by Leah Martyn
‘Terry McNamara,’ the young teacher introduced himself. ‘John said maybe you could use an extra pair of hands.’ He moved to where Riley had begun hauling his ropes from the rear section of the Land Rover.
‘We’ll need to rig up a pulley system.’ Riley’s voice was clipped.
‘Piece of cake.’ Terry looked about him keenly. ‘I’ll go up the tree and position myself above you. That way I can feed you the rope and control your descent to young Max. OK?’
Relief showed in Riley’s face. He even managed a faint grin. ‘Not far short of brilliant, Terry. You’re an ace. We’ll need another ladder for starters.’
‘Should be one in the garden shed.’ The young man dashed away.
Jane began steeling herself for what she had to do. She slung the emergency pack over her shoulder and began moving carefully up the ladder, steadying herself on the third rung from the top.
‘What do you want me to do, Doc?’ The grounds-man was visibly tense from his efforts to try to hold the boy still, sweat seeping out from under his broad-brimmed hat.
‘Just stay where you are.’ Jane strove for calm. ‘You’re doing beautifully. My name’s Jane,’ she said quietly. ‘What should I call you?’
‘Mick’ll do fine. Poor little beggar.’
There was room to manoeuvre—just. Jane was conscious of toning down her movements, doing everything in slow motion. She daren’t fall…
Gently and carefully, she began assessing her small patient, reassuring him over and over. She wasn’t surprised to find that his skin was cold and clammy, indicating shock. But his pulse and blood pressure were better than she’d feared, raised but stable. She could safely administer the painkiller and anti-nausea drugs.
She chose a wide-bore cannula, swabbing the skin and deftly sliding it into place. She was taking no chances here. If the child began bleeding or suddenly went into shock, they’d need to run through high-volume fluids to resuscitate him.
But as long as the foreign object stayed where it was in Max’s arm until it could be safely surgically removed, the little boy was reasonably safe from haemorrhaging.
With a practised eye, she estimated the child’s weight, deciding to administer 2 mg of morphine and 5 mg of antiemetic. If Riley agreed, they’d follow up with midazolam, which would act as a light anaesthetic. Added to that, the drug’s amnesic properties should help combat post-traumatic shock and ease the young boy through the ordeal he was currently experiencing.
‘We’ll have you out of here soon,’ Jane soothed, placing a light absorbent pad around the child’s injured arm. Heavens, I should qualify as a circus performer, she thought ruefully, leaning her weight into the ladder while she used both hands to position a space blanket over the boy.
‘I wouldn’t have your job for quids, Doc.’ The groundsman looked on in awe. ‘Whatever you’ve given him, it’s startin’ to work. I can feel him going a bit limp, like.’
Jane gave the ghost of a smile. ‘He’s beginning to relax, Mick. That’s what we’re aiming for.’
Like a bolt from heaven, Riley appeared, swinging through the tree branches towards them.
Jane looked wryly at Mick. ‘Enter the cavalry.’
‘Geez! I’d have bet it was Tarzan.’ He grinned.
Between them, they’d win this battle. Already, with Riley’s arrival, Jane could feel the crippling responsibility dropping from her. And if, as a medical professional, she felt relief, she could only imagine what Mick must be feeling. For a layman, he’d acted superbly and courageously in what had been an extremely difficult situation.
Within seconds, Riley had relieved Mick. Sitting suspended in his harness, he’d eased the burden of the child across onto his lap. ‘Well done, both of you,’ he said quietly. ‘Janey, get ready to administer the midaz. We’ll pop on the O2 mask, and as soon as he drifts off I should be able to get an airway in.’
‘The Fire and rescue lads are ten minutes away,’ John Abbottsford relayed from the foot of the tree.
‘I hope to God they’ve had the forethought to bring hydraulic cutters,’ Riley growled. ‘After all this, we don’t want the kid shaken to blazes.’
‘Have you got the airway in?’ Jane’s concern was more immediate.
‘Almost there…Right, it’s done. With a bit of luck—and, heaven knows, we’ve earned it—he’ll be fully out of it by the time the rescue guys get here.’
At last Max was cut free. The fire and rescue team had arrived well prepared. Skilfully using hydraulic cutters, they’d severed the wrought-iron spike, freeing the small arm from the fence’s cruel hold.
At the foreman’s signal that the mission had been successful, a subdued cheer went up, and from his anchor in the tree Terry payed out the guide rope, lowering Riley and his precious cargo to the ground.
‘Nice work, folks.’ The ambulance crew had arrived in time to witness the rescue. ‘We’ll take over now.’
Gently Max was stretchered into the waiting ambulance, one officer supporting the little injured arm with the foreign object still in situ.
‘Do you want to go with him, Riley?’ Jane caught his hand urgently and felt his fingers tighten on hers.
Riley shook his head. ‘We’ve about done all we can do. Apparently the father’s arrived for a signature and the surgeon’s scrubbed and ready. But I would like to top up the midazolam before the ambos take off.’
Jane nodded. ‘And to be doubly safe, we should put up IV fluids and run it through stat.’
‘Let’s do that.’ Riley’s mouth compressed. He turned to his wife, increasing the pressure on her fingers. ‘You did great, Janey.’
‘Oh…’ She swallowed, feeling warmed by his praise, but appalled when her eyes filled. ‘I guess we all did.’
They were quiet on the way back to the medical centre. Finally, Riley asked, ‘You OK? You look pale.’
Jane gave a cracked laugh. ‘Well, it was hardly a typical start to the day, was it? And I’ve gone and missed out on my coffee and muffin break,’ she added facetiously. After a second she went on, ‘Max will make it OK, won’t he, Riley?’
‘Lord, yes. The arm will be a bit iffy for a while, but kids spring back remarkably quickly. We’ll check on his progress later today.’ He sent her a brief enquiring glance. ‘What time is it?’
‘Just after eleven.’
‘Think Ralph and Angelo will have seen all our patients by now?’
‘Don’t bet on it. I guess there’ll still be one or two left for us.’
Riley slowed as they approached the practice. ‘I need a quick shower before I see anyone. What about you?’
Jane shrugged. ‘I’m OK. I wasn’t scrabbling around on ropes and flying through tree branches, like you.’
Riley gave a noncommittal grunt. ‘It’s years since I’ve done any abseiling.’
Jane felt suddenly guilty. He’d given it up when they’d married. Because she’d asked him to.
‘We’ve been expecting you for ages.’ Vicki swooped on them as soon as they walked into Reception. ‘Was everything straightforward?’
Jane and Riley exchanged amused glances. ‘Just about,’ Riley understated dryly. ‘Any coffee going, Vick?’
‘I’ve kept topping it up. I guessed you’d be dying for a hit.’ She grinned disarmingly, following them through to the staffroom. ‘There are several patients each left for you.’ Vicki was professionally brisk as she dispensed coffee to the two doctors.
‘Would you mind stalling mine a bit longer while I have a quick shower, please?’ Riley began rolling back his shoulders, relieving muscle tension. ‘Thanks.’ He took the coffee from Vicki’s outstretched hand and, turning abruptly, disappeared upstairs to his flat.
Watching him go, Jane clamped down on a kaleidoscope of feelings. ‘Mmm, that’s good, Vick.’ She drummed up a quick smile and drank thirstily. ‘You’ve really got the hang of the new coffee-maker, huh?’
‘Changed the brand of beans.’ Vicki shrugged casually. ‘Uh…Jane?’ The r
eceptionist looked faintly ill at ease. ‘There’s a new patient who’s asked to see you this morning. Simon Cawley came into the surgery.’
‘Simon Cawley?’ Jane’s brows rose.
‘Mmm. But I used my initiative.’ Vicki paused for effect. ‘I told him I’d have to let him know whether you were taking on any new patients. I know that’s not strictly according to the rules, but I thought I should check with you first. I mean, he’s screwed up, isn’t he?’ she elaborated with youthful candour.
‘Did he seem screwed up?’ Jane asked with faint bemusement.
‘Well, no. He seemed pretty together, actually.’
‘Then I’ll see him.’ Jane drained her coffee. ‘How soon can he get here?’
‘Few minutes. He’s living in one of those flats near the train station.’
‘Fine. I’ll see him at the end of my list. Just give me a few minutes to freshen up, Vicki, then send in the first patient, would you?’
Jane saw out the last of the three patients who’d been waiting then, inhaling a deep breath, she picked up the phone and dialled the number that would connect her to Riley’s consulting room. ‘Hi, it’s me,’ she said breathily, when he answered. ‘Can you talk?’
‘Yep. What’s up?’
Not encouraging. She bit her lip. It had been a reflex action to seek out Riley as a sounding board instead of either Ralph or Angelo. She didn’t dare stop to ask herself why. ‘Simon Cawley has asked for an appointment with me. I’m about to see him.’
She heard Riley’s swift intake of breath. ‘That’s a turn-up. Do you want me in there?’
‘No, of course not. Vicki said he seems relaxed enough and I’ve no reason not to see him…’
‘No, but just watch how you go, Janey. And I’ll be around if you need me—make an excuse and nip out to Reception or something.’
Jane gave a jagged laugh. ‘Aren’t we being a touch dramatic, Riley? The man hasn’t opened his mouth yet.’
‘Hey, you can’t be too careful. You did the right thing in letting me know.’ He hung up abruptly.
Far from being aggressive, Simon Cawley appeared rather tentative when he took a seat at Jane’s request. ‘Thank you for seeing me, Dr Rossiter. Leanne has had only good things to say about your treatment of her and James,’ he said by way of opening.
Jane gave a mental sigh. She just hoped Simon wasn’t in her consulting room under false pretences. Like all doctors, she was bound by the rules of confidentiality. Anything Leanne had discussed with her had to remain just that—confidential.
‘I’m concerned about this rash I have.’ Simon proceeded to roll up the legs of his jeans to exhibit the scaling patches on both knees. ‘It’s as itchy as all hell. Driving me nuts.’
Poor man. Jane was immediately sympathetic. His skin looked a mess, shiny, red and sore. ‘Do you have it anywhere else, Mr Cawley?’
‘Elbows,’ he said economically. ‘And maybe on my scalp.’ He gave Jane a level look. ‘I know it’s not dandruff. I’m meticulous about personal hygiene.’
‘I’m sure you are.’ Jane got to her feet. ‘Just pop up on the couch for me, would you? I’ll have a closer look under the light but I’m reasonably certain you have a condition known as psoriasis.’
Jane’s examination confirmed her suspicions but, as it was Simon Cawley she was dealing with, she decided to leave no room for error. ‘Psoriasis has many subtypes,’ she explained to her patient, ‘so to be quite sure what we’re dealing with, I’ll perform a biopsy, which means I’ll take a sample of the affected part of your skin and send it off to pathology. We’ll do that in the treatment room so you’ll be more comfortable.’
‘This psoriasis thing…’ Simon sat up, swinging his legs over the side of the couch. ‘Is it like dermatitis?’
‘Well, that the general name for inflammation of the skin. I’m afraid psoriasis tends to be chronic. We can treat it and sometimes the condition disappears but then just as unexpectedly it can recur.’
‘So I’m stuck with it.’ He slid his feet to the floor and resumed his chair.
‘We’ll try to manage it as best we can.’ Jane stripped off her gloves and washed her hands at the basin. ‘We’ll start with a steroid cream. That should give you some relief.’ She went back to her desk and began to enter the prescription details on her computer. ‘As for your scalp, there’s a preparation you can get over the counter at the chemist. It’s similar to a shampoo.’ She scribbled the name of the product and handed him the slip of paper. ‘If the treatment needs to be changed when the results of the biopsy come back, we’ll act accordingly.’ She activated the printer and waited while technology did its job.
Simon folded his arms across his chest, his fair head bent questioningly towards Jane. ‘Is there some reason why I would have contracted it now at my age?’
‘Psoriasis does appear to be more common as age increases.’ Jane handed him the printout of the prescription. ‘The frustrating factor appears to be what works for some has negative results for others.’ She smiled wryly. ‘For instance, one patient I had swore that frequent trips to the coast to swim in the salt water and bake in the sun did wonders for his psoriasis. Mind you, he used the opportunity to visit the casino while he was there as well.’
Simon ignored Jane’s small attempt at levity. Instead, he frowned. ‘Is there something I’ve done or not done to cause it?’
Jane appreciated her patient’s right to know all he could about his condition, but with his background of volatility, warned herself to tread softly and nonjudgmentally.
‘Stress and illness are often triggering factors, Mr Cawley. Sometimes certain foods—’
‘I’d qualify for the first one,’ he broke in with a snort. ‘I know I’m a real nerve-worker.’ His mouth compressed. ‘I never used to be.’
Jane waited. ‘I was able to see Leanne at the hospital this morning.’ He shifted uncomfortably. ‘I told her I really want us to put things back together.’
‘Well, that has to be a joint decision between the two of you,’ Jane said carefully, her thoughts sober. She wouldn’t want to be in his wife’s shoes for anything.
Simon leant back in his chair and steepled his fingers, studying them intently. ‘Leanne hasn’t said no.’
‘Then all I can advise you is to keep talking to each other and ask for professional help if you need it.’ Jane sent him a contained little smile and got to her feet. ‘Now, if you’re ready, we’ll get that biopsy organised.’
Riley was hovering when Jane walked Simon Cawley through to Reception. She gave her husband the merest signal that all was well, before turning to her patient. ‘Give me a call towards the end of the week. I should have the lab results back by then. And we’ll go from there.’
‘Uh, thanks, Doctor.’ Simon rocked on the balls of his feet for a second, looking as though he wanted to say something else but changing his mind. ‘Thanks,’ he repeated, turning abruptly to cross to the counter to sign the form to discharge payment for his visit.
Jane went back to her consulting room. Her stomach rumbled, reminding her it was well and truly lunch time. Hefting her bag onto the desk, she shoved in a few leaflets which might be of interest to the residents of the women’s shelter. Should she grab a quick sandwich and make her visit now or later? Decisions, decisions, she mused as a tap sounded on her door.
‘Come in,’ she called, her heart turning over when she realised it was Riley.
‘How did it go with Simon Cawley?’ he asked without preamble, crossing to make himself at home on the edge of her desk.
‘Quite well, I think. He’s obviously pretty strung out but holding himself together.’
Riley made a sound of impatience. ‘How long does he expect to go on like that?’
Jane lifted a shoulder. ‘He has psoriasis.’
‘Poor devil.’ Riley frowned. ‘Stress-related?’
‘I’d say so.’ She looked up. ‘Actually, I felt rather sorry for him. He seems to be trying very hard to get back
with his wife.’
Riley’s mouth worked for a moment. ‘Well, I can identify with that,’ he said quietly.
Jane carefully avoided his eyes. ‘That’s hardly fair, Riley.’
‘I know.’ He held out his hand to her and she took it, allowing him to draw her closer. ‘I’m a lousy candidate as far as patience goes.’ His smile was wry and crooked.
‘I’m not being difficult.’ Jane looked at their interlinked hands. ‘I can’t rush things, that’s all.’
He sighed and held her for a moment, then eased away. ‘What about having lunch with me, Janey? Is that rushing things too much for you?’
Her eyes widened. ‘Lunch? Where?’
‘Upstairs in the flat?’
‘But what will everyone say?’ She bit her lip, absently twisting her wedding ring.
‘Everyone isn’t invited.’ His fingers tipped her chin, bringing her gaze up to meet his. ‘I’ve got soup.’
She looked dubious. ‘Did you make it?’
‘Uh-uh.’ His smile glinted briefly. ‘Not this time.’
Jane felt her senses sharpen and then immediately felt a pang of guilt. If ever she and Riley were to move forward, she’d have to try not to suspect a hidden agenda behind his every action. In other words, she’d have to learn to trust him again. ‘All right, then.’ She manufactured an uncertain little smile and picked up her bag. ‘Lead on, Dr Brennan. I’ll take my chances…’
CHAPTER FIVE
THE soup was a garden-vegetable variety, thick and tasty. Riley placed a wholemeal cob loaf on the table and they pulled off chunks to eat with the soup. It was some moments before either felt the need to speak.
‘Another?’ Riley’s look was softly indulgent as Jane finished off her bowl of soup.
‘No, I couldn’t, thanks.’ She shook her head. ‘It hit the spot, though.’
‘More bread, then?’
She gave a shaky laugh. ‘Perhaps. It’s lovely.’
‘Mmm.’ His mouth compressed for a second. ‘I nipped out early this morning. The bakery opens at seven, did you know?’
