She came straight to the point. ‘Cathy was sent in by her GP with flu-like symptoms but she has a rash on her torso and I think we should probably give her penicillin right away.’ She didn’t want to mention the word ‘meningitis’ because she didn’t want to frighten the patient and she didn’t want to waste time taking Jake out of the room to brief him on her fears.
Jake took one look at Cathy and reached into his pocket for a tourniquet. ‘Have you got the penicillin there?’ His voice calm, he held out a hand for the syringe which Ruth handed him and quickly checked the ampoule. ‘Great. We’re just going to give you an injection of some antibiotic, Cathy, and then we’re going to take some blood and get you transferred somewhere more comfortable. Are you allergic to penicillin?’
Eyes closed, Cathy shook her head slowly and Jake injected the penicillin just as Belinda came back into the room.
‘Oh, Jake, I didn’t know you were out of your meeting. I was going to tell you about Cathy when you—’
‘I want you to take blood cultures and then start an infusion.’ Discarding the empty syringe, Jake rose to his feet, his handsome face serious. ‘I’m going to talk to ITU.’
‘ITU?’ Belinda frowned. ‘But I—’
‘Cultures.’ Jake’s tone was cool. ‘Ruth—get me Geoff Masters on the phone, please. He’s the consultant in Communicable Disease Control. I need to tell him what’s happening.’
After that things moved swiftly. Cathy was transferred to ITU and Jake continued to liaise with other consultants over her management.
‘He’s been up on ITU for hours,’ Ruth told Miranda later as they changed to go home. ‘No one has ever seen a case of meningitis in a pregnant woman before so they’re all huddled around, discussing the best way to treat her.’
‘Is she worse?’
‘No. Better, apparently. Thanks to the brilliance of a certain midwife on the labour ward—Jake’s words, by the way, not mine.’ Ruth wriggled into a thick jumper and reached for her coat. ‘He hauled Dr Morris over the coals. Wanted to know why she hadn’t called him the second she set eyes on the patient.’
Miranda grabbed her bag out of her locker. ‘Maybe she was afraid of getting him out of a meeting.’
Ruth gave her a pointed look. ‘You weren’t.’
‘I think that case of shoulder dystocia has made me jumpy. I see emergencies everywhere.’
‘Well, that’s fortunate for young Cathy, then, but I think you’re dismissing what you’ve done rather lightly. Jake is asking questions as to why the GP didn’t give her penicillin.’
‘Well, to be fair, meningitis wouldn’t be the first thing you think of in a pregnant woman with a temperature and a rash,’ Miranda murmured, and Ruth stopped and looked at her.
‘You thought of it.’
‘And thank goodness for that.’ Jake’s deep drawl came from the doorway and both Ruth and Miranda turned in surprise.
‘You’re not supposed to come in here,’ Ruth scolded. ‘This is the midwives’ changing room. It could be full of naked women.’
Jake smiled placidly. ‘I keep hoping.’
‘How is she?’
‘Better.’ Jake’s blue eyes were warm as he turned to look at Miranda. ‘And it’s undoubtedly thanks to you. If you hadn’t insisted on calling me and having the penicillin ready, it might have been a different story.’
‘I was afraid I might be wasting your time.’
‘I suspect you might have just saved two lives so any time you feel the inclination to bother me, please, do so.’
‘I’m just so relieved she’s all right.’
‘Well, she’s not totally out of the woods, but she’s definitely responding to antibiotics and all the scans and blood tests suggest that the baby is all right, although we won’t know for sure until it’s delivered.’
Ruth put her coat on. ‘If it’s been confirmed as meningitis, shouldn’t Miranda take Rifampicin or something?’
Jake shook his head. ‘We’ve talked about that. For healthcare professionals it’s really only recommended if you’ve given mouth-to-mouth or similar. Given Miranda is pregnant, I’d be reluctant to give her anything, and Geoff Masters agrees.’
‘I wasn’t with her for that long,’ Miranda said reasonably. ‘She was transferred almost immediately. All I really did was take her temperature.’
Jake nodded. ‘The risk is minuscule.’ He glanced at his watch. ‘I’ve told them to call me if there’s any change. Let’s go home.’