Charles would be magnificent in any crisis, Hannah decided. So calm. So in touch with what was happening everywhere in his domain.
‘We’ve been on standby to activate a full code black disaster response, thanks to the cyclone watch on Willie,’ he told the cluster of medics now around him. ‘I’m going to go ahead and push the button. We have no idea how many casualties we might get from this bus but it looks likely we’re in for trouble from Willie so it’ll give us a few hours’ head start. A dry run, if you like.’
‘What’s happening?’ Sophia pushed her way towards Charles. Dora Grubb was not far behind her, the pink flowers on her hat wobbling nervously.
‘There’s been an accident, Sophia,’ Charles said. ‘A bus full of people has vanished off the road near Dan Macker’s place. Big landslide, thanks to all the rain we’ve had this week.’
‘Oh … Oh!’ Sophia crossed herself, her face horrified. ‘This is bad!’
‘I’m going to have to call in all available medical staff, starting with everyone here. Including Mike and Emily. I’m sorry, Sophia.’
‘Oh!’ Sophia looked stricken now. ‘But the cake! The speeches!’ Then she rallied, visibly pulling herself together. She stood as tall as possible for a short, plump person. ‘Of course you need my boy,’ she said proudly. ‘And our Emily. Who else can look after those poor people if they need an operation? Emily! Darling! Let me help you find something else to wear.’
Hannah looked down at the froth of peach tulle around her knees and on to the flimsy white shoes with the flowers on the toes.
Mike noticed the direction of her glance. ‘I’ve got spare flight suits in our room and Em’s probably got a spare set of boots. Ryan? You’d better come and grab a suit, too.’
‘Thanks, mate.’
‘At least you won’t have to roll up the sleeves and legs. Come with me, you guys. Let’s get kitted up.’
It was Susie’s turn to look stricken. ‘I want to help but I’m useless with these crutches!’
‘Not at all,’ Charles said. ‘You can stay with me and Jill. There’s a lot of admin we’ll need to do at the hospital. Code black means we’ve got to empty as many beds as we can. Set up a receiving ward. Mobilise stores. Reorganise ED …’
The list was still continuing as Hannah hurried in the wake of Mike and Ryan. She could also hear Dora Grubb talking excitedly to Sophia.
‘They’ll need food, all these rescue people.’
‘We have food. Too much food. All this lamb! I’ll tell the chef to start making sandwiches.’
It took less than ten minutes for the four young medics to encase themselves in the helicopter service issue overalls.
Emily sighed as she took a glance over her shoulder at the mound of white lace and silk on the bed. ‘It was nice while it lasted,’ she said, ‘being a princess.’
‘You’ll always be a princess, babe,’ Mike assured her. ‘And I reckon you know how sexy I think you look in those overalls.’
Hannah carefully avoided looking anywhere close to Ryan’s direction. She could understand the look that passed between Mike and Emily because she had stolen a glance at Ryan moments before, when he’d bent to lace up the spare pair of Mike’s heavy steel-capped boots, and there had been no danger of him catching her glance.
It was a completely different look to civvies. Or scrubs. Or the white coat that doctors never seemed to bother with any more. He looked taller, somehow. Braver. Ready to get out there and save lives. And there was a very determined tilt to his chin that she hadn’t seen before. Tension that visibly knotted the muscles in his jaw.
Was he anticipating a tough job at the scene of the bus crash or was it controlled anger? Directed at her?
Whatever.
Sexy didn’t begin to cover how he looked.
Hannah scraped back her carefully combed curls and wound an elastic band to form a ponytail. Would Ryan see her as looking adventurous and exciting in these overalls with the huge rolled-up cuffs on the arms and legs?
Not likely.
Especially as he appeared determined not to actually look directly at her at all.
Even in the back of an ambulance a commendably short time later, when they had collected gear and co-ordinated with other personnel at the hospital, he was avoiding anything as personal as direct eye contact.
Mike was with them. Emily had ended up staying behind at the hospital to oversee the set-up and preparation of Theatres. Because of the weather conditions, with injured people exposed to the rain and wind, she needed to organise fluid warming devices and forced-air warmers on top of making sure she was ready to administer a general anaesthetic at short notice.
A second ambulance was following with another crew and all Crocodile Creek’s available fire appliances had gone on ahead. Police had been first on scene, and by the time Hannah arrived, the road was lined with vehicles—a chain of flashing lights they had glimpsed from miles away as they’d sped up the sometimes tortuous curves of the mountain road. Lights that had haloes around them right now thanks to the heavy curtain of rain.
A portable triage tent was erected on the road to one side of the massive obstacle of mud, rocks and vegetation. Guy ropes had it anchored but the inflatable structure was looking alarmingly precarious in the high wind and its sides were being sucked in and then ballooning out almost instantly with a loud snapping sound.
The generators used to fill the outlines of the tent with compressed air were still running, powering lights, including some that were being directed downhill from the point where large skid marks were visible. There was more noise from the fire engines whose crews were rolling out winch cables from the front of the heavy vehicles. Pneumatic tools like the Jaws of Life were being primed and tested. As a background they were already tuning out, the wind howled through the treetops of the dark rainforest around them.
Harry Blake, wearing a fluorescent jacket that designated him as scene commander, met the ambulance, framed by the back doors Mike pushed open and latched.
‘Who’s in charge?’ he queried briskly.
‘I’m liaising with the medical director at the ED.’ Mike clipped his radio to his belt. ‘What frequency are we using on site?’
‘Channel 8.’
Mike nodded. ‘Channel 6 is the hospital link.’ He leapt out of the back of the ambulance. ‘I’ll go down and triage with these two doctors and then we’ll deploy all the other medical crews we get. What’s it looking like down there?’
‘It’s a bloody mess,’ Harry said grimly. ‘The bus must have come off the road at speed and it rolled on the way down. The windows have popped out and we’ve got people and belongings all over the place. Some of the seats have come adrift inside and there’s people trapped, but we can’t get inside until the fire boys get a line or two onto the bus.’
‘It’s not stable?’ Mike was sliding his arms into the straps of his backpack containing medical supplies.
‘Hell, no. It could slide farther, especially if it keeps raining like this.’
Hannah and Ryan were out of the ambulance now, standing beside Mike. ‘Don’t forget your helmets,’ he reminded them. Then his attention was back on Harry. ‘Any fatalities?’
‘At least one.’ Harry raised his voice to a shout to be heard as they started walking and got closer to the generators. ‘There’s a guy who’s been thrown clear and then caught under the bus. He’s at the front and we think he’s probably the driver. We won’t be able to shift him until we can jack up the front corner somehow.’
‘The fire guys going to be able to use their cutting gear down there? Is it safe to have them clambering around?’
‘We’ve got nets anchored on the slope. It’s not too bad for climbing. There’s an SES crew down there at the moment, trying to clear the scene of everybody who’s able to move.’
‘How many are we dealing with?’ Ryan had jammed his hard hat on and was pulling the strap tight.
Harry shook his head. ‘Haven’t been able to do a
head count yet. There’s injured people over quite a wide area. We think there’s two or three still trapped in the bus, from what we can see. One of the passengers who’s not hurt thinks the bus was quite full. There’s about ten people we can bring up now. Could be fifteen or twenty still down there needing attention.’
Mike and Ryan shared a glance. This was huge. It was going to stretch their resources and everybody’s skills.
‘Let’s do it.’ Ryan pulled on latex examination gloves and then heavier ones for climbing. He gave Mike a thumbsup and Mike responded with a terse nod and another shared glance. They had faced difficult situations before. They were more than ready to tackle this one. Together.
Hannah felt oddly excluded. Even when Mike put her after Ryan and before himself to protect her as she climbed down the steep, slippery slope, she didn’t really feel a part of this small team.
Ryan hated her. He didn’t want her there.
Within the first few metres of their climb, however, any thoughts of personality clashes or anything else that could affect a working relationship were forgotten.
A woman lay, moaning. ‘My leg,’ she groaned. ‘I can’t get any further. Help …’
This was an initial triage. No more than thirty seconds could be allocated for any patient to check for life-threatening injuries like uncontrolled haemorrhage or a blocked airway. Mike had triage tags in his pocket. Big, brightly coloured labels with an elastic loop that would alert all other personnel to the priority the victims had for medical attention. This woman was conscious and talking. It took less than thirty seconds for Ryan to examine her.
‘Fractured femur. Closed. No external bleeding. Airway’s clear.’
Mike produced a yellow label. Attention needed but second priority. ‘Someone will be with you as soon as possible,’ he reassured the woman as they moved on. ‘We’ve got to check everybody else first and then we’ll be back.’
‘But it hurts…Oh-h-h….’
It was hard, leaving her to keep descending the slope. A huddle of people near the base of the nets were bypassed. They were all mobile and being looked after by SES people. Grace was there, organising the clearance of the less injured from the scene. Mike gave her a handful of green triage tags that designated the lowest priority. Hannah saw a young Asian couple clinging to each other, looking terrified, and she could hear someone talking in a foreign language that sounded European. Had the bus been full of tourists? It could make their job more difficult if they couldn’t communicate with their patients.
A young woman lay, unconscious, against the base of a huge eucalyptus tree.
‘Hello, can you hear me?’ Hannah pinched the woman’s ear lobe. ‘Non-responsive,’ she told Mike. She laid a hand on the woman’s neck and another on her belly. ‘She’s breathing. Good carotid pulse. Tachy.’
The elastic of a pink triage label went over her wrist. Highest priority. This case was urgent, with the potential to be saved and the likelihood of rapid deterioration if left. They moved on.
‘There’s one over here,’ a fire officer yelled at them. ‘He’s making a weird noise.’
‘Occluded airway.’ Mike repositioned the man’s head and the gurgling sound ceased. Another pink tag.
Winch hooks were being attached to the bus. There were no big lights down here and the rescue workers had to make do with the lamps on their helmets. A curious strobe effect to viewing the disaster was evident as lights intersected and inspected different areas. It made it easier to deal with, Hannah decided, because you could only see a patch at a time. A single patient, a broken window, dented metal, broken tree branches, strewn belongings and luggage.
Just the top half of the unfortunate man who had been caught beneath the front wheel of the bus. It took only a moment to confirm the extinction of life and give the man a white tag to signify a fatality so that nobody would waste time by checking him again.
‘Don’t go downhill from the bus.’ A fire officer with a winch hook in his hand shouted the warning. ‘We haven’t got this thing stable yet.’
The doors of the bus were blocked because it was lying, tilted, on that side. The emergency hatch at the back was open, however, and must have been how some of the less injured had escaped the wreckage.
Mike saw Ryan assessing the access. ‘Not yet, buddy,’ he said firmly. ‘You can just wait until it’s safer.’
Safer, Hannah noted. Not safe. It could never be really safe to do something like this, could it? And yet Ryan was clearly frustrated by having to hold back.
Hannah shook her head to clear the water streaming down her face from looking up at the hatch. She was soaked now and the wind was chilling. She flexed increasingly stiff fingers and cast a glance at her colleagues.
There was certainly no doubting Ryan’s commitment to his work and the people he cared for. How many ED specialists would be prepared to work in conditions like this? To risk their own lives without a moment’s hesitation to try and save others?
Mike might have been off the mark in making people think Ryan was some kind of saint, but he hadn’t been wrong in advertising him as a hero. They both were. The way these two men worked together suggested they had been in situations before that had not been dissimilar. There was a calm confidence about the way they worked that was contagious.
Like Ryan’s courage in that plane turbulence had been.
What if she couldn’t redress the antipathy Ryan now held towards her and the one who didn’t win that consultancy position in ED felt obliged to go and work elsewhere? If she never had the chance to work with him again?
The sense of loss she had experienced watching him dance with Mike came back strongly enough to distract Hannah for several seconds. Was it always going to haunt her? Did she have to be ruthlessly squashed at frequent intervals in order for her to perform to her best ability? Like now?
Hannah continued the triage exercise with grim determination. They found another five people with fractures and lacerations who needed yellow tags. One more pink tag for a partially amputated arm and severe bleeding. An SES worker had been doing a great job of keeping pressure on the wound. Then they were given the all-clear to check out the bus.
‘Not you, Hannah,’ Mike stated. ‘You can check in with the SES guys. Make sure we haven’t missed anyone. Get someone to check further afield as well. We’ve got debris over a wide area and injured people could have moved or even fallen further down the slope.’
Hannah moved to find someone to talk to but she couldn’t help stopping for a moment. Turning back to watch as the two men climbed into the bus.
Turning back again a moment later, when alarmed shouting heralded a noticeable shift in the position of the bus.
‘Oh, my God …’ Was the bus going to move with the extra weight? Slide and possibly roll again down the side of this mountain?
Remove any possibility of repairing the rift she’d created with Ryan?
Remove Ryan from her life with the ultimate finality of death?
‘No-o-o!’
It was a quiet, desperate sound, snatched away and disguised by the howl of the wind. If it was a prayer, it was answered. Having taken up some slack from one of the winch cables, the movement stopped. Mike actually leaned out a broken window with his thumb and forefinger forming the ‘O’ of a signal that they were OK.
It was only then that Hannah realised she had been holding her breath. A couple of minutes later and Ryan and Mike emerged from the bus.
‘One pink, one yellow, one white,’ Mike reported. ‘One’s unconscious and another’s trapped by a seat.’ He reached for his radio. Medical crews could now be co-ordinated, specific tasks allocated, patients treated and evacuated. The most seriously injured patients would be assigned a doctor who would stabilise and then escort them to hospital.
Hannah was joined by a paramedic by the name of Mario, issued a pack of gear and assigned the case of the woman who had been pink-ticketed at the base of the eucalyptus tree. Mike and Ryan were going to work on
the pink-ticket patient inside the bus. Hannah watched them climb inside again. A scoop stretcher was passed in along with the pack of resuscitation gear by firemen who then waited, knowing their muscle would be needed to assist with extrication.
Once again Hannah felt that sense of loss as Ryan vanished from view and this time she couldn’t quite shake it off.
She needed him, dammit! This was so far out of her comfort zone, it wasn’t funny. The rain might be easing but she was still soaked and cold and her fingers felt uselessly stiff and clumsy.
The effort to concentrate seemed harder than it had ever been. Hannah was trying to recall the workshop she’d attended at a conference once, on the practice of emergency medicine in a hostile environment. Control of the airway was the first priority, of course, with cervical spine control if appropriate.
It was appropriate in this case. Hannah’s gloved hand came away streaked with blood after touching the back of the young woman’s head. Had she been thrown clear of the bus and hit the tree she now lay beside? If the blow had been enough to cause her loss of consciousness, it had potentially caused a neck injury as well.
‘I need a collar,’ she told Mario. She placed her hand, side on, on the woman’s shoulder, making a quick estimate of the distance to her jaw line. ‘A short neck, please. And a dressing for this head wound.’
It was difficult, trying to assess how well their patient was breathing. Hard to see, given the narrow focus of the beam of light from her helmet. Hard to feel with her cold hands and impossible to hear with the shouting and noise of machinery. And over it all, the savage wind still howled. Large tree branches cracked ominously and small pieces of debris like broken branches flew through the air, occasionally striking Hannah in the back or hitting the hard helmet she wore with a bang, magnified enough to make her jump more than once.
‘I don’t think we can assess her for equal air entry until we get her into an ambulance, at least,’ she said. ‘She’s certainly breathing on her own without any respiratory distress I can pick up.’
Which was a huge relief. While this woman was probably unconscious enough to be able to be intubated without a drug regime, the lecturer at that conference had discussed the difficulties of intubation in a situation like this. Often, the technique of cricothyroidotomy was more appropriate and that wasn’t something Hannah wanted to attempt with limited light and frozen fingers.
The Australian's Proposal (Mills & Boon By Request): The Doctor's Marriage Wish / The Playboy Doctor's Proposal / The Nurse He's Been Waiting For Page 30
