your cervix, squirt some dye and have a look. We don’t even need to anaesthetise you, but we’ll give you a couple of painkillers as it can be uncomfortable. The good news is that you’ll have the results straight away.’
‘And if my tubes are blocked? What then? Does that mean we won’t be able to have children?’ Mary’s lip trembled. ‘We really want a baby.’ A tear slipped down her cheek. ‘I blame myself. I was determined to wait until my career was established before we started a family. But what if I’ve left it too late?’
‘Hey, let’s not get ahead of ourselves,’ Caitlin said soothingly. ‘Let’s do the echovist first and we can talk again then.’ She took her hand. ‘Anyway, you’re not that old.’ She smiled. ‘Although a woman’s fertility does decline markedly after the age of thirty-five, you’re still on the right side of forty. And there is a test we can do which will tell us just how well your ovaries are responding. I’ll take a blood sample today, and I should have the results for you soon. I also suggest that we test your husband. That way, if you need to think about IVF you’ll be ready to go. How does that sound?’
As she spoke a thought slipped into her head. Time was passing for her too. It was quite possible that if she changed her mind about wanting children, she too would find she’d left it too late. It was one thing not to want children, quite another to have the choice taken away. She squeezed the thought to the back of her mind. Why was she suddenly thinking children might be an option in the future, when until now she had been sure children weren’t for her? She forced her attention back to her patient. It was Mary who she had to think about. She deserved her full attention.
Mary smiled, seeming reassured. ‘That sounds great,’ she said. ‘I just want to know so we can decide our next step. Thank you for taking the trouble to talk to me.’
‘Hey, that’s what we’re here for.’ Caitlin smiled. ‘I’ll see you down in the scanning room shortly. First let’s take that blood sample.’
Quickly, Caitlin took a sample of blood from Mrs Oliphant’s arm and passed it to Linda.
As they moved away Linda said, ‘There’s one more lady I’d like you to see. I’ve already spoken to Dr Bedi about her, and he’s interested to know what you think.’ Curious, Caitlin let herself be led across into one of the single rooms. Sitting up in bed, reading a magazine listlessly, was the patient Linda had asked her to see.
‘This is Mrs Levy,’ Linda said, passing her chart to Caitlin. ‘As you can see, she’s twenty-nine weeks pregnant. She was admitted earlier today with an elevated blood pressure of 160 over 100, plus protein in her urine. In her first pregnancy she had to be delivered prematurely because of high blood pressure.’
Caitlin had seen the condition often. It was always a difficult judgement call. On the one hand, there was no treatment and the only sure way of preventing the condition from getting worse was to deliver the baby. However, Mrs Levy was only twenty-eight weeks pregnant and although Caitlin knew that the hospital had the necessary equipment to look after a pre-term baby, there was always a chance that the baby would suffer brain damage or even worse if it was delivered so early.
‘What does Dr Bedi think?’ she asked Linda as they moved away from the patient.
‘He’d prefer us to wait and monitor her closely over the next few days.’
It wasn’t an unreasonable decision, Caitlin knew. Every day the baby stayed safely in the mother’s womb increased its chances of survival.
‘Could we arrange to have Mrs Levy scanned?’ Caitlin asked, making up her mind. ‘I’ll do it myself before Theatre.’ She went back to her patient.
‘You’re probably well aware of our concerns, Mrs Levy. I’m sure they have been discussed with you.’
‘Please call me Patricia. Mrs Levy always makes me think of my mother-in-law.’ She smiled, before the anxious look returned to her eyes. ‘That nice Dr Bedi came to see me and explained everything.’
Did he, now? Caitlin thought, wishing that he had spoken to her before discussing options with the patient. She decided to wait until she had spoken to him and had the scan results before speaking to Patricia again. ‘I’d like to scan you as soon as we can get a scanner up here,’ she told the patient. ‘I’ll see you in a little while, okay? Then we can decide on the best way forward.’
Patricia clutched Caitlin’s hand. ‘I really want this baby,’ she said. ‘They told me it’s a girl and as I have two boys, it will make my family complete.’
Caitlin patted her hand reassuringly. ‘We’ll do our best for you, I promise. In the meantime, the best thing you can do for your baby is try and relax.’
After rounds Linda took Caitlin into the staffroom for a cup of coffee. ‘What do you think so far?’ she asked as she poured them mugs from the pot that had been made earlier.
‘I’m impressed,’ Caitlin admitted. ‘The facilities, at least what I’ve seen so far, are impressive.’
‘I hear from the others that you know Dr Bedi. He’s lovely, don’t you think?’
Caitlin wasn’t quite sure how to answer. What was she supposed to say to that? That, yes, he was gorgeous and that she fancied the pants off him? ‘He seems very nice,’ she said noncommittally.
‘Half the nurses and doctors here are in love with him. The other half are married.’ Linda laughed. ‘Thank goodness I’m in the second half. Otherwise I’d be doomed to have my heart broken, like the rest.’
Caitlin wasn’t used to such frankness and wasn’t sure how to respond. Thankfully, as she was searching frantically for a more neutral subject, Andrew himself appeared.
‘They told me I’d find you here,’ he said, pouring himself a glass of water from the cooler and gulping it greedily. ‘I wondered if you wanted to see the paeds wards before we have lunch. Your theatre list starts at 1.30. Right?’ She eyed him, mentally readjusting her opinion of him in light of what Linda had told her.
Caitlin stood. ‘I’d love to see the children’s ward,’ she said. ‘And meet the staff.’ She finished her coffee and rinsed her cup. ‘Thanks, Linda,’ she said as she followed Andrew out of the staffroom. ‘I’ll see you after Theatre.’
She followed Andrew out of the staffroom.
‘I don’t think we should leave Mrs Levy any longer,’ she said. ‘She’s showing all the signs of pre-eclampsia—raised blood pressure and protein in her urine. If we don’t deliver her and her condition gets worse then there is a chance she’ll start fitting and we’ll lose her. I’m sure neither of us want to be faced with a maternal death.’
Andrew turned and looked at her. ‘The last two scans place her at twenty-eight weeks,’ he said. ‘There’s not been much growth since then.’ He frowned. Caitlin wondered if he was unused to having his opinion challenged. Underneath his easygoing exterior she thought there was a man who, once he had made up his mind, was loath to change it. It was clear in the way the staff acquiesced to him that he was used to being deferred to. On the other hand, so was she. She trusted her instinct, and if she were back in Ireland nobody would have questioned her decision.
‘If we deliver her now, then there is a chance the baby won’t survive,’ he continued. ‘Even another couple of days would give it a better chance.’
Caitlin
