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‘I’ve never had a headache like this,’ the woman groaned softly as she curled up on the bed and covered her face with her arms. ‘I feel totally hideous—you have no idea.’
‘I’m going to phone the doctor to tell him you’re here and then I’m going to make you more comfortable,’ Miranda told her gently, frowning slightly as she touched the woman’s forehead. She was burning hot and the expression in her eyes was slightly glazed.
Feeling very uneasy and unwilling to leave the woman on her own, Miranda was about to hit the buzzer when Jake’s SHO, Belinda Morris, walked into the room.
‘Hi, there. I spoke to the GP about Cathy,’ she said cheerfully, walking over to the bed and giving the woman a sympathetic look. ‘I’m Dr Morris. You poor thing. Flu is rotten at any time, but even more so when you’re pregnant. Life can be very unfair.’
Clearly the junior doctor wasn’t in the least alarmed by Cathy’s condition and Miranda forced herself to relax, telling herself that she was just being hypersensitive. It was just because of that one case of shoulder dystocia, she told herself. She’d been imagining emergencies with every patient since then.
While Dr Morris carried out an examination, Miranda checked Cathy’s temperature and found it to be extremely high.
‘No surprises there, then,’ Dr Morris said briskly, when Miranda showed her the reading.
Still telling herself that she was being over-anxious, Miranda slipped off Cathy’s top and frowned. ‘How long have you had this rash, Cathy?’
Cathy lay with her eyes closed. Her breathing was shallow and her cheeks were flushed. ‘Don’t know,’ she murmured finally. ‘Nothing there this morning.’
‘Viral rashes are very common with flu,’ Belinda said briskly, pushing her stethoscope back in her pocket. ‘They resolve over time. Nothing to worry about.’
Miranda wished she felt equally confident. Suddenly her anxiety refused to be suppressed. ‘I think we should call Mr Blackwell.’
‘He’s in a meeting at the moment. We’ll just keep her in for the time being, monitor the baby and see how she goes.’ Belinda walked towards the door with a confident and slightly superior smile. ‘I’ll let Jake know that she’s here. Call me if anything changes.’
The door closed behind her and Miranda looked at the rash again. Viruses often cause a rash, she repeated to herself. Viruses often cause a rash. On impulse she picked up a glass from the side of the bed and pressed it against the woman’s skin. The rash didn’t blanch.
Without hesitation, Miranda hit the emergency button and seconds later Ruth came running in.
Her anxiety levels soaring, Miranda checked Cathy’s temperature again, her hands shaking slightly. ‘Call Mr Blackwell. Call him now.’ She hesitated briefly. ‘And we need to give her intravenous penicillin right away.’
Ruth looked at her and then the rash. ‘Right. I’ll arrange it.’ Without argument or discussion, she left the room and was back moments later accompanied by Jake.
Miranda had never been so relieved to see anyone. Calmed by his presence, she turned back to her patient. ‘When did you start to feel ill, Cathy?’
‘Last night.’ Cathy moved her arms and opened her eyes. ‘I can see two of you,’ she murmured drowsily. ‘Is that normal?’
Jake strode over to the bedside. He was dressed in a beautifully cut suit that emphasised the width of his shoulders and the strength of his physique. He looked serious and businesslike and the usual humour was missing from his blue eyes. It was obvious that he’d come straight from a difficult meeting and Miranda felt a flash of insecurity.
What if she’d bothered him for no reason? What if she was wrong?
She came straight to the point. ‘Cathy was sent in by her GP with flu-like symptoms but she has a rash on her torso and I think we should probably give her penicillin right away.’ She didn’t want to mention the word ‘meningitis’ because she didn’t want to frighten the patient and she didn’t want to waste time taking Jake out of the room to brief him on her fears.
Jake took one look at Cathy and reached into his pocket for a tourniquet. ‘Have you got the penicillin there?’ His voice calm, he held out a hand for the syringe which Ruth handed him and quickly checked the ampoule. ‘Great. We’re just going to give you an injection of some antibiotic, Cathy, and then we’re going to take some blood and get you transferred somewhere more comfortable. Are you allergic to penicillin?’
Eyes closed, Cathy shook her head slowly and Jake injected the penicillin just as Belinda came back into the room.
‘Oh, Jake, I didn’t know you were out of your meeting. I was going to tell you about Cathy when you—’
‘I want you to take blood cultures and then start an infusion.’ Discarding the empty syringe, Jake rose to his feet, his handsome face serious. ‘I’m going to talk to ITU.’
‘ITU?’ Belinda frowned. ‘But I—’
‘Cultures.’ Jake’s tone was cool. ‘Ruth—get me Geoff Masters on the phone, please. He’s the consultant in Communicable Disease Control. I need to tell him what’s happening.’
After that things moved swiftly. Cathy was transferred to ITU and Jake continued to liaise with other consultants over her management.
‘He’s been up on ITU for hours,’ Ruth told Miranda later as they changed to go home. ‘No one has ever seen a case of meningitis in a pregnant woman before so they’re all huddled around, discussing the best way to treat her.’
‘Is she worse?’
