‘Three milligrams of morphine IV, but his blood pressure’s dropping. Want to try—?’
The voices washed around Nick, only two things really registering. One was the bruised little face scarcely visible under the mask, most of Jem’s head concealed by the padding of the neck brace; the other was Kate, sodden and bedraggled, standing a few feet away watching as they worked on her little son, her eyes wide with fear, her lips moving soundlessly.
Praying?
Probably. There was little else to do. He crossed over to her, and she gripped his hand and gave a tiny sob.
He squeezed back. He wanted to hug her, to say, ‘It’s OK, it’s going to be all right,’ but he wasn’t sure it was, wasn’t sure she’d want him to hold her, wasn’t sure she’d believe him—and anyway his tongue was glued to the roof of his mouth.
He freed it with effort and concentrated on the facts. ‘Have you done a FAST exam?’ he asked, sticking to something safe, and Ben shook his head.
‘No, we’re just about to.’
‘Fast?’ Kate murmured.
‘Ultrasound, basically,’ Ben said. ‘It might show what’s going on.’
Such as free fluid in the abdomen. Blood, most particularly, from torn arteries, sheered bone ends...
Nick felt the bile welling again, and dragged his free hand over his face.
The radiographer was setting up the X-ray machine as Ben quickly ran the head of the ultrasound wand over Jeremiah’s thin, slightly distended abdomen, and Nick watched the screen, wincing at the image. Free fluid. Lots of it. Damn.
They were handed lead aprons. Ben must have realised they wouldn’t leave, and as the X-rays appeared on the computer screen a few moments later, Nick sucked in a breath.
Even across the room, he could see the fractures on the left side of Jeremiah’s pelvis, the bony ends displaced, the damage they’d caused all too easily imaginable.
‘OK, this needs fixation before he goes anywhere,’ Ben was saying. ‘Are the orthos free?’
‘No. They’re just finishing off so they’re ready for him,’ the charge nurse said. ‘Want me to get Josh?’
‘Please—and fast-bleep the anaesthetist, we need to get on with this.’
‘Who’s Josh?’ Kate asked, her face white.
‘New guy,’ Ben said. ‘He’s good—don’t worry, I’ve known him for years. He’s done a lot of this—he’s a bit of a trauma specialist. But we need to get this pelvis rigid before we move Jem and he needs to go straight up to Theatre if we can’t stop the bleeding here. You need to sign a consent form for that. Why don’t you do that and then get a cup of tea—?’
‘His pressure’s dropping.’
Ben frowned and bent over the boy. ‘OK, Jem, stay with us, come on, you’re doing really well. Let’s give him a 250-mil bolus of O-neg and we’ll see if he stabilises. Kate, I don’t suppose you know his blood group, do you?’
She shook her head, her face terrified. ‘No. No idea. I’m O-positive, if that helps.’
‘Cross-match results are up,’ someone said. ‘He’s B-negative.’
B-negative? Through the roaring in his head, Nick heard Ben sigh harshly. ‘Damn. We used all our stock this morning. I don’t know if it’s been replaced yet.’ Ben’s eyes flicked questioningly to Nick’s, and he swallowed.
‘I’m B-negative,’ he confirmed, the last traces of doubt obliterated from his mind with this one small fact. ‘So’s Jack. We’re both regular donors.’
Ben didn’t miss a beat. ‘OK. Nick, contact Jack and ask him if he’s able to donate today, then we’ll get Haematology to sort it. That’ll give us two units, and we’ll salvage his own in Theatre and recycle it and give it back to him, and we can use O-neg if necessary until we get more, but if we get the ex-fix on, the bleeding may well stop anyway.’
Or it might not. ‘You can take two units from me,’ Nick said, and he saw Kate turn towards him, heard the hitch in her breath as she waited for what he was going to say. Not that. Not out loud, but he met his son-in-law’s eyes squarely, and Ben gave a brief, imperceptible nod of understanding.
A door flapped shut behind him, and Nick turned and looked straight into Jack’s eyes.
‘Kate, Dad—hi. What’s going on?’ he asked. ‘I was out in cubicles—they said Jem was in here.’
‘He is,’ Nick said, and Jack looked at the X-rays, winced and glanced down at the child on the trolley.
‘Hell,’ he said softly. ‘Poor little chap. What’s the damage?’ he asked Ben.
‘Pelvis, for sure, and maybe abdominal and head injuries. We were about to contact you,’ Ben told him. ‘We’re short of B-negative. Have you given blood recently?’
‘Um—about three months ago? No—just before Christmas, so nearly four.’ Jack sighed harshly and glanced at the clock. ‘I’ve got a meeting I should be at and I’m already late. Can you call me if you definitely need me?’
‘We definitely need you,’ Nick said, his voice deliberately low so that only Jack could hear. ‘He’s your brother, Jack,’ he added, and watched the disbelief like a shockwave on his firstborn son’s face.
‘Jeremiah? Kate’s son? He’s—?’
‘My son,’ Nick said softly, voicing the words in public for the first time, and beside him he felt Kate squeeze his hand. His words hung in the air between them for a moment, and Jack’s face was suddenly expressionless.
‘Well, we’d better roll our sleeves up, then, hadn’t we?’ he said after a long pause, and Nick let out his breath on a shuddering little sigh.
‘Thanks,’ he said, but Jack turned to him, his blue eyes like chips of ice.
‘Don’t thank me,’ he said, his voice deadly quiet. ‘I’m not doing it for you.’ He turned back to Ben. ‘Give me five minutes. I just want to make a couple of calls.’
‘That’s fine, we’re using O-neg for now. You’ve got a little while. We’ll save cross-matched blood until he’s stable.’
He nodded curtly and walked out, slapping the door out of the way with his hand, and Nick closed his eyes and swallowed. He’d known it would come out at some time, he’d known it would be hard, but like this, with Jeremiah’s life hanging in the balance—
‘OK, what have we got?’ a new voice asked, and a man strode in, a man they’d never seen before, with a soft, lilting Irish brogue and that dangerous blend of rakish charm and lethal good looks that would leave trouble in his wake.
Nick knew all about that. He’d been like that in his youth; it had gone to his head, and look where it had got him. He almost felt sorry for Josh O’Hara, the new A and E consultant, but maybe this man wouldn’t make the same mistakes he had. He’d have to try hard to do worse.
He was bending over Jeremiah now, smiling at him. ‘Hello, Jem, I’m Josh. I’m just going to have a quick look at your X-rays, and then we’re going to send you to sleep and fix you, OK? That’ll take away a lot of the pain for when you wake up.’
Jem made a feeble sound of assent, and beside him Nick heard Kate give a little sob.
Nick tightened his grip on her fingers. ‘It’s all right,’ he said, reassuring himself as much as her. ‘He’ll be all right,’ he repeated, and hoped to God it wasn’t a lie.
Josh looked up and met their eyes. ‘Are you the parents?’
They nodded, the irony of it striking Nick like a hammer blow. Of all the ways—
‘OK. You need to sign a consent form, and then I think someone needs to take you to the relatives’ room and give you a cup of tea.’
‘I don’t want a cup of tea, I want to be here with my son!’ Kate said adamantly. ‘I’m a midwife, you don’t need to mollycoddle me.’
‘We don’t need to scrape you off the floor, either, and it’s a sterile procedure. You can stay till he’s out, then you go.’
Nick put an arm round her rigid shoulders, squeezing them gently. ‘He’s right,’ he said, fighting his instinct to argue, to stay. ‘You shouldn’t be here. Not for that. And someone needs to take a look at you.’
‘I’m fine.’
‘We don’t know that. Nick’s right, you need your neck checked, Kate,’ Ben said gently, lifting his head to meet her eyes. ‘And your feet. I gather they were trapped. Let us sort Jem out, and then while he’s in Theatre I’ll come and have a look at you, hmm? And in the meantime, go and have something hot to drink, and some biscuits or something. You’re in shock.’
She’d signed the form by the time the anaesthetist arrived a minute later, and Kate clung to her son’s hand, pressing it to her heart and murmuring softly to him as he drifted off, then Nick ushered her away, leading her out of the room and down the corridor to the relatives’ room, his reluctant feet tracing the familiar path.
‘You can wait in here—I’ll bring you both some tea,’ a nurse said with a kind smile. ‘How do you take it?’
‘Hot and sweet, isn’t it?’ Kate said shakily, trying to smile back, but Nick couldn’t say anything, because the last time he’d been in this room had been in the horrendous minutes after Annabel had died, almost exactly five years ago.
It came flooding back the shock, the horror, the guilt. He should have realised she was ill, should have done something, but he’d been so tied up in the practice he’d scarcely noticed she was alive. And then, suddenly, she wasn’t. She’d had a ruptured appendix, and Ben hadn’t been able to save her.
And yet again the guilt and the senseless futility of it threatened to swamp him.
CHAPTER TWO
KATE cradled the tea in her hands and tried to force herself to drink it.
‘I hate sugar in tea,’ she said, and looked up at Nick, trying to smile, trying to be brave, but his face was shut down, expressionless, devoid of colour and emotion, and she felt the fear escalate.
‘Nick? He’ll be OK.’ He had to be, she thought desperately, his stark expression clawing at her control and threatening to destroy it, but Ben had seemed confident, Josh also, and there was no talk of ifs or buts or maybes, so he would be OK. Wouldn’t he?
‘Nick?’
He sucked in a breath, almost as if he’d forgotten to breathe for a while, and turned his head to meet her eyes. ‘Sorry, I was miles away.’
Miles away? When his son was under anaesthetic, having his pelvis stabilised with an external frame so they could try and stop the bleeding that was draining the life out of him? Where on earth had he been, miles away? And with that look in his eyes...
He scanned the room, his face bleak. ‘I haven’t been in here for years. It hasn’t changed. Still got the same awful curtains.’
And then she realised. Realised what he was seeing, what this must cost him, to be here with her, and her heart went out to him.
‘Oh, Nick, I’m sorry,’ she murmured, and he tried to smile.
‘Don’t be, I’m all right. It was five years ago.’ And then he frowned. ‘More to the point, how are you? Were you hurt? What was Ben saying about your feet? I didn’t realise you’d been trapped in the car.’
‘It was nothing—just a pedal. I’m fine.’ Her smile was no more successful than his, she supposed, because he came over and sat beside her, searching her eyes with his.
‘So what happened?’ he asked.
She shrugged. ‘I was picking him up from outside the high school. It was my fault—I parked on the right, hitched up on the kerb and rang him, and he ran up and got in, and I pulled back out onto the road. I couldn’t see a thing—the rain was sheeting down, but there were no lights coming, and I remember thinking only a fool would be out in this without lights, so it must be clear, and I pulled out, and there was an almighty thump and the car slammed sideways into the car I was pulling out around, and the airbags went off and—’
She broke off.
It had been over in an instant.
There had been nothing she could have done at that point, no way she could have changed it, but for the rest of her life, with the stunning clarity of slow motion, she knew she would hear the sliding, grinding crash, the scream of her child, and the thump as the airbag inflated in her face...
‘Ah, Kate,’ he murmured, and she looked up, into dark, fathomless brown eyes that normally hid his feelings all too well. But not now. Now, they were filled with sympathy and something else she couldn’t quite read. ‘I’m sorry. It must have been horrendous.’
She nodded, looking away because if she didn’t she’d lose her grip on her emotions, and she couldn’t afford to do that, couldn’t afford to succumb to the sympathy in his eyes.
‘I can’t believe I didn’t see him coming.’
‘You said there were no lights.’
‘I didn’t see any, and I was looking, but—’
‘Then it’s not your fault.’
She gave a soft snort. ‘Tell it to the fairies, Nick. I pulled out in front of a big, heavy off-roader when I couldn’t see, and Jem could have been killed. How is that not my fault?’
His mouth firmed into a grim line.
‘He must have been speeding, Kate.’
‘Very likely. It doesn’t absolve me of blame.’
‘Don’t,’ he warned, his voice strained. ‘Believe me, don’t take on the blame for this. It’ll destroy you.’
As his guilt over Annabel’s death had nearly destroyed him? She bit her lip, trapped the words, looked at the clock. It had hardly moved, and yet they seemed to have been in there for ever.
‘He’ll be all right, Kate. He’s in good hands.’
‘I know.’
She gave him another little smile, and reached up to touch his cheek fleetingly in comfort. The day’s growth of stubble was rough against her fingers, ruggedly male and oddly reassuring, and somehow his strength centred her. She had to stop herself from stroking her thumb over his cheek, backwards and forwards in a tender caress, the way she would with Jem. With anyone she loved. She dropped her hand hastily back into her lap. ‘Are you OK?’
His smile was crooked. ‘I’m the last person you should be worried about,’ he said gruffly, but it wasn’t true. She always worried about him—always had, always would, and running away wouldn’t change that, she realised. And even though it was tearing him apart, he was here for her now, when she needed him the most, just as he had been on the night her husband James had died. And he needed her now, too, every bit as much as he had then. So, yes, she was worried about him. She could never rely on him, not in the long term, but she worried about him.
‘Don’t be silly,’ she said with a little catch in her voice. ‘I’m really grateful to you for coming. I know it’s really hard for you, being here. All those memories. It was such a dreadful time for you, and I’m sorry to have to put you through it again.’
‘It just caught me by surprise, coming in here again, that’s all. All a bit too familiar.’ His smile was crooked and didn’t quite reach his eyes, and he rested his hand over hers. ‘He’ll be all right, Kate,’ he murmured, his eyes reassuring, his touch steadying her tumbling emotions.
The unexpected tenderness brought a lump to her throat, and gently she eased her hand away before she crumbled. ‘I’m sorry about Jack.’
He shrugged slightly. ‘I knew he’d hate me for it, but it’s not a problem. He’s hated me before, I can live with it.’
It was a lie, even if he was trying to make himself believe it, and she felt herself frown. ‘He’s a good man, Nick. He’ll come round. And he’ll be good to Jem. They all will.’
He nodded, sighed, and stood up, thrusting his hands into his pockets as he crossed to the window and stood staring out into the rain. ‘Oh, they will. They’ll close ranks round him and take him into their hearts, all three of them. They’re like that. They take after Annabel.’ He glanced down at the table, at the mugs sitting there, the tea growing cold.
‘You haven’t touched your tea,’ he said, and she let him change the subject and picked up the mug, giving him room, not crowding him. He hated emotion, and he was awash with it today, trying hard to hang together through all the horror of it. It was all right for her,
she thought, her eyes welling. She could cry her eyes out and everyone would sympathise, but Nick—Nick had to stay aloof and distant, hold himself back, because for him, today was judgement day.
And, boy, would they be judging, and talking, and there would be plenty to say. Nick had been well and truly married twelve years ago, at the time of Jem’s conception, and the good people of Penhally held no truck with infidelity. When they found out...
Not that it mattered now. The only thing that mattered now was that her son—their son, she corrected herself—survived this, and lived long enough for Nick to build a relationship with him. She wondered what they were doing to him at this precise instant, and decided she’d rather not know. Midwife or not, there were things one didn’t need to see.
She pressed her hand against her heart, and realised it hurt. It was tender where the seat belt had tugged tight in the accident, pulling on her lumpectomy scar and the still fragile skin where the radiotherapy had burned it, and she suddenly felt very uncertain. Dr Bower had given her the all-clear from her breast cancer in January, but it was very much an ‘it’s OK for now’ result, and there were no guarantees for the future.
And if anything happened to her, Jem would need Nick. Assuming he survived—
‘Nick, drink your tea,’ she said, slamming the brakes on that thought, and he sat down beside her again and picked up the mug and took a mouthful, toying with the biscuits, crushing them to dust between his fingers, crumbling them all over the table.
‘Josh O’Hara’s a friend of Jack’s from London,’ he said out of the blue. ‘I gather he’s red hot. Ben used to work with him as well. That’s why he sounded him out about the vacancy. And Ben won’t let anything happen to Jeremiah—’
The door opened and Ben came in, and she dropped her mug onto the table with a clatter, fear suddenly closing her throat.
‘How is he?’ she asked, barely able to find the words. ‘Is he—?’
‘He’s stable, his blood pressure’s low but holding, so Josh and the anaesthetist have taken him to CT now to rule out any other injuries, then he’ll be going straight up to Theatre. And we need to check you over. Come on.’
St. Piran's: The Wedding of The Year Page 2