Accidental Rendezvous

‘Anyway,’ he said, just to make the point, ‘I’ve been working in country hospitals for years now, so it’s hardly a change of pace.’

‘No.’ She stood up, put a little cold water in her tea from the tap and drained it, then all but dropped the mug on the worktop in her haste. ‘I have to get on. I’ll see you later.’

‘What are you doing after work?’ he asked impulsively, stopping her in her tracks.

Slowly, as if she was giving herself time, she turned towards him. ‘Nothing,’ she said clearly. ‘Either with you, or anyone else.’

And she turned on her heel and walked away.

He gave a slow smile. It was a putdown, without a shadow of a doubt, but it had failed. ‘Either with you, or anyone else,’ she’d said, and that left the smile on his face, because if there was one thing he didn’t want to do, it was tread on someone else’s toes and upset things for her if she’d got her life on track.

And if she wasn’t doing anything with anyone else, then from where he was sitting right now that was a definite plus.

But progress, he thought with a laughing sigh, was clearly going to be measured in microns …

‘Why, oh, why, oh why—?’

‘Sally?’

She looked up at Ryan, standing beside her and eyeing her quizzically. ‘Hi, there,’ she said brightly. ‘Problem?’

‘Not me,’ he said, his eyes all too perceptive. ‘It was you I was worried about. Are you OK?’

‘Me? Of course,’ she lied.

‘Just wondered. You looked a little poleaxed earlier. It just occurred to me that you and Nick might have had something going once. I hope it won’t be a problem.’

‘No problem,’ she assured him with false cheer, and wondered if it could possibly be true or if it was going to be, as she suspected, a living nightmare until he moved on again. Perhaps it was time to take some in-service training—in Alaska or somewhere. Maybe Ryan could recommend a nice, remote Canadian hospital—

‘Just wondering, that’s all,’ Ryan murmured. ‘You want to talk to me, you know where to find me.’

‘Ryan, thanks, but I’m fine. It was over years ago, and it was nothing much anyway,’ she assured him, and wondered why God didn’t strike her down for such a whopper.

Or maybe it was the truth, and it really had been nothing much, only she’d been too lovestruck and besotted to realise it.

With a sharp sigh, she snatched up the next set of notes, shot through the cubicles and went out to the heaving waiting room. With any luck she’d be able to avoid him for the rest of the day. She scanned the crowd.

‘Mrs Johnson? Can you come through, please?’

Luck wasn’t on her side that day. A scant hour later, Sally stuck her head round the corner of the cubicle where Nick was working and beckoned him.

‘Could I have a quick word, Dr Baker?’ she murmured.

‘Sure. Excuse me a moment.’

He stood up and ducked through the curtain, raising a brow quizzically. ‘Problem?’

‘I will have. There’s an attempted suicide coming in,’ she told him quietly. ‘Young woman who’s thrown herself out of a third-floor window—facial and pelvic injuries. Ryan’s gone to a meeting, Matt’s on holiday and the new SHO is so wet behind the ears I daren’t trust him with a Band-Aid.’

He grinned, sending her off kilter again, and nodded. ‘I’ll get this one sorted out and come through to Resus. Five minutes?’

‘Maximum.’

‘OK. Get the mobile X-ray in there with a radiographer, and call an anaesthetist in case we have airway problems.’

‘Done it.’

‘Good girl.’ With a wink, he ducked back behind the curtain, and she ignored her skittering heart and went into Resus to make sure it was ready for the new arrival.

It was back to normal after the mayhem of the morning, thanks to the cleaners and the nurses who’d restocked the supplies. Thinking of the facial injuries and the effect they might have on the patient’s airway, she checked their stock of all the different sorts of airway the anaesthetist might need, and then went out to meet the ambulance, just as Nick emerged from his cubicle and headed towards the door.

‘Perfect timing,’ she said as the ambulance backed up and the doors opened. As the trolley was lifted out, she winced inwardly. Their casualty was a mess—she was on a spinal board, her face was trashed and her colour was lousy despite the oxygen mask held lightly in place.

The paramedic gave them a quick rundown as they wheeled her rapidly into Resus.

‘Twenty-five-year-old female, name of Jodie Farmer, neighbour saw her jump off her third-floor balcony. She landed on the concrete path outside. GCS 15 at the scene. She needs a tube down really but I thought I’d leave that to you guys as she’s still able to breathe and we were only round the corner—watch her jaw, it’s shattered and her tongue’s bleeding. She’d got umpteen teeth missing, too. It’s a mess in there.’

It certainly was, Sally thought, listening to the list of drugs she’d had on the way in and mentally assessing her. Her left cheekbone was depressed, her eye seemed twisted slightly, her upper lip was huge and torn to ribbons and her lower jaw was grossly misshapen.

In fact, her face was so severely injured Sally was amazed that she hadn’t had a lower score on the Glasgow coma scale, which measured the level of consciousness. She would have expected some degree of concussion, but maybe that would show itself later. She’d have to keep an eye on it and rescore her frequently.

In the meantime, her whole face was swelling before Sally’s eyes, and she was getting restless, moving her head and fluttering her hands, fighting for breath.

It was a fair bet that the inside of her mouth was swelling too, cutting off her air supply. Protecting that had to be the first priority, and the moment she was on the trolley in Resus Sally was ready. ‘Are you going to try and get an airway in?’ she asked doubtfully, but Nick shook his head, confirming her suspicions.

‘Not a chance, and we can’t wait for the anaesthetist, she’s distressed now. I’ll do a laryngostomy. I don’t want to poke about in there. OK, Jodie, just relax, you’re in good hands. I’m just going to get you some air.’

Within seconds he’d located the cricothyroid membrane, made a neat little slit in it and slipped in a tube. Instantly the patient stopped struggling, and her colour started to improve in moments. ‘Right, let’s get some oxygen into her and assess her injuries. I want X-rays of head, chest, total spine and pelvis to start with, and we’ll work from there. Is there a maxillofacial team here?’

‘Yes—I’ve alerted them.’

‘I want them here now. This needs urgent attention. Her eye socket’s compressed and her tongue’s bleeding badly. The orthopaedic reg could do with seeing her when we’ve got the plates, too, because this pelvis needs sorting out.’

They stood back as the radiographer slid the plates into the trolley, took the required shots and disappeared to develop them.

ABCDE, Sally thought. They’d sorted out her airway, made sure she was breathing, they were running in fluids to protect her circulation, Nick had done a brief neurological check to assess any obvious disability, and the last thing on the list was exposure—seeing the whole patient naked to check for anything else they might have missed. Before the door swung shut behind the radiographer, Sally was busy cutting clothes off, and it was immediately obvious that Jodie’s pelvic injuries were very severe.

The skin over her hipbones was stained dark purple with bruises, and there were sharp spikes of bone pushing up against the skin in places.

‘Nasty,’ Nick said softly. The probability of internal injuries is very high, I think. Circulation to both legs seems good, though, amazingly. Watch her pressure—what is it?’

‘A hundred over fifty.’

‘She’s young, but it’s still very low. Watch it like a hawk, please. I don’t want to miss anything. Pulse?’

‘One-twenty and erratic.’

‘She’s breathing all right for herself still, so hopefully her spine’s intact. Let’s check her reflexes.’