not clanging,’ Ruby responded. ‘And he is a doctor.’
Jamelia gave an eye roll and went back into Resus, having clearly decided that Ruby had no idea what she was talking about, and Ruby waited for a shrug from Siobhan as Jamelia headed off. Instead, Siobhan was reading through his obs and calling Reception to ask them to hurry up with Bill’s history.
‘What’s clanging?’ Siobhan asked, and saw Ruby blink. ‘I don’t claim to know everything,’ Siobhan said, and maybe Ruby was seeing things, but for a second there she thought Siobhan smiled. ‘Just most things.’
‘When they’re manic, sometimes they do things with words, and it makes no real sense—like not, hot, cot, dot, or … just vague association. He’s not doing that now, he just can’t get his words out, but they’re lucid words. He’s trying to tell us that there’s something very wrong.’
‘Well, bring him over if you’re worried,’ Siobhan said, and she gave a sigh when Ruby just stood there. ‘Ruby? Do you want to bring a patient over to Resus?’
‘Yes,’ Ruby finally said.
‘Then I’ll give you a hand.’
And Ruby got it a little bit then. It was indecision that was the enemy in this place, because even if she wasn’t sure if it was the right one, as soon as she made the call, whether she turned out to be right or wrong, Siobhan, it would seem, supported her.
So they took off the brakes and wheeled Bill over. Cort was probing an abdominal wound and looked up as they came in.
‘Ruby’s worried about this patient,’ Siobhan explained. ‘He’s waiting on Psych, but she’s looked after him before and says this presentation is unusual for him.’ Which was a far more efficient way than Ruby would have described it!
‘I’ll take a look in a moment,’ Cort said, and frowned as he glanced at Bill, who was breathing more rapidly and was much more sweaty now. As Ruby attached him to the monitors the alarm went off loudly as the cuff inflated and blew up higher to get an accurate reading.
‘Has he had bloods taken?’ Cort checked, and Siobhan nodded.
‘He’s hypertensive. Jamelia gave him some diazepam earlier as well.’
‘I’m not, not, not, not …’ Bill begged, and Ruby tried to reassure him.
‘We know you’re not well, Bill. The doctors are sorting out what’s wrong.’
‘Ring the lab,’ Cort called, ‘and ask them to push his bloods as urgent.’
Ruby did so, only to find out that they hadn’t got them yet. She looked and there they were, still sitting in the chute basket, so Ruby hurriedly sent them.
‘Get Jamelia to come and take another look,’ Cort called, but just as Ruby was about to, Bill let out a strange cry and before it had properly registered, she knew, just knew, that he was going to start seizing. Ruby moved quickly, lowering the head of the bed and pulling out the pillow, while Siobhan put oxygen on him as Sheila came speeding over with the cart and a worried Jamelia running in too.
‘He’s stopped,’ Sheila said, but within seconds, even as she pulled up some medication, he was seizing again, and Cort finished up what he was doing, ripped off his gloves and came over.
‘He was fine …’ Jamelia said, but Cort just ignored her, giving Bill some sedatives. When he continued to seize, he told Sheila to urgently page the medical team.
Bill’s blood pressure was becoming elevated and each seizure was running into the next. All Ruby could think was that he didn’t deserve this.
‘He said this wasn’t normal for him.’ Ruby heard her own voice, but apparently from the lack of response, she was the only one who did.
‘Ring the lab,’ Cort said. ‘Tell them we need those bloods.’ Ruby did so, waiting on the line as they ran some rapid blood tests and delivered the news that Bill’s sodium was dangerously low.
‘At least we know what we’re dealing with.’
They hung some saline, and the medical team worked on him till finally his seizures were halted. But Bill was clearly very sick, and instead of the psychiatric ward he was transferred to ICU. Ruby even went with Siobhan to take him up and hand him over.
‘Nice call,’ Siobhan said, and gave a compliment in her own backhanded way. ‘You have to go with your gut sometimes, even if you have no idea what you’re basing it on …’
Though it was nice of Siobhan to say so, Ruby was incensed on her patient’s behalf, annoyed at how he had been dismissed, and that anger simmered inside her all night, especially when Jamelia carried on as if nothing had happened.
It was just a horrible, busy, chaotic night, though there was order to the chaos and, Ruby realised, even if she didn’t like the bubbling anger inside her, even if resentment didn’t generally suit her, it helped to be carrying some in a place like this. When a group of revellers noisily crossed all boundaries and spilled into Resus, where behind a curtain Ruby had just finished inserting a catheter, to demand when they’d be seen, it was actually Ruby who dealt with them—all five and a bit feet of her. She covered her patient, the poor woman clearly distressed by the intrusion, and Ruby ripped off her gloves and strode over to the three angry men and shooed them out. Sheila, who had been about to summon Security from the waiting room, smothered a smile and replaced the phone.
‘You do not come in here!’ Ruby was enraged. ‘Go back down to the waiting room and when it’s your turn you’ll be called.’
‘Ah, come on, darling …’ They made a few comments about her temper and her hair and Ruby just stood her ground, told them that if they took one step further, she’d have them removed, and she meant it. Absolutely, she meant it.
‘They’re gone.’ She went back in and reassured her patient. ‘I’ll go and get you some water. The doctor wants you to drink a lot.’
‘You did well,’ Cort said as he made himself a drink, while Ruby banged about in the kitchen where she was getting a jug of water for her patient. For a second there she thought she was about to get to say her piece, that finally the way Bill had been treated was about to be acknowledged, except Cort was talking about something else. With the drunks bursting into Resus.
‘It’s good to assert yourself,’ Cort pushed, but still she said nothing, this mini red tornado in the kitchen, and he wanted her to talk to him, to open up to him, to treat him as she did others, so he pushed a little further. ‘You’re angry?’
‘Yes,’ Ruby said. ‘I’m angry.’
‘Which is fine—’
‘Well, I don’t like it,’ Ruby said. ‘I prefer enjoying my work to walking around …’ She couldn’t say it, couldn’t let rip without criticising Jamelia and she didn’t want to do that, so she just ignored him, because they’d used up all the free tokens that had come with their first night together. But Cort wouldn’t let it slide, Cort wanted the ten minutes of Ruby that her friends and colleagues seemed to get.
‘Walking around?’ Cort continued. ‘Walking around, what?’
‘Angry,’
