City Surgeon, Small Town Miracle

‘How bad’s the pain? Scale of one to ten?’

‘Three.’

‘Betty…’

‘Eight, then,’ she said, goaded.

‘You have to let me put up a syringe driver.’ With a permanent syringe, morphine could be delivered continuously so there wasn’t this four-hourly cycle of pain, relief, sleep, pain that Betty was suffering. But so far Betty had resisted. She’d insisted on control at every stage of this illness and she wasn’t letting go now.

‘I’ll take a pill in a few minutes.’

‘Take one now. No, take two.’

‘When I see our baby’s okay,’ Betty said roughly. ‘Oh, my dear…’

‘It’ll be fine.’ Maggie hauled herself around and stretched her hand out to her. Betty’s hand was thin and cold and it trembled.

Probably hers did, too, Maggie thought. Things were going from bad to worse.

Hurry up the man with the ultrasound. Max. A doctor for her baby.

And more.

Max.

He’d carried her and he’d made her feel cared for. The remembered sensation was insidious—almost treacherous. It undermined her independence. Stupidly it made her want to cry.

Max.

He opened the back of the wagon, expecting to see a basic medical kit—or even no kit at all, because he still hardly believed she was a doctor—but what he saw was amazing. The equipment, carefully stored, sorted and readily accessible, was state of the art.

What had she said back at the crash site? She was the ambulance?

Maybe she was, for in the centre of the shelves of equipment lay a stretcher. It had been fitted to custom-built rails, with wheeled legs folded underneath. It was narrow, but otherwise there was little difference to the stretcher trolleys used at his city teaching hospital.

The ultrasound equipment was impossible to miss for it was in a red case labelled ‘Ultrasound’. Useful for a doctor in a crisis, he thought, to be able to say to an onlooker, ‘Fetch me the red case with this label.’ And the cases were stacked and fastened against the sides in such a way that in a crisis they could be pulled out fast.

He had a sudden vision of an emergency—maybe a child with breathing problems. With this set-up Maggie could haul out the side cases fast, then have someone else drive while she worked on the patient until they reached help.

Basic but effective. She was efficient, then, this Dr Maggie.

He needed to be as well. He tugged the ultrasound case, grabbed another case labelled ‘Pain/Anaesthetic’—and then, thinking of the strain on the old lady’s face and the wheeze behind her voice, he grabbed an oxygen canister as well.

Okay. Doctor with equipment.

They dropped their linked hands as he walked back into the room. Up until now he’d seen only an underlying tension, but there was now an obvious tie between the women. Emotional as well as physical?

Was the old lady really dying? He gave himself time to look at her—really look. She was dreadfully gaunt, as though eating had long ceased to be a priority, and her face was taut with pain. And her eyes…He’d seen that look before. Turning inward.

‘Betty needs a shot of morphine,’ Maggie said before he could say anything. ‘Please. Ten milligrams. You’ll find everything in my bag.’

‘The baby…’

‘One injection’s not going to take time. Betty needs it badly.’

‘Diagnosis?’ he said, watching Betty now and talking directly to the elderly woman.

‘Bone metastases,’ Betty whispered. ‘Ovarian cancer ten years back. I knew it’d get me in the end.’

‘Is Maggie your treating doctor?’

‘Now I’m not in hospital, she is,’ Betty said fretfully. ‘But look after her. I’m fine.’

But Max was already flipping open the case, drawing up the injection, aware both women were watching him like two hawks with a mouse between them. Or two mice with a hawk?’

‘You agree to this?’ he said, watching Betty’s face. Feeling Maggie’s tension behind him.

‘Yes,’ Betty whispered. ‘Please.’

He injected the morphine, feeling her pulse as he did so. Faint, irregular. If she was forty he’d be roaring for help, he thought, bullying her into hospital, pulling out all stops to help her, but her body language told him she knew exactly what was happening. He placed pressure on the injection site for a moment and her hand lifted to his and held.

‘Thank you,’ she whispered, and closed her eyes. ‘Now Maggie.’

‘Now Maggie,’ he agreed, and Maggie nodded and pointed to a power plug behind the couch.

‘We can do it here.’

‘You don’t want to be private?’

‘I doubt I’ll shock Betty by showing a bit of skin,’ Maggie said, smiling wryly. ‘And it’s warm in here.’

She shivered as she said it. He didn’t comment, though—she’d know as well as he did that shock would be causing her to shiver.

And internal bleeding?’

Please not.

‘You’ve used one of these before?’ she asked him.

‘Not a portable one.’

‘Nothing to it,’ she said.

And there wasn’t. In moments he had it organised, set up on a side table right by Maggie’s abdomen.

She was wearing jeans with an elasticised waist and a sloppy windcheater that could easily be pulled up. He rubbed the stethoscope in his hands to take away the chill, then knelt beside her. As she tugged up her windcheater, he glanced up at her and once again saw the flash of fear. He should take her blood pressure first, he thought, and check her pulse, but he had a feeling they’d be high and racing until he gave her the reassurance she needed. Was she shivering from shock or shivering from fear? Probably the latter.

So he placed the stethoscope over her tummy and listened.