He’s going to do a thoracotomy, Hannah thought in amazement when he then took a large metal rib spreader, inserted it between two of Ian Simpson’s ribs and spread them wide enough apart to get his hands into the chest cavity. It was a last-ditch effort, but if he pulled it off…
‘BP now, Flo?’ he demanded after he’d cut into the sac round Ian Simpson’s heart and the trapped blood gushed out.
‘Still falling!’
It shouldn’t have been. Hannah could see the patient’s heart beating more forcefully beneath Robert Cunningham’s fingers so the blood pressure should have been going up, not down.
‘There’s a hole in his heart!’ she exclaimed, suddenly seeing it. ‘Lower right side. The knife must have pierced it when he was stabbed!’
Without a second’s thought Robert inserted his finger into the hole and the flow of blood stopped instantly.
‘BP now, Flo?’ he asked.
‘Eighty over sixty…ninety over seventy…You’ve got him, Robert!’
‘Theatre ready?’
‘On standby,’ Jane replied.
‘OK, Flo, let’s go!’
And with Robert’s finger still lodged in Ian Simpson’s heart, Floella Lazear swiftly guided the trolley out of the cubicle and down the corridor, leaving Hannah gazing wistfully after them.
She would have liked to have gone, too. She would have been even happier if Robert Cunningham could have conceded she wasn’t entirely useless, but he hadn’t even glanced in her direction before he’d left.
‘If you’re hoping Robert will ever say “Well done”, I’m afraid you’ll wait until hell freezes over,’ Jane murmured, clearly reading her mind. ‘He’s not being rude, it’s just that he’s always so focused on his work it never occurs to him to give praise.’
‘He’s good, isn’t he?’ Hannah sighed. ‘At his job, I mean?’
Jane nodded. ‘Brilliant. Unfortunately he can also be lethal if he thinks you’re not pulling your weight, as poor Dr Jarvis discovered.’
‘Dr Jarvis?’ Hannah queried.
‘Your predecessor. He only lasted two months with us before he handed in his resignation. He just couldn’t cope, you see,’ Jane added as Hannah stared at her in dismay. ‘I don’t think he realised how stressful working in A and E was going to be, and not everybody is up to it.’
Hannah fervently hoped she was. Robert Cunningham quite clearly was. She’d never seen anyone approach a thoracotomy as casually as he had done, for all the world as though he’d been doing nothing more exotic than removing someone’s tonsils.
‘Robert is one of the best in the business,’ Jane continued, as though she’d read her mind. ‘You’ll learn a tremendous amount from him—we all have. I just wish…’ She sighed and shook her head. ‘I just wish he’d ease up a bit. He virtually lives at the hospital.’
‘He’s a workaholic, then?’ Hannah suggested.
‘He was always a very dedicated doctor, but ever since his wife was killed last year he virtually eats and sleeps A and E.’
‘Had they been married long?’
Jane shook her head. ‘Two years, that’s all. Laura was a junior doctor in the department, and she was knocked down by a car right outside the hospital. Actually, it was pretty awful. Robert was on duty when they brought her in.’
‘But that’s dreadful,’ Hannah gasped, truly shocked. ‘He must have been devastated.’
‘He was—is.’ Jane nodded. ‘And the trouble is, he won’t let any of us help him. He won’t talk about it or discuss it. All he does is work, and everybody knows that doesn’t solve anything.’
Sometimes it did, Hannah thought pensively. Sometimes work could be a panacea for your troubles, as she knew only too well. ‘Jane—’
‘Hey, what’s a nice girl like you doing in a place like this?’
Did every male doctor in this department walk like a cat? Hannah wondered as she turned to find herself gazing up into a pair of deep blue eyes. Deep blue eyes that were set in the handsome face of a man with blond hair. Elliot Mathieson, she decided. It just had to be, and Jane Halden confirmed it.
‘Elliot, that has to be the oldest chat-up line I’ve ever heard,’ she protested, and he grinned.
‘Fair’s fair, Janey. I’ve been up to my elbows in a perforated appy for the last forty minutes. What did you expect—originality?’
‘Something a whole lot better than that hairy old chestnut,’ she said with a laugh. ‘Hannah, this—if you haven’t already guessed—is Elliot Mathieson, our SHO. Elliot, meet Hannah Blake, the latest recruit to the madhouse.’
‘Pleased to meet you,’ he declared, shaking her outstretched hand. ‘Lord, but either I’m getting old, or you look terribly young.’
‘I’m ageing by the minute, believe me,’ she said with feeling, and he chuckled.
‘Rough morning?’
‘Not too bad,’ she replied, but Elliot wasn’t fooled for a second.
‘Had a run-in with Robert already, have you?’ he said shrewdly. ‘Stand up to him, love. If you don’t, he’ll walk all over you.’
She squinted over her shoulder at her back. ‘I think he already has.’
He laughed, then a slight frown appeared in his deep blue eyes. ‘Hannah Blake. Hannah Blake? Look, I know this is going to sound really corny but could we possibly have met before?’
Oh, but she didn’t need this, she thought, not on her first day. The department’s consultant, Mr Mackay, knew who she was, and eventually—inevitably—everyone else would find out, too, but she’d hoped to have established herself, to have proved she was good at her job, before that happened.
She cleared her throat awkwardly but to her relief Jane unwittingly came to her rescue.
‘You’re right, Elliot. That was corny, and clichéd, and undoubtedly the second oldest chat-up line, I’ve ever heard!’ she groaned.
The SHO stuck out his tongue at her. ‘I’m trying my best, Janey.’
‘In that case, maybe you should give up flirting,’ she retorted, and Elliot winked at Hannah.
‘She’s secretly madly in love with me, you know.’
‘Yeah, right, and I’m also six feet tall with a figure like a supermodel.’ Jane laughed. ‘Come on, Hannah. Elliot clearly needs time to think up some new chat-up lines, and you and I have work to do.’
Hannah chuckled as Jane bore her away, but her laughter died when she reached the end of the treatment room and glanced back to see that Elliot was staring after them, a decided frown on his forehead. How long would it be before the SHO remembered why her name sounded so familiar? A month—maybe less? And he would remember. She had no doubt about that.
But at least not today, she thought ruefully as the rest of her shift sped by in an exhausting and bewildering round of casualties. Nobody would have time even to think today, far less remember.
‘Doesn’t it ever ease up?’ she protested when Floella stripped the cover off the examination trolley and replaced it with yet another one in preparation for the next patient. ‘I’ve lost count of the number of casualties I’ve seen.’
‘Wait until you do nights,’ the staff nurse replied. ‘Days are a picnic in comparison.’
Jane had told her earlier that weekends were a nightmare, and now Floella was saying that nights were murder too. Terrific, Hannah thought, trying and failing to ease the ache in her shoulders and back. She could hardly wait.
‘Who’s next?’ she asked.
‘A fifty-two-year-old homeless man, complaining of trouble with his leg. He’s been living rough for the past ten years, so I’d better warn you—he’s pretty ripe.’
Ripe wasn’t the word Hannah would have used to describe the smell that emanated from the man Floella helped into the cubicle. Putrid was closer to the mark.
‘I understand you’re having bother with your leg, sir?’ she said, trying unsuccessfully to hold her breath when the man clambered awkwardly up onto the trolley.
‘I keeps falling over, ducks, and it ain’t becau
se I’m drunk.’ He cackled, revealing a row of broken, discoloured teeth. ‘Leastwise, not always.’
Hannah frowned as she took his blood pressure, pulse and temperature. His pupils were slightly dilated and his heart rate was unsteady. He might be only fifty-two, but he looked at least seventy, and unsteadiness on his feet could mean a stroke, or even heart problems.
The safest thing was to give him a complete examination. It would have been a task made considerably easier if he hadn’t appeared to be wearing every stitch of clothing he possessed, but what really puzzled Hannah was why, with every layer she and Floella removed, a strange, unidentifiable aroma should become stronger.
‘What is that smell?’ she murmured out of the corner of her mouth as Floella gingerly placed yet another layer of filthy clothing on the cubicle floor.
The staff nurse shook her head. ‘Beats me. Some new aftershave called City Streets, perhaps?’
It wasn’t. When they finally removed the last of the homeless man’s clothing the cause of the stench became all too horrifyingly clear. His leg was one huge, ugly, suppurating sore.
‘Dear God!’ Floella whispered, taking an involuntary step back, and it took all Hannah’s self-control not to run straight out of the cubicle.
‘I…I’m afraid I’m going to have to send you up to one of our wards, sir,’ she began. ‘Your leg…’ She took a deep breath and immediately wished she hadn’t. ‘It requires a lot more expert attention than I can give. I’ll get a porter…’
‘You mean I’m going to have to stay, ducks?’ the man asked, his faded brown eyes lighting up. ‘I’ll have a bed for the night? So every cloud does have a silver lining!’
Hannah wondered where her particular silver lining had gone when she turned to summon a porter and saw Robert Cunningham watching her.
She hadn’t seen him for at least a couple of hours, and something about the way he was leaning against the cubicle wall, his arms folded across his chest, told her she didn’t want to see him now.
‘Is there something wrong?’ she asked as soon as one of the porters had wheeled the homeless man away.
‘I won’t insult your intelligence by asking if you’ve kept your tetanus and hepatitis shots up to date,’ he observed, ‘and you’ve at least remembered to put on latex gloves…’
‘But?’ she said stiffly.
‘You didn’t put a mask on that patient and he was coughing.’
She gazed at him in disbelief. ‘Dr Cunningham, the man’s leg was plainly gangrenous, and you’re worried in case he might have a cold?’
He unfolded his arms and straightened up. ‘I am, if it means he has TB.’
‘TB?’ she echoed faintly.
‘Patients bring germs into A and E, Dr Blake. Hepatitis, HIV and TB, to name but three. We have a vaccine for hepatitis, and if you remember to wear gloves you should be safe from being accidentally infected with HIV, but TB is endemic amongst the homeless. Putting a mask on a patient who is coughing is the best—perhaps the only—way of preventing yourself from exposure.’
She opened her mouth, then closed it again. Even a third-year medical student would have remembered the dangers of TB. How could she have forgotten? How could she have been so stupid?
And Robert knew she had been stupid, and yet an unwelcome flicker of sympathy stirred inside him as he gazed down at her.
How old was she? Twenty-three—twenty four? She looked considerably younger with that ridiculous mop of hair, and it was clear from the redness of her cheeks that she didn’t need another lambasting. What she really needed was someone to give her a hug, to tell her they’d all made mistakes at the start of their careers. Well, the hug was a definite no-no, but he could at least provide some encouragement.
‘Look, Dr Blake—’ he began gently, only to spin round as a piercing scream split the air. ‘What the—?’
‘The waiting room!’ Hannah exclaimed. ‘It sounded as though it came from the waiting room!’
It did, but as they ran through the waiting-room doors together Hannah came to a horrified halt when she saw the reason for the disturbance. Two drunks were fighting by the tea and coffee dispenser, while a third was casually urinating against the reception desk.
‘Shocked, Dr Blake?’ Robert murmured, hearing her sharp intake of breath.
Of course she was shocked, he thought as he gazed down at her white face. Only a man like him who had long since lost all feeling wouldn’t have been, and Hannah was plainly sensitive. Sensitive and vulnerable with her big brown eyes and golden brown curls, and suddenly, inexplicably, he knew that he didn’t want to see A and E destroying her freshness and enthusiasm. Didn’t want to watch her becoming hardened and cynical as he knew she must to survive.
‘This is child’s play compared to what you’ll have to face in the future, Dr Blake,’ he continued as two security guards manhandled the drunks away and their receptionist began calming the waiting casualties. ‘Fifteen—even ten years ago hospitals used to be regarded as sacred territory, but not any more. Now, doctors, nurses and porters are routinely threatened or attacked by gangs, disgruntled patients and psychotics.’
She glanced up at him. ‘Are you trying to frighten me?’
His grey eyes held hers. ‘Am I succeeding?’
She lifted her chin a notch. ‘No.’
‘Then you’re a fool,’ he said bluntly. ‘The NHS doesn’t award medals for bravery, and the staff who survive in A and E are the ones who possess a healthy sense of fear.’
Oh, she possessed a healthy sense of fear all right, Hannah thought ruefully, but it wasn’t fear for her own safety. It was fear that in an emergency she might not be able to cope. In a crisis she might be found wanting.
And you’re going to tell Robert Cunningham that, are you? a little voice asked at the back of her mind as she watched him walk back into the treatment room. You’re going to tell him you’re scared you’ll fail?
Unconsciously she shook her head. No, she couldn’t tell him that—she simply couldn’t—but she also realised something else as she stared out over the still crowded waiting room.
It wasn’t only the special registrar’s good opinion that mattered. It was the people sitting there. The people who were in pain, the people who were unhappy, the people who were looking to her to help them.
Nobody had ever said this branch of medicine was easy. Nobody had promised it would be a bed of roses. She had chosen to specialise in A and E, and somehow—some way—she was going to have to cope. She had to. To be able to look Robert Cunningham in the eye, and maintain her own self-respect.
CHAPTER TWO
IT COULDN’T be anyone else, Hannah thought with dismay as she came to a halt in the middle of the pavement. The broad shoulders, the shock of unruly black hair, the way he was walking with his chin hunched deep into his shoulders. Robert Cunningham. Robert Cunningham walking so slowly that unless she made an immediate detour she’d catch up with him.
So, catch up with him, her mind urged. Since you came to St Stephen’s a fortnight ago the man’s scarcely said two words to you. Maybe he’d welcome the opportunity to talk. Maybe he only appears distant and aloof because he’s still hurting over the death of his wife last year.
Yeah, right. And maybe this was really an incredibly bad idea, she decided when she quickened her pace and he greeted her cheery ‘hello’ with all the enthusiasm of someone stuck at a party with the world’s biggest bore.
‘I didn’t know you lived around here,’ he observed, managing to make his comment sound like an accusation and a condemnation at the same time.
‘I’ve got one of the hospital flats in Leyland Court,’ she replied, pointing to the drab grey building behind her. ‘It looks a bit grim from the outside but the flats themselves aren’t too bad.’ Actually, they were dreadful. Minimum furniture, minimum comfort, maximum dreariness. Their sole advantage was their close proximity to St Stephen’s. ‘I understand you live in Wellington Place—in fact, we’re practically neighbours—�
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‘Aren’t you far too early for your shift?’ he interrupted. ‘Or has my watch stopped?’
‘I always come in early. There aren’t any private kitchens in the flats, you see,’ she added as his eyebrows rose. ‘And as the communal one gets a bit frantic in the morning I usually just pick up some coffee and toast in the canteen before I start work.’
‘I see.’
‘St Stephen’s…It does the best breakfast in London.’
And why the heck was she bothering? she wondered when her voice trailed away into silence and he said nothing. He didn’t want to hear about her eating habits. He obviously didn’t want to hear anything she had to say, full stop. The best thing she could do was to make herself scarce, fast.
‘I’d better go…’
‘How are you settling in at the hospital?’ he asked unexpectedly.
Was she supposed to think he cared? ‘Fine, thank you.’
‘No problems, then?’ he pressed.
Lots. Like never seeming to get enough sleep. Like knowing she was surviving each day in A and E on a wing and a prayer. But the main problem at the moment, she thought ruefully, was Robert Cunningham obviously suddenly deciding he ought to talk to her. ‘No problems, thank you, sir.’
‘It’s Robert,’ he said irritably. ‘Everyone calls me Robert.’
She knew that, but now didn’t seem to be the time to point out he’d never actually told her to call him by his first name. ‘I really ought to go—’
‘Do they still serve fried bread in the canteen?’ he interrupted.
‘F-fried bread?’ she stammered, then nodded.
‘Then what are we waiting for?’ he asked, surprising her for a second time. Hannah’s surprise was as nothing to the total bewilderment Robert felt when he found himself standing in line at the hospital canteen.
What in the world was he doing here? he wondered, all too uncomfortably aware of the number of pairs of curious eyes fixed on him. Normally he just had strong black coffee for breakfast. Normally he avoided any kind of social contact with his colleagues like the plague.
A Wife for Dr. Cunningham Page 2