The Princess and the Pediatrician

by Annie O'Neil

  ‘Oliver?’

  He turned as Lia waved to get his attention.

  ‘Could you help me with this sail?’

  He frowned and apologised. ‘Sorry. Away with the fairies.’ He looked at the sail. ‘Should you be hoisting that? In your condition?’

  ‘I’m not made of bone china. I’m pregnant,’ she said, visibly offended.

  ‘I know... I just thought maybe you should take things easy.’

  ‘I’m not going to take to my bed for the next eight months, if that’s what you’re thinking.’ Her eyes blazed with indignation, then lowered to half-mast as she inspected him, no doubt wondering if marrying him was the last thing she should do.

  He wanted to defend himself when suddenly, just like that, he saw her taut, emotionally withdrawn behaviour for what it really was. Frustration with not having a say in her own life. An ache for exactly the same thing he wanted: a normal, happy life.

  She must have sensed his empathy because her expression softened. ‘Sorry. I’m not really good at being told what to do.’

  ‘I get it,’ he said.

  ‘I know. Of all the people in the world who would get it, you are one of them.’ She gave a self-effacing laugh and threw him an apologetic look. ‘I feel like you see right into my brain sometimes.’

  ‘No.’ He shook his head. ‘I see right into this.’ He pointed at her heart.

  She took his hand and laid it on her chest until, sure enough, he felt her heart’s rapid cadence through the light fabric of her top.

  ‘I promise I’ll be careful. That I’ll protect this little one.’ She moved their hands to her belly.

  They shared a smile that instantly swept his fears away. There she was. Lia the Princess who didn’t want to be a princess. The woman who wanted to be a mother...and, hopefully, a wife.

  ‘Here.’ He took the line from her and tugged the sail up. ‘Think of me as your chief galley man.’

  She laughed and said, ‘You’d be making lunch if that was the case. How about first mate?’

  ‘Sounds good.’ He tied the rope off under her instructions and gave her a salute.

  She feigned wiping sweat off her brow and gave him a sheepish smile. ‘Sorry if I’ve been vile. I hate photo shoots.’ She shot him a playful smirk. ‘And we’re going to have to work on your happy-go-lucky look. You looked stiff as board!’

  She cackled, then, as if she were a balloon that had unexpectedly popped, suddenly deflated.

  ‘That was awful,’ she said. ‘You’re going to walk away before the month is over, aren’t you?’

  He shook his head. ‘I’ll never walk away. You have my word on that.’

  She sought his eyes for any hint of wavering. Obviously finding none, she leant in to give him a sweet, soft kiss that filled him with a honeyed warmth.

  ‘I’m sorry I was a pain,’ she whispered against his lips. ‘I’m not used to someone having my back.’

  That admission spoke volumes. Just as he’d built an enormous fortress round his heart after his ex had had her abortion, Lia kept people at arm’s length because it was safer than risking the disappointment of being let down.

  Brick by brick, she was opening up his fortress.

  Millimetre by millimetre, she was letting him in.

  He pulled her to him, one hand on the small of her back, one hand cupping her cheek, and kissed her again. More deeply this time. More meaningfully.

  I’m here for you, the kisses said. You are not alone. You’ll never be alone again.

  Eventually, they drew apart, the demands of the boat taking precedence over their urge to let the rest of the world melt away.

  ‘Want to teach me how this thing works?’ he asked.

  They spent a companionable hour or so, working their way through all the boating terminology. And between learning about winches, pushpins, transoms and jammers, he became aware that their bodies organically sought each other’s.

  The light brush of a hand... Their legs pressing together when they sat side by side... Their eyes catching and heat passing between them as if they were actually sharing energy...

  They were far out enough that they also saw a lot of wildlife. Dolphins...some porpoises. Even a turtle or two.

  ‘Ever seen a manatee?’ he asked.

  She shook her head. ‘They’re usually in the mangroves, and I tend to stick to the boat rather than the dinghy.’

  He looked for and clocked the small RIB attached to the back of the boat. ‘Do you ever use it?

  She shook her head. ‘Not really. I prefer the power of the wind to motorised power.’

  ‘It’s definitely more peaceful this way.’

  She tipped her head to his shoulder and they stayed like that for a while, her hair occasionally tickling his cheek, their little fingers touching, then linking. They’d be all right, Oliver thought. There would be bumps and troughs along the way, but...they’d be all right.

  ‘Now,’ Lia said after they’d brought the boat around to a quieter side of the island, away from the tourist beaches. She turned a knob on the control panel and pointed at the speaker built into the console. ‘Are you ready to learn the radio lingo?’

  ‘Absolutely.’ Oliver gave her a crisp salute. ‘At your service, Captain.’

  She grinned, the bridge of her nose wrinkling just enough to give him a glimpse of what she might have looked like as a little girl, before her parents’ divorce. Happy, light, carefree. He made a silent vow to provide her with a future where she could honour that little girl. Give her a second chance to forge a new life for herself and, of course, for their own child.

  ‘Oliver—’ Lia’s expression changed as she turned up the volume on the radio.

  ‘What?’

  ‘Listen.’

  He focused in on the voices on the radio. ‘It sounds like a distress call.’

  ‘It is. It’s the coastguard. They’re on the far side of the island and they...’ She paused and leant in to listen. ‘It’s kayakers. They’ve got caught in the currents and ended up somewhere around here. In the mangroves, I think. It sounds like one of them needs urgent medical attention.’

  ‘Can we get there?’ He looked up at the vast sails, knowing there was no chance they’d get into the thickly forested inlets.

  ‘We can in that.’ She pointed at the RIB.

  * * *

  Lia’s military training kicked into high gear. She was relieved to note that Oliver worked swiftly and efficiently.

  ‘Two years in a paediatric A&E,’ he explained, when she asked if he’d had any emergency training.

  ‘Hopefully you won’t need it,’ she said grimly as they anchored the boat.

  They lowered the sails, tied them off, then quickly got the RIB into the water.

  ‘Do you know the mangroves?’ she asked.

  He nodded in the affirmative. ‘I’ve taken my kayak in there a lot.’

  ‘You direct, then,’ Lia said, taking up a post at the motor.

  As they fastidiously made their way through the maze, eyes peeled for the kayakers, they heard shouting.

  Nothing prepared them for what they saw.

  Two young women—maybe in their late teens—were in a double kayak. One of the girls was screaming and waving her hands at Lia and Oliver. The second was lying face-down in the small area between the seats, her paddle slipping into the water.

  ‘Barracudas!’ screamed the girl. ‘We were watching the barracudas jump and then one hit Stephanie!’

  Lia’s vision clicked into slow-motion frames of information.

  The injured girl, Stephanie, had an open wound on her left side, in the gap between the front and back pads of her flotation device. Her lung was visible through her ribs.

  After ensuring that the fish were gone, Oliver jumped out of their RIB and began tying the girls’ kayak
to it. He waded through the waist-deep water and, after pulling on a pair of clean surgical gloves, asked for a moment’s silence.

  When Lia heard the gurgle indicating a puncture in Stephanie’s lung, her first thought was that they were moments away from calling a time of death.

  ‘How long ago did this happen?’ she heard Oliver ask.

  ‘Ten minutes ago, maybe?’ the frightened girl answered, tears openly pouring down her cheeks.

  ‘What’s your name?’ Lia asked, her emergency medical training finally clicking into gear, as Oliver’s already had.

  ‘Mary.’

  ‘Okay, Mary. Let’s get you aboard the RIB.’

  Oliver asked Lia for the first aid kit they’d brought along. It was a proper military EMT run bag that she’d used back in her training days, and she’d never been more glad of her precautionary measures to keep it rather than just the customary plasters and paracetamol.

  ‘What’s faster?’ Lia asked Oliver. ‘Getting to shore or sailing back round to the harbour?’

  ‘We can take the RIB in through the mangroves. There’s a small docking area not far from here.’

  ‘Can a helicopter land there?’

  ‘Yes. You ring the rescue crew and I’ll get Stephanie into the RIB for a needle decompression.’

  Lia nodded her agreement. If the injury had happened an hour ago, the girl would have had only a three per cent chance of survival. As things stood, they were at the beginning of the so-called ‘golden hour’. They had about fifty minutes to ensure she would survive.

  After Oliver had put several large bandages round the open wound, protecting it for the transfer, Lia asked Mary to hold the phone, which was on speaker mode, so she could speak to the coastguard while they gently transferred Stephanie to the RIB.

  ‘She’s suffering from a tension pneumothorax,’ Lia explained to the woman on the end of the phone.

  ‘What does that mean?’ Mary wailed.

  As Lia spoke to the emergency services, Oliver explained to Mary that the trauma to Stephanie’s lung had trapped air in her pleural cavity—the space between the lungs—and that they had to release it in order to ensure the rest of the body received oxygen.

  It was more complicated than that, but Lia appreciated Oliver’s attempt to simplify the complicated-sounding situation. The pleural cavity, once filled with air, would cause Stephanie’s left lung to collapse, which would then put pressure on her heart, reducing cardiac output, which would make breathing next to impossible and induce tachycardia. Surviving the domino effect of an untreated pneumothorax was impossible.

  Half listening to Oliver as she spoke with the coastguard, Lia was impressed with the quick efficiency with which he both worked and talked. He didn’t use vocabulary that would alienate Mary. His voice was calm and soothing. He was someone you would trust in an emergency. Someone you would entrust with your child.

  ‘Which hospital?’ the woman on the end of the phone asked.

  ‘The Island Clinic,’ Lia said.

  At the same time Oliver said, ‘St Victoria.’

  ‘We have a landing pad—’

  Again their voices overlapped.

  An ominous sound came from Stephanie’s lung. ‘You choose,’ Oliver said.

  There was no doubt that any more time wasted was at this poor girl’s peril.

  The operator chose for them. ‘There’s a helicopter already en route to The Island Clinic with a VIP patient in it.’

  Time was not their friend. And Lia had no idea what the patient on the helicopter needed. Her hesitation spoke volumes.

  The emergency operator said, ‘After the drop-off it can come and collect you, but it would be faster to bring her to the hospital. Is that acceptable?’

  ‘Very,’ Lia confirmed.

  While the facilities at The Island Clinic were well beyond first rate, St Victoria was a great local hospital. It also had an emergency room, and it was closer to the hotel which had its name emblazoned on the girls’ kayak. More importantly, this was no time to play ‘My Clinic’s Better Than Your Hospital’.

  ‘What’s a tension pneumonia?’ Mary asked, as if absolutely nothing Oliver had said had registered.

  She was shivering, the shock of the incident clearly taking root.

  ‘Pneumothorax,’ Oliver quietly corrected, handing her an emergency foil blanket, despite the heat of the day.

  He began his explanation again in a low voice, so Lia could finish up her phone call with the emergency services.

  Lia pocketed the phone after the rendezvous point had been confirmed and they’d settled Stephanie onto her uninjured right side.

  ‘Why aren’t we going?’ Mary fretted.

  ‘We just need to do this quick release of trapped oxygen and then we’ll be off,’ Oliver explained.

  Lia handed him an eight-millimetre fourteen-gauge needle. His eyes caught hers.

  ‘The military recommends the longer length,’ she explained.

  Military training had not only toughened her up, it had given her access to learn extensive emergency medical treatment, including the latest methods of pre-hospital pneumothorax treatment. Unfortunately, gunshot wounds and stabbings were part and parcel of active duty—and, more to the point, precisely why the palace had forbidden her from serving in a conflict zone.

  ‘No flash chamber,’ Oliver commented as he swept an alcohol disinfectant pad over the spot between Stephanie’s second intercostal space and the mid-clavicular line where the catheter needle would release the trapped air.

  ‘No need for this type of injury,’ she said. ‘It means you don’t have to think about it.’

  He made a noise, as if he was impressed by the forethought, and then got to work. A swift, accurate needle decompression was the only thing that would save this girl’s life.

  Within seconds the sound every doctor wanted to hear mixed with the softly cadenced noise of water lapping against the side of the boat: the hiss of released air.

  Oliver removed the needle but left the catheter in place. Lia took the needle from him and secured it in a proper disposal box. She handed him some tape and he secured the catheter, so that it would continue to act as a valve for any trapped air. They might have to repeat the process, but for now it seemed to have done the trick. Long enough, at least, for them to get the girl to the air ambulance, where she would be able to get an oxygen mask and other critical assistance.

  ‘Are you ready for me to start the engine?’ Lia asked, not wanting to literally rock the boat if he needed it to be still.

  ‘Yes, we’re good.’ He gave her a nod, his eyes still on Stephanie, two fingers pressed to her pulse point.

  She noted a small flush of colour begin to return to the girl’s cheeks. They were out of the woods for now.

  An hour later, having hitched a ride with the air ambulance crew back to the hospital, Mary, Lia and Oliver were sitting side by side in the waiting room of the St Victoria Hospital, waiting to hear a full report from the emergency team who were in with Stephanie now.

  They saw a couple rush in towards the main desk, their faces frantic with worry, and heard them ask after Mary Thewliss and Stephanie Thomas.

  ‘That’ll be Mum and Dad, then,’ Oliver said, already rising.

  Mary ran to them and fell into their arms, crying again, telling them how frightening it had been, and how two people had come to help. She turned and pointed them out.

  Lia and Oliver crossed to the couple, who introduced themselves as Stephanie’s parents. ‘We’re ever so grateful you saved her life.’

  ‘Well,’ Oliver said humbly, ‘we got her to the right place anyhow.’

  Alive, Lia thought grimly.

  After an incident such as Stephanie had been through, a patient would always end up here, but if they hadn’t been as close as they had...

  She shudde
red, not wanting to go there.

  ‘Will she live?’ Stephanie’s mother asked, barely waiting for an answer as she turned on her husband, berating him for letting the girls go out in the kayak.

  Just as quickly, she began explaining their life story. They were in St Victoria on holiday, to celebrate the girls’ graduation from college. The two of them were best friends—had been since they were young. Couldn’t separate them for love nor money. They were even going to the same university. But the girls found everything interesting—too interesting—and this was what came of exploring unknown territories. She knew they should have stayed in the UK and gone camping. Inland. Where it was safe.

  Lia was impressed with the compassion Oliver displayed as he listened and nodded, assuring Stephanie’s parents that, pending any unforeseen complications, their daughter would be absolutely fine and have one heck of a story to tell.

  Then, after the arrival of the team of doctors who had been cleaning and closing Stephanie’s wounds, Oliver and Lia were free to go.

  ‘What do you want to do about the boat?’ Oliver asked.

  Lia squinted out at the setting sun. Night came early in the tropics and, given how much adrenaline they’d shot in the past couple of hours, she wasn’t up for night sailing.

  ‘I can borrow a trailer from the yacht club and pick up the dinghy tomorrow. I’ll go out and get the boat after work.’

  ‘I can help,’ Oliver volunteered.

  She was about to protest, to say she could sort it, but then she reminded herself that this was the man who had put up with her being completely impossible during the photo shoot.

  As if Oliver had seen her hesitation—the mix of longing and fear—he gave her arm a squeeze, then took a step back as if to give her room to think, ‘You know, I’m actually spending tomorrow at The Island Clinic. I could...if you’re happy for me to drive you home...stay there? Maybe try your famed takeaway?’

  She was ready to protest again. So far they’d only gone into the clinic grounds under the cover of darkness, and had never appeared as a couple.

  She was about to say no when she experienced a lightbulb moment.