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The Surrogate's Unexpected Miracle
Alison Roberts
Their unexpected familyEllie Thomas was meant to be a surrogate mum to the baby growing inside her, but when her best friend abandons her, everything changes. The moment her son is born Ellie knows she could never give him up! But the one person she can turn to for help is the doctor who delivered her child.Dr Luke Gilmore didn’t have a picture perfect childhood, but he instinctively wants to protect Ellie and her baby. He was only passing through, but he may have just found a reason to stay…


Their unexpected family
Ellie Thomas was meant to be a surrogate mother to the baby growing inside her, but when her best friend abandons her, everything changes. The moment her son is born, Ellie knows she could never give him up! But the one person she can turn to for help is the doctor who delivered her child.
Dr. Luke Gilmore didn’t have a picture-perfect childhood, but he instinctively wants to protect Ellie and her baby. He was only passing through, but he may have just found a reason to stay…
Dear Reader (#ubdad88ca-0ce1-520c-87be-dd69fac9fe97),
Have you ever been blindsided by something? Something totally unexpected that was huge enough to change your life for ever?
If you have, I really hope it wasn’t something awful—like an accident or a house fire—but something amazing—like meeting the gaze of the love of your life for the first time. Sometimes, though, even a disaster can turn out to be the catalyst for something much better to take its place.
I blindsided my heroine, Ellie, in this story more than once. I gave her a baby she never expected to have to raise. And then I burned her house down!
I guess I blindsided my hero, Luke, as well—but that was a much more gradual process and it took him a long time to realise that it had happened.
And it was definitely something amazing! :)
I do hope you enjoy reading this story as much as I loved writing it.
With love,
Alison xx
The Surrogate’s Unexpected Miracle
Alison Roberts


www.millsandboon.co.uk (http://www.millsandboon.co.uk)
Books by Alison Roberts
Mills & Boon Medical Romance
Paddington Children’s Hospital
A Life-Saving Reunion
Christmas Eve Magic
Their First Family Christmas
Wildfire Island Docs
The Nurse Who Stole His Heart
The Fling That Changed Everything
A Little Christmas Magic
Always the Midwife
Daredevil, Doctor…Husband?
Mills & Boon Cherish
The Wedding Planner and the CEO
The Baby Who Saved Christmas
The Forbidden Prince
Visit the Author Profile page
at millsandboon.co.uk (http://www.millsandboon.co.uk) for more titles.
For Ellie,
with thanks for letting me borrow your name. xx
Contents
Cover (#u68a3c4cc-9c76-5c59-9513-32d454ddf2d6)
Back Cover Text (#uae8a2e0a-7afc-5b77-a65d-7f31abdd57eb)
Dear Reader (#u0750dc11-5162-5391-904e-2779971ec67d)
Title Page (#ud3d087b3-74c5-5920-898f-50596a7bcbe0)
Booklist (#u8c58b0f7-4ae3-5705-908c-a19dbae01bbb)
Dedication (#uc4b32503-e1a8-5a66-be49-d9f8522a5abb)
CHAPTER ONE (#u4ef307f2-5fb5-595f-a50b-fa6affdd1bfd)
CHAPTER TWO (#u6a9618a2-7e44-562a-8f90-e16cae57be44)
CHAPTER THREE (#uef49517a-c0cc-5c6a-aeb7-e857fad11e45)
CHAPTER FOUR (#litres_trial_promo)
CHAPTER FIVE (#litres_trial_promo)
CHAPTER SIX (#litres_trial_promo)
CHAPTER SEVEN (#litres_trial_promo)
CHAPTER EIGHT (#litres_trial_promo)
CHAPTER NINE (#litres_trial_promo)
CHAPTER TEN (#litres_trial_promo)
CHAPTER ELEVEN (#litres_trial_promo)
CHAPTER TWELVE (#litres_trial_promo)
Extract (#litres_trial_promo)
Copyright (#litres_trial_promo)
CHAPTER ONE (#ubdad88ca-0ce1-520c-87be-dd69fac9fe97)
HOW COULD SO many things have gone so terribly, terribly wrong?
Ellie Thomas could feel the shape of the phone she was holding against her ear. The edges felt sharper as her grip tightened. They were tangible and real.
What she was hearing couldn’t possibly be real.
Could it...?
‘Ava—are you still there?’
A moment’s silence and then she heard her friend’s voice again. Her best friend since...since as long as she could remember. A bond that had lasted throughout childhood. Through the trauma of Ava’s surgery and chemotherapy as a teenager. With happy memories like being Ava’s bridesmaid two years ago and the darker memories of her best mate’s despair at not being able to become a mother—a side effect of the treatment that had saved her life.
A friendship that had seemed unbreakable. Until two weeks ago...
‘Yeah...I’m still here.’ A stifled sob could be heard. ‘And...I’m sorry. I’m so sorry, Ellie.’
Sorry? Did that somehow make this okay?
‘Where are you?’ Ellie could hear the sound of an announcement of some kind going on in a noisy background. Was Ava at a train station? ‘Talk to me, Ave. We can sort this out. I’ve been trying to call you since the beginning of last week.’
Ever since she had heard that Marco, Ava’s gorgeous looking but sometimes volatile husband, had packed a bag and walked out on her.
The day after that awful row... The last time she and Ava and Marco had been in the same room together.
‘I was getting frantic,’ Ellie added.
Terrified might be a bit closer to the truth.
The silence on the other end of the line was unnerving. Ellie could feel a tight knot of fear that was making it difficult to draw in a new breath. This couldn’t be happening. A friendship like this couldn’t just evaporate because of something that hadn’t even been her fault. Not after all they’d been through together and especially not with what they were going through right now.
‘I didn’t encourage him, Ava. You know that, don’t you? I was just as horrified as you were that he tried to kiss me.’
‘It wasn’t just you.’ Ava had stopped crying and there was anger in her low, fierce tone. ‘He’s been cheating on me the whole time. He admitted it. Said I would never have been enough for a man like him. That our marriage had been a huge mistake because I couldn’t accept that.’ The tears were obviously flowing again and her next words were totally broken. ‘...that trying to have a baby was just putting a Band-Aid on a wound that was already fatal.’
Ellie could hear an odd humming and there were bright specks in front of her eyes. Oh, yeah...
Breathe...
‘You’re not trying to have a baby.’ Her words came out in a voice she hardly recognised as her own. ‘You are having a baby. In about four weeks.’
‘But don’t you see? I can’t do it now. My world’s fallen apart, Ellie and I can’t hang on to anything. It’s not even my baby...’
Technically, this was true. Technically, this was Ellie’s baby. Ellie and Marco’s. The gift that was the one thing that could make life perfect for Ava. It had been such a huge decision, offering to be a surrogate, but Ellie hadn’t really hesitated. This was something she could do for the most important person in her life—the only real family she had left.
Fear was morphing into anger, which was a relief because it made it easier to breathe again.
‘I’m thirty-six weeks pregnant, Ava. With your baby. Yours and Marco’s. A baby I would never have dreamed of having otherwise. I’m single, remember? I don’t have any family to support me. I don’t even have a boyfriend, as you well know. I’m supposed to go back to work in six weeks and if I don’t, I won’t be able to pay my rent. And you’re sorry?’
The silence against the background noise was astonishingly loud. Time seemed to be standing still. It could have been seconds but it felt like minutes or even hours. And when it was finally broken, the words Ellie could hear were almost too strangled to understand.
‘Got to go...last call...can’t miss my plane...’
Fear was strong enough to feel like pain, now.
‘Plane? Where are you going? Ava...? Ava?’
The beeping of a disconnected line said it all but Ellie couldn’t hang up. She lowered the phone and stared at it. Any moment now, the dropped line would be abandoned and she would see the image that was on the screen of her locked phone. The picture of herself and Ava, with their arms around each other, Ava pressing a kiss to her cheek and the smile on Ellie’s face making it clear that she was the happiest person in the world.
And there it was...
Ellie dropped the phone on the floor. She wrapped her arms around the huge bump that was her belly now and bent her head to try and deal with the wave of fear and pain that was threatening to wash her over the edge of an unimaginably high cliff.
A pain that was an overwhelming swirl of loss and anger and bewilderment and terror.
It wasn’t going to ebb any time soon, either. It filled her chest and made it impossible to breathe again but then it seemed to move to her back as well. And then to her belly, where it gripped harder and harder...
Ellie could feel the muscles under her hands tightening with the strength of a vice. This wasn’t just emotional—it was becoming very, very physical.
She was an emergency department nurse, for heaven’s sake. She knew what this was but it took another five minutes and the start of another contraction to admit it. When she saw the blood trickling down her leg fast enough to be pooling on the worn linoleum of her floor, she realised just how much trouble she might be in.
Gripping the armrest of her chair, she managed to lower herself onto her knees on the floor and reach for her phone. The call was answered instantly.
‘Ambulance... What is your location...?’
* * *
Lucas Gilmore was getting used to pushing through the overgrown shrubs on the front path. He’d find time to trim them soon but there had been more important things to do. Like making the house habitable.
The man walking behind him stopped beside the front steps and brushed pollen and spider webs off the dark trousers of his dress suit. The smile was a little forced but an aspiring leader in local real estate like Mike knew how to disguise distaste.
His smile faded, however, as he turned his head to look at the rambling garden and the exterior of the huge, old wooden villa with its rusting, corrugated iron roof.
‘Bit run down, isn’t it, Dr Gilmore?’
‘Yes. My mother’s been in a rest home for several years and the house has been rented out. The agency clearly wasn’t doing the job they led me to believe they were doing. The last tenants left nearly a year ago and no maintenance was done, unfortunately. And the inside of the place looked like a bunch of possums had got in through a broken window and had a party.’
‘Hmm. You would have done better to use our firm. We’re into rentals now.’ Mike climbed the steps onto the veranda and a board creaked ominously beneath his feet. ‘Hope the inside of the place is in better shape as far as maintenance goes or it’s going to be a bit hard to get a good price.’
The smile reappeared. It was almost a grin. ‘Having said that, Auckland prices are going completely crazy and it’s the land that’s going to sell this place. You’ve got access to an almost private beach and acres of native forest. This is an amazing property. Ripe for redevelopment.’
Lucas could feel a scowl emerging. Redevelopment was a dirty word for him right now. The house was important. Okay, it might be run down but it was a glorious example of an early nineteenth century New Zealand villa—with return verandas and even a turret, for heaven’s sake.
‘I’m working on fixing the house. I got commercial cleaners in as soon as I arrived back in the country three weeks ago. The garden’s next on the list but I’ve been a bit busy.’
‘Did you say you’re working at North Shore General hospital?’
‘Yes.’ Lucas pushed open a front door in need of a new paint job. ‘I took a locum position for three months. I figured that would give me plenty of time to sort things out here.’
And to decide where he wanted to go next to take his career as an emergency specialist to even greater heights.
‘And you’re sure you want to sell?’
Lucas covered his silence by ushering Mike into the house and walking down the wide hallway with its polished wooden floorboards towards the kitchen at the back. Beams of light made mottled red and green coloured shadows on the wall, thanks to the stained glass window over the door behind him.
Did he want to sell the only house that had ever been a home for him?
No. Of course he didn’t. This had been the first place he’d felt wanted. When he was a troubled young teen on the verge of being too old to find another foster home, the Gilmores had taken him in.
And loved him.
It didn’t make any difference that he’d kicked off to accelerate the abandonment process before he could get to like the place. And man, there’d been so much to like. The beach with its tempting surf, the secret silence of the beech forest. The generous home-cooked meals. Even having to take a country bus to the nearest high school had been different enough to be fun. It would have been the biggest wrench ever when the inevitable happened and he wasn’t wanted any longer.
The Gilmores might have been much older than most foster parents but they had been made of tough stuff and they’d seen something no one else had ever seen. They had decided he was worth the effort.
‘You might as well stop acting up,’ they’d told him. ‘Kicking holes in the walls isn’t going to change anything. You’re not going anywhere, son. We’ve adopted you and that’s that.’
But, yes. He did want to sell. There was nothing here for him now. There hadn’t been, ever since the death of Eric Gilmore had revealed that he’d been covering the signs of his wife’s dementia for some time and the heart breaking decision that Dorothy Gilmore needed specialist care had had to be made. He’d found the best home available as close as possible to where he was living and working.
A shame it was in Sydney, Australia, because it meant taking Dorothy away from the area she’d been born and raised in but the alternative was in Auckland and the biggest city in this country had been just as foreign to Dorothy as Sydney and he certainly couldn’t have made his twice-weekly visits. And it hadn’t been long before she didn’t know who he was any more so it really didn’t matter what city was outside the walls of her haven.
And—after five years of being cared for so well—Dorothy had died, at the grand old age of ninety-five, just six weeks ago.
It hadn’t been a surprise to find that he’d inherited this property that had been rural when he’d arrived about twenty years ago but was now within easy commuting distance of what was touted as one of the most desirable cities in the world to live in. What had been a surprise was the distant cousin, Brian Gilmore, a man in his late sixties, who’d emerged to contest the will.
‘You were only a foster kid,’ he’d informed Lucas. ‘Aunt Dorothy and Uncle Eric never formally adopted you. You’ve got no right to inherit anything.’
Brian dabbled in property development. This house and its sprawling garden covered an area of land that had enough space for half a dozen properties. Or a retirement village, perhaps, with this perfect, peaceful location and amazing views of the sea and all the islands in the Gulf.
That would only happen after the house was demolished, of course. And probably more than half the native forest bulldozed.
He’d reached the kitchen. A long room with a slate floor and French doors between big windows that looked out over the garden that Dorothy had loved so much. Down to the huge vegetable garden that had been Eric’s pride and joy. Amongst other outdoor jobs, his contribution to family chores had been to help Eric manage that garden.
He’d hated it, at first.
He’d actually set fire to the potting shed one evening but even that hadn’t been enough to persuade his new parents that they’d made a mistake.
The wash of loss was hard enough to make Lucas pause and take in a long, slow breath. Dorothy and Eric might have been old enough to be his grandparents when they’d taken him in but they were the only real parents he’d ever had and he’d come to love them fiercely. They’d been so proud of him when they’d come to watch his graduation from medical school.
‘We knew you could do it, son. We knew you were special.’
‘This is nice...’ Mike was looking up at the beamed ceiling and then his gaze ran swiftly over the old cooking range and the arched doorway into the big pantry that had once been a creamery for the original farm. He frowned at the masking tape crisscrossing one of the windows where a pane of glass was badly cracked and he was making rapid notes on a tablet device. ‘Good thing you left it fully furnished. It looks like someone’s living in it and these antiques look original.’
‘Some of them probably are,’ Lucas agreed. ‘And it certainly is a lovely home. It needs to be sold to a family that will love it.’ As the Gilmore family had. ‘I’m not selling to anyone who wants to demolish this house.’
Brian’s words still stung. Maybe Dorothy and Eric hadn’t realised what was involved in a formal adoption process. They’d changed his name before enrolling him at his new school and somehow that had been enough and he’d slipped through the system. He’d been Lucas Gilmore ever since.
He’d been their son.
And he wasn’t about to let cousin Brian destroy any part of the miracle that had turned his life around so completely. He had his solicitor working on the legality of the unexpected claim and he was hopeful he could have it overturned in court.
A family of his own was never going to happen—he knew too well the nightmare of things going wrong—and even if he had been planning one, it wouldn’t be here—where the ghosts of what had gone so wrong in his own early life were never very far away.
But that was what this house needed.
A family. Laughter echoing through the rooms and love to be celebrated in meals taken at this old, scrubbed pine table.
Hopefully, what was left of the three months he had signed up for at Auckland General would be long enough to see that happen. As if prompted by the thought, he turned his head to where the grandfather clock in the hallway was ticking again. A slow, steady sound that had always been the heartbeat of this old house.
‘How ’bout I leave you to have a look around at the rest of the place, Mike? If you pull the front door closed, it’ll lock itself. I’m due to start my shift in Emergency in less than an hour and you never know what the traffic’s going to be like on the motorway. I’d better get my skates on.’
* * *
If she hadn’t been so frightened, Ellie would have been mortified, arriving at any emergency department like this, let alone the one she worked in herself!
She was on a narrow ambulance stretcher. On her knees, with her head on her hands and her bottom up in the air.
Knowing she was bleeding had been enough to scare her. The speed with which the paramedics checked her out, got an IV line in and fluids running and then headed for the nearest hospital using lights and sirens told her they were just as worried about the situation as she was. And, moments before they had arrived at the hospital, her waters had broken and, in the wake of the rush of fluid, she knew things had just become a whole lot worse.
‘Something feels weird,’ she told them. ‘I think I might have a cord prolapse.’
A quick glance by the lead paramedic confirmed her fears.
‘As soon as we get you out, we’ll get you head down, on your knees and use gravity to take pressure off the cord. We’ll support you and move slowly, okay?’
‘Okay.’ She felt the clunk as the wheels of the stretcher came down and locked. With help, she turned to get on her knees, putting her elbows on the mattress and lowering her head between her hands.
The warning not to start pushing even if she felt the urge had been unnecessary. Ellie knew how dangerous this was. If the baby’s head put too much pressure on the cord, it would cut off the oxygen supply and lead to a stillbirth. She couldn’t let that happen. Ava and Marco would sort things out. They had really wanted this baby. They’d all gone to that first ultrasound appointment together and there had been tears of joy all round. Surely nobody would really plan to bring a new life into the world just to fix a failing relationship?
The contractions were at increasingly shorter intervals but she hadn’t felt any urge to push.
Yet.
The hospital would have had advance warning of her arrival and the problem with blood loss but there hadn’t been time to warn them about this new complication. Would there be a specialist obstetrician waiting for her in one of the resuscitation rooms already?
In this undignified position, Ellie couldn’t see anybody’s faces. Just their legs, as she was wheeled carefully past the triage desk, with the paramedics on either side of the stretcher, both with one arm over her body to support her balance.
She could recognise voices, however.
‘Cord prolapse,’ one of the paramedics said. ‘Waters broke about two minutes ago.’
‘It’s okay, Ellie. We’ve got this...’ That was Sue—one of her best friends here. ‘Resus One, guys.’ The hand that had given her back a quick, reassuring rub disappeared and Sue’s voice faded as she turned away. ‘Has anyone got an update on that obstetrics consult? Luke? Can you take this in the meantime?’
Ellie watched sets of wheels flash past. That was an ECG monitor and those were a tangle of IV stands. A drug trolley was being pushed in the opposite direction. She could hear the sounds of a busy emergency department all around her. If she’d been on her feet, in her scrubs, with her stethoscope around her neck, this would all be perfectly normal.
She’d never been on this side of the fence before.
Or realised just how horribly vulnerable it made you feel.
‘We’re going to get you onto the bed,’ someone told her. ‘We’ll lift you. Don’t try and help.’
‘We’ll put her in an exaggerated Sims’ position to start with.’ Ellie didn’t recognise this male voice. ‘Left lateral with at least two pillows to support the pelvis. Lower the head of the bed, too. And get some oxygen on the mother.’
The mother? Ellie squeezed her eyes tightly shut. She wasn’t supposed to be about to become the mother. This was a nightmare. Maybe she’d wake up in a minute to find Ava and Marco standing there. Smiling. Excited to be about to meet their new baby...
This was a slightly more dignified position, at least, but she still had a restricted visual field. She could see the length of the body in dark green scrubs beside her, but it wasn’t until he crouched that she could see the face that belonged to that new voice. Tanned skin. Kind of wild brown hair with blond streaks. Hazel eyes. He looked like he’d just come out of some surf, on a hot summer’s day, with a board casually slung under one arm.
‘Hi, Ellie. I’m Luke Gilmore, one of the doctors here. I’m just going to have a look and see what’s going on, okay?’
As another contraction gathered force, Ellie could only nod.
Luke Gilmore? He had to be new here. A locum? She’d stopped work three weeks ago to rest and prepare for the birth so she hadn’t met him. She hadn’t even heard his name.
Or had she? It did seem vaguely familiar...
With the contraction reaching its peak, the thought was obliterated by pain. She pushed her fist into her mouth but couldn’t stifle a cry.
For a long moment, nothing existed except the pain but then she became aware of the voices around her.
‘What was the time interval for that last contraction?’
‘Two minutes.’
‘Estimated blood loss?’
‘Five hundred mils on scene.’ The paramedics were still there. ‘We put in a wide bore IV and she’s had a litre of saline so far.’
‘She’s still bleeding. Let’s get another litre going.’
That was this Dr Gilmore’s voice. Did he know what he was doing? He certainly sounded confident enough. Ellie could feel that her lower body was bare now. Maybe it was a good thing that she didn’t know this person but there were plenty of people she did know seeing a lot more of her than they ever had before. Not that she cared. Nothing mattered right now other than to get through this safely. There was a baby’s life at stake. Maybe even her own, if she was still losing so much blood.
She could feel a hand inside her.
‘Ah...’ The sound was hard to interpret. Satisfaction...or concern? ‘Ellie? You’re going to feel me pushing. I need to take the pressure off the cord.’
He still sounded calm, this Luke. And she could feel him pushing hard against the baby’s head.
‘Any risk factors in the pregnancy?’
‘Not that we know of.’ The paramedic sounded embarrassed. It was a question they should have asked.
‘Low lying placenta,’ Ellie said, but her voice was muffled behind the oxygen mask.
‘Sorry, what was that?’ Luke was still pushing against her baby’s head to ensure it was clear of the cord but he leaned sideways so that she could see his face as she turned her head. In the bustle of people and activity around her, there was something very calming in the steady gaze of those hazel eyes that were visible again.
‘I’ve had a low-lying placenta. Only marginal but I was due for another scan this week and possible admission for observation and a C section if indicated.’
She saw the flicker of surprise in his eyes at her clinical information.
‘Ellie’s a nurse,’ someone behind him said. Sue had come into the resus area. ‘She’s one of our best ED nurses, in fact.’
Luke’s face disappeared from her line of sight. ‘Where’s our Obs consult?’
‘Here.’ A female voice who sounded rather nervous.
‘This is Anne Duffy,’ Sue said. ‘O&G registrar.’
Maybe Luke had picked up on the nervousness. ‘Have you got a theatre available? We’ve got a cord prolapse here. She’s fully dilated but still in stage one. We’re looking at either an emergency C section or an operative delivery.’
‘No.’ Anne sounded young as well as nervous. ‘We’re in the middle of a C section for triplets. It’s got most of our staff tied up for a while but it shouldn’t be too long until one of the consultants is available. Is the baby distressed?’
Maybe it was her imagination but Ellie thought she heard Luke sigh. ‘Have we got that foetal monitor hooked up yet?’
‘Yes. Baby’s heart-rate is one-thirty. No, hang on...one-ten... It’s dropping...’
Ellie could feel her own heart-rate increasing. This was suddenly getting very serious. If the baby’s heart-rate was dropping, it meant that the head was finally putting too much pressure on the cord despite the interventions. The clock was ticking now...
And something else was changing.
‘I need to push,’ she said.
‘Don’t push.’ The registrar definitely sounded nervous now. Terrified, even? ‘Take deep breaths. Try and go limp. Relax your pelvic floor.’
If Ellie had had any spare breath right then, it might have come out as an incredulous huff. Just how much experience had this junior doctor had? She fought the urge to push, her face scrunched as tightly as possible against the pain.
‘Heart-rate’s down to eighty,’ someone said.
‘Not too long isn’t good enough.’ There was a different note in Luke’s voice now. He had made a decision and was taking control. ‘Lay out the forceps kit, please. Can someone put out an urgent page and get a paediatrician down here, stat? Anne—take over here. Two fingers on the baby’s head and upward pressure, okay?’
‘Got it.’
‘Have you done a forceps delivery?’
‘I’ve assisted with one.’
‘Ellie? Can you hear me?’
‘Y-yes.’ Her voice came out sounding oddly croaky. Frightened...
Luke was crouched right beside her now, his face only a few inches from her own.
‘We need to get your baby out as soon as possible. You’re fully dilated and with the help of forceps we can do it. I’ve done a long stint in obstetrics and have experience in assisted delivery. Are you happy for me to go ahead?’
There was nothing about this that Ellie was happy about. But there was something in those eyes that gave her something to cling to.
Confidence. Hope...
She nodded, giving her consent.
‘We can give you some Entonox but there’s no time for any other pain relief to kick in. It’s going to be a bit rough. I’m sorry...’
He was sorry. He looked as though he would take that impending pain himself rather than inflict it on her. Ellie closed her eyes to hold back tears but she nodded again. ‘It’s okay...’
She could feel the tension in the room around her. Hear the clatter of instrument kits being unrolled onto a stainless steel trolley. She felt her body being moved so that she was lying on her back, sterile drapes being folded around her and listened to the instructions Luke was issuing as her legs were lifted and supported.
And he talked to her all through it, too.
‘I’m giving you a bit of local for the episiotomy. You’ll feel it sting for a moment.’
It stung a lot but Ellie knew it was only the start. She sucked on the mouthpiece giving her the inhaled pain relief.
‘I’m inserting the first blade, now. And the second. And I’m locking them. When the next contraction starts, I’m going to need you to push—as hard as you can, sweetheart.’
Sweetheart?
The word cut through the fear and pain. It was just a word that should have evaporated into the ether the moment it had been spoken but it didn’t. It echoed in her head and sent ripples through her body. It was something warm and caring and lovely in the middle of something horrific. And when the instruction to push came moments after the next contraction started she pushed with every ounce of strength she could summon.
And maybe she found more strength than she knew she had because, in the wake of being abandoned by the person she cared about most, he’d called her sweetheart...
It only took two contractions, a minute apart, with her pushing as if her life depended on it and Luke pulling with the baby’s head cradled between the blades of the forceps and she could feel the baby coming into the world.
‘It’s a boy, Ellie,’ someone said.
She knew that. Marco and Ava had known that, too. They’d already picked out a name. Carlos.
Her train of thought vanished as she became aware of the silence in the room. There was no baby crying. And nobody else was saying anything, either. The silence was shocked. And shocking. Ellie jerked her head up to see a tiny, limp body that someone was rubbing briskly with a towel.
A woman she didn’t know—the nervous young registrar, perhaps—saw her looking.
‘It’s okay, Ellie. We’re doing everything we can for your baby.’
Tears that had been building for too long exploded from Ellie as she let her head drop back down.
‘But he’s not my baby,’ she sobbed. ‘And now nobody wants him...’
CHAPTER TWO (#ubdad88ca-0ce1-520c-87be-dd69fac9fe97)
WHAT?
Surely he hadn’t heard correctly?
For a split second, Lucas froze, completely distracted from what he was about to do.
Nobody wanted this baby?
One of the department’s senior nurses, Sue, was right beside him.
‘This was a surrogate pregnancy,’ she told him quietly. ‘But I have no idea what’s gone wrong.’
Lucas couldn’t give a damn about what might have gone wrong. There was a knot in his chest that felt like anger.
He knew what it was like to be an unwanted child. To face a world where you were not worth enough for anybody to want you.
No more than a blink of time had passed but Lucas snapped back to reality.
‘Give him to me,’ he snapped.
Picking up the limp bundle, he carried it to the trolley that had been hastily prepared with neonatal resuscitation gear. He gently laid the tiny body onto the sterile drapes. The miniature mask seemed to cover half the face as he delivered puffs of oxygen. He put his hands around a chest that felt alarmingly fragile, positioning both his thumbs on the sternum. Gentle but rapid compressions. Sue had followed him and picked up the mask. One puff, three compressions. One puff, three compressions.
You can do it... Come on... Fight...it’s worth it, I promise...
Only Luke could hear the words in his head. Or were they coming from his heart?
Someone’s going to love you...
There weren’t any words that came with his next thought—it was just a flash of sensation that came from nowhere.
I love you...
He shook off the bizarre notion. Getting emotionally involved in this unexpected case wasn’t going to help anyone. He needed to think ahead. Professionally. Intubation as the next step... IV access through the umbilical cord...chasing up that specialist paediatric consult...
And then the miracle happened. He felt the tiny body move between his hands. He paused the compressions and felt the push of that little ribcage against the pads of his thumbs as the baby took its own first breath.
And then another. That tiny face scrunched itself into an angry expression and the third breath was enough to provide the power for a warbling sound. The next effort was much more convincing.
This little guy was a fighter, after all.
And then Luke heard another cry from a very unexpected direction. From behind him.
From this new mother who didn’t want this baby.
He could feel his face tightening as he turned. His heart hardening.
And then he saw her face.
Propped up on her elbows, Ellie must have been watching this whole resuscitation effort and she had definitely heard those first sounds of a new life awakening.
Her hair was a tangle of blonde knots around a face that was pale enough to suggest she had lost a concerning amount of blood. And those eyes...
Huge, dark blue pools that were telling him something very different than the last words he had heard her speaking—that this wasn’t her baby and that nobody wanted him.
These were the eyes of a desperate woman. A mother...
‘Please,’ she whispered... ‘Please can I hold my baby?’
* * *
It had been that sound that had done it.
The cry from that tiny human that had been nestled within her body for so many months had taken the world as Ellie knew it and tipped it upside down. It had entered her ears but gone straight to her heart and captured it in the fiercest imaginable grip.
For a long, long moment, caught in what felt like a very disapproving stare from the doctor who’d just delivered her son, she thought that she was facing an impenetrable barrier. Someone who had no intention of letting her close to that tiny being she could just catch a glimpse of behind the solid figure of this new doctor.
But Sue was picking the baby up now.
‘Apgar score is ten at five minutes,’ she said, unable to keep a grin off her face. She was wrapping the baby in soft towels. ‘He’s looking great. I think we could let Mum have a bit of skin contact, until our paediatrician arrives, don’t you think?’
Luke’s response was a huff of sound that seemed indecisive but the anticipation of holding her baby against her own skin was so overwhelming that Ellie’s breath escaped in something that sounded like a sob as she lay back and held her arms out.
‘The placenta’s delivered.’ The young registrar was sounding a lot more confident now. ‘Seems intact and the bleeding’s almost stopped. Let’s prop you up a bit so you can hold your baby.’
Ellie had barely registered the last contractions as she watched the frantic efforts to save her son. Everything was all right now, though. She wasn’t about to bleed to death and the baby’s perfect Apgar score meant that he had come through this crisis with flying colours. With pillows being layered behind her, she was more than ready to accept the precious bundle that Sue was bringing towards her.
But why was this new doctor in her department still staring at her as if she was asking for something she really didn’t deserve?
He’d called her sweetheart only minutes ago.
Before helping her deliver her baby. Before he’d saved her life. Before he’d even properly begun to start saving the life of that baby.
And then something filtered into her brain. An echo of her own voice...
‘But he’s not my baby... And now nobody wants him...’
Oh, God...had she really said that?
No wonder he thought she was crazy. Or some kind of monster.
But Sue was beside her now and everybody else in this room and whatever tasks they were attending to ceased to exist as far as Ellie was concerned. Sue was unwrapping the tiny body of her baby, and another nurse was helping to remove the oversized tee shirt Ellie had been wearing. And her bra.
And there he was. In her arms and snuggled against her bare chest, while Sue arranged some soft, fluffy blankets around them both for warmth and as much privacy as was possible, given the surroundings.
Ellie couldn’t even lift her head to smile her thanks. Her baby’s eyes were open and he was staring up at her and nothing could have induced her to break that astonishing eye contact.
‘Hullo, you...’ she whispered. ‘I’m Mummy.’
The wash of emotion was like nothing Ellie had ever experienced. Something was changing in her body at a cellular level and she would never be the same person she’d been only minutes ago.
Who knew that love could be this powerful? So huge...and every bit of it was for this tiny little human.
Had she really believed she could have given him to someone else?
This baby was a part of herself and she would fight to the death if necessary to protect him.
It was the baby who finally broke that intense eye contact. His head bobbed against the arm it was cradled by and his tiny mouth opened and closed against the skin of Ellie’s breast. Instinctively, she adjusted her position, which brought her nipple within range of the baby’s mouth. And then she watched, in astonishment, as the baby found what it was seeking and latched on to her nipple as though he’d done it many times before.
Ellie’s jaw dropped. ‘He did that all by himself.’
‘He’s a genius.’ Sue smiled. ‘Oh...where’s my phone? We’ve got to get a photo of this.’
But Ellie had closed her eyes by the time Sue had fished her phone from the pocket of her scrub pants and she could feel a tear escape and roll down the side of her nose. And then another.
This feeling—the silky new born skin against her own, the shape of those tiny limbs within her arms and, most of all, the tug of that tiny mouth against her breast—was too much.
It felt like pure joy...
* * *
Luke had rather a lot of paperwork to do to document this emergency delivery that had happened on his watch. Someone had given him the forms on a clipboard and he had a pen in his hand but he hadn’t written a word, yet.
He kept looking sideways. From where he was standing, beside the trolley they’d used to resuscitate this baby, he could see the back of the baby’s head nestled in the crook of Ellie’s arms.
And he could see Ellie’s face.
She had no idea he was watching her. Luke doubted that she was aware of anything other than the baby she was holding.
They seemed to be staring at each other. Locked in a conversation that was so utterly private that Luke felt uncomfortable observing it.
So he looked away.
Eleanor Thomas, someone had filled in under the personal details on the form. Thirty-two years old. Thirty-six weeks pregnant.
He had to look back. It was none of his business that there was something weird going on. A surrogate pregnancy?
Who for?
Why?
And what had gone so wrong that she’d claimed that nobody wanted this child now?
It certainly didn’t look as if nobody wanted him.
Ellie looked, for all the world, as if she was in the middle of a personal miracle. Mesmerised by the face of her child. As though this baby was being bathed in as much love as it was possible for any person to bestow.
It was weird, all right. And disturbing on a level that Luke hadn’t expected. Maybe it was because this was happening so soon after he’d been standing in the home it had taken so many years for him to find.
Had his own mother looked at him like that in the minutes after he’d been born?
No. He’d always known the answer to that.
This time it was easier to look away. To try and focus on the paperwork.
Surely no mother could ever look at her child like that and then simply hand him to strangers when life got tough and never even try to see him again? Had it even occurred to his mother that the scars of being abandoned and finding himself unwanted would be there for the rest of his life?
The paediatrician arrived and Luke gave him a verbal handover. He still had the notes to write up on the baby’s early resuscitation as well.
The new arrival looked at Ellie, who was now breastfeeding the infant, and he was smiling.
‘I think we can get them up to the ward before we examine baby properly. He’s looking pretty happy.’
Anne, the O&G registrar, had joined them. She was nodding. ‘I’ll leave the repair of the episiotomy until then, too. I’ll see what rooms we have available and order a transfer.’
Within minutes, the transfer had been arranged. The bed, with the baby still cradled in Ellie’s arms, was being wheeled out of the resuscitation room and staff members were already busy cleaning up. Luke heard the metallic clang as the forceps and other instruments he had used were dropped into a container to be sent for sterilisation. Blood stained towels and drapes were going into the contaminated linen bag and a cleaner began mopping the floor. A new bed was outside, waiting to take centre stage in a room that would have no evidence of the life and death drama that had just occurred.
Another one would probably take its place very soon but this one was over. Any odd personal connection he might have felt needed to be dismissed. He had done his job and whatever lay ahead for Ellie and her baby was none of his business.
Well, it wasn’t quite over yet. With a sigh, Luke picked up the clipboard. He could finish this paperwork in the office and, if he was lucky, it would be done before he was needed elsewhere. He didn’t want to be here, tying up loose ends like this, when his shift finished late in the evening.
* * *
A visitor was the last thing Ellie was expecting at this time of night.
It was after ten p.m. and she was propped up on her pillows, in the soft glow of the night light in her private room, and she was doing nothing more than being in the moment. Listening to the soft snuffles and squeaks coming from the tiny bundle in the plastic bassinet that was within touching distance of her bed. Trying to absorb this momentous change in her life.
She thought the soft tap on her door would be one of the nursing staff, coming to check that everything was okay and that she was ready to try and get some sleep. When Luke Gilmore stepped into her room, she was too astonished to even say hullo.
‘Is this a bad time? They told me on the desk that you’d just finished a feed and would probably still be awake.’
Ellie was still staring at him. It was obvious she was still awake so there didn’t seem to be anything that needed to be said. She could feel a puzzled frown creasing her brow.
Why was he here? Most emergency department doctors—especially locums—didn’t have the time or the interest in following up their cases. They treated them and moved them on, job done. There were always more to take their places.
But it was nice that he wanted to check up on them. Ellie’s lips curved into a smile, which was taken as an invitation to come into the room, but then the smile wobbled.
Had he come to have a go at her for what had been said in a moment of both physical and emotional agony? When this whole, sorry story of her attempt to be a surrogate mother had looked as if it was about to end in disaster?
He didn’t look as if he was angry about anything. Closing the door softly behind him, Luke stepped towards her bed, stopping to gaze down at the sleeping, snuffling baby.
Ellie found herself gazing at him. There was something about those rather craggy features and that shaggy hair that seemed very familiar. Had he worked in the same hospital as her in the past, maybe? Way back, when she was newly qualified and too focused on doing her job well to take much notice of staff members in other departments?
‘I hear he passed his paediatric check with flying colours.’
‘Mmm.’ Ellie found both her voice and another smile. ‘He’s perfect. A good weight, too, even though he was four weeks early. He’s almost seven pounds.’
She was still trawling through dim memory banks.
Luke Gilmore...doctor...
Or not yet a doctor?
‘Oh, my God...’ Ellie breathed. ‘You’re Lucas Gilmore, aren’t you?’
Startled eyes met her own. ‘Ah...yes. But I haven’t been called Lucas in about fifteen years. By anyone other than my parents, that is...’
‘You went to Kauri Valley District High School?’
His face had gone very still. He didn’t say anything but he was frowning—as though he was searching his own memory banks as he stared at her face.
‘I went there, too. You won’t remember me—I was a couple of years behind you. But we shared the school bus every day. You lived on the coast, didn’t you? Near Moana Beach?’
Uninvited, Luke sank to balance his hip on the end of Ellie’s bed, one arm over the base board, his fingers touching the clip of the board that held her observations chart.
‘No way... Wait...I do remember you. You always sat up the front. You had really long plaits.’
The thought that he’d noticed her at all on a crowded bus made Ellie feel suddenly shy. She would have died if she’d known it at the time. Lucas Gilmore—Kauri Valley high school’s bad boy—aware of her existence? It would have been scary. And...thrilling?
‘You always sat right at the back,’ she heard herself saying. ‘With all the cool kids.’
‘The ones who got into trouble, you mean?’
There was something intense in his glance now. Did he want to know how much Ellie knew about the kind of trouble he’d been in as a kid?
Okay, she knew quite a lot. Ellie could almost hear an echo of her mother’s voice.
‘Stay away from that Gilmore boy. He’s bad news. Nothing but trouble...’
She wasn’t about to say anything now, though. He’d clearly turned his life around. He was a doctor, for heaven’s sake. A doctor who’d just saved the lives of both herself and her baby.
There was a flash of something like relief on Luke’s features as she shrugged his comment away. She could sense the tension ebbing away from his body. Or maybe she could feel it, as the mattress dipped with his settling weight.
‘You were always with another girl who always wore hats.’
Ellie nodded. ‘Ava. My best friend. Her hair was never the same after all the chemo she had and it took her a long time to get used to it.’
‘Chemo? What for?’
‘Leukaemia.’
‘Did she survive?’
‘Oh, yeah... And her hair came back even better than ever. Turned out that she’d never be able to have kids, though.’
The sudden stillness in Luke’s face told her that he’d put two and two together with remarkable speed. Almost as though he was reading her mind.
‘That’s who you were being a surrogate for?’
Ellie nodded. She had to bite her lip to push back the wash of loss. Ava had been such a big part of her life for ever and now she had gone and it was going to leave a gaping hole.
‘Wow...’ She listened to the deep breath that Luke took and then let out in a long sigh as he pushed his fingers through that mop of sun-streaked hair. The front locks immediately flopped down onto his forehead again. ‘That’s an incredible thing to do for a friend. Huge...’
There was a long silence. It had to be obvious that she was struggling to keep herself together right now. Most strangers would have probably realised they were intruding in something very personal and made some kind of apology and then an excuse to let her have some time to herself or an offer to find someone she wanted to talk to. But Luke just sat there quietly. Absorbing her struggle. Offering his company and what felt like...empathy?
‘It’s all gone so terribly wrong,’ she found herself whispering into the silence. ‘Her husband walked out on her a couple of weeks ago. The marriage is over. And now Ava’s gone, too. Just gone...’ She had to stop and take a very shaky breath. ‘And I can’t really blame her. She’s devastated and, as she told me, it’s not really her baby. It was my egg. And now...now it’s my baby and...and I have no idea what I’m going to do...’
Luke’s frown had deepened but he was still listening. Nodding very slowly. ‘And the father?’
‘Marco? I don’t think he’s coming back. Apparently he said he’d never really wanted a baby in the first place.’ Ellie’s voice was stronger now. She was on much more solid ground. ‘And I don’t want him to.’
An eyebrow quirked under that shaggy fringe but Ellie saw the subtle lift of the corners of Luke’s mouth. He liked what he was hearing, she realised, and that made her want to say a whole lot more.
‘I thought I could do it, you know? Donate an egg and carry a baby for someone else. I thought I could hand him over the minute he was born and then just be...I don’t know...a kind of auntie, I guess. We’d planned to tell him eventually. When he was old enough to understand.’
‘But...?’
‘It was when I heard him cry...’ Again, Ellie had to stop talking to try and deal with the flood of emotion but, this time, it wasn’t anything to do with loss or grief. This was joy, pure and simple. ‘That was when I knew that this was my baby. That I could never give him away. That he’s...he’s the most important thing in my life now...’
Ellie had to scrub away an errant tear but it didn’t matter. Luke looked as though he was blinking back some extra moisture in his own eyes. And his voice sounded a bit rusty when he spoke again.
‘Have you given him a name?’
Ellie sniffed inelegantly and then smiled. ‘I had the best dad in the world. He was a forestry worker and got killed in an industrial accident when I was only six but I’ve never forgotten how much he loved me. How much I loved him. His name was James but everyone called him Jamie.’ She had to use the fingers of both hands to wipe her cheeks this time. ‘So that’s what I’m going to call him. Jamie.’
As if he’d heard his name, the baby stirred and started to cry. Ellie turned and leaned towards the bassinet but then froze, unable to stop her gasp of pain. It wasn’t just the stitches in a very tender place. Her whole body felt bruised and battered right now.
‘Let me...’
Luke got to his feet in a smooth movement that was both relaxed and confident. He picked up the swaddled bundle of baby but he didn’t immediately hand him to Ellie. He stood there, holding the baby in his arms, patting him gently as he smiled down at the tiny face.
‘Hi, Jamie,’ he said softly. ‘Welcome to the world...’
Jamie hiccupped and then stopped crying. Luke stopped patting and started rubbing the baby’s back, his hand looking huge against the small bundle.
‘You made a bit of a dramatic entrance,’ Luke continued quietly, still smiling. ‘You had us a bit worried there for a while, mate.’
Ellie was lying back on her pillows as the pain subsided. There was something about watching this big man holding her tiny baby that was doing funny things to her heart and making her want to cry all over again.
Her hormones were all over the place right now, weren’t they?
And then she felt her cheeks flush. ‘I haven’t even said thank you,’ she said. ‘You saved Jamie’s life...probably mine, too.’
It seemed as if Jamie had gone back to sleep but Luke didn’t put him back into the bassinet. He perched on the bed again, holding the bundle as if it was the most natural thing in the world to do.
‘It was my pleasure,’ he said. ‘The best job I’ve had since I came back.’
So had they been just a ‘job’ to him? Just another case and one that would be remembered for snatching success from imminent disaster? Oddly, the disappointment felt crushing.
‘Back?’ Ellie was relieved to achieve a casual tone.
‘I’ve been working in Australia pretty much since I graduated from medical school. I’ve taken a three month locum here because I needed some time to sort my parents’ estate. And I was ready for a change so it’s a good time to take a break and reassess my future.’
So he was a locum. And he was only here for three months.
‘I’ve heard about a couple of great positions already,’ he continued. ‘I’m tossing up whether I want to apply for the one in London or Boston right now. Both of them are in major trauma centres that deal with things you’d be lucky to ever see in Auckland.’
The disappointment was still there, ready to roll in on another wave. How weird was that? Was it because he represented a link to the past? They’d been to the same school. They would know a lot of the same people in the area Ellie had grown up in. She’d already lost so many links to that happy part of her early life and it had seemed as if the last one had gone with Ava’s disappearance.
She swallowed hard. ‘Yeah...I guess that’s exactly what I have to do now. Reassess my future.’
A whimper from the baby prompted Luke to move. This time he transferred the bundle into Ellie’s arms. And then he caught her gaze. He didn’t have to say anything.
She was holding her future.
‘Are you going to manage?’ he asked quietly. ‘Have you got family and friends to support you?’
‘No family,’ Ellie said. ‘But I’ve got some good friends. You’ve met Sue, in ED? Well, she’s organising an emergency baby shower. I don’t have anything. Not even a nappy...’
She had to look away from that steady gaze. She didn’t want him to know how terrifying it was. In a day or two, she had to take this brand new little person back to a totally inappropriate inner city apartment where there was barely enough room for herself, let alone a baby and all the gear she was going to need, like a cot and a pram and stacks of nappies.
She didn’t even know how she was going to pay the rent on that apartment...
Luke was pulling a pen from the top pocket of his scrubs. He fished out a small notebook and ripped out a page.
‘This is my phone number,’ he told her. ‘If you ever need help, ring me.’
Ellie’s eyes widened.
Luke grinned. ‘No, I don’t usually do this for my patients. But you’re special. You’re an old bus buddy so we go way back, even if my memory’s a bit hazy.’
Ellie pressed her lips together. Her memory was getting less hazy by the minute. She had noticed Luke every time he’d sauntered down the bus aisle past her seat. The bad boy who’d been expelled from every school he’d been to until he got to Kauri Valley. The angry kid who’d somehow morphed into the coolest one. The one that every girl had been desperate to be with...
He put the scrap of paper on the top of her locker.
‘Want me to get someone for you? Do you need help with Jamie? Or some pain relief or anything?’
‘I think I’m ready to sleep,’ Ellie told him. ‘Jamie seems to be settled again. Could you put him back in the bassinet for me, please?’
She watched as he carefully positioned the baby on his side and then tucked the sheet securely around him. There was nothing more he needed to do but he paused for a long moment—that big, artistic looking hand cupping the baby’s head so gently that the spikes of dark hair barely moved. Ellie could feel that touch herself and it felt as if it were cupping her heart.
He was quite something now, this grown up bad boy.
‘Sweet dreams, little guy,’ Luke murmured.
And then, with a smile, he was gone, letting himself out of Ellie’s room as quietly as he’d come in. He left the door slightly ajar and she could hear the muted sounds of a maternity ward on night shift. The distant cry of another baby. Soft-soled shoes going past in the corridor.
Her baby was asleep and she needed to rest herself. It was the only opportunity she was going to get to heal and gather her strength for what lay ahead.
Adjusting her body to find a more comfortable position, Ellie could see the top of her locker where that scrap of paper lay beside her water glass.
He’d said they were ‘bus buddies’, she remembered.
He’d said that she was special...
He’d given her his phone number to use if she needed help.
Not that she would, but having it there somehow made her immediate future look a little less terrifying.
Ellie drifted into much-needed sleep unaware of the curve of her lips.
She was special...
CHAPTER THREE (#ubdad88ca-0ce1-520c-87be-dd69fac9fe97)
THE BABY WAS about six weeks old.
A little girl, called Grace, but that didn’t stop Luke Gilmore being instantly reminded of Jamie Thomas.
It had been more than two weeks since he’d delivered Ellie’s baby in such a dramatic fashion. It felt like a long time since he’d shared what seemed like a surprisingly intimate conversation, late that night in her room.
He would never have recognised Ellie from that time in his past. What he had been prompted to remember was a girl with long blonde braids who had been too timid to interest him. The girl who wore the hats—Ava—used to stare at him but Ellie was also memorable for the way she avoided eye contact.
She hadn’t been avoiding it the other night. Quite the opposite. When she had been telling him about the surrogacy arrangement that had gone so wrong and particularly when she’d explained how hearing the baby’s first cry had changed her for ever, she’d held his gaze with an intensity that had made him feel as if he was glimpsing a part of her soul.
A courageous soul, he had realised. And a generous one.
She’d been prepared to do something for a friend that went way beyond the normal boundaries of friendship. And she hadn’t been planning to raise a child on her own but was facing what could be a difficult future with such determination—and such obvious love for the baby she had now claimed as purely her own.
He had to admire that.
To admire Ellie.
And, man...as he’d kept going back to that time together in his head—more often than he was comfortable with, to be honest—he realised that Ellie had matured into a very attractive young woman. Her hair was more honey than white blonde now and, thanks to her avoidance of eye contact, he’d never noticed how astonishingly blue her eyes were. There was a softness about her features, too, that he could imagine being the result of a timid, sensitive teenager gaining confidence with time.
This baby who had just come into the emergency department of North Shore General was crying miserably. So was the mother who was holding her as the nurse, Sue, helped to settle her on the bed. The young father was hovering on the other side of the bed, looking stressed and helpless.
‘We thought it was just a cold,’ he told Luke. ‘But now she’s got this horrible cough and it sounds like she can’t breathe...’
‘Has anyone else in the family been unwell?’ Luke was looking carefully at the baby as Sue undressed her. The baby looked dehydrated but not feverish and, thankfully, there were no signs of a rash that could be meningococcal.
‘I’ve had a bit of a cough,’ the father said. ‘Nothing major. Just one of those irritating dry coughs that won’t go away. I heard someone call it the “Hundred Day” cough.’
Luke’s heart sank as he met Sue’s glance as she helped position the baby so that he could put his stethoscope on the tiny chest. For adults or immunised people, the ‘Hundred Day’ cough was an irritating bug. For babies like this, it could be the life-threatening bacterial infection of whooping cough.
And, sure enough, the baby started coughing. It was too young to have the strength to produce the characteristic ‘whooping’ sound of gasping for air between the coughing spasms but they were severe enough to be causing a dangerous lack of oxygen and both Luke and Sue watched with deepening concern as the blue tinge to the baby’s face advertised a degree of cyanosis that was going to need urgent management.
‘See if we’ve got an oxygen hood in the department,’ Luke said to Sue. ‘And put out a call for an urgent paediatric consult.’
‘I’m going to take a swab,’ he told the mother, ‘and some blood tests but it looks very likely that she has pertussis—whooping cough. We’re going to need to admit her and keep her in isolation.’
‘Whooping cough?’ The mother looked terrified. ‘But that’s impossible. I had the booster vaccination that they recommend when you’re pregnant. They said that would help keep her safe until she gets her first shot next week.’
‘And it does help. You did exactly the right thing.’ Luke nodded. ‘Did everybody in your extended family get boosters, too?’
‘My mother did. I told Gerry that he should get one but...’ The woman glanced up at her husband, who was looking stricken. ‘I guess we kind of forgot...’
‘Work’s been crazy,’ he muttered. ‘And what with Serena having to give up her job, I’ve had to take all the overtime I could get.’ He turned away, putting his hand over his eyes. ‘Oh... God...is this my fault?’
‘The important thing is looking after little Grace, here.’ Luke was pulling supplies from the containers on the bench in this resuscitation area. A tourniquet, the smallest cannula available for IV access, tape and the connecting plug that would enable him to set up a drip. ‘We’re going to start her on antibiotics without waiting for the test results. And we’re going to try and improve her oxygen levels. You must have noticed the way she’s going blue with the coughing fits? That means she’s not getting enough oxygen and that can be dangerous.’
Another nurse came in with the oxygen hood that Luke had requested.
‘We’ll get you to put Grace on the bed by herself, now,’ Luke said gently. ‘This looks scary but it’s just a plastic dome that will go over her head on the bed. It’s an easier way to provide extra oxygen than taping prongs into her nose.’
It was clearly hard for the mother to hand her baby into the care of others and step back, out of touching range. Her husband put his arms around her as she sobbed.
‘Can we stay?’ he asked. ‘Is that all right?’
‘Of course,’ Luke said. ‘And I’ll tell you what we’re doing every step of the way. The first thing we need to do is to put a tiny needle into one of Grace’s veins. Given how small she is, it might need to go into a vein in her scalp, or her foot, but don’t be alarmed. It’s just the same as putting one in an adult’s arm.’
The new nurse was staying to help Sue hold the baby as Luke began to work on starting treatment that would, hopefully, save this baby from the potentially life-threatening complications from whooping cough that were running through his head right now. Luke had seen babies develop pneumonia and encephalitis from this disease. He’d once looked after a baby in Intensive Care who had needed extracorporeal membrane oxygenation, even, where the blood was removed from the body to do the work of the lungs in the same way a heart-lung bypass machine worked.
The sad thing was that this was a preventable disease but he could understand how the idea of having a booster vaccination had seemed unimportant to the father of this baby.
With the cannula safely secured into a scalp vein, Luke had a moment of distraction with the automatic process of attaching the IV line and setting the drip rate of the fluids.
Had Ellie had a booster vaccination while she was pregnant? How many visitors was little Jamie getting and was he in close enough contact with any of them to be in danger of having something like this passed on? A sideways glance at Sue, who was positioning the plastic dome of the oxygen hood over Grace’s head, prompted Luke to make a mental note to talk to her about it. Ellie had told him that Sue was a good friend of hers. She could, at least, pass on the warning that they’d had a serious case here.

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