The Midwife's Courage (Glenfallon) Page 2

  ‘Room Two, Dr Di Luzio.’

  ‘Thanks.’

  He collided with the new midwife—Kit something—right in the doorway, ended up with a hand cupping her elbow and her toe pressuring his foot. He smelled lilac and peaches and the starchy, synthetic smell of new uniform. He had time to notice that her lovely, fine-pored skin was stretched over smooth arms and a very graceful neck.

  ‘Oops,’ she gasped. She looked preoccupied.

  ‘Problem?’ He navigated her by the elbow back out the door, and spoke quietly.

  She looked up into his face. Her almond-shaped brown eyes were fringed with thick lashes and, at the moment, shadowed by a worried frown. And there was something about her mouth, about the fullness of her upper lip, that spoke volumes. He sensed that she had a good bit of history behind that pretty face.

  ‘The heart rate has dropped,’ she said. ‘Pretty suddenly. It’s down to seventy beats a minute during contractions, and barely coming back up between them. I’m not sure what’s going on. The patient says she’s only been in labour since last night, but she’s exhausted. I don’t like the pressure her friends are putting on her. There’s a border-line between encouragement and bullying, and I feel they’re on the wrong side of it. There’s some mec. staining, too.’

  ‘How dilated is she?’

  ‘Well, the policy in this unit—’

  ‘For heaven’s sake, I know the policy in this unit!’ Gian said, and muttered an oath.

  He pushed impatiently past the new midwife, back into the room, keeping his distance from her personal space. There was still a faint aura of sensation…and scent…and warmth…clinging to him from when they’d collided, but he paid it no attention. There were far more important issues uppermost in his mind.

  The patient’s two labour partners looked up at him at once—defiantly, to his critical gaze.

  ‘I want to take a closer look at what’s going on, Laurel,’ he said to the patient herself. Kept his tone brisk and cheerful.

  She gave him an exhausted, agonised glance and didn’t speak. A contraction began, hard on the heels of the one before, and she puffed raggedly through it, gripping her friends’ arms, breaking off to moan. Her control lay in fragments, and her body was bathed in sweat.

  ‘She’s doing fine,’ one of the women said.

  Gian didn’t waste time on questioning his own preconceptions. Whatever the ramifications of the relationship between the three, whatever was signified by the absence of a father, it wasn’t his concern.

  ‘But the baby might need some help,’ he answered gently, hiding his anger. ‘The heart rate is low, and the waters aren’t clear. Laurel, I want to check you out, and the baby, and I want you to prepare yourself for what’s probably going to end up as an emergency Caesarean.’

  ‘She doesn’t want that sort of intervention,’ one of her supporters said.

  Gian ignored her. ‘Laurel, I need to hear from you on this.’

  ‘I don’t care…any more,’ she gasped.

  Gian was already listening to the baby. Seventy beats a minute, Kit McConnell had said. Now it was lower. Erratic, too, and not strong.

  ‘Get Clive,’ he said urgently, then remembered that this peach-and-lilac midwife with history in her face was new. ‘Anaesthetist. She’ll need a general. No time for epidural. They’ll still be clearing up in the ob theatre. This can’t wait. We’ll go down to the main theatre suite. And can you—?’

  ‘Hang on a minute, Dr Whoever-you-are!’ The more vocal of the supporters again.

  ‘Di Luzio. Gian Di Luzio,’ he supplied, terse now.

  ‘This is Laurel’s birth process. Aren’t you going to consult—?’

  There was no sense in losing control, although Gian came close. He said very deliberately and carefully, ‘This isn’t about Laurel now, I’m afraid. It’s about the baby. Which may have serious problems if labour drags on any longer. When did it start?’

  Kit slipped past him, out of the room, as he asked the question. Her hips moved with the grace of a dancer, but her shoulders looked surprisingly square and sturdy. The combination of delicacy and strength that she gave off was unusual.

  ‘She was having contractions on Saturday, but—’ one of the women began defensively.

  ‘No. Friday,’ Laurel gasped.

  ‘Three days ago?’

  ‘They weren’t intense,’ said the second supporter. ‘Not really. And they began quite far apart. About thirty minutes for the first couple of hours, and then—’

  ‘Regular? Increasing in frequency and duration? Painful?’

  ‘Yes, but she could breathe through them quite comfortably until—’

  Emma appeared in the doorway, her dark frown emphasising the habitual brooding look on her face. ‘Clive’s on his way down. Julie will circulate, and Kit’s going to scrub. But Special Care is short-staffed today, and with the little Frampton girl needing some—’

  ‘Try Pete Croft or Alison Cairns, whoever’s closest on hand,’ Gian told her. ‘I want to get this baby out within the next ten minutes.’

  ‘Patriarchal pig,’ came a muttered voice in the background.

  ‘Arrogant bloody creep!’ said a second voice.

  The hair on the back of Gian’s neck began to prickle and he swore. The obscenity—moderate word, strong tone—caught Kit like a slap on her ivory-and-peaches cheek as she appeared again. He hadn’t intended that, but he was angry with her. With everyone, in fact, himself included. This shouldn’t be happening.

  ‘We have an orderly on the way,’ she said, then added quickly and quietly, ‘Dr Di Luzio, I realise you must want me to go on ahead, but I’m not sure where the theatre suite is, and I don’t want—’

  ‘Oh, great!’ came the ‘patriarchal pig’ voice.

  ‘Come on,’ Gian told her, gripping her elbow and pulling her with him. ‘You won’t get lost with me.’

  Walking beside him in a thick silence, Kit had to conclude inwardly, The man is nothing whatsoever like his mother!

  Not in looks, and certainly not in temperament. Replace maternal brown eyes with diamond-hard black ones, add, oh, around a third of a metre of height, change a soft, wide smile to anger-thinned lips and concede that, before she went grey, Federica Di Luzio probably had hair as thick and dark and glossy as her son’s.

  And, OK, maybe their noses were the same, both of them straight and patrician like the noses of marble busts made in ancient Rome. An arrogant nose, in his case, shadowing an angry mouth.

  End of resemblance.

  Kit’s heart thumped with sick-making abruptness in her chest. Dr Di Luzio unsettled her, made her as jumpy as a cat. She knew he had reason to be angry at the labouring woman’s strident supporters, but it seemed as if he had plenty of anger left over for her as well. Her decisions. Her priorities. Her adherence to policy. The fact that she hadn’t probed more deeply into the women’s definition of ‘labour’.

  Emma had said, ‘Get a clear history. Dr Di Luzio overheard something and thinks there’s cause for concern.’

  Kit had agreed, after ten minutes spent with the patient, that her supporters were hindering rather than helping, but they’d been quite firm on one point. ‘Labour, proper labour, as defined in all the reading we did, didn’t start until last night.’

  Laurel herself had confirmed it. Laurel herself had gasped, ‘No, I don’t want an internal exam, or an internal monitor. I’ll know when it’s time to push, right? Has to be soon…’ But apparently the obstetrician’s more detailed probing had yielded a changed story. Labour had actually begun three days ago.

  What if the baby wasn’t all right?

  ‘Here we are,’ Dr Di Luzio said. His voice was deep, and rich in tone.

  Plunging into the familiar routine of a Caesarean delivery, albeit an urgent one, acted as a calming blanket on Kit’s jangled nerves. They prepped the equipment, prepped the patient, adjusted the lights. Dr Di Luzio didn’t waste a word. The baby was out a minute and a half before his darkly threate
ned deadline, and into the hands of the doctor who’d been called in.

  It was a girl. She was limp and unresponsive, and smeared with meconium. The fact that she wasn’t breathing on her own was, for the moment, a plus. It bought the doctor and nurse who were working over her a crucial interval of time in which to suction her nose and mouth so that when she did breathe, she didn’t inhale the dark, sticky and potentially fatal faecal matter.

  ‘Airway clear now,’ the doctor muttered, after the seconds had dragged on. Kit had caught his name at one point, but had forgotten it. Pete, maybe? ‘She’s a bit shocked. I’m going to bag her.’

  ‘You want the pulse oximeter in place?’

  ‘Yes, please, Vanessa.’

  ‘One-minute Apgar score—five,’ the nurse said.

  ‘The five-minute score is the one that really counts.’

  ‘Let’s hope we got to her in time,’ Gian muttered wearily, and turned his attention at last to the patient’s incision.

  His hands were as expressive as his mother’s, Kit conceded. They moved with angular and angry precision, never rough but very crisp and fast. He worked as quickly and neatly as the best obstetricians she’d seen in Canberra and Sydney, but there was no small talk, and over in the far corner, the doctor and nurse were frowning over the little girl.

  In desperation, hating the atmosphere and the pervasive sense that the baby might not be all right, Kit asked the obstetrician quietly, ‘What should I have done differently, Dr Di Luzio? How could I have stopped this from…?’ She stopped, and began again, determined to get this right, so that their working relationship wasn’t ruined from the beginning. ‘I’m not challenging your perspective. I just want to know what you think.’

  ‘You think it’s you I’m angry with,’ he muttered, drawing the two sides of the incision together.

  ‘Yes. Aren’t you? Partly, at least. I don’t imagine being labelled a patriarchal pig and an arrogant creep helped your mood.’

  ‘I’ve heard worse.’ He interrupted himself. ‘Julie, can you—? The black, yes. Thanks.’ He added to Kit, ‘It really doesn’t matter.’

  ‘To be called names?’

  ‘To be disliked. Feared, even. If it gets results.’

  ‘Do we go back half a century, then, Dr Di Luzio?’ Julie asked. ‘With rigid hierarchy, and nurses treated like ignorant maidservants?’

  Pete and Vanessa worked on the baby. Clive minded his own business. The debate took place between Gian and the two midwives.

  ‘Sometimes,’ the obstetrician answered as he worked. ‘If that yields the outcome we want. I think we’re too hung up on the mother having a good birth experience. Sorry. I’m conservative on that. I’m sceptical about home births, and water births, and labours that aren’t fully monitored. The outcome I want is a healthy baby, and if the atmosphere isn’t rosy around the edges, so be it. We may not have achieved the right goal today. This baby may not be all right.’

  ‘Because I didn’t push harder?’ Kit watched another suture slip neatly into position.

  She was pushing now. Pushing him, although she didn’t enjoy doing it. She would have to work with this man, however. It wasn’t the time to be timid.

  ‘And because I didn’t,’ he answered her. ‘Because I didn’t communicate well enough with Emma, and because Emma didn’t communicate well enough with you. Because the mother, bullied by her friends, was putting the birth experience ahead of the baby. We’re all at fault.’

  ‘Looking much better, everybody,’ Pete said. ‘Spontaneous respiration happening now. Five-minute Apgar score is eight.’

  ‘Eight?’ Dr Di Luzio repeated. ‘Couldn’t hope for better than that.’

  ‘Considering how she looked when she came out, yes.’ The highest possible Apgar score was ten. ‘And she’s opened her eyes. She’s looking at me. She’s got her fist in her mouth and she’s sucking it. Hear?’ They all could, a strong, slurping, rhythmic sound. ‘We may have a winner here after all.’

  Kit blinked back hot tears of relief, and watched as Gian’s hands stilled for a moment over the patient’s flaccid, half-stitched lower abdomen. Glancing up, she saw that he’d momentarily closed his eyes above his mask. The stillness in his face emphasised his classic bone structure—smooth forehead, confident jaw, symmetrical cheekbones. She felt a little lurch in her stomach that she couldn’t explain, an awakening of something inside her that she’d feared was gone forever.

  When he opened his eyes again, she caught a glimpse of the same expression that had been on Federica Di Luzio’s face earlier this afternoon, when she’d talked about her granddaughter.

  Ten minutes later, she saw him approach Laurel’s two friends. They were pacing the corridor outside the theatre suite, wearing expressions creased with concern.

  ‘Laurel has a beautiful baby girl,’ he said to them. ‘She’ll spend some time in the special care unit until we can see how she’s doing. And Laurel is in Recovery. You should be able to see her soon. Any questions, please, ask.’

  Much later, after her evening meal break, Kit felt a substantial presence leaning across the desk at the nurses’ station where she was working. She looked up.

  ‘That wasn’t a great introduction for you, today,’ Gian said. ‘I want to apologise for contributing to it.’

  ‘I understood what you were saying,’ she answered, taking her hand from the smooth plastic shape of the computer mouse and curving it around her knee, just where the fabric of her blue surgical gear stretched tight. She was conscious of him, now, in a way that was unsettling—conscious of his bulk, his dark colouring, his instinctive aura of presence and confidence. ‘If you saw more of the really wonderful, relaxed, easy births that the nursing staff so often deal with…’

  ‘I have seen those,’ he pointed out. ‘Plenty of times, during my training. I still see them, with private patients, or when problems we’ve anticipated don’t actually occur. I don’t try to turn every woman’s delivery into a technological nightmare.’

  ‘But a technological miracle…?’

  ‘Yes. It’s worth more than some people think.’

  They smiled at each other. Cautiously. He added, ‘My mother tells me we’re neighbours, at a distance of two kilometres.’

  ‘Oh, you live on the farm with her?’

  ‘No, I have a unit here in town, a couple of streets away. But the farm has always felt like home, and since my little niece came along, I’m spending more time there. Mum needs the help with Bonnie, although she’s having trouble accepting that.’

  ‘She’s pretty good, isn’t she? I liked her.’

  ‘She has her moments!’

  They smiled again.

  Dr Di Luzio was wearing a suit now, and had obviously come in to check on his patients before going out to dinner, or perhaps a meeting. He looked impressive, attractive and very European with his dark colouring. If Kit had never heard him speak before, she might have expected an accent, but even Federica didn’t have one. The family must have been in Australia for a while.

  Still, there was a cultural heritage. Instinctively, as she looked at him, Kit thought not of harsh operating lights and the glare of surgical instruments, or even of a stethoscope pressed questingly to a woman’s warm, swollen belly in search of the sound of a heartbeat, but of far more sensual things. Heat rising from soil, the warm smell of fresh-picked summer fruits and the richness of wine.

  She realised, too late, that she must have been staring at him far too openly. His next words flustered her still further.

  ‘Listen, I wanted to make you welcome here, especially after today,’ he said. ‘Would you like to grab a meal later in the week? Which nights are you free?’

  Kit wasn’t sure if she wanted to go. He was being neighbourly—and ‘welcoming’, as he’d said. Possibly his mother had put him up to it. With her recently developed instinct for self-preservation, she made light of the invitation.

  ‘I’m more than happy to let you off with the apology you’ve already given
, Dr Di Luzio,’ she said.

  He laughed. ‘That’s what you think? This was another apology? It’s not.’

  ‘Then it’s your mother.’

  ‘Not that either, although I recognise it’s a plausible scenario. She’s Italian enough to claim the right to meddle deeply in my personal life.’ His smile was wicked, softening his black eyes into liquid pools. ‘Most of the time, I don’t let her.’

  He paused, obviously waiting for her answer. Kit took a deep breath, but no words issued forth.

  ‘You’re running out of excuses,’ Gian said softly. ‘I can tell.’

  And she had to laugh. ‘A meal would be nice,’ she conceded. ‘I feel like I know the town, since I’ve been here for holidays as a child, but the town doesn’t know me.’

  ‘I’ll…uh…invite some other people, start getting you known around here. I’m sorry, I should have made it clear straight away that’s what I was thinking of.’

  ‘I’d like that,’ she told him truthfully.

  Better than staring across a tiny table at a man she hardly knew, while they racked their brains for small talk.

  It was a long time since she’d been out with a man. Well, with a man who wasn’t James. She’d turned thirty-three at her last birthday, and she and James had been involved…had lived together…for six years.

  ‘Friday?’ Gian suggested, as he studied the shifting emotions reflected on Kit’s expressive, sweet and history-laden face.

  He wasn’t sure if he was glad or sorry that he’d called in at the farm for an hour, late this afternoon. Mum loved to impart the details of other people’s lives. Never maliciously. Always with the best of intentions. Sometimes, however, it was more than he wanted to know.

  ‘Helen says Kit has had a difficult time,’ his mother had said, confirming the instinct he’d had about the new midwife almost at once. ‘A bad break-up. She’s fled here, really. I don’t know the details. I’m not even sure if Helen does—apparently Kit has kept most of it to herself—but I know she’s worried. Be a friend to her, won’t you, Gian, until she’s settled in?’

  This, after he’d already yelled at Kit a couple of hours earlier. Still, one dinner should do it. She seemed attractive, thoughtful, warm. The kind of woman most men would at once want to know better. It shouldn’t take her long to make friends in a place like Glenfallon.