I Follow You

by Peter James

  And it was then he could make a decision. Save him or let him die.

  If he did nothing, within days any treatment would be far too late. Because that good old, trusty perforated bowel would keep on poisoning him from within. Roger would be beyond antibiotics at that stage.

  Of course, much later, if he did not intervene, the pathologist performing the postmortem would find the tear in the bowel. In his report, the pathologist would write that it was almost microscopic in size and would have been virtually impossible to spot during the emergency operation, in which Dr Marcus Valentine carried out an exemplary removal of the spleen, doing all he could to save Mr Richardson.

  No question of any blame on him, Marcus thought. This was a gift, fallen into his hands. Such good fortune he had a non-emergency list today and had been able to attend to the injured man. So lucky, being in the right place at the right time . . .

  Timing is everything!

  44

  Monday 14 January

  After her long, anxious wait in the Relatives’ Waiting Room of the Intensive Care Unit, a nurse came in to see Georgie. A slim lady with long dark hair, she wore black trousers and a charcoal short-sleeved top embroidered in white with the words CRITICAL CARE UNIT. Her plastic name tag, clipped to a pocket, read STATES OF JERSEY. KIERA DALE. CRITICAL CARE MANAGER.

  ‘Georgina Maclean?’

  Georgie stood hastily. ‘Yes.’

  ‘Shall we sit down and have a quick chat?’

  Her heart plunged. Please God, tell me Roger’s alive.

  The nurse perched on a chair next to her. Georgie noticed she was holding the form she had completed earlier on her arrival at the hospital.

  ‘Roger Richardson is your fiancé, is that right?’

  Georgie nodded.

  ‘OK, don’t be worried! He’s just on his way from the Recovery ward to ICU, you’ll be able to go in and see him in a few minutes. You may be a little shocked by his appearance, but he’s doing really well.’

  ‘Yes? He is?’

  ‘The doctors were concerned about his head injuries, that he might have a fractured skull, but he’s had a CT scan which has indicated some bruising from the accident, and possible concussion, but his skull is intact and his brain functions are normal, which is a good sign. But what the surgeon has had to do is perform a splenectomy.’

  ‘Splenectomy? What does that mean, exactly?’

  ‘Do you have any medical knowledge, Georgina?’

  ‘A little – I’m a personal trainer, so I have some, and I’m First Aid trained.’

  ‘Roger suffered a ruptured spleen, causing severe internal bleeding. It’s a common injury in a major trauma. His spleen had to be taken out in order to remove any risk to his life from internal haemorrhaging.’

  ‘Jesus,’ Georgie said. ‘What – what does that mean for him? Will he be able to keep his pilot’s licence? He’s a flying instructor – that’s his livelihood – and he’s just launching a new air taxi business.’

  ‘I’m pretty sure he can retain his licence. We had a patient here only a few weeks ago who had a ruptured spleen from a motorcycle accident. He was a commercial pilot, very panicked about his career. I looked into the situation for him and spoke to the island’s Aeromedical Examiner, Dr James Mair. The doctor told me that the CAA would temporarily suspend his licence, but there was no reason why he wouldn’t be signed off as fit to fly after his recovery. The liver takes over most of the spleen’s functions if it’s removed. Healthy people can live quite normal lives without their spleen – but it will mean that your fiancé has to take penicillin, daily, for the rest of his life.’

  ‘Why’s that?’ she asked.

  ‘It’s an important organ but not a vital one. The spleen provides antibodies – what it means for your fiancé is a slight decrease in his immune system. The penicillin will counteract that. The important thing is that he’s strong – he seems a pretty fit man.’

  ‘He is – he likes to exercise.’

  The nurse smiled. ‘Good. There’s absolutely no reason why he won’t make a full recovery and be able to continue with his career.’

  ‘Thank God.’ She dabbed her eyes. ‘I still don’t know what happened. Do you know? No one’s given me any information. He left home this morning for a busy day of instructing. Then I heard on the news there’d been an accident at the airport. I tried to get hold of him and couldn’t. I panicked and phoned the hospital and they said he’d been admitted. So I came straight here.’

  ‘I’m sorry, Georgina, I don’t know any more than you do at this time.’

  Georgie sat for some moments, twisting her hands nervously. The clock on the wall said 4.43 p.m.

  ‘As I said, don’t be worried by his appearance, Georgina. You’re OK with me calling you that?’

  ‘Everyone knows me as Georgie,’ she replied, quietly.

  ‘OK, Georgie. When we go in, you’ll see Roger surrounded by a lot of apparatus, which may look a little alarming, but it’s all to help him in the critical next few days. He’ll be wearing an oxygen mask, but that’s just to assist with his breathing during the recovery process. We’ll be assessing his post-op pain and delivering morphine intravenously. He’s connected to monitors for his heart rate and blood pressure, and to take his ABG – his arterial blood gas readings – every one to two hours and he’s cannulated with intravenous fluids to keep him stabilized. There’s also a wound drain in his abdomen. You might find him a little confused and talking a bit of nonsense, but don’t worry, he’ll soon be getting back to normal conversation. In a day or two the physiotherapist will get him sitting up and walking around. We have one-on-one nursing care in the unit, which means Roger will have a rota of nurses dedicated solely to him, twenty-four-seven. He’s going to be fine, trust me!’ She gave a reassuring smile.

  Georgie nodded, trying to absorb it all. ‘How long before he can come home?’

  ‘That will depend on how well he responds, but normally a splenectomy patient would be in hospital for a week, with a further four weeks convalescing at home.’

  ‘Can I stay with him? Overnight?’

  ‘If you want to, of course you can. We don’t restrict visiting hours – but our advice is always to get some rest. He has the best possible care here. Stay with him this afternoon but go home tonight and get some sleep. Come back refreshed. It won’t only make you feel better, but psychologically it’ll make him feel better too.’ She smiled again. ‘OK?’

  Georgie shrugged. ‘OK,’ she said, meekly. ‘Thank you.’

  As the nurse left, Georgie was scared rigid. Her insides in turmoil. She wondered if any of Roger’s family in England had been informed of the situation. With trembling hands, she dialled the number of his parents in York.

  45

  Monday 14 January

  Nurse Dale returned twenty minutes later to take Georgie into the ICU. She followed the nurse into the ward, a warm, bright, modern-feeling room painted in soothing tones of fresh mint green and soft white. There were five bays containing beds, each separated by a column, with the nursing station directly opposite.

  Male and female medics were attending every bed, and more nurses were occupied behind the rack of monitors at their station. The room was filled with apparatus, wheeled cabinets and numerous yellow sharps bins, as well as red and white garbage containers side by side. There was a constant beeping.

  Georgie walked past a thin, middle-aged man propped up in bed, with a large blue pad taped to his chest, and past a skeletal elderly woman the colour of chalk, her eyes closed and an oxygen mask over her face.

  Then she saw Roger in the next bed along, lying semi-upright, his eyes open, hair awry, some strands sticking up.

  She hurried over, so relieved to see him. ‘Darling! Darling, hi!’

  He looked around, confused, as if wondering where her voice had come from.

  She stooped and kissed his cheek, which felt cold and moist. ‘My darling, you’re OK, you are!’

  Kiera Dale had wa
rned her not to be shocked. But it was hard. Hard to believe, for an instant, that this was the man she loved so much. It was like looking at a bad facsimile of him. A faded photocopy.

  His face was translucent, almost colourless, with two strips of gauzed plaster on his forehead and another one on his right cheek. He was plumbed into a stack of monitoring apparatus. A rail went around the whole bay, from which hung a green curtain, at this moment wide open. A metal table on wheels, with a number of drawers, stood at the end of the bed, with a chart on top of it.

  Roger was dressed in gauze underpants and a cotton gown which was untied, exposing his bare, muscular chest and six-pack midriff, to which were taped a number of pads. He was hooked up via a cannula on the back of his left hand to a bunch of drip lines, and a meter was clipped to his index finger. What Georgie presumed was the wound drain was inserted in his abdomen.

  Monitors on either side of him beeped steadily. Georgie took a moment to study the digital readouts, trying to work out what each represented. Blood pressure, currently 115 over 68. Heart rate 64. Another monitor, Kiera told her, was the blood-oxygen level, but Georgie wasn’t sure what it should read to be normal.

  She took his free hand and held it. ‘I’m here, darling. How are you feeling?’

  Suddenly, to her joy, he gripped her back, very faintly. ‘They want me to retake geometry,’ he mumbled.

  ‘Geometry, my love? Who wants you to retake geometry?’ She ran a hand gently through his moist hair, smoothing it down, trying to smarten him up a little.

  He replied, his voice slurred. ‘Thing is.’ Then he lapsed back into silence.

  Georgie waited. ‘Yes? The thing is what?’ she asked gently, encouraging him to talk more. To come back to her.

  ‘I was like – fishing. My dad said it was too small. We should throw it back.’

  ‘Where were you fishing? And what do you mean about geometry?’

  ‘The blasted mower never worked. Was always conking out.’

  ‘Mower? Lawn mower?’

  He lapsed into silence again. Georgie turned to the nurse and smiled. She grinned back, then she leaned and whispered to Georgie, ‘It’s the anaesthetics and concussion. A splenectomy is a pretty big operation. Give him a bit of time and he’ll start to talk more sense.’

  ‘Thing is,’ Roger said. ‘The thing—’

  ‘What thing, darling?’ Georgie asked.

  He gave her a dumb, vacant smile as if his brain had become a vast, empty cavern.

  She held his hand, then stroked his hair again. One strand defiantly popped up, sticking in the air. His lips moved but no sound came out. It looked to her as if he was trying to say, I love you.

  ‘I love you so much, my darling.’ She wiped away tears with a tissue from the box on the tray beside him. ‘You’re going to be fine. You’ll pull through. Fight!’

  Kiera Dale had said, earlier, he was going to be fine.

  Of course he would be.

  She just wished she could totally believe that in her heart. But instead there was something telling her that maybe he wouldn’t. And he looked terrible. Worse than the nurse had prepared her for.

  Hell, of course he looked bad. He’d just been in some kind of major accident. Hopefully it was just her messed-up hormones that made her so afraid of everything.

  She sat, stroking his head and feeling hot. Too hot. She’d wrapped up warmly against the cold day outside but was now sweltering in here. She’d already removed her coat when she’d first come in and she was about to take off her pullover when, suddenly, a whole team in scrubs descended on the bay.

  Kiera led Georgie away into the middle of the room, explaining it was a ward round, and telling her who they all were. One of the hospital’s top general surgeons, the duty consultant anaesthetist, the nurse in charge and the pharmacist, to check on Roger’s medication and ensure he was being given sufficient morphine. At the rear was the physiotherapist who would be assessing how soon he could get Roger out of bed and sitting up.

  Green curtains swished around Roger, sealing him from sight.

  The nurse suggested, very kindly, that Georgie took a break, perhaps either sitting in the Relatives’ Room or popping down to the snack bar to get a cup of tea and coming back in a short while.

  But Georgie did not want to leave this room. She took a few paces back and stood beside a yellow triangle warning of a slippery floor, feeling utterly helpless and lost. Behind her was an old man, hooked up to a ventilator, who looked like he had been carved from alabaster. In the furthest bed was someone swathed in bandages, head to foot, moaning in what sounded like terrible pain.

  Maybe she should get some fresh air, she decided. Take a walk around the block.

  Very reluctantly, she left the ward, walked down the corridor, past the Relatives’ Room, and turned a corner, passing a hand sanitizer, an empty trolley and a plethora of signs and arrows.

  SECOND FLOOR. ROBIN WARD. LE QUESNE UNIT. HAEMATOLOGY/ONCOLOGY UNIT. INTENSIVE CARE UNIT. MAIN HOSPITAL AND CHAPEL.

  Chapel?

  For bereaved relatives?

  She walked past the open doors and glanced uncomfortably at the interior of the large chapel.

  Shit. What kind of message was that giving off? The chapel just along from the Intensive Care Unit?

  A nurse hurried past her.

  Georgie stood still. In another life, as a child, with her deeply religious mother, she might have gone and sat in that chapel and prayed for Roger to be OK. But her father had died from a sudden heart attack. No amount of praying had saved him. And prayer hadn’t saved her mother from dying of cancer.

  She walked on and saw the lift and a sign to the stairs just to her right.

  She changed her mind. She didn’t want to leave this floor, did not want to be too far away from Roger. Ahead of her she saw a blue pedal bin with a red bucket on top. On either side was a row of collapsed wheelchairs, and beyond them several stacked plastic chairs.

  She removed the top one, sat down on it and put her head in her hands. Moments later she felt her tears trickling through her fingers. Please make Roger well again. Please.

  Suddenly, she was aware of someone standing over her. She heard a familiar, well-spoken male voice she could not immediately place.

  ‘Georgie, hello!’

  She looked up at the man in blue scrubs, who was staring down at her with a deeply sympathetic smile.

  Marcus Valentine.

  46

  Monday 14 January

  After checking on Roger Richardson, Marcus had helped out in theatre on two more of the casualties from the airport. One was a man in his late fifties, suffering from massive internal injuries. He hadn’t made it. Someone mentioned he was a student pilot who had been under instruction from Richardson at the time of the accident.

  There was always an air of gloom and despondency in the theatre when a patient died – not to mention, he thought, irreverently, as he drove home in the darkness shortly after 7 p.m., the ensuing paperwork, including the report that would have to be written for the coroner about Byron Wilding. But tonight, as he accelerated along Victoria Avenue, enjoying the music of the engine behind him and the responsiveness of the Porsche, he wasn’t feeling any of that. He was feeling pensive.

  He’d seen Georgie Maclean sitting, downcast, in the corridor outside the ICU and, being the kind, caring man he was, had taken the time and trouble to sit down beside her and talk her through all they were doing to save her beloved’s life. Omitting, of course, one small and rather vital detail.

  His little secret.

  How much he’d wanted to hold Georgie’s hand. Put his arm around her and pull her close, breathe in her scents. But, of course, he’d played it straight and proper. The good news, he had been able to tell her, was the successful removal of Roger’s spleen and, honestly, so long as he took penicillin daily, it was barely more relevant than an appendix – and hey, did you ever hear of anyone that had a problem because they had no appendix? It was just a useless
remnant from our evolutionary past – one day humans would be born with no appendix, just like hundreds of thousands of years ago they’d begun to be born without gills. One day they’d be born without spleens, too. Good old Darwin, eh!

  That had made her smile. Albeit thinly.

  He’d qualified it by explaining to her something she might like to know about her developing foetus. That at the early stages of a baby’s development there is a structure known as the pharyngeal arches, which later become the jaw and neck. These, he told her, bear more than just a passing resemblance to the gills of fish.

  He could see his chat was taking her mind off things, and when he finally left, she thanked him and gave him a sad little smile.

  Ten minutes later he was home. He drove up the driveway, clicked the app on his phone to open the garage door, parked next to Claire’s Evoque and killed the engine.

  Then he sat in his car for a while, reflecting. Enjoying this moment of calm. Luxuriating in the comfort of the Porsche’s cabin, the elegant ergonomics and the surroundings of his nice, orderly garage. Keeping the stereo on, he selected some music, the ‘Soldier’s Chorus’ from Gounod’s Faust. Claire wasn’t such a fan of classical music, preferring mindless pop. He turned the sound up loud, almost deafeningly loud. There were moments like this when music lifted him so high he felt he could almost touch the heavens.

  And here in Heaven, he pictured the smile he had brought to Georgie’s face. Despite all her fear and worries, he’d created that smile, and that was enough. The sign he needed. He was the one who could lift her beyond the sadness of this turgid relationship she was in – and be her saviour. Oh Georgie, do trust me!

  He loved this garage; here, everything was in its place. Each of his tools on the wall rack, perfectly aligned – by him. Screwdrivers; chisels; hammers; saws; the perfectly matched rubber tyres hung at the far end, in front of both Claire’s car and his own, at exactly equal heights, to prevent them from ever hitting the end wall. The identical shrimping nets for the twins. The shelf on which sat a row of cans of oil, WD40, 3-In-One and de-icer spray arranged in order of height. Everything where you could see it, find it. Just like the instruments on a surgical tray.