Читать книгу New Surgeon at Ashvale A&E - Joanna Neil - Страница 9

‘THERE you are, young Becky,’ Ruby said with a smile, ‘you’re nice and clean and comfortable now, and I expect you’re ready for some fun.’ She lifted the infant into the air and gently rocked her from side to side, so that she giggled with excitement. ‘Exactly…that’s just what I meant. You are such a lovely baby.’

She drew her back down and held her close for a moment, enjoying the soft, warm feel of her and breathing in the light fragrance of fresh soap. ‘I’ll pop you into your bouncer, shall I, so that you can stretch your chubby little legs for a few minutes while I make your tea.’

Ruby had set up the bouncer in the doorway so that she could comfortably watch the child from the kitchen. Once Becky was happily settled, busy touching her toes to the floor and springing up and down within the harness, Ruby set about preparing her food.

It had been a very odd sort of day, so far, many happy moments with Becky interspersed with worry about her sister…and, on top of that, she was still reeling from the effects of coming face to face with her new boss.

How on earth was that going to turn out: working alongside Sam Boyd each day when they were dramatically opposed to each other’s ideas? Added to that, he already had the notion that she resented him for taking the job she had set her heart on, and she had to admit to more than a few niggles on that score.

After all, she’d worked hard to pass her specialist exams and qualify for promotion. Yet what had she actually managed to achieve? These last few years she’d been driven to succeed, spurred on to do her best for the emergency unit where she’d found joy and heartache in equal measure.

It was never going to be an easy option, working in A&E. They faced huge challenges every day, and now the whole department was facing the threat of closure. Did she really want to go through dealing with the stress of that on top of everything else? She was confused, restless, searching for something that she couldn’t quite define.

Perhaps the fact that her body clock was ticking away in the background had something to do with the way she was feeling. There was no man in her life any more, not since her relationship with Tom from cardiology had turned sour, and she was less hopeful than ever that there was ever going to be a man who would turn out to be everything she wanted. Maybe he simply didn’t exist, or perhaps she was just too cautious.

The trouble was, she had been spoiled by the example of her own extended family. Except for Sophie, who’d had an unfortunate foray into romance with a man who’d left her in the lurch, they were loyal individuals, happy and contented with one another, fulfilled in their relationships. And, as far as Ruby was concerned, no man had ever matched up to the examples she had grown up with.

A few minutes later, as she was spooning hot baby food into a dish, the outer door opened, and Sophie walked into the kitchen. She looked tired, her features pale and drawn.

‘Sophie, there you are, at last. I’ve been so worried about you.’ Ruby abandoned the mix of puréed chicken, vegetables and rice that she had been preparing and went to greet her sister. ‘What happened to you? I expected you back here ages ago.’

Sophie looked at her anxiously for a moment or two. ‘I didn’t…’ She frowned, trying to get her thoughts together. ‘I had to go out…’

‘Yes, you did, that’s true…to the doctor’s surgery, but then you were going to come straight back here, weren’t you?’

‘Was I?’ Sophie frowned, putting a hand to her head as though she was trying to make sense of what was going on. Her dark hair straggled across her cheeks, hiding her face for a moment or two. She reached for a chair and sat down, as though fatigue had overcome her whole body. ‘I’m sorry. It’s just that I can’t seem to think properly these days. I remember there was someone at the surgery…I was worried. I wasn’t sure what to do.’

‘Someone? The doctor, perhaps?’

Sophie frowned. ‘I don’t know. I had to get out of there.’

None of this made any sense to Ruby, and Sophie wasn’t making things any easier. Giving herself time to think things through, she went to fill the kettle with water at the sink and then set it down on the stovetop to heat. ‘I was supposed to go to a meeting. Did you forget about that?’

Sophie’s expression was miserable. ‘I’m sorry. It must have slipped my mind. I didn’t mean to let you down, honestly I didn’t.’

From the doorway, Becky became animated, signalling to her mother in eager baby talk that she was there to be noticed, and Sophie turned towards her.

‘Oh, baby, you’re so beautiful.’ Sophie gave her a sweet smile, her heart-shaped features softening as she looked at her daughter. ‘I love you to bits, angel. I’m sorry I’m such a bad mother to you.’ She glanced at Ruby. ‘It’s getting late, isn’t it? I expect she wants her supper. Shall I give it to her? I see you have it all ready prepared.’

‘Are you going to be able to manage it?’ Ruby sent her sister a concerned look, worried by the general air of weariness that appeared to have descended on her. ‘Maybe if I sit her in the high chair, you could feed her?’

‘Yes, I could do that.’

Ruby went over to Becky and released her from the harness, lifting her into the high chair by the table. Judging by Sophie’s fragile state, she doubted she would be able to do that safely on her own just now. She drew a clean bib out of a kitchen drawer and handed it to her. ‘Here, you’ll need this for her. I’ll make you a cup of tea, and maybe that will help you to feel a bit better.’

‘Thanks, Ruby. You’ve been so good to me, lately.’ Sophie sent her an earnest look. ‘I don’t know how I would have coped without your help these last few weeks. I’ve really appreciated being able to stay here with you.’ Sophie stopped to cuddle her daughter and plant a kiss on her cheek before fastening the bib carefully around her neck.

Ruby checked the dish of baby food to see if the temperature was cool enough, and then she passed it to Sophie. ‘I phoned the surgery, and they told me you hadn’t kept your appointment,’ she said. ‘What happened?’

Sophie frowned. ‘I can’t remember. I think I felt sick and had to go out for some air. I’m not too sure what happened after that. I just started to walk and kept on walking.’

Ruby studied her for a moment or two. ‘You haven’t been sleeping very well, lately, have you? Perhaps you’ll feel better after you’ve had some rest. Then, when you’re up to it, we really need to take you back to the surgery so that the doctor can find out what’s wrong. You can’t go on like this.’

She had the feeling, though, that Sophie was no longer listening to her. Looking over, she saw she was gently coaxing Becky to eat the food, making soft, encouraging noises, as though she was savouring the meal herself.

Ruby sighed inwardly. How were the pair of them going to cope when she wasn’t there to watch over them? She thought briefly about taking a day or two off work, but the image of Sam Boyd crept into her mind, and she imagined those dark brows lifting as he contemplated her lax attitude. She’d been late for the meeting, and if she added time off to that lapse, he would surely have her marked down as unreliable. No, she had to face him on equal terms. It was a matter of pride.

Perhaps she could persuade the next-door neighbour to keep an eye on Sophie and Becky while she went out to work tomorrow? Claire had turned out to be a good friend who was usually glad to help in any way she could.

Either way, it was a worrying situation that had been building up for some time, and it had to be sorted out once and for all. She made up her mind that next time she would go along with her sister to the surgery. That way she could make sure that things went according to plan.

‘Do you think you might be happier going to stay with Mum and Dad for a while?’ she asked, coming to sit down at the table and beginning to pour tea. ‘I think you need someone to look after you properly until you’re feeling better.’

‘Oh, I don’t think that would work out very well,’ Sophie said, shaking her head. ‘Mum and Dad are way too busy. Mum has her job at the office, and Dad has to concentrate on pulling the business into shape. Besides, don’t you remember—they asked me if I would look after the smallholding while Gran and Grandad are away for the next few weeks. I said I would do it…only it would be so much better if you were there with me, and there’s plenty of room at the old farmhouse. I’m not sure I could handle things very well on my own, though. I don’t seem able to think too clearly these days.’

Ruby nodded. ‘I remember.’ The trouble was, Sophie was probably right in thinking she wouldn’t be able to cope, and Ruby didn’t have an easy solution to hand.

Sophie was dejected. ‘I know this place is too small for all of us. I don’t mean to be a burden.’

Ruby frowned. ‘I wasn’t suggesting that I didn’t want you here with me. That wasn’t what I meant at all. I love having you and Becky here…you must know that. It’s just that I think you’re unwell and you need more help than I can give you while I’m working. Of course I’ll come along and stay with you at the old farmhouse, but I don’t think you’re in any state to be left there on your own while I’m out at the hospital.’

Maybe she could make arrangements for someone to keep an eye on her at the smallholding. The local vet, perhaps? He was more of a friend to the family than a professional that they looked to for help on occasion. Ruby and Sophie had even been at school with him. He had his practice close by her grandparents home, and his work often brought him to the farm, where he would check up on the animals.

Sophie didn’t acknowledge any of what she was saying. She seemed depressed, her shoulders slumping as though she was weighed down by an ominous black cloud.

‘I’ll play with Becky for a while, and then I’ll take her upstairs and get her settled down for bed,’ Sophie said a few minutes later as she wiped her daughter’s face clean. ‘After that, I think I’ll have an early night. I’m very tired.’

‘That’s a good idea, but maybe you should have something to eat first. I made a salad, and there’s crusty bread and cheese to go with it.’

‘Okay.’

They ate together in the kitchen, and Sophie perked up enough to ask Ruby about her job at the hospital. ‘You have a new boss taking over from the man who’s retiring, don’t you? Have you met him yet? Do you think things are going to work out for you in A&E with him in charge?’

Ruby’s mouth made a wry twist. ‘I met him today, and he seems to be very determined to push through the changes he has in mind, even though they’re not at all popular. I’m not sure how it’s all going to work out. I expect life in the A&E department is going to be quite rocky from here on.’

A short time later, Sophie helped to clear away the supper dishes and then took Becky upstairs to bathe her and settle her for the night. Ruby went to check on them from time to time to make sure that all was going smoothly, but Sophie seemed to be coping well enough. Once she and the baby were both tucked up in their beds and fast asleep, she slipped next door to ask if Claire would keep an eye on them the following day.

‘I’ll find an excuse to keep popping round,’ Claire said. She was a friendly woman in her early forties, with teenage daughters who simply adored Becky. ‘Don’t you worry. Everything will be fine.’

It was a relief to know that they would be in good hands, and Ruby set out for work next day feeling a little more reassured. She would be able to concentrate on the job in hand, and her biggest worry was whether things would run smoothly in A&E now that Dr Stanford had retired and the new boss was taking his place. With any luck, it would be a seamless transfer.

All was not well, though, she discovered. When she walked into the emergency unit later that morning, after spending some time reviewing patients’ progress in the observation ward, she found that there was a general air of discontent about the place.

‘Okay, so what’s the matter with everyone?’ Ruby asked, taking a quick look around the resuscitation area and then inspecting the assembled crowd in the waiting room. ‘There are far too many long faces around here.’

‘I think you’ve just seen for yourself,’ James murmured. He drew a chart from the pile on the desk and cast a quick glance over the notes. ‘It’s still relatively early in the day, and we’re already stretched tight at the seams.’

‘We’ve had five people brought in by ambulance from rush-hour traffic accidents,’ Olivia added, going over to the whiteboard and writing up more names. ‘And the waiting room is heaving with an assortment of fractures, sprains, nasty infections and people with chest pains.’

‘Sounds like everything’s perfectly normal, then,’ Ruby said with a laugh. ‘It’s a case of heads down and let’s get on with it, to my way of thinking.’

‘Hah! You’d think so, wouldn’t you?’ James’s mouth made a downward turn. ‘Except that two of the nurses are off sick, one of the doctors has gone home to deal with a domestic crisis, and we have no one to replace them.’

Ruby raised her brows. ‘No agency nurses or a locum doctor?’

‘None,’ he answered. ‘Not a one.’

‘Hmm. That certainly is going to make life difficult.’

‘Apparently we’re banned from bringing them in on account of it being too costly, and all overtime beyond a certain level has been stopped.’ James’s tone was edged with annoyance.

‘I almost paged you at one stage, but Dr Boyd said you were dealing with an emergency in the observation ward and we’d cope.’ Olivia pulled a face. ‘I suppose he was right, and we did manage, but we’re run off our feet, and patients are already complaining about waiting times.’

‘I guess Dr Boyd is behind the restriction on agency staff,’ Ruby mused. So he had kept tabs on her while she was working in the observation ward, had he? He obviously had his finger on the pulse of how the department ran, but she could certainly see why the two doctors were feeling under pressure. ‘He didn’t waste any time putting his plans into action, did he? He must be very keen to pull the department into shape.’

‘That’s right. I’m the one who put a stop to the extra staff. It costs way too much to bring in staff from outside.’ A now familiar voice came from behind her, and she swivelled around to see the man himself standing just a couple of feet away. Ruby studied him briefly. He was immaculately dressed, as before, in a dark grey suit and crisply laundered shirt, with a silk tie that was perfect in its understated elegance. ‘What do we have here,’ he asked, ‘a union meeting?’

‘Dr Boyd,’ Ruby acknowledged him. ‘It’s good to see you again…albeit in difficult circumstances.’

‘Call me Sam,’ he said in a brisk tone. ‘No need to stand on ceremony.’ He frowned. ‘As to the circumstances, you should all know from the outset that I don’t believe in letting the grass grow under my feet. It’s important to start as we mean to go on if we’re to have any chance at all of saving the A&E unit. We’re not playing at this. It isn’t a game. It’s for real.’

‘I know. I’m sure we’re all aware of that.’ Ruby made a muted response to his bracing tone. Perhaps he was annoyed because they had been talking about him, and they needed to make allowances for that. She added softly, ‘And I expect the problems that follow will be for real, too. I’ll leave you to deal with the complaints from the patients, shall I, and from the management when we fail to meet targets?’

He acknowledged that with a rueful twist of his mouth. ‘I imagine those will be the least of my worries.’ He gave her an assessing glance, his gaze shimmering downwards over her curves outlined by the soft cotton blouse that clung where it touched and then draped itself loosely over the waistband of her calf-length skirt. ‘Besides, I’m sure I can rely on you to help smooth things over during these difficult times. I hear you’re good at dealing with most problems that come your way. You appear to have a knack for calming troubled waters. Perhaps that’s why the department operated so efficiently while Dr Stanford was winding down for his retirement.’

Ruby’s eyes widened a fraction. Where would he have gleaned that wedge of information? Was it possible that he had been talking to his predecessor? Or maybe one or two of the board members had filled him in on her way of working. They might not have given her the job, but it didn’t necessarily mean they were unaware of her capabilities. Her lips made a wry shape. Perhaps her calm attitude was what had lost her the position. They wanted a lion that would roar and show its teeth.

Sam glanced at James and Olivia. ‘I know this is difficult for all of you, but there’s no point in moping about the situation. What we have to do is prioritise, knuckle down and get on with the job and concentrate on providing the best service we can under the circumstances.’

He turned to James and held out a patient’s file to him, his manner totally businesslike. ‘You examined a man who came in earlier with a broken wrist and suspected head injury after a fall…is that right?’

James nodded. ‘Tony Barton…a young man in his late twenties. I treated him for the wrist fracture and assessed him for brain injury, but his neurological responses were fine. I was getting ready to discharge him.’ He glanced at the file. ‘Are you ready to sign off his notes for me?’

Sam shook his head. ‘His condition has changed, according to the nurse who was following up on him. I’d like you to come with me and take another look at him, please.’

‘Oh…of course.’ James’s colour faded, and Ruby could see that he was wondering if he was in trouble of some sort. He was usually thorough and conscientious in everything that he did, but Sam, being a newcomer, clearly didn’t know that.

Sam nodded towards Ruby and Olivia and then strode off with James in the direction of the treatment room.

Ruby’s gaze met Olivia’s, and the senior house officer rolled her eyes. ‘Does that man ever stop to engage in the niceties of getting to know his colleagues?’ Olivia asked. ‘He’s brisk and businesslike, and his whole attitude is “stop fussing and let’s get on with it”, though I must say he seems half inclined to pass the time of day with you…but as to the rest of us…’ Olivia sucked in a deep breath. ‘He’s only been here five minutes, and I’m already beginning to wish Dr Stanford had delayed his retirement.’

Ruby grinned. ‘I dare say we’ll get used to him, given time. He has a huge task ahead of him, and he’s probably still working on his strategies. I expect he has a heart of gold underneath it all.’

‘We’ll have to dig deep to find it,’ Olivia murmured, moving away in search of her next patient. ‘I have the feeling it’s buried under a ton of steel.’

She could be right in that. Ruby frowned as she riffled through the files in the wire tray. Their new boss didn’t appear to be making any concessions to the fact that he was a stranger in their midst, and that they might have difficulty getting used to this different way of working. It was all or nothing with him.

She glanced through the list of patients waiting to be seen. Her first job was to check on the patients from the traffic accident, and in doing that her time was taken up with a host of complications that had arisen from an assortment of broken bones and punctured blood vessels. Worryingly, one man went into cardiac arrest, and she had to use the defibrillator to shock his heart back into a safe rhythm.

‘He’s back with us,’ she said a few minutes later, addressing the nurse who was monitoring his situation. ‘Give the intensive care unit another call, will you, and see if we can move him over there as soon as possible.’

‘I’ll do that,’ the nurse said.

An hour later things settled down a little, giving her time to attend to a young boy who had been injured during a football match on his local playing field.

‘That was an unlucky game for you, Matt, from the sound of things,’ she said, smiling at the seven-year-old and then inspecting the X-ray film displayed in the light box. ‘When you fell to the ground, you hit it with enough force to break your collarbone. That’s this one, here.’ She pointed out the area of the fracture to the boy and his mother. ‘There’s a line across here that shows the break in the bone.’

She turned to look at Matt once more. ‘The good news is, it should heal up quite well because the two pieces of bone are still in line and touching one another. You’ll need to wear a support sling for a week or two while the bone heals, and we’ll give you some painkillers to help you feel better.’

His mouth made a flat line. ‘If I’d done this in a couple of weeks’ time, when school starts again, I could have had some days off. And I don’t even get a plaster cast for my friends to sign.’ He looked thoroughly disgruntled.

‘Isn’t there any street cred in wearing a sling?’ Ruby lifted a brow. ‘I would have thought you could get some pretty good mileage out of that. And it’s the hand that you write with that’s out of action, isn’t it? I’ll bet you can impress your mates with a left-handed signature.’

His expression brightened. ‘Yeah, maybe.’

His mother smiled as they stood up to leave a few minutes later. ‘I’m sure he’ll milk this for all it’s worth,’ she murmured in an undertone to Ruby. ‘He’ll be playing the part of a wounded secret agent before too long, I’ll be bound.’

Ruby nodded agreement, and gave Matt a bravery certificate as he left the room. It seemed he was already working on his game plan. ‘Tyler didn’t get one of these when he sprained his ankle,’ he said. ‘He only got a badge that was this big.’ His fingers made demonstration of its tiny size.

Ruby laughed and watched them leave before going in search of her next patient. She worked steadily through the morning, dealing with a wide variety of injuries suffered by active young children intent on enjoying their summer holidays to the full, while at the same time keeping an eye on the work of the senior house officers in her charge. Sam was nowhere to be seen.

James had been missing for some time, too, but she caught sight of him when she was heading towards the ambulance bay. An infant with breathing difficulties was being brought in to A&E by ambulance, and she expected him to arrive in the next few minutes.

‘Is everything all right, James?’ she asked now, still continuing on her way. ‘You look as though you’re in shock.’

James fell into step beside her. ‘I’m fine,’ he said. ‘I just don’t know how my patient could have gone downhill so rapidly. One minute he was sitting there, talking to us, and the next his speech started to slur, and he began to sink into unconsciousness. And to think I almost sent him home.’

‘What happened?’

‘Sam—Dr Boyd—did a CT scan and then whisked him up to the operating theatre. He told me to scrub in. It turns out that he specialised as a neurosurgeon originally and then after several years of doing that decided to take up emergency medicine.’ He shook his head in wonder. ‘Everything happened so fast. It seemed like within minutes the anaesthetist was there and the patient was out for the count, and then Sam was cutting a segment out of his skull.’

‘So it was a blood clot causing pressure on the brain?’

James nodded. ‘That’s right. I actually got to suction it out, but then Sam took over and stopped the bleeding. He says we have to watch him for swelling on the brain and seizures, and I have to keep an eye on him. I’m just on my way to talk to the man’s wife. She came in to the hospital expecting to take him home, but now, of course, he’ll be admitted to the surgical ward.’

Ruby glanced at James. ‘You sound as though the experience has opened your eyes in some way. I don’t think I’ve ever seen you quite so shaken up.’

He nodded. ‘Well, he’s not out of the woods yet, and that’s a worry, but thinking about what might have happened, and seeing our new boss at work, has given me something to think about. Not only that, but it’s made me wonder if I ought to consider going in for a surgical specialty after my stint here. Watching him operate really made me see how much of a difference a surgeon can make to someone’s chances of recovery.’

‘Then something good has come out of this. I’m pleased for you, James.’

He made a brief smile and went on his way, while Ruby hurried to the ambulance bay, deep in thought. So Sam was more than just a force to be reckoned with on the hospital administration side of things. He was a first-rate doctor as well. It was more or less what she had expected, but somehow she had thought it might take more time for him to prove himself. At least he had managed to win James over to his side, brisk manner notwithstanding.

She went to meet the paramedics a short time later as they wheeled the infant out of the ambulance on a trolley bed.

‘This is Charlie, eighteen months old,’ the paramedic said. ‘He’s struggling to breathe, and there’s some nasal flaring. His blood oxygen level is low, and he’s in severe distress.’

Ruby could see at once that Charlie was very ill and the muscles of his rib cage were sucking inwards. ‘Let’s get him into the treatment room,’ she said. The toddler was breathing in oxygen through a mask, but she could hear him wheezing, and it was clear he needed urgent help.

Once in the treatment room, she called for a nurse to assist with giving oxygen while she examined the boy. Running the stethoscope over his chest, she heard crackles in his lungs and a wheeze whenever he breathed out.

His mother looked on anxiously the whole time, and after a while Ruby said, ‘He’s feverish and obviously struggling. I believe his air passages could be inflamed, so we’ll try him with a medication to help ease his breathing.’

‘What’s wrong with him?’ his mother asked. ‘He’s had a runny nose for a few days now, but suddenly he seemed to go downhill, breathing fast and getting tired and irritable. He’s been off his food too.’

‘It’s probably a viral infection of some sort,’ Ruby explained. ‘I’ll do a nasal swab and send it to the lab to be sure what we’re dealing with, but in the meantime we’ll concentrate on supporting his breathing. We’ll keep him in our observation ward for the next twenty-four hours, and then we’ll most likely have to move him to the paediatric ward for a few days. The nurse will explain everything to you and make arrangements for you to stay with him if that’s what you want to do.’

‘Yes, I do. Thank you.’ The young woman leaned over and stroked her child’s hand, offering him comfort, but the boy was too ill to respond. He just lay there, unmoving, strands of his hair curling damply over his forehead.

‘Here, take a seat,’ the nurse said, pulling a chair to one side of the bed. Michelle was a capable girl, slender and pretty, with dark hair that fell in a sleek bob to the nape of her neck. ‘I’m sure he knows that you’re here with him, and that will help to ease his distress.’

Ruby knew that she was leaving the mother and child in good hands. She wrote up the boy’s chart, detailing the medication to be given, and then arranged for the nasal swab to be sent to the lab. ‘I’ll look in on Charlie again soon,’ she told the mother, knowing that the nurse would let her know if any problem came up in the meantime.

‘So there you are,’ Sam greeted her as she walked back into the main area of A&E. ‘I’m afraid we have to prepare for another intake of crash victims. There are expected to be around ten of them, according to the paramedics at the scene. The first will be arriving in about fifteen minutes, they say.’ He shook his head. ‘I can’t imagine what’s happening out there on the roads today.’

‘People are travelling to the coast for holidays, or driving back home,’ she guessed. ‘I suppose that means there’s a lot more traffic out there.’

‘Maybe.’ He paused. ‘Before we get ourselves immersed in the chaos of dealing with the intake and I lose sight of you again for the next hour or so, I wanted to ask if you know anything about what the situation is here with the domestic staff. We don’t seem to have a proper clean-up crew—to attend to mishaps and the like in the waiting room. There just seems to be a couple of ward assistants who bring round the coffee, or tend to the book trolley, and descend on the unit if and when they’re called for. I’ve been asking various people, but no one seems to want to give me a proper answer.’

‘Hmm.’ Her brow knotted. ‘I believe you’re talking about Dolly and Mabel. Don’t you go upsetting either of them. They’re our in-house treasures. We rely on them for all sorts of odd jobs, and I don’t think people would take kindly to you striking them off the staff list.’

‘No, probably not.’ He studied her thoughtfully. ‘You’re frowning,’ he said. ‘I have the strong feeling that it’s because of me, or something I’ve said. I’ve been getting a lot of that today. Would you care to enlighten me?’

‘Well, I know the situation here is serious,’ she murmured. ‘Times are hard, and we all have to pull together to get the job done and all that…but I think you really need to try and loosen up a bit.’ She hesitated, not wanting to go too far. He was the one in charge, after all.

‘I do?’

She shrugged her shoulders, giving in to his gentle prompting. What would it matter if she were the one to tell him a few home truths? No one else would consider doing it. ‘Quite definitely. We really shouldn’t lose sight of the human touch, you know. We aren’t in the boardroom now, and even the most difficult of tasks can be made sweeter with a modicum of pleasantry.’

He raised a dark brow. ‘You’re saying you think I’m too abrupt?’

She made a vacillating kind of movement, as though she was weighing things in the balance. ‘I’m afraid you run the risk of alienating the people you depend on,’ she said.

He made a face. ‘I dare say you’re the one to put me right on that score. From what I’ve gathered this morning, I’m sure you’ll be well able to assist me in pulling things into shape. You’re the one topic people are prepared to talk about. I’ve been hearing nothing but glowing accounts of your capabilities in this department.’

‘I’m sorry about that,’ she said with a laugh. ‘You sound as though it’s beginning to grate on your nerves.’

‘Not at all. It’s good to know that we have such a diamond in our midst. I’ll be glad of all the help I can get.’

‘We’ve always been a happy crowd here at Ashvale A&E.’ She didn’t add, before he came along, but he probably caught her meaning.

‘I guess I’ve a lot to learn.’ It didn’t seem to bother him, though. He glanced at the watch on his wrist. ‘Anyway, back to the immediate problem. I’ve asked Michelle to do triage, the senior house officers will take the urgent cases, and you and I will deal with the most seriously injured. It means we’ll be running at full tilt with a minimum of staff.’

He checked the whiteboard, assessing the number of patients still in attendance and needing to be seen. ‘I’ll have a word with the nursing sister on duty and see if we can have some of her specialists attend to the less serious cases in the waiting room. That should clear the backlog.’

He glanced at her as though looking for confirmation, and she raised a brow. ‘Are you asking if I agree? I told you, if you were trying to save money, I think you should have looked to cutting down on the maintenance contracts before you went ahead and dispensed with nursing services. We don’t need to have the light bulbs checked once a month, or have laundry sent to an outside company when we have perfectly adequate facilities on the premises. Nor do we need to order paper plates on a regular basis when we have dishwashers and crockery on site.’

His mouth made a crooked shape. ‘I wasn’t looking for a debate on the whys and wherefores. A simple “yes, that sounds about right” would have done.’ His eyes took on a glimmer of amusement. ‘I was attempting to keep you in the loop, so to speak, since it’s fairly obvious you’re the lynchpin around here. Is there anything else you think we need to have in place?’

She thought about it. ‘Yes,’ she murmured after a second or two. ‘We need doughnuts.’

‘I beg your pardon?’ He looked at her as though for a moment she’d lost the plot.

‘You won’t get by without them,’ she said on a firm note. ‘If you expect your staff to work through their lunch breaks and keep going without flagging, you’ll have to do something to boost their energy as well as their morale.’ She gave him a bright smile. ‘I’ve always found that doughnuts hit the spot. Mark my words. A little bit of sugar goes a long way.’

‘I’ll try to remember that,’ he said. He threw her a teasing look as his gaze wandered over her softly feminine curves. ‘You’re not on any kind of diet, are you? So if I were to feed you sugary sweet doughy treats, would that help to bring you on side? I could rely on you to be my right-hand woman?’

She sent him a direct grey glance. ‘I certainly won’t say no to the food…but as for any other outlandish expectations you might be harbouring, I wouldn’t push your luck, if I were you. I’m only ever on the side that looks to be about right.’

He tilted his head back in a resigned gesture. ‘I might have known,’ he murmured. His mouth curved. ‘Still, it was worth a try.’