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Nothing else could have separated them. The blast hit the pit bull square on the muzzle and drove him back. The hose turned to the spaniel, but he was already whimpering in retreat, badly bitten by the pit bull, while Rachel launched herself at the prone body of the girl.
‘Her leg …’ she breathed.
The girl’s leg was spurting bright arterial blood, a vast pulsating stream. Oh, God, had the dog torn the femoral artery? She’d die in minutes.
The dog had lunged at her upper leg and the girl had been wearing shorts! Dear heaven …
‘Someone, get my bag. Fast! Run!’ Hugo was shouting with urgency. ‘The car’s by the kiosk.’ Car keys were tossed into the crowd—swiftly, because Hugo’s hands were already trying to exert pressure. Rachel was hauling her T-shirt over her head. They needed something for a pressure pad—anything—and decency came a very poor second to lifesaving.
She shoved the shirt into Hugo’s hands and Hugo wasn’t asking questions. He grabbed the T-shirt and pushed.
‘Kim, don’t move,’ Hugo was saying, and with a jolt Rachel realised he was talking to the girl. He was good, this man. Even in extremis he found time to tell his patient what was happening. ‘Your leg’s been badly bitten and we need to stop the bleeding. I know it hurts like hell but someone’s gone for painkillers. Just a few short minutes before we can ease the pain for you, Kim. I promise.’
Could she hear? Rachel didn’t know and she had to concentrate on her own role. Hugo would want a more solid pad than one T-shirt could provide. She stared up into the crowd. ‘Michael,’ she yelled. Hugo was too busy applying pressure to haul off his shirt and he needed something to make a pad. And Michael could help with more than a shirt. He had the skills.
But Michael was gone.
It couldn’t matter. ‘Take mine.’ A burly farmer had seen her need and was hauling off his shirt. She accepted with gratitude, coiling it into a pad.
Out of the corner of her eye she saw her overnight bag, sprawled and open in the dust where she’d dropped it as she’d lunged for the tap. More clothes. Great. As Hugo looked up, searching for whatever she had, she handed him a pad. She made another with what was in the bag. Then she shoved the pad hard down over his and pressed. He pressed with her. Even their combined effort wasn’t enough to stop the flow.
‘I need forceps,’ he said grimly. ‘My bag …’
‘Clive’s gone to fetch it,’ the farmer told them, hovering over both doctors as they worked, his face ashen with concern. ‘He’ll be back any minute. He’s the fastest runner.’
‘Good.’ They were working together, their hands in tandem. Hugo was breathing fast, using all his strength to push tighter, and Rachel realised that she was hardly breathing at all. Live. Please. It was a prayer she’d learned early on in her medical training, and had used over and over. Skills were good but sometimes more was needed.
Luck?
Still the blood oozed. ‘Push down harder,’ Hugo told her. ‘Don’t move off the wound.’
‘I’m not moving,’ she said through gritted teeth. The bite resembled a shark bite—a huge, gaping wound that, left untended, would release all the body’s blood in minutes.
Even if tended …
She was pushing down so hard it hurt.
‘I need forceps.’ Hugo’s voice was growing more urgent as the situation became more desperate. ‘Damn, where’s my bag?’
‘Here.’ A youngster, a boy of about sixteen, was bursting through the crowd, carting a bag that was three times the size of any doctor’s bag that Rachel had ever seen. A country doctor’s bag.
‘Haul it open.’
The boy flicked the bag open and Rachel’s eyes widened. Forceps. There were several and they were sitting on the top as if prepared for just this emergency. She lifted a hand from the wound and grabbed the first pair.
‘We’re not going to stop this without clamping,’ she muttered. ‘The femoral artery has to have been torn to explain this.’
He accepted her medical knowledge without a blink. ‘I agree. Clive, take a shirt and clear as much blood as you can while we work. Let’s go.’ He grabbed forceps himself and then looked across at her. ‘Ready?’
She took a deep breath. This was a huge risk. They needed the pad to stop the spurting, but the only way to stop the bleeding altogether was to remove the pad and locate the source. They had only seconds to do it or the girl would die beneath their hands.
‘OK.’ She took two deep breaths. ‘Now.’
They lifted the pad away from the wound. The blood spurted out and they were working blind, searching in the mess that was the girl’s leg.
Where in this mess was the artery? Dear God, they had to stop it.
‘Take the swab right away, Clive. Just for the moment,’ Hugo said. ‘Be ready to replace it.’
And in the tiny millisecond before the wound refilled with blood …’There!’ Rachel pushed in and grasped, and the forceps linked to the torn artery. She clicked them shut—and the pumping died.
Not enough.
There were more. As well as the femoral artery, two or three minor vessels had been torn. They could kill all by themselves.
Hugo’s forceps clamped shut on another blood vessel and the flow abated still further. Another pair of forceps was in Rachel’s hands and Hugo had another.
She was working like lightning. Without the pads there was no pressure—the blood simply pumped out.
‘Gotcha.’ Another one was under Hugo’s forceps. He clamped.
And another.
And that was it.
The blood was still oozing, but slowly now. The pumping had stopped. It’d be flowing from the ripped veins but they’d done what they had to do. For now.
‘We need to continue with pressure,’ she said, and sat back as Hugo set to work with another shirt, forming another pad. They’d been lucky. Trying to find the blood vessels in these conditions …
Yeah, they’d been lucky—but this man was good!
Hugo was tying the pad firmly around the leg. He gave her a curious glance. There was still urgency but they were working with minutes now rather than seconds. They’d blocked off the blood supply. Now they needed to prevent shock setting in. They needed to replace fluids and they needed to save a leg that no longer had a blood supply.
‘Pete, ring the ambulance,’ Hugo snapped into the crowd. ‘Tell them I want plasma and saline on board and if they’re not here in thirty seconds I’ll have their hides. Dave, can you and a couple of the men find those damned dogs and deal with them before we have another disaster? Toby … Where’s Toby?’ He looked out into the crowd, searching for his little boy. ‘Myra, can you take him?’
‘The first two are already being looked after,’ someone said. ‘The vet’s got the cocker and a couple of guys have gone after the pit bull. The ambulance is on its way.’
Which left Toby.
A middle-aged woman stepped from the crowd of horrified onlookers and took Toby’s hand. The child had been standing white-faced and shocked as Hugo and Rachel had worked. ‘Come on, love,’ she told him. ‘Come with me while Daddy looks after Kim.’
Kim …
Rachel looked up to the girl’s deathly white face. Kim’s eyes were open but it wasn’t clear whether she was conscious or not.
‘You’ll be OK, Kim,’ she told her, taking the opportunity to take the girl’s hand in hers. What she’d most need now would be reassurance. Not panic. ‘We needed to hurt you a bit to stop the bleeding but we’re both doctors. We know what we’re doing. The bleeding’s stopped now.’
The girl’s eyes widened. She was conscious.
‘Mum … Knickers …’
‘Someone find the Sandersons,’ Hugo ordered. ‘It’s OK, Kim. We’ll find your mum and dad now, and Knickers is with the vet. You know Rob will look after Knickers just as I’ll look after you.’
The flaring panic in the girl’s eyes subsided. They were winning. Kind of. For now.
But … was one of the reasons the bleeding had eased because the blood pressure itself had dropped?
‘She hasn’t lost too much,’ Hugo muttered, and Rachel realised he was thinking the same as she was.
Too much blood …
There was certainly a lot. Rachel herself was covered with a spray of gore. She was wearing only a bra above the waist and she looked like something out of a vampire movie. Paramedics were supposed to wear protective clothing, she thought ruefully. If Kim had any sort of blood-borne disease, then she and Hugo were now also infected.
They couldn’t care. Not now.
Hugo was swabbing the girl’s arm and Rachel moved to get a syringe. By the time Hugo had the line ready she was prepared.
‘Five milligrams morphine?’
‘Yeah, and then saline. We need plasma. Hell, where’s the ambulance?’
It was here. There was a shout and then someone was pushing through the crowd. A couple of ambulance officers.
Rachel almost wept with relief. They’d have plasma, saline—everything Hugo needed.
They’d take over. This wasn’t her place. She could go back to being a horrified onlooker.
But …
‘Your husband’s a cardiologist?’ She’d gone back to applying pressure as Hugo inserted an IV line.
Her husband? She stared blankly and then realised who he was talking about. Michael, her husband. What a thought! But now wasn’t the time for fixing misconceptions. ‘Yes.’
‘Thank God for that.’
‘Sorry?’
‘I’m the only doctor in town,’ he told her. ‘Can you ask someone to find him? He’ll be able to help.’
‘He was catching the helicopter back to Sydney,’ Rachel said blankly.
‘There’s a helicopter’s taking off now,’ a voice said helpfully. ‘You can hear it.’
He’d left? Michael had left?
Maybe he hadn’t even noticed what had happened. Rachel had stalked out and it’d be just like Michael to have left as well. He’d have heard the dogfight but he wouldn’t have turned to investigate. She knew him well enough after this weekend to know he wouldn’t deviate from his chosen plan for anyone.
‘He’s taken the helicopter?’ Hugo searched the crowd to find the farmer who’d been the first to offer his shirt. ‘OK, it’ll have to come back. Matt, get onto the radio. Get the chopper returned here. Tell the pilot we need priority. Kim needs emergency surgery if we’re to save this leg. She needs vascular surgeons. We need to evacuate her—now!’
‘Will do,’ Matt muttered, and ran.
There was a crowd of about twenty onlookers around them now, but it wasn’t the sort of crowd you saw in city accidents, Rachel thought. There was horror on everyone’s faces. They all knew Kim. They were all desperate to help.
Rachel was the only woman who’d stripped to her bra but she knew without asking that each and every one of these women would do the same and more if they needed to. Their care and concern were palpable.
Then Kim’s parents were there, running toward their daughter across the showgrounds. Their fear reached the group on the ground before they did, but Kim had drifted into unconsciousness. The combination of shock, blood loss and painkillers had sent her under. Good, Rachel thought as her mother disintegrated into tears, sobbing onto her chest. The horror on her parents’ faces would only have made things worse.
Enough. There was nothing more she could do now. One of the paramedics had taken her position, keeping pressure on the wound. She rose. A buxom woman in floral Crimplene put her arm around her and held. Rachel wasn’t complaining. She was grateful for the support.
‘Who are you?’ Hugo asked. He was adjusting a bag of plasma, the ambulance officers were helping. Rachel wasn’t needed.
‘Rachel. Rachel Harper.’
‘You’re a doctor?’
‘Yes.’
‘You’re not a vascular surgeon, I suppose?’
‘I wish.’ She knew exactly what he was thinking. A vascular surgeon was what they needed, urgently. The chances of saving Kim’s leg were incredibly slim. ‘But Michael has the skills. And he’s still in range.’
He’d be upset at being called back but he had no choice.
‘OK.’ He stared up at her for a moment longer, his intelligent eyes assessing. Each knew what the other was thinking. They couldn’t voice it here—not in front of Kim’s parents—but if the femoral artery wasn’t repaired fast, Kim would lose the leg if not her life.
They needed the helicopter. They needed Michael. Kim’s future depended on it.
There was nothing Rachel could do, though.
For now she was no longer needed.
Mrs Keen, the lady in the Crimplene, ushered Rachel into the showground caretaker’s residence. As the ambulance screamed its way to the hospital she was already under hot water while Mrs Keen tut-tutted about the state of her clothes.
‘And the clothes in your bag are no better,’ she told Rachel through the bathroom door. ‘One of the men brought your bag over but you’ve dropped it, and then used everything to stop the bleeding. Oh, my dear, there’s blood on everything.’
That was a minor worry. For now Rachel couldn’t care. She let the hot water steam away the gore and she worried about the girl. Worried about the leg.
Michael would be really angry at being recalled. He’d hate to miss out on the Witherspoon case.
It couldn’t matter. He wouldn’t have heard the dogfight, she decided. Michael Levering saw only the things that affected him. He was needed in Sydney for a prestigious patient and Rachel wasn’t doing what he wanted. He’d have simply turned on his heel and stalked away. As for Rachel and Penelope—others could pick up the pieces. If Rachel didn’t take his expensive dog and his expensive car back to Sydney, well, Michael had the money to send a lackey to the country to collect them later in the week. Dog-show organisers were hardly likely to let Penelope starve and even if they did …
Penelope was just a possession.
‘Damn the man.’
She was shaking, a combination of anger and reaction to the whole situation. They’d been really, really lucky to save Kim’s life.
Michael would be back. The helicopter would have returned by now and, dislike Michael as she did, she had to concede he possessed the skills she didn’t. He was an incredibly competent vascular surgeon. He might not have noticed the dog fight but if they planned to evacuate Kim on his helicopter, he would, of course, treat her. And with Hugo as back-up …
