by Anne Fraser
‘I’m not sure they would do that if he left of his own free will. There’s nothing to say that a person can’t do that.’
‘But you’re not just an ordinary member of the public, are you? If you wanted to, you could pull strings, couldn’t you?’
‘Possibly. But I don’t think I would want to use my position in that way, unless it was very necessary.’
She looked at him, her green eyes full of concern. ‘What will you do? Is there someone you can rely on who will take over the running of the farm and the land in the meantime?’
‘I’ll do it myself. It’s my job, as head of the family.’
Louise pulled in a quick breath. ‘How will you be able to do that with all your other commitments?’ She frowned. ‘Do you need me to release you from your contract?’
He shook his head. ‘That would leave you in the lurch, wouldn’t it? I wouldn’t do that.’
She swallowed some of her cold drink. ‘Have you thought this through properly? It isn’t just an ordinary household that you’re running, is it? The Ashleigh estate is a huge business enterprise, and it seems to me that you’ve always tried to avoid getting too deeply involved with it. In fact, I’m surprised that Robert kept it going as well as he did, and perhaps it wasn’t as easy as it looked. After all, there must have been a reason why he wanted to change things.’
‘I may have avoided it, but I’ve always been conscious of my responsibilities in that direction.’ He made a grimace. ‘That’s why I kept a weather eye on things to make sure that it was going smoothly, so I know what needs to be done. I just didn’t want Robert to feel that he was being monitored in any way, so I stayed in the background.’
She looked at him with renewed respect. So he hadn’t opted out entirely.
He helped himself to crunchy salad leaves and then added, ‘I think Robert always felt that there was so much more potential locked up in the estate. It wasn’t enough for him to manage the land and bring in enough income to keep the status quo. The upkeep of a place like Ashleigh Manor can be horrendous, and there’s always the possibility that we would be faced with huge bills for repairs.’
He grimaced. ‘In fact, the roof over my grandfather’s area of the house is beginning to show signs of wear and tear. My grandfather knew about it, and it’s something that we’re going to have to address very soon. That’s why we need to make the estate work for us. Robert wanted to build on what we have, and he believed that if we were to open up the house to visitors we could broaden our investments.’
‘Have they been hit hard now that your grandfather has gone? Gemma said that the death duties were a big problem.’
‘They are, but only inasmuch as my grandfather wanted to make an ongoing commitment to the fund for the running of the paediatric A&E unit at the Royal Forest Hospital. That may not be possible in the future. I need to work on that and see if I can come up with something that will enable us to carry out his wishes. I wouldn’t want to see my grandfather’s dreams abandoned. It was important to him to go on with the funding.’
Louise was silent for a while, thinking about that. From her point of view, the unit at the Royal Forest Hospital was in direct competition with her own, but it was something that Joseph had particularly cared about, and she could understand why his grandson would want to go on with what he had started.
‘There’s a lot that you need to think about, isn’t there?’ she murmured. ‘I hope that Robert comes to his senses and you’ll be able to work together on this.’
‘So do I.’ He cast a glance over the empty cartons and packages that were strewn about the table. ‘Have you had enough to eat? There are still some cracker biscuits and a couple of small cheeses if you’d like them.’
‘No, thank you. I’m full up.’ She made a negative gesture with her hands to emphasise the point. ‘I suppose we should make a start on clearing up. It’s almost time for us to be going back to the hospital.’
He cleared away the debris of their meal, throwing the wrappings and containers into a bin that was close by, and a short time later they began to walk back across the park, taking a slightly different route through the shrub garden.
They passed by the Pets’ Corner, hidden away in a shady area, and Louise stopped for a moment to look at the animals.
‘Joseph asked me if there was an aviary here, and I said there were rabbits and guinea pigs, but no birds as far as I knew—I remember he said that things change—but look, there is an aviary, after all.’ She pointed to a large structure that was fronted by meshed wire. Brightly coloured budgerigars and canaries flitted from branch to branch, the noise of their chirruping filling the air, and in a separate section parakeets preened themselves. Her expression was sad. ‘I wish he had been able to come and see it.’
James put an arm around her. ‘You miss him too, don’t you?’
‘I do. Especially being here, in the park…it brings it all back to me. I just remember him so vividly, and how sweet he was, even though he was ill.’ Her voice became muffled, and James gave her a squeeze.
‘He was very fond of you. He was glad that you and I were working together. He said that we could learn from one another, but I’ve no idea what he meant by that.’ He smiled down at her, and it was all Louise could do not to cry. She felt the tears pricking at her eyelids, and she blinked, trying to dash them away.
‘I’m sorry,’ she said. ‘I don’t know why I’m behaving like this. You’re the one who has suffered a dreadful loss, but I just feel so sad that he’s gone.’
James curled up his hand and gently rested it beneath her chin, tilting her face up to him. ‘It’s all right to feel that way,’ he said softly. ‘It’s good that we all mourn him. He was an exceptional man.’
She nodded and, before she could stop them, salt tears trickled down her cheeks. James held her close, sharing her sorrow, his head bent close to hers, his cheek resting against her cheek.
Then she gave a ragged sigh, looking up at him, and in that instant his head lowered slowly, coming closer and closer until his lips were touching hers, brushing against them, testing their soft fullness. Then he laid claim to her mouth, totally, in a fierce, passionate kiss.
A swift, hot surge of need rippled through her body like a forest fire, consuming everything in its path. The kiss was everything she wanted, needed, hoped for, taking her breath away and devouring her in its intensity. Her lips parted beneath his, absorbing his passion and desire, making her desperate in that moment to be one with him.
Obligingly, his arms went around her, holding her tight, and he moved her into the shelter of the shrubbery so that they were hidden from sight, away from the prying eyes of anyone who might happen to pass by. The softness of her curves was crushed against his long body, her legs pressured by the taut, muscled strength of his thighs.
‘I’ve waited so long to hold you this way,’ he said, his voice roughened, his breath escaping him in uneven bursts. ‘I wanted to kiss you, to take you into my arms and feel the warmth of your body next to mine.’
His hands travelled over her, sliding beneath her jacket, tracing the contours of her feminine shape. ‘You are so lovely, Louise…my Louise…why have I waited for you for so long?’
She gazed up at him, her mind hazy with yearning. Was he really saying these wonderful words to her…or was she so taken up with the enchantment of the moment that she had imagined it?
Her hand slid down over the smooth wall of his chest. This was real enough, though, and she could feel the beat of his heart beneath her fingertips, a heavy, discordant thud that told her he was every bit as overwhelmed as she was.
Then something began to intrude on her senses, breaking the spell. From a distance, there came the sound of voices, the light tread of people approaching along the nearby path, and Louise became very still, struggling to pull herself together.
What was she doing, kissing him in a public park, allowing her wayward senses to drive everything out of her mind but the need to have him ho
ld her?
Perhaps James was thinking along much the same lines because he reluctantly eased himself away from her, steadying her with his hands as though he feared she might lose her balance.
And so she might, because the enormity of what had happened suddenly swept over her. She had lost all thought of time and place, had wanted him in those breathless moments to the exclusion of all else, and now she realised with sudden shock that there could only be one possible explanation for that.
She had fallen in love with him. Against all the odds, despite the fact that he had the power to destroy everything she had worked for, she loved him. It was madness, a wild, reckless emotion, because nothing could ever come of it.
His world was light years away from hers. His titled family had moved through generation after generation amongst the rich and famous. His grandfather had endowed the Royal Forest Hospital with a precious gift that threatened to destroy her own dream, and James would not do anything to save what she had built up. Her love for him was doomed from the outset.
‘Perhaps we should go,’ he said in an even tone, bringing her back to cold, harsh reality. ‘We’ll be needed back at the hospital.’
She nodded, not trusting herself to speak just then, and he led the way, his stride as purposeful as ever.
Both of their lives had changed in different ways in these last few weeks, but he would work steadfastly to conquer his demons. She didn’t think she would ever come to terms with hers.
CHAPTER TEN
‘THE child’s lung has collapsed. Jenny, I’ll give her intravenous analgesia and lidocaine, but I need to put a chest tube in place—quickly.’ Louise worked swiftly to identify the point of incision, but looked up momentarily from the patient she was tending to see that Alice had hurried into the room.
‘Is something wrong, Alice?’
‘Yes. James’s patient is struggling to breathe and needs to go to Theatre right now. There’s no anaesthetist available and all the Theatres are occupied. He said to tell you that he’s taking him up to the endoscopy suite.’
Louise frowned, carefully infiltrating lidocaine beneath the child’s skin. ‘All the surgeons are involved with patients right now—and being the weekend we’re short staffed. It will be at least an hour before we could expect Mr Morrison to get here. Our Senior House Officers and the registrar are all working on the trauma victims who came in earlier.’
‘That’s what I told him but he says it’s not a problem. He’ll do the procedure himself, but we need to transfer the boy for endoscopy right now. His condition is deteriorating with every moment.’
‘You’d better go and assist, then,’ Louise told her, getting ready to make the incision in her patient’s chest. ‘I’ll come and find you as soon as I’m finished here.’
‘All right. I’ll tell him.’
Louise watched as Alice went out of the room. Through the glass panel that divided one treatment room from another, she saw that James was setting up an intravenous line in the little boy’s arm, and all around him monitors were bleeping warnings at regular intervals.
Louise inserted the chest tube and connected it to an underwater seal. Then she sutured the drain in place and covered it with a dressing and adhesive tape.
‘That seems to be working just fine,’ she told Jenny a moment or two later. ‘Her breathing is becoming easier, but I’ll need an X-ray of her chest to confirm that the tube hasn’t been inserted too far. Page me if there’s a problem, will you? I’ll be in the endoscopy suite.’
‘I’ll see to it.’ Jenny went to check on the little girl, and Louise left the treatment room and headed for the corridor.
She caught up with James and Alice as they were about to enter the lift. ‘What do we have?’ she asked quietly, stepping inside with them. She looked down at the boy, a five-year-old who was feverish and breathing rapidly, in clear distress. Each breath he pulled in was accompanied by a high-pitched sound that denoted a blockage somewhere in his respiratory system.
James checked the boy’s intravenous line and then adjusted the face mask, making sure that the child was receiving an adequate supply of oxygen.
‘I think it’s a bacterial tracheitis,’ James explained, using a low tone so as not to disturb the child. He punched the button and the lift started to move. ‘His throat’s closing up because of the swelling and I need to get a tube in there before his oxygen saturation level falls any lower. We’re running out of time. He’s been feverish over the last few days, according to the parents, with a barking cough and runny nose. He complained of a sore throat and his voice is hoarse. I’ve examined him, and the lung sounds are decreased in the right lower lobe, with fine crackles.’
‘So you’re going to intubate him and take a look at what’s going on?’
James nodded and, as the lift doors opened on the next floor, he started to wheel the boy towards the endoscopy suite. There was urgency in his movements and Louise could see why hewas so worried. The boy was in greater danger of asphyxiation with every moment that passed.
‘I’m going to anaesthetise him through a breathing mask,’ James told Louise as they settled the child in the room. ‘He’s not in any state to worry about what’s going on, and it will be easier for him that way.’
‘All right. I’ll act as your anaesthetist, and you can do the procedures.’ She glanced at Alice. ‘Do we have a consent form from the parents?’
Alice nodded. ‘The duty nurse is explaining things to them.’
‘That’s good. Will you assist with preparing samples for the lab?’
‘Yes, of course.’
Just a couple of minutes later, the boy was anaesthetised and James was ready to insert a five millimetre endotracheal tube into the child’s throat.
Louise set about collecting blood samples and passed on the vials to Alice for marking up. ‘We need a complete blood count and cultures,’ she told her.
James, in the meantime, had started on the various diagnostic examinations, using a laryngoscope first of all. ‘The vocal cords are swollen,’ he said, his voice showing his concern, and then he moved quickly on to perform a tracheoscopy.
He winced. ‘The trachea is coated with purulent secretions and the mucosa is ulcerated, with sloughing into the tracheal lumen. I’ll do what I can to remove the secretions with suction, and you can prepare the samples for testing, Alice. We’ll need them checked for Gram stain, culture and sensitivities to antibiotic therapy.’
He worked for a few minutes until he was satisfied that he had cleared as much as he could. Then he went on to check the boy’s lung. ‘There are the same secretions here,’ he said. ‘I’ll do what I can to remove them.’
‘From the looks of things he’ll need strong intravenous antibiotic cover,’ Louise said. ‘Do you want me to start that for you?’
James nodded. ‘Yes. Give him cefuroxime to begin with. He’s already had broad-spectrum penicillin, but if it’s a staph aureus infection, as I suspect, the cefuroxime should help to combat it. I can only hope that the secretions don’t start to build up again too quickly.’
‘Okay.’ Louise began to prepare the medication. ‘What are you going to do about the endotracheal tube?’
‘I’ll replace it with a nasotracheal one as soon as I’ve finished, and we’ll keep him on positive pressure ventilation. At least his breathing has improved a little already.’
James glanced at the video monitor a few minutes later. ‘I think I’ve done about all I can here. We’d better transfer him to intensive care, and let the parents know what’s happening.’
Louise smiled at him. ‘You did a great job.’ Glancing at Alice, she added, ‘You too, Alice. Thanks for everything.’
Alice nodded. ‘I just hope the little chap recovers fast. I’ll never get used to seeing them like this, so ill and helpless. That was such a close thing. It’s alarming.’ She sighed. ‘To be honest, I sometimes wonder why I do this job…it can be so distressing.’
‘But then they start feeling
better and begin to demand attention, and you know exactly why you do it.’ Louise said, her mouth curving. ‘Let’s get this little one off to ICU, shall we?’
She knew exactly what Alice was feeling, though. It was something they all went through, and the sad fact was that working with children could be heartbreaking at times.
She wrote up the forms for the laboratory tests and handed them to Alice. ‘I’d better get back to my trauma patients,’ she murmured.
It was some time later, when she was taking a break outside in the quadrangle at the back of the A&E unit, that James came to join her.
‘So this is where you’ve been hiding,’ he said softly, walking over to her in the far corner of the paved square. A patch of lawn edged the terrace and trees grew at intervals, providing shade. ‘Alice said you might be here, but I almost missed you, out of sight here behind the cherry tree.’
‘It makes a good refuge, and it’s peaceful,’ Louise murmured. ‘I’m surprised you haven’t discovered this place for yourself before now.’
‘I can see why you like it,’ he said, coming to sit down beside her on the wooden bench. ‘I thought you’d like to know that I’ve just finished speaking to the boy’s parents and they’re going to stay with him in the intensive care unit. It’ll be a while before we know if he’s going to be all right, but we’ve done all we can for now.’
‘Those sorts of cases are always scary, aren’t they—when the child can’t breathe and the swelling is blocking the windpipe?’
He nodded. ‘As you said to Alice, that’s when you realise why you came into medicine in the first place, because you know you can make a difference. These last few weeks have certainly made me think again about why I wanted to become a doctor. I think, over the years, I had begun to lose sight of that.’
He sent her a thoughtful look. ‘You know, it occurred to me, back in the endoscopy suite, that while we were going through all that worry, feeling the urgency of the situation, you had the opportunity, but you never once stated the obvious.’
