neonatologist said with an equal mix of warmth and authority tempering her voice, ‘you know that Amber’s having the very best care with the finest facilities.’
Jade sat in silence for a moment, gathering her thoughts before the shaky response slipped from her lips. ‘I know, Dr Greaves, and I don’t mean to be abrupt, but I don’t want you to sugar-coat anything. I’ve been working here in the neonatal ICU for over two years now, so please just be honest with me about her prognosis.’
Jade watched the neonatologist as she cast her eyes down and her lips formed a hard line in her somewhat tired face. She knew that the paediatric specialist had been attending Amber all night and the toll of her dedication showed in the morning light. Her naturally thin features were further drawn. But Jade was as tired as the attending physician and that brought her close to becoming a victim of her emotions. She would rather appear forthright and detached at that moment than risk her arm reaching around her in a comforting way and reducing her to a useless, snivelling heap of guilt. Melissa Greaves was that type of doctor. Professional but also motherly. Jade made a space between them to make it difficult for Melissa to reach for her. She had to do this alone.
The doctor’s hesitation in answering confirmed Jade’s fears, and her stomach tensed with a hollow cramp. Her composed veneer of bravado was close to shattering.
Melissa turned to her with a look that signalled she was about to deliver the harsh reality. ‘If complete honesty is to be the call then I have grave concerns for your niece. She’s dropped below her very low birth weight of two pounds, only marginally, but every ounce is critical, as you know, Jade, with VLBW patients.’ She paused for a moment as she slipped her pen inside her coat pocket.
‘Amber’s a little fighter but since you don’t want me to lie to you, if, and that’s a big if, she makes it through the day, I’d still only give her a fifty percent chance of survival. Her gestational age was twenty-nine weeks, so it was always going to be a struggle, but with the compromised maternal metabolic and cardiovascular factors brought about by the accident there are additional complications. With her mother trapped in the vehicle for almost two hours, there was decreased uterine blood flow and abnormal placental conditions prior to the emergency Caesarean, and she is a tiny baby, so Amber has a fight ahead if she is to survive.’
Anxiously, Jade turned to the tiny figure lying behind sterile glass walls. A sea of wires, all linked to monitors, supported her fragile life. Jade gently reached her hand through the porthole door of the incubator and gently stroked Amber’s warm, wrinkled skin. She was like a tiny china doll. Despairingly, Jade looked at her tiny niece’s beautiful face through the transparent head box that was supplying a constant stream of oxygen to make her breathing less difficult. All the while a drip was feeding nutrients through the sole of her swollen foot as the veins in her spindly arms had collapsed and had ceased being of any use for intravenous nourishment. The innocent child was fighting to survive, unaware that her parents’ lives had been taken by the cruel hand of fate.
‘You know, if there’s a glimmer of light in all of this,’ Melissa added, and crossed to Jade and gently placed a hand on her shoulder, ‘Amber isn’t suffering respiratory distress and her tiny lungs appear to be coping so she didn’t need a ventilator. I am amazed and a little bewildered by this and it does give me reason to give you the fifty-fifty chance ratio. Without that, her survival would be much lower than fifty per cent. At birth, I placed her survival at less than twenty per cent.’
Jade took another deep breath. The odds were improving. However, the slight degree of optimism the doctor had imparted didn’t bring her peace of mind. Jade wanted the one hundred per cent guarantee that she knew in reality no one could provide.
This environment was second nature to her, yet now being in neonatal ICU made her fearful. Every day, as a neonatal nurse, she cared for premature infants, yet seeing Amber needing the same level of intense assistance made her feel vulnerable. She had to pull herself together. Not for her sake but for Amber’s. She had to be able to process what was happening and, if called upon, make the right and informed decisions regarding her niece’s care.
‘And you moved her from the open radiant warmer last night?’ Jade asked, appreciating and finding a level of comfort in the compassion she had tried to deflect.
‘Yes. When you fell asleep for a few minutes in the early hours I decided that the increased stimulation from light and noise and the associated risk of decreased growth and weight gain was greater than the disadvantages of the incubator. She is just too tiny to lose any further body mass. The next twenty-four hours will be critical.’
‘Then it looks like we’re here together for another long day, Amber, but you will get through this,’ Jade promised aloud to the sleeping infant, before adding silently, And I will never leave your side. Never. Trying unsuccessfully to quash her unshed tears, she turned away before Melissa witnessed her breakdown. Through a watery blur, she watched the shaky breathing of her niece’s tiny body and felt so helpless it was overwhelming.
She had never felt so totally powerless before in her life. She wished she had saved every forgotten wish from each birthday cake over the past twenty-six years and could tie them together to wish for the one thing she wanted with all her heart. If only she could gently lift the spindly bundle from her tiny glass crib and softly whisper that everything would be all right. But she couldn’t. There was no guarantee that everything would be all right. There were no promises of a future for this little girl clinging tenaciously to life. And if she did have a future it would be one without her mother and father.
The days passed slowly, but each hour that Amber lived gave Jade hope. The hospital granted her compassionate leave to focus on Amber. The baby’s weight was stabilizing and the doctors looked less worried, as did the neonatal nurses, who were all friends as well as colleagues. None of them provided false hope but neither did they talk about the possibility that Amber might not survive.
Her heart ached for the baby she had been with for four days. A baby as wanted and loved as any child could be. She was the daughter that Ruby and David had dreamed of and planned for so many years. It made the bleakness of the prognosis so much harder to handle. She worried that not having her mother’s love and natural bonding could add to the complications of Amber’s early entry into the world. Although Jade wasn’t her mother, she swore to herself she would be the next best thing and do everything in her power for the little girl at that moment and for the rest of her life. Amber had lost the mother she had never known but she would never lose Jade.
She would spend her life making it up to her niece for sending her parents on the holiday that had claimed their lives. And she would spend her life being the woman that Ruby and David would want raising their little girl.
But Jade was also struggling with her own grief. Grief the little girl knew nothing about. Over those first few days it was almost too much to bear. Not only was she close to crippled with worry about her niece, but she had also lost her sister. A sister she’d loved with all of her heart.
Ruby and Jade had been close all their lives and even more so after the loss of their parents. Ruby had been, in Jade’s mind, the most wonderful sister in the world. She had been kind, and funny and nurturing. It was as if half of Jade was gone. Ripped from her life without warning. No chance to say goodbye. No opportunity to thank her sister for everything she had done. All the big sister advice she had given over the years. The advice that Jade had always appreciated but mostly ignored. The tears they had shed over boys who hadn’t been worth it. The late-night calls to chat about nothing much but which had somehow lasted for hours.
It was all gone. She would never laugh with her sister again. She would never watch David look lovingly at his wife and hear them make plans and talk about their daughter’s education. How Ruby would tell him that the little girl would be brighter
