Doctor at Risk

‘I’m almost five foot one,’ Wendy informed him haughtily. ‘And I’m probably a lot fitter than you are, mate.’

‘I certainly wouldn’t try and compete with you on any athletic field.’ Peter handed her the mirror. ‘Any marathons lined up for the near future?’

‘No.’ Wendy tried not to sound despondent. ‘Ross and I were working on a training programme just before the accident to get us on track to do the Coast to Coast race next year.’

Peter’s face advertised his aversion to extreme physical challenges. ‘Whatever spins your wheels, I guess.’ His expression softened. ‘It can’t be easy for you guys at the moment. You’ve lost a lot more in common than most couples would in a situation like this.’

Wendy simply nodded. She didn’t have the heart to keep up with anything more than a minimum jogging routine right now. Not when the reminder of what Ross had probably lost was so painful.

‘I’m not surprised he’s been a bit down for the last day or two,’ Peter added. ‘It’s most likely only just sinking in now. The challenge of recovery is a rather different ball game from choosing to push a healthy body to phys ical limits.’ His smile was encouraging. ‘At least you’ll understand that more than anyone else would.’

‘I don’t think that’s helping,’ Wendy confessed. ‘Maybe I’m too much of a reminder. All the time we’ve had together has been spent doing physical things.’

Peter was grinning broadly now. ‘I’ll bet!’

‘That wasn’t what I meant.’ But Wendy’s smile faded swiftly. How long would it be before she and Ross could make love again? And would it ever be quite as wonderful?

‘Things will get better,’ Peter said gently. ‘Hang in there, Midge.’

Wendy’s fingers closed more tightly over the handle of the mirror. ‘I’m not sure about that. We didn’t part on a very happy note when I went to visit last night.’

‘Ah. That’ll be what they’re for.’

‘What are you talking about?’

‘The flowers.’

‘What flowers?’

‘I was supposed to tell you. There’s a big bunch of flowers at the nurses’ station for you. Red roses, in fact.’

‘Really?’ Wendy sounded less than excited. ‘Again? I hope there’s a card with them this time.’ She had assumed the bunch delivered last week had been from a grateful patient and the card had been lost. The teasing she had received about having a secret admirer had been easily ignored, given her concern for Ross, but it had not been particularly amusing.

‘They’ll be from Ross,’ Peter said confidently. He pulled a rubber band free from a handful of 18-gauge cannulae and added the leftover supplies to the fresh box he had opened. ‘To say sorry.’

‘Doubt it.’ A crease appeared on Wendy’s forehead. ‘I don’t think sending flowers is his style.’

‘How do you know? Has he done anything he’s needed to apologise for before?’

‘No.’

‘There you go, then. It’s classic.’

‘Hmm.’ Wendy summoned a smile as she left the storeroom. It might be classic but it didn’t fit. Ross was too much of an individual to use a hackneyed form of apology like sending flowers. Especially red roses. If he wanted to say sorry, she would have expected something like an invitation to tramp up a particularly difficult hill, had that still been possible. Now she would anticipate some carefully selected words. Just a sincere look from those expressive dark brown eyes would do the trick. However attractive it would be to confirm that Ross had not meant what he’d said, the idea of him sending red roses to do so was somehow disappointing. Wendy put off finding out and returned to her patient instead.

She positioned the mirror for Martin.

‘I can’t see the screws very well.’

‘Having curly hair hides most of it. They shaved a little patch here, see? Then they would have put local anaesthetic in before they screwed in the pins.’

‘It was the local that hurt. I remember that. And I was a bit worried they might screw them right through into my brain.’

Wendy laughed. ‘No chance. One of the screws is spring-loaded so that they know as soon as they’ve attached to the outer table of the skull. They don’t go any further than that.’

Martin was eyeing the band of metal curving over the top of his dark curls. ‘It looks like one of Olivia’s headbands when she hasn’t put it on properly.’

‘There’s an attachment at the back that I don’t think you’ll be able to see,’ Wendy told him. ‘That’s what the weights hang from.’

‘And the weight is stretching my neck so that the bones get back into alignment, right?’

‘We’re hoping so. The next X-ray should let us know whether it’s working.’

‘And what happens then?’

Wendy put the mirror down. ‘That will depend on how well you’re doing. It’s possible you might need an operation to stabilise the fracture.’

‘And if I don’t?’

‘You’ll stay here in Intensive Care for a few days.’

‘Why?’

‘We just like to keep a specially good eye on our new arrivals.’

A list of potential complications from a high spinal injury flashed through Wendy’s mind but she had no intention of frightening her patient by describing any of them. Paralytic ileus, where the small bowel ceased functioning and caused an accumulation of fluid and gas, was a common cause of death if unrecognised within the first forty-eight hours due to aspiration of vomitus. Paralysed patients were unable to cough adequately and death from respiratory arrest could be sudden.

Wendy glanced at the monitor beeping quietly and steadily beside the bed as the ECG spikes drifted across the screen.

Cardiac problems were also significant due to disruption to the vagus nerve that influenced heart rate. Something as simple as using suction or turning a patient could stimulate a vagal reaction and provoke a life-threatening slowing of the heart rate.

Respiratory problems were also high on the list of potential complications. Ross had had a bad spell with his breathing for a day or two when continued swelling of his spinal cord had led to a temporary increase in paralysis of the muscles required for breathing. Martin’s recent blood gas results, showing the level of oxygenation, had been good, however.

‘You get a lot more tests and drugs in the first few days as well. Like this infusion.’ Wendy checked the IV cannulation site in Martin’s arm for any sign of irritation and then ran a practised eye back up the line to ensure that the infusion was still running smoothly.

‘What is in there exactly?’

‘Methyl prednisolone. It’s a steroid that’s supposed to minimise any ongoing damage to the spinal cord. You only get it for twenty-four hours so it will stop by tonight.’

‘Do I get this tube out of my nose then?’

‘Probably not. You might have that for a day or two. It’s important because it helps to make sure you don’t vomit. That can be a problem when you can’t move.’

‘Where do I go when I get out of here?’

‘Into one of the wards.’ Wendy put on gloves before changing the bag attached to Martin’s indwelling urinary catheter. She made a note of output. Martin was unusually talkative for a new arrival but it was part of her job to deal with any concerns her patient had about his immediate future.

‘Will I be by myself?’