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‘Uh—yes. I hit traffic problems so I didn’t get back from Liverpool until pretty late last night. I, um, just need some sleep,’ Holly prevaricated. It was true, up to a point. What she really wanted was time to think, not time to sleep. She gave a huge yawn and hoped it didn’t look as fake as it felt.
Give me time. Give me space to deal with this, she begged. And, right on cue, her pager bleeped. She checked it. ‘Sorry. Gotta dash. Catch you later, Anna, David.’ She gave them both her best smile and left the rest room with indecent haste.
‘Fancy you two knowing each other. Still, at least we don’t have to warn you that Holls isn’t as scary as she seems,’ Anna said.
David frowned. Holly—his Holly—scary? Surely they couldn’t be talking about the same person. Holly had been the epitome of ‘sweet sixteen’. She’d been lovely. A little shy, but once David had got to know her he’d discovered her sense of fun.
Holly Jones, scary?
‘She tells it like it is, and God help you if you make a stupid mistake,’ Anna said, rolling her eyes. ‘But if anyone needs help, she’s the first one to offer.’ She smiled. ‘But I expect you already know all this.’
‘Yes,’ David lied. Maybe he’d been so in love with her that it had blinded him to her real self. If anyone had told him that Holly would dump him without an explanation, he’d have scoffed. He and Holly had told each other everything, even the secret dreams nobody else had known about.
Obviously he’d never really known her. Because the Holly Jones he remembered had planned to be a GP—so she could get to know her patients properly and look after them from cradle to grave. He’d felt the same. They’d even talked about having their own practice, a husband-and-wife team.
Even though he’d chosen his speciality years after their break-up, he hadn’t been able to face a GP rotation. Instead, he’d chosen emergency medicine, where he could do the best for his patients but he could stay uninvolved. He could walk away.
‘Right, now you’ve finished your coffee, I’ll show you round the rest of the department,’ Anna said.
‘Thanks.’ He smiled at Anna. So what if Holly was back in his life? She was probably married—to someone her family thought suitable for her—and used her maiden name for professional purposes. And even if she wasn’t married, David was older and much, much wiser. He wasn’t going to let her get close ever again.
As for her smile making his heart turn over, that was just a reflex action. He hadn’t thought of Holly for ages.
Ha. Who was he trying to kid? At the weekend, when he’d moved into his tiny flat round the corner from the hospital, he’d unpacked a few boxes and come across an old photograph of the two of them together. A photograph he should have thrown out years and years ago. He’d looked at her sweet, shy smile and wondered what she was doing now. Had she become a doctor? Was she married to another GP, with four children and a houseful of cats and dogs and hamsters, living the life they’d always planned, only without him?
Now he knew at least one of the answers. She was a doctor. An emergency specialist. They were going to have to work together and put the past behind them. Somehow.
‘It’s my stomach, doctor,’ Lucy said, doubling over as another spasm hit her. ‘It hurts so much.’
‘Lie back, try to relax and I’ll take a look,’ Holly said gently. ‘Breathe for me. In, out, in, out.’
Gradually Lucy calmed and lay back against the bed.
Holly bared Lucy’s abdomen and palpated it gently. ‘Tell me when it hurts,’ she said.
Lucy flinched wherever Holly touched her. ‘It hurts all over.’
An acute abdomen could mean one of about a dozen things. Holly had to narrow things down. Fast. ‘Have you had any other symptoms?’
Lucy grimaced. ‘I thought it was just a bug—the usual thing, a temperature and a headache and feeling a bit sweaty and tired. I’ve had that horrible summer cough and that makes everyone a bit breathless, doesn’t it?’
‘Maybe,’ Holly said.
‘It’s so hot in here,’ Lucy said, then shook her head. ‘Sorry. I’m trying not to whine.’
‘You’re not feeling well,’ said Holly. ‘And we all think we need air-conditioning, too.’
‘I was going to see my GP. I was starting to think maybe it was the menopause, even though I’m not quite forty.’
‘Because of the sweats?’
‘And my periods are next to nothing,’ Lucy said. She smiled wryly. ‘And I’ve been getting PMT. I mean, really bad PMT. Oliver’ll tell you, I’ve been a monster.’ Her hand tightened round his. ‘But then I got this pain in my stomach.’
‘I thought it might be her appendix so I brought her here,’ said Oliver, Lucy’s husband.
‘Have you been sick at all?’ Holly asked.
Lucy nodded. ‘And I’ve had a bit of a tummy upset. It might have been something I ate.’
‘She’s been eating like a horse lately,’ Oliver said.
‘I don’t think it’s appendicitis,’ Holly said. She checked Lucy’s temperature and pulse. Lucy’s pulse was definitely up—more than Holly had expected from the fever. ‘Have you had any other pains lately?’
‘She won’t admit it, but she’s had chest pains,’ Oliver said.
‘I am not having a heart attack. Will you stop nagging me, Oliver?’ Lucy said crossly. ‘Besides, I’m managing my weight so my heart’ll be fine. I’m on that new diet and it’s actually working.’ Despite the fact that, according to Oliver, Lucy had been eating a lot more than usual.
‘Have you lost much weight?’ Holly asked.
‘A stone and a half. It’s falling off,’ Lucy said. ‘First time ever.’
‘Probably because you never stop. She’s always on the go,’ Oliver added wryly. ‘She’s just been promoted to head teacher.’
‘So I need to put the hours in,’ Lucy said defensively.
‘I need to do some blood tests to rule out some possibilities,’ Holly said. ‘I’ll be back in a second.’ She smiled and left the cubicle.
‘Miche—just the woman I wanted,’ she said, spotting the staff nurse. ‘Can you give me a hand running some tests, please?’
‘Sure. What do you need?’
‘My patient’s in cubicle eight. Her name’s Lucy. I need some bloods done, first. Us and Es, ionised calcium, full blood count and differential. Ask the lab to check T4, T3 and TSH as well.’ Checking the tri-iodothyronine, thryoxine and thyroid stimulating hormone levels in the bloodstream would help Holly find out if it was a problem with Lucy’s endocrine system, and if so the results would help her give the right dosage of medication to get Lucy’s levels back to normal.
‘What’s this? A patient with thyroid problems?’ a male voice asked beside her.
Damn. She could do with some kind of early warning system so she could avoid David—so she could avoid situations like this when he might catch her off guard. ‘I’m not sure. That’s why I’m asking for T4, T3 and TSH levels,’ she said shortly, and turned her attention back to Michelle. ‘Thanks, Miche. I’d also like to do some BMGs.’ BMGs, or bedside strip measurement of glucose, would check Lucy’s blood-sugar levels. ‘And a mid-stream urine specimen—Oh, and she’s got a bit of a chest infection, so ask the lab to run blood cultures, so we can see what’s causing it.’
‘What are her symptoms?’ David asked.
‘Acute abdomen, losing weight despite eating a lot, chest pains, a fast heartbeat, sweating, volatile emotions and tiredness.’
‘What about her blink rate?’ If Lucy was blinking less than normal, it was another pointer towards a thyroid problem. ‘Any swelling in the tissues around her eyes?’
Holly looked at him and had to fight to get her thoughts back in control. Hell, this was just how she’d imagined him as a doctor. Completely focused on his patients. Caring.
If only he’d been like that about her. ‘I’m doing bloods to check if it’s thyroid,’ Holly said.
‘I nearly specialised in endocrinology before I settled on emergency medicine. I could have word with her, if you like.’
No. I don’t want to work with you and I don’t want you interfering with my patients.
On the other hand, she’d taken the Hippocratic oath. She had a choice of letting David help or trying to get hold of Fabian, the endocrine specialist, who almost never answered his bleep and needed at least three follow-up nags. Her patient came first. Even if it meant that Holly was in the awkward position of owing David Neave a favour. ‘Thanks. I’ll introduce you.’
To her relief, he simply followed her back to cubicle eight. ‘Lucy, Oliver, this is David Neave, our new senior registrar. I’ve been talking to him about what the problem might be, and he’s your man for any questions.’
He used to be my man.
She pushed the thought away. The past was over. Over.
She forced a smile to her face. ‘Michelle, our staff nurse, is going to come and take blood for tests.’ She didn’t quite trust her hands to be as steady as usual if she had to take the blood under David’s gaze, and Lucy really didn’t need half a dozen puncture wounds from an incompetent doctor.
‘Do you mind if I have a look at your hand?’ David asked. He pinched the skin on the back of Lucy’s hand, very gently, as Holly watched. When the skin didn’t flatten again instantly, Holly knew that Lucy was dehydrated.
‘Has anyone in your family had problems with their thyroid gland?’ he asked.
‘Not that I can think of. Why?’ Lucy asked.
‘Holly told me about your symptoms and I think your thyroid gland’s overactive. What you’re suffering from is something called thyroid storm.’
‘Is it serious?’ Oliver asked.
Yes. If it went untreated, one in ten cases would die.
‘We can do something about it,’ David reassured them both. ‘Holly’s arranged the blood tests, we’ll give you some paracetamol to get your temperature down, a saline drip to help with the dehydration, some antithyroid medication to deal with the excess thyroid hormones and some beta-blockers to help slow your heart rate down to what it should be.’
‘Heart medicine? But…’ Lucy shook her head. ‘What’s wrong with my heart?’
‘It’s all to do with your thyroid gland producing too many hormones. The thyroid gland is just here in your throat, underneath your voice-box,’ David explained.
When he touched Holly’s throat, to demonstrate, her pulse went into overdrive and she only hoped that he couldn’t feel the frantic flutter.
‘It produces the hormones that regulate your body’s energy levels and at the moment it’s producing too much.’
‘That’s why you’re eating so much,’ Holly said, hoping her voice sounded less shaky than it felt. ‘Your body’s metabolism is working too hard, making you feel hungry so you want to eat, but you’re still losing weight.’
‘It’s also making your heart beat faster than it should,’ David added.
So’s mine, Holly thought in desperation. And it shouldn’t be. I don’t want it to.
‘Thyroid problems? Isn’t that something old people get?’ Lucy asked.
‘No. It’s more common in women, and usually it’s young to middle-aged women, in their thirties to fifties,’ Holly said.
‘If you’ve got an overactive thyroid but you haven’t been treated for it, and then you get an infection or you’re under a lot of stress, you can end up with thyroid storm. We’ll need to get you admitted because we’ll need to run more tests,’ David said. When Lucy coughed, he said, ‘We also want to know what’s causing your cough, so we can treat that, too.’ He looked at Holly. ‘Can you ask a porter to bring a fan in to make Lucy more comfortable, please?’
‘You don’t have to do that if it’s going to mean someone else will be all hot and sticky,’ Lucy said.
‘It won’t,’ Holly said. If necessary, she’d use the fan from her own office—she could manage without for a couple of hours. ‘We want your temperature down.’
‘Cool air, tepid sponging and paracetamol should do it,’ David explained with a smile.
Lucy groaned. ‘That’s what you do to babies! I feel such an idiot. I should have gone to see my GP when it all started, but I was busy and I didn’t want to waste his time.’
‘It might have saved you ending up in here,’ Holly agreed wryly. ‘But if it makes you feel any better, I would’ve done exactly the same.’
Yes, David thought bitterly, watching her retreating back. Holly had always done things her way, and to hell with the consequences. Even though he had the nasty suspicion that it was going to rake open old wounds, he knew they had to talk.
An hour and a half later—by which time Holly had calmed down a hysterical toddler and removed a bead from his nose, put a dislocated elbow back in place and removed broken glass from a nasty wound and then stitched it—she was in definite need of caffeine.
‘I’m taking five,’ she told Michelle, and headed for the rest room.
She’d just fixed herself a black coffee from the vending machine, poured the top quarter off and added enough cold water so she could drink it straight down, when David walked in.
‘Strong stuff, is it?’ he asked, seeing her holding the coffee-cup beneath the tap on the water cooler.
‘No. Just temperature regulation,’ she said, and drank her coffee. ‘Ah. I needed that.’ A caffeine fix might just jolt her body back into reality and stop it overreacting any time he came anywhere near her.
‘Holly,’ he said quietly.
Unwillingly, she faced him. Looked him in the eye. Was that regret she saw there? ‘What?’
‘I had no idea you worked here.’
She shrugged. ‘Why should you?’
He sighed. ‘I think we need to talk.’
Way too dangerous. On the ward, she could cope; in a quiet corner in a bar, it would be too much like old times. Just the two of them. ‘There’s nothing to say.’
‘We need to clear the air.’
‘There’s nothing to say,’ she repeated. Nothing either of them could say would change what had happened.
He raked a hand through his hair and she watched his fingers, mesmerised. She could still remember them running through her own hair. Hair that she’d had cut short the moment she’d recognised the truth, to wipe out the memories. Except it hadn’t really worked.
‘What happened between us was a long time ago.’
Was this his idea of an apology? It certainly wasn’t hers!
‘And in the emergency department we need to be able to work as a team.’
He’d phrased that very carefully. Good. Because if he’d dared to say anything about being able to rely on each other, she would have murdered him. ‘Of course,’ she said, as neutrally as she could.
‘We’re going to have to work together. And it’s better if we can do it without…problems.’
Did he think that she was going to weep and wail and ask him why he’d done it? No. Been there, done that, worn the T-shirt—when she was eighteen. She was older. Much wiser. So she could feel relieved that she’d had a very, very lucky escape. And she most certainly wasn’t going to act on that flicker of attraction. Blue eyes spelled danger. She didn’t make the same mistakes twice. ‘Of course,’ she said again.
At least he hadn’t suggested that they could be friends. Because she didn’t think she could go that far. Just in case he was entertaining the idea, she leapt in fast to state the ground rules. ‘We’re perfectly capable of being colleagues.’
