He left the house with the taste of her on his tongue and an image of her in his head—standing in his house in a very short nightshirt covered with fat angels of some kind. Had she stiffened when he’d kissed her?
Her lips had responded, as they had earlier, but earlier she’d definitely pushed away, and this time …
A paramedic from the ambulance was wheeling a gurney into the ER when Tom reached the hospital. On it, hooked up to monitors and oxygen, was a young woman with dark hair—vaguely familiar, although Tom couldn’t say how he knew her.
The marks on her neck were vivid red welts and she lay carefully still, as if other parts of her body were hurting.
‘What do we know?’ he asked the paramedic.
The man turned to him, shock on his face.
‘It’s Mrs Williams, Nat Williams’s wife. His mother phoned for us.’
‘Police?’
‘Nat’s mother said she wanted to but Mrs Williams said no.’
‘It’s assault—we have to report it,’ Tom said, but he was already bent over the woman, checking the readouts from the monitors, taking in all he could of her outward appearance, lifting her hair and feeling her skull for irregularities, thinking about the damage strangulation could do to the airway, spinal cord and blood vessels within the unprotected structure of the human neck.
‘I’m Tom Fletcher, a doctor,’ he said, but the woman on the gurney didn’t respond, a blank look in her eyes telling Tom she either didn’t hear or couldn’t comprehend.
Blood vessels could be occluded in strangling, blocked arteries causing lack of oxygen to the brain, blocked veins causing increased pressure—so many dangerous possibilities.
‘She spoke to you?’ he asked the paramedic.
‘Just to whisper no when the older Mrs Williams said she was calling the police.’
Tom signed the transfer papers, then read quickly through his copy, checking all that had been done for the woman so far.
She had an oxygen mask on her face but no intubation. Mrs Williams was breathing so apparently her airway wasn’t severely compromised. In such cases, endotracheal intubation wouldn’t have been attempted in the field …
His mind raced through what he knew of strangulation injuries—the airway could swell later and intubation become necessary with little warning. She had an oximeter on one finger and her blood oxyhaemoglobin was good—he didn’t need an arterial blood gas test right now.
Laryngeal fracture was possible, he’d need to do a CT scan of the neck and probably the head, although the first thing to do was make her comfortable.
He set down the papers and began his own examination, speaking quietly to her as he turned her head to examine the bruising, feeling her skull for any other damage, calling for the portable X-ray machine so they could check her here without moving her again.
‘Can you hear me?’
She nodded.
‘Can you talk?’
A whispered ‘No’, so weak and shaky Tom regretted asking her, especially as she was crying now, silent tears sliding down her cheeks.
He touched her shoulder.
‘It’s okay, we’ll look after you. Just nod or shake your head to answer, but don’t shake hard, okay?’
He wiped the tears away, patting her cheek gently at the same time.
‘Are you hurting anywhere else?’
A nod.
‘Your head?’
A shake.
‘We’ll work our way down,’ Tom told her. ‘Shoulders?’
A nod and her left hand lifted to point to her right shoulder.
He should have seen it earlier, but she was so thin her bones stuck out everywhere, the knot where a broken bone had healed masking the dislocation.
‘Your shoulder has popped out of its socket,’ he told her. ‘Easy to fix. I could give you a fast-acting general anaesthetic but don’t want too much fluid running into you right now so I’ll use a couple of local anaesthetics to numb the area around the joint and pop it back in.’
He was doing his best to sound casual about the situation, not wanting to inflict more fear on her—especially fear of more pain.
‘I need to X-ray it but I’ll give you the injections first so they can be working while we do the X-rays.’
The machine was wheeled into place as he injected the local anaesthetic, then he helped her into a sitting position, feeling her wince and knowing she was probably hurting all over but being as gentle as he could. One of the nursing staff was an excellent radiography technician and fortunately she was on duty, taking the shots he needed with minimum fuss.
Tom called another nurse in to hold Mrs Williams in a sitting position while he checked the negatives, realising he’d need to do another X-ray once he’d manoeuvred the joint back into position—then later a CT scan for ligament damage—thinking all the time, blocking the thought of how the injuries might have occurred from his mind with what needed doing right now.
Blocking the thought of Lauren from his mind as well, refusing to think about her uncharacteristic reaction to Nat Williams.
The ball slid into place in the socket, and a second series of X-rays confirmed it was in place. He held his patient’s arm in position against her chest and helped her to lie down again.
‘Later on, I’ll put your arm into a sling to keep the shoulder stable and you’ll need to keep it as immobile as you can until the swelling and inflammation around the joint subside.’
She nodded, her eyes almost closed. The anaesthetic, pain and shock would be making her feel incredibly weary, but Tom knew he had to complete his examination—already interrupted to ease her pain—although if her airway remained unimpaired he could leave the scans until the next day when there’d be a radiographer on duty and specialists available in Port. He could send the scans over the internet to the experts if there was anything worrying on them.
Still talking to her, he lowered the sheet that covered her, not entirely surprised to see that she was naked beneath it—not entirely surprised to see the yellowish marks of old bruising on her breasts. People used near-strangulation in erotic sex games and if she didn’t want the police involved it could be she was a willing participant.
In which case shouldn’t her husband have accompanied her to the hospital?
Her husband, Nat Williams, the man Lauren … feared?
No, too big a leap to make, concentrate on the patient. Alyssa Williams. He called her by her name when he spoke to her this time but she was beyond responding, not unconscious but sleeping.
He completed his examination, almost certain she couldn’t have been a willing participant in whatever sex she’d endured when he saw the bruising on her inner thighs. Yet another instance of the destructive forces of love, he told himself, sickened by the woman’s injuries, angry that a man could get away with such things because his victim refused to seek help …
He left two nurses to carefully collect the evidence needed for a rape kit, explaining that it might not be needed but wanting the evidence kept anyway, reminding them to take photos, apologising to Alyssa for the intrusion. Once that was done, they would clean her carefully and dress her in a hospital gown, women helping another woman in trouble, gentle hands and soft voices.
He cursed softly to himself as he wrote up his notes, aware all the time of tension deep inside him, tension not entirely connected to his patient. Part of it was, of course, the tension he always felt when he saw the damage men could inflict on women.
The other part was personal and the cursing was because he’d never mixed his personal and professional lives, yet now he couldn’t help but feel a niggling suspicion, not to mention a deep, fierce anger, that the same man might once have harmed Lauren!
It’s all supposition, he reminded himself, dragging his mind firmly back to the patient in question.
‘Is there a private room free?’ he asked one of the nurses.
‘There’s that room near the veranda. The woman from the stands’ accident went home
this afternoon,’ the nurse replied.
‘Let’s take Mrs Williams there,’ he said, then, although he knew it was probably useless to remind them of patient confidentiality, he did point out that if word about this got around town her husband might see to it that she suffered even more.
‘And none of us would like that on our consciences,’ he reminded the two women.
They nodded, both of them, he guessed, as affected by the woman’s injuries as he was, and probably more horrified by who had inflicted them—after all the nurses were locals and had probably known Nat Williams in the past.
Like Lauren?
No, the nurses were both older, so hardly likely to have gone out with him, and the patient confidentiality he’d just spoken of applied to him as well so he could hardly question Lauren about her relationship with Nat …
‘I’ll stay with her,’ he said, when they’d settled Alyssa in the bedroom. ‘I’m a little worried about her airway and would rather be on hand if anything goes wrong.’
He sat beside the woman and dozed a little in the chair, waking as the sky lightened across the ocean, and the details of the little town started becoming clearer, lights dimming and finally disappearing as the sun rose and proclaimed a fresh, new day.
Fresh? He felt like death warmed up and it wasn’t only tiredness dogging him.
‘Phone, Tom.’
He took the handpiece and walked out onto the veranda before answering.
‘This is Karen Williams, Nat’s mother, Alyssa’s mother-in-law. How is she?’
‘She’s resting, Mrs Williams. She’ll be all right.’
‘She won’t be all right,’ the forthright woman declared. ‘Not if she goes back to him. I can’t believe my own son—but, still, he’s not your worry. Can you talk her into going to the police? She’ll say he was drunk, he didn’t mean it, but he’s got to be stopped, do you know what I mean?’
‘I do, Mrs Williams, and while I agree, I believe it’s up to Alyssa to make the complaint. The children, are they all right?’
‘I’ll make darned sure they are and that they stay all right, you can tell her that, and she can come home here as soon as she’s ready, because he won’t be staying here, no matter how big a local hero he thinks he is.’
Tom assured her he’d pass the message on, and returned to Alyssa’s room to find her awake, staring at the ceiling, the blankness in her eyes disturbing him more than the very visible bruising on her neck.
‘That was your mother-in-law on the phone. She said to tell you the kids are fine and that she’d welcome you home any time. She wanted to assure you Nat wouldn’t be there.’
Tom sat down by the bed and took Alyssa’s hand.
‘She also thinks you should report him to the police.’
Alyssa shook her head, so tiredly Tom knew she’d been told this before and had probably argued it out with herself many, many times, for some reason always coming up with an excuse to protect the man who battered her.
Love?
‘I know something of domestic violence,’ Tom told her, while his head was scoffing at the ‘love’ question. He might not know much about love but he knew for sure it didn’t inflict pain on the loved one. ‘I’m on the board of the local refuge. If you want to talk about it to someone who understands … ‘
He was about to mention Lauren when his own suspicions stopped him, although Lauren was definitely the person he should bring in.
‘It’s only when he drinks, and maybe does a line of coke,’ Alyssa said.
Tom put the two drugs together in his mind. Coaethylene—more toxic than either drug on its own—caused heart problems not to mention liver toxicity, and the combination accentuated the effect of both drugs.
He wondered just how long Alyssa could go on making excuses for her husband, listening to his words of love, empty words, accepting gestures of love, expensive gifts, believing he loved her because she wanted, perhaps needed to believe?
Until he killed her?
Anger at the man pounded through Tom’s body.
He wondered, too, about his reaction. He’d seen evidence of domestic abuse before, too many times, but had never felt the strong surge of impotent rage that he was feeling now …
Yet in spite of the rage and whatever the cause of it—more than Alyssa’s injuries?—he had to bring Lauren in on the case.
Time to get his head straight!
He left Alyssa in the care of a nurse, asking that someone stay with her at all times, and walked across to his house, drinking in the quiet of the early morning, allowing it to soothe his warring feelings.
Quiet until he entered the front door and heard the argument going on in the kitchen.
Smelt the smoke.
‘Paper doesn’t get into a toaster by accident, Bobby, and you know it. Dr Tom’s being good enough to let us stay here and you want to thank him by setting fire to his house?’
The strain in Lauren’s voice suggested this wasn’t the first time she’d remonstrated with the child they’d promised to protect.
‘Didn’t set it on fire,’ came the sullen reply. ‘Bit of smoke, that’s all.’
‘A bit of smoke that ruined the toaster,’ Lauren pointed out, at which stage Tom considered his options. One—go quietly back to the hospital and try to find a bed there to snatch a couple of hours’ badly needed sleep. Two—see if he could sneak into his bedroom without them hearing, and attempt to sleep there. Or, three, join the pair in the kitchen, perhaps acting as jury to the judge and accused.
At least the prospect of entering the kitchen had diverted his anger!
He called out a slightly forced ‘Good morning’ and proceeded to the kitchen, where Lauren’s pathetically grateful smile more than made up for Bobby’s scowling countenance.
‘Little mishap?’ Tom queried, winking at Lauren to let her know he’d heard the basics.
‘It was nothin’,’ Bobby told him. ‘She’s fussing ‘bout nothin’.’
‘I’m not fussing, Bobby,’ Lauren said, so gently Tom wondered at her patience. ‘I’m just asking you not to do silly things that might injure you or damage Tom’s property. Okay?’
Bobby glared at her, and recognising an impasse when he saw one Tom stepped in again.
‘Let’s all go down the road for breakfast,’ he suggested, although he was so tired and mentally confused he wanted nothing more than to escape into his bedroom. ‘We can eat, then, if you want to go to school, we can drop you off, or if you don’t want to go to school, you and Lauren can make plans for the day. Okay?’
Bobby frowned at him.
‘You’re not angry?’ he finally demanded.
‘Angry about what?’ Tom asked.
The little boy shuffled awkwardly, then looked up at Tom, his dark eyes holding a plea—for understanding?
Or simple affection?
‘I bust your toaster,’ he said.
‘Oh, that’s okay,’ Tom told him. ‘We can buy another one. Just as long as you don’t do it again or set fire to the house, we’ll be okay.’
Bobby beamed at him, then shot Lauren a look that said, See, he’s not upset, far more clearly than words ever would have.
Lauren accepted it with good grace, smiling at Bobby and ruffling his hair.
‘Come on, then, let’s go.’ She turned to Tom. ‘We talked about school and Bobby’s decided not to go. We’re going to go shopping for some boots he can wear at the farm when we go out after Christmas, and some new jeans in case he wants to go riding—’
‘And a checked shirt and a cowboy hat,’ Bobby finished for her.
He scooted off to his room and Lauren looked at Tom, reading the exhaustion in his face but so grateful for the way he’d handled the situation she wanted to hug him.
Again!
‘Thanks,’ she said instead. ‘I realise it’s the last thing you want to do but we’ll eat quickly.’
Tom ignored her gratitude, instead lifting the eyebrow that she so envied as he said, ‘Cowboy
hat?’
Lauren grimaced.
‘I know! I tried to explain it wasn’t exactly the wild west, our family farm, but he has this image in his head and I can’t get rid of it. Still, he’ll need a hat so it might as well be a cowboy hat.’
‘And what was he burning in the toaster?’ Tom asked, and Lauren had to frown.
‘I’ve no idea. I didn’t think of that—I was just so upset to see the flames shooting out of the thing … ‘
She crossed the room and opened the back door, retrieving the ruined toaster from the veranda railing, fishing inside it with her finger, pulling out a corner of paper that had escaped incineration.
‘A photo perhaps?’ she said, bringing it across to show to Tom, but as Bobby had reappeared, an ancient wallet clasped in one hand, Tom slipped the scrap into his pocket and the conversation ended there, while the conversation he knew he had to have about Alyssa hadn’t even started.
Bobby was their immediate priority, he told himself, and Alyssa was having further tests and then would need to rest. If Lauren could see her this afternoon …
If …
Their breakfast was surprisingly enjoyable and Lauren realised that it was because Bobby was relating well to Tom, accepting his word that wholegrain bread made men stronger than white bread so the little boy ordered wholegrain toast, and generally following Tom’s lead in both ordering his breakfast and then in the order of eating it—finishing eggs before they tackled bacon, finishing that before they ate their beans.
‘I can never understand why some people do that,’ Lauren finally declared. ‘It’s the taste of bacon and beans and egg all together that makes breakfast such a good meal.’
Tom smiled at her and although it was a weary effort, it lit the coils of heat again and she had to sternly admonish herself that this was work, not playtime. Well, kind of work!
‘I like things to taste of what they are,’ Tom told her, then he winked—second time this morning—and she felt a shiver run through her, as if the wink had somehow made the simple statement naughty.
‘Me too,’ Bobby declared, and Lauren laughed, aware the little boy who needed someone special in his life had found himself a hero.
New Doc in Town / Orphan Under the Christmas Tree Page 25
