Hawaiian Sunset, Dream Proposal

‘You sound as though things are becoming too much for you,’ she murmured, sending him a sympathetic smile before checking the pulse oximeter reading to see how her patient was doing. The machine kept bleeping, warning her that the level of oxygen in his blood was falling as his circulation became more impaired. She decided to check with the consultant about starting him on thrombolytic drugs to try to dissolve, or reduce, the size of any clot that might have formed.

‘I’m really hoping that we’ll be able to work together at the London University Hospital. We’ve worked well with one another here in A and E, haven’t we?’ Amber studied James closely, seeing the troubled look in his eyes. ‘Perhaps we could have lunch together later today and talk things through? I’m fairly sure that you won’t have any trouble getting the research job you were after.’

‘Maybe. There aren’t that many people lining up to study my particular area of enquiry into asthma. It all depends whether the powers that be can come up with the funding.’

He straightened up, looking more at ease with himself, and moved away from her, towards the door. ‘I’ll go and check in the office again to see if any more news has come in.’ He looked at the man lying motionless in the bed. ‘Poor chap. It looks as though he’s having a rough time.’

Amber nodded, brushing a hand over her temples to tease back tendrils of hair that threatened to obscure her vision. Her chestnut-coloured hair was a shoulderlength mass of wild curls, a genetic gift from her mother that needed to be ruthlessly tamed with clips or scrunches. They shared the same eye colour, too, a soft, jewelled green.

‘I want to start him on thrombolytics,’ she said, ‘but until I have the results from the lab, I’m working in the dark a bit. My boss is operating on a badly injured patient right now, and I don’t want to disturb him unnecessarily, but I don’t think I can afford to wait.’

‘I know what you mean. It’s a balancing act, knowing when to prescribe and when to bide your time. I’d be inclined to interrupt your boss if I were you.’ James walked towards the door. ‘I’ll be back down here in a few minutes to see how you’re doing—I only came to see if you had heard anything about the job you applied for. Someone said letters were being given out this morning but for now I need to go and check up on a patient. Do you want me to check your box for any letters while I’m there?’

‘Yes, thanks.’ Amber nodded and turned her attention back to the businessman, writing up his medication notes on the chart as Sarah came into the room. Sarah shot a glance towards James as they passed each other in the corridor, and a small frown started up on her brow. Martyn’s daughter was by her side, but Caitlin was preoccupied just then, speaking to someone on her mobile phone. She stayed in the doorway, and Amber guessed Sarah had asked her not to bring the phone into the room.

Amber put the chart to one side and looked once more at the chest X-ray in the light box. Martyn’s heart was enlarged, and that was not a good sign.

Sarah inspected the settings on the infusion meter and made sure that their patient was receiving the right amount of medication through a drip in his arm.

‘Is everything okay with you and James?’ she asked in a quiet voice, throwing a brief glance in Amber’s direction. ‘He doesn’t seem to be his usual self these days, does he? It’s hard to pinpoint, but there’s definitely something…’

‘I was just thinking the same thing,’ Amber answered cautiously. ‘I think the world of him, as you know. We’ve been together for over a year now, and I thought everything was fine, but just lately I’m not so sure. He doesn’t smile as often as he did, and he has a sort of hangdog air about him, doesn’t he?’

Sarah nodded. ‘It’s probably the aftermath of exams, and waiting around for results and job offers,’ she remarked. ‘It seems to have affected everyone. My boyfriend’s gone into a bit of a decline, too. We’ve just not been having any fun lately.’

‘I dare say things will get better.’ Amber looked across the room at Caitlin, and saw that there was an awkward air about her, a reticence, as though she was in some way holding back. ‘Was there something you wanted to ask?’ Amber murmured.

Caitlin indicated the phone. ‘It’s my step-cousin, Ethan,’ she said, in a hesitant fashion. ‘He asked me to put him on speaker-phone. He wants to be involved in everything that’s going on.’

‘That’s fine with me.’ Amber nodded. ‘Just don’t bring the phone any closer to the medical equipment, or it might cause interference.’

She checked Martyn’s pulse. It was thready, his features were drained of colour, and she was worried in general about his condition. ‘It must be frustrating for your cousin to be so far away and not know what’s happening.’

‘But not for much longer, I hope.’ A male voice cracked in a whip-like fashion across the room. His tone was concise and authoritative, and Amber braced herself in startled recognition of the fact that he must be able to hear every word that was being spoken. ‘I’d like to talk to the doctor in charge of my uncle’s case,’ he said.

‘That would be me,’ she answered. ‘I’m Dr Amber Shaw. I’m the senior house officer in A and E. I was on duty when your uncle was brought in. I take it you are Ethan Wyndham Brookes?’

‘I’m Ethan Brookes without the Wyndham. Yes, my cousin explained the situation to me. I understand you’ve been taking care of my uncle, and I’m grateful to you for that. I heard that you have him on anticoagulant therapy to prevent any more blood clots from forming, but his condition seems to be deteriorating.’

‘Things are going very much as we might have expected,’ Amber told him. ‘As I explained to your cousin, we’re still waiting on the results of tests, but they should be here very soon.’

‘Hmm. But in these situations time is of the essence, isn’t it? So, I’d like to speak to the consultant in charge, if I may?’

He posed it as a polite question, but Amber was in no doubt that it was a request. She guessed from his deep, well-modulated and assured tones that he was used to having things his own way. He would be somewhere in his mid-thirties, she imagined.

‘Of course, I’ll put you in touch with him as soon as possible, but he’s in Theatre at the moment. Perhaps I could assist you in the meantime? I’d like to reassure you that we’re doing all that we can to make your uncle comfortable.’

‘I’m glad to hear it. My cousin and I are very worried about her father.’

Amber had the feeling he didn’t want to be dealing with an underling at all, but she made an effort to remain calm and not take it personally.

‘I’m very well aware that this is a difficult time for both of you,’ Amber murmured, ‘but I can assure you that everything that can be done is being done. Your uncle has received the recommended treatment so far…oxygen, aspirin, glyceryl trinitrate and painkilling medication, as well as blood-thinning drugs. I’ve already cleared the way for him to be taken up to the angiography suite. As soon as my boss has finished in surgery, he’ll come down and assess your uncle’s state of health.’

‘So you’re thinking about operating on him?’

‘It’s a possibility, if his condition will allow us to do so. We may be able to find the clot that’s causing the damage and remove it by means of a catheter. That might do away with the need for more intrusive, major surgery, but I have to say that Mr Wyndham Brookes’s condition is very precarious. From the looks of his X-ray there could be an underlying disease that might cause more problems. That’s why it would be extremely helpful for us to have access to his medical records.’

‘I’m already onto it, and I’ll send them to you as soon as possible. In the meantime, I’d like to set up a video link with his hospital room. I know you have conferencing capabilities, so it shouldn’t be too difficult to arrange.’

His suggestion took Amber’s breath away. This man clearly knew what he wanted, and didn’t see why he shouldn’t sweep every obstacle to one side in order to get things done.

‘Is that going to be a problem for you? Perhaps I should speak with your chief administrator?’ Perhaps he had heard her swift intake of breath. Ethan Brookes sounded as though he had no time for shilly-shallying. If she couldn’t deal with it, he would go to someone who could.

‘That won’t be necessary,’ she murmured. ‘Your uncle is in a private room, so I’m sure we can accommodate your request, as long as his daughter has no objection.’ She glanced at Caitlin, raising her brow in a faint query.

‘I’d like that,’ Caitlin said. ‘It will make me feel better to know that Ethan’s looking on.’

Amber wasn’t at all sure how she felt about it. Having her every move watched by a stranger wasn’t something she welcomed, but technological advances meant that it could be done, and if it was something that helped unite families in their hour of need, who was she to object?

‘My boss should be here within a few minutes,’ Amber said. ‘I’ll speak to him about it, and if he agrees, we’ll call on one of our technicians to set it up. Now, if you don’t mind, I need to give my full attention to your uncle…unless there was something else that you urgently wanted to discuss?’

‘No…it will keep. Thanks for your co-operation,’ Ethan said. The speaker-phone link was cut, and Caitlin went out into the corridor to finish her conversation with him in private.

Amber drew in a deep breath. It was one thing to deal with worried relatives close at hand, but having difficult, long-distance discussions with someone she had never met was a first for her.

A few minutes later, she left Martyn in Sarah’s care, while another nurse took Caitlin away to show her to a waiting room. There she would be able to sit in comfort and talk about her concerns to the nurse with the aid of a reviving cup of tea. Having Caitlin looked after took a great deal of the strain off Amber’s shoulders and left her free to go and check on her other patients.

When her boss came down from Theatre, Amber grabbed the opportunity to update him on Martyn’s condition.

‘We’ll take him up to the catheter suite as soon as the team is assembled,’ the consultant agreed. ‘As to the video link, I see no reason to object.’ He gave a brief, wry smile. ‘Besides, I’ve heard of the Brookes’s international fruit-shipping company. I read about their goings-on in the newspaper from time to time. These people are high-powered, influential individuals. Let’s not get on the wrong side of any of them, if we can help it. Call the technician and ask him to sort out the video link. Anything to keep them happy.’

Amber lifted a faintly arched brow. Her boss wasn’t someone who usually worried too much about following protocol and treading carefully around people, so if he thought it expedient to appease Ethan Brookes, who was she to argue?

‘Professor Halloran,’ Sarah interrupted, ‘you’re needed in the resuscitation room. One of your pacemaker patients is in difficulty.’

The consultant nodded. ‘Okay, I’ll be along right away.’ He sent a brief glance towards Amber. ‘Prepare Mr Wyndham Brookes for surgery, and I’ll be along as soon as possible.’

Amber did as he asked, leaving a nurse to call in the technician to set up the video link. Martyn was barely conscious, but she spoke to him gently, explaining what they were going to do.

‘Professor Halloran is the best cardiac surgeon we have,’ she told him. ‘He’ll use X-ray images to look at your blood vessels through our cardiac monitor, and that should help him to find exactly where the blockage is. He’ll most likely insert a very thin catheter into a blood vessel of the top of your leg, and then he’ll use specialised instruments to remove the clot that’s causing the problem.’ She looked into his grey eyes. ‘Do you understand what I’m saying?’

He nodded almost imperceptibly. ‘I do.’

‘Is there anything that you’d like to ask me about it?’

‘Nothing. Thank you. I’m very tired.’ He tried to lift his hand and made a frail attempt to pat hers as it rested gently on the bedclothes beside him. His breath came in quick gasps. ‘I know you’ll do your best for me. You mustn’t worry if it all goes wrong.’

Amber felt the quick sting of tears behind her eyelids. Somehow, this man had managed to reach her inner core, the place where she tried to keep her feelings hidden. In the short time she had known him, she had found an affinity with him, and she realised that she cared deeply about what happened to him.