Outback Surgeon

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Outback Surgeon Page 2

by Leah Martyn


  The silence stretched for a tense moment, until Abbey responded steadily, 'Todd's programme is as good as Sunningdale can provide. And distance-wise, it suits his family to have him there. At least they can make the three-hour drive once a week to see him. But realistically, I'd guess, he's gone about as far as he can go there. Sunningdale will want to discharge him soon.'

  'And then what?'

  Abbey frowned. 'Well, at this stage his parents are proposing to have him back home with them.'

  'In the bush?'

  She tilted her chin defensively. 'That's where they live.'

  Nick made an impatient sound. 'What's he going to do there, cut wood for the fire from his wheelchair?' The surgeon shook his head. 'Surely we can do better than that, Abbey? Have you heard of the Dennison Foundation in Sydney?'

  Abbey frowned. 'It's a fairly recent concept, isn't it?'

  'State of the art in every way. Structured specifically for spinal rehab, with patients being taught how to accustom themselves to the physical realities of being disabled in an able-bodied world. I'm sure you'd see a great improvement in your Todd's ability to cope after a stay there. I'd refer him urgently, if I were you.'

  A flush of annoyance rose in Abbey's cheeks. 'Ever heard of waiting lists, Doctor? Besides, his family couldn't afford those kinds of fees. And I can't imagine the management would be prepared to cut a special deal on a rural GP's referral.'

  'What if I referred him?'

  Something like resentment stirred in Abbey and she couldn't let go of it. 'Why should you bother? Todd's nothing to you.'

  Nick Tonnelli's expression closed abruptly. 'As professionals, isn't it up to all of us who go under the guise of medical practitioners to assist all humankind where we can? So, Doctor, I suggest you pocket your false pride and face the facts as we have them.

  'I'm willing to carry out a reassessment on your patient. Like Todd, I'm good at what I do. Maybe I can help him further. Maybe I can't. But I'm willing to try and if you think my name will help, I'll refer him to the Dennison, if I deem it appropriate. It's up to you.'

  Abbey clenched her hands on her lap and stared at them fiercely. He'd given her a terrible dressing-down. All done so quietly and lethally. Dear God! How she would hate to have to work with the man! Thoughts, none of them pleasant, crowded in on her. She should never have agreed to this lunch. She should have quit while she was ahead and left him standing in the car park, watching her dust.

  She took a deep breath and tried to leave personal issues out of it. Todd's youthful face, stark with hope one minute and dark with despair the next, impinged on her vision. Much as she hated to admit it, Tonnelli was right. Pride had no place here. She would swallow hers, no matter how galling it might be, and ask for his help.

  'When could you see Todd?' she asked hesitantly. 'I mean... I don't know your movements... If you have other commitments here...' She broke off helplessly.

  He bit into his bread, his even white teeth leaving a neat half-circle. 'We could start the ball rolling after our lunch, if that suits you.'

  'Fine.' Abbey teased at her lip. She should have known that once the decision was made, he'd want to sweep ahead.

  'I would prefer to keep my involvement quite informal, if you don't mind,' he said easily. 'I'll need some time to study Todd's case details and speak with the staff, his physio and OT in particular.

  'If I decide the programme at the Dennison will benefit Todd, I'll speak personally with the director, Anna Charles.' At once his expression lightened. 'We trained together. She's done extensive post-grad work at Harvard. A brilliant practitioner. Todd couldn't be in better hands.'

  Abbey blinked uncertainly. 'And would she take him—just like that?'

  'As a favour to me? Yes, she would.' He smiled, a mere sensual curving of his lips.

  Abbey felt her cheeks burn as the possible meaning behind his remark occurred to her. She pulled in a shattered breath. Forget Tonnelli and his women and think of Todd, she told herself with quiet desperation. 'What about the fees?'

  Nick lifted a dismissive shoulder. 'I'll arrange something. Nothing in this life is set in concrete, Abbey. Nothing at all.'

  CHAPTER TWO

  The main part of their meal was served just after Abbey's capitulation. She looked down at the appetising char-grilled strips of chicken, the crisp salad and accompanying stuffed potato, and despaired.

  After the last few minutes, the tense trading of words with Nick Tonnelli, her throat seemed closed, her stomach knotted.

  He, on the other hand, she noticed with faint irony, seemed not be suffering any repercussions at all. And after the first few uncomfortable minutes, after which he obviously set out to charm the socks off her, she felt a lessening of tension.

  'So, Abbey, what do you do for relaxation at Wingara?' he asked, as they sat over their coffee later. 'No chance of snow sports, I expect?' he added with a touch of humour.

  'Hardly.' She laughed, activating the tiny dimple in her cheek. 'I play tennis when I can and we have a sports centre with a pool and quite an active Little Theatre. And I have friends there now, good friends. One couple in particular, Stuart and Andrea Fraser, have quite a large property so I'm able to spend the odd weekend there, picnicking and so on.'

  'So, no regrets about opting out of city mainstream medicine, then?' he teased gently, fixing her with his keen, gemstone gaze.

  'Often,' Abbey rebuffed him sharply.

  He blinked, appearing a little surprised by her answer. 'In what way?'

  She lifted a shoulder. 'Broadly speaking, I could give you a dozen examples. But the bottom line is all I can do in a major medical emergency is to stabilise my patient and have them airlifted to the nearest major hospital. And just hope they survive the journey.'

  'So what are you saying?' Nick's eyes took on a steely glint.

  'Nothing I didn't say in the debate,' Abbey responded bluntly. 'That if a specialist surgeon could be on call to come to us, it would halve the trauma for both patient and family. And would, I dare say, be more cost-effective.'

  'Bunkum!' Nick's hand cut the air dismissively. 'Logistics for one thing. Our rural population is so scattered, our distances so vast. All things considered, I believe we, as specialists, do a reasonable job.'

  Abbey tossed her head up, throwing into sharp relief the long silky lashes framing the haunting beauty of her tawny eyes. 'When was the last time you conducted a clinic outside St Thomas's, then?'

  With a reflex reaction Nick's head shot up, his green gaze striking an arc across the space between them. 'I've considered it but so far the consensus seems to be that it's more appropriate for the patients to come to me than vice versa.' In an abrupt movement, he dipped his head and pulled back the sleeve of his pale blue shirt. His mouth compressed briefly. 'If you've quite finished your coffee, we should be moving, I think.'

  So, end of discussion. Abbey curled her mouth into a cynical little moue, bending to retrieve her shoulder- bag from the carpeted floor near her feet. Had she really expected the conversation to go any other way?

  While Nick settled the bill, she made her way slowly outside, annoyance with herself shifting and compressing against her ribcage. It wouldn't do to get the man offside. Not now, when it seemed they were about to become involved professionally with Todd's care.

  Beside her, a butterfly scooped the air, darting in and out of a border of cornflowers, its pale yellow wings a gauzy haze against the deep blue petals. Her shoulders lifted as she took a calming breath, belatedly registering the near-perfection of the afternoon— the crisp air, the softly falling leaves, the sky an unbroken bowl of china blue...

  'Wonderful day.' From behind, Nick softly echoed her thoughts.

  Startled, Abbey jerked back. How long had he been standing there? 'I love autumn.' She rushed into speech, embarrassed to be caught mooning like a teenager. 'Especially in this part of the state where the seasons are so clearly defined.'

  'Perhaps.' Nick looked unconvinced but he was smi
ling. 'I still think I prefer the coast. I can well do without all this.' He scuffed a gathering pile of fallen leaves with his shoe.

  'Didn't you have fun running through them when you were a kid, though?'

  His head went back on a laugh. 'You know, I'd forgotten all that.'

  Abbey listened to the small talk threading between them like a line of careful stitches, but at the same time acknowledging she'd have to upset the pattern and get things rather more settled in her own mind. 'Dr Tonnelli—Nick...' she began awkwardly, 'I hope you didn't feel obligated to get involved with my patient...'

  Nick's gut tightened. She looked so uncertain, so vulnerable, he wanted to just to hold her, reassure her. Instead, he shoved his hands into the pockets of his trousers out of temptation's way. 'Abbey, I want to do it, OK?'

  Her lips parted on a shaky breath. 'Are you sure?'

  'I'm sure.' He permitted himself the ghost of a wry smile. 'Actually, it occurs to me I might have seemed to have taken over in there, come on a bit strong about your management of Todd. If I did, I apologise.'

  Abbey's senses tightened and she felt confused at the odd mix of reactions chasing around inside her. 'Honestly, you don't need to.'

  'Oh, I think I do.' He gave a taut smile. 'I stormed all over you. But, then, I have been accused of being arrogant once or twice. And what's the expression? If you have to eat crow, it's better to do it while it's still warm.'

  Abbey smothered a laugh. 'Consider the crow eaten, then.'

  She was thoughtful as they made their way down the path to the street. She guessed it had cost him something to have placed a question mark over his earlier behaviour.

  But on the other hand, to have put her on the defensive the way he had had probably been nothing more than a normal reaction from him. Everything about the man indicated a natural authority, an obvious ability to give orders and have them carried out without question. There was no doubt about it, Nick Tonnelli was a man of substance and of power.

  She stifled a sightseeing the stream of professional differences between them widen to a river.

  'My time is my own but does it suit you to go across to Sunningdale now?' he was asking.

  She nodded, grateful for his courtesy. 'I'll introduce you and stay for a quick visit with Todd. Then I'm afraid I'll have to leave. I've to go and plead for some lab reports I'm waiting on to be rushed through and collect a package of drugs from the pharmacy— What's that noise?' Suddenly, she turned her head up, listening.

  Nick frowned. 'I don't— Ah! Motorbike by the sound of it.' Instinctively, he stiffened, stepping in front of Abbey as if to shield her. 'And going way too fast for a built-up area. Hell's bells!' he gasped as the high-pitched roar cut the still of the afternoon and a big black machine shot into view at the top of the street.

  'Oh, lord!' Abbey watched in stark disbelief. 'The intersection's too narrow—he'll never take the corner! Nick...' Horrified, she grabbed the surgeon's arm as the bike became airborne.

  Nick reacted like quicksilver. 'My car's closer— get my bag!' Wresting his keys from his side pocket, he slapped them into Abbey's hand. 'In the boot— go!' He'd already taken off, running in the direction of the crash, his arms pumping hard into the rhythm of his long strides, even before the final sickening thump of metal could be heard.

  Abbey bit back a little sob of distress, her heart hammering, as she pelted along the tree-lined street to Nick's car. Hand shaking, she touched the remote locking button on the keyring and whipped the boot open. She hauled his case out, slammed the boot shut and relocked the car, turning to run back to the accident scene as fast as she could in her high heels.

  Hearing the crunching sound of metal, two men had rushed from nearby houses to help.

  'Right—let's do it, lads!' Nick took charge and, with muscles straining, they partially raised the heavy bike, bracing it against their legs.

  'We need traffic lights or a roundabout there.' One of the men was breathing heavily with the effort.

  His companion snorted. 'That won't slow 'em down. 'Struth,' he gasped and they strained again. 'One last heave should do it. You beauty...' he grunted as the motorbike was finally righted.

  'Has someone called an ambulance?' Nick rapped, hunkering down beside the prostrate form of the injured rider.

  'The wife will have done that.' One of the rescuers . flipped his hand towards his house across the street. 'You got first-aid training or something, mate?' he tacked on, watching Nick's hands move with deft swiftness over the accident victim.

  'Doctor.' Nick was curt.

  'How bad is it?' Panting to a stop, Abbey dropped to Nick's side. She felt her throat dry. Dear God, the youth wasn't even wearing proper leathers.

  'Severed femoral artery by the look of it.' Nick looked grim. 'See if you can find a tourniquet, please, Abbey. Step on it! We've got a major problem here.'

  Abbey's hands moved like lightning through his medical supplies. In seconds she'd handed over the belt-like elastic band.

  'How's his pulse?' Nick rapped, expertly securing the tourniquet around the youth's upper thigh.

  'Rapid and thready. He's not responding to stimuli. I'll get an IV in.' Moments later, she was saying tensely, 'This is a nightmare, Nick—I can't find a vein.'

  'Keep trying.'

  'OK, I've got it.' Abbey's words came out in a rush of relief. 'IV's in and holding.'

  Nick swore, his brow furrowing in concentration. 'BP's dropping like a stone. Come on!' he gritted to the youth's unconscious form. 'Don't shut down on me, sunshine—don't you dare!'

  At last the ambulance siren could be heard. The vehicle screamed to a halt beside them, two officers swinging out.

  Nick quickly introduced himself and Abbey, adding authoritatively, 'The patient's in shock. We need to run Haemaccel fast. And alert the hospital, please. We'll need a blood specimen and cross-match immediately on arrival.'

  Within seconds the officer had passed the flask of blood product across to Nick.

  'I found some ID in the kid's saddlebag, Doc.' One of the men who had helped lift the bike flipped open a wallet. 'Bryan Weaver.'

  'Give it to the police when they get here,' Nick said grimly. 'It'll be up to them to get hold of the family. But at least we'll be able to give the hospital a name. Thanks, mate.'

  'Think he'll make it?' the man asked soberly, as the youth was stretchered into the ambulance.

  'Let's be positive.' Nick's response was terse.

  'Are you coming with us, Doc?' The ambulance officer was hovering expectantly by the rear doors of the ambulance.

  'Yes.' Nick slammed his medical case shut and hitched it up. 'Keys.' He put out a hand and touched Abbey's wrist.

  'Oh—sorry.' She fumbled them out of the pocket of her linen blazer. 'He's lost a lot of blood, hasn't he?'

  They stared at each other for a brief, painful moment.

  Nick lifted a shoulder, the lines of strain etching deeper into his mouth. 'Let's pin our hopes on the Haemaccel keeping him stable until he gets some blood.'

  'What about your car?' Abbey blinked uncertainly. 'It's locked but—'

  'I'll get a cab back and collect it later.' He looked at her broodingly. 'And I haven't forgotten about Todd. I'll make my own way over to Sunningdale as soon as I can.'

  'Yes—OK—thanks.' With an odd feeling of finality, Abbey watched as he swung into the waiting ambulance with all the grace of a superbly fit athlete.

  'I'll be in touch,' he called to her before the doors closed and the ambulance was on its way, the chilling sound of the siren pitching into the quiet of the afternoon.

  * * *

  Abbey's thoughts were still scattered as she turned in through the wide gates at Sunningdale. Finding a vacant space in the staff car park, she took it thankfully.

  Already she'd decided not to undertake the long drive back to Wingara. It would be quite late by the time she was ready to get on her way and she had no desire to travel the lonely highway on her own at night. Instead, she'd le
ave at first light tomorrow.

  The rehabilitation centre was a pleasant structure with wide verandahs overlooking the well-tended gardens. There was much good work being done here, Abbey thought earnestly, but in Todd's case was it enough?

  Her insides twisted. The force of Nick Tonnelli's argument had raised more questions than answers for her patient.

  She was relieved to find the nurse manager, Lauren Huxley, still on duty in the Macquarie wing where Todd was a resident. In Abbey's opinion, the bright, vivacious, forty-something nursing sister had great empathy with the patients.

  In the first few weeks after Todd's admission Lauren had kept Abbey in close touch with his state of mind, and now the two women had formed an easy friendship.

  'We expected you much earlier,' Lauren said warmly, ushering Abbey into her office.

  Briefly, Abbey explained about the biker's accident and her involvement.

  'Tea, then,' Lauren said firmly. 'You do have time?' Her fine brow rose in query. She was well aware of Abbey's gruelling schedule on the occasions the young GP was able to get into Hopeton.

  Abbey huffed a wry laugh. 'I've lost so much time today another few minutes won't matter. Tea would be lovely, thanks.'

  'Good.' Lauren flicked on the electric kettle.

  'You've had a face-lift in here since I was in last.' Abbey looked around interestedly, admiring the bright curtains and crisp paintwork. 'It's lovely, Lauren. So cheerful now and comfortable.'

  'That was the idea.' Lauren placed the tea-tray on the table between them. 'The new committee's been pretty generous with funding.'

  'So they gave you carte blanche?'

  'Within reason. But I stuck out for the oval table and upholstered chairs instead of that huge monstrosity of a desk. It's so much less daunting for the families who have to be briefed. I mean, they're down in the pits already in lots of cases. Surely they don't need to be spoken to across a desk like less than bright schoolchildren?'

  Abbey smiled, easing off her shoes and wriggling her toes in relief. 'Mmm, the tea's wonderful, Lauren, thanks.' They sat in companionable silence for a moment, until Abbey asked gently, 'How's Todd doing?'

 

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