There weren’t many people that wanted to work on such tiny hearts and veins—particularly when the tissues were so fragile and these little lives could literally be on a knife edge.
What the staff in the NICU at the Queen Victoria clearly didn’t know was that he was the new visiting surgeon, which meant that, where possible, babies with heart conditions would be brought here for him to operate on. For those who were too sick to travel any distance, he would still go to them. But having a semi-permanent base with a team around him would be good. He’d hoped to find professional colleagues he could trust and rely on. But first impressions of this midwife weren’t exactly good.
There was no way he wanted her watching Billy postsurgery.
But what annoyed him most of all was the way she’d quickly and determinedly told him to get his staff out of ‘her’ NICU.
And she’d been right. They always tried to reduce the amount of close contacts that prem babies had. It was important. Their immune systems were often not fully developed, and most humans were walking petri dishes.
People could be carrying bugs for days without any signs or symptoms. Something that caused a mere sniffle in an adult could be deadly to a premature baby. It might be a teaching hospital but even he wouldn’t expect any NICU to let in that many students and trainees. He’d been in such a hurry to get in here and see his patient, and been so swept away by the enthusiasm of the staff at his side, that he hadn’t stopped to think. And Harry didn’t make mistakes like that. So being called on it was embarrassing.
‘You must have known Billy was going to Theatre today,’ he said briskly to the midwife.
She gave him a weary look that told him she was getting very bored by all this. ‘I hoped you might show your face today. I hoped that Billy wouldn’t have to wait another day for surgery. I was told that you were supposed to turn up today, but no one knew when. I look after both baby and mum, and if you’d communicated a little better, there was also the chance I could have prepared mum more for his surgery today.’
She put her hands at the back of both hips, leaned backwards and winced as if she’d touched something painful.
‘Blood results are in,’ said Francesca in a manner that could only be described as deliberately distracting. It was clear she was trying to break the tension between them. ‘His blood gases are a little lower than I would have liked. But not anything I wouldn’t have expected.’ Francesca gave a little sigh and Harry felt a rush of sympathy for her. They’d worked together for a long time. She was a great anaesthetist. It took great skill to manage these tiny babies in Theatre and he depended on her completely. Francesca’s chair scraped on the ground as she stood up. ‘I need to sound his chest. Let me wash up first.’
He followed her over to the sink in the treatment room, completely sidestepping Esther and washing his hands too. He needed to prioritise this baby, not the midwife who looked as if she could currently fall asleep on her feet.
As he stepped back his arm brushed against hers and she jerked away. But not before he noticed how hot she was. ‘Do you have some kind of infection?’
She looked shocked. ‘What?’
‘You’re burning up. What’s your temperature?’ His arm swept out across all the cribs in the NICU. ‘If you have anything respiratory you’re putting the lives of all these babies at risk.’
‘I don’t have anything respiratory,’ she snapped. ‘My chest is clear as a bell.’
For one strange second he realised that her words had made him look exactly at her breasts hidden under her scrubs. He turned back to Francesca. ‘We should see this baby on our own.’
Esther stepped into his path. ‘No, you won’t. I know Jill, his mum, best. She needs support. She trusts me.’
Harry glared at her and she held up her hands. ‘Okay, I won’t touch Billy, right now. I’ll run down to A&E when you’re done and get a clean bill of health. But you don’t see him without me.’
Harry pressed his lips together, stopping himself from just getting into a pointless argument. ‘Only speak to mum, then,’ he reiterated.
She gave an exasperated nod and held out her hand. ‘This way.’
Harry and Francesca followed her over to the left-hand side of the unit to where a young woman sat staring at her baby lying in the crib and rocking backwards and forward in the nursing chair. Harry had dealt with lots of anxious parents. NICUs were the most intimidating places on earth. Parents frequently felt everything was out of their control, and he was used to comforting and supporting parents who were overwhelmed with helplessness and focused on every word that was said to them. This mother was young. Her lank hair was pulled back from her face. It looked as if it hadn’t been washed for a while and from first appearance he actually wondered when she’d last eaten. Now he understood just why Esther was being so protective of Billy’s mum. It was clear she didn’t have many support systems in place.
‘Jill, this is Harry Beaumont. He’s the surgeon that’s going to do the surgery on Billy.’
Harry crouched down so he was level with Jill. She’d sat forward but hadn’t stood up. He gave her a broad smile. ‘It’s a pleasure to meet you, Jill. I’m here to take a look at Billy. I’m hoping we’ll be able to take him for surgery later today. Do you mind if I examine him?’
Jill paused for a few moments as her eyes filled with tears, then she gave a tiny nod. ‘Of course.’
She was terrified. He got that. Harry used some of the NICU hand sanitiser before opening the crib to examine Billy, while Francesca introduced herself as Billy’s anaesthetist. He could tell straight away that Esther completely understood, and after a few moments, he could see the tension in Jill’s shoulders start to dissolve as he spoke to Billy in a calm, quiet voice as he examined him.
‘Hi, Billy, I’m here to see how you’re doing. Let’s have a little listen to your heart and lungs.’ He took his time, listening carefully, then checking his oxygen sats, his feeding tube and his colour. Babies this small frequently had skin that was almost translucent. Their circulatory systems—and particularly Billy’s—weren’t functioning quite right, and they often couldn’t regulate their temperatures. Operating and anaesthetising these babies carried huge risks. He gave Francesca a nod as he moved his stethoscope back to Billy’s chest. ‘Want to take a listen?’
She nodded and moved alongside him. There was no point her touching Billy too when she really just needed to listen to his heart and lungs. So, she listened through Harry’s stethoscope, nudging him to move it on occasion.
Harry could sense Esther watching them curiously. She wouldn’t know they’d done this a dozen times before. As Francesca finished her examination it struck him how similar Esther and Jill looked. Exhausted and tired. He could understand it for the mother. But for a member of staff—it wasn’t good enough.
Francesca gave him a nod and he removed his stethoscope and pulled a chair over next to Jill and spent the next few minutes explaining Billy’s surgery to her in simple terms. He brought out some notes that he’d prepared earlier. He always gave the parents of the babies he operated on some clear notes that they could refer to later. Experience had taught him that although parents listened, anxiety meant that they didn’t always remember or understand what they’d been told.
He could feel Esther’s eyes on him the whole time. He would expect the midwife assigned
