Chapter 36
27 weeks
"Do you want to look where you're going?" Gem snaps. "That was so not my fault…"
"Not helpful, Gem! Alicia? Alicia, are you alright? Can you sit up for me?" Suddenly Elle is next to her on the floor, arms around her shoulders.
"I can do it," Alicia protests wearily, fights back the tears. "I'm fine…"
Her left elbow buckles underneath her as she tries to push herself upright, and she hisses in pain, back here again and she's sick of it, she's so sick of it…
"Oh, alright. Alright, sweetie, let me help you. Can you all give her some space, please!" Elle shouts, and Alicia doesn't want to look up, doesn't want to know how many of her colleagues in the ED have gathered around to watch it all unfold. "Alicia," she says softly, leans in closer, one hand supporting her elbow, the other around her shoulders. "Alicia, I need you to be honest with me now. Are you in any other pain, besides this elbow? I really need you to tell me, it's important. I don't think you'd be this upset if it was just the tumble, would you?"
She doesn't want to do this. She doesn't want to do it, and she's avoided it for so long, but still there's nothing, nothing but the dull throbbing from the fall and even the uncomfortable twinges have gone and she's so scared, she can't do this…
"I… I haven't… felt her… move… all shift…" Alicia sobs, can hardly force out the words. "I should… have done… something… sooner… but… Bea's… busy and… since… since Eddie… I can't… examinations…"
"Okay. Okay, I need you to take some deep breaths for me, Alicia, this isn't going to help, is it? Hey? Breathe with me. That's it. Just breathe for me. David? David, do you think you could find me an empty side room, please? Quickly."
"I can't…"
"But we can't leave you on the floor like this, can we? Hey? And we need to do something with that elbow," Elle points out gently, reassuringly calm, just the faintest trace of surprise in her voice and Alicia tries to tell herself it's only because she thought she was never going to confront it head-on, allow anyone to acknowledge it all without kicking off spectacularly. "So we'll wait for David to find you a side room, and then we'll take it from there, okay? I'm not going to make you do anything you aren't comfortable with, sweetie. We can take it as slowly as you need to."
"My parents… are in… cubicles…"
"And you don't want to see them?"
Alicia shakes her head, everything spinning. "We… argued… about… this…" She gestures awkwardly with her right hand, decides it's no good now, nothing left to hide, not really.
"Alright. Do you want to see if you can stand, then? I've got you. We'll start heading down, it shouldn't take David long to sort out a side room. You're not bleeding?"
"I don't… think…"
"Okay. Okay, sweetie, it's alright. Can you stand for me? That's it. We'll walk down slowly, okay, we can wait in Connie's office if David isn't ready for us just yet. There you go, you're alright. Or do you want me to get you a wheelchair?"
"I don't… want… everyone… looking…"
"Alright," Elle sighs. "Alright, hold onto me." Gently, slowly, she guides Alicia down the corridor, squeezes her shoulder. "She, then?" she murmurs.
Alicia nods, doesn't even know where to start, where she stands, dreads to even imagine how horribly frustrated Elle must be with her by now. "I'm sorry…"
"No, no, no, no, no, sweetie, you don't need to apologise. I'm just going to treat you," Elle promises. "I'm not going to ask you anything I don't need to know to treat you, alright? I'm not judging you…"
"I'd judge me…"
"Then you need to be kinder to yourself, don't you? Keep taking nice deep breaths for me, Alicia, you're alright."
"I… can't…"
"Yes, you can. You're doing brilliantly, I just need you to stay nice and calm for me. I can go and get Bea?" Elle suggests gently. "I'm assuming you've been more… open, with her…"
"Paeds is… mobbed, there's no way…"
"I think Bea's a bit busy," David interrupts apologetically. "But I've cleared a side room, just through here. I've told everyone I've closed it off to set thing up ready for the medical student simulation later, they won't ask too many questions."
"Thanks, David. She's gone over on her left elbow- is this the one you dislocated before?"
Alicia nods shakily, eyes closed. "It's not that bad…"
This isn't happening, this isn't happening…
"You're a terrible actress. David, can you get me some Entonox, aspirin and a sling, please. Alright, Alicia, come and sit here for me."
She's suddenly aware of Elle leading her gently over to the examination table, doesn't even remember how she got into the side room, can't seem to focus on anything, head spinning, nausea rising in her throat.
"I'm losing her, aren't I?" she whispers tearfully, good hand probing frantically for movement, game well and truly up.
She hadn't realised quite how broken she felt until she can hear it in her own voice, and as it sinks in it only makes her cry harder.
"We don't know that," Elle reminds her gently. "I need you to relax, Alicia, you're not helping yourself, are you? Lie back for me properly, sweetie. That's it. How far along are you?" she asks gently, holds out the tissues. "Alicia?"
"I thought the entire hospital already knew…"
"I'm not asking the ED rumour mill," Elle tells her. "I'm asking you. Look, if I've upset you, I'm so sorry, I've only been trying to…"
"I know. I know, you don't have to apologise. I know I've… well, I've been a moody cow." Alicia wipes at her eyes furiously, desperately trying not to cry but somehow, she just can't stop. "I know I must be a total nightmare to work with at the moment, I'm the one who should be sorry. Twenty-seven," she whispers at last, eyes the door shiftily, just in case. "I'm twenty-seven weeks. This is… this is the longest she's been this still since… since she started moving…"
"It's not all that unusual," Elle tries to reassure her. "It could be absolutely nothing, there's no point getting yourself all worked up like this. I'm going to…"
"It could be…"
"Hey, there's no point thinking like that. Can you try to straighten that elbow for me? Oh, okay. Okay, definitely dislocated."
"I haven't managed to get it completely straight since I went down the stairs…"
"Alicia," Elle sighs. "Then we need to get you back into physio, don't we?"
"I know, I know, but it's… it's been manageable, and I've had… other things… on my mind…"
"Alright. Alright, I'm going to reduce your elbow once David gets back, and then shall I check you over?" Elle suggests carefully. "Or I can… you've been seeing a midwife, right?"
"I'm not completely irresponsible…"
"Okay, I'm sorry. I know, sweetie, I know it hurts, I'm going to reduce it for you as soon as David gets back with some pain relief. Do you want me to see if I can get your midwife down from obstetrics? Would that be easier for you?"
"That would make it ten times worse," Alicia protests anxiously. "We don't really get on."
"But she's been taking your appointments, presumably, is that better than me…"
"Bea's been doing the actual examinations," she admits. "And even then, it's a struggle. I… I know it's ridiculous, I just… I can't…"
"No, it's not ridiculous, sweetie. It's not ridiculous, it's very common in rape victims, it's absolutely nothing to be ashamed of…"
"It was nearly two years ago, Elle…"
"And that's hardly any time at all, really, with something like that," Elle reminds her gently. "Plenty of women find pregnancy difficult after rape…"
"I never said I was finding it difficult…"
"Oh Alicia, it's been written all over your face for weeks," Elle sighs, massages her wrist gently, still supporting her left arm.
"I thought... I mean," Alicia shakes her head. "If it was… right after rape, that makes sense, but this… I just need to pull myself together, and I can't…"
"You're far too hard on yourself, you know that? Yes, even pregnancy years after rape. It's not all that uncommon for women to avoid antenatal appointments altogether. You've got absolutely nothing to be ashamed of, sweetie. Nothing."
"I just… I just can't cope with anyone touching me, but… like… this is fine, probably because I know you, I don't know… hugging and stuff's fine, I just don't understand why I can't deal with…"
"Because you're feeling vulnerable, and that's completely understandable. Will you let me try?" Elle asks softly. "I'm not going to hurt you, I'm not going to do anything you aren't comfortable with. But we need to make sure you and the baby are alright, don't we?"
"I'm scared she's… that she's already…"
"You've got no reason to think that. But if there is something wrong, we need to know now."
His hands are all over her. She's told him no and he just won't listen, he's pushing back the covers and she's frozen, needs to react, needs to do something, anything, to get him away from her but she can't move, can't scream, panic rising within her as it becomes painfully, horrifyingly clear what he's about to do and she can't stop him, she can't stop him…
She has to snap out of it, Alicia realises. She has to snap out of it, her baby needs her to snap out of it, if she can't pull herself together there could be something horribly wrong and she might not know until it's far too late…
"Okay," Alicia whispers shakily, jumps, startled, as the door swings open, curses herself when she realises it's only David. "Okay."
Elle nods, squeezes her hand. "It'll be fine, I promise. We can take it as slowly as you need to. Thanks, David," she smiles gratefully. "I need you to assist me, please, her elbow's definitely dislocated."
It's all something of a blur after that. Perhaps it's because she knows what's coming, has been through all of this too many times over the last eighteen months, enough to know that the pain she's in now is nothing compared to the pain she's going to be in post-reduction, zones out as a means of self-preservation of sorts. One moment everything is a haze of pain and panic and exhaustion and upset, and the next she's startled back to reality, in complete and utter agony, gas and air mask over her face and she can't remember how it got there, David's hand on her shoulder, gentle, steadying her, her left arm in Elle's grip and horrible, crippling pain.
"There we go. There we go, sweetie, it's over. You're alright. You're alright, take some nice, deep breaths for me. Has that done it? Okay. You know the drill then, don't you, by now, you need to keep it immobilised for at least two weeks, this time, I'll do your physio referral once we're finished here, and I'll talk to Mrs Beauchamp- don't look at me like that, Alicia, that's final, I mean it. You're far too brilliant to have your career ruined by an elbow injury you didn't let heal properly. A couple of weeks off will do you the world of good, anyway. David," Elle says quietly. "David, do you think you could find me a foetal Doppler, please? Discretely, if you can. If anyone sees you, tell them anything. Just preferably not that you're bringing it in here."
David nods, meets Alicia's eyes for a moment, and she can't quite place what she sees there- sympathy? Worry?
"Alright. Alright, I'll be right back."
"Thanks, David. Relax for me, Alicia, I need you to relax. Breathe, sweetie. I know, I know it's hard, it won't be much longer. Okay? You're doing really well."
"I can't lose her, Elle," Alicia whispers tearfully. "I can't, she's… she's all I've got left of… of Ethan, I can't… he's not coming back now, I know he's not, and I can't…"
"I know. I know, and I'm going to do everything I can," Elle promises. "We'll wait for David to come back, then I'll shut the door and I'll examine you, alright?"
"Thank you." It feels as though the world is ending, as though she can't possibly focus on anything, can't take anything in at all unless it's the news she desperately needs to hear, but somehow, she understands what Elle is trying to tell her between the lines, that she knows how difficult this is going to be for all sorts of reasons, that she's trying to minimise Alicia's distress as far as she possibly can.
"It's alright. Are you sure you don't want me to see if your parents are still here?"
"No. No, they… they're beyond angry, they… they…" Screw it, Alicia decides, screw it, there's no point hiding any of it, not now, no point even trying. "I haven't told them… well, I suppose I have now, really, I don't know… but they didn't… they didn't know, they didn't take it well, they think… they think…" she shakes her head, dissolves into tears again, can't seem to hold herself together for more than a few minutes at a time.
"What do they think? Alicia?" Elle sits down on the chair next to the hospital bed, squeezes Alicia's good hand tightly.
"They think… I haven't… told… them… because… it's… not… Ethan's…"
"And is it?" Elle asks softly.
"I couldn't ever… do that to him… never… but… especially after… Eddie…"
"Oh, Alicia, come here. It's alright. It's alright, sweetie, I need you to keep taking nice deep breaths for me," Elle reminds her gently, pulls her into a hug.
"It just… all got so… heated… they were just… upset… and… I couldn't…"
"And then it got a bit out of hand? Okay. Okay, darling, I understand."
"I know… I… need… to… just…"
The door opens again, and then there's a flurry of movement, David handing over the foetal Doppler.
"You don't need to do anything, Alicia. Alright? You don't need to do anything except try to relax now, you're still far too tense, you're only going to make it all seem much worse than it is if you're like this when I examine you, aren't you? Thanks, David, I'll handle it from here." Elle pauses, waits until the door is safely closed again. "You okay?" she tries gently. "Alicia?"
Alicia shakes her head, closes her eyes, increasingly panicked and no idea how to cope with it. "Just do it. Just do it, please…"
"Okay. Okay, but if you need me to stop at any point, you only need to tell me. I'm not going to do anything you don't want me to, I promise. You're safe. Can you lift your top for me, sweetie?"
Alicia grimaces, closes her eyes tightly, obliges. "I look bloody massive…"
"No, you don't, don't be so silly."
"I don't know if I want to know, Elle," Alicia sobs. "I just…"
"I know. I know, but this part's nearly over. Just stay still…"
"I had a cigarette this morning, I know I shouldn't have but I was stressed, you don't think…"
"No, I don't," Elle tells her gently, but Alicia can't believe she's being honest with her, not really. "One isn't going to do her any real damage…"
"It isn't the first time though, I… I've probably had one every week or so, maybe less, I know I'm awful but it's a stress thing and I was smoking more than that before twelve weeks but I didn't know then, I wouldn't have if I'd known…"
"Alicia. Alicia, this isn't helping, is it? I'm going to…"
"She's at risk of cardiac complications already and I keep cutting off her oxygen, I'm such…"
"Okay. Okay, it's alright, sweetie, you're alright. I'm going to try to find her heartbeat, and we'll take it from there, there's no point doing this to yourself now, is there? You're okay with me touching you?"
"No, but I want you to do it anyway."
"Well, I suppose that counts as consent." There's a gentle pressure against her abdomen, and she tries to breathe slowly but she just can't, heart racing, completely and utterly terrified and she can't cope with it all ending here, she can't do it, she just can't, not like this…
She doesn't know what she'd do without her at this stage, and perhaps that's ridiculous, given she isn't even born yet. But it feels as though this baby is the only thing worth struggling on for at the moment, all she has left, and she can't face losing her now, she can't do it, not on top of everything else, on top of Ethan…
There's a few moments of silence, horrible silence, and then a loud, frantic thudding, unmistakable, and Alicia can't hold it in anymore, only cries harder, relief flooding through her like nothing she's ever known.
She's alright. She hasn't done her irreversible damage after all, she's alright…
"Hey, it's okay. I know, I know, Alicia. That's a nice strong heartbeat, your baby's absolutely fine. You still haven't felt anything?"
Alicia shakes her head, reaches for the tissues.
"Then I want you to stay in here and rest for a while then, please, just until you do. I think you've overdone it a bit, but there's no reason to think there's anything wrong, okay? Her heartrate's perfectly fine. And then you're going straight home, I'll drive you myself if I have to, and I don't want you back in here for at least a couple of weeks. I'll tell Connie, you need to let that arm heal. But I still want to examine you properly, sweetie, is that alright? You haven't had any discharge?"
"Only the usual shitty stuff no one warns you about until you get pregnant and it's too late. But I can't do virginal, Elle, I can't, everything else is bad enough…"
"Hey, it's okay. Alright. Alright. I'll do an abdominal palpation and we'll take it from there, are you happy with that? You're doing really well, sweetie. You're doing really, really well, I'm going to leave you in peace as soon as I'm satisfied you're both okay."
"I'm not though," Alicia whispers. "I'm not, she needs me to be able to do this and I keep being ridiculous about it…"
"Alicia, you're not being ridiculous. You're being so far from ridiculous, it's perfectly understandable."
"I know you aren't going to… to… to do what he did, it just isn't that simple…"
"I know. I know, Alicia, you don't have to explain. It's perfectly normal, I understand. I'm only going to palpate, I'm not going to do anything else if you're sure you're not bleeding. I'm not going to hurt you. And the moment you start feeling uncomfortable, you just tell me and I'll stop. Okay? You're fine, it's all going to be fine. I'd offer to go and find Bea and swap with her, but it sounds like she's…"
Alicia shakes her head. "I need to get over it. I know I need to get over it…"
"I think you need to stop being so hard on yourself, actually. You've had an awful lot to cope with over the last couple of years, Alicia, let alone recently, it's no wonder you're struggling a bit."
"Okay. Okay, I… I get like this every time, even with Bea, I'm sorry…"
"You have nothing to be sorry for, Alicia. Absolutely nothing. Are you going to move your hands for me then, sweetie? And then we can get it over with."
Only then, still overwhelmed with relief but fast losing control to the fear and the bad memories and the tension and everything else she can't quite define again, does she realise that at some point since the Doppler was discarded she's wrapped her hands around her bump protectively, shut down, firmly communicating that she has no desire to let anyone touch her any further.
She wants Ethan. She just wants Ethan, and perhaps it would have all been just as bad even if he were here, but at least she wouldn't have been going through it all by herself, perhaps it wouldn't have all felt quite so horribly overwhelming…
"Sorry…"
"I've told you, haven't I, you don't need to apologise. I'm going to be really quick, I just want to check you haven't…"
Alicia winces, closes her eyes, knows exactly where she's going with this. "It's going to look worse than it actually is, oligohydramnios…"
"Okay. Okay, well that certainly explains why you managed to cover it up as long as you did," Elle sighs.
"You haven't believed me for months, I know you haven't…"
"No, but I think most of us are still kicking ourselves we didn't realise something was wrong sooner," she admits quietly. "I'm sorry. I'm sorry, I… I realise now, perhaps we haven't been helping, we've just been worried about you, we thought if you could get it all out in the open…"
"I just wanted to deal with it my way, I just couldn't…" Alicia shakes her head, eyes still tightly closed in anticipation. "You wouldn't understand…"
"I can try?" Elle offers gently. "Is this why Ethan left?" she tries carefully. "Did Ethan leave when you told him…?"
"It wasn't like that. I know that must be how it looks, but it really wasn't like that, honestly. It wasn't. He… it's not fair, I can't… it's not fair on Ethan…"
"And you think he worried about what was fair on you? He must have walked out on you when you were, what…"
"Sixteen weeks," Alicia sighs. "Sixteen weeks, and I really, really don't want to talk about Ethan," she says firmly. "She should be moving though, I don't understand why she isn't…"
"Because it happens," Elle reminds her simply. "Sometimes it happens, and I wish I could tell you why, but I can't. You know that. But there's absolutely no reason to think there's anything wrong, her heartrate's fine, it could just be…"
"She's…" Alicia shakes her head, can't remember if she's ever had to say it out loud before or if she's relied on Bea up until now, with the handful of people she's actually told. "She's got… exomphalos… they keep telling me minor, but it's borderline…"
"Oh, Alicia… I'm so sorry." Elle pauses, visibly horrified, holds Alicia's hand tightly in hers. "And we've… I'm so sorry, we've all been piling pressure on you to… if I'd known…"
"No, it's… it's alright. I know I haven't exactly been easy to be around, I know it's obvious, I know I should have… I just wanted to… I don't know, I couldn't get my head around it, I…"
"Is this why you haven't wanted to tell anyone?" Elle asks quietly. "Alicia? We could have helped, sweetie, we could have supported you…"
She almost protests. She almost protests to Elle that she's got it all wrong, that she doesn't know what she's talking about and jumping to all the wrong conclusions.
Then she realises that if she just plays along and doesn't bother correcting her, it offers her a way out, an explanation, gets them all off her back, and suddenly Elle's assumption doesn't seem like such a bad thing.
"I just… we didn't want to say anything at first, Ethan and I… they… confirmed it, a few weeks ago, that it was minor, and I know it could be a lot worse, I know the odds are relatively good as far as major neonatal surgery goes but it just… it freaked me out, and then I knew I needed to tell everyone and make it official and everything but it's just… all… messed with my head a bit…"
"Oh, Alicia," Elle sighs, holds out the tissues, squeezes her shoulder gently. "Oh, Alicia, I'm so sorry. I wish you'd felt you could tell me…:
"It wasn't personal," Alicia insists, half-panicked she's gone too far, upset her, pushed her away completely just as she's made herself so vulnerable and exposed. "It really wasn't, I just… I just didn't want to tell anyone, Bea and Ruby only knew because I really couldn't hide it from them- or deny it, really, I know I haven't exactly been able to hide for weeks now, but it really wasn't personal, Bea and Ruby were just there when I found out and then… after Ethan, I just…"
I'm glad you did. I'm glad you did tell them, you don't have to apologise. You need some support. God knows you aren't getting it from Ethan…"
"I don't want to talk about him," Alicia protests. "He was… before he left, he really was, but I don't want to talk about it."
"Okay," Elle sighs softly. "Okay. But you know I'm here, don't you, if you change your mind? It's a lot, Alicia. Pregnancy's a lot to get your head around at the best of times, let alone after your boyfriend…"
"Not helping, Elle." Alicia blinks wearily, part of her desperate to keep delaying the inevitable and part of her just wanting to get it over with. "That really isn't helping… look, I appreciate it, and everything, but I don't want to talk about it…"
"I understand. As long as you're getting support from Bea and Ruby. If you don't want to talk to me about it, I understand, I'm not going to push it, but you need to talk to someone. I know it's hard, but you need to try not to panic too much. The stats are fantastic nowadays, for exomphalos…"
"And it's easy to think of it like that when it's a patient, but when it's your own baby…"
"You can't help but focus on the complications," Elle finishes for her. "I know. But the mortality rate must be…"
"Ten percent, in isolation. But I can't… any associated complications and it could… she could… I can't even think about that. I can't… she's all I've got left, Elle, I can't lose her…"
"I don't think it's going to come to that," Elle tells her gently. "I really don't think it's going to come to that, but I can do an ultrasound, if that would put your mind at rest? But her heartrate's perfect, Alicia. There's absolutely nothing to worry about based on her heartrate. Shall we get this part over with, then?"
Alicia nods weakly, moves her hands, winces awkwardly at the pain shooting up her arm. "Just… if I start protesting, ignore me, stopping and starting again is so much worse. But I can tell you now, my fluid levels are going to be ridiculous, they always are, there's no point…"
"And I'll feel much better once I'm sure your waters haven't broken…"
"I'd know if they had…"
"You wouldn't be the first woman to miss it."
"I don't know why… it's not even like… I don't know why I can't just…"
"Hey, we've already been through that, haven't we? It's normal, Alicia. You don't have to apologise, you don't have to justify yourself, it's normal. It's not your fault, you didn't cause this. Eddie did that."
"But I'm the one who's letting it control me like this…"
"I don't think you're letting it control you. I think you're doing a pretty good job of not letting it control you, actually, you're just struggling a bit. And who can blame you? You're doing fine. I'm just going to measure your fundal height, sweetie, I need to…"
"I know. I know, just do it." She closes her eyes, tries to block it all out, remove the association with that night she always seems to come back to when it comes to any kind of examination now but it's not that easy, she doesn't want anyone to touch her, just in case, and rationally she knows it isn't going to happen again, not now, not like this, but it just isn't that easy…
"Alicia? Alicia, are you still with me? I don't think your waters have broken, I'm going to request your notes from Obstetrics, unless you can remember…"
"Is it over?"
"Yes, it's over. I'm going to request your notes, if you're sure you don't want to go up to Obstetrics, but I don't think you're measuring abnormally small, if your midwife's already identified oligohydramnios. But I think it's best we keep you in and monitor you for a couple of hours, all things considered. I'll get onto Physiotherapy for you, while you're still here, would you be happier with the same physio as last time? Okay. And that piercing needs to come out."
"It's fine…"
"And it won't be if you leave it in much longer."
"You're not my mam."
"Nope, but I'm old enough to be, just about, and I care about you, so humour me, please. Did your midwife not tell you to…?"
Alicia groans, closes her eyes in protest, disengaged. "You'd have to ask Bea. Probably, but I don't tend to take much notice of her unless it's actually important, we don't really get on…"
"Alicia… All of it's important, it's not just about the obstetrics side, it's about supporting you as well, which you clearly need- I'm not having a go at you, sweetie, I'm really not. But you really need to be looking after yourself better than I think you are right now, and you know that, don't you? But please, take that out, it looks infected. Have you not noticed…"
"No, I haven't, I try not to if I can avoid it because it turns out ignoring a pregnancy for five months just messes with your head so much it's actually ridiculous and it's much easier to just try to pretend I'm not the size of a…" Alicia pauses, suddenly aware that perhaps she's said too much. "I know, I know, I… I'm dealing with it. I really don't want to talk about it, but Bea and Ruby know, it's under control, it's fine…"
"Alicia…"
"There's no point going through it all now," Alicia argues wearily. "There really isn't, I… I've been having counselling, it's got a lot better, in the last couple of weeks, I just want to get on with it…"
"Okay," Elle sighs, her voice laced with considerable reluctance. "Okay, is Ruby working today?"
Alicia shakes her head, knows exactly where this is going.
"Then I'm calling Ruby, and she's coming to get you, you're not going home by yourself. Have you had a break yet?"
Alicia nods. "Bea's only stuck in Paeds because she was covering for me while I went to see my Mam and Dad…"
"And that's obviously upset you, so it doesn't count. Have you had an actual break? An actual, more than two seconds to yourself, cup of tea and no one asking you to do anything urgently and someone else in charge of the Paeds crash bleep kind of break?"
"It's only me in Paeds apart from the F1s," Alicia protests, presses the back of her hand against her forehead. "I've been chasing Paediatrics to send a consultant down all day and they're still trying to sort something, apparently, and we all know how understaffed the ED is since… since… you know what I mean. But I can't leave the F1s on their own without a consultant, and you and Dylan can't exactly babysit them with Mrs Beauchamp on leave. How am I supposed to…?"
"Connie's been making sure you get your breaks, hasn't she?" Elle realises. "Okay. Okay, we… I'm guessing this has been you telling me, yes?"
Alicia nods, flushes, embarrassed. "I'm sorry. I'm so sorry, I know I've been…"
"How many times, you don't need to apologise. I'm the one who needs to be apologising to you, I think we've been going about it all wrong, haven't we? But listen, you've told me now, so I can help, right? Do you think you can live with that? If I just drop down here every couple of hours and make sure you can get out for a few minutes, would that help?"
"I don't want special treatment, I keep telling Mrs Beauchamp that."
"It's not special treatment, I'd do exactly the same for anyone else at this stage," Elle sighs. "You know I would. You look exhausted, Alicia. You look exhausted, you look like you've lost an awful lot of weight, I'm not convinced you're looking after yourself at the best of times, adding twelve hour shifts without proper breaks into the mix at six months pregnant is just a recipe for disaster. So we need to make sure you're getting regular breaks, even when Connie isn't in, and if I have to drag you out of Paeds myself, I will. I remember when I was pregnant, by about halfway through my shifts my ankles used to…"
"Oh my god, don't, I think mine are about five times their normal size already and I'm only, what, halfway through this shift."
"Right, and you weren't going to tell me that, then?" Elle sighs. "You need to disclose these things, Alicia, it could be…"
"I know it isn't preeclampsia, it's fine…"
"And I'd really rather you didn't rely on self-diagnosis, so I'm going to need a urine sample before you leave here, please. I'll get onto Paediatrics, they need to send us down a consultant, it's getting ridiculous now."
"I don't think they've got a spare consultant, that's just it," Alicia confesses. "I mean, it's frustrating, yes, but I don't think they're in a much better position than us at the moment. And I can cope, apart from when…"
"Oh, don't give me that, Alicia, you can't. You can struggle through, maybe, but that isn't coping, that's just… I don't know, damage control. You can't carry on like this. Paeds are just going to have to accept that until we take on another consultant, they need to help us cover the Paeds ED. Why we're still relying on locums, I really don't know…"
"I think… Mrs Beauchamp's been trying to keep Ethan's job open," Alicia explains awkwardly, almost guiltily, because surely if her suspicions are correct, it's her fault, all her fault that they're so understaffed; if Mrs Beauchamp is still holding out for Ethan to change his mind then it's only because she's witnessed her complete and utter breakdown since he went away. "Not that there's any point now, he's made it quite clear he isn't coming back…" She shakes her head, falls silent, torn between desperately wanting to talk about it all at last and a deep-rooted sense of loyalty inside her, can't quite bring herself to betray his confidence, because she promised, promised she wouldn't tell anyone at work and that's exactly what she's going to do, whether he's coming back or not.
"Do you know where he is?" Elle asks carefully, sympathetic. "Alicia?"
"No. No, I don't, and he's…" She shudders, and for a moment she's back at the top of the stairs, falling, everything hazy after that but if she really concentrates she can just about see Ethan's expression, hazy, blurred, but there, the last time she saw him and then he was gone, she was in resus and it was all-too-late…
"There's no point," Alicia says quietly at last, determined not to cry again. "He's not coming back, he doesn't want me to contact him, there's no point talking about it, we all just need to accept he doesn't want to come back and…" she shakes her head. "Mrs Beauchamp's wasting her time if she's holding out on making a permanent appointment on the off-chance. He isn't coming back. I know he isn't. I've just got to accept that I'm doing it all without him, there's no point pretending he's going to change his mind."
"You don't need him, sweetie. If that's how he's going to be, you don't need him anyway. You're going to be an amazing mum, you're going to be perfectly fine without him. You've got us. I'm always here if you want to talk, okay? You know, to someone who's been there, done single motherhood. You're going to be brilliant. Are you going to be alright if I leave you for a couple of minutes and phone Ruby?"
"As long as you don't announce it to the whole ED."
"It's just between us," Elle assures her. "I won't be long. Don't move, don't try and discharge yourself, don't do anything, you're not going home by yourself."
"Elle?" Alicia calls, catches her just as she turns towards the doorway. "Thank you. For… you know. I know I've been completely ridiculous about…"
"It's alright. You don't have to apologise, Alicia, it's alright. I understand. I'll be right back."
It's only after the door is closed again and she's left alone in silence, stillness, mind finally at peace, that she feels it; gentle fluttering within her, momentary, fleeting, but just enough to put her mind at rest.
"Are you sure about this?" Ruby asks her gently, pulls into the pub car park several hours later. "We don't have to do this tonight, if you don't want to. We can…"
"No. No, I'm sure," Alicia tells her, though anxiety is already building within her as she glances out of the window in the direction of the Hope and Anchor. "I need to do it, I just want to get it over with. Bea's managed to gather everyone together in the pub, I can't back out now…"
"You could," Ruby reminds her. "You've had an awful day, Bea would understand."
"I know. But I… I can't leave it hanging over me forever, can I, I just need to do it," Alicia decides, takes one final deep breath before opening the passenger door awkwardly, still adjusting to being one-handed again. "I just need to get it over with…"
Ruby nods, quiet, pensive. "Okay. But we don't have to stay for long," she promises. "We can just stay for one drink, or something, any time you want to leave, just say. I don't think anyone's going to blame you, after today."
"Oh, don't," Alicia sighs. "It's getting ridiculous, now, I mean, the first time, it was a fairly predictable injury really, wasn't it, going through a window and all that. And the second time. But I only went over in the corridor this time, for god's sake, it's… I know, I know, I should have stuck with the physio longer last time," she agrees, knows from Ruby's expression exactly what she's going to say. "I just had other things on my mind then, it wasn't exactly my top priority, obviously I regret that now…"
"I know." Ruby smiles sympathetically, leads Alicia around to the entrance, holds the door open. "I know, but you're going to see it through this time, even if Bea and I have to physically drag you there. And don't even think about taking that off," she warns, somehow manages to spot Alicia fumbling awkwardly with her sling even as her back is momentarily turned. "If you want it to heal properly this time, that's a terrible idea. And I know what you're going to say, but you're telling them now, remember? It doesn't matter how obvious it is or isn't with a sling, because you're telling them, you don't have to worry about hiding it anymore. Come on." She smiles, quietly reassuring. "You'll feel better once you've got it over with."
She's stupidly, ridiculously nervous, that short walk across the pub with Ruby to the table her colleagues are occupying in the corner, absorbed in each other's company, perfectly happy without her, and it's been so long since Alicia has ventured into the pub after work what with everything that's changed over the last few months that she almost bottles out, turns around and bolts and drags Ruby with her, can't go through with it.
It feels like a lifetime ago, that she was last in here. It would have been right before the last round of her ED registrar exams, right before she told Ethan, she would have been in here with him, one of them would have stayed off the alcohol, driven home- back to hers, because hers had practically become his home by that point. They would have gone via a local takeaway place, most likely, late by the time they left the pub and due back in work early the next morning, argued lightly over where to go, she would have turned her nose up at his suggestions on the grounds of lack of vegan options and he would have rejected chana masala, made some sort of dig about chickpeas tasting like cardboard, they would have curled up on the sofa in front of a bad film and he would have tested her on her revision notes, told her she didn't need last minute panic cramming, they would have…
He's never coming back, and she doesn't know how to deal with it. She's going to have to do the rest of it all by herself, pregnancy hell, the delivery part, parenthood, paeds rotation she'd talked through with Ethan after the complete and utter disaster that was moving to Manchester by herself and too much pressure all-too soon after Eddie, consultancy exams in a few years, the rest of her career, the rest of her life, she's going to have to do it all by herself…
"Hey, I was starting to think you weren't coming," Bea greets them, gestures to the two empty chairs beside her, climbs to her feet, pulls Alicia into a hug. "How are you feeling?"
"I'm fine," Alicia assures her quickly, can feel everyone else around the table watching her carefully and she just wants to get this part over with as soon as possible, not entirely sure when she developed this complete and utter hatred of being the centre of attention but she knows it's only going to get worse once she makes the announcement, and she can't do this and then go straight into it, she's going to be practically shuddering by the time she manages to escape. "I'm fine, it was just a stupid accident, really, I slipped…"
"But you're sure everything else is fine?" Bea murmurs, extends the hug just a moment longer to ensure no one else can hear, waits until Alicia has nodded slightly before she pulls away. "Okay. If you're sure. I'll go and order you both a drink, usual, yeah? I'll be right back."
"Are you sure you're alright?" Gem asks, expression rather guilty. "I'm really sorry about earlier, I shouldn't have snapped at you, you just took me by…"
"It's okay. Honestly, don't worry about it, it's fine," Alicia covers quickly, no desire to go through it all again. "It's my own fault, anyway, you were right, I should have been more careful, and you didn't… this elbow was messed up anyway, it wasn't your fault."
"Are you missing us already?" Robyn teases. "If I was signed off injured, there's no way you'd catch me anywhere near this place."
"Something like that. Actually, I…"
She's suddenly aware of everyone's eyes fixed on her, watching intently, pressurised and irrationally anxious and all the words she planned before have left her, no idea where to start, what to say…
Silently, carefully, Alicia reaches into her handbag, rummages for her purse, places her latest ultrasound photo on the table in front of them all.
"Oh my goodness, Alicia, she's gorgeous," Elle exclaims, shoots Alicia a knowing smile as she picks up the scan photo.
"She?" Louise asks suspiciously, sat beside Elle, eyebrows raised. "Did you already…"
"Oh come on, Lou, have you never sat in on an ultrasound before? Perfect angle, she's obviously a girl," Elle covers. "She's got your nose."
"Poor child," Bea teases. "Hey, I'm joking, you know I am. She's beautiful."
"How far along are you?" Robyn asks, taking the scan photo from Elle.
"Twenty-seven weeks," Alicia tells her voice a little shaky and she doesn't quite know why. "But she's a bit on the small side…"
"She looks perfect to me. Ahh, this is so exciting! If you need any baby things, just shout, I'm pretty sure I've still got all Charlotte's stuff in the attic. And if you want to meet for coffee, once you're on maternity leave, if you ever want to talk about… you know. I know all about doing it by yourself."
"Thanks, Robyn," Alicia smiles gratefully. "I… that'd be great, thank you."
Dylan frowns disapprovingly, next to have Alicia's scan passed to him. "Are we really going to all just pretend…"
"Yes, yes, we are," Elle interrupts, forced lightness in her tone and yet absolutely, uncompromisingly firm beneath it all.
"Is it Ethan's?" Rash asks now, visibly recoils as Gem kicks him under the table sharply. "Sorry. Sorry, I shouldn't have…"
"No, it's alright. Yes… Ethan's the father. But he's… he's not going to be involved… not because he didn't want… it's complicated, he knew, and everything, that isn't why he…"
"You don't have to explain," Bea tells her firmly. "You don't have to explain any of it, everyone understands."
"Are you sure there aren't two of them?" Rash questions, evidently an attempt at a joke and not even remotely amusing, doesn't seem to realise his error until it's too late, then suddenly seems to remember that Alicia is still his mentor, does the maths in his head, works out his next portfolio assessment is going to fall perfectly between her coming back into work post latest elbow injury and going on maternity leave, that offending her now is a truly terrible career move. "I mean… not that I think you look… you don't… it just looks like there's a shadow on the scan, I was joking…"
"She's…" Alicia stammers, decides to hell with it, she might as well get it all over with now. "She's got exomphalos… obstetrics think minor, but she's borderline, there's no way of knowing until she's born."
Rash's face is a picture of utter horror.
I am so, so sorry for the delay! I've had a particularly difficult couple of weeks with personal stuff and have just been writing in slow motion when I've had time to myself, I promise I will try not to leave it so long next time!
This chapter in particular was written with Flora in mind, if you know the Max Pemberton Junior Doctor series. I think I've read every medical memoir in existence as research for this story, and I'd already started the past chapters of this story when I read Max Pemberton's third book, in which his junior doctor flatmate, Flora, finds herself pregnant, alone, and just left to get on with it when it comes to work, and medicine is obviously a hugely demanding job at the best of times.
Thank you as always to PanicPeachPit, Katie, 20BlueRoses and Guest for taking the time to review the last chapter, your feedback is always wonderful to receive. I always worry dialogue isn't my forte, so it's honestly really lovely to hear that you enjoy the dialogue scenes. To my guest reviewer- I know exactly what you mean with Louise, I've always felt that she either gets it completely, wonderfully right when she wades into other people's business unwanted or totally, disastrously wrong, but most of the time she gets it wrong and it puts me off her character a little. I'm sorry, Louise fans!
Reviews would be wonderful, please do let me know I haven't lost you all! And I promise you will get lots of Ethan in the next chapter.
-IseultLaBelle x