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CHAPTER THREE

THEY left their unfinished coffee and headed for the ground floor. Gemma Burton, one of the midwives, gave them the case notes and directed them to room two. Nic scanned them swiftly, gave them to Lucy to do the same, knocked on the door and introduced them both to Molly Drake.

‘How have you been feeling?’ he asked, sitting next to her and holding her hand.

‘OK—but then last week I started to feel a bit breathless. And I look like a house—I’m only seventeen weeks and I look like I’m going to deliver any day,’ she said. Her faced was pinched with anxiety. ‘I know I’m having twins but I never expected to be this big. And my tummy’s felt really tight in the last day or so.’

‘Would you mind if I examined you?’ Nic asked.

‘No. I just want to know, are my babies all right? The midwife said she wanted the consultant to see me…’

‘Hey, we always take extra special care of our mums having twins, so you’d get to see me a lot more often than mums of single babies anyway,’ Nic said reassuringly. ‘But, yes, I’m a bit concerned that you’ve put on weight very quickly and you’re breathless. I’d like to do a scan to see what’s going on, if I may?’

Molly nodded.

It didn’t take long for Nic to do the scan and see that his worst fears were realised. One twin was much bigger than the other. It had a full bladder, whereas the other twin’s bladder was empty, and the smaller twin seemed almost stuck to the wall of the placenta—which, he knew, meant that it had much less amniotic fluid in the sac surrounding it.

‘Is everything all right?’ Molly asked.

Nic held her hand again. ‘There’s a bit of a problem, but the good news is that we can do something about it. You have something called TTTS or twin-to-twin transfusion syndrome.’

‘What’s that?’

Nic gestured at Lucy. ‘Over to you, Lucy.’

‘It’s something that happens when identical twins share the same placenta,’ Lucy said. ‘Their blood vessels form a link in the placenta—most of the time that isn’t a problem, but sometimes the link isn’t balanced properly, so one twin ends up donating blood to the other. The babies are perfectly normal—the problem’s in the placenta. We don’t know exactly why it happens, but it might be to do with how late the fertilised egg splits to create two embryos. It happens in around one in a thousand pregnancies.’

‘And that’s what’s wrong with my babies?’ Molly asked.

Lucy nodded and turned the ultrasound screen so that Molly could see it. ‘You can see on the scan here that one twin’s a lot bigger than the other. If we measure their lengths, it looks as if this one’s a week older than his twin, even though we know he’s not. The bigger twin has too much blood going round his system, so his heart has to work harder, and he produces more amniotic fluid—that’s the bag of fluid the baby lives in—so he wees more and his bladder’s full. The smaller twin is anaemic and has less amniotic fluid surrounding him; he doesn’t grow as well and his bladder’s usually empty.’

‘Are they going to be all right? What—what can do you do to stop it?’

‘There are quite a few options,’ Nic said. ‘We can do something called amnioreduction—that means draining some of the fluid from around the bigger twin, which gives the smaller twin more space in the womb and will make you feel a lot more comfortable. It also reduces the chance of you going into premature labour. If we do that, it takes about an hour and we drain off two to three litres of fluid. I’d also like you to stay in hospital for a day or so, so we can monitor you, and then you can go back home, as long as you promise to stay in bed and take it easy for a few days.’ He squeezed her hand. ‘Though if you do take this option, we might need to repeat it later in your pregnancy, depending on how things go with the twins.’

‘There’s also something called a septostomy, where we make a little hole in the membrane that separates the twins and the fluid balances out between the sacs—we often do that at the same time as an amnioreduction,’ Lucy said. ‘Or we can send you to a hospital in London for laser treatment, which will break the joined blood vessels and stop the blood going from one twin to the other—it won’t hurt them and they’ll be able to grow normally. There’s another new treatment being tested at the moment which involves high-frequency ultrasound therapy—the same sort that’s used to treat kidney stones—though again if you choose this we’ll have to send you to a centre in London, as we can’t do it here.’

‘And the babies will both be all right?’

‘We’ve caught you relatively early, which is a good sign,’ Nic said. ‘If they both survive, the smaller twin should catch up on growth after the birth. But at this stage I can’t guarantee they’ll both be fine.’

‘So they might die?’

‘I know it’s a horrible thing to have to consider, but there’s a possibility you might lose one or both of them. I can’t quote any odds at this stage, and we’ll monitor you a lot more often than we’d usually plan and make sure we do everything we can to keep your babies safe,’ Nic reassured her. ‘There are two other options you need to think about, and I’m afraid they’re not very pleasant, but you need to know all the facts before you can make a decision. Some parents opt to have a termination now, because they feel the odds are stacked too high against them. I know it’s an unbearable thing to think about, but if you decide that’s what you want, we’re not going to judge you or criticise you.’

‘We’re here to give you the facts and to support you, whatever decision you make,’ Lucy said. ‘We’re on your side.’

‘I…’ Molly was clearly close to tears and Lucy handed her a tissue.

‘The other option, if we find that the procedures don’t work and the twin-to-twin transfusion is getting worse, is that we might be able to save one twin at the expense of the other,’ Nic said. ‘I know it sounds callous, but it’s a question of weighing up the risks.’

‘But you and your partner really need to discuss it and decide what you want,’ Lucy added.

‘George isn’t here,’ Molly said. ‘He’s away in the States on business. He said he’d change his meetings if I needed him here today, but I thought this’d be just…well, a routine visit.’

‘I know.’ Lucy brought a chair to the other side of the bed and held Molly’s other hand. ‘And this must have come as a shock to you. Is there anyone we can call to be with you?’

Molly shook her head. ‘I’m not on good terms with my parents, and George’s mum panics at the least little thing—she’s the last person I need fluttering round me. I just…’ She bit her lip hard. ‘Twins. When we found out, we never thought we’d cope. We’d just got used to the idea and started getting excited about it, and now this!’

‘Take your time,’ Nic said. ‘I’d like to start treatment in the next twenty-four hours—but if you want to talk to your husband or a friend first, discuss it with them, that’s fine.’

‘Would you explain the options to my husband?’ Molly asked Lucy.

‘Of course,’ Lucy said. ‘There’s no pressure. Take all the time you need. Can I get you some water or anything?’

‘It’s all right. It’s just a shock. I need to think—I need to talk to George.’ She swallowed. ‘I can’t use a mobile in here, can I?’

‘No, it might interfere with the machines,’ Lucy said. ‘But I can take you somewhere where you can use it.’

‘Thanks.’

She looked at Nic. ‘See you back on the ward?’

‘Yeah.’ Nic smiled at Molly. ‘We’re here whenever you need us. If either of us isn’t on duty, just ask someone to bleep us. We’ll be straight here.’

Four hours later, Lucy was sitting in the rest room and trying very hard not to cry. She’d held Molly’s hand throughout the difficult call to the States, and the even more difficult decision that had followed.

Molly had been admitted to the ward and Lucy was well past the time when she was supposed to finish her shift, but her vision was blurred with suppressed tears and she didn’t feel quite up to cycling back to her cottage.

‘Are you OK, Lucy?’

Lucy looked up and gave Nic a watery smile. ‘I thought you were supposed to be off duty ages ago.’

‘I’m not the only one.’ He came to sit next to her. ‘It’s Molly Drake, isn’t it?’ he guessed.

She nodded. ‘I know, I know, these cases are rare and most of the time our mums have a healthy pregnancy and a healthy baby—but I hate to see the heartbreak some of our parents have to go through.’

‘Me, too,’ Nic said. ‘But remember this—we can make a difference. We do make a difference.’

‘Yes. Molly’s having a septostomy tomorrow and we’ll be monitoring her weekly. The twins stand a much better chance now.’

‘Chin up.’ He gave her an exaggerated wink, then sent her hormones into overdrive by gently touching her cheek. ‘Go on. Home with you. And I’ll see you tomorrow.’

Lucy slept badly that night; when she did drift off, her dreams were filled with Nic Alberici. And they were so graphic that she was actually blushing when her alarm went off.

When she got to work, she seemed to hear nothing but Nic’s name. Every single patient beamed when they talked about him—all saying he was far dishier than any Hollywood star and acting as if they were half in love with him. The midwives were similarly smitten—the young and single ones virtually swooned when they heard his name, and the older ones clucked over him like a favourite son. ‘He’s lovely—a real gentleman,’ Rosemary said dreamily. ‘And those gorgeous eyes! If I were twenty years younger…’

‘Oh, he’s just another consultant,’ Lucy said, aware how grumpy she sounded and hoping that no one would pick up on it.

No chance. Rosemary’s eyes widened. ‘Have you two had a fight or something?’

‘No. It’s just a bit wearing hearing how fantastic Mr Alberici is—almost as wearing as Mal’s sense of humour. Even the mums who’ve had a difficult delivery say they’d like another baby right now, please, if it means they’ll have Mr Alberici looking after them.’

Rosemary whistled. ‘Someone got out on the wrong side of the bed this morning, didn’t she?’

If she said anything else, it’d start the hospital rumour mill whirring. ‘Yeah, probably,’ Lucy said, and switched the topic back to work.

Though she couldn’t get Nic out of her mind. She was aware of exactly when he walked onto the ward and exactly when he left. And she hated this out-of-control feeling. It’s like you told Rosemary—he’s just another consultant, she reminded herself.

Except she had a nasty feeling that he wasn’t.

‘I’m worried about this one,’ Beth said, handing Lucy the notes of another patient. ‘Judy Sutherland’s diabetic and the baby’s big. I think there’s a high risk of shoulder dystocia.’ Shoulder dystocia, also known as impacted shoulders, was where the baby’s shoulders couldn’t be delivered after the head had been delivered. It happened when the baby was large, overdue or had a short cord—babies of diabetic mothers had greater shoulder-to-chest ratios so they were particularly prone to it.

‘Judy says she doesn’t want a section under any circumstances,’ Beth added.

‘We might not have to give her a section. If you’re right and the shoulders are impacted, we’ll have to do the McRoberts manoeuvre,’ Lucy said. That meant putting the mother into the lithotomy position with her buttocks supported on a pillow over the edge of the bed, then flexing her hips to make her pelvic outlet bigger, hopefully enough to deliver the baby. ‘Then if we rotate the baby so his anterior shoulder is under the symphysis pubis, we should be OK. Though she’ll need a large epidural and there’s a possibility of problems with the baby—a fractured clavicle at the very least.’ Erb’s palsy, where the nerves in the arm were affected, was another possibility, and a third of babies affected by shoulder dystocia had permanent damage. She sighed. ‘Do you want me to have a word with Judy and check she understands all the risks?’

‘Or maybe we should ask Nic to do it,’ Beth suggested. Lucy sighed inwardly as she saw the familiar glow in the midwife’s face. Beth was clearly yet another member of the Niccolo Alberici fan club. ‘He’s so charming, she’s bound to listen.’

‘Yes, Nic’s very charming, on the surface,’ Lucy agreed, all sweetness and light and wanting to strangle the man.

‘Nice of you to say so, Dr Williams.’

Lucy’s eyes widened as she heard his voice. Her early warning system had just failed spectacularly, and again he’d caught her saying something outrageous. Gingerly, she turned to face Nic.

‘There’s a case I want to discuss with you in my office, Lucy,’ he said. ‘If you’d be so kind.’

‘And then would you have a word with Mrs Sutherland for me, please, Nic?’ Beth asked.

‘Sure.’ Nic gave her one of his trade-mark smiles, his eyes crinkling at the corners in a way that clearly made the midwife melt. ‘Lucy?’

Sighing inwardly, she followed him into his office.

‘Close the door, please,’ he said.

Lucy did so.

‘Take a seat.’ He frowned. ‘This is beginning to be a habit—me overhearing something you’d much rather I didn’t.’

‘Well, eavesdroppers never hear any good of themselves,’ Lucy retorted.

‘I thought we’d sorted out all the problems between us?’

She sighed. ‘OK, OK, I’m sorry.’

He folded his arms. ‘Not good enough.’

She couldn’t read his expression. ‘You’d prefer me to ask for a transfer?’

‘No.’

‘What, then?’

‘Make it up to me.’

Her eyes narrowed with suspicion. ‘What do you have in mind?’

‘Spend the day with me tomorrow.’

‘Spend the day with you tomorrow?’ she echoed, surprised. That was the last thing she’d expected.

‘Mmm-hmm. I’m a new boy in the area. I could do with a hand finding my feet. I want to explore the district and I’d like some company.’

Lucy scoffed. ‘Why ask me? Talk to the midwives. And the nurses. And all the unattached female doctors. They’re lining up in droves for you.’

He grinned. ‘Oh, Lucia mia. You should know better than to believe the hospital rumour mill.’

She didn’t dignify that with a reply.

‘Lucy, I’m off duty tomorrow. So are you.’

How did he know? No, that was an easy one. All he had to do was look in the off-duty book.

‘So spend the day with me, Lucy,’ he coaxed. ‘Show me the area.’

‘You’re perfectly capable of reading a map.’

‘True. But it’s not the same as playing tourist with someone who knows all the good spots.’

‘Your idea of good spots might not be the same as mine.’

‘On the other hand, they might be.’

Lucy shook her head. ‘I don’t think it’s a good idea.’

‘No strings, I promise.’

‘Then two more dates and you’ll leave me alone?’ she asked hopefully.

Nic’s eyes crinkled at the corners. ‘We’re not going on a date, Lucy.’

You couldn’t get more crushing than that. She stared at the floor and wished herself a thousand miles away.

‘We’re merely spending the day together, as friends. Tell you what—I’ll do you a deal. I’ll talk your patient into being sensible over the shoulder dystocia issue and agreeing to a section if we find we have to do one for the baby’s sake, and you can show me your favourite bits of north Cornwall.’

She opened her mouth to say no, but he didn’t give her a chance to speak.

He laced his fingers together. ‘I would suggest sealing the deal properly…But we’re at work, and I promised I wouldn’t touch you without your permission.’ His eyes filled with mischief. ‘It’s a shame you’re not a mind-reader. Then again, if you knew what I was thinking right now, you’d probably slap my face.’

‘Don’t tempt me.’ Though her words were hollow. Just his mere existence tempted her. And she had a nasty feeling that she knew exactly what he was thinking. Sealing the deal with a kiss. Like the one at the fancy-dress ball—a kiss that might start out sweet and innocent but would heat up the minute their mouths met.

He said something in Italian and she folded her arms and glared at him.

‘Translate.’

‘I wouldn’t dare.’ He gave her a lazy grin. ‘If you want to know what I said, you’ll just have to learn Italian, won’t you?’

It wasn’t fair. Why did he have to have such a sensual mouth? And when he smiled like that, it made her want to act completely out of character. It made her want to reach over and kiss him. Passionately. And very, very improperly.

‘Am I dismissed?’ she asked.

‘Are you going to spend tomorrow with me?’

‘No,’ she said crisply.

He clasped his hands theatrically to his heart. ‘I tried.’

‘You’re very trying,’ she snapped back.

He spread his hands. ‘What can I say? The lady’s always right.’

‘I do have patients to see.’

‘Then arrivederci, Lucia mia,’ he said softly.

Corny, smarmy, pathetic…Oh, who was she trying to kid? That Italian accent was way, way too sexy for her peace of mind. Worse, she almost opened her mouth to say she’d changed her mind and, yes, she would spend the day with him.

Almost. Common sense prevailed. Just.

‘You need your head tested, Lucy Williams,’ she muttered to herself as she closed his office door.

Nic touched his mouth. No, it wasn’t hot. And he hadn’t kissed her, much as he’d wanted to. So why did he feel so scorched?

He smiled wryly. It was obvious: it had a lot to do with a certain Dr Williams and that beautiful rosebud mouth. It had taken all his self-control not to pull her into his arms and kiss her, make her feel that same blood-heating passion that zinged through his veins when he saw her.

Working with her was going to be torture.

Working with her was going to be heaven.