hugs and for the basic necessities of life, but as long as those were provided whenever required, he was prepared to accept the assorted childminders he’d met in his short life. He even welcomed them as a wider audience for his incredible stories.
Now, as the helicopter landed at Crocodile Creek and the baby was wheeled into the hospital, as the emergency team sprang into action, Cal motioned to one of the nurses to take care of him.
‘Gina’s a doctor,’ he said briefly-brusquely. ‘She’s a cardiologist, right when we need one most. We need her help with the baby. Grace, can you find someone to take care of Gina’s little boy?’
‘Sure.’ Grace, a young nurse with a wide smile, held out her hand to CJ and beamed a welcome. ‘I hear you guys have been out at the rodeo. Did you see many horses?’
‘I saw lots of horses,’ CJ told her, ready to be friendly.
‘Will you tell me about them while we find you some juice and some cake? Come to the kitchen. Mrs Grubb is making chocolate cake and she loves hearing about horses. If we’re lucky, I think there might even be an icing bowl to lick.’
CJ was sold. He cast an enquiring glance at his mother for approval, then tucked his hand into Grace’s and disappeared cakewards.
‘He’s a great kid,’ Mike said as the paramedic wheeled the trolley through into Paediatrics, and Gina gave him a glance that she hoped was grateful.
She looked back at Cal. There was no gratitude there. His face was set and stern.
Maybe she should have phoned him four years ago.
Or not.
Maybe she shouldn’t be here now.
If she hadn’t been here now, this baby would be dead.
‘We need an echocardiogram,’ Cal said. He hadn’t paused as they moved through the hospital. He was intent only on the baby. Or he acted as if he was intent only on the baby.
‘You said you don’t have a cardiologist? No one with cardiology training?’
‘No.’
‘A paediatrician?’
‘Hamish is on leave. We’re trying to contact him now.’
‘We’re dead short of doctors,’ Mike said, and smiled, but then his smile faded a little. ‘There’s been a couple of…disasters. Just lucky you’re here, huh?’
‘I guess,’ she said dubiously, and cast an uncertain look at Cal. His face said there was no luck about it.
But she couldn’t look at his face. She needed to focus. This baby needed skills that she possessed.
He certainly did.
When the results of the echocardiograph were in front of her she felt her heart sink. Any thoughts she had of flying out of this place tonight were completely gone.
‘It’s pulmonary stenosis.’
With the stethoscope she’d been able to hear the characteristic heart murmur at the left upper chest. That and the fast heart rate had made her fairly sure what was causing the cyanosis. And now… Her fears were confirmed. There was a huge pressure difference between the right ventricle and the pulmonary artery. Blood flowing in one direction and unable to escape fast enough in the other. Recipe for catastrophe.
‘We can’t risk transfer to Brisbane,’ Cal said slowly-reluctantly. ‘We’ll lose him.’
‘What’s happening?’ Mike asked. He’d come in and watched as they worked, but he’d been on the sidelines. Another nurse was there now-a woman in her thirties who’d been introduced as Jill Shaw, the director of nursing. Jill was wheeling the baby back under the nursery lights, with instructions to keep warming, keep monitoring breathing, while the three of them were left staring at the results.
‘We operate,’ Gina said, staring down at her fingers as if there were some sort of easy answer to be read there. There wasn’t. They really needed a paediatric cardiologist, but the nearest available would be in Brisbane and to transfer the baby…
They would have had to if she hadn’t been here. They’d have been forced to. Cal was an excellent general surgeon, she thought, and his additional physician training made him a wonderful all-rounder in this place where multi-skills were vital. She knew that. Cal’s skills were one of the things that had attracted her to him in the first place.
But the operation for pulmonary stenosis on such a tiny child…
The heart valve they’d be working on-the pulmonary valve-was thin, even in adults. Composed of three coverlets, like leaflets, it opened in the direction of the blood flow. With pulmonary stenosis those leaflets were blocked or malformed in some way. In the baby’s case it was a major blockage. His heart was being forced to work far too hard to force blood through.
What she needed to do was to perform a balloon pulmonary valvuloplasty-a tricky manoeuvre even in adults- forcing the valve to open. With babies this size…
She’d normally advise waiting, she thought bleakly. She’d normally advise keeping him on oxygen. She’d try and get him fitter, older. She’d operate at a few weeks.
To operate on such a newborn…
But this was no minor blockage.
‘Do you have the equipment?’ she asked. ‘I’d need to monitor catheters by fluoroscopy.’
‘I’d imagine we have all you need,’ Cal told her. ‘Simon, the cardiologist who’s just left, had the place well set up for heart surgery.’
Gina nodded. She’d worked with this service before, and she’d expected this answer.
Many of the population around Crocodile Creek would be indigenous Australians, and she knew from experience how reluctant they were to leave their people. For a tribal elder to come to Crocodile Creek for an operation would be hugely stressful, but here at least here they could still be surrounded by their own. To be flown to Brisbane, where there was no one of their tribe and no one spoke their language, was often tantamount to killing them. The cultural shock was simply too great for them to handle.
That would be part of the reason Crocodile Creek would be set up so well, she knew. This base would do surgery which would normally only be done in the big teaching hospitals. Death rates would be higher because of it, but the population would accept it. The doctors involved had to accept it.
But this doctor in particular didn’t have to like it.
‘So we have no paediatrician and no cardiologist.’
‘We’re not normally this short-staffed,’ Cal told her. ‘We’ve had a couple of dramas.’
He sounded defensive, she thought. Good. It stopped her thinking about all sorts of things she should be defensive about.
‘Do you have an obstetrician?’
‘Georgie’s mother died last week. She’s flown down to Sydney with her little boy, and we don’t want to pull her back unless we have to. She had back-up-Kirsty was an obs and gynae registrar-but there was a bit of a dust-up and Kirsty and Simon left in a hurry. Emotional stuff.’
‘Emotional stuff?’ she demanded, astonished, and he looked even more discomfited.
‘Um, yeah. We don’t need to go there.’
Of course not. When had he ever?
But she had a baby to take care of. Cal’s emotional entanglement, or lack of it, had to wait.
Mike was waiting for her to make a decision. He was looking interested-as interested in the chemistry between them as he was in the baby-and that made her flush. She remembered how intimate working in this sort of environment could be. She even remembered enjoying it, but she didn’t relish the questions she saw forming in Mike’s eyes now.
‘I’ll wait for an hour and reassess,’ she said, trying to make her voice calm and professional. ‘We need to get him fully warmed and make sure the shock of delivery has worn off. Maybe once he’s settled we might get better circulation.’
‘But probably not,’ Cal said.
‘No,’ she said heavily. ‘Probably not.’
‘So Gina’ll need to stay.’ Mike wasn’t sure what was going on-his eyes were still asking questions-but he was
