A Christmas Knight

From the bruising on Rhiannon’s skin, it looked as if she had several broken ribs. No doubt Dominic wanted to check for pulmonary contusions. There were a lot of problems that could be caused by blunt trauma at high velocity, Louisa knew; with damage in Rhiannon’s chest area, there could be trauma to the heart as well as the lungs.

‘I think we need to intubate.’ He held Rhiannon’s hand as he explained to her what they were doing. ‘You’re struggling to breathe, sweetheart, so we need to help you with that and make sure you get enough oxygen. I’m going to put a tube down your throat so you won’t be able to speak, but I’m going to give you some medication first so you won’t feel it and it won’t hurt—it’ll make you more comfortable. I know you’re feeling tired and it’s hard to talk, so just squeeze my hand if you’re OK with that—once for yes and twice for no.’ He paused. ‘That’s a yes—that’s my girl. We’ll get you comfortable as soon as we can.’

Louisa was just drawing up the ampoules of anaesthetic when one of the drivers who’d been brought in came over to them, his face ashen. ‘Oh, my God, Rhi! I’m so sorry. I couldn’t avoid him—he just pulled out on me and there was nothing I could do.’ He looked distraught as he stared wildly at Dominic and Louisa. ‘I can’t believe I’ve come out with just bruises, and Rhi’s so…so…’ His voice caught.

‘Gary, isn’t it?’ Dominic said, somehow managing to divide his attention and eye contact between his patient and her husband.

‘Yes.’

‘She was asking for you.’

‘Can I hold her hand?’ At Dominic’s brief nod, Gary curled his fingers round his wife. ‘Honey, I’m here, and I love you, and I’m so sorry.’ He dragged in a breath and looked pleadingly at Dominic. ‘Is she going to die?’

‘Not on my shift,’ Dominic said, ‘though it might be easier on you if you wait outside. There’s a vending machine just round the corner. I promise we’ll come and find you as soon as we’ve got her stable and let you know what’s going on, but for now we need to concentrate on Rhiannon here and treat her.’

Gary shook his head. ‘No. I need to stay with her.’

‘Unless you’re a trained medic, it can look very worrying in here,’ Dominic said gently. ‘Especially as we’re just about to intubate her to help her breathe. Trust me, we’re going to do everything we can for your wife, but it will be much better on your nerves if you go and get yourself a hot drink and leave us to it for the next few minutes.’

‘I’ll come and get you as soon as there’s any news,’ Louisa promised. But she noticed that Gary was staring at his wife, looking stunned. In shock, she thought—not the medical kind, but the emotional kind. They needed to get him out of here. ‘Do I have two minutes, Dominic, to show Gary where everything is?’

‘Two minutes,’ Dominic confirmed; the expression in his eyes told Louisa that he knew exactly what she was doing and approved. Which was a huge relief: he was much easier to work with than she’d expected. And he was sensitive with patients and relatives. Maybe she’d just caught him on a bad day on Monday.

‘Come on, I’ll show you where the drinks machine is,’ Louisa said, slipping her arm through Gary’s and guiding him out of Resus.

‘I was coming down the hill. I wasn’t speeding. I could see the other car approaching the junction, but he wasn’t even indicating! And then he just pulled out in front of me. It was as if it all happened in slow motion. I could see we were going to crash, and I couldn’t do anything to stop it. I slammed on the brakes, but it wasn’t enough.’ Gary shivered. ‘We hit him and the car spun round. Rhi’s side of the car was squashed against another one. And…’ He covered his face with his hands. ‘She can’t die. We celebrated our twenty-fifth wedding anniversary last week. I can’t…Not without her…’

Louisa got him a cup of hot, sweet tea from the vending machine—even if he didn’t normally take sugar or drink tea, she knew it would help—and settled him in a chair. ‘Gary, it wasn’t your fault, and the staff here are really good,’ she told him gently. ‘We’re going to do our very, very best. Now I have to go back and help Dominic treat Rhiannon, but I’ll be back as soon as I can with any news.’ She squeezed his shoulder. ‘I know waiting’s hard but hang on in there, love.’

‘You’re so kind. Thank you. And please—’ Gary’s face was stricken ‘—please, don’t let my wife die.’

By the time Louisa got back into Resus, the medication had taken effect, and Dominic started to intubate their patient. She’d seen it done before, but never with this calm, confident efficiency—and he was amazingly quick.

Dominic Hurst was a superb doctor, she thought. And she liked the way he’d made time to talk to his patient and her husband, clearly aware of how important communication was as a way of bringing down stress levels.

He blew up the cuff on the tube and turned to the other nurse. ‘Sally, are they ready for us in Radiology?’

‘Yes.’

‘Great. Thanks for that. Can you bleep the orthopods, please, and let them know we have a patient with suspected flail chest? I want to have a look at the X-rays, so I’m going down to Radiology with Rhiannon.’

‘Do you want me to give ITU a call, to put them on standby?’ Louisa asked quietly, so Rhiannon couldn’t hear her and start to worry. In her experience, it was best to involve the intensive care unit as early as possible, because cases of pulmonary contusions often led to ARDS—adult respiratory distress syndrome. And if there were multiple broken ribs, she’d need careful monitoring.

‘Yes, please. And could you tell Gary I’m taking her to X-Ray? Not because he should worry himself sick, but because it means I can see the X-rays straight off and it’ll save us some time. Tell him I’ll come and talk to him as soon as we know more.’ He smiled at her. ‘Thank you, Sally. You’ve done a really good job. You, too, Louisa. Even though this is the first time we’ve worked together, it’s felt as if we’ve been on the same team for years. Your old department must really be missing you.’

The compliment made her feel warm all over—especially as she hadn’t expected it from him. And it was good to work with a doctor who appreciated the nursing staff rather than taking them for granted, especially one who bothered to give a student praise where it was due. She smiled back at him. ‘Thanks.’

While Dominic went off to X-Ray with Rhiannon, Louisa contacted the intensive care unit to put them in the picture, then went in search of Gary to let him know what was happening.

‘Is she going to be all right?’ he asked. ‘I’ll never forgive myself if anything happens to her. And that stupid guy who tried to get into a gap that wasn’t there, just to save a few seconds…’ He was shaking, clearly near tears.

Louisa put her arm round him. ‘I know, love. You said yourself there was nothing you could do, so don’t blame yourself. The police will deal with the other driver.’ Who’d also walked away without a scratch, according to Ronnie, but that wasn’t something Louisa intended to share. ‘We’ll know a lot more when the X-rays are back, and Dominic will talk you through what Rhiannon’s injuries are and how we’re going to treat her. But for now we’re keeping her comfortable. Try not to worry—and, yes, I know that’s a lot easier said than done.’ She gave him a sympathetic smile. ‘Is there anyone we can call for you?’

‘I…No.’ He shook his head. ‘I’d better call our daughter myself. She’ll be devastated.’ He dragged in a breath. ‘I can’t use a mobile phone here, can I?’

‘In the corridors, you can,’ she reassured him. ‘The phone won’t interfere with equipment there.’ It wasn’t the only reason the hospital preferred not to have people chatting on mobile phones—loud conversations disturbed other patients, and some ringtones sounded eerily like alarms on equipment. The blanket ban on mobile phones throughout the hospital had been relaxed, except for critical-care areas such as the emergency department, the coronary care unit and the special care baby unit, where equipment could be affected by electromagnetic interference.

‘Thank you.’

When Dominic came back from Resus, he looked serious but calm. ‘Gary, I’ve seen the scans and I’m sending Rhiannon up to Theatre where the surgeons can help her. She’s got four ribs broken in two places, pulmonary contusions—that’s a bruise on the lung and you often get that with broken ribs—and what looks to me like a cut to her liver.’

‘So the surgeons can fix her ribs?’

‘They might decide to let them heal without fixing them,’ Dominic said. ‘But the contusions are going to make it a bit hard for Rhiannon to breathe, so she’ll be in Intensive Care afterwards until they heal—they can keep a close eye on her and make sure she’s comfortable.’

‘You mean she’s going to be ventilated?’ Gary’s eyes widened. ‘Oh, my God.’

‘It looks and sounds a lot scarier than it is. It’s going to be the best treatment for her,’ Dominic reassured him. ‘We’re taking her up to Theatre now, and if you’d like to you can come with us, as far as the doors. There’s a waiting area there, and one of the surgeons will come out and talk you through what’s happening. The staff at the ICU—the intensive care unit—are lovely, and they’ll be happy to answer any questions you have.’

They headed up to Theatre, Gary holding his wife’s hand all the way.

‘I’m so sorry, Rhi. I love you,’ he said, clearly trying to hold back tears.

‘They’ll take care of her,’ Louisa said gently, putting her arm round his shoulders as Rhiannon was wheeled through the doors to Theatre. ‘Is your daughter coming?’

‘She’s on her way.’ He bit his lip. ‘And I’m keeping you from your work.’

‘That’s OK.’ If necessary, she’d work through her lunch hour to make sure that the targets were hit. People came before admin, in her book, and always would; and if she had to explain herself to the bean-counters, so be it. Nursing was about people, not numbers. ‘I’ll wait until she gets here.’

When Gary and Rhiannon’s daughter arrived, Louisa explained what had happened and what would happen next, made sure they both had a hot drink, then headed back down to the emergency department. She was back in Minors as nurse practitioner for the rest of her shift, and her lunch break consisted of two minutes to bolt a sandwich so that she could catch up with the delay in treating her patients. When it was clear that she was still running late, she made a quick call to her mother to ask if she could pick up Ty from after-school club, and continued working steadily through her list. After she’d seen her last patient, she headed for Resus, hoping that Dominic would be there and that he knew how Rhiannon was.

‘Shouldn’t you have been off duty half an hour ago?’ he asked.

She shrugged. ‘It happens. I just wondered if you’d heard anything from the ICU about Rhiannon?’

‘Yes, I have.’ He smiled at her.

Without that reserve, he was truly stunning; her heart felt as if it had just done a somersault. Which was crazy, because she wasn’t looking to feel this way about anyone. She didn’t need a relationship to complicate her life.

‘Do you have time for a quick coffee while I fill you in?’ he asked. ‘I could do with a Danish pastry.’

That sounded dangerously close to a date. Even though Essie had said he was wrapped up in his work rather than relationships, she didn’t want Dominic to get the wrong idea. Especially as she was aware of how attractive she found him. ‘Sorry, I can’t. I need to pick up my son. Mum met him for me, but he hates it when I’m late.’

‘Can I give you a lift home and tell you on the way?’ he asked.

‘Thanks for the offer, but my car’s in the staff car park.’

‘Then how about I walk you to your car while I tell you about Rhiannon?’