‘A bit.’ Annie smiled, slightly taken aback that he’d actually deigned to talk to her. ‘Do you need a hand with anything?’
Silly question, she thought as he shook his head. ‘I have an eighteen-month-old with an inhaled foreign body—it’s a partial blockage.’
‘Bring him over,’ Annie said, ready to make room even if they didn’t have any. A partial blockage to the airway could change in a matter of seconds but, despite the urgency of the situation, Iosef shook his head.
‘I have rung the thoracic surgeons. They are in theatre, operating, but are going to send someone down. I think moving him over to Resus will only distress the child and that’s the last thing I want.’ With good reason, too, Annie thought as he placed the chest X-ray on the viewfinder and frowned at the precarious position of the foreign body. The object could move and the situation become potentially life threatening—everything possible needed to be done to keep the baby still and calm until the object could safely be removed by the surgeons. ‘Get everything ready in case he fully obstructs. If he does, we’ll bring him straight over…’ Iosef continued picking up the telephone and barking his orders to the switchboard operator, peering at the X-ray again through narrowed eyes as he spoke at length to the thoracic surgeon while Annie quickly set up an emergency tray—a laryngoscope to allow clear vision of the larynx, McGill’s forceps to pull out the foreign body—and pulled in a trolley ready for the toddler should they need it. ‘I am going to take him straight up to Theatre—they’re expecting him now. He can sit on Mum’s knee on a wheelchair. But I want a porter to push the trolley and resus equipment should I need it on the way. I’ll also need a nurse to come.’
‘Fine.’ Annie nodded, pressing an intercom button and summoning the porter then loading up the trolley with the equipment she had gathered. ‘I’ll just let Cheryl know that I’m—’
‘Beth…’ Ignoring Annie, Iosef called out to her colleague as she raced past. ‘I want you to come up to Theatre with me.’
Surplus to requirements again.
Though it made sense. After all, yesterday when Beth had been in charge of Resus it had been she herself racing around the hospital, and Beth had no doubt already had contact with the child out in the cubicles, but it was the way Iosef again dismissed her that irked Annie.
Not that there was time to dwell on it.
Space needed to be cleared in Resus and after a rather terse conversation with ICU, Annie dispatched Melanie to take up a patient with a severe head injury who had commandeered most of the morning and now that her chest-pain patient was more settled, a semblance of order was finally taking shape.
For about ten seconds.
‘Fifty-seven-year-old male….’ Geoff, the paramedic, gave a running handover as they rolled the stretcher along the polished floor. ‘Liver cancer with secondary mets. Started seizing at home, private nurse present, she’s just giving details at Reception. The wife’s following in a car. He was given rectal diazepam but…’ He didn’t need to elaborate as the frail body on the stretcher started convulsing again, the grey tinge to his face becoming more deeply cyanosed as the paramedic wrestled with the straps and the patient was lifted over.
Annie transferred the portable oxygen to the wall outlet and was attaching monitors as Jackie, seeing what was going on, kicked over the drug trolley and started pulling up drugs. ‘Thanks, guys,’ Jackie said as the paramedics, always happy to help out, held a jerking arm still while she administered anti-seizure medication.
They continued to relay the story. ‘He’s supposed to have been transferred to a palliative care ward of a private hospital, but the wife wants him at home. He’s been having prolonged seizures but they normally respond to the diazepam. This one went on for ages and the wife wanted him bought in.’
‘We need a full history,’ Annie called after Geoff, who was heading to register the patient at Reception. ‘Tell whoever’s on Reception to drop everything, that we need it urgently. Do you want an anaesthetist?’ she asked Jackie, trying to suction the patient with one hand and pull the phone out of her apron with the other.
‘Let’s get the history first,’ Jackie said. ‘I don’t want to intubate him if it turns out he’s not for resuscitation.’
‘One other thing.’ Eric, the second paramedic, was sweating with the exertion of holding the arm still as Jackie shot in more drugs. ‘The wife says that his son’s a doctor here. This is Ivan Kolovsky…you know, the fashion designer?’
Jackie’s eyes met Annie’s just as Beth breezed in.
‘Need a hand?’
‘Where’s Iosef?’ Jackie asked, adding more medication to an IV flask as Annie suctioned Ivan’s airway. His eyes had rolled back in his head, his body exhausted from seizing for so long.
‘On his way. He was just talking to the thoracics. Why?’
‘Meet Mr Kolovsky!’ Jackie said with a dry edge. ‘Annie, you go and tell Iosef what’s happening—preferably before he walks in here. Beth—give me a hand.’
Clearly Iosef hadn’t hung around to make small talk with the thoracics because as Annie sped out of Emergency, hoping to meet him in the corridor and forewarn him, they practically collided at the glass automatic doors.
‘Iosef…’ Annie called as he marched past without even a cursory glance. ‘Can I have a word?’
‘I’m busy.’ He didn’t even turn his head to call it over his shoulder.
‘I need to talk to you!’ she snapped loudly, angry that he made everything so difficult, angry that he was so rude, and nervous at what she had to tell him!
‘Well, make it quick. I have a lot of work.’
He just stood there—stood there right in the middle of the corridor, didn’t move near a wall, didn’t duck into the quieter reception area, didn’t do a single thing to make it easier—just tapped his well-shod foot impatiently as Annie took a deep breath. ‘Could we go somewhere a bit more private?’
‘Why?’ He frowned.
‘Because I need to discuss a patient with you.’ Her cheeks were burning under his scrutiny and out of the corner of her eye and behind his shoulder she could see a rather glamorous mob spilling into Reception, who had to be related to him! ‘And I don’t think the corridor’s a very appropriate place.’
He gave her a thoroughly bored, thoroughly superior look as if to say there was nothing she could possibly tell him that he didn’t already know, but at least he did take a few sideways steps into the IV cupboard and stood there shrugged up against the wall as Annie closed the door and flicked on the light.
‘Your father’s just been brought in.’ Direct and straight to the point she gave him the news and equally as direct and straight to the point he asked her a question.
‘Is he dead?’
‘No, but he’s convulsing and we’re having a lot of trouble stopping that.’ She watched his face for a reaction, but it was utterly unreadable, and in all her years of nursing, all the times she’d broken bad news or difficult news or any sort of news, never, not even once, had anyone shown so little response—not a single flick of his eyes, not one tense swallow. Annie could only liken it to dashing to the shops at six p.m. and finding a ‘Closed’ sign on the door, not a ‘Back in five’ sign, not even ‘Back tomorrow’. Peering into the windows of his soul, all she could see was nothing, just nothing, as if every shelf had been stripped bare.
‘Thank you.’
He didn’t ask for more information, didn’t ask anything of her, just turned and opened the door and headed for Resus. Annie followed him, the rather breathless anaesthetist arriving a second after them, but Iosef took immediate control.
‘He is not to be intubated. He is a terminal patient and for palliative care only.’
‘We’re just waiting on his notes.’
‘His notes are at the private hospital,’ Iosef responded, picking up a wall phone and tapping in a number. ‘I will get his oncologist to speak with you now.’
‘Thanks.’ Jackie gave a grateful nod. It was excru
ciatingly hard dealing with a colleague’s relative, especially one so sick, and it would be far easier to go through his history and prognosis with his doctor rather than his son.
‘He’s stopped seizing,’ Annie said.
The tiny spasms in his hands, the flickering of his eyelids, had ceased now and Ivan fell into a heavy postictal state, his exhausted body dragging in air.
Jackie spoke to Iosef. ‘His stats are dire and his respiration rate is dangerously low.’
‘I can see that.’ He flicked a light in his father’s eyes, examining him carefully, and it could have been any other patient except that he spoke to the unconscious man in Russian, checking his reflexes before replacing the blanket. The only time his shoulders tensed, the only time she saw his jaw clench was when the family was ushered in, the receptionist apologetically introducing Nina Kolovsky whose loud, throaty sobs filled the room.
‘I asked if she’d wait in the interview room,’ Kath, the receptionist, said to Jackie as Nina’s knees buckled at the sight of her husband. ‘She insisted that she be with him.’
‘That’s fine, Kath,’ Iosef said, then spoke in Russian to his mother, abrupt words that halted her tears but had her arguing loudly with him. But Iosef wasn’t having any of it, taking his mother firmly by the elbow and leading her outside as Jackie spoke at length on the phone to the oncologist across the city before hanging up.
‘He’s not for intubation or resuscitation,’ Jackie relayed. ‘Iosef has been trying to get Nina to have him admitted to a palliative care ward, but so far she’s demanding that he be nursed at home. The ward here is more than happy to take him as, frankly, I think he’s way too ill to be transferred—let’s wait and see what Iosef has to say.’
Not very much.
After just a few moments he returned, his face a touch grey now but his voice extremely steady when he spoke.
‘My mother saw something on the news last night about a treatment.’ He shook his head at the hopelessness of it all. ‘She refuses to accept that he is dying—even with round-the-clock nursing and his doctor coming in, she panics all the time. She does not want him to be admitted to the private hospital, but he cannot stay at home like this.’
‘I don’t think he’s well enough to be transferred anyway,’ Jackie said softly. ‘Iosef, would you like to come to my office? We can—’
‘That will not be necessary.’ Again he shook his head, rubbed the top of his forehead with his index finger for a few seconds as he stared at this father, and for no apparent reason Annie felt a well of tears in her eyes, knew, knew that despite his cool demeanour, despite the fact he appeared supremely in control, detached even—somewhere deep inside this had to hurt. ‘I will ring his hospital and have him admitted to their medical ward. I should be able to get her to agree to that and perhaps then we can discuss getting him transferred to the palliative care ward.’
‘Iosef,’ Jackie said slowly, ‘I’ve told you—he’s not well enough to go in an ambulance.’
‘I am well aware of that.’ Grey eyes held Jackie’s. ‘I am also aware of the circus this will become once the media find out that he has been admitted. The private hospital is better equipped to deal with that. I also know my family, Jackie, and this is the only way I can think of to get my father the care he needs at this late stage. So give me whatever it is I need to sign and I will escort him in the ambulance.’
Which didn’t leave much room for manoeuvre.
Still, by the time the ambulance arrived, it felt like every Russian living in Melbourne had trooped through Resus to pay their respects. Ivan Kolovsky was propped up on pillows, sipping lukewarm tea through a straw and cursing in Russian as Annie did his final set of obs before he headed off to the private hospital.
‘What’s he saying?’
‘You don’t want to know.’ Iosef gave a dry smile.
‘Tell me.’ Annie grinned. ‘I won’t be shocked.’
‘Oh, you would…’ His eyes actually held hers, beautiful, beautiful grey eyes that had a tiny swirl of navy around the outer rim of his iris, and she was grateful for what came next, grateful that what he said could allow for the pink flush that came to her cheeks as she held his gaze. ‘No one can insult like a Russian.’
‘I’d already worked that one out!’ Annie retorted, and for the first time they actually shared a smile.
Even though the department was busy, it felt empty when Ivan went—or rather when Iosef went with him. Even though every bed in Resus was full, for Annie it felt…
Empty.
As if she’d walked into the lounge and watched five minutes of the most amazing film only for the power to cut, leaving her feeling like she was missing the most vital piece of the picture. So, when her shift was over, she was unusually reluctant to leave, standing idly flicking through a magazine and chatting to Jackie.
‘It must be hard on him.’ Turning the pages, Annie paused and stared at a very grainy exclusive photo of Levander Kolovsky’s new baby which had clearly been taken through a very long lens. ‘I mean, imagine having your father so sick and having to worry about the press getting hold of it.’
‘We’ve already had a load of enquiries from the press.’ Jackie yawned, stretching and moaning in a chair at the nurses’ station and, annoyingly for Annie, again changing the subject back to her wedding.
‘I’ve had the worst day! I told you about my cousins, didn’t I?’
‘You did,’ Annie sighed.
‘How they could have left it till now to book a flight, I simply don’t know…’ Annie felt her heart skip a beat as Iosef returned, swishing through the swing doors and looking so cranky and exhausted and gorgeous she had to stop herself from jumping up and greeting him, her mind flitting in and out of the conversation as Jackie droned on and on about her blessed wedding preparations! ‘I mean, they’ve known for months when the wedding is. Well, if they think I’m going to sit on the computer tonight, trying to find the cheapest one left, they can jolly well think again—I’ve got enough on my plate. The florist is—Oh, hi, Iosef, how is he doing?’
‘Cantankerous!’ He gave a tight smile. ‘But yet again he surprises us all. He wants to be discharged, they’re trying to persuade him to stay till the morning. How are things here?’
‘All yours! I’ll be back at midnight.’ Jackie rolled her eyes and handed him a stack of pagers. ‘Can you make sure you’re here at eight sharp tomorrow morning? I’ve got to get to the caterers.’
‘Of course.’ Iosef nodded.
‘Did you try that wine?’
‘Sorry…’ Annie caught his frown, watched, annoyed at Jackie, as Iosef clearly had to drag his mind back to her strange train of thought.
‘The one I told you about. You know I think it might just be a touch too sweet. I mean, when I tasted it I thought it was fabulous but now I’m starting to worry that it might be a bit overpowering.’
‘It’s great!’ For the second time that day he caught Annie’s eyes, even gave a thin smile as she winced in apology for her colleague. ‘You’ve made an excellent choice.’
‘Really?’ Jacked asked earnestly, but didn’t wait for an answer, and Annie let out a long breath as she hurried off. They stood in awkward silence for a very long minute, until finally, bravely, Annie broke it.
‘She’s really not like that normally.’
‘It’s fine.’
‘No, it’s not,’ Annie contradicted him. ‘That was horribly insensitive.’
And at that point she expected him to turn his back—terminate the conversation as he always did, be the Iosef he always was with her. But maybe he was tired, or maybe he just needed to talk. She couldn’t really identify it couldn’t really, no matter how she replayed it later that night, define the moment, define how it felt, when, for the first time, he not only prolonged a conversation with her but actually let her glimpse a little piece of him.
Actually, called her by her name.
‘I grew up with insensitive, Annie. Really, I don’t need J
ackie feigning concern.’
‘Still…’
‘Honestly—it’s not a problem.’
‘Do you want a coffee?’ Annie offered, though she’d sworn she never would, but he looked so tired and his mind must surely be all over the place—it seemed the right thing to do. ‘I can grab you one before I go.’
He pulled a face. ‘No, thanks. I’ve had about twenty today.’
‘Fine…’ she hitched her bag higher on her shoulder before she turned to go. ‘I am sorry, today must have been…’ She struggled for the appropriate word and settled for the only one she could think of. ‘Hard.’
‘You know, there is something you could do for me.’ He wasn’t looking at her, instead he was looking at her bag—or rather the massive sun-dried tomato and herb flavoured pretzel peeking out of it, which she’d bought in a moment of weakness. ‘I’m starving and I don’t have any change for the machine.’
‘Enjoy…’ Annie grinned, handing the shiny packet over.
‘You don’t mind?’
‘Not at all,’ Anne said, and patted her stomach. ‘In fact, you’re actually doing me a favour.’
CHAPTER THREE
ONE more day…Increasing the speed and elevation on the treadmill, Annie took a slug of water from her bottle and nearly lost her footing as she pounded the rubber.
Every morning she’d resisted the overwhelming temptation to hit the snooze button. As an added incentive she’d hung the beastly dress on her curtain rail, and it had served its purpose—the dark slender silhouette the first thing she peered at in the morning.
And with any luck it would have had some effect because tomorrow was Friday.
One more day of waking at the crack of dawn and joining the strange specimens of human life who actually seemed to enjoy being here.
She’d been one of them once.
Six a.m. wasn’t the best time for introspection perhaps, but walking and not moving was doing her head in, and watching the swimmers slicing the water below wasn’t exactly riveting viewing.
She’d been scared when Melanie had suggested that she crash-diet.
Billionaire Doctor, Ordinary Nurse Page 3
