‘Give us your pen,’ Fiona had instructed. ‘And some paper. Look…’ A diagram had taken shape. ‘Glucose that’s not needed for energy gets stored as glycogen in the liver and muscle cells. That’s glycogenesis. When it’s needed again, it gets split up. That’s glycogenolysis…’
Twenty minutes later Nick had found the whole physiological picture of diabetes perfectly clear. He’d never forgotten that lesson. The soft, melodious sound of Fi’s voice with the curious accent that had been new for him, the ability to make things simple and the patience to make sure they were understood. The way she’d used her hands as an extension of her voice or to tuck a wayward curl behind her ear when she’d bent forward to write or draw.
Yes. Fiona had been a great teacher all those years ago. She was probably brilliant now, with the addition of maturity and experience. Shane was lucky. The thought made a curious sensation needle Nick. It if wasn’t so ridiculous, he might have labelled it jealousy.
Threading the soft tape under the man’s neck, Nick tied it to the other side of the device intended to keep the tube securely in place. Shane helped to slide a cervical neck collar into place. Nick couldn’t quite shake that odd feeling of envy.
‘How long has Fiona been working here?’
‘Only two years, full time. She started as a volunteer but then Maggie got pregnant and persuaded her to cross-credit her nursing qualifications and then go further. She wanted Fi to take over so she could be a full-time mother for a while.’
‘Maggie?’ The name was familiar.
‘Patterson. She’s married to Hugh who’s the medical director of Lakeview Hospital.’
‘Of course.’ Nick hung a fresh bag of IV fluid, watching the oxygen saturation level on the monitor creep up to a far more acceptable level as Shane continued to assist their patient’s respirations. Hugh Patterson was the doctor he was replacing for the next month so that he could travel for some post-graduate training.
‘Patient status?’ A police officer with a clipboard stepped close.
‘Airway’s secure and blood pressure’s ninety over forty. Stable enough for transport, depending on how far he needs to go and who’s travelling with him.’
‘We’ve got a chopper ready to take two patients to Dunedin with an ICU doctor on board. There’s another chopper due within fifteen minutes but it’s smaller so it’ll only take one.’
Fiona appeared from the bustle of people working around them. Her glance took in the intubation, the spinal immobilisation and the fluid replacement therapy under way. Her quick smile was both impressed and appreciative.
‘You happy if we load your patient now, Nick? I’ve got a woman with a head injury going on the first chopper as well. There’s a man with a fractured pelvis and abdominal injury in line for the second air evac if nobody else deteriorates in the meantime.’
‘I’m happy,’ Nick concurred. Actually, what he was experiencing in the wake of Fiona’s approval went beyond a mundane ‘happy’. How come he’d never had quite this level of satisfaction from impressing some of his senior colleagues in the last few years? He wanted to do more. ‘Do you want me to travel with the second chopper?’
Fiona shook her head. ‘There’s someone coming for transit. I’ve got two people with moderate injuries in an ambulance to go down to Lakeview. Shane, could you drive, please?’
‘Sure.’
‘And, Nick, if you could go with them, it would be great. Hugh’s at the hospital and he’s called in one of the local GPs but when he heard you were here, he asked if you could come as well.’
‘Of course. You going to manage here if I go now?’
Fiona gave a brief nod. ‘We’ll have the most critical patients evacuated very soon. We’ll transport the others to Lakeview, including all the minors. There’s a minibus on the way for them.’
He could see one of the passengers for the bus being escorted from the tent. A young man with a heavily bandaged hand. Fiona followed his gaze.
‘Traumatic amputation of his middle finger,’ she said. ‘He’s pretty upset. Set off a moderate asthma attack that needed treatment as well.’ Her sigh encompassed sympathy for everybody who’d been involved in this incident. ‘It’ll be chaos down there for a while,’ she added thoughtfully.
‘Lakeview doesn’t have surgical facilities, does it?’
‘It’s only set up for minor stuff but we’ve got a fixed-wing aircraft that can transport and we’ll get the chopper back within a couple of hours if it’s needed.’
Someone called her name and Fiona turned automatically. But then her head swung back to Nick.
‘You’ll be around for a while?’ she queried. ‘When this is over, I mean?’
Nick simply nodded. Would a month be long enough?
‘Good.’ With a frown, Fiona turned away again. ‘We can talk later.’
A moment later, she was crouched by a different stretcher, a stethoscope in her hands as she reassessed a victim. That frown line was still creasing her forehead and while it was probably now due to concentration on the task at hand, Nick found he’d been left with the vaguely discomfiting notion that Fiona was not particularly looking forward to the opportunity to talk to him.
And why would she? His presence could only serve to remind her of what she’d lost. To challenge emotional scars that might have taken a very long time to heal. He would understand if that were the case. There was no denying that there were patches on his own soul feeling curiously raw thanks to this unexpected reunion.
Yes. He would understand. But even if his presence stirred up things that might best be forgotten, he was prepared to face this challenge. Maybe he needed to, in order to find closure.
The second helicopter arrived shortly after the ambulance driven by Shane started winding its way carefully down the shingle road. With the critical cases now evacuated and the people with obviously minor injuries climbing aboard the minibus, the scene was suddenly far less overwhelming.
Manageable, in fact.
The occupants of the rally car had been finally freed and, thanks to their harnesses, helmets and suits, they didn’t appear to be badly injured. The co-driver had a possibly fractured ankle and the driver some first-degree burns to his face but no evidence of respiratory tract involvement. They were both Hungarian and the shock of what had happened made their English very difficult to follow. Their distress was all too obvious, however, and their signals made it clear that they wanted everybody else treated before receiving attention themselves.
‘We need a translator,’ Fiona told an official. ‘Someone in their ground crew, perhaps.’
‘Can you come over here?’ A young police officer was waving at Fiona from the doorway of the tent.
She walked towards him. ‘What’s up?’
‘There’s a guy out here that doesn’t seem to have much wrong with him but he’s just sitting and isn’t very co-operative. If he’s just had too much to drink I can deal with him but I thought I’d better get you to check.’
‘Good thinking.’ Fiona approached the youth, who looked to be about eighteen.
‘Go away,’ he said loudly. ‘Leave me alone.’
‘Are you hurt?’ Fiona was trying to assess him visually. He looked pale and the hair at his temples was damp, as though he’d been sweating. ‘You haven’t knocked your head, have you?’
‘No. Go away.’
Fiona couldn’t see any evidence of a head injury and she couldn’t smell any alcohol. Then her gaze paused on the bony wrist protruding from a padded ski jacket.
‘Just let me take your pulse and then I’ll go away.’ Fiona kept her tone reassuring and moved slowly as she crouched and gently captured his wrist. Having spotted the medic alert bracelet, she needed an opportunity to turn the disc over and read the inscription. ‘What’s your name?’ she asked, both to try and start a conversation to assess level of consciousness and to distract the lad from what she was doing.
‘What do you want to know for?’ His glare was suspicious
and the wrist Fiona was holding was attached to a tense fist. It could be jerked from her grasp at any moment and, given the level of combativeness being displayed, there was a distinct possibility the fist could head in the direction of Fiona’s face. She held herself ready to dive for safety if necessary.
It wasn’t the first time she had found herself in such a volatile situation. Most medics faced this kind of thing on occasion. Even if she hadn’t had the shock of seeing Nick so unexpectedly today, she would probably—as she often had—remember him turning up to be the best man at his brother’s wedding with a nasty, swollen black eye that he’d received from an emergency room patient suffering a lowered level of consciousness from a head injury.
She wasn’t still thinking of him as she turned the bracelet over, however. Reading the designation of insulin-dependent diabetes mellitus dragged a corner of her brain back in time instantly. To when she’d found more in common with her future brother-in-law than an antipathy to being under a media spotlight.
Time with Nick that weekend had been an oasis in a totally new landscape for Fiona. A wildly exciting, irresistible landscape. But she had definitely needed the link to her old life. A chance to share knowledge from the career she loved.
Knowledge like the metabolic processes associated with glucose and the kind of symptoms produced when something was out of kilter. Symptoms like those of the young man sitting slumped in front of her right now.
‘When did you last have something to eat?’
Her patient stared at her blankly.
‘I need my kit,’ Fiona told the police officer who was watching. ‘Big grey box with a stethoscope on top of it.’
She wanted the blood-glucose monitor it contained. The glucose jell or IM glucagon or possibly even the IV glucose and the means of administering it.
‘What’s your name?’ she asked again. ‘Mine’s Fiona.’
‘Joe.’ The word was a mumble and the lad’s eyes were drifting shut.
‘Have you got some jelly beans or anything with you, Joe?’ It would be preferable to try and get some glucose on board orally but his level of consciousness was decreasing rapidly. Fiona felt the pockets of his jacket. Most diabetics carried some form of readily absorbed glucose like jelly beans or barley-sugar sweets.
Sure enough, she found a small packet of jelly beans.
‘Ooh, black!’ Fiona’s smile felt a bit rusty. There hadn’t been much to smile about for what seemed like a very long time. ‘My favourite. Try and eat one of these for me, Joe.’ She poked a jelly bean into his mouth. ‘Chew it up,’ she urged.
Agonisingly slowly, Joe complied. Fiona watched him, ready with a second jelly bean, as she waited for the police officer to return with her kit.
He was about the same age Nick had been when Fiona had met him for the first time.
‘I’ve got a kid brother,’ Al had warned her. ‘He’s geeky and gawky but he’s OK.’
Nick had been more than OK as far as Fiona was concerned. She might have been swept off her feet and totally in love with Alistair, the international rally car superstar, not to mention overawed by his equally famous parents, but Nick was the family member she had known she’d had the most in common with.
He was clever and focussed, not geeky.
Young and a bit shy, not gawky.
Fiona slipped another jelly bean into Joe’s mouth. ‘You’re doing great,’ she told him.
This time the chewing was just a little more enthusiastic. She even caught the hint of a smile as a corner of Joe’s mouth lifted.
Nick’s smile had been elusive to start with as well. Until the end of that weekend when Fiona had escaped the filming of a television interview. She’d gone for a walk despite the recent heavy snow. Without thinking, Fiona had taken the easy path left by someone’s footprints and she’d caught up with Nick somewhere on the airfield. Somehow, they’d ended up making a snowman. Having a snowball fight. Even making snow angels by lying in the drifts and sweeping their arms up and down.
Nick’s shyness had evaporated then. He’d smiled at the very idea of making a snowman and he’d laughed when his first snowball had been far more accurate than Fiona’s and elicited a shriek as icy particles had gone down her neck. By the time they’d headed home they’d had flaming red cheeks, frozen fingers and toes and sides that ached from laughing. And, more, they had established a real connection. A genuine friendship.
Or so she’d believed at the time. Even then, Fiona had thought what a fabulous uncle Nick would make to her children. Children he’d probably known his brother never intended having.
What was he going to say when he learned about Sam? Or had he received that letter after all and had decided not to bother responding? Like he hadn’t bothered to come to his only sibling’s funeral.
‘Is this what you wanted?’
‘Yes…thanks…’ Fiona shoved the old hurt aside yet again and dragged her thoughts back to the task at hand, but Joe was already responding to his oral glucose intake. He blinked at Fiona.
‘I’ve had a hypo, haven’t I?’
‘Yeah…I’m just going to check your glucose level. Have another jelly bean while I prick your finger.’
‘I missed lunch. I knew I was getting low so I went to get something to eat.’ Joe’s words were slow and a bit muffled by jelly beans. ‘I had a hot dog in my hand when that car spun out. I dropped it and then…’ He sent a dazed glance behind Fiona. ‘I don’t really remember. Was anyone killed?’
‘No. There’s a few people with serious injuries but they’re all on their way to hospital.’ Fiona was waiting for the test strip to be analysed by the small monitor. ‘How are you feeling now?’
‘A bit rubbish.’
‘You’ll need more than jelly beans. Maybe you’d better come down to the hospital for a while until you come right. Do you often have trouble managing your diabetes?’
‘No. I’m usually good. This was my own fault.’
The monitor beeped and Fiona looked at the screen. ‘Still on the low side. You need some more glucose and then something longer-acting, like some carbs.’
‘I’ll be OK. My girlfriend’s here somewhere. She’ll be wondering where I am. Oh…God!’ Joe blinked again, focussing more intently on their surroundings. ‘Was she hurt? Her name’s Melanie. She’s got long red hair and…and she’s really pretty.’
Fiona touched his arm reassuringly. ‘She wasn’t one of the more seriously injured, anyway. Look, we’ll get this police officer to make some enquiries. You come with me into the tent. That way I can keep an eye on you and we’ll know where to find you when we locate Melanie.’
Joe was perfectly co-operative now, although somewhat wobbly as he climbed to his feet. His lanky frame uncurled to a height of well over six feet and Fiona could feel all his ribs as she put an arm around the young man to steady him.
He still had some growing to do. Maybe he would fill out to the kind of solid, muscular frame that Nick had finally developed in the six years since Fiona had last seen him. It was surprising just how imposing a figure her brother-in-law had become. Shocking, actually.
And not just physically. Nick had an aura of confidence. Of being in command. The kind of charisma Al had had. Or was it? This was confusing, the way the differences between the brothers had somehow blurred. Was it because Nick must now be thirty—much closer to the age that Al had been when he’d died and the only way Fiona could remember him?
Or was it because Nick had been involved in possibly countless situations that had called for the demonstration of advanced skills under extreme pressure? The kind of ability that automatically bestowed that kind of confidence. Nick’s abilities might be used to save someone’s life rather than entertain a huge crowd, but was the background intelligence and courage needed all that dissimilar?
He was a Stewart after all, and charisma had seemed genetic in that family.
Her son had those genes as well.
Fiona suddenly had the overwhelming urge to hear t
he sound of her little boy’s voice. To reassure herself that he was safe. She would check the remaining patients in the triage tent and then take a minute or two to call her mother’s cellphone.
‘Sit down here,’ she instructed Joe. ‘We’ll do another blood-glucose level in a few minutes.’
But Joe stayed standing. He was staring over Fiona’s shoulder to where the police officer was entering the tent behind them, with a young woman by his side.
‘Joe!’
‘Mel!’
‘I couldn’t find you.’ The young woman with long auburn hair threw herself into Joe’s outstretched arms. ‘I was so worried…’
‘What’s happened? Why have you got a bandage on your arm?’
‘I fell over. It’s probably just a sprain. People were pushing and running to get away. I was trying to go the other way to get to the hot-dog stand.’ Mel was crying now. ‘The car crashed into it and I knew you were in the queue and…’
‘It’s OK,’ Joe said. ‘I’m fine…’
‘It is OK,’ Fiona confirmed. ‘Let’s get both of you into the bus and down to the hospital.’
‘I can do that,’ the police officer said. He was smiling at this joyous reunion in front of them. A moment of relief and happiness in the wake of such a terrible ordeal.
‘Excuse me.’ An exhausted-looking race official touched Fiona’s arm. ‘We’ve got someone that can translate now. Could you come and check the drivers?’
Fiona nodded. As she turned, she noticed an altercation going on at the doorway of the tent as people holding television cameras and fluffy microphones on poles were being refused entry.
She couldn’t stop to ring her mother just yet and Fiona could only hope they had gone home long ago. And that nobody knew of Nick’s connections.
Imagine the level of interest if the media caught the angle that Al Stewart’s brother—now an emergency physician—had found himself having to work in a situation that must have been a dreadful reminder of the way his brother had died.
And then they’d find out about Sam and their lives would never be the same.
Fiona unhooked her stethoscope from around her neck in preparation for the thorough assessment she intended to give the Hungarian men. She could feel an odd knot in her stomach that she knew had nothing to do with the level of injuries she might be about to assess.
Her Four-Year Baby Secret Page 3
