He didn’t answer for a long moment, and when he did she realised most of this, to her way of thinking, quite lucid explanation must have gone right over his head.
‘But that’s just it,’ he said. ‘What I saw wasn’t what I got. Or maybe that should have been, what I thought I saw…’
Mac was still staring at her, his face perplexed, then the arm, which had remained around her waist, tightened and his hand drew her up against his body. There was a long, tense pause, then he bent and kissed her.
Part of Amelia registered that it had been a long time since she’d been kissed in the main street of Lakelands—a long time since she’d been kissed anywhere for that matter. Then the kiss took effect with a sizzle of sheer excitement that started somewhere down in the region of her toes and simmered up through her body to lodge in her chest where it triggered such havoc in her heart that that usually reliable organ banged against her ribs with a heavy thudding rhythm.
A spatter of applause broke the spell, and Amelia looked around to find the previously deserted street was now well populated—had a movie just ended? Had anyone she knew seen their behaviour? Not that Mac seemed perturbed—he straightened up but kept a firm grip around Amelia’s waist as he steered her on their way.
Just as well he did, as her legs had lost their ability to hold her upright—which, given her companion, she decided to blame on the alcohol she’d consumed, rather than the kiss.
Somehow they made their way back to her apartment where, without conversation or consideration, the kiss resumed, firing an aching need in Amelia that overcame all restraint or common sense. In what seemed a totally natural, if somewhat hurried progression, they moved towards her bedroom, shedding clothes as their hands sought more contact with each other’s bodies, and their excitement grew.
A long time later, Amelia woke, curled against Mac’s strong warm body.
‘Unexpected, huh?’ he said, his deep voice raising goose-bumps on her skin.
He was propped on one elbow, one hand smoothing her hair against the pillow, his face, lit by a shaft of light from her bathroom, softer than she’d ever seen it.
‘Very,’ she agreed, trying to be as matter-of-fact about this bizarre situation as he was. Then honesty prompted her to add, ‘But very nice.’
‘Only very nice?’ he teased, running his fingers lightly across her breast. ‘Only very nice?’
The teasing fingers drifted lower and within minutes their excitement had built again, not to be denied.
But this time it was a slower, more languorous loving, and when desire was satisfied they didn’t sleep, but lay, pressed against each other, talking desultorily, conversation ranging from work to family, then back to work again. It was inevitable their pasts would come into the conversation, Mac pointing out that though he’d explained how his marriage had broken up through the hours he worked and his determination to remain in A and E, he knew nothing about hers.
‘It seems like ancient history,’ Amelia said, relishing the physical repleteness that led to total relaxation. ‘I married young, halfway through my nursing course. Brad was a friend of my brothers, he worked for my father in the construction business, and getting married was like a natural next step somehow, but nothing happened. Nothing got better, and though we didn’t fight, we just kind of drifted apart.’
She turned, and splayed her hand flat across Mac’s broad chest.
‘We’d been married for five years and though, all through, we’d been trying to have a child, it didn’t happen. I know now it would have been a disaster. We were better off apart. Brad’s remarried now, and we see each other occasionally—no hard feelings, no hassles.’
‘And since? Why no man in your life, Peterson?’
He was threading his fingers through her hair now, as if the length of it could be judged by feel.
Amelia shrugged, mostly in an attempt to shake off the vibrations those delving fingers had prompted.
‘No one’s come along who was worth making an effort for,’ she said, surprising herself with her honesty. ‘Relationships do take an effort, don’t they?’
The chest beneath her fingers rose and fell as Mac heaved a long sigh.
‘They do indeed,’ he said. Then he added, in funereal tones, ‘And time!’
‘Exactly,’ Amelia agreed, but against all odds her body was coming back to life, and only a little exploration told her Mac’s was also stirring.
‘It’s impossible,’ he protested. ‘I’m an aging man!’
‘Ho! All of thirty-five! Poor old fellow!’
So this time, as they made love, they were light-hearted, teasing and joking and smiling through the passion.
And this time, sleep came again, a sleep so deep Amelia didn’t hear Mac leave. But when she woke, close to midday, she was alone in her bed, the vague but not unpleasurable aches in her body the only reminder of the extraordinary night.
She sat up, wondering if he’d gone, then saw the note on the pillow next to hers.
Believe me, Peterson, I’d much rather have stayed, but I woke at nine forty-five and remembered, panic-stricken, that my father’s away and I was supposed to collect my mother at ten to take her to church—new niece’s christening, would you believe? Thank you for a very special night, Mac.
Amelia read it several times, trying hard to imagine Mac with a mother and father, and either a brother or a sister. Maybe he had both.
Were they like him?
She shook her head, smiling at her own absurdity. She didn’t really know what Mac was like—outside work—so how could she possibly imagine his family?
She read the note again, ignoring his reason for leaving.
The last sentence appeared to draw a line under their relationship—if you could call dinner and a night of totally unexpected pleasure and passion a relationship. The message behind that undoubtedly genuine ‘thank you’ was ‘that’s it’. Which was OK with her—after all, she’d only been doing Mac a favour, in return for one for herself. The fact that she’d enjoyed it—all of it—was just a bonus!
Monday at work proved her suppositions correct. Mac was already in the department when she arrived and the first thing she heard was his voice issuing rapid-fire orders to some poor unfortunate in a curtained-off cubicle.
The unfortunate turned out to be a student nurse doing work placement—or so Amelia surmised when the young woman emerged with tears streaming down her cheeks. Amelia stepped towards her, but before she could offer a touch or word of comfort she was paged, the code suggesting an urgent emergency admittance due to arrive within minutes.
She met the ambulance as it pulled in, listening as the female ambulance attendant gave her a brief but concise rundown on the case.
‘Four-year-old burn victim, fire could have started in his bedroom. We intubated him six minutes ago. Parents are on their way to the Royal in another ambulance, but he’ll need to go into the children’s burns ICU here at St Pat’s.’
Amelia checked the child as she helped a porter wheel him into the nearest trauma cubicle. As well as the endotracheal tube into his lungs, a nasogastric tube had been inserted into his left nostril. A sixteen-gauge intraosseus line had been inserted into his lower left leg—part of his body not obviously affected by burns—and fluid was flowing into his body through this. Burns to his face and neck suggested the child had been close to the seat of the fire so inhalation injury could be present.
‘I’ll take over the bag,’ Amelia said to the second attendant, who was pressing oxygen into the child’s lungs by squeezing a ventilation bag. Then she turned to a junior nurse who’d arrived to assist her. ‘Get a respiratory technician here to do this and have another call put out for a doctor. Who the hell was supposed to answer that code?’
‘I was.’ A flustered young man Amelia had never seen before appeared through the gap in the curtain. ‘Bring me up to date.’
Maybe not so flustered, she thought, registering the bossy note in his voice.
The
attendant who’d been ventilating the child handed the doctor the sheet containing all the information collected thus far, then escaped from the cubicle.
‘Estimated weight of eighteen kilograms and they’ve inserted a four-millimetre endotracheal tube?’ he said. ‘Eighteen kilograms should have been a five. Don’t these people have a chart for weights and tube sizes?’
‘The child’s badly burnt around the face and neck so inhalation injury is almost certainly present,’ Amelia said, remaining calm although the doctor’s attitude irritated her. ‘It causes oedema, swelling in the upper airway, peaking in six to eight hours. An ETT a size smaller is usually recommended if there’s a risk of inhalation problems, but right now shouldn’t you be checking his chest—making sure it’s been correctly inserted and is clear of obstruction or kinking?’
‘Don’t tell me about oedema or what to do, Nurse,’ the young man snapped, but he did listen to the child’s chest and draw blood for a blood-gas determination.
He checked the fluid flowing into the child’s leg, then worked out, using the patient’s assumed weight, what extra fluid should be given, and how often. Knowing the child needed massive fluid resuscitation, Amelia was pleased when he sought another site for a second large-bore catheter to be inserted.
The respiratory technician arrived at the same time as the blood-gas results, and saw them before the young doctor.
‘This suggests inadequate ventilation,’ the therapist said, handing the slip to the doctor. ‘I’ll suction out the tube and then connect the oxygen directly to the source.’
Amelia turned to the cupboard for a paediatric suction kit, washing her hands and putting on clean gloves before opening it and setting it up on a trolley beside the therapist. Although she could do this procedure, having someone present who had done probably hundreds of them, made the job safer and simpler.
The young doctor, in the meantime, had inserted a second fluid line into the child’s right leg.
‘Though how the hell we’re going to secure it I don’t know,’ he muttered, and Amelia, seeing the burnt flesh around the catheter, realised that the usual gauze and tape would be useless.
‘I’ll tie it there,’ she offered, and the doctor stepped back, ordering the nurse who’d returned with the blood-gas results to set up more bags of fluid. This was followed by a string of other orders, given too quickly, Amelia was sure, for the young nurse to follow.
Amelia was wrapping gauze bandage around the catheter, ready to secure it by tying it around the child’s leg, when she realised the left leg, where the original line had been inserted, was swelling alarmingly.
‘You’ve got a problem here,’ she said quietly to the doctor, pointing to the swollen leg. ‘The line’s obviously blocked for some reason. It should come out before it causes complications. Can you find a new site?’
‘Who do you think I am—Superman?’ he snapped. ‘I’m trying to insert a catheter to monitor the fluid resuscitation. Severe burns, the child’s in shock, we’ve got to pump fluid into him and you’re suggesting we remove one of the lines?’
Amelia could feel panic fluttering in her heart. The young doctor was probably extremely capable but he was out of his depth in this particular situation, and though she knew she could take over a lot of the tasks he was expected to do, he was resentful of her interference. By now, someone from the burns unit should have arrived. Someone with experience and expertise in burns.
‘We need a new ABG. From the look of the child he’s still getting insufficient ventilation,’ the respiratory tech said, referring to the blood-gas test they’d run earlier. ‘I’ve checked all the equipment and raised the volume of oxygen, but he doesn’t look good.’
‘Doesn’t look good,’ the doctor muttered. ‘Great diagnosis!’
He turned to Amelia.
‘Take more blood and get it tested.’
Amelia didn’t argue, but as she handed the vial to the aide who’d arrived to act as a runner, she whispered, ‘Get Mac.’
Then, with gentle hands, she began to cut charred clothing off the child, removing anything not stuck to his skin. The degree of burning around his chest suggested there was a chance of circumferential burning. The dry crust, eschar, forming from the burn could have become a tight band, preventing chest expansion, and if his lungs couldn’t expand inside his chest, then no amount of ventilation would help.
‘No one from the burns unit here?’
Mac’s voice brought relief flooding through Amelia.
‘I’ve just finished three months up there—I told the triage sister I could manage,’ the young doctor said, and Amelia waited for Mac to explode.
But he said nothing, merely moving into the room, seeing the burns on the child’s chest, seizing the blood result as the runner came in, then ordering a scalpel for an escharotomy.
‘You!’ He caught the runner as she was retreating back towards the opening in the curtain. ‘Get someone from the burns unit down here. Kevin, get another fluid line into this kid now! Peterson, remove the catheter from the left leg, it’s obviously compromised.’
Amelia felt the terrible tension in her shoulders ease, and she hurried to obey, not because she was afraid of Mac’s barked orders but because she knew whatever he ordered her to do was in the best interests of the child.
She watched as he cut through the constricting scar tissue around the child’s chest, then took over the insertion of the second fluid line, this one into the lower end of the child’s left femur. Shelley Bush, a young specialist intensivist and one of four permanent doctors in the burns unit, arrived as Mac stepped back, leaving the doctor he’d called Kevin to attach the fluid line.
‘He ready to go, Mac?’ Shelley asked, and Mac turned to the respiratory tech.
‘You’re happy?’
She nodded. ‘I’ll go with him and bag him on the way,’ she said, shifting the oxygen tube from the wall supply to the small cylinder on the gurney.
Amelia went into action, securing the drip stands to the gurney, checking all the tubes and lines they’d inserted into the little body were secure. She was aware of Mac’s presence—aware of his body in a way she hadn’t been before—but the severity of the child’s injuries had banished any awkwardness that might have accompanied this first meeting since their totally unexpected intimacy the previous Saturday evening.
‘Go up with them to keep an eye on the tubes,’ Mac said to her, and she was happy to obey, the child still the sole focus of her attention.
She returned to find another crisis in full flow, voices calling for help from three cubicles.
‘What’s happening?’ she demanded of the first nurse she saw.
‘Kid rescued from a swimming pool in one, heart attack in two and a fellow who tried to cut his arm off with a circular saw in three.’
Amelia swore under her breath, then asked, ‘Which one’s the new intern in?’
‘Three,’ the nurse said, then she hurried off to complete whatever task had been asked of her.
She walked into three—and a scene of chaos.
‘IV in his left arm has packed up, and doctor’s trying to find a new vein,’ the nurse just inside the curtains whispered at her.
Amelia mentally wished him luck as the patient was grossly overweight and accessible veins were often hard to find.
‘Has Theatre been alerted?’ she asked no one in particular, and won a glare from the doctor.
‘Of course they have, but they won’t have a theatre free for twenty minutes so, rather than give unnecessary advice, why don’t you make yourself useful and loosen that tourniquet? Keep pressure on the wound at the same time to prevent too much blood loss, then retighten it.’
The patient was grey and sweaty, obviously in shock. Amelia touched his feet—very cold and mottled-looking—and wanted to ask about shock trousers, an inflatable suit that could be wrapped around the legs and lower body to counteract hypotension, but one look at the doctor’s face told her she’d better keep her mouth s
hut.
Another look at the patient told her that was wrong.
‘What about shock trousers? Wouldn’t they help restore his blood pressure while he’s waiting for the op?’
The young intern glared again.
‘If the paramedics thought he needed them, they’d have put them on!’ he muttered. ‘He’s lost so much blood he needs fluids fast. That’s my concern. IV first, urinary catheter second, then we’ll look at how he’s going.’
Amelia nodded, but she sent a nurse for a set of trousers which opened flat and could be fitted around a patient and secured with Velcro straps and zippers then inflated in sections. Fortunately, before she could get into an argument with the doctor over using them, two porters from Theatre arrived to take the patient upstairs.
‘That Kevin’s bloody hopeless,’ she said, hours later, to Brian Stubbs, a senior nurse on duty with another A and E team.
They’d met up by the coffee-machine, which was so ancient it dispensed a variety of liquids according to its whim. Today’s concoction, Amelia guessed, sniffing suspiciously at the murk in her paper cup, was a mix of tea and chocolate. Not appetising in any way, but hot and wet.
‘So? You’re the senior, do something about it,’ Brian said, pressing buttons on the machine, then sighing as he, too, sniffed his brew. ‘And do something about this machine while you’re at it. If you’re going to take it to Mac, you might as well get a couple of complaints in before he bellows at you.’
‘You take it to Mac,’ Amelia said, as a shiver of something very like apprehension trickled down her spine.
‘Take what to Mac? Coffee?’
‘You mean tocalate,’ Amelia said, turning around and pressing her cup into Mac’s hands. ‘Tea and chocolate mix. We need a new coffee-machine and a new intern. In either order, I don’t care.’ She looked up at him and the shiver intensified, so she fought it with more words. ‘Well, yes, I do. At least the coffee-machine can only kill the staff—the intern could kill a patient. Change him first.’
The Pregnancy Proposition Page 5