‘Tomorrow? But why?’ Juliet dropped her head into her hands still damp from the antibacterial wash. ‘The lecture is not until next Thursday.’
‘You’re not delivering the lecture in Auckland...you’re off to the UK—’
‘The lecture’s been cancelled?’ she cut in.
‘No, the lecture is going ahead...’
‘But without me?’ she asked as she pulled free her surgical gown and dropped it unceremoniously in the bin alongside her discarded cap.
‘Yes.’
‘And the surgery’s proceeding too, just without me?’ They were framed as questions but Juliet’s tone made it obvious they were statements that she was none too happy about.
‘That’s right.’
‘And I’m off to the UK?’ she continued with the volume of her voice escalating and increasing in speed with each word. ‘Before I go completely loopy, just tell me why my schedule is changing before my eyes without my approval?’
‘The call came through from Cheltenham just now.’
‘Cheltenham? As in the Cotswolds?’
‘One and the same.’
‘And who over there’s making decisions without consulting with me?’
‘The decision was made by four babies.’
Juliet blinked and shook her head. ‘Four? You’re speaking in riddles and you know that frustrates me.’
‘Apparently the Assistant Head of Obstetrics at Teddy’s, which is the maternity wing of the Royal Cheltenham hospital, spoke with our Head of Obstetrics about the quads. Almost twenty-nine weeks’ gestation, suffering twin-to-twin transfusion syndrome. Two sets of monozygotic twins. While the girls are fine at this stage, the boys have developed the TTTS. Oliver Darrington believes you’re the best chance that the quads have of all surviving should the parents agree to the in-utero laser surgery. And Professor Le Messurier just approved your secondment.’
‘That’s all very flattering but why am I being called in at the eleventh hour? If there was a risk, I should’ve been consulted upon the initial diagnosis. Surely being quads they would have been having weekly scans and intense monitoring and they’d know at Teddy’s that the earlier the intervention, the better the outcome.’
‘Apparently the quads were being closely monitored throughout the pregnancy, but the TTTS diagnosis has only just been made,’ her replacement continued as he began scrubbing in, and over the sound of the running water he continued his explanation. ‘The girls have separate placentas while the boys have one shared placenta so they were being scrutinised for any signs of transfusion. Up until now there was no indication of anything being amiss. It was picked up when the patient presented in what she thought was premature labour.’
‘Caused by the amniotic fluid imbalance affecting the recipient twin.’
‘Again, apparently but you’ll know more details when you get there.’
‘But the lecture in Auckland?’
‘Handled. I’m not sure who’s your proxy but your focus needs to be on the quadruplets. Darrington’s worried it could deteriorate quickly and there’s an increased risk they could lose at least one of them if you don’t get over to Teddy’s immediately, and of course we know the risks if one dies to the remaining foetuses. The parents have been briefed and want to be fully informed so they can consider all options, in particular the in-utero surgery.’
‘Anything else I need to know?’
‘Just one thing...the attending OBGYN, Dr Charlie Warren, is averse to fetoscopic laser surgery. Believes the risks are too great so no doubt he’ll be challenging you.’
Juliet took a deep breath. ‘Looks like I’ll be catching a plane tomorrow morning to meet Dr Warren’s challenge and convince him otherwise.’
‘I hope he knows what he’s up against.’
‘He soon will.’ With her head tilted just slightly, and the remnants of bewilderment still lingering, she looked at her replacement. ‘Okay, Dad, looks like Kelly and her baby are in your hands now.’
‘Don’t worry, honey. I’ll do you proud.’
‘DR TURNER, WE’RE about five minutes away from the Royal Cheltenham hospital.’
The voice of the immaculately suited driver made Juliet lift her tired eyes to meet his in the rear-view mirror. They were warm and smiling back at her but with a curiosity that she had been so very accustomed to over the years. She was well aware that she didn’t look her thirty-three years and many apparently found it difficult to believe she was a doctor let alone a surgeon. Her curly brown hair and spattering of freckles along with her petite frame, she realised, didn’t help her quest to be taken seriously. She had no time for make-up except for a natural lip gloss to prevent her lips from cracking, and that too added to her young appearance. It also helped her go under the radar and not gain the attention of the opposite sex and, although it wasn’t her primary motivation, it was a welcome side effect.
But despite the general consensus, she was both a surgeon and a mother and she took both roles incredibly seriously. Her work, she loved with a passion, and her daughter, she loved more than anyone and anything in the world. And more than she had ever dreamed possible.
‘Thank you,’ she responded as she gently turned to stir the little girl fast asleep and leaning against her. Running her fingers down the child’s ruddy cheeks, she softly kissed the top of her head. ‘Wake up, Bea, my precious little sleepyhead.’
The little girl silently protested at being disturbed and nestled in tighter to the warmth of her mother’s woollen overcoat. Her eyelashes flickered but her eyes were far too heavy to open.
‘Well, I hope this part of your marathon travel’s been pleasant,’ the driver commented.
‘Very pleasant, thank you.’
‘So how many hours have you two been travelling to be here this morning?’
‘I think it’s about thirty five hours, but it feels like for ever,’ she replied with a little sigh, thinking back over the logistical nightmare they had survived. ‘We left Perth early yesterday, Australian time, had a layover in Singapore before we headed on to Heathrow, and then the sixty-mile trip to the Cotswolds with you,’ Juliet added as she continued to try and wake her still-drowsy little girl as gently as possible. She wasn’t sure just how coherent she was but didn’t want to appear rude. She had a lot on her mind, including the impending in-utero surgery on the quadruplets within the week. The reason she had been seconded halfway around the world at a minute’s notice.
Keeping all four babies viable was everyone’s focus. And something everyone agreed could not be done with Juliet on the other side of the world. Well, almost everyone agreed. She knew she would have her work cut out convincing the quads’ OBGYN, Dr Charlie Warren. She presumed he would be leaning towards bed rest, high-protein diet and medication for the quads’ mother. It was conservative and Juliet was surprised that he was not encouraging the laser surgery. She’d had no time to research the man but assumed he might be perhaps closer to the driver’s age and had managed previous TTTS cases in that manner. But once he heard her argument for the surgery, surely the traditional English physician would see that her method had clear benefit? Particularly once she stated her case and the supporting statistics. How could he not? With both hospitals