A Consultant Beyond Compare

by Joanna Neil

  Katie laughed. ‘If you like gardens so much, you could set to with a rake, a spade and a hoe in ours. It’s a jungle out there.’

  It was some half an hour later, after Katie had cleared away the breakfast dishes and seen Jessica off to the activities centre, that she started out for the hospital.

  Alex was already on duty when she arrived in A and E, but there must have been a temporary lull in the intake of casualties because he was chatting to the nurses and a couple of doctors who were dealing with forms and writing up charts at the central desk. There was a lot of laughter and Sarah, especially, was standing close to him, her hand resting on his arm in an intimate gesture.

  ‘If you want to make this place the best,’ she was saying with a chuckle, ‘you’ll have to lift it up en masse and transport it to the new wing. With the best will in the world, there’s only so much we can do here. We’re nurses, not miracle-workers.’

  ‘Not true,’ Alex admonished with a wagging finger. ‘I’ve seen you work wonders day after day. What’s the occasional miracle between friends? As to moving to the new wing, just as long as I get to be head of the new unit, everything will be plain sailing. I’ll take you all with me and there won’t be any such things as waiting times and targets to be met. It’ll all work like a dream. You’ll see.’

  ‘Yeah, sure.’ There was more laughter and the group broke up as a siren sounded in the distance.

  ‘Ah, there you are, Katie,’ Alex said coming to meet her. ‘You’re here sooner than I expected. I wasn’t sure how you would cope with these early starts, especially with having Jessica around, but you seem to be managing very well.’

  Katie nodded. ‘I’ve always been a lark rather than an owl. Besides, my neighbour is always up and about early and we often have breakfast together. He’s a lawyer and on several days a week he has to appear in court for his clients early in the morning, so he likes to get up in good time to prepare for the day.’

  ‘It sounds like an ideal situation.’ Alex sent her an odd look. ‘I take it he has no family of his own?’

  ‘No, he doesn’t. He’s fairly new to the area, like me. He’s around your age, and he’s not a natural loner. I think he quite likes the company.’

  Alex’s blue-grey eyes held a sober expression. ‘Yes, I expect he does.’ He picked up a chart from the desk and handed it to her. ‘I’d like you to take a look at the patient in treatment room four, if you will. She’s a woman in her late fifties, complaining of fever and chills, and chest pain that’s radiating into the middle of her back. Colin took a look at her earlier, and noted that there’s some stiffness in her neck. He’s querying whether it’s meningitis, so he did a lumbar puncture and ordered blood and urine tests, but he had to leave to attend a meeting. Perhaps you would take over in his absence?’

  ‘Of course.’ She was a little bemused by his change in manner. Just a moment ago, when he had been talking with Sarah, he had been all smiles, but now that camaraderie had vanished and he was totally professional once more. Perhaps he and Sarah were especially close? A small tremor ran through her limbs. Why did that thought bother her?

  She pushed it out of her mind and went along to see her patient. ‘Mrs Clark, hello,’ she said. ‘I’m Dr Sorenson and I’ve been asked to examine you while Dr Davies is busy elsewhere. I understand you’ve been having some chest pain?’

  ‘I’ve a headache, too.’ The woman frowned. Her hair was black but sprinkled heavily with strands of silver and her complexion was generally pale, except for bright spots of colour in her cheeks. ‘Do you know what’s wrong with me?’

  Katie glanced at the lab results. ‘It looks as though you have a urinary tract infection, and Dr Davies thinks you may have meningitis—an inflammation of the protective membranes that cover the nervous system. The results of the lumbar puncture seem to point to that, and it would certainly account for the headache and the stiffness in your neck.’

  The woman looked worried. ‘Is it serious?’

  ‘It could have been, but now that we have a diagnosis we can begin treatment right away. I think the best course of action would be to start you off on some antibiotics. I’ll ask the nurse to come and see you and make you a little more comfortable, and I’ll pop by to see you in a little while.’

  ‘Thanks, dear.’ She winced with pain as she tried to adjust her position slightly in the bed. ‘My husband will be pleased that you found out what’s wrong, anyway. He worries, you know.’

  Katie gave her a smile and left the room, going in search of a nurse. She worked her way through her list of patients, and it was a couple of hours later when she next popped in to see Mrs Clark.

  ‘How are you doing?’ she asked.

  ‘I’m not sure,’ the woman answered. ‘I have this horrible pain in my chest and I feel a bit strange. It’s probably lying in bed for such a long while that’s doing it. I’m used to being up and about.’

  ‘She says her legs are a bit tingly,’ her husband put in. ‘I expect it’s because she’s had to stay in one position for so long.’

  ‘That could be it,’ Katie agreed. ‘I’ll ask one of the nurses to come along and give her a leg massage to see if that will improve the circulation.’ Katie left the room once more and made up her mind to mention the tingling to Dr Davies. She went in search of him. Perhaps he was back from his meeting by now.

  Colin was in his office, she discovered, but he didn’t think there was any significance in Mrs Clark’s latest symptom when she mentioned it to him.

  ‘She’s perhaps still a bit sore from the lumbar puncture,’ he said, ‘and we need to give the antibiotics time to work.’

  ‘Yes, you’re probably right,’ she murmured doubtfully. ‘I just have a feeling that we ought to be doing more checks, just in case.’

  ‘I wouldn’t have thought that was necessary,’ he said. ‘We’ve already diagnosed the meningitis.’

  ‘Yes.’ She glanced at him. ‘Are you back to work on her case now?’

  ‘Not yet. I need to sort out these notes from my meeting and I have to go out again in a while. I’ll leave her with you for the next hour or so, if you don’t mind.’

  ‘OK.’

  She left him and went back to the desk so that she could glance through her lab test results.

  ‘Is anything wrong?’ Alex caught up with her as she was crossing the main thoroughfare of A and E just a short time later.

  She shook her head, sending the bright mass of her chestnut curls quivering in response. ‘No, nothing at all. I was just mulling something over in my head.’

  ‘From your frown, it looks as though it must be a weighty problem. You haven’t had a break since you started work this morning, have you? Perhaps you should come along with me to the doctors’ lounge and get a cup of coffee.’

  She nodded agreement. ‘That sounds like a good idea.’

  They walked into the doctors’ lounge together, and Alex poured coffee while she idly scanned the notice-board.

  ‘It says here that the new wing is due to be opened in the autumn,’ she noted. ‘Isn’t that what you were all talking about this morning? Is there any chance that A and E will be moved over to there?’

  ‘That’s what we’re all hoping for. It was purpose built, but there’s some question now as to whether we’ll stay here and take care of a certain category of injuries, while another team will take over that department. It would be a promotion for me if I were to be given the job of heading the unit. It all depends how things go here, I suppose. I’ve a good team behind me, but it’s how management views the situation that matters in the end.’

  ‘I can see why you would want to move there. Judging by these sketches, it’s going to be a fabulous place.’ She studied him for a moment or two. ‘I imagine management is very taken with you. From what I’ve heard, you have a great record for making changes that improve the way the department operates. That must count for a lot, surely?’

  ‘Let’s hope so. I like it when things run smoothly. So f
ar everything is going well. I just need to keep it that way.’

  Katie nodded, but his comment disturbed her. She was beginning to settle to the work in this emergency department, but how would it be if her troubles from her former hospital came to haunt her here? How safe would her job be then?

  ‘You look as though there’s something on your mind. Is everything working out all right with Jessica? What are the chances of her going home?’

  ‘None just now. My mother is having a hard time of it. Jessica’s father seems to be irritable a lot of the time and things aren’t going too well. Mum rang the other day to talk to us, and I had the impression that she wants to leave things as they are for a while. Knowing my mother and my stepfather, I guess that means for a long time to come. Jessica’s happy enough with that arrangement, anyway.’

  ‘But what about your feelings? What happens if you decide that you want to be with someone—maybe you’ll meet up with the love of your life and want to set up home with him? Isn’t Jessica going to be in the way?’

  Katie gave him a wry smile. ‘That isn’t going to happen. I’ve seen too many couples that think they’ve fallen in love, only to see their relationships disintegrate. I’ve watched it for myself firsthand, and it isn’t something I want to go through for myself. I think I prefer to keep things light-hearted.’

  He gave her a guarded look. ‘You may change your mind about that.’

  Katie might have answered him, but her phone rang just then, and she flipped it open to take the call.

  It was the project leader from the activity centre. ‘I’m ringing to ask you why Jessica hasn’t turned up,’ the woman said. ‘We were expecting her to be here for 9 o’clock this morning, but so far there’s been no sign of her. Is she ill? If so, we would appreciate it if you would let us know before registration.’

  ‘I don’t understand,’ Katie said. ‘I saw her to the bus stop this morning. Are you sure that she isn’t somewhere else in the building or in the grounds?’

  ‘I’m quite positive. I wouldn’t be ringing you if I hadn’t checked first.’

  ‘I’m sorry. I’ll have to look into this. Thank you for ringing me and letting me know.’ Katie cut the call and stared down at the phone in her hand as though it was about to explode.

  Alex was indented. ‘I take it that Jessica isn’t where she’s supposed to be? That sounds somehow familiar.’

  Katie stared at him. ‘She hasn’t run away. I left her at the bus stop this morning with her friend and she was looking forward to the day ahead. There’s no reason for her to take off.’

  ‘Does she have her phone with her? Can’t you give her a ring?’

  Katie nodded. ‘Yes, of course…I’ll do that.’

  Sarah put her head round the door of the doctors’ lounge just then. ‘Alex, we’ve a road traffic accident injury coming in. Broken bones and suspected internal injuries. ETA five minutes.’

  ‘I’ll be there.’

  Sarah left as Katie was dialling the number. ‘She’s not answering.’ She began to pace the room. ‘Where on earth can she be?’

  ‘If she’s with her friend, I doubt she’ll get into too much bother. Perhaps you should try her number again in a few minutes.’

  ‘Yes, I will.’ She stared around her anxiously, her mind flitting in all directions. ‘I should go and check on Mrs Clark. She wasn’t feeling too well. I know that she has meningitis, but I’m not sure that the antibiotics are the whole answer.’

  Alex’s brow furrowed. ‘What did you have in mind?’

  She looked up at him, her gaze cloudy. ‘I don’t know. I can’t think straight. Perhaps I should just admit her to a medical ward. That would be the next logical step. It’s just that one or two of the symptoms don’t add up and I feel that I’m missing something.’

  She started to key in a text message on the phone. ‘Jessica wouldn’t run away. I know she wouldn’t. She only did it in the first place because she wanted to get away from an untenable situation.’

  ‘Maybe she simply went back to your house for some reason. If that’s so, perhaps your neighbour will have seen her.’

  Katie let out a shaky breath. ‘That’s true. I’ll ring home and then give Nathan a call. I should try Sue’s number as well.’

  A couple of minutes later she was still no wiser. Neither of her neighbours had seen Jessica and her friend, and when she tried the cottage, the phone rang in an empty house.

  ‘Would you like me to ask Martin to take over your patients for you?’ Alex was clearly concerned. ‘You’re obviously distracted and in no fit state to go on working.’

  He came over to her and placed his hands on her arms, circling her smooth flesh with his palms. It was a gentle, caressing gesture, and Katie looked up at him, her gaze bewildered.

  ‘I don’t know. I suppose he could arrange for Mrs Clark to be transferred.’

  ‘If you think that’s what needs to be done. I’ll see to it for you.’ His voice was gentle, soothing, as though he was pacifying a child.

  She blinked. She was supposed to be an experienced A and E doctor. It wasn’t right that she should collapse under pressure, but everything was going wrong and she couldn’t concentrate while he was holding her this way.

  ‘I…No, don’t involve Martin. I’ll be all right. I just need to get myself together. Jessica can’t be in any danger, can she? She wasn’t on her own. She has her phone with her. If there was a problem, she would get in touch with me, wouldn’t she?’

  ‘Yes, I would think so.’ He released her and took a step backwards. ‘Though, if she missed the bus, she might not want to worry you unnecessarily. Perhaps she didn’t realise that the head of the centre would ring you when she didn’t turn up. And if she’s with her friend, they might simply have decided to go and do their own thing. That’s what teenagers are all about, isn’t it? They don’t see the need for rules and regulations and being in the right place at the right time.’

  ‘Jessica isn’t like that.’ She glared at him. ‘She’s my sister, and I trust her. I don’t know why you have to look on the negative side where she’s concerned.’

  ‘Maybe it’s because this isn’t the first time she’s taken matters into her own hands. Perhaps you don’t know your sister as well as you think you do.’

  Katie braced her shoulders. ‘I’ve sent her a text message. Perhaps she’ll get back to me in a while.’ She hesitated, staring around the room before pulling in a deep breath and heading towards the door. ‘I’ll go and check on Mrs Clark.’

  He went with her, and she wondered if he didn’t trust her to do her job properly. ‘What are you planning to do? Do you think you’ve looked properly at all the options? Are you going to go ahead and transfer her?’

  She shook her head. ‘No, that can come later. I think I need to do an MRI. I know it may not be strictly necessary, but something is bothering me, and I want to be on the safe side.’

  ‘So you’re going to do an MRI based purely on instinct?’

  ‘Are you telling me that I shouldn’t? I know I should justify it, but it’s simply that I feel that there’s something I’m not seeing. I know she’s Colin’s patient, but he left me in charge. It’s my decision and I’m prepared to stand by it.’

  ‘By all means go ahead and do the MRI. I wouldn’t deny that instinct is a powerful force. I use it myself quite frequently.’ He smiled briefly. ‘Let me know the result.’

  ‘I will.’

  She hurried away to set the wheels in motion. The fact that Jessica hadn’t answered her text message was playing on her mind the whole time. What was going on? Was she in any danger? Perhaps she ought to hand over her patients to Martin and go out and look for her. But where would she start?

  And why was Alex so sure that her sister was simply playing truant? Did he not care that she might be in trouble? What kind of man was he?

  CHAPTER SIX

  ‘I DON’T know how I’m going to be able to work with these changes in shift patterns, Alex.’ Sarah
was distraught as she wafted a paper in front of him. ‘In fact, all of the nurses are up in arms about them. Just look at these schedules.’

  Katie watched as the girl ran a hand through her fair hair. Thankfully, her own problems had faded into the distance a little. It had been half an hour since she had taken the call from the woman in charge of the activity centre, and Jessica had at least replied to Katie’s text message, so that she knew she was safe.

  Alex ran his gaze over the papers. ‘They do seem a little ambitious,’ he commented.

  ‘Impossible is the word,’ Sarah said with heavy emphasis. ‘I’ve tried talking to the nursing manager about it, but she says it’s out of her hands. She told me that the administration chiefs are determined to bring in new contracts and if we don’t sign we could all be out of a job.’

  ‘That isn’t going to happen,’ Alex said. ‘Think about it. How could they possibly maintain the A and E unit without the nurses? We’d grind to a halt in no time at all.’

  Sarah was still distressed. ‘But she said they were planning on bringing in agency staff to fill any gaps. She’s tried talking to them, but they’re not listening. I’m worried, Alex. I love working here, but I don’t like all these changes that they’re proposing. They’ll be too disruptive.’

  Alex put an arm around the young woman and drew her close. ‘I’ll go and have a word with management. I’m sure it’s just some harebrained idea that they’ve thought up to smooth things over when the new unit is up and running. I’ll persuade them that it won’t work. Don’t worry about it. I’m sure I can make them stop and see sense.’

  Sarah looked up at him, her mouth relaxing a fraction. ‘Thanks, Alex. You’re a treasure. I don’t know where I’d be without you.’

  He gave her shoulder a little squeeze. ‘I’m here for you,’ he said softly. ‘You know that.’

  She nodded, and he released her slowly so that she gathered herself up and moved back to the desk. ‘I’m all right. I’ll be fine now.’

  ‘That’s good.’ He gave her a smile and picked up a file from the rack. ‘I’d better go and check up on my patients.’