Rivals in Practice

by Alison Roberts

  ‘Dr Tremaine? Could you come and check on Liz, please?’ Michelle’s face was anxious. ‘She’s in a lot of pain and the machine that’s doing the baby’s heart rate is beeping.’

  Jennifer caught Andrew’s dark eyes again with a silent plea. He transferred his gaze to Liam, his expression resigned.

  ‘I’ll do the lavage,’ he said. ‘And we’ll take it from there.’

  ‘Thanks.’ Jennifer was suddenly aware of how pale and weary Andrew looked. Her own cold, damp clothing was clinging to her skin and Andrew must be a lot more uncomfortable than she was. He had been out in the storm far longer than she had and he was injured as well, yet he hadn’t voiced a word of complaint.

  ‘Tom Bartlett is here as well,’ Michelle said to Jennifer. ‘He wants to talk to the other people that were in the accident. Oh, and Mickey’s wanted back at the station.’

  ‘OK.’ Jennifer stripped off her gloves. She couldn’t afford to worry too much about Andrew Stephenson’s level of comfort just yet. ‘Wendy, you come with me. Margaret can stay and assist Andrew.’ Jennifer paused as she followed Mickey to the door. ‘Marg, find Andrew a set of scrubs when you get a minute. His clothes are soaked and he must be frozen.’

  Wendy trotted behind Jennifer as they made their way towards the maternity suite. Jennifer grinned at her colleague.

  ‘I wonder if Andrew might fancy doing a Caesarean?’

  ‘Who is he, exactly?’ Wendy’s eyes were round. ‘And where the hell did he appear from?’

  ‘He’s on holiday and was involved in the accident somehow.’ Jennifer stopped beside a large cupboard. ‘I’ll get some dry scrubs for myself, I think.’ She reached for a set of the pale blue theatre clothing.

  ‘He’s amazing,’ Wendy continued in awed tones. ‘And he’s so…He’s…’ She gave a silent whistle.

  ‘You wouldn’t be the first woman to find Andrew Stephenson attractive,’ Jennifer told her nurse wryly. ‘And you won’t be the last.’ She was rapidly unbuttoning her shirt, screened by the open cupboard door.

  ‘How do you know that?’

  ‘I went through medical school with him.’ Jennifer stripped off the damp shirt and replaced it with the loose, thick cotton top. Then she peeled off the oilskin over-trousers she was still wearing.

  ‘Did you go out with him?’

  ‘Heavens, no! I couldn’t stand the man.’ Jennifer pulled scrub trousers over her jeans for extra warmth. ‘And he couldn’t stand me either.’ She shot Wendy a quick grin. ‘I’m quite pleased to have him around right now, though.’

  ‘You and me both. He’s real knight-in-shining-armour stuff, isn’t he?’

  ‘Don’t get your hopes up.’ Jennifer felt obliged to issue the warning, having noted the gleam in Wendy’s eye. She moved on briskly. ‘You’d be wasting your time,’ she added as Wendy caught up.

  ‘Why?’

  ‘He’s on his honeymoon.’ Jennifer didn’t see Wendy’s disappointed expression. She could see Tom waiting further down the hallway. ‘I’ll go and check Liz,’ she told Wendy. ‘You take Tom in to see those other patients. I think Janey might be with them. Find out whether she’s got an update on young Sam as well. I want to know how he’s getting on with that concussion.’

  Elizabeth Bailey was miserable. ‘That stuff isn’t helping any more,’ she told Jennifer, waving dismissively at the Entonox cylinder. ‘My back is killing me.’

  ‘I’ll give you something stronger in a minute.’ Jennifer was watching the foetal monitor as she pulled on clean gloves. The heart rate had dropped a fraction but not enough to be a problem yet. She would reset the level for the alarm as soon as she had examined Liz.

  Suzanne Smith arrived just as Jennifer administered a dose of pethidine to her patient.

  ‘Where do you need me most, Jen?’

  ‘Right here.’ Jennifer moved out of earshot to speak to the nurse. ‘Liz is definitely in labour this time but things are moving very slowly and it’s a classic ‘‘backache’’ labour. She’s been here since this morning and she’s still only six to seven centimetres dilated. She’s had enough and we might have a long way to go till the end of stage one.’ Jennifer shook her head. ‘Goodness knows how we’ll cope if the baby doesn’t turn. Under normal circumstances I’d evacuate her. What’s the weather like out there now?’

  ‘Awful. And the road’s still blocked. I heard it on the radio.’ Suzanne bit her lip. ‘I heard about Liam. How’s he doing?’

  ‘I’m about to find out.’ Jennifer managed to smile at Suzanne. ‘I’m so glad you’re here, Sue. At least I know I’ve got Liz in the hands of a very capable midwife. I may be busy for quite a while.’

  ‘I’ll know if I have to call you. Best of luck.’

  They were going to need more than luck. Liam Bellamy’s condition had deteriorated further by the time Jennifer returned to the treatment room.

  ‘He needs an urgent laparotomy,’ Andrew declared. ‘He also needs a blood transfusion. Have you got any frozen, fresh plasma?’

  ‘No.’ Jennifer eyed the second chest-drain bottle which was nearly full. ‘Maybe we could do an autologous transfusion and reuse his own blood.’

  ‘We’d need to anticoagulate the blood. I don’t expect you’d have a cell-saver system available.’

  ‘No. We’ve got plenty of anticoagulation agents, though.’

  ‘Not much point pouring it back in unless the leak is fixed. My guess is a ruptured spleen. His liver could also be a likely candidate.’

  ‘Could you repair it?’

  Andrew shook his head slowly. ‘You don’t know what you’re asking, Jennifer. We don’t have the facilities or the staff. Not even an anaesthetist.’

  ‘I can do an anaesthetic,’ Jennifer offered promptly. ‘It was my first rotation as a registrar. We’ve got the gear. The instruments are even sterilised on a regular basis. They used to do quite a bit of surgery here in the old days. And my nurses are great. Wendy and Margaret could both help.’

  Andrew was still shaking his head. Jennifer caught hold of his arm. ‘I took a fish hook out of a man’s hand earlier today,’ she told him with quiet intensity. ‘He put himself in considerable danger trying to make sure his boat was going to be safe in this storm. His fishing boat is his living and the only way he can support his family. He’s desperate to hold things together since his wife died three years ago. His kids are all he has. Liam is his eldest son.’

  Jennifer could feel the muscles in Andrew’s arm tense beneath her hand. She fixed her eyes on his face, willing him to agree. He still looked pale. The skin stretched across the strong lines of his features and deep lines around his dark eyes suggested that he was in pain…or unwell. Jennifer swallowed quickly. Was that the reason he’d given up his career? He’d just lost a significant amount of blood himself from the leg injury. He’d been exposed to the elements and put under stress. Had that exacerbated some underlying serious medical condition?

  ‘Are you all right?’ Jennifer queried urgently. ‘Are you able to operate?’ She almost reached up to touch his face. Her concern for Andrew’s state of health wasn’t purely for Liam’s sake. Andrew Stephenson needed medical attention that only she would be able to provide. She was in a position of crisis here and somebody had to lose at least in the short term. The question was, who could afford to wait?

  ‘I’m able.’ Andrew’s response fell into the tense silence. Jennifer felt her breath being released in a sigh of relief and unconsciously tightened her grip on Andrew’s arm with a grateful squeeze.

  Andrew nodded down towards Jennifer’s upturned, eager face. ‘I’m able,’ he repeated with more emphasis. His solemn expression softened as his mouth twisted into a lopsided smile. ‘And I’m willing.’ The smile faded. ‘We’ll need a small miracle if we’re going to be successful, you realise.’

  ‘Miracles happen.’ Jennifer tugged Andrew’s arm gently as she turned him back towards their patient. ‘Sometimes they just need a bit of a push to get them started.’

&n
bsp; CHAPTER THREE

  ‘I STILL can’t believe it.’ Jennifer’s hazel eyes were alight with triumph. ‘We did it!’

  ‘He’s not out of the woods yet.’

  ‘He’s relatively stable. He’s come through the surgery and the bleeding is controlled. His blood pressure’s up and he’s breathing well on ventilation.’ Jennifer was smiling as she leaned over a tray and selected a suture needle. Andrew’s eyelids drifted slowly closed again but Jennifer didn’t notice. ‘They’ve almost cleared that slip on the road and there’s a team coming from Christchurch to transfer Liam to the intensive care unit. They’ll be here within a couple of hours.’

  ‘He still needs blood.’ It seemed to be a major effort to open his eyes again. Andrew had never felt so tired in his entire life. Even the strain of nearly three hours of conducting major surgery under primitive conditions wasn’t enough to explain this weariness. ‘I’m O-negative,’ he informed Jennifer.

  ‘Mmm.’ The light above the couch in the consulting room was catching Jennifer’s bent head. Her hair had dried during its confinement under the cap she had worn in their makeshift operating theatre. Now Andrew could see it was still the colour he remembered so well. A rich honey blonde. And it was still just as curly, with soft waves that almost reached her shoulders. ‘Can you feel this at all?’ Jennifer asked.

  ‘No. You put in enough local to numb an elephant.’

  ‘I needed to. This cut was right down to the bone. It must have hurt like hell.’ Jennifer was concentrating on her task. Andrew watched in fascination as she caught the tip of her tongue between her teeth for a second. He could feel the tug deep in his calf muscle as another stitch was knotted into place. ‘No wonder you bled like a stuck pig,’ Jennifer commented.

  ‘I’m O-negative,’ Andrew repeated.

  ‘So you said.’ Jennifer glanced up. Her lips twitched as she reached for scissors. ‘I have to admit I couldn’t spot that. It looked just like ordinary blood to me.’

  Andrew snorted. ‘You’re missing the point, Dr Tremaine. O-negative is a universal donor.’

  ‘Are you suggesting I’ve forgotten everything we learned at med school?’ Jennifer sounded cool. ‘I might point out that my marks in biochemistry were often better than yours.’

  Andrew sighed inwardly. Jennifer hadn’t changed a bit. She still assumed that anything he said was in some way a criticism of her. She was still far too quick to defend herself by going into verbal attack mode. ‘What I’m suggesting is that I could donate some blood to young Liam Bellamy. A bit more haemoglobin circulating would do him a lot of good right now.’

  ‘You look like you could use a bit more yourself.’ Jennifer dropped the curved needle into a tray and picked up another. ‘We’re up to skin level now,’ she told Andrew. ‘I’ll try not to leave you with too much of a scar.’ She frowned at her patient. ‘You’re still looking rather pale. I think you probably lost more blood than I realised. I certainly wouldn’t even consider taking any more.’ Jennifer bent her head to her task again. ‘Besides,’ she added casually, ‘who knows what sort of condition your blood is in?’

  ‘What’s that supposed to mean?’ Andrew forced his weariness a little further away.

  ‘I’m talking about infectious diseases,’ Jennifer responded calmly. ‘Things like hepatitis or HIV.’

  ‘I wouldn’t have been licensed as a surgeon if I posed any threat of transmitting disease.’

  ‘How would they know?’

  ‘Try regular blood tests.’ Andrew felt a flush of annoyance. ‘I’ve been vaccinated for hepatitis and have documented proof that I’m clear of HIV.’

  ‘And when was your last test? Before or after you gave up your position as a surgeon?’

  Andrew pushed aside the blanket covering his body. He felt distinctly overheated now. ‘Does it matter?’ he snapped. ‘Are you really interested in my sex life?’

  ‘No. Of course not.’ Andrew could see a faint flush of colour staining Jennifer’s cheeks.

  ‘Good. Because I would have nothing of interest to tell you. My sex life would bore anyone. Including me.’

  Andrew felt a trickle of perspiration on his face. Was the heat responsible for giving him this wave of dizziness and nausea? Or was the stress of the last few hours catching up? Jennifer hadn’t been wrong about that cut hurting like hell. The pain hadn’t gone until she’d pumped local anaesthetic into his leg. And he had lost a lot of blood. He’d pushed himself to the limit after agreeing to operate on Liam Bellamy. While the assistance he’d had had exceeded expectations, it had still been a major achievement on his part to remove Liam’s spleen and control the massive abdominal blood loss. He was beginning to feel distinctly spaced out now. He gave up the effort of keeping his eyes open.

  ‘My sex life is non-existent,’ he heard himself saying. ‘How’s that for boring?’

  The silence was odd. Andrew wondered whether he’d actually said the words aloud. Surely not! He opened his eyes to find Jennifer staring at him. Her expression was more peculiar than the silence.

  ‘You said you were on your honeymoon.’

  ‘I am.’ A silly grin plucked at the corners of Andrew’s mouth.

  ‘So where’s your wife?’ Jennifer was still staring. Lord, her eyes were gorgeous. Huge and round with the shade of hazel an exact match for the darker tones in her hair. Andrew blinked.

  ‘I didn’t bring her,’ he told Jennifer cheerfully. What was wrong with him? He was actually enjoying confessing his failure. ‘I’m starting a new trend,’ he added. ‘Solo honeymoons.’

  ‘Are you feeling all right?’ Jennifer was standing up. She appeared to be swaying slightly. ‘You look a bit hot.’

  ‘It is hot. This place is like an oven.’

  ‘It is warmer than it was,’ Jennifer conceded. ‘Jimmy came in to stoke up the old boiler because the emergency generator doesn’t cover the central heating. I’m not hot, though. I think I’ll take your temperature.’

  ‘Who’s Jimmy?’

  ‘Our caretaker. He’s married to Ruby.’

  ‘Who’s Ruby?’

  ‘Our cook.’ Jennifer was rummaging in a drawer. ‘Where is that thermometer?’ She glanced over her shoulder at Andrew. ‘Ruby came in as well. She’s making sandwiches for everybody. Are you hungry?’

  ‘No. Have you finished with my leg?’

  ‘I just need to put a dressing on it.’ Jennifer abandoned her search for the thermometer. She picked up a sterile pad and a crêpe bandage instead. The knock at the door of the consulting room halted her return to Andrew’s side.

  ‘Hi, Tom. Come in. I’m nearly finished here.’

  Tom nodded at Andrew. ‘I just dropped by to let Mr Stephenson here know that his camper van’s been delivered to your place.’

  ‘Thanks, Tom. How are things looking out there?’

  ‘We’re over the worst. The weather’s starting to clear and there’s been no more accidents reported. The kids are all fine, by the way. Saskia wanted to know when you’ll get home.’

  ‘Not for a while yet, I’m afraid.’

  Tom nodded again. ‘I’ll let her know. Is there anything you need here?’

  ‘We’re fine,’ Jennifer told the police officer. ‘Thanks to Andrew here, we’ve managed to cope with a fairly large crisis.’

  ‘So I heard.’ The glance Andrew received was one of respect. ‘John Bellamy’s here. Margaret’s taken him in to sit with Liam. He’d like a word.’

  ‘Of course. Tell him I’ll be there in a minute.’ Jennifer turned quickly back to Andrew as Tom left the room. She peeled the backing off the clear, sticky dressing. Now it was Andrew’s turn to stare at Jennifer.

  ‘Kids?’ he queried softly. ‘How many have you got?’

  Jennifer was beginning to wind the crêpe bandage around his leg. ‘Let’s see.’ She smiled. ‘There’s Angus. He’s three. The twins, Jess and Sophie, are six and Michael’s the oldest at eight.’ She glanced up with a quick grin. ‘I suppose I’d better count Vanessa
as well. She’s still a baby at six months old.’ Jennifer reached for a roll of tape.

  Andrew was stunned. Five children? And the oldest was eight years old? His weary brain didn’t want to do the calculations. His chest felt tight. No wonder he’d never stood a chance. Jennifer must have been pregnant for the first time before she’d even married Hamish. Well before she’d left medical school. No wonder she’d given up her ambitions to be a surgeon herself. It was amazing she found time even to be a country GP.

  ‘There.’ Jennifer smoothed the tape holding the bandage in place and stripped off the gloves she was wearing. ‘Why don’t you have a rest while I go and check on Liam? Ruby’s getting your clothes dry so you’ll be able to get out of those scrubs soon. I’ll get her to bring you a cup of tea.’

  Andrew wasn’t listening. So many questions were forming themselves in his fuzzy brain. Like why wasn’t Jennifer wearing a wedding ring? And where was Hamish? Surely the man voted most likely to succeed in their year hadn’t lowered his sights to a career in a small, rural hospital? But if he wasn’t around, how come Jennifer was still producing babies? And how could she possibly still look as young and attractive as ever when she was the mother of five? The tightness in his chest changed to a tickle and then a major irritation.

  ‘That’s a nasty cough.’ Jennifer frowned. ‘Are you sure you’re feeling all right?’

  ‘I’m fine.’ Andrew forced himself to a sitting position. ‘I had a viral illness a couple of weeks ago. Left me with a touch of bronchitis.’

  Jennifer was still frowning. She fiddled with the end of her stethoscope. ‘Maybe I should give you a proper check-up.’

  ‘Forget it. You’ve got real patients to see to. Like Liam.’

  ‘Wendy’s quite capable of monitoring things. She’ll come and get us if we’re needed.’

  The second knock on the door made them both expect an instant summons to Liam, who still lay in the treatment room, but it was Suzanne who appeared in the doorway.