do if both babies needed high-dependency nursing was another problem entirely. There were never enough beds or specially trained staff to cope, and they would need to do some serious juggling with the babies already in the unit to cope with just one seriously sick preemie. A second one would probably have to face a life-threatening dash to whichever NICU had the nearest free HDU bed. She’d probably have to spend several hours on the phone begging and pleading…
But that was in the future. First they had to deliver the babies.
‘Ready,’ she confirmed as she turned back to the table. Those striking eyes were waiting for her, somehow all the more potent for the fact that they were all she could see of him above his disposable mask. For just a second it almost felt as if the two of them had made some sort of silent connection but then he had his hand out ready to receive the scalpel, and when he immediately applied it to their patient’s skin in an expert arc she knew she must have been mistaken.
It was lovely to watch him work, she thought, admiring the efficient way he’d exposed the uterus. Without a word needing to be spoken, she was ready to zap the inevitable bleeders then stood poised with suction as he carefully chose the site for the second incision. The last thing they needed was to injure one of the babies with an injudicious cut.
Amniotic fluid gushed out of the widening aperture and he had to pause for a moment before he could insert two fingers into the gap as a guide, positioning them between the wall of the uterus and the babies it contained to enable him to continue cutting.
‘It’s all arms and legs in here,’ he muttered as he inserted one long-fingered hand through the incision. ‘Ah! Gotcha! Leah?’ he nodded towards the exposed belly above the incision.
She placed one hand on the strangely brown flesh and waited for his signal, but he hardly needed her assistance, the baby’s head emerging cradled in his palm and the rest of the spindly body following in a rapid slither.
‘It’s a girl!’ Leah announced as the cord was cut and she immediately turned to place the wriggling infant into the waiting warmed blanket held out by Sally just as she let out her first wail.
‘One down, one to go,’ David said as he inserted his hand again, this time emerging with a tiny foot and going back to find the other one of the pair. ‘Come on, sunshine,’ he said encouragingly. ‘There’s a lot of people out here waiting to meet you.’
Leah smiled behind her mask, once more poised for the nod that would come if he needed help to get the baby’s head out into the world.
‘It’s another girl,’ she said, the sex of the baby all too obvious in such an undignified position, then it was time to cut the cord and hand her little charge over to the second waiting team.
She turned back, expecting to find David dealing with the clean removal of two placentas, but found him scowling darkly.
‘I don’t believe it!’ he exclaimed. ‘There’s a third one in here!’
‘What!’ Leah gasped, unable to believe her ears.
For a second nobody moved, then they all spoke at once.
‘You’re joking!’
‘We’ll need another team with an incubator. Hurry.’
‘Her blood pressure’s dropping.’
It was the final voice that silenced them all, and while Leah knew that there was frantic activity behind her as extra help was summoned from the NICU, she was focusing solely on David.
If she hadn’t been so close to him for the last half-hour she probably wouldn’t have noticed the new urgency in his movements, but, as it was, she could almost feel the tension emanating from him.
‘Come on, come on!’ she heard him mutter under his breath, almost growling with frustration.
Perhaps his hands were too large for the job, even though they were relatively slender for a man. Perhaps her smaller ones would help—anything to bring the unexpected third baby out successfully.
‘Do you want me to—?’
‘Got it!’ he exclaimed, interrupting her offer before it had been made. ‘It was a transverse lie and the poor little thing had been squashed by its sisters trying to get out.’
Even as he was speaking he was lifting the tiny scrap out of its mother’s body, and Leah’s heart clenched when she saw the state the infant was in.
‘He’s terribly floppy!’ she exclaimed, already reaching out to take the precious burden. ‘Is he breathing?’
She didn’t really want to pass the tiny being over, all her protective instincts demanding she take care of it herself, but with Ashraf’s renewed warning that they needed to finish the operation as soon as possible, all she could do was relinquish her into Sally’s waiting hands, knowing that her colleague would do everything she could.
In the meantime, there were now three placentas to remove and check for completeness before the incisions in both uterus and skin could be closed—and all with the clock ticking ominously.
‘Damn! Where is all that blood coming from?’ David swore suddenly. ‘Leah, suction! I can’t see what’s going on…’
‘Hurry up, guys,’ Ashraf warned. ‘We’re going to lose her.’
‘Not without a fight,’ David countered fiercely. ‘Get some more fluids into her as fast as you can,’ he directed as he peered into the gaping wound. ‘Damn it, the uterus is paper thin. It’s almost shredding as we look at it.’
‘You’ll have to do a hysterectomy,’ Leah said, hoping she sounded calmer than she felt. ‘With blood loss this rapid there isn’t time for any sort of repair, not if she’s going to be around for those babies.’
David met her eyes for the briefest moment and she knew that they’d both come to that same decision.
She’d thought she’d seen him working quickly before, but it was nothing to the speed at which he excised the life-threatening tissue in a room filled with the din of shrilling monitors warning of imminent disaster.
‘She’s going to crash!’ Ashraf called, and out of the corner of her eye Leah could see his hands flying from one control to another as he tried his best to support their failing patient.
‘Thirty seconds, Ashraf!’ David growled, without pausing for a single one of them in his determination to cheat death. ‘Just keep her going for another thirty seconds.’
‘I’ll do my best, but I can’t promise you’ve got even that long,’ the anaesthetist warned as the monitor told them that their patient’s heart was beating almost out of control in an attempt to circulate the remaining blood, but David didn’t even falter.
Leah was aware of a strange feeling that was almost exhilaration as she assisted in one of the most frantic operations she’d ever witnessed. For the first time ever in an operation, the lead surgeon didn’t even need to say what he wanted. Somehow she just knew and was there ready with the next clamp or the diathermy to seal off another bleeding blood vessel.
‘Bowl,’ David said, even as Leah was holding it out to him. He finally glanced towards Ashraf. ‘How is she doing?’
