Читать книгу Twice as Good - Алисон Робертс - Страница 6

IT HAD to be the Monday morning from hell.

The aggressive burst of steam that escaped as the autoclave hatch opened clutched viciously at Janet Muir’s fingers. She dropped the stainless steel tongs she was holding and swore softly but vehemently.

‘You should open the door a bit more slowly.’

Janet’s gaze flew to the speaker. ‘Thank you, Dr Spencer.’ Her tone was unappreciative. She snatched the tongs from the floor. ‘If I had ten seconds to spare I would have done exactly that.’

‘Sorry, Jan.’ Oliver Spencer’s smile was contrite. ‘Is your hand OK?’

‘Only third-degree burns. I’ll live.’ Janet pulled the tray clear of the autoclave and deposited it onto the waiting towel.

‘Has that lab result on Jessica Andrews come through yet? She still hasn’t shown much improvement and I think we’ll need to change antibiotics.’

‘Try the fax machine,’ Janet suggested. ‘I haven’t had time to look yet. I had no idea how chaotic things would be with both Josh and Toni away on their honeymoon. Has Dr Singh arrived yet?’

‘No.’ Oliver Spencer looked worried. ‘I’m just going to try ringing her again. Did she usually turn up on time when she was doing that week’s locum for me?’

‘Always. In fact, Toni told me she asked for a key so she could turn up early.’

Oliver glanced at his watch. ‘I wouldn’t call 10 a.m. early. I’ll give her a call while I’m in the office.’ Oliver turned away, then paused. ‘On second thoughts, I’ll do it in my room. Who is making that racket?’

‘Sophie’s next patient.’ Janet sighed. The wailing of a fractious baby was a sound that would get on anyone’s nerves in ten seconds flat. The staff of St David’s Medical Centre had been subjected to ten minutes’ worth so far. ‘Maybe Dr Singh will arrive any minute and rescue us.’

There was no sign of any assistance when Janet hurried back into the main office a few minutes later. The young receptionist, Sandy Smith, was looking harassed.

‘I can’t find the file for Joshua Young anywhere and he’s Sophie’s next patient.’

‘Try Josh’s office,’ Janet advised. ‘There are often a few files lurking in a corner. Has Oliver had any luck tracking down our locum yet?’

‘No.’ Sandy bit her lip and looked even more harassed. ‘I’m supposed to ring the agency. I got distracted, hunting for that baby’s file. He won’t stop crying and the phone never stops ringing. See?’ Sandy pointed to the offending device as the telephone rang to illustrate her point.

‘I’ll get it.’ Janet grinned. ‘You go and see if you can find the file. Don’t worry too much if you can’t. I’m sure Sophie will cope.’

Janet dealt quickly with the phone call. She was about to summon her next patient when Oliver beckoned from the office doorway.

‘I’ve got May Little in my room. Could you do a repeat ECG on her, please?’

‘You’re kidding!’ Janet’s dismay was evident. ‘I’ve got an eighteen-month check and immunisation waiting, and Mrs Endicott is here early for her iron shot and blood test. Miss Little’s ECG last Friday took me half an hour!’

The patient’s name was ironically inappropriate. May Little was morbidly obese and the undergarments she used to try and give her bulk some semblance of shape made Janet think of attempts on Fort Knox. She was also a rather odd lady and Janet sighed at the prospect of another encounter so soon.

‘Is she undressed?’ she asked Oliver pointedly.

Oliver was backing out of the office rapidly. ‘Not quite. I’ll send her down to you.’

‘Can’t you do it?’ Janet pleaded, but Oliver was now conveniently out of hearing range. Janet stepped out of the office and stood beneath the archway that separated the waiting room from the hallway. ‘Sorry, Mrs Endicott. I’ll be a few minutes yet.’

‘I’ve got an appointment with my hairdresser at eleven. I can’t wait all day, dear.’

Janet smiled apologetically. Sandy appeared in the hallway, waving a manila case file triumphantly, and Janet’s smile brightened. ‘Good for you,’ she congratulated her.

The front door opened as the telephone rang yet again. Janet hesitated but went back into the office to help Sandy cope for a minute. The new arrival was a woman who was balancing a child on one hip.

‘I’m Ruth Prendergast,’ she told Janet. ‘I haven’t got an appointment and we don’t even live in Christchurch. We’re just down here visiting my mother but Katy has been to see Dr Cooper once before and she’s really not very well this morning.’

‘What’s the problem?’ Janet smiled at the girl who did look rather pale.

‘I think she’s running a temperature and she won’t eat or drink anything. She’s unusually quiet as well. I know it’s probably nothing but Katy has had a heart murmur since birth and I do tend to worry about her.’

‘Did Dr Cooper know of her medical history?’

‘Oh, yes. He was marvellous. He even rang her doctor in Auckland to check up on things.’

‘How long ago would it have been since you saw Dr Cooper?’

‘I think it was about this time last year.’

Sandy had finished her call. Janet pointed at a row of files separated from the main system. ‘See if you can find a file for Katy Prendergast amongst the casuals there.’ Janet turned back to Katy’s mother. ‘We’ll get someone to look at Katy as soon as we can, but I’m afraid you might have a bit of a wait. As you can see, we’re rather busy. Dr Cooper is away on his honeymoon and our locum hasn’t shown up yet.’ Janet heard Sandy groan behind her.

‘Oh, no! I still haven’t rung the agency.’

Ruth Prendergast was smiling. ‘I don’t mind waiting. I feel a lot better just being somewhere close to medical assistance.’

Janet nodded and smiled. ‘Make yourselves comfortable. There are plenty of books and toys.’ She could see Miss Little standing outside the office door. She was clutching a solid-looking handbag. A tight hat was jammed on her head and her thick woollen coat was firmly buttoned. Not quite undressed, indeed!

Janet ushered her patient into the treatment room and closed the door behind them. ‘We’ll need to get you undressed, Miss Little, so I can take the ECG.’ Janet briskly pulled the curtain to screen the bed from the door.

‘Did you know that you have a cat in your waiting room?’

‘Yes. That’s Outboard. St David’s sort of acquired him quite recently. Did you not see him when you came in on Friday? He loves talking to people in the waiting room.’

‘I don’t like cats.’ Miss Little had made no move to start undressing. ‘They carry germs.’

‘We don’t let him come in here,’ Janet said reassuringly. ‘This is the only place we keep sterile equipment.’ She reached out an encouraging hand to relieve her patient of the handbag. ‘Have you been getting some more chest pain?’

Miss Little backed away, a protective arm now enclosing the handbag. ‘Germs travel. They can go a very long way.’

‘Not this far.’ Janet decided to take a firm approach. ‘Just take off everything down to your petticoat for me, Miss Little. Like you did on Friday.’ Janet collected syringes, a vacutainer and tourniquet as she spoke. She opened a small cupboard to extract an ampoule of injectable iron solution. ‘I’ll be back in a minute or two, when you’re all ready.’ Janet moved briskly. She could do Mrs Endicott’s test and treatment in the side room. At least that would be one empty seat in the waiting area.

Mrs Endicott was delighted at the unexpectedly prompt attention.

‘It’s not that I like to make a nuisance of myself,’ she explained to Janet. ‘I don’t even want to go to the hairdresser today. It’s far too nice a day to sit around for hours having a perm.’

‘It is a lovely day,’ Janet agreed. She tied the tourniquet around Mrs Endicott’s upper arm. ‘Just squeeze your hand for me a few times.’

‘A perfect drying day,’ Mrs Endicott continued contentedly. ‘Monday’s always been my washing day.’

‘Every day’s my washing day.’ Janet deftly inserted the needle and clicked the vacutube into the plastic holder. ‘But not today, unfortunately. I turned the washing machine on this morning and the next thing I knew I had a flood on the laundry floor.’

‘Oh, dear! You’ve got two little boys, too, haven’t you?’

‘Yes. Twins. Adam and Rory.’ Janet removed the full test tube and then pressed a cotton ball to Mrs Endicott’s elbow as she withdrew the needle. ‘They’re six. Nearly seven.’

‘You must have a lot of washing to do, then.’

‘Heaps.’ Janet agreed ruefully. She thought of the pile of muddy jeans, track pants and sweatshirts she had walked out on this morning, and sighed deeply. ‘In fact, it’s quite unbelievable how many items of clothing two small boys can go through over a weekend. If I don’t get the machine fixed tonight, they may well have to go to school tomorrow in their pyjamas.’ Janet picked up a syringe. ‘Let’s get this injection over with and that’ll be you. I’ll ring you when we get the results of this sample and let you know when we need to check your levels again. Hopefully, we’re getting your anaemia under control now.’

Miss Little eyed the blood sample Janet carried back into the treatment room for labelling.

‘I hope you’re not intending to take any blood from me.’

‘Dr Spencer hasn’t ordered any blood tests, Miss Little. I think he wants to see the trace of your heart first.’ Janet looked disbelievingly at May Little’s foundation garment. Was it an antique or did they still manufacture genuine corsets? ‘Can we undo this lacing bit on the front?’ Janet struggled to keep her face straight. ‘I need to stick an electrode on just about here.’ She touched what felt like some steel reinforcement.

‘You just never know, do you?’

‘What about, Miss Little?’

‘What they do with the blood. What they really test it for.’

‘Oh, I don’t think they do anything they’re not asked to.’ Janet clipped the electrodes into place on the sticky patches. ‘They haven’t got the time and it’s all too expensive these days.’

May Little looked unconvinced. ‘They already know too much,’ she informed Janet knowingly. ‘They’re not going to get any of my blood.’

‘Mmm.’ Janet ripped off the rhythm strip. If Miss Little needed a blood test Janet was going to make sure it was Oliver who did the deed. ‘Stay here for a moment, Miss Little. I’ll just get Dr Spencer to have a look at this.’

Oliver was pacing around his consulting room. ‘Would you believe it?’ he demanded of Janet incredulously. ‘The locum agency just rang to ask if we’d had the message from Dr Singh. Apparently her mother took ill and she flew back to India yesterday. They wait until 11 a.m. and then ring to ask if we want someone else.’

‘What did you say?’

‘I said of course we want someone else. We wanted someone else at 9 a.m. Before the waiting room started overflowing.’

Janet winced at the choice of vocabulary. She would have to find time to ring a washing-machine repair firm or she would be in trouble tomorrow morning. Oliver was still speaking distractedly.

‘Poor Sophie’s not feeling at all well herself. She threw up three times before we even got to work.’

‘She’s got the written exam for her GP registration tomorrow, hasn’t she? Is it nerves, do you think?’

‘No.’ Oliver couldn’t suppress a grin as he reached for the ECG trace Janet was holding outstretched. ‘We’re pregnant.’

Janet gasped in surprise. ‘I didn’t even think of that!’

‘Neither did we.’ Oliver was still grinning. ‘Toni did. She thought that was why Sophie was so tired and hungry all the time, but she didn’t miss a period. Twice. They were a lot lighter, she said, but they were still on time. You could have bowled us both over when we got the results of the blood test. I talked a mate into doing a scan over the weekend and it turns out she’s about ten weeks along.’

Janet was nodding vigorously. ‘The same thing happened to me. Exactly. Only I didn’t find out until I was twelve weeks pregnant. Gave the father enough time to swan off and get someone else pregnant.’

‘You’re joking!’ Oliver’s face was a picture of disgust. ‘I never knew. What a bastard!’

‘You said it.’ Janet tried to lighten the atmosphere with a grin. ‘No wonder I was put off men for life, was it? No chance now, even if the twins are desperate for a father.’

‘Did he know about the twins?’

‘No.’ Janet looked thoughtful. ‘I was going to tell him but there didn’t seem much point when I found out about the other woman.’ Janet laughed without a trace of amusement. ‘She was my best friend, would you believe?’

Oliver didn’t look amused either. ‘We’re not all like that, Jan. You’ll find the right person one of these days.’

‘That’s the problem, Oliver,’ Janet said sadly. She kept her gaze on the ECG strip which Oliver appeared to have forgotten he was holding. ‘I thought I had found the right person. I was so sure of it. Now I’ll never be able to trust my own judgment again.’ She managed another smile. ‘Anyway, I’m so pleased about you and Sophie. That’s great news.’

‘Thanks. We’re delighted. At least, I’m delighted and I’m sure Sophie will be, too, when she stops throwing up all the time.’ Oliver finally spread the trace out beside the one already on his desk. ‘That’s good.’ He nodded seconds later. ‘No change at all. Tell her to come back in as soon as she’s dressed.’

‘You’ve probably got time for a coffee,’ Janet told him dryly. ‘Or you could have a quick look at a wee girl in the waiting room. She’s a casual, in town visiting her grandmother, but she’s been here before to see Josh. She’s running a fever and is anorexic. She’s also got a cardiac history of some kind.’

‘OK. Put her in the side room and I’ll be there in a minute. I hope we don’t get too many casuals today.’

‘What did the agency say in the end?’

‘They’ll send someone else. When or if they can find someone. There’s a heavy demand for locums at present. Apparently we’re in the middle of conference season.’

Luckily, Miss Little had decided to dress herself again without waiting for clearance. Janet despatched her towards Oliver’s room. There was an unusual silence in the waiting area as she headed back to the front office. All conversation had stopped. Sandy was staring over the counter, looking slightly pale. Janet’s nose provided the first clue to the new development to the day. Young Katy Prendergast had vomited, dousing both the carpet and the contents of the toy basket. Eighteen-month-old Toby Dawson was openly fascinated. Katy’s mother was appalled.

‘Oh, I’m so sorry! Can I find something to clean up with?’

‘I’ll do that,’ Janet told her. ‘Don’t worry. These things happen.’ She nudged Sandy. ‘Take Katy and her mum down to the side room. Get one of the cardboard containers out of my dressings cupboard in case Katy feels sick again.’

Joshua Young’s mother emerged from Sophie Bennett’s room. Joshua was still howling and his mother looked weary. Her expression changed and her nose wrinkled with distaste as she moved towards the counter. Sophie followed her patient out. Her eyes widened in dismay as she neared the waiting room, then she clapped her hand over her mouth and nose and ran for the toilet, slamming the door hurriedly shut behind her.

Janet donned gloves and quickly gathered a bucket of hot water and disinfectant, tucking a supply of floor cloths under her arm. Toby’s mother was trying to keep the active toddler away from the toy basket.

‘Take him into the treatment room, Margaret,’ Janet suggested. ‘I won’t be long. Sorry to have kept you waiting.’

‘No problem.’ Toby’s mother smiled. ‘You look like you’re having a bad morning.’

Janet nodded wearily. There were still three people left in the waiting room after Margaret and Toby left. One was waiting to see Sophie who had still not emerged from the toilet. May Little was in Oliver’s room and Katy was next in line for his attention. The elderly Mr Beaumont and his wife would have to wait a while longer for their appointment to see Dr Spencer.

Sandy Smith looked ready to cry. ‘I wish Toni was here,’ she told Janet mournfully. ‘I don’t think I’m ready to cope with this job on my own. I’m only a receptionist, not a practice manager.’

‘You’re not on your own,’ Janet told her. ‘I’m here. And this is as bad as it gets around here. Honestly! If you can cope with this, you can cope with anything.’

Sandy sniffed dubiously and Janet patted her arm. ‘Open the windows in here for a while. As soon as I’ve finished with wee Toby I’ll come back and look after the desk and you can have half an hour for lunch. Take a walk by the river and get some sunshine and fresh air.’

Sandy brightened. ‘I could go down to the shops. Outboard’s getting low on cat food and kitty litter.’

Janet eyed the still firmly closed door of the toilet. ‘Get some water crackers as well. They’re supposed to be good for morning sickness.’

Not that there was much of the morning left. Toby and his mother had been waiting for over an hour for their appointment.

‘I’m so sorry,’ Janet apologised again. ‘It’s been chaos this morning. I don’t think we had any idea how disruptive it was going to be, having both Josh and Toni away at the same time. And our locum didn’t show up.’

‘I’m not bothered,’ Margaret assured her. ‘It’s not often I get the chance to sit and read magazines. Where did Josh and Toni go for their honeymoon?’

‘They’re cruising the Caribbean,’ Janet said with mock bitterness. ‘If they send a postcard of some tropical paradise with ‘‘wish you were here’’ scribbled on the back, it will definitely be the last straw.’

Both women laughed, and Toby beamed at the sound. Janet held out her hand.

‘Come and stand by the giraffe, sweetheart. Let’s see how tall you’ve got.’

She recorded the measurement on Toby’s file. ‘He’s shot up,’ she told Margaret. ‘That’s a huge increase since his fifteen-month check.’

‘Goodness knows where he’s getting the energy to grow from. I can’t get him to eat a thing.’

‘Tell me about it,’ Janet said with a grin. ‘The fight I had this morning, trying to get my boys to eat breakfast!’

‘You mean they haven’t grown out of it yet?’

‘It gets worse when they start watching TV,’ Janet warned. ‘All the ads for the new high-sugar, high-fat, junk cereal they keep coming up with. It’s a constant battle.’

‘So what do you give the twins for breakfast?’

‘Porridge,’ Janet said defensively. ‘It was good enough for me when I was growing up and I wasn’t even allowed brown sugar and milk on it.’ She lifted Toby onto the scales.

‘Toby likes porridge.’ Margaret sighed. ‘It’s the meat and vegetables I can’t get into him.’

‘You’re obviously doing quite well enough.’ Janet steadied the toddler before checking the reading. ‘He’s right up the charts for both weight and height.’ She lifted Toby onto the bed and tickled a smile out of her small patient. ‘Do you like porridge, then, Toby?’

Toby nodded happily.

‘I wish my boys did. They say it’s got too many toenails in it.’

Toby looked nonplussed. So did Margaret. ‘Toe-nails?’

‘They’re just the oat husks,’ Janet explained. ‘I make the real stuff that you have to soak overnight. It’s healthier, not to mention a lot cheaper.’ She unbuttoned the fastening on the shoulder of Toby’s bright blue jersey. ‘We’ll take this off, shall we, darling? Dr Sophie is going to come and listen to your chest in a minute and look in your ears and down your throat. Do you think she’ll be able to see the porridge you had for breakfast?’

Toby nodded gleefully. He stuck his arms up helpfully as Janet pulled the sleeves of his jersey clear. She excused herself to fetch Sophie but was waylaid by Sandy, who spoke in a whisper.

‘That funny little man that looks like a garden gnome just came in.’

‘Mr Collins?’

Sandy nodded. ‘He hasn’t got an appointment but he says the doctors will want to see him urgently. What shall I say?’

Janet sighed. Mr Collins was a regular patient. Too regular. ‘What are his symptoms today?’

‘He says he’s got a crushing central chest pain radiating to his jaw and left arm. He’s sweating and nauseated and he’s having palpy something or other.’

‘Palpitations.’ Janet chuckled. ‘You’ll have to borrow Mr Collins’s textbook some time. He doesn’t need it any more. I think he’s learned off every symptom by heart.’ Janet pondered the situation briefly. ‘Tell him to have a seat. Maybe I can keep him happy by taking his blood pressure and doing an ECG. He hasn’t picked a very good day to come looking for a bit of attention, has he?’

Sophie hadn’t quite finished with her patient. She still looked wan as she came into the treatment room ten minutes later.

‘I like powwidge,’ Toby informed Sophie. ‘Wiv toenails.’

Sophie gave Janet a despairing glance and rushed out of the room. Janet had to laugh. ‘I don’t believe this. Let me see if Oliver can come and see Toby. Sophie might be held up for a while. She’s in a rather delicate state.’

It was another fifteen minutes before Margaret was able to take Toby home for his lunch. Sandy took the opportunity to escape for her break and Janet tidied up the treatment room, before moving back to the main office to man the telephones. It was only then that she remembered Mr Collins. He was sitting quietly in the corner of the waiting room. Too quietly.

‘Oliver!’ Janet shouted. ‘Sophie! Come quickly!’

Janet Muir’s strength was out of proportion to her slim build. She had no real difficulty transferring Mr Collins to the floor. She had tilted his head back to open his airway and was feeling his neck for the carotid pulse as both doctors rushed in.

‘No pulse, no respirations,’ she reported. Pinching the elderly man’s nose, Janet covered his mouth with her own and inflated his lungs with two deep, full breaths.

Oliver positioned his hands on Mr Collins’s chest to begin cardiac compressions. ‘Grab the life pack,’ he directed Sophie. ‘And a bag mask unit.’

Sophie was back within seconds. She stuck the electrodes in place and Oliver stopped compressions while they looked at the screen.

‘Ventricular fibrillation,’ Oliver muttered. Sophie had the large sticky pads ready as Oliver cut through Mr Collins’s clothing. He positioned the paddles. ‘Everybody clear,’ he instructed.

Janet lifted the mask away from skin contact. Sandy walked in just as Mr Collins’ body jerked in response to the electrical shock.

‘Oh, my God!’ she said in horror.

‘Grab the oxygen cylinder from my room, Sandy,’ Janet called. ‘And then call an ambulance. Mr Collins has had a cardiac arrest.’

Sandy dropped the tins of cat food and the large bag of kitty litter by the front door. She ran to collect the oxygen cylinder.

‘Good girl,’ Janet said calmly. ‘Now call the ambulance.’

Sandy backed away, staring as Oliver raised the paddles again. ‘Charging to 360 joules,’ he stated. ‘Sophie, get an IV line in as soon as you can and draw up one milligram of adrenaline. Janet, find some lignocaine and some more adrenaline.’

Janet opened the drug cupboard in the treatment room hurriedly to locate the requested drugs. She could hear the wail of the ambulance siren in the distance. She could also hear the loud knocking on the front door. Hoping that Sandy would have the initiative not to allow an early afternoon patient to stumble in on the emergency, Janet grabbed some extra IV supplies and headed back.

‘I’m sorry,’ she heard Sandy calling loudly, ‘but we can’t see any patients just yet. We’re in the middle of an—’

Janet saw the door being pushed open firmly. ‘I’m not a patient,’ she heard the visitor assert. ‘I’m the locum. My God, what’s going on in here?’

‘Cardiac arrest,’ Oliver stated tersely. ‘Come and take over the compressions, would you?’

The newcomer moved swiftly. Janet found herself staring at his back as he crouched over Mr Collins. His hands were positioned unerringly, his compressions smoothly confident. ‘How much adrenaline has he had?’

‘Three doses of one milligram so far.’

‘What about a bolus dose of lignocaine?’

Janet handed the ampoule to Oliver and stepped back. Sophie was ventilating Mr Collins, using the bag mask unit, now attached to high-flow oxygen. Janet stood behind the newcomer, listening to his verbal exchanges with Oliver, thankful she wasn’t needed any closer just now. She was aware of her skin prickling all over. Every word uttered by this man sent a new shiver down her spine.

‘How long has CPR been in progress?’

Oliver glanced at the clock. ‘Ten minutes.’ He injected the dose of lignocaine.

‘Was the collapse witnessed?’

‘Not exactly.’ Sophie was squeezing the bag on the mask automatically. ‘Mr Collins was sitting in the waiting room for a while by himself. He was pulseless but not cyanosed when he was found.’ Sophie glanced up at Janet who bit her lip.

She knew how it would sound. Patients dropping dead in a doctor’s waiting room unnoticed wasn’t exactly a great recommendation for a medical centre. It would seem even worse when it was known that Mr Collins had come in describing the classic symptoms of a heart attack. How could she explain that this patient had turned up repeatedly over the years with the classic symptoms of every ailment known to man. That he’d had baseline cardiological investigations only weeks ago which hadn’t revealed any pathology. That their experienced practice manager, who would have instinctively picked up a genuine emergency, was at present on the other side of the world. The bare facts of the emergency would present a picture of a medical centre that wasn’t up to scratch. Janet didn’t want this locum to have that as his first impression of St David’s.

‘Let’s give this another shot.’ Oliver pushed a button on the life pack. ‘Charging to 360 joules again. If this doesn’t do anything, we’ll intubate.’

The ambulance crew arrived as the interference on the monitor screen settled. The spikes of an effective heart rhythm drifted slowly into view. They all watched for several seconds. Janet moved further back as the number of personnel and supplies of equipment increased. Sandy was standing under the archway, sobbing. Janet put her arm around the young girl.

‘I can’t do this job,’ Sandy groaned. ‘If Mr Collins dies it will be all my fault.’

‘Nonsense,’ Janet said firmly. ‘I’m the one who should have checked on him, and I don’t think he’s going to die. His heart’s started again now. As soon as they’re happy it’s going to keep going, the ambulance will get him into the emergency department and the experts will be able to take over.’

Mr Collins was being lifted onto a stretcher. Janet gave Sandy’s arm a comforting squeeze. She smiled gently at the tearstained face in front of her. At thirty, Janet was only twelve years older than Sandy Smith, but right now she felt old enough to be her grandmother. ‘You go and have a cup of tea and talk to Outboard for a wee while. I’ll help them clear up in here.’

Janet opened the front door to allow the stretcher to be carried out. She reached down and picked up the bag of kitty litter which was still lying where Sandy had dropped it. Oliver was standing up now. He had his hand extended towards the newcomer.

‘Not the ideal way to welcome even a temporary colleague,’ he said dryly, ‘but we’re delighted to see you. I’m Oliver Spencer and that’s my wife, Sophie, who’s about to disappear off to hospital with Mr Collins.’

Sophie was walking beside the stretcher. She looked back and gave an apologetic wave, before heading out the door.

‘I’ve arrived at a bad time. Might it be better if I came back later?’

‘No.’ Oliver shook his head firmly. ‘This morning was total chaos and Mr Collins has just finished it off in style. We’re in dire need of assistance.’ He paused. ‘You didn’t tell us your name.’

No! Janet wanted to shout. Don’t say it. She couldn’t believe this was happening. She had never even remotely prepared herself for this possibility. She stood, frozen to the spot, blindly clutching the bag of kitty litter, using it as a shield against the confirmation she knew she couldn’t avoid.

‘I’m sorry,’ the locum apologised. ‘I thought the agency would have been in touch. I’m Dr James McFadden. Jamie,’ he added as an afterthought.

Of course it was Jamie. Janet had known that the instant she’d heard the accent and tone of the once so familiar voice. The emergency had simply postponed the impact of the knowledge. Jamie McFadden. Past colleague. Past lover. The father of her twin sons. What had she told Sandy Smith so confidently? That this morning was as bad as it ever got around here?

Janet Muir had been terribly wrong.

Things had just become immeasurably worse.