Hot-Shot Doc, Christmas Bride / Christmas At Rivercut Manor

by Joanna Neil / Gill Sanderson

  ‘They went out to fetch cold drinks from the machine in the main waiting room. I thought I’d better wait here, in case you wondered where I was, but perhaps we’d better go and see what they’re up to. They should have been back by now, and I daren’t imagine what they might get up to left to their own devices for too long.’

  ‘Good idea,’ she agreed, nodding. The children were eight and nine years old, and full of the joys of life. ‘Knowing Jason and his love of drawing, they could be trying out designs for a new mural by now.’

  ‘Oh, heaven forbid! Don’t say that, please. I can feel an ulcer starting already.’

  She laughed, and they hurried away towards the main waiting room in search of the children. Unfortunately they were nowhere to be seen.

  Alison gazed around her in dismay. ‘We’d have seen them if they were heading back to you in the waiting room, wouldn’t we?’

  Tom nodded, an anxious look spreading over his face.

  ‘Can I help in any way?’ Josh came out of the resuscitation room and strode briskly towards them, delivering the words in an equally vigorous, no-nonsense fashion. ‘Are you looking for the children?’

  Alison nodded, her heart sinking rapidly. He didn’t look at all content with the way his day was going, and his questions didn’t have the tiniest note of pleasant enquiry about them. Something was definitely wrong. ‘They came in here to fetch cold drinks,’ she said. ‘Do you know where they are?’

  ‘The last I saw of them they were playing in the courtyard outside the waiting room.’ He looked directly at Tom. ‘There’s still a lot of snow around, and they were trying to slide down the grass verge. Unfortunately Jason slipped on the ice and cut his knee. He’s okay, but I asked one of the nurses to clean it up and put a dressing on it before she brought the pair of them back to you. You’ll find them in Treatment Room Two, over there.’ He waved a hand in the direction of the room, and Tom thanked him and immediately rushed away.

  Alison gave Josh a brief, apologetic look. ‘I’m so sorry,’ she said. ‘It’s probably my fault the children went exploring. I arranged to meet Tom at the end of my shift, but I was a little late.’

  ‘So I gathered,’ he said. ‘Still, I dare say there’s no harm done. If today’s anything to go by, nothing in this place follows a normal pattern, does it?’

  He walked away from her, heading over to the desk, where he began rifling through lab test results.

  Alison sighed. He was right. This day had been singularly odd—and not just because of the biker invasion, or her car breaking down and Tom and the children coming into the hospital. She had come face to face with her new boss, and she still didn’t have any idea of what kind of man he was. He was full of contradictions, a man of hidden depths. She had no real idea of how she was going to work with him on a day-to-day basis.

  Chapter Three

  ‘YOU look like a sorry bunch of half-frozen characters,’ Josh remarked, as Alison hurried into Reception next day. Katie and the men from the upstairs flat followed close on her heels. ‘Perhaps you should grab a cup of coffee and warm yourselves up before you start work?’

  Alison nodded, blowing on her hands as though to breathe life into them. Josh made an unexpected welcoming committee, though he was definitely a sight for sore eyes. He was every bit as immaculately dressed as he had been the day before, wearing a dark grey suit that drew attention to his broad shoulders and lean, tautly muscled frame.

  He was on great form, poised and ready for work—while she, in contrast, was at a peculiarly low ebb, chilled to the bone from her journey to the hospital, and uncertain as to why Josh had chosen to make his presence felt at this hour. She wasn’t used to having the boss watching over her. His predecessor had usually been found huddled in his office before the shift began, reading through a sheaf of papers.

  ‘I think I’ll do that,’ she murmured. ‘Sam gave us a lift into work this morning, but the heater wasn’t working in his car so we’ve all forgotten what our hands feel like, they’re so numb. Then we ran into a flurry of snow as we walked across the car park.’

  ‘It sounds as though it won’t be long before Tom has another mechanic’s job on his hands,’ Josh murmured. ‘He’s not doing too badly out of his neighbours so far, is he?’

  ‘Much as I get along well with Tom, I won’t be paying out for car repairs any time soon,’ Sam retorted, shrugging out of his soft leather jacket. He was a sturdy, long-limbed young man, with mid-brown hair and blue eyes, and a matter-of-fact manner. ‘Everyone will just have to toughen up. I need to save everything I have for Christmas. I’m planning on going away for the holidays…I have a skiing trip all lined up.’

  ‘Ski slopes?’ Josh’s eyes lit up. ‘That sounds like a good idea.’

  Alison glanced at him briefly. Why would anyone want to go away at Christmas time and leave his family behind? Sam was a different case altogether. He had family overseas, and his skiing holiday was a celebration of their coming together.

  ‘If this weather holds out you might not need to go away to ski,’ Katie put in, heading across the room to the kitchen annexe, where a coffee pot steamed gently on a worktop by the sink. ‘With the snow starting already, it looks as though we could be in for a white Christmas here at home. Wouldn’t that be beautiful?’ A dreamy expression settled on her face. ‘I can just imagine it…A carpet of white over the Pennine Hills, with icicles hanging from the trees and masses of stars in a midnight sky. All the lights of the houses would give out a golden glow…’

  ‘And we could sit inside, all cosy and warm,’ Alison added, rubbing her arms to bring about some heat. ‘With a blazing fire in the hearth. And we’d drink spicy fruit punch and munch on hot mince pies covered with lashings of icing sugar. It would be wonderful, wouldn’t it?’

  ‘I’d sooner go on a pub crawl,’ Taylor put in. ‘Lots of singing and merry-making and people generally having a good time.’

  ‘That’s all a long way off yet,’ Josh said in a laconic tone, pulling mugs down from a shelf. ‘What is the obsession round here with the Christmas season? Snow means blocked roads and skids and lots of yucky snow melt on the verges when the thaw comes. Unless you like it so much you’re planning a mass exodus to the North Pole some time soon? I hope you’re not thinking of leaving me to manage A&E all by myself. I’d need a lot more than Santa and his little elves to help me get through the days.’

  ‘You’re a sad soul,’ Katie said, sending him a pitying glance. ‘What happened? Did you have your fun gland removed at some time?’

  He nodded solemnly. ‘Maybe I did—along with my nonsense nodule. Now, do you think we can push the subject of Christmas to one side and concentrate on limbering up ready for work? The rest of the staff are getting ready to hand over their patients to you. Apparently it’s been a busy night. Several people came in with fractures and other injuries.’

  ‘Well, that’s brought us down to earth with a bump, hasn’t it?’ Alison poured coffee into the mugs and handed them around. She sipped her coffee and watched as Josh morphed smoothly from sympathetic colleague into leadership mode.

  ‘We have three difficult cases to deal with on handover…A patient with an aneurysm that needs careful management, a possible neck fracture, and a patient who suffered a collapsed lung. They’re all under observation at the moment, but I’m assigning responsibility as per the whiteboard. You’ll see there’s a long list of people waiting for treatment, even at this early hour.’

  He turned his attention to Alison, who put down her mug and prepared herself for action. He had that look about him that said he was up and running, and where she was concerned things were about to change…though not necessarily for the better.

  ‘Your young patient from yesterday tried to go on a walkabout again early this morning,’ he said briskly. ‘For all we know he could be looking for drugs. Presumably you’ll take a look at him some time this morning and find out exactly what’s going on?’

  ‘Oh. Right. Well, yes, I’ll try t
o do that.’ Alison blinked. Medical problems she could solve, given time and test results, but dealing with the intricacies of welfare troubles was not her strong point. Another walkabout? Something was obviously not right with Rees, and she definitely needed to find out what it was. First, though, she would make a quick check on her other patients. Right now they were her priority. ‘As to the drugs, I’ve seen no evidence of any addiction.’

  ‘Did you test for it?’

  ‘No. I had no reason to.’ He gave her an ‘I told you so’ look, and she was prompted to add, ‘I was looking for a chest infection.’

  ‘Of course you were. Have you come up with any solution to the problem of what happens when you discharge him from the hospital?’ Josh fell into step beside her as she set off towards the main area of A&E. She did her best to push aside the feeling of wanting to shrug him off. Didn’t he have to go and see any patients of his own?

  ‘Not yet. Other than seeing if I can persuade him to talk to a friend of mine from an agency that supports youngsters like Rees. I phoned Jack last night and asked what he thought I should do.’

  ‘You’re not about to give up on him, then?’

  ‘Of course not.’ She sent him a shocked glance. ‘I’ll do everything I can to make sure that he has someone to look after him when he leaves here.’

  He gave a wry smile, but then his pager bleeped and he crossed over to the desk to answer the call. She went with him, checking the whiteboard for her patients’ names and rummaging through the files for details of their conditions.

  ‘I’ll stop by the clinic later this afternoon when I’ve finished operating,’ he said into the receiver. ‘Make an appointment for him to see me around four-thirty and I’ll decide what needs to be done.’

  Alison frowned. What clinic was he talking about? Wasn’t he going to be here in the hospital at four-thirty?

  She glanced through the file she was holding, skimming through the notes outlining her first patient’s symptoms. An aneurysm meant that the woman needed to be seen by a vascular specialist, and she must keep a check on her blood pressure.

  Josh replaced the receiver on its cradle. ‘Upper Regent Street,’ he said, as though she had asked a question.

  ‘The exclusive part of the city?’ she murmured, a vaguely confused look crossing her face.

  ‘That’s where I have my private practice,’ he responded, with a benign, obliging glance. ‘You looked as though you were curious,’ he explained. ‘It’s where I go when I’m not working here, and it accounts for two full days and two afternoons of my working week.’

  She looked at him oddly. How was it he was so sure that he knew what she was thinking? It annoyed her even more to concede that he was right. ‘You work in private practice?’

  ‘I do—along with a couple of partners.’ He studied her for a moment or two. ‘You appear to be shocked by that information. Does it bother you? Do you have a problem with private medicine?’

  ‘Um…not necessarily.’ That wasn’t exactly the truth. She had never been able to get over the unsavoury picture of people who were ill in bed being presented with bills for their treatment. ‘I mean…I can see where it might benefit some people who can’t get the treatment they want quickly enough, but I’ve always believed medicine should be freely available to all at the point of need.’ Even the mention of it stirred feelings in her that she would rather stayed dormant. Hadn’t her ex-boyfriend thrown away his integrity and gone for the option of wealth over ideals?

  ‘Well, that doesn’t always happen, does it?’ He checked the wire tray on the desk for lab test reports. ‘That’s why people turn to me.’

  ‘People who have money,’ she said. ‘Wealthy people.’ She shook her head, feeling a little sick inside. ‘Don’t get me wrong…I don’t blame them for turning to people like you for help. They can afford it. I just feel that everyone should have the same opportunity.’

  ‘That will never happen, though, will it?’ He grimaced. ‘You’re living in cloud cuckoo land if you think there will ever be a country rich enough to provide that level of care for all its citizens. You’ll never have the idyllic situation where one system covers all.’

  She snapped the folder shut. ‘And that’s where you come in, isn’t it? Wielding your scalpel like a trusty sword. Only there’s always a price to be paid, isn’t there? Or should I say fee?’

  He held up his hands as though to ward her off. ‘Seems I hit a nerve,’ he said. ‘Have you always been this touchy, or is it something about me that brings it on?’

  She frowned, studying his strong, determinedly masculine features with a cautious eye. ‘I’d say probably a bit of both.’ She started to walk away, heading towards one of the treatment rooms. ‘Please excuse me. I have to go and treat a woman suffering from terrible headaches. Of course if she’d had the operation she needs to correct the anomaly in her blood vessels some time ago, she might not be in this situation now.’

  He waved his hands in a gesture of exasperation. ‘You know as well as I do that surgeons err on the side of caution in these situations. It isn’t always a case of putting things off. Maybe it was a minor aneurysm, best left alone.’

  She didn’t answer him, but went instead to talk to her patient about medication to lower her blood pressure. Somehow or other they would keep her healthy until the surgeon deemed it was time to operate.

  ‘I’m going to send you for another CT scan,’ she told the woman. ‘If we find that the aneurysm has become slightly enlarged, I’ll refer you back to the surgeon for his opinion. I believe he may want to bring the surgery date forward. In the meantime, we’ll add another type of medication to your prescription to keep things under control.’

  When she had reassured the woman about the situation, she left the room, and was about to go in search of her next patient when Jenny emerged from the observation ward.

  ‘How’s Rees doing?’ Alison asked. ‘I heard he was a bit restless again.’

  ‘He’s very jumpy and on edge,’ the nurse told her, ‘but I’m afraid he still hasn’t told me what’s wrong’

  Alison nodded. ‘Thanks for keeping an eye on him, Jenny. I’ll go and talk to him later on and see if I can sort things out. How is he doing health-wise?’

  ‘He’s a lot better. His temperature is back to normal, and the chest infection seems to be responding to the antibiotics. He has more colour in his face, too, since we’ve been feeding him up. As to the hand, he’s able to move his fingers well enough, and it appears to be healing nicely.’

  ‘Good. Let’s hope we can manage to find out what’s behind his other problems.’

  Some time later, when she’d finished dealing with all the urgent cases on her list, she headed back towards the central area of A&E, but stopped when she passed by one of the treatment rooms where monitors were bleeping warnings at high pitch.

  Josh was at work in there. His patient was a young boy, around eight years of age, pale and gasping for breath, his lips tinged with blue. The child’s mother looked on, her eyes wide and frightened as she watched Josh at work.

  ‘He was out in the playground at school,’ she said. ‘I think the children were all running about at lunchtime, playing football, when he started to have problems. The teachers called me and said he’d collapsed. I don’t understand what’s happening.’

  ‘I’m concerned that he might be suffering an asthma attack,’ Josh murmured, listening to the boy’s lungs through his stethoscope. ‘He has a chest infection, and I imagine the cold weather must have added to the problem and brought on his breathing difficulties.’

  He spoke gently to the boy, adjusting the breathing mask over his nose and mouth. Alison guessed he was breathing in a mixture of nebulised salbutamol and oxygen. ‘I’m going to give you an injection of something that will help you to breathe more easily, Charlie,’ he said. ‘And we’ll give you medicine to help clear up the problem in your lungs. Don’t worry. You’ll soon start to feel much better, I’m sure.’

  T
he boy was clearly too ill to respond, and Alison went further into the room. Josh was working alone in here, so she guessed the nurse had been called away to tend to another emergency.

  ‘Do you want any help?’ she asked.

  Josh nodded. ‘Thanks. His oxygen saturation is very low, and I may have to intubate,’ he said quietly.

  ‘What does that mean?’ the boy’s mother asked, and Alison hurried over to the bedside to explain as Josh prepared to insert a cannula into the back of the boy’s hand. With that in place, the child would be able to receive various medications that would act more quickly as a result of being passed directly into the bloodstream.

  ‘He’s not breathing very well on his own, so we might need to put a tube down his throat and let a machine do the breathing for him,’ she told the mother. ‘The monitor bleeps every time his oxygen level falls below eighty-one percent. We need to bring it up as near to a hundred as we can manage.’

  The woman sucked in a sharp breath. ‘I’d no idea his chest was this bad,’ she said softly. ‘He was poorly yesterday, with a wheezy cough, but he wanted to go to school and be with his friends because there was a book fair on in the afternoon. I thought he would be all right. Of course I hadn’t bargained on this bitter cold snap coming on.’

  ‘It caught us all by surprise,’ Josh murmured. He looked up at Alison. ‘Will you start an infusion of aminophylline and add one hundred mg hydrocortisone to be given six-hourly? I’m going to add ipratropium to the nebuliser.’ He turned to the mother and added, ‘These drugs will help to widen his airways and should begin to ease his breathing. I’m also going to start him on a broad spectrum antibiotic to help combat the infection while we wait for the results of tests.’

  All the time he was talking he was watching the monitors and assessing the boy’s condition. Once the infusion was set up, and the drugs administered, he filled out the patient’s chart and noted down what further action needed to be taken, so that the nurse would be able to continue with the treatment.