Undressed by the Rebel: The Honourable Maverick

‘Antepartum haemorrhage,’ he told the startled-looking triage nurse as the stretcher burst through the electronic doors into a brightly lit department.

‘Max! What on earth are you doing here?’

He ignored more than one head turning in his direction. Maybe this wasn’t the way he usually arrived at work and he rarely turned up wearing his bike-riding leathers but it was no excuse for unprofessional behaviour from his colleagues.

‘Is Trauma One free?’

‘Yes. We got the radio message. Someone from O and G is on the way down.’ The nurse followed the rapidly moving stretcher. So did the receptionist, who was clutching a clipboard.

‘We haven’t got a name,’ the clerk said anxiously.

‘Ellie,’ Max snapped. They were through another set of double doors now, in the best-equipped area in the department to deal with a critical case. The paramedics stopped the stretcher right beside the bed with its clean, white sheet. Staff were waiting, having been primed to expect them, and they were wearing their aprons and gloves, ready to begin a resuscitation protocol. They all knew their first tasks. The portable monitoring equipment from the ambulance would have to be switched over to the built-in equivalents. A junior nurse held a pair of shears, ready to cut away Ellie’s clothing. A trolley was positioned near the head of the bed, an airway roll already opened in case intubation was necessary.

It was no surprise to see who was ready to control both the airway of this patient and the running of this emergency scenario. Jet was wearing theatre scrubs now and had a stethoscope slung around his neck. There was nothing unprofessional about his immediate reaction to seeing who had come in with this patient. He didn’t even blink.

‘On my count,’ he said smoothly. ‘One, two…three.’

There was a pool of blood on the stretcher as they lifted Ellie across to the bed. She groaned and her eyes flickered open.

‘It’s OK,’ Max said, leaning closer. ‘We’re in the hospital now, Ellie. Jet’s here and he’s going to look after you. We’re all going to look after you.’

Her eyes drifted shut again.

‘GCS is dropping.’ Max tried to sound clinical. Detached. It didn’t work.

Jet was holding Ellie’s head, making sure her airway was open. He was watching the rapid rise and fall of her chest and his gaze went to the monitor as the oxygen saturation probe on her finger began relaying the information he wanted.

He frowned and flicked the briefest glance at Max. ‘What the hell happened?’ he murmured.

‘Massive haemorrhage. Seemed to come from nowhere as soon as she stood up. Severe abdominal pain as well.’

The clerk was still in the room, hovering behind the nursing staff who were changing ECG leads, hanging the bags of fluid and getting a blood-pressure cuff secured.

‘What’s Ellie’s last name?’ she asked. ‘How old is she?’

A registrar had his hands on her swollen abdomen. ‘It’s rigid,’ he announced. ‘Is she in labour? What’s the gestation?’

‘Thirty-six weeks and two days,’ Max said.

Ellie was almost naked now. Totally vulnerable. Exposed to an expanding team of medical personnel. Someone from the obstetric department had arrived, closely followed by a technician pushing a portable ultrasound machine. Jet was holding a mask over Ellie’s face and frowning as he watched the numbers changing on the overhead monitor.

‘Ellie…’ He had his mouth right beside his ear and was speaking loudly. ‘Can you hear me? Open your eyes.’

She wouldn’t want to, Max thought. This would have to be absolutely terrifying.

‘Are there any relatives who could give me her details?’ the clerk persisted. ‘Did her husband come in with her? Or…her partner?’ The woman knew she was failing in her task but she made yet another effort. ‘The father of the baby?’

That flicked a switch in Max’s head and its effect was magnified by how vulnerable Ellie was. How much trouble she was in right now. He had tried to protect her and somehow he had stepped into a new nightmare and was still by her side. Was she aware of what was happening? Still terrified? Did she know he was here?

She had been so determined to stay away from hospitals to protect her child. Maybe the best thing he could do for her at this moment was to respect that determination and carry on with what had already worked once.

‘Yes,’ he said clearly. ‘I’m the father.’

Somebody dropped something metallic on the far side of the room and the sound rang out in the suddenly still moment following his statement. Jet uttered a low profanity but his gaze was still fixed on the monitor and the sound could well have been taken to be concern at a new development in Ellie’s condition. Max was close enough to speak to his friend without being overheard by anyone else.

‘I’ll explain later,’ he murmured. ‘Just back me up.’

The clerk was happy, scribbling on the sheet of paper attached to the clipboard. ‘Surname?’ she chirped briskly.

Oh, Lord. If she got registered under her real name, they have to deal with Marcus Jones turning up and he’d have plenty of time to get here. Even if things went better than any of them could expect in this room, there was no way Ellie would be getting discharged in a hurry.

There was no time to think. In for a penny, in for a pound.

‘McAdam,’ he said wearily. ‘We’re married.’

The nurse, who was sticking on the leads required for a twelve-lead ECG, looked up, open-mouthed, and others exchanged astonished glances but the clerk knew she was on a roll.

‘How old is your wife?’

‘Twenty-eight.’

‘Date of birth?’

As if he’d know. This had gone far enough. Far too far, judging by the look Jet slanted his way.

‘Leave it,’ Max growled. ‘We can sort the paperwork later.’

‘But we need—’

‘Get out,’ Jet snapped. ‘We’re busy.’ He looked up, avoiding Max but catching most others in the room as he issued his orders.

‘I’m going to intubate,’ he warned. ‘Oxygen saturation levels have fallen far enough. We need a central venous line in. And an arterial line.’

‘I’ll do that,’ Max offered.

Jet gave his head a negative jerk. ‘On your wife? I don’t think so.’ He nodded at his registrars, giving them the signal to get started. ‘Get some bloods off as well. We need to know her blood group. Stat.’

‘I’d like a rhesus factor and antibodies, too.’ The obstetric consultant was watching the technician begin the ultrasound examination. ‘Looks like we’ve got a central placenta praevia here and she’s in labour. Fully dilated.’

Less than an hour later, in the middle of the life-and-death battle to save Ellie Peters, she gave birth to a tiny baby girl.

There was a paediatric team amongst the crowd in Trauma One now. And a consultant from the intensive care unit, who was a specialist in dealing with haemorrhagic shock resulting from such massive blood loss. Ellie was being cared for. The baby was being carefully assessed.

Having been forced onto the sidelines due to his own admission of involvement, there seemed to be nothing for Max to do other than watch. He was torn between watching the monitors to evaluate the success of the treatment Ellie was receiving and staring at the scrap of humanity the paediatric consultant was bent over.

‘She’s small but doing OK,’ she pronounced eventually. ‘I’m happy with her breathing but the heart rate’s a bit on the slow side. Did I hear someone say the father is here?’

Ellie was deeply unconscious. The obstetrician was happy that the bleeding had ceased now that delivery was complete but the control of the blood loss might have come too late. The mother of this tiny baby was now on a ventilator to manage what looked like adult respiratory distress from fluid loss. Jet and the ICU consultant were worried about her kidneys. Her production of urine had virtually ceased and her most recent blood test showed deterioration in renal function.