The Consultant's Special Rescue

‘There are one or two more things that I want to check, Mr Carstairs,’ she said. ‘I’d like to listen to your heart through my stethoscope to check for any murmurs and so on, and then I want to take some blood from your arm for testing.’

He let her proceed, and when she had finished and sent off the relevant samples to the laboratory, he asked worriedly, ‘Do you know what’s causing the problem?’

‘I can’t say for certain just yet,’ she answered. ‘It will depend on the results of all the tests. I’ve arranged for an ophthalmologist to come and take a look at you.’

‘Am I going to lose my sight permanently?’ It was a blunt question, and Amber thought he deserved an honest answer.

‘I’m not sure,’ she said. ‘It’s possible that you have a blockage in the retinal artery, and the outcome very much depends on how quickly we can move that blockage. We need to find out what’s causing the obstruction in order to be able to treat it.’

‘But you must have some idea?’

‘It’s probable that you suffered an embolism, and that might be because you have a degree of atherosclerosis. We won’t know until the results come back. In the meantime, I’m going to attempt to lessen the pressure within the eye. That’s probably the best way of trying to save your sight.’

He looked frightened, and she did her best to reassure him. ‘I need to massage your eye,’ she told him, ‘because that may dislodge the embolus and allow the eye to recover a little.’

She settled him into a comfortable position and then for a few seconds she applied direct pressure to the globe. Then she released it and repeated the action several times.

There was still no sign of the specialist putting in an appearance, and Amber was beginning to be concerned. ‘There is something else I can try, while we’re waiting for the consultant,’ she told the man. ‘I can draw a little fluid from the eye to move the embolus even further away. It sounds horrible, I know, but don’t worry—I’ll give you a local anaesthetic. Try to relax and I’ll do what I can to save your sight.’ She called for assistance from a nurse, and Chloe came to help.

‘Are you going to use the slit lamp?’ Chloe asked, and Amber nodded. ‘I’ll need a tuberculin syringe and 27-gauge needle.’

Amber worked carefully for some time, and eventually she was relieved that the pressure within the eye had been reduced. She said, ‘All right, Mr Carstairs…that’s all finished now. Just rest for a while, and then I’ll arrange for you to have a magnetic resonance angiogram so that we can see what’s happened to the embolus now.’

He looked anxious and she said, ‘It’s nothing to worry about, I promise, and when we have a clear picture of what we are dealing with, we’ll be able to give you further treatment to dissolve the blockage and to prevent any further damage. It all depends what the specialist decides once he’s looked over your case notes.’

She smiled at him. ‘You’ve been very brave. Take it easy now, and I’ll leave you with the nurse for a while. I’m sure she’ll answer any questions that you have.’

Chloe went to attend to him, and Amber hurried away to chase up the specialist.

‘He’s dealing with another emergency,’ Mandy said. ‘He said he would get down here as soon as he could.’

Amber wasn’t happy about that. In cases like Jack Carstairs’s, she knew that speedy treatment was imperative. A matter of a few hours could make all the difference. She had done what she could to save his sight, but it all depended whether he had been treated early enough.

She laid her stethoscope down on the desk, and began to write up her notes. Perhaps she should enquire into the possibility of Jack being treated with hyperbaric oxygen therapy. At least if she had set the wheels in motion, the treatment would be available if the specialist decided to go ahead. It was a fine line to tread, but she went ahead anyway and organised it.

The last thing she needed was to be taken to task by the ophthalmologist for not acting quickly enough or for taking on too much and impinging on his area of specialisation. She didn’t know what the rules were here, or anything about individual sensitivities, and she didn’t want to tread on any toes, but her patient’s welfare had to come first. If the consultant decided not to go ahead with what she had arranged, nothing had been lost.

She was just signing off on the chart when she felt something tugging at her cotton over-shirt. Looking down, she was startled to see four-year-old Lucy standing by the desk.

‘Do you know where my mummy is?’ the little girl asked.

Amber knelt down beside the child. ‘Hello, Lucy. What are you doing here? Is someone looking after you?’

‘Mrs Denney’s looking after me. She’s over there.’ Lucy pointed to where a woman was in conversation with Mandy. ‘I wasn’t very well,’ Lucy said, ‘and she brought me to see my mummy. Where is she? Do you know?’

‘Yes, she isn’t far away. I’ll go and find her and tell her that you’re here, shall I?’

‘It’s all right. Mandy said she would find her, but she’s talking to Mrs Denney. I want Mummy to come and take me home.’

‘She’ll be here in a minute or so, I expect.’ Amber paused. ‘You said you weren’t feeling very well…what’s the matter? Is there anything I can do to help?’

‘My chest hurts. I want to go home.’

‘Do you think you’ll feel better there?’

Lucy nodded and Amber said cautiously, ‘Does Mrs Denney look after you while your mummy’s working?’

Lucy nodded again. ‘She works in the nursery upstairs.’

‘Oh, I see.’ She looked at Lucy’s pale face. ‘I wonder why your chest’s hurting. Did the smoke upset you the other day? I saw you coughing.’

‘Yes, it did.’ Lucy’s chin jutted. ‘It made me cough and cough and cough, and the man from the ambulance gave me some medicine. It still hurts, though.’

‘Poor you. I expect your mummy will be here soon, and you can tell her all about it.’ She got to her feet and put her hand out to the little girl. ‘Shall we go and talk to Mrs Denney?’

Lucy went with her, and Mrs Denney put an arm around the child’s shoulders. ‘Your mummy’s coming to see you, chick,’ she said. She glanced around, and added, ‘Here she is now, look. Why don’t you go and give her a cuddle?’

The little girl ran off to her mother, and Mrs Denney said, ‘Thanks for bringing her back to me. I was keeping a discreet eye on her, just in case.’

‘Do you think Chloe will take her home?’ Amber asked.

‘I’m not sure. It may be that Lucy just wants a little bit of reassurance, and then she’ll be fine. If that’s the case, I expect they’ll have a few minutes together and then I’ll take her back up to the nursery. Chloe said it’s all right to bring her down here if there’s a problem. It’s better than having the child upset.’

‘It must have been a bit unsettling for her, having to move out of the flat,’ Mandy put in. ‘I expect she’ll be fine in a little while.’ She glanced at Amber. ‘Do you want me to go and take over from Chloe?’

‘That would be good, thank you. I have another patient waiting. Will you let me know when the specialist arrives?’

‘Will do. Leave it with me.’

Amber went to tend to her next patient, a woman suffering from a fractured hand. It was a nasty injury, and Amber took her time checking that blood circulation had not been impeded.

When she had finished, she walked out of the treatment room and straight into her new boss.

‘Sorry,’ she said. ‘I didn’t see you there.’

‘I gathered that,’ he said dryly. ‘It helps if you look around, you know.’

Amber winced. ‘I was thinking about the patient I’ve just attended to. You’re right, though. I’ll look where I’m going next time.’

‘You can come and examine the youth in room two,’ he said, ‘since you’ve finished in there. He’s having some difficulty with his breathing. I’d be interested to see what you make of him.’

Amber followed him to the room. She guessed he was intent on watching her at work, as he was in between patients just now. She might have known he would check up on her.

Going into the room, she greeted the youth. ‘Hello, Sam. I’m Dr Cavell. I understand you are having some problems with your breathing?’

The young man nodded, and she guessed from the way he spoke and outlined his symptoms that he was suffering from asthma. ‘I’ll just listen to your chest, if I may,’ she said. Reaching into her pocket, she searched for her stethoscope. It wasn’t there.

She looked around, a sense of impending doom settling on her.