Spanish Doctor, Pregnant Nurse

‘You won’t get anywhere with the mother,’ Ciro warned.

‘Just watch me.’

Smiling, Harriet breezed into the cubicle, introducing herself to the patient who lay on the trolley. As Ciro had said, she was swathed in legwarmers and a thick cardigan. Her dark hair was drawn back in a small bun and gorgeous velvet-brown eyes, huge in her face, were blinking in confusion as Harriet produced a gown. Without pausing for breath, as if the entire conversation with Ciro hadn’t happened, as if she had no idea that the mother and patient were resisting treatment, Harriet explained in clear terms what was going to happen.

‘Mrs Harrison.’ Smile still in place, Harriet faced the well-groomed, heavily made-up woman. ‘We’re concerned that Alyssa’s heartbeat is rather irregular at times, so I’m just going to pop her into one of our gowns and then the doctor can examine her properly.’

‘No!’ Mrs Harrison’s voice was firm, her bracelets jangling as she went to grab at the gown, rouged lips furious, but Harriet’s smile remained intact. ‘I’ve already been through all this. I want to take my daughter home.’

‘Of course you do,’ Harriet replied sweetly, ‘but it really is imperative that Alyssa be examined thoroughly. Hopefully it’s nothing serious, but, as I’m sure you’ll understand, Mrs Harrison, we can’t just ignore an irregular heartbeat.’

‘As I’ve explained,’ Mrs Harrison snarled, ‘on several occasions, I’d rather my daughter was seen by our family doctor. I’ll take her there first thing tomorrow—’

‘This can’t wait till tomorrow.’ Harriet’s smile was still intact, but the slightly dizzy air to her tone had gone. Her voice was firm, holding the woman’s gaze as she spoke. ‘Your daughter has a cardiac arrhythmia.’ Still she stared directly at Mrs Harrison. ‘It has to be dealt with tonight. I’m going to get Alyssa into a gown and put her onto one of our monitors so we can keep a closer eye on her.’

And something in her unequivocal stance, something in her voice, must have told the woman that this was non-negotiable, and even though Harriet would never have forced Alyssa to undress, she demanded the mother’s co-operation, told her with her eyes that this had to be confronted. Finally, after the longest time, she felt an inward sigh of relief as Mrs Harrison gave a tiny reluctant nod and turned to her daughter.

‘Listen to the sister, Alyssa.’

‘Harriet,’ she offered, her smile softer now, her eyes kind as she approached the young girl. If Alyssa was, as Ciro suspected, suffering from anorexia nervosa then being undressed and exposed would be traumatic for her, and Harriet was determined to make the entire procedure as gentle and as unintrusive as possible, covering the young girl with a blanket as she helped her out of her clothes. Harriet had to keep her own emotions firmly in check as she briefly witnessed the stick-thin limbs. She talked in gentle soothing tones as she gently leant her patient forward to tie up the gown and even though there hadn’t been much room for doubt, any that might have lingered was quashed as she saw the length of Alyssa’s spinal column, vertebrae protruding, dry, flaky skin hanging off. Glancing up at Mrs Harrison, Harriet saw a flash of shock on the woman’s face but she didn’t comment.

Now wasn’t the time.

‘Well done,’ Harriet reassured the girl. ‘Now, these sticky things just go onto your chest, and it lets us keep an eye on your heartbeat.’ Placing the dots and leads on Alyssa’s frail chest, Harriet quickly covered her back up, before turning on the cardiac monitor. As Ciro made his way in he gave Harriet a brief appreciative nod when he saw that the family was now being more co-operative.

‘Alyssa, Mrs Harrison.’ Ciro smiled warmly. ‘I know you are both keen to go home, but first we need to ensure that Alyssa is well enough. Now, I know you’ve already been through this, but, given the doctor that first treated you has gone home now, can you tell me again what happened this evening when you cut your head?’

‘I was at rehearsal—we’ve got the first performance next Saturday.’ It was the first time Harriet had heard Alyssa speak, her voice, small and breathless, almost drowned out by the busy background noise of the emergency department.

‘She’s the lead,’ Mrs Harrison explained. ‘That’s why I want to get her home. She needs her sleep so she can practise tomorrow. It’s a very demanding role—’

‘Alyssa,’ Ciro broke in, ‘why did you fall?’

‘She landed awkwardly…’ Mrs Harrison started, but her voice trailed away as Ciro and Harriet both looked at Alyssa for the answer.

‘I was halfway through my routine and I just got a bit dizzy. It only lasted a second, but I was in the middle of a jump, so I fell awkwardly.’

‘How often do you get dizzy?’ Ciro asked, and Harriet could only admire his questioning, assuming, as was probably rightly so, that this was probably fairly normal for Alyssa.

‘A bit…’ She gave a tiny shrug.

‘OK.’ Ciro nodded. ‘Alyssa, I’m going to examine you, it’s nothing to worry about, and then I’m going to take some blood from you. Harriet has put you onto one of our heart monitors so that we can see what your heartbeat is doing and maybe find out why you’ve been getting dizzy.’

Infinitely reassuring, still he was commanding, his voice firm but somehow soothing. His hands were gentle as he first pulled down Alyssa’s lower eyelids, examining the conjunctiva, then her hands and nail beds. Lifting the blanket and checking her reflexes, his middle finger probed the swollen ankles that looked out of place on such thin legs.

‘You have some fluid retention. Does this happen often?’

‘Sometimes,’ Alyssa answered, ‘but Mum gives me—’

‘Just some vitamins,’ Mrs Harrison said quickly. ‘I get them at the chemist.’

‘OK.’ Ciro didn’t push for any further details, acted as if the information barely merited a comment, but Harriet knew, just knew, it had been noted, but that for now he was focussed on the important task of gaining Alyssa’s trust.

He listened to her chest, warming the stethoscope in his palms first, all the while keeping as much of Alyssa covered as possible. When he’d finished listening he probed her abdomen for a moment before replacing the blanket.

‘Thank you, Alyssa. I know that wasn’t pleasant for you, but it was necessary. I’m going to take some blood now. I’m going to insert a small cannula and leave it there, but from that I can take blood, and if we need to give you any fluids or medication we can do it all through there, so at least you’ll only get one needle. I’ll try not to hurt you.’

He didn’t. Slipping the needle in neatly, he collected several vials of blood before unclipping the tourniquet and flushing the bung to keep it patent with the heparin flush Harriet had pulled up. Only when the blood had been taken, when the IV was in and Alyssa attached to a monitor did he approach the most difficult part of the whole subject. ‘How much do you weigh, Alyssa?’

‘I’m not sure…’

‘Would you get the scales?’ Ciro asked Harriet.

‘Alyssa knows her weight,’ Harriet responded without looking up at him, keeping her eyes on Alyssa. It would be easy to go and get the scales, but Harriet also knew that the delay and interruption could ruin the relatively compliant mood that they had somehow managed to foster, and it would be far better to forge ahead while the going was good. So instead she broached her patient, knowing, somehow knowing, this was what Ciro wanted her to do. Effective interview skills in Emergency required as much teamwork and synchrony as a surgeon and scrub nurse required, and with some doctors it took for ever—if ever—to perfect, yet with Ciro they fell into it easily, Harriet handing him the metaphoric scalpel without him needing to ask for it. ‘How much do you weigh, Alyssa?’

‘Forty kilos.’ When still Harriet held her gaze, she answered again. ‘Thirty-eight and a half.’

Deliberately Harriet didn’t flinch and she was thankful that, when Ciro spoke, his voice was matter-of-fact.

‘We’ll need to check it before we give any medication,’ he said, more to Harriet, ‘but whatever way you look at it, this is very underweight.’

‘She’s a ballet dancer.’ Mrs Harrison’s voice was terse. ‘She has to watch her weight.’

‘Of course.’ Ciro nodded, smiling at the agitated woman. ‘But Alyssa is extremely underweight. I’m going to run some tests and then I’ll ask one of my colleagues to come down.’

‘And how long is that going to take?’

‘It might take a while,’ Ciro admitted, ‘but I will tell you that it is my belief that Alyssa needs to be admitted—’

‘No!’ Furiously Mrs Harrison shook her head. ‘This can all wait.’

‘I’m afraid not.’ Ciro shook his head. ‘Look, I understand—’

‘No, Doctor, clearly you don’t!’ Mrs Harrison angrily interrupted. ‘My daughter is dancing next week in a role that could see her getting into the most elite dancing school in Australia. She has to rehearse, she has to—’

‘Perhaps we could talk outside,’ Harriet suggested, anxious to move what could be a very emotional discussion well away from Alyssa’s bedside, but Mrs Harrison wasn’t going anywhere.

‘Perhaps we can’t!’ she smartly retorted, and Harriet knew that for now the conversation was over. ‘I’ll wait for those blood results, and then I’m taking my daughter home.’

‘Thank you for your help in there.’ Ciro caught up with Harriet at the nurses’ station as Harriet attempted to put to paper what had just taken place, knowing that a detailed record, though always required, was especially important in cases such as this, so that the staff that were involved later knew exactly what had been broached and what the response had been. ‘You were very good with Alyssa, the mother, too. It looked as if you actually knew what you were doing.’ He smiled as she frowned. ‘That came out wrong, forgive me. What I am trying to say is that you—’

‘I worked on an adolescent psychiatric unit when I did my training,’ Harriet explained, realising that no offence had been meant. ‘I really enjoyed it. For a while there I even thought of…’ Her voice trailed off, long-forgotten dreams briefly surfacing as she remembered the thrill of excitement at being accepted to study psychology and the thud of disappointment when her fledgling plans had been effectively doused. A part-time nursing wage, while she’d studied at uni, had been nowhere near enough to cover a very part-time actor, whose dreams had always somehow been more important than her own. But this was neither the time nor place for what could have been and, quashing memories, she concentrated instead on the matter in hand. ‘Mrs Harrison was shocked when she first saw Alyssa undressed,’ Harriet said. ‘I don’t think she knew, until then, just how thin her daughter was.’

‘Because she doesn’t want to know,’ Ciro responded. ‘At least, not until the concert is over and Alyssa has her scholarship. She wants her daughter to get into this dance school—that is her sole focus.’

‘I think you’re being a bit harsh.’ Harriet frowned, but Ciro stood unmoved.

‘I have worked with many athletes, and with their parents, too. Believe me, Mrs Harrison doesn’t want to hear anything that might compromise her daughter’s chances of performing next week, whatever the cost.’

His arrogant assumption annoyed her, and Harriet let it show, her forehead puckering into a frown, her mouth opening to speak, but Ciro got there first.

‘I don’t want them to leave the department.’

‘We can’t force them to stay—’ Harriet started, but Ciro halted her with a stern gaze, his voice clipped when he spoke.

‘I was not exaggerating earlier, Harriet. I will call Community Services if I have to. If Alyssa goes home, I can guarantee she will be back at the bar first thing tomorrow, rehearsing for her performance. And, from my clinical examination, it is my belief that that child is in danger of collapse and possibly sudden death if she exerts herself.

‘So, I repeat—I do not want her leaving this department!’

As Ciro called over the porter and handed him the bloods to take directly to Pathology, Harriet stood stock-still at the desk, pen poised over the notes she was writing, her eyes shuttered for a moment. It wasn’t Ciro’s ominous warning that caused her eyes to close in horror, but the use of the word ‘child’.

They were talking about a fifteen-year-old child, and she mustn’t lose sight of that fact. It was their duty to protect her, especially if Ciro’s educated hunch proved to be correct.

‘What was all that about?’ Charlotte nudged her, putting a massive pile of drug charts in front of Harriet that needed to be checked.

‘The patient in cubicle four,’ Harriet murmured, her mind ticking over. ‘Alyssa Harrison…’

‘The head injury that’s here with her mother?’ Charlotte checked. ‘I thought she was being discharged.’

‘Not any more. Ciro doesn’t want her to leave the department. I’m going to ask Security to keep an eye on them.’

‘But what if the mother wants to take her?’

‘Then a simple head injury will become incredibly complicated.’ Harriet gave a thin smile. ‘Let’s hope it doesn’t come to that. For now just keep an eye open and let me know straight away if they show signs of leaving.’ The emergency phone trilling loudly interrupted the conversation and had Charlotte practically dancing on the spot with anticipation. When the red phone rang, everything stopped! A direct line to Ambulance Control, it was used to warn the staff about any serious emergencies they could expect, and sometimes, if the situation merited it, an emergency squad of nurses and a doctor would be sent out.

Harriet answered the telephone calmly, listening patiently to Ambulance Control and shaking her head as Susan came over swiftly, with Ciro following closely behind, clearly wanting to find out what was coming in, or whether the squad needed to go out.

‘Just a plane about to land with one engine,’ Harriet said easily, and Susan gave a dismissive shrug, before wandering off. Even the easily excited Charlotte managed a rather bored rolling of her eyes and went off to answer a call bell.

Only Ciro remained, his expressive face clearly appalled at the news.

‘One engine!’

‘Yep,’ Harriet answered. ‘I’ll just let the nursing coordinator know.’

‘And then what?’

‘Sorry?’

‘Then what?’ Ciro barked, clearly frustrated by her obvious lack of urgency. ‘Am I to go out to the airport? Should we start moving patients out of the department?’

‘Ciro…’ Putting up her hand, Harriet stopped him. ‘It’s no big deal.’

‘Tell that to the poor souls flying thirty thousand feet in the air,’ he started, and somewhere deep inside, something flared in Harriet—a twitch of a smile on her lips, a small gurgle of laughter building within, a tiny flash of mischievousness at the realisation that she could prolong his agony, a glimpse of the old Harriet, the old, fun-loving Harriet, that seemed to have been left behind somehow. Ciro responded to it.

‘What?’ His lips were reluctantly twitching into a smile, too. ‘What is so funny? I am overreacting, no?’

‘Yes.’ Harried grinned. ‘You obviously haven’t worked in an emergency department that covers an international airport before.’

‘No.’

‘Those poor souls won’t even know there’s a potential problem. This type of thing happens all the time. Ambulance Control alerts us as a courtesy, to be ready in case…’

‘Then shouldn’t we be doing something, getting ready?’

‘Ciro, we are ready,’ Harriet answered. ‘The mobile emergency equipment was all checked at the beginning of the shift, we’ve got a major disaster procedure plan in place, ready to be implemented at any given moment. This is a fairly regular occurrence. Planes can and do land perfectly well with one engine. However, as a precaution, the airport emergency crews will all be ready to meet the plane and if, if, a disaster were to eventuate, we’d commence the major incident plan. But for now it’s way too soon to do anything.’ He didn’t look particularly convinced. ‘Ciro, if they had rung to say a plane was going to land with no engines, we’d be moving. This time next month you’ll barely turn a hair at the news. They’ll ring soon to say it’s landed safely.’

He gave a relieved nod and she should have left it there, should have ended it with a swift smile and got straight back to work, but she didn’t.

‘Unless, of course, the wheels get stuck in the undercarriage.’

‘Now you are teasing.’

‘Yes.’ Harriet smiled, but somewhere in mid-smile it wavered, somewhere in mid-conversation the witty responses ended and all she could do was stare. Stare back at those mocha eyes that held hers, stare at that full, sensual mouth. He smiled back at her and the terrible realisation hit that she was flirting.

Oh, not licking her lips and hand on hips flirting, but there was a dangerous undercurrent that was pulling her. A rip in the ocean that was slowly but surely dragging her in, this seemingly light conversation peppered with dangerous undertones. Surely, surely she shouldn’t be noticing the tiny golden flecks that lightened those velvet eyes, surely she should no more than vaguely register the heavy, masculine scent of him. But instead it permeated her.

Harriet could feel her own pulse flickering in her throat and from the tiny dart of his eyes Ciro registered it too, and for a slice of time the department faded into insignificance, for a second it was only the two of them, not two colleagues sharing a light-hearted joke, but instead a man and a woman partaking in that primitive, almost indefinable ritual. A ritual that somehow acknowledged mutual attraction, that managed, without words, to voice a thousand questions. Never had she been more grateful for the sharp trill of the emergency phone ringing, dragging her back to reality, a mental slap to her flushed cheeks, a chance to regroup, to pull back, a chance to stop something that must never, ever be started.

‘It landed.’ Her voice was high and slightly breathless as she replaced the receiver, taking great pains to calmly log the call in the book, anything other than look at him. ‘Safely.’

‘I told you it would!’ Blinking in confusion, she dragged her eyes to his, smiling despite herself when he gave a nonchalant shrug and somehow turned the previous few minutes on their head. ‘Didn’t I try and tell you that you were overreacting, Sister?’

One good thing about being busy was that the hours went by quickly. Ciro, clearly used to dealing with a full department, worked his way expertly through the patients. Harriet guessed that once he didn’t have to pause to look up every last phone number and find out where every blessed form was kept to order various tests, he’d be an absolute dream to work with—so long as you followed his rules!

‘Look at you, Harriet!’ Charlotte’s voice was almost a screech. ‘You’re in the newspaper! Why didn’t you say?’

Mortified, clutching a telephone receiver in one hand, with the other Harriet reached out to grab the paper, but Charlotte was having none of it. At twenty-one she was a huge fan of Drew’s and never missed an opportunity to talk about him.

‘I just saw one of the patients reading it! I told them that you worked here so they let me have the paper—Oh, Harriet, you look gorgeous!’

‘I look huge,’ Harriet corrected, refusing to even glance at the beastly photo of her on the red carpet at the acting awards ceremony that had been held the previous night.

‘Any results back on Alyssa?’ Ciro asked as he came over. ‘The medics are waiting to see her, but I want some more information before I speak with the mother again and tell her that we’re keeping her in.’

‘I’m still on hold.’ Harriet didn’t even look at him, couldn’t actually! She was concentrating too hard on breathing, tiny white spots dancing in front of her eyes, sweat beading on her forehead as great waves of nausea rolled over her. And Charlotte’s incessant voice wasn’t exactly helping matters.

‘But you’re not huge, you look stunning!’

‘Who looks stunning?’ she could hear Ciro asking, mortification heaped on mortification as behind her back Charlotte gleefully showed him the photo and took the new doctor on a whirlwind tour of her supposedly wonderful life.

‘Harriet here is married to a soap star.’

‘Soap?’

‘Soap opera!’

‘Her husband is an opera singer?’

‘No, he’s on TV. How come,’ Charlotte asked with the tactlessness only a very pretty twenty-one-year-old could get away with, ‘that with the patients your English is brilliant, but when you’re talking to us it’s—’

‘Charlotte!’ Harriet warned, putting her hand over the mouthpiece of the phone, but Ciro was unfazed.

‘Because most of the English exams that I had to pass concentrated on medical terminology,’ Ciro answered easily. ‘I can name every bone in your body yet I cannot talk easily about television shows.’

‘He could name every bone in my body,’ Susan sighed as Ciro headed back to the cubicles, with Charlotte following like a faithful puppy. ‘He’s very good, isn’t he?’ Susan carried on, following Harriet’s far-away gaze as she sat on the telephone on seemingly eternal hold, trying to chase up Alyssa’s blood results. Despite marking the forms as high priority the results still hadn’t come through and Mrs Harrison’s already short fuse was clearly about to run out. Glancing over to cubicle four, Alyssa frowned as Mrs Harrison pulled the curtain, effectively blocking her view.

‘He’s doing well,’ Harriet admitted almost reluctantly, determined not to let even a hint of what she was feeling carry to her peers, rolling her eyes as yet again the switchboard operator asked her to stay on hold. ‘So long as you don’t ask him for any favours.’

‘Meaning?’

‘Meaning I asked him to write up two Maxalon for me and he refused. He said that he’d only write them up if he examined me first.’

‘And you said no!’ Susan teased. ‘I wouldn’t have to be asked twice to take my kit off. Are you OK?’ she asked more seriously when Harriet didn’t smile back, just fanned her face with her hand and licked lips that were suddenly dry.

‘No,’ Harriet finally admitted. ‘In fact, once I get these results I think I’m going to have to take first break. Susan, would you mind going and checking on Alyssa? Tell Mrs Harrison that we need the curtains kept open, unless she’s using a bedpan, of course.’

‘Sure.’ Susan stepped down from her stool. ‘And when I’ve done that do you want me to ring the supervisor, and see if she can send someone down to replace you?’

‘Fat chance.’ Harriet rolled her eyes. ‘I was the last of the last resorts already. I’ll just have to grin and bear it, I’m afraid. Let’s hope the department stays quiet.’

Jinx!

Even as the words came out of her mouth, even before the two nurses could touch the wooden desk in front of them in an effort to stop the jinx, the urgent call went up!

A loud crash, followed by a wail of horror filled the relatively quiet department and, throwing the receiver down on the desk, Harriet managed a rueful smile as she ran towards cubicle four, Susan quickly apportioning blame as she ran behind. ‘That’s your fault, Harriet!’

CHAPTER TWO

CIRO beat them there.

Pulling back the curtain and assessing in a split second what had happened, Ciro knelt down and swiftly examined Alyssa who lay unconscious on the floor. He checked her vital signs as Harriet pulled an oxygen mask from the wall and placed it over the young girl’s mouth, careful not to move her until Ciro gave the OK.

‘She said she felt OK,’ Mrs Harrison was sobbing. ‘I thought if I got her home to her own bed—’

‘Did she hit her head when she fell?’ Ciro’s question was direct.

‘No. She was just getting off the trolley and she went dizzy.’

‘Did you break her fall?’

‘Yes!’ Mrs Harrison’s voice was a screech. ‘What the hell’s happening? Has she fainted or something?’

That was what Harriet had been hoping when first she’d seen the young girl collapsed on the floor, but normally, with a simple faint, consciousness returned almost as soon as the patient was prone. But despite the oxygen, despite the seconds ticking past, Alyssa still lay unconscious.