скачать книгу бесплатно
‘Your kisses are definitely very convincing,’ she admitted, lowering her eyes from the steadiness of his. ‘But … but aren’t we rushing things a bit?’
‘What do you mean?’
She raised her eyes back to encounter his unwavering dark brown gaze. ‘We may be attracted to each other physically, but we’re poles apart professionally. You have issues with my study and I have issues over your decision to withdraw life support on Tommy Lowe. This is never going to work between us.’
‘Come on, Allegra.’ His tone became impatient. ‘You know the routine with head injuries. Once the patient is declared brain dead by the neurosurgeon we have no choice but to advise the relatives to consider withdrawing life support. It’s not fair to the patient or the relatives to let them hang in limbo for no gain.’
‘Tommy is a young child,’ she countered. ‘Numerous studies have demonstrated the possibility of recovery after more prolonged support in children.’
‘Yes, but exactly what sort of recovery are we talking about?’
‘A full recovery, of course.’
He let out a short rough expletive. ‘You really are off with the fairies, aren’t you? Damn it, Allegra, you know there are degrees of recovery in these sorts of cases. Tommy could end up permanently disabled, either physically or intellectually or, God help him, both. He’d be totally dependent on his father or his mother if she survives. What sort of life is that for any of them?’
‘He’d be alive, that’s all that matters to a parent,’ she argued.
‘Is it?’ he asked, his eyes glittering with some indefinable pent-up emotion she couldn’t quite recognise.
‘Of course it is! Losing a child is the most devastating thing that can happen to a parent. The grief is total and all-consuming.’
‘So is the grief of being totally responsible for a child who will never grow up, either physically or mentally,’ he said, grasping her by the upper arms, his fingers biting into her tender flesh. ‘Have you thought about that any time in your fairy-dust study? Have you ever interviewed the relatives of a child who didn’t get your magical full recovery? Have you asked them what it’s like to have to change their adult child’s nappy several times a day, to spoon food and drink into them while most of it dribbles down their chin? Have you asked them what it’s like to lie awake at night, listening to their child uttering screams and cries that no physical comfort or words will ever ease? Have you asked them what it’s like for the rest of the family, their marriage, and all their other relationships? Have you?’
She shrank back from the vitriol in his tone. ‘I—I … No I haven’t, but I—’
He dropped his hands from her so suddenly she almost stumbled backwards. ‘You don’t know what you’re doing, Allegra. I could see that from the first moment I looked at your study. You can’t keep people alive indefinitely without weighing the costs.’
‘Neither can you play God,’ she said. ‘You can’t possibly think it’s reasonable to wander through ICU and switch off ventilators, without giving the relatives adequate time to make that decision if it’s called for.’
‘Tommy Lowe will be given the same time frame every other patient in his condition is given. But once ten days is up, if there is still no brain activity his father will be informed of his choices. We can keep that child alive for months, but while he’s soaking up valuable resources, three or four other children will die for want of organ donation that Tommy’s brain-dead body could provide. Why don’t you go and visit some of them in the children’s ward? Have a talk to the parents sitting there hour after hour, with the clock on the wall ticking away their child’s last chance at a normal life.’
Allegra knew his argument was reasonable; she was well aware of the lifesaving transplants that offered hope when all else had failed. It was, after all, sometimes the only comfort in losing a loved one to know that some part of them lived on, giving precious life to some other person who then could go on to live a normal life. Julie’s parents had made the very same difficult decision when their daughter’s ventilator had finally been switched off. But Allegra had always thought Julie had deserved more time. It gnawed at her constantly. She couldn’t help feeling her friend’s parents had been pressured into their final decision.
‘I understand what you’re saying, but I still think your bias against me is colouring your judgement,’ she said. ‘All I’m asking is for some extra time to work with Tommy.’
‘You’ve got a week,’ he said, moving past her to the door. ‘Ten days at the most, and then Anthony Pardle and I will have to organise a meeting with the father.’
She swung around to look at him. ‘You don’t have to leave—I thought we were having dinner?’
He gave her one hard look and opened the door. ‘Maybe some other time. I seem to have lost my appetite.’
She frowned as he closed the door, the sound of his footsteps gradually fading before she turned and leaned back against the door, her shoulders slumping despondently against the hard surface. ‘Help me to prove him wrong, Tommy,’ she said out loud, the words bouncing eerily off the stony silence of the walls.
CHAPTER ELEVEN
ALLEGRA arrived in ICTU the following morning well before her shift officially began, and painstakingly looked through the printouts on Tommy’s BIS monitor. There had been no change, which was dispiriting enough, but with the deadline Joel had now attached to the case, the sense of urgency seemed all the more gut-wrenching. She had hardly slept for thinking about the little boy’s life, how he would look in five, ten years’ time if he survived. Would he retain the slight build of his mother, or during adolescence develop the shorter and thicker set of his father? Would he do well at school? What sort of sense of humour would he have?
And what about his aunt? Was Tommy close to her? Did he understand at his young age the difficulties of his father’s relationship with his own parents, Tommy’s grandparents? Did he see much of his mother’s parents and if not, why not?
There were so many unanswerable questions that she was finding difficult enough—how much worse would it be being the parent and never having those questions answered? She had seen that level of devastating grief on the faces of Julie’s parents all those years ago and more recently on the faces of Robyn and Jeff Greeson as their precious daughter’s chest had moved up and down for the very last time. Allegra had seen the pain flash across their faces as they’d come to terms with the fact that they would never know what their daughter would have looked like on her wedding day, never know what sort of man she would have fallen in love with. Every birthday, Christmas or special anniversary would no longer be a cause for celebration but a reminder of their unrelenting pain.
Statistics showed most couples didn’t survive the loss of a child and it was easy to see why. The burden of grief was like a sharp, invisible knife that progressively severed the ties of even the closest couple with cruelly isolating dissection. Allegra had felt it herself all the way through medical school and beyond. She’d felt as if she’d been walled inside a see-through barrier that no one could penetrate. She’d been cut away from the rest of her peers by the experience of her closest friend’s suicide, and her guilt and sense of inadequacy had been intensified by that ongoing isolation.
Allegra looked up from Tommy’s notes to see Judy, the nurse in charge of Kate Lowe’s room, approach. Judy had been the one who had been on duty when Kate Lowe’s ventilator had been sabotaged two nights previously.
‘Dr Tallis? You’re in early this morning. I was just going to call you at home,’ Judy said. ‘I thought you might be interested in Mrs Lowe’s current condition.’
‘How is she?’ Allegra asked.
‘She’s extubated, and drifting in and out of lucidity,’ Judy informed her.
‘Has she said anything at any time during her conscious times?’
‘She’s said Tommy’s name several times and the nurse who covered for me over my break said she asked for Tommy’s aunt once or twice. She hasn’t said anything for several hours now but I thought you might be interested.’
‘I am—very. How are you coping with all this?’ she asked. ‘Is this your first time taking care of a patient with a police guard present?’
‘Here, it is, but at the previous hospital I worked at in Sydney I had to nurse a prisoner who had been injured in a cell brawl. But after what happened the other night, I’m glad someone is keeping watch. I still can’t believe we almost lost her.’
Allegra leaned back in her chair and looked at the nurse intently. ‘So you don’t think she deserves to die for what she tried to do to her son?’
The nurse looked shocked. ‘Of course not! I’m a mother myself. I’ve had some rough times, I can tell you, especially after my husband left me when my daughter was only three weeks old. I know what it’s like to feel overwhelmed and depressed. There were numerous times when I seriously considered ending it all. I think if more women were honest about it, you’d find most would confess to having experienced the same feelings at times. I was lucky, I had a mother who saw the desperate state I was in and stepped in and took over until I got myself back on my feet. Others, like Kate Lowe, obviously don’t have that supportive network. I feel sorry for her. No one has even called to ask after her, which shows how lonely and isolated she must have been at the time.’
‘Yes, that does seem a little unusual,’ Allegra put in. ‘Even the most hardened criminals have relatives who love them and call and ask to see them.’
‘Yes, that’s true …’ Judy gave her a pensive look. ‘But the funny thing was during that time when I wanted to end it all I had systematically cut myself off from all of my friends. It’s the irony of depression, I suppose. The one time in your life you need the loving support of people around to help, you actively push them away. I know I did it, often cruelly at times. A couple of my friends never quite forgave me for it. Maybe Kate over time has pushed everyone away, including her parents. Family feuds are all too common these days. Some people never speak to each other again. It’s such a terrible shame.’
‘I guess you’re right …’ Allegra said, as she got to her feet. She touched the nurse briefly on the arm and added sincerely, ‘The world needs more people like you, Judy.’
Judy gave her a shy smile. ‘I was just thinking that about you, Dr Tallis. I’ve been meaning to tell you how much I admired you for fighting for the opportunity to do this study. If I had taken the drastic step Kate Lowe did—and let me tell you I was close to it—I would have wanted someone like you to give me another chance.’
‘We all deserve a second chance, Judy,’ Allegra said. ‘But unfortunately there’s someone out there or even here in the hospital who doesn’t think the same as you and I. They wanted Kate Lowe to die and if it hadn’t been for you, she very well could have done so.’
‘I hope the police find out who did it soon,’ Judy said. ‘It doesn’t look good for the unit or the new director, does it?’
‘No.’ Allegra let out a little sigh as she thought of the immense pressure Joel was under. She had been too quick to judge him without considering how difficult things had been for him, newly appointed and with so many people’s expectations burdening him. Every time she saw him he looked even more exhausted. No wonder he had been so short with her the night before. He wanted results and he wanted them quickly. And yet, in spite of his misgivings, he had ensured Tommy received only the best attention and care.
‘I’m off home now,’ Judy said, interrupting her reverie.
‘Lucky you,’ Allegra said, wincing as she looked up at the clock on the wall. ‘I’ve only got thirteen and a half hours to go.’
The police officer guarding Kate Lowe’s room looked up as Allegra came in after the mandatory security check. Allegra introduced herself and explained briefly about her study before she came over to the patient’s bed and looked down at the young woman lying there. Without the hiss and groan of the ventilator, the room seemed extraordinarily quiet. The monitoring equipment still attached to Kate made her seem small and vulnerable, not unlike her little son further along the unit.
‘Kate, my name is Allegra Tallis,’ Allegra said, as she took one of the woman’s hands in hers and stroked it gently. ‘I’m a doctor, an anaesthetist, and I’ve been looking after your son, Tommy.’
Kate’s eyelids fluttered for a moment, as if the mention of her son’s name had stirred her from her unconscious state. Allegra waited for several moments before continuing in a soft, soothing voice, ‘He’s doing OK. I’ve been playing his favourite movie for him.’
Kate’s mouth moved and a breathless, almost inaudible sound came out. ‘Tommy …’
‘Tommy is doing as well as can be expected, Kate,’ Allegra reassured her, hoping that by saying the words it would someone make it true.
‘Serena …’ Kate’s lips moved again but then she groaned and slipped back into unconsciousness.
Allegra stroked the woman’s thin hands, using the massage technique she had been taught, separating each finger, stretching them gently, lengthening the tendons to release built-up pressure. She turned over Kate’s hand palm upwards and froze when she saw a series of tiny, nick-like, whitened scars on the underside of the wrist. She reached for Kate’s other arm and found the same bizarre pattern carved on the other wrist.
‘She’s a fruit cake,’ Ruth Tilley, the nurse assigned to the isolation room, muttered under her breath, but even so it was more than obvious that the police officer had heard every word.
Allegra frowned as she turned to face the nurse. ‘Please, keep your personal opinions to yourself. If you feel uncomfortable nursing this patient, I suggest you ask to be transferred.’
The nurse gave an insolent sniff and moved to check the monitors, making a note of Kate’s BP, pulse and sats. ‘I know how to do my job, no matter how horrible the patient is. Anyway, I’ve nursed much worse than her.’
‘I would prefer you to speak appropriately and professionally at all times in this room,’ Allegra insisted. ‘Kate Lowe is unconscious but may well be able to hear everything you say.’
‘I don’t care if she does,’ Ruth said. ‘She’s tried to do herself in numerous times. If she recovers, she’ll only do it again. I’ve seen it all before. These sorts of people are nothing but trouble for their families. They put them through hell, keeping everyone on tenterhooks, wondering when the next attempt is going to happen and whether it will be successful.’
Allegra tightened her mouth as she saw the look the police officer gave the nurse, as if he was in silent agreement.
‘Excuse me,’ she said as she brushed past to leave. ‘I have other patients to see.’
Once outside Kate’s room Allegra expelled a frustrated breath, her hands clenching at her sides to keep control. She walked towards the office of ICTU where Louise was sitting, looking over the night shift notes.
‘Uh-oh,’ Louise said as she looked up. ‘I don’t like the look of your aura right now. I can practically see sparks of anger zapping off the top of your head. Has the dishy director got under your skin again?’
‘Surprising as it may seem, no. It’s not Joel this time—it’s one of the nurses.’
‘So we’re on first-name terms, are we?’ Louise asked with a playful smile.
Allegra ignored her friend’s teasing look. ‘I want Ruth Tilley removed from Kate Lowe’s room immediately.’
Louise frowned. ‘But why? Ruth is one of the most experienced ICTU nurses we have here.’
‘I don’t care how experienced she is, I don’t like her attitude,’ Allegra said. ‘Has Joel Addison arrived yet?’
Louise’s frown deepened. ‘You’re going to ask him to move her?’
‘No,’ she said, as she straightened her spine. ‘I’m not going to ask him—I’m going to tell him.’
‘I think he’s headed down to Gaile Donovan’s room. He’s waiting for Harry Upton,’ Louise said. ‘The husband’s been there all night. Joel came in early to discuss her treatment options with Harry.’ Joel looked up from Gaile Donovan’s notes as Allegra entered the small private room where the patient was being closely monitored. ‘Have you seen Harry come in yet?’ he asked, without so much as offering a simple greeting.
‘Good morning to you, too, Dr Addison,’ Allegra said with an arch look.
He frowned and resumed looking at the notes. ‘Sorry,’ he said a little gruffly. ‘I hadn’t noticed it was even morning. I came in before the sun was up.’
Allegra felt annoyed with herself for being so petty when it was clear Joel had bigger concerns on his mind, such as the patient lying between them. But before she could offer an apology, Harry Upton came in.
‘Morning, Allegra, Joel. How were things overnight with Gaile Donovan?’
‘She’s been stable, Harry,’ Joel answered. ‘Certainly no more bleeding, but Allegra was right about the ARDS. We did a chest X-ray this morning and there is a virtual white-out of most of both lung fields.’
Allegra checked the ventilator readings and reported, ‘Her ventilation pressures are high and she’s needing 40 per cent oxygen.’
‘What about coagulopathy?’ Harry asked. ‘At some stage in the next 48 hours I’m going to have to remove the pelvic packs. How are we placed timing-wise?’
‘She’s stable at the moment and we’ve got her on broad-spectrum antibiotic cover,’ Joel said. ‘My advice would be to leave things alone the full 48 hours. Coags are better than they were, but PT is still prolonged and her platelets are low. We can work at improving those and hope her chest improves, before subjecting her to the potential of another hypovolaemic insult.’ He turned his gaze towards Allegra. ‘Do you agree, Allegra?’
‘Yes.’ Allegra was momentarily taken aback by the dark shadows beneath his eyes. He looked like she felt—tired, defeated, and a little out of his depth. It made him seem less of an enemy and she felt something that had been previously hard and closed off inside her begin to soften a little. She suddenly became aware of both Harry’s and Joel’s expectant gazes trained on her. ‘Um … yes, I would prefer not to have to reanaesthetise her until we see how the lung function pans out.’
Joel shifted his gaze and checked the obs with the attending nurse, Jayne Stephens. He listened to Gaile’s chest but there was very little in terms of air entry, and a lot of crackles and crepitations. He knew Gaile was in for a rough ride but he had seen such patients recover with adequate ICU support—the key was to avoid sepsis and maintain organ support and brain oxygenation.
‘We should go and have a chat with her husband,’ he suggested, once he’d finished his checks. ‘He’s been here all night. I sent him out to the conference room a few minutes ago to stretch his legs.’
Harry’s beeper went off and he grimaced as he looked at the screen. ‘Sorry, guys, I’ve got a surgical tutorial with the trainees and I’m already ten minutes late. You know what these young folk are like—if we don’t turn up on the dot they think we’ve cancelled and go off and have a latte instead.’
Joel smiled at the older surgeon. ‘Can’t say I blame them. I could do with a double-strength latte myself right now.’ He turned to Allegra once Harry had left, his easy smile replaced by a little frown. ‘Do you want to come with me to talk to Neil Donovan or is a coffee more preferable?’
‘I was coming to see you anyway about another matter,’ she said. ‘After we’ve spoken with Mr Donovan, perhaps you could fit me into your busy schedule.’
He gave her an unreadable look as he held the door for her. ‘I’ll see what I can do.’
They moved from the unit past the security guard to the conference room along the corridor, where Neil Donovan was sitting with his head in his hands. He looked up as they came in, the dread on his face clawing at Allegra’s already overstretched emotions.
‘How are you holding up?’ Joel asked.
‘I’m just hoping she’s going to be OK,’ Neil said, his eyes red and weary beyond description. ‘The girls and I just couldn’t go on if …’ His voice trailed off and Allegra swallowed against the lump in her throat.
‘She’s been stable overnight, Neil,’ Joel informed him, closing the small distance to place a reassuring hand on his shoulder. ‘That’s positive. She’s getting the best talent this hospital has.’
‘I know …’ Neil said, not bothering to disguise the track of tears moving down his unshaven cheeks. ‘I just hope it’s enough. I’m not a religious man but I’ve been praying all night for a miracle.’
Joel glanced briefly in Allegra’s direction. ‘Miracles are hard to arrange, Neil. Maybe they happen—certainly some people believe in them. Try to hold onto hope. There’s still a decent chance she can pull through. We’ll explore every feasible option.’
‘Can I go back to her now?’ Neil asked.
‘Of course you can.’ Joel smiled warmly. ‘Who’s looking after the girls for you?’
‘I left them with my mother, although they weren’t too happy about it,’ Neil said.
‘If they want to be here with their mother, that’s where they should be,’ Joel said. ‘If there’s anything you want any of us to do, just let us know.’
‘Thank you, Dr Addison. You, too, Dr Tallis,’ he said. ‘I don’t know how you doctors deal with this stuff day in and day out. It must really get to you after a while.’
‘We’re trained to cope with it,’ Joel said. ‘Mind you, it’s totally different when you’re on the other side. I haven’t as yet been a patient myself, but I’ve had plenty of practice at being a patient’s relative. It’s a tough call. You’re doing a great job, Neil. Your ongoing support is just what your wife needs right now.’
Neil Donovan gave them both a tired smile and, thanking them again, left to be with his wife back in the unit.
‘He’s certainly a very different kettle of fish to our friend Mr Lowe,’ Allegra couldn’t help commenting as the door closed on his exit.
Joel turned and looked down at her, his nostrils instinctively flaring so he could take in more of her light perfume. It reminded him of freshly cut spring flowers warmed by the sun, heady and evocative without being too overpowering. He wanted to haul her into his arms and kiss her deeply so he could carry the sweet tantalising taste of her throughout the long, arduous day ahead. His groin tightened at the thought of slipping his tongue inside her mouth to curl around hers, the palms of his hands sliding under her clothes to cover her breasts to feel their softness crowned with her hardened nipples.
