He nodded. ‘It showed a pseudoaneurysm. I believe there’s a small tear in the vessel, so the nurses are preparing him for surgery now.’
‘I hope it goes well.’ It meant that the patient’s heart would be linked to a bypass machine for a short time, while Josh inserted a repair graft in the leaking artery.
She lingered for a minute or two to chat, before heading back to Rees in the treatment room. Katie and Josh were deep in conversation when she left, and she doubted they would have noticed her departure.
The boy set aside his tray while she put up the X-ray film in the light box and carefully studied it. ‘There’s definitely an infection there,’ she told him after a while, ‘and you have a raised temperature. I think we’ll start you off on antibiotics and keep you here for a few hours in our observation ward. Are you okay with that?’
He nodded. She guessed he was in no hurry to go back out into the cold, and perhaps he had nowhere to go. That was a worrying thought. Strictly speaking she had no real reason to keep him here under observation, or admit him to hospital overnight—which was what she would have preferred to do. That would give her more of a chance to talk to him, and hopefully encourage him to tell her more about the circumstances that brought him here. She wanted to help him in any way possible.
‘All right, then,’ she murmured. ‘I’ll arrange for a nurse to take you to the observation ward next door and get you settled.’
‘Will it be all right if I take the food with me?’
She chuckled. ‘Yes, of course. We’ll make sure that goes along with you. I think, since your blood sugar was low, it’s important to feed you. We also need to bring down your temperature and generally look after you.’ She sent him a quick glance. ‘I don’t want to send you away from here while you’re clearly unwell, and you haven’t given us an address. I’m worried that there’s no family around to take care of you.’ She hesitated. ‘Are you living at home?’
He didn’t answer, but after a moment or two he shook his head.
‘Have you been living out on the streets?’
He hunched his shoulders, and Alison wondered if she should take that as a yes.
‘If you feel that you need to talk to someone about anything that’s bothering you I’m here to listen, you know. Nothing you say will go any further unless you want it to.’
He returned her gaze, not quite meeting her eyes. He appeared to be deep in thought, and for a second or two she was hopeful that he might be about to confide in her. But then he slumped back against his pillows without saying anything, and the moment was lost.
She left him in the care of a nurse, and went to tend to her other patients. With any luck Rees would pluck up the courage to open up to her later on. She just needed to win his trust.
For the next few hours she concentrated all her efforts on looking after the sick and injured. She hoped Josh’s patient was doing well in the operating theatre. Still, she had seen Josh at work in the resuscitation room, and it was plain to see how effective he was in a crisis situation. No wonder he had been chosen to replace Dr Meadows. He was immensely skilled. There was no hesitation, no doubt, not a single moment when he wasn’t in complete control.
That didn’t change when he came back down to A&E some time later. He simply turned his attention to overseeing the work of his subordinates, and that was when Alison felt the first stirrings of unease. He began to leaf through all the patients’ charts.
She went to check through the test results at the desk.
‘Would you care to explain this to me?’ he said, coming over to her a few minutes later. He was frowning as he held out a folder. ‘I don’t see any major problem with this patient, and yet young Rees is still here. By all accounts he could have been discharged some time ago. You’ve examined him and given him the appropriate treatment. Why haven’t you sent him on his way?’
Alison’s spirits plummeted. Was Josh Bentley one of the new breed of ‘time is money; patch them up and move them out’ doctors? How she hated that emphasis on efficiency at all costs. Somehow she had believed he would have better judgement than that.
Alison remained silent for a moment, glancing through the glass door of the observation ward. Rees was dozing peacefully, his face bleached of colour against the stark white of his pillows, and she couldn’t help feeling that he was exhausted, worn out by a combination of factors. The boy’s hair was an unruly tangle of black silky strands, crying out for the tender hand of a mother figure to smooth it into place. Surely Josh wasn’t expecting her to wake him up and turf him out into the cold, soulless streets to fend for himself? What kind of man was he?
His dark brows rose in expectation.
‘The boy’s running a temperature,’ she said, ‘and he has a chest infection. Also, he’s looking gaunt, and I don’t think he’s been eating properly. I prefer to wait for the results of tests, query pneumonia, before I decide what to do. It occurred to me that it might be wise to keep him in overnight.’
Josh gave her a long, thoughtful look. ‘We both know he isn’t that ill. I’ve seen the X-ray film. Besides, I heard he went walkabout for a while and a nurse had to go looking for him. What’s going on here, Alison?’
‘Walkabout?’ She frowned. ‘Where did he go?’
‘The nurse wasn’t sure. She found him in the corridor heading back to the ward. He must have slipped out through the security door when a visitor left.’
‘Did he say where he’d been?’
‘Only some vague comment about trying to find a washroom.’ From his expression it was clear that he was unconvinced by that explanation. ‘The nurse said he appeared to be on edge. She decided he must be feverish and led him back to bed.’
‘Perhaps that’s the truth of it.’ Alison sighed. ‘He’s definitely unwell. I wanted to keep him here so I have a little more time to see if I can get him to open up to me. We don’t know anything about his background, or what will happen to him once he leaves here. He won’t say anything about his parents, and he’s refused to give an address.’
‘Hmm. I can see why you’re concerned, but that isn’t really our problem, is it? Besides, he might be on the run from the law. As to staying here, I already have Management on my back, emphasising the necessity to stick to targets and maximise throughput. Rees isn’t seriously ill, and we’re not obliged to notify the authorities about our worries since he insists he’s sixteen. We haven’t been asked to look out for anyone answering his description.’
‘I know, but I’m pretty sure he’s run away from home, and if he’s living rough there’s a strong possibility his condition will quickly nosedive. I don’t want that on my conscience.’ She frowned. ‘There’s a vulnerability about him that makes me want to do everything I can to help him—and surely we have to pay some heed to the welfare of the people who cross our path? You wouldn’t send an elderly person out onto the streets if you feared for his well-being, would you?’
‘Soft as putty, aren’t you?’ His smile was gently mocking. ‘If you feel so strongly about him, why haven’t you taken steps to contact the police or Social Services?’
‘I don’t want to betray his trust…and I want to give him the chance to confide in me.’
He shook his head. ‘We’re an accident and emergency department,’ he chided softly. ‘Not a holding centre for waifs and strays.’
She glowered at him, her blue eyes sparking. Okay, ultimately he was in charge, but she wasn’t going to allow her decisions to be overridden without a fight. She trusted her instincts and they had never let her down. ‘We have spare beds and we’re not overstretched right now. I don’t see any reason for sending him away just yet.’
‘Maybe not, but you know as well as I do that the situation could change at any moment if we have a sudden influx.’
‘I prefer to base my judgements on the situation as it is at present. He’s unwell, and I know of no responsible adult who will take over his care. It’s my professional opinion that he should stay here.’
>
Josh was silent for a moment or two, his features taut, his mouth pursed in contemplation, and she began to wonder if perhaps she had gone too far. He was new here, and she didn’t yet have the measure of the man. For all she knew he could take offence at her arguments and have her taken off his team.
‘You may be right,’ he said eventually. ‘I’ll give you the benefit of the doubt and go along with you on this one—if only because he complained of dizziness before his fall. That being the case, you’d better go ahead and admit him overnight on the grounds of suspected pneumonia and the possibility of wound infection. But if the situation changes, and we’re overrun with trauma cases and the like, we’ll have to do some creative thinking about where to place him.’
‘That’s great.’ She stared at him, wide eyed, her face lighting up. ‘I take it all back—every bad thing I was thinking about you. You’ve shot up ten times in my estimation. In fact, I could hug you.’
‘Really? I thought you were finished with men?’
‘Ah…well, yes, that’s perfectly true. But then again, I wasn’t planning on a relationship.’ A ripple of warmth ran through her. What was the matter with her? Why couldn’t she glue her lips together and stay out of trouble?
He studied her, a glint of humour flickering in his eyes. ‘So you were thinking bad things about me, were you? That isn’t good, is it? Given first impressions and all that.’
‘Um, well, no,’ she faltered. ‘But then you did manage to redeem yourself after all, didn’t you?’ She studied him guardedly.
He chuckled. ‘Think of it as a thank-you for warning me about the presentation…and for the fruit turnovers. Let’s not forget them.’ He rolled his eyes heavenward. ‘They were out of this world.’
Her features softened in appreciation. ‘I’m glad you think so. If Management complain about Rees being here, perhaps you should offer a few to them, too.’
He sucked in a quick breath. ‘I’m afraid I can’t do that.’
She blinked. ‘You can’t? Why…? Is it because it would reek of bribery and corruption?’
He shook his head. ‘No, not that—though it’s certainly a consideration. It’s because they’ve all gone.’ His mouth turned down at the corners. ‘There’s absolutely nothing left…only crumbs.’
She laughed. ‘Oh, dear. Still, now I know I have the perfect bribe to use whenever I want something to go my way. I didn’t realise how much influence I could bring to bear. Let’s make the most of it. We’re talking turnover power!’
He was smiling when Alison left him after a moment or two to go and get on with her work.
The rest of the day passed in a flash as she was kept busy dealing with new emergencies, but she managed to find time to look in on Rees in the observation ward before the end of her shift.
He still looked weary, and she noted that despite the antibiotics his temperature was a notch higher than normal.
‘I think it would be for the best if we were to admit you overnight,’ she told him. ‘That way we can keep an eye on you while the antibiotics begin to do their stuff, and hopefully we’ll be able to bring your temperature down. We can also keep an eye on the injury to your hand at the same time. How do you feel about that?’
‘Yeah, that’s all right.’ He ran the back of his good hand over his forehead. ‘The nurse said you might want to keep me in. She said she’d find some crossword books and a couple of videos for me to watch when I’m feeling a bit better.’
‘That’s good. You should try to get some rest.’ She gave him a soft smile. ‘I expect they’ll be bringing your tea round before too long, and you’ll need some energy to tackle that.’
His eyes brightened a fraction. ‘That’s great. I’m starving.’
She laughed. ‘I don’t know where you manage to put it all. Still, you could do with building up.’ She smiled at him. ‘I’m going off duty in a while, but the nurse will take care of you. If you have any problems at all, just let her know. She’ll do whatever she can to sort things out. I’ll drop by and see you in the morning.’
He nodded, and she left the bay, going in search of the nurse. She found her checking schedules on the computer, and spent a few minutes bringing her up to date on the situation.
‘I’ll do everything I can to encourage him to confide in me,’ Jenny said. ‘So far he hasn’t said anything that’s of much help. He’s a bit of an enigma, but I’m fairly sure that he’s worried about something. Whatever it is, he’s not letting on.’
‘Thanks, Jenny. I’m sure he’s in good hands in the meantime.’ Alison left her and went to retrieve her jacket from the doctors’ restroom.
As she walked back towards Reception a short time later, she saw that Josh was there, deep in thought as he pored over the contents of a folder.
‘Ah, you’re just the person I wanted to see,’ he said, looking up, his tone brisk. ‘I take it you’re going off duty now?’
‘That’s right. Is there a problem?’
He shook his head. ‘Not at all.’ He waved a hand towards the corridor. ‘You have some visitors…your neighbour and his children. I sent them to the relatives’ waiting room.’
‘Oh, that’s good. Thanks for letting me know. Tom said he would come and pick me up. I just hope he managed to sort out whatever was wrong with my car.’
She would have gone to find them straight away, but she paused long enough to study Josh for a moment or two. There was something about his demeanour that put her on alert. ‘Is everything all right? You look as though you have something on your mind. Has your first day here not gone as well as you might have expected? I know you’ve hardly had a minute to yourself all day. It’s like that sometimes.’
She hesitated before adding, ‘The work in itself can be challenging, can’t it? We have to deal with things that you might come across only once in a blue moon, and there aren’t always simple answers. But generally we’re a supportive bunch of people, and we aim to rub along well together. Of course it’s different when you’re in charge, I suppose. You have a lot more to contend with, and you probably look at everything from a different perspective to the rest of us.’
‘Well, that’s certainly true. I wasn’t expecting to see hordes of bikers about the place this lunchtime. Nor was I expecting to have to make a speech almost as soon as I arrived.’ He frowned. ‘As to this latest request…’ He scowled at the folder he had been studying, tossing the file down on the desktop in a peremptory fashion. ‘I can’t imagine why I’m being asked to take part in a hospital radio show. Since I’m only going to be here for two days a week, I’m sure there are far more pressing demands on my time.’
Alison cast a quick glance over the file. ‘Oh, I see. It’s the outline for the Christmas radio programme. It goes out on air to all the patients, and they schedule it in advance. I don’t imagine the radio committee meant to cause trouble for you. It’s just that…’
‘I know. You don’t need to tell me…’ He put up a hand to stop her. ‘Steve Meadows always had a slot on the show. I’ve been hearing an awful lot about your former boss and his various good deeds. Apparently he was a member of the drama club and gave impromptu entertainment for the children on the wards, and he did charity runs and organised medical care for homeless people.’ His lips compressed. ‘He must rank among the saints, giving his time to every needy cause going. No wonder he suffered a heart attack. Was there anything that man didn’t do?’
‘Um…he did work tremendously hard, and he thought it was important to try to keep the patients happy—especially at Christmas time. It is the Christmas programme they’re asking you to look at, isn’t it?’
His jaw clenched. ‘That’s right…But they—the radio committee—had better think again. I’m a doctor, not a presenter, and at the moment I have more worthy matters to consider. Such as how to take care of the man I operated on this afternoon. If he manages to pull through after losing several pints of blood and having his heart put on bypass I shall count my blessings.’
<
br /> He pushed the folder into the wastepaper basket with a broad sweep of his arm and then began to stride across the room. ‘I shall be in the resuscitation room if anyone needs me.’
Alison nodded, watching him go. ‘I’ll be sure to let the desk clerk know.’
Clearly he was worried about his patient and not in the best of moods right now. Maybe it was bad timing for the radio committee to lay their request on him on his very first day in the job.
She scribbled a message for the clerk, who was temporarily away from the desk. As an afterthought, she pulled the folder out of the wastebin and laid it to one side in a wire tray. Some decisions would have to be made regarding the programme before too long—but they could surely wait for the moment? The new boss obviously needed more time to settle in.
She hurried along to the waiting room. ‘Tom,’ she greeted her neighbour, ‘thanks for coming to fetch me. I’m sorry I’ve kept you waiting. I hope I’ve not put you out too much?’
‘Not at all.’ He was a tall man, with dark hair and features that were carved out of life’s experiences—crinkled lines about his blue eyes and a firm jawline that hinted at a rock-steady character. Alison had taken to him from the instant she met him.
He came towards her now, his arms enclosing her in a brief hug. ‘I had to come into town anyway. I ordered a replacement petrol pump for your car, and the spare parts place promised me they would have it in stock by this evening. Of course Jason and Rachel wanted to come with me. They both needed new trousers, so my wife gave me instructions on what to look out for in the local store.’ He frowned. ‘I can’t keep up with them. They’re forever wearing them out at the knees or snagging them on something or other. Nobody ever told me about the downside of having a family. I’ve become a walking money tree, and I feel as though my roots are beginning to wither.’
She gave him a wry smile. ‘It almost makes me glad I’m not a parent.’ She glanced around the room. ‘Where are they, by the way?’
Hot-Shot Doc, Christmas Bride / Christmas At Rivercut Manor Page 3