some pressure on that,’ Jennifer directed. ‘Thanks.’ Andrew’s tone was much less appreciative this time. ‘But I do remember the basics of haemorrhage control.’
‘Try to implement them effectively, then,’ Jennifer suggested. She turned back to Liam, her stethoscope in her ears again. The gap in time since she had last had any contact with Andrew Stephenson seemed to have evaporated effortlessly. A casual snipe at each other and they were back to communicating the way they always had. Time clearly hadn’t changed Andrew, but Jennifer was faintly ashamed that she could slip so easily into what she considered an immature and less than professional mode of interaction. She rose quickly, bracing herself against the stretcher as she pulled open another locker. She took out a bandage and one of the largest sterile dressings available, ripping open the packages as she turned back.
‘Fold this up,’ she directed Andrew, handing him the large gauze wadding. ‘I’ll put a pressure bandage on and maybe that will stop the bleeding.’ She tried to smile at Andrew as he looked up—a form of apology for her lapse in courtesy—but he didn’t return the gesture. As Jennifer stooped and began to bind the bulky dressing firmly to his leg, he picked up the towel and dried his face. Jennifer worked rapidly, taking only seconds to finish her task. It was long enough to gain a physical impression of the man, however. The muscle beneath her hands felt like iron. Andrew hadn’t gained an ounce of flab over the years. If anything, he was even leaner than he had been.
‘That saline’s almost run through. You’d better start another unit.’
‘OK.’ Jennifer reacted promptly. Perhaps Andrew was taking more notice of Liam’s condition than the impression he had given. Maybe he would be more inclined to offer his assistance when they had some better facilities available. If they ever got back to the hospital. Mickey seemed to have brought the Land Rover to a complete halt.
‘What’s going on, Mickey?’
‘I’m watching the waves,’ Mickey called back. ‘The wash is right over the road just here and I don’t want us stuck in the middle if we catch a big one.’
At least they were only minutes away from the hospital. They only had to head up the hill a little way and turn onto Napoleon Drive. There was a tense silence in the vehicle as they waited. Jennifer listened to the roar of the surf as it covered the sound of more hail on the roof above them. They moved with a jerk as Mickey accelerated to clear the patch of road between waves. Jennifer leaned closer to Liam.
‘We’re almost there,’ she told him. ‘Don’t worry, Liam. We’ll soon have you sorted out.’
Her patient moved convulsively, coughing and then retching. He was gagging on the plastic airway and the oxygen mask filled up with blood. Jennifer uttered a dismayed oath as she wrenched it clear of his face before he could inhale any of the contents. The airway tube fell to the floor and rolled beneath the stretcher.
‘Get him on his side,’ Andrew ordered crisply.
Jennifer was already doing her best but Liam was a well-built young man and hardly moved when she grasped his shoulders to pull him over. Suddenly it seemed as if Liam was rolling himself onto his side and Jennifer realised that Andrew was beside her, lifting and turning the heavy body with apparent ease.
‘Have you got a suction kit?’
‘On the wall behind you. There’s a clip underneath.’ Jennifer was holding Liam’s head, keeping his airway open. She hoped the rough manoeuvre hadn’t exacerbated any injury. ‘I hope he doesn’t have a pelvic fracture.’
‘I’d say his airway and breathing are more of a priority right now,’ Andrew responded coolly. ‘Here…’ He handed her the tube from the suction kit and switched the unit to full power.
‘You do it,’ Jennifer told him. ‘I need to find another OP airway and a bag mask.’
‘I’m not wearing gloves.’
‘Then put some on.’ Jennifer snatched the tube and cleared the blood from Liam’s mouth and nose. She noted the cut inside his lip, the broken teeth and the probable broken nose, but were they enough to explain the amount of blood in the mask?
‘I’ll find another airway for you.’ Andrew reached into the kit to extract one of the plastic devices. The abrupt halt of the Land Rover caused him to overreach.
‘There’s a bloody great tree blocking the driveway,’ Mickey shouted. ‘I nearly hit the damned thing.’
‘Sorry.’ Jennifer braced herself as the vehicle began reversing. ‘I should have warned you about that. We’ll have to go around the back by the kitchens.’
Andrew handed her the airway. He rapidly assembled the bag mask components and Jennifer plugged the tubing into the oxygen supply before fitting it over Liam’s mouth and nose. She glanced at Andrew.
‘GCS is dropping again. He’s lost his gag reflex and his breathing is getting worse. He’s going to need intubation as soon as we get him inside.’
‘He needs evacuation to the nearest major hospital. You can’t possibly have the facilities to deal with a patient in this condition here.’
‘We’ll have to,’ Jennifer said tersely. ‘We’re the only chance he’s got. There’s no hope of evacuation in this weather.’ She sent Andrew a warning glance. ‘And I’m including you in that ‘‘we’’.’
Andrew shook his head. ‘I told you—I’m no longer a doctor. I gave up medicine nearly a year ago.’
‘Why?’
‘That’s my business.’
The Land Rover had stopped moving again. The engine idled and Jennifer could hear rain on the vehicle’s roof in the silence that followed Andrew’s cool comment. She squeezed the bag she was holding again, turning her astonished stare back to her patient. ‘I don’t care what your reasons were,’ she announced. ‘And you don’t stop being a doctor just because you chucked your job in. Right now I need to assess and stabilise my patient. I need help and I’m going to use whatever resources I can find. Including you.’
The back doors opened and Jennifer moved swiftly, unhooking the end of the stretcher. ‘Bring the lifepack and the suction kit,’ she ordered Andrew. ‘And follow us.’
Wendy and Margaret were both waiting by the open door as Mickey and Jennifer raised the stretcher and wheeled it towards the back entrance of the hospital.
‘Tom Bartlett rang us,’ Wendy informed Jennifer in a rush. ‘Janey and Michelle are here, looking after the other patients. Sue’s coming in as soon as she’s dropped off her children. The treatment room’s clear.’ Wendy took a quick breath. ‘How’s Liam doing?’
‘Not great.’ It was Andrew who spoke as they moved past Wendy. ‘Sats are dropping fast. Probably a tension pneumothorax from the rib injuries.’
Jennifer let Margaret take her place pulling the stretcher. ‘I’ll get a chest-drain kit set up,’ she said, moving rapidly ahead and shedding her oilskin parka as she moved. The astonished stare directed at Andrew by both Margaret and Wendy had not been lost on Jennifer but she couldn’t afford to be distracted by introductions just yet. Within seconds they were all crowded into the treatment room. Mickey, Margaret and Wendy positioned themselves around the backboard as Andrew held the head
