White Christmas For The Single Mum

‘One and the same.’

‘And who over there’s making decisions without consulting with me?’

‘The decision was made by four babies.’

Juliet blinked and shook her head. ‘Four? You’re speaking in riddles and you know that frustrates me.’

‘Apparently the Assistant Head of Obstetrics at Teddy’s, which is the maternity wing of the Royal Cheltenham hospital, spoke with our Head of Obstetrics about the quads. Almost twenty-nine weeks’ gestation, suffering twin-to-twin transfusion syndrome. Two sets of monozygotic twins. While the girls are fine at this stage, the boys have developed the TTTS. Oliver Darrington believes you’re the best chance that the quads have of all surviving should the parents agree to the in-utero laser surgery. And Professor Le Messurier just approved your secondment.’

‘That’s all very flattering but why am I being called in at the eleventh hour? If there was a risk, I should’ve been consulted upon the initial diagnosis. Surely being quads they would have been having weekly scans and intense monitoring and they’d know at Teddy’s that the earlier the intervention, the better the outcome.’

‘Apparently the quads were being closely monitored throughout the pregnancy, but the TTTS diagnosis has only just been made,’ her replacement continued as he began scrubbing in, and over the sound of the running water he continued his explanation. ‘The girls have separate placentas while the boys have one shared placenta so they were being scrutinised for any signs of transfusion. Up until now there was no indication of anything being amiss. It was picked up when the patient presented in what she thought was premature labour.’

‘Caused by the amniotic fluid imbalance affecting the recipient twin.’

‘Again, apparently but you’ll know more details when you get there.’

‘But the lecture in Auckland?’

‘Handled. I’m not sure who’s your proxy but your focus needs to be on the quadruplets. Darrington’s worried it could deteriorate quickly and there’s an increased risk they could lose at least one of them if you don’t get over to Teddy’s immediately, and of course we know the risks if one dies to the remaining foetuses. The parents have been briefed and want to be fully informed so they can consider all options, in particular the in-utero surgery.’

‘Anything else I need to know?’

‘Just one thing...the attending OBGYN, Dr Charlie Warren, is averse to fetoscopic laser surgery. Believes the risks are too great so no doubt he’ll be challenging you.’

Juliet took a deep breath. ‘Looks like I’ll be catching a plane tomorrow morning to meet Dr Warren’s challenge and convince him otherwise.’

‘I hope he knows what he’s up against.’

‘He soon will.’ With her head tilted just slightly, and the remnants of bewilderment still lingering, she looked at her replacement. ‘Okay, Dad, looks like Kelly and her baby are in your hands now.’

‘Don’t worry, honey. I’ll do you proud.’

CHAPTER TWO (#u15c068ce-79d5-5569-994c-ee18f5affe6b)

‘DR TURNER, WE’RE about five minutes away from the Royal Cheltenham hospital.’

The voice of the immaculately suited driver made Juliet lift her tired eyes to meet his in the rear-view mirror. They were warm and smiling back at her but with a curiosity that she had been so very accustomed to over the years. She was well aware that she didn’t look her thirty-three years and many apparently found it difficult to believe she was a doctor let alone a surgeon. Her curly brown hair and spattering of freckles along with her petite frame, she realised, didn’t help her quest to be taken seriously. She had no time for make-up except for a natural lip gloss to prevent her lips from cracking, and that too added to her young appearance. It also helped her go under the radar and not gain the attention of the opposite sex and, although it wasn’t her primary motivation, it was a welcome side effect.

But despite the general consensus, she was both a surgeon and a mother and she took both roles incredibly seriously. Her work, she loved with a passion, and her daughter, she loved more than anyone and anything in the world. And more than she had ever dreamed possible.

‘Thank you,’ she responded as she gently turned to stir the little girl fast asleep and leaning against her. Running her fingers down the child’s ruddy cheeks, she softly kissed the top of her head. ‘Wake up, Bea, my precious little sleepyhead.’

The little girl silently protested at being disturbed and nestled in tighter to the warmth of her mother’s woollen overcoat. Her eyelashes flickered but her eyes were far too heavy to open.

‘Well, I hope this part of your marathon travel’s been pleasant,’ the driver commented.

‘Very pleasant, thank you.’

‘So how many hours have you two been travelling to be here this morning?’

‘I think it’s about thirty five hours, but it feels like for ever,’ she replied with a little sigh, thinking back over the logistical nightmare they had survived. ‘We left Perth early yesterday, Australian time, had a layover in Singapore before we headed on to Heathrow, and then the sixty-mile trip to the Cotswolds with you,’ Juliet added as she continued to try and wake her still-drowsy little girl as gently as possible. She wasn’t sure just how coherent she was but didn’t want to appear rude. She had a lot on her mind, including the impending in-utero surgery on the quadruplets within the week. The reason she had been seconded halfway around the world at a minute’s notice.

Keeping all four babies viable was everyone’s focus. And something everyone agreed could not be done with Juliet on the other side of the world. Well, almost everyone agreed. She knew she would have her work cut out convincing the quads’ OBGYN, Dr Charlie Warren. She presumed he would be leaning towards bed rest, high-protein diet and medication for the quads’ mother. It was conservative and Juliet was surprised that he was not encouraging the laser surgery. She’d had no time to research the man but assumed he might be perhaps closer to the driver’s age and had managed previous TTTS cases in that manner. But once he heard her argument for the surgery, surely the traditional English physician would see that her method had clear benefit? Particularly once she stated her case and the supporting statistics. How could he not? With both hospitals agreeing that Juliet was best placed to undertake the procedure, all she needed was the parents’ approval. She was not about to allow Teddy’s overtly conservative OBGYN to question the validity of her surgical intervention. It was an argument she was more than prepared to have. And to win.

But that wasn’t the issue that had weighed most heavily on her mind on the long flights over to the UK. It was her parenting. How responsible was it to drag her daughter with her? she had wondered incessantly. And with less than twenty-four hours’ notice. The poor little girl barely knew what was happening. The only thing that she could really comprehend was a plane trip to see snow.

Up until that point Juliet and Bea’s lives had been so settled and planned. Some might say overly so, and among those were Juliet’s parents. They had openly encouraged her to take Bea with her and together enjoy the opportunity to travel. In her home town, Juliet’s mother looked after Bea three days a week and the other two days Bea was in childcare only five minutes from Juliet’s workplace at the Perth Women’s and Children’s Medical Centre. When the proposition of travelling to the UK had been forced upon her, Juliet’s parents had quickly had to push her out of her comfort zone and into embracing the opportunity. Her mother had immediately brought the suitcases down from the attic and personally delivered them to Juliet’s home and offered to help her pack. Juliet didn’t doubt it would be better for the quads for her to be there but it was not just her any more. She had her daughter to consider in every decision she made.

‘I just hope I’m doing the right thing in dragging Bea to the other side of the world for such a short time,’ Juliet had muttered in the car on the way to the airport at five-thirty in the morning. Her father had been driving, her mother next to Bea in the back seat.

‘That’s just it, honey, it might not be a short time,’ her father reminded her as he pulled up at traffic lights and turned to his daughter. ‘You don’t know when the quads will arrive and it’s best you stay until they do. There could be post-operative or postnatal complications, so it’s better to remain there up to the birth.’

‘I know you’re right, but this whole trip is so rushed, I’ve had no time to prepare mentally. I know it’s too late, but I can’t hide the fact I’m having second thoughts about everything.’

‘It’s an amazing opportunity to consult at Teddy’s and no one can come close to your level of expertise,’ he said with pride colouring his voice as the lights changed and he took off down the highway. ‘It’s part of a teaching hospital, and along with assisting those four babies, not to mention their mother, you can add value to the students’, interns’ and residents’ learning experience. You’re the best in your field, Juliet. And I should know since I’ve operated alongside you more than once. It’s time you took your skills out to the world, not just in research papers and journals and lecture tours, but in person in an operating theatre.’

‘Dad, you’re completely biased.’

‘Nonsense, your father’s right. We’re both proud of you and you need to take that knowledge and expertise where it’s needed most. Those babies and their parents need you,’ her mother argued from the back seat. Her voice was soft but her tone was firm. Gently she kissed the top of her granddaughter’s head. ‘While we’d love to have Bea stay with us if it was for your three-day trip to Auckland, this is not three days. Poor little thing, she would fret terribly without you for any longer than a few days and visiting the UK will be such a wonderful experience for her too. It will be her first white Christmas.’

‘And mine,’ Juliet said, but her tone lacked her mother’s enthusiasm as she drummed her fingers nervously on the leather upholstered seat. There was an uneasiness stirring in the pit of her stomach.

‘Exactly, so stop questioning your decision. It’s made now, you’re both going,’ her father piped up as he took the turnoff to Perth International airport in the dawn light. ‘You’ve been hiding away, Juliet. You’re not the only professional woman who’s going it alone as a single mother. It’s not the eighteen hundreds, and you don’t need a man to help you realise your dreams. You have your career and Bea.’

She was hardly going it alone, in her opinion, with all of the help her parents provided, she thought as she looked out of her window and up into the still-darkened sky. But her father was right, she mused. She didn’t need a man to experience or enjoy life. She and Bea would be just fine on their own. The plane would be up in that same sky in less than two hours, the sun would be up and they would be heading off to the other side of the world. To see four babies...and snow.

Juliet tried to muster a smile for everyone’s sake. Her parents were always forthcoming with their very modern wisdom and they were generally right about everything. The quads needed surgical intervention and Bea needed to be with her mother. And Juliet could hardly stand being away from her daughter for a day, let alone the possibility of three or four weeks. So if Juliet went, then so would Bea.

Initially she wasn’t sure how she would manage but when the information had arrived via email the night before, providing the details of the onsite hospital crèche, it had given Juliet no valid reason not to say yes to everything. Besides which, the tickets had been arranged. There was no turning back. And so it was that, with less than a day’s notice, Juliet and Bea had left their sunburnt homeland behind and were on their way to Teddy’s.

‘It’s a beautiful part of the world,’ the driver announced, bringing Juliet back to the present. ‘I’ve lived here for almost thirty years. Raised my children and now my grandchildren. You’ll be sure to love it too.’

Juliet smiled at the way the man praised his home town. ‘I won’t be here quite that long, but long enough to enjoy the stunning scenery.’ She looked out from the car window across fields blanketed in snow and dotted with trees and bushes in variant shades of green, all dusted by a fresh layer of white drift along the fences. It was so picturesque and a very long way from the long hot summer days of home. Since she could not turn back she had decided that she needed to accept her decision and be excited to share her first white Christmas with Bea. While she knew it had the potential to be a stressful time for her, with the impending surgery she would be performing, she was glad the two of them were together. They were like two musketeers off on an adventure.

Juliet had long accepted there would never be a third musketeer in their lives and that suited her fine. She didn’t need a man in her life. Apart from her father, the rest just brought grief. Even in a new country, a man she had not laid eyes upon, Dr Charlie Warren’s objection to her surgical option was another piece of proof that men caused unnecessary anguish.

And she didn’t need any more of that.

‘So you’re only here for a short visit, then?’

‘I’m consulting at Teddy’s for a few weeks. I agreed because it was a short term. I couldn’t keep my daughter away from her grandparents for too long. They’d miss her terribly.’

‘I can see why. She’s a proper little sweetie,’ the man added, clearly wanting to keep the conversation flowing.

Juliet guessed him to be in his mid-fifties. He looked a little like her father, quite distinguished, greying around his temples with a moustache and fine-rimmed gold glasses. Her father was a chatty man too, even in the operating theatre. Perhaps it was his age that made it easy for her to talk to this man. There was no hidden agenda. Just pleasant conversation.

‘Thank you. She’s my little angel and she’s a real sweetie.’