into cardiac arrest.
Without some secure means of administering oxygen and the supplies to set up an IV line he had no way of improving her tidal volume or boosting her systolic pressure above 80. At the moment it must hovering around 70 because her femoral pulse was barely perceptible. If it dropped below 60 the carotid pulse would disappear, too, and she would be just minutes away from irreversible brain damage and death …
‘Come on! Come on!’ he urged as he transferred her swiftly to the floor and began carefully controlled cardiac compressions to boost the volume of blood going to her brain, desperate to hear the sound of a siren drawing closer.
The weight of his guilt was almost crushing as he kept automatic count inside his head. If he’d come home when he’d said he would, rather than hovering over Sara and waiting till she was settled in her room, would he have arrived in time for Zara to tell him that she was feeling ill?
Would he have been able to prevent her collapsing in the first place?
A sudden hammering on the front door made him realise that he’d completely forgotten to release the catch for the ambulancemen to get into the flat.
‘She’s in here,’ he directed as he quickly led the way back to the bedroom and dropped to his knees beside her again. ‘Her systolic must have been close to 70 when I found her because her femoral pulse was barely palpable and her pupils were fixed and dilated.’ He glanced across at the man who dropped to his knees on the other side of the body to begin his primary survey, and they came face to face for the first time.
‘Dr Lomax!’ the paramedic exclaimed, clearly shocked to see him, but he immediately became the consummate professional. ‘Do you know what happened to her, sir?’ the paramedic asked as he bent over the ominously still figure between them to check her pulse and respiration rates for himself.
As he did so, Dan heard the man’s foot strike something to send it skittering under the bed but no one even bothered to glance at it. At the moment nothing mattered more than giving Zara a chance to continue her vibrant life.
Out of the corner of his eye Dan saw the man’s colleague depositing an oxygen cylinder on the carpet and he reached out for it, leaving him free to set up the defibrillator with the swift ease of much practice.
He was ashamed to see how badly his own hands were trembling as he fumbled to tighten the mask against her face, blocking out the heart-stopping thought that Zara might already be in need of the defibrillator’s violent charge to reset her heart rhythm. It was several horrified seconds before he remembered that it could also be used as a valuable monitoring and diagnostic tool.
‘I’ve no idea what happened to her,’ he said, dragging his thoughts back to the question he’d been asked, frustrated when he saw that the man was having trouble finding a vein. But, then, with her blood pressure so low, it was hardly surprising. Still, he had to fight the urge to take over and do the job himself. They needed to get the IV started and the lactated Ringer’s running into her veins as soon as possible to get her blood pressure up. If she’d had some sort of spontaneous bleed that had caused a catastrophic drop in her blood pressure …
‘I came home from work to find her lying on the bed,’ he continued, forcing himself not to waste any time second-guessing, even as the need to do something urged him to continue CPR. ‘At first, I thought she was sleeping, but when I tried to wake her …’ he shook his head in disbelief. ‘That’s when I realised how ill she was.’
‘Do you know if she’d had any alcohol to drink before you found her?’ he asked, and Dan almost smiled.
‘It’s unlikely. She never drinks anything stronger than a white wine spritzer … too many calories,’ he added.
‘Do you know if she’s taken any drugs, sir?’ the young man asked as he peeled the gel pads from their protective backing and positioned them swiftly on Zara’s chest, and even though Dan knew that the questions were necessary for him to do his job, the suggestion shocked him.
‘No!’ he exclaimed immediately, horrified at even the thought that this bright beautiful woman might have wanted to kill herself. Then he remembered a conversation he’d overheard at one of the parties she’d dragged him to earlier on in their marriage. He’d been shocked to learn just how many of her fellow models resorted to chemical assistance to maintain their almost skeletal slenderness.
‘Oh, God,’ he muttered, praying that Zara hadn’t been tempted down that route. In a profession that valued the freshness of youth above almost everything else, her age was already counting against her. Had she been that desperate to extend her modelling career that she would use drugs to help her compete with all those younger wannabes?
‘I don’t know,’ he admitted finally. ‘I’ve never seen her taking anything, but …’
‘Could you go and have a look in the bathroom, please, sir,’ the paramedic asked firmly, as he gestured to his colleague to take his hands off their patient while he activated the machine to monitor the state of her heart. ‘We’ll take over here now.’
‘Stand clear. Analysing now,’ said the disembodied voice programmed into the machine as he strode into the en suite bathroom, almost grateful for an excuse not to watch if they were going to have to make her beautiful body convulse with the brutality of a shock.
It took precious seconds to search through a mirror-fronted cabinet crammed full of beauty products of every shape and size, but the only tablets he could find were those in a half-full plastic bottle of over-the-counter painkillers.
‘No shock required,’ the voice was advising as he came back into the room, and his heart lifted briefly at the thought that at least Zara hadn’t gone into ventricular fibrillation or cardiac arrest.
‘Did you find anything, sir?’ prompted the paramedic as he rejoined them and he saw that in his absence they’d intubated Zara to secure her airway, rather than relying on the face mask, and had connected her to their portable oxygen cylinder. The monitor clipped to her finger was already starting to record an improvement in the saturation level in her blood.
‘No drugs, other than some generic analgesics,’ he said, disorientated by the fact that he was little more than a bystander in a situation where he was usually the one in charge. But this was completely different to working in A and E. There, he could work fast and effectively, treating any number of cardiac arrest patients in a single day with his brain working swiftly and clearly and every possible piece of equipment readily to hand.
Here, it felt as if his thoughts were travelling through treacle as he saw the paramedic’s gloved fingers sort through the pre-loaded syringes in his kit. Somehow, he just couldn’t get his brain to tell him what the man should be looking for, or why.
‘They were paracetamol and the bottle was half-full,’ he added, before the man could ask.
‘What about the bedside cabinet?’ prompted the other man, and Dan dragged his gaze away from what the two of them were doing to stride across and pull the drawer completely out. He upended it over the bed and several items fell off the edge of the mattress and hit his foot to land out of sight under the bed.
‘Some herbal sleeping tablets and … a bubble pack of contraceptive pills,’ he added in disbelief, suddenly wondering just how many kinds of a fool he’d been. So much for Zara’s grief that she couldn’t give him a child! If she’d been taking contraceptives to prevent herself getting pregnant, had anything about his marriage been real?
He
