The Children's Doctor and the Single Mum

Mrs Parry had begun to bleed too much, a reasonably common side effect following the procedures she’d had over the past few weeks to reduce her amniotic fluid. ‘What’s happening? What’s going on now?’ Chris demanded, distraught. Like his wife, he had fair, freckled colouring, which made him look very pale under the harsh lights. Fran’s lips were white.

Laird couldn’t spare a thought for them right now. Max needed him too much, needed the tube, needed the massage, needed treatment for that thick blood and some relief for his heart as soon as they had him stable.

At every moment, the Tammy nurse was there. Hands in the right place. Voice pitched low enough to soothe the baby but loud enough for Laird to hear. Fingers nimble and delicate. No unguarded exclamations of doom to scare the stricken parents. Laird spared her a glance and managed a muttered ‘Thanks.’ She nodded, and there was this odd little moment that he didn’t understand. More than mere relief at being paired with a competent colleague. More like…recognition?

He didn’t have time to think about it now.

Chris had tears streaming down his cheeks. Fran was pressing her dry lips numbly together and clamping a death-like grip on her husband’s hand.

‘Come on, darling,’ Tammy cooed to the baby. Her fingers seemed to flutter against his miniature sternum, and her voice was delicious, soft and musical and honey sweet. ‘Come on, sweetheart, let’s see what a big strong boy you are. Let’s try really hard…’

‘OK, he’s tubed,’ Laird finally said. Like Tammy, he’d almost been holding his breath. He saw her nod and look of relief. She cared. ‘Heart rate’s coming up. Not counting chickens…’ he added quietly.

She understood. ‘Want the umbilical line?’

‘Can you? I’ll give a first dose of adrenalin via the ETT, but let’s have that UVC.’

She got the line in with incredible speed and dexterity and he delivered a carefully calculated dose of adrenalin through the endotracheal tube. Next, Tammy nested the baby in a rolled and warmed towel and adjusted the radiant heat setting.

Time had passed, ceased to have meaning. All of this took longer than a non-medical person would expect.

‘Let’s move him now,’ Laird murmured. ‘We need to get him stable and quiet, get him under bili lights to get his blood sorted out, and this is torture for the parents.’

‘I know.’

He raised his voice a little, and told them, ‘We’re ready to move him to the NICU now.’

‘Can Chris go with you?’ Fran asked feebly. Tim was still packing her uterus to stop the haemorrhaging and she looked very pale and weak, alert through sheer force of will and a desperate need to know how her babies were doing.

‘Chris, it’s better if you stay here until Fran’s in Recovery,’ Laird said. ‘Then you should be able to come and see both babies and let her know how they are.’

It would be an enormously stressful time for her, he knew. This first hour. The first day. The first week. No guarantees, yet, as to if or when she’d be taking her babies home—her own process of recovery from the stressful pregnancy, the surgery and blood loss almost an afterthought.

The journey to the NICU was short, and there was an incubator already set up for Max at thirty-six degrees Celsius and eighty-five percent humidity. Little Adam had a nurse working over him, checking his temperature, setting up more lines and monitors, applying a pre-warmed soothing and moisturising ointment to his skin.

They moved Max from the resuscitaire into a second incubator, weighed him in at 830 grams, took his temperature and began to set up and secure his lines. The Tammy nurse with the beautiful voice went looking for a bili light and Laird put in an order for blood for Adam, who weighed just 580 grams. Sam was called to the other end of the room to assess one of his patients whose oxygen saturation levels had fallen.

‘Just need to tell you, Tammy, I’m going home, taking a break,’ announced a mother some minutes later, coming over to her after she’d returned with the phototherapy equipment. The woman spoke too loudly and seemed not to notice tiny Max in his humidicrib or that Tammy was now busy making notes in the baby’s brand-new chart. Again, Laird had lost track of time, except as it related to observing Max.

Tammy looked up from her notes. ‘That’s sensible, Mrs Shergold.’ She took the woman’s arm and led her gently away from Max. She spoke quietly. ‘You were only discharged this morning, weren’t you?’

‘I know. I wanted to stay another couple of days, but no go. It’s just wrong, isn’t it? It’s the insurance companies, and the government. Do they have any idea?’ She still spoke too loudly, hadn’t picked up on the soft cue given by Tammy’s lowered voice.

Laird caught an angry glance in the woman’s direction from an exhausted-looking blonde mother in a nightgown and slippers, who was bending over her own baby’s humidicrib.

One of her own babies’ humidicribs, he corrected mentally as he took in who she was. She’d had IVF triplets. Twenty-nine-weekers. Another Caesarean delivery. Five days old. All three babies were very, very fragile and ill. The mother moved gingerly, her incision still fresh and sore, making way for a nurse who was due to give another session of clustered observations and medication.

‘How’s your baby doing?’ Tammy asked the loud woman, still pitching her voice low.

Again the woman ignored the cue regarding her own volume. ‘Oh, she’s great, she’s so beautiful! It’s so hard to see her like this!’ She burst into noisy tears. ‘But she’s coming off the ventilator tomorrow!’

Tammy led her farther away towards the corridor. The mother of triplets checked her babies’ oxygen saturation levels on the monitor. ‘Look, they’ve dropped,’ she said, low and angry, to the babies’nurse. Clearly she blamed the disruptive and self-absorbed presence of the other mother, and quite possibly she was right.

When Tammy came back, she patted the triplet mum—Alison Vitelli—on the shoulder and asked, ‘How’s Riley?’

‘Oh…the same, Dr Lutze says.’ She didn’t look as if she’d brushed her hair that day, and even her skin looked tired. ‘Tammy, can you, please, please, keep that horrible woman away from here?’

‘Well, she has a sick baby of her own.’

‘A thirty-two-weeker!’ Mrs Vitelli said angrily. ‘She keeps crowing about Rachelle’s progress, and how she’ll be graduating out of here in a day or two to the special care unit, as if we all care. As if any of us care! We would care, if she was nicer. But hasn’t she noticed how ill the rest of our babies are? I hope Rachelle does get better fast, because if her horrible mother is around here much longer…’ She trailed off into silent, desperate sobs, and Tammy hugged her and soothed her, stroking her back below the unbrushed tangle of blonde hair.

‘I know, I know,’ she murmured. ‘Try to tune her out, if you can. She’s not important. People can be insensitive sometimes.’

‘Just her,’ Mrs Vitelli sobbed. ‘I hate her! I really hate her! She’s appalling. And I’m going home tomorrow, and I don’t want to leave my babies…’

Tammy looked over Mrs Vitelli’s shoulder and caught Laird’s eye. She was still patting the woman’s back and making low, soothing sounds of agreement, caring—he thought—more than she really should. He read the questions in her face. Is this OK? Do you need me? How is Max?

He made a gesture that said, Stay with her till she’s feeling better, and Tammy nodded. ‘How about you go back to your room and get some sleep now, before morning, Alison?’ she said gently. ‘Your babies don’t need you to get this tired…’

It took Tammy several minutes to soothe Mrs Vitelli’s sobs away and persuade her that sleep was the sensible thing, then she came back to Max and noted the next set of figures in his chart. ‘Oxygen saturation is up,’ she said.

‘Hovering at 93 per cent,’ Laird answered. ‘CO

is within range. I changed the settings a little, as you can see. So far he’s handling the sedation. And he peed.’

‘Wonderful! Adam hasn’t…?’

‘No, not yet.’

‘Let’s hope.’ She cast a practised eye over the monitors, checking the relationship between the various settings. Any time she came near the babies, something changed in the way she moved. She became even gentler, even calmer—but it was more than that. Laird couldn’t put his finger on it.

‘You must have managed a fair bit of practice with some of this stuff over at Royal Victoria,’ he said, curious to know just how lucky he might come to consider himself, professionally, that she belonged to Yarra Hospital now instead.

Beneath the blue halo of her cap, she grinned. ‘They even let us loose on real babies sometimes.’

Laird still hadn’t seen her hair. He had a horrible feeling he might not recognise her if he saw her in another part of the hospital, garbed in street clothes. Her colouring and features were average—Scottish skin, those amazing blue eyes, pretty-ish, from what he could tell, in a nursy kind of way. In his experience, women didn’t go into nursing if they looked like they could be models—which was probably to the benefit of both professions.

Keeping his voice low, he asked, ‘Why did you make the move?’ He waited almost smugly for some line about the fantastic reputation of the NICU at Yarra. He’d felt fortunate to win a position here himself, and intended to bring the profile of the place even higher as he worked his way into a more senior role.

‘It cuts seventeen minutes off my commute,’ she answered at once, without smiling.

He smiled in response, though, and conceded, ‘Question too personal for this time of night? OK. That’s fine.’

‘No, I’m serious.’

‘You changed hospitals to cut seventeen minutes off your commute?’

‘Seventeen minutes each way, four or five days a week, that’s more than two hours. You can get a lot done in two hours.’