Heartbeat (Medical Romance)

by Ramsay, Anna

  Matt, who was assisting, had whistled at the sight of the old Masai's ingenious repair of his son's dreadful wound. 'Remarkable piece of work,' agreed Ross, removing the red cotton loops and dropping them into a kidney dish. 'Obviously a budding Fellow of the Royal College of Surgeons!' During the operation he had been specially considerate of his scrub nurse's tiredness and inexperience; encouraging and kind, not yelling when she handed the wrong instrument, patiently explaining his plan of campaign as he washed out the stomach and inspected the major organs one by one before tackling the ripped intestines, chatting affably to keep his hollow-eyed assistants wide awake.

  'Did you know,' he remarked to Jenni, not looking at her but peering into the operation site as his gloved hands located and examined the liver, 'did you know that these Masai people live on a diet of milk and blood?' Jenni swallowed her disgust and said no, she didn't, but she supposed that since they were continually on the move, driving their herds of cattle to fresh watering-holes, they wouldn't go in for much cooking. 'Fresh blood?' questioned Matt, pushing his green-capped head close to Ross's to get a better view of the patient's spleen.

  'No damage here, thank God for that... Yup, they trap blood from the jugular veins of their cattle in rotation, so I'm told. One might expect to find a high incidence of heart disease among the Masai, but all the exercise they take combats the effects of a high-cholesterol diet. As we can see here, all organs in the pink, and there's no free blood in the peritoneal space. Now, my intention is—scalpel, please, nurse—yes, I'll have a number two— to give the colon a rest by re-routing the faecal stream through the abdominal wall, thus creating a temporary diversion to allow the gastro-intestinal tract to heal.'

  Matt didn't envy the surgeon the prospect of explaining sophisticated Western surgical techniques to a primitive bushman. 'How d’you plan to tell these guys?' he queried.

  'With the aid of diagrams. And Father Thomas translating. It’s not going to be easy.’

  'The old feller'll be camping out at the bottom of the bed for the next few weeks,' predicted Matt lugubriously, 'till you reverse that colostomy. Sister Bea'll go crazy. Say, Boss, maybe one of this guy's great-grandchildren will be a surgeon too. Could be in the family genes.'

  Jenni had blinked and smiled beneath her mask. 'And today's bush children will grow up to be the doctors, priests, teachers and nurses of the future,' she observed with weary satisfaction.

  Matt's next question had her wideawake, ears flapping.

  'How's about sneakin' along to the Chief’s birthday party when we get outa here, Boss? Reckon things'll still be swingin'. Oh, man, the rhythm of those native drums really gets to me!'

  'Dr Blarney, could you try and keep your head out of my field of vision?' complained the much taller surgeon. 'I looked in earlier and paid my respects. And a good job too, since it happened I was within earshot when this excellent theatre nurse decided to take a walk on the wild side… Nurse! have your fingers turned to butter all of a sudden? No, of course I don't want you to pick it up, just give me a replacement.'

  Jenni was late for supper. She was waiting for Dr McDonnell, who always insisted on being called to see any child running a temperature.

  When he came striding in he found her sitting beside the empty cot, cuddling the listless three-year old who had been admitted the previous afternoon for observation.

  Ross rarely wore his white coat on the ward because he maintained it frightened the children unnecessarily. He looked at the charts and examined the girl's chest and ears and throat, humming tunelessly as he went down to the dispensary to locate the antibiotic he was prescribing. He patted the damp curls with a cheerful hand, promising, 'She'll be running around by tomorrow,' and requested Jenni's presence at the crack of dawn to accompany him on a long and uncomfortable trek into deep bush country. Because Sylvia, his usual nurse, was taking three days' leave, and dammit, she deserved the break. Jenni readily agreed, and endeavoured to conceal her pleasure at the prospect of a whole day with Ross beneath a mask of professional gravity.

  They set off next morning after a very early breakfast.

  When the Land Rover was loaded Jenni let Kefa get in first so that if he wished to take the seat next to the driver he could do so. But Kefa climbed into a rear seat and buried his nose in a pharmacology textbook, studying for his next lot of exams.

  'What are you waiting for?' questioned Ross impatiently as Jenni hovered with one foot on the running board and an anxious eye scanning the compound.

  'Merryjane is supposed to be coming with us today.' Merryjane, one of the African girls trained by the nuns to work in the hospital, had been told by Sister Bea that she must travel with Nurse Jenni and do the translating for her, and she must be sure not to keep Dr Ross waiting first thing in the morning. For some unfathomable reason Merryjane had responded with a fit of the sulks. Jenni had a nasty feeling she wasn't going to turn up.

  Kefa looked up and said there was no point waiting for Merryjane. She wouldn't be coming. Evil spirits would get her if she went too far from her village. Anyway, he said, everyone knew she was a lazy good-for-nothing.

  This was vexing, but clearly they must leave without the girl. Jenni hoisted herself in beside Ross, who rolled down his window, let out the clutch and reversed out of the shade of the baobab in a flurry of dust.

  'I do love the early morning,' said Jenni to calm the atmosphere. 'The skies are such a glorious mix of colours - and it's so wonderfully cool.' She had a navy cardigan draped across her shoulders, and in her pocket an old cricket hat of Paul's, shrunken with laundering, to protect the back of her neck.

  'Get out of it!' bawled Ross as one of the village dogs loped across their path. They were soon heading along flinty murram roads through a landscape of yawning distance, the Land Rover chugging along like a sturdy tug through the grey seas of bush.

  In spite of the dust the air was pungent with the spicy smell of African sage. In the far distance hills rose like tombstones, and the sun climbing steadily into the sky glittered on a million cruel thorns. Jenni shivered with a strange excitement. She eyed Ross's hands on the wheel, well-shaped and strong, and yet so sensitive; hands that could work the most delicate miracles of micro-surgery upon damaged eyes.

  'Where is it we're heading for?'

  'Mji wa Huruma—Village of Mercy, so-called because the people are desperately poor and badly needing help. They have no well and the road is no more than a beaten track, which is why this place has only recently come to light. This will be my second visit. Sylvia and I came out here three weeks ago. First chance I've had to get back.' Ross was blatantly eyeing Jenni's exposed thighs where her skirt had rucked up with the swaying of the vehicle. 'They're not used to seeing white women. Lord knows what they'll make of you.'

  The truck hit a series of ruts and she was thrown violently against Ross's shoulder. 'Sorry,' she muttered as she pulled herself upright and hung on to the grab bar. 'What a terrible road. This really is the back of beyond!'

  'Got possibilities, though,' pointed out her laconic companion, apparently impervious to the discomfort. 'Could be suitable for ranching once they solve the problems of water supply and lack of communications. And—' he added, wrenching on the wheel to avoid a particularly lethal pothole, 'eliminate that ... accursed ... tsetse fly. But until large sums of money are made available ... these remote areas are going to stay backward and undeveloped.'

  Jenni was gazing mistily at the huge skies and the strange wild beauty of the bush. Had this man no soul? Trust an Aussie to want to rip up the bush and criss-cross it with tarmac roads and telephone wires. 'I don't see that our western way of life is so wonderful that we should inflict it on black Africa!' she challenged frostily.

  Ross wasn't impressed. 'Let's see if at the end of this day you can look me in the eye and repeat that.'

  But Jenni refused to let herself be intimidated. ‘Who would run your ranches, Dr McDonnell? And who would do the hard graft?' Remembering Kefa, she glanced back acro
ss her shoulder, but his book had fallen to the floor and he was sprawled in a doze across the seats.

  'You don’t know what you are talking about.' The words were ground out between his teeth, for it was taking all Ross's concentration to keep-the truck on course. He was clearly exasperated. 'We're teaching them to run their own show. You've heard Paul say he'll pack his bags when the African priests are ready to take charge. Yes?’

  ‘Yes, of course I have but that doesn’t -’

  Ross wasn’t listening: ‘The best long-term solution to Africa's problems is to help her to help herself—but dammit, girl, it takes time! Europeans have had hundreds of years to build up teaching skills. Skills that can't be acquired overnight.'

  The muscles in his forearms stood out rock-solid as he hurled the Land Rover from side to side. ‘Why do you think I've come out here?' he demanded.' The most valuable contribution I can make is to teach and demonstrate eye surgery in city hospitals. But at the same time, I have to roll up my sleeves and get out among these people who can't wait till Africa has enough doctors of her own.'

  Oh boy! We haven't been on the road five minutes and we're fighting, thought Jenni, her blood stirring with a secret thrill. Life with the ferocious Dr Ross is never boring! I'd better calm him down before he wrecks the truck.

  'Were you born in Oz?' she asked. 'I hear it in those long vowel sounds,' she chirruped brightly.

  'Most perceptive of you,' came the dry response. 'No doubt being blind as a bat has sharpened your hearing.'

  Jenni opened her mouth to protest indignantly, but was forestalled. 'I've seen you holding record cards six inches from the end of your freckly nose. Too vain to wear reading glasses, eh?' Ross threw back his head with a roar of laughter as Jenni looked haughtily away.

  Actually she was pursing her lips to stifle her own laughter. Did nothing escape the doctor's eagle eye?

  'Now let's see: you were investigating my background. Well Nurse Westcott, your powers of detection serve you well. Born in Brisbane, yes, thirty-seven years ago. My mother came originally from Ayr in Scotland. My father from the city of Edinburgh, youngest son of a consultant physician at the Royal Infirmary.'

  'Was he a doctor too?'

  'Nope. An engineer. The only one of the three sons who wasn't interested in a medical career. Soon after they were married, my parents went out to Australia where Dad was working on a hydro-electric project in Queensland. They loved the place so much they stayed.'

  Jenni let go of the grab rail and flexed her aching palms. They had arrived at a road junction and Ross pulled up all of a sudden to check his maps. She practically ended up in his lap. 'How interesting,' she gasped, hauling herself back into her seat. 'When did you come back to the UK?'

  Ross wasn't wearing shorts today, instead a faded grey bush shirt, sleeves rolled up to the elbow, trousers bleached almost white with laundering. 'After my father died,' he said, 'my mother came home to Ayr and I was sent to Gordonstoun. From there I went to medical school—Edinburgh, naturally.' The quirk of his eyebrow said clearly, 'Satisfied now you've dredged up my life history?'

  Jenni wanted to ask why his father had died so young, but didn't like to in case the memory should be upsetting. 'Gordonstoun,' she observed with a grimace. That most rugged of schools where she’d heard that the boys swam in the wintry North Sea and tackle army assault courses before breakfast. 'So life on a mission station’s no hardship for you then, Dr McDonnell.'

  Ross surveyed his companion with a cool and clinical eye. 'You're coping pretty well yourself, Miss Westcott.'

  Jenni decided to take that as a compliment.' Why, Dr McDonnell, does that mean you're glad you kept me on after all?' she queried with a fine trace of sarcasm.

  That very moment they hit a spectacular rut and all four wheels left the ground. Ross gritted his teeth. 'Hold tight! You ok back there, Kefa?'

  'OK, Dr Ross.'

  Jenni twisted round and bestowed a warm smile on their forgotten companion, now wide awake and struggling to a sitting position. Ross's next remark wiped the smile off her face.

  'You seem to have a very strong motivation to stay.' There was a slow deliberation in the way he said it. Jenni knew he had Paul in mind, and that he intended her to know it.

  After a momentary hesitation her reply was cool. 'Perhaps we both have.' It was a shot in the dark. But she was watching Ross closely and didn't miss the flicker of muscle in his cheek, the steel in the jawline. Could you be married? she wondered tensely. Thirty-seven. Devilishly attractive. How could you not be ...

  Back home, the wife. Out here, Sylvia. Perhaps Ross was a man with a heavy conscience. For the rest of the journey Jenni was very subdued and thoughtful.

  At last, at the end of a long dusty track, they came upon the Village of Mercy, and private worries were forgotten.

  At first glance the village looked quite picturesque: a cluster of thatched rondavels shaped like giant windowless beehives, the doorways specially low and small to discourage malevolent spirits from getting inside. But closer inspection showed a clearing in the bush where pathetic efforts had been made to scratch a few meagre crops out of the thin soil. Several scraggy goats were tethered nearby in the shade of a mango tree.

  Slowly and suspiciously the village families emerged from their huts to stare at these intruders. They soon recognised the doctor and Kefa, and began gesturing with some animation at the Red Cross truck. But at the sight of Jenni they muttered and pointed, even giggled.

  Apprehensively she covered her hair with the blue bandana, and stared about her, stunned into silence. This was Africa at its poorest level. The people wore tribal dress, with bead necklaces and charms designed to ward off evil. The youngest children went naked. Most were undernourished and lethargic, with lustreless eyes and sticklike limbs in contrast to their swollen tummies.

  Tears burned in Jenni's eyes at the contrast between these unhealthy mites and the bright, happy children who lived closer to the Mbusa Wa Bwino Mission. It had taken so long to get here: how could a few hours' work do much to help? 'Oh, Ross!' she muttered, and the doctor took one look at the welling eyes and said brusquely, 'Pull yourself together, nurse.'

  That did the trick. Jenni was galvanised into action. Muttering that Dr McDonnell had no heart and well aware that he could hear her grumbles, she set about helping him erect an awning attached to the back of the Land Rover so that they could at least conduct examinations in a bit of shade. The dispenser unpacked his drugs supplies and the rest of the equipment, and some of the mothers, remembering from his last visit that Bwana Mganga had asked for a fire, soon started one going with a pile of dry sticks on which Jenni set a pan of water to boil for sterilising needles and syringes.

  As she leaned over the fire, she felt her white uniform skirt being tugged up and heard shrill laughter break out. 'Ross!' she called out in alarm.

  'Don't panic,' he said with lazy unconcern, 'they don't mean any harm. They just want to see if you're freckled all over.'

  The woman and children closed in a circle round them, their half-naked menfolk at the rear with menacing-looking spears in their hands.

  'Usual procedure,' said Ross. 'Identify all diarrhoea cases and pull them out for immediate treatment. Examine the little ones for signs of dehydration. Sylvia started rehydration therapy last time—see how much they've remembered. I'll make a start on the men. Jambo!’ he greeted the villagers. 'Habari, mzee?’ he questioned an old man waving under his nose an arm still wrapped in weeks-old tattered bandages. Soon there was a queue lining up to be dosed by Kefa with spoonfuls of medicine.

  Jenni started with the babies, cradling tiny heads and with gentle fingers testing the fontanels for signs of dehydration, pinching tummies to see if the skin sprang healthily back into place or stayed limp, looking for dry mouths and sunken dry eyes, a child wailing without tears, classic signs of the dehydration caused by gut infections.

  'Diarrhoea kills a child every six and a half seconds,' the lecturer at the London Schoo
l of Medicine and Tropical Hygiene had pronounced grimly. Along with her fellow students Jenni had gasped aloud in horror. 'Bodily fluids drain away and toxins build up. Within a few hours the kidneys fail and the child dies.'

  Jenni put the last baby into its mother's out-stretched arms. Surprisingly these children were reasonably well. Malnourished, certainly, but one visit from the travelling clinic had already had good effect. Sylvia knew her stuff; she was a very experienced nurse. She and Ross were a first-rate team, and Jenni knew how much the doctor must prefer to work with his girlfriend.

  In a rash moment a few nights ago Jenni had offered to cut Sylvia's hair. To her surprise the offer had been accepted, and while Jenni was carefully snipping away, the older nurse had said she would never leave Africa. Thinking immediately of Ross, Jenni had been secretly appalled. That sounded like blackmail! Was Ross supposed to break his Liverpool contract and stay on here?

  But Sylvia seemed in the mood for confession; Jenni only hoped she wouldn't regret her friendliness later. Coming here, Sylvia confided, had been an escape from a hopeless love affair back home with a married man. She had nothing to go back to, she insisted baldly.

  'Oh, surely that can't be true!' Jenni had burst out. 'Why, you could get a Sister's post at the Li—at a big hospital, and who knows—?'

  Sylvia had looked at her most strangely, and changed the topic of conversation.

  When she had examined all the children and sent to Ross those needing treatment from the doctor, Jenni settled herself cross-legged facing the group of women. She opened the special picture book issued to the nurses and health workers and held it up for all to see, turning the pages slowly. It depicted vividly the signs and symptoms of sickness and diarrhoea, the mother mixing the 'medicine' and giving it to her child, who swiftly recovered.