Nurse, Nanny...Bride!

Maybe she hadn’t believed any of it but allowing Andrew to think she might have was possibly the only defence she had.

They both had something they didn’t want their colleagues to know. Things they didn’t want to lose. Alice was more vulnerable. She had something she didn’t want Andrew to know, as well. It was good that he’d chosen not to acknowledge her. Distance was safe and, if it stopped being safe, then she was prepared to fight, if that was what it would take to protect herself.

Andrew’s gaze was steady. So was he, it told her.

For the moment at least, this appeared to be a standoff.

This was a disaster.

Alice clearly knew a lot more than he would have expected. Was she still in touch with old friends in London? People who would be only too happy to gossip about a police investigation involving a consultant emergency physician? That she knew too much was as unfortunate as knowing he was perpetuating a lie by letting her think he still believed the worst of her. But what else could he do?

He’d come this far and had found what appeared to be the perfect place for himself and Emmy. They’d only been here for a little over a week but he’d never seen his daughter so happy. He knew he’d made the right decision despite how hard leaving had been. Running away from it all had gone against the grain so hard it had been painful. An admission of defeat that some would probably interpret as guilt, but he’d done it for his daughter. He wasn’t going to let his little girl grow up anywhere within reach of a tainted past.

He couldn’t keep running. The world of medicine was surprisingly small and, no matter where you went, someone always knew someone else. Look at the way Dave had contacted him about the possibility of this position when they hadn’t seen each other since a short stint in an American hospital together ten years ago.

Andrew was between a rock and a hard place, here. Damned by his conscience whichever way he turned. The unwanted distraction filled his mind as he waited for Janine’s X-ray views to appear on the screen in front of him. Should he follow his first instinct and simply talk privately to Alice? Tell the truth and then apologize? Lay his cards on the table and ask for her help?

Why would she want to do that? She’d not only lost her job. When he’d heard that she’d left the country, he’d also heard that the sale of her house had been forced by the bank. That she’d lost everything. He could have talked to her then. Tried to make amends, even, but nobody had seemed to know where she’d gone. And then the real trouble had started and he’d forgotten everything other than trying to survive. To keep Emmy safe.

What could he say now? An excuse that he couldn’t have simply taken her word for her innocence and an apology for any inconvenience caused was hardly going to clear the air. It might actually make her jump at the chance for revenge.

The notion was jarring. It didn’t fit with the Alice Palmer he remembered from five years ago. The attractive, competent nurse working in his emergency department. A young woman doing her O. E. who’d made friends with his fiancée. Who’d come to their wedding, in fact. She’d been good at her job. Caring. The evidence that she’d been stealing morphine and other restricted drugs had been shocking. Unbelievable, really, but you never knew with women. Look at how things with Melissa had turned out.

Oh, God…No! Andrew rubbed his temple and then raked his fingers through his hair. He didn’t want to think about Mel. Or London. Or any of what had been left behind and that was why working with Alice Palmer was a complication he didn’t know how to resolve.

Images began appearing on the wall-mounted computer screen. It was a relief to focus as he scrolled through them. The cheekbone probably needed wiring. The nasty fragmented fracture of the radius and ulna would require surgery. Orthopaedics were on the way and someone from plastic surgery should be contacted to deal with the facial suturing that could be done in Theatre as well. Andrew turned back to Resus 1. He had a job to do here. His patient needed care. And protection. A delicate situation when he couldn’t know whether it might make things worse for Janine by encouraging her to lay a complaint about her boyfriend.

Alice would be in Resus 1 as well. Another delicate situation and Andrew needed more time to try and figure out what he was going to do about it. Maybe he could buy time by putting some distance between them. Adjust his shifts, perhaps, so they spent as little time as possible in the department together?

No. Why should he have to do that? He was a senior consultant in this department now and he needed to start the way he intended to carry on. Alice was a nurse. A very good nurse, probably, but as far as a balance of power went, it was weighted firmly on his side. An advantage that Andrew couldn’t afford not to use. He needed to take control and make sure he kept it.

The department was relatively quiet for a long time after Janine had been taken to Theatre. Downright boring, really. Alice was looking after an epileptic man who was sleeping off the post-ictal phase of his seizure, a diabetic patient from a rest home who needed her insulin dose adjusted and another very elderly incontinent woman, Miss Stanbury, who was still suffering the effects of a gastric disturbance and needed rehydrating and frequent changing.

When an ambulance brought in a forty-year-old man with a markedly accelerated heart rate, Alice was more than ready to take on the case.

‘This is Roger,’ the paramedic told her. ‘Narrow complex tachycardia. Rate 196. Oxygen saturation ninety-eight per cent. No cardiac history.’

Roger looked pale and frightened but he wasn’t in the kind of danger he would have been in if the spikes on his ECG were wide enough to suggest the ventricles of his heart were in trouble. Alice enjoyed cardiology. She could read a twelve lead ECG better than most junior doctors and she particularly loved this kind of case. One where a dramatic result and relief for the patient could be provided.

‘Have you got any chest pain?’ she asked Roger.

He shook his head. ‘I feel a bit short of breath, that’s all. And I can feel my heart.’

‘Have you ever felt it going this fast before?’

‘No.’

Alice helped the paramedics transfer Roger to the bed in Resus 2, where they had good telemetry facilities to monitor his heart. She raised the back of the bed so their patient was sitting up, which would help his breathing effort. Jo came in as she was transferring the oxygen tubing from the portable cylinder to the overhead outlet.

‘SVT,’ Alice told her. ‘Is Peter around?’

‘No.’ Another figure pushed through the curtains as the paramedics took the stretcher out of the small area. ‘I’ve got this case.’ Andrew was holding the patient report form the ambulance crew had supplied. A long strip of pink paper recording the cardiac rhythm en route was attached to it and he was looking at the monitor beside the bed as he spoke.

He introduced himself to his patient, who was still looking alarmed.

‘Am I having a heart attack?’

‘It’s one of the possibilities we’re going to investigate,’ Andrew told him. ‘But, so far, we’re not seeing any sign of it. Your heart’s going a bit too fast to really see what’s happening so we’re going to try and slow it down for you. Try and relax.’

Roger made a sound like a strangled bark of laughter and Andrew’s smile was sympathetic.

‘I know. Easy for me to say, standing on this side of the equation, isn’t it?’ He touched his patient’s arm. ‘I know this is scary but we’re on the case and you’re in the best possible place to get things sorted.’

His smile and his touch had a visible effect on Roger, who lay back against the pillow with a sigh and a nod.

They had a hopefully invisible effect on Alice.

This was a glimpse of the real Andrew. How many times had she seen the effects of this man’s words and smile and touch? She hadn’t really been aware of how nobody else quite measured up to the standards Andrew Barrett had set. Or how much she’d missed working with him.

Until now.

Andrew had turned to Jo. ‘Got a straw handy?’

‘Sure.’

‘And grab a technician to come and do a twelve lead, will you, please?’

‘I can do that,’ Alice said quietly.

‘Fine. Go ahead.’ Andrew was pulling on gloves. ‘I’ll get the bloods off.’

Alice could have managed that as well, but maybe the consultants were also finding their day somewhat dull. She pulled the machine she needed from the corner and began attaching all the electrodes needed to get a complete picture of the electrical activity of Roger’s heart.

Jo was cutting a short length of plastic straw.

‘I want you to take a deep breath,’ Andrew instructed Roger. ‘Seal your lips around the straw and then blow through it as hard as you can for as long as you can.’

A valsalva manoeuvre was one of the dramatic ways to get this kind of cardiac arrhythmia to revert to normal. They all watched the monitor screen as Roger’s face reddened with the effort. There was no change to the rate.

‘Get your breath back,’ Andrew said. ‘And then we’ll give it another go.’

The respite gave Alice a chance to get the twelve lead ECG. The electrodes were all in place.

‘Try and keep as still as you can,’ she asked Roger as she pressed the start button.

But he was too out of breath to comply and the trace was nothing like the clean image Alice had hoped for. Dammit! She screwed up the sheet of paper, hoping that Andrew wasn’t watching.

‘Let’s try that again,’ she said calmly. ‘If you could manage to hold your breath for just a second or two while the machine captures a picture, that would be great.’