Her Honourable Playboy

The bonnet of the yellow car had been pushed back into the car, though the vehicle had slewed on impact so the brunt of the impact was on the driver’s side. The lorry driver had climbed out of the cab—so at least that was one less person to worry about, though Seb made a mental note to check him over too. With collisions, sometimes the injuries weren’t apparent straight away. There could be something nasty storing itself up.

‘We’ve called the emergency services. We’re both doctors,’ Seb said. ‘This is Alyssa and I’m Seb. Are you in any pain at all?’

‘No. But where the hell did they come from? I didn’t see them!’ The lorry driver was shaking—whether from fear or anger, Alyssa wasn’t sure. ‘Bloody joy-riders! The lights were green my way. I wouldn’t have pulled out if it wasn’t clear.’

‘They went through a red light,’ Seb said quietly.

‘It wasn’t your fault,’ Alyssa said. ‘Look, can you sit down over there? We’ll check you over when we’ve had a look at this lot.’

‘I’m all right.’ The lorry driver looked at the car. ‘Oh, hell. The driver’s never going to get out of that alive.’

‘He’s alive now,’ Alyssa said, ‘and we’re going to try to keep him that way. And even if you feel fine now, we still need to check you over.’

‘Is there anything we need to worry about in the lorry?’ Seb asked quickly.

The driver shook his head. ‘My load’s just fruit.’

So they didn’t have to deal with the risk of a chemical spill on top of this, Seb thought with relief. Good.

The driver of the car was crying as they went over to him. ‘Don’t hurt me, don’t hurt me. I can’t get out. I’m stuck. Don’t hit me!’

Did the driver really think he was going to beat him up for overtaking him? Seb wondered. That he’d smash his fists into a young lad who was stuck in a crushed car and couldn’t defend himself? Hell, what sort of life had the kid led? ‘I’m a doctor,’ Seb said calmly. ‘And it looks as if you’re hurt enough.’

‘Let me handle this,’ Alyssa said softly.

‘I know I was stupid,’ the driver said, his voice shrill with panic. ‘I was showing off. I’m sorry. My mum’s going to kill me.’

Seb, noting the state of the vehicle, sent Alyssa a speaking glance: the boy’s mum might not get the chance. If there was a penetrating abdominal wound, or if the inside of the car had caused severe crush injuries, they’d be lucky to get the driver out alive.

‘It’s OK,’ Alyssa said. ‘You need to keep calm, so we can get you out of there.’

The driver gave Seb another scared look, and Alyssa nudged Seb. Hard.

‘I’ll check on your mates,’ Seb said quietly. ‘You hang on in there. Alyssa’s going to look after you.’

‘What’s your name?’ Alyssa asked.

‘Gavin. My mates call me Gaz.’

‘I’m Alyssa. I’m a doctor, too. I’m going to try and help you.’

‘I’m so scared!’

He couldn’t be more than eighteen, Alyssa thought. ‘It’s OK, love. We’ll get you out of there. Can you tell me where it hurts?’

‘My arm.’

‘Anywhere else?’

‘No.’

This wasn’t good. From the state of the car, Alyssa knew Gaz’s legs had to be crushed. If they weren’t hurting, that was a bad sign: it meant there could be severe nerve damage.

‘You said you were stuck. Where are you stuck—your arm, your legs?’

‘My legs.’

Probably his feet were jammed underneath the pedals. ‘Can you move your left foot for me?’ she asked.

Gaz began to shake. ‘No.’

‘How about your right?’

‘No. I can’t feel anything.’ Then his eyes widened as realisation hit him. ‘Oh, God, I can’t feel my legs!’

‘It’s OK,’ Alyssa soothed, knowing it was very far from OK. If this was a crush injury, the chances were that Gaz was already bleeding to death—or that the pressure of the car against his legs had stopped the blood flow. Which meant that the second they cut him out and the pressure was released, he’d start to bleed heavily. As it was, there was a risk of compartment syndrome, where his blood would compress the nerves and muscles and the blood wouldn’t go through the tissues properly—so he could end up with a lot of dead muscle tissue.

If he survived that long.

Don’t think about that, she reminded herself. Concentrate on saving him, not on the poor odds. Go through the drill. ABCDE. Airway fine—obviously no obstruction because Gaz could talk. Breathing fine—no pallor, no blueness around the lips, no rasping. Not a tension pneumothorax at this stage, then, though she’d need to keep a close eye on him and act the second she noticed any of the signs. Circulation was the one she was really worried about: if Gaz had a large external haemorrhage, it was going to be hard to staunch it.

But the streetlights weren’t enough to show her what she needed to know. ‘Seb, can I borrow your torch a minute?’ she called. At the same time, the rest of the mnemonics were going through her head. Disability—Gaz was awake and responsive, so neurological worries could be put aside for now. Exposure—well, they couldn’t move him until the fire brigade cut him out, so no point in worrying about that one.

Airway, breathing—her breath hitched—circulation.

Seb appeared with the torch. Alyssa shone it into the car. The light told Alyssa that what she’d most feared wasn’t there: no dark patch of blood spreading across Gaz’s seat.

If only the ambulance and fire crew would get here. Like yesterday.

‘Are my mates OK?’ Gaz asked.

‘Hold on there a second, and I’ll check with Seb,’ she said, and pulled Seb away from the car. ‘We need to get him out of there, fast. I’m not sure if we’re going to have time to get him cut out of the car.’

‘Bad haemorrhage?’

‘No, but probably crush syndrome.’

‘So the second we move him, he’s going to crash,’ Seb said.

‘We are not going to lose him,’ Alyssa said in a fierce whisper. ‘I’m going to try and keep him talking. He wants to know about his mates.’

‘Tell him that one of his mates was knocked out briefly so he needs to go in to be assessed, and the two in the back have whiplash and will be fine. I’ll check the lorry driver and I’ll be back.’

Alyssa went back to Gaz, who’d grown paler and more frightened. She held one of his hands. ‘OK. Seb says your mate in the front was knocked out, so we’ll check him over at the hospital. The two in the back have got whiplash but they’ll be fine—they just won’t be up to going clubbing or playing football for a couple of weeks. Seb’s checking the lorry driver, but he managed to get out of the lorry all right.’

‘Oh, God. He must be so mad with me.’

Yeah. And he’d be giving a statement to the police. So if Gaz had stolen the car and gone joy-riding, the police would throw the book at him. But that was the least of their worries right now. ‘It’s OK,’ she soothed. ‘The fire brigade is on its way and we’ll get you out of there.’