Prescription—One Bride

by Marion Lennox

  Dear heaven…

  ‘Ring him again, then,’ she said harshly. ‘Tell him Mr Reid’s in real trouble and he must come now!’

  ‘He’s at Clinic,’ the nurse told her. ‘He yelled last time when I disturbed him. He said he’d come when he was ready and not before.’

  Instinctively Jess looked to Niall.

  Niall Mountmarche had followed her into the room and was surveying the room with a face that was totally devoid of any expression. It was as if he was deliberately holding himself apart.

  He didn’t want to get involved.

  ‘Dr Mountmarche…’ Jess started.

  ‘Yes?’ It was a clipped, clinical reply. It could have meant anything.

  ‘Please…’ Jessie said helplessly and then, at the look on that cold face, she went further. ‘Frank’s…Frank’s my friend…’

  ‘I’m not practising medicine here, Dr Harvey—especially on someone else’s patient. It’s none of my business.’

  ‘Then Frank will die.’

  The words hung in the air and everyone in the room knew that they were absolute truth.

  Niall looked down at the man on the bed for a long moment. Frank hadn’t acknowledged their presence in any way. His frail body was heaving as if it was trying to rid itself of a poison that was overwhelming.

  ‘Damn him,’ Niall Mountmarche said savagely and Jessie knew that he wasn’t talking of Frank. He was talking of the absent Lionel Hurd. He walked over to the bed and lifted the chart. ‘He’s diabetic, isn’t he?’

  ‘Yes.’ Jessie was hardly breathing.

  ‘What’s his blood sugar?’ Niall snapped at the nurse and the nurse faltered.

  ‘B-blood sugar?’

  ‘Blood sugar, Nurse,’ Niall said and his voice was dangerously calm. Jessie had a sudden vision of Niall in a large teaching hospital, with students behind him. The image of the Ogre of Barega was thoroughly replaced now. There was clinical calm—and clinical, icy professionalism.

  ‘The patient is diabetic, Nurse,’ Niall snapped. ‘You must be doing blood-sugar readings?’

  ‘Dr Hurd didn’t tell me to…’

  ‘Well, I’m telling you,’ Niall snapped. ‘When was the last one done? Yesterday?’

  ‘I don’t know…I mean…We give him his pills for diabetes but I didn’t know we had to do blood sugars…’

  The nurse was close to tears.

  ‘Well, do one now, Nurse,’ Niall said with that same icy calm. ‘Fast.’ He lifted the chart from the end of the bed. ‘History. Dr Harvey, do you know it?’ The nurse was already scurrying for the diabetic testing kit, sniffing back tears, and Niall had obviously given her up as a source of useful information.

  ‘Frank was admitted to hospital a week ago with a bad leg,’ Jess told him. ‘It doesn’t seem to be getting any better. I’m not…Dr Hurd doesn’t discuss his treatment with me. That’s all I know.’

  Niall flicked up the blankets. Frank was wearing short pyjamas and his leg was exposed on the white sheet. The right leg from ankle to knee was red and swollen.

  ‘Cellulitis,’ Niall said grimly. He was holding Frank’s chart in his free hand and glanced at the line of figures. Sarah had filled in temperature and blood pressure readings with neat, precise figures. It was one thing she was good at.

  The nurse was taking a tiny fingerprick blood sample now for a blood-sugar reading and her hand trembled.

  ‘He’s been running a temp of over thirty-eight for seven days,’ Niall said incredulously. ‘There’s no drip up? Has Dr Hurd discontinued intravenous antibiotics?’

  Sarah was placing the blood sample on the stick. She nearly dropped it in her fright.

  ‘He’s had antibiotics orally, Doctor,’ she whispered. ‘And his diabetic tablets…’

  ‘So he’s not on insulin?’

  ‘Tablet only.’ Sarah was sure of her ground here.

  ‘And you haven’t taken a blood-sugar reading?’

  ‘I don’t…’ Sarah looked wildly across at Jessie. ‘Maybe the night nurse did—or Dr Hurd himself—’

  ‘Pigs might fly,’ Niall snapped. He laid the chart on the bed and lifted Frank’s wrist. ‘I need a drip set up fast,’ he told Jess. ‘Can you arrange it…?’

  ‘Dr Harvey’s a vet,’ the nurse said, shocked.

  ‘Yes, she’s a vet,’ Niall growled. ‘And she wouldn’t treat a dog like this man’s been treated. What’s the blood sugar, Nurse?’

  He waited.

  Sarah stared at the tiny chart. It was as much as she could do to keep her hands from trembling too much to read it.

  ‘Th-thirty-two…’

  ‘Thirty-two.’ Niall sighed. His voice was dangerously quiet. ‘A blood sugar of sixteen should be sending danger signals. Thirty-two, and you haven’t been testing…’

  His face set into grim lines. ‘Someone’s been criminally negligent here,’ he snapped. ‘But we’ll worry about that later.

  ‘I want his urine tested for ketones as soon as possible but I won’t wait on the result. He has to be suffering from diabetic ketacidosis and I’ll work on that assumption. I want insulin—now—and I want saline intravenously at maximum flow. We’ll also need blood for electrolytes.’

  ‘H-how much insulin do we give him?’

  ‘Twenty units to begin with.’

  ‘And saline?’ The nurse was practically weeping and Niall winced.

  ‘As much as we can get aboard,’ he said icily. He was taking Frank’s blood pressure as he spoke. ‘Ninety on fifty…And you ask me how much…?’

  ‘Can I help?’ Jess asked quietly.

  ‘I need equipment for an IV line…’

  Jessie had already found it. She’d moved swiftly next door to the small theatre and brought back what was needed. Before Dr Hurd’s arrival, her presence had been welcome in the hospital—as the island doctors’ presence had been welcome in her vet’s clinic. Two halves of a medical team…

  Not now. Not with Dr Hurd…

  Maybe she could again with Niall Mountmarche. He seemed to have accepted her completely as a medical equal. Niall accepted the syringe Jess handed him without comment.

  ‘I want insulin in now and the first litre of saline through within the hour. Then keep right on going—if we’re in time,’ he told Sarah. He was swabbing the back of Frank’s hand and sliding the catheter into place ready for the IV line, taking the blood sample for elecrolytes in the process.

  ‘The insulin can go in with the first litre. You don’t stop the flow until I tell you and I’ll tell you when to stop. You’re not taking instructions from Dr Hurd for this patient, Nurse, but from me. Move…’

  ‘But Dr Hurd…’

  The nurse stared wildly with frightened eyes. She clearly had no idea who this strange man was—to be marching into her ward and giving orders.

  ‘Dr Mountmarche is a qualified doctor,’ Jess said quickly, but the nurse’s unease didn’t diminish.

  ‘I don’t know…’

  Then her face cleared at the sound of footsteps in the hospital corridor.

  ‘Oh, here comes Dr Hurd now,’ she said in relief. ‘He’ll give me orders.’

  ‘You will do as I say. Now!’ Niall snapped. ‘There’s no time for argument. If you don’t then this man will be dead within an hour. Jessie, stay here and see she does what I’ve asked. Brain her and do it yourself if necessary.’ His mouth tightened in a grim line.

  ‘But Dr Hurd won’t let me,’ the nurse sobbed.

  ‘Leave me to deal with Dr Hurd.’

  He hesitated, clearly unsure whether to stop Lionel Hurd in the corridor or stay and risk an altercation in Frank’s room. Jess saw his dilemma. A shouting match by his bedside was the last thing that Frank needed.

  ‘We’ll be right here,’ she said swiftly, and Niall’s eyes met hers in a fleeting moment of comprehension.

  ‘You’re in charge then, Dr Harvey. OK?’

  ‘OK.’

  He nodded, a trace of a smile curving the sides of his mouth. �
�Rather medicine than Dr Hurd?’

  ‘Any day.’

  The smile deepened. ‘So you’re sending me to battle. Well, they don’t call me the Ogre of Barega for nothing,’ he told her, and let his hand drop to touch the back of hers in a fleeting gesture of reassurance.

  Then he handed the tray of equipment across to Jessie and walked out of the room.

  CHAPTER THREE

  JESSIE tried hard not to listen. The voices in the corridor were muted. One doctor discussing a case with another?

  Not likely.

  If Frank wasn’t so desperately ill she’d have no compunction in putting her ear to the door but there was enough to do in the ward for Jessie’s attention to be fully occupied. She worked swiftly with Sarah to set up the drip, trying to dispel the nurse’s doubts as she went but aware all the time that the most important thing was to get the drip going and the fluid and insulin into Frank’s dehydrated body.

  Sarah was like a frightened rabbit.

  The nurse sobbed as she worked and Jess came close to strangling her. Finally, as Sarah dropped a bag of saline, Jess paused.

  ‘Sarah, pull yourself together,’ she told her. ‘Immediately.’

  The nurse gulped on a sob. ‘I c-can’t. I’m so scared.’

  ‘Why?’ Jessie lifted the saline bag and hooked it to the stand, then fitted it to the needle in the back of Frank’s hand. She gave Frank’s arm a reassuring squeeze as she did so.

  ‘You’ll be OK now, Frank,’ she said gently, with more assurance than she was feeling. The elderly farmer seemed beyond hearing but she could hope…‘The insulin’s going in. Just try and relax and let it take over.’

  Relax…

  She looked across at Sarah. Sarah was a crumpled mess.

  ‘I should have insisted,’ Sarah said harshly, self-blame starting to show through her fear. ‘I should have stood my ground and insisted Dr Hurd come back. I knew something was wrong—but Dr Hurd made me feel like a fool. I should have…’

  ‘Trusted your own judgement?’ Jessie bit back irritation, trying to imagine how she’d feel coming back to veterinary medicine after a twenty-year absence. She crossed to take the woman’s hands and gave them a swift squeeze. It was either that or give in to anger—and anger here would help no one.

  ‘Sarah, you’ve been a fine nurse in the past and you’re a sensible woman,’ she said roundly. ‘Coming back after an absence of twenty years must make you nervous—but technology hasn’t changed so much that you can’t tell when a man’s sick. You have to trust what your common sense tells you.’

  ‘But Dr Hurd wouldn’t come and I didn’t think past that,’ Sarah gulped. ‘I hardly thought about the diabetes. I just knew Frank’s leg was infected and maybe the poison had spread.’ She took a deep breath.

  ‘Well, maybe it was my own insecurity working there, too. If I was sure of myself I would have thought things through—thought of the diabetes—instead of blindly waiting for orders.’ She looked doubtfully down at the bed. ‘Oh, Jess, do you think we’re in time?’

  ‘I certainly hope so.’

  The awful heaving had stopped for the moment. Frank was lying back on the pillows, grey with exhaustion, and Jessie’s heart stirred in pity. The fluid was already dripping steadily into his veins—but had they moved fast enough?

  She crossed to the bed and lifted Frank’s hand.

  ‘I have some good news, Frank,’ she gently told the sick man, perching beside him on the bed. She didn’t know whether he could hear her but she could at least try. ‘We’ve found Harry. He’s tired and hungry but he’s asleep in my kitchen right at this minute and as soon as you’re well enough for visitors he’ll be the first one through the door.’

  Lionel Hurd would have a pink fit if he could hear her make such a promise, Jessie knew. Dogs in Lionel’s hospital? Never!

  That fight was for tomorrow. Jess would cross that bridge when she came to it.

  It had been the right thing to say now, though. The old man’s eyes flickered open, bodily ills put aside for an instant. There was relief in the exhausted eyes.

  ‘He’s…Harry’s safe?’ he whispered.

  ‘Quite safe,’ Jessie promised in a voice that wasn’t steady. If only she could say the same for Frank.

  ‘Then I’d best hold on,’ Frank managed, and Jess had to lean down to hear his thready whisper. ‘For Harry…’

  ‘You do that, Frank,’ Jess whispered back. ‘Please…You do that.’

  There was nothing more that Jess could do. It was just a matter of waiting now—and hoping that the insulin would stabilise him and the fluids would save Frank’s life. And hope that not too much damage had been done…

  ‘I’ll look after him now,’ Sarah whispered, smoothing her apron with grim determination. ‘I’m right. Oh, Jess…What if Dr Hurd says to take the drip out?’

  ‘He’ll do no such thing,’ Jessie promised, but she wasn’t all that sure. Lionel Hurd had an ego the size of a house…and Niall Mountmarche had just marched straight over it.

  And Niall didn’t appear the sort of man to wave peace flags either.

  Jessie walked out into the corridor and carefully closed the door behind her—to find the two men still there.

  Lionel Hurd was rigid with anger. His florid complexion was almost beet-red and the hands by his side were clenched into fists. As Jess emerged he wheeled to face her and directed his anger straight at her.

  ‘How dare you, girl?’ he snapped. ‘How dare you…?’

  ‘How dare I what?’ Jess asked, her eyes moving past him to Niall.

  Niall didn’t comment. He stood, a dark, enigmatic stranger. His hands were in the pockets of his riding jodhpurs as he waited.

  As if he was waiting with benign interest to see what would happen.

  He’d lit a fuse. Now he was waiting for an explosion.

  It came.

  Lionel Hurd had obviously not been able to berate Niall as he would have liked. Someone claiming to be another doctor…One he didn’t know…

  He’d be unsure of his ground.

  Jess, though…An insignificant girl vet…

  ‘How dare you drag someone in to see my patient without my permission?’ he remonstrated. ‘You have no right. How many times do I have to tell you your place is on the other side of the building, Jessica Harvey, and neither you nor the animals you treat are to step over the boundary? The island board of management will hear of this. I’ll have you evicted from this building.’

  ‘It’s a privately owned building,’ Jess said mildly. ‘You can’t.’

  ‘Not even with the Health Commission behind me?’ Lionel glared at her with something akin to hatred. ‘If they hear…’

  ‘If they hear anything about Dr Harvey’s interference then they’ll hear you’ve treated one of the locals with what amounts to criminal negligence,’ Niall interceded. Niall’s voice was carefully controlled but Jess had the impression of disgust, well contained.

  ‘I have not…’

  ‘You’ve treated a diabetic suffering from cellulitis with oral antibiotic for over a week with no noticeable improvement and without changing the antibiotic to an intravenous line. One.’ Niall touched a finger on one hand. He lifted the next finger.

  ‘Two, as far as I’ve seen you’ve done no blood-sugar tests in the entire time he’s been in hospital. No check for ketones in his urine or electrolytes done. Three and four. And he’s been vomiting for six hours with you refusing to see him. Five. Nail in the coffin, Dr Hurd. Wouldn’t you say? If I were you I’d keep my tail nicely between my legs and not make any complaints to anyone.’

  ‘Who the hell are you?’ Lionel blustered. ‘Who the hell are you to question my treatment?’

  ‘I’m a qualified medico, believe it or not,’ Niall said wearily. ‘And I don’t want to be involved. Not one bit. You left me with no choice.’

  ‘Qualified…?’ Lionel stared at him belligerently. ‘From where?’

  Niall’s eyes suddenly narrowed. ‘Lo
ndon University,’ he said slowly. ‘And you?’

  ‘I don’t have to tell you…’

  ‘And you?’ Niall snapped the demand in the tone of someone who was brooking no argument and Lionel’s colour rose even further.

  ‘Melbourne,’ he spat. ‘Not that it makes any difference. Whoever you are, I want you to get the hell out of my hospital. Now. You’re not welcome here. Wherever you trained you should know it’s unethical to interfere with a patient without their own doctor’s consent. So clear off. And take your girlfriend with you.’ He cast such a look of sneering dislike at Jessie that she flushed.

  ‘I’m going,’ Niall said evenly. He held out a peremptory hand to Jess, signalling her to silence. ‘But there’s two things you should know, Dr Hurd. One is that I intend to take a look at your credentials. A long look. The second is that if Frank Reid dies then I’ll personally make every effort to have you struck off every medical registry in the known world. And I’ll take personal pleasure doing it.

  ‘So if I were you I wouldn’t interfere with the treatment I’ve instigated. If I were you I’d be very sure my instructions are followed to the letter.’

  And Niall turned and walked out of the hospital entrance, pulling Jessie along with him.

  They didn’t talk until they were outside and even then there was a good two minutes’ silence before Niall spoke. He stood in the sun, taking long deep breaths and staring out at the distant sea.

  In the end it was Jess who broke the silence.

  ‘I’m sorry,’ she said tentatively, ‘to drag you into that…It wasn’t fair.’

  ‘It wasn’t,’ Niall agreed and the anger that Jess hadn’t heard when he’d been talking to Lionel was all there in his voice. ‘How on earth did the island board ever employ such an incompetent oaf?’

  ‘I told you,’ Jess said, trying to keep her voice light. ‘We were desperate.’

  ‘You realise he’ll kill someone?’

  ‘Maybe he won’t,’ Jess said unhappily. ‘Maybe this will give him a fright. If it’s just laziness…’

  ‘I wish I could think this is just laziness,’ Niall growled. ‘But it should be instinct to order blood sugars on diabetic patients.’ He glanced at his watch and swore. ‘Jess, I have to go.’