Undercover at City Hospital

by Carol Marinelli

And delivering it was a sheer pleasure. Reminding Bella for a sentimental moment of the really special times nursing could bring. Lucy O’Keefe’s gaunt face broke into a tearful smile as Bella slipped the drugs into her handbag.

  A tiny woman, despite her illness she was still very attractive with high cheekbones and sharp blue eyes topped off with a gorgeous lilting Dublin accent. Thanking Bella profusely as she rearranged her pillows and held the cup while she had a sip of tea, Bella knew there and then why Hannah had developed a soft spot for this patient. Even the cruel ravages of cancer couldn’t take away her inner beauty, and not for the first time Bella realized how randomly cruel life could be at times.

  Here was a mother, a wife, a daughter and a sister, and she didn’t deserve to be leaving them all so soon.

  ‘There’s ten days’ supply there, Lucy. That’s all we can give you I’m afraid.’

  ‘That’s more than generous.’ Pushing away a plate with a tiny bony hand, she leant back on the pillow, the brightly colored scarf tied around her head not quite enough to put colour in her cheeks. ‘Have you any idea how good that slice of toast tasted?’

  ‘You’re the first patient I’ve heard praise hospital food.’ Bella smiled.

  ‘It’s the simple pleasures you miss the most,’ Lucy sighed. Instinctively almost, Bella took Lucy’s hand, the nursing instinct that had been buried so long coming back as familiar and welcome as a lifelong friend you hadn’t seen in a while. ‘That medicine is not just for me,’ Lucy sighed. ‘Patrick and Marnie, she’s my daughter, get such a kick out of me eating. They’re always mashing bananas and trying to tempt me and it’s not that I don’t want to, it’s just that I can’t keep anything down.’

  “These will help,’ Bella said, knowing that medicine might work wonders, but so did positive thinking.

  ‘They will.’ Lucy smiled. ‘More than you know. Can you thank the doctor for me? What was his name?’

  ‘Heath.’

  Both women looked up as a deep voice answered her question.

  ‘Aren’t you the man?’ Lucy smiled. ‘If I had any eyelashes left, I’d be winking at you, Doctor.’

  ‘I was told you were a happily married woman,’ Heath gently scolded.

  ‘Nothing wrong with a bit of harmless flirting. But thank you, Doctor.’ Her voice wavered. ‘I really mean that.’

  ‘No. Thank you,’ Heath answered. ‘Sometimes we all need a good kick up the backside to remember what we’re really here for, and you, Lucy O’Keefe, have effectively delivered.’

  ‘I’m good at kicking backsides,’ Lucy said. ‘Or I used to be.’

  ‘Enjoy the rest of your holiday,’ Heath said softly, taking the hand Bella wasn’t holding and squeezing it for a moment. ‘And if you need us, we’re here.’

  ‘Aren’t you a love?’ Lucy smiled. ‘And I bet you’ve got a gorgeous wife and kids waiting at home for you.’

  ‘I wouldn’t call my ex-wife gorgeous.’ Heath winked, happy to indulge in a bit of private chit-chat with such a delightful patient, knowing it would make her feel so much more than a number. ‘But the kids certainly are.’

  ‘Divorced!’ Lucy’s mouth gaped open. ‘What was the woman thinking?’

  It was a very good question and one that buzzed annoyingly in Bella’s mind for the rest of the day.

  At every turn he was gorgeous.

  OK, a touch pompous, Bella decided, watching him talking to the medical students, clearly relishing in his acting consultant role, but there was an elusive quality to him that Bella only managed to define at the end of a long shift, pulling out her ponytail and stifling a yawn as she leant over his shoulder and signed on the casualty card he was writing for a tetanus shot she had given, that generous splash of aftershave still vaguely present.

  ‘Finished?’ Looking up, he smiled. It was a totally innocent remark, but Bella felt her insides literally flip over, could feel his breath on her cheek, caught the vague scent of a mint he was chewing on, saw the fan of lines around his eyes that surely hadn’t been there that morning.

  What had Heath’s ex-wife been thinking?

  ‘Who on earth did your off-duty?’ Jayne stared at the roster with an appalled expression on her face, sipping at a coffee and trying to catch up on paperwork before the shift ended.

  It was Bella’s third exhausting day on duty.

  Exhausting because she’d spent two hours at the station the previous evening, going over her findings with Detective Miller.

  Exhausting because she’d arrived at Danny’s nursing home still dressed in her nursing uniform and had had to lie to his tense, anxious parents as to why she was working in Emergency again, simultaneously reassuring them that the doctor who had examined their son that day surely knew best, that if he couldn’t find anything wrong with Danny, maybe they didn’t need to worry.

  Exhausting because she’d sat up till midnight, watching hours of security video footage that Detective Miller had laughingly called her homework as he’d handed them over.

  Exhausting because when finally she’d fallen into bed, instead of sleeping, she stared at the ceiling, her mind constantly drifting to the one thing she shouldn’t even be considering.

  Heath.

  If she’d been a real nurse, she could have avoided him, and she would have, Bella knew that, would have gone to great pains to be terribly busy whenever he needed a hand, to ask Jordan to write up anything she might need. But instead, because she was undercover, because she needed to gather all the facts, her second day in the department had been spent following him around like a lost puppy, bending his ear for the most stupid of questions and generally making a complete idiot of herself when all she’d really wanted to do was hide. The very last thing she wanted to do was get to know Heath any better, spend even a single moment alone with him, because, quite simply, her feelings terrified her.

  Since Danny’s accident no one had even sparked a vague interest, yet within two minutes of meeting Heath she’d felt this sudden awareness, as if every hormone that had laid dormant for ages had somehow awoken.

  And not slowly either.

  No stretching and yawning and a few strong coffees to get them moving.

  Just sitting bolt upright, fizzing through her veins and doing the strangest things, like making her blush, making her drop things, making her acutely aware of the fact she was very much a woman.

  ‘No wonder we can’t get any staff if this is how Admin’s going to treat them. Have you seen the off-duty?’ Calling Bella over, Jayne tutted loudly as she stared at the roster. ‘You’ve got four early shifts this week then they’ve got you down as working on Saturday night. I don’t even want to tell you what they’ve given you next week—you might pack your bag and walk out!’

  ‘It’s fine, Jayne.’ Peering over her shoulder, Bella stared at the roster. ‘Admin have already run it by me. In fact, I volunteered for the Saturday night—I need the money at the moment.’

  The prepared and practised lie rolled easily off Bella’s tongue. The last thing she wanted was for Jayne to change her shifts around. Every last one had been carefully worked out, taking both the medical and nursing roster into consideration. Even the intern who was supposed to be working on Saturday night had been given the night off to ensure that Heath stayed firmly on the hospital floor and in full view of Bella!

  When she’d left Eddie’s office after the first initial interview, Bella had expected to be kept on tenter-hooks for a few days at least, but she’d barely got home from seeing Danny when her telephone had rung and Detective Miller had introduced himself to her; carefully explaining why things had been brought forward. Several of the main suspects would be working together over the next couple of weeks and that it might be prudent for her to start on Monday. At any given time she was working with the maximum number of suspects, and next week she was down to work nights alongside Hannah, with Jayne putting in an appearance for a couple of them and Heath the consultant on call. But from the way Jayne’s eraser was poised ove
r the roster, all the careful planning was about to be rubbed out. Even though Admin would change it back, it could only look suspicious.

  ‘It’s just too many shifts, Bella.’ Jayne looked up. ‘There’s no point burning yourself out. A Saturday night in Emergency is hard at the best of times.’

  ‘You’re doing it,’ Bella pointed out.

  ‘But I’m off then till Wednesday.’ Jayne frowned, her eraser poised over the paper.

  ‘I’ll be fine,’ Bella assured her. ‘Look, Jayne, I really need the cash.’

  ‘And I really need nurses who are awake.’ A deep voice that most definitely wasn’t Jayne’s made Bella jump, and she blushed as she realized Heath had just heard her practically beg, but she was saved from any further discomfort when the red alert phone buzzed on the desk and Jayne promptly answered it, nodding at Heath to stay put for a moment as she took the details.

  ‘Bike versus truck,’ she said grimly to the gathering staff alerted by the emergency phone’s buzzing. ‘Major head injury and leg injuries, intubated at the scene. GCS 3. I’ll put out an emergency page for the orthos. Trish, could you take Bella and start setting up?’

  She didn’t need this, Bella thought with a sinking heart as she headed swiftly to the resuscitation room.

  Really didn’t need this on only her third day back!

  GCS stood for Glasgow coma scale, a rudimentary screening tool that assessed the seriousness of a head injury. The highest score was 15 and perhaps surprisingly the lowest score wasn’t zero but three.

  One point for eyes closed despite painful stimuli.

  One point for zero motor response to pain.

  One point for no verbal response.

  And the patient that was coming in had the lowest score possible.

  The same score that Danny had had.

  Forcibly she pushed that thought away, demanded her brain concentrate as she prepared the trolley along with Trish, checking the oxygen and suction, pulling up drugs, running through drips and finally stepping back slightly as the paramedics dashed in with the unfortunate victim, a first glimpse of the black leather trousers, shredded around the thighs, his hands a mangled, bloody mess.

  ‘On my count,’ Heath called, taking the head end of the patient and assuming the role of leader, especially important with major injuries. The leader over-saw the entire process, co-ordinating the different teams while ensuring the stability of the patient’s neck. The lift over from the stretcher to the trolley was swift but controlled, the anesthetist taking over the patient’s airway. Trish and Bella took one side each, with specially designed scissors ripping through the leather gear the motorcyclist wore, shearing off his protection gear to allow the doctors better access.

  ‘We took the helmet off at the scene.’ The paramedic was sweating profusely, the heavy jacket and exertion of an extensive resuscitation not exactly light work in the mid-thirties heat outside. ‘His airway was blocked and he needed to be intubated. According to his licence and the check police did, his name’s Andrew Stevens, thirty years old. The police are going round to his house now.’

  Heath nodded, flashing a pupil torch into the man’s eyes.

  ‘Left pupil’s fixed and dilated, right pupil’s pinpoint.’ His gloved hands felt the man’s skull, and from the expression on Heath’s face it wasn’t good news. ‘Boggy depressed fracture at the posterior.’ He shone the torch into the man’s ears. ‘Blood in both ear canals. How are we doing at your end, Simon?’

  ‘Compound fractured femur on the right,’ the orthopaedic registrar said grimly, accepting a massive wad of sterile, saline-soaked drapes from Bella and placing them over the exposed fracture. ‘Same again with the tibia on the left.’

  ‘His heart rate’s down,’ Bella observed as she covered the fracture with the drapes, checking the pulse in his groin with her gloved hand. ‘Very poor output.’

  Heath looked over to the screen, checking the patient’s pulse himself before nodding to Bella.

  ‘Commence cardiac massage.’

  The patient was a large, strapping man, probably twice Bella’s size, and for cardiac massage to be delivered effectively, it needed all her weight behind her. Climbing up on the gurney, she knelt beside him, feeling for his sternum then lacing her fingers together and placing the heel of her hands in the right position before starting the massage, leaning over the patient and pushing down rhythmically, counting in her head and listening as the cardiac monitor bleeped regularly now.

  ‘Good output with the massage,’ Simon confirmed as Heath ordered more drugs to be pushed through the IV line in effort to pick up the heart rate. The whole resuscitation was being delivered effectively, yet there was a tension in the air that hadn’t been there that morning. Charles’s cardiac arrest had been the ‘good’ kind to have, a fibrillation, that could generally, if picked up early enough and treated promptly, be countered, but all the signs for this young man were atrocious and everyone knew it.

  Bella was actually glad to be giving the massage, glad to be playing a role she knew she could do well, glad that her hands were knotted together and no one could see them shaking, and because cardiac massage was as exhausting as an aerobic workout, glad of the excuse to be red in the face and slightly breathless.

  Why?

  Staring at the lifeless body beneath her, she asked questions over and over.

  Why did horrible things like this have to happen? Why was a young, fit man lying wasted and practically dead? As the resuscitation stretched on ominously, another question was raising itself. Why were they continuing with this?

  Heath was clearly thinking along the same lines.

  ‘OK, Bella, take a break.’ It was the third time he’d done it—taking over the massage to allow her to catch her breath and give her aching arms a rest—but it wasn’t a matter of Bella simply stopping and getting off the trolley. Heath moved his hands near hers and Bella waited till he gave the nod that he was ready to take over, his height and strength meaning he didn’t need to climb up on the trolley, but it was important for patient care that the handover was done as smoothly as possible…

  Even if there was little hope.

  ‘It’s three-forty guys.’ He looked at the massive clock on the wall, which had been started as soon as the massage had commenced. ‘We’ve been going for forty minutes with no response. We have to ask ourselves at this point if we do get him back what…?’ He paused as the receptionist walked in, obviously embarrassed when everyone looked over at her, but Heath called her over, carrying on the massage as he addressed her.

  ‘Have we got any more details, Shirley?’

  ‘His wife and parents just arrived. I’ve put them in the interview room. There’s a policewoman with them.’

  ‘Thanks, Shirley.’ Heath stared down at the young man for the longest time before continuing. ‘Can someone take over? I’m going to go and talk to the wife.’

  Bella nodded, putting her knee up to climb back on the trolley, but Heath shook his head. ‘Someone else should do it, Bella, you’ve been going for ages. You can come and speak to the wife and parents with me.’

  Appalled she froze, literally froze for a second, not even moving as Jayne came over to climb up onto the gurney, the thought of going into the interview room, of listening as Heath broke the shattering news, watching the family’s reaction, reliving the absolute worst time of her life, almost more than she could bear.

  ‘I’m off in twenty minutes.’ Her voice was barely a croak. She felt as if her throat were full of shards of glass as she plucked at the stifling air for any available excuse. ‘Perhaps it would be better if one of the late staff went in with you and I carry on with the massage. I really need to finish at four.’

  It just didn’t happen.

  Emergency nurses didn’t just walk away, no matter what the time, and everyone present knew it. Apart from the sounds of the monitors the room suddenly fell silent as Bella stood with her cheeks flaming, painfully aware of how shallow she must sound as Heath
stared angrily back, a muscle galloping in his cheek at her apparent callousness.

  ‘I wasn’t asking if you’d like to join me, Sister, I was telling you to come. A fresh pair of arms are needed to deliver effective massage and, given that the place is fit to burst out there, I don’t have the luxury of staring at the roster for ten minutes to work out who’s on late shift and who’s in a rush to get off duty.’

  Nodding to Jayne, his hands lifted as she took over the massage. He checked the patient’s output for a moment before heading out of the resuscitation area and turning angrily to face her when Bella joined him.

  ‘Have you got another job to go to?’ he snarled.

  ‘What?’

  ‘You’re cramming in as many shifts as you can because you need the cash. I heard you, remember. So do you have another shift to get to?’

  ‘Of course not,’ Bella said.

  ‘So what the hell was all that about?’

  ‘I’m sorry,’ Bella started. Tears were dangerously close but she blinked them back, aware that her colleagues in the waiting room were undoubtedly watching the exchange, but also determined not to break down. ‘I just thought it might be better for the family if they got used to one nurse…’

  ‘He’s going to die, Bella. Unfortunately, for Andrew and his family, it isn’t going to take very long at all, but of course, if they get too emotional, if things drag on a bit in there…’ He flashed a nasty, completely false smile as he started to walk. ‘I’ll try to hurry things along for you.’

  ‘Heath…’ she started, but even before he turned around she shook her head. Even if it might be better to explain things to him, there simply wasn’t time. ‘Your shirt’s got blood on it.’ She gestured to a massive linen trolley. ‘Maybe you should change it before we go in.’

  ‘Thanks,’ he said almost grudgingly, staring down at the stained arms of his white shirt as Bella selected a theatre top. She half expected him to nip into a toilet or the staffroom, but, given that time was of the essence, Bella wasn’t particularly surprised when, completely unselfconsciously, he ducked beside the trolley out of view of the waiting room and proceeded to pull off his shirt, taking the blue theatre top Bella handed him and tossing his shirt into a plastic bag. He handed it to a passing porter who took it without comment or wisecrack, the whole department slightly subdued, knowing what was taking place.