with the twin statistics she took him back to the maternity unit and gave him a lightning tour of the department—the gynae, antenatal and postnatal wards, the labour ward, the theatre suite, SCBU as well, just for information, and then handed him over to Evan Jones on the dot of nine thirty and went back to the gynae ward to check her patients from last week. She had three to discharge before the afternoon antenatal clinic, then it was back to the antenatal ward and the young first-time mum with pre-eclampsia that she’d been worrying about.
Evan had said he’d already looked at her, but she wanted to see with her own eyes, and she was glad she did. Clare wasn’t looking so great. Her blood pressure was up, her feet and hands were more swollen and she was complaining of a slight headache.
Daisy had thought they should deliver her on Friday, Evan had wanted to give her longer for the sake of the baby. He’d won. And now it was looking as if it might have been the wrong thing to do.
‘Right, I want you much quieter,’ she told her softly, perching on the bed and taking Clare’s hand. ‘I guess you’ve had a bit of a busy weekend, and we’re going to have to slow things down for you and make you rest much more. So the telly’s going, the visits are down to hubby only, once a day, and I really want you to sleep, OK?’
‘I can’t. I’m too scared.’
‘You don’t need to be scared. We’re taking good care of you, and all you need to do is relax, Clare. I know it’s hard, but you just have to try and find that quiet place and let go, OK? Try for me?’
She nodded, rested her head back and closed her eyes.
‘Good girl. We’ll keep a close eye on you, and I’m tweaking your drugs a bit, and you should feel better soon. If anything changes or you feel unwell, press the bell, and I don’t want you out of bed for anything. OK?’
Clare nodded again, and Daisy left the room, closing the door silently behind her, and was repositioning the ‘Quiet, Please’ sign more prominently when she became aware of someone behind her.
‘Is this the woman you were concerned about?’ he said softly.
‘Yes—Clare Griffiths. She’s got pre-eclampsia.’ Daisy’s voice was a quiet murmur. ‘Actually, can I have a word with you about her?’
‘Sure.’
They walked away from the door, and Daisy filled him in. ‘I don’t know if she’s OK to leave. I was going to order another ultrasound. She’s only 32 weeks, and Evan wants the baby to have as long as possible, so I’ve told her not to move a muscle, to close her eyes and rest, but it’s easy to say and much harder to do, and today her hands and feet are more swollen and she’s complaining of a headache. She’s got a urinary catheter and we’re monitoring her fluid balance.’
‘Are those the notes?’
She handed him the file, and he scanned through it, and met her eyes. ‘Gut feeling?’
‘I think we’re going to end up delivering her today.’ She bit her lip. ‘I wanted to do it on Friday, but Evan—’
‘Evan wanted to wait. And you disagreed. He said something about that.’
She frowned. ‘What?’
‘Oh, just the implication that you were over-cautious.’
Daisy shrugged, disappointed that Evan had thought that rather than respecting her judgement, but maybe he’d been right. Maybe she was overreacting now. ‘Do you want to examine her?’
‘I thought you’d just done it?’
‘I have, but—’
‘But nothing. The notes tell me what I need to know. I don’t want to stress her by going in straight away. If she sees me, she’ll think she has to panic. And I trust you, Daisy.’
‘Is that wise? You know nothing about me.’
‘I know you’re thorough and meticulous with the notes. Evan thought you lacked confidence. That implies to me that you should have more confidence in your judgement, not less.’
She nodded and bit her lip. ‘OK. Well, we can watch her if you’re happy to. She’s had steroids, the baby’s as ready as it can be. I’m thinking that waiting much longer’s probably not an option but I could be wrong.’
‘Or you could be right. So alert Theatre, have SCBU on standby, order another ultrasound and hourly obs, and we’ll give the drugs time to work and wait and see. We aren’t fortune-tellers, we just have to watch and wait. Keep me up to speed.’
She nodded, and with an encouraging wink, he handed her back the notes and walked away.
There wasn’t time for lunch, and she arrived at the antenatal clinic at the same time as Ben and Evan.
They were seeing the tricky patients, the mums with known problems, and she was working her way steadily through the more routine cases and trying not to think about her new neighbour and boss when her pager bleeped.
Clare Griffiths. Damn. She must have deteriorated. Handing her patient over to the clinic midwife to refer to Evan, she went straight up to the ward and found Clare looking pale and sweaty. Her face was looking more bloated, and she was clearly wretched.
As soon as she saw her, Clare started to cry.
‘I’m so glad you’re here. My feet really hurt, and I can’t bend my fingers, my headache’s worse, and I can’t really see—there are flashing lights and it’s as if I’ve got worms wriggling about all over the inside of my eyes. I’m so scared.’
Retinal haemorrhages, Daisy thought, scanning the monitor and her test results and fluid balance. The ultrasound result showed that the baby hadn’t grown since the previous Thursday, and that meant it wasn’t getting enough nutrition. She perched on the bed and held her hand, feeling the difference in her fingers even in two short hours. Have more confidence, Ben had said, and he trusted her. Well, let’s hope I’m not overreacting now, she thought.
She rubbed her fingers soothingly. ‘Don’t be scared, Clare, we’re looking after you,’ she said, trying to inject some of that confidence into her voice, ‘but I’m afraid your blood pressure’s gone up again, and your blood results show your kidneys are struggling and the baby’s not growing. Let me call Mr Walker and ask him to come and look at you.’
‘Is this it?’ she asked, sniffing and looking even more worried. ‘Are you going to have to deliver me?’
‘I think so,’ Daisy told her honestly, and Clare swallowed.
‘But it’s so early—what about the baby?’ she asked, welling up again.
‘The baby should be all right, but if we leave it where it is it certainly won’t be, and nor will you. I’m sorry, Clare, we haven’t got any choice in this. I’ll get Mr Walker, and I’ll ring your husband and get him to come in. You might want him with you.’
She asked the midwife with them to prep her for Theatre, rang the antenatal clinic and then Clare’s husband, and two minutes later Ben was in with Clare examining her. To her relief he backed her without hesitation.
‘Dr Fuller’s absolutely right, Clare, we need to deliver your baby now. We’ll get the anaesthetist to do your epidural, and then we’ll take you into Theatre. You should start to feel better almost immediately, and we have lots of babies born at this stage without any problems. We’ll go and scrub, and we’ll see you in Theatre in a minute. And don’t worry. I know it feels scary, but it’s pretty routine for us, and we’ll look after you.’
His smile was kind, his manner firm and confident, and Daisy felt herself relaxing. He was right, it was routine, but Clare had every right to be scared, and he’d been good with her. Very good. It was the first time she’d seen Ben with a patient, and any reservations she might have had about their new man disappeared instantly.
‘Do you feel ready to lead?’ he asked Daisy