The Surgeon's Engagement Wish

A burly man wearing an orderly’s uniform was standing with his arms folded by the head of the bed, and an equally solid man in police uniform stood in an identical pose at the foot. They both gave Beth a curious stare.

‘Gidday,’ the orderly said. ‘You’re new here, aren’t you?’

‘This is Beth,’ Chelsea told them. ‘It’s her first shift tonight. Beth, this is Sid and that’s Dennis.’

The nods and smiles from the two men were both welcoming and sympathetic. Not a great way to start a new job, they conveyed, but they were pleased to meet her and would make sure she was safe. And Beth smiled back. Suddenly things didn’t seem nearly so disheartening. She would never have been introduced to members of security back-up in her old department and they certainly wouldn’t have made any non-verbal promises about making sure she was looked after. Working in a small community was going to be different.

Better.

‘Who’s on call for surgery tonight?’ Mike’s query broke an almost companionable silence.

‘Luke,’ Maureen told him.

‘Good. He won’t mind being woken up.’

‘Can you call him in, please, Chelsea?’

‘Sure.’

Beth watched as Chelsea headed for the wall phone. She knew there were five surgeons associated with Ocean View hospital. Three general and two orthopaedic. What were the odds that one of them would end up being called Luke?

And how many other reminders would there be for her tonight to let her know that you could never really escape the past and make a brand-new start? Beth shook herself mentally, bending over to pick up packaging from dressings and IV gear that littered the floor.

For heaven’s sake. It had been six years ago. It was pathetic that hearing that particular name could still have any effect on her. And it was weird that it was so much stronger tonight than it had been for a very long time. Maybe that was just because she was displaced. Feeling a little lost in a new environment and seeking links with her past to anchor herself.

‘He’s on his way,’ Chelsea reported. ‘Do you need theatre staff called in?’

Mike angled the ultrasound probe in a new direction, still peering at the screen. Then he nodded. ‘Yes, thanks, Chels. I reckon Jackal here is going to need more of an inside look than I’m getting.’

The gang member’s nickname suddenly seemed quite appropriate. The flash of fear as the comprehension of what was being organised on his behalf filtered through was swiftly followed by an aggressive snarl.

‘No way! You’re not cutting me, man! I’m outta here.’

‘Oi!’ The barked response from both Sid and Dennis was not enough to stop Jackal making an unexpectedly vigorous move to sit up, ripping the IV line from his arm in the process and actually managing to swing both legs over the side of the bed.

Restrained by the larger men, who latched onto both arms, he subsided instantly. In fact, he looked decidedly green within seconds and then, much to Sid’s obvious disgust, he vomited. Sid gamely kept hold of the arm but the restraint was no longer needed. Sitting up had been enough to cut an already diminished blood supply to Jackal’s brain and his level of consciousness was dropping fast.

‘Lay him down.’ Mike sounded almost weary. ‘And watch out for that blood, Sid.’ The orderly was wearing gloves but Jackal’s IV site was bleeding quite heavily. He leaned closer to their patient. ‘Listen, mate. You’re sick. You’ve had a bullet go through your belly. You’re lucky it hasn’t killed you but it’s still done a lot of damage to your spleen. You’re losing blood. Jump up now and you might make things a whole lot worse in a hurry.’

The response was not incoherent enough to disguise the obscenities but Mike simply straightened and reached for a fresh pair of gloves.

‘I’ll get that IV line back in. I don’t think he’s going to put up much of a fight with his blood pressure in his boots.’

Beth looked at the monitor. The pressure reading was 85 over 40. Jackal had to be losing a significant amount of blood. The glance that passed between Sid and Dennis was significant. If this became a homicide, they could all be in for a lot more drama.

Maybe they would be anyway.

Beth handed Mike a new wide-bore cannula and was ready with the luer plug and flush moments later.

‘Any word from Sally?’

‘Sorry.’ Beth shook her head. This was the kind of thing she hated about starting a new job. ‘I don’t know who Sally is.’

‘She’s one of our paramedics,’ Maureen supplied. ‘The ambulance got called not long after Jackal’s mates took off from here.’ Her brief smile was intended to be reassuring for Beth. ‘Police back-up got activated at the same time.’

Beth nodded, pleased to find her hands steady as she completed the fiddly task of screwing the luer plug into place on the cannula hub. She was injecting a bolus of saline to check that the IV line was patent when the radio on the main desk crackled.

‘Ambulance to ED. Do you copy?’

‘Shall I get that?’ Chelsea queried.

‘I’ll do it.’ Mike stripped off his gloves and then glanced at Beth. ‘Can you get some more fluids up?’

‘Sure.’

Beth taped the cannula securely in place, having flushed the line. Then she reached for a giving set and a new bag of saline. The task was automatic enough not to distract her from listening to Mike as he reached for the microphone next to the radio set.

‘Mike here, Sally. Receiving you loud and clear. What have you got?’

‘Status one patient. Car vs pedestrian.’

‘Roger.’ Mike shook his head slowly as he pulled a pen from his shirt pocket. They all knew how unlikely this was to have been any accident. ‘Vital signs?’

‘Heart rate of 130. Respiration rate 36. Oxygen saturation down and blood pressure unrecordable at present. GCS of 8. Head and chest injuries. Multiple fractures.’

Sid and Dennis looked at each other again. They didn’t need medical training to know that this patient was seriously unwell. Neither did they need the ambulance officer’s confirmation that this was another code yellow patient.

The ETA of the ambulance was ten to fifteen minutes and any calm in the small emergency department vanished.

Extra staff began arriving as Beth and Chelsea were assigned the task of setting up Resus 2 in preparation for the new arrival.

‘Have an intubation trolley ready,’ Mike instructed. ‘And a chest decompression kit.’

‘What happens with serious chest injuries here?’ Beth queried, pulling the crumpled sheet from the bed. ‘We don’t have a cardiothoracic surgeon, do we?’

Chelsea shook her head. ‘We stabilise them and then chopper them to Wellington.’ She flapped the clean sheet to spread it over the mattress. ‘Same with head injuries. We don’t run to a neurosurgeon either.’

Chelsea told Beth who the staff members were as the level of activity in the department steadily increased.

‘That’s Kelly—she’s a radiographer. Seth is the house surgeon on call. Looks like Rowena’s coming in to help as well. She’s a midwife.’

The names flowed right over Beth’s head. These people were all still strangers and this was no time to start even trying to remember names.

‘And there’s Luke.’

Beth flicked the laryngoscope she was checking shut to turn off its light. Despite herself, her head turned sharply at that familiar name but any view of the latest newcomer was blocked by the large figure of Dennis, the police officer.

‘The ambulance is here,’ he told them. ‘I’m going to see if they need any help.’