‘Are you OK?’ Ethan’s soft voice washed over her and she shook her head.
‘GPs need to be better informed,’ she said softly. ‘We need to know what to look for, we need more seminars on these sorts of things—especially for those of us in rural or country areas. We’re the first point of contact and we’re the ones who usually look after the patients on a day-to-day basis.’ She opened her eyes and turned to face him. ‘We need to be better informed.’
Ethan listened to what she had to say. She was right. There was a lot of information in hospitals and city centres but they needed to broaden their horizons. ‘You’ve raised a good point, CJ.’ He’d been looking for a new research project and although it wasn’t strictly his speciality, he knew several colleagues who could help him out. ‘I’ll see what I can do. In the meantime, don’t go beating yourself up over Margaret.’
‘Easier said than done. I’ve known her for years and although we’ve never been close friends, she was still a patient of mine and I’ll always feel like I failed her.’
Ethan wanted to go to her, to stop her pain, to stop her hurting, but he knew he couldn’t. To touch CJ, even in a gesture of comfort, wouldn’t get them anywhere. He’d hold her and he’d want to keep her there. He’d want to kiss her, to let her know that he was there and that he really did care.
‘I feel your frustration.’
She nodded as she remembered that this couldn’t be at all easy for him either, given what had happened with his wife. ‘I know you do.’ Her smile encompassed him and immediately his heart, which had started to feel tight and constricted again, began to relax. What was it about her that enabled him to let go of his stress so easily?
‘How’s Elizabeth?’
‘When I last checked with Molly, she was sleeping soundly.’
‘Good.’ He jerked his thumb over his shoulder. ‘I’m going to go check on Margaret again. I think we need to get her transferred to the labour room.’
‘OK. I’ll wait here for Doug and bring him through. He shouldn’t be too much longer.’ Ethan nodded at her words, then headed off to oversee Margaret’s transfer.
* * *
Three hours later, Margaret’s blood alcohol level was reasonable enough for Charlie to attempt an epidural. She had started to feel the contractions, which was a good sign, but Ethan wasn’t happy with the baby’s present situation.
‘Deceleration on the CTG. The baby’s going into distress.’ They shared a look and with a nod CJ turned to Charlie.
‘Give me an epidural block, stat.’
The anaesthetist nodded and set to work.
‘Bonnie,’ CJ said, ‘prep her for an emergency C-section and get the theatre ready.’
‘What? What’s going on?’ Doug asked.
‘The baby’s not coping,’ CJ explained.
‘Not coping with what?’
‘With everything. First of all, Margaret’s blood alcohol level when she came in was point one five. That’s three times the state limit for driving.’
‘But she’s been drinking wine all her life. She can handle it.’
‘She might be able to but the baby can’t. Alcohol in the mother’s blood crosses over to the baby through the placenta so the baby has the same blood alcohol level as Margaret. We’ve been over this several times with you, Doug!’ CJ was feeling incredibly frustrated.
‘What...what needs to happen now?’
‘The baby is in distress, Doug. We need to get the baby out as soon as possible and Margaret’s blood pressure keeps climbing. Both are in danger of losing their lives if we don’t act immediately.’
He paled at her words. While she’d been talking, they’d been getting Margaret ready to move to the theatre. Once everything was ready, they wheeled her bed down, the machines and monitors she was hooked up to coming along beside the bed.
Soon Margaret was settled on the operating table with a screen erected around her shoulders to shield her from the operation. Ethan talked over the procedure with CJ while they scrubbed.
‘Are you happy to take the lead?’ she asked him.
‘It’s been a while since I’ve done a C-section but I did read up on it a few weeks ago to refresh my memory, just in case this eventuality presented itself.’
She nodded. ‘And I’ve been reading up on what to do with the baby, just in case.’
‘So have I.’
‘Good. Then between the two of us we should be fine.’
Once Charlie had given Margaret the block, CJ and Ethan stepped up to the table. It wasn’t long after making the incision that they were able to get the baby out.
‘Congratulations,’ CJ said, holding the baby up so Margaret and Doug could see.
‘A boy!’ Doug whooped. Margaret merely closed her eyes as though in pain. ‘We’re going to call him Joshua. Joshua Douglas,’ Doug continued, a bright smile beaming across his face.
‘That’s a lovely name,’ CJ replied.
Ethan was standing beside her, waiting with a warmed, sterile nappy in which to wrap the premature baby. CJ placed the little boy into Ethan’s waiting hands. ‘Forceps,’ she said, and clamped the cord off with two sets of forceps, cutting the cord in between.
Ethan took the baby to the neonate section trolley, Bonnie working beside him. CJ delivered the placenta before starting to suture. ‘How’s it going?’ she asked.
Ethan was rubbing the baby with one hand, stimulating blood flow. ‘Heart rate is low, breathing isn’t too good. Bonnie, suction.’
Bonnie did as he asked while he checked the baby’s reflexes and colour. ‘Still quite blue. Come on, little man, come on,’ he urged. He shook his head. ‘We’ll need to intubate. Facial features are indicative of FAS. Flat mid-face, low nasal bridge, indistinct philtrum and thin upper lip.’
‘One minute,’ Bonnie said.
‘Apgar score is five,’ Ethan remarked.
‘What...what’s going on?’ Doug asked.
‘The baby’s not responding too well,’
