Grazia Book Club: Sarah Vaughan’s Little Disasters

Little Disasters By Sarah Vaughan: I’m on my way to see a patient. Ten months old: fractious, irritable. She’s vomited, according to A&E, though she hasn’t a fever. She may be no more ill than Sam, my eight- year- old who’s just had a chest infection, though it’s odd to bring in a child who’s not genuinely poorly this late at night. The junior isn’t happy to discharge and asked me to come down. My heart tips at the thought of a complicated case.

Because I could do without another terrifyingly sick child right now. My shift started with a crash call to the delivery suite to resuscitate a newborn: a full term plus thirteen days overdue baby; blue, with a slow heartbeat, and a cord pulled tight around his neck. I got him back: stimulation, a few breaths – but there was that long moment when you fear that it could all go horribly wrong and the mother who has managed to carry her baby beyond term might end up mourning the child she has dreamed of. As every obstetrician knows, birth is the most dangerous day of your life.

Then a child with an immunosuppressant condition and a virus was brought in by ambulance, and just after he’d been admitted, I had to deal with a three- year- old with croup. The mother’s anxiety made the situation far worse, the poor boy gasping for breath as she distracted our attention. Often parents are the most difficult part of this job.

So I’ve had enough drama tonight, I think, as I squeak along the corridor and take in the chaos of paediatric A&E, filled with hot, disgruntled parents and exhausted children. A boy in football kit looks nauseous as he leans against his father in a possible case of concussion. A girl peers at a blood- soaked dressing: she was chopping fruit, says her mum, when the knife slipped. From the main A&E, where the aisles are clogged with trolleys, there’s the sound of drunken, tuneless singing: ‘Why are we waiting’ shouted increasingly belligerently.

I check with the sister in charge, and glance at the patient’s notes: Betsey Curtis. My heart ricochets. Betsey? Jess’s Betsey? The baby of a friend I know well? Jess was in my antenatal group when I was pregnant with Rosa and she with Kit. Together we navigated early motherhood and then our second babies, though we’ve drifted apart since Jess’s third. Perhaps it’s inevitable: I’ve long since left the trenches of babyhood, and work, family life and my suddenly vulnerable mother are all-consuming. Still, I’ve only seen her a handful of times since she’s had this child and I’ve let things slip. She didn’t send Rosa a birthday card and I only noticed because she’s usually so good at remembering. Far better than me, who sometimes forgets Kit’s, a week later. Of course, it doesn’t matter – but I had wondered, as I scooped up the cards this morning, if she was irritated with me.

And now she’s brought in Betsey. I look at the notes again.

‘Ronan, is this the patient you were concerned about?’ I double-check with the junior doctor.

He nods, relieved at deferring responsibility.

‘I’m not sure what’s wrong,’ he says. ‘Wondered if you’d keep her in for observation for twenty-four hours?’

I soften. He’s been a doctor for less than eighteen months. I’ve felt that uncertainty, that embarrassment of asking a senior colleague.

‘Of course – but let’s have a look at her first.’

I pull the curtains aside.

‘Hello, Jess,’ I say.

‘Oh, thank God it’s you.’ My friend’s face softens as I enter the bay, tension easing from her forehead. ‘I didn’t think we should come but Ed was adamant. It’s so unlike him to worry, it panicked me into bringing her in.’

I look up sharply. Panicked’s a strong word from an experienced mother of three.

‘Poor you and poor Betsey.’ Examining someone I know isn’t ideal but with no other paediatric registrar around, there’s no other option. ‘Let’s see what’s wrong with her.’

Jess’s baby is lying on the bed, tiny legs splayed against the paper towel coating its plastic surface; large eyes watchful, her face a tear- streaked, crumpled red. I’d forgotten how pretty she is. Almost doll- like, with thick dark hair framing a heart- shaped face and a cupid’s bow of a mouth. A thumb hangs from one corner and her other fist clutches a dirty rabbit. It’s the toy I bought her when she was born: an unashamedly tasteful, French, velveteen rabbit. Her bottom lip wobbles but then the thumb sucking resumes and she manages to soothe herself. She is heavy-lidded. Looks utterly exhausted.

‘Hello, Betsey,’ I say, bending down to speak on her level. Then I straighten and turn to Jess, whose hand rests lightly on her little girl. It still surprises me that someone this beautiful could be my friend. She’s one of those effortlessly striking women, with copper, pre- Raphaelite curls and slate grey eyes, now red-rimmed and apprehensive – perfectly natural, since no one wants their baby to be this sick. She has fine bones, and slim fingers garlanded with rings that she twists when nervous. A tiny gold star nestles in the dip of her neck. Her glamour is incongruous in this world of specimen containers and stainless-steel trolleys. I think of the shadows under my eyes, the rogue grey hair kinking at my forehead I found this morning. I look a good five or six years older than her, though we’re the same age.

‘Can you run through what you think is wrong?’

‘She isn’t herself. Grizzly, clingy, listless and she was sick. Ed freaked out when that happened.’

‘Is he here, now?’

‘No, he’s at home, with Frankie and Kit.’

I imagine her boys lost to the depths of sleep; her husband unable to settle; and Jess’s loneliness as she sits in A&E with a poorly baby who can’t tell her what the problem is.

She gives me a quick, tense smile, and pulls a charcoal cardigan around her. Her top slips, revealing a black bra strap, sleek against her blanched almond of a shoulder, her improbably smooth skin. The top of her ribs and her clavicle are exposed and I realise she is noticeably thinner than when I last saw her just over a month ago at the school nativity. Under the glare of the fluorescent strip lights, she seems more vulnerable; less assured. And very different to the woman I first met ten years ago, who buzzed with excitement at the thought of having her first child.

Grazia Book Club is a Sunday series, where we share an extract from a book that we think you'll love. You can share your thoughts on the book by using #GraziaBookClub.

Little Disasters is published by Simon & Schuster UK, and available to buy here__.

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