junior, but he liked her confidence and the way her first thoughts were for other people’s well-being. ‘Sure.’
She stopped off at the reception desk and rang down to the emergency department to reassure them that she was on her way, then ushered him out of the department.
‘So talk me through the mentoring stuff,’ he said.
‘You know as well as I do, we have a recruitment crisis in our specialty,’ she said. ‘All the surveys say that students don’t want to work in obs and gynae because they have such a bad time on rotation—either they’re made to feel they get under the feet of the midwives, or they’re stuck in the furthest corner of an operating theatre watching a Caesarean.’
‘So they never really get to do any of the work and they don’t feel part of the team.’
‘Exactly,’ Madison said. ‘We’re organised nowadays so the team means a whole department, rather than the old way of having a “firm” of a consultant, registrar and house officers who always work together, and in a way that’s a shame because it makes it harder for junior doctors to settle into the team. I really think students need a single point of contact in a department to help them feel they’re really part of what’s going on. Yes, they have to sort out their logbooks and what have you, but they also need proper contact with patients and they need real jobs to do if they’re to get the best out of their attachment.’
‘Responsibilities for something practical, such as a departmental audit,’ Theo suggested.
That earned him another of the gorgeous smiles. ‘Absolutely. On our ward, we have two students at a time on attachment. I’m responsible for bedside teaching, and they attend my clinic and theatre sessions.’
‘Are you pure obstetrics?’ Theo asked.
She nodded. ‘Though I’m interested in foetal medicine as well.’
‘So what about the gynae work?’
‘I liaise with the consultants and the other registrars so the students get sessions with them, too—but I’m still their point of contact if they’re worried about anything, or if they want to see more of a particular subspecialty outside pure obstetrics. I also get them to spend time with the midwives, so they develop a rapport and a bit of respect for our colleagues, as well as a chance to see some low-risk births.’
‘Instead of thinking that life in our ward is all epidurals and emergency sections,’ Theo agreed. ‘That sounds good. I notice you have a sensory room here.’
‘And a water-birth suite. We want our mums to have the best, most natural and relaxing experience possible. Our midwives are fantastic, and we only intervene when we’re asked for help.’
‘Amen to that,’ he said feelingly.
The emergency registrar met them practically at the door and gave them a swift handover. Theo recognised the man’s voice—he was the one who’d swept Madison off her feet at the ball. Yet Madison didn’t greet him as if there was anything more than a professional relationship between them. And Iris had said that Madison hadn’t met the man to come between her and her career. So did that mean she was single after all?
Crazy. He shouldn’t even be thinking about her like that.
And yet he couldn’t take his eyes off her. There was something about her. Something that made him want to break all his personal rules.
Which was even crazier.
The registrar introduced them both to the patient, then left to see the next on his list.
‘Mrs Ellis, I’m Madison Gregory and this is Theo Petrakis,’ Madison said. ‘Ed called us from the maternity department. I understand you’ve been having back pain.’
Mrs Ellis nodded. ‘And it hurts here.’ She pointed to her groin, and clearly the movement hurt her because she grimaced.
‘Has it been going on for long?’ Madison asked.
‘I’ve had twinges for the last week, but today it’s absolute agony.’ She dragged in a breath. ‘Please—I’m not going to lose the baby, am I?’
‘Aches and pains are pretty common in pregnancy and they don’t necessarily mean that you’re miscarrying or there’s a problem with the baby,’ Madison reassured her, ‘but you’ve done exactly the right thing coming to see us. Do you mind if I examine you?’
With the patient’s permission, she examined Mrs Ellis gently but effectively, then listened to the baby’s heartbeat. ‘That’s nice and strong, so try not to worry too much. The baby’s doing just fine. But what we need to do is stop this pain. Do you get the pain all the time, and does anything make it feel worse or better?’
‘It’s only there some of the time. It’s worse when I’m going upstairs or getting dressed or turning over in bed,’ Mrs Ellis explained.
Given where the pain was and the description, Theo knew exactly what the problem was. But rather than muscling in, he waited for Madison, who smiled at Mrs Ellis and squeezed her hand. ‘The baby’s in absolutely no danger. What you’ve got is something called symphysis pubis dysfunction—SPD for short. It sounds a lot scarier than it is, and an awful lot of women get it. At eighteen weeks, you’re practically halfway through pregnancy, and that’s the most common time to start noticing the pain.’
She sat down next to the bed, drew a notebook and pen from her pocket, and sketched a swift diagram to show their patient. Theo liked the way she was managing this: focusing on the patient’s worries, making it easy for her to understand. That kind of empathy would make her a brilliant consultant, as Iris had said. And on a personal level…
No. No involvements. He’d made his decision years ago: he wasn’t going to settle down, get married and have children. Sure, he dated—he was only human—but he always made sure his dates knew he wasn’t able to offer anything long term. If that meant people thought he was a shallow playboy, then fine—he could live with that. As far as he was concerned, other people didn’t have to know the real reason behind his decision. He wasn’t prepared to put the woman he loved through childbirth, knowing first-hand what could happen when everything went wrong. And no way was he going to go through what his father had gone through.
He forced himself to concentrate on what Madison was saying, just in case she decided to throw a question or two his way.
‘Basically your pelvis is in two parts and it’s held together by a joint called the symphysis pubis, which is strengthened by lots of ligaments. When you’re pregnant, your body produces a hormone called relaxin, which softens your ligaments to make it easier for you at birth—but that also means your pelvis can move during pregnancy, and the movements are what cause the pain.’
‘Can you make it stop?’ Mrs Ellis asked.
‘I’m going to give you a support belt, which will help, and you can take paracetamol to help with the pain—that’s perfectly safe for the baby. I’m also going to refer you to a physiotherapist, who can teach you some exercises for your tummy and pelvic floor that won’t hurt the baby but will help ease the pain. I can’t promise you’ll get an appointment with the physio today,’ Madison warned, ‘but if I can do it, I will.’
‘Thank you.’ Mrs Ellis wiped away the tears that had started to spill over. ‘I was so scared I was going to lose the baby.’
‘It’s always the first thing that goes through your mind,’ Madison sympathised, ‘but you’re going to be absolutely fine. Even better news is that there are a few things you can do to help make the pain go away.’
This was his cue, he thought. ‘Why don’t I tell Mrs Ellis while you talk to the physios?’ Theo suggested.
Her eyes narrowed for a moment, as if she thought he was trying to take over; but then she nodded, clearly realising that this was going to save them some time. ‘Is that all right with you, Mrs Ellis?’
‘That’s