Читать книгу: «The Pregnant Registrar»

CHAPTER ONE

TAKING a steadying breath, Lydia would have loved to press her face against the cool bathroom tiles, to rinse out her mouth and splash her face with some icy cool water, but the shrill bleeps from her pager merited no such luxury.

She was sure morning sickness should now be horrible distant memory, sure that by five months she should be able to walk into a hospital without diving for the nearest rest room.

Why did the books always get it wrong?

Catching sight of herself as she darted out of the cubicle, Lydia gave a grimace. She’d assumed by the time she hit registrar status that she’d sweep into the ward in chic, well-cut suits and impossibly beautiful shoes attached to thin silk stockinged legs. Not dashing in like some overgrown heifer with baggy theatre blues covering swollen ankles. But the tailored suits she’d envisaged for this stage of her career didn’t equate with the subtropical temperatures of the special care unit and high heels didn’t make for a speedy dash along the corridor. The chocolate curls she’d so neatly tied back this morning were escaping rather alarmingly and she’d have loved to have fiddled with a bit of lipstick, would have loved to have put some blusher on her way too pale cheeks, but there really wasn’t time. As a very new junior registrar on Special Care, the shrieks from her pager could only mean one thing…she was needed, and quickly.

Consoling herself that the last thing a tiny baby would care about was whether the doctor had lipstick on, Lydia wrenched open the bathroom door and practically flew along the highly polished tiles, popping a mint into her mouth as she did so and praying her unfortunate delay would go unnoticed or, more pointedly, wouldn’t have done any damage to the fragile lives that were now in her charge.

Racing through the black swing doors, even though she’d just washed her hands, even though time was of the essence, protocol still had to be adhered to and Lydia squeezed a hefty dose of alcohol rub into her palms as she scanned the special care nursery, watching the crowd huddled around a crib as she deftly made her way over.

She’d so wanted to look cool for this, had wanted to breeze in on her first day supremely in control, to dispel in an instant the questionable merits of filling a three-month maternity leave position with a rather pregnant doctor. But instead of arriving cool and unflappable, it was a rather pale, shaky Lydia that made her way over to the gathered crowd. ‘What’s the problem?’

‘No problem,’ a deep voice clipped, and Lydia looked to the moving mouth on a very tall, very wide-set, very annoyed-looking ogre dressed in theatre blues. His green eyes worked the tiny infant, large hands retaping a probe connected to the baby’s rapidly moving stomach, each tiny fast breath requiring a supreme effort. ‘The drama’s over.’

‘What happened?’ Lydia had to wait a full minute before she got a reply. The crowd was drifting away now and a nurse fiddled with monitors as the avenging ogre suctioned the baby’s airway with surprising gentleness for someone with such large hands.

‘Prolonged apnoeic episode.’ Those green eyes finally met hers, and he flashed a very on-off smile. ‘Extremely prolonged, hence the emergency page.’

‘I’m sorry about that,’ Lydia mumbled, realising the direness of the situation she had just missed. Apnoeic incidents in Special Care were part and parcel of the day. These tiny babies often seemed to forget to breathe which would send most staff into a spin, but here under the controlled setting of Special Care it was routinely dealt with. Lydia was used to having a conversation interrupted as a nurse gently flicked the bottom of a baby’s foot in an effort to stimulate the infant into breathing, then resume the conversation as if nothing had happened. An emergency page wouldn’t have been put out lightly and Lydia knew that from where the man was standing there really was no excuse. ‘I got here as quickly as I could.’

‘You’re the new registrar?’

Lydia nodded. ‘Dr Verhagh.’ She knew she should have given her first name, knew her rather brusque response sounded a touch standoffish, but she was desperate to exert some semblance of control here. ‘And you are?’

‘Corey Hughes. I’m the nurse unit manager.’ He shook her hand briefly before turning back to his small charge.

‘Well, Sister Hughes,’ Lydia ventured, watching him stiffen slightly, as male nurses often did when their formal title was used. Hell, why hadn’t someone come up with an alternative title for a male nurse? Lydia mused while attempting a recovery. ‘I mean, Mr Hughes,’ Lydia corrected. ‘Is there anything I can do here? Though it looks as if he’s stable now.’

Checking the infant’s observations on the monitors, Corey gave a rather curt nod of his head. ‘It’s all under control. It was a mucous plug causing the apnoeic episode. We’ve suctioned his airway and he’s doing well now.

‘And by the way,’ he added with a crisp smile that didn’t meet his eyes, ‘the name’s Corey.’

‘I’m aware of that.’ Lydia flashed an equally brittle smile. ‘But I prefer to save first names for the office and staff room. Out on the ward I think it’s more reassuring and less confusing for the parents if we call each other by our professional titles.’ She could feel the colour whooshing up her pale cheeks. She hadn’t meant to come across as quite so brittle, hadn’t wanted to so forcibly erect the barriers on her first day, but something about those green eyes was unnerving her. ‘So if you’d rather I didn’t call you Sister out on the floor, is it OK if I call you Mr Hughes?’

‘Well, if we’re going to be formal…’ Corey flashed her a dark look ‘…then it’s actually Dr Hughes.’

‘Doctor?’ Lydia frowned, her brown eyes darting down to his name badge. ‘But I though you said you were the nurse—’

‘Unit manager,’ Corey finished for her. ‘That’s right. I also have a doctorate in nursing, and from the confusion it’s obviously caused you, I’m sure you can appreciate how difficult it would be for stressed parents to have to listen to me rattle off my résumé every time I introduce myself, so if it’s OK I’d prefer you to call me by my first name.’ As he stalked off, Lydia let out a low, weary breath. It wasn’t actually the best start to her first day, but just as she thought her rather brief dressing-down was over, the avenging angel paused and turned. ‘Could we have a brief word in my office, before the rounds start, please, Doctor?’

His office was appallingly untidy, mountains of paperwork cluttered each and every available space and Lydia was forced to stand for an uncomfortable moment as he flicked on the kettle before moving a mountain of notes from a chair then gesturing for her to sit.

‘Can I get you a drink?’ Corey offered.

‘No, thanks,’ Lydia declined, not too keen on a repeat dash to the toilet, but her refusal obviously lost her another brownie point as Corey shrugged and made one for himself, spooning in three massive teaspoons of sugar. Leaving the teabag in, he made his way to the desk.

‘Have you been shown around?’ Corey started, and Lydia nodded.

‘At my interview, though I wouldn’t mind a quick refresher.’

Corey nodded. ‘I’ll take you round the patients as soon as we’re finished here. The formal doctors’ round isn’t until nine, so it might make things a bit easier for you if you’ve at least briefly met them before Dr Browne does his rounds. He doesn’t make too many allowances and the fact it’s your first day won’t stand for much when he starts firing questions.’

‘Thanks.’ Lydia gave a small appreciative smile. Dr Browne’s temper was legendary—the fact Lydia had been working on the other side of Melbourne didn’t mean she was completely out of the loop. The great Dr Browne’s reputation preceded him, but even though she was rather nervous of being the target of one of his scathing comments, her nerves were overridden at the prospect of working alongside such a fabulous mentor.

‘About this morning,’ Lydia ventured, determined to set the tone, to push aside the rather awkward initial greeting and forge a more relaxed working relationship. ‘If I came across as rather formal—’

‘I don’t have a problem with formal, Doctor.’ Corey broke in. ‘What you like to be called is your business. I happen to prefer to work on a first-name basis, but that’s my own personal choice. I can understand where you’re coming from and if you choose to keep a distance then that’s fine by me, we all cope with things in different ways, but for my part I’ve found being on first-name terms fosters a better relationship. The parents are generally here for a long time, particularly with premature infants, and despite the initial slight confusion as to who’s who it’s how I prefer to work.’

Lydia gave a small nod, even opened her mouth to speak, but he clearly hadn’t finished yet, continuing before she even got a word out. ‘However,’ he barked, ‘I do have a problem with doctors who don’t respond promptly to an emergency page. I’ve got two new interns who started last week and they weren’t exactly a lot of help this morning. When a baby goes off, you know as well as I do that experienced hands are needed, and quickly. The fact a registrar was fast-paged meant that a rapid response was called for.’

‘I know,’ Lydia agreed, ‘and I really am sorry.’ She hesitated. The last thing she wanted to do was play for the sympathy vote here, to tell this rather arrogant man that she’d had her head down the toilet as her pager had gone off. No doubt he’d roll his eyes, no doubt he’d mentally voice the question that undoubtedly begged—was a pregnant doctor really up to such a demanding job? But even though she’d rather be considered unfit than uncaring, Lydia still didn’t speak up and it was left to Corey to conclude this difficult conversation.

‘Well, thankfully there was no harm done this time. The emergency was dealt with and the baby’s fine, but next time you receive a fast-page…’

‘I’ll be here,’ Lydia said firmly, meeting his assured eyes with a determined glare of her own, grateful for a tiny reprieve when the door flung open and a young nurse breezed in.

‘Sorry to interrupt. I need your signature, Corey.’ Waving a drug chart under his nose, the young nurse looked over and gave Lydia the benefit of a very nice smile.

‘I’m Jo.’

‘Lydia,’ Lydia responded, aware of Corey’s eyes on hers and trying to beat back a beastly blush as she dropped her title.

‘Welcome to the madhouse.’ Retrieving the chart from Corey, she made to go. ‘Are you feeling better?’

‘Sorry?’ Lydia looked up sharply as Jo gave an apologetic shrug.

‘I saw you dashing into the toilet, I doubt you noticed me. I, er, think you were in rather a hurry. If you need a cuppa or anything, just call. Corey makes it like treacle, not exactly the best thing for morning sickness.’

There was the longest silence after she’d gone, filled only by the sound of Corey filling another mug with tea and thankfully pulling the teabag out before it assumed mud-like proportions.

‘Sugar?’

Lydia nodded. ‘Just one, though.’

‘Why didn’t you say?’ Corey asked finally as he placed a steaming mug in front of her, watching as Lydia took a hesitant sip, closing her eyes as the hot sweet liquid hit its mark, warm and soothing and, thankfully, staying put. ‘Why didn’t you just say that you weren’t very well?’

Lydia took a deep breath. ‘I didn’t want you to think I was making excuses.’ She gave a brief shrug. ‘Look, the hospital’s been fantastic. I can’t believe I got the job, given the circumstances.’ She registered his frown. ‘Pregnancy doesn’t normally work in one’s favour when looking for a job.’

‘But it did in this case?’

Lydia shrugged. ‘I’ve got a full-time position for three months while Jackie Gibb’s off on maternity leave, and then, when I come back, we’ll job share. Dr Browne was forward thinking enough to realise that, rather than lose Jackie altogether, job share might be the solution. Most part-time jobs are filled by mothers.’

‘Which you soon will be?’

Her rather nervous smile didn’t go unnoticed. ‘Apparently so.’ She looked down at her softly swollen stomach, disguised under baggy theatre blues but still pretty evident none the less. ‘I’ve got four months to go.’

It was Corey frowning now. ‘I thought morning sickness only lasted for three months or so.’

‘So did I,’ Lydia groaned. ‘Apparently I’m the exception to the rule, though it’s not as bad as it was. At least now it’s living up to its name and only confined to the mornings.’

‘You had it pretty bad, then?’ Corey asked as Lydia grimaced.

‘It was awful. For the most part it’s gone now, but for some reason, within half an hour of stepping into a hospital, no matter how well I feel…’ She gave a rueful smile. ‘I’ll spare you the details. But once it’s over, it’s over, at least until the next day.’

‘Must be the smell,’ Corey mused. ‘My sister used to say just the smell of the place made her feel dizzy every time she came to see me at work.’

‘Used to?’ Lydia looked up, hopeful Corey was about to reveal his sister’s secret, a remedy perhaps that she hadn’t heard about, but from his stance she soon realised she’d picked up on something rather personal and dropped the subject as Corey deftly ignored her question, standing up and gesturing towards the door. ‘How about I give you that handover?’

Taking a last quick sip of her tea, Lydia stood up and for the first time since their awkward meeting they managed a simultaneous smile. ‘About before,’ Lydia started, but Corey waved a large hand dismissively.

‘Forget it. Now, I know there was a reason…’

‘I—I meant the first-name business,’ Lydia stammered. ‘I really do prefer Lydia—I don’t know what I must have been thinking.’

‘Hormones.’ Corey winked.

‘That’s a terribly politically incorrect thing to say.’ Lydia grinned, stepping through the door he held open for her.

‘Oh, there’s plenty more where that came from.’

The same light-hearted chatter continued out on the ward, from Corey at least, various nurses looking up and smiling, introducing themselves as Lydia slowly worked her way around the room. Lydia tried to smile, tried to come up with the odd witty response or friendly greeting, but it was as if her mouth didn’t know how to move any more. She could feel the sweat on her palms as she dug her nails into them, feeling horribly awkward and exposed and praying for a fast forward when all in the unit was familiar.

Special Care Units were intimidating at the best of times, but Corey obviously ran the place well. Somehow there was a balance between quiet efficiency and relaxed friendliness which was no mean feat given the direness of some of the babies’ health and the anxious parents taking each painful step along with their child.

‘Patrick Spence.’ Corey stopped at the incubator where they had first met. ‘He’s six days old now…’ his eyes moved to the little boy still struggling with each ragged breath ‘…which makes it your one-week birthday tomorrow, little guy.’ Rubbing his hands with the mandatory alcohol, Corey put his hands inside the incubator and stroked the tiny infant’s cheek, and such was the tenderness in his touch Lydia felt her breath catch in her throat. They had stopped at every incubator, Corey had regaled the most painful tales but not for a second had he erred from professional detachment.

Till now.

Handling of sick infants was kept to a minimum, yet here was Corey gently stroking this baby’s brow and there was an expression on his harsh, sun-battered face Lydia couldn’t read.

‘We normally save the cuddles for Mum and Dad, but this little guy’s missing out on both counts,’ Corey offered by way of explanation, his eyes never leaving the babe. ‘But we’re more than happy to fill in, aren’t we, Patrick?’ Clearing his throat, he pulled his hand out, fiddling with the oxygen-flow meter for a moment or two before carrying on.

‘Patrick’s mother arrived at the labour ward in advanced second-stage labour. She’d received no antenatal care and a rapid labour followed. Born at thirty-two weeks gestation, as well as being premature, he was also small for dates. Multiple anomalies were noted at birth and on investigation he was found to have major cardiac defects.’

He was silent for a moment as Lydia read the cardiac surgeon’s reports, along with endless reams of ultrasounds, chewing thoughtfully on her lips as she did so. ‘He’ll need surgery,’ she murmured, ‘and preferably sooner rather than later.’

‘Or later rather than sooner.’ The irony in Corey’s voice wasn’t aimed at her and Lydia didn’t have to look up to realise that. Babies this sick and this small were a constant juggling act: drop one ball and the whole lot came tumbling down. To survive, Patrick needed his heart defects corrected, but for his tiny body to make it through the complex surgery he desperately needed to gain some weight and stabilise medically if he was to stand a chance. ‘Twenty-four hours after admission his mother became agitated, and was finally diagnosed as suffering with alcohol withdrawal. Valium was given and the drug and alcohol liaison service notified.’

‘Patrick has foetal alcohol syndrome?’ As Corey nodded, Lydia looked back at the small babe. Foetal alcohol syndrome was one of the few completely preventable causes of congenital anomalies. The babies suffered various levels of handicap, from mild learning difficulties and facial deformities to cardiac problems and marked retardation, but from Lydia’s brief assessment of Patrick, his visible anomalies didn’t entirely fit the picture. Heading to the wash basin, she scrubbed her hands before examining the babe more thoroughly.

‘Have we sent off for a DNA work-up?’ Lydia asked, examining Patrick’s hand and feet, peering closely at his face and taking in the almond-shaped eyes and low-set ears.

‘We have,’ Corey responded, and for a second as she looked up Lydia thought she saw a flicker of admiration in those guarded green eyes. ‘What do you think?’

Lydia gave a brief shrug but it was far from dismissive. ‘He looks like a trisomy baby; of course Down’s syndrome is a far more palatable diagnosis title than foetal alcohol syndrome, but in this case I think it could be both.’

‘It’s a tough call,’ Corey said thoughtfully, ‘but I’m actually glad to hear someone say it. As soon as Jenny, the mother, started to show signs of alcohol withdrawal Patrick was basically labelled as an FAS baby, but I think it might be a touch more complicated, I guess we’ll have to wait for the labs, and on current form we could be waiting another couple of weeks.’

‘How is his mother coping with the news?’

‘She won’t come and see him. Apparently Jenny’s admitted she has a problem with alcohol and has agreed to rehab, but to date she’s refused to come and visit Patrick. She’s talking about putting him up for adoption.’

Which was far easier said than done. The world seemed to be crying out for healthy pink babies but a handicapped child with special needs would take months, years even to place.

If ever.

‘What about the father?’

Again Corey hesitated. Handing her a wad of notes, he gave a small shrug.

‘What father?’

His two words said it all.

Glancing down at the patient notes, she read quietly for a moment. Patrick really had had a difficult start to life. Not only was he born eight weeks before nature intended, with major health problems, he had succumbed to several of the obstacles premature babies faced. His immature lungs had meant he had required forty-eight hours on a ventilator but he had been weaned off that now and was breathing with the help of continuous positive air pressure, a direct, measured flow of oxygen, commonly known as CPAP, but his marked jaundice was still proving to be a major problem and Lydia rummaged through the unfamiliar order of this hospital’s files, trying to verse herself on Patrick’s relevant issues.

‘Here.’ Taking the notes, Corey turned to the back of the folder, locating the blood results for her in a second, not even acknowledging the quiet murmur of thanks Lydia imparted as she studied the blood-work closely. Despite the intensive phototherapy to correct his jaundice, Patrick’s serum bilirubin was still rising and her forehead puckered in concentration as she plotted his results on the graph before her. If they couldn’t get the levels down, Patrick would need an exchange transfusion to remove the toxic blood and replace it, which would hopefully prevent organ damage.

Corey was obviously thinking along the same lines. ‘It’s an uphill battle at the moment, but we’ll get another blood result around midday and hopefully there will be some improvement.’ His eyes moved back to the little baby and they stared for a solemn moment at their small charge, watching the almost transparent abdomen rising painfully up and down with each rapid, exhausting breath, his face grimacing with the pain and effort of merely staying alive.

‘Do you ever just want to take them home?’

‘Heavens, no!’ Her response was immediate, a sort of knee-jerk reaction, an instant erection of the barriers Lydia created just to survive her work. But even as the words left her lips Lydia realised how awful she must have sounded, watching the tiny headway they had made disappear in a puff of smoke. As Corey’s eyes narrowed, she realised he hadn’t actually expected an answer, that he had been talking more to himself than to her. ‘I mean…’ Swallowing hard, Lydia gave a helpless shrug. How could she tell him she was having enough trouble getting her head around the fact she’d be bringing her own child home from hospital in a few short months, let alone someone else’s? ‘I just try not to get too involved.’

When he didn’t respond she pushed on regardless, trying to somehow rewind, to wipe the slate clean without revealing too much of herself. ‘It’s sad and everything, awful actually…’ Her voice trailed off, realising how awful she was sounding, as if she had a plum in her mouth, hating the sound of her own voice as she reeled off a few more platitudes while knowing it was useless.

Unfeeling bitch.

She could almost feel him punching out the letters as he labelled and pigeonholed her, but as Dr Browne and his entourage swept into the ward the rather uncomfortable conversation was left behind as Corey gave a small eye roll. ‘Ready for the off?’

The ward round took for ever. Dr Browne was rather old school and even Lydia was slightly taken aback by the in-depth discussions at the cots, sure the barrage of scenarios he detailed wouldn’t be very comforting for the anxious parents. After a rather gruelling hour it was a rather washed-out Lydia who finally sat down at the nurses’ station, simultaneously clicking away at the computer and wrestling with a mountain of notes to write up the ward round findings and formally prescribe new courses of treatment as the junior doctors set to work on the barrage of tests and drug charts that needed completing. Looking up, Lydia noted Corey quietly making his way around the unit, talking in turn to each of the parents, presumably answering the multitude of questions the ward round would have thrown up and hopefully clarifying a few issues.

He was good, she had to admit it. Most NUMs would be dashing off to a meeting or holing themselves up in the office by now, but Corey had barely left the shop floor all morning.

He was good-looking. too.

Where that thought had appeared from Lydia had no idea. For the last few months she had wandered the world in a curiously asexual state, too focused on her own troubles to register irrelevancies like looks, gender, emotions. Now suddenly here she was, five months into the most nauseous pregnancy in history, sworn off men for the next millennium at the very least, staring across the ward at a man she knew absolutely nothing about and who, more to the point, was probably gay! Giving herself a mental shake, Lydia dragged her eyes back to her notes, trying to cross-reference some lab results on the computer as she filled in the patients’ history in her vibrant purple scrawl. Even though she was a registrar, even though she probably wrote the blessed word five times a working day, as she stumbled through the mental block that the spelling of the word ‘diarrhoea’ eternally produced she found her eyes drifting back to him.

Very good-looking, she mentally reiterated, in a rugged sort of way. Dark curls that needed a cut coiled on the back of a very thick neck, and the set of his wide shoulders made him look more like a rugby player than a neonatal nurse, which, however politically incorrect, begged a question in itself which Lydia answered this time in a nano-second.

Corey Hughes was definitely not gay.

He looked up then, a slightly confused smile crinkling his eyes as he caught her staring. An extremely unbecoming blush whooshed up Lydia’s cheeks as he made his way over.

‘Everything all right?’ he asked, frowning in concern as Lydia fanned her cheeks with a prescription chart.

‘Everything’s fine. It’s just a bit hot in here.’

‘Did you want something?’

She was about to say no but, remembering she’d been caught staring, Lydia forced a hasty question. ‘I’m trying to get into the computer to see if Patrick’s labs are back. I haven’t had much luck.’

‘Have you used the right password?’ Coming round to her side of the desk, Corey peered over her shoulder, leaning forward and tapping away as Lydia sat rigid, staring at the back of his very large hands and trying and failing not to check for a wedding ring.

Absent, as was her pulse for a second as Corey’s arm brushed her cheek.

‘You’re already in,’ he said, bemused. ‘Did you type in the correct UR number?’

‘That must be it.’ Lydia flushed even more as Corey tapped away and Patrick’s results appeared on the screen. ‘They’re still not back.’

‘They won’t be till lunchtime.’ Corey frowned. ‘I already told you that.’

‘So you did.’

He obviously wasn’t one for small talk. He made his way back across the ward and resumed whatever it was he had been doing as Lydia stared helplessly at the screen, cheeks flaming, heart pounding, trying to ignore the delicious lingering waft of his after-shave, stunned at the response he’d elicited from her, curiously irritated at her body’s rather unloyal response.

She was pregnant, for heaven’s sake.

Wasn’t that supposed to exalt her to some sort of nun-like status?

Wasn’t her libido supposed to vanish with her waist line?

Not that it made a scrap of difference. From the black looks Corey flashed at her every now and then, from the rather terse way he addressed her, this was one relationship that was clearly set to stay professional.

Oh, well, Lydia sighed, pulling out her hair tie at the end of a long and exhausting day, snapping the folders closed and flicking off the light in the cupboard that doubled as her new office.

‘I thought you left ages ago.’ Corey looked up as she wandered past his office.

‘One day in and I’m already behind on the paperwork.’

‘Tell me about it.’ Corey grimaced, gesturing to his overloaded desk. ‘I was supposed to be off at four. Four a.m. more like.’

‘You’ve only got yourself to blame.’ When he frowned, Lydia smiled. ‘Most NUMs shut themselves in their offices for the best part of the day.’

‘Not my style.’ Corey shrugged.

‘Then stop complaining.’

She was almost smiling and so was Corey, clearly getting her rather dry off-beat humour.

‘I’ve been thinking about your problem and maybe you should come into work a bit earlier,’ Corey ventured as Lydia made to go.

‘Sorry?’ Turning, it was Lydia’s turn to frown now.

‘In this line of work there will always be paperwork. Why not do only the essentials at the end of the day and leave the rest till the morning, come in half an hour earlier?’ When Lydia’s frown remained he addressed her as one would a bemused three-year-old. ‘Your morning sickness—you said it hits you within half an hour of setting foot in a hospital. If you come in early, you can spend a bit of time acclimatising.’