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‘Anyway,’ he said, just to make the point, ‘I’ve been working in country hospitals for years now, so it’s hardly a change of pace.’
‘No.’ She stood up, put a little cold water in her tea from the tap and drained it, then all but dropped the mug on the worktop in her haste. ‘I have to get on. I’ll see you later.’
‘What are you doing after work?’ he asked impulsively, stopping her in her tracks.
Slowly, as if she was giving herself time, she turned towards him. ‘Nothing,’ she said clearly. ‘Either with you, or anyone else.’
And she turned on her heel and walked away.
He gave a slow smile. It was a putdown, without a shadow of a doubt, but it had failed. ‘Either with you, or anyone else,’ she’d said, and that left the smile on his face, because if there was one thing he didn’t want to do, it was tread on someone else’s toes and upset things for her if she’d got her life on track.
And if she wasn’t doing anything with anyone else, then from where he was sitting right now that was a definite plus.
But progress, he thought with a laughing sigh, was clearly going to be measured in microns …
‘Why, oh, why, oh why—?’
‘Sally?’
She looked up at Ryan, standing beside her and eyeing her quizzically. ‘Hi, there,’ she said brightly. ‘Problem?’
‘Not me,’ he said, his eyes all too perceptive. ‘It was you I was worried about. Are you OK?’
‘Me? Of course,’ she lied.
‘Just wondered. You looked a little poleaxed earlier. It just occurred to me that you and Nick might have had something going once. I hope it won’t be a problem.’
‘No problem,’ she assured him with false cheer, and wondered if it could possibly be true or if it was going to be, as she suspected, a living nightmare until he moved on again. Perhaps it was time to take some in-service training—in Alaska or somewhere. Maybe Ryan could recommend a nice, remote Canadian hospital—
‘Just wondering, that’s all,’ Ryan murmured. ‘You want to talk to me, you know where to find me.’
‘Ryan, thanks, but I’m fine. It was over years ago, and it was nothing much anyway,’ she assured him, and wondered why God didn’t strike her down for such a whopper.
Or maybe it was the truth, and it really had been nothing much, only she’d been too lovestruck and besotted to realise it.
With a sharp sigh, she snatched up the next set of notes, shot through the cubicles and went out to the heaving waiting room. With any luck she’d be able to avoid him for the rest of the day. She scanned the crowd.
‘Mrs Johnson? Can you come through, please?’
Luck wasn’t on her side that day. A scant hour later, Sally stuck her head round the corner of the cubicle where Nick was working and beckoned him.
‘Could I have a quick word, Dr Baker?’ she murmured.
‘Sure. Excuse me a moment.’
He stood up and ducked through the curtain, raising a brow quizzically. ‘Problem?’
‘I will have. There’s an attempted suicide coming in,’ she told him quietly. ‘Young woman who’s thrown herself out of a third-floor window—facial and pelvic injuries. Ryan’s gone to a meeting, Matt’s on holiday and the new SHO is so wet behind the ears I daren’t trust him with a Band-Aid.’
He grinned, sending her off kilter again, and nodded. ‘I’ll get this one sorted out and come through to Resus. Five minutes?’
‘Maximum.’
‘OK. Get the mobile X-ray in there with a radiographer, and call an anaesthetist in case we have airway problems.’
‘Done it.’
‘Good girl.’ With a wink, he ducked back behind the curtain, and she ignored her skittering heart and went into Resus to make sure it was ready for the new arrival.
It was back to normal after the mayhem of the morning, thanks to the cleaners and the nurses who’d restocked the supplies. Thinking of the facial injuries and the effect they might have on the patient’s airway, she checked their stock of all the different sorts of airway the anaesthetist might need, and then went out to meet the ambulance, just as Nick emerged from his cubicle and headed towards the door.
‘Perfect timing,’ she said as the ambulance backed up and the doors opened. As the trolley was lifted out, she winced inwardly. Their casualty was a mess—she was on a spinal board, her face was trashed and her colour was lousy despite the oxygen mask held lightly in place.
The paramedic gave them a quick rundown as they wheeled her rapidly into Resus.
‘Twenty-five-year-old female, name of Jodie Farmer, neighbour saw her jump off her third-floor balcony. She landed on the concrete path outside. GCS 15 at the scene. She needs a tube down really but I thought I’d leave that to you guys as she’s still able to breathe and we were only round the corner—watch her jaw, it’s shattered and her tongue’s bleeding. She’d got umpteen teeth missing, too. It’s a mess in there.’
It certainly was, Sally thought, listening to the list of drugs she’d had on the way in and mentally assessing her. Her left cheekbone was depressed, her eye seemed twisted slightly, her upper lip was huge and torn to ribbons and her lower jaw was grossly misshapen.
In fact, her face was so severely injured Sally was amazed that she hadn’t had a lower score on the Glasgow coma scale, which measured the level of consciousness. She would have expected some degree of concussion, but maybe that would show itself later. She’d have to keep an eye on it and rescore her frequently.
In the meantime, her whole face was swelling before Sally’s eyes, and she was getting restless, moving her head and fluttering her hands, fighting for breath.
It was a fair bet that the inside of her mouth was swelling too, cutting off her air supply. Protecting that had to be the first priority, and the moment she was on the trolley in Resus Sally was ready. ‘Are you going to try and get an airway in?’ she asked doubtfully, but Nick shook his head, confirming her suspicions.
‘Not a chance, and we can’t wait for the anaesthetist, she’s distressed now. I’ll do a laryngostomy. I don’t want to poke about in there. OK, Jodie, just relax, you’re in good hands. I’m just going to get you some air.’
Within seconds he’d located the cricothyroid membrane, made a neat little slit in it and slipped in a tube. Instantly the patient stopped struggling, and her colour started to improve in moments. ‘Right, let’s get some oxygen into her and assess her injuries. I want X-rays of head, chest, total spine and pelvis to start with, and we’ll work from there. Is there a maxillofacial team here?’
‘Yes—I’ve alerted them.’
‘I want them here now. This needs urgent attention. Her eye socket’s compressed and her tongue’s bleeding badly. The orthopaedic reg could do with seeing her when we’ve got the plates, too, because this pelvis needs sorting out.’
They stood back as the radiographer slid the plates into the trolley, took the required shots and disappeared to develop them.
ABCDE, Sally thought. They’d sorted out her airway, made sure she was breathing, they were running in fluids to protect her circulation, Nick had done a brief neurological check to assess any obvious disability, and the last thing on the list was exposure—seeing the whole patient naked to check for anything else they might have missed. Before the door swung shut behind the radiographer, Sally was busy cutting clothes off, and it was immediately obvious that Jodie’s pelvic injuries were very severe.
The skin over her hipbones was stained dark purple with bruises, and there were sharp spikes of bone pushing up against the skin in places.
‘Nasty,’ Nick said softly. The probability of internal injuries is very high, I think. Circulation to both legs seems good, though, amazingly. Watch her pressure—what is it?’
‘A hundred over fifty.’
‘She’s young, but it’s still very low. Watch it like a hawk, please. I don’t want to miss anything. Pulse?’
‘One-twenty and erratic.’
‘She’s breathing all right for herself still, so hopefully her spine’s intact. Let’s check her reflexes.’
He ran a quick neurological check to see if there was any likelihood of spinal damage, and incredibly she seemed to have been lucky. ‘Looks OK. Wonders will never cease,’ he murmured under his breath.
He gave her a little more pain relief, then bent over her, speaking clearly. ‘OK, Jodie, I’m just going to have a look at your mouth and see what you’ve done,’ he told her, then carefully removed the tape from the neck brace and opened her lower jaw a fraction to make sure there was nothing life-threatening that they’d yet to find. He was gentle, but of necessity thorough, and she moaned softly.
‘Sorry, sweetheart,’ he soothed. ‘I won’t be long.’ He sucked out her mouth, his hands gentle as he probed the shattered jaw, and he shook his head.
‘We need to tape this up to support it but there’s nothing much to tape it to. She’ll need it fixing a.s.a.p., and her tongue needs stitching fairly soon, it’s still oozing. Where’s the faciomaxillary surgeon, for heaven’s sake?’
‘Here.’ The door slapped shut behind him, and he moved up beside Nick and assessed the patient rapidly. ‘OK, I can see why you called me,’ he said under his breath. ‘Has she got a name?’
‘Jodie Farmer.’
‘Hello, Jodie, I’m Tom Kievenaar. Don’t worry, we’ll soon have you much more comfortable.’ He turned back to Nick. ‘Got any plates of this yet?’
‘Right here,’ the radiographer said, snapping them up onto the light box.
The evidence was incontrovertible. ‘Ouch,’ Nick said softly, and Tom gave a short, humourless laugh.
‘Oh, yes, this one’s a lulu. Lower jaw, upper jaw, cheekbone, nose, all the top front teeth—there’s enough material here for a whole symposium. The rest of her skull looks all right, though, by a miracle. What’s her GCS?’
‘Fifteen at the scene, but she might have been KO’d. No deterioration since admission.’
‘OK. No obvious neurological signs?’
Nick shook his head. ‘Nothing so far.’
‘Good—let’s hope it stays like that. OK, let’s get cracking. Anything else you’ve found out?’
‘She’s bitten her tongue—it’s still bleeding slightly and it needs stitches, but it’s not a priority. I haven’t checked the spinal X-rays yet, though, so we need to do that before she’s moved.’
They went over them together while Sally continued to monitor their patient and stabilise her. Her pressure was dropping slightly, probably due to the huge blood loss from her many fractures, and Sally opened up the flow on the plasma expander to maximum and reported the pressure drop to the two men.
‘Is she cross-matched?’ Tom asked, and Sally nodded.
‘Six units on their way.’
‘We’d better make it ten,’ Nick said, running an eye rapidly over her again. ‘Those pelvic injuries are worse than we’d thought.’
‘They seem to have taken the brunt of the impact,’ Tom murmured. ‘The orthos might want to work at the other end while I do her face. I wouldn’t want to move her too much until that lot’s stabilised. Let’s get some more plasma expander into her while we wait.’
It took a few more minutes before the orthopaedic registrar had come down and conferred with them, by which time the blood had arrived. Then Jodie was wheeled away and Sally felt the tension drain from her body as the responsibility for their patient passed on to the next team.
‘Nasty mess,’ Nick murmured, watching the trolley disappear through the double doors.
‘Certainly is. I don’t envy her. I wonder why she jumped?’
‘I don’t know, but the third floor isn’t high enough, obviously. If you’re going to do that, you need friends in higher places.’
‘Or a friend with enough gumption to talk you out of it,’ Sally said shortly, and stripped off her blood-streaked gloves and apron, dropping them into the bin. She glanced up at the clock and did a mild double-take. ‘Good grief, is it really five-thirty?’
‘Looks like it.’
She rolled her eyes. ‘Marvellous. I finished at three.’
‘Yes, I can see that,’ Nick said with a grin.
‘Oh, it’s par for the course round here,’ she assured him. ‘If I ever manage to get home before the rush hour, I’m doing well. I usually fail.’
‘Such dedication to duty,’ he teased, and she glowered at him, not in the mood to be criticised for doing her job properly.
‘Don’t knock it,’ she advised tightly. ‘Some of us have to be dedicated.’
He blinked and backed away a step. ‘Ouch,’ he murmured, his mouth twisting in a rueful smile. ‘That wasn’t criticism.’
‘Better not have been,’ she retorted, suppressing a twinge of guilt. ‘Right, I’m going before anything else happens. I’ll see you tomorrow.’
‘How about a cup of tea first?’ he suggested, but she shook her head. She was tempted—oh, how she was tempted—but she knew all about his charm. It was lethal, and she had absolutely no defences against it.
‘I don’t think so, not tonight. I’ve got to do some washing, I’ve got no clothes left.’
‘Now that’s an interesting thought,’ he said softly, and his eyes caressed her, jamming the breath in her throat and draining the strength from her legs again.
‘Forget it,’ she advised, and walked away, resisting the urge to weaken and take him up on the offer of tea. All she needed now was to settle down with him for a cosy chat!
Little chats with Nick had a habit of getting much too cosy, and that lazy charm hadn’t diminished over the years, not one iota. Besides, seeing him again after all this time had left her thoughts in turmoil, and she needed time alone to sort herself out.
Sally kept walking.
CHAPTER TWO (#ufbae4c60-2757-5e8e-bd8e-dea7695ce053)
‘SO, YOU and Sally were quite close at one time, I gather?’
Nick flicked a quick glance at Ryan, but his expression was innocent. ‘We were good friends,’ he said guardedly, unsure what Sally might have told the Canadian consultant and unwilling to fuel hospital gossip at her expense—or his own, come to that.
On the other hand, he was perfectly willing to pump the man for anything he would reveal about Sally’s life now.
‘I haven’t seen her for years,’ he added with truth. ‘It’s good to see her looking so well and happy—I take it she is happy?’
‘Yeah, she seems to be happy—and, no, I’m not going to tell you any more than that,’ Ryan replied with a knowing smile. ‘You want answers to questions, just ask her. I’m sure she’ll tell you anything she wants you to know, she’s usually pretty open.’
That sounded like his Sally, he thought with a pang of sadness. Open and honest and full of the joys of spring. Damn.
‘What about you?’ Ryan asked. ‘Anyone in your life going to be affected by you two meeting up again like this? Strange coincidence, wasn’t it?’
Nick gave a short huff of laughter. Ryan was altogether too smart.
‘Wasn’t it just?’ he said noncommittally. ‘But since you ask, no, there’s no woman in my life.’
‘And what about all the ghosts you’ve got behind you?’ Ryan probed. ‘Is it going to make it difficult for you two to work together?’
