LITMIR.BIZ

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blood examination, bleeding time and factor eight levels. Fast.’

      ‘What are we looking for?’

      ‘I don’t have time to think. You think. Something.’

      He went back to sorting tubing, his mind moving into overdrive. Sifting the facts. She was right. The bleeding was far more severe than it should be. They were fighting to maintain blood pressure.

      Why?

      ‘Von Willebrand’s?’ he said cautiously.

      Was he right? Von Willebrand’s was a blood disorder that impeded clotting. Like haemophilia, it was genetically linked, passing from parents down to children. It usually wasn’t as life-threatening as haemophilia but it did have to be treated. He watched as Gina frowned even more behind her mask. Her fingers were carefully manoeuvring, she was fully absorbed in what she was doing, but he could see her mind start to sort through the repercussions of his tentative diagnosis.

      ‘You could be right,’ she said at last. ‘It fits.’

      ‘I’ll run tests straight away,’ he said. ‘There’s not a lot more we can do about it now, though. And at least it takes away the risks of clotting.’

      ‘Mmm.’

      Silence. The tension was well nigh unbearable. She was measuring the pressures in the right ventricle and the pulmonary artery by placing the catheter tip in each area. It was a tricky procedure in an adult, but in a newborn…

      ‘My face,’ Gina muttered, and Jill saw her need and stepped forward to wipe sweat beads from above her eyes.

      She was good, Cal thought grimly. Good enough?

      The work went on. The child’s tiny heart kept beating. Emily was fighting with everything she had. She had a paediatric anaesthetist on the line from the city, and she was working with a headset. Her soft voice asking questions was the only sound as they worked.

      Cal had seen this done in adults, but he’d never seen the procedure in one so tiny. As a general surgeon he would never think of doing such a procedure himself. He couldn’t, he acknowledged. Somewhere along the line Gina had acquired skills that could only make him wonder.

      Gina was working out diameters now, her eyes moving from fingers to monitor, fingers to monitor, and he could almost see her brain doing the complex calculations as she worked out the next step forward.

      She was brilliant. An amazing surgeon.

      The mother of his son?

      ‘Now the wire,’ she said into the stillness, and the sound of her voice almost made him start.

      Back to silence.

      The balloon valvuloplasty catheter was threaded over the wire, painstakingly positioned so its centre was just at the valve. That was the hard part.

      Now came the hardest.

      Please…

      ‘Let’s try,’ Gina said into a silence that was close to unbearable. ‘I think…’

      The balloon was inflated, showing on the monitor under fluoroscopy, with Gina watching that it remained centred all the time. The balloon had been manoeuvred right to the valve. Now it was stretching the valve, much as a shoe was stretched by a cobbler, hoping that once the stretching was done the valve would self-correct. The pressures would equalise.

      If it didn’t happen, then the build-up of pressure could mean instant heart failure—instant death.

      This was no time for panic. The procedure called for infinite patience.

      The balloon was inflated once. Twice. Three times the valve was stretched.

      ‘Enough,’ Gina said, and Cal heard exhaustion in her voice.

      But she couldn’t stop now. She had to check the pressures again. If the pressures weren’t equalised the whole thing would have to be repeated, using balloons of different lengths and diameters, and this tiny heart was under so much strain anyway…

      The catheters were reinserted, once more measuring the pressures in the right ventricle and the pulmonary artery.

      Please.

      The figures…

      ‘Hey,’ Jill said in a tiny tremulous voice that didn’t sound the least bit like the efficient director of nursing they all knew—and, if truth be told, they often feared. ‘We have liftoff. Isn’t that right, Houston?’

      ‘I…Maybe,’ Gina said. She glanced up at her anaesthetist. ‘What do you think?’

      ‘I think maybe you’ve done it,’ Emily said in a voice that was none too steady. ‘Oh, Gina, that was fantastic.’

      ‘Fantastic? It’s a miracle,’ Gina whispered. ‘If we have indeed won. He’s not out of the woods yet.’

      He wasn’t. They all knew that. To operate on such a tiny baby was asking for post-op complications. Indeed, there might well be complications already. He’d stopped breathing that afternoon. He’d had a birth in circumstances that were appalling. And now maybe he was facing a new threat. Von Willebrand’s?

      For him to pull through…

      ‘He’ll make it,’ Cal said, and he wasn’t sure why he knew or how he knew, it was just definite, absolute knowledge. ‘I know he will. You’ve done it, Gina.’

      ‘Thank God for that, then,’ she whispered. ‘I’m not as sure as you as to the outcome here, but he has every chance. Maybe…maybe for once in this country I’ve done something right.’

      Three hundred miles away the girl lay beneath her bedcovers and shivered. It was hot out here—so hot—and for her family to afford air-conditioning was unthinkable. But despite the heat, she couldn’t stop shivering.

       Her baby…

      Dead.

       ‘Sweetheart?’ It was her mother, knocking on her door for what must be the sixth time since they’d got home from the rodeo. ‘Are you OK?’

       She sounded worried. That was a laugh. When had her mother ever worried about her?

       ‘Go away.’

       ‘What’s wrong?’

       ‘I’ve got my period. I feel sick. Go away.’

       Her mother hesitated and Megan could hear the fear in her voice. ‘You’re not well enough to feed the poddy calves, then?’

       ‘No. Go away.’

       ‘But your father…’

      She roused herself—or she tried to—but the tiredness washing over her body was overwhelming.

       ‘I know Dad’s sick,’ she whispered, loudly enough for her mother to hear through the battered farmhouse door. ‘I know you’ve got too much to do to manage. But, Mum, I can’t. I just can’t. For tonight you’ll just have to manage without me.’

      When she’d done all she could do, Gina stepped away from the table. Her face said it all. Her eyes were drained, her expression slack with exhaustion. She’d called on every resource she had, and then some.

      ‘Can I leave it to you now?’ she asked, unsteadily into the stillness. ‘I’ll be outside. Call me on the PA if you need me. I won’t go away. But I need…some air.’

      ‘You deserve some air,’ Emily said warmly. ‘You even deserve something a bit stronger, like a stiff drink or a cigar. Off you go, Dr Lopez. Cal and I will take it from here. But thank God you were here.’

      ‘Thank you,’ Gina whispered, and with a last, uncertain glance down at the table she started to move away.

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