The Pregnancy Proposition
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Meredith Webber
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CHAPTER ONE
FRASER MCDOUGAL, known to friends, staff and those patients of St Patrick’s Hospital conscious or lucid enough to remember his casually informal introduction as Mac, sat in the small partitioned-off space laughingly called an office and wondered what the treatment was for a doctor drowned in paperwork.
A frustrated, headachy doctor drowned in paperwork.
‘On autopsy, would they find masses of shredded paper blocking my lungs?’ he mused, frowning at the untidy piles as if his disapproval might magically make them disappear. ‘Paper petechiae in my eyes?’
‘Talking to yourself, Mac?’
He looked up and smiled.
For some reason, most people smiled at Peterson. It wasn’t that she was wildly attractive. In fact, she was quite ordinary-looking if you considered her bit by bit—short in stature, body slim as a boy’s, brown hair ruthlessly hauled back into some kind of bunched arrangement at the back, though after even an hour at work, bits of it stuck out every which way on her head—but she had good bones and the kind of mobile face one knew instinctively would smile easily.
‘No more than usual,’ he replied. ‘But if you’ve come to tell me I’m needed out there, forget it. I’ve been officially off duty for two hours, and even in Accident and Emergency I think I’m entitled to a break.’
‘If you want a break, you have to leave the hospital—you should know that by now.’ Without waiting for an invitation, Peterson cleared a pile of papers off the spare chair and plonked herself down on it. ‘Anyway, I don’t want you to see a patient. I want to ask a favour.’
Mac frowned. He had no idea what Peterson’s favour might be, but he hated being put in situations where he had to say no. Best he get in early.
‘If it’s to partner you to the hospital dance, then no. You know I don’t do that stuff. And if it’s to—’
‘Hospital dance? What hospital dance?’
Mac felt his frown grow deeper—just what he needed, ploughed-field-furrow-type wrinkles!
‘Isn’t there always a hospital dance?’
Peterson shrugged.
‘Not that I know of, but, believe me, Mac, I’d as soon ask the lad who delivers gorilla-grams as ask you to a dance. Though, if he wore his gorilla suit, people might think I was with you.’
Mac’s facial expressions shifted from frown to scowl. There’d been some ridiculous movie a few years ago in which, as far as he could make out, an idiot man who thought he was a gorilla was rescued by an unlikely blonde and brought to the big city. Most of the staff had decided Mac could have been his double, and gorilla jokes had raged around the department for weeks. And all because he rarely had time for a haircut, and looked more unshaven than most other male doctors after a twelve-hour stint in A and E.
‘Hardly a diplomatic remark, Peterson, when you’re here to ask a favour!’
‘I know,’ she said penitently, though the sparkle dancing in her brown eyes belied the contrite look on her face.
But still she hesitated, and Mac, feeling more and more certain it was something he definitely didn’t want to do, decided he’d better take the initiative. Again!
‘Well, whatever it is, don’t bother,’ he growled at her. ‘I’m rarely in the mood to do favours for anyone, and right now I’m even less compliant—or complacent, come to that. Can’t you see this paperwork? Can’t you see I’m under siege here? And the department’s as short-staffed as ever, so taking time to do it during working hours just isn’t an option. The paperwork, not whatever favour you want.’
Peterson returned his scowl with one of her own.
‘Oh, spare me!’ she said. ‘I could practically recite your complaints, I’ve heard them all so often. If you didn’t think you had to see, personally, every drifter who wanders through our doors, and if you didn’t feel you had to check on the work of every medical officer under you, and most of the nursing staff as well, you’d have plenty of time to do your paperwork during your shift.’
Incensed by this unjust criticism, Mac scowled harder.
‘You know how many of the medical staff we get lumbered with couldn’t give a damn about A and E patients. They consider their time here a necessary evil in their intern year and treat the patients like objects on a conveyor belt,’ he reminded her. ‘And some of those drifters just might be hatching something deadly so, of course, I like to keep my finger on the pulse of things.’
‘A finger’s OK,’ his visitor retorted, ‘but you give the whole hand, and all the rest of yourself. You’ve no idea of delegation—’
Mac held up his hand to halt the flow, and Peterson grinned at him.
‘OK,’ she conceded. ‘You can recite off my complaints as word perfect as I can spout yours. Quits?’
Mac nodded and, forgetting she’d come in for a reason as yet undivulged, pulled a tray of papers towards him.
Amelia Peterson sighed.
She’d dropped in to ask a simple favour and somehow they’d got sidetracked. Now the wretched man had forgotten she was there.
‘Mac!’
He glanced up, and the face that would have been handsome if it hadn’t been almost permanently etched with tiredness took on a puzzled expression.
‘The favour,’ she said patiently.
Mac’s hazel eyes with their heavy lids and dark rich fringe of lashes peered suspiciously at her.
‘Haven’t you already asked? Didn’t I say no?’
‘You said no to a hospital dance!’ she said crossly. ‘As if!’
If he hadn’t been six-two to her midget dimensions of five-three, she’d have shaken him. Instead she sighed.
‘The favour I want is simple enough. You’re on the medical advisory committee, aren’t you?’
‘The other MAC? Yes, for my sins. I can’t imagine why they wanted me on it—and a bigger waste of time I’ve never known. I mean, I know it’s necessary to have one and there are—’
But Amelia wasn’t going to let him get sidetracked again.
‘Don’t start!’ she warned, holding up her hand to emphasise the warning. ‘Just listen! I want to set up a structured in-service training process here for the A and E nurses, but it would need the approval of the director of nursing—’
‘Well, I’m sure I’d be influential there!’ Mac said dryly. ‘She doesn’t attend all the MAC meetings but even if she did, I doubt we’ve ever met without having a difference of opinion about something.’
‘She’s not that bad,’ Amelia protested. ‘You just don’t like women.’
‘Me not like women?’ He overdid the reaction. ‘Of course I like women. I was even married to one once!’
Sidetracked again, Amelia rolled her eyes.
‘Forget the DON, forget your ex-wife, forget all women, and just listen,’ she said sternly. ‘At the moment—well, almost always, in fact—the majority of the A and E nurses are older, and have worked in every other hospital department before coming here. They need that experience to be able to make the quick assessments necessary down here. But spending ten years in A and E doesn’t necessarily make you better at the job, whereas a structured programme of in-service training would enhance professionalism and give emergency nurses the opportunity to pursue a distinct clinical career.’
The heavy lids lifted so the hazel eyes could look more closely at her.
‘You sound as if you’re reciting something you read in a textbook. Tell me what good would it do. How it would improve nursing services in this department.’
Determined not to sigh again, Amelia closed her eyes—briefly—and took a deep breath.
‘Let’s take communication skills as an example,’ she began. ‘With conscious patients, assessment begins with communication—establishing a dialogue with the patient. Shirley Cribb is probably one of the most experienced nurses in the department and certainly one of the best at inserting an IV catheter. But any patient unlucky enough to strike her for initial assessment would wonder why he’d bothered to come to hospital.’
Mac actually smiled.
‘And what’s wrong with you?’ he growled, imitating Shirley’s gruff voice to perfection. ‘Don’t you have a GP you could have seen rather than wasting our time down here?’
‘Exactly,’ Amelia said. ‘And though we all try to encourage casual attendees to use their own GPs—or a twenty-four-hour clinic—rather than the hospital, that’s not the way to do it.’
‘And you think sending Shirley on a communication course would help? Would she go?’
‘Probably not voluntarily,’ Amelia admitted. ‘In fact, the courses are already offered by the hospital’s professional development team, and Shirley certainly hasn’t taken advantage of the offer up to now, but if it was part of a structured in-service training programme, then she’d have to go.’
‘I can see that,’ Mac agreed, ‘but what’s it got to do with me? You’re the senior A and E nurse. You can do what you like with your staff, arrange whatever programmes you want, can’t you?’
This time Amelia’s sigh escaped. She might have known this would be his reaction. If Mac wanted something done he just did it and worried about the consequences later. Which was OK for a medical head of department, but not quite so OK for a nurse—however senior she might be.
She shook her head. There were days when she was just too tired to talk to Mac, but this was too important to let slide.
‘To a certain extent—yes! But with a programme like this—there are courses in bereavement counselling, in paramedical emergencies, in respiratory therapy, so many things that are relevant to an A and E nurse—you need to have the in-service training as a policy so staff can be allocated paid leave to attend the courses, and the rosters altered so the department isn’t left short-staffed.’
‘Ha! Money! It’ll never happen. You know how tight the budget is, and you’re suggesting I suggest they spend more. Nice one, Peterson!’
‘I’m not suggesting anything of the kind,’ Amelia said crossly. ‘In-service training is supposed to be compulsory in all workplaces, and it’s in place in the hospital, so there’s already a budget for it. But there are no A-and-E-specific courses, so the nursing staff down here ignore the other courses which could be beneficial to them, and no one follows up to see whether they’re complying with the overall hospital policy.’
‘So, how do you get around that? If the courses are already there and no one wants to take them, how do you make people trot along?’
He was worse than a two-year-old with his questions!
Praying for patience, she sorted through her thoughts, still anxious, in spite of his lack of interest, to win his support.
‘By structuring them into an incentive programme. In the US, there’s been an enormous rise in the number of nurse-practitioners, nurses who are able to take more responsibility than regular RNs. And the first of these nurse-practitioners has recently been appointed in New South Wales. They can give drugs without a doctor’s permission, and initiate treatment—’
‘And your nurses would take on those roles?’ Disbelief reverberated in his voice.
‘No, but they’d be on their way to that position should it be introduced here. It makes sense, Mac, because it would free up doctors for more important matters and be a great financial saving throughout the hospital. And the nurses would achieve seniority, and subsequent pay rises, through training, rather than the length of service—or as well as length of service.’
‘I still don’t see where I come into it,’ Mac told her. ‘It’s really got nothing to do with me.’
‘Having more efficient nurses in A and E is nothing to do with you? I’d have thought it had a great deal to do with you!’
Unable to deny this point, he made do with frowning at her. ‘I’d have thought hands-on experience in A and E would be worth a thousand courses. Look at you. How long have you been here? Were you here when I arrived? I seem to remember a little bit of a thing scurrying around the place. Thought we had mice!’
She picked up a medical journal and threw it at him.
‘I’ve already done a range of extra courses and, yes, I think it makes me a better nurse. It’s made me see the job as more than a station on a conveyor belt, where people come in and are either shunted out or shunted up to somewhere else. It helps me remember that each patient is an individual, and that the process of nursing involves treating him or her as such.’
She held up her hand to stop him interrupting again.
‘I know that kind of thing is written in stone in all the hospital aims and objectives and in its mission statement, but in A and E it’s easy to use the excuse of being busy and to duck a lot of the issues involved in measuring up to the highest possible standards.’
Tired though he was, Mac still had the urge to smile at Peterson’s enthusiasm. She was like that whatever she did—whether organising to get the waiting room redecorated or selling raffle tickets for some obscure fundraising appeal—she threw herself whole-heartedly into it.
But he wasn’t going to be inveigled into more effort by Peterson’s enthusiasm.
‘I still don’t see where I come into it,’ he told her, hoping she’d finally get the message that he wasn’t going to get involved. ‘It’s a nursing problem.’
‘Not if you see A and E as an integrated service,’ she snapped, glaring at him, though her eyes glinted as if she knew she’d won the point. ‘Which,’ she added in softer, almost dulcet tones, ‘you are always telling us it is.’
‘Smug doesn’t suit you!’ Knowing he was trapped, he glared right back at her. ‘So forget all the flowery stuff about mission statements and tell me what you think I could possibly do about this great idea.’
‘You could bring it up at a MAC meeting, and then it would be tabled, and next time I talk to the DON, she can’t mouth placating phrases and do absolutely nothing.’
‘You mean you’ve already spoken to her about this?’ Mac demanded. ‘And you expect me to air it again?’ He knew he sounded incredulous, but the word didn’t begin to describe his disbelief. ‘To Enid Biggs? That woman already hates my guts. We argue every time she’s present at a meeting. She—’
‘She won’t be there.’ Peterson interrupted him before he could get into full flow on the problems he’d had with the DON. ‘She’s off at a conference for like-minded autocrats. Won’t be back for a fortnight.’
Peterson’s finely boned face looked momentarily remorseful.
‘That was mean!’ she said quickly. ‘She does a good job, and most Directors of Nursing were excellent nurses before they went into management, but it’s because she won’t be here that I thought now was the time to get it tabled.’
‘Sneak it in under her guard? Couldn’t that bounce back on you?’
Peterson’s elfin face lit up as she smiled with mischievous delight.
‘On me? I didn’t bring it up.’
Mac shook his head.
‘Look, I’d like to help out, but I know damn well what something like that would mean. First they’ll want an analysis of the current system—’
‘There isn’t one!’
He ignored Peterson’s interruption and continued, ‘And evaluations of this, comparisons of that and more paperwork to add to the conglomeration of bumf already accumulated in my office.’
He frowned severely at her, partly because he wanted her to understand no meant no but also because he felt slightly bad about not helping.
‘And don’t bother telling me that I won’t be affected by any change. I spent years convincing the hospital it needed a specialist director of A and E, and when they finally decided I might be right and appointed me, they realised they had somewhere to dump all the stuff other people didn’t want to do. I’m supposed to spend half my life evaluating and analysing and comparing one system with another and I just don’t have the time. So, no, Peterson, count me out.’
Amelia clamped her lips tightly shut so the things she’d have liked to yell at him didn’t escape. Instead she stood up, gave him one final black look and flung open the door.
Which was when her control broke.
‘Thanks for nothing!’ she snapped. ‘And don’t bother asking for my help next time you have an emergency intubation or a cardiac arrest because I’ll be too busy organising staff schedules and doing my own paperwork.’
She slammed the door behind her and stormed down the corridor, heading for her locker, where she retrieved her handbag, but was still too furious to realise she should also have grabbed her jacket. It might be nearly spring in Southern Queensland, but the evenings were still chilly.
Mac watched the door reverberate, and dismissed the faint twinge of regret down deep where his conscience used to be. He assured himself he’d made the right decision, but he felt bad about disappointing Peterson. She was the finest A and E nurse he’d come across. Not that she’d carry out her threat of not assisting him when he needed it. She was far too dedicated to not help where she was needed.
Wasn’t she?
The phone rang before he had time to answer his own question.
He hated the phone almost as much as he hated paperwork.
‘Mac!’ he bellowed into the receiver—knowing such an intimidatory tactic could make wimpy callers hang up.
‘Your phone-answering skills haven’t improved.’
Cool amusement in a so-familiar voice!
‘Helene?’
‘How are you, Mac?’
‘I’m sure you’re not phoning to enquire about my health,’ he told her bluntly, knowing his frown lines were growing deeper by the millisecond, though his ex-wife was close to two thousand kilometres away.
‘No, I’m not. You haven’t returned your A4726.’
Mac took a very deep breath, but that didn’t stop the explosion.
‘Like hell!’ he bellowed into the inoffensive instrument now clutched in a white-knuckled hand. ‘I haven’t a clue what your A-whatever is when it’s at home, but I do know that Ms Running-the-Federal-Health-Department Clinton sure as hell isn’t in charge of collecting them. You must have dozens of minions—hundreds most likely—doing those little menial tasks for you.’
‘The A4726 is part of an Australia-wide survey of A and E Departments, designed for analysis and evaluation of resources available to patient-specific sectors of the community.’
Mac rubbed his pounding temple. ‘Please, tell me you didn’t just say that, Helene?’ he begged. ‘Please, tell me I couldn’t have married someone capable of such painfully bureaucratic mumbo-jumbo?’
‘Don’t play games, Mac,’ Helene said crisply. ‘I’ve been at parties where you’ve bored people rigid with medical jargon. You could bore for Australia on emergency medicine. Anyway, I would have thought filling in the A4726 would have been to your distinct advantage.’
Helene suggesting something to his advantage?
The same Helene who’d left him stuck in a dingy townhouse they’d once bought as an investment because she’d had the nous to hire a divorce lawyer while he’d had some ludicrous idea they could discuss the distribution of their assets like adults?
Adults! Ha! Even a child could divide by two.
‘Well?’
The demand made him shake his head in an effort to get back to the present. The movement reminded him of the headache.
‘Well, what?’ he said stupidly, thinking headache relief not paperwork, and using his free hand to rummage through the mess on his desk in search of a blister pack of paracetamol he knew he had somewhere.
‘Well, didn’t you realise when you read it just how advantageous it could be to you? As the only specialist A and E director in Lakelands, a rationalisation of the A and E departments in the city would be to your advantage. St Pat’s would be sure to get the nod as the main trauma centre, and you’d get funding for extra staff and equipment, plus a bigger annual budget. And I’m just talking Federal funds. Because health is primarily a state concern, the State would come to the party as well. They’re finally seeing the wisdom of rationalisation.’
Mac put his hand across his forehead and tried squeezing his temples, but that didn’t help either the headache or his understanding.
‘Maybe Colleen—’ he began, but Helene cut him short.
‘Don’t blame your secretary because you’re hopeless at paperwork. Honestly, Mac, I thought you might have grown up by now. At least matured enough to realise that the record-keeping you so despise is just as important as the patients you treat.’
He shook his head in disbelief, not so much that anyone could actually think such a thing but that he’d once been in love with someone—a fellow doctor at that—who held so divergent a view of medicine. The head-shaking didn’t help the headache and his searching fingers were yet to find a packet of paracetamol among the debris on his desk.
‘I’ll find the form, I’ll fill it in,’ he promised, willing to do anything to get Helene off the phone.
‘Oh, I’m not ringing about that,’ she said cheerfully. ‘Although the sooner you get it in the better. I’m ringing to say I’ll be in Lakelands for a couple of days. We’ve built a conceptual representation of the situation but need to do some on-site work, and we’ll be starting there.’
‘Conceptual representation?’ Mac repeated helplessly. He’d found the blister pack but, of course, his coffee-cup was completely empty and there was no other fluid within reach. ‘What the hell are you talking about now?’
Maybe he could chew the tablets and swallow them dry.
He’d probably choke to death…
‘Don’t pull the dumb act on me, Mac,’ Helene said. ‘Not that it matters whether you understand or not. I’ll be up there and I thought we might get together. I’d really like to, actually. There’s someone I want you to meet.’
Mac felt his gut tighten. He and Helene had been separated for five years and divorced for three, and the strongest emotion he’d felt at any stage had been relief. Now apprehension was creeping in, and a whole lot of doubt.
‘Why?’
‘Because it’s important to me,’ she said, then she added the clincher. ‘Please, Mac?’
It had taken a while but he’d finally trained himself to say no to any requests that didn’t ultimately help his work or, on increasingly rare occasions, provide pleasure in his life. Hadn’t he just managed it with Peterson?
But before he could utter the simple syllable, Helene said ‘please’ again, and he found ‘Well, if you must!’ coming out instead.
‘Great,’ she purred. ‘We’ll be arriving in town Saturday morning. I’ll get my secretary to book at Capriccio’s. Eight suit you?’
Still recovering from his capitulation, he must have made a garbled noise which Helene took for agreement. Or perhaps she’d simply assumed he’d agree—taken his compliance for granted.
‘Shall I make it for four?’
Four?
Mac lifted the receiver away from his ear and frowned at it, before returning it to position to say, ‘I thought you said eight?’
Low musical laughter.
‘Table for four, you dolt! Surely you’re seeing someone by now?’
‘Seeing someone? Oh! Yes. Of course. Eight at Capriccio’s.’
Mac hung up, then stared blankly into space. Actually he stared blankly ahead, which meant he saw more of his office door than the space.
Office door.
Slamming shut…
Peterson.
He shot out of his chair, crossed the room in two strides, flung open the door and launched himself down the corridor, bellowing ‘Peterson!’ as he went.
‘She’s gone!’ One of the scrub-clad figures hurrying in the other direction pointed towards the staff exit. ‘I saw her shoot through there about five minutes ago.’
Mac followed, hoping he might catch her in the car park. If she had a car…He frowned into the light-brightened area, trying to remember if he’d ever seen Peterson parking a car here—driving a car.
Of course she had a car. Hadn’t he driven her home a couple of times when they’d had a late meeting and it had been being serviced?
The blare of a horn and headlights striking him simultaneously reminded him of where he was, and he stepped back between a row of parked cars. The approaching vehicle stopped, and a familiar head poked out the driver’s window.
‘Feeling so guilty about saying no you’re trying to commit suicide, Mac?’
‘Peterson!’ He greeted the taunting voice with relief. ‘I was looking for you. I wanted to tell you I’d changed my mind.’
The place was well lit enough for him to see the shifts in her expression. Disbelief, fleeting pleasure, then suspicion—the changes as rapid as eye blinks.
‘Why?’
‘So you’d know, of course. The next meeting isn’t until next week, but I’ll bring it up. In the meantime, if we could get together so you can explain it more fully…’
She was frowning now, and the suspicious look had become more marked. Nobody’s fool, Peterson.
‘I meant why did you change your mind, not why were you looking for me,’ she said gruffly.
‘Actually, Peterson, it’s a quid pro quo thing. I’ve a favour to ask of you.’
Ignoring the fact that her car—one of those midget four-wheel-drive vehicles that were proliferating on the roads these days—was blocking the exit lane, she turned off the engine and opened the door, leaping out to land in front of him.
‘You’ve a favour to ask of me?’ she repeated, totally overdoing the incredulity. ‘And if I say yes, you’ll raise the primary nursing issue with the MAC?’
Mac nodded, although, now she’d put it so bluntly, he was beginning to feel a little uncomfortable.
‘It’s a legitimate trade,’ he stressed, looking down into her face which with the play of light and shadow had taken on an even more elfin look—all cheekbones and wide eyes, narrowing to a sultry mouth and pointed chin. ‘Favour for a favour.’
The suspicion didn’t shift.
‘My favour is for the good of the department,’ she said, wrapping her arms around her shoulders as if she was cold. ‘Not even so much a favour as a simple, work-related request.’
‘Yes, well, mine is too,’ Mac hastened to assure her, remembering Helene saying something about how filling out some blasted form would be to St Pat’s benefit.
Amelia rubbed warmth into her arms and looked up at him. Every instinct in her body was telling her to walk away—actually, she’d get back into her car and drive away, but walk away was how her nerves were putting it.
But setting up the in-service training process in A and E was important to her, and what could Mac possibly ask that would be so distasteful she’d rather lose his cooperation than say yes?
‘What’s the favour?’
‘You don’t have to sound so suspicious,’ he grumbled. ‘It’s perfectly simple. All I want you to do is have dinner with me on Saturday night.’
‘Have dinner with you on Saturday night? As in a date, Mac?’
He glared at her.
‘Of course it’s not a date. Just dinner.’
‘With you?’
She was aware she must sound half-witted, but it was like some huge mathematical puzzle so involved her brain refused to process even the simple bits of information.
‘With me,’ he confirmed. ‘Capriccio’s at eight. OK?’
This, too, was bizarre enough to bear repeating, but she had a feeling she’d been repeating things since the strange conversation had begun so made a conscious effort not to do it again. She looked up into his face, wishing she could read the expression in his usually expressive eyes, but with the light behind him his face was nothing more than a dark blur.
‘And if I do this, you’ll bring up the primary nursing process at the next MAC meeting?’
He nodded.
‘You promise?’
‘Oh, for Pete’s sake, Peterson, what do you want? A neon sign? An oath signed in blood? I’ve said I’ll do it and I will. Have you something to wear?’
It was all too much for Amelia. She felt the tickle of a giggle start deep inside her, but she held back the laughter that wanted to follow.
‘No, Mac, I’ll come naked,’ she said, allowing a chuckle to escape as she shook her head at him. ‘Honestly!’
She was still laughing as she climbed back into her car, started the engine, tooted the horn at him, still standing between two parked cars, and drove off into the night.
