He lifted his eyes and met her gaze. Her mouth hung open. “Wow. Okay. Hadn’t expected that. But what about my mother?”
“What about her?”
“Aren’t you worried I’ll turn out like her?”
“What? Where on earth did you get that idea?”
It was Poppy’s turn to stare at the ground.
“Poppy?”
He went to her side and touched her shoulder. She was shaking.
“Bipolar can be hereditary,” she mumbled.
He shrugged. “Low probability. And if it happens, we deal with it.”
He wiped away at a stray tear rolling down her cheek.
“Poppy, we need to talk about this, but not here.” Her hair hung across her face, forming a shield. He tucked it behind both ears and tilted her chin with the palm of his hand until she looked at him again. “Look at me, Poppy. Trust me. I won’t hurt you.”
Tears fell in earnest now. He pulled her into a tight hug. She shivered again and he rubbed her arms. “Come on, let’s keep walking so you can warm up. We’ll head back to the car then I’m taking you out for coffee.”
“What about Kate and Joel? What about your run?”
“We can go next Saturday or the one after.”
“What if I’m not here then?”
He smiled and gave her another hug. “You will be. I’ll make sure of it.”
Chapter 29
On Monday morning, at Liam and Kate’s insistence, Poppy met with Belinda Williams. Belinda was thrilled to see her again and offered her a casual job on the spot, commencing immediately. Poppy tried to tell Belinda she didn’t know how long she was staying for, but Belinda smiled like she knew a secret and shook Poppy’s hand, welcoming her to the team.
Poppy still wasn’t sure she was making the right decision to stay, so she didn’t change her flights. Adam’s impending Independence Day visit played on her mind like a silent newsreel. If she wasn’t there waiting for him in New York, there was no telling what he would do. Poppy had decided the best thing would be to fly back, tell Adam it was over, pack up all her stuff, then come back to Australia. The problem was, if she did that, she’d have to explain what she was doing to Liam and she wasn’t sure she wanted to do that. He might not understand.
Despite Poppy’s misgivings about taking the job, the next day she was working her first shift in the emergency department alongside Mackenzie. Once Poppy got over her embarrassment that Mackenzie had seen her mother’s mental illness at its peak, Poppy knew she’d made her first true friend.
“Who’s that guy?” Poppy asked.
Mackenzie followed her gaze. “My guess? New doctor from Sydney. We get them all the time. They come, they go. Thankfully we get to keep some of the good ones and the bad ones usually don’t last.”
The young man had short cropped black hair and wore a neatly ironed pink check shirt, slim-flitting dress pants and a nervous smile. His glossy ID badge hung from a bright blue lanyard around his neck. Among the doctors and nurses in the emergency department who all wore matching navy blue scrubs, he screamed “just arrived”.
Poppy took a step to the left to peer around Mackenzie. “Check his shoes.”
Mackenzie followed Poppy’s gaze and snickered. “Are they snakeskin or crocodile?”
“No idea. But they look stupid,” Poppy replied, stifling a giggle. “Fifty bucks they’re covered in blood by the end of the shift.”
“You’re on,” Mackenzie said.
He walked toward them flashing them his best smile. “Can one of you nurses help me please?”
“Sure,” Poppy answered sweetly.
“Someone called me down to see a patient with hematuria. Known bladder cancer.”
“That would be me,” Mackenzie replied. When she stuck her chest out, her baby bump jutted out. “I’m the nurse in charge today. Your patient is in cubicle four. Incontinent, blood in the urine in his pad. Some clots.”
The doctor fiddled with the cuffs of his shirt. “I came down to let you know you’ll need to call the urologist, not me.”
“Why’s that?” Mackenzie asked.
“Because I’m Gen-Surg. General Surgical,” he added, giving them a look that suggested they didn’t know the lingo.
“Ah,” Mackenzie drawled. “That means you are urology.”
The young doctor’s face crumpled like a brown paper bag. “What do you mean?”
“Here in Birrangulla Gen-Surg covers everything except ortho,” Mackenzie said. “Orthopedic,” she added, enunciating each syllable slowly.
He made a funny sound. A sound somewhere between a titter and a laugh. “You’re joking, of course.”
“Uh, uh. Definitely not joking.”
“But in Sydney—”
Mackenzie cut him off with one raised eyebrow. “This is not Sydney.”
Poppy stifled a giggle. She was going to love working with Mackenzie.
He swallowed twice and tugged at his collar to loosen it. His face was bright red. “Yes, but this guy has ureteric stents. That’s not my area of expertise. In Sydney—”
“Does it look like you’re in Sydney now?” Mackenzie indicated the small department that screamed country town emergency department louder than a woman screaming Bingo at the CWA hall.
He sighed heavily, clearly having figured out he wasn’t going to win the fight against Mackenzie. “Where will I find cubicle six?” he asked resignedly.
“Four, not six.” Mackenzie flicked her head in the direction he needed to go.
The doctor dragged his feet toward the patient like Mackenzie had just advised him the patient was highly contagious.
Poppy trotted after him. This could be fun. “He’s a little confused,” she said, matching his pace so they walked side by side. “GCS fourteen point five, if you get my drift. Hard to tell whether he’s with it or not, but then again, he is eighty-five. Oh, and he’s in urinary retention too. I’ve bladder scanned him. Over seven hundred mills. If you like I’ll set up for a three way catheter and that way you can do a bladder washout.”
“It’s fine. Thank you. I’ll assess the patient first.”
Poppy felt like she’d been dismissed.
The doctor actually shuddered before pulling his shoulders back and flinging the curtain aside.
“Mr. Ormond, is it?”
“Des,” the man replied from the bed.
“Des. I’m Dr. Richard Graham. One of the general surgeons.”
“You’re the urologist?” Des asked. He looked the doctor up and down. “Richard, eh?” There was a beat, then, “Do they call you Dick?”
Richard tilted his head to the side. “Er, no. They call me Richard.”
Poppy had to turn away to hide the tears in her eyes when Des roared laughing. She glanced at Richard, not believing he didn’t get the joke.
He began his assessment and after a while Poppy grew tired of waiting. She left the cubicle and grabbed the stainless steel trolley stocked with the equipment she’d need to insert a urinary catheter.
She returned as Richard pulled back the curtain and turned up his sleeves. “He’ll need a three way catheter.”
No kidding. “I’m happy to do it,” Poppy said.
“It’s fine. I’ll do it.” It sounded anything but fine.
Poppy shrugged. “No worries.”
He rifled through the drawers and began placing things on the top of the trolley. It was only when he started undoing the contents of the catheterization pack that Poppy realized what it was about him that bugged her. His meticulous manner reminded her of Adam.
Pushing him from her mind, Poppy grabbed gloves, a gown and goggles and quickly donned them. While the doctor continued to set things up Poppy explained the procedure to Des. It appeared Richard had missed that particular lecture at medical school.
Mercifully for everyone, Richard inserted the catheter quickly and relatively painlessly. Poppy handed him the syringe to inflate the balloon with water then collected a rose red sample of urine and screwed on
the lid of the specimen jar. She then attached the catheter bag tubing to one end and inserted a stopper into the other line. She started cleaning Des up.
“I’ll do the washout now,” Richard said.
“Why don’t you let the urine drain first,” Poppy suggested.
“I haven’t got time to wait.” Richard filled a large catheter tip syringe with sterile water and indicated Poppy should remove the catheter bag.
She clamped the catheter tubing between her gloved fingers and removed the bag, being careful to keep the end sterile. Richard leaned over and took the catheter from her. He held it in his gloved fingers like it was a poisonous brown snake. What happened next, happened in slow motion.
Instead of taking his time to ensure he’d inserted the end of the syringe in the end of the catheter, Richard depressed the plunger of the syringe too quickly. It slipped out and water sprayed everywhere and over everyone. Des yelped and Richard dropped everything. Blood-stained urine flowed out. Poppy acted quickly and re-attached the catheter bag while praising God she was wearing protective eye wear.
She snuck a look at Richard. His face was red with embarrassment, but worse, blood-stained urine had sprayed everywhere, covering his shirt and tie. She peered over the edge of the bed, saw his shoes and burst out laughing. Easiest fifty dollars she’d ever earned.
The shrill tone of a phone interrupted Poppy’s laughter. She poked her head around the curtain and looked expectantly at Mackenzie who was approaching to see what Poppy was laughing about.
“That’s our bat phone,” Mackenzie said, before rushing off to answer it.
Adrenaline rushed through Poppy’s body as she followed Mackenzie. She felt her bones liquefy. Every emergency department has a bat phone – a phone with a unique ring tone that is answered immediately because it’s always an ambulance on route, bringing in a critically ill patient.
What would it be? MVA? CVA? STEMI? Gunshot? Stabbing?
Mackenzie returned, her face chalky white. “Two-year-old. Drowning. Not intubated. No access. CPR in progress. Four minutes out.”
Not even a proper sentence – just staccato words – enough to make Poppy’s stomach coil. Bile mixed with fear and rose in her throat. This was not how she imagined spending her first shift.
“I’ll need you to help me in resus, Poppy,” Mackenzie said.
Poppy licked her dry lips and tried to swallow.
“I’m really sorry to throw you in the deep end.” Mackenzie winced the moment she heard the words leave her mouth. “That came out wrong.”
“It’s fine,” Poppy assured her. Thank goodness she knew her way around a resuscitation bay.
“Have you ever done a drowning?” Mackenzie asked.
Poppy nodded and began mentally preparing what she needed. She had less than four minutes to get everything ready to receive a two-year-old who had drowned and was now in cardiac arrest. No tube and no access either meant the paramedics hadn’t had time and had scooped and run, or worse, for some other reason they weren’t able to get a drip in or get the breathing tube down the kid’s throat. She didn’t have time to wonder what the scenario would be.
She raced to the resus bay only to find it was still occupied by a sixty-something-year-old woman who was waiting for the cardiologist to take her upstairs for an angiogram. On admission an hour earlier her ECG was normal but her troponin levels were through the roof, indicating she’d had a massive heart attack.
Poppy unplugged the leads from the monitor and re-attached them to the transport monitor. She didn’t even have time to explain to the patient why she was taking her to another cubicle. She kicked at the brakes, barely registering her stubbed toe and shoved the bed out of resus. An orderly magically appeared and grabbed the other end of the bed before it slammed into the wall. Between them they maneuvered the bed into a free cubicle and reattached the woman’s oxygen to the wall and her leads to the overhead monitor.
“Sorry,” Poppy said as she rushed out, leaving the woman lying in bed with a confused look on her face.
Poppy heard Liam before she saw him. His words echoed as he called out each count of CPR. Panic and fear were written across his face.
A tangle of wet blonde curls greeted Poppy as she peeked around the side of him.
A doctor arrived, clearly a man in charge. He announced he was the team leader. Poppy exhaled in relief. Like the conductor of a finely tuned orchestra it was his job to lead the team and he looked like he was more than capable.
“Okay, people. A quiet resuscitation is a good resuscitation. We’re all stressed, but there’s no need to panic and I don’t want any raised voices.” He had a strong American accent.
His statement drew nods and murmurs of agreement. Even Liam lowered his voice. For a small country department Poppy was surprised at what a well-oiled machine it was. Right now the team reminded her of the mechanics in a Formula One pit stop.
“Poppy, is it?” the doctor asked.
She nodded.
“I’m Oliver Hunter. In charge of the ED. Good to have you on board with us. Can you put in an intra-osseous please?” An intra-osseous needle allowed immediate access to the blood system by drilling straight through the shin bone. She’d only ever done it once, years earlier.
He handed her the instrument and moved to the head of the bed, leaving her to work alone. She identified the correct anatomical position and swabbed the area with an alcohol swab. She let it air dry while she breathed in and out slowly in an effort to still her racing heart and steady her shaking hands. She positioned the instrument, which looked like a small drill, against the child’s skin and depressed the trigger. The needle pierced the skin and with a small screwing motion she attained access. After aspirating bone marrow with a five milliliter syringe she discarded the contents and exhaled loudly in relief. “I’m in.” She secured the needle and attached a primed line someone handed her.
Seconds later Oliver inserted a plastic tube into the boy’s throat and gently pumped air into his lungs with the Air-viva before connecting him to the ventilator circuit. But it wasn’t going to be enough. He needed ICU. Unfortunately, the closest pediatric intensive care unit was Sydney – a flight over the Blue Mountains.
“NETS are on their way,” Mackenzie said. “We’re lucky this time. They were heading back to Sydney from Orange. They’re diverting to us here now. Should be wheels down in ten minutes.”
“Right. Let’s stabilize this kid and get him down to the helicopter pad.”
“Where are the parents?”
“Waiting room.”
“Bring them in. They need to see him before we transfer him out of here.”
The bat phone rang again and a combined groan went up from everyone still working on the little boy.
Mackenzie rushed off to answer it.
Oliver disappeared to find the boy’s parents, leaving Poppy and one of the other nurses to clean up. She peered at the little boy and her heart sank a little further. The ventilator was breathing on his behalf and his face looked angelic but it didn’t hide what might be happening inside his little brain. How long had he been deprived of oxygen?
Out of the corner of her eye Poppy caught sight of Liam. His face was ashen. He stood to one side, bright blue gloves still on, shock written all over his face. It was only then that Poppy realized he was dripping wet. She grabbed a blanket from the warmer and wrapped it around his shoulders. He smiled gratefully.
“Do you want to catch up tonight and talk about it?” she asked.
Liam nodded, grabbed her hand and squeezed her fingers tight. “I’d like that. I’ll meet you at the pub after dinner.”
Chapter 30
Liam was at the pub waiting for Poppy to arrive. He’d already had a few drinks and was feeling mellow. His work colleagues – paramedics and some nurses – surrounded him. He sensed Poppy walk in and looked up. As she weaved her way between tables toward him, his heart sped. Whatever it took, he had to convince her to stay. Perhaps he’d try turning up
the charm a few degrees and see if that helped.
“Is it hot in here or is it just you?” he asked when she reached his side.
“Worst pick-up line ever, Liam,” she said, leaning over and planting a friendly kiss on his cheek.
“Should I try again?”
“Nope. Don’t bother.”
“Do you believe in love at first sight or do you want me to walk past again?”
Poppy groaned. “Seriously. Stop.”
He leaned closer and inhaled her perfume. It went straight to his head and made him feel slightly dizzy. Or perhaps that was the alcohol.
“I’ve got more. I promise this is a good one. You’ll get this one. On a scale of one to ten, you’re a nine and I’m the only one you need.” He grinned at her. “Get it? I’m the only one.”
“How about this one? Are you a red light? Because you need to stop.”
He threw back his head and roared with laughter. People turned to stare.
“You win,” he said, lifting his glass in salute.
“Last I checked, it wasn’t a competition.”
“No, you’re right, it’s not.” The beginning beats of a ballad drifted from the sound system. He stepped closer and discovered he was a little unsteady on his feet. With one hand he grabbed at the bar for a second to right himself. “It’s not a competition, it’s a dance. So dance with me, Poppy.”
He lifted his gaze and was met with raised eyebrows. “How much have you had to drink?” she asked.
“One or two or five. But I’m not drunk. I just had a few beers because I’m feeling sorry for myself.”
“Why?”
“Because you haven’t agreed to stay yet.”
She swiped his beer from his hand and placed it on a nearby table. “I suggest you take a break,” she said. “Or you’ll have a massive hangover tomorrow.”
“Okay. I’ll stop drinking if you dance with me,” he said, reaching for her hands.
She pulled back. “I told you, I don’t dance.”
“Everybody dances.”
“Not me. The last time I danced was in high school with my pimply-faced hormone-driven boyfriend. It was a disaster.”
Critical Condition Page 21
