smiled weakly in response. ‘Tell me about the hospital,’ she said.
By the time they had pulled up in front of the Queensland Royal, Andrew had given her a brief overview of how the medical system in Australia worked. He was a specialist paediatrician, which Caitlin already knew, and had a special interest in heart problems in neonates. The hospital was a gleaming, modern affair, all glass and stainless steel. Andrew told Caitlin that it had some of the best facilities in Australia.
As they got out of the car, an ambulance pulled up, its lights flashing. A trio of nurses was waiting at the entrance, ready to receive the casualties. Caitlin and Andrew were about to leave them to it when a nurse noticed his arrival.
‘Could you hold on a minute, Dr Bedi?’ she said. ‘We might need you.’
Unsure where to go, Caitlin watched as the patient was unloaded. Immediately she could see that it was a woman in advanced pregnancy. From the look of distress on her face, it appeared she was in labour. Suddenly she felt her reflexes kick in. She moved towards the group, making a rapid judgement.
‘Mrs Roland is in the end stage of labour,’ the paramedic intoned. ‘She was due to have her baby at home, but the midwife felt that labour wasn’t progressing quickly enough and decided to call us. The baby’s heartbeat has dropped.’
‘I’m Dr O’Neill,’ Caitlin introduced herself. ‘One of the obstetricians. Let’s get her inside so we can assess her.’
Once inside Caitlin carried out a rapid examination of the woman. It only took her a few seconds to realise that the placenta was lying in front of the baby. It was something that every obstetrician came across on a regular basis. Nevertheless, if they didn’t get the baby delivered there was a chance the woman would bleed to death. In every country there were several maternal deaths every year due to the condition. There was no time to lose. Every second counted if they were to save the woman and her unborn child. ‘Placenta praevia,’ she said. ‘She needs to go to Theatre immediately.’
‘I’ll tell Theatre to expect us,’ one of the nurses said, turning towards the phone.
‘I’ll scrub in too,’ Andrew said. Even if they managed to get the baby delivered safely there was every chance it might need resuscitating. ‘C’mon, Caitlin, let’s go.’
Caitlin struggled to keep up with his long strides as they rushed towards Theatre. A nurse handed her some scrubs and clogs and she scrubbed up beside Andrew, mentally counting off the minutes.
‘Right in at the deep end,’ Andrew said sympathetically. ‘We didn’t even manage to get you up to the ward.’
By the time they were scrubbed and gowned, Mrs Roland had been anesthetised and was lying prepped on the theatre table.
Caitlin cut into the abdomen from left to right just above the pubic bone. As the skin separated, she made another incision into the uterus, careful not to damage the precious contents. As she pulled the baby out, she glanced at the clock. Ten minutes had passed since the patient had arrived at the hospital. She was pleased to see none of her speed had deserted her.
The baby, a little boy, was slightly floppy and blue. Caitlin handed him to the midwife, who rushed the baby across to the resuscitator.
‘He’s a bit flat,’ the midwife called out. As Caitlin started to close she was aware of the tension in the room. Andrew needed to get oxygen into the baby, and soon. Across the woman’s abdomen she watched as he tipped the baby’s head back gently before slipping in a paediatric endotracheal tube, feeling his way through the larynx and into the lungs. Then he attached an ambu-bag and started feeding oxygen into the tiny lungs. Every movement he made was calm and assured, and this fed into the atmosphere of the theatre. There was no panic. Everyone was simply going about their jobs quietly and efficiently. Caitlin was impressed. She guessed the team had worked together many times before.’
‘Heart rate 140 and he’s a good colour now,’ Andrew announced to the room to a collective sigh of relief. ‘I think baby is going to be fine. We’ll get them up to Special Care, but I think we should be able to reunite mother and baby quite soon.’
‘Maybe not tonight,’ Caitlin said. ‘I’ll want to keep an eye on her in the labour ward overnight, in case of postpartum haemorrhage.’
While the baby was being taken away to the special care nursery, accompanied by the paediatric nurse and Andrew, Caitlin finished closing the wound. She felt a trickle of perspiration run down her forehead and was grateful when one of the nurses wiped it away. Once Mrs Roland had woken from the anaesthetic, she would see her and let her know what was happening. She was pleased that her first case had gone well—not that she doubted her ability, but Caitlin knew that sometimes even straightforward cases could suddenly go wrong.
After she had finished in Theatre, she asked one of the nurses to take her to Special Care. She wanted to check on the baby before she spoke to the mother.
She found Andrew bending over the infant, listening to its chest. He looked up at her, his deep brown eyes warm. ‘He’s going to be fine, I think,’ he said. ‘We’ll know better in a few days. You did a good job back there.’
Caitlin looked around the small high-tech unit. It reminded her of the one back in Dublin, but she guessed that there was a uniformity with all hospitals in the Western world. There were five babies in at the moment, with anxious parents sitting by their incubators. Her heart went out to them. It must be so hard to feel so helpless, to know that the life of your child depended on the doctors and nurses.
Having finished examining the baby she had recently delivered, and announcing himself satisfied for the time being, Andrew suggested he show her around.
‘We have around four thousand deliveries a year here,’ he said. ‘We get difficult cases from quite far away. The air ambulance brings mothers and kids in on a regular basis. You might like to go out with the team some time.’
‘I’d love to,’ Caitlin said enthusiastically. ‘I’ve never been on anything like it before. I guess in a country of this size, it happens a lot.’
‘Often enough,’ Andrew said. ‘We take turns being on call for the air ambulance. I’ll rota you in for the same time as me. Okay?’
At Caitlin’s nod he went on. ‘I’ll take you up to Personnel. I know you sent all your paperwork in advance, but there may be one or two pieces they need from you. After that I’ll give you the tour.’
After she’d completed the necessary paperwork, Andrew introduced her to the midwives and doctors she’d be working with. There were too many faces for her to remember everyone’s names straight away, that would take time, but all the staff seemed very welcoming.
Her first afternoon was to be spent in Theatre. One of the senior midwives, a cheerful woman called Linda, took her on a round of the antenatal ward. Andrew left them to it while he went to do his own rounds. After the ward round Linda took Caitlin to the general gynaecology ward and introduced her to the patients she had scheduled for Theatre.
After seeing all the patients on her afternoon’s list, Linda stopped in front of a woman who was perched on the end of the bed and looked as if she was ready to run a mile.
‘This is Mrs Mary Oliphant,’ Linda introduced the woman. ‘She’s in to have her tubes examined. She and her husband have been trying for a baby for a year, and their family doctor thinks she should
