‘It can be.’ He examined the man’s upper abdomen and nodded when he felt tension in the flesh. ‘Yep, there’s definitely something going on in there. With no access to X-rays we just have to trust our instincts, and our best bet is a haemothorax. It will need aspirating, so can I leave you to do that, Rob? You’ve done it before and you know the drill—just insert the needle between the ribs under his left arm and withdraw the blood that’s collected in the pleural cavity.’
‘Easy-peasy,’ Rob agreed cheerfully, getting straight down to work.
Owen left him to it, pleased to see that the young registrar wasn’t letting the strangeness of the situation get to him. It took a lot to put Rob down, he thought as he made his way to the next man. It was no wonder that Rose seemed to enjoy his company.
The thought was more distracting that it should have been, so he put it out of his mind as he knelt down. Two of the paramedics were attending to the man, so he checked that they were happy with his condition and moved on. Rose had worked her way down the line by then and she came hurrying over to him.
‘There’s three I’d like you to look at. The guy Pete is attending to and two others by the far wall. The man on the left has a GCS of eight.’
‘I’ll check him first.’ He made his way over to where the workman was lying. He could see at a glance that the man had extensive head injuries and sighed. ‘Doesn’t look too promising, does it? Can you check his BP for me?’
Rose knelt down and quickly took a reading. He nodded when she told him what it was. ‘Way too low. Let’s get some fluid into him and send him off to hospital a.s.a.p. There’s not much we can do for him here, I’m afraid.’
She took a cannula out of her pack and deftly inserted it into the back of the injured man’s hand while Owen carried on with his examination. He shook his head when she looked questioningly at him.
‘I can’t find much sign of anything else, although something could show up on the X-rays. We’ll put a collar on him and get him on a board, then ship him out.’
Rose selected a cervical collar and fitted it around the man’s neck. The paramedics had brought a spinal board with them and they managed to slide the patient onto it without too much difficulty. Owen slipped an oxygen mask over the man’s face, then cushioned head restraints were used to further protect him during the journey and he was strapped in. A shot of analgesic and they were ready to move him.
‘We need to get him out of here as quickly as possible,’ he explained, beckoning Donald over. The rescue crews were using a mechanical shovel to move some boulders and the noise was deafening—he had to shout to make himself heard above the din.
‘I’ll get a couple of my men to help,’ the chief fire officer offered immediately. ‘They’ll need to manoeuvre him through that narrow section of the tunnel and it won’t be easy.’
‘Thanks. He’s not going to survive if he doesn’t get to hospital soon,’ he explained. ‘Even then, it’s going to be touch and go. He’s suffered a serious head trauma.’
‘Are you sending one of your team with him?’ Donald asked.
‘No. The paramedics can cope from here on. They know what they’re doing,’ he replied, resisting the urge to ask Rose to accompany them. It was tempting to send her along and remove her from any possible danger, but she would be far more valuable to him here.
He left Donald to organise the move and went to check on the other casualties Rose had singled out. She was kneeling beside one of the men so he went straight over and examined him first.
‘Fractured pelvis,’ he said, listing the man’s injuries as he found them. ‘Right femur is fractured as well.’ He slid his hand under the man’s back. ‘Definite misalignment in the lumbar spine, too.’
‘I think he might have suffered a myocardial infarction as well. One of the other workmen told me that he’d been complaining of pains in his chest and jaw shortly before the roof caved in. They were about to call an ambulance when it happened.’
‘It really isn’t his day, is it?’ he observed drolly, and Rose smiled.
‘It certainly isn’t. Do you want me to put in a line?’
‘Please. I’m going to intubate him. We need to make sure that he doesn’t move so I’ll have to anaesthetise him.’ Owen tried not to let her see how he was feeling. However, that smile had had an effect all right. Heat bubbles exploded in his veins and he abruptly stood up. ‘I’ll just check on the other guy first and come back to you.’
‘Fine.’
She bent over the patient, blissfully unaware of what was happening and he was grateful for that. At least he had the comfort of knowing that she had no idea he was making a fool of himself. He went across to the other patient. Pete was with him and, unlike the previous casualties he’d seen, the young man Pete was attending to was conscious. He was obviously in pain, too, because he groaned when Owen crouched down beside him.
‘Can you give me something for the pain, Doc? I’m in agony here.’
‘Where does it hurt?’
‘Just here.’ He touched the left side of his chest, grimacing as another wave of pain hit him.
‘You’ve probably cracked a couple of ribs.’ Owen gently tested the area and nodded when he felt signs of crepitus—a grating sensation caused by the broken ends of bone rubbing together. ‘Yes, just as I thought. It looks as though you’ve given yourself a really nasty knock.’
‘Tell me about it.’ The young man rolled his eyes. ‘A chunk of rock hit me. Mind you, it could have been worse. If I hadn’t managed to dive out of the way the whole roof would have landed on me and I’d have been squashed flat!’
‘A lucky escape, from the sound of it. Anyway, I’ll give you something for the pain.’
He told Pete what drugs he needed, then carried on with his examination while the nurse organised the shot. Although broken ribs could be extremely painful, they weren’t normally a life-threatening injury so he was a little surprised that Rose had singled out this patient for urgent treatment.
‘My name’s Owen Gallagher, by the way,’ he explained as he examined the young man’s hips and pelvis. Maybe Rose had spotted something he hadn’t, and he didn’t intend to overlook something vital by rushing.
‘Tim Lawrence,’ the young man replied.
‘Have you been working on the tunnel for very long?’ he asked, discounting the pelvic area as a source of any major problems.
‘It’s my first week on the job. I only took it because I want to earn a bit of extra money before I go to university this autumn. I’m just back from a gap-year trip to Australia and I thought it would be a good way to boost my finances. Little did I know what I was letting myself in for.’
‘Tough luck,’ Owen observed sympathetically. He checked Tim’s spine next, but found nothing there to alarm him so gave him the shot of morphine Pete had prepared for him, still unsure why Rose had decided the young man was in urgent need of treatment. There had to be a reason for her decision, because she was far too experienced a nurse to waste his time.
The thought that he trusted her clinical judgement was unsettling in view of their rocky relationship to date. However, he refused to let his personal feelings stand in the way of doing his job properly. He decided to re-examine Tim’s chest, just to be on the safe side. His lung sounds were good, with air entry on both sides, so he could rule them out, and there was no problem with his heart. However, he frowned when he detected an unusual degree of swelling in the upper left part of the young man’s abdomen.
‘This is pretty swollen, even allowing for you having busted a couple of ribs.’
‘All I know is that it hurts like mad,’ Tim muttered.
‘The shot will soon take the edge off it,’ he assured him as he considered the implications of what he had found. A severe blow like that could have done more than simply fracture a couple of ribs. The spleen lay in this area of the abdomen and he couldn’t rule out the possibility that it had been ruptured. If that was the case, Tim would need an emergency spl
enectomy to remove it otherwise he could bleed to death.
Owen came to a swift decision, knowing that he couldn’t afford to take any chances. ‘It’s possible your spleen has been damaged, so I’m going to send you straight off to hospital.’
‘My spleen?’ Tim said, turning pale. ‘Does that mean I’ll need an operation?’
‘It might well do. However, the good news is that your spleen isn’t all that important once you’re an adult. There’ll be a slightly increased risk of you contracting infections if it’s removed, but that’s basically it.’
‘Will I be out of action for very long?’ Tim asked anxiously. ‘I’m going to be really stuck if I can’t work before I go to uni. I was relying on what I was going to earn to help pay for my accommodation.’
‘If you do need the operation, you’ll be in hospital for between six to ten days, then need a couple more weeks to recuperate. But you should be fine after that.’ Owen clapped him on the shoulder. ‘You’ll be OK. Really you will.’
Tim didn’t say anything as Owen asked Pete to start him on a drip. The young man was obviously shocked by what had happened to him. Once everything was done, Owen arranged for Tim to be moved immediately to hospital. Another team of medics had arrived by then, so that took the pressure off them a bit. As he went back to Rose he was feeling pretty confident about the outcome. Another half-hour and they should be on their way back to the hospital.
His gaze landed on Rose and he felt a sudden tightening in his chest. Once they were back at the hospital his problems wouldn’t be over, though. There was still the matter of Daniel to worry about. Maybe he did trust her clinical judgement, but could he trust her with his son?
Rose wished that Owen would hurry up and come back. In the past couple of minutes the patient’s condition had deteriorated and he was showing definite signs of slipping into VF. She looked up in relief when Owen appeared.
‘He’s not looking too good,’ she explained, moving aside as he crouched down beside her. ‘His heartbeat is very irregular. I think he’s slipping into VF.’
‘Let me take a look.’
His tone was cool as he bent over the man and she frowned. She had the distinct impression that he was upset, yet she had no idea what she’d done to annoy him. It was on the tip of her tongue to ask him what was wrong when it struck her how stupid it would be. Everything she did seemed to upset him!
‘I’ll give him a shot of lignocaine to settle things down, then intubate him. He’s going to need bagging until we can get him on a ventilator, so can you get one of the paramedics over here to help?’
‘Don’t you want me to do it?’ she said in surprise.
‘No. You go and see if Rob needs any help. Pete can assist me once he’s finished with his patient.’
‘Fine.’ Rose didn’t argue as she stood up. She could tell there was no point. Maybe Owen had decided that enough was enough and working with her for any longer was too much.
The thought hurt, but she refused to dwell on it as she went over to the paramedics and relayed his instructions. Rob was dealing with a broken leg when she went to join him—he looked up and grinned at her.
‘Just in time to help me fix this splint, Robin.’
Rose summoned a smile, refusing to let Owen’s attitude get her down. ‘You mean to say a superhero like you can’t manage on your own?’
‘Every superhero needs a sidekick to perform the menial tasks,’ he told her, smirking.
‘Hmm, I left myself wide open for that, didn’t I?’ She crouched down and helped him fit the inflatable splint to the man’s left leg. It was difficult to fit it correctly without moving the limb and she sighed when the patient groaned. ‘Sorry. I know it must hurt, but it will only take another few seconds now.’
‘It’s OK, love. I can put up with a bit of discomfort from you.’ The elderly workman winked at her. ‘It’s been a long time since I had a lovely young woman ministering to me.’
Rose chuckled. ‘Nice to know that I still fall into the young category. I’ve a birthday coming up next week and I’m starting to feel really old.’
‘How old is old?’ Rob put in, securing the Velcro strip that bound the top sections of the splint together.
‘Old enough not to want to tell you,’ she retorted.
‘Oh, come on! You can’t be that old.’ Rob sat back on his heels and studied her thoughtfully. ‘I’d say you’re about twenty-eight or -nine—a year or so older than me.’
‘Wrong!’ Rose carefully eased the bottom section of the splint together and taped it in place.
‘You mean you’re older than that?’ He shook his head. ‘No way. You’re having me on. I don’t believe you’re thirty.’
‘And then some,’ she replied with a laugh. She dusted off her hands and stood up. ‘OK, so what’s next?’
Rob explained to the man that he would be moved as soon as the paramedics came back and got up as well. ‘That’s about it until they dig out the others. And there’s no knowing how long that will take or what state they’re going to be in either.’
He drew her aside as the paramedics arrived to transport their patient above ground. The mechanical diggers had stopped working now, but there was still a lot of activity as the rescue team continued their efforts to reach the trapped men. He had to stand very close to her to make himself heard.
‘Were you serious just now about your age? I can’t believe you’re that much older than me.’
‘I’ll be thirty-five next week,’ she told him honestly. Although it was flattering to know that he thought she was the same age as him, there was no point lying. Not when she was going to meet her eighteen-year-old son at the weekend.
Instinctively, her gaze moved to Owen, and she felt a shiver skim down her spine when she realised he was watching them. Even though they weren’t doing anything wrong, she was immediately on the defensive.
Stepping away from Rob, she made her way back to the workman and checked that the paramedics were ready to move him. Everyone had been attended to by then and she wasn’t surprised when Donald Grant told them they would be leaving very shortly. Now that the other crews had arrived on scene, they could deal with the rest of the casualties when they were dug out. It was back to base for the St Anne’s team, and back to square one as far as she was concerned.
Had she really hoped that Owen’s attitude might have softened while they’d been working together? She hated to think she was so naïve but she knew it was true. However, nothing had changed. He still didn’t trust her, still didn’t believe she should play any part in Daniel’s life.
If she’d thought for a moment that meeting her would harm Daniel, she wouldn’t have agreed to see him. However, from the impression she’d formed when they’d spoken on the phone, this meeting was as important to Daniel as it was to her. Now nothing was going to stand in the way of doing what was right for her son, and if that meant going against Owen’s wishes, that was what she would do. It was just a shame that they seemed to be on opposite sides when they wanted the same thing. They both wanted Daniel to be happy.
CHAPTER SEVEN
ROSE managed to hitch a ride back to the hospital with the same crew who had ferried her to the tunnel. She spent the journey talking to the elderly workman who’d suffered the leg injuries. His name was Alan Bradbury and he told her that he was due to retire later that year. He regaled her with tales of his experiences of working on various engineering projects, so that before she knew it they’d reached the hospital.
‘I’ll check on you later,’ Rose told him as the crew opened the rear doors. ‘I expect you’ll be going up to Orthopaedics once your leg has been sorted out, so I’ll pop in to see you before I go off duty.’
‘You do that, love. It will do my image the power of good to have a beautiful young woman asking after me,’ he told her cheerily.
Rose laughed as she jumped down from the ambulance and hurried inside. It was nice to be appreciated for once! Charlie was crossing the waiting area wh
en she arrived and he stopped to speak to her.
‘Made it back safely, I see. So how did it go?’
‘Not too badly, all things considered. What about the patients we sent back here—in particular, the guy with the head injury and the man who had a suspected spinal injury?’
‘The head injury is in Theatre—I’m not sure what the outcome will be. As for the other guy, I’m afraid he didn’t make it. He suffered a massive myocardial infarction on his way here and the paramedics weren’t able to resuscitate him.’
‘What a shame. How about the young man with the broken ribs? I had a feeling there was more to it than that…’ She shrugged, unable to explain the feeling she’d had. Had it been the fact that the patient was close to Daniel’s age which had made her ultra-careful? she wondered.
‘You were right, too. He had a ruptured spleen. If he hadn’t been brought in PDQ he might not have made it either, but he’s out of Theatre now and he’s going to be fine. Anyway, leave your coveralls in the bin in the storeroom—they’ll need cleaning—then you can take a break.’
‘Are you sure?’ she queried, glancing at the rows of people who were waiting to be seen. The automated display board above the reception desk was giving a waiting time of four hours—their absolute maximum under current government guidelines.
‘Yes. You need to wind down after an operation like that. Isn’t that right, Owen?’
‘Isn’t what right?’
Rose swung round when she heard Owen’s voice. He must have arrived shortly after she had got there, because he was standing right behind her. She couldn’t help noticing how tired and strained he looked, and her heart immediately went out to him.
‘Charlie was insisting that I should take a break. Maybe you should take one, too. You look all in.’
‘I suggest you leave me to decide whether I’m fit to do my job,’ he said brusquely, striding past her.
Rose felt the embarrassed colour sweep up her cheeks and hurried away. However, she knew that Charlie must be wondering why Owen had spoken to her in that fashion. He’d been little short of rude, and there had been no call for it when she’d been trying to help.
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