The Italian Doctor

by Jennifer Taylor

  Luke was on his feet in a flash. Maggie hurried after him as he ran to the bar. The landlady was standing by the hatch, looking as though she was about to pass out.

  ‘Sit down and put your head between your knees,’ Maggie instructed, steering the woman to a chair. Luke had gone straight down into the cellar but he reappeared almost immediately and her heart turned over when she heard the urgency in his voice.

  ‘I’m going to need some help here,’ he stated, cutting through the excited babble of voices. Everyone in the pub was clustered around the bar now, trying to see what had happened. However, he ignored them as he turned to the two men nearest to him and rattled out instructions. ‘I need something solid to use as a stretcher. See what you can find. And can someone phone for an ambulance and explain what’s happened?’

  The men hurried away while a woman ran to the phone and rang the emergency services. Leaving the landlady in the care of one of the birthday party revellers, Maggie went to see what she could do to help.

  ‘Let’s go and take a proper look at him. We need to assess how badly injured he is before we do anything.’

  Luke’s tone was grim as he led the way down the steep steps. The landlord was lying face down at the bottom and it was obvious from the way it was twisted that his right leg was broken. Maggie carefully stepped over him and knelt down, waiting while Luke swiftly listed his injuries.

  ‘Fractured right femur, possible fracture of the right ankle as well, left knee very swollen so the patella could be smashed.’ He paused while he gently felt the man’s lower body and his expression was even grimmer when he finished. ‘Feels like his pelvis could be fractured, too. Damn!’

  Maggie understood his concern. Although a fractured pelvis healed with very few problems, the real danger was to the internal organs and especially the bladder. It was all too easy for sharp splinters of bone to pierce the soft tissue.

  ‘I’ll see if I can find something to use as bandages,’ she offered. ‘He’ll need immobilising to lessen the risk of internal damage.’

  ‘If there isn’t any already, and we won’t know that until we can get him X-rayed. Is Dalverston the nearest hospital, do you know?’ He sighed when she nodded. ‘That means it will be at least thirty minutes before an ambulance gets here and another thirty to get him back. And that isn’t taking into account how long it will take to lift him out of here.’

  Maggie knew what he was thinking. The first hour after an accident, the so-called ‘golden hour’, was crucial to a person’s chances of survival. If they received proper medical care within that time then the odds of them recovering were greatly increased. But in a situation like this, where it took so much time to reach a casualty and take them to hospital, it lessened their chances considerably.

  ‘I’m going to phone the hospital direct and warn them what’s happened.’ He got up and made his way up the steps then paused at the top. ‘I’ll also get onto Theatre and tell them to expect us. Whatever happens, this guy is going to need surgery fast!’

  She sighed when she heard the worry in his voice. The situation certainly wasn’t looking good. She kept herself busy by checking the man’s vital signs while Luke was gone so that she could report her findings when he came back. The landlord’s pulse was very rapid and thready, but that was to be expected. The shock of the accident would be enough to have caused that, plus there was always the danger of internal blood loss to take into account as well.

  She didn’t let herself dwell on that, however, because there was little they could do at the present time. She checked the man’s fingertips then took off his shoes and socks to check his toes, pleased to find that both looked pink and healthy, a sure sign that his circulation wasn’t impaired. However, she wasn’t at all happy with his breathing, which was becoming increasingly laboured. It was a relief when Luke reappeared and resumed command.

  He shook his head when she swiftly relayed her findings. ‘Lying face down like that can’t be helping any. He’s quite a heavily built guy and the pressure on his chest could be causing the problem. We’re going to have to move him, although I know it’s risky. We’ll just have to do everything we can to minimise the dangers.’

  He smiled encouragingly. ‘I’ll take you up on that offer to find some bandages. I mean to strap him up so tightly that he won’t be able to do himself any more damage!’

  She laughed, feeling the tension ease a little even though the situation was still very fraught. Having Luke there gave her confidence because it was obvious that he knew what he was doing. ‘I’ll see what I can find. I’ll be as quick as I can.’

  She hurried back up to the bar and quickly explained to the landlady what they needed. The poor woman was still very shocked but she rallied once she had something to do. Within a very short time Maggie had an armful of hastily torn-up sheets to take back to the cellar with her. She frowned when she found Luke fashioning an old newspaper into a tight roll.

  ‘What’s that for?’ she asked, dropping her bundle on the floor.

  ‘We can use it as a neck brace in lieu of a proper cervical collar,’ he explained. Dragging his T-shirt over his head, he quickly wrapped the rolled-up newspaper in it then knelt beside the injured man, frowning when he saw that the landlord’s lips were starting to turn blue.

  ‘I need you to hold his head still while I fit this around his neck, but we’d better get a move on. I don’t like the look of him at all.’

  Maggie carefully supported the man’s head while Luke fitted the makeshift collar. Luke seemed totally unconcerned by the fact that he was only partly dressed now that he’d shed his T-shirt. It was rather dark in the cellar and the poor lighting made the tanned skin on his chest gleam the colour of old gold.

  Maggie felt her mouth go dry and looked away, unsure why the sight should affect her so much. She’d seen men wearing far less than that and it had never troubled her before. However, she couldn’t deny that she was acutely aware of Luke as he knelt in front of her. It was a relief to have something to concentrate on when he directed her to knot the ends of the T-shirt together to hold the collar in place.

  ‘That’s the best we can do. It should support his neck when we move him, and that’s all we want.’ He looked up as footsteps announced the arrival of the two men who’d been delegated to help. They had with them what looked suspiciously like one of the pub’s doors.

  ‘Will this do?’ one asked, shooting a worried glance at the injured man. ‘It was the best we could find, I’m afraid.’

  ‘It’s great. Just what we need,’ Luke replied, then wasted no time explaining what he wanted them to do. It was obvious to them all that he was in control of the situation and that helped a lot to inspire confidence.

  ‘Right, just give us a couple of minutes to stabilise his leg and pelvis then we’ll move him onto the board,’ he said once he was sure they all understood what they had to do.

  Maggie helped him, working swiftly as they used the torn-up sheets as bandages. Two broad pieces were fastened around the man’s hips to support his pelvis while another rolled-up newspaper provided a temporary splint for his broken leg and ankle. Once Luke was sure that everything had been done to his liking, he got them into position.

  ‘I want you to support his head,’ he instructed Maggie. ‘Whatever you do, keep a firm hold.’

  She nodded, knowing only too well how vital that was. If there was any damage to the spine then even the smallest jarring could have tragic repercussions and result in paralysis.

  It was a nail-biting experience, turning the unconscious man over and getting him onto the makeshift stretcher. However, Luke gave no sign of nerves as he calmly continued to issue instructions. He seemed to anticipate every problem before it had a chance to occur and Maggie was impressed.

  ‘Thank heaven you were here!’ she said once the injured man was lying flat on his back. ‘That was really scary.’

  ‘It was, but we got there in the end. Great teamwork, guys. Well done.’

  The
two men looked pleased. One muttered something about needing a stiff drink but both of them stayed while Luke made another swift assessment of the landlord’s injuries. He was just finishing when the man started gasping for air.

  ‘Possible tension pneumothorax, left side,’ he bit out, pressing his ear to the man’s chest. ‘How long is that ambulance going to be now?’

  Maggie checked her watch. ‘They should be here soon…’ She broke off when there was a shout from above to tell them the paramedics had arrived. She moved aside as Jenny Partridge and Joe Henderson, Dalverston General’s longest-serving ambulance crew, made their way down to the cellar to join them.

  ‘Right, what have we got…? Oh, hi, you two. What are you doing here?’ Jenny asked in surprise when she saw them.

  ‘We were in the pub, having a drink, when the accident happened,’ Luke explained briefly. ‘We have a possible tension pneumothorax on the left side. Have you got a stethoscope I can borrow?’

  ‘Sure. Here you go.’ Joe handed it over, waiting while Luke listened to the landlord’s chest.

  ‘Yes. I need to get a chest drain in there right away.’

  He worked swiftly, making a small incision in the side of the man’s chest between his ribs then inserting the drain. He removed the inner section from the tube and smiled in satisfaction when air whooshed out of the pleural cavity. ‘That’s got it. Good! Right, the best thing now is to get him to hospital as fast as we can.’

  It wasn’t easy, getting the injured man out of the cellar. It took sheer brute strength to manoeuvre the stretcher up the steps, and a cheer went up when they finally emerged. However, there was still the little matter of carrying him to where the ambulance was parked on the other side of the river. Maggie only relaxed once he’d been loaded on board.

  Luke grabbed a sweater from the back of his car and dragged it on. ‘I’m going with them, Maggie. I hate to leave you in the lurch like this…’

  ‘Don’t worry about me. I’ll be fine,’ she assured him as Jenny started to close the ambulance’s rear doors.

  ‘Would you mind following on in the car?’ he asked, handing her the keys. He suddenly frowned. ‘Will you be all right, driving an automatic?’

  ‘It isn’t a problem,’ she assured him, warmed by his obvious concern. ‘I’ve driven one before.’

  ‘Oh, great. Just take your time, though, and be careful.’ He brushed her cheek with his knuckles and his eyes were gentle. ‘We don’t want anyone else having an accident tonight.’

  Jenny called out to warn him that they were ready to leave and he hurried away. Maggie moved out of the way as Joe backed the ambulance out of its parking space. She got into the car and followed it up the lane. Once they’d reached the top the ambulance roared away, but she didn’t try to keep up with it. Luke had told her to take care and that was what she would do.

  A smile tilted her lips. It was good to know that he cared about her.

  It was almost midnight before Luke came to find her. Maggie was reading a magazine in the waiting-room when he appeared. One glance was enough to show her that he was bone-tired, but it was hardly surprising. He’d just spent three hours operating on the injured man and, coming on top of an already busy day, he must have been exhausted.

  ‘How’s he doing?’ she asked, replacing the magazine on the table as he came and slumped down into a chair.

  ‘He’s gone to ICU but I’m cautiously optimistic, let’s say.’ He ran a weary hand round the back of his aching neck. ‘There was some damage to the bladder, unfortunately, but Morgan came in and he’s done a brilliant job of sorting it all out.’

  She smiled to herself at the unstinted praise for Morgan Gray, the head of the surgical unit. Obviously, Luke wasn’t the sort of man who wanted to claim all the glory for himself and the realisation pleased her enormously. However, she was in no doubt whatsoever about the role he’d played in saving the publican’s life. She’d spoken to Robin earlier and he’d been little short of effusive in his praise of Luke’s skill.

  ‘From what I heard, you were just as brilliant. Robin is in awe of your expertise.’

  He shrugged modestly. ‘It was all pretty straightforward, more a question of putting everything back the way it had been.’

  She didn’t say anything but she knew that the kind of surgery he’d performed that night was a lot more difficult than he was making it out to be. It struck her once again just how far off track her earlier assessment of him had been. Luke wasn’t the arrogant, egotistical man she had thought him to be, but a wonderful doctor. Wasn’t it amazing how wrong she’d been?

  ‘Right, let’s get off home, shall we? I don’t mind admitting that I’m almost out on my feet.’ He covered his mouth as a huge yawn crept up on him. ‘Excuse me!’

  Maggie laughed as she got up. ‘Shall I drive? You look as though you might fall asleep at the wheel.’

  ‘Would you mind? I tell you what, why don’t I leave the car outside your flat tonight and walk home from there? It’s only ten minutes or so and it would be safer than me trying to remember to drive on the left in my less than alert state.’

  ‘Fine by me… Wait a minute, though, why don’t I drive you back to your hotel first then take the car home?’

  ‘No. I wouldn’t get a wink of sleep, worrying if you’d got home safely, Maggie. I prefer to walk from your place. That way I’ll know that you’re safely tucked up in your bed.’

  It was just tiredness that had made his voice grate when he’d said that, she told herself sternly as they went to the lift. However, even knowing that, it didn’t quieten the pounding of her pulse. The image she had conjured up, of her lying in her bed while Luke lay in his and thought about her, seemed to have had the most peculiar effect. It was a relief to get into the car and be forced to concentrate on driving them home safely.

  It didn’t take long to reach her flat. Maggie switched off the engine then turned to Luke and smiled when she saw that his eyes were almost closed. ‘Think you’ll make it home before you fall asleep?’ she teased.

  ‘It will be touch and go…’ Another massive yawn swallowed the rest of the sentence and she shook her head in despair.

  ‘You can’t walk home in that state. At least come in and have a cup of coffee before you totter off.’

  He grinned ruefully. ‘If you’re sure you don’t mind, I’d love to. Totter is right, too. I feel about ninety years old and in desperate need of a Zimmer frame at this moment!’

  She laughed as she got out of the car. ‘Well, I won’t be so cruel as to say that it’s how you look…’

  ‘Wretched woman!’ He aimed a playful cuff at her ear, laughing when she ducked out of the way and ran up the steps to let them in. ‘Don’t think I shall let you get away with that,’ he warned, following her inside. ‘I shall mark it down as an insult that needs punishing as soon as I feel fit enough to think up something suitable.’

  ‘Which means that I’m pretty safe tonight,’ she retorted tartly, leading the way upstairs. ‘Isn’t it way past your bedtime, Grandpa?’

  ‘Oh, talk about hitting a guy when he’s down! What happened to compassion? I thought you nurses were supposed to be dripping with the stuff.’

  ‘Sorry.’ She grinned at him, wondering if she could ever have imagined them having this kind of conversation a few days earlier. It just went to show how far she and Luke had come in a short time, and her heart lifted at the thought. ‘I’m all out of compassion at the moment so it’s coffee or nothing.’

  ‘Then it will have to be coffee, I guess. But you’ve shattered my illusions, you realise. I shall view nurses in a completely different light now that I know just how hard-hearted they can be.’

  Maggie laughed as she let them into the flat and led the way to the sitting room. ‘Oh, dear. I don’t know if that’s a good or a bad thing. Anyway, sit yourself down and I’ll make that coffee. Would you like something to eat as well—a sandwich perhaps?’

  ‘No, coffee’s fine, thanks.’ Luke looked appr
ovingly around the room. ‘I love what you’ve done in here, Maggie. It looks great.’

  She smiled in pleasure. ‘Do you think so? The room was so drab when I moved in. The previous tenants had papered the walls with this hideous flock wallpaper. It had to go! It took me weeks to scrape the walls and paint them, then I wasn’t sure if the colours were too strong. But now I think they go together quite well.’

  ‘They certainly do,’ he agreed, staring appreciatively at the warm terracotta walls and Mediterranean blue curtains and cushions that she’d made. It was obvious that he really liked what he saw as his eyes travelled over the collection of knickknacks and colourful prints she had dotted about the room. ‘The place looks so warm and inviting, lived in, if you know what I mean.’

  She chuckled at that. ‘I do, although my mother’s word for it is cluttered! Anyway, make yourself comfortable and I’ll fetch that coffee.’

  She went to the kitchen and filled the kettle. Recalling Luke’s comments about the instant coffee they drank at work, she decided to make a pot of real coffee for a change. Once it was ready, she loaded everything onto a tray. There had been no sound from the sitting room so she assumed that he’d been enjoying the chance to have a few quiet moments after his hectic evening. However, when she went into the room she discovered that he’d fallen asleep.

  Maggie quietly set the tray on the table, wondering what to do. It seemed a shame to wake him when he was obviously worn out, but he couldn’t stay there for the night…could he?

  She came to a swift decision, prompted solely—or so she assured herself—by common sense. What point was there in waking him when he could spend the night on her sofa?

  It made so much sense that she didn’t hesitate any longer as she went to her bedroom and took a spare blanket out of the cupboard. She took it back to the sitting room and carefully draped it over him, then found herself lingering by the sofa as it struck her how young and surprisingly vulnerable he looked. Luke was always so decisive at work, so confident in his approach to everything he did, that it was a shock in a funny kind of way to see this other side of him.