by Fiona Lowe
He ushered her into his office and picked up a stack of folders from his desk. ‘We have a weekly meeting to discuss medical and nursing issues but I have an open-door policy so, please, don’t wait until Tuesdays at two to discuss something important. Honest and open communication is vital in a department like this.’
Honest and open. As long as it only pertained to work, she was off the hook. She couldn’t work at Warragurra Base if he knew how she really felt about him. She was embarrassed enough by it. She didn’t want to feel this way. She hated it that after everything she’d been through with Nathan, even though she knew she wasn’t ready for another relationship, she couldn’t control her body’s reaction to Linton.
‘Right, I promise I won’t let anything fester.’ She held out her arms. ‘Are they for me?’
He winked. ‘Just a bit of light reading. We’re in the middle of a policy review.’
‘Policy review?’ A vision of reading long into the night popped into her brain. Not that she slept that well, with Linton always hovering in her dreams. ‘Did you just happen to conveniently forget to tell me that when you were twisting my arm in the woolshed?’
His eyes widened in feigned outrage. ‘Twisting your arm? I don’t coerce my staff, Emily.’ He dumped the folders into her outstretched arms. ‘By the way, have you enrolled for your Master’s?’
‘That would be the arm-twisting Master’s?’ She clutched the folders to her chest.
His mouth twitched smugly. ‘All I did was provide you with an opportunity to do something you’ve wanted to do for a while.’ He lowered himself on the corner of his desk, his eyes full of curiosity, appraising her. ‘So, which subject are you starting off with?’
Surprise hit her so hard she swayed on her feet. She stared back at his face, so unexpectedly full of genuine interest. She hadn’t expected that. ‘I, um, I’m starting off with “Interpersonal Relationships in the Clinical Environment”.’
Otherwise known as how to survive working closely with a boss whose presence turns your mind to mush and your heart into a quivering mess.
He rubbed his chin in thought. ‘That sounds meaty. There’s lots of scope there on so many levels—patient-staff, staff-staff, patient-relative, relative-staff.’
His gaze settled back on her, unnerving her with its solicitude. The fun-loving charmer seemed to have taken a back seat. She’d never known him to take such an interest in her before. Her usual approach of friendly mockery didn’t seem right. She managed to stammer out, ‘I—I thought so.’
‘In a high-octane environment like A and E it can be pretty fraught at times, which is why staff wellbeing is high on my agenda.’ He walked her to the door. ‘Let’s do drinks at the end of the shift.’
She almost dropped the folders as blood rushed to her feet, making her fingers numb. He’s inviting you out for a drink.
Not a good idea, Emily.
But common sense had no chance against the endorphin rush. All thoughts of staying detached and professional got swept away by the sheer joy that exploded inside her. Her feet wanted to happy dance and her hands wanted to high-five.
Stay cool and calm. ‘That would—’
‘Emily, Linton, you’re needed,’ Sally, the desk clerk, called them to Reception.
Jodie dashed past, holding two kidney dishes. ‘Gastro in cubicles one, two, three and four.’
Emily picked up the histories and noted the patients all had the same surname. ‘Looks like it’s one family.’ She handed out the histories. ‘Jason, you and Patti share Mr Peterson and Jodie’s in with Mrs Peterson. Get base-line obs and assess for dehydration.’
Linton took the remaining histories. ‘You examine the teenager and then join me with the eight-year-old.’ He shot her a cheeky grin. ‘Your hair colour will convince him you’re a clown and he’ll relax while I’m inserting an IV.’
She rolled her eyes. ‘Ha, ha, very funny. I think I just have my first example for my Master’s of interpersonal relationships with staff and harassment.’ She jokingly tapped his chest with her forefinger. ‘Be nice or I might not help.’
She turned away and pushed open the curtain to see a fourteen-year-old boy heaving into a bowl, his ashen face beaded with sweat. ‘David, I’m Emily.’
He fell back against the pillow, exhausted. ‘I feel terrible.’
‘You don’t look too flash.’ She picked up his wrist and her fingers quickly located his pulse, which beat thinly and rapidly under her fingertips. She pushed an observation chart under the metal clip of the folder and recorded his pulse, respirations, blood pressure and temperature. ‘When did the vomiting start?’
‘After lunch.’ He flinched and gripped his stomach, pulling his legs up. ‘Arrgh, it really hurts.’ His quavering voice stripped away the usual teenage façade of bravado.
She hated seeing people in distress. ‘I can give you something to help with the spasms but first I have to insert a drip, which means a needle in your arm.’
‘Oh, man.’
She stroked his arm. ‘It won’t hurt as much as the cramps. Tell me, what did you eat for lunch?’
‘Sausages and chops.’ He grabbed the bowl again, gagging.
‘Take long, slow deep breaths, it really helps.’ Emily quickly primed the IV. ‘When was the meat cooked?’
‘Dad and I barbequed it and then we ate it straight away.’
She wrinkled her nose. ‘I think I can smell the smoke from the fire on your clothes.’
‘Yeah, it was an awesome bonfire. I’d been collecting the wood for a week.’
What was it about men, testosterone and fire? Her brothers loved nothing better than a midwinter bonfire. ‘Was it a special occasion?’
He nodded weakly. ‘Dad’s birthday. Mum even bought coleslaw and potato salad.’
Wrapping the tourniquet around his arm, she kept mental notes of the food. ‘Did you have cake?’
‘Yeah, one of those mud cakes from the supermarket.’
Swabbing the inner aspect of his left arm she kept talking. ‘Sounds like a lovely party.’
‘It was, until we all started vomiting.’ His arm stiffened as the needle slid into his vein.
‘Sorry.’ She whipped the trocar out of the cannula and attached the Hartmann’s solution. ‘Now I can get you something to lessen the nausea.’
David stiffened on the trolley, his eyes suddenly wide and large.
‘What’s wrong?’
He flushed bright pink. ‘I need to go…now.’
‘Right.’ She grabbed a bedpan from under the trolley and helped him into position. ‘Here’s the bell, ring when you’re done.’ She backed out of the cubicle, feeling sorry for the boy who had left his dignity at the door.
‘Emily, how’s your patient?’ Linton stood at the desk, writing up a drug chart.
‘I’ve inserted a Hartmann’s drip. Can I have a Maxalon order, please?’ She slid her chart next to his.
‘No problem.’ His lean fingers gripped his silver pen as his almost illegible scrawl raced across the paper. ‘So does he have diarrhoea, vomiting and stomach cramps?’
‘Yes, all three, poor guy. He’s pretty miserable. It sounds like a birthday party gone wrong.’ She opened a syringe and assembled it, attaching it to the needle. ‘David said his mum bought coleslaw and potato salad. Mayonnaise can harbour E. coli so I’m wondering if we should ring the health inspector to check out the deli.’ She snapped open the ampoule of Maxalon.
‘Good idea, and worth a phone call.’ Linton rubbed his creased forehead. ‘But if it was the deli we should have other people in with the same symptoms.’
‘Unless the Petersons left their food out of the fridge and in the sun.’ She confirmed the dose of the injection with Linton.
‘It could be the meat.’ He walked with her back toward the cubicle, his hands deep in his pockets.
‘True, except that a dad and his son were barbequing.’
He arched a brow and stared down at her. ‘Meaning?’
&n
bsp; She ignored his supercilious look. ‘Meaning most of the blokes I know tend to char the meat rather than undercooking it.’
‘Now, there’s a sexist statement for you. I’m sure you have to be on the lookout for those in your assignment of interpersonal relationships in the clinical environment.’ He flashed her a challenging grin. ‘I can shoot your gross generalisation down in flames. I happen to be a brilliant barbeque cook and one day I will prove it.’
The dizzy dancing that had been spinning inside her since his invitation to drinks expanded. She couldn’t be imagining this. No, the signals were definitely there. He’d asked about her Master’s, he’d mentioned drinks, and now a barbeque. There was no doubt about it, he wanted to spend some time with her.
She ducked around the corner and helped her patient off the bedpan before inviting Linton in with the injection. ‘David, this is Dr Gergory.’
‘Hey, David.’ Linton extended his hand, treating the teenager like a young adult.
The patient put his hand out to grasp Linton’s and suddenly stopped. He flicked his wrist, shaking his fingers.
‘Is there a problem with your hand?’ Linton turned David’s palm over.
‘My fingers feel numb and tingly, like my hands have gone to sleep.’
‘Hands? Are both of them feeling like that?’ Emily caught Linton’s concerned gaze as her own unease increased a notch.
David nodded. ‘Yeah, it feels really weird.’
Linton placed David’s hand by his side. ‘It could be from all the vomiting. We’re replacing the electrolytes you’ve lost and we’re slowing down the vomiting with the medication. This should fix the tingling.’ He adjusted the drip flow. ‘We need to check on the rest of your family but ring the buzzer if you start to feel any more tingling, OK?’
David nodded wearily, not even raising his head from the pillow.
Emily tucked the blanket around him, made sure he could reach his buzzer and then followed Linton. ‘I’ll organise for bloods to be taken.’
‘Good, but let’s get everyone together and review the rest of the family first.’
Jason, Patti and Jodie all reported that their patients had similar symptoms after eating the same food.
‘So it’s an open and shut case of gastro, right?’ Jason recorded some notes in his spiral bound notebook.
‘Perhaps.’ Linton tugged at his hair, his fingers trailing a path, making his blond tips almost stand on end as he walked back to check on the eight-year-old.
‘Something’s not quite right, is it?’ Emily shared his niggling feeling of doubt.
His eyes reflected his apprehension. ‘I just get the feeling that if I call it gastro, then that’s just too easy. I think I’m missing something.’ He ushered her through the curtain ahead of him.
Little Jade Peterson lay quietly sobbing, her chest rising and falling in shuddering grunts.
‘Honey, does it hurt somewhere new?’ Emily ducked down so she was at eye level with the little girl.
‘No, but who’s going to look after Towzer?’
Emily exchanged a questioning look with Linton.
He shrugged his shoulders, his expression blank.
‘Who’s Towzer, Jade?’
‘My dog.’ She sniffed violently.
Emily stroked the little girl’s hair back behind her ear. ‘I’m sure your dog will be fine and waiting for you when you go home.’
She shook her head sadly. ‘But his tummy hurt too and he was sick.’
Linton bent down next to Emily, his vivid green eyes fixed on Jade’s face. ‘What did Towzwer eat?
She clutched her hospital teddy bear. ‘He loves sausages but he stole a chop too and Dad got cross.’
The meat. The buzzer sounded. ‘That’s David.’ Emily rose and walked quickly back to the cubicle.
Terror shone in the boy’s eyes. ‘My face feels all funny now. It’s like pins and needles and it’s really scary.’
‘We’re working on what’s causing these symptoms. I’m going to take some blood and hopefully that will tell us something.’ She gave him a reassuring smile and hoped her face didn’t show how worried she really was.
Something weird and neurological was going on. She checked his pupils with her penlight. Both were equal and reacting. ‘Can you squeeze my hands, David?’
He put his hands out toward her. Fear shot through her, making her gut lurch. His palms, which had been white before, now looked red and blistered, with flaking skin. If he’d burned himself, they would have known on arrival. Linton would have seen it earlier.
None of this made sense. ‘I’ll be right back, David.’
She stepped out of the cubicle, her mind racing, trying desperately to work out what was going on. She rushed back to Jade and almost collided with Linton as he opened the curtain. ‘Oh, thank goodness you’re here.’
He put his hands out to steady her. ‘What’s wrong? You’re white.’ He gently steered her to one side. ‘You haven’t got gastro too, have you?’
She shook her head. ‘I’m fine but David’s palms are peeling as if they’ve come in contact with a corrosive substance. Everyone is getting sicker and sicker in front of our eyes. What do you think this is?’
He clicked his pen up and down, the sound reflecting his agitation before he shoved it back in his pocket. ‘I wish I knew. We’ve got nausea, vomiting, stomach cramps, and the father has blood in his stools.’ His forefinger flicked off the tip of each finger on his other hand as he listed each symptom.
‘And facial numbness and tingling fingers.’ A horrible thought speared her brain. ‘It sounds like poison.’
He nodded, his expression grim. ‘That is the conclusion I’ve come to. It matches up that it must have been the meat that was poisoned because the dog was sick as well. I’ll call the police. Forget taking blood. Organise for a urine tox screen on everyone and get it to Pathology with an urgent request on it.’ He spun round, abruptly calling over his shoulder as he walked away, ‘Then organise for the whole family to be in one space. I want to talk to everyone together.’
She gave her staff their orders and ten minutes later, with the tests sent off to the lab, Jason and Patti soon had the trolleys in a square. Each family member lay on their trolley in the foetal position, legs drawn up against the severe stomach cramps, and groaning as each spasm hit.
‘I know you’re all feeling really ill, but I need you to concentrate on what we’re saying.’ Emily stood between the trolleys where Christine and Brian Peterson lay. ‘Everyone, including the dog, ate the meat and everyone has similar symptoms. David and Brian are the most unwell but I’m guessing that’s because they ate the most meat.’
She touched Christine’s hand. ‘Where did you buy the meat from, Mrs Peterson?’
The sick woman trembled. ‘It was one of ours. Brian slaughtered it a month ago.’
‘Have you eaten meat from that beast before?’ Linton asked, his voice quiet and nonjudgmental.
‘Yes, we have, and we’ve never been sick.’ She twisted a hankie in her fingers. ‘I defrosted it in the fridge, I did everything the same as normal.’
‘The symptoms are leaning very strongly toward poisoning.’ Linton’s matter-of-fact voice broke the almost surreal news. ‘We’ll know as soon as the urine tests comes back but in the meantime would there be anyone who might want to hurt you in any way?’
The father of two gasped. ‘No, no, no one we know would do such a thing.’
‘I don’t understand.’ Christine gripped the side of the trolley for support, her voice trembling. ‘It was supposed to be a special day for Brian. David did such a great job getting the bonfire ready.’
Dad and I barbequed. It was an awesome bonfire, I’d been collecting the wood for a week. Emily’s hand shot out, gripping Linton’s white, starched sleeve as the thought struck her. ‘David, what sort of things were you burning on the fire?’
The teenager replied listlessly. ‘Just wood and stuff that I found.’
Linto
n’s eyes flashed his understanding as he immediately picked up on her line of thought. ‘Was any of the wood stained green, like the pine they use in the car parks down by the river?’
‘Maybe.’ He gripped his stomach as another spasm hit.
Emily spoke softly. ‘This is really, really important, David. We need you to think. Had any of the wood been treated?’
The boy looked anxiously between Emily and Linton. ‘I…I did get some from the building site next door.’
Linton thumped his fist against his forehead. ‘Copper-chrome-arsenate. You’ve barbequed your meat in arsenic vapours. That’s what’s causing all these symptoms.’
Stunned silence and shocked disbelief scored everyone’s faces.
‘Arsenic. Hell of a birthday present, son.’ Brian grimaced in pain.
‘I’m s-s-sorry, Dad.’ David’s voice quavered as tears filled his eyes. ‘Are we going to die?’
‘Not now that we know what we’re treating.’ Linton gave the boy’s shoulder a reassuring squeeze.’ He turned to Emily. ‘We need dimercaprol up to five milligrams per kilogram by intramuscular injection. It acts as a chelator and the arsenic will bind with the drug so it can be removed from the system.’
‘I’ll ring Pharmacy now.’ Emily turned to her staff. ‘Jodie, Patti and Jason, attach everyone to a cardiac monitor and monitor urine output. You’ll need to weigh each family member so we can work out the dose of dimercaprol. The rest of the nursing care plan is to provide symptomatic care. A cool sponge will help, as well as some refreshing mouthwash.’
Her staff nodded their agreement and everyone attended to their tasks. By the end of the shift the Petersons had been transferred into the high dependency unit for close monitoring. Emily stifled a yawn as she wished the night staff a good shift.
‘You can’t say we didn’t welcome you with a bang. Who would have thought of arsenic poisoning?’ Linton leaned back on his chair, his hands clasped behind his head, his broad chest straining at his now rumpled shirt. ‘Fabulous call, by the way. What made you associate the bonfire?’
His praise sent streaks of happiness though her. ‘At the risk of being called sexist, I have four brothers. When they were younger they’d burn just about anything, and David reminded me of them. Lucky for us, Dad taught us what was toxic and what was safe so we avoided potential tragedies like today.’