‘I
T’S BRILLIANT GOING
out with a doctor!’ Ellie laughed as they drove away from what had surely been the most boring wedding reception in the universe. ‘You have a permanent excuse to get away early!’
‘Good, isn’t it?’ James smiled.
‘So what will we do?’
James wasn’t smiling now. Instead he flashed on his indicator and needlessly changed lanes. ‘I’ve got to pop in to a work thing.’
‘I could come with you and then we can go back to mine.’
‘I’ve got a lot on tomorrow.’
‘You have a day off tomorrow.’ He could hear the strained note to her voice and knew that it was merited—they hadn’t seen each other all week. He also knew what was coming next—it had been a bone of contention since they’d first started going out. ‘Why don’t you ever take me to work things, James?’
‘You know I like to keep things separate. I told you that from the start.’
‘More than a year ago,’ Ellie pointed out. ‘I think it’s
a bit much you have to drop me off home to go for one drink with them.’
‘Fine,’ James said. ‘Come!’ That took the wind out of Ellie’s sails, given that he’d never taken anyone along to a work thing, well, not since Lorna. As they walked through the noisy bar, the emergency team were the noisiest of the lot. They whooped with delight that James had come. Mick was delighted with the gift James had bought him, over and above the collective present. It was a pen James had had engraved, thanking Mick for all his work over the years. But there were a few put-out faces amongst the women and more than a smudge of a frown on May’s brow when James first walked in with Ellie.
Still it was one drink and one drink only. Afterwards they headed back to Ellie’s and, pulling up outside, he felt like the biggest bastard in the world when he didn’t switch off the engine.
‘I’m really tired, Ellie,’ he said, when she asked why he wasn’t coming in.
‘I do have a bed!’ She tried to make a joke but he heard it wobble midway, heard her tears, because he couldn’t bear to see them. ‘Don’t do this, James.’
And about here he should have said, ‘Do what?’ Or, ‘I’m just tired.’ He should have put her mind at rest, except he couldn’t, because he was doing what she was begging him not to.
‘Look, I just need some space.’
‘No,’ she said firmly. ‘No, you don’t. You need to come in with me so we can talk, James.’
‘No.’ He shook his head, because talking was the last thing he needed. How could he talk when he didn’t
know what to say, how could he talk when he didn’t even know how he felt?
‘Ellie, you’re a great girl…’
She slapped his cheek and he took it, because she
was
a great girl and it had been, if not great then as close to it as he’d ever got in years, close enough to believe this might, possibly, just about be the one.
‘Why?’ she demanded. ‘Why would you throw it all away?’
‘It’s not you…’
‘No, it’s bloody Lorna.’
‘It isn’t Lorna,’ James attempted. ‘That’s long since over. She’s seeing someone.’
‘It
is
Lorna!’ Ellie said, wrenching open the car door. ‘After all she did, after the way she treated you, how could you—?’
‘I just need to get my head around things,’ James said.
‘And you can’t do that with me.’
He looked at her then and wished it could be different, but he was honest to a fault—would never consider being unfaithful. Although he and Lorna were hardly going to tumble into bed, although he had absolutely no intention of getting involved with Lorna again, she
was
in his head, which meant he needed to sort that out. He couldn’t do that to Ellie.
Wouldn’t
do that to Ellie.
‘No, Ellie, I can’t do it with you. I’m sorry.’
‘So you should be.’
She slammed out of the car and up her drive and James wanted to go after her, to tell her just how sorry he was again, except that wouldn’t be fair on her.
As he drove off, he was angry—with Lorna.
For coming back into his life just when it was sorted. For messing with his head
again.
He was driving past the hospital, thought of her up there in bed in those neon pyjamas, and not for a minute did he want their marriage back. It had been hell. In hindsight, Lorna had been right to walk out, to end it without excuse or argument.
And yet, letting himself into his smart London town-house, he didn’t notice Ellie’s earrings on the bench or her jacket hanging up in the hall. Instead he went to the cupboard in his bedroom and took down the box he’d always meant to throw out, but never had, and sat on the bed staring at the wedding photos.
She looked so beautiful staring up at him, her amber eyes shining with love. He could remember how he’d felt staring down at her—a mixture of pride and hope laced with certainty. Sure, in that moment that they would make it, that as rushed and as forced on them as this marriage had been, somehow they would be fine. And yet…
They hadn’t even seen out the year.
T
HE TROUBLE WITH
being a patient in a teaching hospital was the teaching!
Oh, it was wonderful to have such excellent care, and as a doctor herself Lorna had stood plenty of times at a bedside and listened intently as the poor patient’s innards were discussed, prodded and poked. She too had always given an apologetic smile to the patient, but it was hell to be on the receiving end.
Monday morning’s ward round seemed to go on for ever. Her warming, the extensive resuscitation were all discussed at length. The trauma consultant, Mr Braun, explained how her seat-belt injury and fractured ribs had been exacerbated by the cardiac massage and Lorna could understand now why she was so bruised and sore. The black hole where her brain had been was filling again, her independence returning. When a clumsy student prodded her abdomen, an intensely private Lorna wanted to weep. Then her scars were discussed.
‘Ruptured ectopic pregnancy.’ The student had done his homework well and read her notes.
‘What did they find when they operated?’
‘Adhesions from her appendectomy.’
‘What other gynaecological problems does Dr McClelland suffer from?’
‘Er, endometriosis.’
‘Which is relevant to her treatment because?’
She felt sorry for the student, more sorry for herself, but, still, she felt sorry for him as his brain frantically tried to scramble as to how an ectopic pregnancy ten years ago and endometriosis now might be relevant to the injuries she had sustained in the accident.
‘Dr McClelland is scheduled to have a hysterectomy early in the new year,’ the consultant pushed. ‘Why would a thirty-two-year-old woman with no children consider such a radical procedure?’
‘For the pain?’ the student answered, and let out a relieved breath when Mr Braun nodded. A long discussion ensued as to how hard it had been to get her pain under control when she’d first come out of ICU. She was on particularly strong pain killers now because her tolerance was high as a result of the strong painkillers she had to take to get through her normal life.
‘Thank you.’ The student gave the familiar apologetic smile as the team drifted out of the room and Lorna gave a rather wobbly one back. She tried not to feel like a thirty-two-year-old childless woman who was electing for a radical procedure. She tried not to think that though on paper she was childless, there had once been a baby, a little heartbeat on the screen, that had meant the world to her—had meant the world to James too.
She could remember the excitement of going for her antenatal appointment. Newly married, she had also
been new to London, having transferred her studies. She had just squeezed onto the full list of the obstetrician at the new teaching hospital, where James had been working and she studying. Pregnancy had suited her. For the first time in her life she’d had if not cleavage then definitely a bust, and her hair had been the shiniest it had ever been. It had even made the morning, noon and night sickness bearable, and there had been this sense of freedom too—away from her parents, married to James, life had seemed pretty much perfect.
Until the registrar had examined her.
Lorna knew she’d been concerned. One minute they had been chatting away about how Lorna was settling into her new medical school, how she would combine finishing off her studies with a new baby, and then as the registrar had probed her stomach, a long silence had fallen.
‘I’ll just get Mr Arnold in to have a feel.’
Lorna lay there, trying not to panic, trying to tell herself that everything was okay, only she knew that it wasn’t. Still, there would be no quick answer. Mr Arnold was in Theatre and the previously chatty registrar was now rather more aloof, filling in forms at her large desk and ringing the ultrasound department.
‘We’ll take some blood and then I want you to go down and have an ultrasound.’
‘Is there something wrong?’
‘Your uterus isn’t the size I’d expect.’ She gave a poor attempt at a reassuring smile. ‘Let’s just get the ultrasound.’
Lorna rang James at that point. She was sitting in the corridor, drinking a litre of water as instructed to push
up her uterus when he arrived. She could tell he was worried and trying not to show it. He asked her a few times what exactly the registrar had said and was a touch on edge at her lack of answers.
‘I know I’m pregnant.’ She was desperate to go to the loo now, and angry with the doctor for putting them through all this, because she
knew
that she was. Morning sickness was a good sign of hormone levels according to her textbook and her breasts had almost doubled in size this week alone. ‘I was sick this morning,’ Lorna said defiantly. She stood when the radiologist called her name.
Kind, polite but business like she asked Lorna to lie down and tucked paper sheets into the top of her panties, poured warm gel over her abdomen. James squeezed Lorna’s hand a fraction tighter as the probe moved over and over her stomach. Then there it was, a moment of relief as she heard the sound of her baby, its heart galloping away, except James wasn’t smiling and neither was the radiologist.
‘If you’ll just wait there for a moment.’ The radiologist had climbed down from her stool and headed out of the darkened room, leaving the still image of their baby on the screen. Lorna couldn’t work out the problem. Oh, she wasn’t an expert on scans but there it was, a head, two arms, two legs. They’d only been in for two minutes, for goodness’ sake. No measurements had been taken, there was a healthy-sounding heartbeat. What could suddenly be so wrong?
‘What is it, James?’
‘I’m not sure.’
‘James, please…’ She knew he was lying, could see
his tense jaw, could feel his hand gripping tightly as he tried not to look at her. ‘Please just tell me. I know something is wrong.’
‘I’m not sure, okay, but…’ He paused for a moment before continuing, ‘Lorna, I’m really not sure, but I think the baby might not be in the right position.’
The door opened then, admitting not just the radiologist but her obstetrician and the registrar too. Lorna was too shocked to say anything. She lay there, willing her baby well. Maybe the placenta was low and she’d be stuck for weeks on bed rest, maybe…
‘Lorna.’ It was the first time she’d met Mr Arnold, her obstetrician, and he introduced himself and then shook James’s hand before taking over the ultrasound. His face was a picture of intense concentration as again the probe was run over her lower abdomen.
‘I’m sorry to have to tell you this, but your pregnancy is ectopic.’
‘No.’ She refused to accept it.
‘Your uterus is empty, Lorna. The foetus has developed in a Fallopian tube.’
‘No.’ She hated it that suddenly they were calling it a foetus when just a few minutes ago it had been her baby.
‘The foetus isn’t viable.’
‘The baby,’ Lorna interrupted.
She completely refused to accept it, refused to listen when they told her that at any moment the tube might rupture, that there was no choice but to have the foetus removed. It was James who had to deal with it all. It was James who held her hand when they gently examined her and then checked their findings with ultrasound
again. The terminology had changed—her baby wasn’t a baby any more, rather a foetus, but she could still see it moving and wriggling on the screen, still hear the whoosh, whoosh, whoosh of its little heartbeat.
‘Could you turn off the sound?’ It was the first time in her life that she had shouted and, Lorna realised, it worked. The room stilled for a moment, the sound of her baby’s heart filling the tense air, then the technician flicked a switch and as easily as that the sound of her baby’s heartbeat was obliterated.
The obstetrician left then, leaving his registrar to complete the necessary paperwork. Only Lorna didn’t want to go directly to Theatre, didn’t want to face the inevitable result.
‘I feel fine.’
‘You have to go to Theatre.’ She could see the tears in James’s green eyes as he forced her to see sense. ‘If it ruptures, and it will rupture,’ James said clearly, ‘I don’t want to lose you both.’
‘Can we just go home?’ Even as she said it, she knew how insane it sounded, and moved swiftly to clarify what she meant. ‘I just need a night to get my head around it.’
‘Lorna.’ The registrar was nicer than her boss. Strict but kind, she spelt out the facts, held Lorna’s hand and took her through it step by step—only despite the registrar’s calm demeanour there was a flurry of activity going on in the room. An IV had been inserted into Lorna’s arm, blood had been taken for a cross-match and a bag of saline was now hanging and dripping into her veins, to keep the line open, the registrar said,
just in case.
Lorna knew what those words meant—on her emergency rotation she’d seen a woman rushed to Theatre, pale and exsanguinated. Her undiagnosed ectopic pregnancy had ruptured. At any moment, Lorna was being told, this could happen to her.
Would
happen to her, the registrar said gently but firmly, reiterating that from everything they could see on the ultrasound, rupture was imminent.
A consent form was there in front of her.
Just that morning she and James had been good-naturedly arguing about whether to find out the sex. Lorna wanted to know so she could make lots of lists and choose names and colours. James preferred to wait, to enjoy the surprise of whatever they were given.
Now they were asking Lorna to sign a death warrant.
‘We’ll try and preserve the tube,’ the registrar explained again, ‘but till we get in and have a look…’
‘No.’ Lorna said it again in the hope someone would listen. She could see James was losing his patience, his jaw tense. He got up to pace the room as a nurse came in and slipped off Lorna’s clothes and taped over her ring even though she was refusing the procedure.
‘We’ll just take off your nail varnish.’ Lorna could smell the acetone and it made her gag. She wished James would do something—he was a doctor, for crying out loud.
‘Even the examination we just performed could have exacerbated things,’ the registrar explained. ‘It’s low in your Fallopian tube and it’s too large for drug treatment. If we let you go home and it ruptures, James is right, we could lose you both.’
‘There’s nothing you can do?’ Lorna begged. ‘I saw a show once, this woman in India.’
‘Lorna.’ James interrupted her pleadings. ‘The pregnancy can’t continue.’
There was no way out—her ectopic pregnancy was at imminent risk of rupture. The pregnancy could not continue and there wasn’t a single thing Lorna could do to change the facts.
She could still remember signing the consent form—laparoscopy for ectopic pregnancy, removal of POC and salpingectomy.
‘POC?’
If it had been any day before this one, Lorna would have soon worked it out, except she felt as if her brain had been left on ice and was drifting into winter.
‘Product of conception,’ the registrar translated. ‘And we’ll do everything we can to preserve the Fallopian tube, but if we have to, we need your permission to perform a salpingectomy, which is the removal of the tube.’
Lorna started to vomit then, though not as she had that morning. Giddy nausea swept over her and she could see James’s look of alarm as the registrar turned up the drip and paged her boss.
‘Just sign the form, Lorna.’
Why couldn’t he sign it? She could remember looking at him and thinking it. If it was so bloody easy, why couldn’t it be him that signed? Except nothing about this was easy, so instead Lorna took the offered pen and signed the form. Then, dizzy, she lay back as she was rushed straight to Theatre.
‘Hey!’ He was standing at the door and though he gave her a smile, Lorna could tell it was a guarded one. He’d
brought two vast take-away cups of coffee and what she assumed was her phone charger in a plastic bag. ‘Sorry I didn’t get in yesterday.’
‘That’s fine.’ Lorna smiled. ‘I was hardly going anywhere.’
He handed her the package and Lorna opened it, wincing as she turned to her bedside table to get her phone. James did it for her, plugging in the charger and making small talk, but awkwardly.
‘Thanks for the coffee.’ Lorna took a grateful sip. ‘I’m starting to look forward to it, the hospital stuff is disgusting.’
‘Tell me about it!’ He sat down and she was glad that he did. Clearly she was getting better because she was at times bored. As a courtesy probably, because she was a doctor, she had her own little side room, but being so far from home, there were no visitors to look forward to and there was way too much time to think. Still, Lorna consoled herself, at least now she had her phone.
‘I saw the mob in the corridor. Have they got to you yet?’
‘Yes, they just finished. I’m doing very well apparently. I might even get home on Wednesday.’
‘That’s good.’
It wasn’t, actually. For Lorna it was daunting.
‘So will you go to your friend’s?’
‘I don’t think so. She’s away for another week and returning to find me in this state might be stretching the boundaries of friendship.’
‘Will you go to your parents’, then?’
Lorna hesitated before answering. ‘I guess I’ll have to. I don’t know…’ Just the thought of sitting in the car
for the six-hour drive with her ribcage like this was bad enough, but with her father driving…Lorna closed her eyes at the horror of moving back there.
‘You don’t seem too pleased at the prospect. Are you not getting on?’
‘We haven’t got on for years, James.’
‘They were desperately worried about you.’
‘I’m their daughter,’ Lorna said. ‘They love me, of course they were worried when I was injured. They weren’t at all pleased that I was thinking of moving back to London. This is proof to them that I shouldn’t come.’
Her phone bleeped then, more than a week’s worth of calls and texts all there, worried friends and family no doubt. She scrolled through them quickly, would get back to them later. It was actually the interview callbacks she really needed to hear about.
‘Do you want me to go?’ James offered, but she shook her head, rolling her eyes as she played back her messages, her pale cheeks tinging pink as four times, though nicely, though regretfully, she found out she’d been rejected.