Consultant In Crisis

‘Damn!’ The drop of blood fell from the end of his finger and splattered the side of the ceramic handbasin.

‘Fletch!’ Ross Turnball sounded shocked. ‘What are you doing, mate?’ He stepped closer. ‘Oh…I had no idea.’

Fletch had a new drop of blood on his finger now. He touched the end of the test strip to the drop and watched the blood travel up the central line. The beep signified that the device had started its measurement. The result was only thirty seconds away. Fletch rinsed his finger, still cursing inwardly that he’d forgotten to shut himself into the privacy of a cubicle.

‘It’s not something I advertise,’ he told Ross curtly.

‘Are you insulin dependent?’

‘No.’ Fletch smiled wryly. ‘Quite the opposite.’

Ross raised an eyebrow. ‘That sounds unusual.’

Fletch pulled the test strip from the device and threw it away. ‘Four point one,’ he murmured. ‘I just need a bit of morning tea.’ He glanced at Ross as he packed away his kit. ‘It’s a long story,’ he said casually. ‘Remind me to bore you with it some time.’

Low blood sugar was not the culprit as far as Fletch’s mood was concerned. Maybe it was being close to Kelly that was disturbing his equilibrium after all. With a cup of coffee in one hand and two biscuits in the other, Fletch moved away from the class group. He found a seat around the side of the building that had the advantage of being in full sunshine, but the pleasant solitary respite didn’t last long.

‘OK, I’m dead curious.’ Ross sat down beside Fletch. ‘You can tell me it’s none of my business but my professional instincts are making me nosy. How long have you been a diabetic?’

‘Two years.’

‘And you get hypoglycaemic even though you don’t take insulin?’

‘Not too often these days, fortunately,’ Fletch responded. ‘I still need to keep a close eye on my levels, though, especially if I’m not well or under stress or miss a meal or something.’ He bit into a biscuit. ‘I just don’t usually make it public.’

Ross nodded. He sipped his own coffee before breaking a thoughtful silence. ‘How were you diagnosed?’

‘Hypoglycaemic crisis,’ Fletch said quietly. ‘Rather a dramatic one, apparently. A taxi driver left me in the middle of the road. Someone called an ambulance and said I was so drunk I was a danger to myself. I was having a grand mal seizure by the time I got delivered to the emergency department and went into a coma after that.’

‘Good grief! Sounds like a major crisis.’ Ross stared at his companion. ‘Did you have some kind of insulin-secreting tumour?’

Fletch looked impressed. ‘You’re more clued up that my doctors were. I was in the intensive care unit for three days before they came up with a definitive diagnosis.’

Ross was nodding. ‘An insulin-secreting islet cell carcinoma. Not malignant, I guess, or you wouldn’t be looking like you do now two years down the track.’

‘No. I’d be dead,’ Fletch agreed. He grinned. ‘Never a good look.’ His smile faded. ‘Waiting to find out whether it was malignant or not wasn’t much of a joke.’

‘I’ll bet it wasn’t.’

‘It was a rough ride all round, actually. I had a partial pancreatectomy. When I got through the complications of pancreatitis and amazed the specialists by surviving, it was decided that my prognosis wasn’t so bad after all. I was in hospital for ten weeks altogether and I came out looking like I’d spent time in a concentration camp. It was another three months before I was back at work.’

Ross shook his head. ‘Amazing story, Fletch.’

‘Not one that I want spread around, mate. I don’t let it interfere with my life but some people would be inclined to regard it as an obstacle to a reliable performance.’

Ross nodded briefly. ‘Nobody will hear anything from me.’ He gave Fletch a curious glance. ‘This wouldn’t have anything to do with the hint of an atmosphere I detected between you and Kelly the other night, would it?’

‘You could say that.’ Fletch’s tone was grim. ‘We were an item…briefly. When she found out how sick I was she decided she didn’t want to deal with it. She left a message with my flatmate to say she wasn’t hanging around. I came out of my coma to find I’d been dumped.’

Ross whistled silently. ‘Hard to believe anyone could be that callous.’

Fletch’s snort was derisive. ‘One way to test a relationship, I guess. I reckon she did me a favour in the long run.’

‘I’ll bet it didn’t feel like it at the time.’

‘It was a fair kick in the pants,’ Fletch agreed lightly. ‘Along with the glimpse of my own mortality, it made me sort out my priorities. I concentrated on getting fit and then took a good look at my career. I’d been cruising for too long. Having fun and not taking anything too seriously. That had a big shake-up.’

‘No more wine, women and wild parties, then?’

‘Wasn’t difficult.’ The lopsided smile was a little poignant. ‘Kelly cured me of trusting women and I got too involved in post-grad studies to have time for any parties—not that they were that wild, anyway. I got my consultancy last year and I have big plans for where the emergency department is heading. Disaster management strategy and this USAR stuff is just my latest hobby.’ Fletch stood up. ‘Speaking of which, we’d better head back inside, mate, before we start any rumours.’

The subject matter had made it an easy day for Kelly. If only she didn’t have the background worry about what was happening at home right now, it would have been a very enjoyable day. There had been no answer to her phone call at lunchtime. How long could it take to visit someone and tell them face to face that there was no going back? That decisions had been made and would not be changed. Face-to-face meetings were dangerous, Kelly knew that. But maybe her mother was right in saying that such a confrontation was essential for closure. Maybe it was the fact that she hadn’t been brave enough to do it herself that had left this uncomfortable impression that there was unfinished business between herself and Neil Fletcher.

Not that Fletch seemed bothered. If it had been an easy day for Kelly, it must have been downright boring for the emergency medicine specialist. The session he had taken on shock had been excellent. Unfortunately, Kelly had been distracted from using the tutor’s expertise to advance her own knowledge. The excuse to observe Fletch for such a long period of time had been irresistible and it was the first time she had allowed her gaze to remain on the man for more than a second or two.

Two years had left their mark. Fletch looked thinner. The brown hair was worn a little shorter these days and were those highlights still sun-streaked blond or had some grey crept into those soft waves? Kelly’s fingers actually tingled as the memory surfaced of just how soft those waves were.

‘So. We’ve defined shock as a state of wide-spread inadequate perfusion at a cellular level. What are the things we need for adequate perfusion?’

Kelly glanced away as Fletch looked in her direction. She wasn’t about to contribute any suggestions. She was too busy trying to figure out what the difference in Fletch’s appearance was. It wasn’t anything physical making him seem so unfamiliar. It was something to do with his manner. He was scribbling on a whiteboard now. Perfusion relied on a functioning pump, an intact set of plumbing and an appropriate volume and content of fluid. Fletch was making the physiology lecture very user friendly for non-medical people. Even funny at times.

That was it. That was the difference. Fletch’s humour and his smile had a different quality. It was more restrained and less frequent. Fletch had never been a serious type. The way he had made Kelly laugh had been why she had fallen in love with him in the first place. Virtually the moment they’d first met. Kelly could remember that first meeting as though it had happened yesterday. Fletch had been a new registrar in Emergency and Kelly had come in with a patient at the end of a long, hard day. The patient had been drunk—found comatose under a hedge with two empty rum bottles nearby. His level of consciousness had improved enough for him to become abusive on the way into hospital and Kelly had had enough. Finishing a long day with her least favourite type of case had been enough to noticeably test her professional manner.

‘This man presented with a GCS of eight, hypotension and bradycardia,’ Kelly informed the triage nurse. ‘There is evidence of an ETOH overdose.’

Fletch heard the tail end of Kelly’s handover as he walked past. He glanced at the empty rum bottles now lying on the end of the stretcher. He leaned towards the triage nurse and spoke in a stage whisper.

‘The technical medical term is “totally pissed”.’

Kelly controlled her threatened giggle more effectively than the triage nurse.

‘We don’t have any details on the patient other than his surname.’ Kelly took another glance at Fletch who seemed in no hurry to move away. ‘Which appears to be Ikkey.’ She spelt it out.

Fletch looked thoughtful. ‘Icky,’ he repeated. He eyed the evidence of recent vomiting on the stretcher blanket and then winked at Kelly. ‘He is, rather, isn’t he? That’s another technical term I went to med school to learn,’ he added to the nurse beside them.

‘Cubicle three.’ The triage nurse was grinning broadly now. ‘Fletch, he’s all yours. In fact, we’ll make sure you get every icky patient that comes in from now on.’

‘I don’t know,’ Fletch grumbled. ‘Here I am sharing my professional knowledge and what thanks do I get for it?’

The humour rescued Kelly’s day and it was so easy to accept that first invitation for a date with the new registrar. That humour underpinned the whole relationship, in fact. Fletch could make anything funny and yet his jokes often displayed a real sensitivity. They helped to achieve a closeness that Kelly had never had with anyone before. Or since. She loved that sense of humour more than anything about Fletch. Not that he couldn’t be serious when he needed to be. He could turn it off in an instant and look intense and serious. Like he did when dealing with an emergency. Or, in a very different way, when he was about to make love to her.

Oh, help! Kelly had to shut her eyes to stifle that particular jog down memory lane. There was no point going there. Things had changed. Fletch had changed. Maybe he’d grown up finally and the change had made him more trustworthy. No. Kelly clamped that train of thought down as well. Her father had taught her only too well how little credence could be placed on any promises or even intentions of becoming trustworthy when it came to that kind of behaviour. And it wouldn’t make any difference now, anyway. Not with the opinion Fletch now held of her.

Joe’s session on immobilisation techniques had been a lot more fun. The quips about bondage and the good-natured teasing of Wendy and Ross now that their relationship was public had made the time pass swiftly. Wendy, Jessica and Sandy had made a good job of soft tissue injury management and the practical scenario at the end of the day would have been a great way to finish if only their instructors hadn’t put her and Fletch into the same group, where she’d also had Kyle to contend with. Wendy had been coerced into being a patient again. This time she had been a crush injury victim with a slab of concrete on her leg. Cardboard boxes had represented the hazards they had marked and the surrounding debris had been removed, allowing access to their victim.

‘Hi, there, Wendy.’ Fletch shifted a last piece of ‘rubble’. ‘Here we are, finally.’

‘Check her airway,’ Kyle said excitedly. He reached out and Wendy ducked her head instinctively to avoid the physical contact.