THE MAVERICK DOCTOR AND MISS PRIM/ABOUT THAT NIGHT... (25 page)

“Let me get this straight. A team member tells you they aren’t feeling great before you leave and you didn’t ask them anything else.”

The words were obviously sticking in his throat. He nodded. He ran his hand through his hair. One of Evan’s signs of frustration.

“What else did she say?”

“Nothing. She said nothing.” He squeezed his eyes shut. “But I should have asked her. I know I should have asked her. If I’d stopped for a second, if I’d thought about it. Helen never complained. It was unusual. I should have asked her to think about it. Why she was feeling unwell. What exactly was wrong.” He was wringing his hands together now.

Violet was running through things in her head. “What difference do you think that would have made? Helen didn’t know she was pregnant. She’d already reported as fit for duty. She hadn’t even told Sawyer she didn’t feel well.”

“Don’t you think I know that?” His voice carried across the compound. “She didn’t tell anyone! Anyone apart from me! And I did nothing!”

Violet flinched back as he shouted. This was turning into a living, breathing nightmare. He stood up and started pacing around, his feet kicking up the dust around them. She shook her head. Her brain was spinning. She couldn’t understand all this.

“What difference do you think you could have made, Evan?”

He stopped pacing. “What?” His head was shaking, ever so slightly.

“She mentioned, in passing, that she didn’t feel great. How could you, by asking her questions, have made a difference? I don’t get it.”

His face was becoming redder and redder by the second. In her heart she would have loved it if anything in the world could have made a difference to her sister-in-law’s outcome but the reality seemed very different.

He held up his hands in frustration. “I should have stopped. I should have paid attention. I should have asked her if there was any possibility she was pregnant!”

“Why would you ask her that? Why would you even think that?”

“Because if maybe I’d considered it a possibility, she might have considered it a possibility!”

The words hung in the air between them. There was so much on the line here. He was exposing everything about himself to her. He was exposing his failings. His failings as a team leader and as a person. What man ever wanted to do that?

She tried to push her family loyalties aside but could feel herself torn. Was there even a shred of possibility that could be true? Would Helen really have stopped to think she might be pregnant if Evan had asked her a few more questions?

She needed to step back. She needed to step out of this situation. She needed time to think.

She lifted her head. It was hard to look at him right now. There was too much conflict here. The rational part of her brain came into play. “Did you ever stop to think that if you’d asked Helen if she could be pregnant, she might have thought you were being sexist? She wouldn’t have thanked you for asking that question, Evan. If you knew Helen as well as I did, you would know she might even have been angry with you.”

His voice was quiet. “She might also still be alive.” He let out the biggest sigh. “An angry Helen I could have lived with. It’s the dead Helen I can’t take.”

Everything was silent round about them. There was no one else around, it was just her and him.

In the heart of Africa even the insects seemed to have become quiet.

Tears prickled in Violet’s eyes. The horrible realization that Evan might be right. If he’d asked Helen if she could be pregnant, would she have checked the calendar? Would she have stopped for a minute to consider it?

Might it have saved her life?

There were so many ifs and buts. There was nothing definite here. Just a world full of possibilities.

Possibilities that neither of them would ever know about, because the time had passed.

It was over. There was no time machine. There was no way to turn back the clock. How many other people felt like that? How many mothers whose child’s hands had slipped from theirs moments before a car had appeared? How many doctors who had sent a patient home, only for them to come back later and die?

And for her, how many women who couldn’t remember the last time they felt their baby move?

A never-ending list. A whole world of don’t-knows. A whole lifetime of what-ifs.

Evan turned to face her, his hands hanging by his sides. Even with his large, broad frame he looked broken. “How can I live with this, Violet? How can I live with knowing if I’d done a better job Helen might still be here?”

She couldn’t speak. She couldn’t find the words she should be saying to comfort him, to reassure him that it wasn’t his fault. That it hadn’t been his responsibility.

It would be so easy to apportion him the blame. But, then, that’s what he’d done to her brother. He spent the past six years blaming her brother for this. Thinking that he’d known about his wife’s condition and had let her go on the mission with them.

He’d turned his anger on her brother rather than on himself.

How wrong. How unfair. As if Sawyer didn’t have enough to live with.

Now he was blaming himself. Finally.

And in her heart of hearts she wanted to blame him too.

But she understood better than anyone what it was like to feel saddled with blame. Every moment in the last three years she’d wondered if she’d done something wrong. Something that had affected her pregnancy and stolen the life of her baby.

She’d interrogated her life to the point of not being able to move forward. Every thing that had crossed her lips during her pregnancy, every tiny twinge, every action she’d taken, every time she hadn’t slept well or felt grumpy.

Anything that she could have changed that would have let her baby live.

Let her baby be born the living, breathing daughter she’d dreamed of.

But she’d had to let it all go.

Because no matter what she analyzed it didn’t change the outcome.

It didn’t change the results of the autopsy by the medical examiner. It didn’t give her a reason for her daughter’s death.

Because there had been no reason. Or none that could be found.

And no matter how hard it was, putting it behind her was the only way to start to move on.

Sometimes there just was no one to blame.

Her throat was dry. The dust in the air around her was stifling, or maybe that was just how she was feeling, as if the whole world was closing in on her again.

She tried to find some words. It didn’t matter how much of a struggle it was to say them.

“You have to realize that Helen was a professional. You have to realize she was responsible for her own well-being. You have to let it go.” Her voice was breaking now.

“But how? How can I let it go?” He reached toward her hand. She didn’t want him to touch her. She wanted him to leave her alone. “Can you forgive me?”

His eyes were pleading with her. She could see how much this had destroyed him. She could see how much this had been eating away at him.

But she was so mixed up right now. Feelings of guilt and responsibility were rushing to the surface and she didn’t feel equipped to deal with them.

There was no one out here to talk to. No one who understood.

She couldn’t deal with his feelings as well as her own.

She felt as if she’d just jumped back a dozen steps.

She needed time. She needed space.

She raised her eyes to meet his. “It’s not my forgiveness you need, Evan. It’s your own.”

And she turned and walked away before he could see her tears start to fall.

CHAPTER TEN

V
IOLET
 
LOOKED
 
AROUND
 
the village they’d just been arrived at. It was the third one they’d visited that day. She was trying to ensure all the local midwives were enrolled in the midwife service scheme and the oral polio vaccine pre-placed in delivery rooms to ensure administration immediately following birth.

She’d barely been in Evan’s company since that fateful night two weeks ago. She just couldn’t find the time and space to deal with him.

Because he’d brought so much to the surface again she was finding this task harder than she’d first thought. She was feeling raw and exposed.

And dodging Evan Hunter had become her number one priority.

She looked around. This was one of the bigger villages, with over two thousand residents and a mixture of midwives and traditional birth attendants. The birth rate was high, as very little form of contraception was used in the village and some of the expectant mothers from neighboring villages even came here to give birth.

Violet could hear some noise coming from the delivery room that was used in the village. She walked over hesitantly, unwilling to disturb the midwife if she was dealing with an expectant mother. Many of the births were attended by female family friends as well as the midwife or birth attendant, so Violet’s presence might be considered intrusive.

As she approached the doorway the first thing she noticed was that, apart from Urbi, the midwife, only one other person was with the expectant mother. She was obviously in hard labor and her moans could be heard from the road, but what Violet hadn’t heard was the fact she was also weeping quietly.

A horrible sense of dread came over her straight away.

Urbi looked up. She was using a traditional midwife’s Pinard to listen to the baby’s heart and waved her hand at Violet to come inside.

“Ah, Dr. Violet. Can you listen for me?”

Violet tried her best to remain calm. “Is there a problem? Where are the rest of the family?”

Urbi shook her head. “I sent them away. Hasana has been in labor for more than twelve hours. I haven’t been able to hear the baby’s heartbeat for the last hour.”

No.
Violet felt a shiver go down her spine. She wanted to turn and run away. She wasn’t specially trained in obstetrics. Her fundamental knowledge was basic at best. How much use could she really be?

But the look on poor Hasana’s face was desperate. And Violet’s heart went out to her. She would be hoping, praying that Urbi had made a mistake. With every breath she would be willing that Violet would be the person to find her child’s heartbeat.

The coiled-up feeling in Violet’s stomach made her feel sick. She had to do her duty as a doctor. This birthing room wasn’t equipped with the latest technology. There was no sonogram. No fetal Doppler, no fetal monitor. The only piece of equipment was the Pinard horn, the most fundamental listening device to detect a baby’s heart.

Violet took a deep breath. There was no running away from this. She couldn’t find any suitable excuse not to do the task she’d been asked to. As a doctor, she had a duty of care. “Is there any possibility that the baby has turned into an awkward position?”

Urbi had her hands on the mother’s stomach. Her eyes were sad. She was one of the most experienced midwives that Violet had met since she’d arrived in Natumba state.

Violet was grasping at straws here and she knew it.

But she knew this situation better than anyone. She’d had the experience of being that mother. It took all her strength and self-resolve not to run and hide away in a corner. She really didn’t know if she could go through this again.

Urbi spoke a few words in Hausa to the expectant mother. She looked back at Violet. “She felt her baby move last night when her labor started. The movement continued for the first few hours. There’s been nothing since.”

Violet pulled her ordinary stethoscope from her bag. She already knew this would be a futile exercise. “Let me try both of these,” she said, taking the Pinard from Urbi’s hands.

Hasana was tightly grasping the midwife’s hand as Violet placed her hands on her stomach. The tightness of the grasp turned her knuckles pale.

Violet felt Hasana’s tight abdomen first to determine the position of the baby. She’d used to do this to herself on a regular basis. It felt good to know which way her baby was lying at different points in the day.

Once she’d determined the baby’s position she placed her stethoscope on the abdomen at the point where she should be able to hear a heartbeat. Her chest felt tight. She could feel Hasana’s anxious eyes burning a hole into the side of her head.

“Has Hasana got any other children? Does she have any medical conditions?” The questions were rudimentary. They weren’t going to change the outcome. But Violet felt she had to go through all the steps methodically.

Urbi shook her head. “This is her first. She has no medical conditions. There have been no problems during the pregnancy.”

Something twisted in Violet’s gut. It could be her they were talking about. No past history. No previous births or complications. A textbook pregnancy. No signs or cause for alarm.

She took the stethoscope from her ears and switched to the Pinard. She waited as Hasana was struck by another contraction and once it subsided she placed the Pinard on Hasana’s abdomen in the hope something might have changed.

She was met with deathly silence.

Her eyes met Urbi’s. “What have you told her? Does she understand English?”

Urbi shook her head. “Only a little. I will translate for you, Dr. Violet. I have already told her that I couldn’t hear the baby’s heartbeat. That was when I sent the family away. She knows I was just asking you to check again—to confirm what I suspected.”

Violet nodded. Her brain was having flashbacks. Her own delivery room couldn’t have been more different from this birthing room in Africa. Hers had been white, bright and modern with all the technology in the world. That hadn’t made a bit of difference to her baby.

The gel being squirted on her stomach. The Doppler unable to find a heartbeat. The change of position. The blank looks on the faces of the delivery room staff—aware that she was a physician and would know exactly what they were doing.

Finally, her obstetrician speaking to her in low, gentle words. The progression of labor. The pain and frustration of knowing that there wouldn’t be a euphoric and happy moment at the end. Her mind filling with the preparations she’d made at home. A bassinet, a stroller, a car seat and drawer after drawer of tiny little clothes.

The bright, colorful letters spelling out the name she’d chosen for her daughter on the nursery door. How could she go back home to all that without her daughter?

She lifted her eyes to meet the dark eyes of Hasana. She had a job to do here. And as much as it pained her, because she understood, she realized she might be the best person to do this job.

She took a deep breath and reached out for Hasana’s free hand. She shook her head and spoke slowly. “I’m so sorry, Hasana, but I can’t find a heartbeat for your child. Your baby isn’t moving. I think your baby is going to be born asleep.”

She hated the word
stillbirth
.

She couldn’t explain why. It just sounded so cold. So distant.

For some reason, to her, a baby being born asleep sounded easier. Even though she knew the reality was that nothing could make it easier. She wasn’t going to keep talking. She wasn’t going to bombard Hasana with anything else.

She wasn’t going to tell her she couldn’t give her a reason why this had happened to her baby. She wasn’t going to tell her there was no reason that she couldn’t have a healthy child in the future.

Because right now this was all about this baby. Hasana still had at least an hour of labor to go through.

A first labor. A long labor. And what should have been labor of love had turned into a labor of sorrow. And in that moment Violet knew. She wasn’t going to go anywhere. She was going to stay right here and hold Hasana’s hand. It was one thing she was absolutely sure of.

Urbi translated her words. Another labor pain gripped Hasana’s body, the tightening of her abdomen apparent. But her sobs were reaching far and beyond the labor pain. The noises she was making sounded like her very heart had been ripped out of her body. Her friend kept her arm wrapped around Hasana’s shoulders, holding her close and letting her sob. Silent tears dripped down her cheeks as she tried to be strong for her friend.

Violet put her hand on top of Urbi’s. “If it’s all right with you, I’ll stay. I’ve got some experience in this. I’ll help you.”

Urbi nodded her head. “Thank you, Dr. Violet.” Her dark eyes watched her carefully. “Most people want to leave the birthing room when they know there isn’t going to be a joyous celebration at the other end.”

Violet could feel the tears pooling in her eyes. She had to stay strong. She had to stay professional. It was the best way she could support Hasana. “Every baby’s birth should be celebrated, Urbi, no matter what the outcome.”

Urbi’s head tilted to one side, her years of experience very evident. It was almost as if she was reading Violet like an open book. Instantly understanding all the secrets she’d kept hidden away for the past three years. She wrapped her hand tightly around Violet’s and gave it a little squeeze. “You are a good woman, Dr. Violet. May the Lord bless you.”

There was a loud noise outside. Indistinguishable.

Urbi started. She spoke rapidly to Hasana then turned to Violet. “Let me go and check what that was.”

She disappeared in a sweep of skirts, the dust clouding around her. Violet peeked out of the door in curiosity. Had a car backfired?

She could see people coming out of the houses surrounding them, all walking in the direction of the noise. Men were shouting at their families to stay inside. Urbi was nowhere in sight.

A horrible sensation started to sweep over her, a real prickling of unease.

She ducked her head back inside, holding Hasana’s hand through another contraction. She pulled a pair of gloves from her bag and signaled to Hasana. “Can I check?”

The language barrier appeared to have disappeared. She knew exactly what Violet wanted to do. Violet did an internal examination and found Hasana was fully dilated. Any time now the baby’s head would start crowning.

She pulled her hand back just as her brain realized what the noise outside was. Hasana let out a little shriek.

Gunfire. That was definitely gunfire.

Panic. She instantly felt sick. Adrenaline started coursing through her veins. The fight-or-flight response had never been so obvious.

In the distance she could hear voices shouting, followed by gunfire. What on earth were they in the middle of?

Hasana’s female companion darted outside. Where was she going? Was she leaving them?

Violet tried to remain focused. She had to make a decision in the next few seconds. Hasana might be able to move in the next few minutes, but once she started crowning it would be virtually impossible.

She had no information to go on. How on earth could she assess their safety, their risk? And where on earth would they go?

Her heart thudded in her chest. For the first time in two weeks she wished Evan was by her side. She didn’t feel strong. She didn’t feel ready to deal with anything like this.

The voices were louder now. Fear started to grip her chest. There had been reports about attempted kidnappings, bomb threats and health staff being slain.

All their intelligence had told them it was in the next state. There had been nothing to indicate any trouble at all near here.

But could she wait and take that chance?

What would Evan do?

Hasana’s friend reappeared. She tugged at Violet’s arm. “Go. Now. They are looking for you.”

It was like all her worst fears realized. Her head went from one woman in the throes of labor to the other tugging her arm and pleading with her to leave.

“What about the rest of the team?” She might be the only doctor, but there had been four other community workers with her today. Where would they go?

Now she knew.

Now she understood what it felt like to have responsibility for the health and wellbeing of team members. Who to leave at risk—the staff or the patients? How on earth could someone make a decision like that?

“The villagers will hide them.” It made sense. The community workers were all from surrounding areas and all had dark skin and wore traditional dress. As long as their equipment was hidden they could easily blend in. Her blond hair and pale skin would make her stand out like a sore thumb. It would put everyone at risk.

Hasana managed to stand up and gripped her other arm. “I need you. Please.” For a woman who couldn’t speak or understand much English, her words were crystal clear.

She’d never felt so conflicted. Evan had given them all clear directions if they encountered any hostility.
Don’t hesitate. Get out
.

But her Hippocratic oath was bouncing around in her head. She had a duty of care to Hasana. She had to help her.

And Evan wasn’t here. No matter how much she wanted him to be.

She darted around the room, picking up the few things she thought she might need. Bags, gloves, the polio supplies to hide and a few blankets. Her brain was frantically trying to formulate a plan. The truck. Evan had said always to head toward the truck. It was their guarantee of getting out. Their safe passage back to camp.

But the noises sounded as if they were coming from that direction—the compound where they had left the truck.

Then she heard it. A loud, screaming woman’s voice. Urbi. And straight away she knew why. She was making as much noise as she could. Obviously to try and warn Violet to get out.

Her voice was up against another, a male voice shouting back. Their dialogue was a mixture of English and Hausa. “The doctor left this morning,” Urbi was shrieking.

Violet headed for the door, dropping the things that she held haphazardly in her arms. “Leave them,” Hasana’s friend hissed as she scrambled about the floor, grabbing what she could.