the blood supply. No doctor could assume an unconscious patient couldn’t feel pain. It didn’t matter that Jack hadn’t responded to the painful stimuli that Nathan had tried as part of the assessment. His breathing wasn’t compromised so they had to administer some general pain relief before they started.
His arm fracture was obvious, with the bones displaced. Thankfully, they hadn’t broken the skin so the risk of infection would be small.
Rachel spun the ampoule she’d just drawn into the syringe around towards Nathan so he could double-check the medicine and the dose. He gave a little nod of his head while she administered it.
He couldn’t help but give a little smile as she positioned herself at Jack’s shoulder. ‘Do you remember how to do this?’
She shook her head. ‘Of course not. Why do you think I’m in the anchor position? The responsibility for the displaced bones and blood supply is yours.’
Of course she was right. It would have been years since she’d been involved in repositioning bones. He’d done it three times in the last month.
It only took a few minutes to reposition the bones and put a splint underneath the arm. The most promising thing was the grunt that came from Jack.
‘Can you patch that head wound?’ he asked. ‘I’m going to arrange to medevac Jack back to the mainland.’
Rachel opened the nearest cupboard and found some antiseptic to clean the wound, some paper stitches and a non-adhesive dressing. She worked quickly while he made the call. She waited until he replaced the receiver and gave him a nervous smile. ‘I haven’t sutured in a while so I’ve left it for the professionals.’
He nodded. It was good she wasn’t trying to do things she wasn’t confident with. She’d just been thrown in at the deep end and coped better than he’d expected. If the shoe was on the other foot and he’d found himself in the middle of a medical unit, how well would he do?
He might be able to diagnose and treat chest infections, some basic cardiac conditions and diagnose a new diabetic but would he really know how to treat any blood disorders or oncology conditions off the top of his head? Absolutely not.
Nathan picked up the phone and dialled through to the emergency number. Thank goodness he’d checked all these yesterday when he arrived. It didn’t matter that Lewis had told him nothing would happen. Working for Doctors Without Borders had taught him to be prepared.
The call was answered straight away and arrangements made for the dispatch of the medevac. ‘It’s coming from Proserpine Airport. We’re in luck; they were already there.’
Her sigh of relief was audible and he joined her back at the trolley. Jack still hadn’t regained consciousness. Nathan took a few more minutes to redo the neuro obs and stimuli.
‘Do you know where the medevac will land?’
He gave a nod of his head. ‘Can you go outside and find Ron? We’ll need some help transporting Jack down to the beach. They’ve probably cleared the landing spot already.’
She disappeared quickly and he sucked in a breath. This was a whole new experience for him. They’d trained together at university and spent their first year working as junior doctors in the same general hospital. But they’d never actually done a shift together. She’d done her six months medical rotation first while he’d done his surgical placement. They’d swapped over six months later.
He’d already known he wanted to specialise in surgery at that point, whereas Rachel had expressed a preference for medicine. They’d applied to the same hospital in Melbourne and been accepted to work there. But he’d been unable to take up his job and had a frantic scramble to find another in England. He’d always assumed that Rachel had just carried on without him. Now he wasn’t so sure.
Ron’s sweaty face appeared at the door. He’d really need to check him over at some point. ‘‘Copter should be here in a few minutes. Once it’s down, there are four guys outside to help you carry the stretcher.’ His brow creased as he glanced at Jack. ‘How is he?’
Nathan gave a little nod. ‘We’ve patched him up as best we could but he’s still unconscious. Hopefully, he’ll wake up soon.’
Ron disappeared and ten minutes later the thwump-thwump of the helicopter could be heard overhead. A wave of familiarity swept over him. For a few seconds he was back in the sand, war all around, his stomach twisting at the thought of what throwing back the medevac door would reveal. But then Rachel rushed back in and the moment vanished. He finished another blood pressure reading and pupil check, then disconnected the monitor.
He pulled the blanket over Jack’s face to protect him from the downdraught and any flying sand but it actually wasn’t quite as bad as he’d expected. Helicopters didn’t faze him at all. He’d spent the best part of five years travelling in them and pulling patients from them. But Rachel looked terrified.
She ducked as they approached the helicopter even though the spinning blades were high above her head. Several of the crew members did the same. The paramedic flung open the door and jumped down.
The handover only took a few seconds. ‘Jack Baker, twenty-four. A few tons of sand-filled barrels landed on him. Suspected broken ulna and radius, blood supply looked compromised so it’s been realigned. Unconscious since the accident. GCS six with recent response to pain. His right pupil has been sluggish. No problems with airway. Breath sounds equal and abdomen soft.’ He handed over the charts he’d made, along with a prescription chart and Jack’s notes. ‘He’s had five of diamorphine.’
The paramedic nodded as he anchored the stretcher inside and started connecting Jack to his equipment. His eyes met Nathan’s. ‘Our control centre will give you a call and keep you updated.’
Nathan pulled the door closed and backed off towards the trees next to the beach. The water rippled as the blades quickened and the helicopter lifted off. After a few minutes the members of the crew started to disperse, mumbling under their breath as they headed back towards the accident site. It would take hours to clean up. It would take even longer to write the report for the insurers.
Nathan started to roll up his khaki shirtsleeves. Report writing could wait. He’d rather be involved in the clean-up and get a better idea of the general set-up. Health and Safety might not be his direct responsibility but, as one of the doctors on the island, he didn’t want to have to deal with something like that again.
Something caught his eye in the foliage next to the beach—a little flash of pink. It wasn’t the tropical flowers that he’d spotted earlier; they’d been yellow, orange and red. This wasn’t fauna. This was man-made.
Rachel was sitting on the edge of the beach, just as it merged with the dark green foliage. Her pink cotton T-shirt stood out. She hadn’t even noticed him, her knees pulled up to her chest and her eyes fixed on the sky above.
He bit his lip. He couldn’t leave her there like that. She wasn’t used to trauma. She wasn’t used to accidents. This was totally out of left field for her.
Part of him wanted to walk in the other direction. The Nathan of eight years ago wanted to leave her sitting there alone. But the Doctors Without Borders medic wouldn’t let him. In his five years he’d never once left a colleague alone after a traumatic incident. He wasn’t about to start now.
His legs moved before his brain started to function. They were on automatic
