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Illegitimacy runs in the family. Cringeworthy at the very least. No chance of sex with him now.
The thought brought a reluctant whisper of ironic amusement and suddenly she didn’t feel the need to sink into that scratchy hospital carpet; she could focus.
Which was lucky because they’d carried on without her.
‘There are three types of foetal surgery. One we do only with a needle. Another is the opposite, and similar to a Caesarean section where we work directly on the anesthetised foetus, which we remove from the uterus and then return.’
Incredible what they could do. Emily watched his face. So intense and obviously passionate about something he knew so well. She couldn’t imagine the tension in an operating theatre for such a procedure. It sounded easy. Too easy for reality.
‘The risks of premature labour are greatest the larger the incision into the uterus, of course, until sometimes it is better to wait to deliver the baby and perform the surgery ex utero.’
Annie was chewing her lip. ‘So can we wait for my baby?’
‘Those cases depend on the foetal problem. Your baby is twenty-six weeks old, too young for the risk of premature labour or delivery, too old to be left much longer before damage cannot be reversed, and so we move on to the next alternative.’
He picked up the large envelope of ultrasounds and crossed to the light projector on the wall to clip up the dark images.
They all moved to fan around the light source. ‘Foetoscopy would be my preferred option in your case. Or Fetendo—like the child’s game—because the instruments are controlled while watching a screen and are less than a pencil width in diameter.’
‘Neat.’
‘Si.’ He smiled, the room lit up, and Emily felt like grabbing her sunglasses from her bag. Probably just because working permanent nights made you sensitive to light.
Marco pointed with one longer finger. ‘Your baby has a narrowing of the neck of the bladder.’ He circled the darkness of the bladder on the film. ‘In simple terms, the door to releasing urine from the bladder has closed almost completely and the kidneys are swelling with the retained fluid. I would have wished to perform this surgery at least four weeks ago for maximum protection of your baby’s kidneys.’
Emily felt she had to explain. ‘We’ve only just found out about my daughter’s pregnancy. This is the first scan she’s had. It’s all been a bit of a shock.’
Understatement. And not just the pregnancy. Disbelief that her daughter had fallen into the same circumstances as herself had paled when they’d discovered Annie’s baby was at risk.
Emily’s fierce protective instinct embraced this tiny new member of their family wholeheartedly because already she loved this little dark gnome on the ultrasound films.
‘Si. So we will schedule surgery as soon as possible. I believe the repair can be achieved by foetoscopy under ultrasound imaging.’
He smiled at Annie. ‘The instruments are fine and require a very small incision.’ He glanced at them both under dark brows. ‘Tomorrow?’
‘Tomorrow?’ Annie’s squeak made Emily’s hand slip across the distance between them to squeeze her daughter’s cold fingers.
‘It’s okay. Better have it done as soon as possible for baby.’ She looked at this man they were entrusting Annie and her baby’s future to.
His strong profile and unwavering eyes somehow imbued the confidence she needed that these risks were worth it. ‘Do you think much damage has been done to baby’s kidneys already?’
He tactfully shrugged his broad shoulders and their eyes met and held. She could feel his compassion. His understanding of her fear.
They both glanced at Annie. ‘We wait. It will be difficult to tell until after the operation. Hopefully the amniotic fluid volume will increase as the bladder is allowed to empty. That will be a good sign.’
He looked at them both. ‘And in a few months, after the birth, there will be tests to give a true indication.’
Marco watched the young woman to see if she realised there was still doubt on the final outcome. They did not intrude on the dark sea of the foetal world without good reason. Annie’s eyes, glistening green like her mother’s, were glued to his face. ‘So the procedure is safe for my baby?’
Ah. She began to comprehend and this part of it he could reassure her on. ‘I have performed foetoscopies many times, and while you must be aware of the risks—your own anesthetic, your baby’s analgesia, which we administer to prevent the procedure causing pain, and the risk of premature labour I spoke about before—to not perform this surgery would ensure a poor quality of life for your child, with extremely damaged kidneys.’
Annie gulped and nodded. ‘Yes. I see.’
Perhaps he had been too blunt? ‘I do not say these things to frighten you, but for you to know I believe this needs to be done, and as soon as possible.’ He touched Annie’s shoulder reassuringly. ‘Do you understand?’
Annie glanced at her mother and nodded her head ‘Okay. But I don’t want to know any more. Let’s just get it over with, then.’
‘Si.’ He moved to the door and they both stood up. ‘I will arrange this now.’ He glanced at the notes in his hand. ‘I have your mobile phone number and will confirm the time Annie is to arrive tomorrow morning. You live together?’
‘Yes.’ Emily nodded. ‘How long will she be in hospital?’
He pursed those sinfully chiselled lips and Emily diverted her glance quickly away to watch her daughter. ‘The risk of premature birth is still present so at least forty-eight hours. My secretary will arrange for Annie to have an injection to help mature her baby’s lungs should premature labour occur. This will be repeated tomorrow before surgery. If we have to open the uterus, her stay in hospital would be almost a week.’
Emily glanced back, careful to avoid looking at his face, stared instead at his collar and nodded. ‘Thank you, Doctor.’
Marco looked at Annie. ‘You are sure you have no other questions?’ All mulishness and bravado had fallen away and Annie looked what she was. An apprehensive young woman scared for her baby.
‘As long as my baby will be all right, Doctor?’
‘Please, call me Marco. And your baby’s wellness is our goal. Bene. I will see you tomorrow.’
Annie stiffened her shoulders and lifted her chin. ‘Tomorrow.’ She nodded, resolute. Now he admired her. No doubt her courage came from her mother. ‘Thank you, Marco.’
The mother, Emily, just smiled and followed her daughter. No doubt this woman’s whole life revolved around the girl, which would explain why there was an imbalance of power for the teenage years. He watched them walk away and readjusted his thinking. The daughter wasn’t too bad. Just stressed. And if his child had required what hers did, he’d be stressed too.
He tried not to think about the mother. Because he really wanted to think about her. A lot.
But she did not look the kind of woman to have an affair, a liaison for just a month, while he worked in Sydney.
Unfortunately, after such brief exposure, her image was burned into his brain. Miss Cooper. Emily. Green eyes and vulnerable wisdom.
Emily went to work that night, like she had so many nights before over the last sixteen years, though times had changed in the last decade as she had progressed in her career. Now she was in charge of the ward at night, instead of being the junior nurse.
She could have risen higher but she chose night work because night duty meant the only person who suffered was her.
Because Gran, dear Gran, the only one in her family who had unconditionally loved her, had supported her, and in the past had minded the sleeping Annie while Emily worked.
Gran was gone now, Annie was certainly old enough not to be minded, and though Emily had almost come to terms with having a grandchild, she hadn’t really come to terms with the fact her daughter had had unprotected sex at sixteen.
Would that have happened if she hadn’t worked nights? Who knew? After all those conversations!
The ward was quiet so far—unlike her mind. She set the scales beside the prepared bed for the impending transfer from a regional hospital and pulled the BP machine close to hand for when their patient arrived. Her thoughts roamed as she taped the name badge to the bed.
The new patient was under Marco D’Arvello as well. So they had an influx of foetal surgery now?
She shook her head.
‘Is something wrong?’ Lily, her colleague and friend, touched her arm and Emily gathered herself.
‘No. I’m thinking about earlier today.’
‘So how was Annie’s appointment and the mysterious Dr D’Arvello?’ Lily had recently met and fallen in love with the man of her dreams, a plastic surgeon, and she was keen for everyone else to be as happy as her. ‘I hear he’s a heartbreaker.’
Um. Gorgeous? Emily could feel the warmth creep up her neck. At least the dimness of night duty was good for hiding blushes. ‘He seemed very nice. You tell me what you think when he comes to see the new admission.’
She didn’t want to think about her visceral reaction at his office. ‘Naturally it would have been better if Annie had had the ultrasound earlier. But I didn’t find out until last week. How history repeats itself.’
Her young friend shook her head emphatically. ‘From where I’m standing, history did not repeat itself. From what you’ve told me, your parents treated you with coldness and contempt. This time it’s different. When you found out you didn’t hesitate to support Annie. You’re there for her and she knows it. Even if she won’t tell you who the father is.’
Emily chewed her lip. ‘She says it’s over and he’s not interested. I’m not pushing. But her life as a child will be gone. And now her baby might be sick.’
Lily might be young but she hadn’t had an easy childhood. She was tough and could work anywhere in the hospital, used to be an agency nurse, but wards were vying for her shifts because she was so versatile. Luckily she loved Maternity and Theatres.
Lily knew how strong a woman could be if she had to be. ‘Lots of girls manage beautifully. Even with sick babies. I survived. You survived. You took it on with your head high. She’ll survive. And if her baby is like you two, she’ll be tough, too.’
Emily breathed deeply. She would love to believe that. She squeezed her friend’s shoulder. ‘Thanks. I’m sorry. I shouldn’t bring my worries to work.’
Lily shook her head emphatically. ‘And where else do you go to unload? I’m glad to be here for you. Which reminds me, we should have coffee this week, and Evie wants to come.’
‘And that’s another thing.’ Emily brushed her hair out of her eyes. ‘Annie wants a baby shower.’
‘Stop beating yourself up. You do a great job. It’s been a hard year with your gran and now Annie’s pregnancy.’
They both looked up at the sound of an approaching wheel chair. ‘I’ll try. Looks like our patient is here.’
The woman in the chair looked even younger than Annie and both women shared a sympathetic glance.
‘Hello, there, June, is it?’ Emily smiled down at the scared young woman. ‘I hear you’re having twins?’
June nodded. ‘That’s what the doctor said. Now I don’t feel so bad I look like the side of a house.’ Her smile dropped a little as her bravado faltered. ‘My babies are going to be all right. Aren’t they?’
‘We’ll be doing everything we can to stop your contractions and as my friend here is fond of saying, babies are tough little creatures.’
The porter wheeled her into the prepared room. June moved carefully, and her large abdomen became more obvious when she moved. She stopped for a moment and breathed through the next contraction and Emily rested her hand on June’s belly to feel the muscles harden. ‘The tightenings seemed strong. You’re managing well with them.’
June breathed out a big sigh when the contraction had passed. ‘I did one of those calming birth weekends. My friend’s mum teaches them and it really does help.’
‘I’ve heard they’re excellent. Must get the number from you for my daughter later.’ Emily helped June balance on the scales. ‘With luck we’ll weigh you and get you into bed and sitting up high before the next one.’
June swayed on the scales and she whistled at the numbers. ‘I never knew babies were so heavy.’
Emily wrote down the weight with a smile. ‘A lot of your tummy is fluid, not just babies.’
June glanced across at Emily. ‘The ultrasound said one baby is bigger than the other.’
Not a good thing with twins, Emily agreed silently. ‘That’s why the new doctor is coming to see you. We’ll get you settled and sorted before he arrives.’
June glanced at the clock on the wall. ‘Is he coming tonight? It’s after midnight.’
‘Doctors work long hours. And this one is a specialist who’s very experienced with twins that are different sized.’
‘Oh.’ June settled back in the bed and forced herself to breathe calmly through the next contraction.
‘I’ve a tablet here for you that should help the contractions ease off while we wait. It’s also used as a blood-pressure tablet so I need to check that before I give it to you.’
Emily wrapped the blood-pressure cuff around June’s arm and pumped it up to check. Normal. Good. ‘I’ll check again in thirty minutes and if you’re still having contractions we’ll give you another then.’
June was well settled before the sound of voices drifted to her room. Emily completed her paperwork and put the chart in the tray at the end of the bed. ‘Ah. Here’s your doctor.’ Lily brought Dr D’Arvello into June’s room.
Lily winked from behind his shoulder and Emily chewed her lip to keep back the smile.
‘Hello, there.’ His eyebrows rose when he recognised Emily. He glanced at her badge. ‘Sister Cooper?’
‘Doctor.’ He looked less immaculate than he had earlier today, with a subtle darkness of new growth over his strong chin and his hair unruly across his forehead as if he’d repeatedly pushed it back. Unfortunately he looked even more wickedly attractive.
‘Ah.’ She saw him file that away before he turned to their patient with a smile that had June relax back into the bed. Nearly as good as calming breaths, Emily thought, with a tinge of sardonic amusement.
‘And this is June, who is expecting twins?’ He shook June’s hand. ‘I am Marco D’Arvello. Congratulations.’ He pulled the chair across and sat down as if it wasn’t really midnight and he hadn’t been at work all day.
Like he had all the time in the world to talk to June. Emily liked that. Not what she needed—to find something else she liked about this guy—but she was pleased for June.
June breathed through another contraction, though this one lasted less than twenty seconds. Marco frowned. ‘She still threatens labour?’
‘That one was shorter after just one dose of the Nifedipine.’
‘Good.’ He smiled at June. ‘Your babies are better off inside at their age so we hope the contractions stop. I’ve looked at your ultrasounds, June, and your twins have a problem that I think I can help you with.’
June squared her shoulders. ‘What sort of problem.’
He smiled. ‘I like a woman who gets straight to the point.’ Emily tried not to file that away.
‘Because your babies share the one placenta, even though they use their own part of the placenta, it seems there’s an extra blood vessel connecting their blood supply that shouldn’t be there. The problem with that is one twin often gets the lion’s share of oxygen and nutrients while the other can be quite disadvantaged.’
‘Is it dangerous?’ June was nothing if not focussed. Emily felt like hugging the girl.
‘For the less fortunate foetus, it certainly can be.’
June turned to look at Emily and then back at Marco. ‘You said you can help?’
He nodded. ‘I offer you the option of an operation with a small instrument that enters your uterus through the abdomen and seals off the unwanted blood vessel between the twins. We use a tiny laser.’
June’s eyes widened with distress? ‘A laser? Near my babies? And you’ve done this before?’
‘Dozens of times.’ He smiled and Emily felt soothed just watching him. ‘Believe me …’ he smiled again ‘… I would do it very carefully but the risks are greater if I do not attempt this closure of the extra vessel.’
He was skilled with reassurance, too, Emily thought, but she could see June’s apprehension so she tried to help with the little she knew. ‘It sounds like science fiction, doesn’t it?’
She gestured to Marco. ‘Dr D’Arvello is consulting here on a secondment. Intrauterine surgery is his specialty and he’s here to help our obstetric and paediatric surgeons increase their skills.’
