on the cardiac monitor was brief. The arrhythmia settled spontaneously after a few erratic heartbeats but it was enough to remind both doctors of their patient’s still critical condition. The tap on the door of the treatment room came in the short silence that followed the cessation of the alarm. A young nurse aide poked her head around the door.
‘Dr Tremaine? Could you come and check on Liz, please?’ Michelle’s face was anxious. ‘She’s in a lot of pain and the machine that’s doing the baby’s heart rate is beeping.’
Jennifer caught Andrew’s dark eyes again with a silent plea. He transferred his gaze to Liam, his expression resigned.
‘I’ll do the lavage,’ he said. ‘And we’ll take it from there.’
‘Thanks.’ Jennifer was suddenly aware of how pale and weary Andrew looked. Her own cold, damp clothing was clinging to her skin and Andrew must be a lot more uncomfortable than she was. He had been out in the storm far longer than she had and he was injured as well, yet he hadn’t voiced a word of complaint.
‘Tom Bartlett is here as well,’ Michelle said to Jennifer. ‘He wants to talk to the other people that were in the accident. Oh, and Mickey’s wanted back at the station.’
‘OK.’ Jennifer stripped off her gloves. She couldn’t afford to worry too much about Andrew Stephenson’s level of comfort just yet. ‘Wendy, you come with me. Margaret can stay and assist Andrew.’ Jennifer paused as she followed Mickey to the door. ‘Marg, find Andrew a set of scrubs when you get a minute. His clothes are soaked and he must be frozen.’
Wendy trotted behind Jennifer as they made their way towards the maternity suite. Jennifer grinned at her colleague.
‘I wonder if Andrew might fancy doing a Caesarean?’
‘Who is he, exactly?’ Wendy’s eyes were round. ‘And where the hell did he appear from?’
‘He’s on holiday and was involved in the accident somehow.’ Jennifer stopped beside a large cupboard. ‘I’ll get some dry scrubs for myself, I think.’ She reached for a set of the pale blue theatre clothing.
‘He’s amazing,’ Wendy continued in awed tones. ‘And he’s so…He’s…’ She gave a silent whistle.
‘You wouldn’t be the first woman to find Andrew Stephenson attractive,’ Jennifer told her nurse wryly. ‘And you won’t be the last.’ She was rapidly unbuttoning her shirt, screened by the open cupboard door.
‘How do you know that?’
‘I went through medical school with him.’ Jennifer stripped off the damp shirt and replaced it with the loose, thick cotton top. Then she peeled off the oilskin over-trousers she was still wearing.
‘Did you go out with him?’
‘Heavens, no! I couldn’t stand the man.’ Jennifer pulled scrub trousers over her jeans for extra warmth. ‘And he couldn’t stand me either.’ She shot Wendy a quick grin. ‘I’m quite pleased to have him around right now, though.’
‘You and me both. He’s real knight-in-shining-armour stuff, isn’t he?’
‘Don’t get your hopes up.’ Jennifer felt obliged to issue the warning, having noted the gleam in Wendy’s eye. She moved on briskly. ‘You’d be wasting your time,’ she added as Wendy caught up.
‘Why?’
‘He’s on his honeymoon.’ Jennifer didn’t see Wendy’s disappointed expression. She could see Tom waiting further down the hallway. ‘I’ll go and check Liz,’ she told Wendy. ‘You take Tom in to see those other patients. I think Janey might be with them. Find out whether she’s got an update on young Sam as well. I want to know how he’s getting on with that concussion.’
Elizabeth Bailey was miserable. ‘That stuff isn’t helping any more,’ she told Jennifer, waving dismissively at the Entonox cylinder. ‘My back is killing me.’
‘I’ll give you something stronger in a minute.’ Jennifer was watching the foetal monitor as she pulled on clean gloves. The heart rate had dropped a fraction but not enough to be a problem yet. She would reset the level for the alarm as soon as she had examined Liz.
Suzanne Smith arrived just as Jennifer administered a dose of pethidine to her patient.
‘Where do you need me most, Jen?’
‘Right here.’ Jennifer moved out of earshot to speak to the nurse. ‘Liz is definitely in labour this time but things are moving very slowly and it’s a classic ‘‘backache’’ labour. She’s been here since this morning and she’s still only six to seven centimetres dilated. She’s had enough and we might have a long way to go till the end of stage one.’ Jennifer shook her head. ‘Goodness knows how we’ll cope if the baby doesn’t turn. Under normal circumstances I’d evacuate her. What’s the weather like out there now?’
‘Awful. And the road’s still blocked. I heard it on the radio.’ Suzanne bit her lip. ‘I heard about Liam. How’s he doing?’
‘I’m about to find out.’ Jennifer managed to smile at Suzanne. ‘I’m so glad you’re here, Sue. At least I know I’ve got Liz in the hands of a very capable midwife. I may be busy for quite a while.’
‘I’ll know if I have to call you. Best of luck.’
They were going to need more than luck. Liam Bellamy’s condition had deteriorated further by the time Jennifer returned to the treatment room.
‘He needs an urgent laparotomy,’ Andrew declared. ‘He also needs a blood transfusion. Have you got any frozen, fresh plasma?’
‘No.’ Jennifer eyed the second chest-drain bottle which was nearly full. ‘Maybe we could do an autologous transfusion and reuse his own blood.’
‘We’d need to anticoagulate the blood. I don’t expect you’d have a cell-saver system available.’
‘No. We’ve got plenty of anticoagulation agents, though.’
‘Not much point pouring it back in unless the leak is fixed. My guess is a ruptured spleen. His liver could also be a likely candidate.’
‘Could you repair it?’
Andrew shook his head slowly. ‘You don’t know what you’re asking, Jennifer. We don’t have the facilities or the staff. Not even an anaesthetist.’
‘I can do an anaesthetic,’ Jennifer offered promptly. ‘It was my first rotation as a registrar. We’ve got the gear. The instruments are even sterilised on a regular basis. They used to do quite a bit of surgery here in the old days. And my nurses are great. Wendy and Margaret could both help.’
Andrew was still shaking his head. Jennifer caught hold of his arm. ‘I took a fish hook out of a man’s hand earlier today,’ she told him with quiet intensity. ‘He put himself in considerable danger trying to make sure his boat was going to be safe in this storm. His fishing boat is his living and the only way he can support his family. He’s desperate to hold things together since his wife died three years ago. His kids are all he has. Liam is his eldest son.’
Jennifer could
