baby was born by Caesarean, so the mother is still a patient,’ Becky, the unit secretary, told them. ‘She’s one floor up, C Ward, room fifteen.’
‘Let’s take the stairs,’ Kate suggested, and when Angus grimaced she added, ‘Not keen on incidental exercise? Don’t you know that even the smallest amount of exercise every day can help keep you healthy?’
Far better to be talking exercise than thinking about empathy…
‘I lived in America for five years, where everyone drives, and already today I’ve walked to work—incidental exercise, but mainly because I don’t have a car.’
‘You lived there for five years?’ Kate queried, taking the second flight two steps at a time, only partly for the exercise. ‘Yet Hamish has a broad Scots accent?’
Angus caught up with her as she opened the door.
‘When my wife died, my mother came out to mind the baby, then my father took early retirement, so he and my mother were Hamish’s prime carers when he learned to talk. They stayed until Hamish was three, then found Juanita for me before they returned to Scotland, where my father’s old firm was only too happy to have him return to work.’
When his wife died?
There were plenty of single parents around, but most of them didn’t have partners who had died!
No wonder he had shadows in his eyes…
Kate tried to make sense of this—and make sense of why a casual answer to her question was having such an impact on her—as she led the way to C Ward, but once inside room fifteen, Angus’s marital state was the last thing on her mind.
‘I really don’t care what you do,’ the woman in the bed in room fifteen announced when they’d introduced themselves and explained the reason for their visit. ‘This is just not the kind of thing that happens to people like us. I mean, my husband has his own business and I’m a barrister—we’re both healthy, and we run in marathons. I keep telling people that the babies must have been mixed up. I held my baby when he was born and there was nothing wrong with him, and then suddenly people are saying his heart’s not right and flying me off to Sydney, even refusing to take my husband in the plane.’
The tirade left Kate so saddened she was speechless, but thankfully Angus was there. He sat down carefully by the side of the bed, and spoke quietly but firmly.
‘Mrs Stamford, I realise this is a terrible shock to you, but with this defect babies always seem perfectly healthy at first. It’s only when a little duct between the two arteries starts to close and oxygenated blood keeps circulating through the lungs rather than around the body that a blueness is noticed, usually in the nail beds and lips of the infant.’
Kate saw the woman’s fury mount, and expected further claims of baby-swapping, but to Kate’s surprise, Mrs Stamford’s anger was directed at Angus’s choice of words.
‘Defect? You’re saying my baby has a defect?’
Time to step in before she became hysterical, Kate decided.
‘It’s fixable, the problem he has,’ she said gently. ‘That’s why we’re here. We need to explain the operation to you and get your permission to perform it.’
‘And if I refuse?’
Oh, hell! Kate tried to think, but once again Angus took over.
‘There could well be legal precedents that would allow us to operate anyway,’ he said. ‘I’m new to Australia but in many of the states in the U.S.—’
‘Well, I very much doubt that,’ Mrs Stamford interrupted him, although she seemed to have calmed down somewhat. Kate sought to reassure the woman.
‘It’s an operation that’s frequently performed, and with excellent results,’ she told her, ‘and we’re lucky to have Dr McDowell here as he specialises in it.’
She looked at Angus, expecting him to begin his explanation, but he hesitated for a moment before taking a small notebook and pen out of his shirt pocket.
‘This might explain it best,’ he said to Mrs Stamford.
Kate wondered about the hesitation—was it to do with the detachment she’d sensed earlier?—although now he was drawing a small heart on a clean page of the notebook, carefully inking in the coronary arteries which clasped the heart like protective fingers, then showing the two major arteries coming out the top of the organ.
‘These coronary arteries which feed oxygenated blood to the heart muscle to keep it beating come off the aorta, the bigger of the two arteries coming out of the heart. The aorta is supposed to come out of the left ventricle while the pulmonary artery that divides in two and goes into the lungs comes out of the right. On rare occasions these two arteries are transposed and the aorta comes out of the right ventricle, with the pulmonary artery coming out of the left.’
Mrs Stamford was at least interested enough to look at Angus’s drawing, and as she was quiet, he continued.
‘What we have to do is first move the two coronary arteries, then we swap the major arteries, cutting the aorta and fixing it to the pulmonary artery where it comes out of the heart, and stitching the pulmonary artery to the aorta so the two arteries are now doing the jobs they’re supposed to be doing.’
‘For ever?’ Mrs Stamford demanded.
Angus hid a sigh. She was right to ask, and had every right to know the truth, but this was one of the reasons he hated getting too involved with parents, having to tell them that the future could hold more operations, having to tell them that, although their child could lead a normal life, there was no guarantee of a permanent fix. Every conversation led to more emotional involvement—and often more pain for the parents.
‘There’s a chance the baby will need another operation when he’s older.’ He spoke calmly and dispassionately—straight medical information. ‘The valves on the pulmonary artery are smaller than the aorta’s valves and as these valves are left in place they might sometimes need to be expanded.’
‘Leave the diagram,’ Mrs Stamford said. Ordered? ‘I’ll speak to my husband and then talk to you again.’
She was dismissing them, and Kate waited while Angus pulled the page from his notebook, then they both left the room.
‘Is there a legal precedent in some places to go ahead without permission?’ Kate asked him.
‘I’ve no idea,’ he replied, ‘but the woman was getting hysterical and I thought, as she’s a barrister, legal talk might calm her down.’
‘I think she’s entitled to a little hysteria,’ Kate muttered, wondering if Angus could really be as detached as he appeared.
She shrugged her shoulders, trying to ease the tension that had coiled in her body.
‘It must be terrible for the parents,’ she reminded him, ‘to learn that there’s something wrong with their child.’
Worse than losing an unborn child?
She thrust the thought away and turned
