Meagan felt a flutter of anxiety. She knew from her obstetric experience that this was bad news for mother and baby. Particularly as they were so far away from a hospital with the specialist obstetric and paediatric facilities such a situation required. Despite Cameron having qualified as a paediatrician, the baby, if it survived, would need admission to a high-dependency unit.
‘When I couldn’t reach you, I took the liberty of phoning the air ambulance. They are on standby, awaiting your call,’ Dorothy went on, calmer now that her colleagues had arrived.
Pretty certain that Dorothy would be correct in her diagnosis, Cameron knew they would have to act quickly if the baby was to have any chance of survival. Putting his own anxieties aside at the thought of dealing with a premature distressed baby, he said, ‘It’ll take at least two hours to get mother and baby to Glasgow. We won’t have that long if we are to save the mother. We’ll need to get her delivered. Meagan, have you performed an emergency section before?’
‘Yes, many times. But always in a proper theatre. Are you suggesting we perform one here?’
‘There is a proper theatre in the local hospital which is ten minutes from here. It’s normally reserved for minor procedures but, as I told you this morning, it is fully equipped for emergencies such as this. Dr Lake, one of the Benbecula GPs, is qualified to act as an anaesthetist if we need one.’
Making up his mind, he turned to Dorothy and Meagan. ‘We don’t have time to wait for the air ambulance. If mother and baby are to stand a chance, we need to deliver the baby straight away. I’ll speak to Katie. Meagan, phone Ambulance Control and tell them what we are planning to do. They’ll need to come to evacuate mother and, hopefully, baby to Glasgow anyway. The surgery will patch you through. Dorothy, get hold of Dr Lake and get him to meet us at the hospital. Then phone the hospital and tell them to prepare the theatre. We’ll take Katie in my car. In the meantime, I’ll insert a catheter into Katie’s bladder to fill it. That’ll help keep the pressure off the cord and should buy us some time. Quickly, everyone. Time is critical.’ And before Meagan could say anything else, he disappeared inside the house.
Meagan and Dorothy looked at each other for one horror-struck moment before swinging into action. Tasks completed, they helped a terrified Katie into the car.
The young mother looked from Meagan to Cameron. She clutched at Meagan’s hand. ‘You’ve got to save my baby. I can’t lose this child. Promise me you’ll do everything you can. And, please, find Neil. I need him.’
By the time they arrived at the hospital Dr Lake had everything in place to perform the operation. Cameron and Meagan scrubbed up together while Dorothy kept an eye on the baby’s heartbeat.
‘Cameron, how many Caesareans have you carried out in the last two years?’ Meagan asked.
‘None,’ Cameron replied. ‘I did a few when I was a senior house officer. But I guess that was some time ago,’ he admitted.
‘I should do it, then,’ said Meagan firmly. ‘I’ve carried out tons in the last year and while I’d rather not be doing one here under these conditions, I think that I should do the procedure. Besides, you’re the one with paediatric experience and I have very little. You are going to have to work on that baby the moment it’s delivered.’
‘I can’t let you do it, Meagan. I made the decision to operate and if anything goes wrong, it will be my responsibility.’
‘Oh, for God’s sake, get off your high horse. The responsibility lies with both of us. Dangerous or not, I agree with you completely. If we are going to save them, we need to operate. And the best chance we have of pulling them through is for me to do the procedure and for you to stand by to resuscitate the baby if need be. Agreed?’
Cameron could tell when he was beaten. Besides, he could see that what Meagan was saying made perfect sense. He would have to trust her operating capabilities, just as she had trusted him enough to go along with his decision in the first place. And they didn’t have time to argue.
‘Well, then, what are we waiting for? Let’s go,’ he said with a swift smile backing into the theatre.
Katie lay on the theatre table. Dr Lake bent over her, ready to administer the anaesthetic. She looked frightened and sought Cameron’s eyes for reassurance.
‘You and baby will be fine,’ he promised. ‘We’ll be transferring you both to Glasgow once we’ve finished here. I’ll travel with you and see you settled. We’ve managed to locate Neil and he’s on his way.’
Slowly Katie’s eyes closed as she succumbed to the anaesthetic. Meagan took a deep breath and in response to a quick nod from Cameron made a deep, sure incision across Katie’s abdomen. Within a matter of minutes she had cut through the protective sac that held the baby and gently lifted it into Cameron’s waiting arms. ‘A little girl,’ Cameron informed the room. ‘And not a bad size, considering she’s early.’
The baby looked blue and was unresponsive. Cameron quickly cleared the tiny girl’s mouth of any mucus that might be clogging her airway. Precious seconds ticked past but the baby’s heartbeat remained slow.
‘I’ll have to intubate,’ Cameron said quietly, and quickly inserted a small tube into the baby’s windpipe before attaching an ambu-bag to breathe air into the baby’s lungs. Dorothy rested her hand gently over the baby’s chest. ‘The heartbeat is improving and she’s pinking up nicely,’ she announced to everyone’s relief. ‘I think she’s going to be fine.’
Cameron removed the tube and moments later the welcome sound of a baby’s cry filled the theatre, causing a collective sigh of relief.
Meagan allowed herself a brief moment of pleasure before turning back to work on Katie. It was important as she sewed her up to ensure that all vessels that might be bleeding were securely tied off. In many ways this was the trickiest part of the procedure.
It was another thirty minutes before Meagan stood back, and peeling off her gloves, said with satisfaction, ‘Katie’ll be fine. She’s beginning to come round. Hopefully the air ambulance will be here by the time she wakes up so we can transfer her straight away. How’s the baby?’
‘She’s fine. But the sooner she gets to the special care baby unit in Glasgow the happier I’ll be. She’s going to need some intensive nursing for the next few days, but the biggest danger’s past. Nicely done, everyone.’ Cameron smiled his relief at Meagan. ‘Particularly you, Dr Galbraith. Welcome to the team.’
Katie, coming around from the anaesthetic, opened her eyes and, although still very sleepy, was alert enough to know that everything had gone well.
‘Thank you,’ she whispered, her eyes fixed on her baby
‘We’re not out of the woods yet,’ Cameron warned her, ‘but I suspect that in a short while we’ll be welcoming you and baby home. ‘
‘The air ambulance is here. And Neil has just arrived,’ called Dorothy, who had left theatre to investigate. Meagan felt the tension leave her body. The quicker mother and baby were safely in Glasgow, the better. As soon as the crew from the air ambulance were ready with their stretcher, they transferred Katie and wheeled her out to the waiting aircraft. Meagan followed them with the warmly wrapped newborn, who had been placed in an incubator. Cameron settled his patients, ensuring he had easy access to them both should they require help during the short flight. Within minutes the plane was making its final preparations for take-off.
‘Meagan, you’ll have to take the on-call tonight until I get back. In the meantime, if there are any problems, give one of the GPs in the other practice a shout. They’ll be glad to help. Won’t they, Dr Lake?’ he said over his shoulder. ‘I should be back in a few hours.’
And with a flurry of activity the plane took off with the small family for its return journey to Glasgow.
Once Meagan had written up her notes, she left the hospital. Before he left, Cameron had suggested that she leave the remaining visits until the next day as there