Tina Beckett - Midwives On-Call At Christmas

Jacob started to swear under his breath. ‘This is looking like HELLP syndrome. Do you mind if I come with you, Sean? We might need to do an emergency twin delivery.’

‘Glad of the help,’ Sean said quickly. He handed some blood forms to Bonnie. ‘Can you get these done as an emergency?’

‘No problem.’ She took them as Sean and Jacob walked into the room to assess Eleanor. Five minutes later the ward clerk arrived with the notes and the phlebotomist answered her page. Bonnie flicked through the notes. Nothing untoward. All Eleanor’s previous appointments had shown a healthy developing pregnancy.

The missed appointments were unfortunate. She just wished Eleanor had phoned her midwife when she’d started to feel unwell. Maybe her condition could have been picked up sooner. HELLP was serious. It could be life-threatening for both mother and babies.

Symptoms could be vague but it always started with pre-eclampsia. One of the crucial tests was the blood work and the quickest turnaround time from the lab would be just over an hour. Eleanor was already showing some of the classic signs.

Sean and Jacob came out of the room, both talking in low voices. The phlebotomist arrived, picked up the blood forms and went to collect the samples that would be needed.

‘I think we should prepare and contact the anaesthetist anyway. Give her an ace-inhibitor to try and bring her blood pressure down and don’t leave her alone.’ Those last words were aimed at Bonnie. It was the first time his eyes had connected with hers.

There was something wrong—which was stupid, because she knew that already. But the look in Jacob’s eyes? It was almost blank. As if there had never been anything between them, and there never would be.

Focus. She sucked in her breath. There was a patient to deal with. But as soon as Eleanor’s condition was under control, Bonnie was definitely calling the letting agency.

She’d become too attached to him. They’d become too attached to him, too quickly. It was time to take stock. To take a breath.

She’d made a massive mistake with Robert. She’d married a man she didn’t really love. When it came to men—her previous choice hadn’t been great. Could she really trust her own judgement now?

Her heart was telling her one thing and her head another. It was all too much.

The phlebotomist appeared and waved the blood bottles at them. ‘I’ll take these direct to the lab and ask for the results to be phoned direct.’

Sean gave a nod. ‘Thanks.’ He turned to face Jacob. ‘If I speak to the anaesthetist now are you free to assist in Theatre if required?’

There was silence for a few seconds. The quiet made Bonnie look up. Jacob always responded immediately. He never hesitated over clinical care.

But this time he did. This time he glanced at his watch. She could see him swallow as if a million things were flashing through his brain. ‘I’ll need to make a call to try to delay something else.’

Sean looked just as surprised as Bonnie. ‘No problem. I can always find Isabel. She’s covering the other theatre list today—but we can cancel the routine procedures for an emergency.’

That was right. The other theatre list. The one that Jacob had refused to cover today because he had somewhere else to be. Where exactly was that?

A whole wash of memories flooded over her. Robert. Continually making excuses about where he was going or where he had been. The way he could never look her in the eye when he’d been telling her those lies. Her stomach was in knots. She hated that Jacob was following the same pattern. He could never know how much those memories and associations hurt.

Jacob wasn’t Robert. He would never be Robert. But he was definitely hiding something. It made her question herself. It made her question her judgement. Her choices had been wrong before. It felt as if she could be walking down the same path.

Where on earth was he going? And why was he being so evasive about it?

Jacob waved his hand at Sean. ‘It will be fine. Give me five minutes to make the call. Let’s just try and make sure that if we need to take Eleanor to Theatre there are no delays and we’re ready to go as soon as we get the blood results.’

Sean nodded towards Bonnie. His initial surprise had died away and now he just looked relieved that he didn’t have to go and call Isabel. What was the deal with those two?

‘I’m going to stay close by. Give me a shout if you need anything.’

Bonnie went back to the room to help Karen. It only took a few minutes to administer the blood-pressure drugs and start some IV fluids. Karen continued to monitor the babies and Bonnie set the blood-pressure cuff for every ten minutes.

Eleanor kept her eyes closed, occasionally wincing and touching her right side. It was a clear sign that her liver was affected.

Jacob seemed impatient. He was pacing up and down the corridor, and phoned the lab twice to harass them for the blood results. She’d never seen him quite so on edge.

On one hand, she knew that he was putting the care of Eleanor and her babies first. On the other, it was obvious he was anxious to still keep his other plans.

The anaesthetist, Laura, appeared and did a quick assessment. While Eleanor’s current condition was serious she had no significant history that would cause any Theatre delays.

Laura was already dressed in theatre scrubs and tucked her hair into her hat as the phone rang. Jacob snatched it up, listening carefully before putting it back down. ‘Her blood tests confirm thrombocytopenia and liver dysfunction.’ These, combined with her other symptoms, meant that Eleanor could be at risk of liver rupture, uncontrolled bleeding or cerebral oedema.

‘Let’s go, then,’ said Laura. ‘I’ll meet you in Theatre once you’ve spoken to Eleanor.’

Things moved quickly. Eleanor’s mother arrived with news that her husband was already on the helicopter and had left the oil rig. It would still be hours before he arrived.

Eleanor’s condition was worsening. She was beginning to get drowsy, so once Jacob had explained what was happening and consented her they prepared her for Theatre in a matter of minutes and whisked her down the corridor.

Jacob and Sean disappeared to scrub and Bonnie hurried back to the labour ward.

It was three long hours before she heard anything else.

Sean walked up to the nursing station and pulled his theatre hat off his head. His mussed-up hair and tired eyes said everything. She looked over his shoulder. ‘Where’s Jacob?’

Sean shrugged. ‘As soon as we had stabilised Eleanor and the babies and everyone was happy he disappeared.’

She bit her lip to stop her saying what she actually thought. ‘What about Eleanor and her babies?’

Sean nodded. ‘Two girls. Both in SCBU. Three pounds, four ounces and three pounds, two ounces. Not bad for twins. One had to have a little support breathing and the other was fine.’

‘And Eleanor?’

He sighed. ‘She started bleeding out almost straight away. Her blood pressure plummeted and she had six units of blood and then some platelets. We caught her just in time.’

‘What’s happening now?’

‘She’s stable. Mainly thanks to Jacob. She’s been transferred to ICU. They need to keep a careful watch for organ failure.’

Bonnie sighed. ‘Poor woman. I hope she’s going to be okay. Will you let me know how she is?’

Sean raised his eyebrow. ‘Won’t Jacob tell you?’

Bonnie felt colour rush into her cheeks. ‘What do you mean?’

Sean seemed completely unperturbed. He leaned on the desk towards her, a cheeky grin on his face. ‘You two had a fight? For a few weeks the world of CRMU thought you’d turned Jacob into Prince Charming. But now he’s back to his usual lovely self. I take it Prince Charming has turned into a frog?’