‘How much school have you missed now?’ Ellie asked her.
The girl frowned as she worked out her answer.
‘About three—maybe five—weeks,’ she said. ‘I just sat around wishing it would all go away.’
‘And if you went back to school here, could you make that up?’
‘You mean now, this year, before the end of term—with this?’
She patted her bump.
‘Why not?’ Ellie said. ‘Even if you go back long enough to get some work to do over the Christmas holidays that will catch you up, then you can go back full time next year.’
‘And when the baby comes?’
Ellie sighed.
‘That’s going to depend on what you want to do about the baby. You don’t have to make any decisions right now, but there are really only two choices.’
‘Keeping it or adoption?’
Tears filled the girl’s eyes.
‘We’ve plenty of time to sort that out,’ Ellie told her. ‘We’ll talk about it, you and me, and Andy. Your boyfriend, Alex, too. Talk to him. He should have some say. Between the lot of us we’ll work out what’s best for both of you.’
Ellie pushed back her chair as she stood up, needing to get back to work and not yet ready for tearful discussions about the baby’s future.
Any baby’s future…
‘If you wouldn’t mind clearing away our plates, then you could have a good look at your room, maybe take down the old posters. You’d better roll them up and put them away somewhere in case they turn out to be precious to their former owner. We can get some paint to freshen up the walls and some new bed linen for you.’
The tears Ellie had been hoping to avoid arrived in full flood, along with mutterings of ‘too good to me,’ and ‘you’re too kind’.
But Ellie was already heading down the steps.
‘Have a shower and a lie down. You’ll feel a lot better after you’ve had a rest.’
The afternoon was blessedly free of any drama, and she even had one cancellation, which gave her a few minutes to think about her concern for the elderly men in town. Her grandmother had regularly attended a sewing, knitting, and craft group once a week in the hall at a local church, going along for a chat more than the knitting or sewing. The Country Women’s Association—an institution in Australia—provided for the women as well, but finding something for the men might prove more difficult.
Many of the local farmers retired to houses in the town, leaving their sons to run the property, and things like indoor bowls or card games might be too tame for them.
A Men’s Shed, that was what she needed, but one with a purpose. She’d talk to Andy about it tonight.
And the ease with which that thought came out startled her enough to spend the rest of the afternoon with her mind focussed fully on work.
Which was just as well, as her next patient presented with a racing pulse and a pallor that would make cream look suntanned. Bill Stevens had a history of atrial fibrillation which was usually controlled by his medication. He’d sensibly bought an app for his phone that could tell him when he was in AF, so he could take three more tablets, upping his medication from one hundred to a total of four hundred mgs.
‘It usually works for me,’ he told Ellie plaintively.
‘Well, maybe it still will,’ she told him, ‘but I’d prefer it if you were in hospital. If it doesn’t settle down, they can give you the drug intravenously, and keep you on a monitor so they know what’s happening. How did you get here?’
‘My wife drove me. She’s doing some shopping while she’s in town.’
The ‘while she’s in town’ reminded Ellie that many of her patients came from properties up to eighty miles away, and although she knew Bill was closer than that, she certainly didn’t want him out there with his heart still playing up, risking a stroke unless they stabilised it. She pressed the buzzer that would bring Maureen into the room.
‘Would you please phone an ambulance for Bill, then keep an eye out for his wife. She’ll be back when she finishes shopping and we need to let her know he’s gone to hospital.’
‘Will I phone and let them know he’s coming?’ Maureen asked.
‘No, I’ll do it. Andy can access Bill’s file there but I’d like to fill him in on today’s situation.’
‘And if we don’t get it back in rhythm with medication?’ Andy asked, when Ellie had explained that Bill was on his way.
‘Are you up for a cardioversion or will you fly him out?’
Andy peered at the phone for a moment. Was Ellie really asking him that?
Okay so he’d trained in the use of the defibrillator—hadn’t they all? He’d even used one to re-start a patient’s heart. But the difference with cardioversion was that it had to be synchronised to a particular point in the heart’s rhythm, and although the machine itself did that job quite efficiently, as long as you pressed the sync button before shocking, he felt uneasy about it.
If something were to go wrong—if Bill had a seizure when they shocked him—what back-up did he have? One anaesthetic-trained nurse and Ellie at a pinch. No cardiologist for hundreds of miles.
‘Send him to the coast,’ he heard Ellie’s voice say, coming from afar as he still had the phone in his hand in front of him, not up to his ear. ‘Presumably he’s had lunch, which means you can’t anaesthetise him for a few hours, so far better to have a specialist do it. He should be at your hospital by now, I’ll send his wife on there. She can either fly out with him or drive to wherever they’re taking him. Maybe do neither. If all goes well, they’ll send him back tomorrow or the next day, whenever they have an ambulance car coming this way.’
Andy was grinning as he hung up. Ellie was so far ahead of him in some ways, you’d think it was she who’d grown up in the bush with its limited facilities, not him. But everything she said made sense. The state-funded ambulance system had several helicopters used for ferrying patients from outlying districts to specialist hospitals.
He went to meet Bill and explain what was going to happen, asking Andrea, who was on duty in the small ED, to phone for the air ambulance.
‘It’ll fix itself, it always does,’ Bill argued as Andy removed the ambulance leads, replacing them with hospital ones and attaching them to the monitor. Bill’s heart rate was still spiking around the one hundred to one hundred and twenty mark, the line occasionally dropping down to ninety-five at the lowest.
‘When did you take the extra dose?’ he asked Bill, who looked mutinous for a moment, then finally admitted it had been first thing in the morning. That he’d woken with his heart bouncing around in his chest.
