Christmas at Jimmie's Children's Unit (4 page)

Kate bit back a defensive retort. The woman was in terrible emotional pain; she was entitled to lash out.

‘My job this morning was to prepare your baby for surgery,’ Kate responded, speaking gently but firmly. ‘As the anaesthetist I’m in charge of everything that goes into his blood and lungs until he goes onto the bypass machine, then afterwards until he’s out of the post-op room. But I’m also a woman, and although I can’t imagine the depth of the pain you’re going through, I thought you might like a sounding board. Or to ask questions. Or just to have someone sitting with you for a while.’

Mrs Stamford’s stiff upper lip did a little wobble, as did her lower lip, then she sniffed deeply as if to control tears that longed to flow.

‘Will he die if he doesn’t have the operation?’ she asked, even paler now, if that was possible.

Kate hesitated.

‘We can keep him alive for a while, but because most of the oxygenated blood is circulating back through his lungs and not getting to his heart and brain, the answer’s yes. But we have kids that have had this op coming back to visit us years later, fine healthy young girls and boys.’

The only response was another sniff, although the way the woman was twisting her hands told of her terrible agitation.

Kate longed to help her but wasn’t sure how.

Maybe…

‘Have you thought what you’d have done if you’d known the baby had a problem early on in your pregnancy. Would you have had a termination?’

Now
colour rose in Mrs Stamford’s cheeks.

‘You mean, an abortion? No, I’d never have done that. A life’s a life—my husband and I both agree on that.’

But now the baby’s here you’d let him die? Kate thought, but she couldn’t say it. Nor could she understand Mrs Stamford’s thinking now, until the woman sighed and said, ‘You’re right. Of course I can’t let him die. It was the shock! Give me whatever I have to sign, then go ahead and operate.’

Kate had won, so why did she feel as if she’d lost?

Because things were never that easy!

‘He could still die,’ she said, even more gently than she’d spoken earlier. ‘These operations are performed quite often and with great success, but with any operation at any age there’s a risk. You understand that.’

‘Scared you’ll be sued if you don’t dot all the
i
’s and cross all the
t
‘s?’ Mrs Stamford snapped, but Kate heard the pain in her voice and knew the woman was close to breaking.

‘I’m more afraid that having given permission if something does happen you’ll blame yourself,’ she said. ‘You’re already doing that, aren’t you? Somehow you’ve convinced yourself this is all your fault, but congenital abnormalities can happen anywhere, any time.’

She stood up and moved closer to Mrs Stamford, putting her arms around her and holding her as the woman wept and wept.

‘This is the damn problem with only having units like this in the capital cities,’ Kate ranted to Angus a little later, the signed permission form in her hand. ‘The patient, and usually the mother, are whisked away and end up miles from family support. She’s got no-one, that woman, until her husband gets here. I know we can’t have units like this in every hospital in Australia, but there should be a better way of doing things.’

Angus gave her shoulder a comforting pat, the physical effect of which jolted her out of her worry over Mrs Stamford’s isolation, especially as she’d written her colleague down as a man who remained detached—too detached, she’d thought, for comforting pats!

‘She’s got the baby,’ he reminded her, and Kate looked up at him.

‘You mean…?’

‘You’ve already achieved one miracle this morning,’ Angus told her, ‘so why not go for two. Go back in there and ask her if she’d like to go with him as he’s wheeled
to Theatre. We can get a wheelchair and she could touch him, hold his hand. Although if she doesn’t want to bond with him in case he doesn’t live—’

‘She
thinks
she doesn’t want to bond with him.’ Kate interrupted his objection, excited now by the idea. ‘But maybe she’s changed her mind about that, as well.’

She’d sounded positive about it, but deep inside she had her doubts, even wondered if it was wise to push Mrs Stamford this little bit more. But Angus seemed to think it was a good idea and he was looking far happier now than he had been earlier, so the least Kate could do was try.

She returned to the room where Mrs Stamford was lying back against the pillows, her eyes closed and only a little more colour in her face than when Kate had first seen her.

‘We’ll be taking him to Theatre very soon, and I wondered if we arranged a wheelchair for you and a wardsman to push it, you’d like to come up to the PICU and go as far as the theatre with him.’

Mrs Stamford’s eyelids lifted and dark brown eyes stared fiercely at Kate.

‘What are you? Some kind of avenging angel, determined to push me further and further?’

‘I just wondered,’ Kate said lamely, ‘seeing as you’re here on your own until your husband arrives and he, the baby, is on his own, as well. Maybe you could support each other.’

Oh, boy! Wrong thing to say! Mrs Stamford was in tears again, flooding tears and great gulping sobs.

Kate held her again, and it was only because she was holding her, she heard the whispered instructions.

‘Get the bloody wheelchair, but I want a nurse not a wardsman wheeling me. Men don’t understand.’

Uh-oh! Was it Mr Stamford, not Mrs Stamford, who’d found it hard to accept a less-than-perfect child? Had she consulted him—phoned him—before she signed the permission-to-operate paper?

And while Kate could have argued that some men were far more understanding and supportive than some women, she held her tongue. She gave Mrs Stamford a final hug and darted off, not wanting to give the woman time to change her mind. She arranged the transportation, then raced back up to the floor above, knowing she had to be there to intubate Baby Stamford and prepare him for his lifesaving op.

‘So tiny, the veins.’

She didn’t have to glance up to know it was Angus hovering beside her in the treatment room as she put a peripheral line into the baby’s foot, already having secured one in his jugular and administered the first mild sedative.

‘So tiny we need to work out better ways of doing this—smaller, more flexible catheters. You’d think it would be easy but I’ve been working with technicians from one of the manufacturing companies for over a year now, and we’re no further advanced. Too fine and they block, or twist or kink—it’s so frustrating!’

Angus studied the back of her head—a coloured scarf now hiding the bright hair—as she concentrated fully on her task.

She’d been working with techies to improve catheters? Kate Armstrong was full of surprises, not least
of which had been the way she’d talked Mrs Stamford out of her indignation and allowed the woman’s natural maternal instincts to come out.

The redhead’s body brushed against his as she straightened up and
his
body went into immediate response mode. Not good where Kate Armstrong was concerned. She wanted kids—well, grandkids, which meant, as she’d pointed out, having kids first.

She was not for him!

Even though the ‘grandmother’ thing intrigued him! Not to mention whatever lay behind it…

Was it because of the familiar noises in the operating theatre, the sizzle of the bovie as it cut and cauterised tiny vessels, the bleeps of the monitors as they kept Kate up-to-date on Baby Stamford’s condition, the subdued chatter of the staff, the music playing in the background, that Angus felt so at home? Although this was not only his first operation at Jimmie’s but the first time he’d worked with any of the team.

Oliver Rankin was assisting. He was quiet, neat and efficient, although Angus rather thought he was casting glances in Kate’s direction a little too often. Clare Jackson was operating the bypass machine, waiting for the order to use it to take over the work of Baby Stamford’s tiny heart. Clare Jackson might not want children, Angus thought, standing back so Oliver could lift the pericardium away from Baby Stamford’s heart.

The thought startled him, and he shut it down immediately, dismayed to find himself, for the first time in years, thinking of something other than the operation while in Theatre. He prided himself on his total
concentration on the job, and although he often joined in the general chat and jokes, his mind never strayed far from the tiny patient on the table.

She was far better looking, beautiful, in fact—Clare Jackson—so why was he, too, glancing up at Kate from time to time.

Because she’s the anaesthetist, of course, and she’s the one who knows how the baby’s doing, down there, all but hidden with the cage to protect his head and wrappings covering all his little body except his chest.

‘Blood gases fine,’ the woman he was trying to block from his mind said. ‘Heartbeats 130 a minute.’

With the little heart fully exposed, Angus inserted cannulas into the aorta and an atrial vein; Oliver attached the tubes that would put Baby Stamford on bypass—the tubes connecting to the machine which would oxygenate his blood and pump it through his body.

‘Pressure’s up,’ Kate said, reassuring everyone, although Clare was now controlling what happened to the baby’s blood pressure.

‘Check blood gases and start cooling him.’ Angus gave the order, one hundred percent of his attention back on his patient, the information coming in from Kate and Clare clicking computerlike into his brain, his mind whirling as he worked, total concentration on what he was doing but thinking ahead, always anticipating any problem, at the same time.

‘Why do we cool them?’ the circulating nurse asked, her voice suggesting she’d often wondered but for some reason had never wanted to ask.

‘It cuts down the risk of organ damage when the flow of blood to the brain and other major organs stops—when we stop the heart to do the repair.’

Oliver explained, while Angus inserted a tiny tube into the aorta, where it was rising out of the heart. Through this he’d put the poison that would stop the heart beating and, once that went in, it was a matter of timing every second of the operation.

Kate watched him at work, waiting patiently until all the blood drained from Baby Stamford’s heart, then switching the coronary arteries so neatly and quickly she didn’t realise they were done until he stood and stretched.

Once straightened, he looked across at her, and she nodded and held up a thumb, but there’d been something in his dark eyes that had suggested he was looking at
her
, not at the anaesthetist. Ridiculous, of course, but she shivered in spite of herself, then turned all of her attention back to the patient on the table and the machines that told her what was happening.

Less than an hour later the baby’s heart was beating on its own, the little hole in his heart repaired, the arteries switched so they would now do the jobs they were intended to do. And though Angus had left a pacemaker in Baby Stamford’s chest to keep his heart rate stable, and various drainage tubes and measuring devices were still attached to him, he was doing well.

Kate had to smile as she accompanied her tiny comatose patient to the intensive-care room. He would be her responsibility until he regained consciousness, although Clare was in charge of the machine that was keeping him breathing.

‘Getting him off the ventilator is the next hurdle,’ Clare, who was walking beside Kate, said.

‘Only if he needs it for a long time, but he’s come through very well—all his blood values were good,’ Kate replied, and Clare smiled.

‘You’re a glass-half-full person, right?’ she said.

Was she?

‘I’ve never thought about it,’ Kate admitted honestly.

‘Never thought about what?’ a deep voice asked, and she turned to see Angus had joined them in the small room.

‘Whether I’m a pessimist or an optimist,’ she said, thinking of the times when sadness and loss had threatened to overwhelm her and whether that was pessimism.

‘Oh, definitely an optimist, I’d say,’ Angus told her, almost smiling, almost teasing. ‘What else would you call a woman who organised childcare for children she doesn’t yet have?’

‘You what?’ Clare demanded, but Kate silenced Angus with a ‘don’t you dare’ look.

Bad enough she’d admitted her grandmother obsession to one person without the entire hospital knowing it.

‘What about you, Angus,’ she asked to divert the conversation. ‘Are you a glass-half-full or a glass-halfempty person?’

He studied her for a moment.

‘You know, I’ve never thought about it. Definitely half full as far as patients are concerned. I could never do an operation if I doubted I’d be improving a child’s quality of life.’

‘You’ve children yourself?’ Clare asked, and Kate felt a surge of something that couldn’t possibly be jealousy flood through her veins at the other woman’s interest.

‘One, Hamish—he’s four,’ Angus answered, while Kate wondered why Alex couldn’t have found a less beautiful perfusionist.

‘Probably ready for a little sister or brother,’ Clare suggested, and though Kate knew this was just idle talk as they all watched the monitors that told them Baby Stamford was doing well, she resented the other woman’s interest. Although Clare probably didn’t know Angus was a widower.

‘Not for Hamish, I’m afraid,’ Angus replied. ‘He’s going to be an only child for life.’

Poor kid, Kate thought, but before she could point out the disadvantages—the haunting loneliness she’d felt as an only child—Clare was talking again, talking and smiling.

Flirting?

‘Good for you!’ she said. ‘I’m one of four and the number of times I’ve wished I was an only child! You’ve no idea. Having to share toys, wearing hand-me-downs—not that we lived on bread and jam or the hand-me-downs were rags, but I think I was born to be an only child.’

Selfish! Kate muttered to herself, but there was something so open and honest about Clare that she found herself looking past the beauty to the woman within.

And liking her!

Damn!

Double damn if Angus were to fall for her, and why wouldn’t he?

Not that it was any of Kate’s business who he fell for, so why was she still thinking about Clare, thinking perhaps she was attached—
surely
she was attached; how could someone so beautiful be unattached?