the Suffolk countryside. ‘Emergency theatre work, mainly. Several casualties after last night’s festive stupidity—I thought you weren’t coming in until tomorrow? It’s a bank holiday today.’
She shrugged and smiled. ‘Thought I’d come and find out where everything was, see if I could help.’
She could see he wasn’t convinced. The scowl lurked in the back of his eyes, and her heart sank even further.
‘It’s all under control,’ he said shortly, snapping the file shut. ‘You should have stayed in bed while the going was good.’
‘It wasn’t that good—the bed. Cold and lumpy, really. Most unappealing. It was no hardship to get out of it.’
His scowl worsened. Oh, damn, she thought, he regretted his impulse. She stifled the sigh and let her smile slip a little. ‘Well, then, if there’s nothing else I can do, do you mind if I watch you operate?’
He shrugged his broad shoulders slightly, and a cynical little smile touched his lips. ‘Oh, I think you can scrub—you never know, I might find a use for you since you’re here. We might as well find out sooner rather than later if you aren’t going to be able to cope.’
Oh, hell. Frankie dredged up a smile. ‘Oh, I’ll cope, Mr Ryder; don’t you worry.’
‘I’m not worried, Dr Bradley—just unconvinced.’
‘Then give me a chance to convince you. What’s the first case?’
He dropped his feet to the floor and stood up, stretching wearily and kneading the back of his neck with one large, long-fingered hand. ‘Here.’ He snapped some X-rays up onto the light box and stood back. ‘What can you tell me about this?’
‘Ouch,’ she murmured.
‘Would you care to be more specific?’ he said drily.
‘Sure.’ She pointed to the radiograph of the right thigh and indicated a long, diagonal fracture of the shaft of the femur. ‘This, obviously, and also here.’ She moved her finger up to the femoral neck, where it angled across to the pelvis. ‘There’s a slightly impacted fracture here, and the hip joint’s gone on the other side, I think,’ she murmured, looking at the other plate of the left side. She peered more closely at it, and frowned. ‘Is there another view of this?’
He snapped it up onto the screen and she nodded. ‘Yes. The pelvis has a slight fracture across the acetabulum, here—’ she pointed out the fine line across the socket of the hip joint ‘—and the whole joint has probably destabilised a little in the collision.’
‘Collision?’
‘Oh, yes, I think so—hasn’t the patient been involved in a car accident? Looks like a telescoped front end, with the bulkhead pushing up against the knees and transmitting the force of the impact through into the thighs and pelvis. I expect she was on the left side of the car and the pelvic fracture resulted from her being slammed against the door or the door slammed against her by another vehicle, perhaps? Were there any other injuries?’
‘Such as?’
She shrugged. ‘Foot or lower leg? Facial? Whiplash to the neck and upper spine? Ribs, maybe, if she was the driver, but I don’t think she was.’
‘She?’
‘Yes, it’s a woman,’ Frankie said confidently. ‘You can tell from the pelvis—and the name on the X-ray plate!’
His mouth twitched and she felt a ripple of relief. At least he appeared to have a sense of humour in there somewhere!
He nodded thoughtfully and answered her previous question. ‘Yes, there were some minor facial and cervical spinal injuries and bruising from the seat belt. The other leg was all right. She was a passenger, travelling on the left of the car in a front right quarter impact. The car then slewed round and hit a wall. The driver was killed outright; so was the rear-seat passenger behind him who wasn’t wearing a seat belt. She was lucky to get away with it so lightly.
‘So,’ he said, leaning back against the desk and bracing his hands on the edge at each side, ‘how would you deal with her?’
Frankie chewed her lip slightly. ‘I’d fix the femur internally, both because it’s a spiral fracture and unstable with traction alone and because the neck of the femur looks stable and I wouldn’t want to go and tug on it. At the moment it isn’t displaced so I’d want to manage it conservatively if possible and just watch it.
‘Also I’d put the other leg in traction to relieve pressure on that acetabulum and rest the damaged tissues in the hip joint.’
‘Just like that.’
‘If the skin’s intact or in good enough condition for the operation and if the soft tissues aren’t too badly damaged. I can’t tell that, of course, from the X-rays.’
‘No. Right, well, she’s our first customer.’
‘And?’
He raised an eyebrow. ‘And what?’
‘Was I right with the treatment?’
A grudging smile touched his eyes. ‘Yes, you were.’
She had to stop herself forcibly from heaving a sigh of relief. Instead she turned to the pile of X-ray envelopes on the desk. ‘What’s next?’
He took down the woman’s X-rays and put them away, then snapped another set up onto the screen. ‘This man.’
He sat back on the edge of the desk again, and Frankie could feel his eyes boring into her. ‘Um—he’s got lower leg fractures—ah—is that an old one?’
She swivelled round to look at him and he shrugged nonchalantly. ‘You tell me—you’re the diagnostician.’
She stifled her retort, turned back to the plates and nodded, running her fingertip down the shin bone and the finer bone—the fibula—beside it. ‘Yes—there’s an old non-union of the tibia, a mal-union of the fibula and another fracture of the tibia and fibula higher up, a new one this time. Looks like a fracture from a direct blow, and as one end of the tib’s free it’s probably caused havoc in the soft tissue.’
‘“Havoc” is putting it mildly,’ he told her, shrugging away from the desk and coming to stand behind her. ‘He was a pedestrian. He was hit by a car bumper at this point—’ His arm reached round her and as he carried on describing the result of the impact his finger pointed out the area of soft tissue damage, invisible on the X-ray.
It would have been invisible to Frankie anyway, because she was suddenly, chokingly aware of him, of the enticing smell of his skin lurking under the smell of antiseptic, the warmth of his arm against her shoulder, the lean, sinuous forearm dusted with dark curls so very, very close to her face …
He muttered something under his breath and moved away, and she released the block of air trapped in her lungs, letting it out on a long, silent sigh, and focused on the X-ray again.
‘So what are you intending to do with him?’ she asked in what she hoped was a normal voice.
‘Open
