by Kate Hardy
CHAPTER THREE
OVER THE NEXT couple of days, Daniel’s determination to keep things strictly professional was sorely tested, particularly when he and Beatrice were rostered on together in Resus.
Their first patient of the day was Maureen Bishop, an elderly woman who’d slipped and fallen backwards off the patio, and was badly injured, enough for the air ambulance to bring her in.
‘Thankfully her neighbour had arranged to pop round for a cup of tea, couldn’t get an answer and went round the back of the house and found her,’ the paramedic from the air ambulance explained. ‘She was unconscious, so the neighbour called the ambulance—who called us to bring her in. She’s come round now, but she’s got a nasty gash in the back of her head from falling against a pot, plus fractured ribs, and we’re a bit worried she might have a crack in her skull or a bleed in her brain.’
‘Have you given her any pain relief?’ Beatrice asked.
The paramedic nodded and gave her full details. ‘We’ve put her on a spinal board with a neck brace.’
‘Great. Has anyone managed to get in touch with her family?’
‘Yes. Her daughter’s on the way in.’
‘That’s good.’ She went over to the trolley with Daniel. ‘Hello, Mrs Bishop, I’m Beatrice and this is Daniel,’ she said. ‘We’re looking after you today. May we call you Maureen?’
‘Yes, love,’ Maureen said.
‘Can you remember what happened?’
The elderly woman grimaced. ‘I slipped and fell.’
‘Can you remember blacking out, or do you have any idea how long you were unconscious?’ Beatrice asked.
‘No,’ Maureen whispered. ‘I’m sorry.’
Beatrice squeezed her hand. ‘No need to apologise. You’ve had a nasty fall. I’m going to send you for a scan because we need to check out that bump to your head, and also for X-rays so we can have a better look at your ribs, because we think you might have broken a few. Your daughter’s on her way.’
‘I didn’t want to worry her. I told them not to call her at work,’ Maureen said.
‘If you were my mum,’ Beatrice said gently, ‘then I’d want to know you’d been taken to hospital. I’d be more upset if they didn’t call me. And I’m betting it’s just the same for your daughter.’
The CT scan showed a bleed to the brain; by the time Beatrice had liaised with the neurology team and persuaded them to admit Maureen, her daughter Jennifer had arrived.
‘What happened?’ Jennifer asked.
‘Your mum slipped off the patio and banged her head against a pot. We know she was unconscious for a while, but not for how long. Fortunately her neighbour found her and called the ambulance,’ Daniel explained.
‘We sent your mum for a scan and X-rays,’ Beatrice said. ‘I’m pleased to say there’s no evidence of any bones broken in her neck, so we can take the spinal collar off now, but she has fractured a couple of ribs, and when she hit her head it caused a bleed in her brain. She seems fine at the moment, but a bleed is a bit like a stroke in that sometimes it takes a few days for us to see what’s happened. We’re going to admit her to the neurology ward, so she’s going to be monitored for the next day or so.’
‘But she’s going to be all right? She’s not going to die?’
‘She’s holding her own at the moment,’ Beatrice said, taking Jennifer’s hand and squeezing it, ‘but we want to keep an eye on her in case that bang on the head causes a problem. She’ll be in good hands and we can treat her straight away if anything happens.’ She smiled at Jennifer. ‘Your mum was a bit worried about the paramedics calling you at work.’
‘I got someone to cover my class,’ Jennifer said. ‘I’d be more upset if they hadn’t called me.’
‘That’s exactly what I told her,’ Beatrice said. ‘I’ll take you through now. It’s going to look a bit scary because your mum’s on a spinal board with a neck collar on, but that’s absolutely standard when someone’s had a fall and we think there might be any damage to the back or the neck. I’ll let you say hello to her, and then we’ll take off the collar and make her a bit more comfortable before she goes up to the ward.’
* * *
It was the first time Daniel had worked with Beatrice, and he could see for himself why Josh had sung her praises. Beatrice was very clear when she was managing Resus; everyone knew what they needed to do, and she was completely approachable. Josh had said that one of the nurses hadn’t quite understood her instructions, the other day, and Beatrice had taken the time afterwards to go through the case, explaining exactly why she’d made certain decisions. And he really liked the way she was calm and kind to their patients.
The more Daniel worked with her, the more he liked her.
And, worse still, the more attracted he was to her. He couldn’t seem to get a grip and push the unwanted feelings aside. Instead, he found himself wondering how soft her hair would be against his skin, and how her arms would feel around him. How her mouth would feel against his own.
For pity’s sake. He was thirty-four, not seventeen. He had responsibilities. He didn’t have time for this. He couldn’t keep wondering what it would be like to date Beatrice.
If he didn’t manage to sort his head out, he thought grimly, he’d need to have a word with whoever was doing the roster next month, to make sure he and Beatrice weren’t working together.
* * *
Late on Thursday afternoon, Beatrice had to steel herself slightly when the paramedics brought in a woman who’d taken an overdose.
‘I brought her in for the same thing, a month ago,’ Dev, the lead paramedic, told Beatrice quietly. ‘And another team brought her in a fortnight ago.’
‘Three times in a month.’ Beatrice frowned. ‘I’ll check her notes to see if anyone’s referred her for counselling, but if they haven’t then I definitely want to bring the psych team in. She needs help with the root cause. We can’t just patch her up and send her home so she takes another overdose and comes back in again. That isn’t fair to anyone.’
Dev spread his hands. ‘Mental health. You know the situation there as well as I do.’
‘Overstretched. I know.’ Beatrice sighed. ‘But I’ll push as much as I can for her. Thanks for your help, Dev.’
She went over to the bed. ‘I’m Beatrice, and I’m part of the team looking after you today,’ she said to her patient. ‘May I call you Sally?’
The young woman nodded.
‘The paramedics tell me you took an overdose of paracetamol.’
Sally hunched her shoulders, and Beatrice sat down and took her hand. ‘I’m not here to judge you, Sally, I’m here to help you. But I do need to know how many tablets you took, when, and over how long a period, so I know the best way to look after you.’
‘A dozen tablets,’ Sally whispered. ‘An hour ago.’
‘What did you take them with?’ Beatrice asked, really hoping that alcohol wasn’t involved.
‘Water.’
That was one good thing; she didn’t have to worry about complications from alcohol. ‘OK. Normally paracetamol’s safe to take as a painkiller, but if you take too much you can risk damaging your liver and your kidneys. I need to take some blood tests, and the results will tell me what the best treatment is for you. Is that OK?’
Sally nodded, and Beatrice took the bloods. ‘Can I get you a cup of tea or something while we’re waiting for the results?’
Sally shook her head. ‘I’m all right.’
‘I’ll need to see some other patients while I’m waiting for the results, but I’ll be back very soon to see you,’ Beatrice said. ‘If you’re worried about anything, just press this buzzer to call one of us and we’ll come in to see you, OK?’
Sally didn’t ask for help while Beatrice called the psych team and asked for an urgent referral, or while Beatrice checked a set of X-rays for Josh an
d dealt with a nasty gash on an elderly man’s arm where he’d slipped and knocked against a gatepost. But finally the blood test results came back, and Beatrice went into the cubicle where Sally was waiting quietly. The poor woman looked as if a huge weight was about to drop on her.
‘I’ve got the test results back,’ Beatrice said. ‘We do need to treat you, to stop any damage happening to your liver, so I’m going to give you a drug through a drip—that’s a line that goes straight into your vein. It means you’ll need to stay with us another day while we give you the drug. Is that OK with you?’
Sally looked worried again. ‘I felt so bad, last time. I was sick everywhere.’
‘This is a different drug from the one you had last time. It’s a special trial, but I used it in my last hospital and it’s really good,’ Beatrice said. ‘It means you’re less likely to have side effects, like being sick or itching. Tomorrow we’ll do another blood test to see how you’re doing, and we’ll be able to let you go home if we’re happy that there’s no damage to your liver.’
Sally bit her lip. ‘I’m so sorry.’
Beatrice squeezed her hand. ‘You really don’t have to apologise. You’re not well and it’s my job to make you better.’
‘I know you’re all busy here and you should be saving lives that matter, not bothering with me.’
‘We are saving a life—yours,’ Beatrice said gently. ‘You’re important, too.’
‘I know I shouldn’t have done it.’
‘We all make mistakes.’ And Beatrice had made this particular one herself. She could still remember how low she’d felt when she’d opened the box of paracetamol and popped the tablets out of their foil packaging. How hopeless.
‘It seemed like the only way out.’
Just as it had for Beatrice. ‘There’s always another way,’ she said, squeezing Sally’s hand again. ‘Though sometimes you need someone else to help you see it. Is there anyone we can call for you to let them know you’re here? Your family, a friend?’
‘Nobody.’
Beatrice remembered that feeling, too. Once she was out of Resus and in cubicles, she hadn’t wanted the emergency staff to call her husband or her family, because she knew they’d blame themselves for not picking up on the signs. And she hadn’t wanted to burden any of her friends with how low she was feeling. She’d just been grateful that she hadn’t been treated in her own department so she hadn’t had the sheer embarrassment of having to face them all afterwards.
‘I just don’t want to be here,’ Sally said, her voice shaking.
‘I know, sweetheart, but I really can’t let you go until you’re better,’ Beatrice said, still holding her hand. ‘I need to be sure you’re not going to collapse with liver damage.’
‘It’s wrong to be here.’ Sally dragged in a breath. ‘I just wish I was dead.’
Beatrice had once been in Sally’s shoes, wanting to be with her lost baby instead of stuck here in this world. ‘I promise, there’s light at the end of the tunnel. We’ll help you find it,’ she said gently.
The psych team had sent a message to say that nobody was going to be available for another hour. Maybe there was something she could do for Sally until they got here, Beatrice thought. The same thing that the psych team at a different hospital had done for her, all those years ago: a grounding exercise she still used from time to time, when things got on top of her.
‘I want you to do something for me, Sally,’ she said. ‘It might sound a bit weird, but humour me.’
‘What’s that?’ Sally asked.
‘I want you to tell me five things you can see.’
Sally blinked and frowned. ‘Um—you, the curtain, the bed, I don’t know the name of the machine over there, and a cup of water.’ She ticked the items off on her fingers.
‘That’s great. Now four things you can hear. It doesn’t have to be here or right now in the hospital, just four sounds.’
‘Waves on a beach, a machine beeping...’ Sally paused. ‘A bird singing, a child laughing.’
‘That’s great.’ Especially because she’d named something positive. ‘Now I want you to name three things you can touch—and touch them.’
‘The sheet, a cup, the bed frame.’ Sally touched them as she named them.
‘That’s really good. Two things you like the smell of?’
‘Coffee and fresh bread.’ Sally sounded more confident now.
‘Brilliant. And now I want you to take one slow, deep breath. In for three—and now out for three.’
Sally did the deep breath while Beatrice counted, then looked at her. ‘I don’t know what you just did, but I don’t feel as panicky as I did.’
‘It’s a grounding technique,’ Beatrice explained. ‘You can do it yourself any time you feel bad. It makes you focus on something external instead of your thoughts and feelings, and it stops the spiral of misery getting tighter. Five things you can see, four things you can hear, three things you can touch, two things you can smell, and one slow, deep breath.’
‘What if I can’t remember the order?’ Sally asked.
‘It doesn’t matter. Just think of the five senses, pick one and start with that,’ Beatrice said. ‘Count down each time, and just remember that one breath at the end.’
Sally’s eyes filled with tears. ‘Thank you.’
‘That’s what I’m here for. To help,’ Beatrice reassured her.
Although it was time for Beatrice’s break, no way was she leaving her patient. She remembered what it was like to feel that you had nobody to understand or rely on. She sat with Sally until one of the nurses came in to say that the psych team had arrived, then headed out of the cubicle briefly to have a word with her colleague first.
‘Keith Bradley from the psych team,’ he said, introducing himself. ‘Apparently you wanted a quick word?’
‘Beatrice Lindford.’ She shook his hand. ‘It’s my patient, Sally. I’m treating her for her third overdose in a month. I know resources are stretched,’ she said, ‘but this is just a revolving door and we’re not helping her. We’re just providing a sticking plaster and that’s not good enough. We need to find the root cause of why she keeps taking an overdose and help her sort that out. Can you get her referred to emergency counselling?’
‘It’s like you said—resources are stretched —but I’ll do what I can,’ Keith said.
She rested her hand on his shoulder. ‘Thanks. I appreciate it. I’ve done a grounding exercise with her, which has helped a bit, but she definitely needs you right now.’
She went back in to the cubicle and introduced Keith to Sally. ‘I’m going to leave you with Keith now, but I’ll be back to see you later today and see how you’re getting on.’
Sally was pale but still determined not to call anyone when Beatrice dropped in to see her at the end of her shift.
‘Keith was nice. And I did that thing you taught me when I felt bad after he’d gone, and it helped,’ Sally said. ‘Thank you.’
‘I’m glad it helped. Are you sure I can’t call anyone for you?’
‘I’m sure. Right now I just can’t face anyone,’ Sally said.
But a good night’s sleep had clearly made her feel differently, because in the morning when Beatrice came in with the blood test results Sally agreed to let the team call her mother.
‘I’m happy to let you go home,’ Beatrice said, ‘but if you get a stomach ache or a really bad headache, you feel sick or drowsy, the whites of your eyes go yellow or you can’t have a wee within the next eight hours, I want you to come back. I know that’s a lot to remember, so I have a leaflet with all the information on that you can take home with you.’
‘Thank you,’ Sally said.
When Sally’s mother came into the department, Beatrice had a quiet word with her in one of the cubicles.
‘Keep an eye on her for the next twenty-fou
r hours,’ she said. ‘I’ve given her a leaflet with symptoms to watch out for, following the treatment we gave her, and I can let you have a copy of that as well. We’ve got her referred to a counsellor, too, which should help.’
Sally’s mother folded her arms; her mouth was set in a thin line. ‘I can’t believe Sally’s done this yet again. This is the third time in a month. She’s so selfish—she doesn’t think about how it feels to get that call from the police or the hospital, or how hard it is to get time off work at the last minute to pick her up from here and look after her because she can’t be left on her own.’
‘I understand that it’s hard for you, and it’s worrying, too, but it’s really not her fault,’ Beatrice said. ‘She’s depressed to the point where she can’t think clearly. She isn’t doing it to cause problems for anyone else.’ Her own family’s stiff upper lip and refusal to talk about things had been tough enough to deal with, but overt hostility and anger like this... Poor Sally. Beatrice just hoped she had some good friends who would support her.
‘I suppose so.’ Sally’s mother rolled her eyes. ‘I’d better get her home. And let’s hope she doesn’t do it all over again next week.’
* * *
Daniel was in the cubicle next door and couldn’t help overhearing the conversation.
Although he agreed with every word Beatrice had said, something about it felt personal. He was even more convinced during his break, when he’d boiled the kettle to make coffee and Beatrice walked into the kitchen, filled only half her mug with boiling water and then topped up her coffee with cold water so she could drink it straight down.
‘Are you OK?’ he asked.
She didn’t meet his eyes and her voice was a little bit too bright when she replied, ‘Yes, thanks, I’m fine.’
‘I couldn’t help overhearing you with the mum of your patient who’d taken an overdose. That sounded rough.’
Beatrice shrugged. ‘I just hope she listened to me and realised that it’s the illness at fault, not her daughter. Mental health’s tricky to handle, and I know it’s hard for the family to deal with.’
