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CHAPTER THREE

‘YOU’RE in luck, Kelly, love. They’re short in ED today.’

‘Cool. Thanks, Elsie.’ Kelly was still tucking the long coil of her braid under the elastic band of the oversized shower-cap-type hat that was part of her uniform. ‘For the whole shift?’

‘Yep.’ Elsie was giving her a curious look. ‘I thought you’d be rapt. Isn’t Emergency your favourite place?’

‘It is.’ Kelly nodded and smiled, but her brain had gone into overdrive.

No wonder Elsie had picked up on something being different. Only last week the prospect of a day in the emergency department would have been a treat.

A poignant treat, mind you—it was like having her face pressed to a shop window that contained something ultimately desirable but equally unaffordable—but still an irresistible one.

‘I’m just a bit tired,’ she told Elsie, by way of excusing her lack of excitement. ‘I didn’t sleep very well.’

‘Are you OK?’

‘I’m fine.’ Kelly’s smile was wider this time. Physically, the only thing that had disturbed her rest was the pleasure of experiencing the delicious tingles her body could conjure up with remarkable ease as she remembered the night with her musketeer. ‘Maybe I just had too much excitement the night before.’

‘Hmm.’ Elsie looked unconvinced. ‘You haven’t said much about that. You did have a good time, then?’

‘Magic,’ Kelly affirmed.

So fabulous she couldn’t begin to try describing it. And she didn’t want to, despite sensing that Elsie felt left out and maybe a little hurt.

‘I only went because of you,’ she added. ‘Thank you so much!’

It had been a night of pure magic. One that she intended to treasure for the rest of her life. And that was where the problem now lay. The repercussions that were going to affect a very large part of her life.

Reality couldn’t be allowed to intrude, because she knew without a shadow of a doubt that reality would tarnish, if not completely destroy, the joy of that magic. That was why she needed to keep it private, and not diminish its perfection by talking about it. It was also why the dreadful prospect of Tony Grimshaw recognising her at work had made sleep so elusive.

‘Is Flipper all right?’ Briefly mollified, Elsie was now frowning anxiously. ‘I did wonder if she had a bit of a sniffle on Saturday night. I noticed she was breathless going up my stairs.’

‘Was she?’ Kelly caught her bottom lip between her teeth, her mind whirling in a new direction. ‘I’ll mention it to Dr Clifford. She’s got a check-up scheduled for this week.’

‘But she’s not sick today?’

‘No. She couldn’t wait to get to crèche. As usual.’

‘What day’s her appointment?’

‘Wednesday. Sorry, Elsie. I forgot to say I wouldn’t be working.’

‘Not a problem. That’s why I keep you on the casual list and why you get sent all over the show. Speaking of which—’ Elsie glanced at her watch ‘—it’s seven-thirty already. They will have finished hand-over.’

‘I’m gone.’ Kelly stood on one foot and then the other to pull disposable shoe-covers over her old, comfortable trainers.

‘Report to the nurse manager when you get there. I’m not sure if they need you out front or in the observation area.’

Kelly took the shortcut of some fire escape stairs, as familiar with the layout of this vast hospital as she was with her own home. It was a world of its own in here, and she loved it despite the fact that her dream had never had her working in quite this capacity.

‘Hey, Tom!’ Kelly gave a cheerful wave to an orderly pushing an empty wheelchair in the opposite direction. Then she turned abruptly and chose a different direction when she saw the group of doctors coming behind Tom. She could take another route to the emergency department. She could use the service elevator and avoid any risk of recognition.

At least her uniform should be an effective disguise. The shower cap, the shapeless pink smock and the shoe-covers. Almost the same uniform the cleaners and kitchen staff wore—because, as a nurse aide, Kelly was part of the faceless army of people whose ranks stretched from groundsmen to technicians and kept this busy city hospital functioning the way it should. Making up the dark sky that allowed stars like Tony Grimshaw to shine so brightly.

Emergency should be safe enough, Kelly reassured herself as she sped down the final corridor, past the pharmacy and gift shop. It was rare for someone other than a registrar to make an initial assessment of a need for surgery. Being around the cardiology wards or theatre suites might be another matter, however. Kelly would need to stay on guard.

Not that she was likely to forget any time soon. Not when he was still in her head to this degree. When just a flicker of memory made her want to smile. Forgetting it enough to focus on her job might prove to be a problem, but it soon became apparent that her concern—for the moment, at least—was groundless.

The department was busy enough to keep her completely focussed. Fetching and carrying supplies, taking patients to the toilet or supplying bedpans, dealing with vomit containers and spills on the floor. She’d worked here often enough to be familiar with everything she needed to know. Many of the staff recognised her. One nurse looked particularly pleased to see her when she took a fresh linen bag to hang in the main resuscitation area.

‘Kelly! Just the person I need. You know where everything is around here, don’t you?’

‘Pretty much.’

‘Help me sort out this mess?’ The wave indicated a benchtop littered with supplies that hadn’t been put away. ‘We’ve got an MVA victim coming in, and if it’s still looking like this when they arrive, my guts will be someone’s garters.’

It was fun, working under pressure. Handling syringes and bags of saline and packages containing endotracheal tubes. Things that had once been so familiar. Part of the dream Kelly had been well on her way to attaining.

‘Want any sizes smaller than a seven on the tray?’ she asked the nurse. ‘Do you know what’s coming in?’

‘Something major.’

More staff were beginning to assemble in the room.

‘Where’s Radiology?’ someone called. ‘And the surgical reg—is she on her way?’

‘I’d better get out of here,’ Kelly said.

‘No! Look!’

Kelly looked. Cupboard doors were open below the bench, with supplies spilling into a heap on the floor. They encroached over the red line on the floor that was there to keep unnecessary personnel from the area around a patient. Right at the head of the bed, too, where the person responsible for the patient’s airway would be in danger of tripping over them.

Swiftly, Kelly crouched and began to stack the awkward packages back into the cupboards, so focussed on doing it as quickly as possible she barely registered the increasing level of activity behind her.

And then suddenly the double doors were pushed open and controlled chaos ensued.

‘Seventeen-year-old, pushbike versus truck,’ a paramedic informed the receiving doctor. ‘Handlebar of the bike penetrated the left side of his chest. Intubated on scene and decompression attempted for a tension pneumothorax. Oxygen saturation’s currently—’

Kelly was rising slowly to her feet, her back to the bench, and she slid sideways to get out of the way, horrified at being somewhere she had no right to be. Her gaze was none the less fixed on the scene so close to her. The transfer of the patient from the ambulance stretcher to the bed.

‘On the count of three. One…two…three!’

There was a reassessment of all the vital signs, like heart-rate and blood pressure and respiration rate. None of them was looking good. Monitors were being hooked up and requests being called for more equipment and extra personnel. No one had time to notice Kelly, still standing in the corner.

She knew she had to leave. There was no way a nurse’s aide could be any use at all in the kind of life-and-death drama about to be played out in here.

Bags of intravenous fluids were being clipped to overhead hooks. The doctor in charge of the airway was bag-masking the teenage boy, his eyes on the monitor screen that was showing him how much oxygen they were getting into his circulation. He didn’t look happy with the figures he could see.

‘Saturation’s dropping. We’re below ninety percent. And what the hell’s happened to that ECG?’

An electrode had been displaced while moving the boy from the stretcher to the bed. Nursing staff were busy cutting away clothing and hadn’t noticed the lead dangling uselessly, tangled up with the curly cord of the blood pressure cuff.

Without thinking, Kelly stepped forward into a gap, untangled the lead, and clipped the end back to the sticky pad attached beneath the patient’s right collarbone.

‘Thanks.’ The doctor hadn’t taken his eyes off the monitor, and Kelly could see why. The trace now travelling across the screen was erratic, and the unusual shapes of the spiky complexes suggested that this young boy was in imminent danger of a cardiac arrest.

Another doctor had his stethoscope on the less injured side of the chest. Was it proving too hard for one lung to function well enough to sustain life? Was the heart itself badly injured? Or was this boy simply bleeding too badly from internal injuries to make saving his life an impossibility?

Kelly was back in her corner. Transfixed. She could feel the tension rising with every second that ticked relentlessly past. With every command from the emergency department specialists, who were finding it difficult to gain extra IV access and infuse the blood volume that was so desperately needed, judging by the way the blood pressure was continuing to fall.

‘Didn’t someone page Cardiothoracic?’ a doctor snapped. ‘Where the hell are they?’

‘Right here,’ a calm voice responded. ‘What are we dealing with?’

Kelly actually gasped aloud as Tony Grimshaw stepped closer to the bed, pulling on a pair of gloves. Not that there was the slightest danger of being noticed. At the precise moment the surgeon finished speaking, an alarm sounded on a monitor. And then another.

‘VF,’ someone called.

‘No pulse,’ another added.

‘Start CPR.’ The order came from the head of the bed. ‘And charge the defibrillator to three-sixty.’

‘Wait!’ Tony’s hands were on the patient’s chest, lifting a blood-soaked dressing to examine the wound. ‘Have you got a thoracotomy trolley set up?’

‘Yes, I’ll get it.’ An ED registrar leaned closer. ‘You’re thinking tamponade? What about a needle pericardiocentesis first?’

‘Wasting time,’ Tony decreed. ‘We’re either dealing with a cardiac injury or major thoracic blood loss that needs controlling. Can I have some rapid skin preparation, please? We’re not going to attempt full asepsis and draping, but I want everyone in here wearing a mask. And let’s see if we can get a central line in while I’m scrubbing.’

Masks were tugged from the boxes attached to the wall as trolleys were moved and rapid preparation for the major intervention of opening the boy’s chest continued. Kelly grabbed a mask for herself. A perfect disguise—just in case she got noticed when she made her move towards the exit.

Except she couldn’t move. A thoracotomy for penetrating chest trauma topped the list for emergency department drama, and staff who had no more reason to be here than she were now finding excuses to slip into the back of the room to observe. House surgeons, registrars and nursing staff were squeezed into the space behind the red lines, and Kelly was trapped at the back. Able to hear everything, and even find a small window between the shoulders of the people directly in front of her, that afforded a good view of the surgeon if not the procedure.

He now had a hat and mask and gown over the Theatre scrubs he had been wearing on arrival. He seemed unconcerned by his audience. Ready to use an incredibly tense situation as a teaching tool, in fact.

‘I’ll use a “clam shell” approach,’ he told the closest doctors. ‘The one you guys would be using if I wasn’t here.’

‘Yeah…right,’ someone near Kelly muttered. An over-awed medical student, perhaps?

She saw the flash of a scalpel being lifted from the sterile cover of the trolley.

‘Bilateral incisions,’ Tony said. ‘About four centimetres in length, in the fifth intercostal space, mid-axillary line.’

Blood trickled down the yellow staining of hurriedly applied antiseptic on the boy’s chest. Kelly was struck by how frail the young chest suddenly seemed.

‘Make sure you breach the intercostal muscles and the parietal pleura. With a bit of luck we might deal with a tension pneumothorax and get some cardiac output at this point.’

They didn’t.

Tony took just a moment to watch the screen, however, and his voice was soft. ‘What’s his name?’

‘Michael.’

‘And he’s seventeen?’

‘Yes.’

‘Family here?’

‘His mother’s just arrived. She’s in the relatives’ room.’

Tony simply nodded, but Kelly was allowing herself to stare at him in the wake of his rapid-fire surprising queries. How had he done that? Made this seem so much more personal? As though he cared more about the patient than demonstrating his obviously not inconsiderable skills? Maybe he wasn’t as hung up on his status as rumour had led her to believe.

She held her breath, watching the swift and decisive actions of this surgeon as he used a fine wire saw to cut though the sternum and then opened the chest with retractors.

‘I’m “tenting” the pericardium,’ he said moments later. ‘Scissors—thanks. Make a long incision like this. If it’s too short, it’ll prevent access to the heart. Suction…’

What would it be like, Kelly wondered, to have this man as a mentor in a career as a cardiothoracic surgeon? Or just to work alongside him as a nurse? To know him on a personal basis?

Maybe she knew him better than anyone else in this room.

A ridiculous thought, given the situation. Given reality. It made her memories of her time with him more dreamlike. Precious, but harder to hang onto. Kelly tucked them protectively into a corner of her mind.

Into that empty space in her heart.

Tony had both hands inside the boy’s chest now, massaging Michael’s heart. ‘Make sure you keep the heart horizontal during massage,’ he told the observers. ‘Lifting the apex can prevent venous filling. I’m aiming for a rate of eighty per minute here, and I’m looking for any obvious bleeding that we need to control.’

The people in front of Kelly were murmuring in awed tones, and they shifted enough to obscure her line of vision. She heard the request for internal defibrillation, however, and could envisage the tiny paddles that would provide a minimal jolt to the cardiac tissue but hopefully restore a more normal heartbeat.

A collective gasp of amazement rippled around the room seconds later, but she could sense no let-up in control of a difficult situation from the star at the centre of this drama.

‘Theatre’s on standby. Let’s get Michael up there while we’ve got a perfusing rhythm.’

There was a new flurry of activity as the open chest wound was covered, and the bed, the monitors and numerous necessary staff members all began moving as a connected unit.

Tony stripped off his gloves, dropping them to the floor and reaching for a fresh pair. His gaze scanned the assembled staff as he took a single step to put him within reach of what he needed. Kelly felt the eye contact like something physical. Almost a blow, the way it sent shock waves through her body. Despite the contact being so brief—less than a heartbeat—the connection was so strong she was sure Tony had to feel it, too. He’d glance back—with a frown, maybe. Needing a second glance without having registered why.

But he didn’t look back. He barely broke his stride as he pulled fresh gloves from the slot on the box and followed his patient towards Theatre.

Maybe he hadn’t seen her. She was unimportant.

Invisible.

‘Wow,’ came a voice beside her. ‘I saw it, but I still don’t believe it.’

‘I don’t believe the mess they’ve left behind. Kelly, would you mind helping clear this up?’

‘Better head back to work myself.’ The first nurse sighed. ‘Guess the excitement’s over.’

Kelly tore her gaze away from the open door that had swallowed the figure of Tony Grimshaw.

Yes. The excitement was definitely over.

‘Are you sure?’

‘I’ve checked three times since you rang this morning, Mr Grimshaw. I’m sorry, but there’s no C. Riley to be found on either the permanent or the casual nursing staff databases.’

‘But…’

‘Are you sure she’s a nurse?’ The woman from Personnel was beginning to sound impatient on the other end of the line. ‘St Patrick’s employs hundreds of people, you know. This Miss Riley you’re trying to locate might be a physiotherapist or a dietician or a social worker—or any number of other things.’

‘But she said…’ Tony paused. She hadn’t actually said she was a nurse, had she? She’d said she worked in a lot of different areas and that her favourite places were Emergency and Theatre. He was standing in the theatre suite right now, and there were people everywhere. Nurses, orderlies, technicians. Even a girl polishing the taps on the handbasins.

There were also two registrars waiting for him at a discreet distance from this wall phone. They were running late for a departmental meeting.

‘Never mind.’ He’d probably started some sort of a rumour by making these enquiries in the first place, but the staff in Personnel weren’t to know why he was trying to locate the woman. It could be to reprimand her or something. ‘Thank you for your help,’ he added.

‘A pleasure. If I hear anything that might be helpful I’ll contact you, shall I?’

Tony could squash any embryonic rumours by saying it really didn’t matter.

But it did, didn’t it?

Since he’d woken up on Sunday morning to reach out and find his bed empty, he’d been unable to get rid of that sense of…loss.

It should have been easy. He’d thought he had it sorted when anger had kicked in briefly. When he’d started feeling as though he’d been used and discarded. But then the doubts had crept in. Excuses his brain was only too willing to come up with on her behalf.

Maybe she’d had a good reason to leave without saying anything. Mind you, there’d have to be a good reason to justify not wanting to repeat that experience. He knew it had been just as good for her as it had been for him. Nobody could fake that kind of responsiveness. Or sincerity. The princess had been genuine and he wanted to find her.

Maybe she was married?

If that was the case, fine. Tony wasn’t about to break up anyone’s marriage. It was this not knowing that was frustrating him. That and the peculiar dream-like quality the whole night had taken on.

But it had been real. Utterly different from anything he’d ever experienced before, but there was no denying it had happened. Or that the impression it had left made it impossible to forget. Perhaps what was really pushing his buttons was the need to prove it had been real. So that he would know what he needed to aim for in his personal life and never allow himself to settle for what had been on offer so far.

Mediocrity. Interest that always became infected with an urge to escape.

‘Thank you,’ Tony said finally, preparing to hang up the receiver. ‘I’d appreciate that.’

His registrar had an armful of paperwork, and there would be a lot more by the end of the usual late Monday afternoon meeting where the cardiologists presented their cases. They would listen to histories, view footage of angiograms showing coronary arteries in various stages of blockage, grade people to score the urgency of intervention and draw up the Theatre list for bypass surgery for the next week.

There would be cases left over from last week who hadn’t made it to Theatre because of emergency procedures taking precedence, and there would be debate over issues such as age and lifestyle and circumstances.

A tedious meeting in many ways. Tony was tempted to leave it to his registrar and attend to something more important. Like yet another check on this morning’s trauma case. Seventeen-year-old Michael was in the intensive care unit, and he was still a sick lad but he was alive. Tony knew his save was the talk of the hospital, but what concerned him was whether the boy would make it through the next critical day or two. Whether he would recover without sequelae that could ruin his quality of life.

The two men he was leading into the meeting room now had been the other musketeers at the ball. Funny how it seemed such a long time ago already. As they sat down around the long table, Tony impulsively turned his head.

‘Josh, you know a lot of the nurses around here, don’t you?’

His registrar grinned. ‘I’m working on it.’

‘Ever come across a Cindy?’

The grin stretched. ‘No. No Barbies, either.’

Tony’s smile felt strained. This should feel like a joke but it didn’t. He nodded at colleagues entering the room, noted that the audiovisual gear wasn’t ready yet, and lowered his voice.

‘Cindy Riley,’ he told Josh. ‘Tall. Long, black hair.’

‘Not the woman you spent most of Saturday night dancing with? Blue dress with a lacey thing down the front?’

Tony gave a slow nod, hopefully not overdoing the effort to appear casual. It wasn’t easy. The memory of that ‘lacey thing’ almost exploded in his head. The way her fingers had assisted him to undo it. The way her breasts had felt when he’d finally got to touch them…

‘Won’t be a moment,’ one of the cardiologists called. ‘We just need another extension cord.’

‘She told you her name was Cindy Riley?’

‘Yes.’

Josh exchanged a glance with the other registrar. ‘And you’re trying to find her?’

‘Ah…yes.’

Josh grinned. ‘Did it occur to you that she might not want to be found?’ he ventured.

‘What on earth makes you say that?’

Josh didn’t respond immediately. Computer printouts were being passed around, listing the cases up for discussion. Tony took his copy but ignored it. He frowned at Josh.

‘It just seems a bit of a coincidence.’ Josh shrugged.

‘What does?’

‘A Cindy Riley. At a ball.’

‘Thanks for coming,’ the head of the cardiology department said, then cleared his throat. ‘We’ve got a lot to get through today, so let’s get started. Case one. Sixty-eight-year-old man with angina occurring with minimal exertion. Investigations so far reveal reduced ventricular function estimated at thirty-eight percent. He has moderate mitral regurgitation. A blocked anterior descending, almost blocked posterior descending, and fifty percent occlusion on his left main.’

The screen flickered into life, and views of dye being injected into coronary arteries were shown from various angles.

Tony was having trouble concentrating. A combination of words had made a loop that went round and round in his head.

Cindy Riley. At a ball.

Again and again the name echoed and merged, and finally morphed into something else.

‘Good grief!’

‘Problem, Tony?’

His soft exclamation had unintentionally reached the presenting cardiologist.

‘Not at all. Ah…could you just rerun that last shot of the left main?’

Josh caught his gaze for a second, the quirk of his lips revealing that he knew exactly why Tony had been surprised.

Cindy Riley.

Cinderella.

No wonder this felt so different. He’d stumbled into a fairytale!