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don’t. But we have an outstanding transaction. It’s a pride thing.’

      ‘Ah…so it’s your ego talking. Poor Cade,’ she cooed. Cade laughed. ‘I’m sure my ego will survive.’

      ‘I’m sure it will, too,’ she quipped.

      ‘Was there a reason you paged me or is it your sole purpose in life to be disagreeable?’

      Callie laughed in his ear and his body remembered vividly the havoc her laugh had wreaked on Saturday night. ‘I need a consult,’ she said. ‘I’m looking at a twin-to-twin transfusion syndrome and I want to give the parents all their options, including that new-fangled fetoscopy thing you do.’

      Cade grinned at the faux reverence in her voice. ‘On my way.’

      Five minutes later there was a knock on her door and Callie took a moment to mentally prepare herself before she said, ‘Come in.’

      She was glad she did. Cade in a tux was a sight to behold. But Cade in a business shirt, stethoscope casually slung around his neck and his tie askew—utterly befitting the image of the dashing, maverick, prenatal surgeon—was tempting on a whole other level. He appealed to the doctor in her and, for Callie, that was way more dangerous than looking sexy in a suit.

      ‘Hey,’ he said.

      His smile was open and friendly and his gaze was full of familiarity, and the sense of emotional danger she felt when he was around increased. ‘Thanks for coming,’ she said. ‘Have a seat.’

      And then she launched straight into her spiel because she suddenly realised that with Cade, everything she’d practised over the years was in peril. That smile could make her do something crazy, like throw every ounce of caution and control she’d ever exercised to the wind.

      It could make her put her heart on the line for him. A man who was as reluctant to get involved and as burned by life as she was. Hadn’t her heart already suffered enough at the hands of a man who wasn’t capable of love?

      No. She’d dodged a bullet when Cade had rejected her advances. Putting herself in front of the gun again was just plain stupid.

      ‘Kathy Street is a twenty-six-year-old multipara. She has three children under five and is now twenty-two weeks with her fourth pregnancy, identical twin boys.’

      ‘With a monochorionic placenta?’

      ‘Yes.’ Callie nodded. ‘She had a scan at twelve weeks, which diagnosed the twin pregnancy, and was supposed to have her standard nineteen-week ultrasound but missed it due to personal circumstances.’

      Cade frowned. ‘Which were?’

      ‘The recent floods prevented her from making the nineteen-week scan. They live three hours west in a small farming community that was flooded in for two weeks and the last week they’ve been cleaning up and trying to get back on their feet. Yesterday was the first chance she had to get to the medical centre for the ultrasound, which is, by the way, an hour’s drive.

      ‘The GP was concerned she was large for dates, which Kathy had put down to carrying twins and the breathlessness and exhaustion she was feeling down to the stress and hard work of mopping up. But the ultrasound…’

      Callie handed over the images that Kathy had brought with her.

      ‘It shows a larger twin with evidence of polyhydramnios and enlarged bladder and the smaller twin with next to no amniotic fluid or discernible bladder.’

      Cade looked at the dramatic images. The larger twin, or the recipient twin as it was medically known, was sitting pretty in its over-filled sac while his brother, the donor twin, was practically shrink-wrapped inside his.

      ‘They were referred here immediately and travelled up last night.’ Callie turned to her computer and retrieved the data she was looking for. She swivelled the monitor round for Cade to see. ‘These are the images I took just now,’ she said.

      Cade shifted forward but the angle and the light in the room made it difficult to see properly so he perched on the edge of her desk, letting his leg swing a little as he leaned in towards the screen.

      As he watched he was thankful he worked in, and had had exposure to, the more advanced technology of a large modern hospital. Still images were fine but to be able to see the babies in action, so to speak, was much more helpful. Callie had been thorough with all her measurements and the colour Doppler flow study was particularly helpful.

      Callie looked up at him. ‘I think she’s a good candidate for FPLT.’

      ‘Well, they’re obviously too young to deliver. Certainly fetoscopic placental laser therapy is an option but reduction amniocentesis would be a more conservative approach.’

      Callie smiled. Cade Coleman was not known for his conservative approach to medicine or else he wouldn’t be blazing a trail in prenatal surgery, but it was good to know he wasn’t a cowboy, either.

      ‘Yes. But I think Kathy and Ray’s personal circumstances lend themselves much better to a one-off therapy like FPLT. You and I both know that removing the excess amniotic fluid from the recipient twin is a procedure that often needs to be done multiple times with associated risk of premature birth each time. Not to mention the need for stringent follow-up.

      ‘They don’t live close to a treatment centre, which would cause a lot of undue stress both physically and, I suspect, financially for them. And she’d need to be on bed rest for the remaining pregnancy. Kathy is not a bed rest kind of woman—she has three little kids and a farm that she helps run. We’d have to admit her for the rest of her pregnancy to ensure that.’

      ‘She’ll still need to rest after laser therapy.’

      ‘I know,’ Callie agreed, tapping her pen absently against the wooden desktop. ‘But if she’s non-compliant or poorly compliant, at least the basic cause has been dealt with.’

      Callie had grown up around women like Kathy—they worked hard from sun-up to sundown. Rest was something people in the city did.

      ‘I think she’d be much happier having weekly follow-up ultrasounds locally than stuck in a city hospital, worrying about how her hubby is coping with the kids and the farm.’

      She put down her pen and stared at him for a moment. She didn’t think she’d have to work this hard to convince Cade Coleman, of all people!

      ‘It has the best outcomes for both twins over any other treatment,’ she said. ‘Prior to your arrival, Kathy and Ray would have to have travelled to Sydney for this.’

      He grinned. ‘You know you’re preaching to the converted, right?’

      Callie shot him an exasperated glare. ‘Well, what are we waiting for?’ she said, standing up. ‘Let’s go and talk to them.’

      He followed her through an interconnecting door to the next room, where a couple sat quietly holding hands. After the introductions were over, Callie gave them a reassuring smile.

      ‘You’ve both had a lot to take in this morning,’ she said. ‘Before I get on to treatment options, have you got any questions about the actual condition?’

      Kathy’s husband, Ray, nodded. ‘Yes. I’m sorry, it’s all a little overwhelming. Did you say that the twins are sharing the same blood supply through the placenta?’

      Callie smiled again encouragingly. ‘Kind of,’ she said. It was often hard for laypeople to understand complex medical conditions and part of Callie’s job was helping them to understand. If that meant she had to go over and over the information again, that’s what she did.

      ‘Your twins share the same placenta—that’s common for identical twins. Usually in this scenario each twin has its own separate connection to the placenta via its umbilical cord, but in TTTS the placenta contains abnormal blood vessels, which connect the umbilical cords and circulations of the twins.’

      Callie

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