‘Daddy,’ she moaned again, and Leah looked over, bracing herself for the worst but giving a relieved, steadying smile as she saw he was conscious.
‘Its OK, Stacey, Daddy’s here.’ His eyes met Leah’s. ‘Get her out, will you?’ he begged, and Leah gave a small nod.
‘As soon as we can.’ In a matter of seconds Leah assessed the small child, attaching a cervical collar first, her fingers working their way down and realising with sweet relief that she seemed relatively unharmed.
‘How are you, sir?’ Leah asked.
‘Don’t worry about me—just get her out.’
‘We will,’ Leah said assuredly, feeling for his pulse as she spoke. ‘My name’s Leah. I’m a nurse.’
‘Greg.’
‘Greg, we’re going to get you both out just as soon as we can.’ Her voice was calm but Greg’s inactivity was unnerving Leah. He was talking to his daughter, trying to reassure her, but he remained still, not looking over, just staring fixedly ahead as Leah tried to climb towards him. ‘Are you hurt anywhere?’
There was the longest pause. Shining her torch into his face, Leah inched her way over. ‘Greg, where are you hurt?’
‘I can’t feel my legs.’
Shining her torch down, she prayed for a twist of metal, something that might be pinning them, but with a nervous gulp she looked at the relatively clear space around them, at the absence of any clear injury, and her heart sank.
‘Just get Stacey out.’
‘I need you to stay still, Greg,’ Leah said, her tone firm, praying the carriage wouldn’t jolt again as she unclipped a hard cervical collar from her bag.
‘I’ve broken my neck, haven’t I?’
Leah knew she should be honest, knew that the truth was needed, but until that hard collar was in place she didn’t want Greg getting any more upset. The chances were he had broken his neck but, with luck, it could be an incomplete fracture or swelling causing the paraplegia. The slightest movement could worsen his injury and render the damage irreversible so it was imperative he stay still.
‘Greg,’ Leah said again, moving ever closer and trying not to create any movement of the seats herself, ‘you have to stay still. I’m going to put a collar on you and then we can talk, but until we do I don’t want you to move. Now, don’t talk, don’t nod, don’t do anything—just let me do all the work.
‘Samuel!’ Leah called into the darkness, not sure if he was in the carriage yet but knowing she was going to need him. ‘I need a hand over here.’
‘What have you got?’ The voice that greeted her was as unexpected as it was familiar, and Leah started slightly as she heard Cole’s voice. She didn’t doubt he knew she was in there, didn’t doubt he wasn’t particularly pleased at the fact, but there was no time to worry about it now. Lives were at stake.
She knew Cole needed an answer, knew he had to weigh up Leah’s demands with whatever he was dealing with, but, not wanting to upset Greg with his neck still unstable, she didn’t want to shout out that Greg had a spinal injury, worried the effect the words would have on her patient. ‘I need a hand to get a neck collar on,’ Leah called, hoping that despite her rather vague reply Cole would read between the lines and realise the urgency behind her summons.
He must have, because in a few minutes he was beside her, taking in the situation in an instant. ‘I’m just going to climb over you.’ He smiled down at the little girl. ‘What’s your name?’
‘Stacey,’ Leah answered for her when it was clear she wasn’t going to. ‘And this is Greg, her dad.’
‘OK, Stacey, my name’s Cole, I’m a doctor. I’m going to climb over you and I’ll try not to knock you, but I need to get to your dad so I want you to stay as still as you can for me.’ He spoke as he moved, all the time reassuring the terrified little girl as he inched his way over. ‘That’s the chap,’ Cole said gently, holding Greg’s head firmly in place as Leah struggled to fit the collar in the horribly confined space. ‘Get a line into him,’ Cole ordered, when finally the cervical collar was firmly in place. ‘He could go into shock. Run through some Gelofusion and, even though the collar’s still in place, warn him that it’s imperative he still stays absolutely still.’
‘Will do.’ Leah nodded as Cole called out his instructions and for a moment so small it was barely there the tension seemed to fade from his face, a flicker of a reassuring smile winging his way to Leah as he comforted her with his eyes.
‘Samuel’s trackside, working on someone, so if you need a doctor call out for me. But I need to get back to my patient now. I’ll tell the paramedics we need a spinal board to move Greg. Hopefully we can clear some space and let more help in.’
‘Go,’ Leah said, then changed her mind. ‘Cole, can you get Stacey out?’
Leah knew the little girl wasn’t a medical priority, but this was surely no place for her to be. ‘There are no obvious injuries, apart from cuts and bruises,’ Leah added as Cole made a swift assessment and gave a quick nod.
‘Stacey?’ Despite his urge to get back to his patient, despite the direness of the situation, Cole took his time to speak slowly to the little girl, knowing if he upset her now there was no way she would comply. ‘We’re going to get you out. You see that light over there? That’s where the firemen have cut a hole so you can escape, that’s what all that horrible noise was. Now, it isn’t far, but you’re going to have to help me by being brave. I need you to climb up onto my shoulders and hold around my neck.’
‘Like a piggy-back,’ Leah said. ‘You can do that, can’t you?’
As the little girl gave a wide-eyed nod of agreement Leah let out a relieved sigh, gently prising her out of her seat as Cole struggled to remain patient. But suddenly Stacey changed her mind, pitiful frightened sobs escaping her lips as she called for her father, refusing to leave his side.
‘Stacey.’ Cole’s voice was a touch louder but still gentle. ‘Daddy needs a special sort of stretcher. Now, you’re going to have to help me get one for him. We’re going to crawl to the light and when the firemen lift you out I want you to say in a very loud voice that they need to help your daddy and fetch him a stretcher. Do you think you can do that?’
It was probably a matter of seconds but it felt like minutes before finally Stacey calmed down, nodding bravely as Leah lifted her over and placed her on Cole’s shoulders.
‘She’s OK now,’ Leah said. Turning back to Greg, she wrapped a tourniquet round his arm and ran through a flask. They even managed to share a wry smile as she found a passenger strap exactly where it should be, the ideal place to hang the fluids. ‘Cole’s taking her out to safety, so let’s see about you.’
‘I’m paralysed, aren’t I?’ Now his daughter was safely taken care of, Greg could concentrate on himself and voice his fears. ‘I’ve broken my neck, haven’t I?’
‘We don’t know that yet,’ Leah said gently. ‘Until we get you to hospital we won’t know exactly what’s going on. There could be any number of things causing your weakness but, as the doctor said, it really is imperative that you stay still.’
‘Don’t lie to me.’ Greg was sobbing now and Leah felt a surge of panic. The collar was secure but if Greg started thrashing around untold damage could be done. If his fracture extended, he could even stop breathing.
‘You mustn’t move,’ Leah warned as Greg attempted to lurch forward, hysteria overwhelming him. ‘If you move you could die,’ Leah said sharply, knowing it was all or nothing but praying that her words would still him.
‘I’d rather die,’ Greg sobbed. ‘I’d rather be dead than spend the rest of my life in a wheelchair.’
Glancing over, she watched as Cole mercifully reached the exit, watched as strong hands reached in and lifted Stacey to safety. As much as Greg mightn’t think it now, he still had a lot to be thankful for.
‘No, Greg,’ Leah said firmly, her eyes locking on her patient’s. Something in her voice stilled him, something in her voice told Greg that now wasn’t the time for dramatics. ‘No, Gr
eg,’ Leah repeated, ‘you wouldn’t.’
CHAPTER TEN
‘THEY’RE calling us out.’
Leah could hear Cole coming towards her but she didn’t look up. She was too busy concentrating on her patient, too busy counting the compressions in her head as she administered cardiac massage to a woman younger than herself. Greg had been safely lifted out, but that hadn’t been the end of it. Stacey and Greg had been the tip of the iceberg, Greg’s safe evacuation paving the torturous way to yet more grief.
Only the woman’s head and chest were exposed and at first Leah had been sure she was dead and had braced herself to move on to the next victim, to look after the living, help someone who had a chance, but a faint flicker of a pulse at the woman’s neck had been enough for Leah to do her best for this stranger.
To afford her a chance.
‘One of the carriages has caught fire, Leah,’ Cole shouted as she carried on with the cardiac massage. ‘They want all emergency personnel out till it’s clear.’
‘She had a pulse when I got to her.’ Leah looked up at him frantically as Cole shone a light in the woman’s eyes.
‘Stop the massage.’ Putting his stethoscope in his ears, Cole slipped the bulb over the woman’s chest, screwing up his face in concentration as he listened for a heartbeat, a breath sound, any indication that she was still alive.
Leah didn’t take the chance of a tiny reprieve. Instead, she concentrated on pulling at the seat that was pinning the woman to the floor, tugging at it with all her might but still not able to move it.
‘She’s dead,’ Cole said gently, his eyes locking on Leah’s. ‘There’s nothing we can do, Leah. We have to get out.’
‘The electricity’s off,’ Leah said, trying helplessly to free her patient. ‘It’s not a diesel train, the whole thing isn’t about to go up. We’ll be all right.’
But Cole shook his head. ‘They think someone used a lighter to see, and a whole carriage has gone up. They’re dousing the carriage with foam and with the extra weight any minute now this whole lot could topple.’
She was about to agree, to give a reluctant nod, but the seat she had been pulling suddenly gave way. Too little, too late, Leah thought with a sob of frustration, as she toppled backwards. As she righted herself, as she started to crawl for the exit, she stopped in her tracks, frowning in bemusement as Cole recommenced the cardiac massage.
‘Did you get a pulse?’ Ignoring the shouts to get out from the firefighters, Leah inched her way back over, but as her head torch shone on the now exposed body of her patient Leah felt her heart somewhere in her mouth as the soft mound of her patient’s stomach caught in her torchlight.
‘She’s pregnant,’ Leah gasped, watching as Cole pulled out an ambu-bag and placed it over the woman’s mouth, pushing air into her lungs as Leah instinctively took over the massage.
‘She had a pulse when you got to her?’ Cole’s eyes met hers and though Leah was sure, as positive as she could be, for a second or two she wavered, knowing the implications of her answer. If the answer was yes, if there was a chance her body had been adequately oxygenated until Leah had arrived, then an emergency Caesarean section would have to be considered.
‘A faint one,’ Leah said, her voice wavering, bile rising in her throat at the preposterousness of the decision they were nearing.
‘Keep up the massage,’ Cole ordered, his hands moving down to the woman’s groin, feeling for her femoral artery. ‘She’s got a good output with the massage.’ She could see the sweat pouring down his dirtied face, the indecision in his eyes, the tension grooved on every feature as he again reinflated the patient’s lungs with the ambu-bag. The fact that the woman had a good femoral pulse meant that the baby could still be getting oxygen, could still be alive, and Leah’s eyes shuttered closed for a second as she rhythmically pounded the woman’s chest, keeping out the world that was forcing this most awful decision upon them.
‘She’s dead, Leah.’ Cole’s eyes were there when hers opened, ‘We both know that there’s nothing we can do for this lady, she’s definitely gone, but there is a chance we could save her baby.’
Leah nodded, words failing her.
‘Leah?’ She heard the question in his voice, but knew deep down that the choice had already been made for them.
It was made every day when they clipped on their name badges and headed for work, it was made every time they rolled up for their shift and went in to bat to save strangers’ lives. And just because they weren’t in the relatively safe confines of a resuscitation room with a full team to support them, just because no one on earth would blame them for walking away now, Leah knew what needed to be done.
All life was precious, all life was valuable, and no matter what the circumstances this baby deserved a chance.
‘What do you want me to do?’ She couldn’t look at him, couldn’t bear to see her indecision reflected in his eyes.
‘Bag her for me,’ Cole said, his voice wavering slightly as he pulled open his backpack and set up his equipment. ‘And keep up the massage till I tell you to stop, then I’ll need you to shine the torch for me.’
It was soon over.
But it was the longest few minutes of her life.
Even under the controlled setting of Theatre, emergency Caesarean sections were amazingly quick, but here, more than ever, time was of the essence, and as Cole ordered her to stop the massage an involuntary sob escaped Leah’s lips. She held the torch with one hand and tried to assist with the other, her breath strangling her as Cole deftly lifted out the pale, limp infant, professional detachment not getting a look-in, tears coursing down both their cheeks as they concentrated on the baby Cole was holding, vigorously rubbing its back as Leah struggled with a rudimentary portable suction machine, trying to clear the baby’s airway, tickling the baby’s feet to stimulate its breathing. Grabbing the ambu-bag, she turned the mask upside down. An adult mask was way too big for a baby, but used upside down enough of a seal could be created. Just when she thought it was useless, that this horrible, horrible choice had been in vain, she felt the tiniest resistance, felt a limp limb stiffen as it flexed into life, the delicious sound of a splutter as the baby took it’s first independent breath.
‘Get out now, Leah!’ Cole ordered. ‘I’ll bring the baby.’
But Leah knew that was easier said than done. The path back was precarious enough without holding a slippery baby. Ignoring his orders, pulling off her bag, Leah grabbed at some sterile drapes. Ripping open the pack, she wrapped a sling around Cole, her hands trembling as she secured the baby to his chest, allowing him to crawl more freely.
‘Leah, out.’
She nodded. She knew she had to go, knew they had to get out, but there was one more thing she had to do first. Taking one of the remaining drapes, she gently placed it over her patient.
‘Your baby’s going to be OK,’ Leah whispered, her eyes blurring with tears as she finally headed for the exit herself.
The glare of the midmorning sun hit her as Leah was hauled out of the carriage and lowered to safety. The paramedics relieved Cole of his precious bundle, moving as swiftly as they were able towards the triage tent. And though she ached to follow to see how the baby was doing, she took a moment to get her breath, to somehow assimilate all she had witnessed before facing it again. Squinting upwards, she could see the news cameras homing in for their shots, the wail of sirens, busy now as they ferried patients to hospital. Never had a bottle of water tasted better as she gulped the icy liquid. Sucking the sweet fresh air into her lungs, gazing at the lush green trees, it was hard to believe the carnage she had just witnessed.
‘Where’s Cole?’ Blinking, she looked around as Samuel came over. ‘Is he over at Triage?’
‘Give him a minute or two, Leah. He’s pretty shaken up.’
‘Following Samuel’s gaze, she saw Cole hunched by a tree, squatting down, his head in his hands, his face grey, and Leah knew how ever hard this morning’s events had been for her. For Cole i
t would have been devastating. Ignoring the suggestion to leave him, she made her way over, offering him the drink bottle for something to do because, quite simply, she didn’t know what to say.
‘I’d better get back.’ Accepting the bottle, he took a long drink before heading back to the train.
‘It’s not secure yet,’ Leah called after him, half running to catch up with his long measured strides, only stopping when Samuel caught up with them.
‘We’re to head back to the hospital now.’ When Cole shook his head, Samuel carried on talking. ‘They want fresh teams in the carriages and, as much as I don’t like it, Cole, you know that’s right. We’re needed back at the hospital.’ His eyes raked the scene and Leah did the same. Cole continued to stare fixedly ahead.
‘Hell, it’s a bloody mess, isn’t it?’ Samuel sighed. ‘Was it you two who delivered the baby?’
Leah nodded but didn’t elaborate, anxious eyes darting to Cole who still wouldn’t look at her.
‘He’s picking up,’ Samuel said, and Leah looked over sharply.
‘It was a little boy?’
Samuel nodded. ‘You did a great job, it must have been hell.’ Worried, knowing eyes drifted to Cole as Samuel carried on talking. ‘If you want to fill me in, Cole, when they locate the father I can talk to him for you,’ he offered. ‘Given what’s happened, I know it might be a bit much—’
‘I’ll be fine,’ Cole said grimly, staring fixedly ahead as he walked.
‘Still, the father’s going to be pretty upset…’
‘Why?’ Cole shouted, calling over his shoulder as he marched angrily ahead. ‘At least he got to keep one of them.’
The Consultant's Accidental Bride Page 12
