Rachel was the only woman who’d stripped to her bra but she knew without asking that each and every one of these women would do the same and more if they needed to. Their care and concern were palpable.
Then Kim’s parents were there, running toward their daughter across the showgrounds. Their fear reached the group on the ground before they did, but Kim had drifted into unconsciousness. The combination of shock, blood loss and painkillers had sent her under. Good, Rachel thought as her mother disintegrated into tears, sobbing onto her chest. The horror on her parents’ faces would only have made things worse.
Enough. There was nothing more she could do now. One of the paramedics had taken her position, keeping pressure on the wound. She rose. A buxom woman in floral Crimplene put her arm around her and held. Rachel wasn’t complaining. She was grateful for the support.
‘Who are you?’ Hugo asked. He was adjusting a bag of plasma, the ambulance officers were helping. Rachel wasn’t needed.
‘Rachel. Rachel Harper.’
‘You’re a doctor?’
‘Yes.’
‘You’re not a vascular surgeon, I suppose?’
‘I wish.’ She knew exactly what he was thinking. A vascular surgeon was what they needed, urgently. The chances of saving Kim’s leg were incredibly slim. ‘But Michael has the skills. And he’s still in range.’
He’d be upset at being called back but he had no choice.
‘OK.’ He stared up at her for a moment longer, his intelligent eyes assessing. Each knew what the other was thinking. They couldn’t voice it here-not in front of Kim’s parents-but if the femoral artery wasn’t repaired fast, Kim would lose the leg if not her life.
They needed the helicopter. They needed Michael. Kim’s future depended on it.
There was nothing Rachel could do, though.
For now she was no longer needed.
Mrs Keen, the lady in the Crimplene, ushered Rachel into the showground caretaker’s residence. As the ambulance screamed its way to the hospital she was already under hot water while Mrs Keen tut-tutted about the state of her clothes.
‘And the clothes in your bag are no better,’ she told Rachel through the bathroom door. ‘One of the men brought your bag over but you’ve dropped it, and then used everything to stop the bleeding. Oh, my dear, there’s blood on everything.’
That was a minor worry. For now Rachel couldn’t care. She let the hot water steam away the gore and she worried about the girl. Worried about the leg.
Michael would be really angry at being recalled. He’d hate to miss out on the Witherspoon case.
It couldn’t matter. He wouldn’t have heard the dogfight, she decided. Michael Levering saw only the things that affected him. He was needed in Sydney for a prestigious patient and Rachel wasn’t doing what he wanted. He’d have simply turned on his heel and stalked away. As for Rachel and Penelope-others could pick up the pieces. If Rachel didn’t take his expensive dog and his expensive car back to Sydney, well, Michael had the money to send a lackey to the country to collect them later in the week. Dog-show organisers were hardly likely to let Penelope starve and even if they did…
Penelope was just a possession.
‘Damn the man.’
She was shaking, a combination of anger and reaction to the whole situation. They’d been really, really lucky to save Kim’s life.
Michael would be back. The helicopter would have returned by now and, dislike Michael as she did, she had to concede he possessed the skills she didn’t. He was an incredibly competent vascular surgeon. He might not have noticed the dog fight but if they planned to evacuate Kim on his helicopter, he would, of course, treat her. And with Hugo as back-up…
She washed the last trace of blood from her arms as Mrs Keen’s face appeared around the door. Her cheeks were crimson with embarrassment and distress.
‘My dear, I’m sorry to disturb you but you’re needed back at the hospital. Dr McInnes has just rung. The helicopter’s refused to turn around,’ she told her. ‘Dr McInnes says he has to operate now or she’ll lose the leg, and you’re all the help he has.’
‘It’s not a publicly owned chopper.’ Harold Keen, the showground caretaker, drove her to the hospital in grim-faced anger. ‘It seems it belongs to the chap that had the heart attack-Hubert Witherspoon. His man’s the pilot. He’s under instructions to take your young man to Sydney and there’s no way he’s turning back.’
‘But Michael’s on board. Surely he can overrule.’
‘I don’t think he has any say in the matter.’
Rachel stared straight ahead. She was wearing one of Doris Keen’s Crimplene dresses. She’d hauled a comb through her hair, but her curls were still dripping. She was wearing a pair of Doris’s sandals. She was heading to a tiny country hospital where they were facing surgery that was a nightmare.
Help!
‘I suppose someone’s looking after Penelope,’ she said in a small voice, and Harold looked her over with evident approval.
‘Your dog’s fine,’ he told her. ‘There’s any amount of folk looking after her. You look after Kim and we’ll look after you.’
‘Thank you.’ She felt like she was about to cry. Damn Michael. Damn him. He had the skills she didn’t. He had the helicopter she needed.
He was gone.
‘It’s no use being angry. We just have to get on with it.’
Hugo was already kitted out for surgery in green theatre gown, cap and slippers. The nurse had ushered Rachel straight through to the theatre. She glanced around and her heart sank. This was a tiny surgery, set up for minor procedures. Not the major trauma that was facing them now.
She swallowed and looked up, and some of her panic must have shown in her face.
‘What’s your background?’ he asked, his voice gentling a little.
‘I’m a registrar at Sydney Central. Emergency medicine. I don’t… I don’t have the surgical skills to cope with this.’
‘But you’re the reason we were able to clamp the arteries so fast,’ he told her. ‘So you saved Kim’s life in the first place. It’s just a matter of finishing what we started.’
Yeah, right. ‘You’re planning on rejoining the femoral artery?’
‘If we can-yes.’ He shook his head. ‘It may be unlikely we’ll succeed but we have to try. I’ve been on the phone to specialists in Sydney and we don’t have a choice. By the time we get her evacuated to Sydney the leg will be dead. If we don’t try then she loses the leg. It’s as simple as that. I’m assuming you can give an anaesthetic?’
He wasn’t expecting her to operate. That was such a relief her knees almost buckled right then.
‘Yes.’ If he was prepared to be heroic then so was she. This was heroic surgery, she thought. Damn fool surgery. The outcome seemed almost inevitable but he was right. They had to try.
‘It’s not as bad as it seems,’ he told her. ‘We have a video link to Sydney. Joe Cartier, one of the country’s leading vascular surgeons, has agreed to help us every step of the way. I’ve hauled in Jane Cross, a local who plays at being a film-maker. She’s setting up computer equipment and she’ll video while we operate. She can do really intricate close-up stuff so everything I do goes straight down the line to Sydney and I get immediate feedback.’
He’d organised all this while she’d been in the shower?
‘I… You’re not a surgeon?’
‘I’m a family doctor,’ he told her. ‘I’m two hours away from back-up. I’m everything. If you weren’t here-if I didn’t have an anaesthetist-then I’d count this impossible. But we have enough going for us now to hope. So what are we waiting for? Let’s go.’
Afterwards, when Rachel was asked to describe what had been done, she’d simply shake her head. How they did it…It was impossible. All she could describe were the technicalities, and they were impressive enough.
They had a speaker-phone mounted just beside the table. Every sound they made went straight down the wire to Sydney.
&nb
sp; Jane Cross, a woman in her forties, looking crazily incongruous with theatre garb covering a purple caftan and a mass of jangling earrings dangling beneath her theatre cap, directed a video camera straight at the wound.
‘You promise you won’t faint?’ Hugo had asked the middle-aged woman as she’d set up the equipment, and Jane had regarded Hugo and Rachel with incredulity. Even with a hint of laughter.
‘What, faint? Me? When I’ve got a captive audience? I intend to faint at least three times and I’ll probably throw up too, but later. Not until I’ve done my job.’
She was wonderful, Rachel decided. She was right there behind Hugo’s hands, but somehow she had the skill and the sensitivity to stay clear enough for his fingers to do their work.
The pictures she took were via a digital video camera linked to video conferencing equipment. In Sydney Joe Cartier had a clear view-and Hugo was asking questions every step of the way.
Rachel couldn’t help him at all. She had her own battles. She wasn’t a trained anaesthetist-she’d done basic training but that was all-and Kim was so severely shocked that just keeping her alive was a major battle.
She worked with a phone link, too. They’d run out of phone lines but Jane’s partner, a dumpy little woman in jeans and sweatshirt, sat in a corner of the theatre where she didn’t have to see-her stomach was evidently not as strong as Jane’s-and relayed Rachel’s questions down the line to an anaesthetist in Sydney.
‘Minimal anaesthesia for such a shocked patient,’ the specialist told her, working her through a careful, haemodynamically neutral induction method. He worked through her needs with her and Rachel wondered that such a small hospital could meet the requirements he snapped down the phone.
It could. For a tiny hospital Hugo had brilliant equipment. It was stunning that they had sufficient blood supplies on hand, but there was so much more. Rachel had blood on request, she had plasma, she had saline and a team outside the theatre was warming all the fluids before she even saw them.
The fluids weren’t the only thing being heated.
‘Keep the patient warm at all costs,’ the anaesthetist barked down the phone, and warmed blankets appeared like magic to cover every part of Kim’s body that Hugo didn’t need to work on. After that one instruction Rachel didn’t need to worry about warming-the blankets were replaced every few minutes by freshly warmed ones handed through the door. There must be a hive of industry out there.
It was an amazing scene. As well as the unseen industry outside, they had two nurses working with them in the theatre.
Elly was a competent middle-aged woman, white-faced and shocked because she was best friends with Kim’s mum, but that fact wasn’t allowed to get in the way of her professionalism. Then there was David, a ginger-headed kid who looked like he was hardly old enough to be qualified-but was magnificent under pressure.
They were all magnificent under pressure, Rachel thought. The whole town.
And Hugo…
What was being asked of him was unthinkable. His concentration was fierce-he didn’t lift his head. He concentrated as she guessed he’d never concentrated in his life.
Where was the laughing man at the dog show? Gone. He’d been replaced by a pure professional-a professional being asked to work well past his level of training.
This was nightmare stuff. The specialist at the end of the phone could only guide-there was no way anyone could help Hugo manoeuvre the fine particles of tissue back into being a viable blood supply.
Rachel, concentrating fiercely on an anaesthetic that was taking her to the limits of her ability, could only wonder. If Hugo hadn’t been there, could she have done such a thing?
No, she thought honestly. Hugo had obviously done far more extensive reading and studying in this area than she had. The questions he asked the specialist showed keen intelligence and an incisive knowledge of what he was trying to achieve.
The man was seriously good.
And he was succeeding.
Even when the femoral artery was somehow-amazingly-reconnected and the first surge of pink started to appear in the lower leg, he didn’t relax. His questions to the unknown Joe in Sydney seemed, if anything, to increase. He worked on and on, tying off vessels that were damaged beyond repair.
He completed the vascular surgery, took a deep breath, and a plastic surgeon came on the line, guiding him through the complex steps in closing such a wound to give a decent cosmetic outcome.
They were worrying about appearances, Rachel thought jubilantly, watching the colour seep back into Kim’s toes and making sure the heart line on her monitor stayed steady as blood pressure stabilised. They were worrying how she’d look in the future.
They were winning!
And finally-finally, after hours without lifting their heads-the team in Sydney let out a cheer down the phone lines.
‘Well done, Cowral,’ they told them. ‘Unless you have any more big dogs menacing the populace, we’ll leave you to it.’
And to the thanks of the entire theatre team, the telephone lines went dead.
The theatre fell silent. Rachel was still concentrating. Hugo was placing dressings around the wound and she had to concentrate on reversing the anaesthetic, having Kim reestablish her own breathing. But the satisfaction…
She glanced up and the joy she felt was reflected in every face in the room.
Except Hugo’s. He looked sick. The strain Rachel had been under had been immense-the strain Hugo had felt must have been well nigh unbearable. He’d won, but at a cost.
She’d worked as a team member for long enough to know that it was time for someone else to take charge. And she was the only possible option.
‘David, take over the dressing,’ she ordered. ‘Hugo, leave the rest to us. We don’t need you here any more.’ He’d been under more pressure than any doctor should face and now, job done, reaction was setting in with a vengeance.
‘I’m OK.’ But the hands holding the pad were suddenly shaking. His fingers had seemed nerveless for hours, skilled and precise past understanding. It was more than understandable that reaction should set in now.
‘Go and tell the Sandersons their kid will keep her leg,’ she told him. ‘Kim’s parents will still be worried sick. Go.’ Kim was taking her first ragged breaths. One of the nurses had given them the news some time ago that their daughter would be fine, but they wouldn’t believe it until they’d heard it from Hugo.
And Hugo needed to tell them. Hugo had achieved the impossible. This was his gift.
The theatre team agreed. David lifted the tape from Hugo’s nerveless fingers and started applying it. Job done.
‘You’re being kicked out of Theatre, Dr McInnes,’ the young nurse told him, giving his senior a cheeky grin that was still flushed with triumph. They were all high on success. It was a fabulous feeling. ‘The lady’s told you to leave and what the lady wants the lady should get. Don’t you agree?’
Hugo stepped back from the table. He gave Rachel a long, assessing look and then his face broke into the beginnings of a crooked smile.
‘I guess. We owe the lady big time.’
‘There you go, then,’ Rachel said with a lot more placidity than she was feeling. ‘Pay your debt to us all by getting out of here.’
‘If you’re sure.’
‘I’m sure.’ And then for some reason she couldn’t fathom she put her hand on his arm. It was a fleeting gesture-of congratulation?-of comfort? She wasn’t sure but she knew that she was compelled to do it.
Her hand stayed. He looked down at her fingers resting on the sleeve of his theatre gown and his face twisted into an expression she didn’t recognise. For one fleeting moment his hand came up to cover hers. Warmth flooded between them-and something else. Something she couldn’t begin to recognise.
‘You’re right, Dr Harper,’ he said softly, so softly she could hardly catch the words. ‘I need to get out of here.’
He left. The two nurses wheeled Kim through to Recovery and Rachel was l
eft with Jane, the lady with the video, and Pat, the lady on the floor holding the mobile phone.
They’d never met until three hours ago and they were grinning at each other like fools.
‘That was fantastic,’ Rachel said, and if she couldn’t keep her voice steady, who could blame her? ‘Jane, I have no idea how you filmed that without fainting.’
‘Fainting isn’t what I felt like,’ Jane admitted. ‘What I felt like was far more messy. But I figured I could do the messy stuff afterwards when no one needed me and, hey, guess what? Now I don’t feel like it at all any more.’
‘You realise you guys saved Kim’s leg.’ The video recording and computer link had meant the specialists on the end of the line had been able to watch them every step of the way and Pat’s relayed instructions had given Rachel every skill she’d needed.
‘We all saved Kim’s leg,’ Pat decreed. She rose and came across to give her friend a hug and then the two of them hugged Rachel. This wasn’t something that’d happen in a big city hospital but it was an entirely appropriate action here. A great action. ‘We make a fantastic team,’ Pat said roundly. ‘We’re so glad you’re here now, Dr Harper. Something tells me Dr McInnes is going to need the best team he can get.’
The words somehow broke through her exhaustion. They didn’t make sense. What was Pat saying? Something about Hugo needing a team? Surely that need was past.
‘Why now?’ she asked. ‘Why would Hugo need me any more now?’
‘A really solid medical team is exactly what we’re going to need now,’ Pat told her. ‘The wind’s swung around. Word came through as we were on our way in here. The fire’s blocking the highway. There’s no way in and there’s no way out, and the fire’s getting bigger by the minute.’
Rachel walked through to the sink and hauled off her theatre gown without even thinking. She was so tired she could hardly stand. She ran cold water over her wrists and then splashed her face, trying to haul her tired mind into gear.
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