The London Doctor

by Joanna Neil

  He nodded. ‘I didn’t realise…that you…worked here,’ he said, but his breathing was so laboured that it was clear it was difficult for him to speak.

  Hannah smiled at him. ‘I’m going to take care of you. Don’t worry…and don’t try to talk. We’ll try to make you more comfortable.’

  Sarah drew her to one side and said quietly, ‘His peak expiratory flow is half what he says his usual reading is. When I first took his pulse it was 110, but then it started falling, until it was below normal. He’s becoming exhausted very fast.’

  Hannah nodded. ‘Let’s get an arterial blood-gas measurement, and we’ll put him on nebulised salbutamol.’ She turned back to her patient. ‘I’m going to give you a steroid to help you through this, Harry,’ she told him.

  Some time later it was clear that his condition wasn’t improving. ‘We’ll add another bronchodilator…ipratropium…to the nebuliser,’ Hannah told Sarah, ‘and I’ll make arrangements to admit him.’

  Adam came to find out what was happening. ‘Is something wrong here?’ he asked.

  Hannah quickly explained the situation to him. ‘He hasn’t been responding to the treatment, and I’m worried about his overall condition, given his age. I would have expected some change for the better by now.’

  ‘Maybe…but it’s possible that he’s been under par for some time before this. He isn’t young any more. Perhaps you shouldn’t expect immediate results.’

  ‘I realise that, but I saw him earlier this morning when I was on my way to work. He didn’t look too well then, but I can see that he’s in a much worse state now.’

  ‘Give the ipratropium a few more minutes. After that, you could try an intravenous infusion of aminophylline,’Adam said. ‘That should help.’

  She nodded. ‘I’ll do that.’ She glanced at him. ‘I take it that your father’s gone, then?’

  ‘That’s right.’ His expression was sombre. ‘From the cool reception you gave him, I guess you two still have issues to resolve?’

  Her mouth tightened. ‘I doubt you would understand. You’ve always sided with your father. Neither of you had much time for my foster-brother.’

  ‘I’d say Ryan brought that on himself, wouldn’t you?’

  She didn’t answer. Instead, she went to check on her patient. His blood pressure and heart rate were giving her cause for concern, and she was beginning to wonder whether she would need to intubate him.

  Adam came to supervise the infusion of aminophylline. ‘Make it a slow infusion over twenty minutes,’ he said. To Harry, he added, ‘This should relax the air passages and help you to breathe more easily.’

  Harry nodded.

  Adam looked at his chart. ‘Are you making arrangements to admit him to a ward?’ he asked Hannah.

  ‘Yes, that’s all in hand.’

  ‘Good. I’ll come back in a little while to see how he’s doing.’

  Hannah checked the infusion, and then went to deal with another patient. She was calmer now, and more in control of herself, and bit by bit the morning’s incident was receding from her thoughts. The mother and child were safe, and she was thankful for that.

  Adam came to monitor Harry’s condition a few minutes later, as he had promised. Harry was more alert now, and his heart rate had improved.

  ‘How are you feeling now, Harry?’ Adam asked. ‘Is the breathing any better?’

  Harry nodded. ‘It’s a lot easier. Thanks.’

  ‘We’re going to keep you in hospital overnight, at least, but we need to sort out why this happened,’ Adam murmured. ‘Did anything in particular bring this on, do you know?’ He laid a hand on the man’s shoulder. ‘There’s no rush for you to answer. Take your time.’

  Harry lifted the oxygen mask a fraction. ‘There was a man…on the tube. He had a knife.’

  Adam frowned. ‘You weren’t hurt, were you?’ He looked concerned all at once. ‘I wasn’t aware that you had any injuries.’

  Harry shook his head. ‘Not me. He went for her.’ Harry pointed a finger at Hannah and then pulled on the oxygen. ‘She…knocked his arm away. Couldn’t let him try again…grabbed him.’

  Adam’s eyes widened. He stared at Hannah and then turned back to Harry. ‘I had no idea about any of this…Was anyone hurt?’

  Once more, Harry shook his head. ‘Lucky escape.’

  Adam nodded. ‘I think I can see that now.’ He patted his shoulder. ‘I’m going to leave you in the care of our nurse, and I want you to try to get some rest. I think you’ve had quite enough excitement for one day, but I do want to thank you for saving our Dr Bennett. I can see now why she’s been giving you special attention. You concentrate on yourself now, and take care.’

  Hannah watched him with Harry. He was gentle, watchful and more than considerate of his patient’s well-being. This was the Adam she had always known, and her heart swelled with respect and admiration for him.

  It was a short-lived feeling, though. When Adam turned and drew her away from the bedside, his manner was grim.

  ‘I can see now why you were late coming in to work this morning,’ he said. ‘Did it not occur to you to tell me what had happened?’

  She shook her head. ‘It was all a bit overwhelming, to be honest, and I needed to think things through.’ She hesitated. ‘The man was a schizophrenic, I think. His behaviour was irrational and unpredictable, and we all had to act quickly.’

  Adam’s brows lifted. ‘What was all that about a knife?’

  ‘It was all over in a matter of minutes, really. He made a lunge at me, but between them the other passengers stopped him. Harry was brilliant.’

  ‘It’s no wonder you were in such a state first thing.’ His expression was harsh. ‘You should have told me. I’m your supervisor and I should know what’s going on, and whether you’re capable of doing your job. I don’t expect to find these things out at second hand.’

  ‘I’m sorry.’ Hannah pressed her lips together. ‘I felt a bit foolish, to be honest. I wasn’t expecting anything like that to happen and it made me a bit jittery for a while.’ She thought about the mother and child and the memories they had evoked of her own childhood. Who had been there to protect her through her early years? Had her father been right when he’d said her mother hadn’t been capable? ‘I think I’d much rather travel to work on a cranky old bus, trundling along country lanes,’ she murmured.

  ‘Yes, I can imagine you would be happier doing that,’ he said. ‘We all know that you would be far more at home in the countryside than you are here.’

  It hurt, hearing him say that, even though he was probably right. Her whole world was unsettling and confusing. Even her plans to find her real mother had gone astray. She hadn’t been able to find any trace of her so far, and it was beginning to look as though she would have to pursue other alternatives.

  Where she might have hoped to look to Adam for support, it simply wasn’t going to happen. She had no choice but to stand alone and take care of herself.

  CHAPTER FOUR

  ‘THERE’S more toast if you want it, Ryan,’ Hannah said, pouring coffee for both of them. She glanced at her foster-brother. ‘You’ve not eaten very much. Are you taking proper care of yourself? You’re looking thinner than you were last time I saw you.’

  ‘Yes, Mum. I’m looking after myself.’ Ryan gave her a cheeky grin. ‘You’ve stuffed me with eggs and bacon, and I’m actually full up. You don’t have to worry about me.’

  ‘If you say so.’ She smiled at him. ‘It’s lovely that you were able to come and visit me, and I just wish that I was free to spend more time with you.’

  He shrugged. ‘I know that you have to work. It’s all right. It’s what I expected, but I thought, since I don’t have to be in college for a few days, I could come down to the city and spend some time with you. I can study just as easily here as I can out in Enfield, and it’s a more pleasant prospect than staying in my room at the college.’

  ‘Well, even here, you shouldn’t stay in all day. You’ll feel b
etter if you can manage to go out and get some fresh air for a while.’

  She sent another quick, searching look in his direction. His wavy black hair was pushed back, as though he had been running his fingers through it, and his brown eyes were troubled. For all that he was putting up a brave front, he wasn’t his usual self, that was for sure, but so far he hadn’t given her even a hint of what was wrong. She knew him well enough to be certain that something untoward was going on. ‘It might cheer you up if you can get out and about a bit and see some of the sights.’

  He nodded. ‘I thought I might do that. I came across your neighbour, Abby, last night, while I was waiting for you to come home, and we stopped to talk for a few minutes. I told her that I was studying countryside management and forestry, and she suggested that I go and visit the Old Park Wood behind Harefield Hospital.’

  Hannah was thoughtful for a moment. ‘I think she said that she used to live near there. It’s probably a good idea. It’s a nice warm day, and it shouldn’t take you too long to get there.’

  ‘It’s worth a visit, isn’t it? She said that this time of year the woods look lovely with bluebells and wood anemones, and even some more unusual plants. There’s a pond and a stream, and there are different varieties of trees—oak, birch, hornbeam and ash, from what she remembered—so there are probably different soil types, and it might actually help with my studies if I go along and take a look.’

  ‘I think you’re probably right.’

  He made a small grimace. ‘It seems as though I’ve been cooped up for a long time, and I could do with a break. The exams aren’t for a while yet, so I still have a bit of breathing space.’

  He was quiet for a moment, mulling things over, and then he added, ‘I could come with you as far as the hospital and then go on from there, if that’s all right with you? I don’t think it will be too far out of my way, and I’ll be able to call in on a student friend while I’m in the city.’

  ‘It sounds good to me. I’m glad that you’re making plans for the day. Will your friend go with you to look at the woods, do you think?’

  ‘I doubt it. He’s having a few problems and he’s ditched his course halfway through. As far as I know, he’s managed to find some temporary work in London, so I thought I’d check up on how he’s doing.’

  She was glad to know that he was keeping in touch with his friends. For all his troubled background, Ryan was good at heart. She believed in him.

  He said lightly, ‘You haven’t told me much about your job at the hospital. Is it going well? Are you getting on all right with the people you’re working with?’

  ‘I haven’t had time to get to know them all yet, but on the whole they seem to be really friendly.’ Hannah was quiet for a moment or two, wondering how she was going to break it to him that she was working with Adam. ‘The job itself is quite a challenge. I’m still feeling my way, for the most part.’

  Ryan studied her. ‘There’s something you’re not telling me. Are you having a problem of some sort?’

  She shook her head. ‘No, it’s nothing like that.’ She hesitated, and then added, ‘Actually, I’m working with Adam Driscoll. He’s the specialist registrar in A and E, so for quite a lot of the time he’s my supervisor. He’s in charge when the consultant isn’t available.’

  Ryan stared at her. Then he seemed to gather himself together and said, grimacing, ‘That must have come as a bit of a shock. I know I certainly wouldn’t want to be working with him…I’d always be watching my back in case something went wrong and I was caught up in the middle of it. I’ve had bitter experience of his family’s peculiar brand of justice.’

  He frowned. ‘I can’t say that I’m surprised he’s in charge, though. He’s always been ambitious, and I would imagine he’s aiming for a post as consultant himself. He wouldn’t be one to let the grass grow under his feet.’

  Hannah nodded. ‘I heard talk that he’s taking the exams and publishing work that will qualify him for a consultant position. Rumour has it that he’ll be moving on after that.’ That didn’t surprise her either. Ever since she had known Adam he had been steadfastly edging towards success.

  She began to clear away the breakfast crockery, while Ryan busied himself folding up the duvet he had used last night, and then he converted the simple sofa bed back into a couch. A few minutes later they were ready to leave.

  He went with her as far as the entrance to the A and E department, and she helped him to work out how he was going to get to the woods later on. ‘It looks as though you’ll need to take the Metropolitan Line,’ she murmured, glancing at her map of the underground.

  He nodded, but she saw that he was looking a little subdued, and she said hesitantly, ‘Are you bothered about going on your own? Maybe you and I could go together another day, or perhaps Abby and her little girl might like a trip out there after she finishes work?’

  ‘No, she can’t manage it. I already asked…I don’t really know her, but she was looking a bit down, and I sort of felt it was the right thing to do, especially since she was the one who told me about it. As it turns out, she’s working all day today. It doesn’t worry me, being on my own. I’m fine.’

  She looked at him. ‘I don’t think you’re fine at all. I know that something’s bothering you. Do you want to talk about it? Are you worried about the exams?’

  ‘No, it isn’t anything to do with my course.’ He looked uncomfortable, obviously diffident about saying any more.

  ‘Is it money?’ she asked. ‘I can let you have some to tide you over…’

  ‘I don’t want you to do that. Anyway, I’ve enough to last me for a while. I might apply for an extension to my student loan.’

  She frowned. ‘Are you sure?’

  His mouth made an odd shape. ‘I’m all right for the time being, anyway.’ He was quiet for a moment, but then seemed to come to a decision and said reluctantly, ‘The truth is, my landlord’s threatening to take me to court…he’s complaining about damage to property of some sort, and on top of that there have been threatening letters from the television rental company and one or two other companies that are getting tough with me over non-payment of bills.’ He straightened his shoulders. ‘I don’t really know what it’s all about, but I’ll sort it out somehow.’

  It didn’t make any sense to Hannah. She had thought Ryan’s troublemaking, rebellious years were behind him, and this wasn’t the sort of difficulty he would normally get into. Something was definitely wrong. She reached out and gave him a hug.

  ‘We’ll sort it out together,’ she said. ‘We’ll talk about it after I finish work, and I’ll do whatever I can to help.’

  Ryan nodded, but then he stiffened, his eyes darkening, and she looked around, following the direction of his gaze.

  ‘Hello, Ryan,’ Adam said. His grey gaze flicked over the pair of them, taking in their close embrace. ‘I didn’t realise that you were in London. Are you staying hereabouts?’

  ‘I’m staying with Hannah. It’s just a temporary arrangement,’ Ryan answered coolly.

  Hannah let her arms drop to her sides, and she drew back from him. The two men were regarding each other with marked suspicion, an undercurrent of hostility flowing between them, each one guarded and standing his ground.

  ‘How have things been going for you?’Adam asked. ‘Have you found a job that suits you?’

  ‘I’m not working,’ Ryan answered. ‘But, then, you’d know all about that, wouldn’t you? Wasn’t that what you expected after your father threw me out on my ear and told me not to go anywhere near his place again? Neither of you had any time for me. You kicked me out and thought that I would roll all the way downhill.’

  ‘I don’t think it was quite like that,’ Adam murmured. ‘It was a long time ago, and you were very young. You were never meant to be working on the estate in a permanent capacity.’

  ‘And that would be because you didn’t think I was good enough, wouldn’t it? Your family wanted to scrape me off their boots and throw me
on the scrap heap.’

  Adam didn’t answer, but inclined his head in Hannah’s direction and said, ‘I’m going into A and E. You and I are going out with the air ambulance today, so you should get ready. We leave in half an hour.’

  Hannah froze. This was the first she had heard of it, and the news threw her into an immediate state of turmoil. She had already shown that she was no good in situations outside the hospital. She felt as though she was inadequate and inexperienced away from the security of the hospital and all its facilities. He knew that, so why was he doing this to her?

  Adam strode away, and Hannah turned to Ryan, her expression bleak. ‘I have to go,’ she said. ‘Don’t concern yourself over what happened before. His family didn’t understand how things were with us, and perhaps they overreacted. I know that you’ve done nothing wrong.’

  ‘That’s because you’re an angel and you see good in everyone.’ He gave her an affectionate look. ‘You’ve been my guiding light over the years, Hannah. I’ve been thankful for your inner strength and your loyalty.’

  She hugged him again, briefly, and said softly, ‘We’ll talk later. Try not to dwell on what was in the past. That’s over and done with and you’re making a fresh start.’

  He walked away, and Hannah turned and went into A and E. She had problems of her own right now, and Adam’s words had sent her adrenaline into overdrive.

  She went into the changing room and pulled on the uniform over-trousers and jacket and then went to find him.

  He was by the desk, studying the day’s staffing schedule, but he glanced up as she came towards him. ‘Good, you’re ready,’ he said. ‘We’ll head up to the air ambulance landing pad.’ He started towards the lift, and ushered her inside.

  ‘You didn’t tell me that I would be doing this today,’ she said, her mouth a little stiff.

  ‘That’s because I had to revise the schedules last night. Colin is off sick, and so I put you in his place. I thought this would be good practice for you. We all do a week or so with the air ambulance. It’s good experience.’