What the hell was going on? Was this a crisis in confidence because the last time he’d needed to use this skill had been such a catastrophe? Had he lost an ability that had been a strength he had relied on more times than he could ever have counted?
He felt, rather than saw, someone coming to stand by his shoulder and he knew, beyond any shadow of doubt, that it was Jenna Armstrong—not just because she was running this workshop and making a point of coaching everybody, but because he could feel that...presence she had. The calmness. Confidence. Empathy...?
Whatever. She was the last person that Mitch wanted to watch him fail. He might have even sworn softly, under his breath.
Jenna’s voice was quiet. She didn’t seem the least bothered by the difficulty he was in.
‘Good to see you’ve found the downside of this new breed of stylet,’ she said. ‘The angle of the curve is sharper than we’ve used in the past. It mirrors the angle of the video laryngoscope’s blade, which is good but it makes it harder to advance the tube once you’ve got the tip through the cords. Try popping the stylet off with your thumb, back it out a bit and then try advancing the tube.’
And, just like that, it was suddenly easy. Mitch slid the tube into place, removed the stylet completely and attached the syringe to the balloon valve, inflating it with enough air to secure it within the trachea. Then he covered the mannequin’s mouth and nose with the mask and squeezed the bag. It was so much easier to watch exposed, pink plastic lungs rather than putting his stethoscope onto a real person to check correct tube positioning by watching and listening to see if the air entry was equal on both sides.
‘Cool...’ The praise from his instructor was matter-of-fact. ‘Now...start again.’
He glanced sideways. Were there enough of the video laryngoscopes for everybody to be getting a chance to practise this much? Tomorrow afternoon would be an assessment scenario and they would all be expected to discuss and demonstrate the use of emergency procedures like this before being signed off as FRAME practitioners. He didn’t want to monopolise this station.
But Jenna met his glance steadily.
As if she knew how important this was to him.
Silently, he removed the tube from the mannequin and set everything up to do it again. He didn’t mind Jenna watching this time. Quite the opposite. Especially when he heard the tiny hum of approval she made.
‘You’ve had a lot of experience with intubation, yes?’
‘Mmm.’ Mitch was focused on the screen. ‘Used to work in an ED,’ he told her, casually. She didn’t need to know that he’d been the head of that department, did she? And it was part of a life he’d left behind so it wasn’t even relevant. ‘It’s a lot different in general practice,’ he added. ‘I’m planning to seriously upgrade our emergency kits. Video laryngoscopes. Flexible endoscopes. If only...’ He trailed into silence, having already said more than he’d intended.
‘If only you’d had one of them on a difficult case?’ Jenna’s voice was quiet. ‘I have to admit that I got the feeling there’s a story behind why you came on this course.’
‘Yeah...’ Mitch could see the vocal cords on the screen now. He could push the stylet and tube through but his hand had stilled.
‘We’ve all got “if only” cases,’ Jenna said. ‘I’ve got a few of my own.’
‘But you wouldn’t get the children coming into your surgery.’ Mitch swallowed hard. ‘Three little kids who are growing up without their mum because it wasn’t possible to give her an airway.’
‘And you think having a video laryngoscope would have made the difference?’
‘They said not. Post-mortem results showed a laryngeal fracture, a C3/4 fracture and cord damage so even if she had survived, she would have been tetraplegic.’
‘Sounds like a very nasty accident. What was she doing?’
Mitch’s gaze flicked up. ‘Riding her horse. Jumping cross country. She was one of our local equestrian stars and she was training for last year’s three-day event at Burghley.’
He saw the way Jenna’s pupils dilated. Heard the sharp intake of her breath. ‘Oh...’ There was no need for her to say that she understand exactly what a gut-punch her introductory video must have been. ‘I’m so sorry, Mitch.’
‘You weren’t to know. It was a good reminder of why I’d come.’ Mitch turned back to his task and, this time, it was a smooth process to get the tube into place and secure it. He was reaching for the bag mask when Jenna spoke again, quietly enough for him to know that these words were only for him to hear.
‘They say so much, don’t they? Or hide it. Those two little words. “If only”. Or “what if”?’
Mitch had two fingers under the mannequin’s jawbone to help hold the mask on firmly. He inflated the bag and watched the lungs fill with air. ‘They do.’
‘I find they can blindside you in the most unexpected moments.’ Jenna’s voice wasn’t much more than a murmur. Certainly none of the other people in this room would be hearing this private conversation.
‘And keep you awake in the tiny hours of the night,’ Mitch agreed.
‘They’re not necessarily a bad thing, though. As long as you don’t let them take too much away from what’s important in your life.’
He didn’t need to inflate the lungs again but he did. Slowly. Without even thinking about what he was doing, because he was wondering what kind of things kept Jenna Armstrong awake at night or blindsided her when she least expected it. What was even more curious was how much he wanted to know. How interested he was in this woman...
‘And they can be a very good thing,’ Jenna added. ‘When they make you grab them with both hands and shake them until an answer falls out, they can be life-changing.’
Mitch looked up again in time to see Jenna’s lips curving into a smile.
‘Like you coming on this course,’ she told him. ‘Becoming someone that’ll be registered on the emergency services system and able to be responded fast to critical situations—with the best kit we can supply.’
‘Jenna?’ Judith was calling from the other side of the room. ‘I’m having trouble with this video thingy.’
‘Coming...’ But Jenna didn’t move for a moment. She was still holding Mitch’s gaze. ‘Think about that the next time you’re doing the “if only” game. Think about how the changes you’re making now might affect future cases. How many lives that might get saved because you’re doing this.’
Mitch watched her walking over to where Judith was working. He needed to tidy up this station and move on himself because he probably had time to practise with the cricothyroidotomy mannequin before he needed to hit the road and battle rush hour traffic to get home.
But he stayed very still for a moment longer.
Watching Jenna.
Letting it sink in that the brief, almost whispered conversation he’d just had with Jenna had done something that might have just lifted the remnants of the significant weight he’d been carrying on his shoulders for the last year.
It was such a cliché to think in terms of a silver lining to a cloud or some such rubbish but there was definitely something profound that Jenna’s words had left him with and...it did feel like coming on this course might be going to mark a changing point in his life. A positive change.
* * *
‘Ah...coffee...’
‘Here, have this one.’ Susie was already pouring a mug of coffee from the table set up at the back of their classroom. ‘You look like you need it more than I do, Mitch.’
‘Early start. And I got home pretty late. The traffic was appalling yesterday evening.’
‘I got the train. Bit of a walk from the station to get home but I rather like that. The calm before the storm.’ Susie was smiling as she handed him a steaming mug. ‘Milk?’
‘No, thanks. Black’s good.’
‘Storm?’ Jenna queried as
she joined them. She picked up two mugs and handed one to Susie.
‘Circus might be a better description. You know—husband, kids and the dog all demanding attention?’
Jenna shook her head. ‘No. I don’t have to cope with any of that. Thank goodness. Good for you, fitting in this course on top of your work and home commitments like that on top. I couldn’t do it.’
Mitch stepped back to one side, sipping his coffee as more people arrived and headed their way. The tone of her voice when she’d said ‘Thank goodness’ made it sound as if a husband and kids were the last thing she would want in her life.
Judith had heard the exchange between Susie and Jenna. ‘You do far more, from what I heard. Someone told me yesterday that you’ve written a book? A textbook for paramedics?’
‘It kind of grew from the first set of clinical guidelines I helped write when the FRAME initiative was set up.’ Jenna’s shrug was modest. ‘And they need updating already, which is an extra project I’ve got on at the moment. Things change, as you’ll all be well aware of—like the emergency management of heart attacks and now occlusive strokes by thrombolysis in the field.’
‘You travel all around the country with your teaching, as well.’ Susie’s tone was admiring. Or possibly envious?
‘Not so much these days. We’re getting a great cohort of instructors based in various cities. In the early days, I was hardly ever at home. I couldn’t have done my job if I’d had a dog, let alone a whole family, like you, Susie.’
‘But you love it.’ Mitch’s quiet comment wasn’t a question. She hadn’t needed to tell them all how much she loved her job yesterday because it had been so obvious. The passion she had for her career gave her a glow that made it hard to look away from her.
Especially when she smiled like that.
‘I do,’ she agreed. ‘I’m particularly loving the work on the new clinical guidelines—which you’ll all receive in the mail as soon as they’re completed, by the way. We’ve got a great team of experts on board, including emergency department consultants and specialists from cardiology, neurology and orthopaedics, to name just a few. It’s exciting.’
‘And you still find time to work on the road,’ Judith said. ‘I can’t even get round to weeding my garden.’
‘I need to keep my own skills current,’ Jenna said. ‘I’d feel like a complete fraud teaching a course like this if I didn’t. Especially when I’ve got a group of doctors who already know more than I do.’
‘Are you kidding?’ Susie raised her eyebrows. ‘I spend half my days writing repeat prescriptions and trying to convince people that they’d feel a lot better if they stopped smoking and lost a bit of weight. I’ve never used a laryngeal mask airway and I have to confess, the thought of having to perform a cricothyroidotomy on a real patient is terrifying. Wrangling three overtired kids into bed is a breeze in comparison. Especially when the husband gives me a hand like he did last night.’
Mitch closed his eyes as he took another sip of his coffee. Ollie hadn’t gone to sleep at his usual time yesterday so he’d been overtired by the time Mitch had got home as well, but how lucky were they both that there was a loving grandparent on hand and bath time had clearly been a joy for both of them.
‘I waited for you, Daddy,’ Ollie had said kindly. ‘I knew you’d want your goodnight kiss...’
And that feeling, when those small arms got wound tightly around his neck—that feeling of being home...
Mitch wouldn’t give that up, no matter how exciting a career it could allow. He’d done the opposite, in fact, hadn’t he? He could have been one of those experts on the team Jenna was working with to produce those updated clinical guidelines. He’d had the fastest-paced, most challenging job ever, running that hectic emergency department, but he’d given it up for his son and he’d do the same again in a heartbeat.
‘Well, you have my respect,’ Jenna told Susie. ‘I think you’re juggling a lot more than I do.’
‘It’s worth it,’ Judith said quietly. ‘My lot have grown up and left home now but you know what? I can’t wait for the grandkids to start arriving. I kind of miss that chaos and clutter.’ She smiled. ‘I won’t have to wait too long, either. My daughter’s pregnant. Due in a few weeks. It hasn’t been an easy pregnancy so we’re both looking forward to the birth.’
Nobody could miss that look that passed between Judith and Susie. The understanding of one mother to another. Mitch could have nodded his own agreement that parenting was worth any struggle but, for some reason, he didn’t. Because he was watching Jenna’s reaction, closely enough to catch a flash of something that caught his attention. Gave his heart a bit of squeeze, to be honest. It looked like she’d lost something and it made him wonder if she’d wanted kids and had found she couldn’t have them for some reason. Or if she’d lost the person she’d wanted to have them with.
The impression was gone in a blink, however, and Jenna was smiling now.
‘I wasn’t kidding when I was banging on yesterday about how much I love my job,’ she said. ‘It’s everything to me and I’m not about to let anything get in the way of being able to give it everything I’ve got. It’s not that I don’t like kids. I love them.’ Her smile widened. ‘As long as they get to go home with someone else.’ She was already turning away. ‘We’d better get cracking. We’ve got a lot to get through today.’
* * *
The stimulating effects of the strong coffee had probably worn off by the time they were into the second session of the morning but Mitch still felt alert enough to be absorbing—and enjoying—everything he was listening to Jenna saying about eye injuries that were considered to be emergencies due to their life-changing potential loss of vision.
‘So the usual cause of an orbital floor fracture is when a blunt object, of equal or greater diameter than the orbital aperture, strikes the eye.’ Jenna grinned at her class. ‘And one of the reasons I love talking about them is that we get to use really cool words when we’re discussing the signs and symptoms. Okay...quick quiz. What’s diplopia?’
‘Double vision,’ Peter answered.
‘Ecchymosis?’
‘Black eye.’ It was Melanie who responded first this time.
‘Ipsilateral epistaxis?’
‘Nose bleed on one side only,’ Indira said.
Jenna was nodding at each correct answer and clicking a remote control to bring up a corresponding image as confirmation. The quiz was rapid and the class members—including Mitch—were clearly enjoying the participation.
He was enjoying more than the quiz, however. The feeling that something had changed yesterday, after that brief, private conversation with Jenna, had not worn off. If anything, it was stronger now and Mitch was feeling a lot more relaxed. As if he’d somehow absorbed some of the serenity that came from the combination of passion and knowledge that gave Jenna that very appealing glow?
Maybe it was the idea that you could look back on even catastrophic events and realise that they were the catalyst for something good that wouldn’t have otherwise happened. Like him coming on this course and putting himself on the front line for local emergency service call-outs. There was a frisson of excitement to be found in the idea that his world would be expanding to include some of the things he thought he’d left far behind in his career but there was something deeper as well. The idea that he was changing more than an element of his working life? That he might become a better doctor because of this? A better person, even?
‘Traumatic hyphaema?’
There was a longer pause before anyone answered this time. Mitch knew the answer but he was momentarily distracted as he watched the way Jenna caught one corner of her bottom lip between her teeth as she waited. She was loving challenging these doctors and that glow had just ramped up a notch or two.
Good Lord...had he really thought that this woman would not stand out in a crowd because of how she lo
oked? Her intelligence was shining just as brightly and Mitch already knew how compassionate Jenna was. How empathetic. She’d known exactly how horrific it must have been for him to watch that dramatic accident scene involving a fall from a horse. He’d also been left with the impression that she more than understood what it was like to lie awake half the night being tortured by thoughts of how different things could have been.
‘Is it blood in the anterior chamber of the eye?’ Jack sounded a little hesitant as he broke the silence in the classroom.
‘Yes...excellent!’ The image that came onto the screen of a close-up shot of blood obscuring even the iris of an eye was enough to make a couple of people groan but Jenna was obviously happy as she clicked through more images and talked more about the implications of the sign.
But Mitch was still watching her rather than the screen.
If he had been looking for another woman in his life—which he wasn’t—then Jenna would have been perfect.
Apart from that one little detail he’d learned over coffee this morning that meant she was actually the absolute opposite of perfect, of course. If he was ever going to share his life with a partner again, he’d have to find someone who not only loved him but would love his child as her own. The fear of risking Ollie’s happiness in any way was so abhorrent it had been more than enough to let Mitch close the door firmly on even thinking about looking for someone.
Not that he’d needed an extra incentive to not get too close to anyone again. He’d loved Tegan. So much. And he’d known for a very long time that that part of his heart had died along with his wife. It was a no-brainer that he could never love another woman in a way that was fearlessly based on the confidence that they had the rest of a normal lifespan to be together. Even if that gaping hole in his heart had somehow, miraculously healed itself, he wouldn’t want to offer that much of himself to someone else. He didn’t even want to try dating anyone to try and find out how much of a relationship might be possible.
Stolen Nights with the Single Dad Page 3