by Sarah Morgan
'Hello, Dr Jordan—I mean Mr Jordan.' She'd suddenly remembered that he was a surgeon and corrected herself hastily.
A smile touched his mouth. 'Just Zach will do fine,' he murmured. 'We're very informal in A and E.'
'Right—well, what a surprise to see you.' She stroked a strand of blonde hair behind her ear and smiled brightly, wondering what it was about those blue eyes that made her revert to a stammering teenager. 'I had no idea that you'd be working here.'
'And is that a problem?' He gave a quizzical smile which made her knees feel weak and her heart misbehave.
'Problem?' Her voice squeaked slightly and she cleared her throat. 'No—of course it's not a problem. Why would it be a problem?'
She could think of a hundred reasons, starting with the physical effect he had on her. Just being in the same room as him brought her close to physiological meltdown.
'So what are you doing here?' He tilted his head speculatively. 'You're a long way from home, Keely Thompson.'
That had been the general idea when she'd chosen the Lake District.
'After six years in London I needed a change,' she said quickly, 'and I love mountains.'
She flushed under his steady regard, remembering that he'd always been perceptive. Could he read her mind? Did he know the real reason she was here? Had he guessed that she'd needed some space to make her own decisions, away from the influence of her family?
'Right.' He continued to watch her thoughtfully. 'And how are Prof and the twins?'
The inevitable question.
'Oh, you know,' Keely pinned a smile on her face, her response automatic. 'Fine. They're fine. Doing very well as usual.'
'I lost touch with Stephen,' Zach confessed, his blue eyes disconcertingly sharp as he looked at her. 'Doubtless he's made it to the top?'
Of course. Where else was there for her family?
'Professor of Immunology,' Keely muttered, still managing to maintain the smile. Just.
'And Eleanor?'
'Consultant Oncologist in London.' The smile was slipping but he didn't seem to notice.
'And the Prof? Is he retired?'
'Dad?' Keely's cheek muscles were aching and she gave up smiling. 'Oh, come on, Zach! Dad will never retire. His whole life revolves round being a professor.'
'I suppose it does.' Zach's voice was suddenly soft. 'And what about you, Keely? What's your chosen career path?'
Did she tell him the truth? That she didn't know? That the whole question of her future was driving her mad—
No, of course she couldn't tell him that! Zach was exactly like the other members of her family—clever, ambitious and totally driven. A born leader who had probably never known a moment of self doubt in his life. He was hardly likely to understand or sympathise with her plight, would he? She could hardly confess that she wasn't entirely sure what she wanted to do with her career—could hardly confide that she wasn't totally enchanted at the prospect of a career as a hospital doctor.
'Well, I'm doing six months of A and E before I commit myself,' she said finally, trying to sound suitably enthusiastic, 'but I'm thinking of doing cardiology. It's always fascinated me and we haven't got a cardiologist in the family.'
'I see.' He spoke quietly, his expression thoughtful, and for a moment she wondered whether he'd guessed that she wasn't being entirely honest.
'And do you think you'll enjoy A and E?'
She swallowed. Did he think she wasn't up to it? He'd already said he hadn't got used to the fact that she'd grown up.
'I know I'll love it,' she said firmly.
'Right.' Those blue eyes fixed on hers a moment longer. 'Well, if you have any problems—any worries at all—I want you to come to me.'
Oh, bother, he definitely didn't think she was up to it.
'I'll be just fine,' she said, a determined expression on her face. 'I'm really looking forward to A and E. It's going to be brilliant. I know I'll love it.'
He seemed amused by her enthusiastic outburst. 'It's nice to see you haven't changed.'
Well! Talk about tactless! Keely gaped at him. Did the man have problems with his eyesight?
'Of course I've changed!' She hoped that none of her new colleagues were listening to this conversation. How embarrassing! Being told she hadn't changed since she was sixteen was hardly flattering. 'Last time you saw me I had a flat chest, long hair and spots.'
He threw his head back and laughed. 'Actually, I wasn't talking about your physical appearance, I was talking about your personality. You always were smiley and good-natured.' His grin faded. 'I just hope you don't find A and E too stressful.'
'Zach, stop treating me like a child!' Keely was still put out by the fact that he didn't think she'd changed. She liked to think of herself as a cool cat. He made her sound more like a fluffy kitten. 'Of course I won't find it too stressful. I'm a doctor now! I'm not some child that needs to be nurtured.'
'I know that.' His voice was a slow drawl and he smiled again, obviously amused by her defensiveness. 'It's just going to take me a bit of time to get used to the idea.'
Oh, great. Then this was going to be every bit as bad as she'd feared when she'd first seen him stride into the lecture theatre.
She clutched her notepad harder and changed the subject. 'So, how long have you been working here?'
'In this department? Two years. I've been a consultant for a year.'
He was young for the post but, then, that was no surprise. He was every bit as bright as her siblings. In fact, she remembered Stephen sulking because Zach had beaten him in several exams.
'Well...' She broke off and cleared her throat. 'I don't suppose we'll see that much of each other, will we? I mean, there are four consultants in the department.'
'True.' His eyes gleamed. 'But we each work with three SHOs and you're on my team. We'll see plenty of each other, Keely.'
Her heart tumbled in her chest. How was she going to work with him every day without making a fool of herself? Just five minutes in his company had been enough to show her that the man still had a powerful effect on her. And what did he think of her? He'd admitted that he needed time to get used to the idea she was grown up. Did he think of her as the schoolgirl who'd proposed to him all those years ago?
She chewed her lower lip and decided she had to get things into the open.
'Listen, Zach...' She coloured furiously and glanced around quickly to check that no one was listening. 'About what happened when I was sixteen...'
His face was impassive but she thought she detected a brief twinkle in his eyes.
'I don't remember anything happening when you were sixteen.'
He was turning a blind eye to the fact that she'd made a total fool of herself over him.
'You're very kind, but I want to apologise. I've wanted to for a long time.' She pressed on, determined to have her say. She couldn't work with him otherwise.
'There's really nothing to apologise for,' he said quietly, and she flushed.
'How can you say that when I—when I—' She broke off, totally swamped with embarrassment, and his face was unbelievably gentle.
'Had a crush on me? There's nothing to apologise for, Keely. These things happen.'
'Are you sure?' She looked up at him anxiously. 'You're not cross? You don't think it's going to be a problem between us?'
One dark eyebrow lifted. 'Why should it be? Unless you're planning to develop another wild crush on me.'
She was beginning to think it was entirely possible but she managed a laugh that she hoped sounded convincing.
'Goodness, no! I think I'm a bit beyond childish crushes now, Zach.'
And even if she wasn't, there was no way he was going to find out about it this time!
His eyes locked with hers. 'Good. Well, in that case we're not going to have a problem, and we won't mention it again.' He held out his hand. 'Welcome to A and E, Dr Thompson.'
With that he turned on his heel and left the room, leaving her staring after him. If he'd been
handsome at twenty-four—and he certainly had been—then at thirty-two he was devastating.
Not that she was going to think about him in those terms, she told herself hastily. She had made a complete fool of herself over Zach all those years ago and once in a lifetime was more than enough for anyone. This time she was .keeping a strict control over her hormones.
She was not going to fall in love with Zach Jordan again...
Zach walked out of the lecture theatre and made his way back to the A and E department, his thoughts full of Keely.
He still couldn't believe it was her.
Last time he'd seen her she'd been little more than a child—and a very engaging child at that. He'd never been able to understand how her family had managed to produce a child like Keely. She was so totally different from the rest of them. Eleanor and Stephen were both like their parents—academic, emotionally reserved and totally driven.
But Keely... Zach gave a slight smile as he thought of how she'd been—Keely was warm, affectionate and slightly scatty. Unfortunately those qualities hadn't been valued enough by her family and he remembered several occasions when Eleanor and Stephen had given their little sister a hard time.
He frowned as he pushed open his office door and put the slides from his lecture back in the cupboard. But somewhere along the line she'd obviously changed if her career plans were anything to go by. Funny really. He wouldn't have thought she was the sort to be happy in a high-powered hospital career. But he was obviously wrong.
He flicked on his computer, checked his messages and then glanced out of the window towards the mountains. This late in January the fells were always topped with snow and the views from the hospital were breathtaking. He loved it here, but would Keely?
Zach frowned slightly as he remembered her breathless enthusiasm for her new job, her transparent embarrassment at seeing him again and her sweet concern that he'd still see her as a child.
Was she right?
Was that how he saw her?
To be honest, he wasn't really sure. Certainly it was hard to imagine her as a doctor and, frankly, he was distinctly uncomfortable about exposing her to some of the horrors that they saw in A and E. But was that because he saw her as a child? He didn't think so. It was more to do with her personality. Keely had a vulnerability about her that brought out all his protective instincts.
He could see immediately why Sean had found her attractive. It wasn't just that she was pretty, although she was. Very pretty. But her appeal went much deeper than just her looks. She had the widest, most compelling smile he'd ever seen, an infectious laugh and a warmth that wrapped itself around you like a blanket from the moment you met her.
And privately he thought she was going to find A and E work emotionally draining. Keely felt things too deeply to be able to successfully shrug off some of the incidents' that burst through their doors on a daily basis. Which meant that he needed to keep a close eye on her. A very close eye on her indeed.
By the end of the week Keely was at screaming pitch.
He was driving her mad. Whereas her colleagues were left to their own devices until they shouted for help, every time she turned round Zach was breathing down her neck. It was doing absolutely nothing for her confidence.
She could do the job—she knew she could. But not if her every move was being watched.
She was going to have to say something. The trouble was, when? Working in A and E was fast-paced to say the least. So far they'd had very little time for cosy chats. Maybe today she'd pluck up courage...
Before she could work out how to tackle the subject without sounding defensive, the paramedics brought in an emergency and she and Adam, one of the other new casualty officers, were called to the resuscitation room.
Seconds later Zach slammed open the swing doors of Resus and joined them at the trolley.
'OK, what have we got?'
'Twenty-five-year-old male, overdose—we don't know what he's taken. He was brought in unconscious.' Nicky Roberts, one of the A and E sisters, briefed him quickly as they all swung into action. 'One of his friends found him. Said he'd been depressed lately but didn't know if he'd been taking any drugs. The ambulance crew put in an airway.'
'OK.' Stethoscope looped round his neck, Zach started to examine the man, his movements swift and methodical. 'No gag reflex. Someone bleep the anaesthetist and let's give him some oxygen.'
Keely tried not to be impressed by the speed and confidence with which he worked as he took charge of the situation.
'He's got dilated pupils, a divergent squint and increased muscle tone and reflexes.' His eyes flickered past Keely and rested on Adam. 'Does that give you any clues as to what he might have taken?'
Keely ground her teeth. He was doing it again.Ignoring her and asking Adam the questions. Why hadn't he asked her? Why wasn't he treating her the same way he was treating the others?
Did he think she didn't know the answer?
She gave Adam a moment to speak but when he hesitated, clearly unsure, she stepped forward, her small chin lifting slightly as she spoke.
'Could it be tricyclics?'
Zach's gaze swivelled to her and she saw the flicker of surprise in his blue eyes. 'It could be.' He looked at her for a long moment, obviously unsure whether to question her further.
Keely took the matter in her own hands. 'Obviously you'll want certain tests done,' she said crisply. 'In my opinion he needs a drug screen and a blood glucose, BMG, ABG and U and Es.' She listed the necessary investigations and then held her breath, waiting for his response. Would he give her a row for interrupting when he'd asked Adam the question?
There was a long silence and then a ghost of a smile played around his firm mouth.
'Then you'd better get a line in and send off those tests.' He shifted his sharp gaze to one of the student nurses. 'Pulse and BP?'
Keely felt a rush of relief and reached for an IV cannula.
'Pulse is 110 and his blood pressure is 70 over 50,' the student nurse said quickly, flushing slightly as that hard gaze shifted in her direction. 'Wh-what are tricyclics, Mr Jordan?'
Zach jerked his head towards Keely. 'Dr Thompson will tell you.'
Was he testing her? Keely taped the cannula in place. 'It's a type of antidepressant. Unfortunately it's quite serious in overdose.'
'He's tachycardic and hypotensive,' Zach muttered, his eyes moving back to Nicky. 'And his skin is dry and hot. Check his temperature, please. I'm sure Keely's right and it's tricyclics. What do you think?'
Nicky shrugged and picked up a thermometer. 'You're the doctor, Zach.'
'That's never stopped you giving an opinion before.' Zach's tone was dry as he returned his attention to the patient. 'OK, is that line in? Well done, Keely. Let's give him a plasma expander—500 mils gelatin. Do we have a name for him yet? Address?'
'The friend was giving his details to Reception. We'll check,' Nicky said quickly, despatching another nurse to talk to the receptionist.
Zach drew breath and wiped his forehead on his sleeve. 'Someone contact the GP, please—find out what he's taking, if anything.' He glanced up as the anaesthetist strode into the room. 'Hi, Doug.'
His colleague gave a brief smile of acknowledgement. 'What's the story?'
'Overdose,' Zach said briefly. 'Don't know what yet. We're working on it, but we're guessing tricyclics.'
The anaesthetist rolled his eyes and snapped open the laryngoscope. 'Bloody antidepressants.'
'Quite.' Zach's gaze returned to his patient. 'He's got no gag reflex. I want to wash him out. We need to intubate him with a cuffed tube.'
'By "we" I assume you mean me,' the anaesthetist said dryly, and Zach grinned.
'I do indeed. I'm not rummaging around in someone's vocal cords unless I have to.'
The anaesthetist frowned and reached for an endotracheal tube. 'Isn't it a bit late for gastric lavage? When did he take them?'
'His friends saw him two hours ago and he was fine,' Zach said calmly. 'I want t
o try it and I want to give him some charcoal.'
'You're the boss.' The anaesthetist shrugged and intubated the patient quickly, using a cuffed endotracheal tube designed to prevent liquid accidentally entering the lungs.
'Great.' Zach lifted his eyes to Nicky. 'Let's wash him out. Keep 20 mils of the aspirate for a drug screen. Then I want 50 grams of activated charcoal down the tube. And let's do an ECG.'
His steady stream of instructions left Keely's head reeling and she watched in awe as he and Nicky worked together, their smooth teamwork a result of years of experience. Nicky seemed to anticipate Zach's every move without being asked and he was so calm and relaxed that Keely's admiration quickly turned to gloom. Would she ever be as confident as that?
'He's in urinary retention,' Nicky said quietly, and Zach nodded.
'That's common after a tricyclic overdose. Try suprapubic pressure. If that doesn't work then let's put in a catheter. How's that ECG?'
He leaned over her shoulder, frowning as he saw the trace. 'Well, that pretty much confirms Keely's diagnosis.'
As if to prove the point the student nurse came back in at that point. 'I've spoken to the GP. He was taking tricyclics. Amitriptyline.'
'Well done, Keely.'
Zach's quiet words of praise brought a faint colour to her cheeks and she suddenly felt deliciously warm inside. Maybe she would be as confident as him one day. He was the consultant after all.
Zach lifted the ECG trace and stared down at it. 'All right, Keely, you're the one who wants to be a cardiologist. Take a look at that and tell me what you see?'
He handed her the ECG trace and waited while she looked at it.
'Prolonged PR interval and QRS widening.'
'Right.' Zach took the trace back. 'Consistent with a tricyclic overdose. Let's give him 8.4 per cent sodium bicarbonate.'
Nicky turned away to do as he'd instructed and Zach turned back to Adam. 'He needs to be admitted to CCU for cardiac monitoring. Can you bleep the medical reg and I'll have a word with him?'
