‘I think she had a needle for that when she was one but I’d have to check.’ Fear brought a quaver to the words. ‘Do you think that’s what it is?’
Mac reached out and touched Sally’s shoulder.
‘We don’t know but the fever means an infection and starting antibiotics straight away will help no matter what it turns out to be.’
He nodded to Izzy, who told Rhia about the needle, and waited until Ben had lifted his daughter into his arms before swabbing the skin, using deadening lotion, then slowly administering the antibiotic.
Rhia cried, but it was a half-hearted effort, and her listlessness made Izzy fear the worst.
Mac was explaining that he would need to take blood and some cerebrospinal fluid for testing, and Izzy suggested they move to the small room that was sometimes used as a second resus room.
Mac nodded, then smiled down at Rhia.
‘Do you mind if I carry you instead of Daddy?’
There was no objection so he lifted her and carried her gently into the more private space. Izzy asked Ben to wait and with his help she filled in the admission form before leading him to join the others.
Mac had settled Rhia on a high table and with Izzy’s help secured an IV port in their patient’s little hand. He handed Izzy a vial of blood to be sent off for testing, then explained to Rhia that he needed her to lie on her side so he could put another needle in her back.
‘I’m sorry sweetheart,’ he said, smiling at the little girl, ‘but we need to find out what’s making you sick. I’ll do my best not to hurt you.’
But Rhia was beyond caring, she simply stared at Mac with those big blank eyes, while Sally cried quietly on her husband’s shoulder.
So Izzy held their patient curled on her side on the table while Mac numbed the site with local anaesthetic, then inserted the needle to test CSF pressure before withdrawing a sample. Izzy cleaned and covered the site with a dressing before gently rolling Rhia onto her back.
Mac was putting details on the chart, so Izzy labelled and packed the fluid container, added the blood sample to the package and passed it to the courier she had phoned earlier.
‘Now we wait,’ Mac said quietly, as Rhia’s parents moved closer to their daughter, one on either side, holding her hands and talking quietly.
Mac followed Izzy out of the room.
‘If it’s confirmed as meningococcal we’ll have to find out who’s been in contact with her for the last week and give them all a dose of clearance antibiotics—starting with her parents. And if it is meningococcal there’ll be a run on the vaccine. Is it subsidised by the government or will people have to pay for it?’
‘If she had the vaccine, and she probably did, it would have been Type C. Since that’s been on the free list the most common strain in Australia is B and although there’s now a vaccine for it, you have to buy it.’
Mac nodded.
‘We’ll have to admit her, if only for observation—at least until the test results come back.’
‘She could go into the family room, and that way her parents could stay with her. She’s an only child and Sally’s a stay-at-home mum so she could be here all the time and Ben go to work from here.’
Mac grinned at her.
‘Family room, huh? I did wonder why one of the rooms had a double bed.’
Was it the grin or the mention of a double bed that raised Izzy’s heart rate?
‘It’s a very useful room to have,’ she said reprovingly. ‘Apart from making it easier for hospitalised children to have their parents with them, it’s been great for elderly people especially. Imagine being married for sixty years and suddenly your spouse is hospitalised twenty miles away. It’s too much to expect them to visit for an hour or two each day.’
Mac’s smile was back and with it Izzy’s heightened pulse.
‘I’m still back at the imagining being married sixty years part—I didn’t make it to three.’
‘Didn’t work out?’
She remembered him saying he’d been married—back at that embarrassing dinner. And something else—that he wouldn’t marry again?
His marriage must have been bad.
And the wretch was still smiling.
‘I think you’ll find in your statistics that something like forty percent of marriages fail.’
‘You’re wrong, it’s one in three marriages fail so that’s thirty-three percent,’ Izzy muttered, disturbed by the conversation, although she couldn’t work out why.
Mac’s life, former, present, or future, had nothing to do with her.
Mac watched her walk along the passage that gave entry to the rooms that made up the ward. He liked the design of the hospital, with an enclosed courtyard garden on the other side of the passage. And along the outside of the patient rooms was a long veranda so those well enough could sit outside, enjoying the sunshine and the view over the town to the ocean.
Halfway down was the nurses’ station, well set up with computers, monitors and light boxes. Someone had taken the trouble to make the new hospital, in the damaged part of the old building, into a relaxed and pleasant place for patients, and a great working environment for the staff.
‘You’re Mac, I believe,’ a voice said from behind him, and he turned to greet a young Asian woman, the crisp white coat and the stethoscope slung around her neck a dead giveaway that she was a doctor.
‘I’m Aisha Narapathan,’ she introduced herself, holding out a slim hand for him to shake. ‘I’ve a patient in Room Fourteen, and I pop in to see her most mornings.’
Mac introduced himself, and smiled.
‘You’re from the local GP group?’
Aisha nodded.
‘We act as on-call doctors when you and Roger are off duty and although our patients are happy with the treatment they get in hospital, I like to check up on them myself. At times when there’s been only one doctor employed at the hospital, and we’ve been rostered on for morning rounds. It might seem a clunky system at first but it works.’
She smiled again, and added, ‘Most of the time. You’ve had a busy weekend, I hear. Normally one of us would have been on call—we cover weekends as well—but Saturday night was our receptionist’s wedding and, it being a country town, we were all invited.’
‘We managed,’ Mac assured her.
‘I’m sure you did,’ Aisha said. ‘With Izzy around, even the most helpless of the contract doctors we’ve had at the hospital can manage.’
She moved on but not before Mac caught the flash of a bright diamond on the ring finger of her left hand.
Was she the doctor engaged to Roger Grey?
His thought was confirmed when he saw her as she was leaving.
‘You must come to dinner one day. Roger and I would love to have you. I’ll tell him to arrange it with you.’
An aide arrived with a message. There was a phone call for him in his office.
He headed in that direction, pausing only to say goodbye to Aisha.
Was this job going to turn into a deskbound one? Surely not—and not if the weekend was anything to go on.
But interaction with people—with patients and their relatives—was the part of medicine he enjoyed the most.
The voice on the phone introduced himself as the pathologist at Braxton Hospital.
‘I’ve emailed the results to you but thought it would be good if we spoke.’
He introduced himself, asked the usual questions about where Mac had trained, seeking acquaintances in common, then explained.
‘It’s meningitis meningococcal for sure. The bacteria are present in the spinal fluid but none in the blood.’
‘Thanks, mate,’ Mac said. ‘I owe you one for getting it done so quickly.’
But as soon as he’d hung up he wondered if the hospital
would have ceftriaxone on hand, or whether he should have ordered some for Braxton.
There were optional drugs, but lately it had been the one of choice for meningococcal attacks on the brain.
He looked up from doodling the name on his desk pad to see Izzy flash past the door.
‘Izzy!’
She turned, stopping in the doorway. For the first time he realised just how horrible the dark blue uniform tunic looked on a redhead, although he still felt his groin tighten just looking at her.
‘Ceftriaxone?’ he asked.
‘So it is meningitis,’ she said, her voice flat with the anxiety she felt for the child. ‘We’ve some in stock. I’ll set up a drip.’
‘I’ll do it,’ he said, ‘but come with me while I tell Rhia’s parents. They’ll feel better with someone they know in the room.’
Will they? Izzy wondered, but she accompanied Mac back to the family room, where Mac explained the result.
He did it well, she realised, listening to his explanation of what was happening inside their daughter’s body, then moved swiftly on to treatment.
‘We’ve got it early,’ he told them. ‘You were right to get help immediately she had the seizure. There are good drugs to treat it and we’ll start a drip straight away so the antibiotic is going directly into her bloodstream. I’ll also give the pair of you antibiotics and later the vaccine.’
He turned his attention to the small patient in the big single bed in the family room.
‘I know you’re feeling bad right now,’ he said, stroking strands of pale brown hair off her face, ‘but we’re going to get you better.
‘She’ll be here for a few days, probably longer,’ he said quietly to Ben on his way out the door. ‘You might want to get some toys she’s familiar with and her own pyjamas and a few clothes for her and the pair of you.’
‘And books. I’ll get books—she loves us reading to her.’
Hmm...Izzy thought to herself when she heard Ben’s voice strengthen at the thought of having something to do to help. She knew already that Mac was a good doctor, he’d shown that in the emergencies over the weekend, but he was also a good psychologist.
Or perhaps just a caring man, sensitive to how Ben must have been feeling?
Whatever! She didn’t need to be seeing these compassionate sides of him, they would add depth to the silly attraction she was already feeling.
But right now at least she could get away from him—she had a job to do in the pharmacy.
Except he caught up with her on the way and it was hardly a pharmacy, just a room where drugs were kept.
A very small room!
She paused outside the door.
She didn’t have to go in!
Of course she did, she knew where it was kept.
He’d stopped beside her and she was so conscious of him her skin itched.
This was crazy—there was no other word for it. She’d been attracted to The Rat, as her family now called the last man in her life, but not like this—not as if the attraction was a tangible thing, not only causing responses inside her body but in her skin as well.
‘What’s the protocol?’ she asked, forcing her mind to matters medical, fumbling with her keys to find the right one as if that, and not her disinclination to be in a very small room with him, was the hold-up.
‘Seven days’ IV for Rhia, in saline, not Ringer’s, because it doesn’t mix well with anything that has calcium in it. Then we’ll have to give antibiotics to any people who’ve been in close contact with her in the last week, and check all of their statuses as far as vaccination goes. We’ll get a list of friends and relations from her parents. Was she at childcare of any kind that you know of?’
Whatever was affecting her couldn’t be affecting him that he was being so practical.
She could do practical!
‘She’s four. She’d be at the local pre-school probably three days a week. I’ll get our secretary to phone the director and get a list.’
‘Of teachers, too,’ Mac reminded her as she finally got the key to fit into the keyhole and unlocked the door of the pharmacy.
They stepped inside together—close—and without turning to face her Mac said, ‘I understand your reluctance to be going out with men because of the adoption business, and I know it’s bizarre, but I’ve never felt an attraction like the one I feel for you. I thought maybe if we gave in to it, say for a week or two, it might go away. That’s if you feel it, too, of course...’
His voice was only slightly strangled, but Izzy knew any words she said would come out far worse—if at all.
He’d touched her lightly and somehow they turned to face each other, not touching, not close enough to cause a scandal should anyone walk past, but Izzy could feel the shape of him in her skin, catch the warmth of his breath on her lips.
‘You must feel it,’ he said. ‘Something this strong can’t be one-sided.
She almost nodded—no way could she deny it. But caution, memory of the last disaster—and somewhere in her head and heart concern for Nikki—held her back.
‘The ceftriaxone should be in here,’ she said, moving towards a cupboard where she knew the powder was kept. It would be dissolved in the saline solution and dripped slowly into Rhia.
Then Mac was right behind her, peering into the cupboard, examining its contents, taking his cue from her—now totally professional.
‘I have had a look inside these cupboards and the refrigerators but, as yet, couldn’t put my hand on anything.’
‘Which is why you have staff,’ Izzy told him, so rattled by his presence she was shaking.
‘Staff I can put my hand on?’ he teased, touching her lightly on the shoulder. Not quite professional!
Was he another Rat or just another touchy person like Roger?
Izzy doubted it—this was something they both felt.
‘We can’t talk here,’ she said desperately, a vial of the yellowish powder in her hand.
‘Then later?’ he asked, his breath now warming her neck.
‘Sometime!’ she said, almost shouting, desperate to get out of the room, away from Mac, if only so her body could settle down and her brain regain some thinking power.
He moved away, finding a bag of saline for all he’d said he didn’t know his way around.
Izzy glanced at her watch—it had been less than five minutes since they’d left the corridor, yet it had seemed like a lifetime.
But was he right? Could a short—short what? Affair? Liaison?—kill the attraction?
She had no idea but as it was impossible to think while he was in such close proximity, she chose escape.
‘I’ll leave you to mix it if that’s okay? I’ve other patients I need to check. They’ll be thinking no one cares about them.’
And she fled, although her excuse hadn’t been entirely true. Patients in a small hospital knew the staff could become caught up in emergencies and they bore it well, knowing it could be them or one of their loved ones who needed urgent attention next time.
And Mac was probably intuitive enough, from what she’d seen of him, to know it, too.
* * *
Was he avoiding her as assiduously as she was avoiding him? Izzy wondered later, when she was sitting in the secretary’s room, working out how she could juggle the rosters for the week.
They would need more nursing staff on duty to handle vaccinations and antibiotics for adults and children who’d been in contact with Rhia, and the budget didn’t have much wriggle room.
‘Here’s the list from Sally and Ben. They’ve included phone numbers where they knew them.’
She looked up to see Mac hovering over her desk, a piece of paper in his hand.
‘One of the aides could have delivered that,’ she said, disconcerted to hav
e him back in her space when she’d thought she’d escaped.
She’d been looking up at him so saw from a half-smile that he was about to say something silly, then he glanced towards Belle at the desk at the back of the room and must have thought better of it.
Instead he tilted his head to see what she’d been doing. ‘Have we enough staff to help out with the vaccinations when people hear about it and start coming in?’
Izzy pointed at the sheet.
‘It’s a juggling act, but staffing at small hospitals always is so, yes, we’ll manage.’
A soft chime told them they had a patient in the ED and the enrolled nurse on duty there needed help.
‘I’ll go,’ Mac said. ‘You keep juggling, and maybe Belle can start on the phone calls.’ He took his list from Izzy and passed it over to Belle, talking to her in a quiet voice, suggesting what she might say, emphasising it was a precautionary move but it was better to be safe than sorry.
As he whisked out of the room, Izzy let out the breath she’d been holding. What was it about this man that had her so uptight? So dithered and confused?
Another soft chime and she knew she was needed. The rosters would have to wait, and as for unanswerable questions—well, those she had to put right out of her mind.
What was quite a large room for a country ED was filling up rapidly—filling up with worried-looking mothers or fathers, each clutching a small child by the hand.
‘Dr Mac told me to phone the pre-school earlier,’ the enrolled nurse on duty told her, ‘and they must have started contacting parents straight away.’
Izzy could see Mac in a curtained alcove already, speaking to an anxious father. He saw Izzy, excused himself, and came across to her.
‘We’ll do antibiotic jabs today and ask parents to check their child’s immunisation schedule and come back if they need the vaccine.’
‘Sounds good,’ Izzy said. ‘I’ll rustle up a few more nurses or aides to organise this scrum.’
As the day wore on, the trickle of people who’d been in contact with Rhia became a flood. Mac had contacted Braxton for more antibiotic and warned they could also be needing vaccine.
A Forever Family for the Army Doc Page 8