Goddamn him.
Isabel threw him a look that she hoped told him where exactly to shove his rules, and strode straight in to Resus. She would deal with Sean Anderson … later … never, if she had her way. ‘Now, Susan? Crikey, love, what on earth has been happening?’ She took hold of her patient’s hand.
Mrs Patterson was lying on a trolley, tears streaming down her cheeks. Pale. Terrified. Her voice was barely audible through the oxygen mask over her nose and mouth. ‘Thank God you’re here, Isabel. I’m so scared. I don’t want to lose this baby. Please. Do something.’
‘I will. I just need some details then we’ll make some decisions. And we’ll be quick, I promise.’ She’d have to be. If it was a placental abruption, as she suspected, both mum and bub were at serious risk. Outcomes weren’t always positive. And well she knew. Too well. Isabel examined Susan’s belly for the baby’s position and well-being. Then she tightened an electro foetal monitor belt over the baby bump. ‘Has anyone called Tony?’
‘I did.’ Jenny, the paramedic, filled her in on further details. ‘He’s on his way. Grandma’s looking after the toddler. They were in the car at the time of impact. Hit from behind. Susan felt a tight pull in her belly. Possibly from an ill-fitting seat belt, but there’s no visible marking or bruising on the abdomen. I have normal saline through a wide-bore IV in situ. Moderate vaginal bleeding. Blood pressure ninety over fifty and dropping. Baby’s heart rate jittery and at times …’ She pointed to her notes and let Isabel read. The baby’s heart rate was dipping, a sign of foetal distress. Mum was clearly shocked. Judging by the blood staining her clothes the baby needed to be out. Now.
‘Okay. Thanks.’ Isabel turned to the ER nurse that had appeared. ‘I need you to cross-match four units of packed cells. I need clotting times, usual bloods and that portable ultrasound over here as quick as you can.’
Susan’s hand squeezed in Isabel’s. ‘But I wanted … I wanted to hang on … two more weeks. …’
‘I know, but these things happen and we just have to deal with them as best we can.’ Isabel gave Susan a quick smile, positioned the ultrasound machine in front of her, squeezed jelly onto the probe and placed it over Susan’s tummy. ‘I’m just going to take a quick look.’ Baby was okay—distressed, but alive. Isabel exhaled deeply. Thank God.
She looked over at Sean and saw his reassuring smile. She gave him a small one back. They both knew that at least some of the immediate anxiety was over.
But the placenta was, indeed, partially separated. The baby was at serious risk and mum’s blood loss was not stopping. Despite the desperate urgency Isabel needed to be calm so as not to frighten mum too much. ‘Okay, Susan, we do have a problem here, but—’
‘Oh, my God. I knew it …’
‘Sweetheart, we’ll do our best. It’ll be okay.’ Isabel prayed silently that it would. ‘Your placenta is failing, I think the car impact may have given it a nasty jolt or tear and there’s a real risk to the baby if we don’t do something soon. As you know the placenta is what keeps baby alive, so we have to take you to the operating theatre and do a Caesarean section. I need your consent—’
‘Where’s Susan? Susan? Where’s Susan?’ A burly-looking stocky man covered in dust pushed his way in, steel-capped boots leaving grubby imprints across the floor. ‘What the hell’s happening?’
Isabel scanned the room for Sean. But he was there already, his hand on Tony’s forearm, gently slowing him down. ‘Are you Tony? Here, let me bring you over. It’s a lot to take in, I know, mate. There’s a few tubes and lines and she looks a little pale. But she’s good.’
‘She is not good. Look at her.’ The room filled with the smell of beer and a voice that was rough round the edges, and getting louder. ‘Is that …? Is that blood? What’s happened? What about my boy? The baby! Susan! Are you all right?’ Then his tone turned darker, he shoved out of Sean’s grip and marched up to Isabel. In her face. Angry and foul-mouthed. ‘You. Do something. Why are you just standing there? Do something, damn it.’
Isabel’s hand began to shake. But she would not let him intimidate her. ‘I’m doing the best I can. We all are. Now, please—’
‘No need for that, mate. Come away.’ Sean’s voice was calm but firm. At six foot one he was by far the bigger man. Broader too. And while Tony was rough and menacing, Sean was authoritative. There was no aggression, but a quietly commanded respect and attention. ‘We’re going to take her to Theatre right now, but first we need to know what we’re dealing with. Yes? Have a few words with Susan, but then we need to get moving. I’ll show you where you can wait.’
‘Get your hands off me.’ Tony pushed his way to the trolley. ‘Susie.’
‘I’ll be fine, Tony. Just do as he says.’ Susan started to shake. ‘I love you.’
‘If they don’t—’
Sean stepped forward. ‘As I said. Come with me. Now. Let’s have a quiet word. Outside.’ He bustled Tony out of the room.
‘He’s not a bad man.’ Isabel’s patient’s voice was fading. Alarms began to blare.
‘I know, I know, he’s scared, is all.’ Thank God Sean was able to contain him because the last thing Isabel needed was a drunk father getting in the way of saving a mother and baby. ‘Now we need to get you sorted, quickly.’ Isabel nodded to the porter. ‘Let’s go.’
She all but ran to the OR, scrubbed up and was in the operating theatre in record time. Sean, somehow, was there before her. ‘So we have a crash C-section scenario. Your call, Izzy. Whatever happens, I’ve got your back.’
‘Thank you.’ And she meant it. Well drilled in dealing with emergencies, she felt competent and confident, but having someone there she knew she could rely on gave her a lift. Even if that lift involved her heart as well as her head.
Within minutes she’d tugged out a live baby boy. Floppy. Apgar of six. But, with oxygen and a little rub, the Apgar score increased to ten. As occurred with every delivery Isabel felt a familiar sting of sadness, and hope. But she didn’t have time for any kind of sentimentality. One life saved wouldn’t be enough for her. Placental abruption was harrowing and scary for the mother but it was high risk too. That amount of blood loss, coupled with the potential for complications, meant they were perilously close to losing her.
‘Blood pressure’s dropping …’ The anaesthetist gave them a warning frown.
‘Hang on in there … I just need to find the tear.’ Isabel breathed a sigh of relief as she reached the placenta and started to remove it. ‘Attagirl.’
Within an hour they’d managed to save Susan’s life too, although she had hung close to the edge. Too close.
And now … well, now that dad was with baby, her patient was in recovery and the rest of the staff had scarpered, Isabel was alone. Alone, that was, with the one person she never wanted to be alone with again. Rather than look at him she stared at the words she was writing. ‘Well, Sean, I don’t want to keep you while I finish writing up these notes. Thanks, you were a great help. Things could have turned nasty with Tony.’
‘He just needed me to explain a few things. Like how to behave in an emergency department. But I get it. The bloke was worried. I would have been too if I was losing my wife and my baby.’
Guilt
