So what was new? She’d coped before, and she’d cope again.
She could have waited until Macka arrived with better light but what she was doing depended mainly on feel. Plus the cooperation of her patient. If she’d been back at the hospital she’d use general anaesthetic. She couldn’t use it here but, blessedly, Marc’s medical training would have him understanding the absolute imperative of keeping still.
Leg first. The shoulder was more painful, but the risk of blocked circulation to the foot meant it was triaged first.
She prepared one of the pieces of wood that had been shoved down the hole with the force of Marc’s fall. She showed it to Marc, who made a crack about her whittling skills before falling silent again as she worked.
He was mentally preparing himself for what lay ahead, she thought. Morphine could only do so much.
Then, moving more slowly than she’d ever worked before, she inched the wood under his leg. With her hands feeling his leg, feeling for bone, she slowly, slowly straightened his knee, then straightened his leg, manoeuvring it onto her makeshift splint.
She cleaned and disinfected and bandaged and then fixed the leg as tightly as she dared to her whittled wood. Marc said nothing the entire time she worked, and she blessed him for it.
Finally she sat back and took a breath. It was cool and damp underground, but she found she was sweating.
‘Well done,’ Marc growled softly, and she caught herself. What was she doing sweating, when it was Marc who’d managed to hold himself rigid?
‘Well...well done yourself,’ she told him. ‘I...’ She caught herself, giving herself space to find the right words. To find a prosaic normalcy. ‘The pulse in your lower leg is stronger. If I keep the morphine for during the night you should be able to sleep without worrying about shifting.’
‘So now the shoulder.’
That was harder. She knew it’d mean more pain for him and she was less sure of herself. Heaven, she wanted an X-ray.
The simplest and safest technique for shoulder reduction was the Stimson technique, where the patient hung his or her arm down and weights were attached at the wrist. This was normally her go-to method but here there was no bed, no raised surface. Scapular manipulation also had to be ruled out. Given the possibility of back injury, there was no way she was rolling him into the position required.
Which left external rotation as the next best option. That could at least be done with the patient lying on his back. She talked to Marc as she thought it through. ‘You reckon?’ she asked him. He was, after all, a colleague—and it was his shoulder.
‘Go for it,’ he urged.
So she did. With his arm tucked in as close to his body as possible, gently, slowly she rotated, letting gravity—and pain—limit the amount of movement. She watched his face every inch of the way, watching the greyness, the tight set of his mouth, the fierce determination to get this done. As his pain level increased his arm automatically tensed. She backed off, waited, then inched again.
And then, miraculously, wonderfully, came the moment when it slid back into place. She saw his face go slack with relief and knew her own face must reflect it.
‘Thank you,’ he said, his eyes closed, his whole body seeming to sag. ‘Oh, my God, thank you.’
‘Think nothing of it,’ she managed, and to her disgust heard a tremor in her own voice. ‘I’ll strap it now. It needs to stay strapped until I get you to where we can check for rotator cuff injury. You must know the drill. Hopefully now though you’ll be comfortable enough to get some sleep.’
‘Sleep...’ He grimaced. ‘Look, now we have everything braced, surely I can be pulled up to the surface.’
‘Not on my watch.’ She had herself back under control now. ‘You heard what I said to Macka. He’ll bring stuff to make us more comfortable, but I’m not risking bringing you up until we have decent light.’
‘But if my leg’s braced...’
‘I’m not thinking about you,’ she told him, only partly truthfully. ‘I’m thinking about the unstable ground and a team up there who aren’t trained cavers. I’m thinking about that ground collapsing. I’m thinking about half the Gannet Island fire department landing on our heads.’
‘Oh,’ he said doubtfully.
‘And I’ve used the last of my bandages,’ she told him. ‘If a team of burly firefighters fall down here, my emergency kit’s going to look pretty darned empty. No. We wait until morning when Macka—he’s our island cop and he’s good—can do a thorough recce of the ground.’
‘Right,’ he said, clearly not liking it but reaching acceptance. ‘But you could go up. There’s no need for both of us to stay down here.’
‘Yeah,’ she told him, thinking of clots, thinking of delayed concussion, thinking of kinked blood vessels that still might block.
‘I can do my own obs.’
That brought a wry smile. ‘Really? A specialist cardiologist doing obs? When was the last time you did such a thing? Don’t cardiologists have nursing staff for that?’
‘You’re not a nurse.’
‘No, I’m a family doctor in a remote community, and as such I’ve even done hourly obs on a pregnant turtle. Mind, it was a special turtle and I had her in a sand tank on my veranda but there you go, needs must.’
‘Did you have a good outcome?’ he asked, distracted as she’d hoped he would be.
‘An excellent outcome. Seventy-three babies that we hope went on to become seventy-three of Gannet Island’s finest. Never doubt my skill, Dr Pierce. I can do your obs, no problem. There’s no need to be scared at all.’
‘Believe it or not, I’m not in the least scared,’ he told her. ‘Not from the moment you slid down your rope.’
‘Then I’ve done my job until now,’ she said cheerfully. ‘And I’ll keep doing it if you don’t mind. So you settle down and see if you can sleep and I’ll check the whereabouts of the team up top.’
‘Elsa...’
‘Yep?’
‘If any of the team up top fall and break a leg...or if there’s an emergency in town tonight...another turtle?’
‘Then Grandpa will cope,’ she told him, making her voice more sure than she felt.
‘Grandpa?’
‘He’s our other doctor on the island. He’s good.’
‘How old is he?’
‘Seventy-eight.’
‘Then...’
‘If you’re going to be ageist I’ll need to report you to the med board for discrimination. Grandpa can cope.’
‘But apart from Grandpa...’
‘His name’s Robert.’
‘Apart from Robert, you’re the only doctor on the island?’
‘I am,’ she told him soundly. ‘Plus vet and sometimes nurse and sometimes cook and sometimes janitor. General dogsbody, that’s me. Grandpa and me and my beagle, Sherlock, together we practically run this island. Now, could you please shush because I need to ring Macka again.’
‘Elsa...’
‘Shush,’ she told him severely. ‘You get on with being a patient, Marcus Pierce, and let me get on with being Doctor in Charge.’
* * *
Macka’s team arrived half an hour later. Sherlock announced their arrival with shrill excited barks—as well he might. These guys were friends and it was way past his dinnertime.
‘Is that our rescue team?’ Marc had been dozing under the effects of the morphine but the barking and yells above them had him opening his eyes.
‘Doc?’ Macka called down, strongly authoritative. ‘Shut up, Sherlock.’
Amazingly, he did. Macka’s word was law on this island.
‘We are,’ she called up. ‘But stay back. The ground’s unstable. Can you see where I’ve tethered my rope? Don’t come any closer than that. I want Marc out of here, but not at the cost of another accident. Who’s there?’
&n
bsp; ‘Denise and Graham. We can call on more if we need them. How are things down there?’
‘Stable,’ she told him. ‘No need for rush. Don’t come any closer, guys. This ground is a trap for the unwary.’
‘But you’re safe?’
‘We’re both safe. Marc has a broken leg and an injured shoulder, but we can hold out until it’s safe to pull us both up. Marc’s going to need a stretcher.’
‘We have the rescue stretcher.’
‘That’s great,’ she told him, thinking thankfully of their newly acquired piece of kit, a collapsible stretcher with straps that could hold a patient completely immobile while being shifted. Or, in this case, lifted.
There was still the possibility of damage to Marc’s back. First rule of medicine—do no harm. Shifting him before she could take an X-ray was the stuff of nightmares.
‘Can you hold out until first light?’ Macka called.
‘I think we must.’ She wanted a steady ascent, everything in their favour, and if it meant waiting then they had no choice. She was looking at Marc, meeting his gaze, calm and steady. He’d know the options.
‘Then we’ll hold off,’ Macka said, sounding relieved. ‘Tell us what’s happened?’
She told him. There was silence as he thought things through.
‘Right, then. We’ll get the gear down to you and set up here. Your guy... Marc? Is there anyone we need to contact on his behalf?’
Marc shook his head, looking grim. ‘No one will miss me until tomorrow.’
She frowned at that but Macka was waiting for a reply. ‘He says not.’
‘Fair enough,’ Macka said.
‘You want us to ring your grandpa? How about Tony?’
‘I’ll ring Grandpa,’ she called back. ‘And don’t you dare ring Tony.’
There was a chuckle and then things turned businesslike.
‘Okay, we’ll use your rope as a pulley and lower enough gear to make you comfortable for the night,’ Macka told her. ‘We brought the medical supplies you need, plus a couple of air mattresses and blankets. You can set the air mattress below the stretcher so it won’t need another shift in the morning. We’ll stay up here in case the situation changes but, unless it does, at first light we’ll organise a line across to keep us stable, get a stretcher down there and winch you both up.’
‘Can you contact the mainland to stand by for an evac flight?’ She wanted an orthopaedic surgeon to take over care of this leg, the sooner the better. ‘We ought to be able to get him to the airport by late morning.’
‘That might be harder,’ Macka called back. ‘There’s bushfires on the mainland and the smoke’s affecting all the major airports. Evac flights are detoured up north, but only if they’re life or death—they have to come from Brisbane and the fires are keeping them flat-out. Normal commuter flights are already called off for tomorrow. Mae’s going nuts because she has an order for forty Christmas turkeys. The way this is looking, they’ll be lucky to arrive Boxing Day.’
‘No! Five of those turkeys are for us.’ She kept her voice deliberately light because the grim look on Marc’s face had intensified. Had he still been hoping to make St Moritz?
It was sad about that, but it was tough for her, too. She’d have to take X-rays and set the leg herself. Grandpa would help, but doing such a procedure on someone who wasn’t an islander and therefore couldn’t be expected to accept the medical limits caused by their remoteness...
She’d worry about that tomorrow, she told herself.
There was a call from above them. A tightly wrapped bundle was descending, tied on her looped rappel rope. First delivery.
She caught it before it reached the ground. A lantern was attached to the side. She flicked it on and for the first time saw the extent of their cavern.
Or, rather, the enormity of it. It stretched downward on all sides. Marc had been so lucky that he’d landed on a site that was almost stable.
She didn’t say anything though, just unfastened the bundle.
Two self-filling air mattresses.
‘Hey, look at this,’ she told him, holding the first up as it inflated. ‘Who needs to go to St Moritz for luxury?’ She shivered. ‘Speaking of which, who needs to go to St Moritz for cold? Did you guys bring blankets?’ she called.
‘Coming down,’ Macka told her, and ten minutes later they had everything they needed to keep themselves if not exactly comfortable, then not too cold and not too uncomfortable.
It took time and skill to move Marc onto the combined mattress and stretcher but at last he was where he needed to be.
‘Done,’ she called back up. ‘All secure.’
‘Then dinner,’ Macka called and an insulated bag came down. ‘Deirdre’s chicken soup and bread rolls. It went in hot so it should still be warm. She figured your guy might be feeling a bit off, so chicken soup might be the ticket.’
‘Wow, thank you,’ she called back and guided the bag down and nestled it beside the now almost comfortable Marc.
Who was looking at her in disbelief.
‘Hot food as well.’
‘Gannet Island’s all about service,’ she told him, smiling. ‘Do you think you can drink some? Let me help you. No, don’t try and sit up. Just let me support your shoulders while you drink.’
‘I can...’
‘I’m very sure you can sit up,’ she told him severely. ‘But you know as well as I do that you risk your leg moving and I’m still worrying about your back. If there’s spinal injury... And if that leg loses circulation...’ She paused while they both thought of the consequences.
‘So you’re telling me to lie back, shut up and do what I’m told,’ he said, still grim.
‘That, Dr Pierce, is exactly what I’m doing, and if you knew how much I, as a family doctor, have longed to say that to a specialist then you’ll know that this night is not all bad.’
‘For who?’
‘For me,’ she told him and grinned. ‘Now shut up and let’s get this soup into you.’
CHAPTER FOUR
MARC LET HER support his shoulders while he drank the soup—for which he was pathetically grateful. For the last twenty-seven hours he’d been in agonising pain. Thirst had broken through, so practically all he’d thought of was fear, water and the pain in his leg and shoulder.
This magical woman had fixed the fear, given him water and made his leg and shoulder little more than dull aches. Now she was pretty much hand-feeding him the most delicious soup he’d ever tasted.
She’d wedged her body under his, sitting on the ground at his head, using her body to prop the pillow of his air mattress higher. There was canvas between them, but it felt as if there was nothing at all. His head seemed to be pillowed on a cushion of warmth and relief and gratitude.
She helped him hold the mug to his lips and he felt the warmth of her hand and he thought he’d never met someone so wonderful in all his life.
‘Marry me,’ he murmured as he finished the last of his soup and she chuckled.
‘That’s not even original. There’s Tony, who asks me that once a week, plus I get proposals from whoever else is grateful right now. I was propositioned only yesterday when I lanced old Roger Havelock’s abscess. He’d been putting up with it for a week so the relief from pressure was nothing less than sensational. I could have asked for half his kingdom. Not that that’s saying anything,’ she added reflectively. She shifted back, lowering his pillowed head gently, and he was aware of a sharp stab of loss as she shifted away. ‘Roger owns fifteen sows, two boars and a handful of scraggy chickens. Are you offering anything better?’
‘Anything better than Tony?’
‘I’m not into comparisons.’
‘Yet you counted sows as an alternative proposal. Surely that means you’re available?’
‘I’m always available,’ she said, and he heard i
rony in the tone. ‘How about you? I’m assuming your offer of marriage was something you make to every doctor who climbs down a hole to save your life, but seriously... Are you sure you don’t have anyone who’ll be out of their mind with worry right now?’
‘I’m positive,’ he said brusquely. ‘I don’t have any close family and I’m supposed to be on vacation. I’m due to fly to Switzerland tomorrow night with a group of fellow medics. That includes Kayla, a colleague. She’ll worry if I don’t turn up to the airport without letting her know, but a phone call tomorrow will fix that. Our relationship’s only casual. She won’t miss me until then, and she’ll have a good time without me.’
‘I suppose that’s a good thing,’ she said doubtfully. ‘You want to sleep?’
‘I guess. You must need to, too.’
‘I do, and apart from checking you I might even get a whole night without interruptions.’ She hauled her mattress to lie beside his and spread out blankets. ‘Maybe I should try this more often—jumping down a hole to get a good night’s sleep.’
‘Is it so hard to get?’
‘Yes, it is,’ she said, tucking her blankets around her with care. ‘You try being the only full-time doctor for a group of islands where every tourist seems intent on putting themselves in harm’s way.’
‘Like me.’
‘You said it.’ She checked out his blankets, twitched another over him and nodded. ‘There. Tucked in and settled. Pain level?’
‘About two.’
‘That’ll have to do.’
‘It’ll do me. Thank you, Elsa.’
‘All my pleasure,’ she told him. ‘Wake me if it gets above three. There are no medals for being a martyr.’
‘Are there any medals for being a lone doctor and a heroine to boot?’
‘I’m not completely alone,’ she said indignantly. ‘There’s Grandpa. He’d be full-time if I let him but there’s the little matter of renal problems and a dicky heart.’
‘Renal problems?’
‘Diabetes. Not so bad.’ Mostly.
‘And a dicky heart?’
Mistletoe Kiss with the Heart Doctor Page 4