Midwives On-Call

‘Whoops,’ she said, as Ruby blew her nose.

He glanced down at the ruined machine. ‘As you say, whoops.’

And as Ruby realised what he was holding, the teenager choked on something that was almost a laugh. ‘Em’s smashed your computer,’ she said, awed. ‘Do you mind?’

‘I can’t afford to mind.’

‘Why not?’ She was caught, pulled out of her misery by a smashed computer.

‘Priorities,’ he said. ‘You. Baby. Computer. In that order.’

‘What about Em?’ she asked, a touch of cheekiness emerging. ‘Is she a priority?’

‘Don’t you dare answer,’ Em told him. ‘Not until you’ve checked that your computer is covered by insurance. Ruby, if you’re rethinking your plans to adopt …’

‘I think … I might be.’

‘Then let’s not make any decisions yet,’ she said, hurriedly. Surely now wasn’t the time to make such an emotional decision? ‘Let’s get this operation over with first.’

Ruby took a deep breath and looked from Oliver to Emily and back again. ‘Maybe I do need a bit of time,’ she conceded. ‘Maybe a sleep … time to think.’

‘Of course you do.’ She pulled up her covers and tucked her in. ‘Ruby, nothing’s urgent. No decisions need to be made now. Just sleep.’

‘Thank you. And, Dr Evans …’

‘Mmm?’ Oliver was about to leave but turned back.

‘I hope your computer’s all right.’

‘It will be,’ he said. But it wouldn’t. Em could see the smashed screen from where she stood. ‘But even if it’s not, it’s not your problem,’ he said, gently now, almost as a blessing. ‘From here on, Ruby, we don’t want you to worry about a thing. You’ve put yourself in our hands and we’ll keep you safe. Em and I are a great team. You and your baby are safe with us.’

His lovely, gentle bedside manner lasted until they were ten feet from Ruby’s door. Em closed the door behind her, looked ahead—and Oliver was staring straight at her. Vibrating with anger.

‘You’re planning on talking her out of keeping her baby?’

The turnabout from empathy to anger was shocking. The gentleness had completely gone from his voice. What she saw now was fury.

She faced him directly, puzzled. ‘What are you saying? I didn’t. I’m not.’

‘You are. She’d decided on adoption but now she’s changing her mind. But you stopped her.’

‘I didn’t stop her. I’d never do that.’ She thought back to the scene she’d just left, trying to replay her words. ‘I just said she had time …’

‘You told her not to make a decision now. Why not? Right now she’s thinking of keeping her baby. You don’t think it’s important to encourage her?’

‘I don’t think it’s my right to direct her one way or another.’ She felt herself getting angry in response. ‘All I saw in there was a frightened, tired kid who’s facing major surgery tomorrow. Who needs to stay calm and focused. Who doesn’t need to be making life-changing decisions right now. She’s already decided enough.’

‘But maybe when you’re emotional, that’s the time to make the decision. When she knows she loves her baby.’

‘She’ll always love her baby.’ Em was struggling to stay calm in the face of his anger—in the face of his accusation? ‘Ruby is a seventeen-year-old, terrified kid with no family support at all. If she decides to keep this baby, it’ll change her life for ever. As it will if she gives it up for adoption. What I did in there—and, yes, I interceded—was give her space. If she wants to keep her baby, she’ll need every ounce of strength and then some.’

‘She’ll get support.’

‘And she can never be a kid again. But, then, after this, maybe being a kid is no longer an option. But I agree, that’s none of my business. Oliver, is this discussion going anywhere? I’ve been away from the birthing suites for over an hour and I don’t know what’s going on. I may well be needed.’

‘You won’t influence her?’

‘Why would I influence her?’

‘Because you believe in adoption.’

‘And you don’t? Because of what happened to you when you were a kid?’ Anger was washing over her now. Yes, she should get back to the birthing suites but what was it he was accusing her of? ‘Get over it, Oliver. Move on. Not every adoptive mother is like yours, and not every birth mother is capable of loving. There’s a whole lot of grey in between the black and white, and it’s about time you saw it.’

‘So you won’t encourage her to adopt?’

‘What are you expecting me to do?’ She was confused now, as well as angry. She put her hands on her hips and glared. ‘Are you thinking I might pop in there, offer to adopt it myself and get myself another baby? Is that what you’re thinking?’

‘I would never—’

‘You’d better not. A midwife influencing a mother’s decision is totally unethical. How much more so is a midwife offering to adopt? I’ll do neither. I have my kids, Oliver, and I love them to bits. I have no wish for more.’

‘But Gretta’s going to die.’

Why had he said it? It had just come out, and he could have bitten his tongue from his head. Em’s face bleached white and she leaned back against the wall for support.

Dear heaven … What sort of emotional drop kick was he? Suggesting one kid was going to die so she was lining up for another? Where had the thought come from?

It was confusion, he thought. Maybe it was even anger that she’d got on with her life without him.

Or maybe it was sheer power of testosterone washing through him—because the woman who should be his wife was looking at him as if he was a piece of dirt.

Where to start with apologies? He’d better haul himself back under control, and fast. ‘Hell, Em, I’m sorry. I didn’t mean that the way it came out, truly.’ He reached out and touched her stricken face, and the way he felt … sick didn’t begin to describe it. ‘Can you forget I said it? Of all the insensitive oafs … I know Gretta’s health has nothing to do with … anything. I’m so sorry. Can you wipe it? I know you love Gretta …’

‘Are you talking about Emily’s little girl?’

They both turned to face the newcomer, and it was a relief to turn away from each other. The tension between them was so tight it was threatening to break, to fly back and hit both of them.

Oliver recognised the young man heading towards them. Oliver had been introduced to Noah Jackson earlier in the week. He was a surgical registrar, almost at the end of his training. ‘Technically brilliant,’ Tristan, the paediatric cardiologist, had told him. ‘But his people skills leave a whole lot to be desired.’

And now he proceeded to display just that.

‘Hi, Em,’ he called, walking up to them with breezy insouciance. ‘Are you discussing Gretta’s progress? How’s she going?’

‘She’s … okay,’ Em said, and by the way she said it Oliver knew there was baggage behind the question.

‘You ought to meet Gretta,’ Noah told Oliver, seemingly oblivious to the way Em’s face had shuttered. ‘She’s worth a look. She has Down’s, with atrioventricular septal defects, massive heart problems, so much deformity that even Tristan felt he couldn’t treat her. Yet she’s survived. I’ve collated her case notes from birth as part of my final-year research work. I’d love to write her up for the med journals. It’d give me a great publication. Em’s care has been nothing short of heroic.’

‘I’ve met her,’ Oliver said shortly, glancing again at Em. Gretta—a research project? He could see Em’s distress. ‘Now’s not …’ he started.

But the young almost-surgeon wouldn’t be stopped. ‘Gretta wasn’t expected to live for more than a year,’ he said, with enthusiasm that wouldn’t be interrupted. ‘It’ll make a brilliant article—the extent of the damage, the moral dilemma facing her birth mother, her decision to walk away—Em’s decision to intervene and now the medical resources and the effort to keep her alive this far. Em, please agree to publication. You still haven’t signed. But Tristan says she’s pretty close to the end. If I could examine her one last time …’

And Oliver saw the wash of anger and revulsion on Em’s face—and finally he moved.

He put his body between the registrar and Em. Noah was tall but right now Oliver felt a good foot taller. Anger did that. Of all the insensitive …

‘You come near Em again with your requests for information about her daughter—her daughter, Noah, not her patient—and I’ll ram every page of your case notes down your throat. Don’t you realise that Em loves Gretta? Don’t you realize she’s breaking in two, and you’re treating her daughter like a bug under a microscope?’

‘Hey, Em’s a medical colleague,’ Noah said, still not getting it. ‘She knows the score—she knew it when she took Gretta home. She can be professional.’

‘Is that what you’re being—professional?’

‘If we can learn anything from this, then, yes …’

Enough. Em looked close to fainting.

The lift was open behind them. Oliver grabbed Noah by the collar of his white jacket, twisted him round and practically kicked him into the lift.

‘What …?’ Noah seemed speechless. ‘What did I say?’

‘You might be nearing the end of your surgical training,’ Oliver snapped. ‘But you sure aren’t at the end of your training to be a decent doctor. You need to learn some people skills, fast. I assume you did a term in family medicine during your general training, but whether you did or not, you’re about to do another. And another after that if you still don’t get it. I want you hands-on, treating people at the coal face, before you’re ever in charge of patients in a surgical setting.’

‘You don’t have that authority.’ The young doctor even had the temerity to sound smug.

‘You can believe that,’ Oliver growled. ‘You’re welcome—for all the good it’ll do you. Now get out of here while I see if I can fix the mess you’ve made.’

‘I haven’t made a mess.’

‘Oh, yes, you have,’ Oliver snapped, hitting the ‘Close’ button on the lift with as much force as he’d like to use on Noah. ‘And you’ve messed with someone who spends her life trying to fix messes. Get out of my sight.’

The lift closed. Oliver turned back to Em. She hadn’t moved. She was still slumped on the wall, her face devoid of colour. A couple of tears were tracking down her face.

‘It’s okay,’ she managed. ‘Oliver, it’s okay. He’s just saying it like it is.’

‘He has no right to say anything at all,’ Oliver snapped, and he couldn’t help himself. She was so bereft. She was so gutted.

She was … his wife?

She wasn’t. Their long separation to all intents and purposes constituted a divorce, but right now that was irrelevant.

His Em was in trouble. His Em.

He walked forward and took her into his arms.

She shouldn’t let him hold her. She had no right to be in his arms.

She had no right to want to be in his arms.

Besides, his words had upset her as much as Noah’s had. His implication that she could replace Gretta …

But she knew this man. She’d figured it out—the hurt he’d gone through as a kid, the rejection, the knowledge that he’d been replaced by his adoptive parents’ ‘real’ son.

Noah was just plain insensitive. He was arrogant and intelligent but he was lacking emotional depth. Oliver’s comments came from a deep, long-ago hurt that had never been resolved.

And even if it hadn’t, she thought helplessly, even if he was as insensitive as Noah, even if she shouldn’t have anything to do with him, for now she wanted to be here.

To be held. By her husband.

For he still felt like her husband. They’d been married for five years. They’d lain in each other’s arms for five years.

For five years she’d thought she had the perfect marriage.

But she hadn’t. Of course she hadn’t. There had been ghosts she’d been unable to expunge, and those ghosts were with him still. He couldn’t see …

Stop thinking, she told herself fiercely, almost desperately. Stop thinking and just be. Just let his arms hold me. Just feel his heart beat against mine. Just pretend …

‘Em, I’m sorry,’ he whispered into her hair.

‘For?’

‘For what I said. Even before Noah, you were hurt. I can’t begin to think how I could have said such a thing.’

‘It doesn’t matter.’ But it did. It was the crux of what had driven them apart. For Oliver, adoption was simply a transaction. Hearts couldn’t be held …

As theirs hadn’t. Their marriage was over.

But still she held. Still she took comfort, where she had no right to take comfort. They’d been separated for five years!

So why did he still feel like … home? Why did everything about him feel as if here was her place in the world?

‘Hey!’ A hospital corridor was hardly the place to hold one’s ex-husband—to hold anyone. It was busy and bustling and their sliver of intimacy couldn’t last.

It was Isla, hurrying along the corridor, smiling—as Isla mostly smiled right now. The sapphire on her finger seemed to have changed Em’s boss’s personality. ‘You know I’m all for romance,’ she said as she approached. ‘But the corridor’s not the place.’ She glanced down at the sapphire on her finger and her smile widened. ‘Alessi and I find the tea room’s useful. No one’s in there right now …’

‘Oh, Isla …’ Em broke away, flushing. ‘Sorry. It’s not … Dr Evans was just … just …’

But Isla had reached them now and was seeing Em’s distress for herself. ‘Nothing’s wrong with Ruby, is there?’ she asked sharply.

‘No.’ Oliver didn’t break his composure. ‘But you have a problem with Dr Noah Jackson. He seems to think Em’s Gretta is a research experiment.’

‘Noah’s been upsetting my midwife?’ Isla’s concern switched to anger, just like that. ‘Let me at him.’

‘I don’t think there’s any need,’ Em managed. ‘Oliver practically threw him into the lift.’

‘Well, good for you,’ Isla said, smiling again. ‘I do like an obstetrician who knows when to act, and one who knows the value of a good cuddle is worth his weight in gold.’ She glanced again at her ring. ‘I should know. But, Em, love, if you’ve finished being cuddled, I would like you back in the birthing suite.’

‘Of course,’ Em said, and fled.

There was a moment’s silence. Then …

‘Don’t you mess with my midwives,’ Isla said, and Oliver looked at her and thought she saw a whole lot more than she let on.

‘I won’t.’

She eyed him some more. ‘You two have baggage? Your name’s the same.’

‘We don’t have … baggage.’

‘I don’t believe it.’ She was still thoughtful. ‘But I’ll let it lie. All I’ll say is to repeat—don’t mess with my midwives.’

Thursday night was blessedly uneventful. Gretta seemed to have settled. Em should have had a good night’s sleep.

She didn’t but the fact that she stared into the dark and thought of Oliver was no fault of … anyone.

Oliver was no business of hers.

But he’d held her and he felt all her business.

Oliver …

Why had he come here to work? Of all the unlucky coincidences …

But it wasn’t a simple coincidence, she conceded. The Victoria had one of Australia’s busiest birthing units. It was also right near her mother’s home so it had made sense that she get a job here after the loss of Josh.

And after the loss of Oliver.

Don’t go there, she told herself. Think of practicalities.

It made sense that Oliver was back here, she told herself. Charles Delamere head-hunted the best, and he’d have known Oliver had links to Melbourne.

So she should leave?

Leave the Victoria? Because Oliver had … cuddled her?

It’s not going to happen again, she told herself fiercely. And I won’t leave because of him. There’s no need to leave.

He could be a friend. Like Isla. Like Sophia.

Yeah, right, she told herself, punching her pillow in frustration. Oliver Evans, just a friend?

Not in a million years.

But she had no choice. She could do this. Bring on tomorrow, she told herself.

Bring on a way she could treat Oliver as a medical colleague and nothing else.

CHAPTER SEVEN

FRIDAY. EM’S DAY was cleared so she could focus on Ruby. Isla was aware of the situation. ‘If she really has no one, then you’d better be with her all the way.’

So she stayed with Ruby in the hour before she was taken to Theatre. She spent their time discussing—of all things—Ruby’s passion for sewing. Ruby had shyly shown her her handiwork the day before, so Em had brought in one of Toby’s sweaters. Ruby was showing her how to darn a hole in the elbow.

‘Darning’s a dying art,’ she’d told Em, so Em had found the sweater and brought a darning mushroom—Adrianna had one her grandmother had used!—and needle and thread and asked for help.

Ruby took exquisite care with the intricate patch. When she was finished Em could scarcely see where the hole had been, and darning and the concentration involved worked a charm. When the orderlies came to take Ruby to Theatre, Ruby was shocked that the time had already arrived.

She squeezed Em’s hand. ‘Th-thank you. Will I see you later?’

‘I’m coming with you,’ Em declared, packing up the darning equipment. ‘Isla’s told me if I’m to help deliver your baby at term then I should introduce myself to her now. So I’m to stay in the background, not faint, and admire Dr Evans’s handiwork.’

‘You’d never faint.’

‘Don’t you believe it,’ Em told her, and proceeded to give her some fairly gross examples. She kept right up with the narrative while Ruby was pushed through to Theatre, while pre-meds were given, while they waited for the theatre to be readied. Finally, as Ruby was wheeled into Theatre, they were both giggling.

Oliver was waiting, gowned and ready. So, it seemed, was a cast of thousands. This was surgery at its most cutting edge. They were operating on two patients, not one, but one of those patients was a foetus that was not yet viable outside her mother. The logistics were mind-bending and it would take the combined skills of the Victoria’s finest to see it succeed.

Shock to the foetus could cause abortion. Therefore the anaesthetic had to be just right—they had not only the Victoria’s top anaesthetist, but also the anaesthetic registrar. Heinz Zigler was gowned and ready. Tristan Hamilton, paediatric cardiologist, was there to check on the baby’s heart every step of the way. There were so many possible complications.

The surgery itself was demanding but everything else had to be perfect, as well. If amniotic fluid was lost it had to be replaced. If the baby bled, that blood had to be replaced, swiftly but so smoothly the loss couldn’t be noticed. Everything had to be done with an eye to keeping the trauma to the baby at the absolute minimum.

‘Hey, Ruby.’ Oliver welcomed the girl warmly as she was wheeled in, and if he was tense he certainly wasn’t showing it. ‘What’s funny?’

‘Em’s been telling me—’ Ruby was almost asleep from the pre-meds but she was still smiling ‘—about muddles. About her work.’

‘Did she tell you about the time she helped deliver twins and the team messed up their bracelets?’ Oliver was smiling with his patient, but he found a chance to glance—and smile—at Em. ‘So Mathew Riley was wrapped in a pink rug and Amanda Riley was wrapped in a blue rug. It could have scarred them for life.’

Em thought back all those years. She’d just qualified, and it had been one of the first prem births where she’d been midwife in charge. Twins, a complex delivery, and the number of people in the birthing room had made her flustered. Afterwards Oliver had come to the prem nursery to check on his handiwork. The nurse in charge—a dragon of a woman who shot first and asked questions later—had been in the background, as Oliver had unwrapped the blue bundle.

Em had been by his side. She’d gasped and lost colour but Oliver hadn’t said a word; hadn’t given away by the slightest intake of breath that he’d become aware she’d made a blunder that could have put her job at risk. But the mistake was obvious—the incubators had been brought straight from the birthing suite and were side by side. There was no question who each baby was. Without saying a word, somehow Oliver helped her swap blankets and wristbands and the charge nurse was unaware to this day.

That one action had left her … smitten.

But it hadn’t just been his action, she conceded. It had also been the way he’d smiled at her, and then as she’d tried to thank him afterwards, it had been the way he’d laughed it off and told her about dumb things he’d done as a student … and then asked her to have dinner with him …

‘I reckon I might like to be a nurse,’ Ruby said sleepily. ‘You reckon I might?’

‘I reckon you’re awesome,’ Oliver told her. ‘I reckon you can do anything you want.’

And then Ruby’s eyes flickered closed. The chief anaesthetist gave Oliver a nod—and the operation was under way.

Lightness was put aside.

Oliver had outlined the risks to Ruby—and there were risks. Exposing this tiny baby to the outside world when she was nowhere near ready for birth was so dangerous. Em had no idea how many times it had been done in the past, how successful it had been, but all she knew as she watched was that if it was her baby there was no one she’d rather have behind the scalpel than Oliver.

He was working side by side with Heinz. They were talking through the procedure together, glancing up every so often at the scans on the screens above their heads, checking positions. They wanted no more of the baby exposed than absolutely necessary.

Another screen showed what they were doing. To Em in the background she could see little of the procedural site but this was being recorded—to be used as Rufus’s operation had been—to reassure another frantic mum?

Please let it have the same result, she pleaded. She was acting as gofer, moving equipment back and forth within reach of the theatre nurse as needed, but she still had plenty of time to watch the screen.

And then the final incision was made. Gently, gently, the baby was rotated within the uterus—and she could see the bulge that was the unsealed spine.

There was a momentary pause as everyone saw it. A collective intake of breath.

‘The poor little tacker,’ Tristan breathed. ‘To be born like that … she’d have had no chance of living a normal life.’

‘Then let’s see if we can fix it,’ Oliver said in a voice Em had never heard before. And she knew that every nerve was on edge, every last ounce of his skill and Heinz’s were at play here.

Please …

The complexity, the minuscule size, the need for accuracy, it was astounding.

Oliver was sweating. Not only was the intensity of his work mind-blowing, but the theatre itself had to be set at a high enough temperature to stop foetal shock.

‘Em.’ Chris, the chief theatre nurse, called back to her. ‘Take over the swabs.’

All hands were needed. Em saw where she, too, was needed. She moved seamlessly into position and acted to stop Oliver’s sweat obscuring his vision.

He wasn’t aware of her. He wasn’t aware of anything.

They were using cameras to blow up the images of the area he and Heinz were working on. Every person there was totally focused on the job or on the screens. Two people at once—two hearts, two lives …

She forgot to breathe. She forgot everything but keeping Oliver’s vision clear so he could do what had to be a miracle.

And finally they were closing. Oliver was stitching—maybe his hands were steadier than Heinz’s because he was working under instruction. He was inserting what seemed almost microstitches, carefully, carefully manoeuvring the spinal wound closed. Covering the spinal cord and the peripheral nerves. Stopping future damage.

The spine was closed. They were replacing the amniotic fluid. Oliver was closing the uterus, conferring with Heinz, seemingly relaxing a little.

The outer wound was being closed.

The thing was done.

Emily felt like sagging.

She wouldn’t. She wiped Oliver’s forehead for the final time and at last he had space to turn and give her a smile. To give the whole team a smile. But his smile ended with Em.