‘Would you mind?’ Josh was still moving but his head tilted in an invitation for her to follow him. ‘She’s on maximum therapy already and I thought we had it sorted. A second opinion would be welcome.’
‘Sure.’ Megan was on her feet and catching up. The thrill of anticipation was due to it having been so long since she’d faced a potential emergency with everything she might need at hand, she told herself.
It had nothing to do with the prospect of working side by side with Josh.
* * *
Six-year-old Bonnie was being given a continuous infusion of salbutamol but she was struggling to breathe. She could only manage sentences of one or two words in response to Josh’s questions and the outline of her ribs was visible even through the hospital gown due to the effort she was making to shift air.
‘What’s the oxygen saturation?’ Megan queried, her hand on Bonnie’s wrist, trying to count an extremely rapid heart rate.
‘Down to eighty-six percent,’ Josh told her. ‘It’s dropped. Respiration rate is up from forty to fifty-six.’ He was frowning. ‘Let’s start a loading dose of aminophylline and get a chest X-ray to exclude a pneumothorax.’ He raised his eyebrows at Megan, who nodded her agreement.
‘We could start her on some positive pressure assisted ventilation, too.’ She squeezed Bonnie’s hand. ‘We’re going to change your face mask, sweetheart and give you one that’s going to make it a bit easier for you to breathe. It’s nothing to be scared about, OK?’
But Bonnie looked terrified. So did her mother, who was sitting close to the head of the bed, holding Bonnie’s other hand. Megan moved closer to Josh and lowered her voice.
‘We need an arterial blood gas. And we need to get her up to PICU as soon as she’s stable.’
Josh murmured his agreement. He was still frowning. Somewhere behind them someone was shouting and a staff member was threatening to call Security if they didn’t calm down. An X-ray technician bustled into the resus area and began moving equipment that clanked loudly against something else. An alarm was sounding on some monitoring equipment nearby.
Josh caught Megan’s gaze. A gesture with his hand encompassed the undecorated walls with the array of potentially frightening supplies and machinery. ‘The sooner we have our unit up and running, the better,’ he muttered, ‘don’t you think?’
‘Mmm.’ Except it wasn’t going to be their unit, was it? Megan was never going to work here again on a permanent basis. The realisation gave her a curiously sharp pang of regret.
She was working here right now, though, and over the next fifteen minutes her energies were directed solely to trying to help Josh stabilise Bonnie. Despite all their efforts, however, her condition was getting worse. Single-word responses became no responses at all and the child’s level of consciousness was dropping noticeably. The level of oxygen in her blood, having gone up for a brief period, dropped with an alarming plunge. Her fingernails took on a bluish tinge.
‘I’m going to intubate,’ Josh decided. ‘Rapid sequence. Megan, can you pre-oxygenate and then give me some cricoid pressure, please?’
Megan took her position and held the mask over Bonnie’s face, turning up the flow of oxygen to try and get as much into her bloodstream as possible before any attempts to breathe were interrupted by the anaesthesia and intubation procedure.
She was ready to push on the front of the now unconscious Bonnie’s throat to help Josh visualise the vocal cords and slip the tube into the correct position but his first attempt was unsuccessful. Megan could see the beads of sweat forming on his forehead. She reached above his head to silence an alarm on the monitor that was insistently beeping.
Josh looked up. He didn’t have to say a word—the communication was simply there telepathically. If the next attempt was unsuccessful they would have to do something more invasive, like puncturing Bonnie’s airway from the front of her neck. They couldn’t afford to have her paralysed and not ventilated adequately for more than a few minutes. Megan had more experience with the smaller and sometimes difficult airways of children. She also had smaller hands that were capable of defter movement.
It wasn’t anything like an admission of defeat on Josh’s part to swap positions. He was simply taking the best advantage of the resources available.
The pressure of needing to perform to the best of her ability was countered by the knowledge that Josh had enough confidence in her to give her the chance. Megan didn’t realise she was holding her own breath until she felt herself release it in a sigh of relief when the tube slipped into place and she could hear the air entry into Bonnie’s lungs with her stethoscope as Josh squeezed the bag attached to her face mask.
The tension was still there for the next few minutes as they hooked Bonnie up to the ventilator and adjusted settings until they were happy with the way she was breathing and the amount of oxygen that was circulating in her bloodstream. And then Megan went with Bonnie to the paediatric intensive care unit to see her settled in and her care passed to the medical team on duty.
Finally, Megan returned to the main part of the emergency department because she wanted to tell Josh that the little girl appeared to be stable and she was already showing some signs of improving.
Josh was standing beside the triage desk, along with several nurses. He was holding a huge bunch of red roses wrapped in Cellophane. He didn’t see Megan approaching because he was reading the small card stapled to the Cellophane.
Red roses. The most romantic of flowers. Who was the lucky recipient? Megan wondered. Or had someone sent them to Josh? Either way, she was experiencing a rush of emotion that was a long way from being pleasant.
Until Josh looked up and smiled at her.
‘These are for you,’ he said.
The unpleasant heaviness in her belly twisted and tried to break up and form something entirely different. Except that Josh’s smile wasn’t reaching his eyes.
‘Apparently, it’s your birthday,’ he added.
‘Oh... Happy birthday, Megan.’ The chorus came from several staff members but Megan barely heard them. If Josh was surprised to learn that it was her birthday today, it meant that the flowers couldn’t possibly have come from him.
And that meant...
Josh had her pinned with his gaze. ‘So, who’s this Charles?’ he asked, his tone deceptively casual.
This was it. A defining moment. There was a choice to be made. Did Megan stick to her new plans for her future or was she going to allow the past to hold her back?
Could she finally accept that what she had once wanted more than life itself was never going to happen and take the final step that would set Josh—and herself—free?
There really wasn’t a choice to make, was there?
Megan took a deep breath and spoke into the waiting silence, ignoring all the expectant faces around her, except one. She was speaking to Josh here.
‘Charles is my fiancé,’ she said quietly.
CHAPTER SIX
FIANCÉ?
Megan had a fiancé?
He shouldn’t feel this shocked, Josh realised. What had he expected—that Megan would stay single for the rest of her life because she couldn’t marry him?
The chorus of ‘happy birthdays’ had turned into a round of congratulations. And questions. Who was Charles? Where had she met him? How long had they been engaged?
‘He’s a tropical diseases specialist,’ he heard Megan telling them. ‘I met him when he came out to Africa. He lives in London and...and we only got engaged very recently.’
‘Is that why you’re not wearing a ring?’
‘Ah...yes...’
The hesitation was tiny. It might not have even been significant except for the way Megan’s gaze finally moved to meet Josh’s intent stare. The contact was brief but he registered two things. That there was more to this engagement than Megan was saying and that she was shocked by the way he was staring at her.
Fair enough. Josh pasted a smile on his face. Fortunately he had long s
ince let go of that bunch of flowers.
‘Congratulations, Megan,’ he heard himself saying in a perfectly normal voice. ‘I hope you’ll be very happy. Now, you’ll have to excuse me. I want to go and see how Bonnie’s getting on.’
It was a good enough reason to walk out of the department, wasn’t it? Josh hadn’t banked on being followed, however. He increased his pace.
‘Josh...wait...’ Megan was closing the gap. ‘That’s what I came to tell you.’
‘What?’ He didn’t turn his head. ‘That you’re engaged?’
‘No...’ The word was a sigh. ‘That Bonnie’s doing well. Tidal volume’s increasing and her blood chemistry’s improving. She’s quite stable.’
‘Good. I’d still like to see for myself.’ Josh kept walking.
‘Josh...’ This time the word was a plea. ‘Don’t be like this...please...’
Her voice was quiet enough to carry no further than his own ears but two nurses coming towards him along the corridor were giving him frankly curious stares. And then they gave each other a significant glance. He could almost hear the newsflash that would hit the hospital grapevine in the very near future.
It’s happening again. They can’t even work together for five minutes without the sparks flying. What is it with the chemistry between those two?
No. It wasn’t happening again. Or it wouldn’t be if he could get a grip and stop behaving like a petulant teenager. He forced himself to slow down. To turn and give Megan a direct look.
‘I need coffee,’ he was saying as the nurses passed them. ‘How ’bout you?’
He hadn’t banked on the cafeteria being so deserted for once, any more than he had on Megan following him. They ended up sitting at one of the prized tables by the windows and there was nobody to overhear their conversation.
Megan had been very quiet during the walk to the cafeteria and while they fixed their drinks. Now she wasn’t even tasting her coffee. She’d sat down at the end of the table, at a right angle to him, the way they’d been in his own kitchen. As though she didn’t want the barrier of the table between them. Did she feel like he had? So close but not close enough?
‘I’m sorry,’ she said. ‘I...should have told you about Charles the other night.’
Josh made a noncommittal sound. She had, hadn’t she? When she’d talked about that ‘someone special’ still in Africa?
‘It’s...complicated,’ Megan continued. ‘I’d like to explain.’
Josh wasn’t at all sure he wanted to hear anything more about Megan’s engagement. He averted his gaze. ‘Why? What’s the point?’
The silence made him look back and the expression on Megan’s face made him catch his breath. His question had made much more of a direct hit than he’d intended. She looked...stricken?
Why? Was she embarrassed at letting him know she’d found someone she loved more than him?
Ashamed that this was evidence that she’d found it easy to move on?
Or did she wish that things could have been different?
Megan’s lips were moving. They trembled, which made the words sound shaky.
‘I don’t want you to hate me,’ she whispered.
Josh could actually feel something melting inside him.
That anger at the way Megan had refused to believe him when he’d tried to explain how he’d ended up in Rebecca’s bed that night. At the way she had walked out of his life at such a dark time when Rebecca had died. He could feel all the resentment he’d clung to just melting. Evaporating.
How could he ever hate the only person he had and ever would truly love?
He had chosen to end things between them. He’d pushed her out of his life so that he only had to think about being a good father and he’d had good reason to do that. The best reason because he’d known how dangerous it was to rely on having a love like that in your life. Having his mother alone and looking older than she should for her years was a reminder he could tap into every day, with the added bonus of remembering what that relationship had been like for himself and his siblings. How it was the children who could be hurt most.
He’d done the right thing. The only thing he could have done, anyway. He’d honoured his vow. But it didn’t mean that he didn’t want Megan to be happy, did it?
Of course it didn’t.
‘I don’t hate you,’ he said aloud. The smile he could feel tugging at his lips came from somewhere very deep. Very tender. It was just there. Kind of like the way his hand moved to cover one of Megan’s. ‘I could never hate you, Megan.’
He had to let go of her hand. But not quite yet. The warmth and silky feel of her skin was irresistible. His thumb moved over it. The memories of this hadn’t done reality justice. He needed to capture it properly.
‘Charles is...’ Megan’s voice sounded curiously thick, as though clogged by tears she was holding back. ‘It’s not perfect, you know...but...but what we had—it’s gone, Josh—and I...I had to try and move on...’
‘Of course you did.’ The movement of his thumb had become something to comfort Megan now. ‘I’m happy for you. Really, I am.’
‘You’ll move on, too.’ He could actually hear Megan swallow.
‘No.’ Josh pulled his hand away.
It wasn’t going to happen because the choice was unacceptable. He couldn’t be with Megan because, even if he could somehow exorcise the ghosts of his own childhood, it was too late. She had found someone else. And to be with anyone else would be a shell of a marriage. The way it had been with Rebecca. He’d only end up messing with someone else’s life and he’d vowed never to do that again.
‘You still blame yourself, don’t you? For everything.’
Josh said nothing.
This time it was Megan who, after a long and increasingly tense silence, reached out and caught his hand.
‘It wasn’t your fault,’ she said softly but fiercely. ‘I’m just as much to blame for getting pregnant that first time. And I didn’t tell you. That was wrong. You thought it might be your son you were trying to save that night in Emergency but even then I didn’t tell you. I let you wonder about that and be haunted for years and years. I...I’m sorry, Josh. I know it was a terrible thing and neither of us will ever forget but it’s far in the past now. We need to let it go.’
‘I married Rebecca,’ Josh muttered. ‘I can blame myself for making her life miserable.’
‘She chose to marry you,’ Megan said quietly. ‘And, from what I heard, you’d made it very clear that you didn’t want children. But you gave up what you did want, didn’t you? For the children. For her.’
Josh had a lump that felt like it had sharp edges stuck in his throat. Oh, yes...he’d given up what he’d really wanted and it had felt like something was trying to die a slow and painful death inside him during those months when he’d pushed Megan away.
He couldn’t tell her that, though, could he? Not when she had moved on and found someone else.
Except...she was still holding his hand. Really holding it now. Somehow their hands had moved and now their fingers were intertwined. Josh could feel himself being drawn closer. His head was moving. Something in Megan’s eyes was pulling him closer and closer.
Any moment now and he would be close enough to touch her lips with his own. In his peripheral vision Josh could see a group of staff coming into the cafeteria. If he kissed Megan right now, it would be all over St Piran’s in a matter of minutes. And the worst thing was, he didn’t give a damn.
Right up until the realisation hit him that this newsflash would come right on the heels of the news that Dr Phillips was engaged to some eminent specialist from London. Another relationship would be under threat. And it would be his fault.
History would be repeating itself.
Somehow, Josh found the strength to break that magnetic pull. To untangle their fingers and move himself away.
* * *
The group of nurses on early dinner break were heading for a table near theirs now.
‘So...it’s going well, isn’t it?’ Josh said, a little more loudly than he needed to. ‘Our paediatric wing is going to be something for St Piran’s to be proud of, don’t you think?’
Megan knew instantly that Josh was trying to put them back onto a professional footing that wouldn’t attract any more than mild curiosity from other staff.
It was a million miles away from the space they’d been in only seconds ago.
What exactly had happened there? She could have sworn that Josh had been thinking about kissing her.
And, dear Lord...all she had been able to think about was how much she wanted him to.
‘Hey, Megan...’ The midwife, Brianna, was amongst the group of nurses. She veered closer, a packet of sandwiches in one hand and a bottle of water in the other. ‘I’ve been hearing great things about what’s happening in A and E.’
‘Yes, it’s going really well, thanks.’ Megan’s smile included Josh. They could do this, it was intended to imply. They could put both their conversation and their interaction with each other back onto a purely professional footing.
Brianna was smiling at Josh. ‘Is it true that a member of the royal family is going to come and cut the ribbon for the opening?’
‘I believe so.’ Josh’s smile was as lazy and gorgeous as any Megan had ever seen. She could still see the lines of tension creasing the corners of his eyes, though. Could Brianna sense the undercurrents happening here?
Apparently not. ‘How exciting,’ she was saying to Josh. ‘You’ll be all over the news on telly. You’re going to be so famous after this’
Josh’s smile faded. ‘I’m not interested in being famous,’ he said. ‘It’s St Piran’s I want to put on the map. And not because it has the flashest emergency department but because of the standard of care people get when they come through our doors.’
‘Mmm...’ But Brianna was grinning. ‘Maybe we’ll all be famous.’ She turned back to Megan. ‘You’ll still be here, won’t you? For the grand ceremony?’
‘I expect so.’ It was only a couple of weeks away, wasn’t it? Megan hadn’t made any plans to leave before then. In fact, she still hadn’t made any definitive plans for what was coming next in her life. Decisions had to be made. Was she using this new project as a means of procrastinating? ‘I’ve still got a lot of work to do on the cottage to get it back into shape.’
St. Piran's: The Wedding! Page 9