Each day seemed to hold a surprise that drew them closer together, weaving a bond of trust and love that appeared unshakable. Like Andrew’s reaction on the day Jennifer was delayed by an emergency at the hospital. He voiced no resentment at having to cope alone for the evening. By the time Jennifer finally arrived home, the children were sound asleep. The living room was softly lit by a dozen fat candles. A hot supper was waiting by the fireside and Andrew’s arms were waiting to welcome and reassure her.
A tension that had been part of her life for a long time evaporated as Jennifer was able to share the huge responsibility she had taken on with her sister’s children. Although capable, Saskia had been little more than a child herself and Jennifer hadn’t realised how much her background concern about her family had pervaded her professional life. Now she could relax, her confidence and trust in Andrew absolute, the unexpected spin-off being an even greater involvement and satisfaction in her work. Jennifer felt there was nothing that could possibly add to her happiness yet she fostered the secret knowledge that something probably would.
She wasn’t wrong. Only a day or two later Andrew left Michael in charge of the younger children, saying that there was something important that Jennifer needed to be shown. The children were impressed by Andrew’s solemn tone and promised to behave, but Jennifer was worried. What could have happened that Andrew didn’t want the children to see? Had the pony, Button, injured himself on that loose bit of fencing near the pond? Had the hens been struck by an incurable illness?
Andrew was giving no clues, merely shaking his head at each of Jennifer’s anxious queries. He led her by the hand, taking her down a track into the bush on the far side of the stream. Jennifer lapsed into silence. Maybe the high winter flow of the stream had caused subsidence that was threatening some of her favourite old trees. Preoccupied by her thoughts, Jennifer was momentarily puzzled when they stopped.
‘What is it? What do I need to see?’
‘Look around you,’ Andrew suggested softly.
Jennifer looked. It took only seconds to understand why Andrew had brought her here. They were standing in the clearing that her grandmother had chosen as the place to plant bluebells. Over the years, the bulbs had multiplied to form a thick carpet, the blooming of which was an eagerly anticipated annual event. How could Jennifer have forgotten to monitor their progress this year? Had Andrew discovered the surprise today or had he been waiting to present the sight in its full glory? The gift was memorable. As memorable as the taste of his kiss, flavoured by the scent of a million tiny blue flowers.
The joy that Andrew and Jennifer were experiencing seemed to be contagious. Michael won a prize at school for his project on pollution and the family celebration clearly added to his new sense of pride in himself. Andrew supervised the twins as they baked a congratulatory chocolate cake. The children unanimously declared the cake to be delicious. The look exchanged by Andrew and Jennifer acknowledged the truth and hid the laughter they knew would be shared when the event was recalled in times to come. Only the adults knew that the theft of the leftover cake by Elvis and Zippy went unpunished.
The call from Saskia to deliver the not entirely unexpected decision to stay with her father was almost welcome. With no other adults in the house, the nights belonged entirely to Jennifer and Andrew. The call from the children’s father, Philip, the following weekend made Jennifer smile.
‘I think he might be jealous of you,’ she told Andrew. ‘He complained that this ‘‘Drew’’ was all the kids could tell him about. He said they weren’t even excited about the visit he’s planning for next month. He wanted to know who you were and what was so special about you.’
‘What did you say?’
‘I said that the children had helped show me just how special you are,’ Jennifer told him. ‘I said that I’d wasted too many years not knowing and that I was making up for lost time.’
‘Come here,’ Andrew ordered. ‘I’ve got some making up to do myself.’
On Sunday, Andrew and Michael sent off to rugby in the pouring rain. When Andrew returned after the session in the pub with the other fathers he gave Jennifer a wry smile. ‘Meet the temporary new coach for the midget team,’ he said. ‘Do you think we can find a pair of boots to fit Angus?’
‘I think they just wear their gumboots to start with.’ Jennifer grinned. ‘Who roped you into that?’
‘Robert Manson, that fire officer I met at the accident. Liam’s dad was there as well. And Tom Bartlett. Tom’s going to come by next week when the weather clears up and show me how to use a fence strainer. Mike and I are going to fix that fence at the back of the pond. Button’s going to get out of that paddock if we don’t do something about it.’
‘Button’s far too lazy to go anywhere by himself. He likes it right here.’
‘So do I.’ Andrew smiled.
Even Sonic the hedgehog was adding to the domestic contentment by appearing to thrive. He now had powdered kitten-weaning formula mixed in with his milk. His eyes had opened and he got positively frisky in the evenings when he was allowed out of the shoebox to play. Soon he would graduate to eating tinned cat meat and they would have to start thinking about releasing him in the garden.
Angus was competing with Elvis for the position of Andrew’s faithful shadow. If Michael was at all jealous, he hid it well. The treehouse took shape over the next week and, watching Andrew manoeuvre the large planks for the flooring high into the shadowy recesses of the ancient macrocarpa tree, Jennifer realised how much of his strength had now returned. Stripped to a T-shirt over his faded jeans, thanks to the warmth of the perfect afternoon weather, the firm shape of the muscles in Andrew’s arms and shoulders was a pleasure to observe. The way the denim clung to the lean contours of his lower body was even more of a pleasure. Jennifer indulged herself until Andrew noticed her gaze.
‘I think you’re completely recovered,’ Jennifer told him hurriedly. She hoped the children wouldn’t notice her heightened colour. ‘You’re looking…good.’
Andrew adjusted his hold on the next plank. The detour that took him close to where Jennifer was standing was too casual to arouse the children’s interest. Only Jennifer was aware of the contact of their hips as Andrew paused. And the tickle of his lips on her ear as he bent forward to speak very quietly.
‘You, my love, look good enough to eat.’ The deep rumble of Andrew’s voice sent a shiver right down to Jennifer’s toes.
‘I don’t know about you—’ Andrew’s tone was deceptively light as he returned to his task ‘—but I’m getting very hungry.’
The children were swift to agree but thoughts of dinner weren’t yet registering with Jennifer. She had caught the blatant message in Andrew’s glance as he moved away. This time her reaction was more than a pleasurable shiver. The sensual promise in those dark eyes was enough to melt her bones.
‘Um…Me, too,’ Jennifer managed. She stooped to extract Angus from the muddy puddle he had created for his plastic duck to swim in. ‘I’ll go and get things ready.’
‘You do that.’ Andrew’s encouragement was as enthusiastic as his grin. ‘Let me know if you need a hand.’
‘I’ll manage.’ Jennifer hoped her voice didn’t sound as strangled as it felt. ‘Maybe I’ll need your help later.’
‘I’m sure you will.’ Andrew sounded supremely confident. ‘In fact, I’m counting on it.’
It became a habit for Andrew to drop into the hospital before collecting the children from school. Angus would vanish into the kitchen where Ruby delivered chocolate cake and cuddles. Andrew would spend time with Jennifer and Brian. His interest in the history of the small hospital had inspired Brian to dig out more and more old records and photographs. The older doctor was beginning to talk about collating them and writing up some sort of a book if he ever found the time. Jennifer relished the opportunity to discuss patients with Andrew. He might be a specialist surgeon but his general knowledge was impressive and he didn’t seem to have forgotten much of wha
t he’d learned at medical school. His practical skills were called on again the following Wednesday when Alice Hogan, the young farmer’s wife whose pregnancy Jennifer had confirmed only weeks ago, was rushed in by her frantic husband.
Alice was pale, sweating and nauseous. ‘I’ve got this terrible pain,’ she told the doctors, and promptly collapsed in the corridor. It was Andrew who swept her up into his arms and carried her to the treatment room. And it was Andrew who diagnosed a ruptured ectopic pregnancy and confirmed Jennifer’s suspicion that they were dealing with a major emergency.
‘What’s her gestation?’
‘About twelve weeks.’
‘What’s the blood pressure?’
‘Only 90 over 60.’
‘Her abdomen’s rigid. She’s losing a lot of blood. How soon can we get her to a surgeon?’
‘A helicopter can be here in twenty minutes. I’ll call them now. Can you get an IV line in and start fluids?’
‘Sure.’
‘Change that acute oxygen mask for a non-rebreather,’ Jennifer instructed Wendy. ‘And get the monitor leads on.’
It was fortunate that the weather was fine enough for an evacuation by air. Jennifer and Andrew found themselves together again in the modified Land Rover that was the local ambulance, monitoring a critically ill patient as they waited for the helicopter to land on the rugby field. Mickey was driving again and took both doctors back to the hospital afterwards.
‘Do you think she’ll be OK?’ he asked. ‘She looked pretty sick.’
‘She’s shocked. She needs to get to Theatre quickly so they can stop the internal bleeding.’
‘Shame you couldn’t have done it here,’ Mickey told Andrew. ‘If we’d had another storm like the last one you might have had to.’
‘I’m not an obstetrician,’ Andrew responded. ‘I wouldn’t be happy tackling something like that.’
‘But you could have if you’d had to,’ Mickey persisted. ‘Couldn’t you?’
‘I suppose so,’ Andrew agreed. ‘In a life-threatening emergency you have to try anything.’
‘Like Liam’s.’ Mickey nodded. ‘You saved him.’ He eyed Andrew in the rear-view mirror. ‘You’re a bit of a hero around here, mate.’
A few days later Andrew Stephenson put the seal on his local reputation. The gathering of parents at the after-school pick-up time was now used to Andrew’s presence and he was becoming accustomed to their sharing of personal information. While he would never consider divulging confidential patient details, he was happy to provide any general medical facts or explanations that were requested. The other parents all knew that Alice Hogan had lost her baby and that the chances of becoming pregnant again had diminished because of the surgery that had necessitated removal of one of her Fallopian tubes. The concern for a well-liked member of their small community had led to discussions about support for Alice and her husband in the future. It had been Andrew they had turned to, wanting to know about the medical possibilities for another baby. Alice’s age and previous difficulty conceiving made IVF sound like the best option, and if funds were needed for the treatment they would all find some way to assist.
The group of parents were mostly female and included Susan Begg, whose oldest child had now started school. Susan had already confided the details of her recent hospital visit to her friends. She did have the condition of hypertrophic cardiomyopathy, where the heart muscle increased in weight and affected the flow of blood. The risk of a sudden cardiac death was present but Susan wasn’t keen on the idea of an implantable cardiac defibrillator. She was now taking a drug that controlled the arrhythmias thought to be responsible for the sudden deaths associated with the condition. Andrew had heard the medical side of the story from Jennifer on one of his recent visits to the hospital.
‘There’s no evidence that the syncopal episodes are caused by a ventricular arrhythmia and an ICD is an invasive treatment,’ Jennifer had told him. ‘The cardiologists want to try amiodarone as a control medication and do some Holter monitoring on a regular basis. If there’s a collapse that can be proved to be due to VT or VF then an implantable defibrillator will be the answer.’
‘If she survives,’ Andrew had added.
Susan would probably not have survived the VF cardiac arrest if she hadn’t happened to suffer it while waiting to pick up her son from school. She was standing right beside Andrew, in fact, when it happened. The preschool children were all occupied in the adventure playground under the supervision of one of the mothers. The rest of the parents were occupied in an ordinary conversation about the upcoming pets’ day at school. Susan suddenly stopped speaking. Her eyes rolled up and her eyelids fluttered. Andrew caught her as she collapsed and eased her to the ground.
‘Susan!’ He rubbed his knuckles on her sternum to provide a painful stimulus. ‘Can you hear me?’
‘My God,’ one of the mothers gasped. ‘What’s happened to her?’
‘Is it her heart?’ someone else asked in a horrified whisper.
Andrew tilted Susan’s head back to open her airway. He placed his cheek near her nose and mouth and rested a hand gently on her abdomen to feel as well as watch and listen for signs of respiration. There were none.
‘Someone call the ambulance,’ he ordered tersely. ‘And call the hospital as well. Let Dr Tremaine know what’s happening.’
Pinching Susan’s nostrils closed, Andrew sealed his mouth over hers and inflated her lungs with a slow, deep breath. Then he repeated the action. His hand moved automatically to Susan’s neck to feel for a carotid pulse. He could feel nothing. Just as automatically, Andrew swiftly ran his hand up the line of Susan’s lower ribs until he reached the sternal notch. Two fingers’ breadth up from the notch he placed the heel of his other hand. With the fingers of both hands then laced together, Andrew straightened his arms and began compressions, counting silently.
One of the group of women began to cry. Another put her arms around the weeping woman. The others stood, overwhelmed by the horror of the situation, waiting for instructions from Andrew who clearly knew exactly what he was doing. Andrew gave Susan another two breaths and continued the compressions.
‘Does anyone here know how to do rescue breathing?’
‘I did a first-aid course years ago,’ Jill McIntosh responded. ‘I’ll try.’
‘Good. Give her one breath for every five compressions,’ Andrew instructed. ‘Make sure you get a good seal around her mouth.’
Jill knelt beside Susan’s head. She looked petrified.
‘One, two, three, four, five,’ Andrew counted aloud. ‘OK—breathe.’ He nodded a second later. ‘That’s great, Jill. I felt that breath going in. Three, four, five. Breathe again.’
They had established a practised rhythm by the time help arrived a few minutes later. Jennifer and Brian were first on the scene. Jennifer leapt from her car, deposited a lifepack beside Susan and uncurled the electrode wires with rapid movements. Brian carried a portable oxygen cylinder and bag mask. Jill moved out of the way to allow the doctors access.
‘Go inside,’ Andrew told Jill. ‘Make sure the children don’t get let out of school just yet.’
The ambulance arrived and Mickey joined the doctors.
‘It’s VF,’ Jennifer confirmed, looking at the screen of the lifepack. ‘Mickey, give Andrew a break with the compressions, would you? He must be getting exhausted.’
Andrew had forgotten how tiring CPR was and how hard it was on the knees to be kneeling on tarmac. He watched as Jennifer applied defibrillation pads to Susan’s chest.
‘I’ll get an IV line in,’ he suggested.
Jennifer nodded. ‘That’d be great. OK, I’m charging up the paddles. Stand clear,’ she ordered seconds later. Brian lifted the bag mask from Susan’s face and moved back. ‘I’m clear,’ Jennifer stated. ‘Everyone else clear?’
Affirmatives were quickly given. Susan’s body jerked in response to the shock but it wasn’t enough to jolt her heart back into a normal rhythm. Andrew qui
ckly slipped the cannula into a vein in Susan’s arm and taped it down. If defibrillation didn’t work soon they would have to start giving drugs.
‘Charging again,’ Jennifer said calmly. ‘Everybody clear.’
The second shock had the same result. ‘Charging to 360,’ Jennifer said quietly. ‘Third time lucky.’
This time the shock worked. Susan’s heart resumed a normal sinus rhythm and she began breathing on her own. Another minute and she began to regain consciousness, struggling to sit up.
‘Stay still for a bit, Susan,’ Jennifer said firmly.
‘Why?’ Susan’s eyes opened and she gazed at the circle of faces above her in confusion. ‘What’s going on? What’s all the fuss about?’
The children were coming out of school now and the crowd around Susan swelled considerably. Excited small voices alerted the adults to the approach of the helicopter. The hum of the rotors soon became louder. ‘Look!’ the children shrieked. ‘It’s going to land on our playground!’
‘Everybody stand right back here,’ their teacher ordered loudly.
‘What’s the helicopter here for?’ Susan sounded bewildered.
‘You,’ Jennifer told her. She gripped Susan’s hand. ‘You’re going to be fine, Susan, but your heart went into just the sort of rhythm we were worried about. The sort that can lead to sudden death.’ She smiled at her patient. ‘It was very sensible of you to be standing beside a doctor when it happened. We’ve got things under control now but you need to be monitored in hospital.’ Jennifer glanced at the long strip of ECG trace the lifepack was now printing out. ‘And we’ve got proof of what happened. They’ll want you to have an implantable defibrillator now to make sure it doesn’t happen again.’
‘You’re telling me I almost died just now.’ Susan was stunned. ‘I think I’ll be quite keen that it doesn’t happen again, too.’
The children and parents all stayed to watch Susan being loaded into the helicopter. Everybody was waving as it took off and hovered briefly before heading back towards Christchurch. Brian, however, wasn’t watching. He was sitting inside Jennifer’s vehicle as the helicopter disappeared over the hills.
Rivals in Practice Page 12
