lunchtime. How long could it take to visit someone and tell them face to face that there was no going back? That decisions had been made and would not be changed. Face-to-face meetings were dangerous, Kelly knew that. But maybe her mother was right in saying that such a confrontation was essential for closure. Maybe it was the fact that she hadn’t been brave enough to do it herself that had left this uncomfortable impression that there was unfinished business between herself and Neil Fletcher.
Not that Fletch seemed bothered. If it had been an easy day for Kelly, it must have been downright boring for the emergency medicine specialist. The session he had taken on shock had been excellent. Unfortunately, Kelly had been distracted from using the tutor’s expertise to advance her own knowledge. The excuse to observe Fletch for such a long period of time had been irresistible and it was the first time she had allowed her gaze to remain on the man for more than a second or two.
Two years had left their mark. Fletch looked thinner. The brown hair was worn a little shorter these days and were those highlights still sun-streaked blond or had some grey crept into those soft waves? Kelly’s fingers actually tingled as the memory surfaced of just how soft those waves were.
‘So. We’ve defined shock as a state of wide-spread inadequate perfusion at a cellular level. What are the things we need for adequate perfusion?’
Kelly glanced away as Fletch looked in her direction. She wasn’t about to contribute any suggestions. She was too busy trying to figure out what the difference in Fletch’s appearance was. It wasn’t anything physical making him seem so unfamiliar. It was something to do with his manner. He was scribbling on a whiteboard now. Perfusion relied on a functioning pump, an intact set of plumbing and an appropriate volume and content of fluid. Fletch was making the physiology lecture very user friendly for non-medical people. Even funny at times.
That was it. That was the difference. Fletch’s humour and his smile had a different quality. It was more restrained and less frequent. Fletch had never been a serious type. The way he had made Kelly laugh had been why she had fallen in love with him in the first place. Virtually the moment they’d first met. Kelly could remember that first meeting as though it had happened yesterday. Fletch had been a new registrar in Emergency and Kelly had come in with a patient at the end of a long, hard day. The patient had been drunk—found comatose under a hedge with two empty rum bottles nearby. His level of consciousness had improved enough for him to become abusive on the way into hospital and Kelly had had enough. Finishing a long day with her least favourite type of case had been enough to noticeably test her professional manner.
‘This man presented with a GCS of eight, hypotension and bradycardia,’ Kelly informed the triage nurse. ‘There is evidence of an ETOH overdose.’
Fletch heard the tail end of Kelly’s handover as he walked past. He glanced at the empty rum bottles now lying on the end of the stretcher. He leaned towards the triage nurse and spoke in a stage whisper.
‘The technical medical term is “totally pissed”.’
Kelly controlled her threatened giggle more effectively than the triage nurse.
‘We don’t have any details on the patient other than his surname.’ Kelly took another glance at Fletch who seemed in no hurry to move away. ‘Which appears to be Ikkey.’ She spelt it out.
Fletch looked thoughtful. ‘Icky,’ he repeated. He eyed the evidence of recent vomiting on the stretcher blanket and then winked at Kelly. ‘He is, rather, isn’t he? That’s another technical term I went to med school to learn,’ he added to the nurse beside them.
‘Cubicle three.’ The triage nurse was grinning broadly now. ‘Fletch, he’s all yours. In fact, we’ll make sure you get every icky patient that comes in from now on.’
‘I don’t know,’ Fletch grumbled. ‘Here I am sharing my professional knowledge and what thanks do I get for it?’
The humour rescued Kelly’s day and it was so easy to accept that first invitation for a date with the new registrar. That humour underpinned the whole relationship, in fact. Fletch could make anything funny and yet his jokes often displayed a real sensitivity. They helped to achieve a closeness that Kelly had never had with anyone before. Or since. She loved that sense of humour more than anything about Fletch. Not that he couldn’t be serious when he needed to be. He could turn it off in an instant and look intense and serious. Like he did when dealing with an emergency. Or, in a very different way, when he was about to make love to her.
Oh, help! Kelly had to shut her eyes to stifle that particular jog down memory lane. There was no point going there. Things had changed. Fletch had changed. Maybe he’d grown up finally and the change had made him more trustworthy. No. Kelly clamped that train of thought down as well. Her father had taught her only too well how little credence could be placed on any promises or even intentions of becoming trustworthy when it came to that kind of behaviour. And it wouldn’t make any difference now, anyway. Not with the opinion Fletch now held of her.
Joe’s session on immobilisation techniques had been a lot more fun. The quips about bondage and the good-natured teasing of Wendy and Ross now that their relationship was public had made the time pass swiftly. Wendy, Jessica and Sandy had made a good job of soft tissue injury management and the practical scenario at the end of the day would have been a great way to finish if only their instructors hadn’t put her and Fletch into the same group, where she’d also had Kyle to contend with. Wendy had been coerced into being a patient again. This time she had been a crush injury victim with a slab of concrete on her leg. Cardboard boxes had represented the hazards they had marked and the surrounding debris had been removed, allowing access to their victim.
‘Hi, there, Wendy.’ Fletch shifted a last piece of ‘rubble’. ‘Here we are, finally.’
‘Check her airway,’ Kyle said excitedly. He reached out and Wendy ducked her head instinctively to avoid the physical contact.
Kelly suppressed a sigh. ‘We’ve been talking to her through the wall, Kyle. She’s been answering us. She’s told us she doesn’t have any breathing problems. There’s no sound of respiratory distress and her respirations are normal depth and rate. We can probably assume her airway is patent.’
Tony was supervising their scenario. ‘Airway is patent,’ he told them, ‘but the respiration rate is 30 and shallow. What are you going to do next, Kelly?’
‘Check circulation.’
Kyle reached for Wendy’s wrist. ‘Good radial pulse,’ he said happily.
‘No.’ Tony shook his head. ‘Pulse is weak and thready. Tachycardia of 120.’
‘I’ll do a body sweep.’ Kelly smiled at Wendy’s look of relief as she got in before Kyle to run her hands down each side of their ‘patient’s’ body.
‘No evidence of major haemorrhage,’ Tony confirmed.
‘We’re assessing the general condition as we look at our patient,’ Fletch contributed. ‘Her colour is good and she’s not diaphoretic.’
Tony smiled. ‘Your patient is pale, sweaty and cool to touch.’
‘We want to check for neck tenderness and put a C-collar on if it’s indicated.’
‘No neck pain,’ Tony decided.
‘She’s in shock,’ Kelly said. ‘We need to get an IV line in and start some fluids.’
Wendy
