any way we can get an arterial blood gas measurement immediately?’
‘Yes.’ Susie took the syringe containing a tiny amount of blood. ‘We’ve got a small lab here and I can run this one myself. If we need anything else, there’ll be a technician on call all night.’
‘I want to get a Foley catheter in as well, to monitor renal perfusion and urine output. And do we have a portable ultrasound?’
‘Yes. Do you want me to call in an ultrasound technician?’
‘No. I’ll do it myself.’
‘Do we need to put Grace on a ventilator?’
‘Not yet. But we’ll keep a close eye on her oxygen saturation levels. We’ll need the go-ahead for any further invasive procedures, won’t we?’
‘Theo’s on his way,’ Janine told them. ‘He’s with the police at the moment. And the security team. They’re having a look at the CCTV footage that covers the car park area.’
Theo Hawkwood arrived as Ryan was completing his ultrasound examination.
‘Are you okay to be doing this?’ he asked Ryan. ‘It’s a bit of an unexpected start, isn’t it? How’s the jet lag?’
‘No problem,’ Ryan assured him. He had forgotten he’d even been weary, in fact, faced by the adrenaline rush of this case.
‘What are we dealing with?’
‘Looks like quite a severe coarctation of the aorta. Along with a ventricular septal defect, although I don’t think that’s overly significant.’
‘She’ll need surgery?’
‘Possibly. We’ll start some medication and I’d like to do an angiographic study as soon as possible, when we’ve got a full team available for the catheter laboratory. I could do a balloon angioplasty as well, which would be a bridge to surgery, if it wasn’t enough by itself. Unless...’ Ryan looked up to meet Theo’s gaze. ‘Can we treat her here or do we need to transfer her to a public hospital?’
Theo shook his head. ‘We’re set up to take a percentage of pro bono cases. Someone has entrusted her to our care and I want Hope Hospital to do everything possible to help.’
‘What did the police say?’
‘They’ve got the CCTV footage. We can’t get a good look at the girl’s face but it’s a start. And they think there must be other people that will know something. She couldn’t have given birth entirely by herself, surely?’
‘It’s not an unlikely scenario,’ Janine said. ‘Especially if the girl was hiding her pregnancy. Poor thing,’ she added. ‘I can’t think of anything worse.’
‘The police are out in the waiting area at the moment. They want the box and any other evidence that might help. I understand there’s a note?’
‘Yes. It doesn’t say much. Just that the mother isn’t able to care for the baby.’
Theo nodded. ‘Someone from Social Services is coming as well. They’re going to take care of registering the baby and signing her over to our care for now.’
‘We’ve given her a name,’ Janine told him. ‘Grace.’
He smiled. ‘Nice. I like it. A name with meaning. Like my Hope.’
‘Your Hope?’ Ryan raised an eyebrow. ‘You mean this hospital?’
‘It was the name of my wife,’ Theo said quietly. ‘And building this hospital had been a dream for both of us.’
‘Grace was Evie’s choice,’ Susie said. ‘Apparently it was her mum’s name.’
Ryan was watching Grace’s ECG trace on the monitor screen again. Evie hadn’t hesitated to offer that name for this baby. The memory of her mother had to be very strong. He’d noticed the way she’d been watching the baby during their assessment of her, too. Did she always bond with her patients so completely? Or maybe it was because she was a mother herself? Hadn’t someone said something about her having kids at home?
She hadn’t wanted to leave the room, either. Oddly, despite his total focus on everything that still needed to be done after that, he’d also noticed her absence. There was certainly something about her that was different, and it wasn’t just her unusual hair colour. Something that interested him. She was completely off limits, though. That comment about her having kids at home had been a red flag. A whole ring of red flags, in fact, that had her penned in its centre. Women who wanted kids were enough of a problem. One who already had them was someone who inhabited a planet Ryan was never going to visit.
Somehow, he wasn’t surprised to find her out in the unit’s reception area, when they’d finally settled baby Grace into a space where she could be monitored continuously until the catheter laboratory was available first thing in the morning. He’d been offered one of the overnight rooms here and he had to pass the reception area on his way to find it.
‘You’re still here,’ he said to Evie. ‘You’re not actually on duty, are you? You must have been on your way home when I met you in the car park?’
She nodded. ‘I was just waiting. To hear an update on Grace...’
The weariness that had been banished by the need for action had come back with a vengeance but Ryan pushed it aside as he pulled out a chair to sit down beside Evie.
He’d seen many faces that looked like this but only on parents who were waiting for news on their sick babies. Desperate faces that could make it very hard to stay professionally distant but that was another one of Ryan’s skills and he knew exactly how to deal with it. By providing whatever information he could and being very honest about his opinions without letting emotion cloud any issues.
‘Grace has a coarctation of her aorta.’ He could see that his words hadn’t triggered any more than superficial recognition. Was Evie only a junior nurse, perhaps? ‘It’s a narrowing of the main blood vessel that comes from the heart,’ he added.
‘Sounds serious.’ Evie’s eyes had darkened.
Hazel eyes, he noticed, which were just perfect framed by that dark blonde hair with its distinct auburn tint. Very expressive eyes, as well. He wanted to offer reassurance now. Comfort, even.
‘It’s a relatively common congenital heart defect,’ he told her. ‘And we have a few things we can do to treat it. She’s going to stay here as well so I’m taking over her case. I’ll do whatever I can to help her.’
‘Like what?’
‘We’ve started some medications. A prostaglandin that can temporarily maintain the patency of the ductus arteriosus. Do you know what that is?’
Her nod was thoughtful. ‘It’s a little vessel that lets blood bypass the lungs until the baby is born, isn’t it? And then it should close. That’s often when congenital heart problems become obvious, isn’t it?’
‘Yes. Or they can become rapidly much worse, which is why we’re going to try and keep it open. We can use inotropic agents to deal with heart failure symptoms as well.
