Seb frowned as he listened to what the patient was saying. ‘So where exactly was this other pain, then?’
‘In my shoulder…just here…’ Alison’s hand fluttered weakly as she touched the tip of her right shoulder, and he nodded.
‘I see,’ he said quietly, not wanting her to know how significant that snippet of information might turn out to be. He glanced over at Libby, wondering if she was adding up the clues as he was doing, and felt his heart jolt painfully when he saw the sadness on her face. She looked so unhappy that he longed to comfort her, but how could he when he had a patient who needed his help?
‘Have you experienced any vaginal bleeding?’ he continued, doing his best to appear calmly in control, although his insides felt as though they were on a merry-go-round. Even if he lived to be a hundred, he doubted if he would ever fully recover from the shock of seeing Libby standing in the waiting room.
‘I’m having a period at the moment,’ Alison muttered, obviously embarrassed at having to talk about something so personal.
‘So there’s no possibility that you might be pregnant?’ he persisted. ‘You haven’t missed a period recently?’
‘Well, I didn’t have one last month, but I’d just stopped taking the Pill and my GP warned me that my periods could be a bit erratic at first,’ Alison explained, blushing furiously.
‘Did you do a home pregnancy test?’ Seb asked, checking the monitor readings. Although Alison’s pulse, BP and heart rate were still within acceptable limits, there had been a slight deterioration in her condition so he decided not to waste any more time.
‘Tell Ben I’m going to need a transvaginal ultrasound done, will you?’ he told Cathy quietly, then turned back to the young woman as she answered his question.
‘No, I didn’t do a test. I didn’t think there was any need to do one because of what my GP had said.’ Alison was starting to look really scared now. ‘Do you think I’m having a miscarriage, Doctor?’
‘It’s possibly a little more complicated than that,’ Seb said gently. He nodded when Marilyn murmured that she would get onto the obstetric’s registrar. Obviously, she’d latched onto his train of thought so he could save his explanations for the patient. Moving to the head of the bed again, he did all he could to sound reassuring but he could tell how terrified the young woman was.
‘It’s possible that you’ve had an ectopic pregnancy, Alison. What that means is that instead of the embryo developing inside your womb, it started to develop somewhere else. The most common place is in one of the Fallopian tubes but we’ll have a better idea after you’ve had an ultrasound scan.’
‘But what’s going to happen if the baby’s growing in the wrong place? Will you be able to put it back where it’s supposed to be?’
‘No. I’m really sorry but that simply isn’t possible.’ Seb squeezed her hand when he saw tears ooze from her eyes. ‘It’s more than likely that the embryo is dead so it will be removed, along with any other damaged tissue.’
‘And that’s all that will happen?’ the girl said through her sobs.
‘A lot will depend on how much damage has been done. If the embryo has developed in one of your Fallopian tubes, the tube might have ruptured and the surgeon will have to decide if he can repair it.’ He squeezed her hand tighter. ‘If that isn’t possible then the tube will need to be removed as well.’
‘Oh!’
The girl broke into a storm of weeping. Seb sighed, wishing that he knew of a way to make this easier for her. He looked up when Libby suddenly appeared at his side.
‘Let me talk to her,’ she said simply.
Seb stepped aside, only half listening as Cathy came over to tell him that Ben was ready to do the scan. Libby was bending over the girl, stroking her hair and murmuring to her. Although Alison was still crying, whatever Libby was saying to her was obviously helping.
If only she would turn her talents to making their marriage better, he thought wistfully, then swung round because there was no point torturing himself with ‘if onlys’. What was done was done and he had to live with the consequences, even though he had no idea how he was going to do that. How did you manage to live without the person you loved most in the whole world?
Libby sighed sadly as she watched Alison being whisked away. Once an ectopic pregnancy was confirmed, the girl would be taken to the obs and gynae unit and prepared for surgery. She felt very sorry for her. It must be a terrible shock for a woman to discover that she was pregnant and that there was no hope of her baby surviving.
‘Thanks for that. I really appreciated it.’
She summoned a smile when Seb came over to her. ‘It was the least I could do.’
‘I’m still grateful, though. You’ve always had the gift of soothing people when they’re at their lowest ebb.’ He shrugged when she looked at him in surprise. ‘Not many folk have that talent, Libby, but you do.’
‘I…um…well, thank you.’ She stumbled over the words and had to make an effort to collect herself, but it was odd that Seb should have said that after what she’d been thinking about him. ‘We had a case similar to this during our first rotation on Casualty, if you remember,’ she said quickly, not wanting to go back down that route again.
‘Oh, I remember all right.’ He rolled his eyes. ‘A woman came in complaining of pains in her abdomen so we ran through everything we could think of—appendicitis, food poisoning, cystitis…’
‘Abdominal colic.’ She laughed. ‘We hadn’t a clue, had we?’
‘No, we hadn’t. We’d still be struggling if the senior reg hadn’t come along and demanded to know if she had a pain in her shoulder.’ Seb grinned. ‘We thought he’d completely lost the plot by asking a question like that, until he informed us that shoulder-tip pain is often a symptom of an ectopic pregnancy.’
‘We’d never even heard of it until then,’ Libby agreed. ‘He had to explain that it was caused by internal bleeding irritating the diaphragm when the patient breathes in and out.’
‘It was one lesson we never forgot, though, especially as we got a real rollicking from him afterwards. What did he call us?’
‘A pair of half-baked, incompetent morons who shouldn’t be allowed anywhere near a member of the public,’ she supplied helpfully, and he laughed.
‘That’s exactly what he said! How on earth did you remember after all this time?’
‘Because that day stuck in my mind for a number of reasons.’
As soon as the words left her mouth Libby wished she hadn’t said them, but it was too late by then. She could tell that Seb had remembered what else had happened that day, too. After their roasting, they had gone back to their flat and one thing had led to another. They’d ended up making love and afterwards, as they had lain in one another’s arms, Seb had asked her to marry him…
‘Right. I’d better go and brief the team so that everyone knows what to expect,’ he said brusquely, swinging round.
‘You mean about this major incident? What’s happened exactly?’ She shrugged when he paused, not wanting him to know how painful it was to recall happier times. There was no point looking back but it wasn’t easy to block out the memories when they were together. ‘I never got a chance to ask you before because we were interrupted. It must be pretty serious, though, if you’ve closed the whole unit.’
‘It is. There’s a tanker adrift and it’s on course to collide with one of the off-shore drilling rigs. We’ll be treating the bulk of the casualties so it’s going to get rather hectic around here.’
‘Good