by Joanna Neil
He was being helpful, co-operative, and she could only hope she would live up to his expectations. Perhaps the situation with Michael had shaken her confidence and filled her with self-doubt. He’d made her question every action she’d taken, every drug she’d prescribed. Towards the end he’d made her life at work seem like hell on earth.
Troubled by these unsettling thoughts, she moved over to the sink unit, where Tyler was standing. She needed something to do to keep herself active and shake off the negativity of the past. It was dark outside now, an inky blackness, and she reached over to close the blind just as Tyler decided to set down his coffee cup on the draining board. Their bodies met in a soft collision. His hand lightly brushed the swell of her hip and an instant shock wave of heat pulsed through her body.
‘Uh, I’m sorry.’ He drew back as though he’d been stung.
‘It’s all right,’ she managed, struggling to calm the pounding beat of her heart. ‘It was an accident.’
‘Yes.’ He was watching her, seemingly mesmerised by her. His blue gaze drifted down over the gentle curves of her body, outlined by the soft material of the black dress. She could feel the warmth of his gaze searing her skin, almost as though he’d touched her, and her heart skipped a beat. A pulse began to throb at the base of her throat, an erratic, fluttery sensation that made her catch her breath.
Neither of them moved. It was as though they were imprisoned in some kind of force field where all her senses were heightened. He felt it too, she was sure.
Slowly, the magnetic tension that held them began to dissipate. In the background she could hear the thud of children’s footsteps clattering down the stairs. The spell was broken and Tyler glanced towards the kitchen door as the sound drew nearer.
‘I—uh... Perhaps I should be going now,’ he said huskily. ‘It sounds as though you’re going to be needed soon.’ He drew in a quick breath. ‘Thanks again for supper. I—uh—I must return the favour some time.’
‘That’s okay, you’re welcome.’ She managed to find her voice, even though her throat was suddenly bone dry. ‘I’ll see you out.’
He left by the back door, looking back briefly before setting off down the moonlit path at the side of the house. She acknowledged him with a wave.
After he’d gone, she stood for some time, slowly breathing in the night air, trying to get her thoughts back together.
He had an extraordinary effect on her, and it seemed that he wasn’t immune to her either. That could be tricky. She wasn’t looking for a relationship, didn’t want to get involved with any man after her experience with Michael. She hadn’t bargained for any of this when she’d come here, or when she’d applied for the job at the hospital.
But now it looked as though they might both be treading on dangerous ground, and if this evening’s events were anything to go by, she’d have to be on her guard.
She was just getting over one bad experience, and she wasn’t about to let herself in for another.
CHAPTER FOUR
‘HEY, IT’S GOOD to see you, Saskia.’ Noah Matheson caught up with Saskia and Tyler at the entrance to A and E. ‘Are you all set for your first day with us?’
‘I think so.’ She returned his smile. ‘Thanks for asking.’
‘You’ll do fine, I’m sure, but if you have any problems, just holler. I’ll be right next door.’ He waved a hand in the direction of the minor injuries unit.
‘I’ll remember that. Thanks. Though I’m hoping Tyler will be here to help me out, for the next few weeks at least.’ She looked at Tyler and he inclined his head in acknowledgement.
Noah shot him a quick glance. ‘Hmm...luck of the devil, that one.’ He leaned closer to Saskia, saying in a stage whisper, ‘Just remember, if you need anything at all, I’m your man.’
‘Of course you are.’ She laughed at his teasing. Noah was never going to be serious, was he? He was one of life’s charmers, a cheerful, buoyant soul who couldn’t resist trying his luck.
Tyler gave him a steely-eyed look. ‘We’ll see you later, Noah,’ he said firmly. He rested a hand lightly in the small of Saskia’s back and shepherded her away from their colleague and through the doors of the A and E unit.
Saskia was all too aware of Tyler’s gentle but determined guidance. His touch was warm and supportive, sending ripples of heat eddying along her spine in a way that was profoundly unsettling. It flustered her, and she could only hope he wouldn’t notice the flush of colour that swept along her cheekbones.
He was oblivious to the effect he was having on her, though, wasn’t he? There wasn’t anything to read into his innocent action. All Tyler wanted was to put some distance between her and Noah, because they both knew his colleague had the potential to be way too much of a distraction.
Once in the emergency department he was completely businesslike, introducing her to the staff on duty and showing her the areas she might have missed on her brief tour on the day of the interview.
‘We keep lab request forms in here,’ he told her, opening up a cupboard that housed myriad specialist documents, blank charts and so on. ‘You’ll find swabs, dressings, et cetera, in the cabinet over there, and tubing, surgical gloves and specimen bottles are stored in the cupboard right next to it.’
‘Okay, I’ll remember that.’
‘It’ll probably take a while for you to get to know where everything is, but the nurses are always willing to help out if you’re unsure of anything.’ His mouth made a crooked line. ‘Most important place of all, of course, is the staff lounge. That’s our main port of call for coffee, tea, biscuits and offloading all the frustrations of the day. It’s along here.’
He led the way down a wide corridor to a room marked ‘Staff only’ and gave her a quick look inside. A couple of people were sitting in there, and she recognised one of them as the young woman doctor she had seen a few days ago, talking to the receptionist.
‘Dr Imogen Lancaster,’ he said, ‘and our Registrar, Dr Jason Samuels. This is our new A and E doctor, Saskia Reynolds.’ They acknowledged one another with murmured comments and smiles, and then she headed back with Tyler to the main body of the emergency unit.
‘Officially, I’m on call this week,’ Tyler murmured, ‘so it could be a baptism of fire for you. We’ll only go out to those cases that the paramedics can’t handle, but you’ll need to be prepared for that. In the meantime, we’ll work through the list of people who’ve turned up in A and E.’ He glanced at the white board that showed the status of patients being seen that morning. ‘It looks as though we have someone here who might fit in with your paediatric specialty,’ he remarked. ‘Tom Carter, in treatment room two, eleven years old. Abdominal pain. Do you want to go and see him while I take a look at the man in the next bay?’
‘Okay.’ She left Tyler and headed towards the room he had pointed out.
A young boy was lying on the treatment couch, looking feverish and ill, while his mother sat in a chair beside his bed. She was extremely anxious, clasping her hands tightly in her lap, the strain showing in her creased brow and the taut line of her mouth.
A nurse was with them, noting down temperature and blood-pressure measurements on the boy’s chart.
Saskia greeted them with a smile and then glanced through the chart the nurse handed to her.
‘I hear you’re not feeling too good, Tom?’ she said, going over to the couch. ‘Can you tell me what the matter is?’
‘My tummy hurts—and my back—and I keep feeling sick,’ he told her. His eyes were puffy, she noticed, and there was some other facial swelling. From the readings the nurse was taking, she saw that his blood pressure was abnormally high.
‘I’ll just do a quick examination of your tummy,’ she said, ‘if that’s all right?’
He nodded, and she proceeded to carefully check him over, asking his mother various questio
ns as she did so to try to find out what might be causing his symptoms.
‘He’s not eating properly,’ his mother said, ‘and he told me his urine’s a dark colour. Do you think there’s something wrong with his waterworks?’
‘Possibly,’ Saskia murmured. ‘I’m seeing quite a bit of swelling, which is due to salt and water retention, and that means his kidneys aren’t working as well as they should. There could be some inflammation there.’ The nurse had done a urine test that showed there was blood in the boy’s urine and leakage of protein. They were not good signs.
She listened to the boy’s chest and then examined the glands in his neck and asked him to open his mouth so that she could look at his throat. ‘We need to do some tests to find out what’s causing the problem,’ she said, looking over at his mother. ‘Some simple blood tests and another urine test. Has he been poorly in the weeks leading up to this?’
‘He had a sore throat,’ the woman answered. ‘We thought it was just a cold and that it would clear up on its own but it seemed to hang on for quite a while.’
‘It hurt me to swallow,’ Tom put in.
‘Yes, your glands are still a bit swollen,’ Saskia said. ‘I think I’ll take a throat swab to see whether you have an infection there that we need to treat.’ Tom looked anxious at that and she said hurriedly, ‘It’s nothing to worry about—I’ll use a small cotton wool swab and just gently stroke inside your throat. It won’t hurt.’
He relaxed, and she excused herself while she went to find the testing kit. Tyler was standing outside the nearby treatment room, talking to a nurse about his patient, but he broke off when he saw Saskia. ‘How’s it going? Is everything okay?’
Saskia nodded. ‘It’s looking as though the boy has a problem with his kidneys and I’m a bit worried about him. There’s some swelling to his face and abdomen and he’s quite poorly. I’m just going to do a throat swab to see if it’s the result of a streptococcal infection.’
He winced. ‘That sounds nasty. Okay. Let me know how you go on.’
‘I will.’
She went back to her young patient a few minutes later and took a swab from his throat.
‘When will we know the results?’ his mother asked.
‘In a few minutes,’ Saskia answered. ‘I’ll check the swab here and now, but in the meantime I’ll organise some medication to help bring down the swelling and get his blood pressure back down to a reasonable level. I think we’re going to have to admit him to hospital for a few days so that we can limit his fluids and put him on a special diet to reduce his protein and salt intake.’ She wrote out a prescription for the nurse and then went to set up the testing kit to determine the results of the swab.
A short time later she went back to the bedside. ‘The swab was positive for a streptococcal infection,’ she told the boy’s mother, ‘so we need to treat that with antibiotics. Does Tom have any problems with taking penicillin? Any allergies at all?’
His mother gave it some thought and then shook her head. ‘No, I don’t think so.’
‘Okay, then. We’ll start him on the tablets right away.’ She smiled reassuringly at the boy and his mother. ‘I know this might be very confusing for you, but if you have any questions at all, we’re here to help.’
‘Thank you.’ The woman clasped Tom’s hand in a comforting gesture. ‘I’ll stay with you, sweetie,’ she told him. ‘You’re going to be all right.’
Saskia left them a few minutes later and went to the nurses’ station to make arrangements to admit Tom to one of the wards. Passing by one of the treatment rooms, she saw Tyler deep in conversation with Dr Lancaster. The woman was smiling up at him, her long, chestnut-coloured hair falling in a silky swathe about her shoulders and swishing gently as she moved her arms to illustrate a point. Tyler grinned at something she said, and a moment or two later he lightly touched her shoulder in a farewell gesture as he made to leave the room.
Saskia hurriedly dragged her gaze away from them, not wanting to be caught staring. All the same, she frowned. Was there something going on between the two of them? Imogen seemed completely at ease with Tyler and he was relaxed and animated in her company.
But why wouldn’t he be? she admonished herself a moment later. They must have worked together for some time, and they were obviously friendly with one another. Wasn’t that how things should be?
She went to see her next patient, a toddler who was suffering from a respiratory infection, and when she was satisfied that he was comfortable and responding to oxygen treatment and nebulised salbutamol, she headed over to the computer area to type up her notes.
‘Hi, there.’ Tyler came to stand beside the desk, watching as she entered the details of the medication into the file on screen. ‘I hear you’ve decided to admit the boy with the kidney problem. Is there no way he can be treated at home?’
She shook her head. ‘No, or I wouldn’t have taken that decision. Why, is there a problem?’
‘Not at all. It’s just that we only have a few inpatient beds here, so we have to be careful about admissions.’
‘I understand that, but I think this child is suffering from acute glomerulonephritis and I don’t want to take any risks. He follows all the criteria for admission.’
Perhaps her words came out with more of a sharp edge than she intended, because he said calmly, ‘That’s okay. You don’t need to defend yourself. I was only—’
He broke off as the nurse who had been assisting Saskia earlier hurried towards them. She seemed worried and her tone was urgent. ‘I need you to come and take a look at Tom Carter,’ she said, looking at Saskia.
‘What’s wrong, Katie? What’s happened?’ Tyler was immediately on the alert, already starting towards the treatment room.
‘I don’t know. He suddenly collapsed. He started to complain of dizziness and feeling faint and his blood pressure has dropped far too quickly. Now he can’t get his breath and he’s losing consciousness. We’re giving him oxygen.’
‘All right. That was good thinking.’
Saskia hurried alongside him. What could have gone wrong? She’d made all the necessary checks and was confident in her diagnosis, but there had been nothing in the child’s condition that might have led them to expect this sudden deterioration.
Once in the treatment room, though, she could see straight away that Tom was in trouble. White faced, she checked him over, noting that his pulse was weak and his skin was turning a bluish colour. Understandably, his mother was frantic with worry. ‘What’s wrong with him?’ she asked. ‘Why is this happening?’
Tyler shot a glance at Saskia and she said huskily, ‘He must be reacting to the medication—to the penicillin.’
Tyler nodded agreement. ‘He’s gone into anaphylactic shock. We need to give him an adrenaline shot, fast.’
Saskia was already preparing the injection, while Tyler pulled up the boy’s trouser leg to expose his thigh in readiness.
They waited anxiously for the injection to take effect, and as time went on, Saskia realised that she was holding her breath. This had to work. This had to bring him round.
After what seemed like an age Tom gasped and began to breathe erratically, sucking air wheezily into his lungs.
‘He’s coming out of it,’ Tyler said, beginning to relax a little, ‘but I think we should give him a dose of antihistamine and corticosteroids.’
Saskia nodded agreement. She couldn’t speak just then. She wanted to, but the words just wouldn’t come out. This was her first patient on the first day of her new job and he’d collapsed from something she’d prescribed for him. It was awful to see the boy in this state, and even worse to know that she had unwittingly been the cause of his troubles.
She set up an intravenous line so that Tom could be given the medication he needed. She stayed with him as the drugs began to take effect, and al
l the time she could hear Tyler talking to the mother, asking about the boy’s previous medical history and experience with penicillin.
‘Well, he had a chest infection about a year ago,’ the woman told him. ‘The doctor prescribed penicillin for it. He took the tablets, as he was supposed to, but afterwards he was wheezing more than ever and he said he didn’t feel right. We didn’t think the antibiotics were working, so we took him back to the GP and he gave him something else to take.’
Tyler nodded, and carefully explained that Tom should never be given penicillin after this reaction. ‘He’ll need to wear a medic-alert bracelet,’ he said, ‘and we need to make sure everyone who treats him in the future knows about his sensitivity to the drug. In the meantime, we’ll treat him with a different antibiotic.’
By now, Tom was breathing more easily, but was still feeling too unwell to say very much, and when the orderlies came to take him along to his new ward Saskia could do nothing but watch, heart in mouth, as they wheeled him away.
It was a dreadful start to her first day in her new job.
‘Shall we go to my office?’
She realised with a jolt that Tyler was waiting for her to go with him. ‘Yes, of course.’ Things looked bad. The nurse, Katie, was frowning, concerned for the boy, obviously, but could it be that she was wondering if Saskia knew what she was doing?
Saskia followed Tyler to his office. Perhaps she should be grateful that he was considerate enough to talk to her in private about what happened.
‘So, tell me about it,’ he said, coming straight to the point as they stood and faced each other across the room. He had his back to the window, making a tall, dark silhouette that was framed against the grey, rain-soaked backcloth of the sky. For Saskia, it felt as though the weather was accurately following the course of her mood. ‘How did you come to prescribe penicillin if the boy had already had one bad reaction to it?’
‘I didn’t know about it. His mother didn’t mention what happened before.’
