looked ominously flat, suggesting the baby was in some distress. Wordlessly she passed it to Jamie. ‘Get the obstetrican back down here stat, please, Lizzie. As well as a paediatrician and anaesthetist,’ she added quietly, not wishing to further alarm the already terrified mother.
Jamie looked at the tracing and nodded at Sarah.
‘I’d just like to have another look at your tummy if I may, Lucy.’
Jamie lifted Lucy’s gown and felt her abdomen. ‘Her abdomen feels soft and normal but…’ He stepped back, looking puzzled for a moment. ‘Sarah, what do you make of this?’ Sarah bent over the woman. She could just make out a line of discolouration underneath Lucy’s swollen abdomen.
‘It looks like bruising from the seat belt.’
Jamie nodded grimly.
‘It wasn’t here when I first examined her. But bruising can take an hour or two to develop.’ Sarah knew immediately what was causing his frown of concern.
‘Lucy, I just want to examine you down below.’
Lucy’s frantic eyes darted from Jamie to Sarah. It was clear she could sense their concern.
‘She has some bleeding.’ Sarah finished examining Lucy and looked at Jamie. She read the confirmation in his eyes.
‘Lucy,’ Jamie said gently, ‘we think you might have had an abruption. It’s where the placenta—the bit that nourishes the baby—breaks away from the wall of the uterus. It means we are going to have to get your baby delivered straight away.’
‘Is my baby going to die?’ Lucy whispered.
‘Not if we’ve got anything to do with it. We’re going to have to perform a Caesarean section and get the baby out. Lizzie, could you set up Resus for the op?’
Damn, where was the obstetrician? Sarah thought. It had been a few years since she had done a section. As an accident and emergency trainee she had been taught how to do it for emergencies such as this. But it had always been under the supervision of a consultant obstetrician.
Jamie caught her look and smiled reassuringly as he started scrubbing up. He seemed to read her mind. ‘We don’t have time to wait. Hopefully Donald will be here shortly, but I’ve done dozens of C-sections in Africa. We didn’t have the luxury of obstetricians in the hospital I worked in, so we all had plenty of practice. How do you feel about assisting?’
‘Like a hole in the head,’ Sarah muttered under her breath. Some first day! Could it possibly get any worse? But she couldn’t let her anxiety show. Not when everyone was watching her closely. ‘Of course I’m happy to assist.’
‘Better still, why don’t you do it and I’ll talk you through it?’ Jamie suggested.
He was right, of course. It would be a good way for her to brush up on her technique while having someone experienced standing by. She had always loved the surgical part of her training, taking pride in her neat needlework.
His confidence in her helped her make up her mind. ‘OK. Lizzie, could you call in the medical staff who are free to observe?’ It would be good experience for them. They were part of a teaching hospital after all. Part of the consultants’ responsibilities was to ensure that junior medical staff got thorough training in all aspects of emergency medicine. She looked at Lucy, who had been listening in, clearly terrified.
‘Do we have your permission, Lucy?’ she asked gently. ‘It really is necessary to get baby out as soon as possible.’
Lucy looked from Sarah to Jamie for a moment before making up her mind. Mutely, she nodded her agreement. ‘Just save my baby,’ she pleaded.
Within minutes the young mother was draped and the staff gowned up. The anaesthetist arrived and gave her a spinal anaesthetic to deaden the feeling below her waist. The medical and nursing staff stood around to observe. Sarah knew they’d be interested to see how their new boss coped with the emergency.
Sarah took the scalpel Jamie held out for her and made a neat incision across Lucy’s abdomen roughly where the