by Fiona Lowe
‘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, crosschecking 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 haemat
uria, 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 leaden 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.
He’d called into the clinic at three a.m. but Jimmy had been stable and sleeping and she’d sent him away, promising to catch a few hours’ sleep herself. He took the tray from her. ‘I learned the hard way and now I have a secret stash of food.’
‘Ah, yet another trick of remote medicine I have to learn.’ She pulled a tiny spiral notebook and pencil out of her pocket and wrote ‘Food supplies’ in it, under a list of other short notes, the bridge of her nose creasing in concentration.
The action surprised him. He’d understand if she wrote down a reminder for a drug order or something related to work, but some extra food?
She caught him staring at her and she quickly flicked the notebook closed, jamming it back in her pocket as if caught out doing something wrong. ‘Let’s give the boy round three of his breakfast.’
Jimmy sat crossed-legged on the bed, crumbs scattered all around him.
‘Is that all that’s left of three slices of toast and Vegemite?’ Mia teased as she brushed away the crumbs. ‘I had a brother who had hollow legs like you. He used to eat and eat and eat.’
Flynn slid the tray onto the over-bed table, wondering about the words ‘had a brother’. Wouldn’t people normally say, ‘My brother used to have hollow legs like you’? ‘Tuck into this, mate, and then I’ll come back and have a look at your dressing, OK?’
Jimmy bit into a yellow banana and nodded as Flynn motioned for Mia to leave the room with him.
He strode into the kitchen and plugged in the coffee-machine. ‘I need a cappuccino—what about you?’
‘That sounds great.’ Mia cut two slices of hearty wholemeal bread and dropped them into the toaster. ‘So, will Jimmy be discharged home to rest today or do you want to keep him in a bit longer so that his wound can be kept clean and dry?’
Flynn glanced at her over the top of the opened fridge door, knowing what she was really asking. ‘Have you done many home visits yet?’
She nodded, her teeth snagging her bottom lip. ‘A few. I’ve worked in disadvantaged areas in Tasmania but I was pretty shocked by the state of some of the houses here and the overcrowding.’
He closed the fridge and at the same time tried to close his mind against the vulnerable image of pearly white teeth on pink, moist skin. The milk slopped into the jug rather than being poured. ‘Yeah, the poverty is confronting. Over twenty per cent of the houses need replacing but the good news is that the land council is on target with their three-year plan to replace and build new ones.’
‘That’s great but I guess what I’m really asking is does Jimmy live in a condemned house? We can’t risk him getting a raging infection and damaging his kidney.’
‘True, but Jimmy’s very fortunate. Both his parents have jobs and although there are ten people in the house, Ruby has it well organised.’ He placed the jug under the stainless-steel steam jet and heated the milk. ‘We’ll get Ruby to bring him in each day and you can do the dressing. That way he can be at home but we can keep a close eye on him.’
The toast popped up and Mia put the slices on plates and buttered them. ‘OK, so I’ll remove his IV after breakfast. Do you want one last dose of IV antibiotics first?’
‘Yes, that’s a good way to do it and then he can go home with a seven-day course.’ Flynn poured the foaming milk over the coffee, picked up the mugs and turned to see Mia writing again in her notebook. ‘Discharge planning?’
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nbsp; She gave a curt nod, the shadows in her eyes suddenly looming large. She shoved the pad into her pocket as if the fact it was out of sight meant it no longer existed. ‘Thanks for the coffee. Help yourself to toast.’
Her reaction to the notepad puzzled him but the delicious smell of the toast distracted him and he bit into it, enjoying the combination of seeds and grains. He hadn’t tasted bread like this on any of the islands. ‘This tastes sensational. Where did you order it from?’
She looked coy. ‘I baked it?’
‘You made this? No wonder Jimmy virtually inhaled it. He’s probably never tasted bread like it. We only get the mass-produced loaves sent over from Darwin.’
She gave a wry smile. ‘And that’s why I brought my bread-maker.’
An idea struck him. ‘This would be fabulous bread for the diabetics due to its low-glycaemic index. Is there any way you could work out how to cook it on a campfire?’
Disbelief swept across her face. ‘A campfire? Why a campfire? I’ve seen ovens in houses.’
He shrugged. ‘Many Kirri people prefer to cook on open fires.’
‘I thought they’d only cook on a fire when they’re out bush, hunting or collecting bush tucker.’
‘They do that too but there’s a campfire in every yard. It’s an easier way to cook when you never know how many people are going to be eating with you.’
She sighed. ‘There are so many unexpected things. For instance, I didn’t realise that English would be the second or third language. It’s all so very different, but different in a good way.’
He nodded as an unexpected sensation of shared companionship streaked through him. ‘And that is what most southerners just don’t get.’
She reached for her pocket but caught his gaze, which had followed her movement. She let her hand fall back onto the table and fiddled with the mug handle, anxiety scudding across her eyes. ‘I’ll practise and see how the bread comes out unleavened, kind of like a wholemeal damper.’ He saw the thought travel across her high cheeks as her mouth curved into a smile. ‘If it doesn’t work, the kids could use it as a football.’