Still unnerved, I headed back into my little pink bedroom to the bureau and flicked through a few more of Henry’s letters.
I found Christabelle.
… You’d like Christabelle, or I think you would. She’s her own woman. I don’t usually separate my cows and calves too early, but she was orphaned at birth—her mother got milk fever and there was no saving her. She refused to join the other calves, following me around like a pup since the day I first handled her. Every time I go outside she’s standing by the fence waiting for me.
She’s a terrible milker. It might be from her bad start but it’s more likely because she spends more time mooning over the back fence waiting for me than she does grazing and milk producing. I should cull her—but how can I cull her when she just … looks at me?
Christabelle. Salami.
I thumped another cushion without thinking. Mistake. More feathers.
‘Damn him,’ I muttered. ‘And damn old cows and everything to do with this place. Put it on the market and go home.’ I glared at Muriel’s bedroom door. ‘Come on, Muriel. I’ll make you a cup of tea. I need you to wake up so we can begin.’
But there was a slight flaw in my plan. Muriel was going nowhere.
I edged into Muriel’s room with her tea. Weak black, with a sliver of a lemon picked from the tree outside.
Muriel lay in the huge bed looking white-faced, terrified and every day of her seventy-five years.
‘Grandma?’
And, appallingly, she didn’t even snap.
‘I can’t move my leg.’ Her voice wobbled. ‘I guess … I guess it’s just a bad cramp, but it’s starting to scare me.’
Elderly lady. Long plane flight. Leg.
Dear God…
I rested her tea on the bedside table and fought back panic.
‘Does it hurt?’
‘It’s just numb.’
No!
Pain in her leg—possible deep vein thrombosis. Blood couldn’t get back to the heart. Serious.
Numb leg? Possible blocked artery. No blood entering the leg at all. More than serious. Emergency.
‘Let me look.’ Somehow I kept my voice professionally calm.
‘You don’t need to look,’ she told me. ‘But I think I’ll stay in bed a while longer.’ She tugged her bedclothes to her chin and I could see her withdrawing into herself. I’d learned early this was how she was. Muriel had two settings—in charge, or totally withdrawn. There was no in-between.
But this was no time for withdrawal, and I could be autocratic as well. ‘Show me,’ I said and whisked off the blankets before she could react.
It only needed a cursory inspection to confirm what I was most afraid of. Blocked circulation.
‘What’s wrong?’ Muriel whispered, reading my face as I ran my fingers down her leg to her toes.
The toes weren’t completely cold. Thank you, God. If complete blockage had happened hours ago the leg would be dead by now and no medical miracle could save it. It’d have the same effect as tying a tourniquet and leaving it too long.
‘There’s a block in the circulation. Muriel, the medication you take for your heart…Have you been taking it?’
Muriel’s eyes confirmed my fears before she opened her mouth. ‘You know I can’t stay on the medication without having tests every month,’ she retorted. ‘It’s dangerous not to test. You told me that, and Al did, too. So as soon as I knew I was coming here I stopped taking it.’
‘You stopped?’
‘It seemed sensible. I was overdue for a test and Al’s fussy.’
‘Of course he’s fussy. Al’s a retired physician. He knows how important it is. If you didn’t believe him you could have asked me.’
Muriel ask me for advice? That was a joke.
‘I was fine before I started the medication,’ Muriel said, gathering her dignity about her again. ‘You know I was. The pills I take are just to stop long-term problems.’
‘Or short-term clots. That’s what seems to have happened. It looks like you have a clot blocking the artery, cutting the circulation to your leg.’
‘Maybe I should try and move around a bit,’ Muriel said dubiously. ‘Maybe if you give my leg a good rub…’
‘That’s exactly what not to do. The clot’s a worry where it is, but your leg’s not completely cold. That means there’s a little blood coming through to your toes. If you move around, the clot might block the artery completely.’
‘So … what do I do?’
‘We move you very carefully to hospital. Then we find a doctor who can get you started on anticoagulants. You might even need an operation—we need to get rid of the clot before it does any permanent damage.’
So far, so good. I knew what had to be done. But how?
Should I phone for an ambulance? We were five miles out of town. Muriel had pointed out the hospital as we’d driven through yesterday. ‘The hospital was built just before I came to live here,’ she’d said curtly. ‘It was state of the art.’
It wasn’t likely to be state of the art now, I thought grimly, but it was the best there was. And how did one go about calling an ambulance? As far as I could tell, Henry hadn’t had the phone on, and there wasn’t a phone book.
I tried 911 on my cell phone and nothing happened. The voice said: ‘Check the number and try again.’ What was the emergency code here? 999? Shouldn’t it redirect? Surely panicking tourists were universal.
Should I find Jack? Could he help?
But a glance out the window showed that his truck, parked under the jacaranda when I woke, was now gone. The cows were meandering back to their morning’s grazing. I was on my own.
‘I need to get you to hospital,’ I told Muriel. ‘I’ll back the buggy to the gate and carry you.’
‘You will not.’ Muriel might be ill but she still had her pride. No one helped Muriel. ‘I can walk.’
‘You shift that clot and I’ll be taking you home in a coffin. Is that what you want?’
And for once in her long life Muriel was shocked into silence.
‘No,’ she said, in a scared little voice that was unlike any Muriel I’d ever known. ‘If you can carry me … I’d be grateful.’ Then she took a deep breath. ‘But hand me my hairbrush and my lipstick first!’
I drove as fast as I dared to the hospital. Driving the buggy at high speed on country roads—and on the wrong side!—was like playing some nightmare computer game without Restart. It took all my attention. But for some reason, as I drove, a word she’d used played repeatedly in my head.
Grateful.
This was the first time in my life that Muriel had asked anything of me. We had the strangest relationship. Muriel’s definition of relationships was weird.
Throughout her life, Muriel had enjoyed a string of seemingly very satisfactory relationships with wealthy men, but as soon as her current man started to rely on her or plan things in a ‘together’ kind of way, she moved on. She’d implemented the same rule with her granddaughter, the only difference being that, instead of moving on, she’d employed servants to do the caring.
We’d been an ill-matched pair for over twenty years now and I knew the rules. I asked nothing of Muriel, and Muriel asked nothing of me.
Until now.
I flicked a glance to the buggy’s back seat. Muriel was sitting bolt upright, still swathed in her fabulous negligee, but with a blanket wrapping her slight frame and her legs stretched out in front of her. Her face looked almost blank. She was scared witless, I thought, but she wouldn’t admit it. Muriel wouldn’t weep and she wouldn’t falter.
‘It’s your fault,’ she threw at me, and I blinked.
‘Excuse me?’
‘I should have sat in the aisle seat. Then I could have wriggled my leg.’
‘You were travelling first class. There was lots of wriggle room, and you wanted the window.’
‘The seaplane didn’t have first class and you should have known that I needed the aisle seat. You should have insisted. All t
hat money on a medical degree…’
‘How could I have insisted? Tell me how that would work, Muriel. And it was none of your money spent on my medical degree.’
‘That’s immaterial. I would have paid if you’d needed it. Those appalling jobs you took. You were headstrong, wilful and stupid. Coming here when I warned you not to. Which is another reason why this is your fault.’
‘Okay, Grandma, it’s my fault.’
‘Don’t call me that.’
Her rebuff almost made me smile. She wasn’t dead yet.
The hospital was a simple, single-storey weatherboard building on the bluff on the far side of town. Compared to my workplace in Manhattan, it looked ludicrous.
But it did seem efficient. The minute we drew to a halt, a forty-something woman in spotless hospital whites emerged through the entrance. Cars—or buggies—arriving fast at a hospital obviously meant trouble the world over. The woman was focusing on Muriel before I was out of the car. Janet Ramsay, her name tag said. Charge Nurse.
‘What’s happening?’ she asked Muriel. Then, as the white-faced Muriel didn’t answer, ‘Is your breathing in trouble?’ Her voice was calm and direct.
Behind her came an orderly. The man looked close to eighty, but there was nothing old in the way he was moving. He was hauling a trolley forward in readiness, moving with speed.
Muriel found her voice before I did. ‘My breathing’s fine. It’s my leg. It’s Jennifer’s fault.’
Janet was tugging aside Muriel’s blanket and her eyes travelled down to where Muriel’s thin legs emerged from under her negligee. Despite Muriel’s tan—not fake like mine—the difference in colour between her legs was horribly and immediately obvious.
‘Fraser, ring Code One,’ Janet told the ancient orderly.
The orderly, creaky but startlingly competent, disappeared at a trot, with only one swift concerned glance back to Muriel. The charge nurse’s attention turned fleetingly to me.
‘It’s okay.’ She laid a hand on my shoulder—nurse calming obviously terrified relative. ‘The doctor will be here in minutes.’
For some reason I was near to tears, but somehow I collected myself. ‘I’m a doctor,’ I told her. ‘Muriel’s been through a long plane flight and she’s discontinued her medication for atrial fibrillation. It’ll be a blood clot. Artery, not vein. There’s almost complete blockage.’
‘She made me sit in the window seat,’ Muriel snapped.
Jane’s lips compressed—just a touch—enough to bite back a smile. She turned back to Muriel and nodded, as if they had all the time in the world, holding out her hand in greeting.
‘You’ll be Muriel Kelly. We knew your husband well, and we heard you were on the island. I’m Janet. Let’s not worry too much. Our doctor’s the best. We’ll get you settled somewhere where he can examine you. Are you in pain? I can give you something right now.’
I couldn’t fault them. As I followed the trolley into the examination cubicle I decided that this was a city hospital in miniature. If I couldn’t transport Muriel to my New York hospital, then surely this was second best.
Or maybe it was better. There were no queues here—no multiple traumas taking precedence over an elderly lady with a blood clot. Even if the orderly was ancient, even if the woman on the reception desk had to put her knitting aside to attend to us, they were good.
As long as the doctor was just as competent, I thought, but as if on cue, the doors swung wide and in walked the doctor.
White coat. Stethoscope. Doctor.
Jack McLachlan.
To say this was the culmination of a long four days was an understatement. For me, it seemed almost the end of a crazy, disorienting dream.
Maybe I was mistaken. Maybe this was the man’s twin.
There were differences. This man was clean-shaven. He was wearing tailored pants and a neat, open-necked shirt under his white coat. His unkempt hair had been brushed to almost neatness. He was every inch a doctor.
But he was also Jack McLachlan. The brown hair with sunbleached ends, the crinkle of accustomed laughter around those amazing blue eyes, the strong bone structure of his face … He was unmistakably my turtle healer. The surfer. The milker.
‘Jack …’
He gave me an absent smile, his attention already on Muriel.
‘What’s the trouble?’
He’d been sent a Code One notification. Medical procedures were similar enough around the world that I could be sure he’d have dropped whatever he was doing. He’d have walked in expecting a crisis.
As this was.
‘Muriel has arteriosclerosis with peripheral vascular disease,’ I told him, pulling myself together. ‘She stopped her medication for atrial fibrillation, and her leg’s numb. It has to be a clot.’
‘And it’s all Jennifer’s fault,’ Janet said—and smiled.
Jack flashed me a strange look but stayed focused.
‘How long’s it been numb?’ His hands were already probing Muriel’s leg, his eyes creasing in concern. He waited quietly until she was ready to answer.
‘It felt odd when I woke an hour ago,’ Muriel said, her voice quavering. ‘I thought I’d wriggle my toes and it’d stop, but it got worse. Jennifer should have let me sit in the aisle seat.’
‘There was still some warmth twenty minutes ago,’ I told him.
‘Good.’ As he gently probed the leg, his eyes rested on Muriel’s face. ‘Do you understand what’s happening?’ he asked, and she shook her head.
‘Jenny said it’s a clot.’ Her glance my way implied anything I said was probably nonsense. But … Jenny. She called me Jenny. That was a small miracle, but I’d take it.
‘I guess it’s that deep vein thrombosis everyone warns you about when you fly,’ she added.
‘It’s something like that,’ Jack admitted. ‘But in your case it’s a bit different.’ He cast a sideways look at me—a half smile—before turning back to Muriel. ‘Maybe we can’t completely blame Jenny, even though I agree it must be tempting. Mrs Kelly, you have a clot, but it’s blocking an artery rather than a vein. Jenny says you have arteriosclerosis—a narrowing of your arteries. That’s what’s caused this. That and stopping your medication. If the clot was blocking a vein, the blood would have trouble getting back to your heart. You’d be in pain but we’d have time to unblock it. Because the clot’s in an artery, the leg’s not getting blood in the first place, and without blood your leg will suffer irreversible damage.’ He glanced again at the leg and his face set. ‘We need to operate.’
‘Operate? Here?’ It was impossible to keep the fear from my voice and Jack shot me a frown, reminding me the first priority was to reassure the patient.
‘Yes. And you’re going to help,’ he told me. ‘This gives you a chance to redeem yourself for so selfishly taking the aisle seat. Muriel, if it’s okay with you, we’ll do an ultrasound to find out exactly where this clot is. Janet will give you a sedative in preparation for surgery. You will need a general anaesthetic, though.’
‘You’ll remove the clot?’ she asked.
‘Yes.’ His voice was steady and confident. The best specialist in New York couldn’t be more reassuring.
‘And I’ll be okay?’
‘I’ll do my best.’ His eyes held hers. ‘My best is all I can promise, but I believe we have every chance of keeping your leg as good as new. Will you trust me to take care of you?’
Muriel stared up into his eyes while the rest of the room held its breath. She was just as likely to refuse. She was pig-headed and stubborn and she took perverse delight in doing the unexpected.
But Jack’s gaze held, and Jack’s gaze was magnetic. As we watched, some of the terror faded from her face—and all of the belligerence. Her decision made, she visibly relaxed back against her pillows.
‘Yes, dear, I do.’
Oh, of course. I tried not to think of all the times I’d been unable to convince Muriel to do something sensible. Like taking pills for her arteriosclerosis.
‘I’ll be getting you and your granddaughter to sign the consent forms,’ he told Muriel. ‘And we’ll begin.’
‘So who’s giving the anaesthetic?’ I’d been polite for long enough. I barely let the door close behind us before I let anger, frustration and worry hold sway. ‘How can you operate here? Who’s your anaesthetist?’
‘I’m hoping you are.’ He gave a lopsided smile. ‘After all, you did take the aisle seat.’
‘What?’ I had to fight for breath. ‘Me? You can’t be serious.’
He was already putting on a surgical gown. His smile had faded. ‘Jenny, I acknowledge the setting’s far from ideal, but the alternative’s worse. That leg’s dying. We can organise evacuation to Sydney but she’ll lose the leg by then.’
I was so astounded I could hardly speak. ‘Are you a surgeon?’
‘I am.’
‘I don’t believe it.’
‘Just because I wander around stealing turtles…’ He spread his hands as if in surrender. ‘I know. I’m hardly your stereotypical hospital surgeon, but I am qualified, or I wouldn’t propose it. You know we have no choice.’
‘But…’ Once more I was getting close to wailing. ‘The anaesthetic…’
‘We’ve been in this situation before. I’ve taught Janet to give an anaesthetic in an emergency. It’s called island medicine. We do what we must. If you don’t think you can handle it, then I’ll use Janet.’
‘I’m an obstetrician.’
He gave me a long, cool look. ‘Then Janet it is. I’m assuming you did learn to give an anaesthetic in general training, but if you’re wasting my time…’
‘I’m not wasting anyone’s time. I just don’t understand. If this was the US—’
‘If this was nearly anywhere else then we’d have a full surgical team. I’d even have a radiologist on hand who might be able to manoeuvre a stent into the artery to get past the block. But I make do with what I have, Dr Kelly, and right now I’m seeing a qualified doctor. So I’m asking you. Are you going to help or are you not?’
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