Chapter Eleven
HER LAST SHIFT at The Primary.
A late shift.
It was a gorgeous spring day—her first warm one in London—and to celebrate, Rachel had put on a flimsy dress that tied at the side and topped it with a white cardigan and some flat sandals.
She wasn’t the only one. Cheered by the first glimpse of sun, everyone seemed to have taken the chance to lose their dark coats and boots. There were people outside the cafés and flowers in pots outside the pub.
It was as if London were pulling out all the stops and trying to persuade her to stay, because she had never seen it so vibrant and pretty.
It was rather a different case at The Primary.
May and a porter were running through the car park with a gurney. Rachel considered going to help, then saw them helping a heavily pregnant woman to stand up and realised it was all under control and she might be needed more inside.
There were ambulances and police cars lined up, and police officers in the corridor when Rachel stepped inside. In fact, the place was so busy that there wasn’t even time for a handover.
She went quickly to change into scrubs, then put her hand up for Minor Injuries, where she practically lived now.
Or rather, where she practically hid.
When she went for her coffee break, before the early staff headed off, thankfully there was no Dominic in the staff room.
‘Rachel!’
Just as she had on her first day there, she heard May calling her down to the main section.
The timing could not have been worse—because as she walked through the department, she saw Richard and Dominic there.
‘I need a word with you before I head off,’ May said as she wrote on the whiteboard and then took off her glasses.
‘What a day!’ She closed her eyes and massaged her temples.
‘I have not drawn breath since I got here this morning. That poor woman fainting in the car park...hostage negotiations with a psych patient...’
‘Sounds like I missed a bad one.’ Rachel pushed out a smile, relieved when she saw that both Dominic and Richard had stood up and were clearly about to leave.
‘We’re heading back to the ITU, May,’ Richard told her.
‘But Labour and Delivery are looking for you,’ May said.
Richard rolled his eyes. ‘We’re not covering them.’
‘Please, Richard,’ May said. ‘It’s for a patient who was here earlier.’
Richard took the phone with a sigh, and told L&D the same, but then he fell quiet. ‘Okay, I’ll be right up.’
‘I can go.’
‘No, no...’ Richard said, but then his pager buzzed in his pocket.
Rachel glanced up when he sighed.
‘Actually, I have to go to the ITU, so if you could go to L&D? Epidural...’
‘Sure,’ Dominic said.
‘I’ll fill you in on the way up.’
This would be the last time she saw Dominic, Rachel thought. Standing there sullen and ignoring her. And she would miss him for ever.
‘Poor lass...’ May tutted. ‘She was going to leave it all to nature, but they must have decided to induce her...’
‘Who?’ Rachel asked.
May was too busy to answer her, but her words were enough to have Rachel looking at the admission log.
Vanda Callum, aged twenty-seven, was the ‘poor lass’ who had fainted in the car park.
She’d been in the Emergency Department for all of fifteen minutes, and had soon been transferred to the maternity unit, but there was enough written in the notes for Rachel to know that she had suffered a death in utero.
This type of patient was the very reason that Rachel hadn’t been able to face midwifery.
Well, that and the healthy pink babies who cried, too.
How did Dominic do it? Rachel wondered as he and Richard headed off. Because she felt sick inside.
* * *
How did he do this? Dominic asked himself as he arrived at Labour and Delivery and Stella, the associate unit manager, handed him the notes.
‘Thanks for coming. I know you’re not covering us today, but I couldn’t get anyone else.
Freya’s set up for you. Full term,’ she said, and went through the history.
‘Vanda came up from Antenatal this morning, when they couldn’t find a heartbeat.
She and her husband decided to go home and have some time there, wait for a natural delivery, but on her way out she fainted in the car park and came back up to us via the ED.
She had an ECG and bloods, but it was a simple faint. Just overwhelmed and grieving.’
‘Okay,’ Dominic said, looking carefully at the heart tracing and blood results as Stella continued to bring him up to speed.
‘Dr Mina induced her, and initially Vanda said she didn’t want an epidural, but it’s all getting too much for her.’
Dominic nodded.
The Primary was a very busy hospital, with a huge maternity unit, so naturally he had dealt with this sad situation many times, and it was never easy on anyone. But for Dominic, who normally did his level best to keep his memories at bay, today was proving a struggle.
Since seeing those photos, since being with Rachel, it felt new and raw again—as if it had happened only recently.
He slipped quietly into the dark room.
‘Here’s the anaesthetist now,’ Freya said to the patient, with her signature light touch, and she gave Dominic a smile.
Vanda’s partner looked up with a grim, helpless and desperate expression that Dominic recognised—for he’d once worn that same expression himself.
‘I’m Dominic Hadley, the registrar anaesthetist. What would you prefer me to call you?’
The patient didn’t respond.
‘Vanda,’ her husband said for her. ‘And I’m Greg.’
Dominic shook his hand and then explained to Vanda what would be happening. ‘I know I can’t take the pain of your loss away,’ he added. ‘But I can make you more comfortable.’
He checked all her vitals himself, and then the epidural was quietly done, with Freya holding Vanda as Greg sat with his head in his hands—trying, Dominic guessed, to summon the strength for the next bit.
Rachel hadn’t wanted an epidural either.
He remembered standing in a small interview room, with her father and four hulking brothers, trying his eighteen-year-old best to explain to her father what was going on against the background sound of Rachel’s pained moans.
‘Can’t they give her something?’ Dave had come close to shouting. ‘Can’t she have an operation?’
‘The doctor says there are risks with surgery.’
‘But can’t they numb her or something?’ Dave had started pacing. ‘Can’t they give her something to take away her pain? She shouldn’t have to go through this. She won’t be able to handle it,’ Dave had said. ‘I’m going to speak to the doctor myself...’
He’d stormed off and Dominic had gone after him, desperate to avoid her father bursting into the delivery suite and causing a scene.
‘Dave, I really think we should listen to Rachel...’
‘What would you know? This is all your bloody fault!’ Dave had flung at him.
And then he’d given Dominic a look—such a look—for all the ways he had made his daughter suffer.
Dominic had forced himself to speak. ‘Dave... Can we put things aside for tonight, please? Just keep it down for Rachel’s sake? She needs us to be calm.’
‘You don’t get it. It’s going to be like when her mum died all over again. She was inconsolable, Dominic...’
Dave had pressed his fingers into his eyes and Dominic had stood there, not knowing what to say because he simply hadn’t known this side of Rachel.
‘We were all upset—of course we were,’ Dave had continued. ‘I was devastated. But Rachel was terrible. Every night she cried herself to sleep, and then woke up crying the next day. I had to fetch her out of school more times than I can count.’
‘I didn’t know that,’ Dominic had admitted. ‘But, Dave, I can only go on what she’s telling me now. And she’s telling me and the midwife and the doctor that she doesn’t want anything for the pain...’
Dave had started to cry then—only the second time he’d seen Rachel’s father’s tears. The first time had been when Dominic had told him his daughter was pregnant and Dave had said he wished her mother was here. He’d said the same thing again.
‘I wish her mother was here. She’d know what to do.’ And then he’d wiped his eyes and blown his nose and taken a big breath. ‘Tears aren’t going to get us anywhere. You’re right, lad. We have to listen to Rachel. We both want what’s best for her.’
‘We do,’ Dominic had said, relieved that her father wasn’t going to make a scene. ‘I’d better go back in.’
He did not want to relive that night.
But he was doing it—he was—and he ached for this young couple and their journey ahead.
‘There you go,’ Dominic said as he secured the epidural. ‘It’s all done. It will start to take effect very soon.’
He helped Freya get Vanda lying back in the bed, and then slipped away to write up his notes.
A short while later Freya joined him. ‘Thanks for that.’
‘No problem.’
‘I’m just giving them some space,’ Freya said, and then sighed as she sat down. ‘I’ve got the best job in the world most of the time, but nights like this kind of redress the balance.’
Dominic made no comment. He was in absolutely no mood for a chat.
Freya looked over to him. ‘You were ever so nice to her.’
‘I would hope so,’ Dominic clipped.
He did not want to talk about this, so he quickly concluded his notes. But as he headed off, he ran into Richard coming out of the lift.
‘Everything okay?’ he asked.
‘Yep.’ Dominic nodded. ‘Freya’s at the desk.’
‘I’m not looking for Freya—I came to check on you.’
‘Why?’
‘Because I saw your ex-wife’s face when she looked at the admissions log.
Because there’s an obvious reason why teenagers might feel they have to get married.
And because, assuming you don’t have a teenager of your own that you haven’t told me about, this patient will have been difficult for you. Freya and I—’
‘Oh, for God’s sake!’ Dominic retorted. So that attempt at a chat from Freya had been for his benefit. ‘Leave it, Richard,’ Dominic warned him—except the muscles in his jaw knitted and he was appalled to feel that he might break down in the hospital corridor.