Rivals In Practice

‘Have you checked the foetal heartbeat?’

Wendy nodded. ‘Nothing’s changed. There’s no sign of foetal distress.’ She grinned at Jennifer. ‘Only the maternal variety.’

Jennifer sipped her tea thoughtfully. ‘At this rate Liz is going to be worn out well before we get anywhere near the second stage. If I’d sent her into town yesterday she could have been managed more effectively. They could have speeded things up and done a Caesarean if a forceps delivery failed.’

‘Liz wanted to wait to give Peter a chance to get home,’ Wendy added. ‘She was quite pleased when things ground to a halt. Are we likely to run into trouble, do you think?’

‘I hope not. It’s been a while since I did a forceps rotation and delivery, though.’ Jennifer glanced towards the small kitchen window as a wave of hail assaulted the glass. ‘I’m worried about the road being cut off. Having that on top of a potential complication makes us feel rather isolated. Let’s just hope the baby decides to co-operate and turn itself around.’

Wendy followed her glance with a grimace. ‘It’s probably snowing on the hilltop by now.’ She looked at her watch. ‘I’d better go and check on Liz after I’ve given this to Mrs D.’ Wendy picked up the plate with the chocolate biscuit. ‘Then I’ll take Brian a cup of tea. He wasn’t in the office when I went past.’

‘I’ve sent him home.’ Jennifer caught Wendy’s surprised expression and smiled a trifle grimly. ‘He’s getting angina again.’

‘Oh, no!’ The biscuit was in danger of sliding off the plate. ‘How bad is it?’

‘Hard to know. I suspect Brian hasn’t lost his touch at hiding symptoms. I checked him out and I’ll do another ECG in the morning, but I didn’t want him here just in case things do get busy.’

A faint noise reached the women above the howl of the midwinter storm. A noise that rose and fell with an easily recognised urgency. The warning siren was used to call the local volunteer fire officers in to their station. It was unlikely that their fire-fighting skills would be required right now, however. Far more likely that their role as first responders for ambulance or rescue work was being summoned. Even while the noise was being registered in the kitchen, a much closer signal sounded.

‘That’s the surgery bell. Shall I go?’ Mrs D.’s biscuit was abandoned on the bench.

‘No, I’ll go.’ Jennifer tipped out the rest of her tea. ‘You stay with Liz.’ She looked over her shoulder as she moved to the door. ‘And could you ring home for me when you’ve got a minute? I still haven’t checked on the children.’

The large man standing in the tiny waiting room was wearing an oilskin parka that streamed water onto the linoleum floor. He held one hand clutched to his chest and well-diluted blood was staining the rapidly growing puddle. ‘John! What’s happened?’ Jennifer held open the door of the treatment room. ‘Come straight in here.’

‘It’s a bit of a mess, Doc.’ John Bellamy sat down heavily on a chair as Jennifer pulled gloves on and reached for a pack of sterile dressings. ‘I was just making sure the boat was secure and this wave rolled right over the deck. I landed in my tackle box.’ His face twisted as Jennifer moved his hand to place it on a towel on the bed beside him. She pulled the head of the angle lamp out from the wall and clicked on the light. ‘I got one of the damned hooks out but there’s another one that’s too deep.’

‘Sure is.’ Jennifer looked at the fish hook buried in the calloused pad below John’s thumb. ‘And you’ve got a nasty tear where you pulled the other one out. It’s going to need a stitch or two. Let’s get your coat off and make you a bit more comfortable first.’

‘No point in getting dry.’ John shook his head firmly. ‘I need to get back and keep an eye on the boat. The tide’s not full in yet and we’ve got waves breaking on the road already.’

Jennifer was drawing up local anaesthetic into a syringe. ‘It’s going to be too dangerous to be anywhere near the boats, then.’ She looked at her patient with concern. ‘You’re not thinking of getting back on board, I hope.’

John shook his head wearily, releasing more droplets of water from his grizzled hair. ‘I just need to watch,’ he said quietly. ‘That’s my livelihood out there.’

‘I know.’ Jennifer’s tone was sympathetic. ‘Let’s hope things don’t get any worse.’

The surgery bell rang again just as Jennifer eased the fish hook from the incision she had made with a scalpel. She pressed a sterile gauze pad over the wound. ‘Hold that on for a second, John. I’d better see who that is.’

Two women stood in the waiting room. The younger woman looked anxious. ‘Mum’s had a fall, Dr Tremaine.’

‘I couldn’t see a thing when the lights went out!’ The older woman sounded annoyed. ‘I tripped over the coffee-table.’

‘Were you knocked out?’

‘No, but I’ve cut my leg and you know what my skin’s like.’

Jennifer nodded. Edith Turner had been on steroids for years to treat her lung condition. Even a slight knock could tear her papery skin badly. Judging by the blood-soaked towel around her lower leg, this accident had been more than a slight knock. She touched the towel to find the stain almost dry.

‘It’s stopped bleeding, anyway. Take a seat in the consulting room and I’ll be with you in a couple of minutes. I’ve just got a few stitches and a dressing to take care of.’ Jennifer was debating whether to open the internal door from the waiting room to call for Wendy’s assistance when the outside door opened again.

‘The front driveway is completely blocked!’ a cheerful voice informed Jennifer. ‘So I had to come in this way.’

‘Margaret!’ Jennifer was delighted to see another of her senior nurses. The uniform the older woman was wearing was a surprise. ‘You’re on night duty. You’re not due in for hours yet.’

‘Thought you might need some extra help what with this weather.’ Margaret Coates pulled a clear plastic hood clear of her grey hair.

‘You’re an angel,’ Jennifer told her. ‘Can you take Edith in to the consulting room and have a look at her leg? You might need to soak that towel off. I’ve got a bit of stitching to finish in the treatment room.’

The last stitch in John’s palm was being tied when Wendy came into the room. ‘Contractions are back to ten minutes apart,’ she reported to Jennifer. ‘Liz is asking for some pain relief.’

‘I’ll go and see her. Could you dress John’s hand? Put a plastic bag over it all when you’ve finished so it doesn’t get wet. John wants to go and have another look at his boat.’ Jennifer stripped off her gloves and stood up. ‘Did you get hold of Saskia?’

‘Sorry, the phone lines seem to be out.’ Wendy was ripping the covering off a crêpe bandage. ‘I’ll try again later.’

Margaret signalled to Jennifer as she stepped into the hallway. ‘Edith’s got a nasty avulsion,’ she said. ‘And the skin flap’s all scrunched up and torn.’

‘Put a moist dressing on it,’ Jennifer directed. ‘I’ll come and sort it out in a few minutes.’ She moved quickly towards the door further down the hallway as the surgery bell sounded again. Jennifer paused for a second, not wanting to enter the maternity suite until she was able to focus completely on her patient. Her level of tension needed lowering.

If the phones were out there was no way of ringing home, but Saskia was far more responsible than most girls her age. If there had been any problem getting all the children home safely, she would have found some way to contact Jennifer on her mobile. She could reach Brian on his own cellphone if absolutely necessary but calling him in to help deal with a stressful influx of casualties was the last thing Jennifer wanted to do. Wendy and Margaret were both very capable nurses. Surely even this storm couldn’t throw anything at them more than the three medical staff could deal with. There was nothing life-threatening about the injuries arriving so far and as long as Liz’s labour was straightforward, they should be fine. Jennifer took a deep breath and entered the maternity suite.

‘Sorry to have been gone so long, Liz,’ she told her patient cheerfully. ‘Let’s have a look at you and see what’s happening.’

Ten minutes later, Jennifer headed back to the treatment room. Wendy and Margaret now had Edith on the bed.

‘I’ve had a go at straightening this flap.’ Wendy looked up, the tweezers poised in her gloved hand. ‘What do you think?’

Jennifer eyed the wound. ‘Couldn’t have done better myself. Could you dress that, please, Margaret?’ She waited until Wendy had dropped her gloves into the rubbish bin near the door. ‘Liz is about six centimetres dilated so she’s definitely in labour. I’ve set up the Entonox for her to use for pain relief but it’s better if she keeps moving at the moment. Can you stay with her?’

‘Sure.’ Wendy nodded. ‘Sam McIntosh is in the consulting room with his mother. He needs looking at.’

‘What happened?’

‘Apparently the wind caught the garage door and it hit him on the head. Possibly unconscious but only very briefly. He seemed fine but rather quiet. Jill got worried when he vomited about half an hour ago. Looks like concussion.’

Jennifer knew Sam well. Six years old, he was the same age as the twins. Sam lived just down the valley from Jennifer’s property and often came to play after school. He looked pale and unusually subdued at present.

‘I’m going to shine a bright light in your eyes,’ Jennifer told the small boy. ‘Try and keep them open for me.’

She managed to complete a full neurological check and reassure Sam’s mother before another interruption occurred. This time it was her cellphone. The flash of panic that something had happened at home intensified when the caller identified himself as Robert Manson, one of the local fire officers.

‘We’ve got an accident near Barry’s Bay.’ Robert’s voice was difficult to hear over the crackle of static and the background noise of the weather and people shouting. ‘We need you on scene, Jennifer.’

‘How bad is it?’ Barry’s Bay was well away from the route the children would have taken and they had probably been home for hours by now.

‘We’ve got one of the drivers trapped. He’s unconscious. He’s the worst but we’ve got a couple more patients.’

‘I’m on my way.’ Jennifer moved fast. She was donning over-trousers and her oilskin parka by the time Wendy found her.