A Paramedic to Change Her Life
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Alison Roberts
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CHAPTER ONE
THE FIRST CLUE that it might be harder than usual for Dr Joanna Bishop to ignore the significance of this particular day of the year came in the form of the rather startling noise of a nearby car horn.
Not that she had any premonition of the ripple effect the noise might have, of course. All she was thinking about, as she looked through the glass doors of the exterior entrance, was why someone might have parked a car at such an odd angle in the ambulance bay of Dunedin’s Princess Margaret Hospital’s emergency department and why they were now leaning repeatedly on the horn. Clearly, assistance was needed. Urgently.
Pulling on gloves as she moved swiftly to follow a triage nurse and registrar through the double sets of sliding doors, she could see frantic movement around the car as the driver jumped out and opened a back door. A security guard was opening the other door. By the time Jo reached the car, the male driver was halfway into the back seat on the driver’s side. A woman had one leg out of the vehicle on the other side but was clinging to the sides of the passenger seat in front of her. And screaming.
‘Oh, my God...the baby’s coming... Like, right now...’
‘She started having contractions all of a sudden.’ The man sounded terrified. ‘About twenty minutes ago. I didn’t think we were going to make it. I didn’t know what to do...’
‘You’ve done exactly the right thing,’ Jo told him. She tucked the front locks of her short, dark bob behind her ears, bent down to the woman, who was still lost in her pain, and put one hand on her back to let her know she wasn’t alone. She put her other hand on what looked to be a belly in the late stages of pregnancy to feel the iron-hard clench of contracting muscles. They couldn’t try moving her from the car just yet but they would need to be ready when the contraction ended because an upward glance revealed clouds that looked threatening enough to be about to resume the heavy rain showers they’d been having on and off all morning. Jo turned to the senior triage nurse beside her but she didn’t need to say anything.
‘I’ll grab a wheelchair,’ Hanna said. ‘And an obstetrics kit—just in case.’
Jo nodded her approval of Hanna’s initiative. She needed to raise her voice to talk to the woman’s partner over the sound of the loud groaning. ‘How often are the contractions happening?’
‘I dunno. Every couple of minutes?’ The man wriggled further onto the back seat and sounded as if he was on the verge of tears now. ‘It’s not supposed to be happening like this.’
‘How many weeks along is she?’
‘Thirty-six.’
‘Just the one baby?’
‘Yeah.’
‘Have there been any problems with the pregnancy?’
‘No.’ The man’s face twisted. ‘Not until now...’ He put his arm around his wife’s shoulders. ‘It’s okay, babe. We’re here now. You’re gonna be okay...’
He seemed to be trying to reassure himself as much as the woman, but for Jo there was relief to be found in knowing that this was a singleton pregnancy that was this close to full term. A high-risk situation like a very premature delivery or the imminent arrival of twins or triplets would have rung much louder alarm bells, but Jo still turned to the young doctor beside her.
‘Page whoever’s on call from Obstetrics, please, David. And let’s get someone from Paediatrics down as well.’ If this was going to turn into the fairly rare event of a birth in the emergency department Jo still needed to plan for any complications such as post-partum haemorrhage for the mother or a newborn with a respiratory arrest. They had two patients here.
It was also a relief to feel the rigidity beneath her hand beginning to soften. The woman’s contraction, along with her groaning, was beginning to subside.
‘I’m Jo,’ she introduced herself, ‘one of the doctors here. We’re going to take good care of you and your baby. What’s your name?’
‘She’s Susie,’ her partner answered for her. ‘She’s my wife.’
‘Is this your first baby?’
‘Yeah...’
Still clinging to the passenger seat, Susie’s breath came out in a sob. ‘I think I’m bleeding. There’s something horribly wrong, isn’t there?’ She turned her head to hide her face against her partner. ‘Jack... I’m scared...’
Jack put both arms around her. They were both crying.
‘You’re not bleeding.’ Jo had already checked what she could see of the towel Susie was sitting on. ‘You’re feeling wet because your waters have broken, which is perfectly normal at this stage of labour.’ There was some staining in the fluid that could be meconium, which would suggest the baby was stressed, but Susie didn’t need to know that. ‘Let’s get you inside before your next contraction and then we’ll be able to see what’s happening.’
Hanna was beside her again, with a wheelchair that she was using to carry a blanket, the equipment roll that contained things that might be needed for a birth, like clamps, scissors and a scalpel, pads and a suction bulb. She had also thought to grab a cylinder of Entonox but it quickly became apparent that providing Susie with inhaled pain relief, let alone trying to move her into a more desirable environment might not be possible. She was gasping, crying out and trying to speak all at the same time.
‘It’s coming... I can feel the head... Oh... Oh...’
There was a short period of controlled chaos as Susie was helped to turn onto her back, her upper body cradled against her husband as she lay on the back seat of the car and staff rushed to respond to orders for supplies like oxygen, an IV trolley and towels and to find out whether the specialist consults had arrived in the department yet.
Hanna used shears from the obstetrics kit she had unrolled to cut through clothing and they could both see that Susie was quite right—her baby’s head was visible and about to be born. Jo’s priority, as she knelt beside the car, was to try and control the speed with which it happened, by putting gentle pressure on the baby’s head, to minimise trauma to both mother and baby.
As soon as the head had emerged, Jo used her finger to check for the position of the umbilical cord and found it around the baby’s neck. Her careful attempt to bring it over the baby’s head or even loosen it was unsuccessful.
‘It’s too tight,’ she told Hanna. ‘I’ll have to clamp and cut it.’
Hanna handed her two clamps and then the sterile scissors to cut through the cord between them. Delivery of the baby had just become more urgent but, although Jo could feel that Susie was pushing, there was no progress to be seen in the movement of the baby’s body.
‘We’re nearly there, Susie. Give me a really big push.’
Jo kept her voice calm but Hanna had picked up on the urgency as she held onto Susie’s legs to support her.
‘You’re doing so well,’ she told the young mother. ‘One more big push, hon. Hard as you can. Push, push, push...’
In her peripheral vision, Jo caught the arrival of the obstetric consultant but there was no way she could hand over the management of this birth at this critical moment. She was holding the baby with both hands and she pushed gently downwards to free the first shoulder and then applied upward traction to free the second. The rest of the baby boy’s body slid out rapidly and, at the same time, there was a loud, warbling cry from the infant that sparked an audible sigh of relief from the group of medical staff surrounding Jo and Hanna, a nod of approval from the obstetrician and the sight of both the first-time parents bursting into tears.
The baby was moving and clearly breathing well enough to cry so the priority was to keep him warm and get both mother and baby into the emergency department for a thorough assessment and the next Apgar score, which was due at five minutes after birth. Hanna handed Jo a warm, dry towel which she used to wrap around the infant, cradling him in her arms, and she got to her feet so that she could hand the baby to his mother as soon as she’d been helped into the wheelchair.
It had been a very long time since Jo had delivered a baby and, on that occasion, it had been put straight onto the mother’s abdomen so it was even longer since she’d held one in her own arms. For just a heartbeat she looked down at the crumpled, angry little face of this tiny human that had just entered the world rather abruptly and it felt...heartbreaking.
Not in a bad way. It felt as if something had broken that had been filled with a liquid warmth that was now seeping, with the speed of light, right through Jo’s body. The kind of warmth that came from the best of what life could ever offer. The kind of warmth that only really came from human connection.
From love...
Susie was in the wheelchair now, blankets around her shoulders and tears streaming down her face as she held her arms out for her baby.
‘Here you go. He’s just gorgeous.’ Jo carefully transferred the bundle and had to blink away a tear or two of her own. ‘This little guy’s had a birthday you’re never going to forget, hasn’t he?’
She stayed where she was for a moment, peeling off her gloves, as Susie was wheeled into the department. She could see that her colleagues from both the obstetric and paediatric departments had already taken over the care of mother and baby so her own part in this drama was no longer essential and, well... Jo needed to take a quick breath before joining them to continue any involvement in the case.
Hanna rolled up the sterile cloth that had contained the scissors and clamps.
‘Reckon this is one you’re never going to forget either.’ Her smile widened. ‘Happy Birthday, Jo.’
Jo couldn’t smile back at her friend. If anything, she could feel her expression becoming quite sombre. It wasn’t because she didn’t want to think about her own birthday—she was looking forward to the planned celebration with Hanna after work, where they were going to try the tapas and sangria at the new Spanish restaurant in town.
No. It was because something much more important was happening. Jo could still feel that odd warmth that holding the baby had triggered and it felt as if a switch had been flicked, in her head as well as her heart.
‘You know what?’
‘What?’ Hanna’s eyebrows rose and then lowered into a concerned frown. ‘Are you okay, Jo?’
‘Never better.’ Jo led the way back into the emergency department. ‘I’ve just realised something.’
‘Oh?’
Jo pulled in a deep breath as she turned her head. ‘If I don’t do it now, I never will because it’ll be too late. It might be too late already but I won’t know until I try, will I?’
‘Oh, no...’ Hanna stopped in her tracks before the automatic door could be triggered ahead of them. ‘Delivering that baby has blown a fuse, hasn’t it? You want one of your own?’
‘I’ve always wanted one. One day. It’s just never been the right time. And it never will be if I keep waiting for it to arrive. It’s my birthday, Hanna. I’m forty-six.’ Jo blew out a breath. How on earth had that apparently sneaked up on her? ‘Forty. Six. Time isn’t just running out...it’s disappearing around the corner.’
‘But...’
Was Hanna about to point out that Jo didn’t even have a man in her life, let alone a partner to raise a child with? Jo didn’t need to be reminded. It was also time to stop this snatched conversation and get back to work, but Hanna was looking worried now. As if she thought Jo might be completely losing the plot?
‘There’s something you don’t know about me,’ Jo told her. ‘Something nobody knows.’
‘Go on then... Tell me. I can keep a secret.’
But Jo shook her head. ‘We can’t talk about it here.’
‘Just as well we’re going out for dinner then, isn’t it?’ Hanna followed her inside.
Jo was already switching off from anything personal as she walked towards the resuscitation area that Susie and her baby had been taken to. She’d have to tell Hanna about it later because she’d already opened the bag that contained the cat, hadn’t she? And when she started talking about it out loud it would become real and would end up changing her life.
But that was okay. Because that feeling was only getting stronger and it ramped up to a new level as she walked into Resus and saw Susie cradling her baby boy on the bed beside her.
The fuse had blown. The switch had been flicked. And Jo had meant what she’d said.
It really was now or never.
‘Whoa.’
‘It’s all good, mate.’ Cade Cameron threw the briefest of glances towards his junior crew partner, who was reaching to catch the water bottle that was sliding off his lap. ‘I know what I’m doing.’
But his partner, Geoff, was grinning. ‘I know. Word is that you’ve done a bit of rally car racing back in the day.’
Cade didn’t look sideways again as the next twist of the hilly road demanded his full focus. ‘Yeah...it’s been one of my hobbies in the past. Off road driving too.’
Flickers of colour from the flashing beacons on the roof of the vehicle were lighting up the shadows of the pine forest they were driving through and reflecting on the wet tarmac beneath them. There wasn’t much traffic on this road now that they were well out of the city so Cade didn’t flick the siren again until they were behind a logging truck that obligingly slowed and pulled to the left as they reached a straighter stretch. Cade put his foot down then.
This was great. His first day in his new job and he was getting one of his favourite kinds of callout. Outdoors. Away from any main roads. Something that could well provide the kind of challenge an adrenaline junkie thrived on. Even the weather looked as if it was going to add another level to an unknown and potentially dangerous situation and that was fine by Cade.
Bring it on...
‘Any more info coming through?’
Geoff scrolled through the information on screen. ‘Twenty-three-year-old female. Slipped and fell while crossing a creek. Her leg’s wedged between boulders up to her knee and she was in too much pain when they made an attempt to pull her free. They were worried that the leg could be fractured and they might be making things worse. She’s conscious and cold.’
Cade was checking another screen that was providing his GPS, noting that he needed to slow down so that he didn’t miss the upcoming turnoff. His thoughts, however, were mostly with a young woman who was in severe pain, possible losing blood and almost certainly very frightened. The sooner they got there, the better. It had already taken too long to get here from the central city.
‘Who’s on scene already?’
‘There were three others on the tramp, all uni students. Two forestry guys who were working nearby heard someone yelling for help. They happen to be part of the local search and rescue team, knew that mobile phone reception can be dodgy out here and they texted someone who called emergency services. One of them will be waiting for us at the car park to show us the way and help carry any gear. It’s about a fifteen to twenty-minute walk uphill to the scene. Fire service and police are on the way. ETA another five to ten minutes. Sounds like we might need their heavy gear and more manpower to shift a rock or two.’
Cade nodded. ‘We’ll see what we can do before they get here as long as it’s safe for everybody. Might be a good workout for us. Any update on air rescue? We’ll be well over forty minutes from the hospital if we factor in getting down that track.’
‘They’re still transporting a patient to hospital. Could be a while before they’re clear.’
Cade turned into the parking area, making a mental note that it was big enough for a helicopter to land as long as the fire trucks and police vehicles stayed on the road. He also noted the steep set of wooden stairs that marked the start of the forest track. Shifting rocks wasn’t the only workout they had ahead of them, with at least a fifteen-minute walk to reach the scene and having to carry a lot of gear, including a scoop stretcher, trauma pack, oxygen tank and life pack. There were fat raindrops hitting the windscreen as they came to a halt and he could see the grim expressions on the faces of the two men who were waiting for them.
‘We know this area,’ one of them told Cade as they prepared to set off up the track only a minute or two later, carrying a basket stretcher laden with gear. ‘The girl’s sitting in a creek that looks like nothing much but the water level can rise surprisingly fast with even a small amount of rain.’ He turned up the collar of his raincoat. ‘And this isn’t a small amount.’
So Cade could add in a ticking clock to his assessment of environmental hazards before he even got to the scene. Yep...this was looking like a good challenge already. The urgency with which he got to the scene and gathered all the information he needed to determine just how serious this situation was—with both the condition of his patient and the environmental danger—made it feel as if time had sped up. Waiting for the air rescue helicopter to arrive, with the requested medical practitioner whose advanced skills he feared might be necessary if the only way to free this victim was by amputation of her trapped leg, made it feel as if time was going far too slowly.
And then, when the helicopter crew arrived on scene at the creek, for just an instant, it felt as if time completely stopped.
It wasn’t that the emergency specialist he’d requested was a woman that surprised him so much. Or that she’d made it up that steep track so fast that she had to be easily as fit as he was. No...it was more that he’d never seen a face that was so instantly captivating. Intelligent. Passionate.
Quite possibly the most intriguing face Cade had ever laid eyes on.
Not that she was looking at him as she got closer, mind you. Her focus, as it should be, was on the young woman he was holding in his arms to keep her head well away from the rising water of this creek—a task that was becoming progressively more difficult as the force of the water behind him steadily increased. But then her gaze flicked up and Cade got the full effect of having that focus on him and, crikey...he could swear it felt like some sort of electrical shock.
‘I’m Jo Bishop,’ she told him. ‘Trauma specialist. Talk to me...’
