Accidental Rendezvous

by Caroline Anderson

  She grabbed the chance to do some teaching with her new nurses, told them to do a totally unnecessary stock-check of the stores and went round the waiting room, ripping down torn posters and sticking up fresh ones.

  'Very pretty,' Nick said from behind her. 'How about a breath of fresh air? I've got some sandwiches from the trolley—care to join me?'

  'I'm busy,' she lied, and he snorted.

  'Sally, you've been killing time for the past hour. You have to eat, you may as well do it now.'

  'Has it occurred to you that maybe I don't want to eat with you?' she snapped, and then regretted it when she saw the flicker of reproach in his eyes. 'I'm sorry,' she said with a sigh, too honest to lie to him, too kind to hurt him so casually. 'OK, I'll have lunch with you, just this once.'

  'Such generosity,' he murmured drily, just to make her feel even worse!

  They collected the sandwiches from his locker and filled fresh mugs with coffee, then headed out into the warm, humid August day. She led him round the corner of the building to a quiet, shady spot under the trees on the edge of a little garden. There was a bench there, and by a miracle there was nobody sitting on it.

  'Perfect,' Nick said with a grin, and settled down, opening packets and offering them to her. 'Prawn salad and mayo, egg mayo or BLT?'

  All her favourites. She sighed softly. 'Thank you,' she murmured, taking a prawn salad to start with and avoiding the knowing glint in his eye.

  'So, tell me,' he said without preamble. 'What have you been up to for the past seven years?'

  Getting over you, she thought, but that one was definitely staying private.

  'Work, mostly. I've been here three years now, two as a junior sister, one as a G grade.'

  'Still enjoying it?'

  She nodded slowly, thoughtfully. 'Yes. It's tough—it's a difficult job, A and E. You see too much.'

  'Tell me about it,' he said drily. 'I don't know why I went for it, except that it appealed to my sense of drama. I'm still an adrenaline junky, and I like making snap decisions and staying on my toes. It seemed to answer all the relevant criteria better than any other branch of medicine.'

  That sounded like Nick. She remembered the dangerous sports he'd indulged in, the way he'd always driven just that tiny bit too fast for absolute safety— the times they'd failed to use contraception because they'd been somewhere unprepared and playing Russian roulette had appealed to him.

  Except, of course, it hadn't been him who'd lost—

  'Egg mayo?'

  'Please,' Sally said, dragging her mind back to the present and safer territory. He held the packet out to her, and she eased the sandwich out, her fingers brushing his as she did so.

  Heat shot up her arm, and she all but snatched the sandwich away and scooted further into the corner of the bench, taking her coffee with her and busying herself with eating and drinking for a minute to give her feelings time to subside.

  Her body had other ideas, though. It remembered his touch, the caress of his hands, the feel of his body on hers. She closed her eyes, stifling a tiny moan of need.

  No, she told herself firmly. He's bad news for you. You won't get over him again, it'll kill you. Just keep your distance.

  'You look tired,' he said softly, and there was a thread of tender concern in his voice that nearly reduced her to tears.

  'I am tired,' she confessed, swallowing the lump in her throat. She glanced at her watch and stood up. 'We need to go back. They don't know where we are, and I don't trust this quiet spell. All hell's going to break loose any minute, I just know it.'

  Right on cue a siren sounded, and an ambulance swept out towards the gate, followed by another and another.

  'Looks like trouble brewing,' Nick murmured. Scooping up the last of the sandwiches and wrappers, he dropped them in a bin and fell in beside her as she hurried round the corner, mugs in hand. The sirens were fading as they went through the doors, and the staff nurse in the triage room stuck her head out.

  'Thank God you're back, they were about to page you. There's been a pile-up on the bypass near the Yarmouth Road roundabout—ten cars or something. At least fifteen casualties coming in, the police say, some serious. The worst are trapped and they want a medical team on the spot. Ryan wants you two to go.'

  'OK,' she said, her blood pumping, her thoughts whirling. She ran down the corridor past Resus to the store, where Ryan was checking the emergency bag.

  'Ah, you're here, good—right, Sally, take this lot. You'll need more fluids as well—there's another bag there. Don't think there's anything hazardous involved, it seems to be just cars, but apparently there was a diesel spill, so take care and keep out of it if you can. You'll need yellow coats—here, Nick, take this one.'

  He handed him a coat with DOCTOR emblazoned across the back, and Sally grabbed her own off the back of the door.

  'Do we have an exact location?' she asked, rapidly filling the other bag with fluids.

  'East of the roundabout. Just head that way, I don't think you can miss it, by all accounts. We'll contact you with more specific directions when we get them.' Ryan chucked Nick the keys of his car, and they ran out, jumped into it and headed out of the car park.

  'You'll have to tell me where to go,' he said, cutting through the traffic with the siren wailing and the green light flashing on the roof.

  She resisted the urge to make a smart remark, and directed him the quickest way out of the town and onto the bypass. Within five minutes Ambulance Control had contacted them with more specific directions, and ten minutes later, her heart in her mouth, Sally saw the first signs of the accident in the tailback ahead.

  'Siren again, I think,' Nick said, and shot her a grim smile. 'It's a pity that the only time I ever get to do this, I'm too busy thinking about what we might find to enjoy the power trip.'

  The traffic seemed to melt away in front of them, cars squeezing up onto the verges and pulling over to let them through, and then they were there in the thick of it, surrounded by flashing lights and screams and sobs and shouted commands. People were wandering around aimlessly, obviously in shock, and some of them were bleeding from head wounds.

  'OK, let's see what the problems are,' Nick said, hoisting the heavier of the bags into his arms and running towards the ambulance teams.

  'What have you got for us?' he asked, shrugging into his coat, and the man in charge directed them towards the centre of the carnage.

  'We can handle the walking wounded for now,' he said, 'but we've got a couple of entrapments that need your help. That blue Fiesta is the worst, I believe, and the red BMW is the other one.'

  Sally looked the way he was pointing, and saw a car just like hers with the nose tucked under the side of a lorry. The roof was crushed in, and she gave a little shudder. It was a little close to home.

  They walked quickly over there. A paramedic was half in, half out of the back window of the car, contorted into an impossible position, and while Sally tried not to shudder at the state of the car, Nick squatted down and spoke to him.

  'I think this lady's got a tension pneumothorax, but I'm too big to do anything about it,' he said over his shoulder. 'There's no room to move. Hang on, I'll come out.'

  He squirmed out backwards, and looked assessingly at them both. 'You could get in,' he said to Sally, and she nodded, suppressing her feelings.

  'OK. What do you want me to do, Nick?'

  'Check her for signs of pneumothorax or cardiac tamponade,' he said. 'Has she got oxygen?'

  The paramedic nodded. 'Yes. She's in pain, but I didn't want to give her anything that would lower her blood pressure. The steering-wheel's rammed into her chest. She's bound to have internal injuries.'

  'Where are the fire brigade? They should be cutting her out.'

  'They're here—they're working on the other entrapment. He's got severe bleeding from the leg. We're bagging in fluids but we're only just holding him. We've assessed them all for priority but you might want to reassess them in a minute. There was
a doctor in one of the cars, he's giving us a hand, too.'

  'Where does this one come in the priority list?' Nick asked, jerking his head towards the Fiesta.

  'The top at the moment. The other guy's grim but, like I said we're holding him for the minute, and we've got two fatalities, but this lady's going to join them if you can't do something soon.'

  'I'll go in,' Sally said. 'You can pass me the things I need.'

  She hated small spaces, but there were times when you just had to forget about things like that. She squirmed through the narrow opening left by the bent roof, and laid her hand on the lady's shoulder.

  She moaned and turned her head towards Sally, but she couldn't speak.

  'It's all right, I'm going to help you,' Sally said with a quick squeeze to her shoulder. Talking softly to reassure her patient, she rapidly checked her symptoms.

  The woman had distended jugular veins, which meant that the blood vessels in her chest were being compressed and causing a build-up of pressure. Her chest seemed distended on the left side, although it moved less when she breathed in and out, and she was restless and her pulse was rapid. The picture was consistent with a lung leaking air into the chest and collapsing the lungs—rapidly fatal if left untreated.

  Sally turned her head and reported to Nick. 'I think it is a tension pneumothorax,' she said. "The signs all fit. She's looking pretty rough.' She ran through the symptoms and he nodded.

  'Certainly sounds like it. Can you get enough access to do a decompression?'

  She looked at the woman's chest. The simple answer was no, but the simple answer meant that she'd die. 'Yes, I can do it,' she said firmly. If she could just get the needle in at the right angle...

  'OK. I'll talk you through it. Find the second or fourth intercostal space, and insert the needle along the upper border of the rib. Don't go below it, you'll get the artery and nerve. I'll hand you the needle and a wipe now.'

  'Pass me scissors first, her blouse is in the way,' she said, and, taking them, she sliced away the clothes over the woman's collar-bone and then handed them back. 'Right, let's have a wipe and the needle.'

  He talked her through it, and seconds later there was a little pop, and a rush of air through the end of the cannula.

  'OK, can you slide the catheter in now and take the needle out?' he asked, and when she'd done that and had checked it was still venting, she taped it in place and wriggled back out.

  'She's looking better,' she said, 'but she needs to come out of there fast. I don't think I can do anything else in there, the space is too tight.'

  Nick nodded, and hailed the fire brigade officer who was in charge of freeing the casualties. 'We need to get this lady out fast.'

  'Give me ten more minutes and we'll be with you. Can she last that long?'

  Sally shrugged. 'I hope so.'

  'We need to reassess the others,' Nick said briskly.

  'Status can change very rapidly under these conditions.'

  Just then they were hailed by the paramedic working on the person with the trapped and bleeding leg, and they had no choice but to leave their lady with the pneumothorax. With a last glance over her shoulder, Sally followed Nick and found herself down in the passenger footwell of the BMW, applying a compression bandage to the lacerated limb to try and prevent any further blood loss while the fire brigade worked on the bulkhead with the air cutters.

  It was only a few moments before he was released, and then Nick left the other casualties he was treating and came over to supervise his extraction from the car and make sure he was stable before he was whisked away to hospital.

  Most of the casualties were suffering from cuts and bruises, and some were dealt with on the spot by the ambulance staff and taken to hospital for a routine check-up; others went straight off in the ambulances for treatment of fractures and stitching of lacerations once their condition was known to be stable.

  Once the critical patients were dealt with, Nick and Sally turned their attention to the noisy ones—anyone who could make a fuss was going to live at least a few more minutes, and they worked their way through them as rapidly as possible.

  The lady with the pneumothorax was freed after half an hour, and they broke off to supervise her removal and dispatch before going back to the less seriously injured.

  Finally everyone had been dealt with, and Nick straightened up and stripped off his gloves, scrubbing his face on his shoulder in a weary gesture that tugged at Sally's heartstrings.

  'Well, at least we didn't lose anyone else,' she said softly, and he nodded.

  'I know. Right, we need to get back to the unit. No doubt they'll be in chaos.'

  They stripped off their yellow coats and stashed them in the boot, along with the depleted bags of emergency supplies, and then Nick reversed back out of the wreckage that surrounded them and they drove slowly away, leaving the police to clear the crumpled cars away and get the road open.

  'It's nearly five again,' he said to her as they pulled up outside the hospital a short while later.

  Sally sighed. 'I know. Maybe one day I'll knock off on time.'

  'I shouldn't hold your breath,' he said with a chuckle, and she smiled wryly.

  'Don't worry, I'm not. I wonder if they still need me, or if I can get away?'

  Nick cut the engine and looked across at her, then reached out and brushed his knuckles across her cheek. 'Nobody's indispensable, Sal,' he said softly. 'Why don't you go home? You look all in.'

  She dragged her eyes from his and turned away, reaching blindly for the doorhandle. 'I'm fine. I want to make sure my pneumothorax lady is OK before I go, if I do nothing else.'

  'OK, but then you go,' he said firmly.

  She made a noncommittal noise and opened the door, climbing out and looking towards the doors. The waiting room was full, no doubt with people who'd been delayed because of the crash and put to the back of the queue. If she stayed, she could help them get through the backlog quicker—

  'No.'

  He'd appeared beside her; she glanced up into his face and saw his eyes were filled with gentle understanding. 'No, what?' she asked defensively. 'I'm my own boss, Nick.'

  'You always were,' he reminded her, and there was a thread of reproach in his voice.

  She felt a twinge of guilt, and then reminded herself of the facts. 'I only refused to move to Manchester with you because our relationship was going nowhere.'

  'Was it? I didn't know where it was going. I wanted to find out. It was you who didn't care.'

  'I cared!' she exclaimed. 'You told me to forget it, because I wouldn't drop everything and go with you to the other end of the country! And then, when I tried to contact you, you didn't bother to ring.'

  He paused, his eyes searching. 'I did try and ring,' he said quietly. 'I tried that number you gave me several times. Nobody had ever heard of a Staff Nurse Clarke. I assumed, in the end, that you must have been working for an agency, so I rang all the agencies I could get hold of. None of them had a Sally Clarke registered with them. I didn't understand. I thought, if it was important enough, you'd ring me again—but you didn't.'

  She looked away, her heart pounding. She didn't need this conversation—not now, when she was tired and stressed and pulled in all directions.

  'So what happened, Sal?' he asked. 'Where were you? How did you disappear?'

  'I—left,' she lied, and opened the boot, hauling out bags. 'Come on, we need to get inside and make ourselves useful.'

  'You're avoiding me.'

  It wasn't a question, so she didn't bother to answer. She just picked up a bag, slung the straps over her shoulder and headed off towards A and E, leaving Nick behind her to deal with the other bag.

  After a second she heard the boot lid slam and the click of the central locking, and his firm, crisp footsteps followed her. As they reached the door he grasped her arm and turned her towards him, his eyes glittering with determination.

  'Sally, I want to know. Why; did you ring me—and why did you disappear?
'

  His voice was controlled, but he was angry, she could tell—angry and not about to be fobbed off again. She had to give him something, so she gave him a carefully doctored version of the truth.

  'I wanted to speak to you,' she said evenly, avoiding those piercing blue eyes. 'A member of my family was in hospital—I just needed to talk to you. I didn't contact you again because it didn't matter any more. It was no longer relevant.'

  One of the nurses hailed them, and she turned away and pulled her arm back. 'Come on, we're needed,' she told him, and headed through the doors.

  'What do you mean, no longer relevant?' he asked, pulling her to a halt again.

  Sally swallowed and forced herself to meet his eyes, praying that the emotion she was feeling didn't show.

  'She died.'

  He sighed and thrust a hand through his hair. 'Oh, Sal, I'm sorry. Someone special?'

  She rammed down the huge wave of pain that threatened to rise up and swamp her.

  'Yes. Very special,' she said honestly, and turned away, blinded by sudden tears. 'Very special,' she repeated in a whisper, and all but ran away from him down the corridor to the stores.

  There she dumped the bag, hung her coat up on the peg and headed back out to the work station. Angela, the senior sister, was there, filling out notes, and she looked up and smiled distractedly.

  'Good grief, Sally, isn't it time you went home?' she asked.

  'Do you need me?

  The smile softened. 'We always need you, but you look bushed.' Her eyes narrowed. 'In fact, you look like hell. Go home. Have a nice strong whisky in the bath—it'll do you good.'

  'I might do that,' Sally said with a vain attempt at a smile. 'How's my pneumothorax?'

  'Doing fine. She's gone up to the ward.'

  'Good. Right, I'll go, then.' She fumbled her things out of the locker in the staffroom and headed for the door, only to find Nick standing in her way.

  'Not now, please,' she said wearily, right at the end of her tether.

  'When, then? Tomorrow? The next day? Or never?'

  She closed her eyes, her control hanging by a thread. 'Please, Nick,' she begged, and she felt his hands close over her arms and support her.