Second Opinion (2 page)

The pupil shook her head miserably. ‘Don’t know, Sister. This is the only baby in here right now and I was told to leave her to rest and …’ She gulped again and Sister looked at her briefly and then away, her disdain at the girl’s
feebleness so visible that the pupil herself winced at the sight of it. But Sister said nothing. She lifted her chin at the glass door through which Audrey was peering, with several of the other staff behind her, and Audrey at once obeyed and came in.

‘You people, get on with your work,’ Sister Lichfield said sharply and turned to Nuala. ‘You too — go and get yourself some coffee. And don’t go near Mrs Chowdary, whatever you do. Leave her to us. Now, Audrey —’

‘Oh, lor’,’ Audrey said as she looked at the pitiful little creature in the cot. ‘Another one? How long is it since the last? We haven’t lost a baby here for … I can’t remember how long. And now two, so close together. It’ll cause an uproar upstairs.’

‘That’s the least of my worries,’ Sister Lichfield said. She looked down at the baby again. ‘That poor couple. This was the most precious baby … Oh, shit!’

Audrey glanced at her and then away, almost embarrassed. It was unusual in the extreme for Sister Lichfield to indulge in street language. ‘Yes,’ she said. ‘Will you tell her?’

‘I’ll have to. Oh, blast it all to hell and back.’ Using her own form of swearing again seemed to strengthen Sister Lichfield and she straightened her shoulders. ‘I’ll get back into uniform, then. Look, tell the staff to keep quiet about this. It’ll get out, of course, but if we can contain it for a while it’ll help …’

But she was too late. Already all the staff and most of the mothers knew a baby had died, and there was a great deal of noise and running about going on as the mothers wept and demanded an immediate check on their own babies and wanted to know what the baby had died of and was it catching? Audrey set to work to soothe them all and make what reassuring noises she could while Celia Lichfield steeled herself to talk to Angela.

At least, Sister Lichfield thought, her husband was back
with her, and at least she was in a single room which helped. But not a lot. At first they stared at her blankly when she told them their daughter had been found dead.

‘A cot death, I think,’ Sister said wretchedly, breaking her own rule about saying anything about diagnoses until she was sure, but needing to say something to these two people who stared at her with uncomprehending eyes and blank faces. ‘It’s something that happens sometimes, I’m afraid. I am so sorry. I can’t tell you how sorry. It’s a tragedy, a dreadful thing to have happened …’

It was Viv who spoke first. ‘It’s not possible,’ he said, his voice hoarse. ‘I saw her this morning. I held her. She was wide awake and looked at me. She knew me. It isn’t possible.’

‘I’m sorry, Mr Chowdary,’ Sister said clearly and very directly. She felt her heart sinking even lower. This was going to be particularly difficult. ‘I’m afraid it’s true. I — er —’ She thought quickly about how the baby had looked. Tolerable, she decided. ‘Would you care to come and see her? I’m afraid there can be no doubt, and she looks rather different to the way she did when she was newly born, of course, but —’

Angela stirred for the first time, opened her mouth, and screamed. It was a penetrating, agonized howl and Sister Lichfield felt the skin on the back of her neck crawl. She said, more sharply than she meant, ‘Now, please, my dear —’

‘What have you done to my daughter?’ It was Viv who was shouting now, clutching the still shrieking Angela to him and staring at Sister Lichfield over her head with wide eyes, so wide that rims of white could be seen above the iris. ‘For Christ’s sake, what did you
do
?’

It went downhill from there. The parents wept, refused to be comforted, began to scream together and carried on doing so until Angela, given an injection of a sedative, collapsed into dim uncomprehending silence, and Viv, offered brandy by the Registrar in Obstetrics, Didier St
Cloud (who had been hurriedly sent for by Audrey to help in the reassurance of the mothers), took it and also lapsed into a stunned and miserable quietness. Which made it possible for Sister Lichfield and her staff at last to reassure all the mothers that this was a rare event, a one-off that could not possibly hurt their babies, and for Didier St Cloud to look at the pathetic little body of Baby Chowdary and pronounce her dead.

‘PM as soon as we can fix it,’ he said. ‘I’ll do the paperwork, shall I? You’ve got enough on your plate with the mothers.’ Sister Lichfield looked up at him briefly and nodded. They often fought, she and St Cloud, since he, in her estimation, cherished a great deal too many fancy notions about obstetrics that he pushed on the basis of damn-all evidence, and she, in his eyes, was a fuddy duddy who ought to have been put out to grass years ago; but in this situation they had a lively awareness of each other’s worth and were grateful for the mutual support they provided.

‘If you would, yes please,’ she said. ‘I suppose there’ll be no end of a fuss, seeing it was my delivery. I saw no problem, so I didn’t call you or Fay Buckland. I didn’t think it necessary. I had the child checked by the Paed. team, though. So maybe —’

‘It’ll be fine,’ he said, picking up the notes to take them with him to the office he shared with the other registrars so that he could write up his last examination of the infant. ‘No one can blame you for anything. These things happen. A stormy delivery or a normal one, it makes no odds. If they’re going to go in a SIDS, go they will.’

‘I suppose that’s what it is,’ Sister said a little fretfully. ‘It couldn’t be anything else, could it?’

‘Precisely,’ Didier said and went away. ‘It couldn’t be anything else.’

And greatly to Sister Lichfield’s relief, the coroner agreed.

The inquest was little more than a formality, and when it was over Angela and Viv Chowdary went drearily home and Sister Lichfield did her best to forget them, though it wasn’t easy. The woman who had been so excited and pleased with herself the morning her baby was born looked, by the end of the first week after the birth, twice her age and half her size and grey with misery. Her husband had a remote and chilled air about him and, watching them leave, Audrey murmured to Celia Lichfield, ‘I wouldn’t be surprised to hear he’d dropped her and found himself someone new after a while.’

Celia looked at her and frowned. ‘You’re being dramatic again.’

‘No, this time I’m not. Did you see that man’s face when the child was born? It was like someone had lit a bonfire in him. And look at him now. He’s the same age as she is, lots of time for him to start again, find someone else to have babies with. She’s got a very small chance, after all. Poor cow.’

And Sister Lichfield couldn’t argue with that. She’d come across similar stories before. She knew, better than most, that there was more to having babies than just long labours and stitches and painful perineums. She could write a book, she sometimes told people, about the things she saw and heard in her Obstetric Unit.

But she didn’t write a book. She went back to work and for a while everything went as smoothly as could be wished. The department managed to streamline its systems to get the patients in and out faster, and so pushed up the throughput (‘What a horrible word!’ Sister Lichfield said to Fay Buckland, the senior consultant on the unit. ‘Makes it sound like those things they use to clean rifles.’ ‘Hush,’ said Fay Buckland. ‘They’re pull-throughs. And the marketeers’ll get you if you talk like that.’) and the Finance Department found them some money to upgrade some of their wards a little. ‘We have to market our Obs department very
vigorously, Sister,’ said Margaret Cotton, who was the Director of Finance for the NHS Trust that the hospital had become the previous April. ‘Because if we don’t the London Implementation Group’ll come and close us down. And we wouldn’t want that, would we?’

Agreeing sourly that indeed we wouldn’t, Sister Lichfield pushed herself harder than ever, not only doing more than her share of deliveries and teaching the pupils and hustling the less experienced of the house officers along so that they learned their business faster, but also spending (wasting, she called it) long hours in meetings with the head of the Family Directorate which covered Obs and Gynae. and Paediatrics as well as Family Planning and the Fertility Clinic, while they tried to sort out their finances and think of what wheezes they could use to lure pregnant mothers away from the more attractive hospitals in proximity to Old East and into their own eager arms. It was more than enough to expunge from her mind all thoughts of the sad Chowdarys and their dead baby.

Until one evening in winter, the first of December, when it happened again. This time the baby was a boy, a large and bouncing child who had given them no cause for anxiety at all. He had been born after a mere seven-hour labour of great tranquillity to a relaxed and experienced mother, Helen Popodopoulos, who was delivering herself of her third child in the ward while expecting to be treated on a Domino basis; domiciliary care had been given right up to the time of her starting labour, so she had never attended the hospital’s antenatal clinic, and she had come into Old East only for her delivery, accompanied by her own district midwife, Ann Powell. Sister Lichfield knew her; indeed Ann Powell had been one of her own trainees long ago, and the hospital (as represented by herself) and the district (as represented by Ann) had long enjoyed a happy relationship. So there was no need for her to have any anxiety about the case. The mother was in excellent hands, and should have
gone the morning after she delivered to complete the acronym: domiciliary — in — out.

But she didn’t. Because at six a.m. when the night staff went to fetch the baby to take to his mother — the four babies from the bay Helen was in had been relegated to the nursery for the night because two of the mums were particularly tired after difficult deliveries, and the others hadn’t in the least minded being assured a night’s sleep totally free of the sounds of their crying infants — baby Popodopoulos was dead.

And this time the reaction was very different, because George Postern Barnabas, who had been on holiday when the first baby had died and off sick with an infected injury to her left hand when the second one came down to her morgue, was very much on duty. And there was no way she was going to accept as mere coincidence the occurrence of three cot deaths in Old East within a matter of five months. George knew better than that. And anyway, she was worried.

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‘Nasty to come back to,’ Sheila said with rich sympathy. ‘It’s awful when babies die. All that wasted promise and the poor mother left with empty arms …’

George grimaced, more irritated than usual by Sheila’s sentimentality, but very aware of the fact that she was in general irritated by everything this morning.

The weather was foul, for a start; not cold and brisk, which she could handle easily, but dank with a bone-deadening chill from the river mist which filled the air with the acrid scent of oil and mud and old dead things. Everything she had touched since she got out of bed in her noisy little flat just over the river in Bermondsey had seemed slimy with condensation and sticky with heaven knew what in the way of pollution; and her hand felt heavy and dull and less responsive to the demands she had made on it as she worked on the small body that had been waiting for her in the morgue. Fortunately, it had been her left hand she had accidently stuck with the point of a scalpel during a PM on a vagrant’s corpse — a piece of clumsiness over which she was still furious; even thinking about it made her flush with shame — but all the same it slowed her down, even though it was now officially regarded as healed and free from infection, and made her painfully conscious of what she was doing.

At least this morning’s PM hadn’t been observed by anyone from Ratcliffe Street nick, she thought. It would have been dreadful to have had Rupert Dudley there, looking his usual sardonic and unpleasant self, or one of the younger ones — like Michael Urquhart, who would have been sympathetic and understanding which, in a way, would have been worse than Rupert’s sneering gaze. She deliberately didn’t think about what it might have been like to have had Gus Hathaway there; he belonged in another part of her mind entirely, and she wouldn’t let him intrude where he didn’t belong. A thought which she knew was stupid and which therefore made her even more irritable.

And then there was the state of the department when she came back. She’d been off sick for a month, admittedly, but there’d been no need to let the paperwork pile up on her desk so appallingly. Everything looked shabbier and messier than usual, too, and she’d said as much to Sheila, seeing she was the senior technician responsible for efficiency, as soon as she returned. Sheila had bridled and looked offended, then admitted that George was right; things had slipped badly. But what could she, Sheila, do when they refused to replace either Barbara Pratt, the haematological technician, or the junior, Tracy, both of whom had left this summer, and the locum pathologist had been so uninterested in what he was doing? She did her best to keep the work going through but with staffing levels the way they were, how could she, Sheila, be expected to cope? She wasn’t a miracle worker, after all, just a humble toiler in the vineyard doing her best with what she had.