by Penny Parkes
She looked up, utterly appalled that the thought hadn’t occurred to her sooner. ‘The parents? Where are Jessica’s parents?’
‘I’m on it,’ said Teddy, gratefully thrusting his phone into Holly’s hand, relieved of his post as ambulance liaison. He jogged away across the showground, heading straight for the VIP hospitality suite. There was no way that Jessica’s family would have been roughing it with the hoi polloi in the beer tent, but surely it wasn’t possible that the carnage outside their silk-lined cocoon had eluded them, thought Holly crossly.
The vulnerable figure of their only daughter lying on the grass in such an awkward position would be horrifying either way, Holly realised, shrugging off her jacket and laying it over Jessica despite the warmth of the day. Even though she wasn’t conscious, her slight body would be experiencing all manner of shock reactions.
There was a flurry of conversation behind them, as Holly methodically updated the trauma unit in Bristol as to what they might expect and Alice diligently checked Jessica’s vitals again – whispering, shouting, tears and a wailing sob that could only have been Lavinia Hearst. Quite why she was yelling at Teddy and the Major rather than rushing to her daughter’s side was not for her to say, thought Holly, but seriously? There would be plenty of opportunities for blaming and shaming later; herself included, for that awful moment of frozen indecision between her role as parent or doctor.
With no helpful information about the Air Ambulance ETA forthcoming on the phone, time seemed to expand and contract around her. Holly felt swamped. Somebody needed to talk to the parents and Jessica required absolute focus – there was no margin for error here. The slightest slip could mean paralysis or, with a traumatic injury to the head like this, there were any number of complications that Holly didn’t even want to contemplate.
But she simply didn’t know whether Alice was up to the job of coping with an hysterical Lavinia Hearst, and Jessica had to be their priority.
The discussions around her grew more strident as Lavinia ranted.
‘Lavinia? Hi, I’m Dr Graham. Jessica’s vitals are stable at the moment but there’s help on the way to take her to Frenchay. She’s had rather a nasty bash on her head. Can you take a deep breath for me, because Jessica needs you to be calm right now. We need to focus on Jessica. Okay?’ Holly said with gentle but non-negotiable firmness, unwilling to leave Alice unsupported in such a challenging situation for too long, but aware that Lavinia was two ticks away from spiralling into a panic attack.
Dan arrived, slightly out of breath from his exertions with the Major, and knelt down in the grass beside them; it was obvious from his whole demeanour that he didn’t come bearing good news. ‘You’re doing a great job, guys,’ he said softly, ‘but now I want you to listen to me and then we’re going to work together, okay? I’ve just spoken to dispatch. There’s no Air Ambulance available today. It’s not coming. This is going to be a longer journey for Jessica than I’d like.’
The commotion of voices and moving equipment broke over them like another wave, jolting Holly out of her focus, as the ambulance pulled up beside them and the doors were flung open. Discussions about the bumpiness of the track across the showground began throwing open a whole new set of problems.
Holly and Alice were both swept aside as Dan took over, conferring with the paramedics and taking control.
Holly gave Alice a hug. ‘You did such a brilliant job, Alice. But it’s time to let Dan step in. He really is the best person for this job now; the things he learned in the Army . . . ’
Alice nodded, her eyes never once leaving the tiny figure now being transferred to a backboard and swamped by the neck brace that the paramedics and Dan had prioritised before anything else. ‘It’s the right thing to do,’ Alice said awkwardly.
From this point though, as Holly remembered only too well from her years in A&E, ‘time was brain’ – it was a race now to stop any secondary swelling causing yet more irreversible damage.
They might not see too many traumatic brain injuries at The Practice, but they all knew that Dan was no stranger to life-changing injuries, and his experience patching together survivors of roadside bombs gave him the obvious advantage.
Holly turned her attention back to Lavinia Hearst, outlining in simple terms what would happen next and gently explaining the reality of the situation for her – a filthy concussion was actually a best-case scenario for Jessica right now, as she still remained unconscious. Not that Lavinia appeared to be listening – whether from shock or sheer bloody stupidity, she swung from yelling at the Major to trying to reach her daughter ‘just to hold her’.
Watching the paramedics gently transferring Jessica to a backboard was a lesson in caution all of its own; any benefit from rushing negated by the obvious risks of paralysis. Allowing Lavinia into the mix while she was so overwrought and unpredictable could have devastating consequences.
Holly glanced up and saw that Alice’s face was now sheet-white and her eyes were wide, as the shock of the whole accident began to catch up with her. ‘You okay?’ Holly said gently, grateful that Mr Hearst had finally turned up in time to comfort his wife in her transition from anger to terrified disbelief.
‘He was right to bench me,’ said Alice quietly, if a little begrudgingly. ‘I’m out of my depth.’ She waved a hand towards Dan, where he was intently discussing and implementing the optimum oxygenation rate for Jessica. It was all a question of balance to avoid the twin extremes of hypoxia and hypocapnea. ‘In all honesty,’ Alice confessed to Holly, ‘I’m not sure I would have remembered that, would I?’
Holly said nothing for a moment – it was a common rookie mistake: when it came to oxygen, the instinctive assumption was that more would be better. It was also much better that Alice had come to this realisation on her own. ‘Don’t overthink this, Alice,’ Holly said quietly. ‘This is why we have paramedics. Obviously we need to know the basics of trauma management, but we’re GPs, not A&E consultants. I can see you beating yourself up about this already, but we can’t all be everything. Or we’d end up being jacks of all trades and masters of none.’
Alice nodded, watching as Dan leapt into the back of the ambulance and the doors swung slowly shut. ‘You’re right, of course, but shouldn’t we have the best emergency training possible?’
Her plaintive question gave Holly the perfect opportunity to bring her back into the moment; whilst Jessica’s injuries were obviously life-threatening, there were still plenty of Larkford’s residents around them that needed their help. From cuts and bruises, to a shock-induced asthma attack, to the Major, who now seemed to be having some sort of nervous breakdown, aghast that his celebratory surprise might yet have such catastrophic consequences.
Holly took a deep breath. ‘That’s certainly a conversation we should have. Another day. Right now, our patients need us. You take the Major and I’ll pop Geoffrey Larch on the portable nebuliser,’ Holly said, surveying the damage.
Taffy had already established a triage system in the Main Arena and now had all the riders dismounted and under control. To Holly’s immense surprise it was Cassie Holland who was in her element. She was walking amongst them with her clipboard and a mobile phone, contacting relatives, handing out hot sweet tea to those in shock. She looked poised and in control – clearly someone who rose to a challenge.
Alice nodded and walked over to the Major, Holly watching her closely. It was clear that Alice had always considered herself to be one of those people too. And, as with all high-achievers, she could only focus on her weaknesses, rather than her achievements. Holly was quite convinced that Alice couldn’t see the amazing courage that had propelled her forward to Jessica in those first few minutes; she would, in all likelihood, be focusing instead on the ambulance driving away without her on board. Replaceable, replaced and out of her depth. Alice Walker was a fabulous doctor, no doubt, but she was also her own harshest critic.
Holly sighed deeply, hoping that Alice’s confidence wouldn’t be yet another trage
dy of this afternoon’s events.
Chapter 4
It was only natural, Alice supposed, that she might experience a shock reaction to what she had seen – strike that, what she had been involved in, earlier that day. She still shuddered slightly at the idea that her own arrogance in pushing forward to help might ultimately have had a negative impact on Jessica’s recovery. She couldn’t put her finger on why she’d done it though, and with Holly standing right there beside her! And once she’d begun to take care of Jessica, she couldn’t deny that she’d felt personally invested in that little girl’s recovery and utterly piqued when Dan had swept in and taken over.
She shivered under the blanket that her aunt Pru had wrapped around her shoulders, tucking her feet up under herself on the sofa and sipping at her cup of tea – tea being the balm for all ills, in her aunt’s opinion. With Coco fast asleep beside her, Alice tried to relax.
But it wasn’t that easy.
‘Honestly,’ she said to her aunt, who was fussing around her sitting room, ‘do leave it. I’ll get everything sorted when I get a weekend off.’ It took all of Alice’s restraint not to leap up and prise the books and photographs out of her aunt’s well-meaning hands, as she continued to ‘give the place a little tidy’.
Catching the edge in her niece’s voice, Pru sat down reluctantly – one of those women for whom sitting idle was anathema. After all, she would reason, time spent chatting could also be time spent cleaning, cooking, gardening.
‘Alice, love,’ she began tentatively, casting her eye around the sitting room, ‘I really think you need to take some time to unpack properly. You’ve been in this house for months now and you’ve storage boxes everywhere. How long would it take for the two of us to really knuckle down and get you properly settled?’ She waved a hand at the large wall behind the sofa. ‘A nice bookshelf from that Swedish Eekoo place would do just the job.’
Alice couldn’t help but smile at her aunt’s earnest expression. ‘Do you mean Ikea, Aunty Pru?’ she offered, without judgement. She was well used to her aunt’s propensity for muddling up words – indeed this habit had often been the only highlight of family get-togethers when Alice had been small and the only child in the family, not a cousin in sight.
‘I think I’ll wait until I’ve time to do it properly,’ she said, taking a sip of tea and trying not to let the panic show on her face. The very idea of somebody else unpacking her boxes or decorating her sitting room made the skin on her neck prickle. She attempted to soften her abrupt tone as soon as she saw the hurt expression on Pru’s face. ‘It is my very first home of my own, after all. Even if it is just a rental. I want it to be fun and take my time with it – get it just the way I want it. Maybe head into Bath for the Antiques Market and sniff out a bargain?’
‘Of course,’ her aunt nodded, mollified at least that Alice had a plan in place. ‘You’re quite right.’ As Pru stood up yet again to go and fiddle in the kitchen, a running narrative floated through the archway that divided the ground floor of this terraced cottage in two, with Alice only picking up half the monologue. The other half of her attention was focused on ways to keep her aunt downstairs; if she thought this looked bad, there was no way Alice was going to allow her to see the bedrooms upstairs.
‘You know, I’m so grateful for you bringing me home,’ Alice began, pushing off the blanket and wandering through to the kitchen, ‘but I think a good night’s sleep is probably just what the doctor ordered.’ She didn’t specifically ask her aunt to leave, couldn’t bring herself to be that blunt, but the message was clear, as she let the sentiment dangle.
Pru wiped her hands on a tea towel and cast one more glance around the newly sparkling kitchen. ‘Well, at least I don’t have to worry about you starving,’ she said, with an attempt at humour. She waved a hand at Alice’s over-stocked larder. ‘In fact, with all that food in there, you’re probably covered through to Christmas.’ She leaned in and kissed Alice on the cheek, brushing away the stray frond of hair that always tumbled forward into her eyes. ‘I’ll give you a ring tomorrow, love, okay? Just to make sure there’s no ill-effects from your heroics?’
As the front door slammed shut behind her, there was a moment of suspended silence, before Alice’s anguished sobs could be restrained no longer. She slid down against the cabinets in the kitchen, her bizarre bunny slippers sticking out in front of her, as the roiling anxiety in her stomach was allowed free rein. Holding it together in front of her aunt had only served to exacerbate the angst – not just about poor little Jessica Hearst or the unexpected trauma of the afternoon, but all of it compounded by the stress of having someone, anyone really, rootling through her things.
She knew it wasn’t a proportionate reaction, just as she knew it was a sentiment best kept to herself. She simply couldn’t stand to share her space and incur judgement. And judgement was inevitable really, if anybody looked too closely.
Coco’s sniffing attentions brought her back into the moment, as they always did. There was only ever unconditional love and acceptance from her little spaniel – and for Alice, this was one of the greatest gifts of all.
Hours later, as Coco lay diagonally across Alice’s bed, the only light in the bedroom came from the flickering glow of Alice’s laptop. An early night may have seemed like the best recovery plan, but her body refused to comply. With her blood sugar fluctuating more than usual, Alice felt the ever-present nervousness about submitting to sleep. She knew that Coco was there to alert her to any problems in the night, but that wasn’t always enough to take away the fear. Especially after a day like today.
She missed Tilly, her best friend, confidante and social conscience. Tilly brought focus and perspective to Alice’s life, even though their friendship these days was mainly conducted via Skype and Facebook, while Tilly was busy travelling around the world, taking her medical skills to wherever needed her most. She was in South America right now and, to Alice, had never felt further away. She clicked onto Skype in hope more than expectation of finding a little green tick next to her name. No such luck.
So instead, Alice trawled the internet as she always did, erratically clicking from one designer website to another, with no particular goal in mind. The very action of hunting out a bargain soothing in itself.
As she compared prices on a particularly lovely MaxMara bracelet she categorically did not need, Alice’s focus was so absolute that she finally felt that ‘give’ – the release she’d been hoping for. It was hard to know when this habit had become a ritual, but Alice tried not to think about it. All she cared about was that it worked.
She clicked through the checkout, her card details already saved, but barely missing a beat when the font changed to red and her transaction was declined. She reached across a slumbering Coco for her wallet on the bedside table, ignoring the little dog’s groans of protest at being disturbed. Without hesitation, Alice picked a different credit card at random and typed the numbers in by the light of the screen. As her order confirmation number flashed up and the bracelet became rightfully hers, she sighed. Maybe this time, her pick-me-up purchase would actually do its job when it arrived.
The phone beside her trilled into the darkness, jolting Coco awake, startling them both – who could be phoning at this time of night, Alice cursed. ‘Hello?’ she answered curtly, before noticing the digits on the clock beside her – it was only ten o’clock.
‘Alice? It’s Jamie. Everything okay?’
Typical of him to notice every nuance of her tone, she thought as she hurriedly tried to regroup. ‘Fine, honestly fine,’ she said. ‘I just grabbed an early night, that’s all.’
‘And I woke you up? Shit. And here was me trying to be helpful and supportive!’ When Alice didn’t reply he blundered on. ‘I just saw the local news, that’s all. I wanted to see if you were alright?’ The openness and ease in his voice was something Alice envied – his motivations always transparent. If he said he was phoning to see how she was, that was actually what he was doing – this w
as no late-night booty call.
If only, Alice sighed, before sharply reining in her thoughts. Jamie Yardley was categorically not the answer to her problems. But he was her friend, one of her best friends really, and she appreciated their relationship more than he would probably ever know. ‘That’s very sweet,’ she replied, her tone softening. ‘And you only woke up Coco, so she’ll be expecting restitution when she sees you next.’
Jamie’s laugh rumbled down the phone line. ‘She can have some extra bacon, how’s that? I imagine she’s earned it today—’ The humour barely disguised the concern in his voice. After all, as Coco’s dog trainer, he was utterly au fait with the nightly balancing act that Coco and Alice endured, knowing only too well how much stress and adrenalin could throw a Type One diabetic off balance. There were certainly very few other people in her life who realised, truly realised, what she went through every day just to appear normal and functional. ‘How are you two really doing?’
Jamie was never one to be fobbed off lightly and Alice struggled with that – some days it was exactly what she needed, longed for even, but others? Well, it was only a small click over to intrusive.
‘We’re okay, Jamie,’ Alice replied, after a pause, where she had weighed up the options of bullshitting him. ‘It might be a long night though.’
She could almost hear him nod down the line, his phone wedged under his chin as always, another chronic multitasker. ‘The news said Jessica’s making a good recovery,’ Jamie said gently, ‘so you can relax now. Your part is over and, by all accounts, Walker, you did good.’
Alice took a breath, about to interrupt, about to tell him that she’d had no business stepping forward to help that girl in the first place, but something stopped her. She didn’t want him to see all her insecurities after all. ‘I might watch a movie,’ she proffered.
‘Do you want me to stay on the line and watch the same one, Harry-met-Sally style?’ he suggested teasingly, knowing exactly what kind of movie Alice always reached for. He’d tried to widen her horizons, offering DVDs of epic spy movies, Marvel superheroes or even Star Wars trilogies, but Alice was firmly wedded to the Happy-Ever-Afters – anything by Working Title, or starring Hugh Grant, and Alice was happy. It was the only area of her life where she was content to be a cliché.