The Spanish Doctor's Convenient Bride

‘I have patients to see on the ward then a list of out-patient appointments. Have you met whoever you’ll be working under in A and E?’

‘Anxious to be rid of me?’ Carlos asked.

‘Anxious to get to work,’ Marty retorted, although her habit of getting to work an hour or two early had only begun with Natalie’s admission. Since Emmaline’s birth, she’d been coming to work earlier and earlier, checking the baby first, then tackling paperwork, so she could free up small pockets of time later in the day to spend with the newborn infant.

‘Not up to the NICU?’ Carlos said, as Marty stood up and moved towards the sink with her coffee mug.

Marty spun towards him.

‘What’s that supposed to mean?’

‘Exactly what I said! If you were not in the habit of visiting Emmaline before you started work each morning, I have seriously misjudged you.’

‘And is that good or bad—this misjudgement thing?’

He held up his hands as she had earlier.

‘It is neither. I have spoken clumsily. I am trying to say that I appreciate what you have done, and realise you have grown attached to the baby. I have nothing against you continuing to visit her. In fact, I would appreciate it.’

‘Why?’ Marty demanded. ‘Because you have no intention of providing involvement yourself? Because working here is more important to you than getting to know your own baby? A few dozen scalpels, some old autoclave machines and a clutch of crutches for some people in Sudan are more important than your own flesh and blood?’

She took a deep breath, hoping it might calm her down, then added, ‘You’re right, I have been coming early and, yes, my first visit was usually to either the ICU or latterly the NICU, but the baby’s father is here now, so she doesn’t need me.’

‘You called her “the baby”,’ Carlos said, the accusation in his voice mirrored in his eyes. ‘So, having provided her with a bond, you’ll now drop her—even drop the name you gave her? Well, I won’t. I’ll call her Emmaline and tell the nurses and doctors to do the same, and your friends will use the name and you will be the loser.’

He stood up and followed her path, carrying his cup to the sink.

‘But Emmaline will also lose,’ he continued. ‘She will miss your company, your touch, your voice, and maybe have a setback—develop one of the complications so prevalent in low birth weight babies.’

He put down his cup and stood looking down at her.

‘Is this fair to Emmaline? You may not like me, Martina Cox, but would you jeopardise that baby’s health because of personal antagonism?’

It was a great exit line, Marty had to admit. She was still staring at the empty doorway minutes later. All she’d wanted to do was give him a clear field to get to know his child, and the wretch had twisted things around so she was the bad guy in this scenario.

Could Emmaline suffer a setback if she no longer visited the NICU? Right on cue, her mind conveniently produced a list of all the things that could beset such infants—hypoglycaemia, pulmonary insufficiency, apnoea and bradycardia—not to mention SIDS.

She’d have to work out a programme so she could visit Emmaline at unexpected times when Carlos was unlikely to be there, and though this would eventually make it harder for her to separate from Emmaline, at least she’d be sending home a well and contented infant.

She’d worry about her own contentment at a later date.

This would have worked if Carlos hadn’t also chosen one of Marty’s unexpected times to visit his daughter. Or maybe someone had contacted him to tell him it was feeding time, for he was holding Emmaline in his arms, peering down into her crinkled face, a look of bemusement on his usually impassive features.

Marty backed down the corridor, right into Sophie, who was heading for the unit.

‘He looks as if he’s holding an unexploded bomb,’ Sophie remarked, nodding towards the tall man with the little pink bundle clutched gingerly to his chest.

‘I think he might see her in those terms,’ Marty replied. ‘He feels she’s already wreaked havoc in his life, he’s just not sure when the next upheaval will take place.’

‘Right about now,’ Sophie predicted as a nurse approached with a feeding bottle. But although she proffered it to Carlos, he shook his head, handing back the baby with the tense arms of a man who was indeed holding a bomb.

‘That’s no way to bond with her,’ Marty snorted, and was about to stride into the room and tell him so, but Sophie held her back.

‘He has to do it in his own way and in his own time, Marty,’ Sophie reminded her friend. ‘You can’t force someone to love their child. Love’s organic—it needs time and nurturing in order to grow.’

Sophie spoke with the conviction of a woman deeply in love and Marty forbore to point out it had taken Gib and his new bride all of three weeks to decide they were made for each other, all of six weeks before they’d married.

But Sophie’s words were comforting in a very different way, confirming Marty’s belief that what she was feeling towards Carlos was a purely physical reaction and nothing whatsoever to do with love.

‘I’d better go,’ she said to Sophie, as Carlos moved towards the public exit from the NICU.

‘You won’t stay and feed her?’

Marty felt the ache in her chest that could only be alleviated by cuddling that small bundle in her arms, but the nurse would cuddle Emmaline and talk to her as she fed her and what was that, if not human interaction? It was during the time between feeds and changing that Emmaline needed company…

‘I’ve got to wean myself away from her,’ Marty explained, and Sophie, understanding, gave her a hug.

But avoiding Carlos was less easy. She had barely finished a planned Caesarean delivery of triplets when she was called to A and E—an ambulance bringing in a teenager with severe abdominal pain and vaginal bleeding.

Marty beat the ambulance, but not by much, and wasn’t surprised to find Carlos by her side as the attendants wheeled the young woman, looking childlike in her green and white checked school uniform, into the trauma room.

‘Regan Collins, fifteen, BP 120 over 65, pulse 90 and firm, temp 99.3, severe cramps and bleeding,’ the ambo recited as he handed over the paperwork. ‘We have her on fluid replacement but haven’t done anything for the pain.’

‘Because she could be pregnant,’ Marty murmured under her breath to Carlos.

She stepped forward and introduced herself to Regan, who looked as if she needed a hug more than medication.

‘You’ll be OK,’ Marty reassured her instead. ‘We’ll take a look at you and see what’s what.’

The girl grasped her hand and squeezed it tightly, fever-bright eyes looking pleadingly into Marty’s.

‘You won’t tell Mum,’ she begged, and Marty’s stomach tightened. She hated these situations—hated being the one who had to break her patient’s confidence.

‘You’re a minor, Regan, and you were at school when this happened. The school will already have contacted someone in your family.’

‘But I could just be sick—she needn’t know what it is,’ the girl said desperately, still clinging to Marty as if she held the promise of salvation.

‘Well, I can’t tell your mother what it is if I don’t know,’ she told Regan. ‘So how about I examine you and we take it from there?’

‘Mum can’t know,’ Regan wailed, then burst into noisy sobs.

Now Marty did hug her, gathering the girl’s upper body in her arms and holding her close, making soothing noises as she patted Regan’s back.

She used her free hand to smooth dark strands of hair back from the girl’s face, while an errant thought flashed through her mind. Would Emmaline’s hair stay black?

It was none of Marty’s business.

‘Hush now,’ she said to Regan, when the storm of tears appeared to be subsiding. ‘We’ll sort it out.’

But Regan’s head moved against her chest, denying this as an option, her drama-filled adolescent mind certain this was the end of life as she had known it.

‘You can’t, nobody can,’ Regan cried, confirming Marty’s thoughts, but the teenager allowed herself to be lowered back on the trolley so Marty could examine her, questioning her gently all the time.

When did she last have a period? Were they regular? Did she have a boyfriend? Was she having regular sex? Using protection?

Beside her, Marty could feel Carlos all but squirming—it was obvious why he hadn’t become an O and G specialist! But when he murmured, ‘I could never ask Sudanese women these questions,’ she understood.

‘Maybe a female nurse could,’ she suggested, as she completed a gentle internal examination of the patient.

‘It’s all Rosemary’s fault!’

Marty looked across at Carlos and smiled but he was looking slightly ill and so anxious Marty felt she should be reassuring him as well. He obviously didn’t know that once teenagers starting blaming someone else, they were back in control.

‘Why?’ Marty said, and Regan started crying again.

But this time Marty continued about her business, asking Carlos to take some blood to go to the lab. ‘We’ll do beta HCG as well as the usual tests, and blood typing in case we need to operate,’ she told him, knowing he’d know enough to realise the test for human chorionic gonadotropin would tell them if Regan was pregnant.

Or had been!

Palpating Regan’s stomach, Marty found it to be soft, with no discernible lumps or masses, although Regan moaned with pain when Marty pressed on the uterus.

‘We’ll do an ultrasound now.’

‘Rosemary said she knew how to get rid of a baby.’

Images of olden times—of back-yard abortions and quack remedies to bring on a miscarriage—flashed through Marty’s head while her chest tightened with anxiety for the young woman—barely out of childhood—and the damage she might have done to herself.

But when she said, ‘How was that?’ her voice was gentle and contained, and Regan, taking heart apparently from Marty’s tone, admitted to exactly what Marty had been dreading.

‘With a knitting needle.’ The words were little more than a breath of sound but the thought of the damage Regan might have done herself made Marty shudder. Although in early pregnancy, with the foetus so tiny, it was unlikely any amount of poking would have caused the miscarriage.

Regan began to cry again, but this time defensively.

‘I had to do something! My mum would have killed me.’

‘Instead of which you could have killed yourself if you’d got septicaemia or bled to death before someone realised you were in trouble,’ Marty told her.

She wanted to say more—to wag her finger at the girl and yell a little. Say things like, ‘Surely you’ve heard of safe sex? Surely by your age you know something about birth control. The pill?’ but angry though she was about what she felt was the stupidity of teenagers, she knew now wasn’t the time for a lecture. Later on she’d have to counsel the girl on just these things, but if Regan was angry and resentful towards her, she wouldn’t listen.

The ultrasound revealed early pregnancy, now interrupted by this episode of blood loss.

‘I need to take you into Theatre for a small operation to have a look in there and clean things up. We call it a D and C, dilatation—opening up your cervix—and curettage, scraping around your uterine walls.’

‘That’s gross!’ Regan protested, then she brightened. ‘But it’ll get rid of the baby.’

‘We’re not doing it to “get rid of the baby”, as you so bluntly put it,’ Marty retorted. She was finding it more and more difficult to maintain sympathy for this self-focussed young woman. ‘We’re doing it to minimise the risk of infection and, far from being gross, it could well save your life.’

Regan must have picked up on Marty’s mood, for a tear slipped from one eye and slid down her cheek.

‘I’ve been stupid, haven’t I?’ she quavered.

‘Very!’ Marty agreed, but she gave the girl a warm hug. ‘And although in the end things will be OK again, they’re going to get worse right about now because we need your mother’s permission to do the op.’

Carlos waited for the teenager’s reaction, sure there’d be more histrionics. The more he’d seen of this particular patient, the more sure he’d become that he’d leave any O and G work, particularly with teenage patients, to whatever other medical or nursing staff he could beg or bribe to take over.

But the girl surprised him by accepting that her mother would have to know, although she looked pale, and so young Carlos felt his heart ache with sympathy for her. Then he thought of another girl—even younger—a baby girl high above them in the hospital.

He’d been beginning to think that, with sufficient help, he might be able to bring up a child, but no way would he be able to handle this kind of thing. Was it because she was a woman that Marty seemed a natural at it? Or was it her training that she’d been firm when she needed to be firm, while her underlying compassion came through in even her sternest words?

A nurse came in to tell Marty Regan’s mother was here, and Marty nodded, then told the nurse with them to contact Theatre to make arrangements for the minor op and for an anaesthetist to meet them there. She turned to Carlos.

‘Will you go with Regan and the nurse to Theatre?’

This was colleague-to-colleague conversation, so why did he notice her eyes as they met his when she asked her question? And notice how fine her skin was—smooth, lightly tanned and unblemished except for a small freckle just above her lip on the left hand side?

In days gone by, women with such a mark would have darkened it to make a beauty spot, drawing their admirers’ attention to the full lips beneath it.

‘Carlos?’

Had he not answered her?

Had the sleepless night confused his mind to the extent he was distracted by a freckle?

‘Of course,’ he said, and saw a slight smile flash across Marty’s face.

She suspected he was thinking of Emmaline—which he had been earlier.

‘Keep Regan here a few minutes while I talk to her mother,’ Marty suggested, as another nurse and an orderly came into the small trauma room.

Carlos moved to stand beside the girl while the nurse attached the drip to the small stand on the trolley and readied the patient for her move. Then Marty returned with an anxious, harried-looking woman, who rushed towards her daughter, caught her in her arms, and scolded her and hugged her all at once.

‘Stupid, stupid girl! You know we can talk about anything, yet you didn’t tell me. Honestly, Regan, sometimes I wonder if all your brains are in your toes. But you’ll be all right, pet. The doctor will fix you up and everything will be fine, but I tell you, if you ever, ever pull a stunt like this again, I will personally kill you then cut you into tiny pieces and feed them to the dog!’

‘Oh, Mum!’ Regan sobbed into her mother’s shoulder. ‘I was so scared.’

‘Of course you were,’ her mother whispered brokenly, crying now as much as her daughter. ‘All the silly stuff I told you about my getting pregnant too early and the struggle I had to keep you. Of course you didn’t want to tell me.’

Carlos watched and listened with a sense of wonder and discovery, as if he’d sailed into foreign seas—or landed on a planet called ‘Women’—and was learning firsthand just how different this world was. For these two were angry and upset yet obviously deeply loving towards each other in spite of the other emotions—the mother accepting, concerned, forgiving and nurturing all at once.

He could never handle that role for Emmaline…

It was obviously something only women could do…

He glanced towards Marty, who’d stood back and watched the reunion with that small shy smile on her face.

She already loved his baby…

‘Moving time, people,’ she said briskly. ‘Ms Collins, you can come with us up to the next floor. There’s a waiting room there where you can get tea or coffee. Do you have to let anyone know you’re here?’

The woman shook her head, gave her daughter one last pat, then stood back so the professionals could do their job.

‘She obviously loves her daughter very much,’ Carlos murmured to Marty as they fell in a small distance behind the procession. ‘So why was Regan so concerned?’

This time Marty’s smile was just for him.

‘It’s complicated,’ she said.

‘That I had realised,’ he assured her. ‘But how? Why?’

‘It’s a lot to do with expectations,’ Marty explained. ‘For some reason they seem to grow exponentially with love. Because these two are very close, Regan feels far worse about disappointing her mother than she would if perhaps she had a less involved and caring mother. Her mother has probably always told her she can talk about anything with her, and Regan believes that, but she also feels that her mother would be disappointed in her if she found out Regan wanted to have sex with her boyfriend, so to avoid hurting her mother she didn’t tell her.’

She smiled again, this time less shyly, and added, ‘That probably doesn’t make a jot of sense to you but, believe me, in the spider’s web of mother-daughter relationships, it’s near to normal.’

They’d reached the theatre and Marty was once again all business.

‘I’d have suggested you do it for practice,’ she said to Carlos, ‘but given how the haemorrhage happened, I’d better see what’s happening in there. If we leave a bit of tissue, she could end up with infection, and if there’s damage to the uterine wall, I’ll need to fix it.’

More than happy to be left on the sidelines, Carlos moved to stand beside the anaesthetist, who was questioning Regan about her health and explaining what she was about to do, inserting a mild sedative into the drip, attaching an oxygen mask, talking quietly and reassuringly as she worked.

Female anaesthetist, female surgeon—a woman’s world again. Was he more aware of it because in Sudan he’d seen less of the women? Their husbands brought the children for attention, or brought their wives and explained their conditions, wary about letting a man touch—or even look at in some cases—their women.

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