The Doctor's Unexpected Proposal

Emily glanced back at Mike as she climbed the steps but he looked just as puzzled. Why did Honey seem frightened? Just who was their patient going to be here, and was the situation anywhere near urgent enough to have summoned a rescue helicopter across hundreds of miles?

The furnishings of the small house were faded, the floors bare, and there was no sign of a television or music centre or anything else that might add comfort to an isolated lifestyle. That the house was so immaculately clean and tidy somehow added to the sad feeling it engendered.

Emily followed Mrs Cooper from the living area into a narrow hallway that led towards her daughter’s bedroom. The struggle this family was having had undoubtedly been going on for a long time. The house seemed to have absorbed some of its inhabitants’ weariness and it felt like they were only a very small step away from giving up.

They were clinging to something, however—this small family. Seeing the way Honey rushed to the side of the small, wiry man waiting near the last doorway in the hall and the way he reached out to take her hands, Emily could sense the bond between this couple. A belief that, no matter how bad things got, they would make it through simply because they still had each other.

‘Jim! What on earth’s happened?’

‘It’s all right, Hon, don’t panic. I’m sorry—I thought you’d be back long before the medics got here. I went out to look for you but I ran out of puff.’

‘I was right over by the creek. The cattle had broken through the fence there, too. They’re desperate for feed, poor things. What’s wrong with Megan?’

‘I dunno. She doesn’t seem so bad now.’ Jim turned an apologetic gaze towards Mike. ‘I’m sorry. I’ve probably called you out all this way for nothing.’

‘We’d much rather get called out and find it’s not serious than the other way round,’ Mike assured him. ‘But seeing as we’re here now, how ’bout we check Megan out?’

And Jim, Emily thought as she moved after them. She wasn’t surprised he’d ‘run out of puff’ if he’d gone looking for his wife. He looked as though he could well be in some degree of heart failure or respiratory distress from other causes. There was a nasty grey tinge to his skin and Emily did not need a stethoscope to hear the harsh sounds his breathing was making.

The girl in the bed looked even more taken aback to see the AMS crew arrive than her mother had, and it seemed to be more than an unwelcome surprise. It verged on being a last straw. There was no sense of the strength her parents gained from each other. Megan looked as though she didn’t have any desire to fight anything and Emily was struck by the air of hopelessness. She was, what, nineteen years old? It was far too young to have given up.

Megan turned her face away from the strangers invading her bedroom. ‘I’m fine,’ she said tonelessly. ‘Go away. I told Dad not to call any doctors.’

‘You weren’t fine when I called,’ Jim reminded her. ‘You fainted, remember? And you’ve been shivering fit to bust on and off ever since, even in your sleep.’

Mike crouched beside the girl. He reached out and touched his fingers to her cheek.

‘Hey.’

The tone was so gentle, and the following silence so patient, that Megan slowly turned her head inch by inch until she could see the man who had spoken. Then she received one of his most charming smiles.

‘I’m Mike,’ he introduced himself. ‘You’re Megan, right? And you’re not feeling so flash at the moment, are you, sweetheart?’

Emily could see that Megan was caught by Mike’s smile and the concerned expression that she would have to be seeing in those dark eyes. And who wouldn’t respond to that? What female on earth wouldn’t want to be made to feel special by having a man like Mike concerned about them?

Megan nodded reluctantly.

‘Do you remember what happened when you got out of bed before?’

‘I…got a bit dizzy, that’s all.’

‘She hasn’t eaten anything for days,’ Honey put in. ‘I don’t think she even ate a hot dog at the rodeo and that was last Thursday.’ She was clutching Jim’s hand and they were both staring anxiously at their daughter.

Mike laid his hand on Megan’s forehead and Emily knew exactly why the young girl closed her eyes as though the touch was comforting.

‘You’re running a bit of a temperature. What else is going on for you, Megan?’

Emily unzipped the pack to locate a stethoscope and a blood-pressure cuff. ‘Is it OK if I take your blood pressure, Megan?’

‘I guess.’ The assent was grudging.

Emily moved to the other side of the bed. She was happy to play a supporting role here. Mike was just as capable as she was of doing a patient assessment and he had already established far more rapport with Megan than she herself was likely to achieve. The teenager was still watching Mike as Emily wrapped the cuff around her upper arm.

Megan was overweight and the cuff didn’t have much of an overlap so Emily had to hope the Velcro would stay fastened as she pumped up the pressure. Other impressions were also crowding in. The girl’s breathing was faster than it should be and so was her heart rate. Not surprising given her fever and not unexpected if this was a viral illness, but something was triggering a faint alarm bell for Emily.

And for Mike, it appeared. He was frowning.

‘What about these stomach pains your dad said you were getting?’

Emily could swear she heard a faint gasp from Honey but when she looked up her attention was caught by what she saw Jim holding in his free hand. A small red canister with a white pump nozzle on the top.

‘Do you get angina?’ she asked Jim. ‘Have you needed your spray tonight?’

‘I used it a while back.’

‘Do you have any chest pain at the moment?’

‘No. I’m fine. It’s Megan you need to worry about.’

Emily turned back. ‘BP’s 95 on 50, Mike.’

‘Mmm.’ Mike had coaxed Megan into letting him examine her abdomen. Emily could see that even gentle pressure was causing considerable pain. The glance she caught from Mike made that alarm bell ring more clearly.

‘I’ll set up an IV,’ Emily said quietly. ‘We don’t want that blood pressure getting any lower.’

‘Tell me about these stomach pains.’ Mike encouraged Megan again. ‘When did they start?’

‘A few days ago.’

‘And have you had anything like this before?’

‘She’s always had painful periods,’ Honey offered quickly, with a swift, almost apologetic glance at her husband. ‘But they don’t usually make her sick. She’s just caught a bug at a bad time of the month, hasn’t she?’

Mike’s attention was fixed on Megan. ‘So you’ve got your period at the moment?’

A face that had already been flushed from fever seemed to lose colour and then go astonishingly red. Megan shot an agonised glance in her father’s direction and it was only when Jim muttered something about putting the kettle on and left the bedroom that she finally nodded with extreme reluctance.

‘Sorry, sweets, I know this is a bit personal but it could be important. Would you rather just talk to Emily?’

Megan shook her head emphatically but Emily wasn’t offended. Given the choice, Mike would win as far as she was concerned as well.

‘OK. Do you use tampons?’

Emily almost nodded at the line she could see Mike following. Septic shock from ill-advised tampon use was a real possibility here. Appendicitis was also amongst a raft of conditions that could produce severe abdominal symptoms. A ruptured ectopic pregnancy was unlikely to cause the fever but Emily was running through every possibility she could think of. She had a strong impression that they were missing something important.

‘Sharp scratch, Megan, I’m sorry.’ The cannula slid into a vein on the back of the girl’s hand and Emily secured the line and attached a bag of saline as Mike continued his examination and assessment.

Emily held the bag of saline towards Honey. ‘Would you mind holding that for the moment, please?’