position in the hierarchy of life on earth was somewhere below pond scum.
‘Never mind,’ she snapped. ‘You can give me all the excuses in the world after we’ve seen to Kit’s hand. Let’s get him to Theatre. Now.’
AND THEN THINGS reassembled themselves. Sort of. This was a small country hospital but it was geared for emergencies, and many emergencies involved rapid blood loss.
Kit had lost so much that cardiac arrest was still a real possibility. Treatment of his hand—apart from stemming the bleeding—had to wait until that threat was past.
And in Rachel he had a godsend. She was an angry godsend, judgemental and furious, but she was a doctor.
Maybe he could have coped alone—maybe—but he was acting on autopilot. A part of his brain seemed to have frozen. The sight of one little boy, unconscious, a child he’d learned to love, had knocked him sideways.
It was an insidious thing, this love. It had crept up and caught him unawares, and loving came with strings. He couldn’t care for these kids—and love them—without his heart being wrenched, over and over again.
It was lurching now, sickeningly, and after that one incredulous look, that one outburst of anger, Rachel had subtly taken control.
As he went to put in the IV line his hand shook, and she took the equipment from him. ‘Get the monitors working,’ she told him. ‘I’ll take over here.’
The cardiac monitors… He needed to set them up. He did, with speed. A shaking hand could manage pads and monitors.
‘Pain relief and anaesthetic,’ she said. ‘Do you have an anaesthetist?’
‘There’s only me,’ he told her.
‘Two of us, then,’ she said curtly. ‘Or one and a half if you’re emotionally involved. But I’m trusting you have a good nursing staff.’
‘The best,’ Roscoe growled, and she nodded acknowledgement. This was no time for false modesty and she obviously accepted it.
And then Kit’s eyes flickered open again, fighting to focus. Falling on Rachel first. Terror came flooding back, and Rachel saw.
‘Hey, we found your Tom,’ she told him. ‘And here he is.’ Her anger and her judgement had obviously been set aside with the need for reassurance. She edged aside so the little boy could see him. ‘Kit, we’re going to fix your hand. The bleeding’s made you feel funny, and I know it hurts, but we’re giving you something that’ll make you feel better really fast. Tom’s just going to test your fingers. Will you do what he tells you?’
And she stepped back, turning to the instrument tray, setting the scene so Kit could only see Tom.
She was impelling him to steady. She was pushing him to do what he had to do.
He had to focus and somehow he did.
Appallingly, he was still seeing terror as well as pain in the little boy’s eyes. Legacy of his ghastly grandparents?
‘Hey, Kit, you’re here now, with me,’ he said as they rolled the trolley into Theatre. He touched the little boy’s face, willing the fear to disappear. ‘You’ve cut your hand but we’ll fix it. I know it hurts, but we’ll stop it hurting really soon.’
‘I broke… You’re not mad…?’
‘Dr Rachel tells me you broke her window,’ he managed. ‘I broke four windows when I was your age. I used to tell my mum and dad the cat did it. They didn’t believe me but they weren’t mad and neither am I. Accidents happen. Kit, can you tell me what you feel when I touch your fingers? Can you press back when I press? Here? Here?’
He was now in professional mode—sort of—but the lurch in his stomach wasn’t going away.
And the information he gained from Kit as they settled him into Theatre wasn’t helping.
He was checking for damage to the tendons that ran through the palm and attached to the finger bones. Secondly, for nerve damage, which could result in permanent loss of function or sensation. Tom was applying gentle pressure to the tips of Kit’s fingers, asking him to push back.
The responses weren’t good.
And Rachel got it. She was focusing on the IV, on getting pain relief on board, but she was listening to Kit’s quavering answers. Knowing what they meant.
‘Okay, Dr Lavery, tell me the set-up,’ she said as Tom’s testing finished. ‘Do you have anyone here who can cope with paediatric plastics? Or someone who can get here fast?’
‘No,’ he said shortly. Stemming the bleeding seemed straightforward. It looked as if the radial artery had been nicked—it must have been to cause this amount of bleeding. They could fix that. But what his examination had told them was that Kit needed a plastic surgeon or a vascular surgeon or both if he wasn’t to lose part or all of the use of that hand.
That meant evacuation. It was eight hours by road to Melbourne, ten to Sydney or Canberra. Shallow Bay wasn’t the most remote place in Australia but its position, nestled on the far south-east coast, surrounded by hundreds of miles of mountainous forests, meant that reaching skilled help could be a logistical nightmare.
‘Where?’ Rachel said, and he had to give her credit for incisiveness.
‘Sydney.’
‘You have air transfer?’
‘It’ll take medevac an hour to reach us in the chopper, but yes.’
‘Can someone organise that?’ she said to Roscoe. ‘Now?’ And then she turned back to the child she was treating and her voice gentled. ‘Kit, we’re going to get your hand bandaged now, and stop things hurting, but there’s a bit of damage deep inside that might make your fingers not as strong as they should be. We need to take you to a big hospital to get your hand mended.’
‘Tom can fix it.’ Kit’s voice quavered.
‘He can,’ she said, injecting her voice with confidence. ‘I know that. And so can I, because Tom and I are both doctors. If Tom agrees, I’ll do the first part now. But have you ever seen Tom sew something that’s ripped? Like a pair of jeans?’
‘He did once,’ Kit managed, trying gamely to sound normal. ‘Big stitches. It came apart again.’
‘Hey, how did I guess?’ she said, smiling down at him. ‘So Tom’s not very good at sewing and neither am I. Kit, there are things in your hand called tendons which make your fingers work. You’ve hurt them, so what you need is a doctor who’s really good at tiny stitches. Don’t worry, we’ll give you something that stops you feeling what we need to do. We’ll make sure nothing hurts, I promise. You’ll end up with a neat scar you’ll be able to show your friends, but a good needleworking doctor will make sure your fingers end up stronger than ever. So what that means is that we need to take you to Sydney.’
‘I
