by Anne Fraser
‘Flynn, I got a bush saw.’ Walter ran up holding a bright orange-handled saw.
‘Thanks, Walter, excellent work.’ Flynn took the proffered saw.
Mia immediately opened a sterile pack and covered the gauze she’d placed around the spear entry point with a small theatre towel. ‘We don’t need wood shavings in there as well. I hope you’re as good with a bush saw as you are with a scalpel.’ She gripped the spear firmly at the entry point and glanced up at him, giving a quiet, companionable smile.
A completely unexpected smile.
He found himself smiling back. ‘I’ve improved with practice.’ He tapped the back of his hand where a long, jagged scar ran across three knuckles.
‘Ouch.’
‘My seven stitches were a badge of honour but Dad didn’t let me loose in the carving shed after that. Right, holding tight.’ The large bush saw seemed ludicrous against the narrow width of the spear but it was all they had. And he was used to making do. Medicine in remote rural communities was as much about improvisation as it was about modern medicine. He placed the bush saw a couple of centimetres above her hand.
Her hand tightened on the spear. ‘You need to leave more room.’
He tamped down his frustration at her tone. ‘I know what I’m doing, your knuckles will be safe.’
‘I’ll hold you to that.’ She spoke softly and flicked her gaze to his, sea-blue irises sparkling at him like sunshine on water.
His heart rate unexpectedly kicked up for the first time in a very long time, pushing delicious languid heat through him, warming places that had been cold since Brooke’s betrayal.
His hand instantly gripped the saw harder, willing the sensation away. He refused to accept the feeling, hating that it could even happen after two years of self-imposed celibacy. Forcing his attention to the spear and the saw, he spoke slowly. ‘Jimmy, I’m going to cut the spear. I need you to keep as still as possible.’
He carefully pulled the serrated silver blade through the wood and five quick cuts later, the spear was in two pieces.
Mia checked Jimmy’s pulse and stroked his head. ‘You’re doing really well.’
The boy whimpered.
Flynn touched the boy’s shoulder. ‘Jimmy, we’re going to slide you onto a trolley and take you inside.’
‘I’ll steady his hips, you take his shoulders and, Walter, you can take the feet.’ Mia raised herself from kneeling to a low squat, ready to move, and gave Flynn an expectant look. ‘On your count, Flynn, when you’re ready.’
She’d taken over again. ‘Thanks for that.’ He couldn’t stop the sarcasm leaking into his voice.
Mia blinked against a flash of confusion and a slight frown creased her forehead.
You’re being petty. He shut his ears to the voice and crawled around behind Jimmy’s head, putting his arms under the boy’s left shoulder. ‘One, two, three.’
The young boy bit his lip as he was carefully slid down the tray on his side and then lifted onto the trolley.
‘We need you to lie very still on your front.’ Their voices collided, deep resonance tumbling with gentle softness.
Mia shrugged her shoulders, a wry smile hovering around her mouth. ‘What can I say? I’m a firstborn and we always tend to take charge.’
His mouth twitched despite him wanting to keep a straight face, the truth of her comment hitting home. ‘You and me both.’
A trickle of laughter sprinkled her words. ‘Oh, dear, we could be in strife, then. All chiefs and no Indians.’ Her smile expanded, dancing down into the deep creases that formed around her plump mouth.
Irrational disappointment streaked through him when she looked away and spoke to Jimmy.
‘Are you OK?’
‘Just OK.’ Jimmy’s scared voice was barely audible.
‘Walter, go and get Ruby.’ Flynn knew the father wouldn’t want to be in the clinic and the boy needed his mother.
‘I’ll bring her.’ The stressed man hopped into the truck and drove off.
‘Let’s go.’ Flynn flicked the brakes on the trolley upward with his foot, releasing the wheels, and together he and Mia quickly pushed the trolley inside.
‘How about I prime the Hartmann’s and insert the IV while you examine him?’ Mia ripped open an IV set and plunged the metal-tipped top into a bag of electrolyte fluid.
He caught the subtle change in her tone. She’d tried to convert her ‘in-charge’ statement into a question. ‘Good idea.’ He had to agree with her—the division of jobs was in Jimmy’s best interests.
He pulled his stethoscope off the hook and pushed it into his ears. He listened intently to the air entry, even though the puncture wound was probably lower than the lungs. Who knew which direction the spear was lying internally?
‘Jimmy, I need to put a needle into your arm so we can give you something to drink through your veins.’ Mia wrapped the tourniquet around Jimmy’s thin, left arm. ‘I promise it will hurt a lot less than the spear.’
The boy squeezed his eyes shut as if he didn’t want to think about it.
‘Air entry good, respirations slightly elevated.’ Flynn wrapped the blood-pressure cuff around the boy’s arm and listened to the sound of the whoosh and thump of the blood pounding in the arteries. He swung the stethoscope around his neck. ‘BP’s dropping slowly. He’s bleeding somewhere.’
‘Or leaking somewhere?’ Her brows drew together in concentration as she examined Jimmy’s arm. ‘He’s not exactly in shutdown but some of his veins have collapsed.’
‘A slow bleed.’ He mulled over the idea, enjoying having someone to talk to about a diagnosis.
She tapped the sluggish vein on the boy’s arm, her eyes glued to the spot. The tip of her pink tongue ran across her top teeth in an action of pure concentration.
Flynn’s gaze zeroed in on her lush, red lips, the moist tongue holding his gaze like a magnet. An age-old surge of lust—hot, hard and intense—rocked through him so unexpectedly he almost staggered.
Her mouth closed and with practised care she slid the wide-bore cannula into the dark vein just below his elbow. ‘I’m in—line established.’
Her words broke over him and it was like being released from a trance. What was wrong with him today? He didn’t react like this. He knew only too well it led to heartache and loss. He cleared his throat and spoke gruffly. ‘Great. Give him five hundred millilitres stat while we work out what’s going on.’
He bent down so his face was close to his patient’s. ‘Jimmy, I have to roll you onto your side for a moment so we can put some dots on your chest.’
‘Why?’ The young lad gripped the trolley’s mattress.
‘So we can see your heartbeat on the screen.’ Mia pointed to the ECG machine. ‘It’s pretty cool to watch.’
‘Will you help me?’ Jimmy asked Mia.
‘Of course I will.’ Mia smiled down at him.
‘But it hurts to move.’
The plaintive wail tore at Flynn. ‘I know, mate, and as soon as I’ve examined you I can give you something for the pain. You just have to be brave for a bit longer, OK?’
Jimmy’s brown curls bobbed sadly as he nodded his acquiescence.
‘You steady his hips and protect the spear while I fix the dots,’ Flynn instructed.
Mia nodded and quickly placed her hands into position. ‘Ready when you are.’
Flynn tore the backing paper off the dots in preparation. ‘One, two, three.’
Mia eased Jimmy into position with a smooth movement and a worried frown. A frown which carved three horizontal lines across the bridge of her nose, giving her a pixie look that clashed with her competent ‘in-charge’persona. Nothing about this woman matched up or made sense.
Nothing about your reaction to her makes sense either.
With speed borne of experience, it only took Flynn a minute to have Jimmy connected to the ECG. ‘And roll him back.’ He didn’t look at Mia, he wasn’t risking any more crazy lust-fuelled reactions. Instead, he stared
at the ECG and the ever-increasing pulse rate.
‘Well done, Jimmy.’ Mia stroked his head. ‘You’re doing so well.’
‘Where’s my dad?’
‘I’m here.’ Walter rushed through the door, quickly followed by Jimmy’s mother, Ruby.
‘Good timing, Walter.’ Flynn tilted his head toward Jimmy. ‘Ruby, you get up near Jimmy’s head and stay with him. He needs his mum.’
Ruby didn’t speak, she just moved quietly beside her son, her hand gripping his.
Walter immediately backed out of the room to wait outside.
Flynn pulled the stethoscope from his ears, having just taken Jimmy’s blood pressure again. ‘His pressure’s still dropping slowly.’ He turned up the drip rate on the IV.
‘Do you want plasma expander?’ Mia quickly wrote the current IV bolus on the fluid balance chart.
The thought had crossed his mind a moment before she’d spoken. She certainly knew her emergency medicine. ‘I’ll keep it as an option. I’ll do the ultrasound and then reassess.’
‘Pethidine first?’ Mia half turned toward the drug box.
He raised his brows. ‘Mind-reading again?’
She nodded slowly. ‘It’s what I do.’
Her deadpan expression made him want to laugh. He realised she had a knack of being right without being dogmatic. ‘Ruby, any idea how much Jimmy weighs?’
The worried mother silently shook her head.
‘We just done that at school for maths. I was forty-five kilograms.’ Jimmy’s voice sounded muffled against the trolley mattress.
‘Good going, mate. Thanks.’ He gave Jimmy a reassuring pat before turning back to Mia, who was priming the pump. ‘Given we’re not sure what is bleeding or not, it’s best to be cautious. We don’t need him going into respiratory distress as well.’
‘So…zero point two five per kilogram rather than zero point five?’ She flicked back some stray hair from her face and then slowly brought the back of her hand under her chin in a caress of concentration as she worked out the dose.
The action mesmerised him and he was horrified to find he was staring. ‘Yes, I’ll draw it up.’ He seized the proffered needle and syringe and concentrated on opening the ampoule, drawing up the solution, cross-checking the dose with Mia and injecting it into a small bag of saline.
Concentrating on the job rather than speculating on the intriguing nurse working next to him who wasn’t fitting at all into the power-hungry, bossy role he’d assigned her at the start of the emergency. ‘Jimmy, you might start to feel a bit sleepy.’
The pulsometer pinged loudly and Mia rechecked Jimmy’s blood pressure. ‘It’s steadied but still too low.’ She turned on the oxygen and carefully placed the prongs in Jimmy’s nostrils. ‘You just breathe normally, Jimmy, OK?’
The lad silently accepted the elastic being put around his head and gripped his mother’s hand more tightly.
‘How’s that spear hurt him?’ Ruby spoke for the first time.
Flynn pulled the ultrasound machine into place and squirted gel onto Jimmy’s back. ‘That’s what we’re going to find out.’
The black and white swirl of the ultrasound slowly morphed from a snowstorm into clear vision. Flynn’s eyes adjusted to the images on the screen.
‘It always looks like fuzz to me.’ Mia gave a self-deprecating chuckle from the other side of the trolley.
Her candour startled him. He wasn’t used to people publicly admitting what they didn’t know. He tilted the screen so she could see it and pointed to a white shape surrounded by black. ‘Recognise that?’
She peered toward the screen. ‘Is that the spear? I thought it would show up as black.’
‘It’s solid so it reflects a greater amount of sound or echo and it gives out a more intense signal which shows up as white.’ A familiar surge of satisfaction welled inside him—he’d always enjoyed teaching staff when he’d been down south.
‘That makes sense. Thanks for explaining it.’ Smile lines curved around her mouth for a moment before fading.
She’s open to learning.
He ignored the unwanted voice of reason. Holding up his fingers ten centimetres apart, he spoke to Ruby. ‘It’s gone inside Jimmy that much.’
Ruby silently absorbed the information, her eyes glued to the screen.
He slowly explored the peritoneum, heart, diaphragm, the liver, spleen, kidneys and bowel, looking for signs of black and grey, which would indicate fresh bleeding. ‘It’s torn a small hole in the liver.’
‘Would that account for his BP?’
Flynn rubbed his chin, enjoying having such an interested colleague. ‘Perhaps, but it’s not a big hole and a haematoma’s already forming.’
‘I need to pee.’ Jimmy started to wriggle.
Mia quickly grabbed a urinal and a privacy sheet, and helped the boy get into position to void.
‘Test it, Mia.’
‘I thought I might.’ The words hung in the air as she walked out with the filled bottle.
Her soft and reasonable tone at his unnecessary order slugged him. Nurses always tested urine and he had no idea why he’d even said it, especially as they’d seemed to settle into a truce of sorts and were working together quite well.
Because she’s got under your skin.
He turned his attention to the examination of Jimmy’s right kidney. It was the organ closest to the liver and as the liver had been nicked, there might be damage there. The kidney came into focus.
‘Flynn, he’s got gross haematuria, his urine is pink. Can you see signs of bleeding on the ultrasound?’ Mia’s voice carried across the room.
He tilted his head. ‘Come and look at this.’ He pointed to the image of Jimmy’s right kidney, which showed a small tear at the top. ‘It’s sliced through the top of the kidney, torn the liver and come to a halt.’
She leaned in close and he caught the scent of sun and sand, with a hint of the heady perfume of frangipani. He stifled the urge to breathe in more deeply.
‘Will he need surgery to repair the tears?’
He kept his eyes on the screen, checking he hadn’t missed anything. ‘I think that the haematoma will stop the bleeding. To a certain extent it already has because his pressure’s steadied and the kidney and liver should heal just fine on their own.’
‘So we can remove the spear tip safely now without fear of causing a big bleed?’
He turned to face her. ‘We can.’
‘That’s excellent news.’ Happiness for their patient radiated from her and her face glowed. ‘After a few days of close monitoring he’ll be back kicking the footy.’
Flynn deliberately looked away from her smile, trying to stall the rush of blood to his groin. He caught sight of the protocol handbook resting on the desk. Written by bureaucrats in Darwin and issued to every new health-care worker, Mia must have been reading it before Jimmy’s arrival. ‘Technically, the clinic doesn’t allow for overnight stays and any major medical emergency should be evacuated.’
Again Mia frowned, the bridge of her nose wrinkling. ‘Surely he’d be better off here close to his family. I’m happy to nurse him and you’re on the island if his condition unexpectedly deteriorates.’ Her eyes suddenly teased. ‘I’ll toss you for the three a.m. to five shift.’
He smiled broadly. ‘You’re on.’ He couldn’t believe his luck—she knew her medicine and she was prepared to bend the rules. The Kirri people hated leaving the island and Ruby would be out of her depth in Darwin.
‘For two firstborns, we seemed to manage that pretty well, didn’t we?’ She spoke quietly, suddenly serious.
The look in her deep aqua eyes whipped him hard in the gut. A look that was devoid of any grandstanding, the look that was completely inclusive and said loudly, We’re a team.
A team. She was right—they had worked well together. He should be thrilled that after all this time he was finally working with a RAN who wanted to be a team player because that would make his working life so much easier. But a l
eaden feeling settled in his gut and thrilled didn’t come close to describing it. He ran his hand through his hair, his brain scrambling to make sense of his feelings.
She’s just an average nurse like every other one you’ve met, worked with and forgotten.
But there was nothing average about Mia and that was the problem.
CHAPTER THREE
FLYNN walked over to the clinic from his residence, smelling the salt lingering on the early Saturday morning air, and breathed in deeply, savouring the freshness. Not one breath of wind rippled the trees and he knew the sea would be flat and calm—an ideal morning to go fishing.
He had a patient to see and a patient to hopefully discharge and then the day was his, emergencies notwithstanding. He’d ask around and perhaps drive up to the north of the island and see if anyone was heading out to fish. He could do with a day away from the clinic.
A day away from Mia. He needed to clear his mind.
He shoved his hands deep into his pockets. He should have taken the three to five a.m. shift for all the sleep he’d got. Images of Mia had floated through his mind despite him trying to shut them out, despite practising deep breathing and attempting relaxation. Hell, he’d come to these islands to avoid women and life had been easy. He wasn’t going to let one nurse change that.
As he pushed the clinic door open he heard Jimmy calling out.
‘Mia, is there more toast?’
Relief settled over him. He’d made the right decision in not evacuating Jimmy. A boy with a healthy appetite was a great sign.
Mia appeared from the kitchen holding a tray with cereal, milk and fruit. ‘Good morning.’ A warm smile tinged with familiar tension washed across her face. ‘I hope you ate breakfast at home because the way Jimmy is eating, my supplies are dwindling at a rapid rate.’
Her tinkling laugh spun around him, pulling at him with its intoxicating, sweet sound. For a woman who’d been up half the night she had no right to look so fresh and alluring. Her face, free from make-up, shone with a healthy glow, and her hair framed her cheeks, not yet pulled back into its usual neat ponytail.