‘Everything sorted?’
Adam came into the room with the injured man draped over his shoulders. Daniel and Alan helped him lie the man on the table then he looked round. ‘Right. I don’t need all of you here so I’ll just take a couple of volunteers. June will you do the honours? And, Daniel if you could cover the anaesthetic?’
‘Excuse me?’ Kasey stepped forward, barely able to contain her annoyance at the way he had deliberately cut her out of the proceedings. ‘There’s no need to involve Daniel. I’m perfectly capable of handling this.’
‘You had a shock tonight,’ he replied curtly, walking into the kitchen and turning on the old-fashioned, hot-water geyser. ‘I suggest you get a good night’s sleep and give yourself time to get over it.’
‘Was that a suggestion or an order?’ she demanded, following him into the room.
‘It’s simple common sense.’ He pumped a handful of antiseptic solution out of the dispenser she’d placed there for them to use and lathered his forearms.
‘In that case, wouldn’t it be sensible if you excused yourself as well?’ She stared back at him, experiencing a pang of regret when she saw the flicker of annoyance that had lit his green eyes. There was no sign of amusement in them now. ‘You were shot at, too, Adam, don’t forget, so you had just as big a shock as me. If I’m not up to handling this job, neither are you.’
‘I shall decide whether or not I’m fit to operate.’
‘And I shall decide whether or not I’m fit to act as your anaesthetist.’
She stared back at him, knowing that if she lost this battle it wouldn’t be worth her staying on in Mwuranda. If he didn’t trust her to do her job then she would have to go home. Maybe she could put up with his hostility on a personal level but she refused to compromise when it came to her work.
‘Fair enough.’
He inclined his head in brief acknowledgement then spun round on his heel. Kasey let out her breath in a small sigh of relief, only then acknowledging how important it was to her that she should be allowed to stay. She quickly scrubbed up and put on a gown then went back to the kitchen. June had set up a drip and was now cleaning the injured man’s shoulder with antiseptic solution. The rest of the team had gone back to bed, so all she could hope was that Adam’s apparent lack of faith in her hadn’t caused any long-term damage. It would be difficult to work with the other members of the team if they had doubts about her ability.
It was a sobering thought and it put her on her mettle as she began anaesthetising the patient. Without the aid of artificial ventilation equipment, she couldn’t administer a muscle relaxant otherwise the patient wouldn’t be able to breathe, so she opted for an anaesthetic agent and pain relief, administering the drugs via a cannula in the back of the man’s hand because it would be easy to top up the drugs throughout the operation.
The lack of modern equipment also meant that she would have to rely more heavily on physical signs to ensure the patient was maintained at a suitable level of unconsciousness. Increased sweating and salivation, irregular breathing, changes in muscle tone and eye movement were all indications that a patient was receiving an inadequate level of anaesthesia. She would also need to monitor his general status through his heart rate and blood pressure, so she would be kept busy, but she had no doubts about her ability to do the job. She was a first-rate anaesthetist and she intended to prove that to Adam and everyone else on the team.
‘I’ll just get this mess tidied up first.’
Adam snapped on a second pair of gloves as he came over to the table. They were all wearing a double layer of gloves because they’d been warned about the dangers of HIV. He quickly debrided the torn flesh surrounding the exit wounds then removed some splinters of bone that had sheared off from the shoulder joint. He delicately probed the trajectory the bullets had taken with his finger and shook his head.
‘No sign of any more bullets lodged in there, I’m pleased to say.’
Kasey nodded, not wanting anything to distract her as she checked the patient’s BP. It was a little on the low side, which wasn’t unusual considering the amount of blood he’d lost, but she still reported her findings.
‘BP’s a bit low. I’ll increase the drip.’
‘Fine.’ Adam barely glanced at her as he began the delicate task of repairing the torn shoulder muscle. He shook his head. ‘There’s a tear right through the deltoid. It’s going to need a lot of physio to get this arm moving properly again.’
Once again Kasey didn’t say anything. She was too busy checking her patient. His skin was dry to the touch and there was no sign of an increase in his temperature, which were both good signs.
‘How’s he doing so far?’
She looked up when Adam spoke to her, feeling her tension lessen just a little when she saw no sign of concern in the green eyes that were watching her over the top of his face mask. ‘He’s stable at the moment. BP has levelled out and his temperature is normal. Pulse rate and breathing are both within acceptable levels.’
‘Good.’
He gave her the ghost of a smile, only visible by the slight lifting at the corners of his eyes, and she huffed out a tiny sigh of relief at having passed muster. June handed him a scalpel then winked at her, and Kasey chuckled. June had obviously noted the small improvement in his attitude towards her so all she could do now was hope that it would last.
They carried on in surprising harmony after that until Adam nodded. ‘That’s about all I can do for now. I’ll just pack the wound and leave it open to drain. Infection is always a major problem with this type of injury because the bullet carries all sorts of gunk into the body, but we’ll just have to deal with it as and when it happens. There might be other damage, of course. A high-velocity gunshot injury causes shock waves to pass through the body but we’ll have to wait for the X-rays before we can know for certain what’s happened.’
‘Will you do the X-rays here or at the hospital?’ Kasey asked.
‘Hospital. We’ll have him moved over there tomorrow if he’s fit enough to withstand the journey.’
Adam slid a drainage tube into the wound, packed it with layers of gauze then covered it with a light dressing before they rolled the patient onto his side so he could dress the entry wounds, which were far smaller—no bigger than a couple of ten-pence pieces.
‘It might be best if we kept him sedated tonight,’ he told her when he’d finished. ‘We have no idea who he is and I don’t want to take the chance of him wandering around during the night.’
‘I’ll sort it out,’ she assured him as June went to fetch some more dressings from the storeroom. ‘And I’ll stay with him, of course, to make sure there isn’t a problem.’
‘There’s no need. I’ll do it myself.’
He turned away but if he thought she was letting him get away with that, he could think again. She grabbed hold of his arm, her blue eyes filled with a mixture of pain and injured pride as she stared into his face.
‘What is it with you, Adam? Do you get a thrill out of undermining me all the time? Or are you hoping that I’ll crack if you keep on pushing me? I know I hurt you—’
‘It has nothing to do with what happened between us,’ he said curtly, shrugging off her hand.
‘No?’ She laughed scornfully. ‘Come on, Adam, at least have the guts to tell me the truth. We both know that you didn’t want me along on this trip and we both know why, too.’
‘And that has nothing whatsoever to do with my decision to take charge of this patient tonight.’
He brushed past her, his face like thunder as he stripped off his gloves and tossed them into the waste sack. Kasey followed him into the kitchen, too incensed to care if she was making matters worse. Maybe she should accept his decision, but how could she when it seemed to be yet another deliberate slight?
‘Then what does it have to do with? I think I deserve an answer, Adam.’
‘I don’t have to give you an answer.’ He gripped hold of the sink and she could tell t
hat he was struggling to keep a rein on his temper. ‘I’m in charge of this team and it’s up to me what happens.’
‘I should have known you’d take the easy way out,’ she scoffed. ‘You’re very good at finding fault with people but you’re not so good when it comes to backing it up with cold, hard facts.’
‘I am not finding fault with you or your work!’
‘Then why won’t you leave me in charge of this patient?’
‘Because it’s too bloody dangerous, that’s why!’
He swung round and she took a step back when she saw the anger in his eyes yet she knew on some inner level that it wasn’t directed at her but at himself. Her heart began to pound so that it was difficult to hear what he was saying as he continued in the same biting tone.
‘I am simply not prepared to put your life at risk, Kasey. And if you don’t like it then there isn’t much I can do because nothing you say or do will make me change my mind.’
‘I didn’t realise…’
She stopped and swallowed because she couldn’t seem to find the right words to explain that she’d never expected him to be concerned about her safety. It seemed too incredible to believe after what had gone on between them, yet there wasn’t a doubt in her mind that he was telling her the truth.
‘If you could just make sure that he’ll be unconscious for the rest of the night that will be fine.’ His tone was less abrasive now, softer, and she took a deep breath as her anger suddenly melted away leaving her feeling incredibly vulnerable.
‘Of course,’ she murmured, turning to hurry back into the dining room before he realised how shaken she felt.
Adam followed her and her heart ached when she glanced up and saw him standing at the end of the table. He looked so tired and drawn, his skin tinged with the grey hue of fatigue, that all of a sudden she felt her eyes welling with tears. It was her presence that had caused him to look like this and it wasn’t what she’d intended. She’d come on this trip first and foremost to make the lives of the people they treated that bit better, not to make his life more stressful.
‘I’m sorry,’ she whispered, overwhelmed by guilt.
‘Because you stood up for yourself?’ He shrugged. ‘I’d have done the same thing, Kasey, so there’s no need to apologise.’
‘I’m sorry for making things difficult for you,’ she corrected, wanting—needing—to explain. ‘I never meant to do that.’
‘Didn’t you?’ His voice sounded flat, emotionless, and she sighed, understanding why he found it so hard to believe her.
‘No,’ she said briefly, because there was no point trying to convince him when he didn’t want to be convinced. She topped up the patient’s anaesthetic then checked his vital signs one last time and stepped away from the table.
‘He should be OK now but you can top up the anaesthetic if you need to. I’ve left everything ready for you.’ She pointed to the vials of drugs then made her way to the door. ‘Goodnight.’
‘Goodnight, Kasey. And thank you.’
She didn’t pause, didn’t turn back to ask him what exactly he was thanking her for, because she knew what his answer would be and that it wasn’t the one she really wanted to hear. Adam was thanking her for her work that night, for acting as his anaesthetist and doing her job well. Every surgeon she’d ever worked with had done that because it was what was expected of one professional to another. However, as she made her way upstairs, she couldn’t help wishing that Adam’s thanks had been a bit more personal, that he’d thanked her for being her, not just a colleague.
It made her see just how ambivalent her feelings were towards him, and how hard it was going to be to work with him because of that. She might be ready to fight tooth and nail to uphold her status within the team but it didn’t mean that she didn’t want Adam’s approval, did it?
All of a sudden it felt as though she’d come full circle and was back to where she’d been five years ago, when wanting and hating Adam had almost destroyed her. Would she survive this time?
CHAPTER THREE
‘START her off with two litres of saline but I want it pushed through as quickly as possible.’
Adam was hard-pressed to contain his anger as he looked at the young girl lying on the bed. Amelia Undobe had been celebrating her thirteenth birthday that day when she’d stepped on a land-mine close to her home. Her right foot had been blown off in the explosion and the left one had suffered such extensive damage that he wasn’t sure if he’d be able to save it. It was hard to suppress his fury when he saw what had been done to the child, but he couldn’t allow his emotions to get the better of him or he wouldn’t be able to do his job properly. He turned to June and there was no trace of what he was feeling as he continued.
‘She’s too dehydrated to undergo surgery at the moment so we need to get her fluid levels up. I’ll be back in a few minutes to take another look at her so do what you can.’
He stripped off his gloves and tossed them into the waste sack then left the treatment room. Every muscle in his body was aching with tiredness and it was his own fault, too. Hadn’t he laid down the law about people not trying to prove themselves? So why was he pushing himself to the point of exhaustion? Did he really think it would stop him thinking about Kasey if he worked until he dropped? He’d still be thinking about her on his deathbed at this rate, still feeling this same mixture of longing and anguish that was eating away at him, and he sighed wearily as he headed along the corridor because he knew what had set it off.
Feeling her lying beneath him the other night had awoken urges he’d thought he’d conquered years ago. He might have been trying to protect her but his body had taken a completely different view of what had been happening and he’d been paying the penalty ever since. For the past three nights he’d dreamt about her—felt her softness over and over again, smelled the perfume of her skin—and now the images seemed to be locked inside his head and he couldn’t seem to shift them no matter how hard he tried. The thought of having to put up with such misery for an unknown period of time was more than he could bear and he cursed roundly as he veered off towards the canteen. Maybe a cup of coffee would give him the boost he needed and set him back on track.
‘Ah, Adam, my friend. I was just coming to find you.’
‘That sounds ominous.’
Adam drummed up a smile when Matthias caught up with him. He’d met Matthias when he’d been working with the French aid team during his first visit to the country and they had remained friends ever since. Matthias had qualified as a doctor in England but he’d returned to Mwuranda after completing his training and worked in the hospital they were currently using as their base. Adam knew that Matthias could have left when so many other educated people had fled the country but he’d stayed and done all he could to help his people during the war. It was because of Matthias that he’d agreed to run this mission, in fact.
‘So what’s gone wrong this time?’ he demanded as Matthias fell into step with him.
‘How do you know it’s bad news?’
Matthias smiled at him, his teeth gleaming against his black skin. A tall, handsome man in his thirties, he had the looks and the bearing to have achieved great things in the world of medicine. It was a measure of his character that he’d turned his back on material success to help his countrymen.
‘Instinct? A lucky guess?’ Adam replied drolly, shouldering his way into the canteen. Although the catering team had done their best, the place still bore the evidence of the recent turmoil—the walls were riddled with bullet holes and most of the glass was missing from the windows. Still, the coffee was hot and strong so that was something to be grateful for.
He went over to the urn and filled a couple of mugs with the steaming black brew then carried them over to a table. There were a few other people taking a break as well, and he averted his eyes when he spotted Kasey and Daniel sitting at a table in the corner. Hooking out a chair with his foot, he sat down and shoved one of the mugs across the table.
&nb
sp; ‘You are far too cynical, my friend,’ Matthias reproached him. ‘It does no good to expect bad things to happen all the time. What is the point of always expecting the worst?’
‘That way you don’t risk being disappointed,’ he replied shortly, his eyes skittering across the room before he could stop them. His mouth thinned when he saw Daniel lean over and pluck something out of Kasey’s hair. It was a gesture that positively reeked of intimacy and he couldn’t help glowering at the couple. To his mind, they were getting far too familiar and he would have to have a word with them—remind them that they weren’t there for fun but had a job to do.
‘Something has upset you, Adam?’
‘What?’ His gaze swivelled round when Matthias interrupted his thoughts.
‘The way you were glaring at that young couple, I assumed they must have done something to upset you.’ Matthias’s tone was bland but the look he gave him was far too knowing for Adam’s liking.
‘I prefer it if members of my team don’t fraternise during working hours,’ he said shortly, knowing that he sounded like a leftover from the Victorian era.
‘Ah, I see. It’s important to have clear guidelines so everyone understands what is expected of them, although it must be difficult for you to ensure that people stay within the accepted limits.’
Adam scowled when he heard the amusement in his friend’s voice. ‘I came here to do a job, not win a popularity contest, if that’s what you mean. If the members of this team won’t abide by my rules then they will be sent back to England.’
‘But all Daniel was doing was removing a piece of lint from Dr Harris’s hair. Hardly a major crime, I would have thought.’ Matthias smiled faintly. ‘You seem a little…sensitive where that young woman is concerned. It isn’t the first time I’ve noticed you glaring at her.’
‘Maybe I’ve had good reason,’ he replied tersely because he hadn’t realised that he’d made his feelings quite so obvious. ‘Anyway, what did you want to speak to me about?’ he added, swiftly changing the subject because he didn’t want to talk about Kasey or his feelings for her—whatever they were. Telling her that he’d been concerned about her safety the other night was something else that had been playing on his mind. He’d tried telling himself that he would have been equally concerned for any member of the team but even he wasn’t convinced it was true.
The Forever Assignment Page 4