Page 45 of Heartbreak for the Irish Midwife

Gently, Alex ran the pads of his fingers over the baby’s scalp, commenting on what he was seeing and feeling. The diamond shaped fontanelle – the soft spot – at the top, where the bones of the skull had not yet fully developed, was very slightly depressed, not sunken as it had been yesterday, while the triangular fontanelle at the back was entirely normal. The baby was not crying tears – which was normal for a child this age – but his mouth was moist, as were the eyes.

‘Sister reports good wet nappies since last night,’ he continued, ‘and I understand baby fed a lot during the night. So, taking everything into account, my diagnosis is that the dehydration which was previously diagnosed and documented in the notes’ – he paused to let that sink in – ‘is now resolving nicely.’ Was Fenton referring to something else? ‘Skin temperature feels normal, and the observations from overnight are all within the normal range. I’m not seeing any signs of infection?’

He made this a question. After all, he was only newly qualified. Fenton had many years of experience on him, and it was entirely possible that the senior doctor had noticed something that he had not.

But Fenton was now looking decidedly discomfited. ‘Yes, well, you should have asked my permission before discharging him from the nursery. Anything might have happened.’

Alex was astounded. There was no emergency, it seemed, and Fenton had bellowed all over the ward, upsetting mothers and babies, because . . . Because he is angry with me.

Alex stood his ground, keeping his tone mild. ‘Russell told us specifically that we shouldn’t be seeking permission from senior doctors for straightforward decisions. The baby was well, his mother’s milk was coming in, and I didn’t want her to get mastitis. It seemed a reasonable option.’ A notion came to him. ‘I’m happy to discuss my rationale with Russell, if you’d like. He told us he’d be happy to give a second opinion on any case we are involved in.’

‘That won’t be necessary.’ Fenton’s tone was clipped, his expression guarded.

Aye, you don’t like the notion of a second opinion, do you?

‘Just make sure you check for dehydration in future.’ Wheeling, Fenton strode off down the centre of the ward, a king surveying his subjects. Some of the babies were still crying, all being comforted by their mothers – except this one. Bending, Alex lifted Baby Watson from his cot alongside the bed and passed him to his terrified-looking mother, who immediately began positioning him for a feed.

‘Is he all right, Doctor? What’s goin’ on?’

‘He’s fine. Nothing to worry about.’ She needed a better explanation, so he went through the signs the baby had been showing yesterday, and how he was so much better this morning.

Wonderingly, she passed a gentle hand over her baby’s anterior soft spot. ‘I can feel it! Only a wee bit dipped, so it is.’

‘So now you know what to watch out for,’ he said, picking up the notes from the foot of the bed. ‘Although he’s feeding so well now I can’t see it getting worse again.’ Taking a pen from the top pocket of his white coat, he added a note to confirm baby’s current condition, noticing as he did so that his previous entry was there, and worded in a way that was entirely clear.

‘Well, I’m gonna bliddy feed him all day if I have to!’ Realising she had used strong language, she added sheepishly, ‘Sorry, Doctor.’

He waved this away, sliding his pen back into its pocket and replacing the notes. ‘You need your rest too, though. If you find yourself getting sleepy, make sure and put him down safely.’

‘I will, Doctor. Thanks.’

‘No worries.’ Still feeling slightly churned up inside, he made his way back to the ward office, passing Priscilla Gildea, who was pulling a screen across to a bed on the right – presumably a woman’s pads needed changing.

‘What was all that about?’ Sister Campbell – who had clearly heard Fenton’s bellow – looked bemused. Peggy was in the office too, but Fenton had gone – running away like the coward he is. Briefly, Alex explained, keeping his account neutral and professional. ‘. . . but the baby is much better this morning – the slightest of dips in the anterior fontanelle, feeding well, eyes and mouth moist . . .’

‘And good wet nappies,’ Sister concluded. ‘Are the notes there?’

Only the newer beds had a space at the bottom designed for holding notes. Hospital staff never wanted to frighten patients, so a combination of medical jargon and half-deliberate bad handwriting prevented patients from reading things they shouldn’t.

‘Aye. I’ve added another update.’

‘Right.’ She knows. Sister clearly understood that Fenton hadn’t bothered reading the notes before he went mad. The midwives always knew. Nurses too. These women were smart. In fact, he was beginning to suspect that most professionals in the hospital were probably smarter than Fenton, and that the man lived in constant fear of being exposed.

Doesn’t mean he should bully people, though. Dimly, he recalled his own schooldays. He had managed to avoid the attention of the bullies there, but had done little to protect their victims. He had stood by, relieved they weren’t targeting him.

Regret pierced him, but once again the wisdom of Maisie – or, more accurately, Maisie’s mother – came to him. Things you can’t control. He could do nothing to protect those boys now. What he could do was be as courageous as he could manage here, now, with an out-and-out bully causing potential harm to mothers, babies, and colleagues. He glanced at Peggy, who had paused from doing paperwork at one of the desks to listen, her eyes wide.

Potential harm? Mrs Lennon was living proof of actual harm. Sitting at the other desk, he began working on her discharge letter and forms, explaining to Sister that Fenton had discharged the woman. She sent him a concerned look, and he sighed. ‘I know. But she really wants to go home, and Fenton agreed.’

‘Right. Who can pick her up?’

‘She mentioned her sister – Carmel. I said I’d come back to her to get the details, but then . . .’ he gestured towards Mrs Watson’s end of the ward.

‘I’ll do it.’ Sister picked up a clipboard. ‘We’ll send a messenger boy to the sister’s house and ask her to come and collect Mrs Lennon.’ She frowned. ‘They won’t have a motor car.’

‘I’ll pay for a taxi,’ he said hastily, immediately continuing with, ‘and we’ll need to send supplies home with her.’

‘Aye, we’ll give her plenty of pads. Least we can do.’