Doctors at Risk

by Alison Roberts

  ‘Allow me.’ Peter was grinning. ‘It’s tough being a midget, isn’t it?’

  ‘I’m almost five foot one,’ Wendy informed him haughtily. ‘And I’m probably a lot fitter than you are, mate.’

  ‘I certainly wouldn’t try and compete with you on any athletic field.’ Peter handed her the mirror. ‘Any marathons lined up for the near future?’

  ‘No.’ Wendy tried not to sound despondent. ‘Ross and I were working on a training programme just before the accident to get us on track to do the Coast to Coast race next year.’

  Peter’s face advertised his aversion to extreme physical challenges. ‘Whatever spins your wheels, I guess.’ His expression softened. ‘It can’t be easy for you guys at the moment. You’ve lost a lot more in common than most couples would in a situation like this.’

  Wendy simply nodded. She didn’t have the heart to keep up with anything more than a minimum jogging routine right now. Not when the reminder of what Ross had probably lost was so painful.

  ‘I’m not surprised he’s been a bit down for the last day or two,’ Peter added. ‘It’s most likely only just sinking in now. The challenge of recovery is a rather different ball game from choosing to push a healthy body to physical limits.’ His smile was encouraging. ‘At least you’ll understand that more than anyone else would.’

  ‘I don’t think that’s helping,’ Wendy confessed. ‘Maybe I’m too much of a reminder. All the time we’ve had together has been spent doing physical things.’

  Peter was grinning broadly now. ‘I’ll bet!’

  ‘That wasn’t what I meant.’ But Wendy’s smile faded swiftly. How long would it be before she and Ross could make love again? And would it ever be quite as wonderful?

  ‘Things will get better,’ Peter said gently. ‘Hang in there, Midge.’

  Wendy’s fingers closed more tightly over the handle of the mirror. ‘I’m not sure about that. We didn’t part on a very happy note when I went to visit last night.’

  ‘Ah. That’ll be what they’re for.’

  ‘What are you talking about?’

  ‘The flowers.’

  ‘What flowers?’

  ‘I was supposed to tell you. There’s a big bunch of flowers at the nurses’ station for you. Red roses, in fact.’

  ‘Really?’ Wendy sounded less than excited. ‘Again? I hope there’s a card with them this time.’ She had assumed the bunch delivered last week had been from a grateful patient and the card had been lost. The teasing she had received about having a secret admirer had been easily ignored, given her concern for Ross, but it had not been particularly amusing.

  ‘They’ll be from Ross,’ Peter said confidently. He pulled a rubber band free from a handful of 18-gauge cannulae and added the leftover supplies to the fresh box he had opened. ‘To say sorry.’

  ‘Doubt it.’ A crease appeared on Wendy’s forehead. ‘I don’t think sending flowers is his style.’

  ‘How do you know? Has he done anything he’s needed to apologise for before?’

  ‘No.’

  ‘There you go, then. It’s classic.’

  ‘Hmm.’ Wendy summoned a smile as she left the storeroom. It might be classic but it didn’t fit. Ross was too much of an individual to use a hackneyed form of apology like sending flowers. Especially red roses. If he wanted to say sorry, she would have expected something like an invitation to tramp up a particularly difficult hill, had that still been possible. Now she would anticipate some carefully selected words. Just a sincere look from those expressive dark brown eyes would do the trick. However attractive it would be to confirm that Ross had not meant what he’d said, the idea of him sending red roses to do so was somehow disappointing. Wendy put off finding out and returned to her patient instead.

  She positioned the mirror for Martin.

  ‘I can’t see the screws very well.’

  ‘Having curly hair hides most of it. They shaved a little patch here, see? Then they would have put local anaesthetic in before they screwed in the pins.’

  ‘It was the local that hurt. I remember that. And I was a bit worried they might screw them right through into my brain.’

  Wendy laughed. ‘No chance. One of the screws is spring-loaded so that they know as soon as they’ve attached to the outer table of the skull. They don’t go any further than that.’

  Martin was eyeing the band of metal curving over the top of his dark curls. ‘It looks like one of Olivia’s headbands when she hasn’t put it on properly.’

  ‘There’s an attachment at the back that I don’t think you’ll be able to see,’ Wendy told him. ‘That’s what the weights hang from.’

  ‘And the weight is stretching my neck so that the bones get back into alignment, right?’

  ‘We’re hoping so. The next X-ray should let us know whether it’s working.’

  ‘And what happens then?’

  Wendy put the mirror down. ‘That will depend on how well you’re doing. It’s possible you might need an operation to stabilise the fracture.’

  ‘And if I don’t?’

  ‘You’ll stay here in Intensive Care for a few days.’

  ‘Why?’

  ‘We just like to keep a specially good eye on our new arrivals.’

  A list of potential complications from a high spinal injury flashed through Wendy’s mind but she had no intention of frightening her patient by describing any of them. Paralytic ileus, where the small bowel ceased functioning and caused an accumulation of fluid and gas, was a common cause of death if unrecognised within the first forty-eight hours due to aspiration of vomitus. Paralysed patients were unable to cough adequately and death from respiratory arrest could be sudden.

  Wendy glanced at the monitor beeping quietly and steadily beside the bed as the ECG spikes drifted across the screen.

  Cardiac problems were also significant due to disruption to the vagus nerve that influenced heart rate. Something as simple as using suction or turning a patient could stimulate a vagal reaction and provoke a life-threatening slowing of the heart rate.

  Respiratory problems were also high on the list of potential complications. Ross had had a bad spell with his breathing for a day or two when continued swelling of his spinal cord had led to a temporary increase in paralysis of the muscles required for breathing. Martin’s recent blood gas results, showing the level of oxygenation, had been good, however.

  ‘You get a lot more tests and drugs in the first few days as well. Like this infusion.’ Wendy checked the IV cannulation site in Martin’s arm for any sign of irritation and then ran a practised eye back up the line to ensure that the infusion was still running smoothly.

  ‘What is in there exactly?’

  ‘Methyl prednisolone. It’s a steroid that’s supposed to minimise any ongoing damage to the spinal cord. You only get it for twenty-four hours so it will stop by tonight.’

  ‘Do I get this tube out of my nose then?’

  ‘Probably not. You might have that for a day or two. It’s important because it helps to make sure you don’t vomit. That can be a problem when you can’t move.’

  ‘Where do I go when I get out of here?’

  ‘Into one of the wards.’ Wendy put on gloves before changing the bag attached to Martin’s indwelling urinary catheter. She made a note of output. Martin was unusually talkative for a new arrival but it was part of her job to deal with any concerns her patient had about his immediate future.

  ‘Will I be by myself?’

  ‘No. The wards have four beds in each room. Most patients find it’s much better to have some company.’

  ‘They’re all people with spinal injuries here, aren’t they?’

  Wendy nodded. ‘Not all from accidents, though. Some diseases like cancer can cause spinal problems and some come from birth defects like spina bifida or cerebral palsy. And not all the injuries are recent. There are people here at all stages of recovery and lots of return patients who come back to have their kidney function checked or some other pro
blem sorted out. Coronation Hospital is a specialist spinal injury and rehabilitation centre.’ She smiled at Martin. ‘It’s the best in the country.’

  ‘How long have you worked here?’

  ‘Nearly three years,’ Wendy responded. ‘Before that I worked in the intensive care unit of Christchurch Hospital and before that I spent a few years in a specialist spinal hospital in England.’

  ‘You don’t look old enough to have been working for that long.’

  ‘I’m thirty-two.’ Wendy grinned. ‘I just look younger because I’m so short.’

  ‘Is that why you wear your hair all spiked up like that? To make you look taller?’

  Wendy laughed. ‘I hadn’t thought of that. I cut it short because I do a lot of outdoor stuff, like running and rock-climbing. Long hair’s a nuisance.’ She reached up to run her fingers through the blonde tufts. ‘And if I don’t put gel in and scrunch it up then it looks like some sort of weird lid.’

  Martin smiled but his face was pinched and very pale.

  ‘How’s the pain level?’ Wendy reached for the button on the monitor to take a blood-pressure recording.

  ‘The worst bit at the moment is the back of my head. It really hurts.’

  Wendy jotted down the blood-pressure measurement and moved to the head of her patient’s bed. She carefully slipped her fingers under the occipital area. It was a problem spot for pressure sores and she checked carefully for any matted hair that might be making complications more likely before she began rubbing the area gently. ‘Does this help?’

  ‘Yeah. Thanks.’

  Wendy rubbed in silence for a minute. Martin’s eyes were closed and she hoped that he might be able to sleep for a while before any visits from family, doctors or other staff members, like representatives of the radiology or physiotherapy departments.

  ‘I’m thirty-two as well.’ Martin kept his eyes shut. ‘But even if I do end up in a wheelchair, it doesn’t mean my life is over, does it?’

  ‘Of course not.’ There was no chance Martin would escape the fate of being confined to a wheelchair. The best he could hope for would be retaining some function of his arms and hands. Ross had regained almost normal neurology in his upper limbs now. He was even getting some sensation back in his legs. Unfair luck as far as Martin went. Ross had fallen nearly five metres onto a surface jagged with broken concrete. Martin had dived into only one metre of water but his life had changed irrevocably. Wendy hoped he would be able to retain at least part of his positive attitude in the coming weeks.

  ‘Some people do amazing things in wheelchairs,’ Martin continued. ‘They can still drive cars.’

  ‘Sure. I know of someone who got their pilot’s licence.’

  ‘There’s even Olympic Games for people in wheelchairs, isn’t there?’

  ‘Absolutely.’ Wendy kept up her gentle rubbing. Why couldn’t Ross have an attitude like this? Even if he couldn’t do the kind of physical activities he had been used to, it was no reason to decide that any interest in sport was over. He wouldn’t even watch it on television now. Their mutual love of challenging outdoor pursuits had been what they’d had most in common and it had given them both the perfect opportunity to explore the attraction that made Wendy’s memory of that first classroom session of the Urban Search and Rescue course something of a blur.

  The wait for the morning tea-break had seemed agonisingly long and the opportunity had almost been ruined by the general amusement at the very obvious beeline Kyle Dickson had made to corner Wendy. She had been relieved as well as delighted to turn away from the young volunteer firefighter to respond to the quiet doctor’s comment.

  ‘You sounded pretty keen on outdoor pursuits when you introduced yourself. I do a bit of running myself.’

  ‘Do you?’ At close quarters for the first time, Wendy could appreciate the individual features that made Ross Turnball such an attractive package. Standing up showed off his slim, athletic build and Wendy had to look a long way up to catch the thoughtful expression in the brown eyes. Mind you, even Kyle topped Wendy by a few inches and his head only reached the jaw of the man he was now standing beside. ‘Are you into marathons?’

  ‘I’ve done one or two.’

  Wendy liked the quiet modesty of the response. It fitted the impression she had already gained of Ross. He seemed an intelligent and committed GP who was probably happy to work in a rather isolated area due to the fact that he had already sorted out who he was and what he wanted from life.

  ‘The running’s more to keep me fit for the stuff I really enjoy.’

  ‘Which is?’

  ‘Cycling. Surf canoeing. Tramping. It’s why I live on the West Coast. I’ve got the best playground possible literally right at my back door.’

  ‘I do a bit of running myself.’ Kyle failed miserably in his attempt to imitate Ross’s modest tone. ‘I’m planning on doing a marathon soon.’

  ‘Good for you.’ Wendy’s smile was a little strained. Kyle had to be ten years younger than Wendy and his over-confidence had jarred more than one person in this gathering already. What Kyle couldn’t appreciate was that his presence was only serving to increase the attraction of the quiet and far more mature man beside him. When her gaze met Ross’s, the silent communication acknowledged the fact that Kyle was trying to move in on her but didn’t stand a snowball’s chance in hell, and Wendy’s smile curved into genuine pleasure. The connection was mutual and they had already established a platform on which to build.

  Wendy was not slow to grasp an opportunity and nobody had ever suggested that she suffered from shyness. Some men had been intimidated by her direct approach in the past, but Ross seemed delighted to respond to her more personal queries over the next few days. She discovered that he was thirty-seven years old, had never been married and lived in an eco-friendly house, which he’d designed himself, in a pocket of the native bush that bordered long stretches of the West Coast. He was a GP but had trained initially as a surgeon and was also on the staff of the local Coast Hospital some distance from his home just out of Charleston. The more Wendy learned, the deeper her conviction was that she had found the man she had been searching for. It was an easy step to invite him out that first weekend.

  ‘I’m going rock-climbing on Saturday,’ she informed Ross. ‘Well, more bouldering, really.’

  ‘What’s bouldering?’

  ‘Rock-climbing without a rope.’ Wendy grinned.

  ‘Sounds dangerous.’

  ‘We don’t go too high. It’s a matter of picking a difficult route sideways and using tricky moves. It’s a mental exercise as much as physical. You have to gauge your power-to-weight ratio and be fairly agile. You’d probably be very good at it.’

  ‘It’s not something I’ve ever tried.’

  ‘First time for everything.’ Wendy’s cheerful tone disguised the fact that her heart rate had picked up considerably. ‘Why don’t you come with me on Saturday?’

  ‘What about gear?’

  ‘I’ve got a friend who’s about your size. I’ll organise some rock shoes and a helmet and I’ve got harnesses and rope and carabiners if you decide you’d like some more traditional climbing.’

  ‘I’m keen.’ The slow smile indicated a contained but genuine enthusiasm. ‘It’s a date.’

  It was a date Wendy would never forget. One that ended up lasting the entire weekend but still seemed to end far too soon.

  ‘I’m not going to let this beat me.’ Martin’s soft words interrupted Wendy’s escape into introspection. ‘Nobody can say for sure how bad things will end up being. The doctor I saw at home said I had spinal shock, which can make it seem worse than it is. How long does that last?’

  ‘It varies. Average time is three to four weeks.’ Ross was only two weeks into that period now. It was far too early to make any assumptions about his outcome.

  ‘What is it exactly?’

  ‘It’s basically a disruption of transmission between the brain and the spinal cord. It’s also called altered ref
lex activity.’

  ‘So it could be ages before I really know how paralysed I’m going to be, right? I might have a complete recovery.’

  He was a fighter, that was for sure. Wendy would have loved to encourage him but she knew that if there was going to be a miraculous recovery from a period of spinal shock, it was normal to see at least some signs of it within the first twenty-four hours after the injury, as Ross had done. In Martin’s case, his level of neurological sparing was deteriorating. ‘We’re going to do our best to make sure your outcome is as good as it can possibly be,’ she responded carefully.

  ‘You’ll see.’ Martin wasn’t content with such a cautious response. ‘I’m going to win this battle.’

  ‘Good for you.’ Wendy eased her fingers over the fluid-filled cushion under Martin’s head. ‘I need to check some other things now but we’ll be turning you in fifteen minutes so that will help the pressure on your head.’ She made a note on the chart about the discomfort and then ran off an ECG rhythm strip.

  Ross wasn’t looking on his recovery as any kind of battle. Was he just too accepting? Was he going to throw in the towel before he’d even tried to help himself? No. Wendy might not have known Ross for a great length of time but she knew he had far more spirit than that. Nobody who could train himself and then compete in the gruelling Coast to Coast race would ever simply turn away from a challenge. He was fighting in his own way and maybe he was strong enough to do it alone. Maybe he wanted to do it alone.

  He had been something of a loner. He’d told Wendy that he’d never had the desire to share his life intimately with anyone on a long-term basis. Until he’d met her. His home stood as testimony to his ability to meet challenges with his own resources. He had chosen and cleared the area himself and had spent five years keeping a hands-on involvement with building the log house he had designed. He had perseverance as well as the ability to think outside the square. The house was a perfect match to its untamed surroundings and Ross had enhanced its setting by avoiding any contrived garden. The solar heating was innovative, large, double-glazed windows helping to harness the heat of the sun, with the bonus of providing amazing views of the unspoilt landscape. The weekend Wendy had spent on the Coast had been memorable for far more than seeing the house Ross lived in, however.