The medical centre was equipped with a wide range of laboratory equipment that allowed the staff to carry out many diagnostic tests that were essential to diagnosing and treating patients. Kevin arrived a few minutes later, hair mussed, took the blood samples and prepared them for testing. When she returned to the room Gabriel was sitting next to the examination trolley, talking to Elena. Francesca could see the serious expression on his face and watched as he gently took Elena’s hand to explain her condition. Gabriel was surprising her. He was taking time to talk to Elena, to hold her hand and explain clearly what was happening. For some reason she found it almost the opposite of what she’d expected. This was a man who’d flung her friend out on the street at three o’clock in the morning yet here he was as a doctor, doing everything he should and showing empathy for his patient. In her head that just didn’t fit. Her curiosity was piqued.
She listened quietly in the background.
‘Elena,’ he said gently, ‘I think it is likely that you’re having an ectopic pregnancy.’ He noticed the complete confusion on her face, and realised she hadn’t really understood. ‘Your urine test shows that you are pregnant—but this is not a normal pregnancy.’
‘But I can’t be pregnant—I have endometriosis—it’s not possible for me to be pregnant.’ Her face was filled with shock.
‘It is possible,’ Gabriel continued carefully. ‘Have you had sex in the last six weeks?’
Elena nodded numbly.
‘Although your condition makes it difficult to conceive, it is not impossible. It is likely that because you were taking the contraceptive pill you’ve become unclear about when your next period was due. Your urine test is definitely positive. However, the pain and discomfort that you are feeling makes it likely that, instead of implanting in the womb, the fertilised egg has implanted in your Fallopian tube.’ He picked up a nearby book with pictures of the female reproductive system and pointed to the various areas, showing her where the fertilised ovum had likely reached.
The medical staff often used these clear diagrammatic books to explain conditions to crew members of different nationalities. ‘The embryo can’t develop within this confined space and causes bleeding and pain. Sometimes the tube can rupture and that can be very serious. But in all cases the pregnancy can’t continue.’
He waited for a moment, until he could tell that Elena had processed the information he had given her. Elena started sobbing uncontrollably. Gabriel had been right. The news of a pregnancy, followed by the news that it was ectopic and couldn’t produce a baby, had devastated her.
‘What happens now?’ she asked.
Gabriel stood up from the chair. ‘We have to watch you very closely so we are going to admit you to our intensive care unit. I’ll put up some fluids and give you some pain relief. One of our nurses will come and take some more bloods from you in the next few hours. I will have to arrange for you to go to hospital at the next port.’
Kevin appeared and handed Gabriel the blood results. Haemoglobin eight point seven. Gabriel glanced in Francesca’s direction. No words were needed. They both knew that was much lower than normal for a woman of her age and more than likely an indicator of some internal bleeding.
Francesca felt the flush of relief rush through her system. She’d been right. For once her instincts had been good. If things weren’t so serious for their patient right now she would run outside and breathe a big sigh of relief.
When had been the last time she’d felt like this? The last time she’d had real confidence in her abilities as a nurse?
After her initial meeting with Gabriel, she couldn’t have blamed him if he’d ignored her instincts at all. But he hadn’t.
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