February 1999 London
The smartly dressed man I spotted with Simone at the Camden club was indeed Hugh Warrington. Suave, with slick dark hair brushed back over a handsome, if slightly arrogant, face.
‘Don’t you think Dr Warrington’s a bit of all right?’ I’d said to her, one evening, a few days after I heard Becky and the junior doctor gossiping. We were travelling back on the bus to Walthamstow together and she still hadn’t told me she lived at home with her parents in the other direction. Oliver and I had agreed to continue our romance, promising to visit each other when we could. Simone had seemed happy for us when I told her about it and joked how she’d love me as her sister-in-law one day.
‘What?’ She’d laughed, too loudly. ‘Hugh? He’s, like, forty! Way too old for me!’
But she’d shifted in her seat and looked uneasy. It was another lie, I was sure.
After that, I watched them closely, but they always appeared professional when they were together. I did notice that they were mostly working the same shift, but I wasn’t sure who organized the rota and it could have been a coincidence.
One day I saw them coming out of the walk-in cabinet where the medications were kept under lock and key. They were obviously arguing under their breath. I watched as she angrily thrust a large box into his arms and they stalked off in opposite directions. When Simone saw me hovering by the medical waste bins she smiled as though nothing had happened and continued briskly down the corridor.
One day, a week or so later, Janice asked me to assist Simone with a birth. ‘The woman has been in early labour for hours,’ she explained. ‘She’s young, a first pregnancy, thirty-nine weeks’ gestation. She’s becoming very tired. Birthing Suite Two.’
The woman in labour didn’t look that much older than me and her pale face was contorted in pain. I was taken aback by how childlike in proportion she was. Even her bump was small and neat. She couldn’t have been more than five foot. There was nobody in the room with her apart from Simone, who was standing by the foot of the bed with the chart in her hands. She glanced up in surprise when I walked in. ‘Oh, where’s Janice?’
‘She sent me.’
She didn’t say anything more, but I was sure I saw annoyance in her face. Instead she read out the information on her chart. ‘Natalie Grant. Six centimetres dilated. Twenty-two years old. Weighs forty-eight kilos. I’ve prescribed hertwo five-milligram shots of diamorphine, but she’s still in a lot of pain. It’s been a long early labour. Dr Warrington is coming in to give her a third dose and a further anti-emetic.’
Midwives were forbidden to administer the third dose of opioids at this hospital. It had to be done by a doctor.
‘Does she have a partner or someone with her?’ I whispered. My heart immediately went out to the girl on the bed, who was panting through a contraction, her dark hair hanging either side of her pale face.
Simone guided me away from the bed so Natalie couldn’t hear us. ‘Partner not on the scene. Her mother is with her, but I sent her to the canteen to get some refreshments. She’ll be back soon.’ She was talking in an urgent way and her gaze kept sliding towards the door.
‘What do you want me to do?’
‘Sit with Natalie until her mum returns. Reassure her. She’s refused an epidural, but she’s tired. The baby isn’t in any distress and the heartbeat is good, so it’s just about managing Natalie’s pain right now.’
‘Okay.’ I went to the bed and held Natalie’s hand, talking gently to her, telling her my name and reiterating how well she was doing. Simone was standing at the foot of the bed writing something on the chart.
‘You’re doing great,’ I said to Natalie again, as a contraction took hold, but I was worried about how pale she was. Simone didn’t seem concerned although there was a strange energy coming from her and she kept throwing glances towards the door.
‘Where’s my mum?’
‘She’s just getting a cup of tea and a bite to eat. She’ll be right back.’
‘Oh, okay, thank you.’ Natalie smiled up at me through her pain and then her face contorted again as another contraction ripped through her. She squeezed my hand tightly. I always felt useless at this stage, wishing I could do more to help rather than just assist. Janice had allowed me to deliver a few babies, making sure she was there to help if I needed it.
Simone clipped the chart back on to the end of the bed as Dr Hugh Warrington swept in. Immediately her face lit up. His smile faded as soon as he saw me sitting in the corner, Natalie’s hand in mine.
‘You can go, Lena,’ Simone said. ‘It’s all okay now Dr Warrington is here.’
I was about to get up when Natalie squeezed my hand. ‘No!’ she cried. ‘Not until my mum gets back.’
Simone and Dr Warrington exchanged glances, but they kept quiet. I watched as he talked gently to Natalie about how he was going to administer the diamorphine. Then he and Simone walked to the trolley in the corner, their backs to us. They were conferring, but I couldn’t hear what they were saying. Dr Warrington approached the bed with a syringe and explained to Natalie that he was going to inject it into her thigh. She gripped my hand as he stuck the needle into her flesh.
‘Ten milligrams,’ he said to Simone, who picked up the chart from the end of the bed and scribbled on it.
I was confused. Ten milligrams was a lot, especially for Natalie, who was tiny. And I was sure I saw him administera five-milligram dose. But I didn’t feel I was in any position to contradict a doctor. He left without further acknowledging me and, when Natalie’s mum returned with drinks and snacks and Simone was filling her in on what had happened while she was away, I sneaked a quick glance at the chart.
Three doses of diamorphine had been administered to Natalie, one every three hours. And, according to Simone’s records, all were ten-milligram injections. Yet Simone had told me herself that she’d administered five milligrams. Natalie’s weight on the chart was also noted as being 58 kilos, not 48, as Simone had said to me. Why would Simone record Natalie’s weight as much heavier? Was it a simple mistake?
When Natalie was distracted by another contraction, her mother rubbing her back, I took Simone aside and pointed out the mistake. Instead of being grateful she just looked irritated. ‘Oh, slip of the pen. I’ll sort it. Just leave it for now,’ she said.
Something else was bothering me too. ‘Her hands look swollen to me,’ I began, thinking of pre-eclampsia. ‘Have you checked her blood pressure?’
