The Consultant's Surprise Child

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The Consultant's Surprise Child Page 3

by Joanna Neil


  'He is, but I want to see how the unit works.' He sent her an oblique glance. 'Does it bother you that I'll be going with you?' His eyes said that he was very well aware that it did.

  She shook her head, clamping her lips together. 'No, not really,' she said, but it was an outright lie, and he probably recognised that. Just knowing that he was nearby and that they would be in each other's company day after day was already having a disastrous effect on her nervous system.

  In fact, she wouldn't have been surprised to learn that he had arranged to be part of the response team deliberately, just so that they would have to work together. Was he paying her back for walking out on him?

  He didn't pursue the matter any further. 'You looked preoccupied when I came to find you just then,' he murmured. 'Was your patient giving you problems?'

  'No. It was just that he reminded me so much of Steve, Rhea's ex. I couldn't help but think back to how much trouble he used to cause her.'

  He frowned. 'But that's all over with now, isn't it? She married someone else and had a child, or so I heard.'

  'Yes, she did, but the marriage didn't work out, and I don't know that Steve ever gave up on stalking her. She's had to move house several times in the last few years just to keep one step ahead of him.'

  By now they had collected their gear and they hurried out to the waiting ambulance car. Taylor slid behind the wheel and started up the engine.

  'I didn't know that...but I seem to have missed out on quite a lot of the news while I've been working down in Hampshire. What else has happened while I've been away? I see you qualified as an A and E doctor but, then, I always knew you would. It was either that or paediatrics, with you.'

  Her heart wrenched. Paediatrics had been crossed off her list once she had given birth to her son. Holding him in her arms, she had known that she wouldn't be able to cope with the stress of treating sick children every day.

  He was waiting for an answer as to what had been happening, and she could have used that opportunity to say to him, 'When you left, I discovered that I was pregnant. I gave birth to your son.' But the words stuck in her throat and her pulse began to hammer. Of course it was the wrong time to say any of that.

  Instead, she told him, 'After we sold Mum's house, I moved into a property in Kilburn, and Nick used his part of the proceeds to set up in business once more in a place just outside the City.' It was a sore point, the fact that her brother had had to start over, and she wondered how Taylor would react to that comment. Wasn't he partly to blame for her brother's troubles?

  His eyes narrowed, but other than that he didn't respond, except to ask, 'Is he still in partnership with Ben?'

  She nodded. 'Of course. Why wouldn't he be? They're both skilled craftsmen, and they work well together.' Her brother's bespoke furniture business was still in its infancy, but she had every faith in him to make it succeed this time around.

  They were travelling as fast as traffic restrictions allowed, passing through the residential suburbs of West London, and Taylor followed a route by the Grand Union Canal. Through the trees Allison caught a glimpse of colourful barges moving slowly on the water. It was a leisurely kind of existence that seemed incongruous with the fast pace of London life, but it was something she longed to experience.

  'I'm taking a short cut,' he told her. 'I used to come out here with my sister, when we were younger, to wander through Perivale Wood. They open it up to the public when the bluebells are in full bloom, but otherwise it's kept as a nature reserve for members or for groups of school children to visit. There are nature trails to follow, and we used to like looking at the ponds and streams. Claire had a thing for wildlife. She couldn't get enough of trips out.'

  'Yes, I remember that.' Allison glanced at the distant stretch of trees and green open space. 'She has children now, doesn't she? Do they get to share in her love of nature?'

  He gave a short laugh. 'I expect so, from time to time, but you have to go carefully with those two boys. Trouble seems to be their middle name and you might be able to take them out somewhere, but you wouldn't necessarily want to take them back there again.'

  Allison smiled wryly. His comments made her forget for the moment that they were headed out to the site of an accident, but he brought her back to reality soon enough.

  'We're here.' He pulled up some distance from the bus depot, and even from here they could see and smell the cloying thick black smoke that billowed into the air. 'This is about as close as we can get, I think.'

  'How did the fire come about, do you know?'

  'I don't think they have any real idea yet, but there was some talk of an engine catching fire and igniting the blaze elsewhere. I imagine there will be an enquiry into the cause.'

  They stepped out of the car and began to hurry towards the depot. Allison could see that two of the buses were on fire, but as they approached there was a sudden explosion and the sound of breaking glass ripped through the air. In an instant Taylor had pulled her to one side, holding her back against a wall and sheltering her with his tall frame.

  She was stunned by the force of the explosion, and shocked by the roaring sound of the fire, mixed with the noise of shattered fragments falling to the ground. Most of all she was aware of Taylor's strong body against hers, his jaw lightly grazing her cheek so that she registered the slight roughness of his skin as he bent his head to protect her. Her breasts were crushed against the hard wall of his chest, and she could feel the warmth emanating from him. She felt the heavy thud of his heartbeat as he leaned into her, keeping her from harm.

  Being this close to him made her senses spin. It called to mind how it had been that night so long ago when he had held her in his arms, and the heat rose in her, stifling her common sense and making her want what could not possibly be. It was madness to think that their coming together back then had been anything more than a momentary lapse.

  After a while he eased himself away from her, hesitating before he glanced around. Smoke drifted around them, carried on the air by a gust of wind. 'I think the explosions have stopped for the moment,' he said in a gruff, thickened voice. 'There must have been a build-up of intense heat to cause the blow-out, but it looks as though the firemen are moving in with foam spray. Perhaps we can safely get to our patients now.'

  Had he been at all affected by their unexpected closeness? Allison glanced at him. He seemed to be very much his usual self now, and it must have simply been the smoke in the atmosphere that had roughened his voice. She wasn't sure quite how she felt about him recovering so easily, but she decided to take her lead from him. It was important that she should bring her mind back on track. After all, they had a job to do.

  Allison went with him to where the ambulance crew was gathered. A young woman was sitting on a bench by a wall, being attended to by a paramedic as she struggled to breathe, and near to her there was a man who was lying down on an ambulance trolley. He was suffering from obvious burns to his hands, and there was an oxygen mask in place over his nose and mouth. He looked to be in a bad way.

  The second paramedic was looking after the man, dressing his burns, and he said quietly, 'This is Jacob. He was in the driver's cab when the engine caught fire and I'm concerned about his condition. Apart from the burns, he's suffering from smoke inhalation, and I'm afraid that some of the fumes in the depot must be toxic. His consciousness level is falling and his heart rhythm has been affected.'

  'I'll try to intubate him,' Taylor said, looking grim. 'The sooner we can get an airway into him the better.'

  The paramedic made way for him and Taylor introduced himself to the patient. 'Jacob, I'm Dr Briscoe. Can you hear me? How are you doing?' Allison guessed that he was looking for a response so that he could assess the man's level of consciousness.

  Jacob mumbled something, but the words were indistinct, and Taylor said quickly, 'It's all right.. .we're going to look after you. I just need to look down your throat for a moment.' He worked swiftly after that, grimacing as he said to Allison, The
throat tissues are swelling up. This is going to be tricky.'

  At the second attempt he managed to insert the tube, and the paramedic hurried to hook Jacob up to an oxygen supply. Allison set up an intravenous line so that they could give him resuscitating fluids, and then, at a shout from the paramedic nearby, she handed over to Taylor and went to take a look at the young woman.

  'Her name is Tracey,' the man who was helping her said. 'She's eight months pregnant and suffering from asthma. She's used her salbutamol inhaler, but it doesn't seem to be working.' As he spoke, the woman started to slip sideways, and he caught her, supporting her and laying her down along the bench.

  'She's not with us,' Allison said in alarm, feeling for her pulse. 'I'm going to give her a shot of epinephrine.' She used an auto-injector, but it didn't cause the reaction she hoped for and she and the paramedic started immediate cardiopulmonary resuscitation. Taylor came to assist, and between them they managed to put in an airway and shock the heart back to a sinus rhythm.

  'Let's get both patients into the ambulance,' Taylor said. 'You go with them to the hospital, and I'll follow in the car.'

  Allison nodded agreement. She was worried about the woman, but the man wasn't doing well, either, and her heart was in her mouth on the journey back to King's Bridge.

  Taylor met up with them in the ambulance bay a few minutes after they got back to the hospital. 'Has there been any change?' he asked.

  'Tracey's pulse is thready,' Allison told him, as they hurried into A and E, 'and the foetal heart rate is slow. I'm worried that neither of them is receiving enough oxygen. We're going to have to do an emergency Caesarean, or we risk losing both of them.'

  'Did you call ahead to have the anaesthetist standing by?'

  'Yes, I did that. I asked for a team to make themselves ready, but they said all the theatres are occupied right now.'

  She grimaced. 'As to Jacob, I'm concerned about his cardiovascular symptoms.'

  'We'll get some lab tests done,' Taylor said, 'but I expect in Jacob's case the result will show cyanide poisoning along with carbon monoxide. I thought I detected a smell of bitter almonds in the air when we were at the depot. Cyanide gas is given off when things like plastics, wool and rubber are burned and it can have a disastrous effect on the nervous or cardiovascular systems.'

  He turned to the nurse who had come to assist. 'Take him into the resuscitation bay for the time being. Keep him on high-flow oxygen and monitor his heart rhythm, pulse and blood pressure while we wait for the results,' he said. To Allison, he added, 'Let's get Tracey into the treatment room. We need to get her prepped for a Caesarean. We'll do it here. We don't have time to get her up to Theatre anyway. Her oxygen level is falling dangerously low.'

  It was a nerve-racking time for all of them. Sarah called once more for the obstetrician and the paediatrician to come down to A and E and be ready to assist, and as soon as the anaesthetist had made sure that the epidural injection was working properly to numb the area, Taylor started the procedure. The mother-to-be was weakening fast, and there was no time to waste.

  'I'm going to make a small incision across the bikini line,' he said, looking at Tracey to see if there was any response. 'You might feel a slight pulling sensation, but you won't feel any pain.' Tracey didn't answer, and he went to work swiftly, skilfully, so that within a very short time he had cut into the uterus and was ready to bring the baby into the world.

  'It's a boy,' Taylor said, a minute or so later, his tone flat, 'but he doesn't seem to be in good shape.'

  Allison could see straight away that there was a problem. The infant wasn't making a sound. He was limp and unmoving, and she felt her heart contract. Were they too late?

  Taylor clamped and cut the cord, then handed the baby to her, before turning his attention back to the mother.

  Allison hurried to one side of the room to examine the infant. 'He isn't breathing,' she told Sarah. 'I'll have to apply suction to clean out his mouth and nose.' Once she had done that, she checked again to see if he was breathing and then shook her head. Sarah looked distressed, but quickly fetched an oxygen mask.

  Allison started chest compressions on the infant, circling her hands around him so that her thumbs met over his breastbone. 'There's still no response,' she whispered after a minute. 'I'll intubate and give him intravenous epinephrine and maybe check for acidosis. I might need to give him bicarbonate.'

  Things looked bad, but Allison went on with her efforts and after a while the baby's abdomen made a small movement and his chest wall rose slightly. Sarah made a choking sound. 'He's breathing,' she said, her mouth breaking into a smile. 'You've brought him back.'

  'We've brought him back,' Allison said, her own tension slipping away. 'He's beginning to pink up nicely, isn't he?' She glanced to where Taylor was still working to bring the mother's breathing under control, and he returned her gaze, his grey eyes showing a gleam of satisfaction.

  The paediatrician arrived soon after that, and Allison left the baby in her care while she went to see how the mother was doing.

  'She's a little better,' Taylor said in a low voice. 'Once the baby was delivered, the pressure on her blood vessels was relieved. The inferior vena cava decompressed and with that her circulation started to improve. She isn't out of the woods yet, though. We need to add a bronchodilator to the nebuliser to help with her breathing and we have to monitor the corticosteroid dosage. That baby won't have a mother unless we can put an end to this asthma attack.'

  She worked with him for the next hour, until they had done all they could to stabilise Tracey's condition, and then Taylor went to check on the bus driver, who was still in dire straits.

  'I'll come with you,' Allison said, but he stopped her.

  'No. You should go and take a break. I'll deal with this. We've been on the go all day and it's coming up to the end of your shift. You look drained, and I don't recall you having taken a break yet, apart from a quick five minutes you managed to snatch earlier on.'

  She frowned. How had he known about that? How could he have managed to keep an eye on her movements while he'd been busy tending to his patients? Every time she had looked for him that morning, he had been occupied elsewhere, dealing with some trauma or other, and yet it seemed that he had somehow kept tabs on everyone. This afternoon, even though they had been taking care of the bus-depot patients, he had been aware of everyone's individual assignment.

  'I need to keep watch on the rest of my patients,' she protested. 'The man with the broken ribs was admitted to the observation ward, and I have someone else waiting for results of a liver biopsy.' Besides, she was anxious to see how the driver was doing.

  'The registrar will see to that.' His tone was firm, brooking no argument. 'He's back from his meeting, so you've no worries there.'

  She made a face. It was no wonder he had achieved the exalted position of consultant while he was still in his mid-thirties. He must have eyes in the back of his head, as well as the ability to supervise several tasks at one time.

  His comment about not taking a break worked both ways, though. He had been monitoring his patients constantly, and she hadn't noticed him pause to swallow as much as a sip of coffee. Even so, he wasn't showing any signs of fatigue. He was still straight-backed, driven and totally in command of himself.

  She gave in, going along to the rest room to help herself to coffee and a sandwich. It was true enough that she was beginning to feel the strain. Not only did she have more patients to attend to but Connor was expecting her to take him to the park later on, and she didn't want to let him down. She needed to revitalise herself, though, before she even contemplated doing that.

  Allison stayed in the room long enough to splash water on her face and run a brush through her long, fair hair. Then, feeling refreshed, she took a deep breath and stepped back into the fray once more. She headed for the patients' waiting room.

  When they weren't coping with life-or-death situations, there were always the everyday emergencies to be dealt
with. The waiting room was full of a seemingly endless number of people, and she took a chart from off the top of the pile and went to call her next patient.

  'Mrs Westerby?'

  A woman in her thirties stood up and walked towards Allison, her wrist supported by a makeshift sling. She had a child with her, a little boy, around the same age as Connor. A minute ago he had been sitting next to her, swinging his legs to and fro, but now he jumped up, sending his chair skidding across the floor.

  Allison winced at the screeching sound it made. The noise became louder as the child pushed it back into position. When he had finished what he was doing, she directed the woman along the corridor towards the treatment bay and suggested that she sit down. The boy came with them, standing next to his mother and looking around with interest.

  Allison put the X-ray film into the light box. 'You've broken a bone in your wrist,' she said, pointing out the line of the fracture. 'It's a straightforward one, so we'll just need to put a cast on that for you. I'll give you a prescription for some painkillers, as well.' She gave the woman a brief smile. 'Excuse me for a moment while I go and see if I can find a nurse to prepare the cast for me.'

  She went out into the main treatment area and signalled to Sarah to come over to the treatment bay. 'Would you put Mrs Westbury's wrist in a cast for me?' she asked, and Sarah nodded, going off to fetch what she needed.

  'The coffee-break must have done you some good,' Taylor said, glancing at Allison as he passed by on his way to the central desk. 'You're looking fresh as a daisy, and the sparkle's back in your eyes.'

  'Is it?' Colour washed into her cheeks.

  'Oh, yes.' He looked her over, his gaze taking in the smooth line of her cotton top where it clung to her curves and noting the gentle swell where her skirt lightly skimmed her hips. 'Definitely.'

  He moved towards her, coming closer, and she wondered what was causing the faint upward tilt of his mouth. She sent him a cautious glance, trying to fathom his mood, but he seemed to be distracted. He was looking at the silky sweep of her hair where it lightly brushed her shoulders.

 

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