Frantic (4 page)

Sophie raised Julie’s sodden nightdress and saw the baby was crowning. Immediately she turned to Mick. ‘Open the kit.’

As he tore the top off the maternity kit Julie groaned and the baby’s head was born. Sophie supported it while checking that the cord was not around the neck. The shoulders delivered; then, with a rush of blood and fluid, the slippery purple body was in Sophie’s hands. She felt the newborn’s wet heat through her thin gloves and smelled the blood and vernix that coated the tiny form, and in a split second was taken back to her own delivery of Lachlan, her first touch of his skin, the feather weight of his body on her chest, the look on Chris’s face as he embraced them both. There’d been such magnificent promise in that moment – where had it gone?

‘It’s a girl!’ Mick crowed.

Blinking back tears, Sophie wrapped a sterile blanket around the baby. She glanced at her watch to note the time. ‘Congratulations, Julie. She’s beautiful.’ She laid the baby, still attached by the umbilical cord, on Julie’s exposed abdomen. Crying, Boyd Sawyer reached out and stroked the tiny face.

Julie cradled the small form while Mick worked the thin suction tube into the baby’s mouth then nose to clear the fluid. Sophie rubbed the little girl vigorously. Her arms and legs jiggled as Sophie massaged her torso with the flannel blanket. Julie tried to sit up. ‘Why isn’t she crying?’

‘She will in a second.’ Sophie paused in her rubbing to make sure the baby’s pulse was still strong. ‘Better bag her,’ she said to Mick. He grabbed the paediatric resus bag and fitted the round silicone mask over the baby’s face. The little rib cage rose and fell but when he stopped squeezing the bag the baby didn’t take a breath for herself. Nor did she move her limbs or open her eyes.

Mick kept bagging while Sophie attached the cardiac monitor. The three electrodes almost covered the baby’s tiny chest. Her pulse was fast and the high blips filled the room.

Sophie and Mick exchanged glances. The baby should have taken a breath by now. They’d had no chance to cut the cord and Sophie saw that Julie was bleeding. ‘Get back-up,’ she said. Mick handed her the bag and pulled the portable radio from his belt.

Sophie felt her chest tighten in the iron grip of her need to control the situation. She struggled to set up an oxygen mask for Julie with one hand while continuing to bag the baby and mentally mapping the new course of the case. Once the baby started breathing she’d still need to monitor her closely in case the tiny girl went apnoeic again. They’d cannulate Julie and pump the fluids in to replace her blood loss, monitor her blood pressure, make sure she was stable. But this was assuming that nature, the universe, whatever, would play its role by having them both respond to treatment. Sophie grimaced as tension pulled her neck and back muscles taut. So far nature was failing. Badly.

Boyd crouched to connect the oxygen tubing for her. He loosened the elastic strap on the mask and slid it gently over his wife’s pale face.

‘Thanks.’ Sophie hesitated. ‘You’re a surgeon.’

He nodded.

‘Would you be comfortable trying for an IV?’

He pulled the drug kit open and found the alcohol swabs and intravenous cannulas. His eyes darted from his wife’s pale face and flowing tears to his new baby’s motionless body. He clipped a tourniquet around Julie’s arm.

‘You understand why we had to stay here for the delivery,’ Sophie said. ‘Even knowing she was premature. At least here we have some room. The back of the ambulance…’

Boyd Sawyer’s hand holding the cannula trembled over his wife’s arm. Sweat hung in beads on his brow. The tight brown curls at the back of his neck were wet.

Mick hurried back in. ‘Back-up’s three minutes away and Control’s notifying RPA.’ He followed Sophie’s deliberate glance and hastily exchanged the cannula Boyd held for the sealed packet of cord clamps. Boyd moved aside and wiped his eyes on his forearm.

Royal Prince Alfred Hospital was only five minutes away on the siren but at the moment it felt as far as the moon. ‘Julie, how are you feeling?’ Sophie asked.

‘Tired.’ Julie hardly opened her eyes. Her face was paler than ever, and sweaty. Mick cannulated her arm and started IV fluids. He took a blood pressure reading. ‘Ninety systolic, with pulse of one-ten,’ he reported, and opened the clamp on the IV line to let the fluid run in fast.

Boyd clamped and cut the umbilical cord. With the baby separated from Julie, Sophie lifted the little form onto the lounge and wrapped her more firmly in the blanket. New babies lost their heat quickly and there were enough problems to fight without adding hypothermia to the mix.

In a moment the baby was completely encased. Only her face was exposed for the mask. The monitor leads snaked out of the top fold of the blanket. Sophie knelt by the lounge, her forearms either side of the baby, her hands starting to cramp with the continuous effort of rapid bagging.
Come on
, she thought, leaning close over the little girl.
Open your eyes. Look up at me. Scream, and we will know that you are all right
.

Behind her she could hear Mick inflating the BP cuff. ‘Eighty-five.’

Boyd clutched his head. ‘What are we waiting for? They need to be in hospital.’

Sophie heard a siren in the distance. ‘As soon as the other crew arrives we’ll get the baby on her way, then we’ll take Julie,’ she said. ‘We’re doing everything we can, Mr Sawyer.’ She saw tears in his eyes and quickly looked down at the baby. Before she had Lachlan she’d thought she’d known fear, and joy, but holding her newborn son she’d realised she’d known nothing about either.

Mick searched Julie’s other arm for a vein without success. The siren stopped outside. Feet pounded up the steps and across the small porch. Two paramedics hurried into the room. Rob Nestor, shaved head and almost two metres tall, kneeled beside Sophie. ‘Still apnoeic?’

Sophie nodded. ‘Her pulse is strong.’ The rest didn’t need to be said. One glance showed the baby was unresponsive. She handed the baby and the resuscitation bag over to him. Mick disconnected the monitor as Rob’s partner, Dave O’Brien, yanked the oxygen tubing free. The uniform tie he always wore swung madly. The crew rushed the baby outside.

‘What’s happening?’ Boyd said.

‘They’re taking her to hospital,’ Mick replied. Outside, the ambulance motor revved, then the siren began to wail again. ‘She needs to be there sooner than we can get Julie ready to move.’

‘I wanted them both there from the start,’ Boyd said.

Arguing with him gained nothing. Sophie changed her gloves and checked the pad between Julie’s legs. It was soaked with blood. The placenta hadn’t delivered. ‘Julie, do you still have pain?’

Julie nodded slowly without opening her eyes. Her lack of emotion was a bad sign. Sophie took a quick blood pressure. Down to seventy. She replaced the nearly empty fluid bag with a full one and started pumping it in while searching for even the smallest blue vein worthy of a second cannulation attempt. Mick hurried in with the stretcher. They lowered it beside Julie then lifted her onto it. Blood gushed to the floor.

‘Oh my God,’ Boyd said.

‘It’s okay,’ Mick said. ‘It’s probably just the placenta delivering.’ Sophie hoped her own anxiety was better hidden.

Sophie shoved the Oxy-Viva under the foot of the stretcher mattress to elevate Julie’s legs and get blood into her upper body. They loaded the stretcher into the ambulance and Sophie climbed in. Massaging the uterus could help it contract and seal off bleeding vessels. She pressed the heel of her hand onto Julie’s lower abdomen and made firm circles. Midwives could give an injection that did the same job but there was no time to call one.

‘Julie, I’ll follow you in, okay?’ Boyd called. Julie murmured something but didn’t open her eyes.

About to close the back door, Mick nodded at the cardiac monitor. Julie’s heart rate was up to one hundred and forty beats per minute.

‘Pedal to the metal.’ Sophie made sure the straps across Julie were snug and clipped her own seatbelt into place. She leaned over the stretcher and gripped the stainless-steel frame with one hand, pressing hard into Julie’s abdomen with the other. Blood ran off the sides of the stretcher mattress and dripped onto the floor. The siren was loud even in there.

Julie’s face was porcelain white, her skin slippery with sweat and cold even through Sophie’s gloves. ‘Julie, how do you feel?’

She moaned.

‘The siren’s just to get through traffic, okay? It’s busy out there.’

It did no good to tell a person they were dying.

In the ambulance bay of Royal Prince Alfred Hospital a doctor in a gown wrenched the back door open before Mick had completely stopped. ‘This is the post-partum haemorrhage?’

Sophie nodded. ‘Baby was born at nine fifty-four this morning, six weeks early. The patient’s had increasing blood loss since then.’

Mick grabbed the stretcher and pulled it out of the vehicle. Blood had run along the floor and under the back door, and dripped from the back step onto the ground. Sophie jumped down. She continued massaging Julie’s abdomen and giving her report to the doctor as they hurried inside. ‘First obs after the birth were BP of ninety, pulse one-ten. She’s had two litres of Hartmann’s. Last obs were beep of seventy, pulse one-forty. Level of consciousness decreasing.’

They hurried along the Emergency Department corridor. Robert and Dave, the paramedics who’d brought in the baby, stood to one side to let them pass. Their stretcher was empty except for a pile of equipment. There was no time to ask about the baby’s condition but they weren’t smiling.

In the resuscitation room one nurse searched for veins in Julie’s pale arms while another took a blood pressure reading. ‘Sixty on thirty.’

‘She’s unconscious,’ someone said.

The doctor said, ‘Let’s intubate, get blood off for cross-matching and get to theatre.’

Sophie felt a touch on her arm. A nurse held a clipboard. ‘Do you have her details?’

‘Only her name and address.’

‘The husband was right behind us,’ Mick said. ‘He should be at the front desk by now.’

Sophie said to the nurse, ‘How’s the baby?’

She made a face. ‘They were still ventilating her when they came belting through here. She’s in the Neonatal Intensive Care Unit. She’s critical.’

The doctor said, ‘Let’s move.’ An oxygen cylinder and the cardiac monitor were crammed on the end of Julie’s bed. Someone kicked the brakes off. They rushed her out of the room and down the corridor to theatre, leaving Sophie to step carefully over the drops of blood that marked their path.

She walked outside in time to see Rob and Dave’s ambulance accelerating out of the hospital driveway. ‘They got another case, huh?’

‘Yeah. Fall with a fractured leg.’ Mick stood at the ambulance’s rear door with an armful of towels. Lemon-scented steam rose from a mop bucket labelled ‘
RPA Hospital Property’
. ‘Man, look at this.’

The pool of blood on the ambulance floor lay still and smooth. The air was full of its cold butcher’s shop smell. Sophie said, ‘That must be two litres.’

‘I wouldn’t be surprised,’ Mick said. ‘Poor woman.’ He gently laid a towel over the centre of the pool and it instantly turned red.

Sophie retrieved the case-sheet folder from the cabin. She needed details about Julie Sawyer but didn’t feel like approaching the husband just yet. From the ambulance bay she watched the traffic drone by on Missenden Road, the sound overlaid with the rustle of plastic as Mick lowered sodden towels into a bag. The air was humid. Her shirt clung to her aching back and she realised how much she’d sweated on the case. She was still sweating. There was a sick feeling low down in her stomach.
This job, sometimes…
You felt capable, powerful even, then the universe showed you exactly who was boss. She wished it could’ve waited to show her on some other job and kept a baby out of it.

‘Hey.’ Mick peered around the side at her. ‘Doing okay?’

Sophie let out the breath she hadn’t known she’d been holding. Her chest felt sore when she drew in a fresh lungful of air. The iron grip loosened, but only a little. ‘Yeah. You?’

He shrugged and nodded at the same time, and kept looking at her.

‘What?’

‘We should buy that baby something. A soft toy,’ he said. ‘A pink fluffy rabbit.’

Sophie nodded. The baby might not make it, they both knew that, but they weren’t going to say so. You could talk about the likelihood of your adult patients pegging out, but kids were different.

Mick lifted his collar off the back of his neck. ‘That second little kid from the fire died.’

Sophie closed her eyes. On Missenden Road a truck ground its gears. Somewhere a siren wailed, distance making the sound small and forlorn.

‘And I heard some interesting police news,’ Mick said.

‘What?’ Sophie was relieved by the change of subject.

‘A man walked into St Vincent’s this morning, weak from blood loss and septicaemia.’

She went to the back of the ambulance. ‘Dog bite?’

Most of the blood was cleaned up. Mick stood with his head against the padded vinyl roof and dunked the mop into the bucket then slopped it on the floor. The lemon disinfectant overpowered the meaty metallic smell.

‘Nope. He has a wound, left lateral hip, looks like a bullet entry. No exit wound. The injury looks maybe a day or so old. The doctor says, “How’d this happen?” And the guy says, “I was walking through the city and I got mugged. I was slow giving up my wallet and they shot me.” The doctor says, “Why didn’t you come in straightaway? You could’ve died. This is the sort of stuff you should call an ambulance for.” The guy goes, “Yes but I was scared. I was drunk, I was looking for a good time if you know what I mean, and all I could think was that it would all be more ammo for my ex-wife to keep my kid from me.”’