The Consultant's Adopted Son

She broke off and gulped. Owen frowned when he saw her start struggling for breath. ‘Can you tell me how severe the pain is at this moment?’

‘It’s really bad, Doctor, and I can’t seem to breathe properly…’ She suddenly stopped talking and her eyes rolled up into her head. The cardiac monitor started beeping to warn them that there was no output from her heart.

‘She’s in VF.’ Owen turned to his registrar. ‘I think it’s a cardiac tamponade—the heart is being compressed because blood is collecting in the pericardium. I’ll need to draw it off to relieve the pressure.’

‘You think it’s a fractured rib that’s caused it?’ Suzanne queried, hurrying round the bed.

‘More likely to be the sternum. That would explain the severe pain she’s been in. If the sternum has fractured, it could have pierced the pericardium, which is why there’s blood collecting around her heart. She’ll need to go straight to Theatre once we’ve finished. Shock her and give her a shot of adrenaline, but don’t apply external cardiac compression—it will only make matters worse.’

He left it to Suzanne to resuscitate the woman, knowing that the registrar was perfectly capable of following his instructions. His main concern was to deal with the cause of the patient’s arrest. It took him just a few moments to insert a hollow needle into the woman’s chest and he nodded as he watched the blood gush back into the syringe.

‘Just as I thought—cardiac tamponade. The sternum will need wiring up and the pericardium will need repairing, so the cardio team will have to crack open her chest.’

He drew off another syringe full of blood before Suzanne told him the patient’s heart was beating and they had established sinus rhythm. ‘Good. Get onto the cardio reg and tell him what’s happened,’ he instructed, peeling off his gloves. ‘Make sure he understands how urgent it is. This is one occasion when queue-jumping is absolutely essential.’

Suzanne made the call, then came back to him. ‘I wouldn’t have known what to do if you hadn’t been here. It never occurred to me that it could be a tamponade. I always associate that with a penetrating chest injury. I never considered the possibility that the sternum had fractured and pierced the pericardium even though I could see all that bruising.’

‘Don’t be so hard on yourself, Suzanne. There’s a dozen different reasons why she could have arrested. You know that as well as I do.’

‘Maybe. But you still managed to come up with the correct diagnosis.’

Suzanne looked downhearted as she went to meet the paramedics who’d arrived with another casualty. Owen made a note to have a word with her later and went to check on the young man with the leg injuries. Beth had the X-rays on the computer screen and he sighed when he saw the extent of the damage that had been done to the man’s ankle.

‘That’s going to take some sorting out. It will be a while before he’ll be able to walk on it. It causes a major problem when ligaments are torn like that.’

‘What about his leg?’ Rob queried, coming over to have a look. ‘It’s a real mess.’

‘That’s going to take time, too, and it will need external fixation from the look of it. The bone’s in bits just here,’ he explained, pointing to the screen. ‘It will take several weeks to lay down new bone and the biggest problem will be to ensure that the tibia doesn’t shorten in the meantime. That’s why external fixation is the best option.’

He looked round when he sensed that someone was standing behind him and stiffened when he saw Rose. ‘Yes?’

‘Mrs Robinson’s daughter is on her way in. ETA three minutes,’ she told him quietly, then moved away.

Owen watched her walk over to the bed and it was all he could do not to go after her and demand to know what she was doing there. He’d barely slept since the night he’d met her in the pub. He knew that he’d handled the situation badly by offering her money, but it had been his last resort after everything else had failed. Now he had no idea what she was up to, but he couldn’t accept that it was coincidence that had brought her to his department that day. She was planning something and, whatever it was it would have an impact on Daniel.

The thought of the damage she might cause was too much to deal with. Owen knew that he had to put some distance between himself and Rose Tremayne, otherwise he couldn’t be held responsible for his actions. Spinning round on his heel, he strode out of the room, ignoring the startled looks from his staff as they watched him leave. He needed a couple of minutes on his own to think things through. If Rose did have a plan, he intended to be one step ahead of her!

Rose bit her lip as she watched the doors swing shut after Owen Gallagher had left. She knew he was furious about her being there but it wasn’t her fault. She’d had no idea that he worked at St Anne’s when she’d accepted this job, otherwise she wouldn’t have taken it. Now she couldn’t decide what to do. Should she go after him and explain that she hadn’t intended to make life difficult for him by turning up in his department? Or would it be better if she left well alone?

‘I wonder what’s up with His Highness today.’

Rose summoned a smile when Rob Lomax came over to her. Instinct told her that it would be a mistake to let anyone know about her link to Owen Gallagher so she feigned ignorance. ‘Do you mean Dr Gallagher?’

‘Uh-huh. He’s like a cat on a hot tin roof today and it isn’t like him. That guy is the epitome of cool normally. Isn’t that right, Suzie?’

‘Isn’t what right? And don’t call me Suzie. You know I don’t like it.’

‘I know how you feel.’ Rose smiled as the other registrar joined them. ‘I hate it when people call me Rosie.’

Suzanne grimaced. ‘Then my advice to you is to make sure that certain members of this staff are fully acquainted with your views.’ She shot a speaking look at Rob, who tried to look hurt.

‘Do you mean me?’

‘If the cap fits…’ Suzanne sniffed loftily and walked away.

Rose chuckled. ‘That put you in your place, didn’t it?’

‘She loves me really,’ Rob assured her, grinning. ‘So, I know that your name is Rose but I don’t know much else. How about filling me in over a cup of coffee after we finish up here?’

‘Sorry, but I think I’d better stick to what I’m getting paid for.’

Rose smiled to take the sting out of her refusal, but nowadays she made a point of not getting involved with the male members of staff wherever she was sent to work. The few times she’d been out with a man in the past it had usually ended badly—her date had expected more from her than she’d been prepared to give. But she had made up her mind after Daniel had been adopted that she would never put herself in the position of being hurt like that again. It was much easier if she kept things on a strictly friendly footing.

‘That makes a change,’ Rob declared, unfazed by her refusal. ‘Most of the agency staff seem to think they’re here to socialise. Angie—that’s the charge nurse—keeps threatening to padlock the staffroom door. Usually they spend more time in there drinking coffee than doing any work!’

‘You must have been using the wrong agency,’ she said lightly, not wanting to be drawn into a discussion about the merits—or pitfalls—of employing agency nurses. There was enough ill feeling as it was, without her encouraging people to think badly of all agency staff.

The porters arrived just then, to take the motorcyclist up to Theatre. Rose checked that his notes were up to date and handed him over, then went to help with the patient who’d been brought in. It was Michelle Robinson, the daughter of the woman who had suffered the heart attack, and she was in a very bad way.

Owen reappeared, and he and the team did all they could for her, but it was a losing battle from the outset. The young woman’s injuries were just too extensive and she died thirty minutes later. Rose nodded when Angie asked her to remove all the leads and tubes before her family came to identify her. It would be distressing enough for them without them having to see all the unpleasant details.

Another couple of patients were brought into Resus, but Rose was asked to work the cubicles and didn’t deal with them. She was glad of the change because dealing with the most severely injured was always harrowing. As she went to report to the triage nurse, she found herself remembering what Rob had said about Owen Gallagher’s mood that day and sighed.

It didn’t take a genius to work out why he was out of sorts. Seeing her there must have been as big a shock for him as it had been for her. All she could hope was that it wouldn’t make a difficult situation any worse. No matter what he believed, she only had Daniel’s best interests at heart, and if getting in touch with her would help Daniel then she most certainly wasn’t going to refuse to see him.

The day wore on, the usual mix of high drama and the mundane. Overcrowded GP surgeries meant that a lot of people who came to the department didn’t actually need to be treated there. Rose dealt with half a dozen minor injuries ranging from a deeply embedded splinter to a sore throat then, at Angie’s behest, went for a break.

There were a couple of other nurses in the staffroom when she went in and she tried not to take it personally when they ignored her. She never stayed in one place long enough to make friends, so she was used to being ignored. She made herself a cup of coffee and had just sat down to drink it when the door opened and Owen Gallagher appeared.

She had managed to keep out of his way since she’d left Resus. With her working the cubicles, it hadn’t been that difficult to avoid him and she’d been glad of the respite. Knowing that she was an object of loathing in his eyes wasn’t the most pleasant experience she’d ever had. Now she stiffened as his gaze skimmed over the other nurses and landed on her. Even from that distance she could see the chill in his grey eyes. He strode towards her and his face was like thunder when he stopped in front of her.

‘There is a waiting-room full of people out there. I suggest you attend to what you’re being paid for, Ms Tremayne. And, to my knowledge, that doesn’t include sitting here, drinking coffee.’

His tone was icy with contempt and Rose flushed. She didn’t say a word as she got up, took her mug to the sink and emptied the coffee down the drain. Nobody said anything as she left the staffroom but she could feel the other nurses watching her and it was galling to know what they must be thinking.

They probably thought she wasn’t pulling her weight after what Owen Gallagher had said, and the unfairness of being labelled as lazy was very hard to take. She did a good job wherever she worked and put one hundred per cent effort into it, too. That was why she’d been offered so many permanent posts—every hospital she’d worked at had asked her if she would like to join their staff, but she’d had to refuse.

It wasn’t that she didn’t like the idea of working in one place, because she would have loved to do so. It was the fact that she wouldn’t earn her current salary that stopped her. As her father had sunk deeper into the grip of Alzheimer’s disease she’d had to move him into a nursing-home, and the fees were extortionate. Agency work paid far more than she could earn by working for the NHS, plus she could top up her income by working nights if the nursing-home’s fees increased. Maybe she should have explained all that to Owen—only what would have been the point? He wasn’t interested in her problems, he was only interested in keeping her away from Daniel.

Rose went back to the unit and took a fresh file out of the tray, determined that she wouldn’t give him the opportunity to accuse her of wasting time again. The waiting-room was packed and she had to shout to make herself heard above the din.

‘Vicky Smith.’

A girl in her twenties stood up, clutching her left hand. Rose grimaced when she saw the state of her ring finger. ‘That looks very nasty,’ she said, leading the young woman to a cubicle. ‘How did it happen?’

‘I was bringing my horse in from the field when he tried to bolt. The lead rope must have got wrapped around my finger somehow because I heard it make this horrible popping sound.’ Vicky sat down on the bed, looking very pale as she studied her swollen hand. ‘Do you think it’s broken?’

‘It could be, but I’ll have to get one of the doctors to take a look at it before we can be sure.’ Rose smiled at her. ‘It will probably need X-raying so there’ll be a bit of wait. Did you come here on your own or did someone bring you?’