Emergency: Mother Wanted

by Sarah Morgan

  'No!' Keely stared at her in consternation. 'It isn't like that—really.'

  'Oh, come on, Keely.' Ally reached for a lemon and cut off several slices, which she popped into the glasses. 'You're the envy of the entire female population of Cumbria. Don't try telling me you don't find Zach attractive.'

  'Don't you ever give up, Ally?' Zach's mild reproof came from the doorway and Keely blushed scarlet.

  How much had he heard? Oh, no, he was going to think they'd been gossiping about him. She took a large slug of her drink, thoroughly embarrassed.

  Ally, on the other hand, didn't seem at all embarrassed. She smiled broadly and handed Zach a drink.

  'Just worrying about your welfare.' She slipped her arm through his and they walked towards the living room. 'So how's Phoebe been, Zach?'

  'She's doing very well—which reminds me.' Zach's eyes flickered to Keely. 'She wanted you to go and give her a goodnight kiss.'

  'No problem.' Relieved to have an excuse to get away from Ally's quizzical gaze, Keely hurried off to find Phoebe.

  She took much longer than was necessary to settle the little girl down, curling up on the bed and reading her an extra story.

  By the time she rejoined the rest of the adults, they were all seated at the table and Ally was placing an elaborate-looking starter in front of them all.

  'It's a new recipe,' she declared with a flourish. 'You're guinea pigs.'

  'Great. You really know how to whet someone's appetite.' Sean shook his head in exasperation as he looked at his pretty wife. 'You're not meant to tell the guests they're guinea pigs.'

  'So how's general practice,' Zach asked Ally as he tucked into his starter. 'Still seeing all the usual trivia?'

  'Trivia?' Ally glared at him and then subsided and smiled when she saw the twinkle in his eye. 'Zach Jordan, you're always winding me up and I fall for it every time. The answer to your question is that general practice is great and, no, I'm not seeing trivia.'

  Keely took a sip of wine and looked at her shyly. 'Do you work full time?'

  'Yes.' Ally glanced at Sean and laughed. 'But only three days a week in general practice. The rest of the time I'm a general slave and dogsbody.'

  'Stop moaning, woman,' Sean growled, but his eyes twinkled and there was no missing the closeness between the couple.

  Zach helped himself to a bread roll. 'Don't you ever miss real medicine?'

  'No,' Ally said calmly, 'because I'm practising real medicine every day. It's you lot that work in a strange environment. Hospitals are totally alien places. You just treat symptoms there. Never people. In general practice we treat the whole person.'

  Sean grinned. 'Since when did you need to treat the whole person to manage an ingrowing toenail?'

  'Go ahead. Patronise me,' Ally said loftily, 'but I've lost count of the number of times we've had patients home from hospital—your hospital—with no end of problems that none of you managed to identify. The problem with hospitals is that each consultant just manages the bit he knows about. No one looks at the overall patient. That's what I do.'

  Sean gave a smile. 'And you do it very well, angel. Your patients are damned lucky.'

  Keely put her fork down, her appetite suddenly gone. Hearing Ally talk had made her realise just how much she didn't want to pursue a career in hospital medicine. She felt exactly the way that Ally did. That there was more to caring for a patient than managing a symptom.

  Which wasn't going to make her much of a cardiologist...

  'Are you all right, Keely?' Ally was looking at her, suddenly concerned. 'You look as though you've seen a ghost.'

  'I'm fine.' Keely smiled at her through stiff lips. 'Tell me more about your job.'

  'My job?' Ally shrugged and glanced round at the others. 'Well, why not? It's a quick way to irritate these two and that's always good for a laugh.'

  She started to talk, telling them all about the day she'd had in the surgery, about a woman who'd been admitted to hospital with a broken leg, about how they'd had to arrange for all her animals to be cared for.

  'The hospital didn't even realise she had animals,' Ally said shortly, clearing the plates and standing up. 'Fortunately one of the neighbours saw the ambulance arrive to pick her up and came haring round here to ask us to sort it out. Which we did, of course.'

  She took the plates into the kitchen and returned with the main course, a delicious chicken dish with rice.

  'So what about you, Keely?' She served everyone and then looked at Keely curiously. 'Are you staying in A and E or are you doing a GP rotation?'

  'Neither.' Keely picked up her fork and tried to summon up an appetite. 'I'm going to be a cardiologist.'

  Except that she really, really didn't want to be one. Maybe she should talk to her father. Ask his advice. He was very career orientated but she knew that he loved her dearly. He wouldn't want her to do anything that she wasn't sure about.

  'A cardiologist?' Ally glanced up and nodded. 'In Glyn Hughes's team?'

  'Not Glyn Hughes's.' Zach's voice was strangely flat. 'Keely's not staying in Cumbria for long. She's going back to London at the end of her six months.'

  Ally's face fell. 'You're not staying?' She looked visibly disappointed as she glanced from one to the other. 'But I thought—I assumed—'

  'We all know what you assumed, sweetheart, but we'd rather you kept it to yourself,' Sean said gently, topping up her glass and giving her a smile. 'Now, buck up and eat your dinner before it gets cold.'

  Ally ignored him, her eyes on Zach. 'I really hoped that—'

  'Ally!' This time Sean's voice was sharp and Ally seemed to pull herself together.

  'Sorry.' She turned her attention to her dinner. 'Cardiology. You must be a very clever girl, Keely.'

  Keely shook her head, embarrassed by the sudden attention. She didn't feel clever. She felt confused. More confused than she'd ever felt in her whole life.

  'We went sledging last week.' Zach picked up his wineglass and changed the subject neatly. 'The snow was fantastic.'

  'Where did you go?' Sean topped up the rest of the glasses and they chatted about the snow for a while, swapping stories and anecdotes.

  'I must admit it's the first time I've had a snowball thrown at me since I was about ten years old,' Zach said dryly, smiling across at Keely who stared at him, outraged.

  'At least mine just hit you on the outside You stuffed yours down my jacket! I nearly had frostbite.'

  Ally glanced up, her face brightening. 'So, do you do lots of things together with Phoebe?' she asked casually, and Zach sighed.

  'No, Ally. Generally we don't. The whole point of Keely living with me is that she's there to cover when I'm working so it's very rare that we're at home at the same time.'

  Ally cleared her plate and put her knife and fork down thoughtfully. 'But Phoebe doesn't go to people very easily, does she, Zach? So she must really have taken to Keely.'

  'She has taken to Keely,' Zach said, his smile exasperated. 'Now, drop it Ally. You're like a dog with a bone.'

  'She's worse than that. She's embarrassing,' Sean growled, glaring at his wife. 'I'd buy her a bow and arrow for Christmas so that she can play Cupid full time, but her aim is so lousy I dread to think what it would do for our workload in A and E.'

  They all laughed and after that the evening improved and Keely found herself relaxing in their company.

  By the time they scooped a sleeping Phoebe up from the bed and transferred her to the car, she was sorry to leave. The Nicholsons were a lovely family. And Ally was a lucky woman. Sean was drop-dead gorgeous and clearly very much in love with his pretty, if rather indiscreet wife.

  'Thanks for coming.' Ally gave her a warm hug and then turned to Zach and lowered her voice. 'You should marry her, Zach. Snap her up quickly before she goes to London. She'd make a lovely mother for Phoebe.'

  Keely sank into the driver's seat, mortified, relieved that she hadn't been able to hear Zach's reply. She could guess what it probably would have been
.

  He slid in next to her and she drove carefully out of the drive and into the tiny lane that led to the main road.

  'I'm sorry about Ally.' Zach settled himself into his seat and closed his eyes. 'I did warn you that she was rather obsessed with pairing me up.'

  'Yes.' Keely stared at the road, not daring to look at him. 'It doesn't matter.'

  'Did she spoil the evening for you?'

  She could feel his gaze on her and her hands tightened on the wheel. 'No. Not at all. I thought she was lovely.'

  'She is, actually,' Zach agreed softly, 'just rather meddling.'

  And very astute. Keely suspected that the other woman had had no trouble guessing exactly how she felt about Zach.

  'Does she always try and pair you up with whoever you take there to dinner?'

  'Well, I don't usually take women there to dinner,' he admitted with a wry smile, 'so I suppose in a way it was my fault. Taking you and admitting that you're living in my house is tantamount to putting an ad in The Times as far as Ally is concerned.'

  'But she's tried matchmaking before?'

  'On countless occasions.' He gave a short laugh. 'At one time or another I've been introduced to every one of Sean and Ally's single female friends.'

  'How awful for you.' Keely's glance was sympathetic. 'Still, I suppose she means well.'

  'She does indeed. And I suspect that her meddling streak makes her a very good GP.' He stifled a yawn. 'She knows everything there is to know about her patients and what makes them tick. What she does is very different to what we do, and whenever we get together we're always teasing each other.'

  It certainly was different. And the more she thought about it, the more she thought it might be exactly what she wanted to do. Work in a small, country practice where she could get to know the patients inside out and help them. Not just deal with one crisis and then abandon them.

  So what was she going to do?

  There was no point in mentioning it to Zach. In fact, there was no way she could mention it to Zach, He'd assume that her change of heart was something to do with him. No. She'd have to do some research quietly by herself and then talk to her father.

  CHAPTER EIGHT

  They were working together the following morning when a young girl was brought in who'd collapsed.

  Keely helped the ambulance crew move the patient onto the trolley and glanced at the girl's mother who was hovering anxiously in the doorway.

  'What happened?'

  'I really don't know.' The woman was obviously beside herself with panic. 'She was fine. Absolutely fine. One minute we were in a cafe together and the next minute she'd collapsed.'

  Zach started to examine the girl. 'What were you eating?'

  'Sorry?' The girl's mother looked at him blankly.

  'What were you eating just before she collapsed?' Zach glanced at Keely. 'Let's get a line in, give her high dose oxygen and attach a cardiac monitor and a pulse oximeter. We need to get her stats above 94 per cent'

  'Cake.' The mother looked confused. 'We were eating cake, but I don't see—'

  'Is she allergic to anything that you're aware of?'

  'Nuts.' The woman went pale. 'But there were no nuts in the cake. I checked.'

  'Are you sure?' Zach turned to Nicky. 'She's wheezing badly. I want .3 mils of one in one thousand adrenaline. Give it intramuscularly, please.'

  Nicky turned away to the drug trolley and Zach glanced at the mother. 'This is a very severe reaction. I think for the moment we'll have to assume that it was nuts.'

  Nicky thrust an ampoule under Zach's nose and he read the label and nodded.

  'Fine. And let's give her 200 mg hydrocortisone IV and nebulised salbutamol.'

  They worked for half an hour and finally the young girl was stabilised.

  'Right.' Zach wiped his forehead with the back of his hand and gave the mother a tired smile. 'I'm going to refer her to the medical team. She needs to be admitted and we need to find out exactly what caused this reaction.'

  The girl's mother nodded, obviously still worried.

  'Will she be all right?'

  Zach glanced at the girl and nodded. 'I think so. She seems stable now but I'm going to play it safe and admit her. It was a nasty reaction.'

  They transferred the girl to the medical ward and Zach slumped against the wall, wearily surveying the mess in the room.

  'I've got a really, really bad feeling about this week,' he muttered, and Nicky groaned as she tossed a discarded IV bag into the bin.

  'Don't say that. Last time you had one of your feelings we were deluged with awful accidents.'

  'I know that.' Zach straightened and rubbed a hand over the back of his neck. 'But look at the weather. The roads are like glass and people still insist on driving everywhere.'

  No sooner had he said the words than the doors from the ambulance bay flew open and another accident victim was admitted.

  After that there was a steady stream of patients and by the time Keely arrived home she was exhausted. So was Zach.

  'That,' he said quietly, sinking into a chair in the kitchen, 'was a very bad day. Let's hope the rest of the week is better.'

  It wasn't.

  In fact, it got worse.

  Every time the doors to A and E opened, drama followed, and by the end of the week Keely felt emotionally drained.

  Dealing with critically injured patients was bad enough, but for Keely the worst bit was telling the relatives. Telling someone that their loved one had just died was the hardest thing she'd ever had to do.

  'How do you do it?' she asked Zach one afternoon after they'd failed to resuscitate a twenty-year-old motorcyclist. 'How do you cope with telling them that their child is dead?'

  Zach poured them both a cup of coffee, his face drawn. 'How do I cope? I suppose I switch off. I treat it as a job to be done. But it doesn't mean I don't feel it.'

  He did feel it, Keely knew that. She'd seen the strain on his face after a week of repeated tragedy.

  'I almost wanted to lie to those parents,' she admitted quietly, staring down at the coffee he handed her. 'The way they looked at me when I walked into the room, I wanted to tell them that there might be hope.'

  'I know the feeling,' Zach said gruffly. 'But you mustn't ever do that. As it is, people find it hard to take in bad news. Harsh though it sounds, the only way to do it is to be blunt early on. And don't use euphemisms. Relatives will try very hard to misunderstand you because they don't want to hear the truth. If the patient is dead then you need to use the word "dead" very early on in the conversation and then use it several times. It's kinder in the long run.'

  Keely looked at her coffee without enthusiasm. She didn't think her stomach would tolerate anything at the moment.

  'Well, I'm seriously hoping not to have to use the word "dead" for a long time,' she said gloomily. 'I've used it enough this week to last me a lifetime. Surely we can't have any more tragedy.'

  They did.

  It was later in the afternoon when the hotline—the phone that connected straight to Ambulance Control— rang.

  Nicky picked it up, listened and made notes, asked a few questions and then replaced the receiver.

  'They're bringing in a four-year-old with difficulty breathing,' she told Keely quickly. 'I'll check everything in Resus. Will you make sure you're ready when they arrive?'

  The doors to the ambulance bay crashed open only minutes later and the crew hurried in with mother and child.

  Keely took one look at the child and turned to Nicky.

  'I want the paediatric consultant, the ENT guys and an anaesthetist down here now!'

  Quickly they took them into Resus and Keely pushed forward a chair.

  'Sit down, Mrs Potter. Keep her on your lap.' She glanced at Nicky. 'Let's keep her with her mother so we don't upset her further, and give her some humidified oxygen, please.'

  Zoe, the paediatric staff nurse, reached for the oxygen and placed a mask near the child's face, murmuring soothin
g noises as she did so.

  The child looked severely ill, her face pale as she leaned forward on her mother's knee, drooling slightly.

  'I need some details from you, Mrs Potter,' Keely said quietly, her eyes never leaving the child as she watched for any change in her condition. 'How long has she been ill?'

  'Alice was fine yesterday.' The mother stroked the child's hair. 'I can't believe that she can have got like this so quickly.'

  'Has she complained of any pain? Has she been coughing?'

  'She said her throat was sore and she stopped eating because she couldn't swallow,' Mrs Potter said, and Keely nodded, her eyes still on little Alice.

  The child was ominously quiet and Keely had a very, very bad feeling about her.

  'Zoe, let's give her some nebulised adrenaline.' Hopefully that would buy her some time until the team arrived. She turned back to the mother. 'And has she had all her childhood immunisations?'

  Mrs Potter suddenly looked wary. 'No. No, she hasn't. I don't believe in all that, I'm afraid. I think children are better off picking up the germs and developing their own immunity.'

  Keely swallowed her frustration, reminding herself that everyone had the right to make their own choice about immunisation. The trouble was, she had a strong suspicion that Alice Potter was suffering from a disease that had been virtually eradicated thanks to the success of the vaccination programme.

  'Shall I check her BP?' Nicky asked quietly, and Keely shook her head vigorously.

  'No. Don't disturb her at all.'

  Mrs Potter looked up. 'What's wrong with her?'

  Keely took a deep breath. 'I think she has something called epiglottitis,' she said finally, and Mrs Potter frowned.

  'I've never even heard of it.'

  'It's extremely rare now,' Keely told her quietly, 'because most children are vaccinated when they're babies.'

  Mrs Potter went slightly pale. 'But she'll be all right, won't she?'

  Keely hesitated. 'She's seriously ill, Mrs Potter—very seriously ill.'

  'Are you sure it's not just a bad sore throat?' Mrs Potter became slightly belligerent. 'You haven't even looked in her throat.'