Angel Kate

by Ramsay, Anna

  Angel Kate, Mike had nicknamed the new staff nurse. She was very competent in spite of that self-confessed secret terror. If he hadn't heard it from her own lips, he wouldn't have believed it. 'So-o-o?' he teased, leaning on the nurses' station and grinning all over that boyish freckled face which had inspired so many unwise confidences in the past. 'Why should Brownley be rewarded with smiles, while I get the cold shoulder? Stop fighting it, Angel Kate. You know you feel an overwhelming desire for my fit young body.'

  Kate's look of annoyance shut Mike up for all of ten seconds, but he knew he'd sussed her out. Oh yes! Someone that cool just had to be a volcano underneath. What was she doing with a boring git like Mallory?

  Mike never gave up easily. He could generally wear them down. He followed her into the sluice and Kate found herself trapped in a corner by the sink clutching an armful of grey papier mâché vomit bowls. She sighed and looked pointedly at the fob watch pinned upside down on her tunic, waiting patiently for Mike to get bored and abandon this ridiculous carry-on.

  She'd got such perfect skin. He leaned closer. 'What you need is someone to show you how to do yourself up a bit. Put stuff on your eyes, bit of lippy, make the best of yourself. With your figure you could be one of those top models. You'd earn a damn sight more than you will slaving away here at Crisp's.'

  Kate went tense. 'Don't be silly,' she said tightly. 'Please let me get on.'

  Wouldn't get any encouragement from James Mallory though, would she. A pathologist, for chrissake! One of that breed who hide themselves away in laboratories because they can't cope with real live people … Well, that was Mike's theory. He dashed a hand through his mop of red curls. How the hell did these two get involved in the first place?

  'Mike!' complained a voice from the doorway, 'I've been looking for you everywhere! You promised you'd supervise me doing bloods.' It was the plump blonde medical student from Leeds, mask dangling beneath her chin, doing volunteer work in order to get some extra clinical experience during the Easter vacation under the guidance of the elusive Dr Filing.

  'Nope, hadn't forgotten you, Em. Staff here was in need of my advice and expertise, but we're finished here now.'

  Kate raised an eyebrow and got a broad grin in return.

  'I told you I'd been invited to a party over in the block,' complained Em. 'Now it's too late for me to go home and change.'

  'They'll turn the lights off,' said Mike knowingly, 'who's to notice? Might pop across later myself to check you're ok.'

  Kate made good her escape.

  * * *

  Emergency! The red phone had a direct line linking St Crispin's with the ambulance station. Its urgent message shrilled through the department. Kate—nearest member of the team—had her hand on the phone within seconds.

  She would never forget the horror of that September day when she had crouched helplessly over her father's body. If only she'd know what to do, how to help him. It was knowing he need not have died that had been the wake-up call to make her change her silly selfish life. To grow up and make herself useful in the world.

  This night, hand and voice were steady and confident as she took the emergency call.

  'St Crispin's. Accident and Emergency.'

  The staff nurse's ear received the terse message with alert detachment: three minutes warning of a bad RTA being brought in from the motorway.

  Simon Brownley, the Resident Surgical Officer, was back from supper but busy in theatre patching up a teenage motor-cyclist with a number of nasty, though not disabling, injuries.

  'Sue! Get Mike Filing!'

  Kate called urgently to a third-year nurse who had heard the emergency phone and was holding aside the curtains of the cubicle in which she'd been dressing a knife wound.

  'RTA, one man—multiple injuries, arriving in two minutes!'

  As the ambulance raced up to the emergency doors Kate was ready and waiting, glancing back anxiously over her shoulder for reinforcements. The ambulance crew would have done all they could as trained paramedics, but right now that patient needed the doctors! Where the hell had Mike got to? Surely everyone must have been alerted by the shrill call of the emergency phone.

  'Any other casualties, Ted?' she questioned breathlessly as the driver of the ambulance ran round to open up the rear doors for her to board.

  Ted Piggott shook his head, his face unusually grim. 'Poor devil must've fallen asleep at the wheel, hit one of the motorway bridges. They work too damn 'ard, our doctors. Brace yourself, Staff, we've got Mr Galvan in here!'

  The world spun.

  Then a sort of frozen professionalism urged Kate to her patient's side. Only the thick black curls were just about recognisable beneath a film of pale dust that must have showered Tom Galvan when he smashed into the concrete obstruction. He didn't seem to be wearing his thick overcoat. His swollen face was a mess of bloody lacerations. The features could have belonged to anyone.

  'You're sure it's Mr Galvan?' There was a shudder in Kate's voice as she recalled the surgeon as she'd seen him only a short while ago, tall, handsome, at the height of his physical and intellectual powers, sombrely shrugged into his heavy black overcoat.

  Tim O'Reilly winced at the memory of that tangle of yellow twisted metal. Mr Galvan had operated on his father-in-law once—removed a clot from his brain and made a new man of him. His voice was choked with emotion. 'Soon as I saw the wrecked car, I knew! I shouted it out loud. 'Not him. Not our Tom.'

  At this, though to all appearances unconscious, the injured man groaned. Kate remembered that the sense of hearing remained acute even in those close to death. She put her finger to her lips.

  The crew had seen to the basics, checking the airway and keeping their surgeon warm beneath a space blanket. Carefully Kate exposed the upper body, noting the evidence of traumatic injury: left arm oddly distorted and clutched across the chest in such a way that it was impossible to gauge the damage to heart or lungs.

  That was definitely a grunt of protest.

  'Won't let us near that arm, Staff.'

  As if he comprehended what was being said Tom Galvan sighed and muttered, and it seemed to Kate that an almost subliminal determination on the injured surgeon's part held his shattered arm immobile. Chill droplets of perspiration beaded his forehead mingling with the cuts and dirt. Reaching beneath the blanket, she noted the cold clammy feel of hands and feet, the racing, thready pulse reflecting a heart struggling to circulate its diminishing supplies of blood.

  An icy desperate calm took hold of her as her worst fears were realised. Somewhere deep within there must be haemorrhage, the silent unseen oozing of blood into the cavities of the body.

  'BP a hundred over sixty,' hissed O'Reilly. 'Pulse a hundred and fifty and rising.'

  Kate nodded, her face stiff with tension. In the absence of a doctor it was up to her to assess Mr Galvan's most urgent needs … A low reading, to be sure, but as yet not disastrous. Blood pressure is resilient, she reminded herself, the last thing to go. But when it can hold out no longer the drop will be sudden and Tom Galvan will be minutes from death.

  As she replaced the blanket her fingers grazed the damaged arm and the man's lips moved in silent protest. Gently she touched the swollen hand in comforting reassurance. 'No one is going to move your arm.' She spoke very distinctly, bending close to his ear.

  Another sigh escaped the bruised lips and he drifted deeper into unconsciousness.

  The ambulance crew were not in the least offended by this angry and curt young staff nurse issuing orders right left and centre. They quite agreed: where the hell were all the bloody doctors? Yes, they would transfer their gravely injured patient with due care and speed to the Emergency Room while Kate Wisdom personally dragged the duty surgeon screaming and kicking out of theatre.

  Hard-bitten after years of experience, O'Reilly and Piggott looked grimly at each other.

  They sympathised with the nurse's desperation. Lose Tom Galvan? It was unthinkable…

  But when the chips
were down even a neuro-surgeon was only human. And they both knew the score. This one wasn't going to make it. No one could save Tom Galvan now.

  Chapter Two

  The senior consultant in General Surgery fished out his Blackberry and rang home.

  'I'm leaving in five minutes.'

  'Do hurry up, darling, you're going to miss the Pavlova.' Mary sounded annoyed and he couldn't blame her, single-handedly holding the fort with their guests, four visiting American VIPs.

  Pavlova, his favourite pudding! Wretched woman, interrupting his evening with her neurotic bowels. But the Night Sister had been right to call him: it might have turned out to be an early obstruction and Mrs Lah-di-dah was paying the earth to be sure of Professor Davy's personal attention.

  And St Crispin's benefited, Frank saw to that.

  For a man of his age the Professor was in fair shape. Ignoring the lift, he came nimbly down the stairs leading to the main foyer of the Maynard private wing. It was surgery that kept him so spry at sixty-three. He loved his job. Not one of them had dared hint at the looming spectre of Frank Davy's retirement. Let 'em dare!

  Glass doors glided open at his approach. A shallow bank of steps flanked the entrance and lent a certain grandeur to the private wing. To the side was the slope of a wheelchair ramp.

  The Professor paused, filling his lungs with a deep draught of night air. The last niggle of irritation wafted away on the breeze which was now teasingly revealing the bald spot in his thinning hair. Definitely a touch of spring tonight. Pity he'd had to refuse the offer of a coffee with that charming Night Sister upstairs …

  Now if I hadn't told Mary I was on my way I could have taken Sister Lewis up on that coffee.

  But there was a raspberry pavlova waiting. And, of course, the visiting American consultants.

  The Bentley was parked close by. Elderly but well-preserved, mused Professor Davy fondly, and that goes for the two of us. Never given me a moment's trouble, have you, old girl. Not in fifteen years.

  He turned the key in the polished walnut dashboard and immediately the engine purred as if it ran on cream. Humming 'Love Me Do', he drove slowlyg along the one-way system, past the mortuary and the chapel, turning right when he reached the exit road. Then all of a sudden, 'What the devil!!' he exploded.

  Out of the shadows raced a tall nurse, right into the Bentley's path - arms waving wildly, grasping the handle even as he slowed to a halt, wrenching the driver's door open and urgently clutching at his sleeve.

  'Professor Davy!' the nurse gasped, 'come quickly, quickly! Mr Galvan's very badly injured. We may be too late.'

  The words tumbled from Kate's lips in an urgent gabble, but with immediate effect. 'Hop in, lass!'

  Ignoring the 10 mph limit he sped round to A&E, abandoning his car at the ambulance entrance, following hot on Kate's heels as the desperate staff nurse raced back into the bright lights of Casualty.

  Much later, Kate couldn't believe what she'd done. Dragged the Professor out of his Bentley, racing him to Tom Galvan's side about thirty seconds before the SHO himself arrived on the scene to get the pasting of his career.

  Rapidly the head of General Surgery assessed Tom's injuries, calling down the wrath of the gods on every doctor within scolding distance.

  And at this point Mike rolled up: he'd been genuinely detained with another emergency but this didn't save him from the great man's blistering Welsh tongue. 'Blithering idiots, the lot of you!' he was storming - a general description that included every member of the team including Kate herself—and quite deservingly, she was agreeing silently as she cut away Tom Galvan's clothing and prepared him for surgery.

  'I find Tom in a state of shock and not a doctor in sight! Now get him into theatre immediately, d'you hear me?'

  'Yes, sir.' The SHO's freckled face was grimly adult, no trace of boyishness now. Em, the medical student, rushed up with a Giving Set for Dr Filing to administer fluids. Kate ripped open the sterile pack while a third-year student nurse scurried off to fetch a drip stand.

  'Haven't you got that drip up yet?'

  'Just—er—seeing to it, sir,' muttered Mike, struggling to find a vein in Tom Galvan's right arm.

  'Professor!' interrupted Kate, her voice sharp with urgency. For even as the riot act was being read over him, Tom Galvan's face was altering to an ominous pallor.

  'Oh shit!' muttered the surgeon beneath his breath as his experienced clinical eye warned that Galvan had perhaps two minutes to live. He wrenched off his jacket and rolled his sleeves up tight over surprisingly muscular forearms. It wouldn't be the first time he'd operated in his shirt sleeves.

  'He needs blood. Five units immediately and probably another four litres to come. Staff Nurse—I want two more Giving Sets and two drip stands and on the double. We'll give him the blood twice as fast.'

  Kate moved like greased lightning.

  'As for you, boyo,' continued Frank, breathing down Dr Filing's neck, 'if he's not on the table and ready for me in seconds, I'll have y'r guts for garters.'

  Now it was Mike's turn to blench. The duty registrar came bursting into the emergency theatre, his white coat spattered with dark red spots, face shocked and anxious.

  'Mister Brownley,' observed Professor Davy with ominous sing-song calm. 'Good of you to pop in and see us.'

  'Appalling!' Mr Brownley was shaking his head over the unconscious neuro-surgeon. 'Tom Galvan of all people. Hell of a decent bloke.' He peered at the more obvious injuries and whistled through his teeth. 'Really don't like the look of that. What are you going to tackle first, Frank?'

  Scrubbed and gowned, Kate stood shivering with shock by the instruments trolley. She fixed her eyes on Mr Galvan's face as if committing every inch of torn and bruised flesh and bone to memory. In fact she was trying to relate this battered mess with the face she remembered in the car park. With half of her concentration she picked up fragments of what the two surgeons were discussing … shattered arm … miracle … smallest movement could have sent a sliver of bone ripping through the main artery to the left hand … 'Is he going to make it, do you think?' Simon Brownley's lean face was shocked and grave. The Professor's response was brisk. 'Not if we stand around gossiping. Now make yourself useful, Mr Brownley—get a haematology technician to come in and crossmatch that blood immediately.'

  The adrenal glands were already responding to the excitement of challenge, pouring their secretions into the surgeon's bloodstream as he extended a gloved hand for the first instrument. The surge of adrenalin drove the last thought of raspberry pavlova from the Professor's keenly concentrating brain. 'We're going to pull our man through,' he pronounced to his team with grand and confident optimism.

  And behind her mask Staff Nurse Wisdom held her breath. She was banking on it.

  * * *

  Next morning, just as she was going off-duty and heading for the locker room, Kate was hailed in the main entrance hall. Professor Davy had been making a visit to Critical Care before starting his ward rounds. He was smiling. Kate smiled back, her hopes rising.

  'Our Tom's holding his own. Not out of the woods by any means, but he's still with us.'

  Still with us …! Kate felt nauseous with fear and fatigue.

  'Sent a rocket round your department, mind you, but it turns out no one was to blame. Brownley was dealing with an obstetric emergency, and that whipper-snapper SHO —forget exactly what his excuse was but it held water. More hands on deck, that's what's needed in A & E. What did you say your name was again? Kate Wisdom?'

  Wisdom—now that rings a bell, mused the professor, observing the dark circles under Kate's tired brown eyes and the drained pallor of her skin. But of course it couldn't be … Archie Wisdom's daughter an RGN? Just not possible. A girl like that wouldn't be working in a provincial hospital in a sedate cathedral city. She'd be at Guy's or Tommy's, sticking with the London scene.

  'Away to your bed, girlie. That was one scary night for us all. I don't mind admitting it now, see. If we'd lost Tom I'd
never have forgiven myself. But we'll get him through this, won't we, have him back at St Crispin's almost as good as new. I'm ready to take a bet on it, I am.'

  At this, Kate heaved a mighty sigh of relief. Her sudden smile was like the sun breaking through and Professor Davy, on the receiving end, mentally revised his first impression of her as a rather prim-looking young woman.

  'I'm just starting my nights off,' she said wistfully, wishing for once that she was going to be back on A&E that evening so she could keep a close eye on the neuro-surgeon's progress.

  'Well you've earned your break,' the Professor said kindly, putting his hand on her bare arm. And the eyes of those who passed along the corridor gleamed with curiosity because very senior consultants did not as a rule fondle junior staff nurses in public places.

  The professor strolled away and Kate hesitated for a moment, deep in thought. She'd dearly like to slip up to CCU and see Mr Galvan with her own eyes. See that all was as well as could be expected, considering the gravity of his injuries.

  After all, she wouldn't be back for the next six nights. Yes, she'd do that. Kate took the lift up to the second floor.

  But they were very busy in the Unit and it wasn't the most convenient moment to interrupt the day staff and ask for a progress report. Peering through the glass screens, she could see that seven of the ten beds were occupied, each surrounded by its quota of the sort of machinery that figured in a layman's nightmare visions. Seven people who were very ill indeed. But which one was her man?

  The level of heat was getting to her, and she winced at the trickle of sweat stealing down between her shoulder-blades and the constriction in her throat as if she too breathed only with difficulty.

  Nothing for it but to go on home. Her shoulders drooped in weary disappointment. Come off it, Katie, she scolded herself. You can't afford to get wound up about patients; a nurse would soon burn out if she didn't exercise some self-control.