LITMIR.BIZ

      Prologue

      PATRICK strode through the doors of the labour ward, his bleep and his phone buzzing simultaneously. Pushing open the doors of the delivery room, he walked straight into an atmosphere of palpable tension.

      His eyes met those of a white-faced midwife. Despite the soothing words she was muttering to the panicking mother, there was no missing the strain in her expression and her relief at seeing him.

      ‘Cord prolapse, Patrick. The trace has shown persistent variable decelerations and prolonged bradychardia. I’ve put her in the knee-elbow position, they’re preparing Theatre and I’ve emergency-bleeped the anaesthetist. I’m so sorry to drag you out of your meeting. I know the chief exec gets furious when you go running off.’

      ‘It’s not a problem.’ Patrick shrugged off the jacket of his suit, slung it over the back of the nearest chair and unbuttoned his shirtsleeves. ‘Ed?’ He turned to his registrar and noticed that he looked unusually stressed.

      ‘She needs a crash section,’ his colleague muttered in an undertone. ‘After I called you, I put a line in and infused 50 mils of saline into her bladder, as you instructed. Did I miss anything?’

      ‘Did you do an ultrasound?’

      ‘Yes. There’s good blood flow through the cord.’

      ‘All right. Good job. So we’ve bought ourselves some time.’ Patrick rolled up the sleeves of his shirt. ‘You say she isn’t suitable for a general anaesthetic?’

      ‘That’s right.’ The registrar handed him the notes but Patrick gave a brief shake of his head and walked to the head of the bed.

      ‘Hello, Katherine. I’m Patrick Buchannan, one of the obstetric consultants.’

      ‘I know what you’re going to say and I don’t want a Caesarean section,’ the mother wailed. ‘I want to have this baby naturally. That’s why I only came into hospital half an hour ago. I knew this would happen. I knew if I came in earlier, you’d muck about with me.’ She was kneeling face down on the trolley, her bottom in the air in an attempt to prevent the cord being compressed between the pelvis and the baby’s head. ‘I feel ridiculous in this position. It’s so undignified.’

      ‘This position is saving your baby’s life.’ Patrick squatted down next to her so that he could have a proper conversation and build a connection with the labouring woman. ‘Do you understand what is happening, Katherine?’

      ‘Yes. You’re going to cut me open instead of letting me have the baby the way nature intended!’ The woman was sobbing now, her head on her arms. ‘I hate you. I hate you all. Oh God, why did this have to happen?’

      ‘You’re very tired, Katherine.’ Patrick spoke gently. ‘From what I’ve been told, you were in labour for a long time at home before you came to us.’

      ‘I didn’t want to come to you at all! I just want to have the baby naturally.’

      Seeing how terrified she was, Patrick felt his heart twist in sympathy. ‘You can’t have this baby naturally, sweetheart. It’s too much of a risk. The cord is prolapsed—that means that it’s dropped down below the baby’s head. That’s why you’re lying in this undignified position. The cord is your baby’s blood supply—if that blood supply is obstructed, the baby could die.’

      Katherine gave a low moan and turned her blotched, tearstreaked face to him. ‘Don’t say that! Don’t say that!’

      ‘It’s the truth. And I won’t lie to you.’

      ‘You’re putting pressure on me to have the one thing I don’t want!’

      ‘I’m putting pressure on you, that’s true—but because this is a medical emergency, not for any other reason.’

      ‘You’re a surgeon. You’d much rather intervene than let women do it by themselves.’

      ‘I’m the last person

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