Twice as Good

Janet lifted the mask away from skin contact. Sandy walked in just as Mr Collins’ body jerked in response to the electrical shock.

‘Oh, my God!’ she said in horror.

‘Grab the oxygen cylinder from my room, Sandy,’ Janet called. ‘And then call an ambulance. Mr Collins has had a cardiac arrest.’

Sandy dropped the tins of cat food and the large bag of kitty litter by the front door. She ran to collect the oxygen cylinder.

‘Good girl,’ Janet said calmly. ‘Now call the ambulance.’

Sandy backed away, staring as Oliver raised the paddles again. ‘Charging to 360 joules,’ he stated. ‘Sophie, get an IV line in as soon as you can and draw up one milligram of adrenaline. Janet, find some lignocaine and some more adrenaline.’

Janet opened the drug cupboard in the treatment room hurriedly to locate the requested drugs. She could hear the wail of the ambulance siren in the distance. She could also hear the loud knocking on the front door. Hoping that Sandy would have the initiative not to allow an early afternoon patient to stumble in on the emergency, Janet grabbed some extra IV supplies and headed back.

‘I’m sorry,’ she heard Sandy calling loudly, ‘but we can’t see any patients just yet. We’re in the middle of an—’

Janet saw the door being pushed open firmly. ‘I’m not a patient,’ she heard the visitor assert. ‘I’m the locum. My God, what’s going on in here?’

‘Cardiac arrest,’ Oliver stated tersely. ‘Come and take over the compressions, would you?’

The newcomer moved swiftly. Janet found herself staring at his back as he crouched over Mr Collins. His hands were positioned unerringly, his compressions smoothly confident. ‘How much adrenaline has he had?’

‘Three doses of one milligram so far.’

‘What about a bolus dose of lignocaine?’

Janet handed the ampoule to Oliver and stepped back. Sophie was ventilating Mr Collins, using the bag mask unit, now attached to high-flow oxygen. Janet stood behind the newcomer, listening to his verbal exchanges with Oliver, thankful she wasn’t needed any closer just now. She was aware of her skin prickling all over. Every word uttered by this man sent a new shiver down her spine.

‘How long has CPR been in progress?’

Oliver glanced at the clock. ‘Ten minutes.’ He injected the dose of lignocaine.

‘Was the collapse witnessed?’

‘Not exactly.’ Sophie was squeezing the bag on the mask automatically. ‘Mr Collins was sitting in the waiting room for a while by himself. He was pulseless but not cyanosed when he was found.’ Sophie glanced up at Janet who bit her lip.

She knew how it would sound. Patients dropping dead in a doctor’s waiting room unnoticed wasn’t exactly a great recommendation for a medical centre. It would seem even worse when it was known that Mr Collins had come in describing the classic symptoms of a heart attack. How could she explain that this patient had turned up repeatedly over the years with the classic symptoms of every ailment known to man. That he’d had baseline cardiological investigations only weeks ago which hadn’t revealed any pathology. That their experienced practice manager, who would have instinctively picked up a genuine emergency, was at present on the other side of the world. The bare facts of the emergency would present a picture of a medical centre that wasn’t up to scratch. Janet didn’t want this locum to have that as his first impression of St David’s.

‘Let’s give this another shot.’ Oliver pushed a button on the life pack. ‘Charging to 360 joules again. If this doesn’t do anything, we’ll intubate.’

The ambulance crew arrived as the interference on the monitor screen settled. The spikes of an effective heart rhythm drifted slowly into view. They all watched for several seconds. Janet moved further back as the number of personnel and supplies of equipment increased. Sandy was standing under the archway, sobbing. Janet put her arm around the young girl.

‘I can’t do this job,’ Sandy groaned. ‘If Mr Collins dies it will be all my fault.’

‘Nonsense,’ Janet said firmly. ‘I’m the one who should have checked on him, and I don’t think he’s going to die. His heart’s started again now. As soon as they’re happy it’s going to keep going, the ambulance will get him into the emergency department and the experts will be able to take over.’

Mr Collins was being lifted onto a stretcher. Janet gave Sandy’s arm a comforting squeeze. She smiled gently at the tearstained face in front of her. At thirty, Janet was only twelve years older than Sandy Smith, but right now she felt old enough to be her grandmother. ‘You go and have a cup of tea and talk to Outboard for a wee while. I’ll help them clear up in here.’

Janet opened the front door to allow the stretcher to be carried out. She reached down and picked up the bag of kitty litter which was still lying where Sandy had dropped it. Oliver was standing up now. He had his hand extended towards the newcomer.

‘Not the ideal way to welcome even a temporary colleague,’ he said dryly, ‘but we’re delighted to see you. I’m Oliver Spencer and that’s my wife, Sophie, who’s about to disappear off to hospital with Mr Collins.’

Sophie was walking beside the stretcher. She looked back and gave an apologetic wave, before heading out the door.

‘I’ve arrived at a bad time. Might it be better if I came back later?’

‘No.’ Oliver shook his head firmly. ‘This morning was total chaos and Mr Collins has just finished it off in style. We’re in dire need of assistance.’ He paused. ‘You didn’t tell us your name.’

No! Janet wanted to shout. Don’t say it. She couldn’t believe this was happening. She had never even remotely prepared herself for this possibility. She stood, frozen to the spot, blindly clutching the bag of kitty litter, using it as a shield against the confirmation she knew she couldn’t avoid.

‘I’m sorry,’ the locum apologised. ‘I thought the agency would have been in touch. I’m Dr James McFadden. Jamie,’ he added as an afterthought.

Of course it was Jamie. Janet had known that the instant she’d heard the accent and tone of the once so familiar voice. The emergency had simply postponed the impact of the knowledge. Jamie McFadden. Past colleague. Past lover. The father of her twin sons. What had she told Sandy Smith so confidently? That this morning was as bad as it ever got around here?

Janet Muir had been terribly wrong.

Things had just become immeasurably worse.

CHAPTER TWO

ANY second now, Janet Muir warned herself.

The eye contact between them had all the dreadful inevitability of a slow-motion car crash. You saw the collision coming, knew the impact would be disastrous, but there wasn’t a damned thing you could do to avoid it.

Would Jamie McFadden recognise her? Would he acknowledge the recognition? Would the memory be as overwhelmingly gut-wrenching as that which she was experiencing? Janet could feel the hard plastic handle of the bag she was clutching biting into her collar-bone. She welcomed the physical discomfort. It was something real she could focus on in this developing nightmare.

‘You’re Scottish,’ Oliver observed, with an amused tilt to his mouth.

‘Aye.’ Jamie McFadden acknowledged the obvious with a brief nod. His wavy hair had darkened over the years, Janet noted. It was almost brown now. There were enough blond streaks left to make it catch the sunlight that streamed through the bay window of the waiting room. It was a glorious day outside. This really could not be happening to her.

‘What part are you from?’ Oliver queried.

‘Glasgow,’ Jamie responded. He stepped aside to allow an ambulance officer, burdened with equipment, access to the front door.

‘Really?’ Oliver sounded intrigued. ‘Just like Janet!’

‘Sorry?’ James McFadden’s total lack of comprehension was evident.

‘Janet Muir, our practice nurse.’ Oliver’s hand was coming up, ready to point her out. Jamie was turning even as Oliver finished his sentence. ‘Janet’s from Glasgow, too. Maybe you know each other.’

Janet didn’t even attempt a smile. She knew it would have been a physical impossibility. She didn’t try to speak either. She needed to concentrate on simply drawing breath. The shock in those brown eyes was startling. Janet almost felt sorry for him. She’d had several minutes since she’d recognised his voice. Several long minutes in which to try and prepare herself for this moment. Jamie had been thrown in at the deep end.

Janet’s question about whether he would recognise her had been answered. Her question about the effect of the recognition was also answered. For a split second, James McFadden looked as though he’d been violently assaulted. Stabbed. Or shot. Things didn’t come any more gut-wrenching than that—no matter how quickly the reaction could be shuttered.

But what of the third question? How was he going to react? Would he acknowledge her? Janet waited. Jamie was the one who had stepped—uninvited and unwanted—into her world. It was his call. If he wanted to pretend they’d never met then that was fine by her. In fact, it would be infinitely preferable to … to the warmth in Jamie McFadden’s tone.

‘Janet! I don’t believe it! After all these years!’ Jamie’s hand was stretching towards her. Janet hugged the prickly bag of kitty litter more tightly.

‘Jamie.’ She tried to smile but her lips simply wouldn’t co-operate. Jamie’s hand faltered and then dropped to his side.