He and Izzy. He watched as she tended to Janice, getting her a drink of water, wiping her face, constantly keeping an eye on the baby, showing Janice how to hold her, to rub her. Oh, yes, Izzy was good at this.
His mouth dried and his heart thumped. What was he going to do?
* * *
Just after midnight on Wednesday Isabella lifted the ward phone and speed-dialled Raphael. ‘You’re needed. Tania Newman’s showing signs of puerperal sepsis.’
‘I’m putting you on speaker phone so you can fill me in on the details while I dress.’
That she did not need to think about. ‘Heart and resp rates are high, BP’s down, and she’s running a temperature. White count an hour ago was slightly elevated but no indicators of infection.’
‘Any abdo pain that’s nothing to do with contractions?’
‘Yes, and she’s started vomiting.’
‘I’m heading out the door now. Take another blood for CBC, mark it urgent,’ Raphael told her. ‘Always happens at night time, doesn’t it?’ Click. He was gone.
Had he really had time to haul on some pants and a shirt? Guess he was used to dressing in seconds. There was always a pile of clothes on his dresser, no doubt just for moments like this. Isabella rushed back to Tania’s room with the phlebotomy kit in her hand. ‘Mr Dubois’s on his way. He wants another blood test done.’
Katie, the nurse on with her, nodded. ‘You take the sample while I wipe Tania down again.’
Isabella set the kit on the bed beside the terrified woman. ‘Tania, I know you don’t like needles but this is really important.’
‘Do whatever you have to,’ the thirty-four-year-old woman grunted through her pain. ‘Just save my baby.’
‘We’re doing everything we can, and like I said, Raphael is on his way. Pushing his speed to the limit, I bet.’
‘Hope he’s careful. We need him here,’ Dominic Newman said as he held his wife’s hand, looking lost and nothing like the notorious criminal lawyer he was. Babies were great levellers. ‘What can I do? There’s got to be something other than sitting here like a useless lump.’
‘You’re on keeping Tania calm duty.’ It was a big ask. The woman was frantic with worry and fear.
‘I read about puerperal sepsis on a website,’ Tania cried. ‘It’s bad. Really bad. Baby might not make it.’
True, sepsis at this stage of pregnancy was not good. ‘Sometimes I wish the internet had never been invented.’ Isabella slid the tourniquet up Tania’s arm. ‘Tighten your hand into a fist. That’s it. Now, a small prick.’ She hit the vein immediately and released the tourniquet as the tube filled.
‘Why do you always say that? It’s not the first time I’ve had my blood taken,’ Tania shouted.
‘It’s routine.’ Isabella drew the blood, placed a cotton ball over the site and slid the needle out. ‘There you go. All done.’ She named the tube and filled out a form, marked it urgent. ‘I’ll get that up to the lab now. Hopefully we’ll have the results by the time Mr Dubois gets here.’ Hopefully the lab tech would make a film when he received the sample and not wait to find out what the white count was. The film would be required to do a white cell differential count to ascertain the number of neutrophil band forms which were indicative of infection. The more bands and even earlier forms of that particular white cell, the stronger the infection.
‘Agh!’ Tania cried, and straightened out on the bed, grabbing at Dominic and gripping his wrists like a vice.
His face paled, but he didn’t budge, let his wife squeeze as though her life depended on it.
‘Deep breaths,’ Isabella said, and rubbed her shoulder constantly until the spasm passed. ‘Well done.’
‘Like I had any choice,’ Tania snapped.
‘Hey, steady, darling. Isabella and Katie are here to help us.’
‘It’s all right.’ Katie grinned. ‘We’ve heard worse.’
‘I’m sorry.’ Tania looked contrite. ‘I really am. It’s just so painful, and then this puerperal infection. I’m terrified.’ She struggled upright and leaned her head in against Dominic, who took over the rubbing.
‘Can I take a look at your cervix?’ Isabella preferred asking rather than just saying that’s what she had to do. A simple question gave her patient some sense of control over a situation where she had absolutely none. Especially in this case. As soon as Raphael got here there’d be a lot going on, and Tania wouldn’t be given a chance to say anything. Urgency was now a major factor in this delivery. If this was PS, then the infection would run away on them if they weren’t careful. Antibiotics had already been administered, but Rafe might up the dosage.
‘Why have I got an infection down there?’
Katie answered, ‘You said your breasts were sore when you first arrived, and I thought it looked as though you’ve got a small infection in your nipples.’
‘The other doctor gave me antibiotics for it. She said it would be all right for baby to take them.’
‘The infection could’ve already spread, and the symptoms have only just begun showing up in the last little while.’
Isabella waited until Tania gulped hard and nodded at her. ‘Go for it. Hopefully baby’s nearly here and we can get this nightmare over and done with. What if he gets the infection too?’
That was the problem. ‘Mr Dubois will explain everything when he arrives.’ Ducking for cover, but it wasn’t her place to fill this couple in on what might happen. Times like this she was glad to be a nurse and midwife, and not a doctor. They could have handing out the grim news. She’d seen how much it upset Raphael. Tugging on gloves she positioned herself at the end of the bed and waited for Tania to lie back. ‘Okay, try and relax.’
It didn’t take long to get the measurement and Isabella felt relief. ‘Nine centimetres. We’re nearly there.’
‘About time,’ Tania grumped. ‘I’ve had enough.’
There was still the pushing to undertake, but best keep that to herself for now. No point in upsetting her patient any more than she already was. Hopefully Raphael would be here before they started.
‘Hello, Tania, Dominic.’ The man himself strode into the room minutes later, looking beyond calm.
But Isabella knew better, saw the tell-tale sign where his mouth tightened in one corner. ‘That was quick.’
‘The roads were fairly quiet for a change. Right, let’s see what’s happening, shall we? Tania, tell me about the pain in your belly.’
From then on everything happened fast. A phone call came from the lab alerting them to the CBC results and the raised white cell and band form counts. Raphael administered another antibiotic intravenously. Tania began pushing before she was told to, and reluctantly stopped, only to have baby make her own mind up that it was time to come, and soon it was over. Baby Sophie met her parents, had a brief, safe cuddle from each before being whisked into the specialised cot and wiped over extra carefully because of the infection mum had.
‘I’m going to give Sophie antibiotics too,’ Raphael told the worried parents. ‘We don’t know yet if she’d caught the infection, but I prefer to be on the safe side. You have to understand what this means.’ He ran through what could go wrong, then reassured them it was unlikely, but they had to know. ‘Then she’ll go to PICU where they’ll monitor her continuously.’
Tania was crying. ‘I want to hold her. I want her here, not on a different floor.’ She hiccupped. ‘I know what you’re doing is the right thing, but it’s so unfair. We’ve waited years for her and now we can’t keep her with us.’
Dominic wrapped his wife in his arms, tears streaming down his face to mingle with hers. ‘Shh, darling. It’s going to be all right.’
Raphael talked to the couple some more, working at pacifying them.
When he’d finished, Isabella looked at him and Katie, and they nodded agreement, then left the room quietly, pushing S
ophie’s cot ahead of them.
‘Phew,’ Isabella sighed. ‘It never gets any easier with distraught parents.’
‘The day it does is the time for you to walk out of here and go work as an interior decorator.’ Raphael chuckled. ‘Me, I’ll learn to play the banjo and sit on my back step all day.’
Katie agreed. ‘I’ll find a rich man and retire for good. Right, come on, Sophie, let’s get you settled in PICU.’
As Katie headed down the corridor at a fast clip with her special cargo, Isabella’s heart went with the wee tot. ‘She’s so vulnerable.’
Raphael moved closer. ‘Oui, they all are. I wonder how something so fragile and tiny can be so strong. It scares me sometimes.’
‘Would we be worse parents because we know all the things that can go wrong?’