as that is quite incorrect. In the past the twin survival rate with severe TTTS was very low, around ten per cent before ultrasound made it possible for us to make an early diagnosis and the introduction of laser surgery. I think you should consider taking advantage of this medical advance. In years gone by women had no choice but to wait and pray they did not give birth to a stillborn baby. As I have mentioned excess amniotic fluid caused by the TTTS is causing your uterus to grow to an unsustainable size. It’s a condition called polyhydramnios, and it can cause premature labour.’
‘I have a fifty-four-inch waist now.’
‘Yes, that’s a combination of four babies and the fluid and it will continue to increase,’ Charlie added. ‘We’re monitoring that and can continue to do so, and perform the amniotic reduction procedure.’
Juliet bit her lip again. Charlie was not allowing her much space to move.
‘Georgina, you will be monitored in hospital until all four babies are born, no matter your decision. However, I’m suggesting surgery because there are four very tiny babies still growing inside you and they need optimum time to grow. The final decision rests with you.’
Georgina shifted on the bed and raised her feet again. Her rounded stomach was still covered by the sheet and lightweight blanket, but only just. Her pretty face was almost hidden by the mound that held her precious babies. Juliet knew the young woman’s ribs would be excruciatingly tender from the pressure of four babies.
‘So you can definitely separate the blood supply?’ Georgina finally asked.
‘The tiny telescope in your uterus will allow me to find and destroy all the connecting vessels. This is the only treatment that can disconnect the twins.’
‘How common is it for parents to choose laser surgery?’
‘Laser surgery is now performed all over the world as more and increasing numbers of progressively attuned doctors are convinced that this will lead to the best outcomes.’ Juliet’s words were directed at Charlie but she did not pause over the words or look in his direction. Two could play at the same game. ‘Most physicians worldwide agree that placental laser surgery results in the highest numbers of healthy survivors.’
‘Including those in the UK?’ Leo enquired.
‘Yes, particularly in a hospital like Teddy’s.’
Georgina and Leo gave each other a knowing look. ‘Would I be awake?’
‘Yes, Georgie, you’d be awake. You would be under conscious sedation and local anaesthetic for this procedure. We need you and the babies to be relaxed and pain free during the procedure but there’s no need for a general anaesthetic.’
Leo straightened his back, took a deep resonating breath and looked at Charlie. ‘Charlie, by what we’re hearing, and the urgency of everything, are we right in thinking we have to make the decision tonight? It’s a lot to take in and not a decision we want to make in a hurry.’
Charlie cleared his throat and stepped a little closer. ‘Not quite tonight but, yes, if you choose Dr Turner’s surgical option you would only have a day or two to make that decision. However, my plan would not see you making any changes other than looking at prescribing heart medication as pills given to Georgie, or injected directly into the twin if he is showing signs of heart failure. We can also look at another therapy using medication to decrease the urine output in the recipient and lessen the amount of amniotic fluid that is causing Georgie’s uterus to expand.’
Juliet bit her lip. She could counter but chose not to do so. She had said enough and if they chose the non-surgical option she would remain on staff at Teddy’s to help in any way she could, including the delivery. But she hoped they would choose her way forward and she would be able to use her surgical skills to increase the babies’ chances of survival and happy and healthy lives.
Georgina and Leo looked at each other with what Juliet knew would feel like the weight of the world on their shoulders but their love for each other still shone brightly in their eyes. Finally Leo spoke. ‘Is it all right if we sleep on it?’
‘Of course,’ Charlie and Juliet said in unison then they too looked at each other. But it was not lovingly; their look was more of an aloof stare.
Juliet had felt as if she were on a roller coaster since she’d touched down at Heathrow, and even before that with the last-minute packing. But now it was a different type of roller coaster. The emotional type. And for which she had not willingly purchased a ticket, nor even had any idea she would be experiencing. But in the few hours since Charlie had stepped into her life and lifted her tiny daughter into his arms, she had ridden highs and lows that she’d never imagined. He was opinionated and brash; considerate and caring; her old school colleague and stubborn opponent; and still, to her annoyance, attractive.
He was quite the package and she definitely didn’t want to peel back too many layers or get too close. Charlie was confusing her and, working together for the next few weeks, she wondered how successfully she could avoid getting to know more about him. A conservative, bad-boy biker with attitude who seemed to adore children, or at least her child. Could he be any more complex? She doubted it.
And she wasn’t convinced she wanted to understand Charlie Warren.
WITH LEO AND GEORGINA left alone to think everything over, Juliet had a chance to meet the rest of Teddy’s nursing staff. Although Juliet had seen the Royal Cheltenham hospital emergency department up close and personal with Bea, Charlie knew that she had not seen Teddy’s properly, so he took it upon himself to offer to show her around the centre dedicated to babies and birth. But not before setting the parameters of the working relationship in his mind.
‘I think you would have to agree that we both behaved quite poorly in there,’ he began, thinking that they should get everything out in the open and start afresh. ‘Fortunately not that Georgina or Leo noticed.’
‘I’m sorry, are you questioning my behaviour?’
‘I’m just saying that we could have handled things a little more diplomatically.’
‘So you’re saying that we both behaved poorly and we could have handled things better?’
Charlie frowned. ‘Yes, as I also said, it was done in a very polite manner so that the Abbiatis did not sense any professional tension, but you have to admit we were walking a fine line.’
Juliet’s hands suddenly took pride of place on her hips as she began pacing, then drew to a halt in front of him. ‘I can’t believe what you’re saying and I refuse to accept culpability for your, as you Englishmen say, poor form. I was seconded over here and you were clearly the one stirring doubt, if not confusion.’
* * *
Charlie studied Juliet’s face. Even angry, she was very beautiful. And Juliet was clearly angry. She was riled up and ready to pounce on him for even suggesting that she had participated in the battle of wills. It was apparent when challenged Juliet was like a cat with an arched back. He wondered what made her so defensive. Had she been on the receiving end of too many challenges over her career? Or was it more than that? Was her attitude of fight or flight born from something outside work?
He suddenly stopped his line of thought mid-journey.
