give a damn about someone else’s feelings. She blurted out her anger and frustration because it helped and, she decided, choking through her vented fury, he didn’t have a clue what she was going on about. Her rapid spate of furious words was way too fast for him to understand.

All he had to do was hold her hand—which he was.

Nod at her very occasional pauses—which he did.

And give an occasional sympathetic murmur when her voice shrilled—rather regularly.

And through it all he didn’t say a word, didn’t attempt to say he understood as Harriet ranted on. ‘Since he got this bloody job, I’m not good enough,’ Harriet raged. ‘Not thin enough, or demure enough, not quite the happening young metrosexual’s partner.’ She registered his frown.

‘He is gay?’ Ciro finally spoke.

‘No.’ Somehow Harriet managed a strangled gurgle of laughter. ‘Metrosexual, it’s the buzz word for today’s kind of man. A man who doesn’t mind admitting he takes care of himself.’

His frown only deepened.

‘He has facials, dresses well, has his hair coloured, his eyebrows…’ Her voice petered out.

‘And he doesn’t sleep with you?’ There was just a hint of innuendo to his voice that really wasn’t helping matters.

‘He’s under a lot of pressure at the moment,’ Harriet offered in her husband’s defence. ‘He has to get up at the crack of dawn for early shoots, it’s the only time the beach is empty.’

Which mollified him not! Clearly the Spanish didn’t need a full eight hours in the cot for a performance! Clearly the Spanish didn’t give a hoot about eyebrows and waxing and face creams. And it would have been so much easier if Ciro was ugly. If his eyebrows joined or he smelt of garlic, if she could just somehow eke out a hint of justification as to why Drew needed to spend so much energy and money to be a man, when this very unpampered male sat opposite her.

‘I’m sorry!’ She gave a rather ungracious sniff. ‘If it was embarrassing before, it positively—’

‘It’s fine.’ He smiled. ‘You’re not the first patient I’ve had tell me her marriage is in trouble.’

‘I wouldn’t exactly say that it’s in trouble…’ Harriet started, but her voice trailed off as she conceded the point. ‘OK, it’s in big trouble.’

‘I’m sorry,’ Ciro responded politely. ‘But at least it means that we can rule out an ectopic! Now…’ Sensing her need to change the subject, he stood up and adopted a rather more professional distance. ‘Which means we have to consider that you could have appendicitis.’

‘No.’

‘Are you going to tell me that your appendix and you haven’t been getting on for a while, that it’s been treating itself to massages while you weren’t looking? That it’s been so neglected there isn’t any chance it could be inflamed?’

A tiny smile wobbled on her pale lips.

‘I’ll need to examine you properly, Harriet, there’s absolutely nothing to be embarrassed about.’

There was everything to be embarrassed about. He could be as matter-of-fact as he liked, pull on a pair of gloves as casually as if he were about to do the dishes, but there was no way, no way, she was going to let Ciro Delgato examine her there. She’d never in a million years be able to work with him if she allowed him to. Quite simply, she’d have to resign.

‘I’ll go to my own GP tomorrow,’ Harriet begged, desperate suddenly for the lyrical sound of her lovely GP’s voice as she chatted about her children and grandchildren, a GP who somehow made even the most uncomfortable procedures as routine as a gossip at the supermarket checkout—not like this Spanish dynamo that she’d have to work with again.

‘What is it about me that all my patients wish to suddenly leave and see their own GPs in the morning?’

‘It isn’t you,’ Harriet lied. ‘It’s just…’ She struggled for an explanation. ‘I want to go home, Ciro, to my own bed. If this had happened at home I wouldn’t have even come into hospital.’

‘What if I call down one of the surgeons to examine you, see if there’s a female doctor on?’

‘I just want to go home. Drew will be there. If I get worse, he’ll bring me straight back.’

‘I thought you said—’

‘We’re having some problems, Ciro, but he’s not going to leave me rolling around in agony, it’s not that bad!’

He stared at her thoughtfully for a long moment and just when she thought he was about to read the Riot Act, amazingly he conceded—albeit reluctantly.

‘If it worsens, you are to come straight back to the hospital.’

‘I will.’

‘And even if you feel better, you are to see your GP first thing in the morning.’

‘Yes.’

‘Can I at least take some blood and I’ll fax the results over to your GP? You can give me his name.’

‘Her name,’ Harriet needlessly corrected. ‘And yes.’ She’d have agreed to anything just to get the hell out of there.

‘Would you like me to call your husband to come and fetch you?’

‘No,’ Harriet answered immediately, imagining Drew’s mood if she dragged him out of bed at one a.m. because of a stomach pain when he had a photo shoot in the morning.

‘You’re not driving yourself home.’

‘Then I’ll take a taxi,’ Harriet responded, with absolutely no intention of doing so, given she felt so much better.

‘OK, I’ll draw some blood and leave you to get dressed.’

But any thoughts of dashing to the car park were soon laid to rest when Ciro insisted on walking her to the taxi rank outside Emergency and ensuring she was safely in a taxi, even reminding her, as if she were a child, to put her seat belt on.

‘Do you escort all your patients to their vehicles?’ Harriet bristled.

‘Only if I believe they’d be stupid enough to ignore my instructions. If you get any worse, you’re—’

‘To come straight back. I know, I know.’

As the taxi pulled off, despite her reddened eyes and nose, despite the pain in her stomach and the appalling mess of her marriage, Harriet felt a feeling so unfamiliar it took a second or two to register what it was.

Peace.

A tiny corner of peace in her soul.

Finally she’d told someone, finally she’d admitted the truth, and the world hadn’t stopped turning. In fact, the world had carried happily on. Ciro hadn’t stared at her, utterly appalled. Instead, he’d told her a simple truth.