The Elusive Consultant

‘We’ve put the wedding plans on hold.’ A smile tugged at the side of his mouth. ‘Aren’t you going to say “oh” again?’

‘Oh,’ Tessa squeaked, her mind working ten to the dozen.

‘Thing’s aren’t too great between Emily and I at the moment, but that’s just between you and me, so don’t go firing it around the hospital.’

‘I wouldn’t,’ Tessa said indignantly. ‘I only listen to the gossip, I never start it.’ They sat in silence again, but this time it certainly wasn’t comfortable. Endless questions bobbed on her tongue, but Tessa bit them back, knowing it was none of her business, knowing Max would tell her only what he wanted to.

‘London won’t know what’s hit them.’ It was a small attempt to break the strained atmosphere, a little joke to desperately lighten the mood that had suddenly taken a massive dive. ‘You’ll have to smarten up a bit.’

‘What’s wrong with what I’m wearing?’ Max replied indignantly, but he was at least smiling now they were on the familiar territory of his appalling dress sense.

‘Nothing.’ Tessa gave a cheeky wink. ‘For a walk along the beach, anyway.’

‘They’re smart shorts!’ Max protested.

‘They might be if you ironed them, and I can’t really imagine the consultants there wearing T-shirts and boat shoes.’ Tessa put up her hands in mock defence as Max opened his mouth to protest. ‘Just a mental picture I’ve got of London, Max—you know, doctors in smart suits, nurses with starched uniforms and caps.’

‘It’s the twenty-first century, Tess, that all went out with the ark.’

Tessa laughed. ‘I could be wrong, but you’re in a little bay-side town here Max, most of the patients know you already, the staff certainly do. We know that under that scruffy hair is a brilliant medical brain.’

‘Well, I’m not wearing a suit,’ Max shrugged defiantly. ‘For anyone.’

Tessa turned back to her coffee staring dreamily out of the window, images of London dancing through her mind—Piccadilly Circus, the Houses of Parliament, tree-lined streets she had seen only in televised weddings and funerals. So far away it might just as well be on another planet, and Max was actually going to be there, riding on the subway or the tube or whatever its name was, having short days and cold Christmases. Her mind danced around London as she sat there. She’d never had any desire to go, it had never even entered her head before. Despite being an eternal romantic, Tessa had her head screwed on firmly enough to realise it wasn’t all going to be rosy-cheeked children singing around Christmas trees and rolling English countryside littered with wildlife. And, no doubt, Max would grumble like crazy about the warm beer and the exchange rate, but London...

‘Maybe I should get some smart trousers,’ Max relented after a few moments’ silence, his mind obviously still on the conversation. ‘I guess I could buy a couple of shirts as well.’

‘A tie even?’ Tessa teased, and Max shuddered. ‘And while you’re at it, you might even get a haircut.’

‘You’re pushing it now,’ Max grumbled. ‘Still, I am going to have to start sorting things out, it’s only two weeks until I go.’

‘Are you excited?’

‘Yes and no.’ Max shrugged but didn’t give any more away.

‘It’s a big move, though,’ Tessa pushed, even though it was obvious that Max wanted to end the conversation. ‘You must at least be a bit nervous. Will you miss us all?’

‘It’s only for a year, Tess,’ he said, but the raw note of urgency to his voice had Tessa convinced he was assuring himself more than her. ‘Peninsula Hospital will still be here when I get back. I’m just taking a year out—things will stay the same, won’t they?’ His face was serious, his hand was back on her arm and Tessa swallowed the lump that had mysteriously appeared in her throat. ‘You’d do the same, wouldn’t you? I mean, if your dream job came up you’d grab it.’

For an age she stared at Max, but it became too hard. Too hard to look him in the eye and tell him she was OK with this. Dragging her eyes away, she drank in the view—the fisherman on the jetty, the endless beach that constantly beckoned her, the jagged rocks full of tiny pools, each one a Pandora’s box of treasures she’d gaze into and dream away the hours as she swirled her hands through the water.

Maybe London was glamorous and exciting, but it wasn’t home.

‘I’ve got my dream job, Max,’ she said softly, her eyes slowly moving back to him. ‘OK, it’s not the cutting edge of nursing, people aren’t going to look at my résumé and shake with excitement, but it’s all I want—Charge Nurse of the emergency department at Peninsula. Enough emergencies to keep the adrenaline flowing and plenty of stunning views to calm me down when it all gets too much. This is enough for me, Max. I thought it was for you as well.’

‘It is, it’s just...’ A long-fingered hand ran through his tousled hair and he let out a ragged sigh. ‘I need to talk to you, Tess.’

‘We are talking,’ Tessa said lightly, a forced smile taut on her strained face.

‘I mean away from here.’ He gestured to the room, his eyes never leaving her. ‘Away from the hospital.’

‘What about Emily?’ Tessa asked slowly.

‘She’s on call tonight.’

Another wrong answer. As the shutters came down on her eyes Max broke in quickly. ‘I don’t mean it like that, Tessa, I just really need to talk to you.’

‘No!’ Tessa said rather too forcefully. ‘It’s Emily you should be talking to about any problem you’re having with your relationship—she’s the one with your ring on her finger. And if it’s an impartial, feminine viewpoint you’re after, believe me, Max, you’re asking the wrong woman.’

‘What’s that supposed to mean?’

‘Well...’ Tessa’s eyes darted nervously, wishing she could take back the words she had just uttered and frantically searching her mind for a way to diffuse them. ‘I’m not exactly an authority on the perfect relationship. Look how many dating disasters I’ve endured in my time.’

‘I’m not asking you out for a counselling session, Tessa, I just want to talk to you.’

‘Sorry, Max.’ Tessa gave a vague shrug. ‘I’m a bit tied up at the moment.’

Never had the chimes of the emergency loudspeaker springing into life been more gratefully received and Tessa jumped up, grabbing her pager from the table as Max reluctantly joined her. ‘Come on, it looks like we’re wanted.’

‘Tessa?’ The question in his voice didn’t go unnoticed, but so innocent was the smiling face that turned to him, so wide her smile, that Max hesitated, his pensive expression shifting, his own face breaking into a wide smile that matched hers. ‘Come on, I’ll race you.’

They sped along the corridor, laughing as they did so, Tessa’s long brown hair flying behind her as she tried to keep up with Max’s effortless strides, their pagers shrilling in their pockets alerting them to head to Emergency as other hospital personnel flattened against the walls to let them past.

And to anyone watching, Tessa didn’t look as if she had a care in the world as she burst through the swing doors and headed straight for Resus.

‘Beat you.’ Max smiled before turning to Jane and getting the run-down of the trauma that was about to come through the doors.

‘You always do,’ Tessa grumbled as she ran through and set up the necessary equipment.

‘Ah, but I had an added incentive to stay ahead of you this morning.’ Max grinned as Tessa’s forehead creased. ‘How many eggs did you say you’d had?’

It was a joke, a below-the-belt joke that nurses and doctors dished out almost by the minute, a brother-sister-type tease that normally Tessa would have shrugged off before it had even registered in her brain.

But it wasn’t a normal morning, and there was nothing sisterly about the way Tessa was feeling. Max was leaving, there was no denying it now, she’d heard it straight from the horse’s mouth.

It really was going to happen.

All that talk, all that bravado about being friends had all been a lie—a lie she was so used to living. After five years it came as naturally as breathing. And her excuse to him about not being able to offer an impartial feminine viewpoint had been another one.

Feminine she could readily manage, but impartial, well, it wasn’t even a vague possibility.

Max, with his curly brown hair and teasing smile, had never, since the moment Tessa had first laid eyes on him, been just a friend. Max, with his crumpled clothes and banana-skin humour, who could make her cry with laughter one minute and suddenly be serious the next, was so much more than her work confidant, brunch buddy and sounding-board.

There was nothing impartial about Tessa’s feelings.

Max Slater was the man that she loved.

CHAPTER TWO

‘SORRY to drag you back, guys. The story’s a bit vague from Ambulance Control so I thought it best to be prepared.’

‘No problem,’ Max replied easily. ‘What do we know so far?’

‘Speedboat versus jet-ski.’

‘Ouch.’ Max rolled his eyes. ‘How many?’

‘Three from the boat, two with seemingly minor injuries and one unconscious, thankfully they were all wearing life jackets.’

‘And the jet-skier?’ Tessa asked, mentally assessing the injuries and matching her staff available.

‘He’s not been so lucky, I’m afraid. It would seem he wasn’t wearing a life jacket. The report from Ambulance Control is that he’s got multiple injuries, including a possible broken neck. They were going to take him straight to the spinal unit, that’s why I held off calling you, but apparently he’s gone into full cardiac arrest in the helicopter so they’re bringing him here.’

The spinal unit was only another thirty minutes or so in the helicopter but, given that full resuscitation was in progress, thirty minutes along the bay was too long and Tessa gave a small grimace. ‘Hopefully we can get him there later. How do you want to work this, Jane?’

Technically the allocation was up to Tessa as she was the charge nurse on duty, but Jane was a senior nurse and this morning Tessa had let her be in charge, gradually allowing more responsibility to fall onto Jane’s shoulders, with the intention being that she could soon oversee the department by herself.

‘Well, I’d like to take the full resus, but I guess if I’m supposed to be running the show I should take the unconscious boat victim and direct traffic.’

‘Good call.’ Tessa’s voice was encouraging, but inwardly she sighed at Jane’s persistent lack of foresight. As good an emergency nurse as Jane was, she had rather too much bravado about her and a noticeable unwillingness to delegate, far happier to be in the thick of things than running the show. It was something Tessa was working on quietly, but with rather limited success. ‘But the boat victim is an unknown entity. You might find yourself just as tied up with him.’

Jane chewed her lip thoughtfully, and Tessa glanced at her fob watch, willing her colleague to hurry up and make a decision.

‘Why don’t you send Kim in?’ Tessa said finally when it was obviously they weren’t getting anywhere.

‘But she’s only a grad nurse,’ Jane protested, itching to pull on her latex gloves and get on with the job she loved.

‘A grad nurse who needs more resuscitation experience,’ Tessa pointed out. ‘First-hand experience is the only way she’ll learn and at least Max is on so he’ll watch her like a hawk. I can oversee them while I deal with the boat victim.’

‘So when I’m in charge I just get to stay in the corridor and direct traffic?’

‘Well, there’s a bit more than that.’ Tessa smiled at her colleague’s disappointed face. ‘You’ll be run off your feet with relatives and us calling for things, but that’s the way it is when you’re in charge, Jane. Someone has to be the chief.’

‘Great,’ Jane muttered as Tessa made her way into Resus, more than happy to be in the thick of things again.

‘Sorry, guys, I was stuck in Theatre. What’s the story?’

Even if Tessa hadn’t recognised the voice, the sudden tension that filled the room told Tessa that Emily had arrived and, more annoyingly, Tessa didn’t even have to look up to know that the sight that would have greeted her would have been one of unruffled, petite beauty.

Emily never looked ruffled. The woman had probably spent the morning pulling dislocated hips and shoulders into place and yet her blonde hair was pulled back into a perfectly neat ponytail, her theatre blues looked tailor-made and her clear, china blue eyes never wandered as she listened intently to the brief history given by a suddenly nervous Jane.

Emily had that effect on women.

On men, too.

Come to think of it, Tessa grumbled to herself as she assembled equipment, even three-year-olds quaked when Emily approached.

She might look like a tiny fragile porcelain doll, but two minutes in her company soon put paid to that. Emily Elves hadn’t made it to orthopaedic registrar courtesy of her good looks, and the fact her father was the top obstetrician in the hospital wouldn’t count for anything when she went for the consultant’s position at the end of the month. No, Emily had made it this far in a man’s world through steely determination, a brilliant medical mind and an utter disregard for emotion.

‘So the jet-skier wasn’t wearing a life jacket.’ Her blue eyes finally swivelled to Max when the history was completed and a wry smile appeared on her smooth face. ‘Did you hear that, Max?’

‘No doubt it’s all I’m going to hear for the next few days,’ Max responded with a slight edge to his voice that instantly had the room enthralled.

‘You see,’ Emily explained, still smiling as she started to pull up some drugs from the trolley, ‘Max Slater, your, oh, so responsible emergency consultant, the lynchpin of the department, the one we’re supposed to look to for guidance, well, he thought he might try his hand at jet-skiing last weekend.’

Everyone laughed. It was the type of conversation that often took place as the adrenaline kicked in while they waited for the arrival of patients, but even though Tessa joined in the laughter a small frown puckered her brow. As commonplace as this type of conversation might be amongst the staff in Emergency, it was a revelation to hear Emily opening up. Emily Elves was eternally private. In fact, normally she went out of her way to keep her professional and personal lives completely separate, yet here she was for the first time in memory telling anyone who was interested about her weekend with Max. There was definitely something strange going on.

But Tessa had no choice but to listen and laugh along with the rest of the rabble and it hurt.

Really hurt.

‘Of course,’ Emily continued, ‘I knew nothing about it. There I was, having a doze on the beach, half listening as some hoon came in way too close to the shore, laughing his head off, whooping with enjoyment and generally making a nuisance of himself, you get the picture. It was only when the yob in question started calling my name did I sit up and take notice...’

‘I was only on the jet-ski for ten minutes,’ Max argued. ‘If that. Mind you...’ he grinned ‘...it was the best ten minutes of my life.’

‘And it could very well have been the last ten minutes,’ Emily said pointedly, cocking her head as the sound of the chopper got louder. ‘Need I say more?’

Thankfully she didn’t. The last thing Tessa needed this morning was cosy little images of Emily and Max at the beach, no doubt with Emily skinny and gorgeous, some tiny little bikini accentuating her smooth brown skin, good-naturedly bickering about Max’s casual attitude to the world at large, Max’s take-it-or-leave-it slant on things.

It was a relief when the patients arrived and Tessa could concentrate on work.

The first victim to arrive was the unfortunate jet-skier. Though no longer in full arrest, he was still dangerously close to it.

‘OK, Kim, just listen to Max, he’s supporting the neck so he’s the team leader.’ Tessa hovered in the background, watching closely as Kim worked intently. As important as it was to give the staff experience, it could never be at the expense of patient care, and in this instance any hesitation could prove fatal. The lift over to the trolley was swift but very controlled, given the likelihood of spinal injuries, and Tessa tried not to interfere too much as she watched Kim’s shaking hands change over the equipment from the rescue team’s to the unit’s own. Already the young man was intubated. The paramedics had put a tube in place in his throat, thus securing the airway, and intravenous access had been established.

‘Right, Kim, look at the cardiac monitor. What do you see?’

Kim swallowed hard, her cheeks colouring as she stared at the machine. ‘His heart rate’s slow.’

‘Yep, he’s in sinus bradycardia, so what drugs do you think he’ll need?’

‘Atropine?’ The answer was right but Tessa could hear the question in the Kim’s voice.

‘Good,’ Tessa said encouragingly. ‘Max is checking his airway now—that’s the first priority—but once he looks at the monitor no doubt he’ll be calling for atropine or adrenaline so if you can try to preempt what he’ll need, you’ll have a head start. You may well be wrong but at least it’s easier to pull up the drugs and have them ready to hand over to him before he starts calling for them.’

‘Atropine.’ Max’s word was clipped, not even looking up he placed an impatient hand out, and thankfully Kim was able to pass him the drug immediately.

‘Get the chest-tube pack out,’ Tessa whispered, watching Max frown as he palpated the young man’s ribcage and run through a flask of mannitol. As the resus doors slid open and Tessa’s patient arrived, she gave her colleague’s shoulder a quick squeeze. ‘Don’t mind Max if he shouts. It’s not aimed at you personally, it’s just his way.’

It was just his way, Tessa thought as she started to work on her own patient, ignoring a rather loud expletive coming from Max’s general direction. Max, passionate about every patient, would be working on the young jet-skier as if it were his own family member lying near to death on the resus trolley. And if he lost his temper, if he shouted because the equipment he’d only just asked for wasn’t in his hand now, it was easily forgiven. Everyone knew they were watching a genius at work, and a genius was surely allowed the odd eccentricity.

Unlike Emily, Tessa thought to herself as she set to work on the latest admission. Not that Emily wasn’t a diligent and talented doctor, but her work technique and bedside manner didn’t even begin to compare to Max’s. The young man before them was flailing around on the gurney, distressed, in pain, terrified and, Tessa thought, confused, which was more ominous than the rest of his symptoms put together. And with little reassurance to her patient, Emily commenced her examination as Tessa struggled to hold the young man down and reassure him.

‘Stay still for me.’ That was the sum total of Emily’s communication with her patient as her hands worked their way down his body, leaving it to Tessa to attempt an explanation. But explanations were hard to give in the absence of information and Emily, as usual, was giving nothing away.

Emily worked in a completely different manner to Max. Emotions were kept strictly in check as she thought things through in her own time, and from a nursing perspective she wasn’t the easiest doctor to work with. There was no pre-empting her, no little clues along the way, nothing in her calm exterior to indicate what was going in that clever head of hers.

‘What’s his blood pressure?’ Emily’s voice was completely calm, as if she were asking if there was any milk in the fridge or if anyone had thought to buy a newspaper this morning. The coffee-room or the resus ward was all dealt with in the same unflappable manner. Her meticulous, very neat little hands methodically examined the restless body.

‘It’s up,’ Tessa said, glancing over at the machine. ‘One hundred and ninety on a hundred.’

There was no reaction from Emily as she carried on working her way down the patient. ‘Do we have a name?’

‘Phil’s all we’ve got at the moment,’ a voice called from the back of the room, and Tessa nodded her thanks to the paramedic who was writing up his notes in the corner.

‘Phil, try and stay still for me while I examine you.’

Which didn’t exactly calm the agitated man down.

‘You’ve been in an accident, Phil,’ Tessa added as diplomatically as she could, keeping her voice calm and even as she orientated her patient. ‘You’re at Peninsula Hospital. Dr Elves here is just going have a look at you.’

‘His shoulder’s dislocated,’ Emily said, more to herself than anyone.

‘His oxygen sats are low,’ Tessa said grimly, ‘even though he’s on ten litres of oxygen.’

‘Hmm, he’s got a few fractured ribs as well.’

Sometimes Tessa wanted to shake Emily. An excellent doctor she might be, but she was a lousy team player. Nothing in her calm expression, her clear blue eyes let the staff know what she was thinking—unlike Max, who wore his heart on the sleeve. Right now Tessa was worried about the head injury. By all accounts, Phil had been unconscious for some time, his agitated ramblings and high blood pressure all indicative of a serious head injury, but Emily, though aware of the facts, seemed more concerned about his shoulder.

‘Let’s get his shoulder back in place then we’ll see where we are.’

‘Do you need anything?’ Tessa ventured, hoping against hope Emily wasn’t going to do the procedure without anaesthetic but knowing the call was Emily’s.

‘Some traction, please,’ Emily said without looking up. ‘And make sure the brakes are on the trolley.’

Tessa bit her tongue. Giving the patient pain control now would mask any symptoms of his head injury, but to do it without anaesthetic would be agony. She watched as Emily slipped off her shoes and realised Phil was going to need all the sweet-talking Tessa could manage.

‘It will only take a second,’ Emily said assuredly. ‘Are you going to provide the traction?’

It was more an order than a request. Reluctantly, and trying hard not to show it, Tessa held onto the unfortunate man’s shoulder, watching as Emily placed the ball of her foot in his armpit. For someone so tiny she was incredibly strong, which was an absolute prerequisite in orthopaedics. Leaning back, Emily pulled as Tessa took the head end and utilised every last bit of her strength to hold the trolley steady and provide the necessary traction that would enable Emily to slip the shoulder back into place. Engaged in their own tug of war for a moment, just as Emily had predicted, the shoulder slipped back easily into place and instantly Tessa felt Phil relax under her hands.

Emily was good, Tessa admitted grudgingly.

Very good.

‘Better?’ Tessa asked gently, smiling as her patient nodded, responding appropriately for the first time since his arrival. His eyes were closed, though, only opening when Tessa spoke.

‘It was killing me.’

‘Do you know where you are?’

Phil didn’t answer immediately, his eyes closing between sentences, and Tessa had to prompt him to stay awake. ‘Phil, do you know where you are?’

His battered, sunburnt face turned and stared at the badge hanging around Tessa’s neck. ‘Hospital?’

Tessa smiled. ‘Is that an educated guess?’

‘I’m afraid so,’ he answered, drifting off again until Tessa none too gently tweaked his ear, which roused him enough for a slightly longer conversation.

‘Do you remember anything that happened?’ Ticking off Phil’s responses in the observation chart, Tessa tried to keep the assessment as light as possible. She could see the effort in Phil’s face as he attempted to recall the morning’s events, see the fear in his eyes, the slight note of panic in his voice, and knew it was only a matter of time before the full impact of what had happened took hold.

‘We were just out, doing some waterskiing, having a laugh...’ He frowned as loud rhythmic banging came from behind the curtain, and Tessa felt her heart sink as she realised that the other young man had obviously slipped back into cardiac arrest, the rhythmic banging a desperate attempt to massage the stilled heart into action. ‘Some kid on a jet-ski, he’d have only been about nineteen... He just came from nowhere.’