And though he didn’t want to say as much to Cassie, he suspected she was safe for a while yet. The killer hadn’t finished playing with her. Though they didn’t know for sure about Lisa’s communications, Mrs Ambrose and Judy Griffiths had each received five letters. If the man—or woman, though serial killers were usually men—ran true to form, then Cassie had a couple more warnings to go before danger moved closer.
Cassie made her way to Cynthia Bennett’s room, her feet on autopilot as her mind pondered the new situation in which she found herself. Though there was no way she was going to admit it, either to Dave or to McCall himself, having someone on her side—for that was how it seemed—against the unknown enemy was definitely comforting.
Considering this ‘comfort’ phenomenon, she entered 4A to find Cynthia sitting up in bed, flailing wildly around as she tried to find the call button at the end of the lead.
‘Oh, Cassie, thank goodness you’re here. I’m bleeding again and it’s bad this time.’
Cassie grabbed the cord and pressed the button. Two nurses appeared almost immediately—a response that pleased the administration part of Cassie’s mind.
‘Jenny, Mike’s not in this morning so could you go up to my office and tell the man who’s there he’s needed in Theatre? You’ll have to show him where to go and then explain the set-up. He should put on a gown, hood and paper overshoes, but needn’t scrub yet. Kay, send a porter in—I’m taking Cynthia to Theatre. Then get Admin to track down the flying gynae and patch him through to me wherever I am. And I’ll need cross-matched blood in Theatre—take Cynthia’s chart with you as you go. And grab the foetal heart monitor from the delivery suite.’
As the two women bustled off, Cassie turned back to her patient.
‘Cynthia, I’m taking you to Theatre just in case the bleeding doesn’t stop. I’d rather have you there than here.’
‘The baby’s still too young, isn’t it?’ Cynthia fretted, while Cassie lifted the bed’s legs so it could be rolled on wheels into Theatre.
‘Not necessarily,’ she said, as the porter came in and moved the bed towards the door, Cassie guiding it from the side where she could still see Cynthia’s face as she reassured her. ‘And, anyway, the bleeding might stop like it did last time. Remember it’s your blood you’re losing, not the baby’s, so it’s still OK.’
McCall must have moved quickly, for he was there in Theatre, twiddling with the dials on the anaesthetist’s monitor, when the patient arrived.
‘Your placenta praevia?’ he asked Cassie, then, as Cynthia was pushed into position, he leaned over and introduced himself.
‘Will you have to do a Caesar?’
‘I don’t know,’ Cassie told him. ‘I’m hoping not, but if you could hook Cynthia up to that monitor, I’ll get an external foetal heart monitor set up for the baby and some IV lines in to start replacing the blood she’s losing.’
She kept working, explaining to Cynthia what she was doing, giving orders to the nurses to bring in what might be needed—drugs, obstetrics bundle, crib.
‘And find whoever’s on duty with midwifery experience. I want someone standing by to take charge of the baby if we get that far,’ she added to the runner.
‘Well, the machine says you’re doing just fine,’ McCall told their patient, when he had her hooked up.
Cynthia smiled at him.
‘It might sound strange, but I feel just fine,’ she said. ‘No pain at all. Wouldn’t know anything was happening if Cassie didn’t look so worried.’
‘Geez, so much for hiding my thoughts and feelings from the patient,’ Cassie muttered. ‘The baby’s also feeling fine if his or her heartbeat is any indication,’ she added, then turned away as Kay handed her a phone handset.
‘Gregor? Cassie Carew. I don’t suppose you’re within flying distance of Wakefield, with nothing much on your plate for the next hour or two?’
‘Cynthia Bennett?’
Gregor Prentice’s deep voice was soothingly sympathetic.
‘Yes.’ Cassie walked out of Theatre as she answered him. ‘Another bleed, quite bad. She’s thirty-two weeks. I’ve got her in Theatre in case her blood pressure drops suddenly. Mike’s off duty but I have a doctor of sorts here who can help with the anaesthetic, though I’d prefer your team to do the job if it’s at all possible.’
‘But you may not need me,’ Gregor reminded her. ‘It stopped spontaneously last time. Thirty-two weeks, there’s still a risk of respiratory distress syndrome in the infant. I think steroids now—you’d have betamethosone—to enhance lung maturity, just in case.’
Cassie nodded, although she knew Gregor wouldn’t see it. She’d already decided to take that course.
‘And didn’t all the local service clubs chip in for a new resuscitation crib for Wakefield recently?’
Cassie confirmed this, then Gregor added, ‘Look, I’ve a patient prepped and sedated here in Gilgudgel—cervical conisation. I’ll have to go ahead with it, but we can fly home via Wakefield. With the op and flying time, you’re looking at about eighty minutes. You said you’ve got someone available to do the anaesthetic if you need to go ahead before I get there?’
‘Yes.’
How she made the single syllable sound doubtful, Cassie didn’t know, but she must have done, for Gregor immediately queried her.
‘You don’t sound sure.’
‘Well, I’m not. He’s just arrived today—not as a doctor, as something else. His name’s McCall.’
‘Not Henry?’ Gregor exclaimed, delighted surprise so evident in his tone Cassie felt annoyed with him.
‘Yes!’ she said again, only this time there was no doubt, only dislike, shadowing the word.
‘Well, you couldn’t be in better hands. Ran the Royal’s A and E department for years, and would turn his hand to anything to save a patient. Now I’ll definitely drop in!’
‘Well, I suppose I should be glad a reunion with McCall might benefit my patient,’ Cassie told him, but he’d already hung up and her cranky words just echoed back to her.
But as she returned to her patient, she wondered why a man who’d run what must be one of the busiest A and E departments in the state should give up medicine.
‘You’ll have to scrub,’ the man in question greeted her. ‘Her BP’s dropping fast. I’m starting sedation.’
Cassie didn’t hesitate, dressing, scrubbing and gloving up so swiftly that barely minutes had passed before she was back in Theatre, a message already on its way to tell the flying gynae not to come, another message going out for a medical retrieval flight as both mother and baby would have to be airlifted to a major centre with facilities for caring for pre-term infants.
Paula, the hospital’s most experienced theatre sister, had appeared from somewhere, and the swollen prepped belly was poking through green drapes, ready for Cassie to begin.
‘It’s like riding a bike,’ McCall murmured, and though she knew he’d said it to reassure her, she didn’t want reassurances from this man who was invading her life.
‘I was never any good on a bike,’ she told him. ‘Always falling off.’
‘And she’s got scarred knees to prove it!’ Paula added. ‘Tried to tell people she spent a lot of time in prayer, and the scars were calluses, but no one was going to fall for that one.’
Cassie worked swiftly, able to concentrate wholly on what she was doing, with Paula’s casual chat as relaxing background noise. Then McCall asked if she could hurry, and she didn’t have to check the monitor to know Cynthia’s blood pressure was dropping dangerously. With Paula acting as assistant now, cauterising the tiny blood vessels as Cassie cut them, the pace speeded up, tension thick as soup, silencing the chat, so the noise of the machines was all she could hear.
The incisions through skin, abdomen wall and uterus made, Cassie reached in to slip her hand around the infant’s body, making sure she had a good grip before she lifted it out.
‘One beautiful baby boy—not a bad size considering how early he is
,’ she said, as the tiny form was revealed and the midwife suctioned his mouth and nose.
To Cassie’s great relief, the baby objected to this procedure with a loud cry, a sure sign he wasn’t too traumatised by what had been happening. She clipped then cut his umbilical cord, held him momentarily in front of his mother then passed him to the midwife, who wrapped him in a sterile cloth and placed him on the warmed pad in the crib.
While the midwife dried the little one and checked him out, Cassie concentrated on removing the placenta, making sure no remnants were left to cause Cynthia more trouble.
Then she was done. Inner and outer stitches in place, the wound dressed and a drowsy Cynthia able to sit up and look at her tiny baby.
‘We’ll airlift you both out, probably to Mackay,’ Cassie told her. ‘He seems fine but needs to be in Special Care for a little while in case he has a setback. I know your mother is at your place, minding the other children—if I phone her to pack a bag, will she know what you need?’
‘I can’t go and leave the other kids,’ Cynthia cried. ‘Not that far away. It was OK being in hospital because they could visit so I saw them every day, but to go over to the coast…’
‘Well, the baby could go on his own,’ a deep voice said, and Cassie glared at McCall for weighing into this discussion. ‘He’d be well looked after, but you still won’t be able to go home for a few days, not after the Caesarean. Wouldn’t you be better off in Mackay, where you can spend time with this little fellow and express milk for him to give him the best possible chance?’
To Cassie’s surprise—and just a smidgen of chagrin—Cynthia seemed to be swayed by this not-so-subtle blackmail.
‘Mum’ll know what to pack—just some clothes for the baby,’ she told Cassie. ‘I’ve got clothes here in hospital with me, and once I know how long I’ll be, Warren can bring over whatever else I need.’
Cassie knew she should be grateful, but instead found herself irritated that it was McCall who’d brought about the capitulation. She crossed to the crib, and peered in at the baby. He was now attached to the crib’s monitors, which counted his respiration rate, heart rate and checked oxygen saturation in his blood. Mandy, the midwife who’d been caring for him, watched the screen to make sure he was stable.
The air he was breathing in the crib was oxygen rich to save his fragile lungs working too hard, and the crib was warm, as heat loss was his greatest enemy at this stage.
Knowing he was safe until the retrieval team arrived to take him to a specialist centre, Cassie rubbed her fingers against the plastic top of the crib, as if by touching it she could transmit her reassurance to the baby.
‘Want one?’
McCall’s question startled her. For a big man, he moved very quietly, coming to stand right beside her and gaze into the cot.
‘No,’ she said, thoughts of the past too strong for her to object to his teasing remark. ‘But once this was what I thought I’d do—paediatrics but specialising in neonatal care.’
She moved away from the crib, stripping off her gown and tossing it into a bin.
‘What made you change your mind?’
McCall had followed her, and his gown followed hers into the bin.
‘Stuff happened,’ Cassie told him, shutting back the flood of memories—her father’s death while Em had still been at university and Anne not yet in high school, her mother returning to work in the law firm so Em could finish her training. ‘I needed to come home.’
McCall nodded as if he understood, but no one could understand just what she’d gone through at that time—including Ross’s ultimatum that if she went back to the country their engagement would be off. Not that losing Ross had turned out a bad thing. Seen from the pain-free threshold of six years, he’d been an overbearing, autocratic, selfish and demanding snob. All the things Em had always said he was!
‘Do you want to move Cynthia back to her room before she leaves?’
Paula’s question brought her out of the past.
‘No, I don’t see any sense in that. Get an aide to pack her things—make sure she checks nothing’s left behind in the bathroom—and bring them to Recovery. We’ll take Cynthia in there.’
‘Do we get her ready to fly, or does the retrieval team bring its own gear?’
Cassie turned towards McCall as he asked the question. He’d crossed back to check on Cynthia before she was moved out of Theatre.
‘Don’t tell me you’re getting interested in medical matters,’ Cassie teased. ‘The retrieval team bring their own gear—wheeled stretcher with special attachments to hold fluid bags in place, keep drip lines untangled, hold a monitor and oxygen bottle, the works. We can do that from here but it’s safer for the patient if the retrieval people secure everything their own way. There are so many airlifts of patients out of country towns these days that flight medicine is becoming a speciality of its own.’
‘Interesting,’ McCall commented, as he and the porter moved the bed into the small room adjoining Theatre, where post-op patients were watched until they were fully conscious.
As Cassie tidied up, she could hear McCall talking to Paula, no doubt about the patient who was now in his care, as the anaesthetist in charge.
‘And what about the baby?’ McCall asked, returning to Theatre and dropping his mask and cap into the bin.
Cassie studied him for a moment. Was he just making conversation or did he really want to know?
Keen brown eyes met hers, and his lips slid into a smile.
‘I’m naturally nosy,’ he said, as if he’d guessed what she was thinking. ‘My mother said it started before I could talk—I’d point to something and shriek until told what it was, and what it did.’
Cassie didn’t quite believe him, but she smiled at the image he’d conjured up.
‘Because this is a neonatal retrieval, the team will include a specialist neonatal nurse and the doctor on the team will have some paediatric experience, or even training. They’ll bring their own crib—a much more high-tech affair than we have—and they’ll examine the little fellow more thoroughly before they leave. Our job is to keep him warm and breathing easily until they arrive.’
‘And in the old days—before retrieval teams?’
‘The babies lived or died. More often than not, I suspect, a neonate his size would have been OK. But you have to remember that country hospitals were much bigger and had far more experienced staff, simply because there was no alternative. Country doctors performed operations and delivered babies, while country nursing sisters nearly all had two or three certificates—general nursing, midwifery and maternal and child welfare—while others were experts in assisting in Theatre.’
‘So today country doctors and nurses aren’t as skilled?’
She checked his face again, but he didn’t seem to be deliberately baiting her. Apparently it was his curiosity again.
‘They have different skills,’ she told him. ‘They need a lot more emergency skills, because a lot of our work is stabilising accident victims before retrieval. And changing times have brought other pressures. I’m sure we see a lot more alcohol abuse than our predecessors did, and our nurses are trained to deal with that. Sex education and contraception, teenage pregnancies, help and counselling for teenage mothers—we have nurses who specialise in these things.’
‘The plane’s landed, ambulance on its way with the team.’
Suzy poked her head around the door to deliver this message, and Cassie, realising she hadn’t got far changing out of theatre gear, stripped off her cap and ran her fingers through her hair.
McCall felt his own fingers tingle, as if they knew what her fingers were experiencing.
Sick, that’s what you are, he told himself. Finger experiences indeed!
And completely off track.
You’re here to find a killer, not be attracted to a woman, and definitely not to get involved with hands-on medicine again.
She’d moved away now, peering into the crib, speaking to the nurse wh
o was caring for the baby. The curiosity he’d joked about earlier made him wonder what had changed the course of Cassie Carew’s life, and he found himself hoping it hadn’t been as gut-wrenchingly disastrous as the event that had caused his own about-turn.
Habit blocked the memories and turned his thoughts back to work. Dave had shown him the letters Cassie had received.
Watch for me.
Wait for me.
Listen for me.
Compared to the ones Mrs Ambrose’s daughter had found, Cassie’s letters were more intimate, and somehow that made them more threatening.
It also suggested the killer was someone Cassie knew, someone who was watching, because seeing her reaction to the letters—seeing her fear—would be part of the thrill of his deadly game.
‘OK, where’s this baby? And his mum? Are we all ready to go?
McCall turned from his contemplation of the dirty clothes bin to find the theatre suddenly full of people. A lanky male figure in white who could be either a doctor or a nurse was carrying a crib, while another white-clad man, younger than the first, helped one of the hospital staff—McCall had seen enough of them today to know the uniforms—with a wheeled stretcher.
Cassie was talking, explaining, then she left the first man with the infant and led the second into the recovery room.
Though he was interested in what was happening, and would have liked to see Cynthia being shifted onto the retrieval team’s stretcher and secured for transport, McCall knew he’d only be in the way. He drifted into the changing room, stripped off his paper bootees, then pulled a notebook out of his pocket.
He’d make a list of what he needed to find out from Cassie, starting with males she knew between the ages of twenty and forty—a wide span for serial killers, but better to start big and winnow down the list later.
‘But that’s just about every man between those ages in town,’ Cassie said, laughing at the absurdity of his request.
They were driving towards her home at a little after six o’clock, her day finally over because her resident was now on duty at the hospital.
Doctor and Protector Page 4
