by Sarah Morgan
They walked for another fifteen minutes and then Jake waved a hand. ‘There she is. I see her. By that tree.’
‘She looks all huddled up.’ Miranda frowned. ‘I hope she’s all right.’
‘Let’s find out, shall we?’
They reached the woman and she gave a wan smile. ‘I didn’t think anyone else would be stupid enough to walk along here in this weather, but I see I was wrong.’
‘I’m Jake Blackwell, I’m from the mountain rescue team.’ Jake dropped down so that he could examine her ankle. ‘I’m going to make you comfortable and then we’re going to get you out of here. Some of my colleagues are coming with a stretcher and we’ll carry you back to the ambulance. What’s your name?’
‘Verity. Verity Williams. This is so embarrassing.’ The woman closed her eyes briefly. ‘I’ve always scoffed at people who need the services of the mountain rescue team—always thought they were frivolous or badly equipped.’
Miranda shot a guilty look at Jake, who winked at her.
‘It can happen to the best of us, Verity. Now, if you don’t mind, I’m just going to take a look at the damage.’ His tone reassuring, he undid the laces of her boot and Miranda caught hold of the woman’s hand and encouraged her to squeeze.
‘Oh, that’s agony!’ Verity’s face drained of colour and she gasped in pain as Jake carefully eased the boot off her foot.
Miranda pulled a face. She could see instantly that Verity’s foot was badly swollen and discoloured. Was it broken? And what, she wondered, was Jake going to do about that out here in the middle of nowhere?
‘Does it hurt here?’ Jake was examining the ankle carefully and the woman gasped again.
‘Yes. It’s just a sprain, I’m sure, not a break.’ She winced and tried to wriggle into a more comfortable position while Jake dug his mobile phone out of his pocket and opened the top of his rucksack.
He pulled out a pad, a coiled rope and a knife and set about making a splint, his movements slick and confident.
‘Miranda, can you just check her pedal pulse? The foot looks a reasonable colour and she has sensation and movement so I’m assuming her circulation isn’t impaired, but I want to check.’ The phone tucked under his ear, he started talking to the person on the other end, giving a report on the woman’s condition and a description of their whereabouts, while he cut the pad and fashioned a splint.
Miranda removed her glove and checked the pulse in the woman’s foot, feeling the delicate throb under her fingertips with relief. ‘She has a good pulse,’ she told Jake as he snapped the phone shut and finished splinting the leg.
‘Right.’ Jake secured the splint and glanced at his watch. ‘I think they’ll be along with that stretcher in another fifteen minutes, Verity, so hang in there.’
‘Fifteen minutes?’ Miranda gaped at him. ‘It’s taken us almost an hour to get to this point.’
‘The mountain rescue team aren’t in the advanced stages of pregnancy,’ he reminded her, rocking back on his heels and pushing his hand back into his rucksack.
Verity’s face brightened. ‘You’re about to have a baby? Oh, you lucky things. How wonderful for you.’
Miranda frowned. ‘Well, actually, the baby isn’t—’
‘We’re thrilled,’ Jake said firmly, pulling out an extra layer and slipping it around Verity’s shoulders. ‘Best thing that could have happened.’
Confused as to why he would let the woman continue with her misunderstanding, Miranda opened her mouth to correct him and gave a gasp of shock as Jake leaned forward and kissed her. ‘I’m plucking up courage to ask her to marry me,’ he murmured, ‘but I have a feeling she’s going to turn me down so I keep postponing the moment.’
Marry him?
Miranda was speechless and Verity gave a sigh.
‘You don’t want to marry him?’ She turned to look at Miranda who managed a weak smile.
‘I haven’t known him that long.’ Realising how that sounded, Miranda felt a rush of embarrassment. What would Verity think of her? She could hardly explain that she couldn’t marry him because she was pregnant with another man’s baby, could she?
‘I knew my husband for about five minutes before I realised that he was the one.’ Verity sighed. ‘When it’s right, there’s just no point in waiting.’
Jake smiled. ‘My point exactly.’
Miranda looked at him, trying to read his mind. Was he serious? Why did something that seemed so complicated to her seem so simple to everyone else?
Still reeling from his words, she tried to concentrate as Jake engaged Verity in conversation about marriage, babies and life generally, but her mind kept wandering back to his surprise announcement.
Did he really want to marry her?
And then she glanced across at him, saw the way he was taking Verity’s mind off the pain with an animated discussion on the risks of a certain climbing technique and she suddenly realised that he’d just been trying to distract Verity.
Her spirits slumped and she gave an irritated frown, totally unable to understand her own reaction. She didn’t want to marry him. She didn’t want to marry anyone. So why did the realisation that his proposal had been nothing more than distraction therapy leave her feeling so flat?
‘Here come the cavalry.’ Rising to his feet in an athletic movement, Jake gave Verity a quick smile. ‘We’ll soon have you back to civilisation.’
‘What a pity.’ Verity glanced round her with a sigh. ‘I love it here. This view is vastly preferably to the view from my office window, but there you are. Can’t always have what you want in life.’
‘Why not? I always think that what you want is worth fighting for.’ Jake’s gaze lingered on Miranda for a brief moment and then he turned his attention to his colleagues who arrived carrying the stretcher and other equipment.
After that it all happened so quickly and smoothly that Miranda could do little except watch in amazement.
With the efficiency of a team clearly used to working together, they assembled the stretcher and in no time at all they were ready to carry her Verity along the path towards the ambulance.
‘I’m not going to be able to keep up with you,’ Miranda told Verity, ‘so I’ll say goodbye now. I hope your ankle doesn’t take long to heal.’
‘And I hope you agree to marry your young man!’ Verity smiled her thanks at Jake. ‘Men like him don’t come along very often. You should snap him up.’
‘I agree. She definitely should.’ Ignoring the curious glances of the rest of the team, Jake strolled back to collect his gear, leaving his colleagues to set off down the path.
Miranda stood still, chewing her lip, a frown on her face. ‘Don’t you mind that they’re all gossiping now?’
‘Why would I mind?’
‘You let her think that the baby is yours and that you want to marry me. Just how far are you prepared to go in the name of distraction?’
‘It wasn’t about distraction.’ He swung his rucksack onto his back. ‘I’m crazy about you, Miranda, and the baby is part of you. You’ve got to stop thinking that your pregnancy makes any difference to the way I feel about you.’
The way he felt about her?
She felt suddenly light-headed. He was crazy about her? She felt a flicker of happiness and excitement that she ruthlessly squashed. ‘You might think you don’t mind about the baby, but that’s before reality sets in.’
His eyes were amused. ‘You think I don’t know about babies?’
‘You know about delivering babies, Jake. Delivering them isn’t the same as living with them.’ Especially when that baby wasn’t his.
‘I have nieces and nephews. I’m a very hands-on uncle and godfather.’
‘And you return home to your perfect, peaceful house at night. It isn’t the same thing at all!’
He took her arm and tucked it through his as they walked back down the path towards the car. ‘I’m not precious about my house, Miranda. A house is a home, not a showpiece, despite what my sister
may think.’
‘Do you have any idea what children would do to your cream sofa?’
‘Actually, yes,’ he said in a lazy, masculine drawl. ‘My godson, Ben, is always spilling drinks. My sofa has been the lucky recipient on at least three occasions.’
She sighed. ‘You’ve got an answer for everything.’
‘If you’re telling me that I’m persistent, yes, I am. But I’m also patient.’ The amusement in his eyes faded. ‘I don’t want you to feel under pressure. I’m willing to wait for you to make the first move.’
They were back at the car and she’d never felt so confused in her life. ‘I’m not going to make the first move.’
He unlocked the car with a smile, his expression unperturbed. ‘Then we’re in for a frustrating few months, angel. Good job there are plenty of frozen lakes for me to jump into.’
He kept his word about not making the first move and for the next two weeks they worked together, ate dinner together, chatted about everything. But he didn’t kiss her. And she didn’t kiss him.
What was the point, when she knew it wasn’t going anywhere?
No matter how great the attraction, she wasn’t willing to subject herself to more trauma when it ended, and she knew it would end.
So she gritted her teeth and ignored the rush of excitement she felt whenever he walked into a room and she forced herself not to stare at him when they ate a meal together and not once did she reach for him even though her hands were burning to touch him.
Jake himself worked punishing hours, sometimes spending whole nights at the hospital, returning home briefly just to shower and shave before returning to do his ward round. His commitment to his patients was absolute and his skill and patience with the mothers astonished her. And she learned a great deal from him and found her confidence growing. He taught her to trust her instincts and not doubt herself.
Just how far she’d come was brought home to her when a young woman was admitted to the labour ward with flu-like symptoms.
Miranda helped her into one of the side rooms and quickly glanced at the letter from the GP. Clearly he’d spoken to one of the obstetric registrars, who had then arranged for admission.
‘I’ve never had a headache like this,’ the woman groaned softly as she curled up on the bed and covered her face with her arms. ‘I feel totally hideous—you have no idea.’
‘I’m going to phone the doctor to tell him you’re here and then I’m going to make you more comfortable,’ Miranda told her gently, frowning slightly as she touched the woman’s forehead. She was burning hot and the expression in her eyes was slightly glazed.
Feeling very uneasy and unwilling to leave the woman on her own, Miranda was about to hit the buzzer when Jake’s SHO, Belinda Morris, walked into the room.
‘Hi, there. I spoke to the GP about Cathy,’ she said cheerfully, walking over to the bed and giving the woman a sympathetic look. ‘I’m Dr Morris. You poor thing. Flu is rotten at any time, but even more so when you’re pregnant. Life can be very unfair.’
Clearly the junior doctor wasn’t in the least alarmed by Cathy’s condition and Miranda forced herself to relax, telling herself that she was just being hypersensitive. It was just because of that one case of shoulder dystocia, she told herself. She’d been imagining emergencies with every patient since then.
While Dr Morris carried out an examination, Miranda checked Cathy’s temperature and found it to be extremely high.
‘No surprises there, then,’ Dr Morris said briskly, when Miranda showed her the reading.
Still telling herself that she was being over-anxious, Miranda slipped off Cathy’s top and frowned. ‘How long have you had this rash, Cathy?’
Cathy lay with her eyes closed. Her breathing was shallow and her cheeks were flushed. ‘Don’t know,’ she murmured finally. ‘Nothing there this morning.’
‘Viral rashes are very common with flu,’ Belinda said briskly, pushing her stethoscope back in her pocket. ‘They resolve over time. Nothing to worry about.’
Miranda wished she felt equally confident. Suddenly her anxiety refused to be suppressed. ‘I think we should call Mr Blackwell.’
‘He’s in a meeting at the moment. We’ll just keep her in for the time being, monitor the baby and see how she goes.’ Belinda walked towards the door with a confident and slightly superior smile. ‘I’ll let Jake know that she’s here. Call me if anything changes.’
The door closed behind her and Miranda looked at the rash again. Viruses often cause a rash, she repeated to herself. Viruses often cause a rash. On impulse she picked up a glass from the side of the bed and pressed it against the woman’s skin. The rash didn’t blanch.
Without hesitation, Miranda hit the emergency button and seconds later Ruth came running in.
Her anxiety levels soaring, Miranda checked Cathy’s temperature again, her hands shaking slightly. ‘Call Mr Blackwell. Call him now.’ She hesitated briefly. ‘And we need to give her intravenous penicillin right away.’
Ruth looked at her and then the rash. ‘Right. I’ll arrange it.’ Without argument or discussion, she left the room and was back moments later accompanied by Jake.
Miranda had never been so relieved to see anyone. Calmed by his presence, she turned back to her patient. ‘When did you start to feel ill, Cathy?’
‘Last night.’ Cathy moved her arms and opened her eyes. ‘I can see two of you,’ she murmured drowsily. ‘Is that normal?’
Jake strode over to the bedside. He was dressed in a beautifully cut suit that emphasised the width of his shoulders and the strength of his physique. He looked serious and businesslike and the usual humour was missing from his blue eyes. It was obvious that he’d come straight from a difficult meeting and Miranda felt a flash of insecurity.
What if she’d bothered him for no reason? What if she was wrong?
She came straight to the point. ‘Cathy was sent in by her GP with flu-like symptoms but she has a rash on her torso and I think we should probably give her penicillin right away.’ She didn’t want to mention the word ‘meningitis’ because she didn’t want to frighten the patient and she didn’t want to waste time taking Jake out of the room to brief him on her fears.
Jake took one look at Cathy and reached into his pocket for a tourniquet. ‘Have you got the penicillin there?’ His voice calm, he held out a hand for the syringe which Ruth handed him and quickly checked the ampoule. ‘Great. We’re just going to give you an injection of some antibiotic, Cathy, and then we’re going to take some blood and get you transferred somewhere more comfortable. Are you allergic to penicillin?’
Eyes closed, Cathy shook her head slowly and Jake injected the penicillin just as Belinda came back into the room.
‘Oh, Jake, I didn’t know you were out of your meeting. I was going to tell you about Cathy when you—’
‘I want you to take blood cultures and then start an infusion.’ Discarding the empty syringe, Jake rose to his feet, his handsome face serious. ‘I’m going to talk to ITU.’
‘ITU?’ Belinda frowned. ‘But I—’
‘Cultures.’ Jake’s tone was cool. ‘Ruth—get me Geoff Masters on the phone, please. He’s the consultant in Communicable Disease Control. I need to tell him what’s happening.’
After that things moved swiftly. Cathy was transferred to ITU and Jake continued to liaise with other consultants over her management.
‘He’s been up on ITU for hours,’ Ruth told Miranda later as they changed to go home. ‘No one has ever seen a case of meningitis in a pregnant woman before so they’re all huddled around, discussing the best way to treat her.’
‘Is she worse?’
‘No. Better, apparently. Thanks to the brilliance of a certain midwife on the labour ward—Jake’s words, by the way, not mine.’ Ruth wriggled into a thick jumper and reached for her coat. ‘He hauled Dr Morris over the coals. Wanted to know why she hadn’t called him the second she set eyes on the patient.’
Miranda grabbed her bag
out of her locker. ‘Maybe she was afraid of getting him out of a meeting.’
Ruth gave her a pointed look. ‘You weren’t.’
‘I think that case of shoulder dystocia has made me jumpy. I see emergencies everywhere.’
‘Well, that’s fortunate for young Cathy, then, but I think you’re dismissing what you’ve done rather lightly. Jake is asking questions as to why the GP didn’t give her penicillin.’
‘Well, to be fair, meningitis wouldn’t be the first thing you think of in a pregnant woman with a temperature and a rash,’ Miranda murmured, and Ruth stopped and looked at her.
‘You thought of it.’
‘And thank goodness for that.’ Jake’s deep drawl came from the doorway and both Ruth and Miranda turned in surprise.
‘You’re not supposed to come in here,’ Ruth scolded. ‘This is the midwives’ changing room. It could be full of naked women.’
Jake smiled placidly. ‘I keep hoping.’
‘How is she?’
‘Better.’ Jake’s blue eyes were warm as he turned to look at Miranda. ‘And it’s undoubtedly thanks to you. If you hadn’t insisted on calling me and having the penicillin ready, it might have been a different story.’
‘I was afraid I might be wasting your time.’
‘I suspect you might have just saved two lives so any time you feel the inclination to bother me, please, do so.’
‘I’m just so relieved she’s all right.’
‘Well, she’s not totally out of the woods, but she’s definitely responding to antibiotics and all the scans and blood tests suggest that the baby is all right, although we won’t know for sure until it’s delivered.’
Ruth put her coat on. ‘If it’s been confirmed as meningitis, shouldn’t Miranda take Rifampicin or something?’
Jake shook his head. ‘We’ve talked about that. For healthcare professionals it’s really only recommended if you’ve given mouth-to-mouth or similar. Given Miranda is pregnant, I’d be reluctant to give her anything, and Geoff Masters agrees.’
‘I wasn’t with her for that long,’ Miranda said reasonably. ‘She was transferred almost immediately. All I really did was take her temperature.’
