St Piran's: The Wedding!

As if it mattered. Tasha would want to know the trouble that both her brother and her best friend were in right now.

Her loyalty would be tested. She knew the empty space he was in now, having sacrificed a relationship with the woman he truly loved for the sake of his children. To keep a marriage, even in name only, so that he wouldn’t repeat history by being the kind of man their father had been. She would know how devastating it would be, being faced with the prospect of losing those children.

But she would also know how hard this had to be for Megan. To be expected to save his babies that were being carried by another woman. The babies she could never have given him because losing their son, all those years ago, meant she could never have another child.

Josh had to stifle an audible groan.

He was a reasonably intelligent man. He was damned good at the job he did, running the emergency department of St Piran’s.

How was it that he always messed things up so badly when it came to his relationships with women?

He could save lives.

But he was just as good at breaking hearts.

It was his fault Rebecca hadn’t had medical help in time to prevent this catastrophe.

His fault that Megan had become pregnant with his first child.

His fault that she’d lost the baby. That she’d never have another.

No wonder Megan had blanked him at Tasha’s wedding. He’d done it to her, hadn’t he?

Twice.

Every time he’d come to a point in his life where he was losing control … faced with the absolute vulnerability of loving someone—Megan—enough to give them the power to make or break him … he had frozen. Backed away and stayed with what he knew. What seemed to work.

He was an emotional coward.

Or a control freak?

As a modus operandi it was fine as far as his career went. Kept him on top. Moving forward. He could deal with a thousand people professionally and win acclaim. But he didn’t seem to be able to deal with even one person on an intimate level and not cause serious harm.

What made anybody think he would be a good father?

Maybe he’d end up just like his own father had been. Worse than useless.

Maybe he would fail all his children before they even had a chance of life.

No.

The word was wrenched from deep inside Josh.

These babies couldn’t die.

Megan wouldn’t let them.

The baby looked dead.

Delivered to Megan’s area of the theatre seemingly within seconds of the emergency surgery starting, the nurse laid her limp burden down under the lights, gave the paediatric team a grim glance and moved swiftly back towards the main table. Another baby would be delivered almost as quickly.

The resuscitation protocol was automatic for Megan. Airway, breathing, circulation, drugs.

She couldn’t allow the fact that this was Josh’s baby anywhere near the conscious part of her brain. Even a hint of distraction, let alone panic, could be disastrous.

‘Suction,’ she ordered.

Making sure the newborn’s head was at the correct angle to keep the airway open and holding the end of the soft tubing at a length that couldn’t go too far and trigger a laryngeal spasm, Megan cleared away any possible obstruction. Against the soft chugging of the suction machine, Matt was gently stimulating the baby’s body by rubbing the skin with a warmed towel.

To one side of them, the tension was escalating.

‘Pressure’s dropping again.’ The anaesthetist’s tone was a sharp warning. ‘Ectopic activity increasing.’

‘We’ve got to get this second baby out. Where the hell’s the suction? I can’t see a damned thing …’

On Megan’s side of the theatre the baby was showing no signs of starting to breathe.

‘Bag mask.’ Megan’s order was clipped.

With the tiny mask covering both the mouth and nose of the infant, she gently depressed the soft bag to deliver the tiny amount of air needed to inflate the lungs. Again. And again.

‘Not pinking up,’ Matt noted.

‘He’s in shock.’ Megan signalled for a technician to take over the bag mask. ‘Start chest compressions, Matt.’

‘You going to intubate?’ Matt was already slipping his hands around the tiny chest, keeping his thumbs in front ready to start compressions.

‘In a minute.’ Megan could see over her registrar’s shoulder. The second baby was lying on a towel a nurse was holding flat on both hands as the cord was cut. She was close enough to be able to see if there were any signs of life.

There weren’t.

They needed a second paediatric team in here but there hadn’t been one available. It was up to Megan and Matt here. At least they had a second resuscitation trolley set up.

‘Keep up the CPR,’ she instructed Matt. ‘One hundred and twenty beats per minute. He may need some adrenaline. We’ll need to cannulate the umbilical vein as well as soon as we can. Let’s see where we are with baby two.’

Baby two was a girl. Just as flat as her brother was.

Or maybe she wasn’t. After the first puff or two of air from the bag mask, the tiny girl gave a gasp and began trying to breathe on her own. It wasn’t enough, though. The heart rate was still falling.

At ten minutes the Apgar score for both babies was still unacceptably low. They needed intubation, stabilisation and transfer to PICU—the neonatal intensive care unit.

They were both alive, however, and Megan was fighting to keep them that way.

The battle on the other side of Theatre Three was not going so well.

Part of Megan’s brain was registering the increasing tension as she slid a small tube down the first baby’s airway to secure ventilation. The obstetric surgeon had found the torn abdominal artery but too much blood had been lost. The fluid replacement and the drugs being used were not enough. Rebecca’s heart had stopped.

CPR continued on the mother as Megan checked the settings on both incubators and watched the recordings being taken on both babies reach a level that meant it was safe to transfer them to PICU.