The Elusive Consultant

Max’s orders were coming thick and fast now, and as she heard his call for two hundred joules Tessa forced her eyes to stay on her patient, listening to the defibrillator charging up behind her. She could hear Jane’s voice, so there was no need for her to go and help, but it didn’t mean her heart wasn’t on the other side of the curtain, willing the young man to pull through.

‘Do you remember anything else?’ Tessa asked gently, but as Phil went to answer again Max’s voice broke in.

‘Everybody back.’

Phil lay in agonised silence as the click of the shock being delivered filled the resuscitation room. ‘Is that him?’

Technically Tessa didn’t need to answer. Discussing other patients was taboo at the best of times but, given that only a thin curtain separated the two patients, it seemed cruel and pointless to dismiss Phil’s heavy question with a dismissive shrug, so instead she gave a small nod, watching as Phil’s face dropped, placing a gentle hand on his good arm.

‘They’re doing everything they can.’

‘How’s it going?’ Jane’s grim face popped around the curtain.

‘Emily’s just popped his shoulder back, he’s a lot more comfortable.’

‘Do you want to move him over to one of the cubicles?’ Jane’s wide eyes left Tessa in no doubt that the news was only going to get worse for the young jet-skier. And it would probably be kinder to move Phil, less traumatic for him to be in his own space with his own thoughts, rather than listening to the terrible events unfolding a few steps away. Now was a time for one of nursings tough calls. Despite the reduction of his shoulder dislocation, Phil’s blood pressure was still dangerously high, and Tessa still wasn’t satisfied with his consciousness level. The ease at which he drifted off when she wasn’t prompting him worried Tessa, and the thought of him unobserved in a cubicle couldn’t be justified because of the traumatic events taking place in the resuscitation room.

‘We’ll keep him here for now.’ Tessa made a small gesture to the monitors and Jane nodded her understanding, moving aside as Luke appeared with the portable X-ray machine and handed Tessa a lead gown.

‘I think Max wants a quick C-spine in the next cubicle,’ Tessa said in businesslike tones, ignoring the rather eager smile Luke was wearing. Six weeks ago they had shared one very questionable date, and for Luke, at least, it wasn’t over yet. ‘Then, no doubt, there’ll be a pile of films for you to do here. I’ll take a lead gown for the doctors, and Kim next door as well.’

‘Tessa.’ Kim’s call from the next cubicle merited more than a ‘yes’ and, nodding to Emily, Tessa ducked round the curtain, attempting to slip a very heavy lead coat over Max’s head as he examined the patient, tying it up at the sides she tried, and failed, not to notice the musky scent of him, the light hairs on his arms, the quiet strength of his lean body.

He didn’t acknowledge her and neither did Tessa expect him to.

‘Sorry to be a pain,’ Kim started, as Tessa offered to slip a protective coat gown on her, her face red from the exertion of giving cardiac massage. ‘It’s just...I’d rather not be here while they do the X-rays.’

Her already red face was almost beetroot now and Tessa felt sorry for her. That was the trouble with nursing: nothing was sacred. The fact Kim didn’t want to stay while the films were being done could only mean she was either pregnant or hoping to be, and while most of the general population were able to sit on their secrets, emergency nurses didn’t have that luxury. Though Tessa’s curiosity was naturally aroused, she didn’t show it.

‘Sure,’ Tessa said lightly. ‘You take over Phil next door and duck outside while the X-rays are being done.’

‘I’m sorry,’ Kim said again, needlessly. ‘I should have said something earlier.’

‘That’s the trouble with this place,’ Max said dryly, ‘it’s never early enough. Go,’ he said with a small wink. ‘Tessa and I know now, that’s enough to be going on with, and don’t worry about Fred here.’ He gestured to the anaesthetist who looked up at the mention of his name. ‘We’ll cover for you till you’re ready for the world at large. Isn’t that right, Fred?’

‘Sure,’ Fred mumbled, obviously bemused at what he was agreeing to.

‘Thanks, guys.’

Taking over the massage, Tessa called Kim back. ‘Phil’s upset about this one,’ she said in low tones, ‘but I don’t think he’s well enough to be moved. I know that he looks pretty good on paper, but I’m not happy with him.’

‘What does Emily say about him?’ Max asked, not even bothering to look up from the array of monitors he was watching like a hawk.

‘Not much,’ Tessa said tactfully. ‘She’s reduced his shoulder, so he’s a lot more settled. She’ll probably do another neurological assessment now that he’s calmer.’

‘Well, keep a close eye on his neuro obs, and if you’re worried, I’m only here,’ he offered, which was the closest to an acknowledgment of Emily’s poor communication skills they were going to get.

‘Sure.’

Fred spoke with an air of weary resignation. ‘Max, we’ve been going for fifteen minutes with no response—there’s been nothing since he arrested in the ambulance.’

‘He had a pulse when they pulled him out of the water, and a pulse when he first arrived here,’ Max snapped, but the anaesthetist shook his head.

‘Yes, but he wasn’t breathing, heaven only knows for how long. His neck’s broken, he’s got multiple injuries—’

‘Let’s just wait for the X-ray, shall we.’ It wasn’t a question, it was a statement, and Fred shrugged and raised his eyebrows at Tessa who, in an attempt at diplomacy, said nothing. There was nothing unkind in Fred’s words or actions, just the awful deliverance of the truth.

But Max didn’t want to hear it.

Fred held the X-ray film against the patient’s neck as Luke lined up the machine for his shot.

‘What time do you finish, Tessa? I thought we might hit that new wine bar that’s opened.’ Luke’s apparent casualness belied his slightly nervous stance.

‘I don’t think so,’ Tessa said abruptly, annoyed with Luke not only for embarrassing her but also for his blatant disregard for the patient. Unconscious he might be, but attempting to arrange a date when a young man lay desperately ill was pushing the boundaries of decency in Tessa’s book.

Max’s, too, from the dark look he shot at them both.

‘I’ll take over the massage.’ Max moved in, clearly annoyed. ‘You wait outside.’

Tessa shook her head. ‘I’m fine,’ she said quickly. ‘We’ve already had one change-over with the massage, it’s better not to disrupt things again. Anyway, it’s only one X-ray and I’ve got a protective gown on.’

‘Which isn’t done up,’ Max pointed out. ‘Hold on a second, Luke.’

Like a reflex action, Tessa pulled in her stomach as Max came around, his deft hands pulling the ties together as Tessa worked seemingly unruffled by his closeness. ‘Got to protect those ovaries.’

Another tiny comment, another little reference to her femininity, and from anyone else it would have left her mind as soon as it had been said.

But that was the problem with being in love.

Every tiny statement, every throw-away comment was stored and filed then taken out later, poured over and analysed. And every touch, however fleeting, however unambiguous, registered like a size five earthquake on the Richter scale.

It took every ounce of Tessa’s professionalism to carry on counting in her mind as she carried on the massage.

The X-rays seemed to take for ever to be developed. Tessa carried on with the massage as Max snapped his orders to a flustered Kim, who was running between the two beds. He used every drug on the trolley and a few more, gave the young man every last shot, used every trick in the book in an attempt to get his youthful heart started, but when Luke came back and pushed the film on the viewfinder Tessa knew at a glance it had all been futile.

For a moment or three Max stared, taking the film down and holding it up to the light as if a different view might make the terrible image look different.

‘Max.’ It was all she said but it was enough to break the awful loaded silence.

‘Maybe we should try...’ he began, his eyes darting to the drug trolley, his hands reaching for the internal telephone.

Max could summon who he liked to the department, use every last drug on the trolley, surf the net for any breakthroughs since yesterday with spinal injuries, but for the young man who lay on the resuscitation no amount of technology was going to save him, and the horror of his X-ray only confirmed the fact.

He was beyond saving.

‘Max.’ Tessa said again this time more definitely as Fred swivelled his eyes between them.

Max nodded then, the tiniest briefest of nods as he replaced the receiver in its cradle. ‘Stop the massage.’

Only then did Tessa stop. It had been Max’s call and she knew how hard it had been for him to make it. The three stood there, waited and watched the machines, because that was what they had to do, that was what protocol dictated.

It was Fred who moved first, flicking off the monitor and turning off the oxygen when the miracle they had all been secretly hoping for didn’t materialise. ‘Sorry, guys.’

Nobody spoke as Max performed his final examination. ‘Time of death, twelve fifty-two.’ He didn’t write it down, just stood for a quiet moment, his fists clenched in a strange, defiant sort of salute, then strode off, as Tessa wrote the time in her notebook, knowing Max would need it later.

‘Sorry,’ Fred said again. ‘It’s horrible, losing them when they’re this young.’ Shaking his head, he gave Tessa a weary smile. ‘I wouldn’t like to be around Max in London, when it’s little children lying on the resus bed. It’s going to hurt like hell there.’

The fact Tessa didn’t know her patient’s name didn’t stop her from caring, didn’t stop the sting of tears in her eyes when she looked at the young body before her. Yes, it was part of the job and, yes, she was used to dealing with death, but the professionalism ingrained into her, the familiar scenario of an emergency room, didn’t provide enough of a buffer for the emotions that assailed her. Fred was right, the loss of a young life hurt like hell.

Always would.

Somewhere she had read or heard that a spirit stayed with the body for a while, and though Tessa really didn’t know if that was true or not, the thought made her stay a while longer than needed. A moment or two of gentle talk and a little prayer because maybe, and again she wasn’t sure, maybe it helped. And when there was nothing more she could do, she quietly made her way out from the curtain.

‘No good, huh?’

Phil was still staring at the ceiling, a salty tear slipping down his temple into his hair.

‘No,’ Tessa said softly. ‘I’m sorry you had to hear all that.’

‘Don’t worry about me, love. In some ways it was better.’ He gave a very wobbly smile. ‘Better than being just told he died, that I’d just killed someone.’

‘It was an accident, Phil,’ Tessa pointed out, but he just shook his head, refusing her crumbs of comfort.

‘I got up this morning and the sun was shining and all I could think was what a great day it was to be alive. You just never know how your life’s going to change, do you? Still, at least I know you all did your best for him, I know that he was given every chance. I’m just going to have to learn how to live with it now.’

‘Go and grab a coffee,’ Kim mouthed over the patient, and even though Tessa didn’t particularly want a drink, even though she knew that Kim was just as upset as she was, Tessa also knew that in a few moments she’d have to face the relatives.

Five minutes out was too good to pass up.

* * *

‘Before you say “I can’t save them all,” I know all that.’ Max was staring out of the window, his shoulders hunched as if there was a cold wind, not even bothering to turn as Tessa tentatively came into the staffroom.

For a second she wondered how he had known it was her, but she didn’t say anything, just stood at the door, watching Max, feeling his pain and wishing more than anything in the world that she could go over and put her arms around him, somehow ease some of the agony she knew that he was feeling.

But it wasn’t her place.

‘Here...’ Walking over, she handed him the casualty card which Max stared at for a moment. ‘You’d best write it up while it’s still fresh in your mind.’

‘As if I’m going to forget.’ Tossing the card down, he moved nearer the window. ‘Did you finish arranging your date with Luke?’

There was a spiteful note to his voice that Tessa for the moment ignored, choosing instead to put him right in a calm and matter-of-fact voice. ‘It was Luke who was inappropriate in there, Max, not me.’

Tessa’s apparent calmness only accentuated his pettiness and Max at least had the grace to look shamefaced. ‘I’m sorry.’

‘What’s going on, Max?’ She watched as he stiffened, and though her question was bold and direct, there was nothing brave about how Tessa was feeling. She had only been gone a week, but in that short space of time so much seemed to have changed. Something had happened, not just between Max and Emily, not just the fact he was leaving for London. Their friendship seemed to have shifted, subtly perhaps but there was a definite move away from the easy comradeship they had enjoyed for the last five years, a definite shift in Max’s demeanour towards her.

‘Nothing’s going on,’ Max finally answered. ‘I just didn’t like the way Luke was behaving. I shouldn’t have taken it out on you, I know you’ve got more integrity than to speak over a patient like that.’

She could have pushed, could have insisted on a deeper response, but even as Tessa opened her mouth to probe further, she knew she wasn’t going to. Max wanted to talk, he’d already told her that, and though a cosy meal might answer a few of her questions, it could only generate a multitude of others.

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