Under Special Care
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Laura MacDonald
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CHAPTER ONE
‘HAVE you seen him yet?’ Staff Nurse Michelle Burns’s face took on an anxious expression.
‘No, not yet,’ Louise Keating shrugged in what she hoped was an attempt to appear casual, nonchalant even while at the same time she was only too aware that her stomach had churned at the very mention of him.
‘Was it a shock when you heard he was coming back?’
‘Not really.’ Louise shook her head. ‘It was always on the cards that he would return to Ellie’s after his stint in Scotland.’
‘He must be well on his way to his consultancy now,’ mused Michelle thoughtfully.
‘Yes, I would imagine so.’ Louise nodded, wishing her insides would return to normal. If she was like this now, what would she be like when she came face to face with him? And she would, she knew that. There would be no escaping that moment just as she would have to get used to seeing him every day and working alongside him here on the special care baby unit at Ellie’s, as it was fondly known, or to give it its correct name, the Eleanor James Memorial Hospital.
‘How long is it now since he went to Scotland?’ asked Michelle.
‘Just over a year,’ Louise’s reply was terse, almost abrupt and Michelle threw her another anxious glance.
‘I thought it must be something like that.’ Michelle paused and began sorting through a bundle of folders on the desk. ‘Louise…’ she began tentatively.
‘Yes, Michelle?’ Louise raised her eyebrows, somehow anticipating her friend’s next question.
‘You don’t think…I mean…you and Matt…I don’t suppose there’s a chance…?’ She trailed off uncertainly.
‘No,’ said Louise firmly. ‘Absolutely not.’
‘Oh, well, never mind…I just wondered, that’s all.’ Michelle sighed. ‘It’s just that you seemed…well, I don’t know, you seemed so right together somehow and it just seems such a shame that you can’t…’
‘Michelle, please, just leave it, will you?’
‘All right, Louise, I’m sorry.’
‘OK,’ Louise sighed. ‘I know you mean well, but it’s all far too late.’ She shook her head. ‘Now, can we get on with some work? Baby Ruth looks like she needs some attention and here comes Dr Rawlings—she’ll be wanting to look at Liam.’ She looked up as Senior House Officer Sandie Rawlings hurried onto the ward, her dark hair awry and her white coat flapping.
‘Sorry. I’m late. Again,’ the doctor said breathlessly. ‘It’s bedlam down on the children’s ward this morning. But I’m here now. I gather there’s a problem with Liam Kerrigan?’
‘Yes, Louise replied. ‘He isn’t feeding very well this morning. Oh, and, Sandie, maybe you could stick around for a while because we have a new baby on the way down from Maternity.’
‘Sure.’ Sandie nodded. ‘Do we have any details yet?’
‘Caesarean birth, six weeks early. A little boy, I believe. Baby has breathing problems and is jaundiced.’
As Sandie Rawlings moved across the ward to the far side where a nursery nurse was attending to baby Liam Kerrigan, Louise paused and looked around the unit with its mass of high-tech equipment, incubators and cots for eight babies, five of which were occupied that morning with a sixth being prepared at that very moment by another member of her team for the expected new arrival. It gave her a surge of pride and pleasure to know that for part of each day, at least, this was her ward, her domain, and that the post of sister-manager for which she had worked so hard was at last hers. This was her world, this high-tech unit with its tiny, precious patients, most of whom had to fight so valiantly for life itself as the medical teams around them battled to save them. It was a world of extremes: intense happiness and sometimes anguish and despair; full of laughter at times but at others awash with the tears of distraught parents as they struggled to cope with seemingly impossible situations.
Her thoughts were interrupted by the arrival of that morning’s newest patient. He arrived in an incubator, accompanied by a midwife from Maternity and his father, who looked shocked and dishevelled, his eyes red-rimmed through lack of sleep, his expression full of anxiety and bewilderment as he attempted to cope with what was happening.
‘Good morning, Sister Keating.’ The midwife smiled. ‘This is Baby Barrett and this is his father, Joe.’ The midwife turned to the man at her side. ‘Joe, this is Sister Keating—she’s in charge of the special care baby unit.’
‘Hello, Mr Barrett.’ Louise took his hand. ‘Welcome to the unit.’ She turned to Michelle. ‘This is Staff Nurse Burns. She will settle your son into his new surroundings. You can go with her, and then afterwards we’ll have a little chat. I’m sure there will be lots of things you will be wanting to ask me.’
Joe Barrett nodded numbly and moved obediently onto the ward after Michelle, unaware that the midwife who until that moment had been his lifeline had left the ward to return to Maternity.
For the next half-hour Louise was occupied with the everyday procedures that comprised the running of the unit—the planning and administration, the delegation of tasks to other members of her team and the endless telephone calls and e-mails to other departments arranging, among other things, visits from members of staff from the consultant paediatricians to heart specialists, from therapists to social workers.
She had just hung up after talking to the theatre sister on Obstetrics when one of her staff nurses popped her head around the door of her office to say that Neil Richardson, the consultant paediatrician, had just arrived on the unit for his morning rounds.
‘Right, Nicola, thank you.’ Louise rose to her feet, aware that her heart had started to hammer uncomfortably. If the consultant paediatrician had arrived then it stood to reason that his registrar would be with him. She had to get it over with. Maybe once she had got that initial meeting over it wouldn’t be so bad. Taking a deep breath, Louise smoothed down her uniform and with her head high stepped out of her office onto the ward.
She saw him immediately, and in spite of the fact that she had prepared herself her heart turned over. He looked exactly the same as he had the last time she had seen him, on that cold March day over a year ago when they had agreed to part and he had walked out of the house and into a waiting taxi.
Just for a moment she had the advantage for she had seen him before he had seen her, and briefly she was able to observe him. He looked well, she had to admit that, fit and athletic-looking with his reddish-blonde hair cropped short, and when at last he turned and his eyes met hers the expression in those green eyes was the same as it had always been, as if he was faintly amused by something.
By this time, however, Neil Richardson had also caught sight of Louise. ‘Sister.’ Without smiling, he inclined his head in that rather old-fashioned way he had. ‘Good morning.’
‘Good morning, Mr Richardson.’ Louise swallowed, only to find that her mouth was suddenly surprisingly dry. ‘Dr Forrester,’ she managed to add at last.
‘Hello, Louise,’ said Matt softly.
For a moment there was silence as if those around them, from Neil Richardson himself to the staff on the unit, were all waiting to see what would happen as she and Matt came face to face again, which was ridiculous really because apart from Michelle and Neil Richardson, hardly anyone else knew. And then, mercifully, it was over as the consultant spoke. ‘What do you have for us this morning, Sister Keating?’ he asked.
‘Liam Kerrigan has been giving a little cause for concern over his feeding,’ Louise replied, surprising even herself at how normal she sounded, ‘Dr Rawlings has taken a look at him and we have a new addition—Baby Barrett.’
‘Ah, yes, I was present at that birth. Shall we take a look at him, Sister?’
‘Of course.’ Trying to ignore the fact that Matt was watching her, Louise led the way down the ward to where Joe Barrett sat beside his tiny son’s incubator. ‘Mr Barrett,’ she said as they approached, ‘this is Mr Richardson, our consultant paediatrician, and his registrar, Dr Forrester. They would like to take a look at your son.’
Joe Barrett looked up and Louise was quick to notice that he had the same bewildered, almost shell-shocked expression on his face that had been there when he had first arrived on the ward.
‘Hello again, Mr Barrett.’ Neil Richardson nodded. ‘We met in Theatre.’
‘Did we? I’m sorry I don’t remember…’ Joe struggled to get to his feet.
‘Please, don’t get up,’ said the consultant in his calm, unhurried way. ‘You probably don’t remember because I was behind a cap and mask and covered in a green gown at the time. I was the one who whisked your son away.’
‘Oh, were you?’ Joe frowned. ‘My wife…was upset about that…’
‘Yes, I’m sure she was,’ Neil Richardson agreed. ‘Unfortunately, it was unavoidable as he was showing signs of distress.’ Taking the notes that Louise passed to him, he studied them for a time then stood looking down at the baby in the incubator who was linked to a heart monitor and who was breathing by means of a respirator. ‘We have him stabilised now, Mr Barrett,’ he went on after a moment, ‘and there is every indication that he will make good progress.’
‘Thank you,’ mumbled Joe. ‘Thank you very much.’ He looked exhausted.
Louise’s heart went out to him and she resolved to have that chat she had promised sooner rather than later.
They moved on to Liam Kerrigan’s incubator where Nursery Nurse Roma Gawn had just unsuccessfully tried to feed him and his mother Lisa was changing his nappy.
Liam had been on the unit for four and a half weeks since his premature birth at thirty-two weeks’ gestation. At first he had given grave cause for concern as his birth weight had been very low at a little over two pounds, but each day since he had shown a little improvement.
Louise watched as Neil Richardson carefully and gently examined the baby, doing as little as possible to not disturb him any more than was necessary. It was a scene she watched every day, part of a routine that was to her so commonplace it was as natural as breathing, but today it was different. Today it was as if each of her senses was heightened with an awareness that was almost painful. And what made this even more difficult was that she knew exactly what was responsible, knew precisely what it was that made that day different from any one of those countless others. The cause of her discomfort was the presence of the man who stood opposite her on the far side of Liam’s incubator, and as she looked up and their eyes met for the second time that morning she couldn’t help wondering whether he felt as she did. Then, averting her gaze, she dismissed the thought. Of course he didn’t, she should know better. It would take more than this to faze Matt Forrester.
She had known he was coming, of course she had, had known it was always on the cards that he would return to Ellie’s to complete his training and it was pretty inevitable that he would be working here to gain further experience on the special care baby unit since his training in Scotland had been in a neonatal unit. They hadn’t actually worked on the same unit before because when he had previously been at Ellie’s his work had been on the paediatric ward, while she had been working as a midwife on Maternity before transferring to SCBU. Now, of course, it was different. Now he was Neil Richardson’s registrar while she was sister of the unit, so they would have daily contact and would be working together in many situations.
Could she cope with it? she asked herself as they left Liam and moved on to the next baby. Of course she could, she told herself firmly. Besides, she had very little choice and if Matt could cope, so could she.
When the ward round was complete she led the way back to her office where they had a brief case conference on each baby before Neil prepared to leave. It was as Louise was escorting them to the door of the unit that the paediatrician paused to speak to the parents of a baby who was about to be discharged from the unit and Matt turned briefly to her.
‘How are you?’ he asked quietly.
‘I’m fine, Matt,’ she replied. ‘And you?’
‘Yes. Pretty good.’ He nodded. ‘Congratulations on your promotion, by the way.’
‘Thanks. And you on yours,’ she added after a moment.
He nodded and she thought she detected a sad little smile around his mouth. Then it was gone and there was an awkward silence between them. As the silence grew, becoming embarrassing, unbearable even, and Louise desperately sought for something to say to end it, Neil took his leave of the couple he was talking to and began walking towards them.
‘I’ll…I’ll catch up with you later, Louise,’ said Matt quickly.
There was only time for her to nod in reply then after a brief word to the paediatrician they were gone. Louise clicked the security lock on the doors of the unit behind them and made her way back to her office, surprised to find as she did so that her knees felt quite weak. It was with a decided sense of relief that she sank down onto her chair. It was never going to be easy, that first meeting again between Matt and herself after a year apart, she’d known that, but it was over now so surely they could simply get on with their jobs and their lives?
He’d said he’d catch up with her later. She frowned as she poured herself a badly needed cup of coffee from the machine in her office. What had he meant by that? Probably only tying up the loose ends, she thought as she sipped the coffee, allowing herself to be comforted by its warmth and flavour. And there were loose ends, of course there were. She acknowledged that, just as she knew they had to be dealt with. And probably it was better they were dealt with right away, instead of letting things go on longer than they already had. No doubt, that was all Matt had meant when he’d said he’d catch up with her later. If she was honest, she didn’t really want him coming to the house…she somehow doubted she could cope with that. Someone had said he was living in hospital accommodation. Maybe they could meet there to discuss things…or the hospital social club…
She was jolted out of her daydreaming by a tap on her door. ‘Come in,’ she called, looking up as Nicola Edmunds came in. ‘Nicky?’
‘Sorry to disturb you, Louise, but were you intending having a word with Mr Barrett?’
‘Yes, I was.’ Louise nodded.
‘Only he seems in a bit of a state.’
‘Tell him to come in. I’ll see him now.’ Louise leaned back in her chair, composing herself and putting all thoughts of Matt firmly from her mind as she prepared to deal with the task in hand.
Joe almost stumbled into her office and sank down onto the chair she indicated. He still looked bewildered, as if what was happening in his world was totally beyond his comprehension.
‘I was just having a coffee,’ said Louise in as friendly and matter-of-fact a tone as she could. ‘Would you like one?’
Joe stared blankly at her as if coffee was the last thing on his mind, but when Louise stood up and moved towards the filter coffee machine he managed a slight nod of his head.
‘This must have all come as something of a shock,’ said Louise as she poured the coffee and handed him the mug, noticing as she did so that his hands were shaking as he added milk and sugar.
‘Yes,’ he agreed, ‘it did. I’d just come in from work last night and Tracey, my wife, said she wasn’t feeling very well. She went to bed and I made her tea, but by late evening she was feeling worse so I rang the doctor.’ He gulped as if he found it difficult to go on. ‘He came and saw her,’ he went on at last, ‘and said he was going to admit her because he felt that the baby might be in some sort of trouble. It…he wasn’t due for another six weeks…We hadn’t decided on a name or anything.’
‘This is your first baby isn’t, Mr Barrett—Joe?’ said Louise gently.
‘Yes—that’s right.’ He nodded and passed a hand over the stubble on his jaw. ‘When we got here in the ambulance,’ he went on after a moment, ‘we were seen by one doctor after another then that Mr…Mr…the one who’s been seeing Tracey all along…’
‘Mr Finlay?’
‘Yes, that’s the one.’
‘He’s the consultant obstetrician,’ said Louise.
‘Well, he came in and examined her and said he wanted to do an emergency Caesarean. I couldn’t believe it. I thought it was much too soon.’
‘Caesareans are carried out even earlier than this if they’re necessary.’
‘Really?’ Joe Barrett took a gulp of his coffee. ‘I’m amazed. I didn’t think the baby would stand a chance. I was there, you know, when he was born—in the theatre. I couldn’t really see what was going on—I’m not sure I would have coped if I had been able to—but I sat with Tracey and held her hand.’
‘That’s good.’ Louise nodded. ‘It will have meant a lot to your wife to know you were there beside her.’
‘I saw the baby when the surgeon lifted him up…then…then they took him straight away…That doctor who was here just now…he…’
‘Mr Richardson—yes, he’s the consultant paediatrician,’ said Louise. ‘You had one of the best teams possible with Mr Finlay and Mr Richardson,’ she added.
‘But…but he…the baby was so small,’ said Joe. ‘At first, I didn’t think…I didn’t think he was alive. I didn’t think he could possibly be alive. I didn’t know what to say to Tracey…then afterwards they said he was in an incubator in Intensive Care…I still don’t know quite what to say to Tracey. What if he…? Oh God, what if he…?’ With his hands shaking violently now, the coffee slopped over the side of the mug and he set it down on the desk.
Calmly Louise handed him some tissues. As he wiped his hands and she mopped up the coffee on the desk she said, ‘There’s every chance your son will be fine, you know.’
‘Really?’ There was no denying the anguish in Joe’s eyes as he looked up. ‘Do you really mean that or are you just trying to make me feel better?’
‘I really mean it.’ Louise smiled.
‘But he’s so small,’ said Joe for the second time, as if it was totally beyond him that a baby that small could have any chance of survival.
‘He is small, yes,’ Louise agreed. ‘But we’ve had smaller babies on this unit, I can assure you. One of our smallest was under two pounds and she came back to see us last week on her first birthday.’
‘Was she all right?’ Joe stared at her.
‘She’s a perfectly healthy, beautiful little girl.’
‘But…his problems, the doctor said he had problems,’ protested Joe. ‘I heard him.’
‘Yes,’ Louise agreed calmly, ‘at the moment he does have some problems but we are doing everything we can to sort out those problems. Now, tell me, did the doctor explain the nature of the problems to you?’
‘Yes, I think he did.’ Joe nodded slowly then a frown creased his forehead. ‘Trouble is, I can’t remember what he said.’
‘Well, we’ll go through them again.’ Louise opened a folder on her desk labelled BABY BARRETT. ‘To start with,’ she went on, ‘because baby was so early his lungs aren’t quite fully developed so he’s having difficulty with his breathing. That’s why he is having oxygen—to help him to breathe. He’s also attached to a heart monitor so that we can keep an eye on his heartbeat—so far, however, there aren’t any indications there’s anything wrong with his heart. The other thing is that he’s rather jaundiced but that happens with many premature babies. You will find that we will have a phototherapy lamp on him until the jaundice fades.’
‘What about feeding him?’ asked Joe anxiously.
‘He will be fed through a tube.’
‘But Tracey wanted to breastfeed him.’
‘She still can,’ Louise replied. ‘She will be able to express her milk and it will then be frozen until it’s needed. That way baby will have Tracey’s milk from the very start.’
‘Well, that’s great,’ said Joe slowly.
Louise smiled as she realised that during the time he had been in her office Joe had relaxed and seemed much more positive about his son’s future than he had when he’d first come in. ‘I’ll tell you what we’ll do,’ she said as he finished his coffee. ‘As soon as Tracey is feeling a bit better we’ll get her into a wheelchair and you can bring her down here to see baby.’
‘Really?’ Joe looked amazed. ‘Can we do that?’
‘Of course,’ said Louise. ‘Baby will be wondering where his mum is and I know for certain that Tracey will be longing to see him.’ She stood up. ‘In fact, I think I’ll see if we can’t get this organised now.’
By the time they left the office Joe Barrett was practically beaming.
‘What did you give him?’ whispered Nicola as he ambled off down the ward to take another look at his son. ‘He looks like a different man.’
‘It’s called hope,’ Louise murmured. ‘I’m just going to ring through to Postnatal and check on his wife’s condition. Then, if all is well, I’d like you to go with Mr Barrett and bring her back here so that they can visit their son together.’
Ten minutes later, after Louise had checked that Tracey had indeed recovered sufficiently to visit her son and, together with Joe, Nicola had departed for the postnatal suite, Louise returned briefly to the mountain of paperwork that seemed to permanently occupy her desk.
She’d barely had a chance to check a couple of forms when Michelle came into the office with the staff holiday rosters.
‘I think I’ve sorted these out now,’ she said. ‘Jilly is going to swap some shifts while I am away—she wasn’t too keen at first but when Nicky pointed out that this is my honeymoon after all, she relented.’
‘Not long now, Michelle,’ said Louise with a smile.
‘I know,’ said Michelle fearfully. ‘For the first time last night I started to feel a bit nervous. I think it was talking to the vicar that did it when he mentioned the rehearsal and I realised just how many people will actually be in church.’
‘You’ll be fine, Michelle, really you will,’ said Louise, ‘but while we’re on the subject, didn’t you say you wanted me for a final fitting?’
‘Oh, yes.’ Michelle’s hand flew to her mouth. ‘I almost forgot. Mrs Nesbitt is coming to the house on Wednesday evening—is that all right for you? We’ve sorted out the little ones but I will need my chief attendant there.’
‘Of course, Wednesday’s no problem.’ Louise paused. ‘How’s Andy in all this?’ she asked a moment later.
‘He’s been fine.’ Michelle grinned. ‘But he’s starting to get the jitters now.’ Then, growing serious again, she said, ‘I have to say, though, Louise, he was over the moon when he knew Matt was back.’
‘Well, they always were good mates.’ Louise shrugged. ‘They went right through medical school together.’
‘The thing is…’ Michelle hesitated. ‘He wants…’
‘He wants Matt to be at the wedding,’ Louise finished the sentence for her. ‘Is that it?’
‘That’s right.’ Michelle looked anxious. ‘Will that be a problem for you, having him there?’
‘Why should it be?’ Louise shrugged again. ‘I have to get used to him being around again and, let’s face it, if I have to work with him on a daily basis I’m sure I can cope with being at the same wedding with him.’
‘Isn’t it going to be difficult for you, working with him?’ asked Michelle curiously.
‘I’m not pretending it will be easy,’ replied Louise. ‘It’s just one of those things you have to get on with.’
‘Even so, it can’t be easy, seeing your ex-husband every day.’
‘Actually,’ said Louise coolly, ‘he isn’t my ex-husband yet—we’re only separated.’
‘Yes, of course.’ Michelle frowned. ‘But will you be divorcing?’
‘Yes, I’m sure that’s the next thing on the agenda,’ Louise agreed. Her reply was casual, but even as she spoke and, in spite of the fact that she knew divorce was the next inevitable and logical step, she was aware of a sudden sinking feeling in the pit of her stomach.
