The Dreyfuss Trilogy

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Sunday, 16 December 2012

Sample Sunday December 16th

Final preview chapter of Bedlam Maternity which launches this coming Friday.

Leave a comment on the this post to enter into a giveaway for a free copy of the ebook.

There was no answer to give to that question and as the year moved on and slowly began to turn on itself, they gave up talking about the situation.  There had been no more occurrences and no more information had come forward about Shafiah from anyone.  Tommy had offered to talk to the local Imam about how the Islamic communities viewed ghosts, but Google could furnish her with that and not get her into trouble with either the hospital, or the community that was protecting Shafiah’s identity.
The walk to work, or rather the walk from work, got more troublesome in freezing cold and rain, but turned out to be a lifesaver for the ice and snow.  As London once more literally slid to a stop around her, with ‘unseasonable’ winter snow, she was one of the few staff members who always made it on shift.  It might take two hours to slog in on ice grips, and sometimes three to get home, but she was managing it.  It was doing wonders for her thighs.  So few of the others were managing in the worst of the weather that she took her sleeping bag in and left it in her locker.  She wasn’t going to be charged £25 per night for the privilege of sleeping in a hospital bed when she was saving the hospital’s neck: which is exactly what the Trust had done to staff the previous winter.
The ice was flooding out Accident & Emergency, as it always did.  Broken limbs from falls were straining resources and every now and then a bed was being used in Maternity for some poor battered soul that couldn’t find refuge elsewhere.  So when her beeper had gone off to call A&E urgently, she hadn’t been too concerned, thinking it was a bed chase for another ice victim.  Another ice victim it was, but one far more serious than anyone had anticipated.  The woman, who had slipped backwards and smashed her head on a wall, had lain unconscious for an hour or so in the snow before being discovered.  She was suffering from concussion, hypothermia, and blood loss.  The flap of skin that had been opened on the back of her head had bled freely the entire time she’d been down.  She was also heavily pregnant, easily over eight months gone. 
Rose reached A&E as the OB registrar was sending out the orders for theatre.  Despite their best efforts to stabilise the mother, the baby was in distress and was coming out.  The mother had drifted in and out of consciousness in the ambulance, and the senior anaesthetist was being called in.  The neo-natal unit was at full stretch and short on staff for Theatre.  Rose was due off shift in 30 minutes and Lucy, her relief, wasn’t in yet.  Lucy had a long way to come from Essex and had been making shifts, more or less, but had been hours late in the past week.  Rose made sure the delivery unit was as well prepared as it could be, warned all the staff where she’d be on change over, and confirmed she would attend.  She changed into theatre blues and scrubbed up.
The attempts to remove the baby were being hampered by the problems of trying to get the mother’s core temperature up at the same time as opening her for major surgery.  Theatre was so packed with surgeons and doctors, Rose couldn’t get anywhere near the mother, who was plugged into several high tech pieces of equipment she didn’t recognise. 
Rose hated theatre and avoided it at all costs: it was a bad shift if she found herself in there.
There wasn’t much to assist with, given the stream of specialists each trying to maintain their discipline over the body of the poor mother.  Dr McGhee, the head of the neo-natal unit, was working hand in hand with Dr Gray, the OB consultant.  They were prepping everything before making the first incision, in order to reduce the stress on the mother.  Rose had seen Dr Gray do a caesarean in under three minutes, from first cut to baby free, and had little worry about the intervention.  The issue was the accident.  They were clearly ready to proceed, as Dr McGhee had turned to Rose and indicated she wanted a warmed receiving blanket, which Rose unfolded across the older woman’s arms.  Rose picked up a neo-natal breathing mask and had her hand poised on the oxygen switch.  McGhee turned and nodded to Gray, who put the scalpel to the swollen belly beneath her.  Rose averted her eyes as the steel sliced through skin, blood vessels and muscles.  When she looked back, one of the other masked surgeons in the room was pulling open the cavity whilst Gray sliced on down to release the baby.  She pulled the head up and out, and between them, Gray and Dr McGhee had the baby out and on the cloth within 30 seconds.  Rose moved forward with the mask.  Dr Gray clamped and severed the umbilical cord and the press of bodies closed out the mother from Rose’s view.  She kept her thoughts on the tiny baby girl Dr McGhee was dealing with.  Behind her, the steady beep of the heart machine reassured everyone the mother should make it.
McGhee and Rose assessed the baby.  She was perfectly warm, small, and tightly curled.  She did not like being manhandled and Rose was sure the tension levels in the room halved when the little girl burst forth her outrage at the manner of her birth and the sudden removal from her mother.  Lung development was Good Enough.  She was also sure she heard the mother’s heartbeat double blip in response to the cries.
When McGhee had the baby connected to the monitors and the temperature and oxygen levels stabilised, they moved her upstairs to the Neo-Natal Unit.  Behind them, the others carried on working for the safety of the mother.
McGhee and Rose barely spoke to each other in the lift, their thoughts and efforts were only for the tiny bundle of life in their hands.  She was thin, but steadily flushing through with pink, and still squalling in fits and starts.  
Baby Nakalinzi was weighed, checked, prodded, injected, and generally fussed over for more than an hour, then settled into a deep and much needed sleep by the caress of her attentive nurses.  Rose had felt the heavy stab in her heart ease as the little one had settled into life, and stayed over long in the unit until the babe was softly asleep.  She then went to check on the mother and put in place all the arrangements they’d need for her to start to care for her baby when she woke from surgery.
The mother, Mercy, was out of theatre but being kept under sedation.  Her body had stayed strong throughout and her heartbeat was regular.  Discussions were taking place on where she should be placed and Rose spoke up for her going into the new rooms designed on the fourth floor to accommodate mothers in need of post-operative surgical care.  Yes, she was more high-dependency than usual for that unit, but her baby would be just upstairs and it would facilitate skin to skin and establishing breastfeeding.  Wasn’t that the whole point of the new rooms?
When the discussion got heated, Rose backed out of it and waited respectfully for the surgeons to finish arguing their territory.  The decision was tipped by Dr Gray, who argued that care was care, no matter where the machines were plugged in and that getting Mum and Baby together was best for both of them.  The unit was designed to give specialist post-natal care and the head injury was not that major.  Mercy was moved to a side room in the maternity special care unit on the fourth floor.  Baby would come down to join her as soon as it was safe to do so.
Rose was watching the thick snow settle outside as she did the paperwork for Mercy.  Her temperature was stabilised and her stomach wound clean and neatly sutured.  All her vitals were excellent and her prognosis was good.  She’d be kept sedated for about 24 hours, to give her body time to recover and heal, and then they’d proceed with waking her up.  The x-ray had shown a small fracture on her skull, but there shouldn’t be much more complication than the concussion.  The snow and ice had robbed her of more than the backwards slam into the top of a low brick wall. 
Her nose twitched by the lack of father, or any other human being in attendance at the unit to see how she and the baby were, Rose went looking for relatives.  A couple of hours on the phone to Social Services provided the answer that there were none, well, no adults.  Mercy had only arrived in London two days earlier, from an immigration detention centre.  She and her three year old son had been in detention for the past six months, nearly 60 miles north of London, in Bedfordshire.  She’d been released to have the baby and the boy was already in foster care, having been found by police when the ambulance had been called for Mercy.  The hostel they had been in was paid for by Social Services and they only had info on her from her two nights previous.  Typically, she’d been released to the local borough that she’d been in before she was lifted by the Borders Agency, and returned to it, despite not having any home or connections there for the months she’d been away.
Rose sent two messages out to the local charities and the churches that supported refugee claimants.  Someone would have been helping her when she was locked in Yarl’s Wood, but it may take time to track someone down who knew her.  She spoke to Social Services again, to confirm the boy was okay and to get the name of whoever was going to be assigned to sort all this out.  Rose had a bad feeling in her bones.  The East End had seen generations of refugees swarm through its streets: in many ways the times were the worst possible for them.  She’d tended the birth of babies that had then been deported in their mother’s arms, back to whatever terror they had been fleeing from.  She prayed the baby upstairs now would not be another one.

By now she was several hours past her shift end.  The snow outside was building up.  The entire unit was understaffed.  She argued with herself about the best course of action: go home where she wouldn’t have much time for sleep, but could let go the stresses, or stay here and sleep where she could, for as long as she could manage.  Indecision took her back up to the neo-natal unit, where the baby was still fast asleep, the monitors pinging away as they should.  It occurred to her that no one may have told the mother she had a daughter: she’d been in general surgical care after all.
She slipped down the back stairs, something she had been avoiding where possible these past few months.  As she passed the fourth floor window she expected to feel a shiver, but did not.  Telling herself again she was being ridiculous, she went on down to the ward, and went into the room Mercy was in.  The woman was alone, the machines all keeping their vigil for the staff.  Rose pulled a chair up to the head of the bed, and seated herself.  She held the woman’s hand in her own, stroking the back of her hand, as she told her that she had a daughter.  A healthy and happy daughter who was being cared for by loving arms, just above her head, on the floor above.  Her daughter would be down to see her the next day, when she woke, and that Mercy was not to worry about her son.  He, too, was safe.  Both her children were safe, and Mercy should sleep, rest and recover.  So she could wake up and hold them close.
Rose blinked the tears from the corners of her eyes as she patted the woman’s hands, and stood up.   
The shiver caught her breath.  Her feet felt frozen to the ground.  Her breathing stalled.
There was someone standing on the other side of the bed.

The need to react was totally overtaken by the door behind them opening and closing with a bang.  Rose turned her head too quickly, and felt dizzy, slumping onto the seat.  Dr Gray came over.
‘Are you all right, Rose?’
Rose, who was as pale as the snow catching on the window sill, nodded.  ‘Startled, just a little startled.  Been a long shift.’
Shafiah was gone.  Obviously, since Dr Gray hadn’t screamed. 
‘I do appreciate the over-time Rose, I really do.  Especially now.’  Dr Gray left Rose to pick up Mercy’s chart and give it a quick look see.  Fiona Gray was not an emotional person, not in the least sentimental or personable.  She took everything and everyone at face value and never seemed to notice that most of the staff didn’t like her very much.  Professional respect was all she required from everyone and Rose wasn’t offended by the absent way Fiona didn’t quite chat to her as she conducted her analysis of Mercy’s chart.  She was grateful for the opportunity to collect her thoughts and to calm her racing pulse.  Dr Gray moved down to where Shafiah had been standing, and addressed Mercy.
‘Apologies, Miss Nakalinzi, I came to inform you your daughter was safe and well.  But I suspect that Rose got here first.’  Dr Gray smiled over at Rose, who was almost as thunderstruck by the comments as she had been by Shafiah’s appearance.
‘I’ll leave you to it, Rose.  Good evening, Miss Nakalinzi.’  Dr Gray left the room.
Rose stayed seated as she tried to piece her thoughts and feelings back into some sort of shape.  This task was overtaken by the arrival of Lucy Manning, who had finally made it in.  Rose and she retired for some strong tea, and a brief hand-over.

Whilst she was nodding on the couch in the staff lounge, snug in her sleeping bag, Rose realised that Dr Gray would not have screamed even if she had seen Shafiah.  She’d never met her, and what was the strangeness of a woman standing in a room by a bedside?  The strangeness would have been the supernatural appearance and disappearance. Besides, she, Rose, hadn’t screamed on either occasion.  She wished she could talk to Tommy Doyle: she fell asleep praying.
Lucy Manning shook her awake in the wee small hours.  Rose knew from the touch and the pale face that something was very wrong.  As her own eyelids flickered open, Rose saw that tears had been shed by Lucy’s.  What on earth was wrong?
‘I’m sorry to wake you.  I just had to have someone to talk to.’
Rose pulled herself out of the shreds of sleep as she pulled herself out of the sleeping bag.  There were two steaming hot mugs of tea by the table.  Lucy sat and huddled round hers, waiting for Rose to wake up enough to join her.  Rose ran her hands through her hair, gave her face a quick rub and sat down, blinking.  She lifted the mug up and wrapped her hands round it, breathing in the heat. 
She listened.
Tears came first, and Lucy dabbed at her eyes with a paper hanky.  It was scrunched and well used.  She blew her nose.
‘Sorry, Rose.  I couldn’t let the younger ones see me.  It’s not good.’
Rose nodded.
‘Is it a baby?’  Rose had never known a midwife who didn’t cry after a still birth, or an early death.  You just did it in private, away from the family.  Their grief came first.  You let it out afterwards.
Lucy shook her head. 
Rose sipped the tea.  It was sweet.  Lucy had put sugar in it; sugar for shock.
‘No, it’s a mother.’
Rose swallowed more tea which no longer tasted sweet.
‘A mother.  They’re taking her downstairs now.’
Every nurse referred to the morgue as ‘downstairs’, no matter where it was located.
‘The baby?’
‘It’s Mercy, Rose.  Mercy is dead.  She had a heart attack and… and she never held her baby, not once.’
Lucy dissolved into sobs, quiet wracking sobs.  Rose placed her right hand on Lucy’s shoulder, witness to her distress.

It took ten minutes or so for them to get each other in full control.  Lucy washed her face in cold water to calm her eyes, and Rose did the best she could to make it look as if she hadn’t slept on a couch.  Lucy’s tears had stained her blues so she changed into new ones as Rose dressed for her shift.
Together, they went over all the paperwork, making sure every i was dotted and every t crossed.  The normal paperwork of the ward was an impeccable detailing of every moment, intervention, and event of the birth and after care.  There was precious little detail in Mercy’s, given she’d been in Theatre and then unconscious, but they checked and double checked everything was sensible, in order, and as it should have been.  There would be an internal inquiry; there always was.
Rose watched Lucy begin the long trek home in the snow and ice, and set herself to the task of keeping the entire shift on track.  It was usually the next shift in from a death that saw the most disruption.  The staff on duty took their shock home, but the next shift came in under a pall.  Every subsequent birth was high tension in the minds of the workers, and every happy mother holding a baby an invite to tears.  She also spent some time with Maggie, going over even more paper work.  Maggie was controlled and deadly rage: she was personally insulted any time a mother died under her care.  She’d seen too many dead mothers in some of the places she’d worked with relief agencies.  In war and famine, the mothers and children usually came last.
With some relief, Rose trudged back home over the melting ice, some fourteen hours in Lucy’s wake.  Another four days of rest was in front of her, and the pain of the death behind her, disappearing in the rain.  
She bought smoked salmon from the all night deli.

Tommy had once again lit up his pipe, and sat puffing away, the smoke drifting around the living room.  Rose was huddled over another steaming hot mug of tea, this time it had a liberal application of whisky, care of Tommy.
The silence, the easy, comfortable, friendly and well-used silence between them, was doing more to soothe her than speech.  The silence allowed her tears to flow.  Tommy puffed away as the salty fluid dripping from her eyes drained out the canker in her soul.
Rummaging for a hanky and blowing her nose and drying her eyes, was the signal for conversation to start up again.
‘You think it’s coincidence?’  Her voice was too defensive, and she knew it.
‘No, I don’t, lass.  I think there is a puzzle here.’  He tapped out his pipe before tapping more of his special baccy mix in. ‘I just don’t know what it is. What she is trying to say to us.’
‘Death is pretty simple.’ Rose sat back, exhausted. 
‘Dying may be simple, in a first this happens, then that sort of way.  But death itself… that is never simple.’  Three deep puffs, and a long stream of smoke sent upwards, away from the table.
‘Death is a divine mystery…?’  She tried for a rueful smile.
‘Is it death, ‘tho?’
‘What do you mean?’
‘How many people have died in the hospital, since that poor lass fell to her death?’
Rose considered.  ‘Lots’.
Tommy nodded.  ‘Now, this is a hard one.  Have any mothers died, since?’
Rose swallowed hard as the tears swelled up.
‘Or babies, in fact?’
Rose looked over to Tommy, pinning him with her gaze.  Tommy took the assault, and sat quietly until Rose herself looked to one side, breaking off the connection.
‘Your brain is like a steel trap, Father Doyle.’
‘It takes one to know one, Sister Templar.’ It was an old joke between them, since Rose had once been a ward sister, before titles had become managerial gobbledygook.
‘And the answer…?’
‘Two mothers and one baby have died since Shafiah did, in the wards.  One was a woman who’d been in cancer treatment when she became pregnant unexpectedly.  She was dying and there was very little hope of more than a year in any event.  She stopped all treatment, went home, and prepared for her baby.  She died in the unit, with the baby in her arms, about two days after the birth.’  Rose envisioned the scene that Lucy had described so poignantly:  Mum and Dad in bed together, the baby on Mum’s chest, Dad’s arms holding them both.  The mother’s parents sitting in the room, grieving the loss of their child whilst trying to hold onto the joy of a new grand-daughter.  She left a few moments’ silence, to collect her thoughts.
‘Then there was the Mum and baby we lost a few months ago.  Very unusual. Mum was on holiday here, from Devon.  Hit by a car.  Placenta previa, in addition to serious chest injuries.  She bled to death, baby died in utero.'
‘You were on duty?’
‘For that one I was on stand-by, she was in theatre when I came on shift.’
‘And did you… have a visit… for either…?’
‘Could someone else have?’

Rose had no idea, and she had a delicate look around, chatting to people, listening hard, looking for signs over the next few weeks.  There was no hint anywhere that anything unusual had been occurring. Given how superstitious most hospital staff were, she didn’t know if she was relieved, or disappointed.  The inquest on Mercy recorded it as a tragedy and the hospital was praised for how well it had cared for her.  Anyone can have a heart attack, at any time, and the fact she was wired up to a series of machines when she had hers, was evidence that all measures to keep her safe had been taken.  Both children were put into the system for adoption and thus become British citizens.  Rose had the comfort of that; that Mercy rested with both her babies safe from deportation.  She was buried not far from Shafiah’s unmarked spot, having the same anonymous burial on the council funds.  Rose would walk past, and say silent hellos to them both, and assure them their children were happy and well cared for.
Or so she prayed.

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