The Pregnant Intern

‘So how did you get pregnant?’

Alice laughed. ‘I would have thought that you of all people would know by now where babies come from.’

Jeremy grinned, but pressed on unfazed. ‘It’s a natural question to ask. Was it planned?’

‘That’s none of your business,’ Alice responded. ‘You were the one who said I didn’t have to reveal anything I didn’t want to.’

‘But that was to the patients,’ Jeremy answered straightforwardly. ‘I’m a friend.’

Alice looked at him. ‘You’re also my boss.’

CAROL MARINELLI did her nursing training in England and then worked for a number of years in Casualty. A holiday romance while backpacking led to her marriage and emigration to Australia. Eight years and three children later, the romance continues…

Today she considers both England and Australia her home. The sudden death of her father prompted a reappraisal of her life’s goals and inspired her to tackle romance-writing seriously.

The Pregnant Intern

Carol Marinelli

www.millsandboon.co.uk

For Sam, Alex and Lucinda

with love.

CONTENTS

Cover

About the Author

Title Page

Dedication

PROLOGUE

CHAPTER ONE

CHAPTER TWO

CHAPTER THREE

CHAPTER FOUR

CHAPTER FIVE

CHAPTER SIX

CHAPTER SEVEN

CHAPTER EIGHT

CHAPTER NINE

CHAPTER TEN

EPILOGUE

Copyright

PROLOGUE

‘YOUR blood pressure’s up.’

Alice let out the breath she had inadvertently been holding. She had been trying to keep her breathing even and think only pleasant thoughts as Brett Halliday, her obstetrician, checked her blood pressure, apparently to no avail.

‘By very much?’

Brett shook his head as he unwrapped the cuff. ‘Not much. It’s just up a touch, and still within a safe margin, but still...’ He sat down at his heavy wooden desk and leant across the table as Alice, avoiding his gaze and desperately trying to avoid the ensuing conversation, concentrated rather too intently on rolling down her sleeve.

‘I’ve been rushing around this morning, and it’s terribly hot. Anyway, you know how nervous I get at these antenatal appointments.’

Brett nodded. ‘All of which I’ve taken into consideration, but it still doesn’t alter the fact that your blood pressure is a little higher than I’d like it to be.’ He flicked through the pile of pathology results in front of him.

‘Your blood work all looks OK, though your haemoglobin level is only scraping into the normal limits range. You’re still taking your iron tablets, I assume?’

Alice nodded.

‘Well, try to increase your iron intake from natural means also. Lots of green leaf vegetables and iron-rich foods—and plenty of vitamin C,’ he added. ‘It helps with iron absorption. You know the routine.’

‘But everything is all right with the baby?’ she asked anxiously.

Brett gave her a reassuring smile. ‘The baby’s doing nicely—nice size, lots of movement. It’s the mum I’m more worried about.’

‘Honestly, Brett, I’m fine.’ Her words came out rather too harshly. Alice could hear the anxiety in her own voice and paused for a second to regain control. It was imperative to have Brett Halliday onside. With a stroke of his expensive fountain pen he could sign her off work and that was absolutely the last thing she needed at the moment. ‘Really, I’m fine,’ Alice said, more evenly, even managing a small smile.

But she wasn’t going to escape a lecture. ‘Look, Alice, you’re twenty-five weeks now. Most women at this stage are starting to wind down and looking forward to their maternity leave, not about to commence a three-month surgical internship at a busy city hospital. You don’t need me to tell you how busy Melbourne City is—you’ve spent the last nine months there for yourself. And Jeremy Foster may be a fine surgeon, but he’s coming back from a long stint on sick leave. He’s going to have a large backlog to catch up on and, more to the point, a lot to prove.’

‘What do you mean?’ Alice asked, her curiosity about her new boss for a moment overriding the issue of whether or not she worked.

‘Well, it was a serious motor crash he was in. No one really expected him to live, let alone walk. And now here he is, less than a year later, returning to work, apparently none the worse for wear. There’s going to be people watching him—rightly or wrongly, he’s going to have to do a lot of spadework to convince them he’s up to the job.’

‘But he’s a brilliant surgeon,’ Alice argued defensively. She hadn’t yet met Jeremy Foster, but you didn’t have to meet Jeremy to feel as if you knew him. He had broken more hearts throughout the hospital than Alice could keep track of. But despite his somewhat scandalous reputation there had never been any question as to his surgical brilliance. ‘He was the hospital’s rising star—I’m lucky to have got a place on his team.’

‘“Was” being the operative word. Look, Alice, Jeremy’s going to be under the pump and that means more work for you.’

‘I can handle it. Honestly, Brett, I’ll be fine. This three-month stint will take me up to thirty-seven weeks. Lots of first babies come late, which will give me nearly a month to put my feet up and think baby thoughts. Heaps of women work practically until they go into labour these days.’ She sounded so confident Alice almost convinced herself that she could handle it, but Brett wasn’t about to be fobbed off.

‘True,’ he said, then added gently, ‘But those women probably have a partner to come home to, or at least a supportive family. Someone to give them a bit of help and take away some of the strain. I know how much you need this, Alice, and I don’t want to ruin your plans—but I have to be sure you know what you’re doing.’

His words, however kindly meant, tore through her. The cool, confident façade melted in an instant and as she crumpled before him Brett came around the desk and handed her a handful of tissues.

‘I’m sorry,’ she sniffed. ‘I didn’t want to cry in front of you. In front of anyone,’ she added.

‘Cry away,’ Brett said kindly. ‘I see a lot of tears in here. You’re not the only pregnant woman trying to make it all work. Trying to cram it all in before the baby comes along. Sometimes you need someone else to make the decision for you. To put the brakes on and tell you to slow down.’

Alice didn’t answer. Accepting the tissues, she wept for a moment. She felt mortified that it had come to this: sitting in a doctor’s office, begging to be allowed to work, begging for the chance to support her baby.

‘If I don’t finish my internship I won’t be registered as a doctor and that means I can’t apply to go on a GP training rotation.’

‘But you can do your surgical internship once the baby comes along.’

Alice shook her head. ‘I’m living in a bedsit. I can hardly afford the rent as it is. If I stop working—’

‘You can claim child support,’ Brett said in a practical voice. ‘You won’t starve.’

‘I don’t want my baby to start out life like that. You know how big the incentives are for country GPs. I’d have a home, a job. I could afford to have someone look after the baby while I work. I’d be able to give it a real future. If I don’t do this it will put my plans back by months.’

‘What about your parents? I know they’re in Adelaide and you’ve had your differences, but maybe they’re starting to get used to the idea now. Perhaps if you explained to your mum the problems that you’re having, trying to make it all work...’

Her stricken look said it all. ‘Then what about the baby’s father?’ Brett ventured gently. ‘Shouldn’t he be helping? After all, legally it is his responsibility.’

He watched as she stiffened. ‘He wants nothing to do with me or the baby,’ Alice said in a strained voice. ‘He made that perfectly clear.’

‘He might not want anything to do with you both,’ Brett said, making his way back to his seat, ‘but there are laws out there to protect women in exactly your position. Maybe it’s time he faced up to the truth that he’s about to become a father and the responsibility that entails. Even if it’s only financially.’

For the first time Alice didn’t have to pretend to be assured or confident; this was the one area of her life that was unequivocal. ‘I’m not asking him for a single cent. He’s either in or out of this baby’s life—not somewhere in between. Marcus made it perfectly clear it was the latter he was choosing when I found out I was pregnant, and as far as I’m concerned it can stay that way. I want nothing more to do with him.

‘Look, Brett, I really need this job,’ she pleaded. ‘If you think I’m stressed now, I’d be ten times worse if you told me I couldn’t work. If there was any question that my baby was in danger, of course I wouldn’t start, but you said yourself the baby’s fine.’

Brett didn’t answer for what seemed like an age. Instead, he started writing up her notes before finally looking up. ‘All right, then. But I want to see you fortnightly from now on. And if your blood pressure creeps any higher, or I’ve even the slightest hint that either you or the baby aren’t coping, I’ll sign you off—and I mean it, Alice. Get yourself some support tights, eat the right food and put your feet up every chance you get.’

Alice grinned as she stood up. ‘I promise.’

Brett found himself smiling back at her. He had been unsure there as to what to do. Instinct told him to sign her off, but he could understand her desperation. It was a tough call all right. Yet there was no doubt that Alice looked a lot more relaxed now she could go ahead with her plans. If he took her blood pressure now, he’d half expect it to be normal.

‘Make an appointment with Madge on your way out. I do late nights on Mondays for my working mums—that’ll probably suit you better.’

‘Thanks.’ Smiling, she made her way down the long carpeted corridor to the reception desk. ‘It’s OK, baby,’ she whispered, gently patting her bump as she walked. ‘Mummy’s going to be able to take good care of you now. We’re going to be just fine.’

CHAPTER ONE

WHOEVER had written in the mother-and-baby magazine Alice had read in the doctor’s waiting room that there was a lot more choice in maternity wear these days either had a bottomless wallet or terrible taste in clothes, Alice thought ruefully as she dressed. Her ‘bump’ seemed to have grown practically overnight. Though somewhat excited by the rapid changes in her body, the down side was she could no longer get by with undoing the buttons of her skirts and wearing loose-fitting clothes. Her trip to the maternity departments hadn’t been a howling success. Everything was either ludicrously expensive or trimmed with a disgusting lace Peter Pan collar or bow. Finally she had settled on a ‘maternity kit’ which consisted of a black Lycra skirt, swing top and trousers, and a little black dress which showed off rather a lot of her expanding bust line. Still, it was reasonably priced and, teamed with a couple of shirts, it should get her through the remainder of her pregnancy.

Settling on the black skirt and top, she pulled her dark hair back into a low ponytail and applied her make-up. The ‘glow’ the same magazine had promised would appear by mid-pregnancy seemed to be about as evasive as a black maternity bra. But with a touch of eyeliner and mascara on her long lashes, and a dash of lipstick on her full mouth, she didn’t look too bad, Alice thought as she eyed herself in her bathroom mirror. Picking up her bag, she had a quick check in the full-length mirror and let out a groan. She looked as if she were going to a funeral. Despite the manufacturer’s claims, there was obviously no such thing as ‘sheer’ forty denier support tights. ‘You’re going to be late on your first day,’ Alice warned herself as she hastily ripped off the offending garment and grappled through her bathroom cabinet for some tinted moisturiser. She hadn’t been near the beach in months and her pale legs needed a bit of help. Finally—if not entirely happy with her appearance, at least feeling marginally better—Alice took a tram the short distance to the hospital and amazingly arrived with ten minutes to spare.

‘Morning. It’s Alice Masters, isn’t it?’

‘That’s right.’ She smiled at the friendly freckled face. ‘You must be Josh Winters, the surgical resident.’

‘The one and only. Looks as if it’s only us two here. Linda McFarlane’s probably sucking a few lemons before the ward round.’

‘I’m glad it’s not just me who thinks like that. I had more than a few reservations when I first met her. She’s not very friendly, is she?’ Alice said, referring to the surgical registrar who had been particularly condescending at her interview.

‘Tell me about it! Darren Barker, the other reg, is nice to work with but unfortunately he’s on annual leave for a month now Jeremy’s back. I wish it was Linda who was on leave—she told me to get a haircut before they’d consider me.’

‘And did you?’ Alice asked eyeing the long shaggy locks reaching well past his collar.

‘Yes, believe it or not. Though she’ll still probably take the scissors to me herself later. We clashed a few times when I was an intern. I must be a glutton for punishment, coming back to do it all again. Still, Jeremy Foster on my résumé will look pretty impressive—you can learn a lot from him.’

Alice nodded. She had been thinking absolutely the same thing when she’d applied for this rotation.

‘I thought Linda was just giving me a hard time because I was pregnant,’ Alice admitted.

‘You’re not, are you?’ Josh asked feigning surprise. ‘You poor old thing. My wife’s expecting twins any day now—she gave up work ages ago. I have to say I admire you, taking this lot on.’

‘Your wife’s expecting twins?’ Alice asked, unable to keep the surprise from her voice. Josh Winters looked like he should have had a surfboard under his arm, not a stethoscope around his neck. He certainly didn’t fit the image of a young doctor, married with twins on the way.

‘I know, I know.’ He laughed, then added, ‘Don’t worry about old sour-grapes Linda. She’s just peeved that the great Jeremy Foster is actually coming back. No one had written him off more completely than her. She was hoping for a nice fast ticket to consultant. And to make matters worse,’ he said in undertones, ‘Linda is the only woman in this hospital Jeremy hasn’t even attempted to pull.’

‘He surely can’t be that bad.’

‘You mark my words, he’s insatiable. At least you’re one female intern that doesn’t have to worry about succumbing to his charms. That bump of yours will act like a crucifix to a vampire for our Jeremy, so at least you won’t be putting Linda offside on that score. I hope she’s shaved this morning.’

Alice found herself smiling, which was quite a revelation in itself. She hadn’t been doing too much of that lately. It looked as if Josh was going to be nice to work with—heaven knew, she could use a few allies with the insatiable Jeremy and the bearded Linda breathing down her neck.

‘There you are. I assume your letters of confirmation did explain it was this Monday you started.’ Linda McFarlane’s tone was anything but friendly. ‘We’re all waiting for you at the nurses’ station.’

‘You said to meet outside the ward,’ Josh argued, apparently unruffled by her tones.

‘I most certainly did not. What are you going to learn here? The medical students have been at the nurses’ station, going through the patients notes and X-rays for half an hour now. At least they’re showing some initiative.’ And, turning on her heel, she walked smartly onto the ward.

‘But she did say to meet outside,’ Alice whispered furiously to Josh as they followed her onto the ward. Linda McFarlane, with her cold grey eyes and severe hairstyle, did nothing to endear herself to Alice.

‘What Linda says and what she actually admits to are somewhat conflicting,’ Josh said darkly. ‘Watch your back.’

But Alice wasn’t listening. The only back she was watching at the moment was the impeccably suited, wide-shouldered back of her new boss as he held an X-ray up to the light. His blond hair, expertly cut, tapered into his long neck. He looked as immaculately groomed and tastefully dressed as any film star from the glossies, and by hospital standards he was the closest thing to a legend Melbourne City was likely to produce.

‘Finally, we can start,’ Linda said pointedly, and Alice found herself holding her breath as Jeremy Foster turned and gave the briefest of smiles, his blue eyes flicking briefly down to her bulging stomach. Alice felt a small blush appear as she remembered Josh’s ‘vampire’ comment.

‘Pleased to meet you.’ He held out his hand as the introductions were made, and Alice was painfully aware of her moist palms as she returned his handshake. No amount of gossip—and there had been plenty—had done him justice or even come close to adequately describing him: sun-bleached blond hair, blue eyes and an arrogant haughty smile. Momentarily stunned, she stared back at him, lost in her thoughts.

‘We’ll get started, then,’ he said in a clipped voice, and Alice looked away, suddenly embarrassed.

She tried desperately to concentrate as they made their way around the ward, to ignore the flutter of butterflies Jeremy seemed to so effortlessly have started. Linda had the most to say—after all she had already met most of the patients and seemed to take every available opportunity to ram home how well she had coped. Jeremy didn’t seem fazed by her attitude, listening intently. But every now and then he overrode a decision Linda had made or changed a drug regime, effectively assuring all present that he was the one in charge. It soon became apparent to everyone that Linda was having a lot of trouble accepting her boss’s return. Her simmering resentment became increasingly obvious as they made their way around and at the final patient’s bedside Linda let her bitterness surface.

‘Mrs Marshall came in on Thursday with acute pancreatitis. She has a history of alcohol abuse. She’s been nil by mouth on IV fluids with a pethidine infusion to control her pain. Currently, we’re weaning her off the pethidine and she’s now on five mls an hour. I was thinking of starting her this morning on clear fluids.’

‘Good morning, Mrs Marshall. I’m Mr Foster, the surgical consultant. How are you feeling this morning?’

Mrs Marshall was struggling to sit up. ‘A bit better, but I’d really like a drink of water.’ Alice looked on. If this was Mrs Marshall looking better she’d have hated to have seen her on Thursday. Pancreatitis could either be acute or chronic. It caused severe abdominal pain and the patient rapidly became seriously ill. Although managed medically, it still came under the domain of the surgeons. In this case it had been precipitated by Mrs Marshall’s ingestion of large quantities of alcohol.

Jeremy flicked through the patient’s blood results as Mrs Marshall fiddled in her locker. ‘Her amylase levels are still very high.’

‘But they’ve come down markedly,’ Linda said.

‘Still, it might be a bit early to be starting her on fluids,’ Jeremy responded calmly.

‘Just small sips—you can see yourself how agitated she is,’ Linda pointed out. ‘She’s making a lot of work for the nursing staff, trying to get out of bed and get a drink.’

‘Which is probably more related to her pain and her alcoholism. Keep her nil by mouth for now and increase her pethidine,’ Jeremy said.

Linda pursed her lips. ‘Surely we’re just replacing one addiction with another. A few sips of water must be better than increasing her pethidine.’

Jeremy picked up the drug chart. ‘Mrs Marshall is in pain, and that needs to be addressed. A PRN order of Valium might be wise also, given her withdrawal from alcohol.’

He turned from Linda’s angry gaze and addressed the patient.

‘Mrs Marshall, we’re going to keep you nil by mouth for now. I know you want a drink but it really is safer not to at the moment. We’ll increase your pain control and I’ve written up an order for some Valium which will help you to settle.’

Surprisingly, Mrs Marshall seemed a lot happier with his decision than Linda and leant back resignedly on her pillows.

‘A psychiatric and social work referral would also be appropriate,’ Jeremy said, handing her folder back to the charge nurse.

‘She had all that last time she was in,’ Linda said. ‘That’s why I didn’t order the works this time around. She always swears she’s going to give up this time, and then back she bounces.’

Jeremy nodded. ‘Which, while mildly frustrating for us, must be absolute hell for Mrs Marshall and her family. See she gets the appropriate referrals.’

‘Bravo, Jeremy,’ Josh whispered, and Alice actually found she felt like cheering herself. Jeremy had certainly put the obnoxious Linda in her place.

‘I’m not entirely happy with her.’ Jeremy looked over at Alice. ‘When we finish up here, can you do some blood gases on Mrs Marshall?’

‘Sure.’

‘I’ll see you both later in pre-op clinic.’ With a small nod he walked off, as Linda marched furiously behind him.

‘I’ll start writing up the notes, then, while you do the gases,’ Josh suggested. ‘Then we can grab a coffee.’

‘I doubt it,’ Alice said with a sigh. ‘I’ve got three IVs to resite and a pile of drug charts that need writing up, and there’s a couple of bloods that need doing.’

‘Alice, Alice, Alice.’ Josh gave her a wide smile. ‘You have so much to learn. Fi,’ he called to the charge nurse, who came over with a smile, ‘this young intern hasn’t yet learnt how to ask for favours. Do you think we should teach her?’

Fi smiled warmly at Alice. ‘You’re not listening to Josh, are you? He’ll get you into all sorts of trouble.’ Fi had delicate oriental features and a kind smile but, despite her seemingly easygoing nature, Alice knew just from this morning’s ward round that Fi ran the ward with impeccable efficiency.

‘That’s not fair, Fi.’ Josh winked at Alice. ‘Fi and I worked together when I was a surgical intern,’ he explained. ‘Now, Fi, tell Alice the truth—didn’t I always come at night when you paged me? Didn’t I listen to you and call the reg when you were worried? Didn’t I always bring doughnuts in?’

Fi nodded. ‘And in return I had to do half your bloods and IVs.’

‘Cheap at half the price. Come on, Fi, don’t say you’ve gone all hard on me? You’re the only reason I came back to this ward.’

Fi laughed. ‘All right, I’ll help with your bloods, if I get the time. But I’m on nights next week,’ she warned, ‘and you’d better remember your side of the deal.’

As Josh made his way to do his notes, Fi turned her attention to Alice, who was filling up a kidney dish with blood-gas syringes and alcohol swabs.

‘When you’ve done the blood gases, I’ll show you around,’ she offered. ‘Let you know how Jeremy likes things.’

‘Thanks ever so much.’

Fi looked at her thoughtfully for a moment. ‘Listen to me for a moment, Alice. I know I always look busy but I’ve always got time if you need to run something by me. If there’s something you’re not sure about, you can always come to me.’

Alice nodded. It was a kind offer that a lot of charge nurses made when new interns started and one that was much appreciated. Heaven knew, it was a busy enough job and you needed all the support you could get. But there was something about Fi’s offer that sounded ominous, as if she almost expected trouble.