concerned about GBS, so I’d like a high vaginal swab, please.’
‘Rightio,’ Shannon said. ‘I’ll bring Leona up to you when we’ve finished down here.’
‘Thanks.’ He smiled at her and took Ricky up to the neonatal unit.
‘Tilly said you had a suspected GBS,’ Claire said, coming over to the cubicle just as Eliot settled the baby into the cot.
Eliot nodded. ‘He’s lethargic, he’s not feeding properly—even though the first couple of times at the breast were fine—his heart rate’s a bit on the high side, he’s grunting and his temperature’s up. I know it could be RDS—’ RDS, or respiratory distress syndrome, was common in early babies ‘—but at this stage it’s too early to tell if it’s that or something else. The mum’s got a temperature, too.’
‘What’s his blood pressure?’
Eliot checked. ‘Low. And his breathing’s fast. I’ve asked Shannon on Maternity to give the mum a swab for group B strep—there weren’t any indications in the notes.’
‘Three out of ten pregnant women have group B strep without any symptoms, and the only reliable test is the enrichment culture method—which isn’t widely available,’ Claire said. ‘So if there weren’t any indications to give her antibiotics in labour, the baby could have picked it up as he came through the birth canal. I take it that it was a normal delivery, not a section?’
‘Ventouse,’ Eliot said. ‘So I don’t want to take any chances. If it is group B strep, time isn’t on our side. I’ll get bloods done, a lumbar puncture and an X-ray, but I don’t want to wait for a culture. I think we should start him on antibiotics now. Penicillin for group B strep and gentamycin in case it’s pneumococcus.’
Claire nodded. Sepsis could suddenly become overwhelming in tiny babies, and if the sepsis was untreated there was a fifty per cent risk of the baby dying. If the lumbar puncture results were clear, they could discontinue antibiotics in forty-eight hours. ‘We need to keep a really close eye on him in the next two days in case it turns into pneumonia or meningitis. Is the mum coming up?’
‘When she’s had her swab.’
‘Good. Do you want me to talk to her about the possibility of group B strep?’ Claire asked.
‘No, I’ll do it,’ Eliot said. ‘But if you’re offering...’
‘You want me to do the lumbar puncture?’ Claire guessed.
He nodded. ‘I really hate doing them.’
Claire brushed the backs of her fingers against the baby’s cheek. ‘I’ll try not to hurt you, little one. I’ll get the pack while you sort out the bloods,’ she said.
Weird, Eliot thought as he took the blood samples and labelled them carefully. Although he’d spent a week on the ward, it felt as if they’d worked together for years. It was as if she could read his mind. Or maybe it was just as Tilly had said: Claire was a good doctor. She knew her job so well that of course she could second-guess everything he was going to say. Just as she would with any other SHO.
‘Can you hold him in position for me?’ Claire asked.
‘Sure.’ Gently, Eliot manoeuvred the baby into position.
‘Thanks.’ Claire counted down to the space between the third and fourth vertebrae and cleaned the area thoroughly. Then she gave the baby a local anaesthetic, waited a couple of minutes for the lignocaine to numb his back, then took the sample of cerebrospinal fluid. ‘All done, littlie,’ she said softly to the baby. She capped the needle and put a fresh sterile swab over the puncture, pressing on the area to stop the flow of fluid, then applied a spray dressing.
‘There you go,’ she said, stroking the baby’s arm. ‘We’ll have your mum up to see you any second now. And Eliot’s going to sort out your temperature and make it easier for you to breathe.’
She’d used his first name almost unconsciously, and Eliot was shocked by the pleasure that glowed through him. No. He couldn’t start thinking like that about Claire Thurman. She might be single, but nothing could happen between them. Number one, she was his boss. Number two, and most importantly, he had to put Ryan first. Number three, Claire had made it very clear she wasn’t looking for marriage and babies—if she didn’t want her own child, she certainly wouldn’t want to take on someone else’s.
This relationship was going to be professional only, he told himself. And he wasn’t going to start thinking about her chestnut hair, how it might look if he loosened it from the stern French pleat and let it run through his fingers. He wasn’t going to start thinking about what colour her dark eyes would be when she’d just been kissed. And he definitely wasn’t going to start thinking about her beautifully shaped mouth...
‘So you’ll explain to the mum that we’re going to feed him through a line?’
Eliot pulled himself together with difficulty. ‘And that if it is group B strep, he’ll need to be in for ten days or so.’
‘Right. I’ll get this lot off to the lab, then.’ She swiftly measured six drops of spinal fluid into three sample bottles and labelled them.
Just as Claire was about to leave, Shannon Hooper brought Leona Peters up in a wheelchair.
‘Is he all right?’ Leona asked, visibly panicking.
‘He’ll be fine. He’s having a bit of a rough ride at the moment, but we’re keeping him comfortable while we find out what the bug is,’ Claire said. ‘I’m Claire Thurman, the senior registrar on the neonatal unit. I believe you’ve already met Dr Slater, who’s looking after Ricky for you.’
‘Yes.’ Leona’s face was pinched with strain.
‘It can be a bit scary up here, with all the wires and equipment,’ Claire said, ‘but try not to worry. It’s there so we can make sure he gets enough oxygen and his temperature’s under control. I’m taking these samples off to the lab, and Dr Slater will tell you more about what’s happening.’
Eliot smiled reassuringly at Leona. ‘We think he might have something called group B streptococcus. It’s a bacterium that lives in just about everyone’s body at some point, usually without any effects, but babies can’t cope very well with it—especially if they’re a bit early. We’ve put Ricky on some antibiotics, and he’s going to find it very hard to feed for the next day or so—he’ll be tired because he’s found it a bit difficult to breathe—but we’re going to give him some food through a line in his arm until he’s up to feeding again, and he’ll be able to take some breast milk from you later.’
‘Can I touch him?’ Leona asked.
‘Of course you can. Hold his hand, stroke him, talk to him—he’ll know you’re here and it will help him.’
‘How long will he be in here?’
‘It depends how he responds to the antibiotics,’ Eliot said. ‘Probably ten days or so.’ Unless there was a complication such as meningitis, when it would be another three or four days. ‘It’s probably best to take it day by day for now.’
‘Is he going to die?’ Leona asked, her face crumpling.
‘We’ve
