‘What sort of tests?’
‘Blood or urine,’ he said. ‘They test for the same chemicals as they would in a pregnancy test, so you need to make sure you don’t try for a baby until you’ve had a chance to recover.’
‘Grow back?’ Mr Scott asked. ‘You mean, it’s like a cancer?’
‘Not quite. It’s called a gestational trophoblastic tumour—but the important things to remember are that it’s benign and it’s curable. If the mole does grow back, we’ll have to treat it with chemotherapy,’ Theo explained gently, ‘but because you have a partial mole rather than a complete mole, it’s much less likely to happen to you. When your hCG levels are back to zero, in about six months’ time, you’ll be able to start trying for a baby.’
Mrs Scott was clearly trying to hold back her tears. ‘If we try for another baby…will this happen again?’
‘The odds of you having another molar pregnancy are pretty low,’ Theo reassured her. ‘There’s absolutely no reason why you can’t have a normal pregnancy next time, and you won’t have increased risk of any complications.’ He was still holding her hand. ‘We’ll need to take you to Theatre to remove the mole—it’s an operation you may have heard of called a D and C.’ Quietly, he talked her through the procedure, explaining exactly what he was going to do. ‘I do need to do the operation under a general anaesthetic, so you won’t be able to have anyone in Theatre with you, but you’ll be able to wait outside the theatre if you want to, Mr Scott.’
‘So when does my wife have to have the operation?’ Mr Scott asked.
‘It’s entirely up to the two of you,’ Theo said. ‘We can do it this afternoon, or if you’d rather wait a day or two to come to terms with everything first, that’s also fine.’
‘It’s a thing growing inside me, not my baby.’ Finally, a tear trickled down Mrs Scott’s face. ‘Do it today. Please. I don’t want it inside me any more.’
‘When did you last eat?’ he asked.
‘Breakfast. I was too worried to eat lunch, and Maddie told me not to eat or drink anything in case you needed to take me to Theatre.’
He nodded his approval. ‘That’s fine. Have you ever had any allergies or any reaction to a previous anaesthetic?’
‘I’ve never had an anaesthetic,’ she said.
‘As with any operation under a general anaesthetic, there are risks,’ Theo explained, ‘but I’ll get the anaesthetist to come and have a chat with you and you’ll be able to ask her any questions. And if there’s anything else you want to know, Maddie and I are here.’
‘And there are support groups that can help when you go home,’ Madison said. ‘I’ll get the numbers for you. You’ll be able to talk to other mums who’ve been through the same thing and who can reassure you that they went on to have a healthy baby. I know right now this is scary because molar pregnancies aren’t that common, but the main thing to remember is that it isn’t your fault. It could happen to anyone.’
Mrs Scott swallowed hard. ‘I just wish it hadn’t happened to us.’
‘Will Denise have to stay in?’ Mr Scott asked.
Theo shook his head. ‘There’s no reason why you can’t go home together afterwards. I would advise you to take at least tomorrow off work, Mrs Scott, and maybe a day or two after—just see how you feel, and be kind to yourself. And do talk to people about how you’re feeling rather than bottling it up.’
Theo was telling someone not to bottle things up?
Madison caught his eye briefly, and saw the wry recognition in his gaze—he’d clearly guessed what she was thinking. Definitely a case of pots and kettles.
‘We’ll send the anaesthetist through to you now,’ Theo said. ‘And we’ll see you in Theatre. Try not to worry,’ he added gently.
When he and Madison had left the consulting room, he turned to her. ‘Do you want to assist?’
‘Is this part of your job enrichment thing?’
He nodded. ‘Which isn’t me being cruel and heartless, by the way. This is a horrible situation and we need to get something positive out of it—so if it gives you more of an insight into another specialty, that’s a good thing.’
‘In other words, if life gives you lemons, make lemonade.’
He gave her a half-smile. ‘That’s a pretty good philosophy. Works for me.’
But did it? she wondered. Because, despite the fact he loved his family and he liked children, he still refused to face his fears. He was still adamant that he’d never get married and have children.
They both changed into Theatre greens and scrubbed up.
‘You’re probably aware that the risks of the op are quite minor,’ Theo said. ‘Because of her pregnancy, her uterus is soft, so the biggest risk is perforation—I need to watch for that, and I also need to make sure I remove all the mole and send samples to the lab.’
‘All textbook stuff.’ She took a deep breath. ‘But textbooks don’t prepare you for the way you feel, do they? The Scotts really wanted this baby, Theo, and they’d been trying for almost a year. They’re completely broken-hearted. And I feel so bad that I can’t fix it for them.’
‘It isn’t your fault, Maddie. And there’s no reason why they can’t try for another baby in the future.’
How could he say that so coolly and calmly? she wondered. How, when he wasn’t prepared to face those risks himself?
The operation went smoothly, and after Mrs Scott had come round in the recovery room, Madison brought Mr Scott in to see his wife and sat with them for a while. ‘I know Theo talked to you about what to expect after the operation, but you’ve had a lot to take in so I thought you might find this useful.’ She gave them one of the patient advice sheets she’d written the previous year and had updated a couple of months before. ‘Don’t worry if you have any irregular bleeding, because that’s perfectly normal—but if you develop a temperature or you have a tummy ache or you find your period’s very heavy and clotty, you need to talk to your family doctor as you might have an infection. Don’t use a tampon until your next period, and it’s a good idea to avoid sex until the bleeding’s stopped.’
‘How long will it go on?’
‘It varies—a few days. But if the bleeding goes on for longer than that, come back and see us and we’ll check you out.’ Prolonged bleeding might mean that the molar tissue had grown into the muscle layer of Mrs Scott’s uterus—not that she was going to worry her patient with potential complications.
When Madison finally left the ward, she passed Theo’s open door; some instinct made him glance up. She looked really miserable, he thought. ‘Maddie—a word?’ he called.
‘Sure.’ She walked into his office.
‘Close the door.’
As she did so, he got up and walked towards her, then slid his arms round her, holding her close.
She pulled away. ‘Theo, this isn’t a good idea.’
‘I’m merely giving you a hug,’ he said softly. ‘As I would any colleague who looked as upset as you do right now. As you said to me once, it’s what friends are for. And I’m here for you.’ He paused. ‘Is it the Scotts?’
‘Partly.’ She sighed. ‘It’s been one of those days. The radiologist called me down to see one of our mums this morning because the baby’s heartbeat wasn’t there. I had to explain to her that she’d lost the baby and was going to miscarry over the next few days—and if she didn’t, she’d have to