‘Hello! You’re never going to guess what.’ As soon as her mother’s face appeared on screen, Isla knew something big had happened. She was laughing and crying and, as she turned the iPad slightly, Isla’s heart seemed to skip a beat. There, behind her, were Lexi and Josh, each with a tiny baby in their arms. Even though it was a picture that needed no narration, her mother did it anyway. ‘They’re here! And everyone’s safe and well, and it’s just been the most incredible day ever.’
Her mother burst into tears again at that point, and it was left to Josh to explain what had happened. Lexi’s waters had broken just after midnight US time, but she hadn’t gone into labour. When she’d arrived at the hospital and was scanned to check the position of the babies, it turned out that twin one had moved into a transverse position. After that, everything had happened quickly and they’d made the decision not to call the rest of the family in the UK, until they knew the babies were okay, toavoid causing them any unnecessary worry. The babies had been born by caesarean, two weeks earlier than planned. Thankfully everything had gone well and the first twin, a little girl, who they were naming Nicole, in honour of her grandfather, had arrived just before her brother, whose name was Theodore. Lexi had told Isla that she’d considered calling her son Nicholas, but that name would always belong to their father.
The arrival of the babies had lifted Isla’s mood in a way nothing else possibly could have done and as the family excitedly talked about all the things they were going to do when they went out to meet the twins in just three weeks’ time, she was already looking to the future again. Aidan and Jase might have decided against using her eggs, but that didn’t mean she might not want to use them herself one day and she didn’t want to write off the possibility. She was still mulling it over much later, when she got a second call from her mum.
‘I just wanted to make sure you’re okay, sweetheart? You didn’t seem quite yourself earlier.’ Her mother’s voice was warm, and Isla found herself wishing, for the hundredth time, that they weren’t so far apart. ‘I know how much Lexi wishes you could have been here, and I know missing out on seeing the twins arrive has probably been tough on you too.’
‘All I care about is that everyone is okay, but I can’t wait to meet them.’ Isla meant what she said, but a part of her had to admit her mother was right that this was hard. Not because she’d missed out on seeing the twins arrive, but because any journey to motherhood she might make wasn’t going to be easy. It would mean pausing her treatment, or trying a different medication while she was pregnant. Everything she’d read suggested she could have a baby, and that pausing her treatment shouldn’t have irreversible consequences. But nothing about it would be ‘normal’ and the usual pregnancy fears would be far more intense. Even if she was lucky enough to get the familyshe now knew she wanted, she’d never be able to just get on with life as a mother, taking her health for granted the way other people did, and assuming she’d always be there for her children. Why couldn’t she be like Lexi and everyone else? She didn’t want to have CML, and she didn’t want it hanging over her head for the rest of her life. She wished she could be one of these saintly people she’d seen on the Instagram accounts she’d started following, about living with cancer, who used the phrase ‘why not me?’ She was still angry that it had happened to her, after everything her parents had done to try and safeguard their daughters’ health, which meant asking ‘why me’ was something she hadn’t managed to stop doing yet.
‘Oh Isla, they’re beautiful.’ Her mother was obviously already head-over-heels in love with her grandchildren. ‘And I can’t help thinking they were born on your dad’s anniversary for a reason. All these years of pain, even before he died, and never feeling like I could look forward to the future, because it was so goddamn terrifying. Only now I can, because Nicole and Theodore are the future. I know it sounds crazy and, maybe it’s the sleep deprivation, but it feels like a bit of a rebirth for me too.’
‘I’m so happy for you, Mum, and I’m so glad they’re here.’ Isla was just grateful that her mother had called instead of FaceTiming, because she hadn’t been able to stop her face from twisting in pain at how unfair all of this was. There was no happy-ever-after, at least, there wouldn’t be if she told her mother the truth about her diagnosis now. It would take Clare right back to the place where she’d spent so many years of her life, fearing with every breath she took for what the future might bring. She couldn’t do it, and when they finally ended the call, Isla curled up into a ball on her bed. Burdening the people she loved most with the news of her diagnosis was more unthinkable than ever. She’d been able to cope with that, by leaning on Aidanand Reuben, but she wasn’t sure if she could do that any more either. Aidan and Jase needed to push ahead with their plans to have a baby, and the truth was her head was in far too much of a mess to get any more involved with Reuben. Maybe it was for the best, because it would have hurt like hell to be on the periphery of things, when Aidan and Jase took the next step towards parenthood without her. It would probably be less painful to stay on in the States when she went to meet the twins, but she had no idea if that was even an option with her diagnosis hanging over her head. Getting the health care insurance she needed for permanent residency, when she required treatment for the rest of her life, could well be impossible. And it was just one more choice she might never get the chance to make.
Aidan had been trying to talk to Isla on her own ever since the barbecue. Despite her responses to his messages claiming that everything was okay, he was really worried about her. But when he’d said he was going to go round to check on her, Jase had talked him out of it, pointing out that she knew they were there if she needed them, and the last thing they should do was make it feel like they were putting any kind of pressure on her, even if it wasn’t intended that way. But it hadn’t stopped Aidan worrying, and he wasn’t the only one.
Reuben had come to see him and Jase the night before, anxious that he’d blown his friendship with Isla by finally admitting how much he liked her. Jase had been the wise oracle again, telling his nephew that it was obvious to anyone who saw them together that Isla liked him just as much. But she had a lot going on, no one could deny that, and what they all needed to do was to give her space. If Reuben was finding that half asdifficult as Aidan was, his nephew had his sympathy, because the urge to reach out to her, and try to make everything better, was almost overwhelming. Except Jase was right. No one could do that, and knowing Isla, she’d end up trying to make them all feel better about it instead. She’d even pulled out of the fundraiser at The Pavilion, two days after Tash’s birthday, just hours before the event was due to start. There were whispered conversations between those who knew about her diagnosis, and who were concerned about why she’d cancelled. Amy had reassured them that Isla was fine, and that there’d just been some family stuff going on which she needed to focus on.
It wasn’t until the first time they were on shift together after the barbecue, he’d overheard Amy congratulating Isla on the birth of her niece and nephew, and he tried not to feel hurt that she hadn’t told him they’d arrived. He suspected it had been another attempt from Isla to protect him, worrying that talk about new babies would be hard for him to hear. He just hoped she knew him well enough to realise he’d be happy for her, and her family. A part of Aidan was frustrated too, that Isla was still putting everyone before herself. Worrying about how he might feel hearing baby news was typical of her, but she was shouldering the worry of her diagnosis because she desperately wanted to save her family any pain. That might be admirable, but she was in danger of hurting herself in the process. Everyone needed someone to lean on at times, and he was almost certain her family would want to support her given the choice. That’s what families were for; the good ones at least.
If Jase had been there, he would have told Aidan he was being overly sensitive, because of the message he’d got from his mother that morning, asking him if he was planning to come over for his father’s seventieth birthday celebrations. She’d also asked Aidan to send over any photographs and memories he had of special times he’d spent with his father, to go in the slide showhis oldest sister was putting together for the party. His mother clearly had no idea how strained his relationship with his father had been for years, or at least she pretended not to. The anger May had told him their mother felt towards Sean had clearly dissipated, and she kept saying she wanted things to go back to ‘how they were’ before his last visit, as if they’d been fine up to that point. But there were no special moments he’d had with his father, let alone any precious photographs, captured in the twenty years since Aidan had left home.
Thankfully it had been a busy shift, without too much time to dwell on anything, but without any life-threatening admissions to the department either, which could break his heart in an entirely different way. But then a cardiac call had come through on the hospital’s dedicated number.
‘There’s been a suspected cardiac arrest in The Sycamore Centre. A forty-three-year-old male, who’d brought his daughter in for an appointment, suddenly keeled over. Two of the staff from the centre are already doing CPR, but they haven’t been able to find a pulse.’ Aidan relayed the information to Zahir, and the well-oiled machine that was the A&E department swung into action.
‘We need a trolley, oxygen and a defib over there now and I want you and Isla to come with me. If he’s asystole, we’ll need to give him adrenaline to try and restore his heart to a shockable rhythm.’
‘We’re on it.’ Aidan exchanged a look with Isla who nodded. It would be quicker for them to go to the patient, rather than for him to be moved to A&E. They were the designated staff on shift, who’d undergone the necessary training to respond to in-hospital cardiac arrests. Once the patient was stabilised, they’d be able to transfer him, but for now the priority was to get his heart working again. At times like this, being a part of the team was almost like a well-choreographed dance, where everyoneknew their steps and no one missed a beat. It meant the three of them were over at The Sycamore Centre within minutes. Joe and Chooky were working on the patient when they arrived, desperately trying to save his life, but the look on their faces said it all. Aidan knew it was almost certainly over, even before he took in the grey pallor of the man lying on the floor of the waiting room, protected by a makeshift screen. All of the other patients had been moved out of the waiting area, and only the sound of a child crying could be heard in the otherwise eerie silence of the room.
‘That’s Mark’s daughter; one of the nurses took her into a consulting room when her dad collapsed.’ Chooky looked close to tears as her eyes met Aidan’s. Joe was still performing CPR, and he shook his head when Zahir offered to take over.
‘I can’t feel a pulse either.’ Zahir frowned. ‘But I think we should attach the defib to check.’
‘Did his daughter see what happened?’ Isla’s voice caught on the words and it made Aidan’s chest ache when he looked at her – she knew just how much this would hurt. Aidan had never had to face something like that, and yet it felt in some ways as though he’d been grieving the loss of his father for years.
‘She did and she was screaming at him to wake up.’ Chooky gave a shuddering sigh, as Aidan affixed the pads for the defibrillator. Moments later, the monotone voice of the machine stated that no shock was advised.
‘He’s asystole.’ Zahir shook his head again. ‘I’m going to administer some adrenaline and then we can check again. If that doesn’t work, we can try moving him to resus, or…’
‘We might have to call it.’ It was Aidan who voiced words that no one wanted to say. The idea of taking the man through the hospital, as they tried to continue CPR, while everyone they passed had a ringside seat, was unbearable. The chances of bringing him back, if the medication and ongoing CPRdidn’t work, were almost negligible, and the colour of his skin suggested he’d been gone before they even got there.
‘We might have to, but let’s give it all we’ve got until then.’ Zahir touched Joe’s arm. ‘You need to let Aidan take over now, you can’t keep this up.’
‘Okay.’ Joe finally stepped back as Aidan took over, while Zahir administered the potentially lifesaving medication, and instructed Isla to check whether anything had changed.
‘Any pulse?’
‘No, shall I see if the defib can pick up a trace?’
‘Okay.’
Aidan was certain he wasn’t the only one holding his breath as they waited for the verdict, but the monotone voice came back with the same conclusion: no shock advised.
It was a cycle that was repeated as they continued CPR and further doses of adrenaline. A specialist from the cardiac team arrived about ten minutes after the team from A&E, and she and Zahir discussed the use of other medication, but it was increasingly clear that nothing was going to work, and that Mark had probably been dead before he hit the ground. Even on the tiny chance that the other medications made a difference, the likely damage to Mark’s brain would be catastrophic.
‘I think we need to call it. Everyone in agreement?’ Zahir looked around, and every single person gave their agreement to the decision not one of them wanted to make.
‘Whoever said tea can make everything better was a liar.’ Chooky put down the cup she’d been holding.