New Surgeon at Ashvale A&E

by Joanna Neil

  She went to check up on him. ‘Hello again, Nick,’ she said. ‘How are you feeling?’

  He held out a hand palm down and moved it from side to side. ‘So-so,’ he said.

  ‘Hmmm. I’d like to check your blood pressure again if that’s okay with you,’ she murmured.

  He nodded.

  The pressure was falling, she discovered, and his pulse was faster than the last reading.

  She asked him about his daily routine. ‘You’re not working at the moment, are you?’

  He shook his head. ‘I was laid off after the car accident.’

  ‘And has anything happened to you in the last week or so?’

  ‘Nothing, really. The most exciting thing that happened to me was I went to a mate’s house with some friends the day before yesterday, and we watched the football match on TV. Our team won, so we were well made up.’

  ‘Sounds good.’ Ruby gave a brief smile.

  ‘Yeah. I stood up to cheer and lock arms with my mate and fell over the table. Caught myself right here.’ He ran a hand over the upper part of his abdomen and grinned. ‘Too much lager. Made me grunt a bit at the time, but it’s more or less okay now. It’s a bit sore.’

  Ruby was beginning to be slightly concerned. ‘I think we’ll do an abdominal CT scan to see if anything untoward is going on,’ she told him. ‘I’ll arrange for the nurse to take you down to radiology as soon as she’s free.’

  She left the room and made the arrangements with Michelle, leaving Nick in the care of the nurse while she wrote up his radiology form. A few minutes later, as she was checking details of her other patients, Sam came to find her.

  ‘I’ve just seen Michelle preparing to take your patient down to radiology,’ he said. ‘She tells me that you’ve ordered an abdominal CT scan.’

  ‘That’s right. Why, is there a problem?’

  He frowned. ‘You do know that he’s a regular here, don’t you? I’ve taken a look at his notes, and it’s clear that Dr Stanford believed he was simply a drug seeker. He may well have suffered an accident at some time, but there’s no evidence of permanent injury on all the scans and X-rays that have been done.’

  ‘Maybe so, but I prefer to do the tests anyway. Something about him doesn’t seem quite right. It doesn’t add up.’

  He made a short laugh. ‘Yes, well, I can understand that. You do realise that he was the one who almost knocked you over the other day outside the hospital…don’t you remember? He didn’t even stop to apologise.’

  Recognition dawned all at once, and her mouth dropped open a fraction. ‘Ah, I knew there was something about him that bothered me. Yes, I remember now.’

  ‘Good. Then perhaps you’ll think twice about wasting resources on someone who’s probably just here to get his hands on stronger painkillers. He’s done it before, several times. It’s more than likely he’s taking you for a ride, Ruby. He probably thinks you’re a soft touch.’

  ‘Well, it’s possible, I suppose.’ She looked him in the eye, her grey gaze smoky with annoyance. ‘Still, I decided to take his claims at face value and examined him accordingly, and my feeling is that there may be something wrong with him.’ She drew herself up to her full height. ‘Last time I looked, my qualifications said I was a specialist registrar—so I think that gives me enough leeway to act on my gut instinct, don’t you?’ It was a low trick, but he had pulled rank with her earlier, and she didn’t see why she should allow him to browbeat her on this.

  He didn’t react in quite the way she’d expected. There was no rising hauteur or demand for her to retract. Instead, he held up his hands in a gesture of conciliation. ‘Okay. Whoa there. Steady.’ He let his arms fall to his sides. ‘I suppose I deserved that response, but the truth is, I’m not trying to tell you what to do. I’m just saying you should bear in mind that he’s probably just after a prescription for stronger narcotics. He’s had a few X-rays and CT scans, and nothing has ever showed up.’

  ‘I’ll take that on board,’ she said. ‘Thank you for pointing it out. And now I need to go and see to my other patients…unless there was something else you wanted?’

  He made an exaggerated movement away from her, backing off and indicating with a swish of his hands that she was free to go on her way. ‘Don’t let me stop you,’ he said.

  ‘I won’t.’

  She was in no mood to parry words with Sam Boyd any longer. In fact, one way or another, she was coming close to the end of her tether. Over the course of the last couple of weeks she’d lost the job she’d set her heart on, the department looked as if it was heading down the road to closure, her sister had disappeared, leaving her with a baby to look after, and as soon as she left here, she had to go and take over the reins of her grandparents’ smallholding. And that was without battling to stay composed while doing the work of several people because of staff shortages.

  It dawned on her as she went about her work that there was only one course of action to take…and there was no time like the present to see it through. As soon as she had a free moment, she stopped by the human resources office and informed the admin clerk that she would not be renewing her contract.

  ‘I’ll pass the information on to your head of department,’ the clerk said, ‘but I expect you’ll want to do that personally, too.’ She carefully checked the details on the computer. ‘You still have a couple of weeks’ leave due,’ the woman said. ‘You’ll need to take it right away.’

  ‘Okay. I’ll do that.’

  Ruby left the office a few minutes later. A feeling of relief washed over her now that it was done, and all she had to do now was go in search of Sam and let him know what was happening. When she couldn’t find him, she told his secretary what she was doing and left a note on the desk in his office before going back to work.

  The calm feeling stayed with her, even when Michelle came hurrying over to her.

  ‘Ruby, you need to come right away. It’s your patient, Mr Dryden—his scan shows a nasty laceration to his spleen. He’s bleeding internally, and the radiologist says he needs to go to theatre right away.’

  ‘Okay,’ she said. ‘I’ll organise it. Thanks, Michelle.’

  Somehow, it wasn’t unexpected. She studied the radiology films and then gathered a team together, making sure that her patient was prepped for surgery. She would have preferred to do a repair operation, but, as things turned out, the damage to his spleen was too great, and she had no choice but to remove it.

  It meant that his health would need to be monitored on a regular basis from now on since he could be more prone to suffer infections, but at least disaster had been averted, and his life had been saved.

  When she came back down from theatre some time later, she wrote up the patient’s notes and arranged for him to be admitted to a surgical ward.

  ‘You’ll probably need to stay in hospital for a few days,’ she told him when the nurse came to transfer him over there. ‘After that, you should be fine, but you’ll need to see your GP to arrange follow-up appointments.’

  ‘Thanks,’ he said. He was still pale and drowsy from the operation. ‘The nurse told me you saved my life.’

  She smiled. ‘You’re welcome. That’s what I’m here for, to do whatever I can.’

  Michelle wheeled him away with the help of a porter, and Ruby headed back towards the central desk.

  ‘You see,’ she told Sam when she discovered him there, rummaging through the patients’ files. ‘I knew things were not quite right with our Mr Dryden.’ The urge to say I told you so had the better of her. ‘You should take note of what my instincts tell me. I don’t make these decisions lightly.’

  ‘You’re right,’ he said, giving her a wry smile. ‘It’s because of your actions that he’s here to tell the tale.’ His gaze drifted over her. ‘And I’ll bet you’re going to make me pay big time for my remarks, aren’t you? I expect you’ll be gloating all through next week.’

  She shook her head. ‘Not at all,’ she murmured. ‘In fact, I won’t be here�
��I start my annual leave as of tomorrow. And I’ve been over to personnel and told them I won’t be renewing my contract.’

  He sent her a stunned look. ‘I don’t believe it,’ he ground out on a terse note. ‘How come I didn’t know anything about this?’

  ‘It was a last-minute decision on my part, I admit,’ she said, ‘but I did let it be known some time ago that I wasn’t sure about staying on here as registrar once my contract came to an end.’ She gave him a sweet smile. ‘Perhaps you should have read the memo,’ she said.

  Chapter Four

  RUBY gazed at the phone, willing it to ring. All she needed was a message from Sophie to say that she was well and that she would be coming back home just as soon as she could get her head together. Just one call to give her peace of mind…was that too much to ask? At least the police would be able to track Sophie’s movements from a phone call, wouldn’t they?

  Frustration tugged her stomach into tight knots. It had been over a week now, and there had been no sign of her sister, no clue as to where she might be. The agony of not knowing what had happened to her was unbearable. Was she safe? Was she well? There was no rhyme or reason behind her disappearance. Sophie loved her baby, so why would she go? Nothing made sense any more.

  ‘Da-da,’ Becky chanted, looking up at Ruby from the comfort of the mat on the floor, where she was enjoying her newfound ability to sit up straight all by herself. She was holding out a circular teething ring, and now she quickly lifted her arms up and down in unison as though she would bang the floor with the ring and hear the rattling noise it made.

  Ruby’s mouth turned down at the corners. ‘No, baby,’ she murmured, kneeling down beside her. ‘No Da-da.’ She gave a soft sigh. ‘No anybody, except me. I guess that means we’re stuck with one another, but I’m okay with it if you are.’

  Becky gurgled, biting down on the toy and coming out with an excited babble of baby talk, so that Ruby smiled. ‘You’re absolutely right,’ she told the infant. ‘We’ll just have to make the best of things, won’t we? At least we get to stay in this lovely farmhouse and enjoy the comfort of a log fire of an evening.’

  The one consolation in all of this was that she had the opportunity to spend time with Becky, playing with her and cuddling her to her heart’s content. If Becky wondered where her mother had gone, Ruby guessed it was in those fleeting moments when a door creaked and she looked up expectantly, waiting to see if Sophie would walk in, or on those occasions when Ruby laid her in her cot so that she could take a nap. Then the child would give a small frown and look around as though sensing that something was missing and all was not as it should be.

  She could not explain to her what was going on. All she could do was offer comfort and kisses in between the time she spent tending to the animals and weeding around the vegetables that grew in abundance on this rambling four-acre plot.

  ‘And I do look forward to sitting by that huge old fireplace this evening,’ she told Becky. ‘Truth is, I’m too exhausted to do anything else.’

  She looked around the cosy living room, pleasingly furnished with sofas and chairs in softly textured upholstery, and lifted here and there with splashes of bright colour in the cushions. The drapes were beautifully elegant, providing a sumptuous backdrop to the fine pieces of solid golden oak furniture. Wide French doors looked out on to the landscaped gardens beyond. ‘It could be so restful here if it wasn’t for worrying about you and your mother and about the animals getting sick.’

  And, if she was honest with herself, wasn’t there also the faint tinge of regret for the career that she had left behind? How were they coping without her at the hospital? Had Sam recovered from his dismay at seeing her go? Even as she had teased him about not being on top of the staffing rota, she had been aware of a twinge of guilt. She had left the decision too much to the last minute, and now he was left to cope with the beleaguered department on his own. Would he be able to lift it out of the doldrums without help?

  Maybe she had been too hasty in giving it all up? A week or more of reflection had left her feeling regretful about the colleagues she had left behind and uncertain about which path to take to secure her future happiness.

  The doorbell rang, and Becky looked puzzled, her lips moving on a questioning sound as though she was asking who it could be.

  ‘It’s probably Craig, the vet, come to look at the pony,’ Ruby told her. ‘I asked him if he could spare the time to check him out…the ducks too, because, as you know, nothing is working out as it should just lately.’

  Becky frowned, and Ruby lightly ruffled her dark gold curls. ‘Don’t worry about it, poppet. Your aunty is not quite herself, but she’ll get better.’

  She stood up and went to answer the door, startled to discover that it wasn’t the vet who stood in the porch, but Sam Boyd, immaculately dressed as ever, though in slightly more casual attire, wearing perfectly fitting dark trousers, a crisp linen shirt in a pleasing shade of blue, and a soft suede jacket that he had left unzipped.

  ‘Oh,’ she said, her eyes widening. ‘This is a surprise. I thought you were the vet come to look at the animals.’

  He appeared to be confused for a moment, then lightly ran the palm of his hand over his chest. ‘No, it’s me, Sam, as far as I know. I never did take any veterinary exams. I always thought animals were way too unpredictable to make good patients. Cute, maybe, and loveable to a certain extent, but definitely not my calling.’

  ‘You’re incorrigible,’ she said, moving back from the door and ushering him inside the house. ‘Come in. Watch your step; there are hazards everywhere…toys, baby walker, linen baskets—I haven’t quite got the hang of this baby business yet.’

  ‘You haven’t?’

  ‘No.’

  He looked puzzled, and then that expression changed to a frown as he stepped around the baby-changing unit that partly blocked the hallway.

  ‘It’s too heavy for me to move by myself,’ she offered in explanation. ‘It’s solid wood, and the cupboard part of it is full of baby equipment. I suppose I really need to get around to emptying it at some point and put it where it would best fit. Someone dropped it off for me, and I couldn’t quite decide where it needed to go.’

  ‘Oh, I see. Well, I can always move it for you if you tell me where.’

  It was fairly obvious that he didn’t see at all, but Ruby ignored all that and ushered him into the large farmhouse kitchen. ‘Thanks. Maybe we could shift it together later. I’ve decided it can go in the utility room just off the kitchen.’ She waved a hand in the direction of the L-shaped annexe. ‘There’s a space just big enough for it by the wall.’

  She went over to the worktop at the side of the kitchen. ‘I was just about to make a pot of tea and grab a sandwich,’ she told him, picking up the kettle and taking it over to the sink. ‘Would you like something to eat and drink?’ He looked as though he could do with taking time out for a while, and whatever pressing problem had brought him here could probably wait while she brewed up.

  He was busy looking around the room as she spoke, absorbing its wide proportions, his glance drifting over the sturdy oak table and chairs and the homely touches in the colourful curtains and small items of linen that were lying around. He seemed a trifle tense, out of place in this homely farmhouse, as though he was uncomfortable about something or other. Perhaps he hadn’t wanted to come here to see her, but found it necessary for some reason…problems at work, maybe?

  ‘Uh, thanks,’ he said. He seemed a touch taken aback by her offer. Perhaps he wasn’t used to impromptu invitations of that sort, but Ruby had been hard at work all day, and she was both hungry and thirsty and didn’t see the point in waiting to satisfy those needs.

  ‘I have some home-made pizza slices that are still warm from the oven,’ she told him as she filled the kettle with water, ‘and there are some scones that I baked this morning.’ It was fairly late in the afternoon, and she guessed he might have been caught up for most of the day in the fast-paced, energy-drain
ing routine of the A&E department.

  He brightened a little. ‘That would be great if it’s not too much trouble. I didn’t get the chance to eat at the hospital.’

  She nodded. ‘I heard on the news that there was an industrial accident in one of the town factories. I thought they would probably send most of the injured to Ashvale.’

  ‘Yes, they did.’

  She switched on the kettle and then glanced at him briefly. ‘I noticed that you would rarely take time out to go and eat a proper meal if we were busy at work. If it hadn’t been for my policy of having a trolley laden with snacks on hand, I don’t know how you would have fared. You always have that lean and hungry look.’ She turned towards the living room. ‘Anyway, sit yourself down at the table. I’ll just go and fetch Becky. She can sit in her high chair and nibble on a rusk while we eat.’

  He did as she suggested, pulling out a chair and carefully removing the large, floppy-eared, patchwork quilt rabbit from the seat, giving it an uncertain look before placing it down on an unused part of the worktop. She sent him a benign smile. There weren’t too many empty areas left since she had been far too busy to clear away all the fruits of her labour today.

  There was a wicker basket of eggs that should have been stowed away in the fridge, a few jars of home-made preserve that her mother had dropped off that morning, and a selection of toys that she had kept handy to amuse Becky while she’d attempted to deal with various tasks during the day.

  ‘How do you cope with all th—?’ He broke off midsentence as though he’d suddenly thought better of what he was about to say.

  ‘With all this clutter?’ she supplied helpfully. ‘It’s easy. I simply ignore it. I have to, otherwise I’d probably go quietly mad.’

  She hurried away to go and fetch Becky, leaving him sitting there with a bemused look on his face.

  Becky seemed pleased to see him when Ruby carried her into the room a few moments later. She broke into a babble of excited chatter and tried to grab a handful of his hair as she passed by.