Читать книгу The Playboy Doctor's Proposal - Алисон Робертс - Страница 8

‘YOU’RE not!’

‘Yes, I am. What’s the big deal? It’s only a few days off work.’

‘You never take days off work. In all the time I’ve known you, Hannah, and that’s, what—three years? You’ve never missed a shift.’

Senior Nurse Jennifer Bradley collected the paper emerging from the twelve-lead ECG machine and Dr Hannah Jackson cast an experienced eye over the results.

‘Bit of right heart failure—there’s notching on the P waves but everything else looks pretty good for an eighty-six-year-old. No sign of infarct.’

The elderly patient, who had been sound asleep while the recording was being taken, suddenly opened her eyes.

‘Give it back,’ she said loudly. ‘You’re a naughty girl!’

The complaint was loud enough to attract the attention of several staff members near the central desk. Heads turned in astonishment and Hannah sighed inwardly. One of them would be her fellow senior registrar, Ryan Fisher, wouldn’t it? And, of course, he had a grin from ear to ear on overhearing the accusation.

Jennifer was stifling a smile with difficulty. ‘What’s the matter, Mrs Matheson?’

‘She’s stolen my handbag! I’ve got a lot of money in my purse and she’s taken it, the little blonde trollop!’

Hannah heard a snigger from the small audience by the central desk. It would have been a good idea to pull the curtain of this cubicle but in the early hours of a Monday morning, with the emergency department virtually empty, it hadn’t seemed a priority.

‘Your handbag’s quite safe, Mrs Matheson,’ she said soothingly. ‘It’s in the bag with your other belongings.’

‘Show me!’

Hannah fished in the large, brown paper bag printed with the label PATIENT PROPERTY and withdrew a cavernous black handbag that must have been purchased at least forty years ago.

‘Give it to me!’

Hands gnarled with arthritis fumbled with the clasp. The bag was tipped upside down and several items fell onto Doris Matheson’s lap. The contents of the opened packet of peppermints rolled off to bounce on the floor and a number of used, screwed-up handkerchiefs were thrown after them.

‘There, I told you! There was a thousand dollars in here and it’s gone!’ A shaky finger pointed at Hannah. ‘She’s taken it! Call the police!’

Ryan wasn’t content to observe now. He was standing at the end of the bed. Faded blue eyes peered suspiciously at the tall, broad masculine figure.

‘Are you the police?’

Ryan flashed the ghost of a wink at both Jennifer and Hannah. ‘I’ve had some experience with handcuffs, if that’s any help.’

Hannah shut her eyes briefly. How did Ryan get away with this sort of behaviour? Sometimes, if he was any more laid back, he’d be asleep. What a shame Doris hadn’t stayed asleep. She was sniffing imperiously now.

‘Arrest that woman,’ she commanded.

‘Dr Jackson?’ Ryan eyed Hannah with great interest. She couldn’t help the way the corners of her mouth twitched. This was pretty funny. It was just a shame it was going to give Ryan ammunition he wouldn’t hesitate to use.

‘She’s stolen my money.’

Ryan stepped closer. He leaned down and smiled at Doris. One of those killer smiles he usually reserved for the women he was flirting with. Which was just about every female member of staff.

Except Hannah.

His voice was a deep, sexy rumble. ‘Really?’

Doris Matheson stared back. Her mouth opened and then closed. Hannah could swear she fluttered her eyelashes and stifled another sigh at the typical feminine reaction to being the centre of this man’s attention. The coy smile Ryan received was only surprising because of the age of their patient.

‘What’s your name, young man?’

‘Ryan Fisher, ma’am.’

‘And you’re a policeman?’

‘Not really.’ Ryan’s tone was that of a conspirator revealing a secret. ‘I’m a doctor.’

The charm he was exuding was palpable. Totally fake but, for once, Hannah could appreciate the talent. It wasn’t being directed at her, was it? She didn’t need to arm herself with the memories of the misery men like Ryan could cause the women who trusted them. It was certainly defusing a potentially aggravating situation here.

‘Ooh,’ Doris said. ‘Are you going to look after me?’

‘You’re about to go to X-Ray, Mrs Matheson,’ Hannah said.

‘What for?’

‘We think you’ve broken your hip.’

‘How did I do that?’

‘You fell over.’

‘Did I?’ The question, like the others, was directed at Ryan despite it being Hannah who was supplying the answers.

‘Yes.’ Hannah looped her stethoscope back around her neck. ‘And we can’t find any medical reason why you might have fallen.’ The cause had been obvious as soon as Hannah had been within sniffing distance of her patient. She hadn’t needed the ambulance officer’s report of an astonishing number of empty whisky bottles lined up on window-sills.

Ryan was smiling again but with mock severity this time. ‘Have you had something to drink tonight, Mrs Matheson?’

She actually giggled. ‘Call me Doris, dear. And, yes, I do like a wee dram. Helps me sleep, you know.’

‘I’m sure it does, Doris.’ Ryan’s tone was understanding. He raised an eyebrow. ‘But it can make it difficult to remember some things, too, can’t it?’

‘Ooh, yes.’ Doris was looking coy again. ‘Do you know, I almost forgot where the bathroom was one night?’

‘Did you forget how much money you might have had in your purse, too?’

‘I never keep money in my purse, dear! It might get stolen.’

‘It might, indeed.’ Hannah got a ‘there you go, all sorted’ kind of glance from Ryan. She tried hard to look suitably grateful.

‘I keep it in the fridge,’ Doris continued happily. ‘In the margarine tub.’

‘Good thinking.’ Ryan stepped back as an orderly entered the cubicle. ‘Maybe I’ll see you when you get back from X-Ray, Doris.’

‘Oh, I hope so, dear.’

Hannah held up her hand as her patient’s bed was pushed away. ‘Don’t say it,’ she warned.

‘Say what?’ Ryan asked innocently.

‘Anything about naughty girls,’ Jennifer supplied helpfully. ‘Or arresting them. And especially nothing about handcuffs.’

‘Not even fluffy ones?’

Jennifer gave him a shove. ‘Go away. Try and find something useful to do.’

They were both laughing as Ryan walked away. Relaxed. Enjoying the diversion of an amusing incident. But Jennifer could afford to enjoy Ryan’s company, couldn’t she? Happily married with two adorable small children at home, she was in no danger of being led astray.

Neither was Hannah, of course. She knew too much about men like Ryan Fisher. Great-looking, fun men like the ones who’d made her mother’s life a misery after her dad died, not to mention the guy who’d broken her sister’s heart not so long ago.

Hannah only ever let herself get involved with nice, trustworthy, serious men like her father had been. She’d believed herself to be totally immune to men of Ryan’s ilk.

Until three months ago.

Until she’d met Ryan Fisher.

Jennifer was still smiling as she tidied the ECG leads away. ‘I still can’t believe you’re taking time off,’ she told Hannah. ‘I’ve never even known you to be sick. You’re the one who always fills in for other people like Ryan when they take days off work.’

Hannah glanced towards the central desk. Ryan—the king of holidays and all other good things life had to offer—was now leaning casually on the counter, talking to a tired-looking receptionist. Probably telling her one of his inexhaustible supply of dumb blonde jokes. Sure enough, a smile was starting to edge the lines of weariness from Maureen’s face.

‘I’m going to check the trauma room while it’s quiet,’ Hannah told Jennifer.

‘I’ll help you.’ Hannah’s news of taking time off had clearly intrigued her friend, who didn’t consider their conversation finished. ‘And there I was thinking that, if I didn’t drag you out occasionally, you’d spend all your time off studying or something.’

Hannah picked up the laryngoscope on top of the airway trolley and pulled the blade open to check that the battery for the light was still functional. ‘Are you saying I have no life?’

‘I’m saying your career takes the prize as your raison d’etre.’

‘I always wanted to be a doctor.’ Hannah snapped the blade back in line with its handle, switching off the light. ‘Now that I am one, I intend to be a very good one.’

‘You are a very good one. The best.’

‘We’ll see.’ The glance between the two women acknowledged the growing speculation within the department over who was going to win the new consultant position. She had been the only serious contender until Ryan had thrown his hat into the ring today. Was that why she was so aware of his presence in the department tonight? Why everything about him seemed to be rubbing her up the wrong way even more than usual?

‘Anyway…’ The wind had been taken out of Jenny’s sails, but not by much. She opened a box of syringes to restock the IV trolley. ‘You don’t need to prove how good you are by living and breathing emergency medicine.’

‘So you’re saying I’m an emergency department geek?’ Hannah tilted the ceiling-mounted, operating-theatre light so it was in a neutral position. It would be fair enough if she was. Hannah loved this space. Fabulous lighting, X-ray and ultrasound facilities, every piece of equipment they could possibly need to cover the basics of resuscitation and stabilisation of a critically ill patient. Airway, breathing, circulation. To be faced with a life-threatening emergency and succeed in saving that life was all the excitement Hannah needed in her life.

Jenny caught her expression and clicked her tongue with mock exasperation. ‘I’m just saying you could do with more in your life than work.’

‘And that’s precisely why I’m taking a few days off.’

‘Touché.’ Jenny grinned, magnanimous in defeat. ‘OK.’ She shoved the syringes into their allocated slot and then used her forefinger to stir the supply of luer plugs and IV connectors, pretending to count. ‘So where the hell is Crocodile Creek, anyway?’

‘Australia. Far north Queensland.’

‘Oh! Has this got something to do with your sister?’

‘Yes. I’ve been invited to a wedding.’

‘Susie’s getting married?’

‘No, though I’m sure she’d be over the moon if it was her wedding. She’s being a bridesmaid to her best friend, Emily.’

‘Do you know Emily?’

‘No.’

‘So why have you been invited to her wedding?’

‘Well…’ Hannah leaned against the bed for a moment. It wasn’t often they got a quiet spell, even at 2 a.m. on a Monday morning and the break hadn’t gone on long enough to get boring yet. ‘Susie didn’t have a partner to invite and we haven’t seen each other since she jumped the ditch and came to New Zealand for Christmas. I’m starting to feel guilty about how long it’s been.’

‘It’s only March and it’s a hell of a long way to go to ease a guilty conscience. Auckland to Cairns is about a six-hour flight, isn’t it?’

‘It sure is.’ Hannah groaned. ‘And then there’s the little plane from Cairns to Crocodile Creek, which will take another couple of hours, I guess.’

‘It must be a long way north.’

‘About as far as you can get. The hospital there is the rescue base for the whole of far north Queensland. That’s why I need the Friday on top of the weekend. I have to get right into the heartland of sugar and cane toads.’

‘Eew!’

‘Actually, it’s right on the coast. It sounds gorgeous.’

‘You’ve never been there before?’

‘No, and Susie’s been living there for as long as I’ve been working here. It’s high time I checked out what my little sister is up to.’

‘I thought you were twins.’

By tacit consent, the doctor and nurse were leaving the trauma room, satisfied it was ready for a new emergency. Hopefully, they’d be back in there soon with some real work to do.

‘She’s four minutes younger than me.’

‘And she’s a physiotherapist, right?’

‘Yeah. She started medical school with me but she hated it. Too much pressure.’

‘You must be quite different.’

‘Personality-wise, definitely. To look at, no. We’re identical.’

‘Wow! Do you have, like, that twin thing?’

‘Which “twin thing” is that?’ They were near the central desk now. Ryan had disappeared, presumably into the only cubicle with a drawn curtain. The nurse on triage duty, Wayne, was sitting, drumming his fingers on the counter.

‘You know, when one twin sprains her ankle, say, here in Auckland and the other twin falls over in a supermarket in central London.’

Hannah laughed, dismissing the suggestion with a shake of her sleek head. But was it so ridiculous? Was it just that she was missing a sister who had always also been her best friend or did those niggling doubts about how happy Susie was have a basis in some form of telepathic communication? Was the urge to travel thousands of miles at a very inconvenient time to attend the wedding of two people she only knew through Susie’s emails just an excuse?

‘Apparently this wedding is going to be great fun.’ Hannah tried to find a more rational explanation for the urge she hadn’t been able to resist. ‘The groom, Mike, is Greek and his parents own a boutique hotel right in the cove. Susie reckons it’ll be the biggest party the Creek has ever seen.’

Jennifer’s peal of laughter made several heads turn.

‘What’s so funny?’ Hannah’s eye was caught by the light on the radio receiver that linked the department with the ambulance service. It was blinking.

Jennifer could hardly get the words out clearly. ‘You’re going to My Big Fat Creek Wedding!’

Grinning, Hannah still managed to beat Wayne to the microphone. ‘Emergency Department.’

‘Auckland four eight here. How do you receive?’

‘Loud and clear,’ Hannah responded, her grin fading rapidly. ‘Go ahead.’

‘We’re coming to you from the scene of a high-speed multiple MVA. The chopper’s just landing to collect a second seriously injured patient who’s currently trapped, but we’re coming to you with a status-one seven-year-old boy.’

The grin had long gone. Status one was as serious as it could get. Under CPR, not breathing or uncontrollable haemorrhage were all possibilities for the priority designation. This ambulance would be coming towards the hospital under lights and sirens.

‘Injuries?’

‘Head and facial trauma. Partially unrestrained front-seat passenger—the safety belt wasn’t latched securely.’

This wasn’t the time to feel angry at someone failing to strap a child into a car seat properly. Or to wonder why they were travelling at 2 a.m. in the first place.

‘Vital signs?’

‘GCS of 3.’

The child was profoundly unconscious. Quite possibly due to bleeding around his brain.

‘Airway?’

‘Unsecured.’ The paramedic raised his voice as the siren came on in the background. The vehicle must be in heavier traffic now. At night, just having the beacons flashing could be enough warning of the urgency of their mission. ‘There’s severe facial trauma and swelling. We’ve got an OP airway in but that’s all.’

The boy needed intubation. Securing an airway and optimising oxygen levels were a priority in a head injury. Especially in a child because they had a greater chance of neurological recovery than an adult after a head injury and therefore warranted aggressive treatment in the early stages. If the paramedics had been unable to intubate due to the level of trauma, it could mean that this was going to be a challenging case.

Hannah could feel her adrenaline levels rising and the tension was spreading. Nearby staff were all listening avidly and the curtain on cubicle 4 flicked back to reveal that Ryan was also aware of what was happening. Hannah’s heightened awareness registered the interest and at some subconscious level something like satisfaction was added to the emotional mix. She was taking this call.

This would be her case, not Ryan’s. Just the kind of case she needed to showcase the skills that would be a major consideration in choosing the new consultant for the department.

‘What’s the oxygen saturation level?’ she queried briskly.

‘Ninety-four percent.’

Too low. ‘Blood pressure?’

‘One-thirty over sixty-five. Up from one-twenty five minutes ago.’

Too high for a seven-year-old. And rising. It could well be a sign of increasing intracranial pressure.

‘Heart rate?’

‘One hundred. Down from about one-thirty.’

Too slow for Hannah’s peace of mind. And dropping. It could also be a worrying sign. ‘What’s your ETA?’

‘Approximately five minutes.’

‘We’ll be ready for you.’ Casting a glance over her shoulder, Hannah could see Ryan moving towards the resuscitation area she and Jennifer had just checked. Not that she was about to decline any assistance for dealing with the incoming case but she didn’t want Ryan taking over. It wasn’t as though there was only one victim arriving, was it? She pushed the button on the microphone again.

‘Do you know the ETA for the chopper?’

‘Negative. Fire service is on scene, though.’

It shouldn’t take them long to cut the second victim clear of the wreckage, then. ‘And that’s also a status-one patient?’

‘Affirmative. Chest trauma. It’s the mother of our patient.’

Ryan would be able to lead the team on that case. In resus 2. Or they could share the main trauma room if necessary. Hannah’s plan of action was forming rapidly as she replaced the microphone.

‘Put out a call for an anaesthetist, please, Wayne,’ she directed. ‘And let’s get a neurosurgical consult down here. Sounds like we might need someone from Plastics, too. Jenny, you’re on the trauma team tonight, aren’t you?’

‘Yes.’

‘And you, Wayne?’

‘Yes. Resus 1?’

Hannah nodded, already moving towards the area. She pulled one of the protective plastic aprons from the large box on the wall. Ryan was already tying his behind his back.

‘Could be a tricky airway management,’ he said.

‘Mmm. I’ve called for some anaesthetic back-up but I’ll see how I go.’ The direct look Hannah gave Ryan could leave him in no doubt that she intended to lead this resuscitation effort. The subtle twitch of an eyebrow let her know the message had been received and understood. It also hinted at amusement rather than intimidation.

‘I’ll stay until the mother gets here,’ he said calmly. ‘In case you need a hand.’

‘Thanks.’ The acknowledgement was perfectly sincere. There was a child’s life at stake here and Hannah would never let any personal considerations affect her performance. She would stand back in a flash if she thought Ryan’s skills would improve the management. Never mind that he would get the credit for managing a difficult case.

It was just annoying that people that mattered were keeping a count of those credits at present. And disappointing that a competitive edge of any kind had crept into Hannah’s working environment when one of the things she loved best about her work was the way a team of people could work together and the only kudos that really mattered was a successful outcome to that work.

The decision on the consultant’s position was only a week or two away. A position that represented everything Hannah was striving towards in a career she was passionate about. Why had Ryan decided to compete at the last minute like this? It wasn’t as if he really needed the position. He didn’t have a massive student loan, the repayments of which would benefit enormously from an increase in salary. He didn’t need to prove himself in a field that was still dominated by males in senior positions. He was an Australian. Auckland wasn’t even his home town.

She couldn’t help flicking a glance towards the tall man who had now donned protective eyewear and a pair of gloves and was lounging at the head end of the bed. Why hadn’t Ryan Fisher just stayed on his side of the ditch? In that Sydney emergency department where he’d honed his not inconsiderable skills? Life would be so much easier if he had. And it wasn’t just due to that professional competition.

Jenny pushed the IV trolley into an easily accessible position and then stood on tiptoe to check that the tubes attached to the overhead suction and oxygen supplies were firmly in place. It was still a stretch for her short stature and Ryan was quick to step forward.

Without a word, he saved Jenny the awkward task and then gave her one of those killer smiles in response to her thanks. The senior nurse turned back to the IV trolley but Hannah noticed the extra glance that went in Ryan’s direction.

Not that he had noticed. The registrar was lounging again, his keen glance taking in the mill of the gathering trauma team and registering the growing tension.

The few minutes before the arrival of a serious case was a strange time. A calm before a storm of unknown proportions. Equipment was primed and ready. Staff were wearing protective gear and waiting. Wayne stood behind a kind of lectern that had the paperwork necessary to document every moment of the resuscitation effort and he was fiddling with a pen.

Hannah had pulled on gloves and was unrolling the airway pack on the top of a stainless-steel trolley. Others were simply standing. Waiting. There was nothing to do until their patient came rolling through those double doors. Nobody liked to speculate in too much detail on what was about to arrive because that could give them tunnel vision. A conversation that required distraction of mental focus was just as unwanted. What usually happened was a bit of gossip or a joke. Light-hearted banter that could relieve tension before it achieved destructive proportions. Something that could be abandoned as easily as begun.

And Ryan could always be counted on to provide a joke that would make everybody laugh.

Everybody except Hannah. She made a point of never laughing at Ryan’s jokes because the vast majority of them were at the expense of women with blonde hair. Like hers.

Sure enough, he was telling one now.

‘So this blonde—Cindy—is in desperate financial straights and she prays for help. “Please, God, let me win the lottery or I’ll have to sell my car.” But she doesn’t win so she prays again, “Please, God, let me win the lottery. I’m going to have to sell my car and my house.”’

Everybody was listening. Or half listening. Waiting for the distant wail of the siren that would advertise that the calm was over. Hannah kept her gaze on the trolley, checking that there was a range of paediatric-sized tubes and that the laryngoscope was still working.

She didn’t have to look at Ryan to know exactly what the image would be. He would be standing completely at ease with just a hint of a smile and a twinkle in those dark eyes that advertised an upcoming punchline. It might be a terrible joke but everybody would be listening and would be prepared to laugh because Ryan commanded that sort of attention. And popularity. Without even trying.

Hannah lips pressed themselves into a thinner line as she made sure that the more serious gear that might be needed for a surgical airway was at hand. No, it wasn’t just the professional competition that irked her. It was the fact that she had been as attracted to Ryan as every other woman who’d set eyes on him from the moment he’d arrived in this department three months ago.

It had been so unexpected. He was the epitome of the type of man she had always steered very well clear of. Despised, even, thanks to the collateral damage she had seen them produce in the lives of women she cared about. One of life’s golden people. She had probably been the first woman ever to freeze out an advance from him. Was that why he was persevering for so long? Did she represent some kind of challenge?

‘She still didn’t win,’ Ryan was continuing. ‘She’s down on her knees, pleading and this time God speaks to her.’ His voice dropped to a deep rumble that Hannah could actually feel in her bones. ‘And he says, “Work with me here, Cindy. Buy a ticket!”’

Sure enough, there was a wave of laughter. A wave that faded with dramatic swiftness, drowned out by the faint wail of a siren. Then the sound of the approaching siren died as it sped onto the hospital grounds with just its beacons flashing. Seconds later, the stretcher appeared. A third crew member was moving rapidly beside the stretcher, a bag-mask unit over the face of the child, trying to keep oxygen levels up on the short journey between the ambulance and the trauma bay.

The team went into action as a unit. The transfer of the small body was smooth—made easier by the fact he was strapped to a backboard with a collar to protect his neck. And although this team was well used to seeing victims of major trauma, it was a shock to get their first close-up view of this little boy.

Waiting at the head of the bed to manage the airway, Hannah sucked in a quick breath that was almost a gasp. No wonder he hadn’t been intubated and it would have been far too dangerous to attempt a nasopharyngeal airway. His nose and mouth were almost lost beneath swollen and lacerated tissue. There were obvious facial fractures and the eyelids were so swollen it was impossible to open them enough to assess the pupils with a torch.

‘Do we know his name?’

‘Brendon,’ one of the paramedics supplied. ‘His mother was initially conscious enough to be calling for him.’

He was wearing pyjamas, Hannah noticed as she leaned forward. Bright red racing cars on a blue background. ‘Brendon, can you hear me?’ She reached over his shoulder. Why had he been in a car in pyjamas instead of safely asleep in his bed? ‘Squeeze my hand if you can hear me, sweetheart.’

A response hadn’t really been expected and Hannah moved swiftly to take the tip of the suction unit Jennifer was holding. The child was moving air but there was a nasty bubbling sound and the probe on his finger revealed an oxygen saturation level that was far too low to be acceptable.

‘Rapid sequence intubation?’

‘If it’s possible.’ Hannah’s gaze flicked up, relieved to find one of the senior anaesthetic registrars now standing right beside her.

Ryan was on the other side of the bed and farther down, moving in to assess IV access and flow and to look for other potential injuries as the pyjamas were cut clear of the small body.

ECG electrodes were being attached. Jennifer was using a bag mask to assist the delivery of oxygen. Hannah suctioned as much blood as she could from Brendon’s mouth and nose.

‘I can’t see anything that clearly looks like CSF,’ she said. Not that that discounted the possibility of skull fractures or spinal damage.

‘Saturation’s down to ninety per cent. Let’s go for the intubation,’ the anaesthetist advised. He took the bag mask from Jennifer and began to squeeze it rapidly, increasing the amount of oxygen reserves to cover the down time for trying to get a tube into Brendon’s throat. He was clearly prepared to provide back-up rather than taking over the procedure.

Hannah drew in a slow breath to dispel any nerves. She heard herself issue instructions for the drugs needed, like suxamethonium to relax muscles and atropine to prevent the heart slowing dangerously. The formula for determining the size of the endotracheal tube was there instantly—the diameter equalled the age of the child divided by four, plus four.

‘I’ll need a 6 millimetre, uncuffed tube,’ she informed Jennifer. ‘And I want you to hold his head while we ease this collar off.’

It was a challenge, easing the blade of the laryngoscope past the swollen lips, broken teeth and a badly lacerated tongue, and Hannah had to use the suction unit more than once. It was an unexpectedly easy victory to visualise the vocal cords and slip the tube into place.

‘I’m in.’ The tone was one of satisfaction rather than triumph, however. There was still a long way to go but at least they were on the way to stabilising a critically ill patient.

‘Well done.’

With her stethoscope now on Brendon’s chest to check for correct tube placement and equal air entry, the quiet words of praise were muted and, for a moment, Hannah thought they might have come from Ryan.

But he was no longer standing beside Brendon. Hannah had been concentrating so hard on her task she had managed to block the sounds of the second patient’s arrival and the stretcher was now being swiftly manoeuvred to the other side of the trauma room.

‘Blunt chest trauma with tachycardia and hypotension. No sign of a tension pneumothorax.’ she heard Ryan stating. ‘We could be dealing with an acute pericardial tamponade.’

Would Ryan attempt a procedure to drain off the fluid inhibiting the function of the young mother’s heart? It would be a very impressive coup as far as patient treatment if it was successful. Hannah couldn’t help casting frequent glances towards his side of the room as she worked with the anaesthetist to get Brendon’s ventilator setting right, supervised the amount of IV fluid that was being administered, started an infusion of mannitol, which could help reduce intracranial pressure, and arranged transfer for an urgent CT scan of the boy’s head and neck.

Sure enough, Ryan was preparing to intubate his patient, cardiac monitoring was established and kits requested for both pericardiocentesis and chest drainage. Ryan looked determined and confident but less than happy about the challenge he was about to face. And no wonder. From what Hannah could see, the woman’s condition was deteriorating rapidly.

Ominous extra beats were disrupting the line of the ECG trace on the screen of the monitor.

There was time for one more, rapid secondary survey on Brendon before he was taken to the CT suite.

‘Some of these bruises look old,’ she commented.

‘Maybe he plays rugby,’ Jennifer suggested.

‘You reckon his mother does as well?’ Wayne had been helping Ryan’s team in the initial preparation of his patient. ‘She’s covered in bruises as well.’

Hannah eyed the clothing remnants Wayne was putting into a patient property bag. ‘Dressing-gown?’ she queried.

He nodded. ‘I don’t think their trip was planned.’

A police officer was standing well to one side of the now crowded area. ‘Have any relatives been contacted?’ Hannah asked him.

‘We didn’t need to. The car she was driving had just been reported stolen.’ The police officer’s face was grim. ‘By her husband.’

Hannah absorbed the information like a kind of physical blow. Was her patient an innocent young victim caught up in a situation involving domestic violence? Had his mother’s desperate bid to protect him ended in a disaster he might never recover from? Would he even still have a mother?

It seemed unlikely. Ryan was sounding uncharacteristically tense as Brendon’s stretcher was taken through the double doors on the way to CT.

‘We’ve got VF. She’s arrested. Charging to 200 joules. Stand clear!’ He looked up as he recharged the paddles. ‘Hannah, are you free?’

Hannah’s hesitation was only momentary. She had been planning to follow protocol and accompany Brendon but he already had an expert medical escort in the anaesthetic registrar. She knew what Ryan would do if the roles were reversed and she asked for assistance. Hannah turned back.

‘I’m free,’ she said quietly. ‘What do you need?’