The Doctor's Pregnancy Secret, page 4
‘There’s no time to wait for a cross-match. That’ll have to come later.’ Callum was already preparing an IV line. ‘We’ll run Haemaccel in the interim. Re-check for any bleeding, please, Fliss.’
‘Some seepage but it’s holding.’ Fliss replaced the loose dressing. Taking a reading from the oximeter, she reported, ‘Oxygen sats ninety per cent.’ She began scribbling on Scott’s chart. ‘What’s his BP doing, Callum?’
‘Let’s see. BP a hundred over sixty. Pulse one-twenty. Respiration twenty-four. I’ll get the drugs.’
When Callum returned with the painkiller and anti-emetic, he saw Fliss had already hooked their young patient up to a heart monitor. The little box like a clock radio would keep them apprised of Scott’s heart rate. And in the case of a sudden bleed the team would be immediately alerted.
‘Good work.’ He looked fleetingly at Fliss before injecting the prepared drugs. ‘I’ll escort him to Theatre now. Thanks for your help.’
Fliss began putting the resus room back to rights. Ordinarily there would have been a nursing assistant on hand but today it was obvious everyone had to get outside their normal duties and pitch in.
When she was more or less satisfied she had left everything in order, she went back to the nurses’ station. ‘Mr Buchan still about?’ she asked Troy.
‘Waiting in Reception.’ The charge handed over the notes. ‘I got what history I could but he’ll obviously want to speak to you in more depth about Scott.’
‘Thanks.’ Fliss’s eyes flew over the information then she looked up. ‘I’ll have a chat to Mr Buchan now, Troy. For privacy, we’ll use Callum’s office.’
‘Call me Tony, Doctor,’ the manager said, as they settled in chairs near the window. ‘This is a bad business,’ he added worriedly. ‘We go all out to provide a safe environment for the boys.’
‘I’m sure you do,’ Fliss said diplomatically. ‘But it can’t be the first time a lad has pushed the boundaries, surely?’
Tony’s mouth drew in. ‘Of course not. But we take our professional role seriously. After all, the boys are in our care.’ He sent a slightly trapped look at Fliss. ‘What’s the prognosis on Scott? I believe you attended to him when he was brought in.’
‘Along with Dr O’Byrne.’ Fliss nodded. ‘Very fortunately the main artery escaped damage but there’ll be quite involved surgery to repair the injury caused by Scott’s collision with the wire. I understand he’s relatively new to Trail Farm?’
‘Only arrived a couple of weeks ago. And like all our newcomers, Scott was still finding his way.’
Fliss frowned a bit. ‘How are the boys sent to you, Tony?’
‘They’re referred from the courts. We only take nonviolent cases.’
‘And what was Scott’s misdemeanour?’
‘Nothing that endangered lives. But he’d been cautioned three times and that’s the cut-off point for the magistrate.’
Fliss looked down at the notes. ‘I understand Scott is cared for by his paternal grandparents. Why is that?’
Tony lifted a shoulder in a shrug. ‘His mother and stepfather are substance users. There’s been Family Services intervention countless times apparently, especially as there are two younger siblings. The upshot was Mr and Mrs Owens approached the court for legal custody until, hopefully, the mother and stepfather sort themselves out.’
So Scott probably had quite a bit of anger and frustration tucked away inside his head, Fliss thought sadly. But practical things first. ‘Have his grandparents been notified?’
‘I’ve spoken to his grandmother myself. I’ve explained someone will get back to her when we know more.’
‘I’ll do that,’ Fliss volunteered. ‘Meanwhile, is someone from the family able to be here for Scott?’
Tony scraped a hand around his jaw. ‘The grandparents live in Brisbane but I should think they’d want to come if they possibly can. Scott being taken away from them has hit them pretty hard.’
Fliss thought for a moment. ‘While Scott is in hospital, it would probably be best if either Dr O’Byrne or I liaise with the family.’
‘If you think it’s appropriate,’ the manager said slowly. ‘We’ll have to put in a report to our relative departmental head, of course, but I’d like to keep the local media out of it if that’s possible—for all our sakes. But mostly for Scott and his family.’
‘I think we can manage that.’ Fliss got to her feet, indicating the interview was at an end.
Tony offered his hand. ‘Thank you for your direct approach, Dr Wakefield. I’d like to assure you that even if we do run a tight ship, it’s a fair one and we’ve had more successes than failures among the lads who’ve come to us.’
‘We’ll keep in touch,’ Fliss said as she saw him out. ‘And I’d like to come and have a look at Trail Farm some time, if I may.’
‘Certainly.’ Tony spared a brief smile. ‘We’ve nothing to hide.’
Fliss was thoughtful as she finished writing up the notes on Scott. She wondered whether Trail Farm had a decent sports programme for the boys. The competitive nature of team sport was a sure-fire way of deflecting the aggression peculiar to adolescent males and giving them a different focus. She’d have a chat to Callum about it. Meanwhile, there was something else she needed to do. She picked up the phone to call Jo at her GP surgery.
CHAPTER THREE
‘OH, HI, sweetie!’ Jo responded eagerly. ‘I’ve been wondering how your first day’s going.’
‘Let’s say better than I feared,’ Fliss said carefully.
‘And Callum? How are you getting on with him?’
Fliss’s laugh was forced and she wondered why she felt a little rush of adrenaline at the sound of his name. ‘All right, I think.’
‘Well, that’s a turn up. I’m so pleased for you, Flissy.’
‘Yes, well, don’t get carried away, Josephine. It’s early days yet. And by the way, this isn’t a social call.’
‘It’s not?’
Fliss chuckled. ‘No. I’m looking for a speech therapist. Does Mt Pryde have any such person?’
‘Laura Sabatini at the school,’ Jo said promptly. ‘She has extra qualifications beyond her teaching degree. But Callum should know all that.’
‘I expect he does. I’m just making my own inquiries and getting a feel for things.’
‘And you don’t want to have to run to him for every darn thing.’
‘You know me too well,’ Fliss said ruefully. ‘Anyway, better go. Thanks, Jo.’
‘Any time, honey. Came and see us soon, hmm?’
‘I will. Bye.’ Fliss replaced the receiver and then got to her feet. She needed coffee.
She found Nick Rossi in the staffroom. He was standing at the window, nursing a carton of chocolate-flavoured milk. ‘Energy hit.’ He grinned and slurped the last of the contents down and then aimed the carton with deadly accuracy towards the bin.
Fliss made a face. He was such a boy! Nice though. Blond and good looking and probably breaking female hearts all over Mt Pryde. ‘I’ll settle for a coffee.’ She made her way to the filter machine.
‘How’s it going?’ Nick asked, planting himself against the wall and folding his arms.
Fliss shrugged. ‘Pretty good. Very different than I’m used to but interesting for all that. Do you have a specialty you want to go for after your time here?’
‘Nah.’ He shook his head. ‘I’ll leave that for the heavy hitters. I really want to do my GP training, include a rural component and head bush again. Become what they’re calling now a “rural generalist”.
‘Crikey,’ Fliss said mildly. ‘I’ll have to start reading my medical journals to keep up with the new terminology. You’re enjoying your time here, then?’
The resident nodded. ‘I’m learning a lot and Callum’s a good boss. I just hope I can get into a decent GP program somewhere.’ He sent Fliss one of his lopsided grins. ‘I don’t have anyone in high places to go to bat for me.’
‘You’ll make it,’ Fliss said wisely. ‘If you want it enough. By the way.’ She changed topics deftly. ‘Do you know anything about Trail Farm?’
‘Never been there.’ Nick shook his head. ‘But Callum has. Whenever they’ve called for a doctor, he’s gone out there. Ah—that’s me,’ he said ruefully, as his pager beeped. ‘Catch you later, Fliss.’
A dry smile curved Fliss’s mouth. ‘I’m here for six months, so you probably will. Yell, if you need a hand.’
Fliss was barely halfway through her coffee when Jess popped her head in. ‘Could you see an infant, please, Fliss? Looks like nappy rash to me but the Mum’s frantic. And young,’ she added with a roll of her eyes.
Fliss got to her feet and tipped the remains of her coffee down the sink. She glanced at her watch. ‘Shouldn’t you be gone?’
‘Just about to,’ the RN said. ‘But don’t worry, we’re on track for a full complement for the late shift. Troy will be here until six and Leanne and Tammy have just arrived.’
She’d never had to concern herself with staffing problems until now, Fliss realised with something like guilt. She’d taken so much for granted in her upmarket clinic in the city…She sent a wry smile towards Jess. ‘I guess I’ll get around to putting the names to all the faces eventually.’
‘It’s awful, being new in the zoo,’ Jess agreed, a wry smile tickling the corners of her mouth. ‘But I bet by this time next week you’ll feel like you’ve been here for a hundred years.’
‘As long as I’m not looking like it,’ Fliss said. ‘I’d frighten the patients.’
They stopped by the nurses’ station and Jess handed Fliss the notes for her new patient. ‘Zoe Fielding, aged six months. Mum is Emma.’
‘Thanks, Jess. You take off.’ Fliss knew the nurse had a little one to collect from school. ‘I’m sure I can manage one small patient on my own.’
‘OK, thanks. See you tomorrow.’ Jess waggled a couple of fingers in farewell and took off towards the staffroom.
Fliss swished back the curtain of the cubicle and went in. She greeted the young mother and introduced herself. ‘And this is Zoe, I take it?’
Emma nodded and bit her lips together. ‘I’ve really stuffed up. She’s in such a mess—’
‘Well, let’s have a look, shall we?’ Fliss turned her attention to the infant. Jess had obviously removed the nappy and the little one was kicking happily, her bright gaze darting everywhere like that of a small bird’s. Fliss’s look became soft. Apart from the angry red areas of skin around her bottom, the baby looked healthy and well cared-for. A real poppet, in fact. ‘How long has Zoe had the rash, Emma?’
‘A week or more.’
‘So, any changes in her care that would account for it?’ Fliss asked. ‘Like a different soap perhaps?’
The young mother shook her head. ‘But I’ve had to switch from disposable to cloth nappies,’ she explained after a minute. ‘And we’re living at the caravan park and the laundry facilities are pretty pathetic—’
‘So maybe you’re not able to wash them as thoroughly as you like to,’ Fliss finished for her. ‘Is there a reason you have to use the cloth nappies?’
‘I simply can’t afford the disposable nappies.’
OK, let’s find a way around the problem, Fliss thought practically. Get some history. ‘Tell me a bit about your situation, Emma,’ she said kindly, noticing the young mother looked tired, her fair hair tied back in an untidy knot.
Emma pressed her hands between her jeans-clad knees, her throat constricting as she swallowed. ‘We’re pickers,’ she explained. ‘We follow the crops, pick what’s in season. Here in Mt Pryde it’s beans and carrots. But this year, we only have my husband’s wage ’cos I have the baby. But we love her to bits and we wanted her.’ Emma’s eyes filled suddenly and she flipped her hands against them almost fiercely. ‘But we’ve credit-card debt and Shane’s pay just doesn’t stretch to disposable nappies.’ She took a jerky breath. ‘How bad is she, Doctor?’
‘Not so bad we can’t fix it.’ Fliss smiled. ‘But you were wise to bring her in. And just so you know, most nappy rashes are a normal part of babyhood. It’s not a sign of neglect on the part of the parents.’
‘Oh.’ Emma’s shoulders slumped as though all the fight had suddenly gone out of her. ‘I thought you might have to report me or something.’
‘Heavens, I hope we’re about healing, not policing.’ Fliss reached out a finger and gently stroked the soft skin of Zoe’s cheek. ‘Right now, though, we need to get this little one more comfortable. For starters, don’t use any soap for the moment.’
‘OK…’ Emma bit the underside of her lip. ‘If you think it’s best.’
‘Soap can remove the natural oils that protect the baby’s skin,’ Fliss explained. ‘But you could use one of the baby-bath liquids that don’t contain any soap ingredients.’
‘So, will I put something on the rash itself, Doctor?’
‘Yes, but I’m sure we’ll have a sample of cream in our dispensary here that will be suitable. And while I’m about it, I’ll see if I can chase down a way for you to have access to a supply of disposable nappies.’ She put a hand on the young mother’s shoulder and squeezed. ‘We’ll sort this out, Emma,’ she affirmed gently. Or my name is not Felicity Wakefield, she added with silent determination.
Fliss went straight along to Maddie’s office. She’d been impressed by the secretary’s local knowledge and practical thinking and as the hospital had no social worker on staff, Fliss guessed that if there was a way through this dilemma, Maddie would know about it. Without breaking doctor-patient confidentiality, she gave Maddie the gist of the situation. ‘I want to help this young family, Maddie,’ Fliss said earnestly. ‘And disposable nappies would save the mum so much washing.’
‘Absolutely.’ Maddie made a face. ‘I don’t know how our mothers coped with those wretched cloth things. But they seemed to, of course, and we’re all here to tell the tale,’ she finished with a dry little laugh. ‘Anyway, to get back to the problem in hand. If you think this mother’s need is genuine, you can give her a note for the community aid shop. It’s right at the end of the main street as you go up the hill towards the park.’
‘And they’ll supply her with the disposables nappies?’
‘As well as secondhand clothes and furniture, they also carry a range of basic grocery and household items. Any folk experiencing hardship can access them as long as they have a referral from a registered service provider. And if folk can afford a nominal payment, that’s fine too. All donations gratefully received, as they say.’
‘That’s brilliant, Maddie.’ Fliss’s mouth turned up in a quick smile. ‘I’ll get onto things straight away.’
On her way back to the emergency department Fliss ran into Callum coming from the opposite direction. She drew to a halt. ‘How did things go with Scott?’
‘Pretty well. Once we’d cleaned him up and got in there, there wasn’t as much damage as we’d feared. But enough to keep him quiet for a while. Uh, could you spare a few minutes for a chat?’
‘Yes, of course. I’m just finishing with a patient,’ Fliss said. ‘Where will I find you?’
‘My office?’ The corners of his mouth compressed ruefully. ‘I’ve some notes to write up.’
Thirty minutes later Fliss tapped on Callum’s door and went in. ‘I pushed the boat out and got us a hot chocolate from the canteen. Comfort food,’ she said with a stilted little laugh as she handed the disposable cup across to him.
‘Thanks,’ he acknowledged gruffly. He eyed her a bit warily, seeming surprised and even a bit taken aback. and Fliss wondered how long it had been since anyone had done a simple act of kindness for him. Apart from Maddie, of course. ‘How did you guess I needed this?’
Fliss sent him a guarded smile. ‘Put it down to my powers of observation.’ Hooking one foot casually behind the leg of the chair, she cradled her cup between her hands and said, ‘While you were in Theatre, I had quite a chat to Tony Buchan. What kind of operation does he run?’
‘He seems a straightforward kind of guy. Tries really hard with all the lads.’
‘Nick said you’ve some knowledge of Trail Farm.’
‘I’m the designated MO for the place so, yes, I’ve been there off and on. The facilities are good and the staff professional.’
‘How long do the boys stay?’
‘Depends. The kids are there mainly because they’re marginalised in some way. There are no hard-core offenders. The programme embraces a kind of outreach structure. The staff try to set the lads some challenges that will increase their self-esteem and they stress teamwork. They’re counselled as a matter of course.’
Fliss looked thoughtful. ‘What if their families don’t want them back?’
‘Mostly, they do. But where not, a suitable foster placement is found for them.’ Callum drained his chocolate and threw the container into the bin under his desk. ‘Thanks for that.’ He looked at her through half-closed eyes. ‘It really hit the spot.’
Fliss palmed away his thanks, saying, ‘Could we liaise with Scott’s grandparents? I understand from Tony they have to travel from Brisbane but I’d like to encourage them to be here for him.’
‘Fine with me,’ Callum said mildly. ‘I’ll brief you about his surgery and fill in any gaps you need to cover. As a matter of course, we’ll need to have a speech therapist review his swallow in a few days.’
‘That’s Laura Sabatini, right? I’ve already teed her up.’
‘You’ve been busy. Or do they call it being pro-active these days?’
‘Probably.’ Fliss’s response was touched with dry humour. ‘I feel as though I haven’t stopped learning today.’
‘Coming back for more tomorrow, then?’
‘You bet I am. I believe in honouring contracts, whatever it takes.’
A tight little smile drifted around Callum’s mouth. At that rate, the lady opposite him would probably not be too impressed to learn he’d officially ended his marriage that very day. But he’d had no choice. Well, that was his story anyway.
