‘Not sure why the boss is insisting pulling out all the stops,’ Aleem said. ‘The CT scan’s not looking good. Look.’
Molly took the report and read through it with a sinking heart. A positive outcome was very unlikely. What had Lucas been thinking? Surely he of all people knew the data on severe brain injuries? It wasn’t fair to give the family unrealistic expectations. They needed to be gently prepared for the imminent loss of their loved one. It might be days, or weeks, sometimes even months, but someone as badly injured as Tim Merrick might not leave ICU alive, or if he did, he would be severely compromised.
‘I sure wouldn’t want to be the one who was driving,’ Aleem said as he leaned back against the desk. ‘Can you imagine living with that for the rest of your life?’
Molly frowned as she looked at the registrar. ‘Pardon?’
‘Tim Merrick’s mate,’ he said. ‘He was the one driving. All he got was a fractured patella.’
Molly bit her lip. Was that why Lucas was doing everything he could to keep Tim alive? He was reliving his own nightmare through the driver. He would be feeling the anguish of the young man, having been through it himself. Keeping Tim Merrick on life support indefinitely was his way of giving the young driver time to come to terms with what had happened. But while she understood Lucas’s motives, she wasn’t sure she agreed with giving the family false hope. They could end up suffering more in the long run.
‘No alcohol involved, which is one thing to be grateful for, I suppose,’ Aleem said. ‘Apparently he swerved to avoid a kid on a bike. Missed the kid but as good as wrote off his best mate. Can you imagine having that on your conscience? I’d never get behind the wheel again.’
Molly put down the CT report. ‘I think I’ll have a word with Tim’s parents. Dr Banning should be finished with them now.’ She turned at the door. ‘Can you ring the orthopaedic ward and find out the driver’s name? I think I’ll visit him before I go home.’
‘Will do,’ Aleem said, and reached for the phone.
* * *
‘Mr and Mrs Merrick?’ Molly gently addressed the middle-aged couple who were still sitting huddled together in the counselling room.
There was no sign of Lucas, although Molly could pick up a faint trace of his light aftershave in the small room, suggesting he had not long ago left. A pile of used tissues was on the table beside the wife and she had another one screwed up in her hand. The husband was dry-eyed but his Adam’s apple was going up and down like a piston.
‘I’m Dr Drummond,’ Molly said. ‘I’ve been looking after your son in ICU. He’s on the ventilator now and comfortable.’
‘Can we see him?’ the wife asked, absently tearing the tissue in her hand into shreds.
‘Yes, of course,’ Molly said. ‘But first...I think I should warn you that ICU can be an upsetting place. There are lots of machines making all sorts of noises. You are free to come and go as you like but we have a strict hygiene policy to reduce the risk of infection. Did Dr Banning go through all this with you?’
The wife nodded. ‘He said Tim’s stable for the time being. He said we should talk to him as much as possible...that it might help bring him round.’
‘It will certainly do no harm to sit with him and talk to him,’ Molly said. ‘Has Dr Banning been through Tim’s scans with you?’
‘He said it’s too early to be certain what’s going on,’ the husband said. ‘There’s a lot of swelling and bleeding. He said he’d like to wait till that settles before giving a more definitive diagnosis.’
Molly could see the sense in what Lucas had told the Merricks but she wondered if he was just buying time. She had seen the scans. Bleeding and swelling notwithstanding, Tim was critically injured and nothing short of a miracle could turn things around.
She took the parents to their son’s bedside and watched as they spoke to him and touched him. It was heart-wrenching to think that in a few days they might lose him for ever.
It was impossible not to think about her brother’s death at times like this, how that night in A and E had been such a surreal nightmare. Her parents had done the same as the Merricks. They had touched and stroked Matt, talking to him even though they had already been told he had gone. Molly had seen Lucas on their way out of the hospital. He had been standing with his parents, his face so stricken it had been like looking at someone else entirely. Matt had lost his life, but in a way so too had Lucas. Nothing would ever be the same for him again.
‘Dr Drummond?’ Mrs Merrick’s voice interrupted Molly’s reverie. ‘Can I talk to you for a minute?’
‘Sure,’ Molly said.
Mrs Merrick looked at her son again, tears rolling down her face. She brushed at them with her hand and turned back to Molly. ‘Tim would hate to be left an invalid. He wouldn’t cope with it. We talked about it only recently. A relative’his cousin’had a serious accident at work and was left a quadriplegic. He’s totally dependent on carers for everything now.
‘Tim said it would destroy him to be left like that. That he would rather die. He insisted on drawing up an end-of-life directive. We tried to talk him out of it. We thought only old or terminally ill people signed them but he was adamant. I suppose what I’m saying is...I want to know what we’re dealing with here. I want to do the right thing by my son. I want to be...’ She glanced at her husband and continued, ‘We want to be prepared for whatever is ahead.’
‘I understand,’ Molly said. ‘We’ll keep you well informed on Tim’s progress. There are protocols to go through in regard to end-of-life directives. I’ll speak to Dr Banning about it.’
‘There’s one other thing,’ Mr Merrick said as he came and stood by his wife. ‘I want to be clear on this. We don’t blame Hamish for what happened to Tim. This is an accident’a terrible, tragic accident. It could’ve been the other way round. We’re devastated for Hamish as well as ourselves.’
Molly felt a lump come up in her throat. She could remember all too well the dreadful words her father had shouted at Lucas and his parents in A and E all those years ago. Everyone had known it had been the raw grief talking but it hadn’t made it any easier to witness. If only her father had demonstrated even a fraction of the dignity and grace of the Merricks. ‘I’m going to see Hamish now,’ she said. ‘I’ll tell him you’re thinking of him.’
* * *
Molly went to the orthopaedic ward where Hamish Fisher was spending the night prior to having his knee repaired the following morning. She found him lying in a four-bed ward with the curtains drawn around his bed. Curled up there with his back to the room, he looked a lot younger than twenty-one. Her heart ached for him. He looked so alone and broken. From this day forward his life would never be the same. She wondered if in seventeen years’ time he would be just as locked away and lonely as Lucas.
‘Hamish?’ she said. ‘I’m one of the ICU doctors, Molly Drummond.’
Hamish opened his reddened eyes. ‘He’s dead, isn’t he?’ he said in a bleak tone.
‘No,’ she said, taking the chair beside the bed. ‘He’s on a ventilator and at this point he’s stable.’
The young man’s chin shook as he fought to control his emotion. ‘But he’s going to die, isn’t he?’ he said. ‘I heard the ER doctors talking.’
‘No one can say for sure at this stage,’ Molly said.
He swallowed convulsively. ‘I swerved to avoid a kid on a bike,’ he said. ‘It all happened so quickly. I saw this little kid coming out of nowhere and I hit the brakes but there must have been oil on the road. I lost control...’
Molly put her hand on his where it was gripping the sheet with white-knuckled force. ‘Tim’s parents don’t blame you,’ she said. ‘They’re with Tim now but I’m sure they’ll come down to see you when they get the chance. Do you have anyone here with you? Your parents?’
He shook his head. ‘I haven�
�t got a dad. My mum is on her way. She’s been on a cruise with friends. She’d saved up for years to go... She’s flying home tonight.’
‘It’s important you have people around to support you,’ Molly said. ‘I can organise for the hospital chaplain to visit you. It helps to talk to someone at a time like this.’
‘Talking isn’t going to turn back the clock, is it?’ Hamish said.
She gave his hand another squeeze. ‘Just try and take it one day at a time.’
* * *
Molly didn’t see Lucas again until later that night. He came in just before midnight, his face looking drawn and his eyes hollow, as if two fingers had pushed them right back into his head.
‘Are you OK?’ she asked, rising from the sofa where she had been flicking through a home renovating magazine without managing to remember a word of what she had read.
He scraped a hand through his hair. ‘Yeah,’ he said. ‘Why wouldn’t I be? It was just another day at the office.’
‘It was hardly that,’ Molly said.
He dismissed her with a look and turned to leave. ‘I’m going to bed.’
‘Lucas?’
His back looked concrete tight with tension in that infinitesimal moment before he turned to look at her. ‘I’ve handled hundreds of critically ill trauma patients,’ he said. ‘This is just another case.’
She came over to where he was standing. ‘It’s not just another case,’ she said. ‘It’s like you and Matt all over again.’
A stone mask covered his features. ‘Leave it, Molly.’
‘I think we should talk about it,’ she said. ‘I think my parents should’ve talked to you about it long ago. It was wrong to blame you the way they did. Tim’s parents are obviously shattered by what’s happened but at least they’re not blaming Hamish.’
‘That will come later,’ he said grimly.
‘I don’t think so,’ she said. ‘I think they realise it could just have easily been Tim behind that wheel. It’s devastating for them to face the prospect of losing their son but’’
‘They are not going to lose their son,’ Lucas said with implacable force.
Molly frowned at him. ‘Lucas, you can’t possibly think he’s going to survive more than a few days or a week or two at the most.’
A thread of steel stitched his mouth into a flat, determined line. ‘I’ve seen plenty of critically injured patients come off ventilators. He deserves every chance to make it. I’m not withdrawing support.’
‘But what if that’s not what Tim would’ve wanted?’
‘We’ll find out what he wants when he wakes up,’ he said.
‘What if he doesn’t wake up?’ Molly asked. ‘You saw the scans. It’s not looking good right now.’
‘Early scans can be misleading,’ he said. ‘You know that. There’s bleeding and swelling everywhere. It can take days or even weeks to get a clear idea of what’s going on.’
‘I don’t think it’s fair to give his family false hope,’ she said. ‘I think they’re the sort of people who need to know what they’re up against right from the get-go. They want to be prepared.’
His eyes were hard as they clashed with hers. ‘I hate to pull rank here but I have a lot more clinical experience than you,’ he said. ‘His parents are still in shock. This is not the time to be dumping unnecessary and distressing information on them.’
‘Tim Merrick signed an end-of-life directive,’ Molly said. ‘His mother told me. They all did it a couple of years ago after a relative was made a quadriplegic in a workplace accident.’
Lucas drew in a short breath and then slowly released it. ‘So?’
‘So his wishes should be acknowledged,’ Molly said. ‘He didn’t want to be left languishing in some care facility for the rest of his life. Evidently he was quite adamant about it. He couldn’t bear the thought of being dependent on others for everything.’
He moved to the other side of the room, his gait stiff and jerky as if his inner turmoil was manifested in his body. He rubbed the back of his neck. The sound of his hand moving over his skin was amplified in the silence.
‘He would want the ventilator turned off, Lucas.’
‘It’s too early to decide that.’
‘There might be a time when it’s too late to decide,’ Molly pointed out. ‘What will you say to him then? “Sorry, we disregarded your directive because we thought you were going to wake up and be back to normal”?’
He cut his gaze to hers. ‘I’ve seen patients with much worse injuries walk out of ICU,’ he said.
Molly gave him an incredulous look. ‘You think Tim Merrick is going to walk when he can’t even breathe on his own? Come on, Lucas, surely you haven’t abandoned the science you were trained to respect and rely on? He’s not going to walk again. He’s probably not going to do anything for himself again. And you’re prolonging his and his family’s agony by insisting on keeping him hooked up to that ventilator.’
‘What about Hamish Fisher?’ he asked, nailing her with a look.
Molly released a little breath. ‘Lucas, it’s not Hamish Fisher lying in that bed.’
‘No,’ he said. ‘But he’s the one who’s going to spend the rest of his life wishing to hell it had been.’
Molly felt the anguish behind his statement. She saw the agony of it on his face. For all these years he would have given anything to trade places with her brother. But that’s not how fate had decided things would be. ‘I know this is difficult for you,’ she said. ‘But you have to keep your clinical hat on. You can’t let what happened to you all those years ago influence your decision in managing Tim Merrick’s care.’
He looked at her for a long, tense moment. ‘Just give him some time,’ he said. ‘Surely he deserves that?’
‘Are we talking about Tim or Hamish?’ Molly asked.
He walked to the other side of the room and looked out of the window at the blizzard-like conditions outside. Molly saw his shoulders rise and fall as he let out a long, jagged sigh. She wanted to go to him, to wrap her arms around him and hold him close. But just as she took the first step towards him he turned and looked at her.
‘I had a patient a few months back,’ he said, ‘a young girl of nineteen who’d fallen from a balcony at a party. She fell five metres onto concrete. It was a miracle she survived the fall. She had multiple fractures, including a base-of-skull fracture. She was in a coma for a month. Just when she was showing signs of waking up she got meningitis. The scans looked as if things were going downhill. Every other doctor and specialist involved with her care was ready to give up. I refused to do so. In my view, she just needed more time. I was right. She was young and fit and her other injuries were healing well. After another week she started to improve. It was slow but sure. She’s back at university now, doing a fine arts degree. She comes in now and again and brings cupcakes for us all.’
‘I’m glad it worked out that way for you and for her,’ Molly said. ‘But there are just as many cases where it doesn’t.’
He held her look for a long moment. ‘The day she walked out of hospital with her parents I went to my office and closed the door and cried like a baby.’
Molly could picture him doing it. He had depths to his character that could so easily go unnoticed in a brief encounter. He was dedicated and professional at all times and yet he was as human as the next person. It was perhaps his humanity that made him such a wonderful ICU doctor. He didn’t want anyone to suffer as he had suffered. He worked tirelessly to give his patients the best possible chance of recovery.
His own personal tragedy had moulded him into the man he was today’strong, driven and determined. He was a leader, not a follower. He expected a lot from his staff but he didn’t ask anything of them he wasn’t prepared to do himself. She could not think of a more wonderful ally in the fight for
a patient’s life. But she wondered if it all took its toll on him personally. Was that why he was all work and no play? He simply had nothing left to given anyone outside work.
‘It must have been an amazing moment to see her walk out of hospital,’ she said.
‘It was,’ he said. ‘I know doctors are meant to keep a clinical distance. You can’t make sound judgements when your emotions are involved. But once the patient is in the clear, sometimes the relief is overwhelming. I’ve had staff go on stress leave after a patient leaves. It’s those sorts of miracles that make our jobs so rewarding and yet so utterly demanding.’
‘How do you deal with the stress?’ she asked.
‘I fix stuff.’
‘Fix stuff?’
He wafted a hand at their surroundings. ‘There’s nothing quite like tearing down a wall or painting or replastering or refitting a kitchen or bathroom,’ he said. ‘I’m thinking of selling in the spring. I’ve just about run out of things to do.’
‘But this is such a fabulous house,’ Molly said.
He gave a shrug. ‘It’s just a roof and four walls.’
‘It’s much more than that, surely?’ she said. ‘You’ve put so much work into it. It seems a shame not to get the benefit of it for a while.’
‘Don’t worry,’ he said as he hooked his jacket over one shoulder. ‘I’ll give you plenty of notice before I let the realtor bring potential buyers through.’
Molly bit her lip. ‘I’m having trouble finding anywhere else to live so far.’
‘There’s no hurry. You can stay here as long as you need to.’
‘But not for the whole three months.’
He held her look for a beat. ‘I can’t imagine that you’d want to. I’m not the most genial host.’
‘I think it’s best if I keep looking,’ she said. ‘I’m having a hard time convincing everyone we’re not a couple.’
‘And that embarrasses you?’
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