by Sarah Morgan
‘Pulse is two hundred and twenty,’ Lara said, her eyes flickering to the monitor as she swiftly and competently attached the electrodes to the patient. ‘Do you want me to call the cardiologists?’
Christian looped the stethoscope back around his neck and gave a swift nod. ‘Please.’
Ellen clutched his arm, her outward appearance of calm slipping. ‘Am I having a heart attack?’
‘We need to perform some tests before we make a diagnosis, but I don’t think you’re having a heart attack, Ellen.’ His gaze flickered to Lara just as she switched on the machine. ‘Are you ready to do a trace?’
‘Coming right up.’
Ellen gave a whimper and shifted on the trolley. ‘I feel all sweaty and clammy. Oh, God, something awful is happening, isn’t it? I knew I’d been working too hard lately.’
‘Try not to panic,’ Lara murmured, but Ellen didn’t even look in her direction. It was clear that all her hope for the future was fixed on Christian, who was studying the ECG machine. It purred softly as it produced a trace and he watched for a moment, his eyes narrowed. ‘Her ECG is showing regular narrow complex tachycardia with retrograde P waves.’
Interested, Lara leaned forward to take a closer look. ‘Mmm. There’s a shortened PR interval and a delta wave.’
Christian glanced at her in astonishment. ‘Yes,’ he murmured, ‘there is.’
‘So…’ Why was he staring at her? ‘Do you want to try adenosine or go straight for cardioversion?’ She knew that some doctors were reluctant to give adenosine in the emergency setting.
He was still staring. ‘We’ll give her 6 milligrams of adenosine by rapid IV push and see if we can get her back into sinus rhythm.’ He paused and she nodded to indicate that she understood that there was always the chance that the patient might develop a life-threatening arrhythmia.
‘So we’ll just have this within grabbing distance,’ she said quietly, moving the defibrillator next to the trolley.
Then she prepared the drug and handed it to Christian, who checked it and inserted the syringe into the venflon.
‘What’s happening?’ Ellen moaned, rubbing her hand over her chest. ‘What’s happening?’
‘Ellen, the conduction system of your heart isn’t working properly and your heart is being overstimulated. That’s why you’re feeling the way you are. The drug I’m giving you should prevent some of the electrical impulses getting through and slow the heart.’ Christian depressed the syringe to push the drug into the vein then dropped the empty syringe onto the tray next to him.
‘I’ll do you a rhythm strip,’ Lara said, programming the ECG machine and then standing to one side so that he could see the printout.
Ellen gave a sigh. ‘I’m feeling a bit better. But my face feels really hot.’
‘That’s a side effect of the drug we just gave you. Nothing to worry about.’ Christian’s gaze flickered to the monitor. ‘I’m going to refer you to the cardiologists, Ellen. They’ll want to do some more tests.’
‘Do you know what’s wrong?’
He looped the stethoscope back around his neck. ‘The electric currents that control your heart aren’t working properly. Put simply, they’re taking a short cut.’
‘I’m a lawyer. I don’t need the simple version.’
Christian studied her for a moment. ‘All right. Do you know anything about normal conduction pathways in the heart?’
‘No, but I’m a fast learner.’
Christian pulled a piece of paper and a pen out of his pocket and swiftly drew a diagram. ‘In the normal heart, electrical impulses start in the sinoatrial node in the right atrium—the atria are the chambers at the top of your heart—’ his pen flew over the page to illustrate his point ‘—and pass through the atrioventricular node to the ventricles in the bottom of your heart. The atrioventricular node limits the electrical activity that passes through to the ventricles and acts as a break on the heart rate. That’s what happens in the normal heart.’
Ellen looked at the drawing and gave a hollow laugh. ‘And that’s not me, right?’
‘Sometimes there’s an extra electrical pathway that bypasses the normal process and conducts electricity at a higher rate—there’s no filter, if you like. The result is that the heart can beat very quickly and that causes the symptoms you felt today.’
Lara studied the ECG again. ‘If she has an accessory pathway, why does the QRS complex look normal?’
‘Because ventricular depolarisation can occur through the normal pathway. It’s a combination of pre-excitation and normal conduction.’
‘You’ve lost me.’ Ellen sighed. ‘So how did I get this extra pathway? Was I born with it?’
‘Yes, it’s congenital. Some people have more than one. Basically it happens when the atria and the ventricles fail to separate completely.’
‘But why hasn’t it been picked up before?’
‘Because the majority of the time the normal pathway is used.’
‘And can it be fixed?’
‘Extremely successfully.’ Christian folded the ECG strip and attached it to the notes. ‘We’ll refer you to the cardiologists and they’ll carry out electrophysiological studies—basically, looking at the conduction of your heart.’
Ellen frowned. ‘And then?’
‘If they think you’re an appropriate candidate, then they may do something called radiofrequency ablation—to put it simply, they destroy the extra electrical pathway by sending an electric current through it.’
‘Sounds scary.’
‘Actually, it’s a very successful procedure. It takes a few hours and requires an overnight stay in hospital, but no more than that.’
Ellen gave a wan smile. ‘I’m not allowed time off in my job. Even sleeping is banned.’
‘Sounds familiar,’ Lara murmured, watching as Christian scribbled on the notes. Over the past two months, she’d developed enormous respect for him. No matter what the situation, he never lost his cool. He was focused and skilled and didn’t let emotion cloud his judgement.
Lara studied him for a moment, wondering whether he was even aware of Ellen’s advances.
As if to test the theory, the woman gave him a smile that was pure invitation. ‘If I’m in hospital, will you visit me? I never get to meet anyone except boring lawyers in my job. I bet you only ever meet boring nurses.’
‘That’s me,’ Lara said lightly, slipping the tourniquet back into her pocket. ‘Boring nurse.’
Ellen turned her head and looked at her, as if only now noticing that there was someone else in the room with Christian. Her eyes widened as she stared at Lara. ‘Boring maybe, but beautiful,’ she muttered with a faint smile. ‘How do you manage to look so good in that shapeless blue thing? I dress in designer wear from head to foot and I don’t manage to look as good as you. Who does your hair? It’s fabulous.’
‘My hair?’ Taken aback by the question, it took Lara a moment to answer. ‘No one. Most of the time I don’t even do it. I mean, I wake up with it looking like this. That’s when my job allows me the luxury of sleep, which isn’t often.’
Ellen gave a wry smile. ‘Your job sounds a lot like mine. Except that I don’t look a fraction as beautiful as you even after eleven undisturbed hours of sleep. Someone must do your colour. Those blonde streaks are gorgeous. So natural.’
‘That’s because they are natural,’ Lara muttered, wondering why she was discussing her hair with a patient. In the circumstances it seemed utterly bizarre. Any moment now they’d be talking about shoes. Bracing herself for a sharp comment from Christian about her lack of professionalism, her eyes slid in his direction and she found him studying her with a curiously intent look in his eyes.
As if it was the first time he’d seen her.
Awareness shimmered between them, as powerful as it was unexpected, and then he turned back to his patient, leaving Lara to cope with a frantically pumping heart and shaky knees.
It would have been hard to guess who, out of the two of
them, was more shocked.
She didn’t gaze at married men.
And even if he wasn’t married, she still wouldn’t be interested. She had no interest in a relationship at this point in her life.
Ellen was concentrating her attention on Christian again. ‘So is that it, then? I see a cardiologist now?’
‘That’s right.’ His voice suddenly clipped, Christian picked up her chart and started to move away from the trolley, but she caught his arm.
‘Let me give you my number. If you’re at a loose end over Christmas, you can call me. I hate the festive season.You and I could console each other.’
Give the man a bodyguard, Lara thought wearily as Christian carefully extricated himself from Ellen’s grip.
‘I have your number on the notes in the event that the hospital needs to contact you about something,’ he said smoothly, and Ellen’s laugh was resigned.
‘You’re giving me the brush-off, but I suppose that was inevitable. Are you married? Well, of course you’re married, the truly gorgeous ones always are. Oh, well, my loss, handsome.’
Christian stilled and Lara held her breath, wondering if he was going to finally lose his cool and say something cutting. Or perhaps he’d produce a picture of his stunning wife and Ellen would spend the rest of Christmas feeling nauseated with jealousy. And it would be no more than she deserved for being so pushy. Just because the guy looked like a sex god, it didn’t mean he had to be harassed.
But Christian said nothing. In fact, the only suggestion that he’d even heard the question was the faint flicker of a muscle in his jaw. He lowered his head, scribbled something onto the chart and placed it with the rest of the notes. ‘The cardiologist is on his way down,’ he said evenly, as if he hadn’t just been propositioned by a patient. ‘He’s an excellent doctor and he’ll be more than happy to answer all the questions you have about your condition. Staff Nurse King? Nice job.’ He studied her for a moment longer than was necessary. ‘It’s your half-day, isn’t it? You should have gone home an hour ago.’
How did he know it was her half-day?
Astonished, Lara watched as he strode out of the room with a firm, confident stride.
He was Christian, the consultant. Christian, the doctor.
He never allowed the smallest glimpse of Christian, the man.
Which was probably why she hadn’t bothered looking for flaws.
CHAPTER TWO
‘ARE you excited, Daddy? Are you?’
Christian glanced down into the shining eyes of his seven-year-old daughter. Excited? ‘I’m extremely pleased that you’re so happy,’ he drawled softly, and she slid her hand into his.
‘I’m excited. This is the best day of my life. Will it be our turn soon? Will it? We’ve been waiting for ages. Do you think Father Christmas too busy to see us? Are we going to have to come back another time?’ Aggie was wearing a bright pink coat with matching gloves and her whole face was a smile as she chattered non-stop. The sound of a choir singing Christmas carols blared and crackled through loudspeakers and the dull ache in Christian’s head threatened to turn into a ghastly throb.
The morning had been hideously busy, and prising himself away from the department for a few hours had proved even harder than he’d anticipated.
‘He’s not too busy to see you, but there are lots of children waiting.’ He reached out with his free hand and gently stroked her blonde curls while he glanced along the queue, looking to see if he could track down one of the ‘fairies’ employed to occupy the children with small toys and sweets while they were waiting. He glanced at his older daughter, who was gazing into space. ‘You’re quiet, Chloe. Are you all right?’
She sent him a quick smile. ‘I’m fine, Daddy. Thanks.’
He looked at her, trying to work out the immediate problem. And there was a problem, he knew there was. He gritted his teeth. Until he’d had daughters, he’d thought he’d known a lot about women. ‘Is twelve too old to be seeing Father Christmas?’
Was he supposed to know these things?
Colour seeped into her cheeks. ‘It’s fine, Daddy.’
‘She has to see Father Christmas,’ Aggie announced, hopping from one leg to the other, ‘otherwise how is he ever going to know what she wants more than anything in the world?’
Chloe’s eyes slid to her sister. ‘Father Christmas can’t give you everything you want. He isn’t a miracle worker.’
‘Yes, he is. Try asking and see.’
Had he ever been that innocent or that optimistic?
Wondering whether it was age or life that had turned him into a cynic, Christian studied his eldest daughter’s tense profile. She stood quietly in the queue, a far-away look in her eyes. Her cheeks were pale and the skin beneath her eyes was shadowed, as if she wasn’t sleeping well. And she was far too quiet, as she so often was these days.
Tension ripped through him.
Could he have changed things? Could he have done things differently?
‘Have you made a list? I’ve made my list.’Aggie danced on the spot, her hand curled tightly around the piece of paper she’d been clutching since he’d collected her from school. ‘It’s a bit long but I’ve been good this year.’ She peeped cautiously up at her father. ‘Sort of…a lot of the time…’
Christian lifted an eyebrow. ‘You mean, if I ignore the flooded bathroom, the fire in the kitchen and the ketchup stains on your bedroom carpet?’
‘They were accidents.’
‘I know they were accidents.’ And he’d been working. He shuddered when he thought how much worse the ‘accidents’ could have been. ‘It doesn’t matter, sweetheart.’
‘It wasn’t exactly my fault, was it?’ Aggie frowned. ‘She should have been keeping an eye on me. Nanny TV.’
‘Nanny asleep-on-the-sofa,’ Chloe murmured, and Christian felt the tension increase dramatically.
Nanny TV. It was only after his daughters had started using that nickname that he’d realised just what the nanny had been doing all day. And it hadn’t been looking after his children.
‘She’s gone,’ he said grimly, a flash of anger exploding through his body. ‘The new nanny starts tomorrow.’
‘Another nanny?’ Aggie glanced at her sister. ‘What if she doesn’t like us?’
‘Of course she’ll like you.’ Christian frowned. ‘All nannies like children. That’s why they’re nannies.’
‘Nanny TV didn’t like children. She told me that I was more trouble than I was worth.’ Aggie smoothed her coat. ‘Do we have to have another nanny? We’re at school all day. Can’t we just come home with you in the evening?’
Chloe shook her head. ‘You know we can’t do that. Daddy has to work. He has a very important job. He can’t always leave at the same time every day. And then there are the nights and the holidays and all the things to be done around the house, like picking up the clothes you drop everywhere.’
Christian let out a long breath. ‘Chloe’s right, sweetheart. And, at the moment, my work is very busy.’ He didn’t even want to think about it. Even taking two hours off to take his daughters to see Father Christmas pricked at his conscience. His colleagues in the emergency department would be stretched to breaking point. But there was no way he was disappointing his children.
They’d had the year from hell.
He glanced at his watch again and then at the queue, which just didn’t seem to be moving.
Aggie tilted her head to one side. ‘Are there lots of broken people at the moment?’
Christian blinked at her description. ‘Yes—I suppose so. People have accidents—’
‘And you stick them back together again.’Aggie gave an understanding smile. ‘I know. I know you’re very clever. And you need to work, otherwise we wouldn’t have any money. Would we have to go to the workhouse?’
‘The workhouse?’
‘We’re learning about it in history. In Victorian times poor children sometimes went into the workhouse. I hope we don’t do that. I reall
y like our new house and I love my bedroom. Will we be able to unpack soon?’
Christian opened his mouth and closed it again. Keeping up with the speed of his daughter’s conversation required a decent night’s sleep and he hadn’t had one of those for months. ‘We’re not poor, Aggie, and you won’t go into the workhouse. Workhouses were abolished a long time ago.’
‘What’s abolished?’
Chloe hushed her. ‘Stop asking questions, Aggie! All you do is ask questions and talk, talk, talk! It’s no wonder Nanny TV fell asleep on the sofa. She probably died of exhaustion, listening to your chatter!’
‘It’s fine to ask questions,’ Christian interjected swiftly, noticing Aggie’s lip wobble in response to her sister’s rebuke. ‘And abolish means to do away with something. And we’re not leaving our new house and we’ll finish unpacking the boxes as soon as I get a free minute—’ He broke off as the queue moved forward a little and then stopped again. His heart sank. ‘Aggie, how badly do you want to see Father Christmas?’
Aggie beamed. ‘More than anything. I think this is the happiest, most exciting day of my life. Thank you, Daddy, for bringing me here. It’s my dream.’
No chance of leaving, then, Christian thought wryly as he discreetly checked his watch. He cast a look at Chloe, worried about how quiet she was.
She intercepted his concerned glance and gave a brave smile. ‘It’s OK, Dad,’ she said in a faltering voice. ‘Everything is going to be OK. Our new house is lovely. We’re all going to have a great Christmas. As soon as I’ve broken up from school, I can start on those boxes. If Aggie would just stop talking for five minutes and help me, we’ll get it done really quickly.’
‘You’re amazing, do you know that?’ Unfailingly impressed by his daughter’s resilience, Christian reached for her hand and gave it a squeeze. ‘What do you want from Father Christmas, sweetheart?’
He would have given a lot to know, but Chloe didn’t reveal her feelings.
Did she talk to her friends?
He almost laughed. Who was he to criticise? He didn’t talk to anyone, either.
She looked at him now, her gaze clear and direct. ‘I want you to be happy again. I want you to have fun,’ she softly. ‘That’s what I want more than anything.’
