CONSULTANT IN CRISIS

by Alison Roberts

  ‘You’ll change your mind one of these days, mate.’ Fletch leaned slightly across Kelly to speak to Joe. ‘I can just see us all meeting for a ten-year class reunion. You’ll probably have six kids by then.’

  ‘No way.’

  ‘Grandchildren are great,’ June put in. ‘I’ve just got my second one.’ She chuckled. ‘I’ll probably be a great-grandmother in ten years’ time.’

  The relief Kelly had experienced when the conversation had been diverted from her drinking habits was replaced by an inexplicable sadness. Where would she be in ten years’ time? Still focused on a career without any kind of real home or family? Her goals had been so clearly set but she had almost achieved them now. What could she aim for when she had succeeded in helping to sort out her mother’s current situation and cut her own ties to an unhappy past at the same time?

  ‘You got any children, Fletch?’ Wendy’s query came as Fletch turned his attention to his glass of beer with obvious relish.

  ‘Not yet, but I’m working on it.’

  Kelly was jolted from her own thoughts. She had wondered repeatedly over the last two weeks whether Fletch was in another relationship. The thought of it being meaningful enough to produce children in the foreseeable future gave her a distinctly unpleasant sensation.

  ‘I intend to one of these days,’ Fletch continued. ‘Unlike Joe, I really enjoy the company of children.’

  ‘I had four,’ June told him. ‘In fact, it was my daughter that got me involved with Red Cross in the first place.’

  Kelly didn’t want to listen to any plans Fletch had to start a family. Once again she was grateful for an interruption from Kyle, who called loudly from the other side of the group.

  ‘Is that it, Dave?’ He sounded disappointed. ‘For the debrief?’

  Dave nodded. ‘We can pick over the details next week. I think we need some time out. And some food.’ He waved at the waitresses carrying huge wooden platters in their direction. ‘I hope you’re coming our way.’

  Kelly was hungry enough to enjoy the slice of Mexican pizza laden with hot peppers and sour cream. She had a slice of the vegetarian pizza that was offered next. The conversations around her were becoming increasingly difficult to hear as laughter from the other end of the table increased. Soon they were all listening to Gerry giving a convincing imitation of the kind of groaning they had heard the taped ‘victim’ uttering. Kyle was clearly more amused than anyone else as they rehashed their search for the groaning woman.

  ‘I was sure we were going to find two people trapped under there.’ Owen laughed.

  ‘Would have been a sin to disturb them.’ Roger chuckled and then winked at Kelly who smiled briefly before shifting her gaze.

  Kyle took the opportunity to interrupt the last pocket of conversation left at the table. ‘That’s not the way we’d do it,’ he informed the fireman beside him.

  ‘You’re a volunteer firefighter, Kyle.’ The older man sounded tolerant. ‘In a small, rural district. How much experience of big blazes do you get?’

  ‘Enough,’ Kyle responded defensively. ‘We’ve had a serial arsonist at work for months now. The school got torched. And the church.’

  ‘I read about that.’ Roger looked interested. ‘Have they caught the arsonist yet?’

  ‘Probably kids,’ Joe muttered.

  ‘No.’ Kyle clearly still wanted to prove his credentials. He ignored the distraction. ‘Besides, I use the internet a lot. I’ve learned heaps about major fires. And USAR stuff.’ Green eyes brightened as he grinned at the audience he’d collected. ‘I’ve downloaded some great pictures of the Oklahoma bombing. I’ll bring them in next week and show you.’

  Roger had lost interest. He collected his empty beer glass and stood up. ‘Can I get anybody another drink?’ Spotting Kelly’s empty glass, he moved down the length of the table. ‘What are you having, Kelly?’

  ‘I’m fine for now, thanks.’

  But Roger was reaching for her glass. ‘What was it? Vodka and orange?’

  Fletch’s raised eyebrow was uncalled for. His look of amusement was even more irritating.

  ‘I don’t want another drink, thanks, Roger.’

  Fletch was still looking amused. ‘Very wise, Kelly. You don’t want to overindulge.’

  Kelly forgot her intention to maintain the pretence they were strangers. She didn’t like being patronised.

  ‘You’re certainly experienced enough in that department to be in a position to give advice.’ Her tone was light-hearted enough to make Roger grin.

  ‘So…you’ve got a reputation, have you, Dr Fletcher? How come Kelly knows and we don’t?’

  ‘There’s nothing to know.’ Fletch managed to sound convincingly surprised.

  ‘Oh, come on.’ Roger was still grinning. ‘What was it, Kelly? A past filled with wine, women and wild parties?’

  ‘Something like that,’ Kelly agreed.

  ‘How do you know?’ Wendy looked curious. ‘You weren’t one of the women, were you?’

  Joe was also looking at Kelly. His raised eyebrow expressed surprise that she’d got herself into this verbal corner. His shrug suggested that he couldn’t think of any way to help extricate his colleague.

  ‘I’m sure she was.’ Roger’s glance was appreciative. ‘If Fletch had any taste, that is.’

  ‘Taste was never one of my strongest points.’ Fletch’s grin made the comment a joke to everyone other than Kelly. ‘Except for beer,’ he added. ‘I’ll come with you if you’re heading for the bar, Rog.’ He stood up.

  ‘Sure.’ But Roger wasn’t ready to move quite yet. He was still looking at Kelly, his curiosity unsatisfied. Fletch noticed the unspoken question as he waited. He shrugged offhandedly.

  ‘Kelly and I knew each other,’ he said casually. ‘It was a long time ago. Before she went to Australia. And it was no big deal, was it, Kelly?’

  ‘No.’ Kelly’s smile felt tight but she held Fletch’s gaze as steadily as she could. ‘It was no big deal.’

  But it had been. Kelly had to force herself to break the eye contact with Fletch. It felt like a physical connection and it was suddenly unbearable. Their time together had certainly been a long time ago and maybe it hadn’t been a big deal for Fletch, but it had been big for her. As big as it got. Kelly tried to shake off the dismay that threatened to overwhelm her as Fletch turned to walk away.

  Maybe it still was.

  CHAPTER TWO

  SHE was late.

  Neil found he was watching Kelly’s hurried entrance to the classroom with as much attention as everyone else. There was a flush of colour on her cheeks that suggested annoyance. That figured. Kelly set high standards for herself and attracting attention by being late would not be acceptable behaviour. The long, dark ponytail swung across her back as she turned to push the door shut.

  ‘Sorry I’m late.’ Clearly embarrassed by disrupting a session that had already started, Kelly sat down beside Joe, flashing a rueful smile at her colleague before opening her rucksack to extract writing materials. Fletch wondered if the smile meant that Joe was privy to personal circumstances that had provided an unwelcome obstacle to her arriving on time. Unaccountably, the thought provoked a feeling of irritation.

  ‘No problem, Kelly.’ Dave wasn’t feeling irritated. He was smiling at Kelly. ‘Except that you’re going to be running the first session this morning.’

  ‘What?’ Kelly’s jaw dropped and Fletch suppressed the twinge of sympathy that replaced the irritation. Why should he care that her composure was now thoroughly ruffled? Why had she been running late, anyway? Had she slept in? Had someone been sharing her bed? Fletch settled back in his chair with an uncharacteristic frown. He wasn’t going to help her out. No way.

  Neither was her friend, Joe. ‘We took a vote,’ he told her cheerfully. ‘And you’re it.’

  Kelly looked frankly worried now. Already dark blue eyes looked almost brown and a vertical crease appeared between them. Lord, had he forgotten what those glimpses of
vulnerability had done to him? He had to fight the temptation to step in, to say something encouraging or comforting. She could cope. The Kelly Drummond Fletch had known had never backed away from a challenge. She didn’t need anyone’s support and she certainly wasn’t about to get his.

  ‘Cool.’ The tiny head shake confirmed that Kelly was ready to handle whatever was about to be thrown in her direction. ‘What is it? Hide and seek in the rubbish tip again?’

  The groan was general. Some class members were still feeling the effects of that full-scale scenario.

  Dave shook his head as he smiled. ‘Today’s session, as Kelly is about to find out, is medical. We’re going to focus on developing basic skills in patient assessment, resuscitation and trauma management.’

  Dave’s attention shifted away from Kelly. It had only taken a few days for the class to divide itself into two distinct groups and Dave was directing his next words towards the less medically qualified course members who had come from the ranks of the fire service and civil defence.

  ‘As USAR team members you may well be the first to reach an injured person. You may, in fact, be their only contact for some time. The team you are part of may not be fortunate enough to have the kind of medical expertise that we have represented here.’

  Dave’s glance returned to Fletch’s side of the room. ‘Today’s course module will be redundant for some of you—Fletch and Ross as doctors, Joe and Kelly as paramedics and Wendy, Jessica and Sandy as nurses. It’s not just because Tony and I feel like a day off that we’re turning these sessions over to you guys. I expect we’re going to learn something, too. We intend to take full advantage of your skills and knowledge.’

  ‘Especially Kelly’s.’ Joe sounded smug.

  ‘Your turn is coming, Joe.’ Dave smiled at Kelly. ‘Your name just came out of the hat first. I hope you’ll all keep in mind that we’re going for a strong emphasis on practical skills today. We’re learning what we need to use in the field.’

  ‘I’m hardly the most qualified person to start,’ Kelly reminded Dave. ‘You’ve got an emergency department consultant here, you know.’

  The emphasis rankled. Was it so hard for her to use his name? To make him a person instead of a profession? Or had Kelly been surprised to discover that Fletch had gone from a registrar position to a consultancy in the space of only two years? Maybe thirty-two was young to have achieved such a senior position but it hadn’t been easy. He’d worked extremely hard and he deserved his success. Everyone was looking at him now. Except Kelly.

  ‘I disagree,’ Fletch said calmly. ‘By and large the trauma patients that turn up in Emergency have already been assessed and neatly packaged by the ambulance service. We work under controlled conditions with plenty of equipment and staff available. Hardly what we’re going to encounter in a USAR call-out.’

  Dave nodded his agreement. ‘Don’t worry, Kelly. You won’t have to do it all by yourself. Your task is to take us through a primary survey. Ross is going to do vital signs and CPR. Joe’s going to cover immobilisation techniques. Fletch is going to talk about shock and Wendy and Jessica are going to cover treatment of soft tissue injuries. This afternoon we’ll try and pull it all together with some scenario work in small groups.’ Dave gestured towards the space he had left at the front of the class. ‘Over to you, Kelly. Let’s get stuck in.’

  Kelly looked quite relaxed as she moved to lean against the table at the front of the room, but that was because most people wouldn’t know that the habit of tucking a tendril of dark hair behind her right ear only surfaced when she was nervous. Fletch knew. He also knew what she looked like when that magnificent mane of hair was unleashed from its restraint…when it fell like the softest curtain imaginable to screen a slim, naked back.

  Shutting his eyes to kill the memories the sight of Kelly’s hair evoked, and shutting his mind to the emotional effect that kicked in like a bad aftertaste, Fletch tried to concentrate on what the young paramedic was saying.

  ‘A primary survey is a means of identifying life-threatening situations or injuries in order to treat them appropriately at the earliest opportunity.’

  Fletch opened his eyes again. Now it was her voice that was stirring emotions he would rather not explore. It was a voice that had haunted him for months after she’d left. Deceptively soft, it belied a determination and courage that had been one of the qualities Fletch had admired most in this woman. He sighed inwardly. Last week he’d thought he’d had this unexpected reunion taped. He could handle seeing Kelly again. It made no difference. Had that brief confrontation at the pizza restaurant when they had made an acknowledgement, albeit understated, of a past relationship been enough to change things? Or was his resistance just wearing thin? Why was it that things that one knew to be self-destructive were still capable of exerting such a powerful attraction?

  ‘Assuming that the scene has been made safe enough for us to approach our patient, what’s the first thing we’re going to do to start our primary survey?’ Warming to her role as tutor, Kelly had written a series of letters on a whiteboard—S, L, A, B, C, D and E. S had just become the word safety.

  Kyle, as usual, was the most eager to respond. ‘See if they’ve got a pulse.’

  ‘Are we going to check their breathing?’ June was a grey-haired woman with many years’ experience in civil defence work.

  ‘Good,’ Kelly responded. ‘But what will we do as part of, or even before, that check?’

  ‘Talk to them,’ June expanded. ‘Ask them if they’re OK.’

  Kelly ignored Kyle’s dismissive head shake. ‘That’s exactly right, June. In other words, we’re going to determine our patient’s level of consciousness.’

  Kyle slumped down in his chair and fiddled with his pen. Fletch watched as Kelly caught the attention of more people on the other side of the room.

  ‘We won’t worry about the more complicated methods of assessing LOC, like the Glasgow coma scale. Basically, we’re going to find out if the patient is spontaneously responsive or whether he responds to vocal or painful stimuli.’

  The group of men sitting near June were all listening carefully now. Owen was the oldest of the four fire officers from various city stations.

  ‘What kind of painful stimuli are we going to use?’

  ‘What about a pen?’ Roger looked pleased to attract Kelly’s notice. ‘You put it between the fingers and then squeeze them together. Hurts a lot.’

  Pens got picked up around the group and experimented with. Fletch was more interested in watching Roger. Why hadn’t he noticed before that the younger fireman was rather good-looking? That he wasn’t taking his own gaze off Kelly? Had Fletch missed something brewing between those two in the last couple of weeks? Roger had certainly been determined to find out what the past connection between Fletch and Kelly had been. If he was interested, then good luck to him, Fletch thought bitterly. He had no idea what he was letting himself in for.

  ‘Try a knuckle rub on the sternum,’ Kelly told the group. ‘Just as painful and you don’t need to go hunting for a pen. OK. Let’s say there’s no response. What next?’

  ‘See if they’re breathing?’

  ‘Sure.’ Kelly nodded at Kyle’s suggestion. ‘But there’s something else we might need to do before that.’

  Roger’s gaze was still locked on their novice instructor. As though he felt the observation he was under from Fletch, Roger looked up. He stared back at Fletch for just long enough to issue an unspoken challenge.

  ‘What could interfere with someone’s ability to breathe?’ Kelly prompted.

  ‘Oedema,’ Wendy responded. ‘Soft tissue injury.’

  ‘Being dead,’ Fletch suggested dryly.

  Joe snorted with laughter. ‘Yep. That’ll do it every time.’

  Kelly’s lips quirked. A tiny, one-sided curl and quick correction that Fletch recognised as easily as her hair-tucking gesture. A sign that his black humour had amused her but it was not appropriate to indulge the response. How often h
ad Fletch deliberately evoked that quirk in the past? A private joke subtly hinted at in front of a patient, a not-so-subtle murmur in her ear as he passed. Did Roger have any idea how easily Kelly’s sense of humour could be tickled? Fletch had always been able to make her laugh and he had taken enormous pleasure in doing so, especially when she’d been stressed or unhappy. Sometimes she’d appeared to be under perfect control but he’d known she’d still been laughing on the inside. A sparkle of glee had made those gorgeous blue eyes dance and Fletch had been able to hug the satisfaction that he had been the one to provide that enjoyment.

  Not that there was any hint of sparkle this time. The look that Kelly threw both Fletch and Joe was purely exasperated. She walked towards the firemen. ‘Owen, pretend you’re a disaster victim.’

  ‘No pretence needed,’ Gerry quipped. ‘He is a disaster.’

  This time Kelly acknowledged the humour with a real smile. A quick grin that gave Fletch an odd sensation, as though he’d been kicked in the stomach by someone wearing very soft shoes.

  ‘You’ve been trapped for a long time in a collapsed building,’ Kelly continued. ‘You’re sitting against a wall. Your leg is caught under a timber beam. Oxygen level’s getting low. You’re in pain from a fractured femur and you’ve been bleeding from a laceration on your arm. Your blood pressure’s dropping. Rescue isn’t far away. You’ve been listening to them getting closer for hours now but you can’t hold out any longer. You lose consciousness.’

  Obligingly, Owen made a gagging sound and his chin dropped to his chest.

  ‘Excellent!’ Kelly’s grin was broader this time. ‘What’s happening now?’

  ‘He’s snoring,’ Roger observed.

  ‘As usual,’ added Gerry.

  ‘He’s obstructed his airway,’ Jessica informed them.

  ‘And if he’s unconscious he won’t be able to correct it.’ Kelly nodded. ‘It could lead to a respiratory arrest and death, despite imminent rescue and non-life-threatening injuries. So—we get into the space. There’s no response. What do we do?’ Kelly pointed at Owen’s mouth. ‘We’d do a rapid finger sweep just to check that his false teeth haven’t fallen out and then…’ She took Owen’s chin with one hand and his forehead with the other and as she tilted his head back to open the airway the snoring sound stopped. ‘Now we can assess his breathing.’