Claiming His Pregnant Princess

by Annie O'Neil

  “Jessica’s lost consciousness.” Dr. Brandisi’s voice rose above the rest. “Can we get a check on her stats, please?”

  “Where’s the oxygen? We need to get some oxygen.”

  “It’s impossible to attach the monitor tabs.”

  “Use your fingers. The woman’s still got pulse points.”

  The tension in the room ratcheted up another notch. After a moment of taut silence and furious concentration a nurse rattled off some numbers. The voices rose around Jessica’s bed, then dropped just as suddenly.

  “What’s going on?” Monica whispered.

  “Can we get an intubation kit?” Dr. Brandisi asked.

  “Anyone clear on the ambient temperature? We don’t want to add hypo to the symptoms.” Jamie threw the question over his shoulder to the stand-by staff awaiting orders.

  “They’re doing everything they can for your sister,” Beatrice told Monica, taking as much of the her top off as she was able to, steering clear of the burns. Thank goodness it was cotton. A synthetic top would have melted instantly. “Hypothermia can be a problem if the room’s too cool and there’s a large burn surface.”

  “I never should’ve suggested making pancakes! It was ridiculous!”

  “There’s soot in Jessica’s airway.”

  “Better that than losing oxygen.”

  “She’s not breathing?” Monica rasped, lifting the oxygen mask from her mouth, her throat losing its battle for moisture.

  Bea looked across to Jamie. He nodded. She knew that nod. Go ahead and be honest, it said. But do it with care.

  Bea ran her fingers as gently as she could against the unburnt skin of the woman’s cheek. “This team of doctors are exactly who she needs to be with right now. Let us focus on you.”

  “Give me a moment.” Dr. Brandisi silenced his team as they prepared to intubate Jessica. “All right—we’re in. Let’s get her into surgery, people.”

  As one, the team flicked switches, unlocked wheels, tugged rolling IV stands close and moved toward the swinging doors that led to the small surgical ward.

  “Is my sister going to be all right?” Monica tried to sit up again, screaming when her exposed arm brushed against the side of the gurney. “Cut it off!” she pleaded, her one good hand clutching at Bea’s surgical gown. “Please—cut it off if you have to, but make the pain stop!”

  “We’re doing everything we can. As soon as your IV is in, the pain will begin to ease.” Bea turned to the nurse hanging up the bag of electrolyte fluid. “How much lidocaine do you have in there?”

  The nurse told her she’d used the standard calculation.

  “Ten milliliters to a five hundred milligram bag?”

  The nurse nodded.

  “There isn’t any potassium in the bag, right?”

  “No. We’ve heard about the risks. Even up here in the hinterlands.”

  Bea’s eyes flicked to Jamie’s at the comment. She hadn’t been questioning the nurse—just making sure all the bases were covered.

  She returned her attention to Monica. This wasn’t the time to bicker about whose pool of knowledge was bigger, even if her specialty had been trauma. Malnutrition and respiratory infections had been her bread and butter at the charity clinic in Venice, but today she was going to have to draw on every ounce of experience she’d had at Northern General. And rely on Jamie. This was his turf. His call to make.

  “I know it’s difficult, Monica, but if you could lie back it will help with the pain.” Her eyes flicked to Jamie. Which way would he want to go with this?

  “Have you done the fluids calculation for the first twenty-four?” Jamie asked. He had removed all the clothing he could from Monica’s side and begun checking her circumferential burns.

  “Four mils multiplied by the patient’s body weight by TBSA?” She winced. She hadn’t meant it to sound like a question.

  “You’ve got it.” He didn’t sound surprised. “Make sure fifty percent of that is fed through in the first eight hours, the rest infused over the last sixteen. Are you all right to oversee this?”

  “Sure.” Bea turned to the nurse and asked for extra bags of the electrolyte solutions essential for rehydrating the patient, along with giving her a request to monitor the urine output.

  “I’m swabbing for microbiological contamination.”

  Jamie looked to Bea. Again, as if reading his mind, she knew what he was saying. Brace your patient. It would hurt, but Monica had been in a lake. They had to know what germs they’d be fighting.

  After talking Monica through the pain of the swabs, Bea returned her attention to Jamie. If he was needed for other cases she should show she was on top of this. Or was he babysitting her? Making sure nothing else had changed about the woman he’d thought he’d known inside and out?

  Either way, it just showed he was a good doctor. It wasn’t anything to get bristly about.

  “Warm water wash before dressing, and then what would you like?”

  “We’ll need a CBC and ABG, a check on urea and electrolytes.” Jamie turned to the nurse. “Would you please get Monica’s blood glucose levels, B-HCG and an albumin test?”

  “What is all that? Am I going to live?” Monica’s hoarse voice croaked up through the list of instructions.

  “We’re doing our best to get you through this,” Bea replied.

  She would have loved to say yes. Make assurances. But burns this big opened a patient up to multiple complications. The tests Jamie had ordered were only the beginning of weeks, if not months of treatment. The poor woman would no doubt need extensive time with multiple therapists as her body was healed from its devastating injuries. Luckily, it seemed most of hers were second-degree burns—unlike her sister, who seemed to have taken the bulk of the fireball’s heat.

  * * *

  “We need to get some saline into her. And some blood. Her heart’s going to need all the help it can get.” Jamie nodded at Beatrice to get the IV. “Anyone ascertained a blood type?”

  “O positive,” answered a dark-haired nurse, Giulietta. “And her husband said she doesn’t have any allergies. Do you want me to organize a transfusion?”

  “Not just yet. Let’s see how she goes with the rehydration solutions and lidocaine first. Dr. Jesolo, have you established the TBSA yet?”

  Beatrice pulled a sterile needle from its packaging and prepared to inject antibiotics into the fresh IV bag. “To me it looks like thirty percent. Maybe a little bit more.”

  He nodded. “Good.” His eyes flicked to Giulietta. “Can we get a call in to the burns unit in Pisa? These two are going to need to be transferred as soon as they’re stabilized.”

  “They’re from the UK. Is it worth putting a call into a hospital there? A medevac?”

  He shook his head. The hospitals in the UK were terrific, but time was a factor. “Let’s get her stabilized and en route to Pisa for the time being. We’ll call in a translator if necessary.”

  “Yes, Dr. Coutts.”

  Another nurse filled her spot as quickly as Giulietta left.

  “I’m just going to check on Jessica—are you all right on your own?” He knew what the answer would be, but wanted to triple-check with Beatrice. There was something a bit fragile about her today. Something in direct contrast to the slight bloom he’d thought he could see in her cheeks when she’d come in this morning. He’d been a fool to cross the line as he had with that blasted kiss, but it was too late to wish it back now.

  “We’re going to be just fine here. Aren’t we, Monica?”

  Jamie watched as Beatrice bent close to her patient’s lips, listening intently as a message was relayed.

  When she looked up at him, there were tears in her eyes. “Could you let Jessica know that her sister loves her?”

  “Of course.” Jamie nodded s
omberly as he met Beatrice’s gaze.

  They both knew how severe these two cases were. How, even if their patients survived the blast, their lives would be changed forever.

  “Straightaway.”

  From the moment he entered the operating theater he sensed something was wrong.

  The instant he heard the words hypovolemic shock, his mind went into overdrive.

  Jessica’s extensive burns meant her body couldn’t retain fluids—crucially, blood.

  Dr. Brandisi gave Jamie a curt nod when he joined the table, tying on a fresh gown as he did so. “We can’t get enough blood into her. Or saline fluids. Her heart’s beginning to fail.”

  “Raise the feet, please.” It was a last-ditch attempt to try to increase her circulation, but a quick glimpse at her heart rate and pulse were sure signs that there was little hope. The atmosphere in the room intensified.

  “I don’t suppose there are any peristaltic pumps hidden in a cupboard somewhere,” he said to no one in particular. He knew as well as everyone else that there weren’t, and rehydrating the patient was critical. Despite the fact they were a midsize clinic, they simply weren’t equipped to deal with an injury of this nature.

  “Negative,” Teo replied needlessly, his expression grim. “The chopper is on its way. Potassium levels are too high. Can we try to get more fluids in her?”

  “She’s going into cardiac arrest.”

  “Kidneys are failing.”

  “Temperature’s falling. Let’s not add hypothermia to the list, people!”

  Jamie scanned the woman’s chest. The burns were too deep to consider using the standard defibrillation equipment. They could try for open-heart surgery, but they simply didn’t have the means of getting enough blood into her body to warrant any success.

  As the team worked with a feverish intensity, Jamie did what he had promised. Jessica’s chances were fading with each passing moment, and he sure as hell wasn’t going to let her die without hearing her sister’s words. He knelt low beside her, gently holding each side of her head as he did so, and passed on the message of love.

  All too quickly the team had exhausted every means of keeping Jessica alive.

  “Do you want to call it?” Teo stood back from the operating table, angrily pulling his gloves off and throwing them in the bin. No one liked to lose a patient. No one liked to make the call.

  Jamie glanced up at the digital clock as he pulled off his own gloves. “Time of death—”

  “The helicopter’s here. Are you ready?”

  Beatrice burst through the doors of the operating theater holding a mask in front of her face, her eyes darting around the room until they landed on Jamie.

  “Time of death,” he repeated, with more feeling than he’d anticipated, “nine-oh-seven.”

  Beatrice dropped the mask, a flash of dismay darkening her features before she quickly composed herself. She gave Jamie a quick nod. “I’ll let the staff know. I might hold off on telling the sister until her transfer is complete.”

  “As you see fit,” Jamie agreed.

  It was always a delicate balance. Family desperate for information. Taking it hard. Losing the will to survive. Monica’s burns were severe, and she would need every ounce of fight she had left in her.

  He nodded his thanks to the support team and went out through the back of the clinic for just a moment to recover. Regroup.

  Behind the clinic was a small courtyard, paved with big slabs of mountain granite. One of the nurses kept the flower boxes bright with fresh blooms. They were a cheery, lively contrast to the hollow sensation that never failed to hit him whenever their efforts failed.

  He heard the helicopter rotors begin their slow phwamp, phwamp, building up speed and ultimately taking off, banking to the south to head for the burns unit in Pisa.

  His thoughts were with Monica’s husband, still in Casualty with his children, where the nurses and doctors were tending to their minor injuries. His holiday up in the mountains turned into a living nightmare.

  Jamie wouldn’t have wished what they were going through on anyone.

  It was a vivid reminder that no matter how difficult he’d found it to see Beatrice these past few days, she was alive. While they were obviously still stinging from their breakup, neither of them was going to have to deal with the physical traumas Monica would for the rest of her life.

  The poor woman would have to focus with all the power of her being on the silver linings. Her children had escaped injury for the most part. Her husband was fine, dedicated to his family and their welfare. Monica would bear the scars of this day forever, but in her heart she would be eternally grateful for pulling through.

  He looked up into the bright blue sky, dappled with a smattering of big cotton-ball clouds. He picked one and stared, squinting against the brightness of the morning sun as it rose at the far end of the lake.

  So Beatrice had left him to do right by her family. She had never been a woman to take a decision lightly, so there must have been something deep within her, compelling her to choose to fall in and play the good daughter. His family had made sacrifices for him. Life-changing sacrifices so that he wouldn’t have to. What if he had been put in a similar situation?

  He closed his eyes and let the sun beat down on his face.

  His family wouldn’t have had a similar situation, but he knew that if push had come to shove he’d have laid his life on the line for any single member. It would be two-faced of him not to expect Beatrice to do the same.

  At the time her decision had hurt as badly as if she’d stabbed him and left him for dead. But she’d never said she didn’t love him. Never said she didn’t care. And when he’d kissed her... The sensation had kept him up near enough half the night. He knew what he had felt—and it was about as close to love as he dared let himself believe.

  He opened his eyes, surprised to feel a soft smile playing on his lips. Tough start to the day. But it had given him some much needed perspective. A way to get through the summer with his heart intact.

  * * *

  It was at moments like these that Bea felt overwhelmed by the beauty of the human spirit.

  The day had been a long one and having heard at long last that Monica had arrived at the specialist burns unit and was receiving the best treatment she could get, Bea had felt the tightness in her chest loosen a bit. When the doctor changing shifts with her had mentioned the community’s response to the accident she’d taken a walk down to the lake, and the sight that greeted her now set her heart aglow.

  The lake was sparkling so brightly it looked as if it were inhabited by thousands of tiny stars, and out of respect for the family who had suffered such a heavy loss today holidaymakers and locals had joined forces, piling huge bouquets of flowers on the boat launch where the accident had taken place. As the sun set one by one people were releasing floating candles onto the lake. Hundreds of people had turned up. The overall effect—shimmery, magical, otherworldly—was healing.

  “Quite a turnout.”

  A spray of goose bumps rippled up her arms. No need to turn around to guess the man behind the voice. But before she could think better of it Bea did turn, her body registering Jamie’s presence and her brain still spinning to catch up, as if her skin remembered what it was like to be touched by him without a prompt.

  Little wonder. When she’d agreed to the arranged marriage she had forced herself to preserve her time in England in a little memory bubble and hide it as far away as she could. How else would she have survived?

  And now that she was pregnant... Oh, Dio! It was as if the bubble had been sliced open and her dream man had been put in front of her just in case she hadn’t already known what she’d given up.

  She was going to have to find a way to be stronger than this, better than this, when her child was born. There was no way he
r baby was going to suffer for her own madness-fueled mistake. Because it did boil down to just one. Leaving Jamie.

  “Really good work today.” Jamie tucked his chin down so that his eyes were on a level with hers. A move he’d once used to great effect to tug a smile out of her after a rough shift.

  She swallowed before she answered, knowing those ever-ready tears would come if she spoke straightaway. “You, too.” She went for a casual, buddy tone. “I’d almost forgotten how well we work together.”

  “I hadn’t.” He pushed up to his full height, eyes looking out upon the lake. “Look, do you see there, where the moonlight meets up with the candles? It’s as if they’re drawn to one another.”

  Unable to respond, she murmured an acknowledgment and looked back out at the lake.

  Drawn to each other...

  Just like the pair of them. She’d used to think their combined energies made them a force to be reckoned with. Now, with the situation she’d found herself in—correction, put herself in—she was a moth drawn to the flame. Falling in love with Jamie again would be all consuming. Something she wouldn’t be able to come back from.

  In a few months’ time she would need to give all her energy to her child. Figure out how to pay the bills. Work. Breastfeed. Love. Laugh. Cry. All of it with one sole focus. Her newborn child.

  So right here and now, opening up the heart she knew was near to bursting with love for the man she’d left behind wasn’t an option.

  They stood for a few moments in silence, gazing out at the lake. The area was crowded, and there wasn’t much room. Someone trying to get a lakeside view caught Bea off balance, and despite her best attempts not to reach out to regain her balance her hands widened and found purchase on Jamie’s chest. His arms automatically cinched around her back, creating a protective barrier by pulling her in close to his chest.

  Bea was hit by a raft of sensations.

  The scents she would have been unable to describe a fortnight earlier came to her now as clear as day. Cotton. Cedar. Spice and citrus.

  The feel of the firm wall of chest her fingers hadn’t been able to resist pressing into.