‘Isla.’
‘Anyone else?’ The light was flashing around the vehicle now, taking in every detail, working out the casualties, their positions and the wreckage that encased them, but all the time keeping up what seemed like almost idle chatter.
‘Ted,’ Isla gasped.
‘I’m here,’ Ted responded. ‘Don’t worry about me, just get Isla out.’
‘We will,’ Mike assured him. ‘Is there anyone else in here?’
‘Dougie, he’s the driver,’ Ted answered, his voice flat as the torch flashed towards his colleague. ‘You’re too late.’
‘Did you have any passengers?’ Mike asked and maybe his lack of acknowledgement for Dougie sounded callous, but right now his main priority was to look after the living. Mourning the loss of a fellow emergency worker would come later. Isla and Ted thankfully didn’t know the full extent of the damage, that a car was sandwiching them against a set of traffic lights, that an engine fire had almost taken hold, and with the combination of oxygen tanks and fuel a massive explosion had just been averted. ‘OK, guys, I’m going to get a paramedic and doctor in to you now, then we’re going to get the side off the vehicle—which is going to make one helluva noise, but once we’ve done that we’ll be able to get some of this wreckage away and get you both out.’
‘Which doctor?’ Isla asked, but Mike wasn’t listening. His shadow disappeared, her question apparently irrelevant, but the thought of Sav seeing her unprepared, of him thinking this was just another accident and then seeing her trapped there, was causing Isla more angst than the metal pressing down on her. ‘Which doctor, Mike?’
‘This one!’ It was the second last voice she wanted to hear.
A—Isla thought as her nightmare plunged from horrific into dire, she hated him.
B—from what she’d seen so far, Heath wasn’t the greatest doctor in the world.
And most importantly…
C—if Heath was here, did Sav know?
‘Sav?’ It was her first question as Heath climbed through the shattered window and made his way over slowly, followed by a paramedic who moved directly towards where Ted lay trapped.
‘Sav knows.’ Heath was beside her now, picking up her wrist and feeling the flickering pulse for a moment, then pulling out a cervical collar and starting to apply it.
‘My neck’s fine.’
‘Save your breath, Ramirez,’ Heath said, but she could hear a hint of kindness behind his voice. Once her neck was stabilized and an oxygen mask put on to deliver oxygen, he squeezed her arm just above the wrist in an attempt to bring up a vein. ‘I brought Sav with me—figured you could use a bit of diversion.
‘Sharp scratch coming,’ he added needlessly, because a sting in the back of her hand was the least of her problems. ‘Sav’s outside. As soon as I’ve got you stable, I’ll let him in.’
‘Why did it take so long for help to come?’ Her words were muffled under the mask and she pulled it off. ‘Why did it take so long?’
‘The engine was smoking,’ Heath replied, replacing the mask, but again Isla pulled it off with her free hand.
‘I want nasal prongs.’
‘You need oxygen,’ Heath insisted.
‘Then I’ll breathe through my nose. I need to talk, Heath.’
‘Who was it that said nurses make the worst patients?’ But amazingly he complied, replacing the mask with prongs, watching her oxygen saturation while he carried on talking. Isla dragged in the air through her nose, determined not to be smothered with a mask as he connected IV fluids and hung them on a hook, giving a wry smile as he did so. The IV hook was the one thing in the ambulance that was where it was supposed to be. ‘The first on the scene dealt with the car that went into you—they couldn’t get to the ambulance.’
Isla’s voice wobbled as the full magnitude of the accident started to hit home. ‘Is it a family? Are there children?’
‘I don’t know,’ Heath answered, and Isla had no choice but to believe him. ‘You’re my patient, Isla, you’re the only one I’m worried about right now, and given that you’re my boss’s wife, I’m going to make damn sure you’re OK.’
‘Is Sav OK?’
‘Worry about yourself for now, Isla.’ He was examining her now as best he could with the snarl of metal around her. ‘Where does it hurt most?’
‘My chest.’
‘How are your legs?’
‘OK, I think.’
He shone a torch over down to her feet. ‘Wiggle your toes.’
‘I am.’ She snapped a nervous look up at him. ‘Aren’t I?’
‘You are!’ He gave a relieved smile and Isla even managed a small one back as Heath pulled on his stethoscope, trying to listen to her chest, but the mangled stretcher allowed only very limited access. ‘Poor air entry, but with a stretcher on your chest you’ve got a good excuse.’
He was good, Isla had to hand it to him. Somehow his flip remarks almost reassured her, but even if she’d been away from nursing for an age, some things stayed with you for ever, and the look of controlled urgency in Heath’s eyes needed no translation.
This was serious.
‘How’s my blood pressure?’ Isla asked, as Heath pumped the cuff over and over.
‘Not bad.’
‘In my boots, then.’
‘How’s the pain?’
She hesitated, but only for a second. ‘Bad.’
He was listening to the top of her chest again, trying to slip the stethoscope down further, but the tight band of metal around her chest prevented him.
‘Tell me, Heath,’ Isla insisted. ‘What’s going on?’
‘I’m not sure,’ Heath said finally, but realizing she needed a small dose of truth he relented slightly, understanding she was an emergency nurse, that platitudes would do nothing to reassure her, but the truth wasn’t particularly palatable either. ‘Your air entry on the right is markedly reduced. It could be bad bruising, the pressure of the stretcher…’
‘Or?’ He didn’t answer so Isla did it for him. ‘I could have punctured my lung. I could have a pneumothorax or, worse, a haemopneumothorax. Shouldn’t you put in a chest drain?’ Panic was rising in her now and Heath moved quickly to soothe her.
‘Don’t go there, Isla. Right now, I can’t get in to listen properly to your chest, let alone put a chest tube in, but you’re holding your oxygen saturation with the oxygen. For now we’ll give you fluids and oxygen and in the meantime I’ll get all the equipment ready. We’ll know more when we move the stretcher,’ Heath said firmly.
Despite his assured tones Isla felt anything but reassured. If the stretcher had punctured her lung, it would be as dangerous as removing a knife from a stab wound once the stretcher was lifted. She could bleed out quickly. Even the rapid insertion of a chest tube and a massive transfusion of blood might not be enough to save her.
‘I’m going to give you something for the pain, something to settle you before they lift the roof.’
She would have nodded but the hard collar prevented it.
‘Any allergies?’
‘Strawberries.’
‘Well, luckily we’re in short supply of strawberries at the moment. Do you have any medical conditions I should know about?’
‘No.’
‘Diabetes, epilepsy?’
‘Nothing.’
He was pulling up a vial now, chatting away as he flipped the bung on her IV access.
‘Any chance you could be pregnant?’
‘Not after the stunt you pulled a couple of weeks ago.’ It was a vague attempt at humour as the foggy twilight world of pethidine descended, but Heath carried on talking, asking the questions. ‘When was your last period, Isla? They’re going to do a stack of X-rays when we get you to the hospital.’
‘If you get me there.’ Terrified eyes met his, finally admitting to herself her very real plight. The moments after the stretcher was removed would be the most critical time. If her injuries were serious, and from the way Heath was struggling to fi
nd a BP, from the giddy dots dancing in her eyes and the appalling dry mouth, Isla knew there was a fair chance they were, the moment the metal was removed her trauma would become apparent, and they both knew it.
‘When was your last period, Isla?’ Heath asked again, dodging the real issue.
‘Dunno,’ Isla mumbled, her eyes closing, sweet oblivion creeping in as the pethidine started working.
‘Last week?’
‘Dunno,’ Isla mumbled again, but something in Heath’s voice was dragging her back, forcing her to concentrate, to remember the last time she’d dragged the twins around the supermarket, blushing as Harry had pulled a pile of tampons off the shelf and Luke asking what they were for; to try and pinpoint when she’d scrabbled through the bathroom, tipped out her handbags in an attempt to find that one elusive tampon, to picture in her mind the last time she’d asked Sav to nip to the garage at some ungodly hour.
‘You can buy them without milk, you know.’
‘Sorry?’
‘That’s what the girl at the garage said to Sav. He bought a load of chocolate and about four litres of milk. He couldn’t bring himself to just walk in and buy tampons.’
‘When, Isla?’ Heath pressed, and Isla closed her eyes.
‘I don’t know. I need Sav. Can he come in?’
Immediately Heath shook his head. ‘We’re going to get the side off. Once there’s better access—’
‘I need him, Heath.’
‘Isla, I can’t.’
‘You have to.’ Urgent eyes implored him. ‘You have to, Heath, because you know as well as I do that once the side comes off, once the firefighters come in here with their gear, that could be it for me. He has to be here.’
‘What if it’s too much for him?’
She welcomed his honesty, stared at him through the darkness and prayed she might reach him.
‘He can take it, Heath. He’ll take it better being here with me than being left outside.’
‘Ready, Doc?’ Mike’s voice boomed over the noise of the cutter revving up in the distance, and Isla held her breath.
‘Not yet.’ Heath put up his hand. ‘Dr Ramirez is out there—the consultant. I think he’s the one who should be here when they move the equipment. Could you have someone call him? Bring more blood in as well.’
‘Thank you,’ Isla whispered.
‘Can I be godfather?’ Heath grinned and then he did the nicest thing, slipped off his latex glove and held her hand, skin on skin as they waited for Sav to arrive. ‘You’ll be OK, Isla.’
‘I have to be OK,’ Isla gasped. ‘I’ve got the twins…’
‘And Sav,’ Heath said, squeezing her hand harder. ‘Here he is now.’
There was an appalling wait as Heath left her side, the confined space not enough for two, and Isla dragged on the oxygen and willed herself to stay calm as Heath gave a rapid handover to his senior. She felt more than heard Sav crawl towards her, her one free hand coiling into his as his hand closed around hers. Maybe her eyes had accustomed or perhaps it was a face she was used to seeing in the darkness, but every feature she needed to see was visible, from the dark, knowing eyes to the strong contours of his jaw, every vestige of reserve that had held her together disintegrating now as finally she didn’t need to be brave, finally she could fall.
He was here.
Finally, she could just be.
‘I can’t remember when my last period was.’
Not the most romantic of greetings, but Sav understood, kissing the salty tears that sprang from her eyes, inhaling the scent of her hair as she lay there.
‘I had that wine, that pâté, we went to that—’
‘Hey!’ Even as he spoke he was working, picking up her other arm and getting a second IV line into her. ‘How many babies are conceived on the wedding night?’ Somehow he smiled—somehow, just as he always did, when it really mattered he came up trumps. ‘How much pâté, champagne and rotten moldy cheese floats around then?’
‘But—’
‘Isla, you’re worrying about listeria, foetal alcohol syndrome and a million maybes when the truth of the matter is that you’ve got a bloody stretcher wrapped around you.’
And it was so bizarre it was funny.
But that was Sav.
The one guy who could, in the most dire, the most vile circumstances make her smile.
‘Remember when you were pregnant with the twins?’ He was ripping a unit of blood out of its plastic case, squeezing it into her as he spoke. ‘Remember how I had to hide the textbooks? You had everything from pre-eclampsia to thalassaemia and you’re not even of Mediterranean origin.’ She could hear a machine bleeping, watched as Sav tried not to frown. ‘What the hell’s Heath doing, putting on nasal prongs? I’m going to change you to a mask.’
‘No!’ It wasn’t a shout, her breathing didn’t allow for that, but her voice was urgent. ‘I want to talk, Sav.’
‘Not now,’ he said. ‘Not now.’
‘Yes, now,’ Isla gasped, as Mike appeared again in the window.
‘We’re taking the dashboard off first instead of the side, Doc. We’re getting the front passenger out first and then we’ll be able to get better access to your patient.’
‘No!’ Sav shook his head fiercely. ‘My…’ He swallowed hard. ‘This patient is bleeding, she’s got a query pneumothorax, she needs to be freed first.’
‘The other passenger has just lost consciousness. His respiration rate has gone right down and he’s blown a pupil and needs urgent attention the doctor in charge says…’
‘I’m the doctor in—’ A squeeze on his hand held him back.
‘Let them get Ted out,’ Isla begged. ‘Heath has to be the one to make the call, Sav. You’re too close to be objective.’
‘There’s no such thing as too close, Isla,’ Sav said softly. ‘Not where we’re concerned.’
And he was right.
Because closeness was the one thing that had been missing, and in the most dire of circumstances somehow they’d found it again when it had appeared to be lost for ever.
Closer perhaps than they’d ever been.
Lying in a hellhole, listening to the precarious task of extracting a critically ill patient who happened to be a friend, and colleague as well.
Ted.
As sick as Isla was right now, Ted was worse.
Harsh decisions, emergency triage, perhaps one of the toughest of all asks, because it wasn’t figures you were shuffling, or deadlines you were trying to meet, but real lives and real outcomes that were being decided in limited time, with limited resources.
Not just who lived and who died—that would almost be too easy. The doctor in charge had, in that tiny slice of time, to assess a thousand different things.
Yes, Isla could go first, and maybe Ted would still live.
But a severe head injury without swift treatment would probably render him brain damaged, but with proper treatment, with the pressure on his brain relieved and adequate oxygenation, he might just walk out of the hospital, might just walk back into a life, a job and a family who needed him.
Whose condition needed the most rapid response was the tough call, and Sav couldn’t be the one to make it.
‘Talk to me,’ Isla begged.
‘I love you,’ he soothed, but she shook her head.
‘Please, Sav,’ Isla gasped as they listened to the doctors and paramedics working, the urgent shouts for more blood, the snapping of metal as Ted was prised out. ‘Talk to me.’
It felt like an age, but finally, almost imperceptibly he nodded, and if her oxygen saturation hadn’t been on the wrong side of ninety per cent Isla would have held her breath, but no blessed machine bleeping was going to spoil this moment so she dragged the oxygen into her lungs and waited for him to finally tell her just how he was feeling.
‘I miss him.’ His face buried in her hair, his tears mingling with hers. ‘Sometimes I feel better, sometimes I feel happy for a moment, and then I feel guilty—guilty for being
OK, guilty for being able to smile when my little boy’s dead. I still can’t believe he’s really gone.’
He isn’t gone, she wanted to scream. She wanted to sob in his arms, wanted to wrap her arms around him and hold him tight, but all she had was her voice. ‘He’s there, he’s everywhere, Sav, he’s never going to leave us. I can still hear those songs he used to sing if I listen, hear those little giggles. I can smell him. He still makes me laugh. He isn’t gone—as long as we keep him close he’s here.’
‘I just miss him so much.’
‘I miss him, too,’ Isla said. ‘But I miss you as well, Sav, and so do the twins.’ Her face crumpled, and the nasal prongs were not enough now, the tears so deep she needed every last bit of help just to breathe, not even resisting as Sav slipped the mask over her face. ‘Oh, God, I just want to close my eyes and be with him but I love you all, too. I don’t want us to separate…’
‘But you went to a solicitor, Isla…’
‘I didn’t know what else to do,’ Isla admitted. ‘I wanted change, Sav, and I didn’t know how else to get it.’
‘We’re coming now, Doc.’ Mike’s voice seemed to be coming through a fog, dragging them back to reality.
‘Won’t be long now.’ Sav smiled down, but it faded midway. His face seemed to be blurring around the edges as he stared down at her, one hand held high above where she lay, squeezing the blood through. The blood-pressure machine alarm started as her blood pressure plummeted so dangerously low that it couldn’t pick up a reading. Sav pulled on his stethoscope, used the old method, as Heath had.
‘I need her out.’ Sav’s voice was urgent. ‘I need help in here now!’
And it should have been scary, should have been the most frightening time of her life, but inexplicably it wasn’t. She’d been through more pain than any mother ever should, nothing could now hurt her. And she’d never felt more tired. Sav’s beautiful face wasn’t quite enough to keep her eyes open. It would be so much easier to say goodbye to the pain and the agony, the sweet thought of just closing her eyes, of seeing Casey, her baby, her little boy, just a tiny step away.
Emergency--A Marriage Worth Keeping Page 13
