by Amy Andrews
‘No.’
‘Any itching or welts or rashes?’
‘No.’
He nodded. ‘Come on, then, Josh, climb up on my bench over there and I’ll have a look at your sniffle.’
Josh picked up his cars and followed James over. He placed the cars on the examination couch as he stepped on the footstool and climbed onto the bed.
James took a moment to look at his young patient. He noted the exudate collecting in the corner of Josh’s left eye and listened carefully to the boy’s breathing. He put his finger against Josh’s right nostril. ‘Big breath in, Josh.’
Josh puffed up his chest and James noted that the inhalation seemed a little obstructed. ‘Again,’ he said.
Josh repeated the action and James was even more convinced there was some kind of blockage in his nose. He pulled a penlight out of his pocket, tilted Josh’s head back and directed the beam of light into the left nostril. He thought he could see an odd fleck of blue right at the back.
‘Josh, I’m going to keep my finger on this nostril and I want you to blow really hard through the other one, OK? Just like you’re blowing your nose.’
The boy nodded and blew. Nothing. ‘Again,’ James said. ‘Really hard.’ Still nothing. He shone the light up again but whatever the blue fleck was, it hadn’t budged.
‘Well, Val,’ James said. ‘I think there may be a foreign body up there. Something irritating the mucous membrane and obstructing the left side of his nose.’
‘Oh, no.’ Val leapt to her feet. ‘Josh, did you put something up your nose?’ she asked.
Josh looked at his mother and James could see the sudden look of wariness on his face. He knew he was in trouble. He shook his head but it was plain that Josh wasn’t telling the truth.
‘What are we going to do?’
James could see the worry and gathering tears on the mother’s face. ‘It’s OK, Val. I’ll have a go at pulling it out. If I can grasp it easily, it should be OK. But if it’s hard to remove we don’t want to push it further into his airway so he’ll need an X-ray and maybe he’ll need to have it removed under general anaesthetic.’
‘Oh, God,’ said Val.
‘It’s OK.’ James took a moment to reassure her. ‘That’s the worst-case scenario.’
Val nodded and James hit the intercom. ‘Helen, could I see you for a moment, please?’
Four weeks, Helen thought. Only four more weeks of her stomach doing that silly loopy thing every time his voice purred into her ear.
‘You called?’ she said as she opened the door.
‘Josh appears to have a foreign body up his nose. Do we keep some long-nosed forceps for this kind of extraction?’
‘Joshua Lutton,’ Helen said, shaking her head at the guilty-looking child. ‘Boys, huh?’ she said to Val.
‘Hey!’ James protested.
Val laughed. ‘Katrina never did anything like this.’
Helen laughed, too. ‘Hang tight. I’ll be back in a jiffy.’
Helen returned a couple of minutes later with sterile packaged forceps. ‘Do you need a hand?’
‘Maybe just to hold him.’
Helen nodded. ‘OK, then, come on, Josh. Lie back on the pillow. This won’t take a moment.’ The child looked at her apprehensively and seemed as if he was about to cry. ‘Mummy’s going to be here, holding your hand, aren’t you, Mummy?’
Val dabbed at her eyes. ‘Yes,’ she said, smiling at her son as she took his hand.
James undid the packaging and positioned himself near Josh’s head. ‘You ready?’ he said to Helen.
She nodded. ‘OK, Josh, we need you to be very still and very brave now.’
‘That shouldn’t be hard,’ James said to Helen. ‘I heard Josh Lutton is the bravest kid in Skye.’
‘That’s right.’ Helen smiled at James. ‘Isn’t that right, Josh?’
Josh’s wobbling chin smoothed out and he nodded bravely. ‘That’s what Grandpa Alf says,’ he agreed in a little voice as the three adults loomed over him.
‘He’s a very wise man is your grandpa,’ James agreed. ‘All righty, then, Helen’s going to tilt your head up and I’m going to pull whatever’s up there out. On three. Ready? One.’
James advanced the small metal forceps to sit just outside the nose entrance. Helen held the penlight in one hand and the patient’s head in the other. She shone it up Josh’s nostril as she held him securely.
‘Two.’ James inserted the forceps gently. Josh flinched a little and Helen increased the pressure on the boy’s forehead, but he stayed still.
‘Three.’ He opened the forceps and made a grab for the fleck of blue he could see. The forceps scraped against something hard and he manoeuvred them gently to grasp it, hoping he wouldn’t push the object further into the airway and possibly block it altogether.
‘Got it,’ he said, breathing out as he slowly withdrew the forceps. He had no idea how big the object was or if it had any sharp edges that could cause damage on the way out, so he took his time to remove it gently.
James bought the object out into the open and held it up to the light. It was a small, white, hard, plastic figure in a sitting position with blue feet.
Val gasped. ‘It’s from one of his toy cars,’ she said.
Helen released her hold on Josh and he sat up. Val grabbed him and hugged him. ‘Never, ever put anything up your nose, Joshy. Never. Do you hear me?’ She gave her son a gentle shake.
‘It seems like we are constantly in debt to you, Dr Remington,’ Val said, turning to him as she rocked a bewildered Josh in her arms.
James shrugged. ‘Nonsense. It’s my job and boys are natural explorers. Let me just have another look up to make sure he didn’t decide to put another one up there in case that one got lonely.’
James shone his torch up again and was satisfied he couldn’t see anything more. He asked Josh to breathe again through one nostril and was pleased to hear that it no longer sounded obstructed.
‘Thanks again, Dr Remington. He’s a gem, that one, Helen,’ Val said to her as she gathered Josh to go.
‘Yes,’ Helen said, conscious of James’s amused gaze.
‘Are you sure you can’t stay? Skye’s going to miss you. I don’t think Josh will want to see anyone else ever again.’
Helen turned and raised an eyebrow at him. ‘James isn’t a stayer,’ she said dryly.
He ignored her. ‘I’m sorry, Val. I’ve already said yes to another locum job up north. I start in five weeks.’
Helen wasn’t prepared for that piece of news. She pulled the white sheet off the examination table to hide the squall of emotions that lashed her insides. He really was leaving. He hadn’t even checked to see if they wanted him for longer in case Genevieve changed her mind about coming back so early after the baby’s birth. He’d obviously stayed as long as he was going to in Skye.
‘Our loss,’ Val said. ‘Say goodbye to Dr Remington, Josh.’
‘Knowing Josh, we should maybe just say see you later.’ James smiled.
Val laughed. ‘Believe me sincerely when I say this, Dr Remington. I like you. A lot. But I hope Josh never has to see you in a medical context ever again.’
‘Fair enough.’ James grinned and waved at Josh as they walked out the door.
They watched the empty doorway for a few seconds. ‘Where up north?’ she asked.
He turned to face her. ‘The gemfields.’
She nodded. ‘It’s nice around there.’ She looked down at the sheet bundled up in her arms. ‘I’ll send your next patient in.’
James watched her go. It was pretty nice around here, too.
A week later the telephone rang at two a.m. Helen, who had only fallen asleep twenty minutes before and was consequently deep in the land of nod, didn’t even hear it. It wasn’t until James knocked on her door that she pulled herself out of the sticky bonds of slumber.
‘What?’ she called, completely disorientated for a few seconds.
‘The phone’s for you. I
t’s Duncan.’
It took a few more seconds for her to wake up properly. She flew out of bed and nearly ran straight into James as she pulled the door open and raced to the phone.
‘Hello?’
James stood nearby as Helen took the call. A phone call in the middle of the night could not be good. He watched her face. Her loose hair fell forward and obscured it as she said ‘Uhuh’ and ‘Yep’ and shook her head a lot.
Helen replaced the receiver. ‘Elsie’s been rushed to hospital. They found her unconscious half an hour ago. She was in cardiac arrest. They think she’s had a massive heart attack.’
‘Oh, Helen,’ he said, moving towards her, ‘I’m so sorry.’
She looked at him. ‘Duncan said Jonathon doesn’t think she’ll recover.’
He moved closer and held out his arms. He was wearing boxers and a tight T-shirt and his chest looked so cosy, so right, but she daren’t succumb to its lure.
‘No,’ she said, slipping past him. ‘I’m OK. I just have to get there.’
When Helen came out of the bedroom James was dressed in jeans and a T-shirt, waiting for her. She stopped short. ‘Go to bed, James,’ she said. ‘You don’t have to come with me.’
James shook his head. ‘I know. But what kind of human being would I be if I let you go alone? Come on, I’ll drive you.’
Helen opened her mouth to argue. She didn’t need his help. She was used to doing things alone. She’d been dealing with things alone for all her life. It would be dangerous to get used to having him around. To depend on him.
If only the ache in her arms, in her heart would go away. The need to be held for once, to lean on someone at this moment, was almost unbearable. She’d known this day would come eventually but now it was here her courage was deserting her.
‘Helen?’
His voice was soft, his turquoise gaze compassionate, and for a moment her composure teetered. But she snatched it back at the last second, acquiescing with a brisk nod, not trusting her voice.
They drove in silence and were at their destination in under ten minutes. He followed her in and Helen didn’t protest. She realised two things. One, she was scared. Scared of what she was about to see. And, two, she didn’t want to be alone.
‘Hi, Helen,’ the night nurse greeted her, and filled her in on Elsie’s condition. ‘She’s in the HDU.’ The high dependency unit. Things were serious.
Helen nodded and made her way there. Duncan embraced her, his worried face speaking volumes. She stood at the end of Elsie’s bed, the only thing visible from her vantage point was sparse white hair. She was too frightened to get closer.
James could sense Helen was only just holding it all together. She was standing so rigidly not even her ponytail moved. Her hand gripped the bed end with white-knuckled intensity. She looked so isolated, so remote it was painful to watch. He desperately wanted to touch her, pull her into his arms, but he’d never seen her look more untouchable. He doubted she would welcome it.
Instead, he pulled up a chair for her. ‘Sit,’ he said to her gently, touching her arm to bring her out of her almost trance-like state. She looked at him blankly and he pointed to the chair he’d placed next to Duncan’s, on the side Elsie was facing.
‘Th-thanks,’ Helen said, her legs responding automatically to his command.
Helen sank into the chair slowly. She could see Elsie fully now and her appearance was deeply shocking. She looked like a shadow of herself, a shadow of the woman she’d seen only yesterday. She looked almost unrecognisable.
Helen pulled the lever on the bedframe near her knees and collapsed the side rail that was barricading Elsie from them. She touched her hand tentatively, the sensation evoking a hundred memories.
Suddenly she wanted to be closer. She wanted to crawl into bed beside her, like she had as a little girl. She wanted to hear Elsie’s smooth voice singing to her, cuddling her, telling her everything was going to be fine.
She felt hot tears well in her eyes and spill down her cheeks. The one person who’d given her the one thing her childish heart had craved more than anything—a sense of family—was fading away. She dashed them away.
She wouldn’t cry. Elsie didn’t approve of tears. Elsie believed that when your time was up it was up, and particularly since the stroke she’d known she’d been living on borrowed time. And one look at an utterly devastated Duncan told her she had to be strong for this last part. She grabbed her surrogate brother’s hand and gave it a squeeze.
Absurdly, she wished her father was there. Just for once she wished he was there for her. She glanced at James. He was here. Ironic that the one man that was here for her was as much of a gypsy as her father. A man cut from the same cloth. He was here now and she was grateful but in a few weeks he’d get on his Harley and disappear. She’d never felt lonely before. Not ever. Until tonight.
‘Hello, Elsie. It’s Helen. Duncan and I are here. We’re right here. We’re not going anywhere.’
Nothing. Elsie’s breath misted the inside of the oxygen mask that covered her face. What had she expected? For Elsie to open her eyes and smile at her? Make a last-ditch crack at getting her and James together? She stroked the aged hand, the papery skin, the prominent bones. An IV taped securely into the crook of Elsie’s elbow dripped a steady supply of sugary saline into her system to keep her hydrated. A monitor blipped in the background and Helen was alarmed at the frequency of ectopic beats.
She looked at James over her mother’s head. He was sitting on the opposite side of the bed, yawning, feigning interest in a two-year-old woman’s magazine. ‘You should go. You don’t need to hang around.’
He shrugged. ‘I don’t mind.’
‘It’s not necessary.’ Their gazes locked. ‘Duncan’s here.’
Duncan looked incapable of any higher functions. He looked absolutely gutted. ‘I’ll stay another hour or so.’
Helen didn’t have the inclination to argue with him. It somehow didn’t seem peculiar that someone who had been a complete stranger to her three months ago was sitting with her while the woman who had been more of a mother to her than her own mother slowly let go of life. Oddly enough, it seemed kind of right.
Helen shuffled her chair closer to the bed and laid her head on the mattress close to her Elsie’s face. It was wrinkled and gaunt, her eyes sunken, her mouth minus her dentures sucked in, her lips thin and dry. This wasn’t Elsie. Helen cradled a bony hand against her face and shut her eyes, letting memories of her childhood wash over her.
An hour later the small magazine print started to blur and James’s eyes lost the battle to stay open. As he slipped into slumber his neck slowly lost its ability to hold his head up. It nodded forward and he woke with a start, snapping his head back up.
His eyes slowly came back into focus and he rubbed at the crick in his neck. Duncan had nodded off in his chair. Helen appeared to have fallen asleep also, her head resting on the mattress. He stood and stretched, the hard plastic chair not the most comfortable piece of furniture he’d ever sat on.
The air-conditioning was quite cool and he wandered out to the nurses’station and asked for a blanket. They furnished him with one and he placed it gently over Helen’s shoulders. She murmured something unintelligible and snuggled into the folds.
Elsie’s breath still misted the mask and, along with the monitor noise, James knew she was still with them. For now anyway. James had read Elsie’s chart and she appeared to have had an extended down time. At her age, and with her history, her care was purely palliative. He took his seat again.
A nurse came by every half an hour and checked on their patient. One of them bought him a steaming-hot coffee at one stage and he sipped it gratefully. It had been a long time since he had maintained a bedside vigil and he’d forgotten how much caffeine helped. Even bad-tasting caffeine.
The day dawned, soft light blanketing the landscape. The sun rose, pushing the velvety glow aside, streaming in through the windows, its brightness an early warning of anot
her hot day.
Two nurses came in to shift Elsie’s position. They shook Helen gently and she stirred, her eyes opening to see the reassuring misting of the face mask.
She sat up slowly and rubbed at her neck. Her bleary-eyed gaze fell on a yawning James. He’d been there all night? ‘You stayed,’ she murmured, as she moved out of the way.
‘Yes.’
The slow smile he gave her banished the tired lines around his eyes and she felt stupidly happy. ‘You shouldn’t have. You’ve got to work today.’
He shrugged. ‘I’m a doctor. I’m no stranger to allnighters.’
Helen yawned. ‘What’s the time?’
‘Six. Let’s get a coffee while they do this,’ he suggested.
Helen saw Duncan off—he needed to duck home for a few hours—and then joined James in the lounge area. She stared out the window while he made her a drink.
‘Here. I’m sorry, it’s just that horrible instant stuff.’
He nudged her shoulder and she turned away from the view of Main Street, accepting the cup. They sipped in silence for a while.
‘I have to make some phone calls,’ Helen said. ‘I need to arrange for Donna to take over at the surgery.’
James nodded. Donna was a local mother who worked as a part-time receptionist when Helen manned the extra clinics the surgery ran.
‘Will she be able to at such short notice?’
‘I hope so,’ Helen said. ‘Given the circumstances, I’m sure she won’t mind. It won’t be for long.’ Helen stood as the import of her words hit her. Elsie was dying. This really was the end.
James watched as she paced to the window and felt completely helpless. She was standing rigidly again, looking so very, very alone.
‘I have to ring my father, too. He’ll want to know.’
‘Where is he at the moment? Will it take him long to get here?’ James felt certain that Elsie’s death was reasonably imminent. Helen may not look like she needed anyone but surely her father should be there.
‘I have no idea where he is. Or if he’ll make it in time. I just have a number of a service to ring. He checks it every now and then.’
