pressure eighty on forty.’ The resident looked up at the overhead monitor. ‘And heart rate is one-thirty. Oxygen saturation ninety-four percent.’
‘Is that bleeding under control, Grace?’
‘Almost. I’d like to get a traction splint on asap for definitive control. It’s a mid-shaft femoral fracture.’
Another nod from Charles. ‘As soon as you’ve done that, we need a second line in and more fluids running. And I want an abdominal ultrasound as soon as I’ve intubated. Can someone ring through to Theatre and see what the situation is up there?’
The buzz of activity around the patient picked up pace and the noise level rose so much that Grace barely noticed the arrival of more paramedics and another patient being delivered to the adjoining trauma room, separated only by curtains. Working conditions were difficult, especially when some of the staff members were directed to the new arrival, but they were by no means impossible. Even with the murky half-light when a torch wasn’t being directed at the arm she was working on, Grace managed to get a wide-bore IV line inserted and secured, attaching more fluids to try and stabilise this patient’s blood pressure.
With the airway and breathing secured by intubation and ventilation, Charles was able to step back and oversee everything else being done here. He could also watch what was happening on the neighbouring bed, as the curtain had been pulled halfway open. As Grace picked up the ultrasound transducer and squeezed some jelly onto her patient’s abdomen, she got a glimpse of what was happening next door.
Judging by the spinal board and the neck collar immobilising the Spanish-looking woman, this was the ‘fall down stairs’ patient they had been alerted to. What was more of a surprise was that Charles was already in position at the head of this new patient. And he looked...fresher, somehow. Younger...?
No... Grace blinked. It wasn’t Charles.
And then she remembered. He’d had a twin brother who’d gone to a different medical school. Elijah? And hadn’t their father been the chief of emergency services at a prestigious New York hospital?
This hospital. Of course it was.
Waiting for the image to become readable on her screen as she angled the transducer, Grace allowed herself a moment to think about that. The dynasty was clearly continuing with the Davenport family front and centre in Manhattan Mercy’s ER. Hadn’t there been a younger sister who was expected to go into medicine as well? It wouldn’t surprise her if there was yet another Davenport on the staff here. That was how rich and powerful families worked, wasn’t it—sticking together to become even more powerful?
A beat of something like resentment appeared. Or was it an old disappointment that she’d been so insignificant compared to the importance of family for Charles? That she’d become instantly invisible the moment that scandal had erupted?
Whatever. It was easy to push aside. Part of a past that had absolutely nothing to do with the present. Or the future.
‘We’ve got free fluid in the abdomen and pelvis,’ she announced. ‘Looks like it’s coming from the spleen.’
‘Let’s get him to Theatre,’ Charles ordered. ‘They’ve got power and they’ve been cleared to only take emergencies. He’s stable enough for transfer but he needs a medical escort. Grace, can you go with him, please?’
The metallic sounds of brakes being released and sidebars being raised and locked were almost instant. Grace only had time to ensure that IV lines were safe from snagging before the bed began moving. This was an efficient team who were well used to working together and following the directions of their chief. Even in the thick of what had to be an unusually stressful shift for this department, Grace could feel the respect with which Charles was regarded.
Behind her, as she stayed close to the head of the bed to monitor her patient’s airway and breathing en route to Theatre, Grace could hear Charles moving onto a new task without missing a beat.
‘Any signs of spinal injury, Elijah? Want me to see if the CT lab is clear?’
And then she heard his voice change. ‘Oh, my God... Maria?’
He must know this patient, she realised. And he was clearly horrified. She could still hear him even though she was some distance on the other side of the curtain now.
‘What happened? Where are the boys?’
* * *
A break from the barely controlled chaos in a badly lit emergency department was exactly what Grace needed to catch her breath but it was a worry how crowded the corridors were. And a glimpse into the main waiting area as they rushed past on their way to the only elevators being run on a generator suggested that the workload wasn’t going to diminish any time soon.
This was a different planet from the kind of environment Grace had been working in for the last few years and the overall impression was initially overwhelming. Why on earth had she thought she could thrive with a volume of work that was so fast-paced? In a totally new place and in a huge city that was at the opposite end of the spectrum from where she’d chosen to be for such a long time.
Because her friend Helena had convinced her that it was time to reconnect with the real world? Because she had become exhausted by relying solely on personal resources to fight every battle that presented itself? Because the isolation of the places she had chosen to practise medicine had finally tipped the balance from being a welcome escape to a bone-deep loneliness that couldn’t be ignored for ever?
Like another omen, lights flickered overhead as neon strips came alive with a renewed supply of power. Everybody, including the porters and nurses guiding this bed towards Theatre, looked up and Grace could hear a collective sigh of relief. Normal life would be resumed as soon as the aftermath of this unexpected challenge was dealt with.
And she could cope, too. Possibly even thrive, which had been the plan when she’d signed the contract to begin work in Manhattan Mercy’s ER. This was a new beginning and Grace knew better than most that to get the best out of new beginnings you had to draw a line under the past and move on. And yes...some things needed more time to heal but she had taken that time. A lot more time than she had anticipated needing, in fact.
She was ready.
Having stayed longer than the rest of the transfer team so that she could give the anaesthetist and surgeons a comprehensive handover, Grace found that she needed to find her own way back to the ER and it turned out to be a slightly more circuitous route than before. Instead of passing the main reception area, she went past an orthopaedic room where casts were being applied, what looked like a small operating theatre that was labelled for minor surgery and seemed to have someone having a major laceration stitched and then a couple of smaller rooms that looked as if they had been designed for privacy. Were these rooms used for family consultations, perhaps? Or a space where people could be with a loved one who was dying?
A nurse was peering out of one of the doors.
‘Oh, thank goodness,’ she said, when she saw Grace approaching. ‘I’m about to burst... Could you please, please stay with the boys in here for two minutes while I dash to the bathroom?’
The young nurse, whose name badge introduced her as ‘Jackie’, certainly looked desperate. Having had to grab a bathroom stop herself on her way back from Theatre, Grace could sympathise with the urgency. She was probably already later in her return to the ER than might have been expected so another
