Crisis at Katoomba Hospital

by Lucy Clark

  ‘You’re here, Nic.’ At Stephanie’s call, the bubble surrounding them burst and both shifted away, Nicolette bumping clumsily into the cupboard behind her.

  Stephen reached out a hand to steady her but she smiled and waved it away. ‘I’m fine.’ She laughed with nervous tension as his sister came over to them. Stephanie looked from one to the other and when Stephen saw that knowing glint in her eyes he immediately knew he had to disappear.

  ‘Right. I’ll be in EC-7 if anyone needs me.’

  ‘Don’t forget about the cat,’ Nicolette found herself saying, surprised her voice actually sounded fairly normal after the intense moment they’d just shared.

  ‘Cat?’ Stephanie looked from one to the other.

  ‘Yes, the cat. Thank you.’ He pivoted on his heel and went to see Mrs Bevan first.

  ‘What was that all about?’ Stephanie asked, looking at her friend.

  ‘What was what all about?’

  ‘You and Stephen.’

  Nicolette forced herself to shrug nonchalantly. ‘We were just talking.’

  ‘Looked more like a staring competition to me. Sorry. Next time I’ll make myself scarce so you two can connect without interruption.’

  ‘What do you mean, next time? We were just talking,’ she reiterated. ‘We’re colleagues so I think it might just happen again, Stephanie, whether you’re around or not. You should be glad your staff are actually communicating.’ She laughed, hoping her attempts to cover up the moment was working.

  ‘Whatever you say.’ Stephanie obviously didn’t believe a word but let it drop.

  ‘What have you got for me? And sorry again I was late. I think I need a new car.’

  ‘Did you take a taxi here?’

  ‘Yes.’

  ‘Put in a claim form and the hospital can reimburse you.’

  ‘It’s fine.’

  ‘It’s protocol,’ Stephanie pointed out. ‘Believe me, I’ve become very familiar with protocols I never knew existed until I took on this job. Use them.’

  Nicolette laughed. ‘If you say so.’

  ‘Patient in EC-9 is waiting for attention. Oh, and by the way, I’m counting on your sponsorship for my radical new hairdo.’ Stephanie patted her red curls.

  ‘You’re really going through with it?’

  ‘Sure am. Raising money for childhood cancer is a worthy cause. You know, you could always join me and get your gorgeous blonde locks cropped off.’

  Nicolette instantly raised a hand to her hair, which was secured back from her face in a ponytail. ‘I’m not as brave as you but you can definitely count on my donation. When is it?’

  ‘Next Tuesday. Sarah from Oncology and Pierce from the MRI unit are also doing it, so you may want to sponsor them, too.’

  ‘Sure.’ Nicolette hugged the file to her chest and decided to get into the act of seeing patients before Stephanie emptied her bank account. She glanced at her patient’s notes and headed into EC-9.

  ‘Mr Stenton. I’m Dr Bourgeois.’ Nicolette smiled politely at her patient and his wife, who was sitting beside him. ‘It says in your file you’ve been having some abdominal pain.’ Nicolette read the chart at the end of the bed as a nurse entered the cubicle.

  ‘It’s not good. I’ve had it for some time but tonight it got worse. So much so my wife had to drive me in and, let me tell you, that made the pain levels go through the roof.’ He said the last bit in a conspiratorial whisper and then chuckled. A moment later he gripped his side in pain. ‘See, Dr Bourgeois. That’s what I mean. It’s hard and it’s sudden.’

  ‘OK. Let’s have a feel.’ Nicolette washed her hands and pulled on a pair of gloves before pulling back the blanket and palpating her patient’s stomach. Mr Stenton was a thin, wiry man and although she couldn’t feel anything out of the ordinary, he groaned in pain when she touched him on the right side.

  She checked his notes again. ‘Medical history says you’ve had your appendix out.’

  ‘Just after we got married,’ Mrs Stenton supplied. ‘Not a nice way to spend your honeymoon but very memorable.’

  ‘So it was quite some time ago, then.’

  ‘Oh, no.’ She giggled. ‘We’ve only been married for two years. It’s the second marriage for both of us. Our children have all grown and now we have six grandchildren between us and another one on the way.’

  ‘I’ll bet you’re looking forward to it.’ Nicolette smiled at Mrs Stenton before writing up her findings. ‘Mr Stenton, I’d like to run some tests—blood test, urine analysis—and also do an ultrasound.’ She filled in the necessary forms and handed them to the nurse. ‘I see you haven’t been given anything for the pain. Are you allergic to anything?’

  ‘No. Not that I know of.’

  ‘Good.’ Nicolette ordered a dose of paracetamol and codeine and signed off on the notes. ‘I’ll be back to check on you later.’ She headed back to the nurses’ station where Stephanie was frantically scribbling down notes, her ear glued to the phone receiver.

  ‘OK. See you in five.’ She replaced the receiver and looked up. ‘Nic. Are you free? We have a gunshot wound patient and a police officer who’s been stabbed, both ETA five minutes. You and Stephen have had experience with those so I’ll need you both in TR-1.’

  ‘What’s the background?’

  ‘A domestic. Neighbours called the police and by the time the police arrived the husband was threatening his wife with a knife. Police tried to talk him down but the man threw the knife at the cop and got him in the right side of the chest. Another police officer shot at the man to try and stop him, and the bullet has gone into his pelvis.’

  Nicolette mentally went through the scenario in her head. ‘What about the wife?’

  ‘She was unharmed. The police are questioning her and then bringing her in to be checked out.’

  ‘I’ll get Stephen.’

  ‘I’ll call the necessary specialists we’ll need and see if these people have patient files here.’

  ‘Where is Stephen?’

  ‘EC-7.’

  ‘Thanks.’ Nicolette headed over and walked into the cubicle. Stephen was sitting in the chair beside the bed, winding a bandage around his patient’s hand. ‘Dr Brooks. Can I have a word?’

  ‘Certainly.’ He finished what he was doing and stood, pulling off his gloves and pushing back the chair. ‘That should do you fine,’ he told his patient. ‘Either go and see Dr Bourgeois here…’ he indicated Nicolette ‘…at her clinic at the end of next week or come into A and E and we’ll see if those stitches are ready to be removed.’

  ‘Right you are, Doctor.’

  ‘And remember to wear gloves next time,’ he chastised good-naturedly.

  ‘I’ve learnt my lesson, Doctor,’ the man replied. ‘Much obliged.’

  Stephen took the notes with him and headed out. ‘What’s up?’

  ‘Emergency coming in. Two patients. Gunshot wound to the pelvis and the other is stab wound to the shoulder. Stephanie wants us on the gunshot wound.’

  He nodded. ‘Let’s go.’ They headed into Trauma Room 1 where Sophie was getting things ready. They both scrubbed their hands and were assisted with gowns and gloves, ready for their patient. The paramedics wheeled the knife-wielding husband into TR-1, along with a police escort. The police officer who’d been stabbed was in TR-2 with Stephanie.

  ‘Twenty-nine-year-old male,’ the paramedic said as he gave the hand-over. ‘Dale Hennesey. Gunshot wound to the right lower quadrant of abdomen. Penthrane given for pain relief, oxygen eight litres per minute. No allergies known. Patient alert and orientated.’

  ‘Dale. I’m Nicolette. Do you know where you are?’ she asked as they got into position to move him off the ambulance stretcher.

  ‘In the hospital.’

  ‘Good,’ Stephen replied. ‘Three, two, one, lift.’ They transferred him across and the paramedics took their equipment and headed out. ‘I’m Stephen Brooks. We’ll get you sorted out.’ Nicolette was inserting an IV into Dale’s left forear
m to get things started while Sophie was doing his observations. Another nurse was removing Dale’s clothes, using a pair of heavy-duty scissors to cut through the fabric. The police officer stood to the side, watching what they did.

  ‘BP 140 over 60, pulse 72, resps 22,’ Sophie announced, and the scribe nurse wrote everything down on the whiteboard for all staff to see. Next, Sophie set up oxygen via a non-rebreather mask.

  ‘How are you doing, Dale?’ Stephen asked as he removed the padded bandage the paramedics had put on. ‘Allergic to anything? Had a tetanus shot recently?’

  ‘Not that I know of, and no,’ he mumbled. It was hard to talk when wearing a cervical collar.

  ‘Good. Maxolon 10 milligrams, morphine 10 milligrams, tetanus shot and Cephazolin 1 gram. Cross-type and match blood,’ he ordered as he tossed the bandage aside and took a good look at the wound before him. ‘Nicolette, I want you to check for an exit wound. The paramedics didn’t note one but on the count of three, if we could just shift him a little to check.’

  The staff followed Stephen’s instructions. ‘No exit wound,’ Nicolette reported.

  ‘Then the bullet’s still inside. Order X-rays of right hip, abdomen and chest. Make sure the general and orthopaedic surgeons have been called.’ Stephen didn’t like the look of the wound site, and when Nicolette was free he motioned for her to take a look.

  ‘There’s more blood than there should be,’ she said quietly.

  ‘That’s what I thought. Have you had much experience with gunshot wounds?’

  ‘Plenty.’ He obviously didn’t know she’d also worked in a war zone, where she’d treated at least one gunshot wound a day. Then again, she supposed there wasn’t any reason why he should know. She hadn’t yet given him her résumé as she hadn’t officially applied for the job on offer in his new GP practice.

  ‘So have I. There’s no time to take him to Theatre.’ He turned to Sophie. ‘Midazolam 2.5 milligrams,’ he requested. ‘We’ll debride and take a closer look.’ They scrubbed and gowned, working together, each reading the other’s mind and doing exactly what needed to be done.

  ‘BP’s dropping,’ Sophie called.

  ‘He’s bleeding internally somewhere.’ Stephen searched the wound frantically, looking for the source of the problem.

  ‘There. In there,’ Nicolette said quickly, and held the retractor out for him to take, which he did. ‘Hold still.’ She grabbed a set of locking forceps. ‘I can see the bullet. Once I remove it, take a look at the arteries.’ She concentrated, the skill of removing a bullet coming back to her in a flash. In the next instant the tinkling sound of metal against metal could be heard throughout the room as the bullet dropped into the dish.

  ‘Take the retractor,’ Stephen said. ‘Suction.’

  Nicolette did as he asked.

  ‘BP’s still dropping,’ Sophie said. ‘Find it quickly, people.’

  ‘Where are you?’ he mumbled. ‘Suction.’ Although there was urgency in his voice, he still kept his cool. ‘There.’ With a satisfied nod, he clamped off the offending artery. ‘Get an anaesthetist in here and book a theatre. How’s his BP, Sophie?’

  ‘Improving.’

  ‘Good. One unit of plasma.’ Stephen and Nicolette continued to check the area. Once they were satisfied with their patient’s condition, Dale was taken to Radiology for X-rays.

  ‘Thanks,’ Stephen said. ‘I’m glad you were around.’ He tossed his gown and gloves into the appropriate bins.

  ‘I could say the same about you.’

  ‘Did you do trauma medicine long?’

  ‘Six months normal, six months highly intense. I much prefer GP work. I like to follow through with patients.’

  ‘I know what you mean.’

  ‘I’ve had too much…excitement in both my working life and private life. I want steady and easy and comfortable.’

  Stephen frowned at her words, amazed at how her thoughts mirrored his own. He acknowledged her words with a slight inclination of his head. ‘I need to check on Mrs Bevan.’

  ‘The cat lady?’

  ‘Yes. Once she knew her darling was safe, her heart rate settled into a more normal rhythm. She said she saw Dr River the other week. He sent her off for scans but apparently they came back clean.’

  ‘So?’

  ‘The woman has angina and isn’t on any medication for it.’

  ‘What are you implying?’

  ‘I’m not implying anything. I’m merely stating facts. I would like to ask, though, what your opinion of Dr River is, but it will have to wait. How about coffee in the tearoom in twenty minutes? Does that suit you?’

  ‘Emergencies notwithstanding, yes.’ Nicolette tried not to smile like a Cheshire cat. It was only coffee and in the tearoom where they’d be easily reached if an emergency came in. It was nothing special. At least that’s what she told herself as she went off to check on Mr Stenton and Stephen headed off to see his cat lady.

  Mr Stenton had just returned from his sonogram with the report. Nicolette read it with interest.

  ‘Gallstones,’ she told her patient and his wife.

  ‘But you haven’t got all the test results back in yet,’ Mrs Stenton protested.

  ‘Did the sonographer show you the scans she took?’

  ‘Yes. We could see the stones quite clearly,’ Mr Stenton said, patting his wife’s hand reassuringly.

  ‘I’ll hand you over to the general surgical registrar and he’ll take over your care from here.’

  ‘Will he need an operation?’ Mrs Stenton asked, her voice trembling.

  ‘I’m not sure. Sometimes the stones can be broken down through a technique called lithotripsy, where sound waves are administered via ultrasound—similar to the one you’ve just had. Most times the stones then pass normally through the system, but the registrar will be able to tell you more.’

  ‘Thank you, Dr Bourgeois.’

  ‘You’re more than welcome.’ Nicolette headed back to the nurses’ station, wrote up her findings on Mr Stenton and left a note for the general surgical registrar. When she checked her watch, she realised it was way past twenty minutes since she’d seen Stephen. She went to the tearoom, wondering if he was still there. He was.

  ‘You only just made it,’ he stated as he stood and made her a cup of coffee. He asked about milk and sugar and she gave her order. He stirred the sugar in slowly, watching her all the time before handing it over—not saying a word.

  Once he was seated again he took a sip from his cup and swallowed. She watched the action of his Adam’s apple, amazed at how gracefully he did everything. Nothing was ever hurried or forced. Even when he’d been treating Dale Hennesey he hadn’t allowed himself to be rushed.

  ‘Tell me about Dr River.’

  Those were the words which eventually came out of his mouth and Nicolette almost groaned. He’d been looking at her, his blue eyes full of meaning, and that had been the last thing she’d expected him to say.

  Nicolette thought carefully, also pleased it was her turn to make him wait. ‘He’s ready to retire,’ she said eventually, and Stephen nodded as though he’d been expecting her to say those exact words all along.

  ‘Do you think he’s becoming a little…lax in his treatment of patients?’

  Nicolette chose her words carefully. ‘He has been leaving a lot of the day-to-day consulting up to me.’

  ‘Tactful.’ He nodded as though he approved. ‘I like that.’

  ‘How’s Mrs Bevan?’

  ‘Doing just fine. I’ve admitted her overnight for observation but she’ll be at home and reunited with her cat tomorrow morning. I’ve also put her on angina medication, which should help control her symptoms a lot better.’

  Nicolette smiled. ‘I’m glad she’s going to be reunited with her cat. She’s such a sweet lady.’

  ‘We need to discuss the new clinic,’ he stated matter-of-factly.

  ‘We do?’

  ‘I thought you wanted to work in my clinic.’ What he’d seen tonight ha
d impressed him and it also seemed that, whatever Simone had said about him, it didn’t matter to Nicolette—at least as far as her professional life went. He respected her for that.

  ‘You want to work with me?’

  ‘You seem surprised.’

  ‘I just thought…’ She trailed off and looked at him, searching for something in his face that might indicate he was joking. ‘I haven’t even given you my résumé.’

  ‘I’ve seen quite a bit the past two shifts we’ve worked together.’ He stood and carried his empty cup to the sink. ‘Are you free tomorrow?’

  Nicolette spluttered on the mouthful of coffee she’d sucked in. Quickly recovering, she coughed a few times before looking up at him in puzzlement. ‘Tomorrow is Sunday.’

  ‘Correct. Are you free?’

  ‘Er…yes.’

  ‘I’ll pick you up at ten. Does that suit?’

  ‘Pick me up? You mean as in a date?’ she asked incredulously.

  CHAPTER THREE

  NICOLETTE saw humour light up in Stephen’s eyes and a slight tug at the corners of his mouth. ‘You can call it a date if you like, but don’t get upset if we start discussing business.’

  She was still taking in his words as he walked from the room and realised he’d been teasing her. She groaned and slumped forward, putting her head between her knees. A date? Why on earth had she said that out loud?

  And the effect his ever so slight smile had had on her? Devastating. Seeing the brightness of amusement catch in his blue eyes was rocking her senses and she was glad she’d been sitting down. The man was enigmatic and she was captivated by him, eager to know more, wanting to find out just what made him tick.

  It was a bad sign. She’d vowed not to get involved with another man…at least, not for some time. Although Simone had told her plenty of stories about the handsome Stephen Brooks, Nicolette knew she had to trust her own instincts, especially if she was going to work with him. She needed to put aside all Simone had said and form her own opinions. The problem was, she couldn’t deny the attraction that existed between them.

  ‘Attention.’ She warned herself as she stood and took her cup to the sink. It was good advice because if she wasn’t careful, she’d end up making an enormous fool of herself and that was the last thing she needed.