The Pregnant Intern

‘I’d better get those gases done.’

‘I’ll get you some ice.’

Although Mrs Marshall was on oxygen, Alice removed the mask before she took the blood gases, as the blood taken while the patient was breathing only air would enable them to get a truer picture of her condition. Although obviously unwell, the increased pain control had already kicked in and she actually seemed in the mood for a chat.

‘I’m just going to take a small sample of blood from your wrist, Mrs Marshall, so just hold still while I inject some anaesthetic.’

‘No one else has bothered with anaesthetic. How come?’

‘Maybe you were too sick and they needed the blood urgently,’ Alice suggested diplomatically.

‘Maybe they were in too much of a hurry,’ the patient said pointedly. ‘When are you due?’

‘In about three months’ time,’ Alice muttered reluctantly.

‘Your first?’

Alice nodded. She really didn’t want to discuss her private life with Mrs Marshall but, as she was increasingly finding out, her obvious condition seemed to be a licence for all and sundry to strike up a conversation about the most personal of subjects.

‘Must be hard on your own.’ She gestured to Alice’s naked ring finger.

Alice concentrated on finding the pulsing artery. ‘Hold still, please, Mrs Marshall.’

Thankfully she hit the jackpot first time and the bright red arterial blood spurted up the syringe.

‘She got it first go and even gave me an anaesthetic first,’ Mrs Marshall said loudly—to whom, Alice had no idea.

‘Glad to hear it.’

Alice nearly jumped out of her skin as Jeremy made his way over. ‘Let’s pop your oxygen back on now.’ He replaced the mask over the patient’s face.

‘I was just saying how hard it must be for the young doctor, being pregnant and on her own.’

Alice wished the ground would open up and swallow her, but she had no choice other than to stand there and press the cotton-wool swab for a full two minutes on the site where she had taken the arterial blood.

‘Oh, I don’t know,’ Jeremy said lightly. ‘Solitude has its virtues. I think you can stop pressing now,’ he added to Alice.

Mortified, she followed him out of the room.

‘Don’t tell them so much next time,’ Jeremy said, taking her to one side.

Alice, blushing furiously, looked down at her feet. Her tinted moisturiser had gone all blotchy. ‘I’m sorry, I know it mustn’t look very good—professionally, I mean—what with me being a single mother and all that.’

To her utter amazement Jeremy gave a small laugh. ‘We’re in the twenty-first century, Alice, for heaven’s sake, not the nineteen-fifties. Nobody gives a damn these days about pregnant women being single.’

‘Well, I do.’ Alice said curtly, though the fact he wasn’t bothered by her status was somehow strangely comforting.

‘I know,’ he said, and Alice looked up, surprised at his perception. ‘I could tell Mrs Marshall’s probing was making you uncomfortable. Next time tell them your fingers have got too fat to put your rings on, or tell them you don’t want to talk about it. Tell them what you like. You’re the doctor. It’s you holding the consultation, not the other way around.’

‘Thanks, I never thought of it like that.’

‘You’d better get those blood gases over to ICU.’

Only then did Alice remember the kidney dish she was holding. ‘I’ll take them down to the lab myself. We’re not allowed to use the ICU blood-gas machine for ward patients unless it’s a real emergency,’ she reminded him.

Jeremy screwed up his nose. ‘Since when?’

‘Since for ever—well, at least in the nine months I’ve been here.’

But Jeremy didn’t look convinced. ‘I’ve never had a problem. Maybe it’s because I’m consultant,’ he said pompously.

Well, you wouldn’t have a problem, would you? Alice thought to herself as they entered the intensive care unit. One glimpse of those impossibly blue eyes and a flash of that ready smile and everyone melted. Even Flynn, the gayest of porters, smoothed down his hair when Jeremy walked past. They were all so delighted to see him that Alice stood there awkwardly as they chatted away, greeting him like a long-lost friend. Finally Jeremy seemed to remember why they were there.

‘I’d better get these bloods done, or we’ll have to get a fresh sample.’

Far from the grumbling staff that reluctantly allowed her to do blood gases in only the most dire of emergencies, for Jeremy it seemed it was absolutely no trouble at all. They even offered to run the test for him.

‘No, but thanks anyway. I just want to have a quick look at the printout and then hopefully dash off. I’ll catch you all later.’

Alice could find neither rhyme nor reason for her indignation as she smeared a drop of blood onto the machine and punched in her request.

‘Don’t take it personally,’ Jeremy said, glancing at her sideways as she glared at the machine. ‘They probably let me use the machine because they’ve got a bit of a soft spot for me. I was a patient here for a while.’

Alice gave a cynical laugh as the printout appeared. The staff might well have a soft spot for Jeremy Foster, but it certainly wasn’t all down to the fact he had been a patient here, or even that he was a consultant.

Ripping the result off, she handed it to him.

‘Better than I thought. Good. But keep an eye on her, Alice. Given that I’ve upped her pethidine and prescribed her Valium, her respiration rate could go down. Tell the nurses to do strict one- to two-hourly obs and keep a close eye on her oxygen saturations.’

Alice nodded.

‘I’ll catch you later, then.’

As he left the tiny annexe, the baby suddenly let out a massive kick. Alice’s hands instinctively moved to her stomach and she tenderly massaged it. ‘Don’t worry, I haven’t forgotten you’re in there,’ she whispered, and watched out of the window as Jeremy made his way down the unit, every nurse in the place turning her head to catch a glimpse as he left. At least she didn’t have to worry about Jeremy trying his well-rehearsed lines on her. Just as well really, Alice thought to herself as she made her way back to the ward. With those blue eyes and that sultry smile she doubted whether even she would be able to offer much resistance.

Pre-op clinics always ran overtime and today was no exception, given the fact it was the intern’s first day and the consultant had only just returned from sick leave.

It was Alice’s job to clerk the patients, which involved taking a full medical history. From there she would order any test she thought necessary prior to the patient’s admission, such as ECGs and blood tests. Then the consultant would review the patient and agree or disagree with the intern’s suggestions, invariably adding or removing a test. At this point, Jeremy explained, he would like her to be present.

‘There’s not much point otherwise. At least we can both explain our thought processes behind the pre-op work-ups. The down side is it means we won’t be out of here much before six.’ He gave her a sideways look. ‘Or maybe even seven. Is that a problem?’

Alice shook her head. ‘Sounds fine to me.’

And so they battled away. Alice took excellent histories. Somehow she managed to get the patients to open up—maybe because she gave a bit of herself back. But under her steady, unaccusing gaze the ‘occasional smoker’ would admit to a twenty a day habit and even the ‘social drinker’ admitted to a few cans mid-week. She took Jeremy’s advice, though, and somehow by remembering that it was she that was holding the consultation she managed to avoid some of the more embarrassing questions that, until now, patients had assumed it was their right to ask. Not that she wasn’t personable and friendly, but Marcus’s rejection and her current circumstances were something Alice was having difficulty dealing with herself without the constant, however well meaning, advice from strangers.

Jeremy, on the other hand, seemed to be taking his own advice to the extreme. He was courteous, friendly even, yet he gave nothing away about himself. Every personal comment, every attempt by a patient to make small talk was immediately and skilfully rebuffed. So skilfully, in fact, that it took Alice the full afternoon to realise he never spoke about himself other than with reference to his work.

Jeremy didn’t seem remotely bothered by her apparent slowness. In fact, by the time the last patient had been seen and the clock was edging towards seven, he seemed more than happy to prolong the evening with a chat.

‘That’s the last, Mr Foster.’

The young nurse popped her head around the door and Alice noticed her looking pointedly at her watch.

‘Thanks, Emily, you did a great job today. I’m sorry we’ve made you so late. And, by the way, it’s Jeremy.’

Instantly the bitter expression melted.

‘No problem.’ Emily paused. ‘Jeremy. It’s nice to have you back.’

That man could get away with murder, Alice thought. Why, even the most respected consultant wouldn’t be left in doubt of the nurse’s wrath if he let the clinic run more than two hours over, but for some reason Jeremy could get away with it. The nurses had been just as forgiving as the patients.

‘I’d just like to run a couple of things by you before you go,’ Jeremy said, interrupting her thoughts.

‘OK.’ Putting the pile of notes she had completed into the in-tray, Alice took a seat at his desk.

‘You’re sure?’ Jeremy checked. ‘You haven’t got a babysitter you’ve got to get back to or anything?’

‘I don’t have to worry about that for a few months yet.’

‘And if Mrs Marshall’s observations were correct, I can assume you don’t have a husband or partner wanting his dinner on the table?’

Alice swallowed nervously. She had known it would only be a matter of time before he asked. ‘Another thing I don’t have to worry about.’

‘Good.’

Alice looked up sharply. ‘Is it?’

Jeremy gave her a brief smile. ‘For me it is. Look, Alice, you’ve heard the gossip. I’m a has-been, I’m coming back too soon, I’m half the surgeon I used to be, and all that.’

Alice flushed. ‘I’ve heard nothing of the sort,’ she lied.

‘Bull.’

His expletive hit the mark. ‘Well, maybe a few remarks,’ she admitted. ‘But you know what this place is like. Once you’ve been back for a couple of weeks you’ll soon put them right. Anyway,’ she added somewhat more forcefully, ‘what on earth has any of this to do with my marital status?’

‘Everything and nothing. You know how politically correct everything is these days, Alice. Apparently, I’m not supposed to notice the obvious fact that you’re pregnant. And even if it’s brought to my attention I’m not supposed to let it affect my judgement of you in any way. Even by having this conversation, effectively you could run off to the anti-discrimination council and have me up to my neck in hot water.’

Alice was totally confused. ‘Why would I?’

‘Because, as I said, your rather large bump supposedly shouldn’t affect my judgement of you in the slightest.’

‘And does it?’ Alice asked boldly.

Jeremy stared at her for an age. Her heavy dark hair was too much for the loose scrunchy she was wearing and was slipping from its grasp, and dark grey eyes were staring up at him as if waiting for his judgement. For a second he lost his train of thought, but only for a second. His eyes flicked downwards again, and came to rest on the soft yet firm swell of her stomach.

‘Yes,’ he answered simply. ‘Yes, it does.’

‘But why? Just because I’m pregnant, it doesn’t make me any less a doctor.’

Jeremy put his hands up. Tanned, manicured, long-fingered hands, Alice noticed...surgeon’s hands. ‘I never meant—’

But Alice interrupted him, jumping to her feet. Suddenly she felt threatened. Maybe he was about to say he didn’t want her on his team, would never have agreed to it had he been in on the interview. All she knew was that it was imperative he let her stay. ‘Being pregnant makes me a better doctor. I now know what it’s like to lie on an examining couch and be prodded and poked. I know how it feels to be vulnerable, to be a number in the system.’

‘Whoa.’ Jeremy gestured for her to sit down.

Furious with herself for reacting so violently, Alice meekly did as she was told. Not trusting herself to speak, she looked up at him.

Jeremy cleared his throat before speaking. ‘Firstly, I have absolutely no doubt you’re a fine doctor. Your references are exemplary, and from what I’ve seen today you merit every word that was written. Secondly, I’m sure you really are a better doctor for being on the receiving end of the health system. I know without a shadow of doubt that I am, or at least I hope I will be. Take Mrs Marshall today. Normally I’d have dropped her pethidine down even further, and I’m not proud of that fact. But, having been in pain myself, I now recognise it all the more.’ He stopped talking and for a moment Alice thought he had forgotten she was even there.

‘And thirdly,’ she prompted. ‘I assume there’s more?’

Jeremy snapped back to attention, a wry smile touching the edge of his lips. ‘I’m not an obstetrician, and with good reason.’

Alice’s eyebrows shot up in a questioning look.

‘Heaven knows, they make enough money.’

‘Tell me about it,’ Alice grumbled, thinking of the invoice from Brett Halliday sitting in her bedside drawer amongst the other pile of unpaid bills.

‘What I’m trying to say,’ Jeremy continued, ‘albeit not very well, is that pregnant women terrify me.’

Alice started to laugh, then stifled her giggle as she realised he wasn’t joking.

‘You’re not serious?’

Jeremy nodded. ‘Deadly serious. I mean, see it from my angle. If I bawl you out, are you going to burst into tears or, worse, will I induce premature labour? If I keep you behind in a clinic or call you into Theatre at midnight, am I going to do irreparable damage to the baby?’

Alice really was laughing now. ‘Jeremy, I’m not a doll. I’m not some precious Ming vase that’s about to shatter, for heaven’s sake. I’m pregnant, that’s all. Women have been managing it throughout time, in fact.’

‘I know, I know. Look, I’m probably not being fair, landing this lot on you. I know you haven’t asked for special favours or anything. It’s just that I’m going to be pretty full-on in the ensuing months, far more so than any of the other surgeons, and that means I’m going to be asking a lot from you. I just need to know that you’re up to it and if you’re not I need you to tell me.’

‘I’m up to it.’ Alice said with conviction, but it wasn’t the answer Jeremy wanted to hear.

‘You still don’t understand, do you?’

Alice looked at him, nonplussed. What more did he want—an affidavit?

‘If I’m piling it on too thick I need to know you’ll tell me. I’m single-minded where work’s concerned. What I’m trying to say is that my career is everything to me. Now, I might expect loyalty and hard work from my staff and sometimes I admit I stretch the limits, but in your case you have a baby to think of. I’m not a soft touch—anything but—and I need to know that you’ll tell me if there’s a problem. It might not be politically correct, or whatever you want to call it, but I can’t pretend your condition doesn’t exist. If I’m coming down too hard, you must say so.’

Alice was surprised by his words, stunned even. From what she had heard of Jeremy Foster, compassion and understanding weren’t on his list of credentials, and even if his attempt at these had been somewhat bumbling and massively sexist, she was touched at his attempt. ‘I will,’ she said softly.

‘So long as we’ve cleared that up, then.’ Jeremy gave her a dismissive nod and Alice said goodnight. Retrieving her bag from the nurses’ station, it suddenly became imperative that she thank him. Making her way back to his room, she stepped inside. Jeremy was sitting there, his head in his hands. Two soluble painkillers were fizzing away in the glass next to him. From the hunch of his wide shoulders she could tell he was tense, possibly in pain. Sensing someone’s presence, he sat up smartly and turned around.

‘Was there anything else?’

Alice hesitated. Suddenly she felt as if she had witnessed a side that Jeremy didn’t want to be seen, as if she had somehow invaded his privacy.

‘I just wanted to thank you.’

‘There’s really no need. You’ll be calling me all sorts of names by the end of the week.’

Alice gave a small smile. She knew she should go now, but for some reason she found herself standing there. He might be her consultant, but at this moment Jeremy Foster looked nothing like the dashing, confident man she had met this morning. He looked exhausted—the day must have taken its toll—and in pain, too. ‘Er, is there anything I can get you?’

Jeremy gave her a quizzical look. ‘Like what?’

Alice shrugged. ‘A cup of tea perhaps?’

Jeremy gave a low laugh before answering sarcastically, ‘A woman’s solution to everything.’ When Alice flushed he added more kindly, ‘At least, it’s my mother’s solution.’ He shook his head. ‘I’ve got a headache, that’s all. I’ll be fine.’ And, turning his back, he started dictating his notes into a machine for his secretary.

Well, what had she expected? For Jeremy Foster to confide in her, to tell her how bad he was feeling? She let out a low moan. Imagine offering him a cup of tea! Of all the stupid things to say—in one sentence she had relegated herself to the little-woman role where Jeremy so obviously thought she belonged.

If only she had known that at that same moment Jeremy’s head was back in his hands and he was thinking that maybe he should have accepted that cup of tea. Maybe a few minutes spent talking to Alice would have made things a bit easier for him if he’d told her how it was for him, that the accident hadn’t left him completely unscathed. That his back was killing him and he suffered headaches that were indescribable. After all, he was going to be relying a lot on her over the next few months and he was hardly about to bare his soul to Linda. And as for Josh—well, Josh was a good bloke but he gossiped far too much. Maybe talking to Alice would have helped lighten his load. But what good could have come from it? She seemed like a nice girl, but he hardly knew her. No doubt in five minutes’ flat the word would be around the hospital. Has-been, past it, came back too soon. Jeremy pulled a face as he downed the rest of the revolting medicine. He’d just have to wear it for now.

CHAPTER TWO

‘COULD I have a bit more light? It’s like operating in a bloody dungeon here.’ Alice moved the overhead light a fraction. She was too focussed on the direness of the situation to take Jeremy’s comments personally.

‘Dear God, why didn’t they bring him in sooner?’

Alice didn’t answer. She knew Jeremy was talking more to himself than to anyone else.

‘More traction,’ he ordered, and Alice pulled back on the retractor holding the incision Jeremy had swiftly cut further back to allow for greater visibility. She could see the sweat pouring down his forehead. No matter how many times the nurse wiped it, only seconds later he was drenched again.

He’s in pain again, Alice thought, suddenly feeling sorry for him.

She had been working with Jeremy for two weeks now, and whatever Jeremy lacked in social skills he made up for in the operating room. He was quite simply the best surgeon she had ever seen. His long fingers worked deftly, his vivid blue eyes seemed to pick up the minutest detail almost before it became apparent to anyone else. But were his skills enough to save this young life?

Lachlan Scott had been wheeled into the accident and emergency department less than two hours previously. The young medical student had been complaining of abdominal pain for a couple of days now, but hadn’t thought to do anything about it. Only this morning had he turned up at his father’s house, vomiting and in great pain. His father, one of the leading physicians at the hospital, had immediately rushed him in. The diagnosis of appendicitis had been made even before he had hit the accident and emergency department; but it soon became clear from his rigid abdomen and shocked appearance that his appendix had already ruptured and the patient was now suffering from peritonitis. Linda and Josh had been in the middle of a hernia repair, which had left Jeremy with only the most junior of assistants.

Alice’s back was killing her. Lachlan Scott had come in on the end of an already busy morning in the operating theatre, but for now her back was the least of her concerns.

‘I think we’re winning.’ Jeremy looked up briefly and Alice could read the look of sheer relief in his vivid eyes. By the time Jeremy had stitched the last of the drains into place, which would drain any excess fluid from Lachlan’s abdomen, and had covered the wound with a huge clear dressing, they had been operating for over two hours. ‘Good work, everyone. Let’s get him out to Recovery.’

Alice would have liked nothing more than to peel off her theatre scrubs, stand under a cool shower and follow it up with a huge mug of tea, but that luxury was going to have to wait. Lachlan had been resuscitated with fluids in the emergency department and huge doses of antibiotics had already been administered, but his post-operative IV and drug regime would have to be worked out carefully if they were to allay any of the multitude of post-operative complications he might succumb to.

‘His father’s just outside,’ Carrie, the theatre charge nurse, prompted. Alice watched as the faintest hint of a frown appeared on Jeremy’s face. ‘Jeremy, he’s a consultant. It will have to be you that talks to him,’ Carrie said firmly.

‘I know, I know,’ he said irritably. ‘I’ll talk to him, but first I’m having a shower. I’ll be back to check on Lachlan shortly.’

‘Why is he so worried about talking to him?’ Alice couldn’t refrain from asking when Jeremy turned on his heel and left. ‘I mean, he did a brilliant job in there. You’d think he’d be the rushing off to tell Dr Scott.’

Carrie shrugged. ‘Probably terrified he might have to get out his handkerchief.’ She gave a small laugh and Alice heard the trace of bitterness in her voice. ‘Jeremy doesn’t like scenes or confrontations. If Lachlan had been a straightforward appendicitis he’d be out there now, grinning like a Cheshire cat and saying how well it had gone. You know as well as I do it’s going to be pretty hard telling Lachlan’s parents how sick he is. He may be out of Theatre but he certainly isn’t out of the woods yet. No doubt Jeremy’s hoping that by the time he’s had his shower someone will have done the dirty deed for him. You’ll get used to his underhand methods. I know I have.’

‘I hear you’ve been having a bit of excitement?’ Alice swung around and smiled as she saw Josh entering the recovery area. Carrie muttered something and went to check on Lachlan.

‘Too much for one morning. How about you, Josh? How was your morning with Linda?’

Josh rolled his eyes. ‘Bearable. At least the mask covers up her face.’

‘Josh, you’re terrible.’ Alice giggled.

‘I just say things as I see them.’ He lowered his voice. ‘Speaking of which, what was Carrie bitching about?’

‘Nothing, she was just saying how Jeremy avoids talking to relatives when the news is bad.’

‘Take everything Carrie says about Jeremy with a pinch of salt. She’s just bitter because he dumped her. Or rather, he didn’t dump her—he got a “friend” to do it for him.’

‘Ouch,’ Alice winced. ‘I thought there was a bit of an undercurrent between them.’

But Josh shook his head. ‘Not where Jeremy’s concerned. As soon as a relationship’s over, he forgets the woman ever existed and moves happily on to the next one. It’s the women who are left simmering—any undercurrents come from them. Jeremy’s exes probably radiate enough energy to act as the hospital’s back-up generator.’

Alice’s laughter was interrupted by Josh’s pager. ‘Now what does Linda want?’ he muttered, but his face paled as he read the message.

‘It’s Dianne ringing,’ he said, referring to his wife. Grabbing the nearest phone, he picked it up and, shaking, attempted to dial home, but kept misdialling.