Jen, finishing first, checked their patient’s blood pressure and pulse again, then studied the readout with trepidation.
‘His blood pressure’s dropping. I saw you examining him all over earlier—there were no deep wounds we’ve missed?’
Kam shook his head.
‘But there’s extensive bruising to his lower back and abdomen, which suggests he might have been kicked. There could be damage to his spleen or kidneys and internal bleeding, which we won’t find without an X-ray or ultrasound.’
‘Do you have a radio in your car? Do you know enough about the health services available locally to know if we could radio for a helicopter to take him out?’
Kam shook his head.
‘I imagine you drove in, camping out in the desert for one night on the way. That’s not because we—I mean the locals—want to put aid workers to as much hardship as they can, but because of the mountains around here. They have temperamental updraughts and downdraughts that can cause tremendous problems to the rotors on a helicopter, so they don’t fly here. Fixed-wing aircraft are a different matter, they fly higher so aren’t affected, but, of course, there’s no handy airfield for even a light plane to use!’
He studied her as if to gauge her reaction to his explanation, but when he spoke again she realised he’d gone back further than the helicopters.
‘You asked about a radio in my car—yes, I do have one, but so should you. One in the car and one for your office or wherever you want to keep it—they’re listed on the inventory you’re given with your supplies.’
Jen smiled at him.
‘The one in the car disappeared within two days of our arrival and the other one a couple of days after that. You can’t dig a hole and bury radios. No matter how well you wrap them, you can’t seal them completely and they tend to stop working when sand gets into their bits.’
She was smiling at him, but Kam couldn’t return the smile, too angered by the artless conversation. He couldn’t believe that things had got so bad people were stealing from an aid organisation, although he imagined these refugees had so little, he could hardly blame them for the thefts.
But how to fix this? How to redress the balance in his country? Could he and his twin achieve what needed to be done in a lifetime? Arun was working in the city, talking to the people there, seeking information about the government and whether, as their father’s influence slipped, corruption had crept in.
Or had the people elected into positions of power only seen the city as their responsibility, ignoring what was happening in the country, ignorant of this camp on the border?
As he and Arun had been, he reminded himself with a feeling of deep shame. He couldn’t speak for his twin, but nothing—neither work and study programmes, nor his father’s orders to keep his nose out of the ruler’s business—excused the way he, as heir, had allowed neglect to hurt his people. And nothing would stop his drive to fix this hurt.
Nothing!
Their patient groaned and Kam brought his mind sharply back to the job in hand.
‘A drop in blood pressure certainly suggests he’s bleeding somewhere. If you’re short of fluid, we should consider whole blood.’
The woman he’d been surprised to find in this place nodded. He’d known she was here, of course, but he’d expected…
What?
Some dowdy female?
OK, not some dowdy female, but definitely not a beauty like this golden woman was. He checked the dusting of freckles again and even in the dimmer light of the tent saw the colour of them.
‘Sorry?’ Checking out her freckles, he’d seen her lips moving and realised she was talking to him.
‘I was just offering to take some blood from him and test it, then maybe find some volunteers willing to be tested,’ Jen suggested.
‘His friends will surely volunteer. Take some blood. You can test it here? You have a kit?’
She nodded.
‘Good,’ Kam said, pleased his mind was back on the job, though the greater job still awaited him. ‘We’ve got him this far, let’s see if we can finish the job. Internal bleeding will sometimes stop, leaking vessels sealing themselves off, but if it doesn’t, without an ultrasound I’d have to open him up and have a look. He’s suffered so much already I wouldn’t like to risk it until he’s much stronger, so let’s wait and see. We’ll have to monitor him closely, of course.’
We’ll have to monitor him? The words echoed in Jen’s head.
The stranger intended staying?
Here?
In her tent?
Of course he intended staying—he was another aid worker, one who was sorely needed, and right now there wasn’t another tent to house him or his clinic.
Unease fluttered like panicking moths in her stomach—or maybe that was hunger, it was well past lunchtime.
She turned her attention back to the job she was supposed to be doing—taking blood.
Marij had returned, having belatedly finished the morning’s TB testing.
‘Can I help?’ she asked, in her soft, gentle voice. ‘Would you type this blood for me?’ Jen asked her, handing her the vial.
‘Of course,’ Marij replied, adding, ‘And then you’ll want volunteers—I will ask around and begin typing them as well.’
Jen turned her attention back to the patient.
‘Shall we ease him back onto his side? And what about antibiotics? I have some but they’re in tablet form. For a start at least, he should be getting them through his drip. And tetanus? Who knows if he’s ever had a tetanus shot, but if it was a horse whip he was hit with, he’ll need one.’
He helped her move the patient back onto his side, propping cushions gently against his injured back to keep him from rolling over.
‘I’ve stuff like that in the car,’ Kam said. ‘Not much because this visit was more a recce to see what was needed, but I’ll go and get what I have.’
Once again suspicion fluttered in Jen’s chest. Would he really undertake a two-day drive just to see what was happening? And then drive back to the city to get what was needed and drive up here again? Six days going back and forth across desert roads that could swallow a car whole?
Or was the flutter discomfort at the thought of the man moving his things in here—moving in himself?
So close that if she woke in the night she might hear him shifting in his sleep, hear him breathing?
But where else could he stay? Until they had another tent, and she’d believe he could muster one when she saw it, he’d have to live and work here. If she put up another rug across the far corner…
She shook her head at her own folly. Whatever it was about this man that was affecting her, it wasn’t going to be stopped by a brightly woven rug hung down between them. The way they blew when the tent sides were rolled up to allow cool air in, another rug would barely provide privacy.
She checked her patient, then looked up as a shadow fell across them. The cause of her concern was standing over them, a large cardboard box in his hands.
Was she staring that he offered a half smile?
The flutters she felt were definitely not suspicion, and all the more worrying because of that.
‘I have some more pethidine,’ he said, such an ordinary conversation, ‘and antibiotics. The blood test?’
‘Marij is checking now.’
Jen climbed carefully to her feet, but even with care she stumbled when she put her weight on a foot that had gone to sleep.
Kam’s hand reached out to steady her, his grip surprisingly strong. She turned to thank him, but the words wouldn’t come, held captive in her throat by something she couldn’t explain.
She stamped her unresponsive foot, and caught his lips curving into a smile.
‘That’s not a sign of a tantrum,’ she assured him, with a tentative smile of her own. ‘The darned thing’s gone to sleep. And so’s my brain. I know you introduced yourself earlier, but did I? My name’s Jenny.’
She held out her hand and watched him take it—saw
the tanned skin of his fingers against her own pale flesh, felt warmth and something else—something she didn’t want to put a name to.
‘I knew the Jennifer part, but wondered if you shortened it.’
Jenny removed her hand from his, and tucked it in the pocket of her tunic, out of danger’s way.
‘Jen, Jenny, even, hey, you—I answer to them all,’ she said, trying desperately to sound casual and light-hearted, although her arm where he had touched it, and the fingers he’d briefly held, burned as if they’d been branded.
The patient’s name, they learned, was Akbar, and his blood group was B.
‘Mine’s B,’ Jenny told Kam, who was sitting, cross-legged, by their patient, talking quietly to Lia, Akbar’s wife. ‘Let’s do a cross-match and see if it’s OK for him to have mine.’
Kam studied her for a moment, wondering about this woman he’d found on the border of his country. Wondering if she was the first fair-haired Westerner to ever tread these particular desert sands.
Wondering if he should take her blood…
Take her, as his ancestors might have…
The sudden heat in his body shocked him back to the matter in hand. Of all the times to be distracted by a woman…
‘You need your strength for your job,’ he objected.
It was a token protest and she took it that way.
‘The loss of a couple of pints of blood won’t hurt me,’ she insisted, handing him a syringe with a needle attached so he could draw blood from her forearm for cross-matching. She had pulled off her soiled tunic and now rolled up the sleeve of her shirt so he could access a vein, yet he felt strangely reluctant to move closer to her—to touch her.
He had to move closer—how else could he withdraw some blood?—and if their patient was bleeding internally, and his blood pressure drop suggested he was, he would need blood.
Kam crossed the distance between them in one long stride and took her arm, seeing as he did so pale scars like snail tracks, paler than the lightly tanned skin and puckered here and there.
Without regard to the intrusiveness of the gesture, he ran his forefinger lightly down the longest of them, then looked up into her eyes, knowing she’d read the question in his own.
Defiance was his answer, as clear as if it was written on a whiteboard. Ask me if you dare, she was saying, and though Kam knew he shouldn’t, he couldn’t help himself.
‘Accident?’
She nodded briefly then swabbed the spot where a vein showed blue beneath the fine skin of her inner elbow.
Take the blood, she was saying with the gesture—take the blood and mind your own business. But Kam’s mind was already racing off along a tangent—did the scars explain why such a beautiful woman, and she was beautiful in her golden, glowing way, would hide herself away in a refugee camp on the edge of a little-known country?
Was she hiding only these surface scars or were there deeper ones?
Had she lost someone she loved, leaving scars on her heart?
‘Was it bad?’
She stared at him as if she didn’t understand his question, but a shadow had crossed her face and he had his answer.
Very bad, that shadow told him, while the set of her lips again warned him off further questions.
But his sympathy for her made him gentle as he held her arm and eased the needle into the vein. He watched the vial fill with dark blood, trying to keep his mind on the job—on their patient and what might lie ahead for him, and for himself and Jenny as his doctors—not on snail-track-like scars on a woman’s arm, or the dark shadow that had crossed her face.
Fortunately, the woman—Jenny—recovered her composure and her sensible conversation brought him back to the present.
‘If it works in a cross-match, you can take it directly from me to him, although you’ll have to keep an eye on him for any transfusion reaction because I’ll be lying beside him.’
She smiled as if this were a little joke at her expense, but Kam couldn’t return the smile, his thoughts veering back to the puzzle of why this woman was willing to do so much for people she didn’t know, in an inhospitable place, and with no friends or family to support her.
Had she come to escape her memories?
Her pain?
‘Well?’ she prompted. ‘Are you going to do a cross-match or should I?’
With his mind back on the job, Kam took another vial and drew a little blood from their patient, Jenny acting as nurse, tightening the tourniquet on the man’s arm to bring up a vein then taping a dressing over the small wound. Kam mixed the contents of the two vials, watching anxiously for any sign of clotting, which would tell them the blood samples were not compatible. But the blood didn’t clot and the intrepid woman who puzzled him now produced a cannula and loop of tubing.
‘Let’s go,’ she said, sitting down beside Akbar while one of the nurses who worked with her explained to Akbar’s wife what was happening.
Lia shifted to sit beside Jenny and hold her hand, babbling her thanks for the gift of blood—the gift of life.
‘You need to be higher,’ Kam told the unexpected donor. ‘Are you all right to sit up if we stack pillows behind you?’
‘I’ve two bedrolls behind the partition,’ Jenny told him. ‘I can sit with those behind me to prop me up and that way my arm is higher than Akbar’s and it will feed down into him.’
She half smiled, while the nurse, Aisha, fetched the bedrolls.
‘It will be up to you to check the blood’s going the right way. I don’t want to be taking more of it from the poor man.’
Not only was she here in this desperate situation but she was joking about it. Kam thought back to the women he had studied with, both women from his own land and Western women, but none of them had been anything like this particular female doctor. No fuss, no nonsense, just get on with the job.
Although there was one problem now he thought about it…
‘I don’t think we should run it direct into Akbar. We should measure the amount—both for your sake as a donor and his as the recipient,’ he said, trying to be as efficient as she was at getting on with the job. ‘Do you have a container?’
‘The fluid bag is nearly empty. What if we run my blood into it, a pint at a time, then transfer it across to Akbar? We could fill something else, but at least we know the bag is sterile. And we can time it, so we know how long it takes to fill a bag then do away with that middle stage when he needs more.’
Kam realised he should have thought of these things. Had he become too used to have everything he needed for his work right at his fingertips—too used to modern medical practices—to think laterally?
Setting the questions aside, he did as she’d advised, siting the cannula carefully into Jenny’s arm, feeling the slight resistance as he pushed the needle through her skin then withdrew it carefully from the cannula, leaving the tube in place. He let this fill with blood before closing off the fluid running into Akbar and replacing that tube with the one through which Jenny’s blood was running.
He switched the tubes again and began running the precious red liquid far more slowly into the patient. And he did watch for a reaction, feeling Akbar’s skin, already hot with the beginnings of a fever, probably caused by infection, seeking other signs of transfusion reaction like violent shivering. But Akbar’s body gave no indication that the stranger’s blood was upsetting him. He lay still and barely conscious and hopefully would remain that way for some time, below the level of pain, while antibiotics and the body’s natural defences began to heal his wounds.
‘As if such wounds could ever heal!’ Kam muttered to himself, but his second patient had heard him. ‘To be beaten must be the height of humiliation,’ he added, to explain his thoughts.
‘We can only do so much,’ Jen reminded him, as they sat and watched in case there was a delayed reaction. ‘We can get him physically well, then hope that love and support and his own determination will get him the rest of the way.’
This was too mu
ch altogether for Kam—the woman was too good to be true. There had to be a catch, some reason she’d hidden herself out here, hiding her body under all-enveloping clothes and her golden hair under a scarf.
Surely this was taking escape too far!
‘Why are you here?’
In this, his land, such a question was extremely rude, but Kam asked it anyway, wanting to know, although uncomfortable with his curiosity.
‘To run a TB eradication programme,’ she replied, a tiny smile flickering about her lips. ‘We’ve covered that.’
‘But why here? There must be people in your own land who need medical help. Your accent says you’re Australian—isn’t that right?’
She nodded, but her gold-brown eyes looked preoccupied, as if she’d never really thought about answers to his questions before that moment.
‘I do work in the outback at home as well,’ she finally told him. ‘One placement at home, then one overseas.’
She paused, studying him for a moment as if deciding whether she’d elaborate on this answer or not.
What had she seen that she spoke again?
‘I actually like the foreign placements better. At home, I feel a sense of helplessness that I will never be able to do enough, as if my efforts are nothing more than one grain of sand in a wide desert—scarcely seen or felt, and certainly of no significance. But here, and in other places I’ve been—in Africa, in Colombia—I feel whatever I do is helping, even if it’s only in a very small way. And I do particular projects, like this TB programme, that have a beginning and an end.’
This time her smile was wider, and her eyes gleamed as if in offering him a confidence she was conferring a present on him.
‘I look on these trips as my reward.’
Kam saw the smile but her eyes, not her lips, had caught, and held, his attention. Hadn’t someone once said that the eyes were the mirror of the soul? In this woman’s eyes he’d seen compassion, and pain for their patient, and now a gleam that suggested a sense of humour.
Which she’d certainly need out here.
But still he was intrigued. ‘So, working, moving on—that’s what you like. Is it the freedom? The lack of ties to one particular place or person?’
Desert Doctor, Secret Sheikh Page 3