Emergency: Mother Wanted

by Sarah Morgan

  'So maybe it is the boyfriend and he's out of control.' Zach shrugged and held the door open for her. 'Either way, it's not our problem any more. Paeds can deal with it. If necessary, they'll get an emergency protection order.'

  Keely bit her lip. 'But maybe I should contact the health visitor or the GP, or maybe—'

  'Keely, this is A and E,' Zach pointed out gently. 'The child has been admitted. Paeds will deal with all that.'

  'But—'

  'We can't get involved in the small details of people's lives,' Zach reminded her. 'We just repair the surface damage and leave the rest to someone else.'

  But that wasn't what she wanted to do. She wanted to see it through. She wanted to make sure that the patients were all right once they got home, that they could cope...

  'Three cheers for Keely.' Adam was back in the common room, a big grin on his face. 'What you don't know, Dr Thompson, is that we all sneaked down after you to watch you with that child. We thought we might learn something.'

  'Never knew you liked trains so much,' Nicky teased, 'or that you found the floor so comfortable.'

  Keely rolled her eyes. 'Pick up any tips?'

  'Yes.' Adam gave a broad grin. 'If it's a child, call Keely. I need all the help I can get when it comes to children. I'm the first to admit it. I never know where to start but you were fantastic.'

  'You're being ridiculous,' Keely said gruffly, blushing as she walked across to the kettle and flicked the switch. 'I'm no better with children than anyone else is.'

  'Yes, you are.' Zach looked at her steadily. 'Adam's right. You're incredibly good with children. You know just what to say and what to do to get the best out of them. You're great at averting tantrums and you seem to be able to coax a smile from the most moody, miserable child.'

  She stared at him, stunned by his praise, and then Adam cleared his throat.

  'So, on the strength of that reference, Dr Thompson, maybe you should be applying for a job as a paediatrician. What is it you're planning to do when you finish here?'

  Keely licked dry lips. 'Cardiology.'

  'Well, it's a waste,' Adam said cheerfully. 'You should definitely go into paediatrics. Don't you agree, Zach?'

  There was a brief silence while Zach watched her. 'I think she should do whatever she wants to do.'

  Keely turned away quickly and busied herself making the coffee. She wished they'd change the subject. She really didn't know what she wanted to do, or how she felt about her career.

  She passed Zach a coffee and for a brief moment their eyes meshed. And she knew. Knew without a doubt that there was one thing she was sure of. She loved Zach Jordan.

  She always had done, and she always would do.

  CHAPTER FIVE

  It was her turn to cook supper.

  Keely let herself into the house, said goodnight to Barbara, who'd been in charge all day, then played a game about body parts with a giggling Phoebe.

  'Nose.' Phoebe put a little hand over her nose and then touched Keely's nose.

  'Eyes.' Keely pointed to her eyes and then her chin. 'What's this?'

  'Chin.' Phoebe clambered onto Keely's lap and buried her face in her chest. 'Bosoms. Nice. Soft.'

  Keely's chuckle turned to a blush as she glanced up and saw Zach standing there. 'Oh!' her voice was an embarrassed squeak. 'We didn't hear you.'

  He didn't even try and hide his laughter. 'Obviously not.'

  Help! Why did he make her feel so hot and bothered? And why, when she was dying to see the man laugh, did it have to be at her expense?

  'Well, now you're home you can take over and I'll make supper. You did it last night.' Keely stood up and handed him his daughter, her face still burning with mortification.

  'Neck.' Phoebe reached out and wrapped her arms around her father's neck, and Keely slunk out of the room before the child picked out any more embarrassing bits. Next time she'd just play a quiet game of hide and seek.

  She concentrated her attentions on the supper and by the time Zach reappeared, having put Phoebe to bed, she had herself under control again.

  'Adam was right. You're so good with small children,'

  he observed, leaning forward and helping himself to some olives she'd put on the table.

  Keely laughed and gave the casserole a stir. 'Don't tell me—you think I should be a paediatrician, too.'

  He sat back in his chair. 'What I think doesn't matter— you should be what you want to be.' His tone was even. 'Why do you want to be a cardiologist?'

  Her hand froze and for a moment she stopped stirring. The honest answer was that she didn't know that she did want to be a cardiologist. But she couldn't tell him that. Zach was like the rest of her family, ferociously intelligent and aiming for the top of his profession. He wouldn't understand her doubts. Wouldn't understand if she confessed that she wasn't sure she wanted any sort of hospital career.

  'Why do I want to be a cardiologist?' She started stirring again and fished around in her brain for the sort of plausible answer one might give at an interview. 'All sorts of reasons. I find cardiology fascinating, I like the intellectual challenge, the variety, the research opportunities—loads of things.'

  She tasted the casserole, added more salt and then placed it in the centre of the table.

  'This smells delicious.' Zach leaned forward and gave an appreciative sniff. 'So, have you applied for anything?'

  'Not yet.' She handed him a spoon and watched while he served himself. 'There's a post coming up in London that Dad wants me to apply for. It's with Professor Harding.'

  'The Professor Harding?' Zach lifted an eyebrow. 'I'm impressed. You're certainly heading for the big time.'

  'I didn't say I'd got the post,' Keely reminded him dryly. 'I just said that Dad wants me to apply.'

  Zach was suddenly still. 'And are you going to?'

  'Probably,' Keely said quietly, carefully hiding just how unenthusiastic she felt about the whole thing. 'But he gets loads of applicants, of course, so I probably won't even get an interview.'

  'You're a clever girl, Keely. I'm sure you'll walk into any job you want.' His jaw was tense. 'So you're definitely planning on going back to London at the end of your six months, then?'

  His tone was slightly cool and she frowned slightly, wondering why. Was he checking that she wasn't getting any silly ideas about staying near him? That she wasn't altering her career plans for him? Well, he didn't need to worry on that score. Whatever she decided about her future, she was going to make sure it was well away from Zach. He'd made it crystal clear that he didn't want any sort of relationship with her. Or with any other woman.

  She gave a nod. 'Yes, I'm going back to London.'

  It would be the best thing for all of them. Obviously what he'd shared with his wife had been too special ever to be repeated. But everyone needed friends and she could be a good friend to him. She'd stay around and help him until he sorted out his child-care arrangements and then she'd move out and try to build a life without him.

  The next day they were both working the early shift and it turned into a horrendously busy morning. The weather was freezing, the roads were icy and by nine o'clock they'd had two nasty RTAs—road traffic accidents—admitted to the unit.

  They'd only just cleared up and restocked the resus room when a man was admitted with a penetrating chest injury.

  'He was stabbed on his way to work. Would you believe it? Broad daylight. What a bloodbath,' Nicky muttered as she applied pressure to the wounds and jerked her head towards a nurse. 'Someone call Zach now! Move!'

  'What happened?' Zach came into Resus seconds later, took one look at the patient and started scrubbing.

  'He was stabbed twice in the chest.' Keely's voice faltered slightly as she struggled to get a line in. Thank goodness Zach was here. For once she was willing to admit that she was totally out of her depth. 'He's got distended neck veins, hypotension and muffled heart sounds. I think he might have a cardiac tamponade.'

  A tamponade was bleed
ing into the sac that surrounded the heart and Keely knew it was potentially life-threatening.

  Zach lathered down to his elbows. 'Has he got an output?'

  'Yes—I've fast-bleeped the cardiothoracic team but they're in Theatre. They'll be here as soon as possible.'

  'OK.' Zach turned the taps off with his elbows. 'Let's give him oxygen, Nicky, and get two lines in. And someone get me a thoracotomy tray just in case.'

  'It's on your left,' Nicky said as she glanced at the monitor. 'Damn. He's arrested.'

  'OK, we're going to have to open him up.' Zach spoke calmly, as if it were an everyday occurrence. 'Get that pack open, Nicky, and let's get some blood down here fast. I'm going to open his chest.'

  He worked with such speed and skill that Keely couldn't keep pace with him.

  'Rib retractors!'

  Obediently Keely produced the retractors and helped him position them so that he had better access to the chest cavity.

  'OK, I can see the heart. Hell, what a mess.' He frowned and reached into the chest while Keely watched in silent admiration. How could he begin to see what he was doing? With a sure movement he cut through the bulging pericardium and evacuated the blood. 'I can see a tear.' . He put his finger over the defect and performed internal cardiac massage by pressing the heart between his hands.

  Just then the doors flew open and the cardiothoracic. surgeon strode in. 'For Pete's sake, Zach, couldn't you wait?'

  'Needed the practice.' Zach grinned and glanced towards Nicky. 'Get the expert some gloves, will you? And some 4/0 prolene sutures.'

  Swiftly the team worked together to save the man, and finally Zach glanced up at the monitor. 'All right, I'm stopping massage.'

  There was a tense silence in the room while everyone watched the monitor and then Zach muttered under his breath, 'Come on, come on, give; me an output.'

  As if following his instructions, the ECG machine sprang to life and Keely gasped with delight, as did the rest of the team.

  'Good work, folks.' Zach glanced up. 'Let's get a CVP line in and give him some cefuroxime. Then I want an arterial line inserted and a catheter. Keely, recheck his U and E, glucose, FBC and clotting, please. Anything else, David?'

  'You've just about covered it,' the cardiothoracic surgeon drawled, lifting an eyebrow. 'Are you after my job?'

  'Most definitely not.' Zach stripped off his gloves and gave a wry smile. 'I can't stand the sight of blood.'

  The immediate crisis over, Keely treated herself to a long look at Zach. His short hair was slightly dishevelled, his jaw was already showing signs of stubble and his eyes were beginning to show the strain of the past few hours. But she'd never loved him more in her life. Not just because he was so handsome that he made her knees weak, but because he was the cleverest, most impressive man she'd ever met.

  Her siblings were clever, but somehow they always managed to make her feel inferior. Zach never did that. He made everyone feel that their contribution was important. And no matter what came through the doors, Zach never lost his cool. Even when he was operating under pressure, he still found time to involve and praise the staff who worked with him. He'd thanked them as a team for saving the young man's life, but in reality the skill had been his.

  'Snap out of it.' Nicky's soft voice brought her back to earth sharply and Keely gave a weak smile.

  'Sorry. I was dreaming.'

  'And no prizes for guessing who you were dreaming about.' Nicky adjusted the IV and put the notes on the trolley, ready for transfer to ITU. 'Mind you, I don't blame you. That was some performance. Impressive, isn't he?'

  Keely nodded and glanced across the room to where Zach was standing with the cardiothoracic surgeon. 'How does he do it?' She kept her voice low so that he couldn't hear her. 'How can he stay so calm? All I could see was blood. Why didn't he panic?'

  'Zach? Zach never panics,' Nicky said simply. 'Nothing ever throws him. Certainly not blood. But, then, he was a surgeon, of course. I suppose that helps.'

  And he'd been a very skilled surgeon if her father's reports were correct.

  'Well, that man was jolly lucky he was on duty,' Keely said gruffly, and Nicky gave her a sympathetic smile.

  'Oh, dear, you really have got him badly, haven't you?'

  Keely opened her mouth to deny it but then decided not to bother. 'Very badly. I can't sleep without dreaming of him and I lose concentration at work if I'm not very, very careful. I'm afraid I'm going to do myself serious internal damage hiding it from him.'

  'Never mind that,' Nicky muttered hastily. 'Just make sure you do hide it or you'll find that he also has a reputation for biting impatience with women who drool over him.'

  Keely bit her lip and then gave a start as she realised that he'd walked over to her, his blue eyes quizzical.

  'Is something wrong?' His voice was quiet.

  'Yes. I'm feeling totally incompetent,' she confessed, sliding her fingers through her blonde hair and giving a helpless shrug. 'I was useless back there and I'm really sorry.'

  'Useless?' He looked genuinely puzzled. 'When were you useless?'

  'With that patient. I didn't have a clue what to do, and I couldn't keep up with you—'

  'Keely, the man was stabbed through the heart. I wouldn't have expected you to know what to do.' He frowned and shook his head slightly. 'That sort of emergency happens about once every year or even less in A and E. It's almost impossible to gain experience in that sort of technique.'

  'But you knew what to do, Zach.'

  And from what she'd seen, he always knew what to do.

  'I'm a consultant, Keely,' he reminded her gently. 'I'm supposed to know what to do. In another seven years you'll know what to do as well if you choose to stay in this discipline. Don't lose confidence. You're an excellent doctor.'

  'Oh.' She blushed slightly, warmed by his praise. 'Had you done that before?'

  'Several times.' He gave a wry smile. 'I worked in South Africa for a while and there's no shortage of trauma experience there, I can assure you.'

  He stepped to one side to have a final word with the cardiothoracic surgeon, and Keely dragged her eyes away from him with a huge effort.

  'Keely, you're doing it again,' Nicky muttered in an undertone. 'Get a grip.'

  'Sorry.'

  She couldn't help the way she felt about him. She loved him more every day and she loved Phoebe, too. And the more she loved them, the more she wanted to make everything better for them.

  Arriving at work the next morning, Keely wondered how much longer she was going to be able to carry on working with Zach without giving herself away. Every time he walked into the room her knees wobbled alarmingly and her pulse rate soared.

  At least the department was busy, which helped take her mind off him for some of the time.

  She was seeing a woman with an injured wrist when she heard screaming from Resus.

  Now what?

  Even as she was wondering what was happening one of the student nurses appeared at her elbow.

  'Can you come quickly, Dr Thompson?'

  Immediately Keely excused herself and hurried into Resus.

  'What's the problem?'

  'Help!' A young woman was sobbing and yelling, her white-faced husband clutching her hand as she writhed on the trolley.

  'How are you at delivering babies?' Nicky asked grimly, wrenching open a delivery pack and addressing the student nurse. 'Call the labour ward now, please—get them down here urgently. Zach's on his way.'

  Delivering babies?

  Keely felt a twinge of panic. She hadn't done obstetrics yet and although she'd seen a baby delivered as a medical student, she was hardly an expert.

  'When's the baby due?'

  The woman groaned but her husband glanced up, his face strained. 'Not for another week.'

  'And is this your first baby?'

  He nodded. 'Yes. I thought first labours were supposed to last a long time.'

  'Not always,' Keely murmured, giving them a reassuring smi
le. 'But don't worry. Everything will be fine. OK.' She took a deep breath. 'Can I have some size-six gloves, please, Nicky, and let's listen to the foetal heart.'

  She was washing her hands when Zach arrived, his eyes focusing straight on Keely.

  'What's the story?'

  'Precipitate labour,' Keely said quickly, relief flooding through her. At least the responsibility wasn't all hers now. Would Zach know what to do?

  He did, of course, dragging on a pair of sterile gloves and examining the labouring woman, talking quietly to her all the time.

  His voice seemed to calm her and the woman stopped screaming, instead tightening her grip on her husband's hand and fastening her eyes on Zach with a trusting expression on her face.

  'It's coming, isn't it?'

  'It certainly is.' Zach gave a lopsided grin and then glanced at the notes to check the woman's name. 'Try and remember your breathing, Tina. That's it—good.' He looked at Nicky. 'Let's give her some Entonox, please. Keely? Do you want to...?'

  He was asking her if she wanted to deliver the baby and she shook her head vigorously. She didn't have the confidence to deliver a baby.

  'No—no, you do it.'

  He gave a slight smile and stood on the right of the patient. 'OK, Tina, just keep breathing, that's it...'

  'I've rung the labour ward,' Nicky said in an undertone, 'and someone is coming down to help.'

  'Well, they're not going to be much help unless they're here in the next two minutes,' Zach said calmly, 'because this baby isn't going to wait. All right, Tina, you're doing well. I can see the baby's head. Let's see if we can get you a bit more upright.'

  They helped Tina wriggle into a better position and Zach waited until her next contraction.

  'Keely, come a bit closer so that you can see.'.

  Keely obeyed his instruction, watching with fascination as the baby's head crowned.

  'The foetal heart is dipping,' Nicky said quietly, and Zach nodded.

  'Pant for me, Tina,' he said quietly. 'Don't push. Good girl, well done. Let's get this baby out.'

  Keely watched as he used his left hand to control the rate of escape of the head.

  'Excellent.' Having delivered the head, he allowed it to extend and then used his fingers to feel for the cord, slipping it over the baby's neck. 'There we are. Nicky, have you got the ergometrine ready?' He turned back to Tina. 'We're just going to give you something to make your uterus contract once the baby is delivered. It's perfectly normal.'