Accidental Reunion

by Carol Marinelli

  Hester looked at her suspiciously. ‘You promise?’

  Lila nodded. ‘Look, Hester, I have to go.’ As she left she turned briefly. ‘But I’m really glad you’re here.’

  The strangest thing was, she was actually speaking the truth.

  A blue light was flashing past the windows of Resus. Dashing out to the ambulance bay, the cool night air hit Lila. Running, she pulled open the rear ambulance door, praying that the sight that would greet her would be another crying child.

  It wasn’t.

  The pink face of the five-year-old girl belied how sick she was. Carbon monoxide, a silent killer, caused the skin to turn a false, healthy-looking pink.

  Lila took over the cardiac massage as the paramedics raced the trolley into the resuscitation room.

  ‘Pulled out of the front bedroom, no pulse or respiratory effort, we’ve been working on her for fourteen minutes now.’ A paramedic reeled off the drugs the child had been given. They had already intubated the little girl and the anaesthetist took over, pushing the oxygen gently but rapidly into the child in an effort to increase her oxygen concentration.

  ‘There’s another ambulance working on child number three at the scene. She was flat when they pulled her out but I just heard from Ambulance Control that she seems to be picking up.’

  Lila nodded, not looking up as she carried on the necessary conversation. It was imperative they knew what else to expect, but she continued with the cardiac massage. ‘I thought there were four children.’

  The paramedic nodded grimly. ‘The firefighters are still searching.’

  ‘What about the parents?’ Declan’s voice sounded strangely hoarse as he pushed some drugs into the intravenous line that had been inserted into the child’s hand. No one liked dealing with such sick children and Lila knew he was devastated by the turn of events that had seen a usual busy night turn into a disaster for one family and an emotional roller-coaster for all the emergency staff involved.

  ‘Dad’s away on business, Mum’s got facial and hand burns but she won’t leave till we find the fourth child. The police are contacting the father now, poor guy. Imagine picking up the telephone and hearing about this.’

  ‘How old is the child that’s missing?’

  ‘Two.’ He turned and made his way down the corridor. Back to the ambulance, back to the scene to do whatever had to be done.

  There was no goodbye. No cheery ‘Catch you later’.

  Two.

  The tiny number said it all.

  CHAPTER EIGHT

  ‘STOP the massage.’ Declan raised one hand as he watched the cardiac monitor. The other hand was placed on the child’s neck, his eyes, his ears, his fingers straining to acknowledge even the tiniest sign of life in this precious young child.

  Lila rested back on her heels. Long ago she had abandoned standing on the floor as she’d given cardiac massage. Up on the trolley, astride the patient, the massage was more effective. On a small child like this it was important not to apply too much force, but in prolonged resuscitations such as this one it was tiring work. It was the fourth time Declan had told her to stop, the fourth time they’d held their breaths as they’d willed the drugs, the massage, the utter energy they’d been expending to somehow do its magic and work.

  They didn’t say anything—there was no need. But as the flat line on the monitor suddenly blipped, then blipped again, the flickering of a rhythm as it picked up the electrical impulses in the child’s heart, she heard Declan exhale and realised he’d been holding his breath also.

  ‘Come on, baby,’ he urged. ‘Come on.’ As if hearing the urgency in his voice, the rhythm picked up, slow and tentative at first but gaining in momentum until a steady pulse could not only be seen but palpated in her neck and her wrists.

  But this was only the first step. The real test came later. They might have got her heart beating again, but there was still a long way to go. Now she needed to breathe unaided, to show a sign that her brain hadn’t been damaged. There was no way of knowing how long she had been down before the firefighters had got to her.

  Her fixed, dilated pupils were an ominous sign of brain damage but, as Declan optimistically pointed out, the drugs she had been given at the scene of the fire and again in Resus would cause that also.

  ‘I’ll keep hyperventilating her,’ the anaesthetist said as the latest blood-gas results were thrust at him. ‘Blow off some of this carbon monoxide. She should have some mannitol as well—there’s bound to be some cerebral oedema. Apart from that, it’s wait and see.’

  ‘Have you got a bed?’

  The anaesthetist shook his head. ‘We’re getting Amy up there. I’ve got a patient that can be moved in the morning but it will mean keeping this little lady down here till then.’

  Lila chewed her lip. ‘I’ll have to see—we’re so busy. If not, the supervisor will have to do a ring around the other hospitals and see where there’s a bed.’

  ‘No worries,’ the anaesthetist said with an easy smile. ‘Let me know what happens. I’m not going anywhere for the moment.’

  ‘How’s Amy?’ Lila asked as Sue made her way in.

  Sue’s grimace spoke volumes. ‘Not the best. They’ve intubated her and I’m going to get her up to ICU now. Declan’s in with her parents. Any news on the fourth child?’

  Lila shook her head. ‘The nurse supervisor will take Amy up for you. Can you set up this bed for child three? They’ve alerted us to say she’s on the way now, though happily this one’s breathing. Once you’ve got the bed set up, help the anaesthetist with child two. I’d better go out—the firefighters are starting to trickle in.’

  She stood in the corridor, directing traffic for a moment. Catching sight of Hester’s stricken face, Lila popped her head in.

  ‘It’s all under control, Hester.’

  ‘All the children accounted for?’

  Lila shook her head. ‘All bar one. The firefighters are still looking.’

  ‘No doubt they’ll be in as patients next. Those guys never give up. Why don’t you page the medics? They can take over the firefighters’ care.’

  ‘Done.’

  Hester nodded. ‘I feel so useless, lying here,’ she admitted.

  Lila gave a tight smile. ‘We all feel like that, Hester, we all do.’

  If Hester had been a reluctant patient, the firefighters were even worse. Desperate to get back to the scene, the emergency department was the last place they wanted to be.

  Not when a two-year-old child was missing.

  Assessing them was made harder by the layers of heavy clothing and apparatus, and their soot-blackened faces.

  ‘You need oxygen and a chest X-ray,’ Lila said firmly to Bruce Thomson, a young firefighter who struggled to get off the trolley.

  ‘I ought to get back there.’

  ‘You can’t,’ Lila said, exasperated. Flashing a torch up his nose, she saw the singed hairs which indicated his breathing passages could be burnt.

  ‘She’s right.’ Declan came in behind her. His white coat was practically black, his hair was tousled and a streak of soot where he’d wiped his brow made him look as if he’d been out fighting the fire himself. Glancing at the casualty card, he shook Bruce’s hand.

  ‘Have you got kids, Bruce?’

  ‘Yeah, one. He’s the same age as the little tacker that’s missing.’

  ‘And, God forbid, if you were in these parents’ position, would you want a firefighter with smoke inhalation on the scene? Wouldn’t you rather the guys were looking for your child rather than looking out for their colleague?’

  ‘I guess.’

  She left them to it, grateful for Declan’s tact and insight, grateful to all her staff for coping so well.

  A tear-stained face greeted her as she pulled back the curtain. ‘I want to help…’ Vera was tearful, agitated. The unfolding events would have been especially traumatic for her, given her fragile mental state.

  ‘Vera, please.’ Lila heard the impatience in h
er own voice and immediately checked herself and changed track. ‘There’s really nothing you can do,’ she finished gently.

  ‘But the children, those poor babies…’

  ‘We’re looking after them.’

  But Vera wasn’t going to be mollified. ‘I have to help, there must be something I can do, something I can do to help the babies…’ It was the last thing Lila needed on top of everything else and she ran an exasperated hand, still dirtied with ash from the firefighter, through her long hair, trying to work out what on earth she was going to do with Vera.

  ‘I could use a cuppa, Vera.’ Declan’s casual tone was a sharp contrast to Vera’s. ‘In fact, I’m sure all of the staff will be needing some refreshments fairly soon. Perhaps you could help with that later. I know the paramedics and firemen will be gasping.’

  ‘And that will help?’

  Declan grinned, his eyes crinkling in that, oh, so familiar fashion. ‘Course it will, Vera. You know the saying that an army marches on its stomach. When things quieten down we’ll let you know and you can make us all a cuppa. For now, though, if you take a seat we can get on.’

  ‘You be sure and call me…’

  ‘We will.’

  Lila watched as Vera made her way towards the waiting room. ‘Thanks for that. It’s probably my fault in the first place for letting her hang around, but she’s never got in the way before.’

  Declan shrugged, only this time it didn’t annoy her. If anything, there was an endearing nonchalance about him. ‘She’s not in the way now, just concerned. Everyone is.’

  ‘Tell me about it. I’ve got Vera wanting to assist in Resus, Hester climbing off the gurney and firemen trying to escape.’

  Declan laughed at her description. ‘People just want to help. We’ve done all right, though. In fact, I think we’ve done a bloody good job.’

  ‘We haven’t finished yet,’ Lila groaned. ‘Now we’ve got the backlog to deal with.’

  The trim phone was ringing shrilly, making them both jump.

  ‘The backlog will have to wait,’ Declan said pointedly as she picked up the phone, watching her face as she took Ambulance Control’s message. ‘What is it?’

  ‘They’re bringing the two-year-old in.’ He saw the sparkle of tears glistening in her blue eyes.

  ‘Bad?’

  ‘No.’ Her face broke into a wobbly grin. ‘He’s screaming the place down. Apparently he’d got out through the back laundry and climbed into a shed. They were just letting us know so we could stand down the paediatric Resus bed. He just needs to be checked over.’

  ‘See?’ Declan’s face lit up at the unexpected happy news. ‘Good things do happen, even when there seems no hope.’

  Lila pulled a face. ‘Don’t go getting all philosophical on me, Declan. There’s also two more firefighters coming in and the mother. The night’s young yet.’

  *

  ‘Ah, this is the life.’ Declan pulled off his tie and accepted a mug of coffee from Jez, carefully poured by Vera. ‘How do you do it, Lila? You’ve got the surgical resident doing a drink round here.’

  Lila took a grateful sip of her steaming drink. ‘Teamwork. Jez, like every other mortal in the department, wanted to help, but for once there wasn’t an abdo pain in sight so Sue suggested he take Vera around. At least there was less chance with Jez of the nil-by-mouth patients getting a drink.’ Lila winked at Sue. ‘Looks like you’ve got a sweetheart there, Sue.’

  ‘Don’t I know it! Thank heaven you never came back to claim your drink.’

  The less said about that the better! ‘Can you believe how good the patients in the waiting room have been? Normally they’d be singing ‘‘Why Are We Waiting’’ by now and tearing the place to bits.’

  Declan shook his head. ‘People are good really. A cup of coffee and an explanation work wonders.’

  Draining her coffee, Lila stood up. ‘Well, the coffee certainly does. I’d better go and do the Horse’s obs.’

  ‘With a bit of luck we’ll be able to let her out of the stable by the morning.’ Sue laughed loudly at her own joke.

  There was a slightly manic edge to the conversation. The clock was edging towards six a.m. and the department was still full, yet for the first time on this shift there was no one critically ill, no one’s life hanging in the balance. There was finally a chance for a quick drink and the zany type of debriefing emergency staff did only too well.

  It was a slightly nervous Lila who made way for Vera to come out of Hester’s cubicle.

  ‘Sorry, Hester.’ Lila gave her boss an apologetic smile. ‘Vera wanted so badly to help, so I let her make the patients and staff a drink. Jez took her around, though,’ Lila added hastily. ‘None of the patients were compromised.’

  ‘I’m sure they weren’t. And the coffee was very welcome, too, I hasten to add.’ Hester replaced her cup in its saucer. ‘Vera was just telling me she used to get breakfast here until ‘‘the blooming boss’’ clamped down.’

  Lila’s already flushed cheeks grew even pinker.

  ‘So, am I right in assuming that that’s the reason for the increase in breakfast orders when you’re in charge, Sister Bailey?’

  There was no point in lying. She’d been well and truly caught. ‘I don’t do it all the time, just for a few of the regulars that come in now and then to have their ulcers dressed or get their antibiotics, that type of thing. It seems such a shame to send them off hungry so sometimes I order breakfast for them.’

  ‘Sometimes!’ The irony in Hester’s voice was blatant.

  ‘Well, maybe a bit more than that sometimes.’

  ‘Sister Bailey, we’re not a drop-in centre, we can’t cater for every homeless person, as much as we’d like to.’

  ‘I know,’ Lila admitted, scuffing the floor with her foot.

  ‘But I can’t see that the occasional meal every now and then could do any harm. Perhaps, if it’s not too late, you should ring the kitchen and order Vera a breakfast this morning. After all, she really has been a big help.’

  Lila looked up sharply, unable to believe what she was hearing. ‘She has, hasn’t she?’

  Hester nodded. ‘But, Sister Bailey, please, listen to me for a moment before you rush off. If you make a habit of it, providing food and blankets and shelter, people like Vera will come to expect it, depend on it even. Before you know it we’ll have more people than we can deal with and nobody can benefit from a situation like that. There are services that provide meals for the homeless—we’re an emergency unit. However, I do agree that now and then a bit of charity is merited. I’ll leave it to you, Sister, to make that call.’

  ‘Thanks, Hester.’ Lila found she was smiling genuinely at her boss for the first time in her memory. Declan’s image of Hester in black velvet helped just a touch, though! ‘Your obs are fine. No doubt Declan will give you your marching orders now.’

  ‘Well, if he doesn’t, I’m off anyway. I’ll take a couple of days off but I’ll be back soon enough.’ For the first time ever Hester looked unsure of herself. Lila watched as she pleated the blanket between her fingers. ‘You did very well last night under difficult circumstances. It can’t have been easy.’

  ‘It wasn’t.’ Lila gave her boss a cheeky grin. ‘My one major incident and I’ve got the unit manager with a ringside seat. That horse of yours must have had a sixth sense you needed to be at work.’

  ‘Poor Trigger, he must have got such a fright. I can’t wait to get home and see for myself how he’s doing. He must be feeling awful right now.’

  Lila rolled her eyes as she left the cubicle.

  One day…one day Hester’s voice was going to soften when she spoke about a human, and the whole department would stop dead in its tracks. Hester had missed her vocation in life—she really would have done better as a veterinary nurse!

  *

  Shirley took the news well that Lila was going to be late. The handover took for ever and a lot of time was spent on the telephone, arranging agency staff and extra cover
to cope with the previous night’s backlog as well as Hester’s temporary absence. Still, as Lila made her way up the corridor towards the car park she couldn’t resist popping into Intensive Care. As tired as Lila was, there was a method in her madness, for if she didn’t see how the children were for herself she knew she would never get to sleep.

  Part of the attraction of Emergency was the fact that no patient was ever there long enough to get on your nerves. Not that you didn’t form relationships in the relatively short time you looked after them. Emergency was a strange place. Here people were at their worst, the patients incredibly sick or scared, overwhelmed by the events that had bought them to this strange, fast-moving place. Emergency was such a contrast to the organised structure of the wards. Even the intimidating atmosphere of Intensive Care held a certain aura of calmness and quiet control.

  Patients seemed to forget the staff in Emergency. The wards weren’t lined with thank-you cards and the nurses’ station didn’t groan with the weight of flowers and chocolates from grateful patients.

  Lila stood a moment after buzzing, waiting for permission to enter, her sleep-deprived brain forming an answer to the conundrum she had just raised. Maybe it was too painful for the patients and relatives to remember their time in Emergency. Maybe it was just a bit too close to the bone.

  There was one thing Lila was sure of, though. The nurses in emergency never forgot the patients. Not tiny ones like this anyway.

  As she looked at the blonde locks plastered to the tiny flushed face Lila swallowed a lump in her throat.

  ‘How’s she doing?’

  ‘Good.’ The optimism in the intensive care nurse’s voice came as a delightful surprise. ‘They’re going to extubate her this morning. Touch wood, this one will be a happy ending.’

  ‘And Amy, the little girl with meningococcal?’

  ‘That miracle might take a bit longer.’ The look that passed between the two women needed no words. With a small nod of thanks Lila made her way over to the glass window of the isolation ward and stood silently watching the little child swamped by machines and tubes, battling to stay with the world.