muttered incoherently and groaned frequently as Mike helped Emily collect the blood samples required. Jill was charting a new set of vital signs and looked up as the tympanic thermometer beeped.
‘Temp’s up to 40.2.’
Emily nodded. ‘We’ll need to cool her down.’ The blood pressure showing on the monitor was also a concern, having dropped a little to 90 over 45. ‘I’ll get that dopamine infusion started.’
Within twenty minutes the medical care Megan was receiving seemed to be helping. Her level of consciousness improved with a drug-induced rise in blood pressure and reduction in her body temperature, and by the time Emily was ready to do a pelvic examination Megan was alert and orientated. She understood Emily’s explanation of what she was about to do.
And she was not happy about it.
‘Why do you want to do that?’
‘I’m concerned about your bleeding,’ Emily said carefully. ‘It doesn’t seem quite like a normal period.’ Which was an understatement. The pad Jill removed in preparation for the necessary urinary catheter looked, and smelt, very abnormal.
Megan stared at her doctor. ‘What if I refuse? I can refuse, can’t I?’
‘I’m only trying to help you, Megan.’ Emily hesitated then took a steadying breath. She really needed some answers here. ‘Is there something worrying you, Megan?’ she asked gently. She took hold of her patient’s hand. ‘Are you—or have you been—pregnant?’
‘No!’
Emily stayed still for a moment, maintaining eye contact. Offering what she hoped was a sympathetic and nonjudgmental ear. Jill was quietly busy, noting observations on the chart in a corner of the room. Mike had taken the blood samples to the lab where Charles was getting set up to do the analyses.
But Megan looked away. ‘I’m not pregnant,’ she told Emily. ‘And I don’t need any internal examination. I’ve just got the flu.’
‘Having flu wouldn’t be giving you such a sore tummy,’ Emily said patiently. ‘We need to find out what’s making you this sick, Megan. If it’s something like your appendix, then it’s possible you may need an operation.’
‘Is that what you think it is?’ Megan sounded almost hopeful. ‘My appendix?’
‘We won’t know unless you let me do what I need to do. I know it’s not pleasant, Megan, but I’ll be as quick and as gentle as I can be.’
This time Megan nodded and she stayed co-operative as Emily put gloves on and got Jill to assist in positioning Megan. The older nurse moved to hold Megan’s hand reassuringly.
Emily was careful. And thorough. And very surprised. She caught Jill’s gaze and the older nurse blinked. Megan stared at Jill. Then her gaze flicked to Emily who tried to keep both her face and tone very calm.
‘Jill, can you take these swabs through to Charles and see what’s happening with the blood samples?’
Jill eyed her curiously but nodded. ‘Of course.’
‘I’m feeling better now,’ Megan announced as Jill left the room.
‘That’s great.’ Emily smiled. ‘We’ll have to make sure you keep getting better.’
‘I’m really thirsty.’ Megan was staring at Emily with unnerving intensity. Had she guessed what Emily was thinking?
‘We can’t give you anything to drink just yet, I’m sorry—just in case you need to go to Theatre. Not until we’re sure of our diagnosis.’ Emily was sure now. All she needed was a minute to collect her thoughts and decide how to handle the new information she had.
‘I need to go to the toilet.’
‘I’ll find you a bedpan.’
‘Ew!’ Megan looked disgusted. ‘But I feel fine. Why can’t I use a proper toilet?’
‘You might not feel so good if you try standing up. And we need to do some tests on your urine in any case. Can’t you wait just a minute or two? I don’t want to leave you alone to go and get a pan.’
‘No. I’m busting.’
Emily scanned the monitors. Everything was stable, and looking better than it had. She nodded reluctantly. ‘OK. Just rest there, Megan,’ she instructed. ‘I’ll be back in just a second.’
‘Where are you going?’
‘To the sluice room.’ Emily hesitated. ‘Do you want me to wait until Jill comes back? Or find another nurse to sit with you?’
‘No, I told you—I’m busting!’
Emily’s path back from the sluice room intersected with that of Mike as he came back into the department.
‘Results will be through in another few minutes,’ he told her. Then he peered at Emily’s face. ‘What’s up, Em? Is it Megan?’
She nodded. ‘I’ve just done a pelvic exam. I know what’s wrong with her.’
Mike was still studying Emily’s expression. ‘She’s had a miscarriage?’
‘No.’ Emily had used the last minute or so to assimilate the most recent information she had gathered on her patient. ‘I think she’s given birth. Very recently.’
Mike whistled silently. ‘Like…in the last few days?’
Emily nodded again. Very slowly. ‘She’s got a perineal tear that’s just starting to heal. The only likely explanation for that is giving birth—to at least a close to full-term baby.’
‘And Megan was at the rodeo on Thursday. Her mother said she hadn’t eaten any hot dogs.’
Emily’s nod was excited this time.
‘Which would make it entirely possible that Megan is—’
‘Lucky’s mother,’ Emily breathed. ‘Oh, Mike!’ She held onto Mike’s gaze. ‘Do you know what this means?’
‘That she might be septic from a fragment of retained placenta?’
‘Yes, but…’ It was almost too much to get her head around. Emily could so easily imagine what it would have been like if she’d been told her baby wasn’t dead after all. Megan must think she’d lost her infant. Gina—the doctor who had discovered Lucky behind the bushes at the rodeo—had been convinced that the mother would have believed it to be a stillbirth.
‘Should we tell her now?’
‘Has she said anything about being pregnant?’
‘She denied it.’ Emily frowned. ‘But, then, she would, wouldn’t she? She might think she’d get into trouble for leaving it behind the bushes. I think she thinks I might know something now, though—after that examination.’
‘Her family didn’t
