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‘I’m married, Cal. My husband needs me. Absolutely. I can’t talk to you any more.’
Married. Married.
He needed to concentrate on his job. His fingers were lying lightly against the baby’s neck, monitoring his vital signs by touch as well as by sight, but there was still time and still room for him to look at her again. She wasn’t looking at him. She was staring down at her hands. She was wearing a plain gold wedding ring. Her fingers had clenched to white.
Why had she come?
Questions. There were questions everywhere. But for now only one mattered, he told himself.
Would this little one live?
He dragged his eyes away from Gina, back to the baby.
Needful or not, he’d continue to monitor him by sight, he decided. And by every other sense—because there was no way he could bear to look at Gina.
And he hardly dared to as much as glance at the little boy sitting next to Mike in the copilot’s seat.
Questions. Too many questions.
They scared him to death.
CJ was fantastic.
Over and over Gina how thought how lucky she’d been to have a little boy who demanded so little. CJ lived in his own small world, where his imagination ran riot. His requirements from his mother were for security and for hugs and for the basic necessities of life, but as long as those were provided whenever required, he was prepared to accept the assorted childminders he’d met in his short life. He even welcomed them as a wider audience for his incredible stories.
Now, as the helicopter landed at Crocodile Creek and the baby was wheeled into the hospital, as the emergency team sprang into action, Cal motioned to one of the nurses to take care of him.
‘Gina’s a doctor,’ he said briefly—brusquely. ‘She’s a cardiologist, right when we need one most. We need her help with the baby. Grace, can you find someone to take care of Gina’s little boy?’
‘Sure.’ Grace, a young nurse with a wide smile, held out her hand to CJ and beamed a welcome. ‘I hear you guys have been out at the rodeo. Did you see many horses?’
‘I saw lots of horses,’ CJ told her, ready to be friendly.
‘Will you tell me about them while we find you some juice and some cake? Come to the kitchen. Mrs Grubb is making chocolate cake and she loves hearing about horses. If we’re lucky, I think there might even be an icing bowl to lick.’
CJ was sold. He cast an enquiring glance at his mother for approval, then tucked his hand into Grace’s and disappeared cakewards.
‘He’s a great kid,’ Mike said as the paramedic wheeled the trolley through into Paediatrics, and Gina gave him a glance that she hoped was grateful.
She looked back at Cal. There was no gratitude there. His face was set and stern.
Maybe she should have phoned him four years ago.
Or not.
Maybe she shouldn’t be here now.
If she hadn’t been here now, this baby would be dead.
‘We need an echocardiogram,’ Cal said. He hadn’t paused as they moved through the hospital. He was intent only on the baby. Or he acted as if he was intent only on the baby.
‘You said you don’t have a cardiologist? No one with cardiology training?’
‘No.’
‘A paediatrician?’
‘Hamish is on leave. We’re trying to contact him now.’
‘We’re dead short of doctors,’ Mike said, and smiled, but then his smile faded a little. ‘There’s been a couple of…disasters. Just lucky you’re here, huh?’
‘I guess,’ she said dubiously, and cast an uncertain look at Cal. His face said there was no luck about it.
But she couldn’t look at his face. She needed to focus. This baby needed skills that she possessed.
He certainly did.
When the results of the echocardiograph were in front of her she felt her heart sink. Any thoughts she had of flying out of this place tonight were completely gone.
‘It’s pulmonary stenosis.’
With the stethoscope she’d been able to hear the characteristic heart murmur at the left upper chest. That and the fast heart rate had made her fairly sure what was causing the cyanosis. And now… Her fears were confirmed. There was a huge pressure difference between the right ventricle and the pulmonary artery. Blood flowing in one direction and unable to escape fast enough in the other. Recipe for catastrophe.
‘We can’t risk transfer to Brisbane,’ Cal said slowly—reluctantly. ‘We’ll lose him.’
‘What’s happening?’ Mike asked. He’d come in and watched as they worked, but he’d been on the sidelines. Another nurse was there now—a woman in her thirties who’d been introduced as Jill Shaw, the director of nursing. Jill was wheeling the baby back under the nursery lights, with instructions to keep warming, keep monitoring breathing, while the three of them were left staring at the results.
‘We operate,’ Gina said, staring down at her fingers as if there were some sort of easy answer to be read there. There wasn’t. They really needed a paediatric cardiologist, but the nearest available would be in Brisbane and to transfer the baby…
They would have had to if she hadn’t been here. They’d have been forced to. Cal was an excellent general surgeon, she thought, and his additional physician training made him a wonderful all-rounder in this place where multi-skills were vital. She knew that. Cal’s skills were one of the things that had attracted her to him in the first place.
But the operation for pulmonary stenosis on such a tiny child…
The heart valve they’d be working on—the pulmonary valve—was thin, even in adults. Composed of three coverlets, like leaflets, it opened in the direction of the blood flow. With pulmonary stenosis those leaflets were blocked or malformed in some way. In the baby’s case it was a major blockage. His heart was being forced to work far too hard to force blood through.
What she needed to do was to perform a balloon pulmonary valvuloplasty—a tricky manoeuvre even in adults—forcing the valve to open. With babies this size…
She’d normally advise waiting, she thought bleakly. She’d normally advise keeping him on oxygen. She’d try and get him fitter, older. She’d operate at a few weeks.
To operate on such a newborn…
But this was no minor blockage.
‘Do you have the equipment?’ she asked. ‘I’d need to monitor catheters by fluoroscopy.’
‘I’d imagine we have all you need,’ Cal told her. ‘Simon, the cardiologist who’s just left, had the place well set up for heart surgery.’
Gina nodded. She’d worked with this service before, and she’d expected this answer.
Many of the population around Crocodile Creek would be indigenous Australians, and she knew from experience how reluctant they were to leave their people. For a tribal elder to come to Crocodile Creek for an operation would be hugely stressful, but here at least here they could still be surrounded by their own. To be flown to Brisbane, where there was no one of their tribe and no one spoke their language, was often tantamount to killing them. The cultural shock was simply too great for them to handle.
That would be part of the reason Crocodile Creek would be set up so well, she knew. This base would do surgery which would normally only be done in the big teaching hospitals. Death rates would be higher because of it, but the population would accept it. The doctors involved had to accept it.
But this doctor in particular didn’t have to like it.
‘So we have no paediatrician and no cardiologist.’
‘We’re not normally this short-staffed,’ Cal told her. ‘We’ve had a couple of dramas.’
He sounded defensive, she thought. Good. It stopped her thinking about all sorts of things she should be defensive about.
‘Do you have an obstetrician?’
‘Georgie’s mother died last week. She’s flown down to Sydney with her little boy, and we don’t want to pull her back unless we have to. She had back-up—Kirsty was an obs and gynae registrar—but there was a bit of a dust-up and Kirsty and Simon left in a hurry. Emotional stuff.’
‘Emotional stuff?’ she demanded, astonished, and he looked even more discomfited.
‘Um, yeah. We don’t need to go there.’
Of course not. When had he ever?
But she had a baby to take care of. Cal’s emotional entanglement, or lack of it, had to wait.
Mike was waiting for her to make a decision. He was looking interested—as interested in the chemistry between them as he was in the baby—and that made her flush. She remembered how intimate working in this sort of environment could be. She even remembered enjoying it, but she didn’t relish the questions she saw forming in Mike’s eyes now.
‘I’ll wait for an hour and reassess,’ she said, trying to make her voice calm and professional. ‘We need to get him fully warmed and make sure the shock of delivery has worn off. Maybe once he’s settled we might get better circulation.’
‘But probably not,’ Cal said.
‘No,’ she said heavily. ‘Probably not.’
‘So Gina’ll need to stay.’ Mike wasn’t sure what was going on—his eyes were still asking questions—but he was certainly prepared to be friendly while he found out. He gave Cal a rueful smile. ‘Just lucky we have plenty of room in the doctors’ quarters, eh?’
Cal’s face tightened. ‘She can’t stay in the doctors’ quarters.’
‘Why not?’ Mike was confused.
‘I’ll stay in town,’ Gina said hurriedly, but Mike shook his head. He was obviously a skilled paramedic, accustomed to making hard decisions, fast decisions, and he made one now.
‘No way. I’m sorry, Gina, but this baby is sick.’ He cast a dubious glance at Cal—as if he thought Cal might just be losing his mind. ‘We all know this baby’s high risk. It seems to me that we need our cardiologist on hand, right here. Wouldn’t you say, Cal?’
‘Of course.’ The words were tight and blunt. Cal turned away to pack equipment and Mike shook his head at his friend. He was obviously still confused.
‘Cal’s being a bore,’ he told Gina, with another dubious glance at his friend. ‘He’s tired. Too much work. But there’s plenty of us around here who are gentlemen.’ He tried a smile. ‘Especially me.’ He waited to see if he’d teased a reaction from Cal, but a reaction wasn’t anywhere in sight. ‘OK.’ He sighed. ‘Let’s find your son and find you a bedroom.’
‘I’ll stay here and monitor the baby,’ Cal told them, still without turning around.
‘Of course,’ Mike said politely. ‘How did I know you were going to say that?’
‘The baby needs monitoring.’
‘Of course he does, Dr Jamieson,’ Mike agreed. He compressed his lips in disapproval and then he turned to Gina. ‘OK. There’s obviously just me being a gentleman, but I’m all yours. Take me or leave me.’
Charles entered the nursery silently, wheeling his chair across the smooth linoleum until he came to rest against the incubator under the overhead lights. Cal was gazing down at the baby and, seeing the look of his face, Charles thought, Uh-oh.
‘Will we lose him?’
Cal turned and stared, almost unseeingly, down at his friend.
‘I don’t know. He has a chance.’ There was a moment’s silence. ‘Gina’s here.’
‘I heard.’ Charles hesitated. He’d met Gina before, just the once. He’d been astounded by the change the relationship had wrought on his reserved friend, and when it had gone pear-shaped he’d felt ill. Now Mike had given him a quick update on what was happening, and he was even more concerned. He’d suspected Cal’s past would catch up with him sooner or later but, damn, he didn’t want him to be presented with it now.
From a selfish point of view they were too many doctors down already. He couldn’t afford to have another of his staff in emotional crisis.
‘Are you coping?’ he asked, and Cal shrugged.
‘I’m coping. You’ve seen the kid?’
‘I’ve seen the little boy, yes.’
‘Dammit, Charles, he looks like me.’
‘Could you be his father?’
It was a direct question and it jolted Cal. He stared at the question from all sides and there was only one answer.
‘Yeah,’ he said heavily. ‘I could.’
‘And that makes you feel—how?’
‘How do you suppose it makes me feel?’ Cal turned and faced his friend square on. ‘If it’s true… She got pregnant and left? Went back to the States to her husband?’ He closed his eyes. ‘Hell, Charles, I don’t want to think about it. I can’t think. I don’t have time. We need to get this baby viable. He needs urgent surgery and we’re stuck with Gina to do it. No one else has the skills.’
He stared down into the crib and his mouth twisted. ‘We’ll do the best for him, poor little scrap. He’s been abandoned, too. People…they play games. They have kids for all sorts of reasons. Who knows what the reason is behind this little one and who knows what the reason is behind the child who’s out in Mrs Grubb’s kitchen, waiting for his mother to take him home? I can’t face any of it. Just… Let’s stick to medicine. It’s all I know. It’s all I want to know.’
There was a moment’s silence. Move on, Cal willed Charles, and finally he seemed to decide that was all there was to do.
‘Emily will do the anaesthetic,’ Charles said mildly, his voice carefully neutral, not giving away any of the anxiety that someone who knew him well could detect behind his eyes. ‘She’s contacting a paediatric colleague in the city who’ll stay on the phone throughout. Do you want to assist, or will I find someone else?’
‘Who?’ He was the only surgeon, and both of them knew it. But he shrugged. ‘It’s OK. I want to assist.’
‘So you can bear to be in the same room as her?’
‘I thought I loved her,’ Cal said heavily. ‘Once. I was a fool—but sure I can stay in the same room as her. I need to be able to. If that’s really my son…’ His voice trailed off.
‘Well, let’s get on with it,’ Charles said, and there was still heavy anxiety behind his eyes. ‘We need to save this life. For now, Cal, that’s all we can think about.’
CHAPTER THREE
