Unlocking the Rebel's Heart

by Alison Roberts

  Only because she wanted to tell him how well the lamb was doing, of course. Joy was proud of herself for how well she was coping with not only getting used to the strange isolation of living in the country but with the added pressure that went with the responsibility of raising an orphaned lamb and keeping up with the feeding schedule. Shaun was clearly thriving, according to the local vet who’d dropped in to introduce himself a couple of days ago and check on how she was doing. What she was a lot less likely to admit, however, was how the small, woolly creature had surprisingly sneaked into a corner of her heart. Maybe it was the anxious bleating that greeted her as soon as Shaun spotted her arrival beside his box, or the pleasure of holding that bottle until the enthusiastic sucking had emptied it. Or perhaps it was the way that the lamb followed her everywhere, as if she was the most important person in the world, until she put it back in its box.

  Still in a reorganising mode after work yesterday, she’d cleaned out one of the stalls in the old barn beside her cottage, covering the cobbled floor with a deep layer of clean straw so that Shaun could move out of her tiny kitchen. This morning, heading to work, she’d noticed a stack of old gates behind the barn and wondered if she could make some sort of pen so that the lamb could have time on the grass, as well. She knew she might need a hand to put that together and who better to ask than the person who’d dumped the lamb in her lap in the first place?

  It wasn’t just an excuse to spend some more time with Ben.

  Or was it?

  Oh, my... To her consternation, Joy could actually feel her cheeks warming up enough that they would be noticeably pink for some time. Hopefully, the colour would be attributed to her focus on performing well in her new job and not embarrassment that she might have been having some rather explicit and totally inappropriate thoughts about Ben Marshall late at night when a little distraction was needed to prevent the quietness of her solitude dialling itself up from strange to scary.

  It would be a good thing if it was Ben bringing this patient in. Seeing the real man instead of the fantasy version would probably clear her head instantly. And remind her of why someone like him was absolutely the last kind of man she would want anything to do with in real life. A reality that Joy was not about to let herself get distracted from, especially when she was about to deal with her first emergency case in Cutler’s Creek.

  They had time to put disposable gowns over their clothes and pull on some gloves before that patient arrived and Joy took pleasure in scanning a room that had been...well...a bit on the chaotic side yesterday. Now there was a logical order and clear labelling to the supplies and equipment and she had to admit she was proud of this, too.

  It was a bit of a stretch calling the minor procedures room an emergency department but it was all that Cutler’s Creek community hospital had to deal with serious medical or trauma cases and they had everything they needed, including ultrasound, X-ray, ECG and ventilation equipment. Patients that needed more intensive management could be stabilised and then flown by helicopter or taken by ambulance to a larger centre that had the kind of ED Joy was more familiar with.

  Two men came in with an elderly man sitting up on the stretcher and, oh, help... Joy could feel the thump in her chest as her heart skipped a beat and then sped up when she recognised Ben. Seeing those blond streaks in that slightly disreputably tousled hair and, worse, having her gaze met by those astonishingly blue eyes made it actually impossible not to think about those small but oddly satisfying fantasies she’d been toying with in the last couple of nights.

  Fortunately, the temptation lasted no more than a nanosecond but squashing it so relentlessly probably contributed to her ultra-professional expression that made Ben raise an eyebrow. He turned to his partner.

  ‘Mike...you won’t have met our new locum doctor, JJ Hamilton, yet.’

  ‘G’day, JJ,’ Mike said. ‘I’m one of the firies around here but I help out with ambulance shifts on my days off sometimes.’

  ‘And this is Albert Flewellan, eighty-six years old.’ Ben was standing at the head of the stretcher and he had a clipboard, with what looked like a patient report form attached to it, in one hand. ‘One of our frequent flyers. A neighbour called us because they hadn’t seen him out in his veggie garden for a few days and he didn’t answer his door when they knocked. He’s got acute exacerbation of his COPD due to a chest infection.’ A corner of Ben’s mouth quirked. ‘He’s also forgotten where he put his hearing aids.’

  He leaned down and raised his voice. ‘You’ve been feeling a bit short of puff for a few days now, haven’t you, Albie?’

  Albie lifted the nebuliser mask covering his mouth and nose. ‘It’s Wednesday today, lad... I think... Could be Thursday, mind...’

  This casual handover of a patient was like nothing Joy had ever experienced before. Acute exacerbation of COPD could be serious. If oxygen saturation dropped too low, the patient could need to be intubated and put on a ventilator. He might require a bed in an intensive care unit. Although Albert didn’t look in any danger of an immediate respiratory arrest, Joy was still going to follow her normal protocol. To do that, she needed more information.

  ‘What was the oxygen saturation on arrival?’ she queried. ‘And other vital signs?’

  Ben glanced at Mike. ‘JJ’s down from the big smoke so we’ll have to be on our game, here, mate.’ He didn’t bother looking at the clipboard as he cleared his throat. ‘On arrival, we found our patient sitting up in bed.’ His tone was formal. ‘He had a productive cough and was noticeably short of breath with accessory muscle use and an audible wheeze. Temperature was thirty-eight point one, respiratory rate of thirty-six, blood pressure elevated at one-eighty over one-fifteen, in sinus rhythm but tachycardic at one-ten, two to three words per breath and an oxygen saturation of eighty-eight, which is a bit low, even for Albie.’

  The summary was succinct and clear. Joy suspected that, if she asked for the next set of vital signs that should have been taken en route, Ben would be able to recite those from memory, as well.

  ‘Thank you,’ was all she said, however, as she unhooked her stethoscope from around her neck. ‘Let me just have a listen to your chest before we move you onto the bed, Mr Flewellan.’

  ‘Howdy,’ Albie said, pulling his mask clear of his face again. ‘Are you new around here...?’

  ‘He’s responded well to a short-acting bronchodilator and oxygen,’ Ben added. ‘His oxygen saturation came up to over ninety within five minutes but we transported him because he usually needs a few days’ monitoring until the antibiotics and a course of corticosteroids kick in.’

  Zac wasn’t looking too concerned that a paramedic was outlining a treatment plan for a potential inpatient. He was, in fact, looking rather intently at Joy.

  ‘JJ?’ He asked. ‘Is that what you prefer to be called, Joy?’

  Listening to the wheeze and crackle in the elderly man’s lungs gave Joy a perfect excuse not to respond. She didn’t want to respond because...actually, yes...she rather liked this new idea of being called by her initials. It seemed kind of cool. Not something a boring sort of person would prefer. She could also feel her heart sinking. Would Ben remember his promise not to broadcast her unusual first name?

  ‘I suspect it was my idea,’ Ben told Zac. ‘I’ve got history with someone called Joy and you know how you can be put off a name? Long story. I’ll bore you with it some other time.’

  Zac just gave his head a small shake, dismissing the distraction as he saw Joy finish her initial assessment of their patient’s breathing. ‘Want him on the bed now, JJ?’

  A nod was all it took. For both her patient to be transferred and apparently for her new name to be established. Which was fine. New life, new name. Why not? At least all personal distractions were now over and done with and she could focus completely on the job at hand.

  She watched as Ben and Mike settled Albie on the bed. Ben raised the
end and used an extra pillow as more support to make the task of breathing easier. His movements were swift and efficient as he changed the ECG monitor leads and blood pressure cuff.

  ‘We’ll need a chest X-ray to rule out pneumonia, pneumothorax or a pleural effusion,’ JJ said crisply. ‘Is there any history of congestive heart failure or cardiac arrhythmia?’

  ‘He’s on an ACE inhibitor and a diuretic to manage a bit of right heart failure and hypertension,’ Zac responded. ‘I’ll dig out his file for you but, generally, Albie keeps pretty well between episodes like this. Last one was right at the start of winter so it’s a few months ago now.’

  ‘You don’t need us to hang around any longer, do you?’ Ben handed Zac the patient report form but it was Joy he smiled at. ‘Unless there’s something I can do to help?’

  Oh...that smile... For another nanosecond, it was all JJ could think about. Instant warmth, that’s what it was. Like sunshine... Fortunately, it only took a single blink to dismiss the distraction. She didn’t do distraction when she had a patient to focus on. And she certainly wasn’t going to smile back.

  ‘For future reference, I can recommend Ben as a physician’s assistant any time you find yourself short-staffed,’ Zac told her. ‘As far as any emergency intervention goes, you’ll find his skills are as good as any colleagues you’ve had in an ED.’

  That was some recommendation and JJ acknowledged it with a nod and just the briefest flick of eye contact. God forbid that it might be taken as encouragement to smile at her again. She could feel herself straightening her spine at the same time. She needed to assert her own place here as well and she was more than comfortable being in charge of a situation such as this.

  ‘I think we could change Mr Flewellan to nasal cannula until he needs another dose of a bronchodilator. He’ll be more comfortable breathing that way with a flow of two to four litres per minute.’

  ‘Sure...’ Ben turned and walked towards the bench at the side of the room. Then he stopped abruptly. ‘Where’s the box gone?’

  ‘You’ll find them in the Airway cupboard right in front of you. Top shelf, along with other types of masks. You’ll also find they’re all labelled.’ JJ felt another flash of that pride in her achievement of making this area so much more streamlined. In another moment or so, Ben would probably send an admiring glance in her direction. She could actually feel her response to the expected glance starting already—an even more intense glow of pride because it was Ben Marshall she was impressing?

  But Ben’s jaw actually dropped as he opened the cupboard and scanned the shelves. He looked up to exchange an incredulous glance with Mike, who was folding blankets to put back on the stretcher, and then one with Zac, who simply shrugged and then smiled.

  ‘We’ll get used to it,’ he said. ‘And, I have to say, it all looks a lot more efficient. Almost like a small version of a real ED instead of a minor procedures room trying to be one.’

  ‘Won’t be efficient if you can’t find something you need in a hurry,’ Ben muttered. ‘What if we need a cricothyroidotomy kit urgently after a failed intubation?’

  ‘You’ll find it in the next cupboard.’ JJ’s calm tone gave no hint of the disappointment of her not inconsiderable efforts being unappreciated. But then again, this was a good thing. Her hope that replacing a fantasy version of the man with the real one would spell the end of this slightly awkward tension between them was going better than she’d hoped. Clearly, he was not only the sort of man she would never go near on a personal basis, he had a few shortcomings in the professional department, as well.

  ‘The one labelled “Breathing”,’ she added. ‘Middle shelf, along with the chest drain and tracheostomy kits. Circulation supplies like IV kits, syringes, IV fluids are in the next cupboard. It’s all organised along the ABC guidelines for primary and secondary surveys that I’m sure you’re very familiar with.’ JJ knew that the comment was a little condescending but...okay...she was a little annoyed. ‘Take a few minutes sometime and you’ll see it should be intuitive and easy to find whatever you’re looking for.’

  ‘Right...’ The syllable was drawn out, which gave it a distinctly dubious note that was even more annoying but Ben found a set of nasal cannula and put them on Albie, gently inserting the prongs into his nose and adjusting the loop to fit securely around his ears. ‘You’re in expert hands, Albie,’ he told him loudly. ‘But you’d better make sure you behave yourself.’

  Albie seemed to have heard that because he gave Ben a thumbs up signal as he went to help Mike with the stretcher. But then he started coughing and by the time JJ had checked that the figures on the monitor weren’t showing a sudden deterioration in his condition and glanced towards the door, Ben had gone. Without any kind of farewell and leaving the unmistakable impression in his wake that he wasn’t too thrilled with the changes she’d made here. Or her personality?

  Not that she was bothered. It was, in fact, a bonus to add a low level of rudeness to the faults Ben Marshall had already revealed. That she had a mental list of these faults she was only too happy to add to was a bit concerning but she could deal with that without letting it interfere with her new life.

  She wasn’t going to let anything about the local head paramedic—or possibly the only qualified paramedic in the district—bother her at all.

  * * *

  He had to admit it was bothering him.

  For some inexplicable reason, Ben was finding himself thinking about the new doctor in Cutler’s Creek far more often than he could find a reason for. Like right now, when he was speeding towards an emergency callout.

  She was annoying, that’s what it was. A little too neat and tidy, Too organised. Good grief...who labelled spaces on shelves for different types of oxygen masks when you could see what they were through their clear plastic wrapping? Or maybe, if Ben was really honest, the most annoying thing about JJ Hamilton was that she found him annoying but she was so determined not to let him get under her skin. She hadn’t batted an eyelash at him refusing to use her real name and she’d taken on the challenge of raising that orphaned lamb even though it had to have been a considerable extra stress on top of getting to know a new town and hospital and sorting out a new car.

  According to Greg, the local vet Ben and Mike had met at the pub last night, JJ was doing a great job with that lamb that was now living happily in her barn and putting weight on fast. She’d sorted out the insurance on her car in record time and had even made a good choice for a rural vehicle of an SUV with four-wheel drive capabilities. She’d sorted out old Albie Flewellan, as well, and he’d been discharged from hospital with his medications altered and a home oxygen supply available.

  Albie, who’d also been back on his favourite bar stool at the pub last night, thought the new doc was the best thing since sliced bread but, for Ben, she gave him the sensation of an itchy patch that you couldn’t quite reach and, what was most annoying was that she popped into his head at the strangest moments, like when he saw some new lambs in a paddock as he drove by, or—like now—when he was nearing the scene of an MVA and considering where to stop his ambulance so that it would protect the emergency service personnel as they assessed, treated and transported any victims.

  It was only to be expected that he’d be thinking about one of the local doctors, of course, because he was almost surprised not to find Zac or Doc Donaldson or perhaps even JJ there already. This was a priority one callout, which implied that it could be a critical traumatic or medical incident, and the scene was a little closer to the hospital than the ambulance and fire station. The information about the call and its designation as critical would have been sent through to the doctors’ phones at the same time he’d been paged.

  Not that it mattered that they weren’t here. There would soon be more than just himself and his volunteer, first responder colleague, Chris. Bruce was on his way from the police station and they knew Mike was not far behind them,
bringing the fire engine and extra volunteers. The initial call about this accident had given them the information that there was someone trapped in the wreckage so the equipment carried on the fire truck that could cut a car into pieces and release the victim could well be vital. Whether additional resources, such as a rescue helicopter, were required was something Ben knew he needed to assess as soon as possible after arrival so it was disturbing to have something else trying to grab some of his attention.

  There was another—just as valid—reason that JJ had crossed his mind, however, so the fact that Ben could see her in his mind’s eye so damned clearly really wasn’t something to be too disturbed about. Like the accident that had written off her car, this was a single vehicle incident, but instead of being on the side of the road, the driver had clearly caught the gravel edge at high speed, gone out of control and flipped, taking out the barbed wire fence and a couple of posts before continuing to roll more than once, by the look of it, to end up on its roof well inside the paddock’s boundary.

  The only car on the roadside was the person who’d stopped and made the call to the emergency services and, sensibly, had their hazard lights flashing. Rolling down his window, Ben thanked the middle-aged woman and asked if she could stay long enough to be confirmation for the next vehicles that they were on scene. Then he glanced at Chris.

  ‘There should be a gate further down this road. I’d rather drive in so that we’ve got all our gear handy.’

  ‘I can see it. At the end of that macrocarpa shelter belt between the paddocks.’ Chris reached for the radio. ‘I’ll let Mike know where we are.’