The Bush Doctor's Challenge

by Carol Marinelli

  ‘Which he has been. Look, Abby, the angina attacks are getting more and more frequent, invariably he spends a couple of days here and Clara and I get a heap of overtime, but nothing Ross or anyone can say will get him on that plane and into surgery. He knows the risks, knows that he might die bumping along in a four-wheel-drive on the way to the clinic, but that’s the way he wants it. Tennengarrah’s his home, he doesn’t want to leave it. I know you don’t understand, Abby, and I can see why, but this place…’ A wistful look came over his face and his voice lowered a touch. ‘It’s in your blood, Abby. For someone like Bill to leave, it would be a tough call.’ A hooting car made them both look up. ‘Your first patient.’

  ‘Second,’ Abby corrected, following him out. ‘Don’t forget yesterday.’

  She could have bitten her tongue off as Kell paused and turned slowly to face her. ‘And here I was thinking that was exactly what you wanted me to do.’

  One look at Bill Nash was enough to tell Abby that he was in trouble. She could hear the rattle of his chest as she crossed the room! His skin was tinged grey and though sweat was pouring off him, to the touch he was cold and clammy.

  ‘Bill, I’m Abby, Abby Hampton—’

  ‘The new doc,’ Kell broke in, slipping an oxygen mask over Bill’s face as he attached him to a monitor then tied a tourniquet around his thin wrist to bring up the veins in his hand. ‘So you just try and relax, Bill, and let Abby take care of you.’

  Bill gave a weak nod, leaning forward on the trolley in a desperate attempt to draw breath into his lungs while Kell established IV access and his daughter filled Abby in on the drugs her father had taken.

  ‘Normally the spray works straight away,’ the anxious young woman said, wringing her hands as she eyed her father. ‘Or at least after ten minutes or so. He wasn’t this bad when I rang—he got worse in the Jeep.’

  ‘Well, he’s here now,’ Abby said kindly, deliberately not voicing her misgivings as to the wisdom of driving Bill here. Hopefully there’d be time for that later! As she listened carefully to Bill’s chest Abby caught Kell’s eye. ‘Ten milligrams of morphine, please, and I’d like twenty of Lasix as well.’ Even before she had pulled the stethoscope out of her ears an ECG tracing was being pressed into her hands by Clara, and Abby didn’t have to look too carefully to see that the recording confirmed her findings. Bill wasn’t suffering from angina, he was having a heart attack.

  ‘Bill.’ Abby came close to his ear and spoke in calm tones. ‘Don’t try and answer, I know you’re very short of breath, just nod if you understand.’

  Bill gave a small nod before Abby continued pushing the drugs through the IV bung Kell had inserted the second Bill had hit the clinic. ‘There’s a lot of fluid on your chest, which is making it difficult for you to breathe. I’m giving you some Lasix now, it’s a strong diuretic and will soon get rid of that fluid and have you more comfortable. I’ve also given you some morphine, the pain will settle in just a moment or two.’

  ‘I’m having—’ Bill started, his words faint, but their meaning clear.

  ‘Don’t try and talk, Dad,’ his daughter interrupted. ‘Just try and do what the doctor says.’

  But her words just upset Bill who tore at the mask, trying to make himself heard.

  ‘Am I having—?’

  ‘Yes, Bill.’ Abby held his frightened eyes. ‘You are having a heart attack, but we’re dealing with it. You just need to lie back and let us do the worrying.’

  Amazingly Bill accepted her words and with some relief Abby watched as he nodded then finally relaxed back onto the pillow as the drugs started to take effect.

  ‘Do you want me to put a catheter in?’ Kell asked. Given the amount of diuretics Abby had given Bill, a catheter was necessary and Abby gave a grateful nod just as Ross Bodey arrived somewhat breathlessly at the clinic.

  ‘Sorry, Abby,’ he murmured, leaning over her shoulder Ross looked at the ECG. ‘I’m already wondering how on earth we managed without you. How about you, Kell?’ he asked as Kell came over.

  ‘It’s starting to look that way.’ Kell smiled, but the smile on his face didn’t quite meet his eyes. ‘But first things first. How’re Shelly and the baby?’

  ‘Great.’ Ross’s face literally lit up just at the mention of them. ‘Although I thought babies normally slept a lot for the first twenty-four hours. Kate’s been singing like a lark all night.’

  ‘Kate.’ Abby smiled as the word popped out of her mouth. ‘Kate Bodey, that’s just gorgeous.’

  ‘Thanks,’ Ross said with the grinning enthusiasm of a new father. ‘She was supposed to be Catherine, but one hour into it we’d reduced it to Kate, so I think that’s what’s going to go on the birth certificate! Kell,’ Ross added, his voice a touch more serious, ‘would you mind popping over before you head off for the clinic? Shelly’s having a bit of trouble feeding, and she’s never…’ he gave a small embarrassed cough as Kell listened, totally unfazed ‘…breastfed. I’ve tried to make a few suggestions, but I think it might come better from a midwife. Apparently, Matty wasn’t well enough to feed when he was born so he got everything through a tube, but Shelly’s determined…’

  ‘No worries,’ Kell broke him off in mid-sentence. Did nothing ruffle this guy? Abby mused. ‘I’ll go and see her soon, but for now could one of you have a word with Martha? Bill’s daughter,’ Kell explained to Abby. ‘She’s really worked up and it’s not helping Bill.’

  Ross nodded but Abby moved first. ‘I’ll do it.’

  ‘Are you sure?’ Ross frowned. ‘It’s a bit delicate. Bill doesn’t want surgery—’

  ‘Kell already explained,’ Abby responded. ‘I’m more than happy to talk to her.’

  More than happy, Abby thought as Kell led them both to a small coffee-room. If Bill didn’t want surgery that was his prerogative, but Abby wanted to be sure of her facts next time Bill arrived on death’s doorstep at the clinic.

  ‘Is this it?’ Abby hadn’t even closed the door behind him before Martha dissolved into a flood of tears. ‘Is this the end for Dad?’

  Pulling up a chair, Abby waited for the initial surge of tears to subside, and even though Abby had never even been in this room before, never set foot in the clinic or met Martha until now, she didn’t feel uncomfortable.

  Grief, fear, the uncertainty of dealing with the human body, was a scene Abby was all too familiar with.

  ‘Your father’s had a heart attack, Martha,’ Abby said gently. ‘And from his history this isn’t the first. Am I right?

  With a teary sniff Martha nodded. ‘He had two before he had his bypass. Dr Bodey warned us that without another operation this was going to happen.’

  ‘Why won’t your father have the surgery?’

  ‘He’s convinced he won’t survive,’ Martha said resignedly. ‘We’ve all tried to persuade him, but he’s a stubborn old bull, says if he’s going to die he wants it to be here, the same as Mum.’

  ‘When did your mother die?’ Abby probed gently.

  ‘Two years ago.’

  ‘And Bill, your father, he’s been depressed since then?’

  Martha gave a small nod then shook her head. ‘We’ve already been there, with Ross. Dad refuses to accept he’s depressed, he won’t hear of taking any medication, or talking to anyone. He seems resigned to it, as if he hasn’t really got anything to live for.’ Martha started crying in earnest now. ‘I don’t want to lose my father, Doctor, he’s only forty-eight. Is it too late if he changes his mind? I mean, would he still have a chance?’

  Abby gave a tentative nod of her head, but her voice was guarded. ‘He’s obviously not well, but I certainly haven’t written him off. We could stabilise him and the flying doctors could transfer him to a major hospital, but it has to be his decision, Martha, we can’t strap him to the plane.’

  Martha gave a weak smile. ‘Believe me, I’ve thought about it. So what now?’

  ‘Well, we’ll treat the acute heart attack, and the next forty-eight hours will
be critical, but if he survives this event, we’ll review his meds again, see if we can help make him a bit more comfortable. The medication we’ll give him now will hopefully minimise the damage to his heart from the attack, but what’s happened this morning certainly isn’t going to help his long-term prognosis.’

  ‘Old fool,’ Martha said, but not unkindly. ‘Why can’t he see how much we all need him, how much we all love him?’ Standing, she gave Abby a tired smile. ‘Thank you, for being direct I mean. Maybe you can try doing a bit more straight talking with Dad.’

  ‘I intend to,’ Abby agreed. ‘But when he’s a bit better.’ Her sympathetic smile faded as Martha closed her eyes, paling as she fumbled for the chair behind her. Reaching out her hands, Abby guided her to the chair behind. ‘Hey, are you OK?’ Abby asked as Martha took a few deep breaths.

  ‘I’m fine. Too much drama on top of an empty stomach.’

  But Abby wasn’t convinced. ‘Let me take a look at you.’

  ‘No.’ Martha’s voice was firm. ‘I’m honestly fine. Can you tell Dad I’ll be along in a minute?’

  ‘Sure,’ Abby agreed reluctantly, but an internal voice told her that Bill’s stubborn streak was clearly hereditary. ‘But if you change your mind, you know where you can find me.’

  ‘How is she?’ Kell looked up from the notes he was writing as Abby made her way over.

  ‘Upset, understandably. He really ought to be transferred.’

  ‘I know,’ Kell sighed. ‘Ross is having another word with him, but it would seem Bill’s mind is made up.’

  Abby looked over at the thin man, attached to monitors, his face covered by an oxygen mask, shaking his head against the pillow as Ross presumably implored him to think again. Even though Abby knew he was getting the right treatment, she also knew that it was only a short-term solution. Bill needed surgery. As Ross made his way over the news only got worse. ‘He wants active treatment for the heart attack, but he’s made it very clear that if his heart stops or he stops breathing he doesn’t want to be resuscitated,’ Ross said grimly.

  ‘Well, I’m not sure Bill’s in the right state of mind to be making such decisions,’ Abby responded quickly. ‘He’s scared and in pain and he’s also had a hefty dose of morphine. In good faith I can’t just stand by and watch if he does arrest.’

  Abby watched a quick look pass between the two men and though she’d probably overstepped some imaginary mark for such a new staff member, Abby truly didn’t care!

  She wasn’t here to make friends and influence people, she was here to practise medicine; and medicine, as always in Abby’s usually ordered life, came first last and always.

  ‘From the conversation I had with Martha it appears that Bill’s depressed.’

  ‘He is,’ Ross agreed, but before he could add to his argument Abby stepped in.

  ‘When Bill’s medically stable we’ll go over his options again. Until then I think it would be unwise to withhold treatment.’ To the uninitiated, Abby’s statement didn’t sound particularly profound, but from the sudden dive in the atmosphere Abby knew her words had hit the mark.

  The new girl she may be, but she was also a well-qualified doctor and for Ross to ignore her opinion could have huge legal ramifications!

  ‘I’m sorry, Ross,’ she added. ‘I understand you know Bill well, but in all good faith I can’t suspend my beliefs just because I’m not in my usual surroundings. Maybe a rather more objective opinion is called for. I’ll let you know my findings when I’ve spoken at length to Bill, but until then if anything happens he’s to be fully resuscitated!’ And turning on her heel, Abby walked off, not really knowing where she was going but hoping it was in the vague direction of the staffroom.

  ‘I don’t want to discuss it,’ Abby started as Kell followed her in.

  ‘Neither do I,’ Kell said grimly. ‘It’s mobile clinic day today. Ross thought it might be a good idea if you came along, met a few of the locals.’

  ‘What about Bill?’

  ‘There’s an emergency bell that goes directly over to Ross’s house and Clara will stay with him.’

  Abby gave a hesitant nod. A day with Kell wasn’t exactly at the top of her agenda, but maybe it was best to get it over with if they were ever going to establish a normal working relationship.

  ‘I’m just going to check on Shelly,’ he said vaguely, with no suggestion that she join him, ‘and then we’ll head off.’

  Of course, there was no such thing as just ‘heading off’ in the outback. An inordinate amount of time was spent checking the cold-boxes, loading them with medicines and vaccinations, before finally Kell did a quick check on the Jeep itself, ensuring the two-way radio was working and there was plenty of water on board.

  ‘How’s Shelly and Kate?’ Abby asked, attempting to flick a fly and look calm at the same time, determined not to show Kell she was even remotely bothered at the prospect of spending a morning with him.

  ‘They’re going really well. Shelly just wasn’t positioning her right and only putting her nipple in, so Kate was having trouble latching on.’

  ‘Oh.’

  Well, what else could she say? Here was a guy with all the muscles and brawn of a labourer talking about ‘nipples’ and ‘latching on’ and not even breaking a blush. Heavens, even the father, a doctor to boot, had had trouble with the subject. Kell Bevan really was a one-off!

  ‘Do you want to get the sandwiches?’ Kell suggested as Abby wilted in the already sweltering heat. ‘We won’t exactly be inundated with burger bars on the way,’ he added, noting Abby’s rather reluctant stance. ‘And a Thermos of coffee wouldn’t go amiss,’ Kell shouted as Abby stomped back into the clinic.

  So she was the tea girl now?

  Opening the fridge, Abby’s heart sank lower, if that was possible.

  Where was the prosciutto, pastrami, sun-dried tomatoes and olives?

  Where were the bagels and crusty rolls when you fancied one?

  Pulling a loaf out of the bread bin, Abby made do with the provisions to hand.

  Peanut butter or Vegemite wasn’t exactly going to provide a gourmet picnic but, then, what had she expected?

  She was an outback doctor for now.

  ‘What are you doing?’

  Kell’s presence made the tiny kitchen even smaller and it wasn’t just because of his imposing height either—the very fresh scent of him, the million or so male hormones flying around the air, coupled with the cringe factor of a night of exhausting passion in his very strong brown arms, made buttering a round of Vegemite sandwiches seem suddenly extremely complicated.

  ‘I’m making lunch,’ Abby said through slightly gritted teeth. ‘Just as you asked.’

  ‘I asked you to get the lunch,’ Kell said patiently, as if he were talking to a petulant two-year-old, ‘not make it. Heavens, where would we be if we treated our doctors like that?’

  His sarcasm wasn’t wasted, and a blushing Abby followed him out of the clinic kitchen into the staffroom where Kell pulled the lid off an esky.

  ‘Fresh damper, cream cheese, roast beef and home-made chutney. There’s a bit of room still—I mean, if you’re really partial to Vegemite sandwiches.’

  ‘The roast beef will be fine,’ Abby said grudgingly, as Kell took two seconds flat to make a Thermos of coffee.

  ‘Be a shame to waste them, though.’ Kell winked, grabbing Abby’s rather paltry attempt as they went past and somehow managing to look sexy as he ate and walked towards the car.

  She sat in the furnace of the Jeep as Kell loaded the esky into the back with her mouth watering. Only then did she realise that, apart from the cheese and crackers she had shared with Kell last night and the meal on the plane, she’d barely eaten a thing in two days.

  ‘Do you want one?’ Kell offered, climbing in beside her and turning on the engine.

  After a second’s hesitation Abby took the wretched Vegemite sandwich, and as the air-conditioning kicked in and the salt of the Vegemite worked its magic, the butterflies th
at had been present since she had woken in Kell’s arms settled a notch.

  ‘Better?’ Kell asked after ten minutes or so of driving.

  ‘Much. How far is it?’

  ‘A couple of hours.’ He smiled at Abby’s rather pained expression. ‘Abby…’

  The teasing note had gone from his voice and Abby knew what was coming next.

  ‘If you’re going to say, “About last night,”’ Abby said, staring out of the window and wishing this conversation could be over, ‘then don’t.’

  ‘I think a few words might be called for.’

  Abby didn’t want a few words, didn’t want a postmortem as to what could possibly have possessed her to sleep with him. Actually, she didn’t need one. As Kell hauled the Jeep over to the side of the red dusty road, the engine still idling to allow the air-conditioning to work, she met those dark eyes for the first time since last night and there and then she answered her own question.

  He was divine.

  Seriously so.

  ‘I like you, Abby.’

  It seemed such a strange thing to say. Not ‘I fancy you, Abby’ or ‘let’s pretend last night never happened’ or even ‘No one will see us out here if you’re up for a repeat’, and the simpleness of his statement startled her.

  ‘You don’t even know me,’ was all Abby managed as she picked at one perfectly manicured little fingernail.

  ‘You don’t have to know someone to like them,’ Kell said seriously. ‘You don’t have to know their family history and how many sugars they have in their coffee to know how you feel.’ When she didn’t answer, didn’t even manage a half-smile, he carried on. ‘I just like you. I like the way that even though you’d never been on a bike before, you got on, I like the way you weren’t too intimidated to ask for your computer, that you chatted away to Shelly about getting her whites whiter when I’m sure there was a million and one things you’d rather have been doing…’

  That was rewarded with a very grudging smile and Abby was rewarded tenfold with a slightly wider one back.

  ‘I even like the way you stood up to Ross and me this morning. How you put the patient first. It can’t have been easy, and I admire you for it.