‘run the saline through a paediatric burette. She’s extremely underweight so we have to be very careful of doses.’
‘We need to be very careful not to overload her with fluid,’ Ciro confirmed and even though he was busy, inserting an IV and connecting the drips, he still managed to find the time to explain his thought process to the eager grad nurse. ‘Her heart is beating irregularly, she may have some heart failure, so the last thing we want to do is give her more fluid than her heart can deal with. On the other hand…’ He paused as he carefully examined Alyssa’s neck, checking her jugular venous pressure. Then he whipped out his stethoscope and listened carefully to her lungs for a moment before resuming his knowledgeable lecture. ‘She is undoubtedly dehydrated. Let’s give her a stat 200 ml bolus. I want a catheter put in and her input and output strictly monitored.
‘Come on, Alyssa.’ His words were loud, the call to his patient sharp as he not-too-gently rubbed her sternum. It worked. Alyssa’s eyes flickered open as she attempted to push him away. ‘Good girl.’ Ciro’s voice was more soothing now, moving quickly to orientate his patient to her new surroundings. ‘You lost consciousness again, Alyssa, so we have moved you to a different area of Emergency where we can keep a closer eye on you…’ The frantic running of feet along the corridor outside heralded the arrival of the paediatric team, but instead of turning to greet them, Harriet noted with approval that he carried on talking to Alyssa, perhaps sensing that a full emergency team arriving at her bedside would be daunting for the young girl. Ciro took time to reassure her that, despite the apparent chaos, everything was very much in order. ‘We were concerned about you so there are going to be a lot of doctors arriving and a lot of talk that you don’t understand, but you are going to be OK.’
There certainly were a lot of doctors arriving. An emergency call always merited a rapid response, but the page had been put out as a paediatric emergency and though the difference was probably negligible, Harriet was sure that everyone had run just that bit faster to get there, from the anaesthetist to the nursing supervisor.
‘Alyssa Harrison,’ Ciro explained, ‘presented with a head injury secondary to a fall while dancing…’
Harriet listened as she worked on, listened to his heavily accented English barely faltering as he explained Alyssa’s complicated symptoms, and even though it was his first night, even though none of the doctors had met him before, he delivered his findings with a calm authority that demanded respect, explained without words to the rapidly gathering crowd that he was very much in control.
‘Can you chase up those results?’ Ciro looked over and Harriet let out a low moan.
‘I’ve left the pathologist hanging on the line.’
‘Tell him we’ll be sending some blood gases along shortly,’ Ciro called as Harriet rapidly headed back for the nurses’ station.
It took for ever to get through, the switchboard operator telling her in a rather pained voice that ‘yet again’ she was about to be connected, but suddenly those tiny white spots that had been dancing in front of her eyes earlier seemed to have returned for an encore. The nurses’ station seemed impossibly small all of a sudden. Sweat trickled between her breasts as she choked back bile, pleading with the powers that be to just let her get through the next few minutes of her life without major problems. If she could just get the blessed results down, she could hopefully escape the department for five minutes.
‘Harriet, we need those results!’ Ciro’s voice was booming at her, his impatient face swimming before her eyes as she looked up. Finally Harriet conceded to herself that she had to get to the bathroom at once. Hurling the receiver somewhere in Ciro’s direction, she stumbled off the stool.
‘The pathologist is on the line now.’
‘So, what are the results?’
‘I don’t know,’ she mumbled, backing out, her hand over her mouth. Thankfully Susan was around, and recognised potential disaster before it hit. Susan’s reflexes were like lightning, guiding Harriet to a vacant cubicle, sitting her on a chair and mercifully producing a bowl as she pulled the curtains on one of the many humiliating moments in Harriet’s life!
‘GIVE her the Maxalon, you meanie,’ Susan teased as Ciro stepped into the cubicle a few moments later.
Thankfully his telephone conversation with the pathologist had at least given Susan enough time to remove the offending bowl and for Harriet to rinse her mouth and at least manage a semblance of dignity.
‘I’ve already discussed this with Harriet,’ Ciro said, completely unmoved. ‘Now, will you let me examine you?’
‘There’s no need,’ Harriet insisted. ‘I went out to dinner last night, the food was really rich…’
‘Did you have a lot to drink?’
‘Apart from mineral water, no.’ Standing, attempting not to wince with the pain that small exertion caused, she attempted a brisk smile. ‘I’d better get back out there.’
‘You are in no fit state to be working.’
‘I’m much better now,’ Harriet muttered.
‘I disagree. I have already spoken with the nurse supervisor and she is arranging cover for you.’
‘You’ve what?’ Appalled, she glared at him. ‘How dare you?’
‘I dare because I am the doctor in charge tonight and I need my colleagues, especially my senior ones, to be completely on the ball. There is no room for error in Emergency.’
He was right, of course, Harriet knew that deep down, but it didn’t make her feel any better.
‘Now, are you going to let me examine you?’
‘No,’ Harriet answered tartly. ‘You should be in with Alyssa, instead of worrying about me.’
‘The paediatricians are in with Alyssa now. Everything is under control.’
‘Including me.’ Harriet bristled. ‘I’m going to wait for the nurse supervisor to arrange cover and then I’m going to take some paracetamol and lie down for an hour or so until I feel well enough to start working again.’
‘You shouldn’t take anything until you know what’s wrong with you. I’m not going to give you anything.’
‘You really are the limit, you know!’ Embarrassment was turning into anger now, furious at his control, his authoritative air—well, it might quiet his patients but it damn well wasn’t going to silence her into submission. ‘Well, Dr Delgato, as it happens, I have some painkillers in my handbag, painkillers that don’t require some over-inflated doctor’s signature to take, unless there’s a rule that’s suddenly been invented that I don’t know about, unless I’m not allowed to go into my locker without your consent, unless I’m not allowed to open my bag and take my own tablets without your permission!’
‘You are being childish,’ Ciro responded, not remotely fazed by her outburst. ‘But as you’re now off duty, that is entirely your prerogative.
‘Now, I suggest you put on a gown, lie down on the trolley and rest for a while. Then, with your consent, I will come in and
