Hannah nodded unsteadily. ‘The poor man. He was trying so hard to be romantic for his wife’s birthday, and now he’s going to be in traction for weeks with that slipped disc.’
‘His wife didn’t think it was particularly romantic,’ Jane observed, her grey eyes dancing. ‘Not when he got stuck halfway between the roof of their garden shed and bedroom with that box of chocolates in his mouth.’
‘And the fire brigade didn’t think it was very romantic either when they had to rescue him,’ Floella gurgled. ‘In fact, they said it was the best laugh they’d had in years. The poor man’s never going to live it down. He’ll probably have to move house, leave town—’
‘And if you three have got nothing better to do than stand around gossiping all evening, perhaps Mr Mackay and I should take a long hard look at our staffing requirements!’ Robert snapped as he strode past them.
Hannah bit her lip, Jane flushed crimson and Floella spluttered with indignation as Robert disappeared into the office.
‘I’ve had it!’ she exclaimed. ‘I really have had it! I know he’s always expected high standards from us—and quite right, too—and I know he has a quick temper, but these last two weeks have been impossible. You only have to smile and you get your head bitten off!’
‘And I was beginning to think he didn’t look quite so stressed,’ Jane sighed. ‘That he was starting to ease up on his workload, but…’
‘Someone is going to have to talk to him,’ Floella said firmly. ‘Working in A and E is hard enough, without having to tiptoe around your special reg, especially when you haven’t got the faintest idea why you’re tiptoeing around him in the first place!’
Hannah nodded absently, only to suddenly realise that two pairs of eyes were fixed expectantly on her. ‘Oh, no—no way—not me! I’m just the junior doctor, the new kid on the block.’
‘Yes, but he likes you,’ Jane urged. ‘In fact, you’re the only person he hasn’t been appallingly rude to recently.’
‘Give him time,’ Hannah said ruefully. ‘Look, if you’re so worried about him, why don’t you speak to Mr Mackay, the department consultant? He’s the boss—’
‘And about as much use for something like this as a wet flannel,’ Floella said. ‘You’d be so much better, Hannah. He likes you, as Jane said, and—’
‘No,’ Hannah interrupted firmly. ‘I’m sorry, but there’s no way I’m going to talk to him—no way!’
And she couldn’t, she thought as she walked quickly down the treatment room. How could she speak to a man who was doing his level best to avoid her? How could she possibly have any kind of conversation with someone who spent the whole time fidgeting with his watch, examining his tie and looking everywhere but at her?
And it had been like that ever since Gwen Ogilvie’s death. Since he’d told her, quite callously and dismissively, that he never thought about his wife.
She didn’t believe him. Oh, she’d been shocked and horrified at the time, but the more she’d thought about it, the more she’d become convinced that he’d deliberately set out to make her think the worst of him.
And yet why in the world would anyone want to do that? It didn’t make any sense. In fact, nothing about Robert Cunningham made sense at the moment, she thought in confusion, turning in answer to Jane’s urgent call.
‘RTA on the way, Hannah! ETA, five minutes, and it looks like a bad one!’
It was. In fact, it was by far the worst road accident Hannah had ever seen.
‘How on earth did that happen?’ she said with horror as the paramedics carefully transferred their casualty onto the examination trolley and she saw the two-foot steel bar imbedded in his chest.
‘Mr Ingram was on his way to collect his kid from a Hallowe’ en party when he hit some ice on the motorway and collided with the crash barriers,’ one of the paramedics replied. ‘His seat belt snapped, he went straight through the windscreen—’
‘And part of the crash barrier ended up imbedded in his chest,’ Robert finished grimly as he, Floella and Jane joined them. ‘What’s his GCS?’
‘Two-two-five.’
A score of 8 or lower on the Glasgow coma scale meant you had very serious injuries indeed and, at 9, Trevor Ingram was much too close for comfort. There was no way they could remove the metal bar—that was a job for the operating-theatre staff—but if they didn’t stabilise him quickly, the young man wouldn’t even reach the theatre.
‘Intubation?’ Hannah declared, immediately reaching for an endotracheal tube to replace the ambu-bag the paramedics had been using, but Robert shook his head.
‘Not with those facial injuries. I doubt if you’d be able to see clearly enough into his mouth to be sure of getting the tube down his throat and into his trachea. I’ll have to do a crike.’
A cricothyrotomy. A delicate and precise procedure which involved making a vertical incision into the throat, followed by a horizontal cut into the cricothyroid membrane. A breathing tube was then inserted into the hole and attached to the ventilator, but in inexperienced hands a lot could go wrong. You could put the tube in the wrong place, even sever one of the big arteries in the oesophagus, and if you did that then your patient was in mega-trouble.
‘BP dropping,’ Floella warned after Robert had performed the cricothyrotomy, making the whole procedure look like child’s play. ‘Sixty over forty.’
‘And he doesn’t seem to have any breath sounds on the right side,’ Hannah advised, listening carefully to Trevor Ingram’s chest through her stethoscope.
Air was seeping into the young man’s chest with every breath he took but it wasn’t going out again, and a large bubble of air was compressing the collapsed lung on his right side. Unless they relieved the tension pneumothorax, Trevor Ingram’s heart, and the great blood vessels surrounding it, would eventually become so compressed that no pumping action would be possible, and no blood would reach his brain.
‘ECG status, Jane?’ Robert demanded.
‘Jumping around a bit, but not worryingly so.’
He nodded and quickly stabbed a needle into the young man’s chest. The trapped air was released almost immediately, but though Trevor’s trachea started to shift back to the middle of his neck, a chest tube would have to be inserted to help re-expand his lung.
‘O-negative up and running, Robert,’ Floella called.
‘OK, get me a CBC, urine sample and guiac test. I’ll want chest, neck and pelvis X-rays as well. Hannah—chest tube, please.’
Did he mean she was to insert it? It certainly looked that way, and carefully she made a small incision into Trevor Ingram’s chest down into the lining around his lung. With equal care she then inserted the tube, which would suck out the blood and air and eventually reinflate the young man’s lung.
‘BP rising,’ Jane announced, ‘but we can’t get the IVs in, Robert. His veins won’t take them.’
Robert swore under his breath. Without IV lines to provide the fluids needed to temporarily replace the blood Trevor Ingram was losing, there was no way they could support his blood pressure while they attempted to bring his bleeding under control.
‘I’m going to have to go for a central line directly into the internal subclavian veins in his neck,’ Robert declared.
It required great skill to do that without hitting a major artery, but with an ease Hannah could only admire Robert soon had the central line inserted.
God, he was good, she thought enviously. Nothing threw him, nothing disturbed him. OK, so perhaps he’d been a little—all right, then, very—difficult to work with lately, but he was still the best special registrar in the business. And the kindest, she added mentally as Craig Larkin arrived to take the X-rays they needed.
Robert had been as good as his word about contacting Radiology to tell them Jerry Clark was no longer welcome in A and E. Craig Larkin had taken his place the very next day—calm, efficient and utterly professional—and he was now an accepted member of the team. What Jerry thought of the change was anybody’s gu
ess, and Hannah neither knew nor cared.
But she did care about the man standing opposite her, oblivious to everything apart from the patient in his charge. Cared deeply and desperately, but from the distant way he’d been treating her since Gwen Ogilvie’s death she’d been forced to come to the depressing conclusion that her feelings weren’t reciprocated.
‘No blood in the urine or guiac test, Robert,’ Jane declared, ‘and the CBC results suggest we’re winning.’
They were when Floella finally announced Trevor Ingram’s BP was 95 over 60.
It wasn’t a wonderful blood pressure, but at least it meant they’d stabilised him sufficiently to be sent to the operating theatre where the difficult task of removing the metal bar from his chest could begin.
‘Well done, everybody,’ Robert said, pulling off his latex gloves and running his fingers through his damp hair. ‘That was good work.’
It was. Good, united teamwork. The kind of work Hannah had always dreamt, hoped, she’d be a part of and, though she felt completely drained, she felt elated, too.
‘Do you think he’ll make it, Robert?’ she asked as Trevor Ingram was wheeled out of the treatment room, the IV bags swinging above him.
‘It all depends upon what they find when they remove the steel bar,’ he said, rubbing the back of his neck wearily. ‘I hope he makes it. After what he’s been through, he certainly deserves to.’
‘If I’d been through what he has, I’d want to keep a part of that crash barrier as a souvenir,’ she observed.
‘If it were me I’d have it mounted permanently on my dashboard as a reminder to slow down the next time there’s icy weather,’ he replied.
She chuckled, and for a second—an infinitesimal second—saw the beginnings of an answering smile curve his lips. Then it was gone.
‘Right—Yes, well, this certainly isn’t getting on with the work,’ he declared brusquely, and before she could say a word he walked away, leaving her gazing unhappily after him.
Was this how it was going to be from now on? Conversations limited to a simple ‘yes’ or a ‘no’ unless it was something to do with work? Shared smiles out of the question because they suggested a familiarity and friendship that didn’t exist?
It had all been so different two weeks ago when little Miss No Name had been born. Then she’d felt a closeness to him, a bond she’d believed he felt as well, and yet now…
Now she would infinitely have preferred Robert to have been as sharp with her as he was with everyone else in the department. At least it would have been better than this cool distancing. At least it would have shown he recognised she was alive, that she was there.
‘I take it things aren’t going well in the romance stakes?’ Elliot murmured softly as he joined her.
‘You could say that,’ she replied through a throat so tight it hurt.
The SHO sighed. ‘Well, all I can say is the guy needs his head examined.’
‘I think maybe I’m the one who should be having that done, don’t you?’ she replied sadly.
‘You’re far too good for him—he doesn’t deserve you,’ Elliot declared stoutly. ‘In fact, I never could understand what you saw in him in the first place, especially when there was someone like me around.’
She blew her nose and managed a watery smile. ‘So you’re on offer, are you?’
‘I could be if I thought you’d be even remotely interested.’ He smiled, and if his smile didn’t quite reach his eyes she never noticed. ‘Robert is in love with you, you know. He may not realise yet—or perhaps want to admit it…’
‘So you’ve got the second sight now, have you?’ She couldn’t help but chuckle.
‘Absolutely,’ he replied, his mouth turning up at the corners. ‘Not to mention also being modest, shy, retiring—’
‘And soon to be made redundant if you don’t get back to work!’ Robert exclaimed as he strode past them and into cubicle 6.
For a moment Elliot said nothing, then he turned to Hannah, his face rueful. ‘All I can say is if he doesn’t face up to the fact that he’s besotted with you soon, he won’t have a member of staff left who’s still speaking to him.’
She bit her lip. ‘Elliot, it isn’t me. I wish it was, but it’s not. I don’t know what’s wrong with him, but his bad temper’s got nothing to do with me.’
‘If you say so, love,’ he said. ‘But in the meantime I’m afraid it’s back to the grindstone, and roll on eleven o’clock.’
Hannah heartily wished it was eleven o’clock, too, by the time she’d finished examining her next patient—a tiny, frail-looking eighty-five-year-old—who despite her apparent fragility had managed in the space of fifteen minutes to comment adversely on her hairstyle, clothes and medical abilities.
‘Boy, but is she a real charmer,’ Floella muttered as she collected the blood samples Hannah had asked for.
‘To be fair, she has very bad arthritis in her hands and feet, which probably doesn’t do a lot for her temper,’ Hannah murmured back, determined to be charitable, then frowned. ‘Reception said she had a suspected fractured leg, didn’t they?’
Floella nodded. ‘According to her son, she fell in the house just before dinner, and he’s worried she might have broken her leg.’
There hadn’t been a single bruise on the old woman’s leg, neither had she complained of any pain when Hannah had examined her. She’d complained about everything else, but not about pain in her leg.
‘Flo, could you go out to the waiting room and check with her son again? Maybe he’s given Reception the wrong information. It’s very easily done when someone’s upset.’
Floella was back within seconds, her face furious. ‘We’ve been had, Hannah. It’s a granny drop!’
‘A what?’ Hannah said in confusion.
‘The classic answer of what to do with Grandma or Grandad when you decide to take a holiday,’ the sister replied bitterly. ‘If you’re too mean to spend money on a home help or a hotel, you simply drive to the nearest A and E and drop the problem off.’
‘I don’t believe it!’ Hannah gasped.
‘Neither will Robert when he finds out we’ve been conned,’ Floella groaned. ‘He’ll have to phone Geriatrics to see if they can find her a bed, and by the time they’ve finished giving him merry hell he’ll want our guts for garters.’
He did. Or, more precisely, he wanted Hannah’s.
‘How could you have been so stupid?’ he demanded, angrily stabbing his hands through his black hair. ‘Falling for a scam like that. It’s one of the oldest tricks in the book!’
‘In which case you should have warned me and I’d have been prepared,’ she protested.
‘Do you have to be told everything?’ he snapped. ‘Can’t you use whatever little brain and common sense you’ve got and figure some things out for yourself?’
Well, she’d wanted him to be rude to her, she remembered, but that didn’t mean she had to like it, and she discovered she didn’t—not at all.
‘And just how—exactly—am I supposed to predict which sons are going to dump their mothers on us?’ she retorted.
‘Perhaps if you weren’t so damned naïve—’
‘I’d rather be naïve than a complete cynic like you!’ she threw back at him. ‘Look, I made a mistake, OK? I’m sorry, OK? What do you want from me—blood?’
What he wanted, he realised, looking down at her flushed cheeks and furious eyes, was to kiss her senseless. What he really wanted was to take her to bed and make love to her.
Why couldn’t he just fall out of love with her? He’d fallen out of love with Laura, so why couldn’t he do the same with Hannah? Hell, he’d tried hard enough. Keeping out of her way, exchanging the barest minimum of conversation with her—but it hadn’t worked.
All he felt was lousier than before. Lousy, and frustrated, and angry. Angry with her for making him feel this way. Angry with himself for being stupid enough to have fallen in love again. And angry with everybody else because…because…We
ll, he didn’t know why he was angry with everybody else. He just knew that he was.
‘What I want, Dr Blake, is for you to shape up your ideas,’ he said tightly. And to stop wearing that damn perfume you always wear. The one that smells of bluebells and daffodils. To stop looking at me with those big brown eyes of yours, all hurt, and baffled, and confused. ‘What I want is you to start behaving in a professional manner!’
‘A professional manner?’ she repeated. ‘You have the nerve—the gall—to suggest that because I was conned by that old lady’s son I’m not professional?’
Of course he hadn’t meant that, but there was no way he was going to explain to her what he really meant. And to his relief he didn’t have to. As he cleared his throat to reply, the doors of the treatment room suddenly clattered open and a wild-eyed, panic-stricken girl appeared, with a baby in her arms.
‘Please—please, will somebody help me? My son…My baby’s not breathing properly!’
The tiny mite was almost blue, his chest was caving in with the effort to breathe, and together Robert and Hannah rushed towards him, their argument immediately forgotten.
‘How old is he?’ Hannah asked, taking the child from his mother’s arms and quickly carrying him into one of the cubicles.
‘Two weeks old. He was born two weeks ago.’
A premature baby for sure, Hannah decided, placing her stethoscope swiftly onto its little chest. A full-term baby wouldn’t have been nearly so small and fragile, and though the poor little mite had obviously been crying, he wasn’t crying now. All of his tiny energies were concentrated on simply trying to breathe.
‘How long has your son been like this?’ Robert asked, quickly setting up a tiny drip and linking the baby to the ECG monitor.
‘Two—maybe three days.’
Robert’s eyes met Hannah’s. Three days? What kind of mother allowed her child to suffer like this for three days? Judging by his temperature, the baby probably had a massive infection of some kind, and leaving him without medical treatment for even three hours was far too long.
A Wife for Dr. Cunningham Page 13
