Unlocking the Rebel's Heart

by Alison Roberts

  Ben could hear Chris confirming that they’d located the scene but his mind was racing in another direction. Not yet on what he might find in the overturned vehicle but he knew that focus would come the moment he got through the gate and into the paddock.

  No...dammit, it was JJ Hamilton he was thinking about. Again. She could have hit the gravel like the driver who’d crashed here if she’d swerved too hard to avoid that sheep. Her car could have been flipped if he’d come round that bend and hit the back of it full on instead of just collecting the door and ripping it off. Ben could see that moment of impact in his mind’s eye, like a movie flashback. He could see JJ’s body fully airborne and the relief of finding her conscious and relatively unhurt only seconds later.

  Oddly, he could also remember that blip of curiosity that went beyond a normal assessment of a potentially injured person. Like how he’d wondered why she’d made it sound as if she was always alone. He could also remember the surprise of his eyes meeting hers that very first time. Because they were so dark? Or was it something more significant, like recognising that she was about to become an annoying presence in his life?

  He had a few more seconds as Chris got out of the ambulance and wrestled to pull an old, wire gate through long grass far enough for the ambulance to get into the paddock. His brain was determined to use that tiny amount of time to let one more thought morph with a new one with lightning fast speed—as if it was determined to solve an irritating puzzle by joining the dots in a mental image.

  JJ’s eyes. How dark they were. The way they’d lit up with delight when she’d been feeding Shaun the lamb that first time. The way it had made him smile. And tease her about a name for the lamb.

  The shock of thinking it was possible he was attracted to her.

  It felt good to put his foot on the accelerator and bump the ambulance over old tractor ruts in the ground. He was shaking off unwelcome thoughts at the same time.

  Of course he wasn’t attracted to JJ. Or, if he had been for a nanosecond or two, their last encounter had been more than enough to make any attraction sink as fast as a lead balloon. He liked his women to embrace adventure and the adrenaline rush of the unexpected—just like he did himself. It was obvious that Dr Hamilton compartmentalised her entire life and then probably put labels on the boxes.

  And, if that wasn’t enough in itself, her real name was Joy, and that reminded him of his grandmother’s patience with the old gossip down the road. And that only made him remember his grandmother and feel the ache of loss that the only person who had ever truly loved him was long gone.

  It was always best not to think about anything that could pull you down like that and Ben had learned just how to banish thoughts effectively enough to make sure they weren’t going to reappear in a hurry. You just needed to keep busy. Keep moving. To embrace any new adventure and that included women, of course. Maybe that annoying niggle he was so aware of was there because he hadn’t done anything to fill the gap that Ingrid’s departure had left in his life?

  Bit of a shame the locum doctor was so not his type. And that she found him so annoying. No chance to get bored or have someone wanting more than he was prepared to offer when they were only in town for a month or three.

  He stopped the ambulance just long enough for Chris to clamber back in and then they were off across the paddock. Heading for the unexpected and a potentially challenging job. Ben could feel his adrenaline levels climbing as he prepared for that challenge and he was now completely focused on the only thing that mattered. Throwing himself into a new challenge.

  Finding out whether the unfortunate driver of this car was still alive. And then doing whatever it took to keep him that way.

  CHAPTER FOUR

  AMAZINGLY, THE DRIVER was more than simply alive. He was conscious and alert.

  ‘What’s your name?’ Ben asked, after introducing himself through the shattered window. While he could see that the young man was upside down and clearly uncomfortable with his head pressed onto the back of a mangled seat, amongst deflated airbags, he was breathing reasonably well and looked alert enough for Ben to think there might be no need to summon backup with extra skills and equipment to deal with critical injuries.

  ‘Nathan.’

  ‘Does it hurt when you breathe?’ Reaching through the window, Ben put his fingers on Nathan’s wrist, to feel for his heart rate and rhythm.

  ‘Nah...it’s all good...’

  ‘Were you knocked out?’

  ‘Dunno...’

  ‘Can you remember what happened?’

  ‘Guess so...it was all a bit quick.’

  ‘Anything else hurting?’

  ‘My leg, man... I can’t move it.’

  Ben shone his torch up into the interior of the vehicle, to the floor that was currently the roof. ‘That’s because it’s caught under the dash.’ The light caught a blood stain on Nathan’s jeans but, again, it didn’t look enough of an ongoing blood loss to be alarming. ‘We’re going to need some help from the firies to get you out of here, mate.’ He looked over his shoulder to see the fire truck currently negotiating its way past the larger rocks in this paddock.

  Nathan groaned. ‘I’ve wrecked my car, haven’t I? And I’ve only...had it for...a week or two.’

  The increasing effort of breathing upside down was obvious. So was something else that Ben could smell on the young man’s breath.

  ‘You’ve been drinking, mate?’

  ‘Nah...not since last night. Never...drink and drive...’

  Ben caught his Mike’s gaze as the older man walked around the car, assessing how they were going to get their patient out. The erroneous notion that you could party hard until the early hours and then get up and be sober enough to drive safely wasn’t uncommon.

  ‘You weren’t wearing your safety belt, either, were you?’

  Nathan closed his eyes. ‘I forgot... You’re not going to...give me a hard time, are you?’

  ‘Let’s get you out of here. You can talk to Bruce about that one later.’ Ben unzipped the pack of gear he had beside him. ‘We’re going to see if we can get a collar on you to protect your neck and then Chris, here, is going to give you an oxygen mask, because it’s a bit difficult breathing upside down, isn’t it?’

  Nathan was groaning again. ‘My leg...it’s really hurting...’

  ‘On a scale of zero to ten, zero being no pain at all and ten being the worst you can imagine, what score would you give it?’

  ‘Eleven...no...ahh...make that a twelve.’

  ‘That bad, huh? I’m going to put a line in your arm as soon as I can,’ Ben told him. ‘And then I can give you something for the pain, okay?’

  ‘Yeah...that’d be good...’

  The car jerked as Mike wrenched a door on the other side of the car. ‘I’ve got this one open enough,’ he told Ben. ‘Can you work on him from this side while we get that other door off so we can roll that dash back?’

  ‘Sure thing.’

  ‘Right.’ Mike turned to the volunteer fire officers he had with him. ‘Let’s get some chocks in to stabilise the car and then I’ll need the spreaders.’

  It was more than awkward to squeeze far enough into the car’s interior to get a cervical collar onto Nathan and there wasn’t enough space to make it simple to get an IV line inserted into his arm. Ben’s first attempt to find a vein was unsuccessful. The second failed because, as he started to push the cannula into place, the screech of metal being prised open made Nathan jerk his arm clear.

  ‘Try and hold still for me, mate,’ Ben said calmly. ‘It’s going to be a bit noisy because we have to cut the car up to get you out. Chris, can you give me a dot to cover this and another cannula, please?’

  He had to make a third attempt. IV access wasn’t important just for the pain relief that Nathan needed. Ben wanted a line available and fluid to keep it open in case his c
ondition deteriorated. He could see the blood stain on the jeans spreading and he had no idea what was happening to the lower part of Nathan’s leg that was hidden behind the squashed dashboard. How long it would take to get him clear was also unknown and if there was significant, ongoing blood loss, the longer it took to get venous access the harder it would get as blood pressure dropped and veins shrank.

  The team around him might be mostly volunteers rather than paid employees like himself and Mike but these men—and women—were passionate about the contribution they made to their community by keeping the emergency services viable. They took on as much training as they were offered to learn and practise techniques and protocols and Ben was proud of their skills and commitment. The door of this wrecked car was cut free, the crushed dashboard rolled back enough to release Nathan’s leg and then as many sets of leather gloved hands that could get close enough got him onto a hard backboard and gently slid him clear of the car and onto the waiting stretcher.

  ‘Hang on...’ Ben warned. ‘Watch out for the tubing.’

  His warning came too late. While he was holding the bag of IV fluid well out of the way as Nathan was being lifted out, the tubing snagged on a rough piece of metal. While he’d taped the tubing in place, he hadn’t had time to put a bandage over it as well and it didn’t take much of a jerk to pull the tape off Nathan’s arm and then the cannula out of his vein. But the amount of blood that was being lost from that puncture wound was not as much of a concern as the bleeding from their patient’s leg that had increased dramatically having been freed from beneath the dashboard. The sheet on the stretcher was getting rapidly soaked and Ben’s white shirt had blood smears in several places.

  ‘Put a pressure dot on that arm,’ Ben instructed Chris. ‘I’ll deal with his leg.’

  ‘Can I help?’ Mike was right beside him.

  Ben was using his shears to cut away what was left of Nathan’s jeans on this side. ‘I need a large gauze pad,’ he told Mike. ‘And then a couple of bandages. I’ll have to try and control this bleeding with pressure.’

  It was just as well he’d had time to give Nathan some IV pain relief because he could feel the crunch of a broken bone as he put enough pressure on the deep cut to stop the blood loss. It was still painful enough to make his patient cry out, however, and there was no quick way to top up the analgesic.

  ‘Do you want the IV roll?’ Chris asked, as he put another round, sticky dot over the puncture wound on Nathan’s arm. ‘To get a new line in?’

  Ben wrapped a bandage as tightly as he could to keep pressure on the leg wound.

  ‘No,’ he responded. ‘Grab a splint. I’ll stay in the back and keep an eye out for breakthrough bleeding but we’re close enough to the hospital and it’ll be easier to sort everything there.’ Ben had to shake away the thought that it would give JJ a chance to show off her newly organised emergency department again.

  ‘Let’s load and go,’ he told Chris, as soon as he’d secured the splint as well as his pressure bandage.

  ‘I feel sick...’ Nathan was looking pale.

  It was Mike who reached for a container and a towel but he was too late. He gave Ben a sympathetic glance as they loaded and secured the stretcher in the ambulance.

  ‘Don’t breathe too deeply,’ he murmured. ‘It might put you over the limit.’

  Slamming the doors shut as they took off only intensified the smell in the back of the ambulance but it wasn’t anything Ben hadn’t already dealt with too many times to count. JJ might find it a bit more confronting, he thought as they got closer to Cutler’s Creek Hospital. It wasn’t as if they had a team of nursing and ancillary staff to deal with messy stuff like this.

  To her credit, however, JJ did not appear fazed by either the smell or the appearance of her new patient when they arrived a few minutes later. She watched intently as Ben and Chris transferred Nathan to the bed and listened, just as carefully, to their handover.

  ‘Nathan Brown, twenty-one years old. His car came off the road at speed, rolled and ended up on its roof with Nathan trapped. He had a GCS of fifteen on arrival, probably wasn’t KO’d and doesn’t appear to have a head injury.’ Ben had to pause and take a breath before he listed vital signs that had all, surprisingly, been within normal limits. ‘It took approximately twenty-five minutes to get him out,’ he finished, as he tucked a pillow beneath Nathan’s head. ‘He’s had five milligrams of morphine for the pain from that fractured tib/fib.’

  ‘How’s the pain level now?’ JJ asked, stepping closer to Nathan. ‘On a scale of zero to ten?’

  ‘Ten,’ Nathan told her.

  The look Ben received suggested that he hadn’t provided enough pain relief for his patient.

  ‘To be fair,’ he said, ‘Nathan did say it was twelve initially, so it’s improved.’

  He noticed that JJ was checking the monitor and knew that she would be thinking that the heart rate and general appearance of this patient did not back up his claim that he was in severe pain and, if anything, his blood pressure was lower than might be expected. He also noticed the way her nose wrinkled, just a little, as she took in a new breath.

  It was a very subtle admission of how bad Nathan smelled with that combination of stale alcohol and vomit. A tiny, rabbit-like twitch. Cute, Ben found himself thinking instantly, until he realised that this might be another impression of this woman that would pop into his head at unexpected moments and add to that background level of annoyance she was causing. Not that she noticed his frown, because she had turned to the nurse in the room with them, Debbie, who had shears in her hand, ready to cut away the remnants of Nathan’s jeans.

  ‘Maybe you could find a gown for Nathan soon? That way we could...ah...dispose of his clothing?’

  Her attention was on the monitor again. ‘Blood pressure’s a bit on the low side of normal,’ she murmured. Her next glance was back at the stained sheet of the stretcher but quickly shifted to Ben. ‘Estimated blood loss?’

  ‘Hard to say.’ Even a small amount of blood could look like a lot when it was spread around and wicked into fabric. ‘Less than five hundred mils, I’d guess.’

  But Ben was getting another look that he could read only too easily. Strike two for his patient care? Was she thinking she might want to see their SOPS—standard operating procedures—with reference to controlling haemorrhage on scene? Maybe she had no real understanding of how difficult it could be to control external blood loss when you couldn’t actually reach the body part that was bleeding? Or when it took time to remove a victim from wreckage so that you could get close enough to do something like put pressure on a laceration?

  That look was no more than a brief glance but it also made Ben suddenly aware of how scruffy he must look, as well, with his bloodstained shirt and it was quite likely he didn’t smell so great himself. But it went with the job, didn’t it? And he knew he did his job damned well. He certainly didn’t need someone giving him a school teacherish look that suggested he could have done better. Ben was officially annoyed now but there were no surprises there, were there? This was Dr Journey Joy Hamilton, after all. Big city girl with a dose of prim and proper and an addiction to protocols.

  ‘We did have a patent IV line and fluids up,’ he said, keeping his tone perfectly even. ‘Unfortunately the line got caught as we were extricating Nathan from the car. I didn’t want to hang around to put another one in.’

  He didn’t need to add that it had taken more than one attempt to get an IV in in the first place. He could see JJ noting the sticky spots covering the puncture sites before she wrapped a tourniquet around his other arm. Her slick insertion of a cannula, the snap of the tourniquet being released and the tape being torn off to secure the new line was impressively efficient but it felt like another judgement of his skills. Even attaching the tubing and the bag of IV fluid was swift and professional. Of course it was. They were in a controlled environment and everythi
ng was far simpler—including the availability of the two-way stopcock in the tubing as a painless way to remove a blood sample or inject medications when needed. The way JJ’s gaze grazed his as she moved on was really an unnecessary confirmation of that judgement.

  See? It seemed to say. This is how it should be done. Easy-peasy...

  * * *

  ‘There we go, Nathan. I’m going to top up your pain relief a bit while we have a good look at your leg. If it’s anything more than a simple fracture, though, we’ll have to transfer you to a bigger hospital.’

  She’d have to ask Ben what the protocol was for a transfer like that, JJ realised, because it wasn’t something she’d talked about in any detail to Zac yet and he wasn’t here today. Ben didn’t seem that happy to be here today, either, for some reason. He’d been almost glaring at her as she’d finished setting up the bag of IV fluid. Was he bothered that she was replacing the IV line that had been pulled out?

  If so, he needed to get over himself. It wasn’t a criticism of his work, she was just getting on with what needed to be done. And one of those things was collecting a blood sample. It was quite obvious that this young man had been drinking heavily and, no doubt, Bruce the local cop would want to know the level of intoxication.

  Was he annoyed because he was just standing there and watching her work when he could have been more usefully employed by replacing that IV line himself? His colleague was almost finished tidying up the stretcher so it was quite possible that he would head out the door any moment, perhaps without even saying goodbye again? JJ didn’t want that to happen. She was the only doctor in the hospital at the moment and, while she could manage on her own if she had to, she’d would much prefer to have Ben’s assistance to take X-rays and organise a patient transfer if it was needed.

  At least she could give credit where it was due when she took the pressure bandage off Nathan’s leg.