Page 36 of Heartbreak for the Irish Midwife

As she returned to the ward and Mrs Lennon, she reflected on the similarities between Fenton and Gerald. Both superficially charming and confident. Both selfish and self-centred. That would have seemed like weakness to him. Alex’s words about Fenton came back to her. Gerald had detested being wrong – even in the smallest of matters. He had much preferred to be the all-knowing one who never, ever made mistakes.

A flash of memory came to her now, one small moment from her time in London. Or at least it had seemed small at the time. They had been at one of the regular hospital socials when one of the nurses had merrily talked about having been to Westminster that day and seen Chamberlain emerge from a motor car and enter his home in Downing Street. Gerald had insisted that she couldn’t possibly have seen Chamberlain as the Prime Minister was known to be abroad. The girl had laughed and said she knew what she had seen, and Gerald had ranted about it to Maisie for hours afterwards.

And when the papers the next day had confirmed that Chamberlain had indeed returned the day before, the topic had never been mentioned again. Not by Gerald, and certainly not by Maisie. At the time she recalled telling herself she was not petty, and that only pettiness might have made her bring this evidence of his error to Gerald’s attention. Besides, she wouldn’t want him to feel uncomfortable.

Now, though, she saw it rather differently. What she now understood was that even then, she had been wary of challenging Gerald. While knowing how sensitive he was to criticism and to being caught out in a falsehood, she had foolishly thought it endearing – evidence that she was coming to understand the parts of him that others could not see. She had thought it showed vulnerability. God, I was a fool!

And if Fenton’s actions really had been driven by fear and pride – if his motivation for treating Mrs Lennon so dreadfully had been to protect himself from demonstrating failure and inadequacy, then that pointed to a character flaw so dreadful as to be unforgivable, given the consequences. Maybe it’s him that has committed the mortal sin today. The man had killed a baby against the wishes of its mother, and without a sound reason – or at least, without any valid reason that Maisie could discern. He should have allowed the woman to make her own choice without pressure. If God had any sense of true justice then it would be Fenton who would be punished, and Mrs Lennon forgiven.

And what did it all tell her about Gerald? She circled back round to him again. Caught up in the romance of it all, she had excused his tantrums, but maybe she should not have done so. Maybe, like Fenton, he too had a character flaw that simply could not be fixed. And maybe he too should not be excused. Maybe . . . maybe Gerald should not be forgiven.

11

Alex was called to carry out an emergency caesarean section that afternoon, and as he went through the surgery he was acutely conscious of the responsibility he carried. The lives of a mother and a baby were in his hands, and he had to stay focused in the moment, noticing every single detail, in order to give them both the best chance of thriving.

As ever, the fastest part would be getting the baby out. Deftly, he incised the skin, a thin layer of fat, and the fascia, before manually separating the abdominal muscles to expose the abdominal cavity. After carefully cutting through the peritoneum – the membrane lining the cavity – he could see the womb, which had grown massively during the past nine months. He already knew that the baby was transverse – lying crossways – and it had been impossible for the woman to birth the child in the usual way.

Feeling his way carefully, he made the incision across the lower part of the womb, keeping to the recommended location about two inches above the pubic bone. The trick here was to use enough force to get through the uterine tissue without nicking the baby. Watching carefully as the tissue separated, he stopped at exactly the right moment, barely noticing how the theatre sister was anticipating his every need as well as suctioning the surgical field to keep it visually clear. In the background he was aware that his anaesthetic colleague was monitoring the lady’s vital signs – ensuring she remained unconscious and pain-free while still maintaining a good heart rate, oxygenation, and blood pressure.

And there was the baby, still encased in its amniotic sac, lying comfortably crosswise and entirely unaware of the trouble it had caused its mother. Piercing the sac, he reached in with both gloved hands to gently but firmly release the child – head first – and bring it out into the world.

A wee girl! He passed her immediately to Sister Marshall, relieved to see the child looked pink and vigorous, then began the laborious process of stitching the woman back together again, layer by layer. It was always nice to see that baby was out and doing well so early in the process. Cutting was quick; stitching took forever. He was vaguely aware that Sister had called in a midwife – one he only vaguely knew – who was now tending to the baby in the corner of the room. The baby girl had cried straight away, which was always reassuring.

Maintaining his focus and concentration he carefully sutured the woman’s womb, with the double layer closure technique he had been taught in Edinburgh. He then worked his way outwards, layer by layer, until, finally, he placed the last stitch in the woman’s skin, tied it off, and cut the excess catgut. Done!

He straightened, moving his shoulders to release the tension, then stepped away, allowing Sister to apply a clean dressing and the anaesthetist to begin the process of carefully bringing the lady back to consciousness.

Stripping off his gloves and cotton gown, he placed them into the appropriate bins while simultaneously hearing from the midwife (Midwife McCrea if he was not mistaken) that baby was doing very well indeed.

‘Glad to hear it!’ Relief coursed through him as he left the theatre, and he couldn’t help but wonder if it was the same room used for Mrs Lennon’s procedure earlier in the day. Memories struck him like a punch in the gut. Fenton. Mr Lennon’s bewilderment. Mrs Lennon’s distress . . .

And Maisie. His heart seemed to turn over in his chest as he recalled how she had accepted his comfort, told him her concerns, trusted him. It had been him that she had run to in a last-minute attempt to avoid disaster. Him, and no one else.

And I failed her. He had been unable to avert the tragedy. Mrs Lennon’s baby was gone, and her entire family – her husband, her other children – would feel the effects of it for years to come. Perhaps forever. And Alex could do nothing about any of it.

His theatre shift done, he made a quick visit to the bathroom, then found his feet taking him to A Ward once again. After knocking on the door to the side room, he waited for almost a minute before Sister Campbell came out. ‘How is she?’

‘Awful. Been crying non-stop for hours.’ Her face twisted. ‘Doctor Fenton called.’

‘And?

‘He’s prescribed a sedative.’

‘A sedative? A feckin’sedative?’

She rolled her eyes. ‘I know.’

Jesus Christ, the man had some nerve. He wasn’t even going to ask Sister if Fenton had shown any remorse whatsoever, for he knew what the answer would be.

‘Can I do anything?’

Sister shook her head. ‘Her husband is away on home. Apparently Teresa’s sister Carmel is looking after the other children, but she has wee ones of her own to see to. She lives nearby though, so at least that.’

‘Thanks, Sister. I suppose there’s not much any of us can do.’

‘Actually, there is one thing. Can you check on Midwife Canavan? I sent her back to the clinic a wee while ago as she’s been with Mrs Lennon most of the day. I think she’s taking it really hard.’

‘Aye, I will.’ He straightened. ‘I just have to check in with a couple of my patients here first.’