I stood by the bed and then reached out and stroked away the damp hair that had fallen across Maura's forehead. It was the first time I had ever touched a patient in that way.
'How are you feeling, Maura?'
She moaned and looked away. Daft question. I took her hand.
'How long have you been in labour?'
'Fifteen hours,' replied Jenny, on Maura's behalf. 'She was induced last night. At forty-two weeks.' The last sounded slightly accusatory. No one wanted a pregnancy to last forty-two weeks, least of all me. By that stage the placenta is starting to deteriorate, sometimes seriously, and the percentage of stillbirths rises dramatically. I'd seen Maura a week ago and she'd been adamant she didn't want to be induced at all. I'd let her go the full forty-two weeks at her insistence but against my better instincts.
She jerked upwards for another contraction. Jenny and the student shouted encouragement and I watched the monitor. 'Who's the house officer?' I asked the student.
'Dave Renald,' she replied.
'Ask him to come in, please.'
She scurried out.
The contraction faded and one look at Jenny's face told me we were making no progress down at the sharp end.
I took hold of Maura's free hand. 'Maura, look at me,' I said, forcing her to make eye contact. Her eyes were glazed but they held my own. 'This has been an unusually painful labour,' I said, 'and you have done amazingly well to get this far.' She had, too. Inductions were always more intense and few managed without an epidural. 'But you have to let us help you now.'
I could see from the monitor that another contraction was building. I was running out of time.
'I'm going to give you a local anaesthetic and I'm going to try forceps. If that doesn't work, we have to go straight into theatre for an emergency Caesarean. Now are you OK with that?'
She looked back at me and her voice came out cracked. 'Can you give me a minute to think about it?'
I shook my head as the house officer and a nurse came into the room. In a bigger hospital, a paediatrician would usually be present at a forceps delivery, but here we had to make do with whoever was on duty. Jenny whispered something to the student and she scuttled out again to put theatre on alert.
'No, Maura,' I said. 'We don't have a minute. Your baby needs to be born now.' She didn't reply and I took her silence for acquiescence. I sat down. Jenny had the instruments all ready and began, without being asked, to lift Maura's legs into stirrups. I administered the anaesthetic into Maura's perineum and made a small cut to enlarge her vaginal outlet. I inserted the forceps and waited for the next contraction. As Maura pushed, I pulled, gently, gently. The head moved closer.
'Rest now, rest,' I instructed. 'Next one's the big one.'
She began to push again and I pulled. Almost there, almost… the head was out. I loosened the forceps, handed them to Jenny and reached… Shit! An inch of grey membrane appeared – the umbilical cord was wrapped around the baby's neck and I'd nearly missed it. I hooked one finger under it, pulling gently until I could loop it over the head and then, as I reached for the shoulders again, Maura gave one last push and they came out by themselves, followed by the rest of the baby. I handed the solid, slimy, unspeakably beautiful little body to Jenny, who took her up to meet her parents. There came the sound of sobbing and for a moment I thought it was me. I shook myself, wiped a sleeve across my eyes and delivered the placenta. The student – Grace, I remembered now, her name was Grace – helped me sew and clean our patient up. Her eyes were shining but she was quick and neat in everything she did. She'd make a good midwife.
Over at the paediatrician's table, the house officer had finished his checks.
'Everything's fine,' he said, handing the baby back to Maura.
17
I STAYED IN THE DELIVERY ROOM FOR ANOTHER FIFTEEN minutes, making sure mother and baby were OK. Then an orderly came to take Maura for a shower and I had a quick wander round the ward to check on the rest of my patients. We weren't expecting another birth before midweek so with a bit of luck it would be a quiet weekend. I decided I could be spared and headed for the exit.
Jenny, the midwife, was coming back into the unit as I left.
'Well done, Miss Hamilton,' she said, and instantly I suspected sarcasm.
'Is anything wrong?' I asked, hackles up.
She looked puzzled. 'Not now,' she said. 'But before you arrived, I really thought I was going to lose that one. And I haven't said that in a few years.'
She must have seen something give in my face because she stepped forward and lowered her voice.
'I spent fourteen sweaty hours with that lassie. I've been shouted at, kicked, sworn at and had my hand squeezed so tight it feels like the bones are broken. And it's your praises she and her man are singing right now, not mine.'
She reached out for my arm and gave it a squeeze.
'Well done, lass.'
I climbed the stairs to where the senior members of the medical team had their offices. Gifford's was the last along the corridor, the largest, on the corner. It was the first time I'd been in there and it came as something of a surprise, reminding me of private consulting rooms I'd visited during my student days: buttermilk-washed walls, heavy, striped curtains, brown studded leather armchairs and a dark wooden desk, whether antique or reproduction I couldn't tell. The desk was almost empty, with just a closed laptop computer and a solitary manila file. I was willing to lay bets it contained the records of Melissa Gair.
Gifford had his back to the door. He was leaning forward, elbows on the window ledge, staring out over the buildings towards the ocean. I didn't knock, just pushed the already open door; it made no sound on the thick, patterned carpet. He turned.
'How'd you get on?' he asked.
'It's a girl,' I answered, crossing the carpet to the middle of the room.
'Congratulations.' He stood there looking at me, the picture of self-possession. At any moment, he was going to tilt his head on one side, assume a polite but firm expression and ask, 'Will that be all, Miss Hamilton?'
Well, I was having none of it. 'I am this close -' I held up my left hand, making a pinch-of-salt type of gesture, 'just this close to throwing the biggest tantrum of my life. And you know what? I think I'd get away with it.'
'Please don't,' he said, crossing the room and leaning back against his desk. 'I have a splitting headache.'
'You deserve one. What the fuck are you lot playing at? Do you have any idea how serious this is?'
He sighed, looking suddenly tired. 'What do you want to know, Tora?'
'Everything. I want a goddamned explanation.'
His response was a weary smile, a small shake of the head and an exhalation of air from his nose – it was a laugh, as economical in mirth as it was in duration. 'Don't we all,' he said. He ran both hands over his face, sweeping his hair back and up. There were sweat stains under his arms. 'I can tell you what's happened while you've been in delivery. Will that do?'
'It's a start.'
'Do you want to sit down?' He nodded towards a chair. I did. In fact, I needed to, as though his despondency was infectious. The chair was absurdly comfortable and the room hot. I made myself sit upright.
'Detective Superintendent Harris is on his way over from Inverness. He is taking personal control of the situation. Andy Dunn came here twenty minutes ago to collect details of the two doctors and three nurses who treated Mrs Gair. Three of the five are currently at the station being interviewed. One is on holiday, the other left the hospital and is being tracked down. Mrs Gair's GP is also at the station.'
'What about you?'
He smiled again, reading my mind.
'I often take extended leave in the late summer or autumn. When Mrs Gair was admitted, I was in New Zealand. She'd been dead five days by the time I got back.'