In Her Boss's Special Care

by MELANIE MILBURNE

  ‘You’ll supervise the resus, then, Rod? I’ll lend a hand with Justin,’ Joel said.

  ‘I don’t mind,’ Rod said, ‘but why don’t you take this one? Justin and I were up half of last night at the resident’s dinner—we’ve both feeling a bit seedy.’

  ‘OK, it looks like we’re on, then,’ Joel said, as the ambulance crew wheeled in a pallid man, head bandaged, his neck in a cervical collar, intubated and being ventilated by one of the crew.

  ‘Justin, you take over ventilation,’ Joel directed. ‘Rod, can you supervise the transfer to the trauma bed, check the line and get in another IV, and get off bloods for pathology?’

  He turned his attention to the attending nursing staff, issuing directions on removing the patient’s overalls and inserting a nasogastric tube. As the nurses cut away the patient’s clothing, Joel noticed the logo on the right-hand breast pocket, which seemed to suggest the man was some type of pool maintenance technician. Presumably he had met with some sort of accident, perhaps falling into a pool he was servicing.

  He turned to address the ambulance crew. ‘Any details on this patient?’

  The senior paramedic spoke first. ‘We were called by the neighbour next door. She claims she heard some sort of argument going on but she was busy with one of her young kids so didn’t go out to investigate. A short time later she came out and looked over the fence and saw this guy face down in the pool. She called out to another neighbour on the other side who was mowing his lawn. He hauled the patient out of the pool while she ran back and phoned the emergency services. When we got there the patient had sputtering respirations, obviously lungs still full of water and a stream of blood from the back of his head. I intubated him and sucked out his lungs as best as I could, put on a hard cervical collar and bandaged his head to control the bleeding. My guess is he’s got a fractured skull.’

  ‘What’s with the police?’ Joel asked, nodding his head to where two officers were standing across the corridor.

  ‘I called them,’ the senior paramedic said. ‘It’s now our standard protocol if there is a potentially fatal trauma. They seemed a bit agitated at the scene. The extent of the head injury doesn’t sit well with where he was found.’

  Joel made a mental note to confer with the police once he had stabilised the patient.

  ‘Second line’s in,’ Rod said. ‘And the nasogastric’s returned about a litre of bile-tinged pool water. This guy didn’t go down without a fight. To swallow all that water you’d have to be conscious for a fair while.’

  ‘It doesn’t look like an accident,’ Joel said. ‘The police are interested and the ambos suspect a fractured skull. Can we reassess the primary survey? Then I want a look at that skull and do the secondary survey.’

  Joel replaced his gloves with a clean pair and, adjusting his splash-guard goggles, removed the head bandage from the patient. What he saw was clearly not the result of an accidental poolside slip or fall. The back and the side of the skull were crushed, there was bony crepitus, and obvious cerebrospinal fluid leakage from one ear, as well as renewed bleeding once the pressure from the bandage was removed.

  ‘Hell, what’s happened to this guy?’ he said, in shock at the extent of injury.

  Rod inspected the site and grimaced. ‘Doesn’t look like a trip on slippery tiles, does it?’

  Joel gave him a grim glance before he ensured the head bandage was adequately reapplied. ‘No, it does not.’ He swivelled to address the nurse. ‘Get Neurosurgery on the phone. We need an immediate CAT scan to establish the extent of injury.’

  Once the nurse had left to do as he’d instructed, Joel turned back to Rod. ‘Let’s run through the secondary survey, then I’d better have a word with the police.’

  ‘He’s not going to make it, is he?’ Rod asked.

  ‘If he does, he might not like what’s left of his life,’ Joel said, performing a detailed head-to-toe examination of the now stabilised patient. Stripping off his gloves and protective gear, he then made his way over to where the police were waiting to speak to him.

  After receiving a brief description of the patient’s injuries, the officer in charge of the investigation said, ‘We’d like to follow up on this. You said you’ve ordered blood tests, I assume you have included a drug screen?’

  ‘Yes, it’s standard procedure,’ Joel said. ‘Do you guys have any personal details on this man? His name or relatives who need to be informed of his condition?’

  ‘His name is Terry Fowler,’ the second officer informed him. ‘He’s well known to us, if you know what I mean.’

  Joel screwed up his mouth for a moment as he took this in. ‘He’s got some sort of record?’

  ‘As long as your arm,’ the older officer said. ‘Looks like someone meant business. He wasn’t meant to survive, going by what we saw at the scene.’

  ‘So it’s an attempted murder investigation?’ Joel queried.

  ‘We’re treating it that way for the moment, yes. We’re following up on a couple of other leads,’ the officer said. ‘We’ll keep you informed of anything relevant. We’ve organised a guard. We’ll try and keep it quiet. This place has had its share of publicity lately.’

  ‘Have you progressed any further in your enquiries into the attempt on Kate Lowe’s life?’

  The officers exchanged a brief glance before the senior officer turned back to Joel. ‘We’ve now gone through hours of security tapes filmed on the night in question. The image is not as clear as we’d like, but a man with features remarkably similar to Terry Fowler’s was captured on tape entering the hospital during the time frame the attempt on Mrs Lowe’s life was made.’

  Joel frowned, his brain reeling with possible motives. ‘Have you any idea what his connection to Kate Lowe would be?’

  ‘Not as yet but, as we said, we have a few leads we’re following up. In the meantime, if you think of anything that might be in any way significant, please contact us.’ The officer handed Joel a card. ‘And it goes without saying that if Mrs Lowe regains full consciousness, we’d like to be informed immediately.’

  ‘Of course,’ Joel said.

  ‘How is the little boy doing?’ the younger officer asked. ‘I have a son the same age.’

  ‘I’ve been an intensivist too long to offer hope when there isn’t any,’ Joel said. ‘He’s showing no signs of brain activity, which means a decision will have to made soon as to what to do next.’

  ‘How’s the father taking things?’

  ‘He’s doing his best to resign himself for the worst,’ Joel said.

  ‘I’m sure his mistress is offering the best comfort she can under the circumstances,’ the junior officer said, receiving a quick reproving frown from his superior.

  ‘Yes, well, that’s his business, I suppose,’ Joel said. ‘His sister has been in a few times, or so I’m told.’

  ‘His sister?’ The senior officer’s frown deepened.

  ‘Yes, I can’t quite recall her name…’ Joel wrinkled his brow as he tried to recall the name Allegra had been searching for last night before they’d gone for dinner. ‘It started with F—Fair-something, I think.’

  ‘Serena Fairbright,’ the officer said.

  ‘Yes, that’s it. Fairbright.’

  ‘Thank you, Dr Addison,’ the officer said. ‘We’d better let you get back to your work.’

  Joel stood for a while after the police had driven away, a small frown drawing his brows together.

  ‘Dr Addison?’ Rod Banks approached. ‘I’ve just had news about the head-injury guy. He had an arrest in CT—they’d just got him off the scanner. I don’t think there was much Mr Pardle could have done, there was major brain damage under the fractures.’

  Joel blew out a breath as he turned to go back inside. ‘It’s probably just as well.’

  ‘Don’t let Allegra Tallis hear you say that,’ Rod said, more than a little wryly. ‘She’s in with little Tommy Lowe right now. Apparently the BIS monitor started showing brain activity last night. Allegr
a whizzed through here and filled me in on the news some time ago—she’s busy arranging a repeat EEG.’

  Joel stared at him, hope lifting for a moment then crashing back down in his chest. ‘What sort of BIS activity did she mention?’

  ‘Not much apparently, but enough to justify another few extra days of monitoring, she thinks,’ Rod answered.

  ‘Has the father been told?’

  ‘According to Allegra, he’s on his way in.’ Rod hesitated for a moment before adding, ‘Sorry we couldn’t salvage the Fowler chap. I guess his number was up.’

  Joel gave the young man a world-weary glance. ‘Believe me, he wouldn’t have wanted it any other way.’

  CHAPTER SIXTEEN

  ALLEGRA had not thought when she’d arrived for work that morning that the ache she had felt in her heart could have been eased in any way, but when she had looked at Tommy’s overnight BIS monitor scores her hopes had soared in spite of her fractured relationship with Joel.

  Kellie, the medical registrar, went through them with Allegra. ‘See there, that’s definite cerebral activity—at one point it’s as high as eight. It’s small but there’s been nothing prior to that, and the activity has continued at a lower level since then.’

  Allegra knew an eight was not an indication of full recovery, far from it, but it meant Tommy had an intact cerebral cortex, and that was the basis for recovery of consciousness.

  ‘Can I see his obs chart for last night?’ she requested.

  ‘Sure, here is the chart from midnight the previous night,’ Kellie said, as she passed across a large sheet with manually entered graphs.

  ‘Look at this, Kellie—at around the same time as the first BIS response, there is a rapid rise in pulse and BP. Like a stress response,’ Allegra observed.

  ‘I’d not noticed that.’

  ‘Did Tommy have any visitors last night?’ Allegra asked. ‘His father or aunt?’

  ‘I don’t really know. As far as I’ve heard, it was fairly quiet. I’ve only just started my shift. I could check with the nurses. Why, do you think something precipitated this?’

  Allegra frowned as she looked back at the printouts. ‘It’s hard to tell. Nothing I’ve done so far has stirred him and yet here we have an eight seemingly out of the blue.’

  ‘Yeah, well, you and I know an eight isn’t exactly an indication that a rocket scientist is still residing inside that little head,’ Kellie said.

  Allegra flicked a quick glance in her friend’s direction. ‘No, but it means he deserves more time.’

  ‘Have you told Joel Addison about this latest development?’

  Allegra carefully avoided her friend’s eyes. ‘No, not yet, but no doubt he will soon hear of it and dismiss it as insignificant.’

  ‘Yes, but the father will be pleased surely? He has the final say.’

  ‘The father gave up hope days ago,’ Allegra said. ‘He’s terrified of being left with a permanently disabled child.’

  ‘I can’t say I blame him,’ Kellie said. ‘Have you ever thought about what sort of life some of our patients go on to live once we patch them up and send them on their way?’

  ‘I had the very same conversation with Joel Addison the other night,’ Allegra said. ‘But then I think of Alice Greeson’s parents, who would have been grateful to have taken their daughter home in whatever state she was in. They would have nursed her lovingly for the rest of her life.’

  ‘But what happens when they get too old to do the care?’ Kellie asked. ‘It falls on the siblings or other relatives, and that’s hardly fair. They have their own lives to live.’

  Allegra sighed as she thought about it. ‘Yes…I can see it’s not exactly a black-and-white issue, but I want to do my best in this case. I feel I owe it to Tommy. His mother is clearly mentally ill. Have you seen the self-mutilation scars on her wrists?’

  Kellie nodded. ‘Sad, isn’t it? I wonder what her story is?’

  ‘Probably abuse of some sort in her childhood,’ Allegra said. ‘The husband intimated as much. He has also had his fair share apparently, his sister, too.’

  ‘They’re very close, aren’t they?’

  Allegra swung her chair around. ‘Who, Serena and Kate?’

  ‘No, Keith and his sister.’

  ‘What do you mean, close?’

  Kellie gave a little shrug. ‘I don’t know…it’s just an impression I got. You know that date I had organised with the internet dating agency? Well, we met for drinks and then went to that new swanky restaurant on St Kilda Beach. I saw Keith and his sister at a nearby table. I don’t think they recognised me. Besides, they hardly even once looked my way. At first I was a bit surprised that a brother and sister would…you know…act that way. It seemed a little weird, sort of creepy.’

  ‘Weird? In what way?’ Allegra could feel a strange chill being to pass over her.

  ‘Well…’ Kellie dangled her leg from her position where she was perched on the desk beside Allegra. ‘I have three brothers and let me tell you as much I love each of them dearly I would never let any of them hold my hands for ages across a restaurant table, and I certainly would never let them kiss me full on the mouth.’ She gave a little grimace.

  Allegra stared at her friend for so long without speaking that Kellie gave her a little nudge with her foot. ‘Hey, what did I say?’

  Allegra got to her feet, the office chair she’d been sitting on rolling backwards to bump against the filing cabinet. ‘Excuse me, Kel. I have to see Joel Addison for a minute. Page me if anything else happens with Tommy.’

  Kellie turned to watch her leave the unit. ‘That girl really needs to get out more,’ she said to herself, before sliding off the desk and answering the phone that had just started to ring.

  Joel was just coming out of his office when he saw Allegra heading his way. He straightened to his full height, mentally preparing himself for yet another showdown, but to his surprise as she got closer he could see no trace of anger on her beautiful face, but worry instead.

  ‘Can I see you for a minute?’ she asked.

  ‘Sure.’ He reopened his office door and waited for her to precede him, her perfume filling his nostrils as she moved past. ‘What can I do for you?’

  ‘Well, for a start let me assure you this is not one of those morning-after-the-night-before scenes,’ she said turning to face him, her slim hands twisting in front of her. ‘Neither am I going to apologise and beg you to reconsider our relationship. As far as I’m concerned, you and I are not going to work. It was a moment of madness to even make an attempt.’

  ‘I agree,’ he returned coolly.

  Allegra fought down the disappointment his response triggered. Couldn’t he have at least shown a little remorse for his part in last night? He had offered her nothing but an affair, and it had hurt her terribly to be considered a temporary option. She knew she deserved better than that and he did, too, but for some reason he wasn’t interested in even giving it a chance.

  ‘I heard about the BIS monitor scores on the Lowe boy,’ he said into the little silence. ‘What was the reading?’

  Allegra dearly wished she could tell him fifteen, but there was no point lying when he could just as easily verify the results for himself. ‘It was an eight for a brief period last night, and a few low-level traces since,’ she said. ‘His pulse and blood pressure went up for about twenty minutes around the same time.’

  ‘Can you account for it in any of the things you’ve been doing with him? I heard you were playing his favourite movie repeatedly. Do you think that had something to do with it?’

  ‘I don’t know…’ She undid her hands to tuck a strand of her hair behind her ear that had slipped from its restraining clip. ‘Kellie Wilton, the medical registrar, is checking with the night staff to see if anyone noticed anything.’

  ‘Did he have any visitors during the night?’

  ‘I’m not sure. I’m waiting for the father to come in to ask him. He doesn’t usually come in at night, or at least not for
very long.’

  ‘I expect he is too busy with his mistress,’ Joel said, echoing the cynical opinion of the police officer he’d spoken to earlier.

  ‘Yes…I suppose you could be right…’ She worried her bottom lip for a moment before she went on, ‘Joel, have you ever met Keith Lowe’s sister?’

  ‘No. Why?’

  ‘I have a funny feeling about her,’ she said.

  ‘We’re not talking auras here, are we?’

  Allegra looked up at him but for once there was no sign of mockery on his face. ‘Kellie saw Keith and his sister having dinner in a restaurant a couple of nights ago,’ she said. ‘She saw them holding hands and kissing in a way that suggested they have a slightly unusual relationship for two people who claim to be siblings.’

  Joel listened as intently as he could, his brain shooting off in all directions when Allegra tapped into some of his own lurking suspicions. His conversation with the police had stirred up questions that he would very much like some answers to.

  ‘Each family has its own code of affection.’ He did his best to go down the logically sequential route. ‘Hugs, kisses, that sort of thing vary between family groups, even between individuals within the one family.’

  ‘Yes, I know that, but remember I told you about Keith Lowe’s background? How he had been brought up in an overly strict, punitive way? He spoke openly of the difficulty he had showing affection, and yet Kellie swore she saw him holding his sister’s hands for ages and kissing her on the mouth. That doesn’t add up, to my way of thinking. Besides, I know you don’t give much credence to my reading of body language, but I can’t help feeling something is not quite right with those two. I understand how having a relative in ICTU is traumatic and makes people act in unpredictable ways, but Serena Fairbright doesn’t seem at all attached to Tommy. She barely spends more than a minute or two by his bedside. She hasn’t even brought a special toy or anything to him. I know men sometimes overlook those sorts of things, but women are usually good at that. Look at Jonathon Sprent. He may be a fully grown adult but his mum and his sister brought in his childhood teddy bear and a fluffy one-eared rabbit and propped them by his bedside on the very first day he came in.’