These Are Our Children

by Julie Maxwell

Genres: General Fiction

Synopsis

Florence is pregnant and 99% sure it's her husband's. But it could be Thomas's. Thomas is a neo-natal doctor whose invention could save premature babies. Helen is a midwife grieving for her baby, lost before the technology was invented. This is a novel that explores what love can drive us to do; searingly funny, audaciously smart and devastatingly moving.

Release date: August 1, 2013

Publisher: RiverRun

Print pages: 249

Sample

The last time she knew anything about herself for certain, Florence was thirty-one years old and six-and-a-half weeks pregnant. The pregnancy, which she had confirmed by tests taken a fortnight before, was planned but it surprised her anyway. After so many years of protected sex, it was faintly astonishing to discover that the method actually ‘worked’.

‘No surprise to me,’ Robert had said, grinning triumphantly, when she emerged from the bathroom.

But to Florence it was as if a long-suspected theorem had finally been proven. Public opinion was right about something at last. The rumours were all true. In less than nine months, Florence Brown, curator of the museum that combined the treasures of Little Dillyford with those of Greater Dillyford, would have a baby of her own.

Now, however, the six-and-a-half-week pregnant woman found herself sitting in a hospital emergency room twenty-four miles away.

‘One of your fallopian tubes may be about to rupture,’ the consultant surgeon said.

He spoke quite casually. Then the consultant surgeon decided to take his patient’s pulse. Placing his thumb firmly across Florence’s left wrist, applying a pressure that was soon slightly uncomfortable, he glanced at his watch, closed his eyes, and after a short interval looked again at the watch.

‘It’s rather high,’ he said. ‘A high pulse can be a sign that the tube is about to erupt.’

(A high pulse can be a sign you’ve been told you might explode imminently.)

‘What are the other signs?’ Florence asked, as the surgeon took his seat behind the desk.

‘Yes, what are the other signs?’ echoed Florence’s mother Lydia. An effort to contribute which only gained her an impatient look from Florence.

The surgeon, a second-generation Kenyan, tilted his head in the direction of speech like a mannerly daisy. His patient’s hair was dyed a childlike white-blonde. She had very large breasts that were slightly squashed by her salmon pink shirt.

He answered her gravely: ‘Severe abdominal pain.’

‘But I’m not in pain!’ Florence objected.

(And an absence of pain can be a sign that there is nothing wrong with you.)

The surgeon, however, only looked at his patient so very pityingly that Florence thought she must be deceiving herself.

‘No,’ he agreed, nodding, ‘no you’re not in pain, as such, but …’

Florence waited rather neutrally for the surgeon to explain. Not for the first time, she had begun to feel at some remove from her own life, as though it were all happening, in reality, to some other person. Who just happened to reside within the confines of her own body. As though she were merely a spectator of the farce rather than – as she had so often allowed herself to believe – its central participant.

‘But,’ the surgeon continued, ‘it may be that you’ve got rather a stoic disposition. It may be that the pain is worse than you realize because you have such a high pain threshold. Sometimes patients are like that.’

Florence was in fact a naturally hypersensitive and alarmist character. Momentarily, however, she was so pleased by these compliments about herself – her distant self, that familiar companion – that she felt almost convinced of the surgeon’s judgement. She saw herself newly revealed: Florence Brown, woman of strength and fortitude.

‘And tell me again about the bleeding. How would you describe it?’

Last night: Worcester sauce. This morning: mulled wine. Ten minutes ago: filmy, like the skin that forms on boiled milk.

‘Tell him about the Roman milk pan,’ Lydia intervened. ‘My daughter is a curator.’

‘Okay, well, I’d like you to be scanned as soon as possible, Mrs Brown. That all right?’

So Florence and Lydia were hurried out to wait in the corridor lounge. They resumed their seats beside the unstaffed emergency reception ‘desk’ – merely a stool and whiteboard with ‘Urge Gynae’ written in small curly green letters. Opposite were two doors: Ultrasound 2B and Breastfeeding Counsellor. Ultrasound 2B opened and shut regularly as patients were called to their appointments by the sonographer, a woman in a ballet cardigan, who smiled blindly at the waiting room audience, nose wrinkled like a small friendly mammal, and leant her left hand heavily against the door handle. Breastfeeding Counsellor, the other door, was permanently open and empty, allowing Florence and Lydia to observe a green carpet, two matching pictures of the seaside and a straw-weave basket whose homeliness was evidently considered an aid to lactation. Every so often, a large midwife sailed past.

‘Well, you never know, you see,’ Lydia said, referring to her growing certainty that the very next person to appear in the corridor would be ‘that Professor’ she had read about last Thursday in the paper. ‘Didn’t you meet him once?’

Florence nodded weakly. She could see that her mother felt vindicated.

‘And he’s a widower,’ Lydia added. ‘Which is very sad.’

But the Professor of Neonatology was out of the hospital, giving a press conference, so the scene that Lydia had imagined did not arise. Instead they watched as dismal refreshments arrayed on two brown tea trays – Cornish pasties with dinosaur spines, white bread sandwiches that sagged and smeared their cling-film wrappings over-intimately – were sold, or rather not sold, from an aperture with a redundant rain canopy. Florence had already eaten. They decided to share a pot of tea for one, and to stave off the terror with a little humour. As they took turns with the cup, each time positioning it to avoid the other’s lipstick trace, they kept repeating, in significant whispers which slightly thrilled them both, what the surgeon had said. As though they had not both been there at the time.

‘He said the high pulse could be a sign the tube is just about to erupt.’

‘And the pain may be worse than you realize.’

Since they were both capable of going on like this for hours, days even, about the most mundane events, the pair had a sense of the remarkable luck, the heaven-sent gift, as it were, of this plentiful new material.

‘Actually, Flo,’ her mother teased, ‘you may have quite a severe case of Stoic Disposition.’

But they were cut short forty minutes later by the announcement of Florence’s name.

‘Florence? Florence Brown?’

With a sense of having been called to the podium, Florence and Lydia rose.

In the small dark room Florence sat by a desk with a Gestapo lamp and was asked to confirm her DOB as 22.03.92 and supply her LMP. The light was making her eyes water.

‘1992!’ Lydia interrupted with mild outrage. ‘I’d have been fifty by then!’

‘It’s not ‘92,’ Florence explained, blinking. ‘My date of birth is 22.03.77. What’s an LMP?’

‘First day of your Last Menstrual Period,’ the sonographer replied, offering Florence one of the small blue boxes of tissues – a new one for each patient – piled neatly towards the back of the desk.

Florence pulled away the cardboard oval – easy enough. After some further effort, however, she seemed to be holding only the remnants of a former tissue. Then a great clump of the tissues emerged all at once, in one solid impenetrable fold.

‘Do you know what date it was? Your LMP?’

The woman looked up encouragingly from her notes, and smiled so hard she seemed to have to shut her eyes at the same time.

‘Oh!’ Florence was sure about this one. It was the twenty-third of April, the day the builders started.

‘So that would make you …’

The sonographer took a second to calculate. She wrote down a strange fraction – 6/40 – then stood and walked to the other side of the room. Using both hands she ripped a very wide sheet of pea-green paper energetically from a dispenser on the wall. The action was almost unnerving. Laying it over a thin maroon plastic mattress, she directed Florence to lie down on the table and pull up her shirt. The paper was slightly abrasive against Florence’s palms. The patient shut her eyes and heard a jangling sound. It was the skating of metal rings on the metal pole, almost indecently joyful, as the woman drew a shower curtain across the length of the room. Just in case, she explained, anyone should happen to come in. Then the woman washed her hands and there was something like a small foghorn blast as the leg of a chair was pushed back. Really, Florence wanted to think of something other than what was happening. Alas, this only brought her to thoughts of Andy.

Andy Hunt was the owner of MyBuild, the recently established local company that Florence and her husband Robert were employing for the renovation of their Victorian home. And MyBuild, as Andy had explained to Florence on the first day, were setting out not only to transform individual properties and sites into domestic dwellings of exceptional character, but to transform the building trade itself. Unlike other building companies, they would not fail to turn up for work without notice. They would not leave you in the lurch with unfinished projects. They would not spend half their time on another job. Florence was pleased and everything was promising: the builder’s frankness, his way of nodding confidently and laughing loudly, of moving his head and long neck about, very deliberately, as though expressing his grasp of the whole scope of the undertaking and exactly what it would take to achieve it. And of course his name, Andy, which encouraged confidence in an inevitable ‘handiness’. Even, indeed, the builder’s unexpectedly thin legs, in particular his ridiculous bony knees in their ridiculous shorts (clean pale denim, with proper sewn hems, not torn-off ends), spoke an appealing vulnerability that seemed decently English and home-owning. He looked as if he were welcoming you to his family barbecue. In short – and this was what Andrew really traded on – he was middle class. He was not gruff and rough. Homeowners could feel that it was more or less their own, well brought-up son working away quietly at the new patio or porch.

But now MyBuild had failed to turn up without notice, left them in the lurch without a toilet or a shower, and spent half their time on another, more lucrative project up the road. The day before yesterday, Andy was good enough to call in long after working hours (twenty past three) to explain why.

Firstly, he re-emphasized, it was not because they were just like all the other companies around.

‘I wouldn’t want you to think that. Because that’s really not it. And it would be such a pity if you thought that, after the good start we’ve had here. The thing is …’

The thing was: they weren’t, generally speaking, like other companies. They had just – exceptionally – appeared to behave like other companies, in this one, particular, sad, unfortunate instance. She understood that, didn’t she?

‘Are you cross?’ Andy asked finally. ‘Because I’d understand if you are. Are you cross and you don’t like to say?’

Florence had shaken her head as gently as she could manage. Andy’s moods were delicate and she did not want to give him an excuse not to return at all. Two weeks before, he became depressed by one of the folding French doors that were being stored under tarpaulin. He took it badly when four panes of the ‘historic’ glass (they had paid extra for glass that deliberately warped the view) shattered following an accidental encounter with his drill. Then he left for the rest of the day. So, in the interests of forward progress, and because she had never been any good at confrontation anyway, Florence consoled him with coffee from her Thermos. She listened as he confided that he had recently become the victim of his own success: now that his small business was earning more than ever before and he could draw a larger salary, he would soon have to pay income tax at the higher rate.

‘It’s like,’ he’d said slowly, frowning, as though trying to express a very difficult formula in words, ‘the harder I work and the more I earn, the more I’m being penalized, you know?’

Florence nodded sympathetically at the injured party, poured herself another cup of coffee and moved onto a second chocolate digestive. She heard more about the victimization of the British entrepreneur, and about MyBuild restoring – or rather, introducing, perhaps for the first time in its history – customer relations, customer choice and customer power to a profession notorious for its rudeness, dogmatism and inefficiency. She wondered, not for the first time, whether a surly manner might in fact be necessary for success in the building trade. Whether class might be inversely proportional to competence, after all.

‘Chris should be here soon,’ Andy added. ‘So hopefully we’ll be able to crack on. I hope you don’t mind me telling you all this. It’s just that I want you to know there’s a very good reason for what’s been happening here.’

Or not happening. After Chris arrived, Florence had heard some drilling – that was good – followed by a great shout of ‘Oh fuck! It’s leaking everywhere now!’

Yes, it would be better not to think of Andy or Chris or what could happen on a building site. She thought instead of her GP, who had sent her here this morning after their brief telephone conversation. ‘Yes, I’m afraid it could be a miscarriage, Mrs Brown, because of the bleeding, and in this early type of miscarriage’ (there were types? Apparently there were types) the ‘issue’ would be much like an ordinary period. There would be no discernible body parts – the point Florence had particularly wanted to clarify. But it would be better not to think of her GP either. The woman was elegant but unreliable. All of the books on the shelves in her office were called things like Medicine – At A Glance, Prescribing Without Peril, and Doctoring In A Day. And her watercolours were of louring navy skies and unpredictable shafts of light.

Reluctantly Florence’s thoughts now returned to the monitor on her right and the woman who was quietly looking, clicking, moving – sometimes perched on the high chair, sometimes standing in her ballet pumps. With the scan stick she applied varying amounts of pressure to Florence’s belly: it was like being investigated by an unusually inquisitive roll-on deodorant. After a few minutes she switched to a transvaginal probe in the hope of obtaining a clearer image. Lydia occupied a hard plastic chair to the left and offered bolstering smiles whenever Florence turned in that direction. Surely, Florence reasoned, the consultant surgeon was wrong. Her alarm at his words, her shooting pulse, had been momentary. Hopefully, hopefully the ultrasound scan would show that she was, despite the bleeding, still pregnant. She felt a surge of weepy joy at the idea. On the other hand – she said to herself, thinking it might be best not to get her hopes up too much – perhaps it would show that she had miscarried. This news would be sad but she would do her best to think of the scan as a sort of reverse pregnancy test – and try again next month. She had always liked to think of herself as a pragmatist.

‘And you were very sure about your dates, weren’t you,’ the woman said, ‘which would make you about six-and-a-half weeks?’

Florence nodded apprehensively.

‘Well, I can’t see anything that would correspond to that. Look for yourself,’ she said, almost challengingly.

And so Florence looked at the monitor for the first time. It was true that the image did not in any way resemble the six-week-old embryo like a cashew nut she had found a few days before on the internet. She could make out the large, upside-down, partial cone shape, like the area cleared by her rear windscreen wiper. But as for what lay within those parameters – well, Florence Brown could make no sense of that at all.

‘The womb certainly looks pregnant,’ the sonographer continued. ‘But what I’m seeing …’

With the very tip of an elaborately painted nail she pointed to a tiny spotty white area around an even tinier black hole. Florence tried to peer more closely, even hunched her shoulders, feeling surprised that they were really making a serious attempt to look at such a confined and minuscule area of the image. Surely one might as well examine outer space without a telescope.

‘That might be a pregnancy sac of about four weeks, okay?’ the sonographer explained.

‘But the test?’ Florence objected for the second time that morning. How feeble her protest sounded. ‘The test showed I was pregnant then.’ Pregnant, that was, with her husband Robert’s baby. A pregnancy that should now be six-and-a-half weeks.

‘Was it a very faint line?’

‘No,’ Florence replied, feeling increasingly agitated.

No, it was not. It was a thick blue indelible cross. Then she’d tried another brand and it was two pink lines – the universal sign, she fancied, for twin girls. One line was, admittedly, ever so slightly weaker than the other: but that must be the twin with the hypersensitive disposition like herself. Or perhaps the thicker line was the one with the stoical disposition like herself. Finally, when she used the most expensive of the tests, it had made the unambiguous statement ‘Pregnant’.

‘To get a positive result you must have been at least three-and-a-half weeks at the time you took it,’ the sonographer said thoughtfully. ‘But …’

But: there it was again.

‘But this could be another pregnancy.’

Suddenly the woman looked excited, she looked as though she might pirouette, and it was always worrying when you excited the medical profession enough for them to pirouette. Florence could see the words ‘Case Study’ shining in the woman’s eyes, closely followed by ‘Clinical Trial’, ‘Research Cluster’, ‘Conference Paper’, and ‘Peer-Reviewed Dissemination Streams’. She turned to her mother, who looked equally pleased. Whether it was a four-week or six-week-old granddaughter was surely immaterial.

‘Is that – possible?’ Florence asked in disbelief.

‘Oh yes,’ the sonographer continued, smiling as she had when she first opened the door. ‘You could have been pregnant at the time of the test, and at some later point your body absorbed – ’ she laid strange and unaccountable emphasis on this word – ‘that pregnancy and then you fell pregnant again.’

The woman seemed weirdly thrilled by this idea of Florence’s cannibalistic, infanticidal womb machine, and repeated the word ‘absorbed’ in one or two further sentences to the same effect. Florence hadn’t realized that such things were possible. And Lydia definitely hadn’t. No, in Lydia’s day, you had sex the once or maybe it was twice, you began to vomit, and nine months later you no longer had a bathroom but a small launderette dedicated to servicing terry-towelling nappies. Suddenly, however, impregnation seemed less like a bodily event and more like a complex legal proceeding, with unfamiliar loopholes. Florence regretted not having taken professional advice about all of the possibilities first.

If it was four weeks, then it was Thomas’s. Thomas Marvelle – the Professor her mother knew only from the paper – and all the expertise that Florence could ever have wanted. And if it was Thomas’s …

‘Of course,’ the sonographer added, cutting across these thoughts, ‘I can’t be sure that what I’m seeing even is a pregnancy sac. There are all sorts of explanations. All sorts of possibilities we need to look into.’

All sorts? How many could there really be?

‘What worries me now,’ the woman continued by way of example, ‘is your right ovary. I can definitely see an eighteen millimetre growth there.’

She pointed to the evidence but again Florence could only take her word for it.

‘So what we could be looking at in the uterus is not a four-week pregnancy at all, but a pseudo-sac.’

She paused significantly.

‘A what?’ Florence asked.

‘A pregnancy sac that’s empty, because the pregnancy – the real embryo – is somewhere else.’

Lydia looked perplexed by the idea that her grandchild might be discovered, in the end, up one of her daughter’s nostrils or curled around an eardrum.

‘You mean like an ectopic pregnancy?’ Florence asked, beginning to realize her situation.

She knew that an ectopic pregnancy occurred when the embryo implanted itself in the wrong place. Usually, as the consultant surgeon had speculated an hour earlier, it misplaced itself in one of the fallopian tubes. Meanwhile another, empty, pseudo-pregnancy sac continued to grow in the womb, sometimes for several weeks. But just occasionally, when there was someone like Florence around to provide the medical profession with variety, an ectopic embryo was discovered in an ovary instead.

‘Once,’ the sonographer said dreamily, ‘we found it in the bowel.’

Whatever the location of the ectopic pregnancy, it was a medical emergency and the embryo could not be saved. ‘In nature,’ Florence had often heard Thomas say, ‘an ectopic pregnancy is a disaster; in science, however, it’s a solution.’

‘Yes exactly,’ the sonographer replied. ‘An ectopic pregnancy. You’ll have to discuss your options with one of our surgeons.’

Professor Thomas J. Marvelle was notorious for writing F*ck On, a popular bestseller in the science of sex with an accompanying video. It made him a fortune. However, he would be remembered for inventing Wet Incubation – one of the greatest advances in medical technology that the twenty-first century would see.

This new technology was the most important development in neonatal medicine for decades. Everyone in the department thought that the Professor would surely be a candidate for the Nobel Prize. In the early years of the Wet Incubator’s history, however, before it was adopted in hospitals throughout the Western world, Thomas had no illusions of glory. Whether his work took the form of a clinical experiment, journal article, or even, like The Survival of the Foetus, a book for general readers published to coincide with today’s formal announcement of Wet Incubation to the world, this rule held infallibly true: it was always flawless and always denounced. Faultless and at fault. Usually, as the regional journalist who was the first to get hold of the story would say, it had been widely denounced. That was the trouble with being a man of genuine brilliance and professional integrity: Thomas’s enemies were like his skin tags – acquired with ease, self-multiplying, and never truly shed. But nothing in his long and difficult career would ever compare to the controversy that surrounded Wet Incubation.

The Wet Incubator solved the problem of lungs. Florence remembered his explanations, which were always lucid and very certain. Extremely premature babies – especially those born before the twenty-fourth week of pregnancy – could not survive outside of the maternal body principally because their lungs were undeveloped. The lungs were the last major organ of the body to reach an adequate capacity in the womb. There were other problems of severe prematurity, of course, like low immunity, but having nothing to breathe with was, he said, the main obstacle. Infant Respiratory Distress Syndrome (RDS) had been at the centre of neonatalogical research for over half a century. After RDS claimed the brief life of Patrick Bouvier Kennedy, the firstborn of First Lady Jacqueline Kennedy, neonatology had developed into a fully professional and well-funded branch of medicine in the . . .