by Sarah Morgan
‘You needn’t bother.’ Jago’s voice was soft and his eyes were still fixed on Katy’s pale face. ‘Dr Westerling will be working with me.’
His colleague looked startled. ‘Oh, right—well, you’ve obviously already met Jago Rodriguez, one of our other consultants. In that case, I’ll leave you in his capable hands. I’m sure you’re keen to get started.’
Jago’s mouth curled into a smile. ‘I’m sure Dr Westerling can’t wait.’
There was a sardonic gleam in his sexy dark eyes that brought a flush to her pale cheeks and a sick feeling to the pit of her stomach.
Working with Jago wasn’t just going to be difficult.
It was going to be a nightmare.
Twenty-four hours later Katy was wondering why she’d ever thought she’d be able to cope with A and E.
She’d seen a never-ending stream of patients, most of them angry at having been kept waiting for hours.
‘Can’t we see patients any faster?’ she asked Charlotte, the sister who had looked after her when she’d been brought in after her car accident. ‘I’m fed up with being verbally abused by everyone I see.’
‘Welcome to A and E.’ Charlotte handed her a set of X-rays to check. ‘We make a dent and then an emergency comes in and takes priority. That’s the way it works. That’s why we have triage. Non-emergency cases go to the bottom of the pile and they stay there until someone has time to see them.’ She smiled sympathetically at Katy’s drawn expression. ‘Don’t worry, you get used to people yelling at you after a while.’
‘I don’t mind people yelling,’ Katy lied quickly, not wanting to risk Charlotte telling Jago that she couldn’t cope. ‘I just wish we didn’t have to keep people waiting.’
‘At least you’re working with Jago. He can be a pretty hard taskmaster, I know, but he’s a brilliant doctor. You’re lucky.’
Katy kept her mouth clamped shut. Lucky? She certainly didn’t feel lucky to be working with Jago. She felt as though she must have done something seriously wrong in a previous life to have deserved such punishment.
Realising that Charlotte was looking at her oddly, she managed a smile.
‘I’m sure you’re right,’ she replied smoothly. ‘I’m looking forward to learning from him.’
‘As a doctor he’s staggeringly gifted,’ Charlotte went on. ‘He has this uncanny ability to spot things that other people miss, but sometimes he forgets that the rest of us are human. Don’t let him get to you.’
He was getting to her.
He made it perfectly obvious that he didn’t think she had what it took to work in A and E and he was watching her every move, waiting for her to make a mistake.
Why did he hate her so much?
All she’d ever done had been to fall in love with him, and surely that was her problem, not his.
They hadn’t really talked about what had happened in the past. Maybe she should bring it up. Clear the air.
Feeling totally miserable, Katy sighed and reached for the X-rays but at that moment Annie, one of the staff nurses, rushed up.
‘Ambulance Control just rang. They’re bringing in a forty-year-old man who’s had an accident in a warehouse. He got caught by a forklift truck. Apparently he’s in a bad way. Very weak pulse and virtually no blood pressure. They should be here in less than five minutes.’
‘Find Jago,’ Charlotte said immediately, but his voice came from behind them.
‘I heard. Annie, get the trauma team together in Resus and make sure we have a radiographer. I don’t want to be hanging around for X-rays.’ His gaze flickered to Katy. ‘You can join us in Resus and act as one of the circulation doctors. You saw us in action yesterday—do you think you can cope?’
Katy’s stomach lurched and her pulse rate quickened, but she met his gaze without flinching.
‘Of course.’
She’d cope or die in the attempt.
‘Good.’ His dark eyes locked on hers moodily and then he strode off towards Resus, leaving her to follow.
Charlotte alerted the nursing team and one of them was given the task of informing people in the waiting room that the waiting time was likely to be increased because a major injury was coming in.
‘There’ll be a riot,’ Annie predicted gloomily, and Harry, one of the other consultants, nodded.
‘Very probably, but there isn’t much we can do about it except mop up the blood afterwards.’
Jago was prowling around Resus, checking that the right equipment was ready and everything was where he wanted it.
Moments later the doors crashed open and the paramedics hurried in with the stretcher.
‘This is Dan Walker. He’s a warehouse supervisor. He was caught under the ribs by a forklift truck. No obvious injury but he’s shocked and his pulse is thready. We’ve given him high-flow oxygen and we managed to get a line in at the scene…’
The paramedic outlined the care they’d given and Jago moved to the head of the trolley.
‘OK, let’s move him across, on my count—one two three.’
They lifted the man carefully and he groaned slightly, his skin pale and clammy.
Katy’s blood was pounding in her veins. This was her first real trauma case. What if she did something wrong?
But it soon became clear to her that she couldn’t possibly do anything wrong because Jago was directing the entire operation with an air of cool command which left no doubt in anyone’s mind who was in charge.
Having secured the man’s airway and satisfied himself that there was no damage to the cervical spine, he turned his attention to the work of the rest of the team.
‘Get another line in. I want vital signs recorded every five minutes and get his clothes off fast—I want every inch of him examined.’
Using sharp scissors, they cut off his clothes and Katy reached for the man’s wrist to insert another line. One of the nurses handed her a swab and venflon and she searched frantically for a vein.
‘Everything’s shutting down,’ she murmured, her fingers slipping on the man’s skin as she nervously tried to find a vein.
‘Let Harry try,’ Jago said sharply, and she gritted her teeth and felt around again for a vein.
‘Give me one more go—I think I felt something then.’
Please—please…
Something moved under her fingers. Was that it?
She slid the needle through the skin and breathed a sigh of relief as blood came back into the venflon.
‘I’ve done it. I’m in.’
‘Well done.’ Harry gave her an encouraging smile but Jago merely barked out more instructions.
‘Take blood for group and cross-match, full blood count, urea and electrolytes, and get a catheter in so that we can assess his fluid output. What’s his blood pressure doing?’
‘It’s falling.’ Annie checked the reading and recorded it on the chart.
‘Remember that there is a consistent fall in the systolic blood pressure only after 30 per cent of blood volume is lost,’ Jago said, his tone cool. ‘Get him attached to an ECG monitor and let’s give him a bolus of fluid. Start with a litre of warm colloid and then we’ll reassess.’
There were so many questions that Katy wanted to ask but she knew they were going to have to wait until the patient was stable.
She watched while Jago examined the patient’s abdomen, his hands moving skilfully as he looked for signs of tenderness.
‘There’s bruising and tenderness under the ribs,’ he murmured, and then glanced at Annie. ‘Phone down and see if they’ve confirmed the blood group yet. It’s been ten minutes so they should have. Once they have, get some blood up here,’ he ordered sharply, and Annie hurried to the phone just as another nurse popped her head round the door.
‘His wife is in the relatives’ room. Is there someone who can see her?’
Jago glanced at Charlotte. ‘Can one of your team go to her until we’ve stabilised him? Tell her we’ll be with her as soon as we have some news.’
Charlotte moved towards the door. ‘And if she wants to come and see him?’
Jago didn’t hesitate. ‘Then let her.’
Katy frowned and Jago raised an eyebrow in her direction.
‘Something wrong, Katy?’
At least he was calling her by her first name now, instead of referring to her as ‘Dr Westerling’. ‘I just thought it might be distressing for her to see him like this.’
‘It is distressing…’ Jago glanced across to check the ECG and the blood-pressure reading ‘…but studies have shown that on balance it’s probably better for the relatives to see the patient in Resus than not to see them.’
Annie looked up. ‘His blood pressure is falling, Jago.’
‘He needs blood and we need to call the surgeons and warn them that he’s likely to need a laparotomy.’
Jago looked impatiently towards the door and at that moment one of the nurses came hurrying in, carrying the blood bags.
‘At last.’ Jago reached out a hand and took one of the blood bags, attaching it quickly to the giving set. ‘Open the tap and let’s see if that helps.’
They worked to stabilise the man but the blood trans-fusion seemed to have no effect.
‘Still no improvement. OK, that tells us one of two things.’ Jago’s expression was grim. ‘Either the shock isn’t caused by bleeding, or he’s bleeding faster than we can infuse the blood—my money’s on the latter. He needs urgent surgical intervention. Has someone bleeped the surgeons?’
Charlotte nodded. ‘Mr Hart is on his way.’
‘Well, he’d better be quick.’ Jago turned his attention back to the patient, who was deteriorating by the minute.
‘His blood pressure is still falling.’ Annie looked at Jago expectantly and his mouth tightened.
‘Push that blood through faster.’
At that moment the door swung open and a tall, blond man strode into the room. ‘Jago?’
Jago gave a succinct report on the man’s condition and the surgeon examined him briefly.
‘You’re right. He’s bleeding. Let’s take him straight to Theatre.’
There was a flurry of activity and the man was transferred to the operating theatre for a laparotomy which would allow the surgeons to assess any internal damage.
Katy found herself alone in Resus with Charlotte. ‘Phew, what a mess!’ She glanced around the room, taking in the discarded blood bags, needles and other equipment.
‘What happens now?’
‘We clear it up ready for the next patient,’ Charlotte said immediately, thrusting needles into the sharps bin and scooping up soiled dressings. ‘Jago’s gone to talk to the relatives with Annie. Can I ask you something?’
‘Of course.’ Katy checked the intubation tray and ran another bag of saline through a giving set.
‘How do you two know each other?’
Katy’s eyes flew to hers and she thought about denying their past acquaintance, but Charlotte’s next words made her realise the futility of that approach.
‘When you were brought in here two weeks ago, he was the one who identified you.’
‘Oh.’ Katy concentrated on the equipment she was checking, wondering what Jago had felt when he’d seen her lying on the ambulance stretcher. Had he felt any guilt at all? ‘We knew each other years ago. He used to work for my father.’
‘In the bank?’ Charlotte’s eyes widened. ‘He’s filthy rich and we’ve all been dying to know how he made his money. I suppose that answers the question.’
‘I suppose so.’
Katy moved away, hoping that was the end of it. She hated gossiping about people.
Charlotte was still looking at her in fascination. ‘Did you know him well?’
Katy shook her head and avoided eye contact. ‘Not that well.’
She’d thought that there had been gentleness under the strength but she’d been wrong.
Charlotte gave a wistful sigh. ‘He’s the hospital heart-throb.’
Katy kept her eyes fixed on the intubation tray. Of course he was. Jago Rodriguez was seriously rich, stunningly good-looking and single. A prime target for every woman on the planet.
Except her.
She’d learned her lesson the hard way eleven years ago and she wasn’t that innocent, naïve girl anymore.
Charlotte sighed. ‘Every available woman in the hospital dreams of being the one to tame him and marry him.’
Katy looked up at that, unable to hide her incredulous expression. ‘Marry him?’ Well that showed how well they knew Jago. I don’t do commitment, Katy. ‘If you know him then you’ll know he isn’t the marrying kind.’
Charlotte shrugged. ‘Everyone’s the marrying kind if they meet the right person.’
‘I don’t think so.’ Katy’s voice was soft and thoughtful. ‘I think some people just can’t allow themselves to be that vulnerable.’
And Jago didn’t have a vulnerable part to his make-up.
At one point she’d thought he had. He’d fooled her with a display of gentleness that had turned her insides to jelly but she knew now that that was just part of his superior bedroom technique.
‘You’ve obviously thought about it a lot.’ Charlotte hung the giving set over the stand and looked at her quizzically. ‘But you’re getting married so you must believe in love and commitment.’
Did she?
Katy turned her attention back to the intubation tray, not wanting to shatter Charlotte’s romantic illusions.
She certainly wasn’t in love with Freddie.
And she didn’t feel guilty about it because she knew that Freddie wasn’t in love with her either. He was marrying her because she was the right sort of girl with the right sort of connections and that suited her fine. She didn’t want love.
Her one experience of love had been a shattering, all-consuming experience that had threatened her very existence.
I don’t do commitment, Katy.
‘Not that we hospital staff really get a look in,’ Charlotte said gloomily, tearing off her plastic apron and lobbing it in the bin. ‘He’s dating a stunning Brazilian model at the moment. The real woman type. Legs up to her armpits and boobs to make a man drool. She’s a very lucky woman.’
Katy clenched her fists and told herself firmly that she didn’t care who Jago was dating. It was none of her business.
And she wanted to end the conversation.
‘I’d better get back to the main area and see some more patients,’ she said quickly, anxious to get away from Charlotte. She was nice but she didn’t need to talk about Jago. Working with him and seeing him every day was bad enough without talking about him as well.
CHAPTER FOUR
KATY’S first week passed quickly and every time she looked up Jago seemed to be there, challenging her, asking questions, his handsome face inscrutable.
Determined not to make a mistake, she examined every patient meticulously, made sure that her questions were detailed, never took anything at face value. And in her opinion she’d performed well. But Jago hadn’t uttered a single word of praise and she was starting to feel the strain.
Was he going to keep this up indefinitely?
Did he really think that she wasn’t up to the pressures of A and E or did he have another reason for not wanting her in his department.
A more personal reason perhaps?
On her first Saturday night working on A and E a fight broke out in the street behind the hospital. They heard the sound of police sirens and a few minutes later a group of drunks staggered through the door that led to the ambulance bay, half-supporting a man who seemed barely conscious.
‘Hey, you!’ One of the drunks waved a hand at Charlotte who frowned with distaste.
‘You can’t come in through that entrance,’ she said tightly. ‘It’s reserved for emergency vehicles. You need to—’
‘Don’t tell me what I can and can’t do,’ the man slurred, his eyes flashing angrily at Charlotte as he struggled to remain upright and focus. ‘Get me
a bloody doctor. Now!’
Charlotte stiffened and turned to Jago expectantly.
‘This is one for Katy,’ he delivered softly, his dark eyes connecting with Katy’s in unmistakable challenge.
There was no missing the message in his gaze. This was one of the situations he was convinced she’d never be able to deal with, and he was testing her.
She almost laughed. She’d probably had more experience with drunk, violent men than he had.
Ignoring Charlotte’s shocked murmur of protest, Katy stepped forward, her manner calm and professional.
‘That looks like a nasty cut.’
She addressed her remarks directly to the injured man, who barely acknowledged her presence.
His head rolled onto his chest and his expression was glazed.
Was he drunk or was he suffering the consequences of a head injury?
She’d read enough to be aware of the potential pitfalls of dismissing someone as drunk. There were plenty of horror stories about people who’d been discharged from Casualty only to die the next day as a result of a head injury that no one had taken seriously. Drink could mask a number of symptoms and she had no intention of missing anything.
She turned to his friend, who was clearly having trouble staying upright. ‘What’s his name?’
‘James.’
‘And what happened?’
The man swayed slightly. ‘He fell over and banged his head.’
He was slurring his words so badly that it was difficult to understand him, but Katy knew how important it was to obtain some sort of history. ‘And did he knock himself out?’
The man shrugged, his eyes glazed. ‘Dunno.’
Great. Some history.
‘All right.’ Katy’s tone was brisk. ‘Well, I need to take a look at his head. Why don’t you sit him over there and then go and give his details to Reception?’
The man didn’t answer, his body swaying as he watched her. ‘I asked for a doctor. You’re never a doctor.’
Katy gave a calm smile. The same smile she’d used on her father time and time again.
Don’t antagonise him, Katy.