Sixty-four-year-old Gerald was still conscious, despite falling blood pressure and having difficulty breathing.
‘I’m Mitch,’ He crouched at the head of the stretcher after the rapid-fire information-sharing. ‘I’ve got Jenna with me as well and we’re going to help look after you and get you safely into hospital just as quickly as we can.’
‘Okay...thanks...’ Gerald’s voice was muffled by his panting breaths beneath the oxygen mask.
Mitch glanced up. ‘Blood pressure now?’
‘Systolic still dropping. Eighty-four.’
‘Oxygen saturation?’
‘Seventy-eight.’
‘Has he got a pelvic wrap on?’
‘Yes.’
‘We need another line in. Preferably central. Jenna? Could you pass me the portable ultrasound, please? And set up for the line?’
‘Sure.’
It was getting crowded in the back of this ambulance as its crew shifted back to make room for the more advanced procedures their back-up medics could provide. Gerald already had a peripheral IV line in his arm but a central line was an intravenous catheter placed in a large vein near the heart and it had the advantage of letting them infuse a large volume of fluid rapidly, which their patient might well need if his blood pressure fell any further and he crashed.
Jenna could see Mitch using the probe from the ultrasound as she set out the cannula and attachments, adhesive coverings and alcohol wipes she needed to insert the subclavian line. She could sense his concentration and how fast his brain was working, not only to interpret the grainy images of what he was seeing on the screen but to weigh up every treatment option and the order they might need to be done to keep this critically ill person alive.
‘Okay,’ he said moments later. ‘Here’s the plan.’ He was speaking to the medical team around him but including Gerald as well. ‘You’ve got a collapsed lung and it’s getting harder for you to breathe, so we’re going to give you some more pain medication and try putting a needle into your chest. If that doesn’t help enough, we’re going to give you some stronger medication that will make you very sleepy. You won’t know what’s happening but we’ll be taking over helping you to breathe for a while—until we can get you into hospital.’
Gerald nodded. He seemed to be trying to say something but his words were no more than incoherent gasps and his anxious head movements gradually slowed as the medication took effect.
Jenna had the central line in place by the time Mitch had the chest decompression needle inserted but the numbers on the monitor weren’t going in the right direction.
‘O2 sats down to seventy-four.’ Jenna knew they were going to have to do something a lot more invasive and they probably only had one shot to obtain control of the airway and to improve how much oxygen was circulating. She’d have to step in if Mitch didn’t move fast but he was speaking even before she’d finished her sentence. He’d also seen the numbers on the monitor.
‘Let’s have the RSI kit,’ he said. ‘We’re going to do a crash intubation and see if we can get those sats up. I need one person to pre-oxygenate. Jenna, could you draw up the ketamine and suxamethonium, please? And I need a rolled-up towel to go under his shoulders.’
It was the first time Jenna had seen Mitch work on a real person rather than a mannequin but it was no surprise that his intubation technique was smooth and confident. It was also successful but even with the high level of oxygen being provided, the figure on the monitor remained dangerously low.
Mitch caught Jenna’s gaze. They were going to lose this patient if they didn’t try something else. She waited a beat to see if the procedure she was thinking of was also at the top of Mitch’s list. A surgical intervention only authorised to be performed out of hospital by doctors or paramedics with advanced training.
‘Finger thoracostomy?’ he suggested quietly.
‘It’s what I’d do.’ Jenna nodded.
Gerald was unconscious. Unaware of the slice of the scalpel or the pressure of Mitch’s gloved finger pushing through the muscle of his chest wall. The white towel underneath that side of the chest caught the rush of blood that obviously had air pressure behind it but the bleeding subsided relatively quickly. As quickly as the percentage of oxygen in the blood being displayed on the monitor began to increase. Back into the eighties. Into the nineties when Jenna could see Mitch releasing a relieved breath of his own but then he turned instantly to the next issue.
‘Blood pressure’s still too low,’ he said. ‘Let’s get more fluids up and I think it’s time to move. He could well be bleeding somewhere else. Jenna?’
‘Totally agree.’ She nodded. ‘We’ll stay with him in the ambulance. Can one of you guys follow us in with our vehicle, please?’
‘I could do that.’ A policewoman was standing at the open back door. ‘I need to come in with you, anyway. I’ve got a little girl here who says that your patient is her grandfather. We’re trying to contact other members of her family but it will be easier to meet them at the hospital.’
Jenna blinked. Was that what Gerald had been trying to tell them when he was so anxious before they knocked him out to take over his breathing? The policewoman moved and now Jenna could see a girl who was about five or six years old. Her long dark braids were framing a very pale, frightened little face and the child was crying silently, fat tears rolling down her cheeks.
‘Oh...sweetheart...’ Jenna stopped packing up some of their gear in preparation for transport and stepped towards the doors. She jumped out and crouched down so that she was on the same level as the girl. ‘I know it’s scary,’ she said, ‘but Dr Mitch is looking after your grandad and we’re going to take him to the hospital where there are even more doctors to take good care of him.’ She reached out to brush the tears from that small face. ‘What’s your name?’
‘K-Kirsty.’
‘Can you be brave, Kirsty? And come to the hospital with...’ She glanced up at the policewoman.
‘Lydia,’ she supplied.
Kirsty nodded slowly.
‘Good girl...’
Jenna only intended to smile at Kirsty but somehow she ended up with two small arms around her neck and legs that wound themselves around her waist as she stood up. For just a heartbeat, and then another, she pressed her cheek against that soft hair, closing her eyes as she felt and responded to that plea for comfort. When she opened her eyes again, she could see over Kirsty’s shoulder into the back of the ambulance where things were moving fast to tidy up the clutter of used packaging and equipment enough to make sure they could monitor their patient and keep anything they might need for the journey close at hand.
Mitch was already seated at the head of the stretcher, holding and squeezing the bag mask to keep Gerald breathing. He had the monitor screen close by but, right now, he was watching Jenna and Kirsty and there was a concerned frown on his face. Because she was holding them up? Fair enough.
‘Come on,’ she said, gently disengaging the limbs of the frightened child. ‘I’m going to put you in my special car because Lydia’s going to drive you to the hospital. I’ve got to go and help take care of your grandad.’
If Mitch had shown his ability to take command of a tense medical situation when they’d arrived on scene, he was even more in his element as they rushed the stretcher into the Trauma Resus room at the hospital they transported Gerald to. The specialist ED consultant leading the trauma team took a second look as someone led the transfer of their patient from stretcher to bed.
‘On my count. On three. One...two...three...’
There was controlled chaos behind them as everybody played their part in rearranging the attachments for an oxygen supply, replacing ambulance monitoring gear with their own, hooking up a mechanical ventilator and taking a new set of vital signs. Someone was also cutting away the remnants of Gerald’s clothing to expose his entire body for a detailed exam
ination. It would be a few moments before everybody was ready for a detailed handover.
‘Mitch?’ The consultant took a third glance. ‘What on earth are you doing out on the road? Last I heard you were HOD at St Barnabas.’
Jenna’s head turned sharply. Mitch had told her that he’d worked in an emergency department before moving into general practice but he’d been Head of Department? In one of London’s most prestigious trauma centres?
No wonder he had that kind of confidence she’d seen on scene today.
But why on earth had he gone from one end of the spectrum to the other as far as fast-paced medical careers could be lined up?
Mitch was simply shaking his head, dismissing the query. His attention was on the consultant in charge of the airway and breathing who was examining the hole in the side of Gerald’s chest.
‘Can you feel the lung? Has it re-inflated?’
‘Yes. And we’ll get a tube in to make sure it stays that way. Good job sorting that in the field. What was the initial blood loss?’
‘Only a couple of hundred mils. Not enough to account for that level of hypotension.’
Jenna stepped back as the lead ambulance paramedic detailed their findings on arrival at the scene and Mitch took over to cover the more advanced interventions they’d supplied. There was ultrasound gear being manoeuvred into position beside the bed, a radiographer was getting ready to take any X-rays ordered and so many other people around that she could only catch a glimpse of Gerald.
Near the half-open door to this highly specialised and equipped space, she could see into the emergency department and the central desk. Lydia, the policewoman, was standing there and she was holding Kirsty’s hand. A nurse was leading a distressed-looking woman towards the pair. Kirsty’s mother? Gerald’s daughter? Jenna felt a lump in her throat that was actually painful as she saw the expression on the woman’s face.
She knew that kind of fear.
The kind of despair that could come later as a family was shattered.
She watched the woman scoop Kirsty into her arms and remembered the feeling of having those small limbs wound around her and that made the lump even bigger. Sharper. Enough to make it hard to breathe so Jenna automatically turned away. She watched what was happening in Resus for another minute but then moved out of the way completely. She could wait in the car until Mitch came out and make herself useful by seeing what needed to be restocked with their gear and starting on their own paperwork, which would be added to the ambulance report forms.
Finding a smile for Kirsty as she walked past, Jenna sincerely hoped that the news this family would be receiving later on would be good. Or at least hopeful. It was satisfying to know that everything possible that could have been done medically to make that a possibility had been done at the scene.
And done brilliantly. Jenna would have no hesitation at all in letting Mitch lead any job she was dispatched to when he was with her. She would trust him with her own life with any medical emergency.
She had already trusted him with her body in another way, after all.
Phew... It was just as well she was already walking through the automatic doors to leave the emergency department as that thought entered her mind because it immediately triggered memories of that night that actually felt like Mitch was touching her again. She could feel the intensity of the strokes of his hands. The touch of his fingers. The glide of his tongue. She was even aware of a spear of sensation deep inside to remind her of how that had felt as well and a ripple that was a faint echo of just how powerful her climax had been.
Oh, my... Jenna was grateful for the cool air outside, knowing that her cheeks had to have reddened. She knew they’d both been thinking about it when Mitch had arrived on station and they’d made eye contact for the first time since he’d left her flat that evening but that had been okay. There had been an instant, tacit agreement that it was not something they were going to think about, let alone discuss, while they were together in a professional arena. It had felt almost like friends thinking about a shared night out of going to the movies or out for dinner or something. It had only been intended to be a one-off, after all—to see how rusty they might both have become in the area of sexual skills?
Andrew Mitchell hadn’t been at all rusty. She almost wished she hadn’t reassured him about that at the time because, that way, they have come to an agreement to arrange another skill refresher session.
Any disturbing feeling of being disloyal to Stefan’s memory had worn off since then so Jenna didn’t even try and contradict the assessment that the sex with Mitch had been the best sex she’d ever experienced in her life. But how big a part of that was due to having gone without intimate touch for so long? A starving person would probably find any kind of food delicious, wouldn’t they?
There was a level of curiosity in Jenna’s mind now. Would a second time with Mitch be as good as the first? Because she was still thinking about that as Mitch climbed back into the passenger seat of the car, Jenna instantly found something else to talk about. Something professional.
‘How good was that? You got to tick off three major skill sets that you haven’t used for a while. Needle decompression, intubation and a finger thoracostomy as a bonus.’ She was speaking a little too fast but Mitch was smiling.
‘I think he’s going to be okay. They’re taking him up to Theatre. Ultrasound showed some abdominal bleeding that looks like it could be coming from a ruptured spleen. He’s got blood products running now, which has stabilised his blood pressure.’ His smile widened. ‘It was a great job, wasn’t it?’
Jenna nodded. ‘And I have to say, I was impressed with how not rusty you were with your skills.’
Uh-oh...that was rather too similar to what she’d said to him that night. Jenna grabbed the handpiece to her radio from its clip on the dashboard. ‘Rapid Response One available,’ she told Control. ‘We’ll return to station to restock but we’re still okay to respond in the meantime.’
Mitch clicked his seatbelt into place but he wasn’t saying anything so Jenna filled the silence quickly.
‘Not that I’m surprised you did so well,’ she said. ‘There I was thinking you’d done a registrar rotation or something in an ED but you were head of department? At St Barnabas?’ Jenna couldn’t help the admiration in her tone. ‘Bit of a career change to become a GP, wasn’t it?’
Mitch shrugged. ‘Crossroads in your life appear for all sorts of reasons’ was all he said.
Jenna turned out of the hospital entranceway to join the heavy traffic of a late London weekday afternoon. She had to weave across lanes so it didn’t feel like an awkward silence between them. She wasn’t just thinking about what lane she needed to be in, however, because it was impossible not to pick up on the message that his dramatic change in career was not something that Mitch wanted to talk about.
Fair enough.
Would she want to talk about the how and why of how she’d ended up in this particular branch of her career as a paramedic?
Absolutely not. And, if he’d been nosey about her personal history when they’d first spent time together, she would have put distance between them as fast as possible and that night would never have happened. And she was very, very glad that it had happened. This connection she’d discovered with this man was very new.
It was exciting.
She’d taken a huge leap reintroducing sex back into her life again and that time with Mitch had confirmed that being close to someone like that was definitely a missing piece. Whether she could find anyone else that might be interested in an occasional, purely physical interaction was an entirely different matter, mind you. But...maybe she didn’t need to...?
‘Good to know that you thought my skills weren’t too rusty.’ Mitch was smiling at her again. ‘But there’s always room for improvement, isn’t there? Practice makes perfect.’
* * *
Oh...man...
That smile...
That flash of complete understanding in her eyes. Jenna had been completely in sync with the skills he was actually talking about when he’d suggested that practice made perfect. Okay...when he’d pretty much asked if she was up for a repeat of their ‘no strings’, ‘no pressure’ sexual encounter from the other week.
Not that she’d responded straight away. No...another emergency call had been a great excuse to shelve saying anything and it wasn’t until the shift had ended more than an hour later that she’d caught Mitch’s gaze and suggested a debrief over a beer or coffee—at her flat—and the way she’d held his gaze had told him that she had understood his earlier, subtle invitation. And that she was more than happy to accept it.
She understood a lot of things without needing any kind of explanation, Mitch thought as he followed her up those narrow stairs again and waited for her to unlock the door to her flat. Like the way she’d known how hard it had been for him to watch that dramatisation of a nasty horse-riding accident. And that he didn’t want to talk about the reasons he’d left his position at St Barnabas to become a small town GP.
He liked that she was respecting his privacy but it actually had a contradictory effect because Mitch found himself wanting to tell her the truth about why he’d given up the career he loved.
About Ollie...
Except that would change things and they were perfect just as they were. Mitch pushed the door shut behind him as Jenna dropped her keys onto a table and hung her uniform jacket over the back of a chair. She pulled pens from her shirt pocket and a tourniquet and notepad from a pocket in her trousers and then stooped to unzip the sides of her heavy boots.
It looked as though she was getting undressed already and Mitch could feel his heart rate pick up and the curl of desire in his belly grow instantly a hell of a lot more noticeable.
Stolen Nights with the Single Dad Page 6