It was all Hannah Blake’s fault, he decided, glancing irritably across to where she’d found them an empty table by the window. If she hadn’t looked so ill at ease talking to him. If he hadn’t found himself suddenly feeling guilty for the way he’d been ignoring her since she’d come to St Stephen’s…
And was it any wonder he felt guilty? Little Miss Muffet who looked as though a puff of wind would blow her away. Little Miss Muffet with her snub nose, too-large brown eyes and skin so pale he suspected a kiss would bruise it.
Not that he ever had any intention of finding out. Good God, no. He wasn’t looking for a relationship, and, even if he had been, cradle-snatching had never been in his line. He simply felt sorry for her, he told himself firmly, as he would have for any junior doctor new to A and E. And someone had to make sure she was starting an eight-hour shift with something more substantial than a cup of coffee and some toast in her stomach.
‘That isn’t what I ordered,’ she protested when he arrived at the table carrying two heavily laden plates of the St Stephen’s special.
‘You need feeding up.’
‘But—’
‘Eat,’ Robert ordered, putting one of the plates down in front of her.
‘Aye aye, sir,’ she muttered, but he heard her.
‘Insubordination, Dr Blake?’
That was very nearly a joke, she thought in amazement, and sure enough, when she glanced up at him, there was actually a ghost of a smile playing round his lips.
‘Mutiny, more like,’ she observed wryly. ‘If I eat even half of that I’ll be comatose by eleven.’
‘Not with our workload, you won’t. Look, Dr Blake—’
‘My name’s Hannah,’ she interrupted, ‘and if you’re worried in case I’m either too poor to buy myself breakfast or anorexic, you can relax. I’ve never eaten much for breakfast and I’ve always been thin.’
Skinny would have been a much more accurate description, he thought critically. Skinny, and pale, and he’d bet money those dark shadows under her eyes weren’t smudges of mascara.
‘Hannah, nobody can work a sixty-hour week and study at the same time if they’re not eating properly,’ he insisted, then bit his lip. He was beginning to sound like her mother. He’d be asking her next if she was getting enough sleep, remembering to wrap up warm. ‘And we’re short-staffed enough in A and E as it is, without you suddenly going off sick,’ he added brusquely.
The smile that had been lurking in her eyes died. ‘I’m sorry,’ she murmured, picking up her knife and fork. ‘I’ll try my best not to inconvenience you by becoming ill.’
Which was all he was interested in, he told himself, so why did he suddenly feel like a complete and utter heel? And he did as he watched her silently beginning to eat her breakfast. She hadn’t asked him to join her—he’d invited himself—and what had he done? Supplied her with a breakfast she didn’t want, and made her feel guilty into the bargain.
‘Look, are you really settling in all right in A and E?’ he asked before he had time to consider the wisdom of his question.
‘Of course I am,’ Hannah began brightly, then sighed a little wryly when his eyebrows rose. ‘OK—all right—I’ll admit it’s a lot more immediate than I’d expected. One minute you’re dealing with a splinter in somebody’s finger, the next it’s a possible heart attack.’
‘And with no medical records to go on, “What’s wrong with the patient?” can all too quickly become “What did the patient die of?”’ He nodded. ‘The trick is to become very skilled at asking the right kind of questions.’
‘Yes, but even asking someone “How badly does it hurt?” doesn’t help a lot when pain is such a very personal thing,’ she exclaimed, forking some egg into her mouth. ‘I mean, what you might find quite bearable, I could say was excruciating.’
Robert doubted it. She might look as though a puff of wind would blow her away but now that he was looking at her—really looking—he could see a hint of stubbornness about her jaw despite her apparent fragility, a determination in her large brown eyes he hadn’t noticed before. Miss Muffet had backbone. The big question was whether she had enough.
‘I think the best advice I can give is always think the worst,’ he observed, taking a sip of his coffee. ‘Rule that out first, then you can safely move on to investigate other possibilities.’
It was good advice. What amazed her most was that it was Robert Cunningham who was giving it. Robert Cunningham, whose habitual response to any question she’d asked since she’d arrived at St Stephen’s had been a brusque, ‘Ask Elliot.’
He looked different, too, today, she decided, though she couldn’t for a moment figure out why. His faded green shirt was just as crumpled as all the other shirts he normally wore, and though his corduroys were black this morning instead of brown, that hardly explained the difference.
It was because he was smiling, she suddenly realised. OK, so it wasn’t a full-blown, right-up-to-the eyes effort, but it was still a smile and she’d been right when she’d thought it would change him. It made him look considerably younger and quite unexpectedly attractive. His hair badly needed cutting, of course, and his shirt could have done with an iron…
And you need your eyes tested if you think this man’s attractive, her mind protested. Elliot Mathieson’s an attractive man. Robert Cunningham’s a mess. Yes, but a mess with a very nice smile when he chooses to use it.
‘And don’t ever be afraid to ask for help,’ Robert continued, clearly taking her silence to mean just that. ‘Nobody expects you to be an expert when you’re first starting out.’
Kindness, understanding from Robert Cunningham? Wonders would never cease, she thought in amazement. In fact, if he was going to be this accommodating perhaps she might actually be able to start relaxing at St Stephen’s.
And then again, perhaps not, she thought, her heart skipping a beat when he suddenly added, ‘According to your CV, you were born in Edinburgh, and did all your training there. What brought you to London? I mean, wouldn’t it have made more sense to look for your first post in your home town?’
‘I wanted a change of scene,’ she replied lightly, ‘and as I used to come to London a lot for holidays when I was a little girl, I thought, why not?’
It had been the answer she and Mr Mackay, the consultant in charge of A and E, had agreed upon, and none of the rest of the staff had ever queried it, but, then, none of them, as she quickly discovered, was Robert Cunningham.
‘You have relatives here, then?’ he pressed. ‘If you came often when you were a child…?’
‘Not relatives, no,’ she floundered. ‘My father…he just happened to like London.’
A slight frown appeared in his dark grey eyes. ‘It still seems rather a long way to come on the strength of holiday memories. Personally, I’d have thought starting a new job was enough of an upheaval without uprooting yourself as well.’
‘Like I said, I wanted a change,’ Hannah declared, striving to sound casual, dismissive, only to feel her cheeks heating up under his steady gaze. Why, oh, why did she always have to blush at the most inconvenient moments? It was a childish habit she should have outgrown years ago. ‘And it seemed the right moment to make the break.’
‘Yes, but—’
‘Good grief, is that the time?’ she interrupted, getting to her feet. ‘We’d better go, or we’ll be late for the start of our shift.’
She was right, they would, but Robert’s frown deepened as he followed her out of the canteen and into A and E. Hannah Blake wasn’t telling the truth about why she’d come to St Stephen’s. She had a secret—a secret she didn’t want discovered—and he didn’t like secrets, never had. Secrets meant guilt. Secrets meant complications, and A and E had no room for either.
‘Hannah, about this decision of yours to come to London—’
‘RTA on the way, Robert!’ Jane called. ‘ETA five minutes.’
‘Injuries?’ he demanded, instantly focused.
‘One female a
ged twenty-nine with minor cuts and bruises,’ the sister replied, ‘and a six-year-old girl with chest and head injuries. I’ve alerted the chest surgeon in case we need him, told Theatre to be on standby, and Jerry’s on his way down from radiology.’
Robert started towards the treatment room door, then glanced back at Hannah. ‘Would you like to assist me on this one?’
She gazed at him, open-mouthed. Did he mean it or was he joking? The question was academic. Robert Cunningham didn’t joke. ‘You bet!’ she breathed.
‘Just remember—’
‘To keep out from under your feet at all times.’ She nodded. ‘I haven’t forgotten.’
A faint smile appeared in his eyes. ‘Actually, I was going to say, if we need to intubate the little girl would you like to tackle it?’
‘Oh—Right—Of course,’ she replied, mentally kicking herself. ‘I thought…when you said—’
‘Hannah, will you relax?’ he said gently. ‘I’m not an ogre, you know.’
Perhaps not, she thought with a sigh as the ambulance arrived, its siren wailing, but he certainly could give a pretty good impression of being one at times.
‘The kid and her mother are in London for a few days’ holiday,’ one of the paramedics announced as he and his colleague transferred the little girl from the stretcher onto the trolley. ‘They were coming down The Mall when some maniac sideswiped their car, then took off.’
‘Wonderful,’ Robert commented dryly as Floella began inserting more IV lines to carry the O-negative blood which had already arrived, and Jerry Clark wheeled in his portable X-ray machine. ‘Jerry, I’d like X-rays of her chest, pelvis and cervical spine. Hannah—’
‘Get ready to intubate.’ She nodded.
The little girl’s head might be covered in blood, and her kneecap protruding at a grotesque angle through her skin, but the first priority was to regulate her breathing. At the moment it was ragged and uneven, and if they didn’t alleviate it her brain would start to swell because of the reduced oxygen it was receiving.
‘Are you ready, Hannah?’ Robert asked, after he’d inserted a catheter into the child’s urethra to drain her bladder and given her an injection to temporarily sedate and paralyse her.
She nodded. Once Robert opened the front of the cervical collar round the little girl’s neck, and pressed down firmly on the cricoid cartilage so her stomach contents couldn’t reflux into her airway, they’d have to work fast.
‘I’m ready,’ she said.
‘OK, let’s go,’ he ordered.
Swiftly Hannah inserted the laryngoscope blade into the girl’s mouth and suctioned away the blood and saliva obscuring her vocal cords. Then very gently she eased the endotracheal tube past her vocal cords and down into the child’s trachea.
‘Everything OK, Hannah?’ Robert murmured.
It felt all right, it seemed all right, and she placed her stethoscope on the child’s chest and listened. Bingo! She was breathing deeply and evenly without effort.
‘Everything’s fine,’ she replied with relief.
‘Is the haematocrit back on those blood samples yet?’ Robert demanded. Floella held out the results to him, but to Hannah’s surprise he waved them towards her. ‘What have we got, Hannah?’
Quickly she scanned the results. ‘Red cell count very low. How’s her BP?’
‘Stable,’ Floella called.
‘X-rays of the chest, pelvis and cervical spine are ready, too, Robert,’ Jerry declared, but again, to Hannah’s bewilderment, the special registrar nodded towards her.
‘Any problems, Hannah?’ he asked, snaking an orogastric tube into the little girl’s mouth, past the endotracheal tube and into her oesophagus to empty her stomach.
‘Two broken ribs—pelvis fine, cervical spine fine. On the evidence of these I’d say she should probably have a CT scan to check out those head injuries before she goes to Theatre, but…’
‘But?’ Robert prompted, his eyes fixed on her.
‘To be perfectly honest, I’m not sure,’ she admitted. ‘It’s her stomach, you see. It looks very firm to me, and it also seems slightly distended.’
‘So?’ Robert pressed.
Hannah took a deep breath. If she was wrong, so be it. If she looked like an idiot, she’d survive.
‘I think the haematocrit result is too low for the amount of blood the child seems to have lost. I think she could be bleeding into her stomach and I’d send her to Theatre right away.’
For a moment Robert said nothing, then he smiled—a real, honest-to-goodness smile. ‘So would I. Well done.’
He’d praised her, she thought in amazement as Floella and one of the porters wheeled the little girl out of the cubicle. She couldn’t believe it, but he’d actually praised her.
‘If your smile was any bigger I’d say you’d just won the lottery,’ Jane observed, meeting her as she made her way to the white board to erase the child’s name. ‘Care to explain why?’
Hannah’s smile widened as Robert strode past them and into cubicle 3 to talk to the child’s mother. ‘Would you believe hell just froze over?’
‘Hell just…?’ Jane gazed at her in confusion, then shook her head. ‘Insanity. Normally it takes two to three months for people working in A and E to succumb—’
‘Succumb to what?’ Elliot asked curiously, overhearing her.
‘Insanity,’ Jane declared. ‘Poor Hannah here. Right as rain two weeks ago and now…’ She sighed and shook her head mournfully. ‘Completely nuts, like the rest of us.’
Quickly Elliot clasped Hannah’s wrist between his fingers and consulted his watch. ‘Pulse rate fast and erratic, silly smile on her face…Yup, it looks like insanity to me, but I’d have to make a full examination to be sure. How about my place, tonight, eight o’clock?’
‘Elliot, I said the girl was nuts, not stupid!’ Jane exclaimed and Hannah chuckled as the sister hurried to answer the phone.
‘I think I’ll give the examination a miss, Elliot.’ Hannah smiled.
‘Do I look like the sort of man who’d take advantage?’ he protested, his blue eyes wide and innocent.
‘Elliot, you look like the man who wrote the book on how to!’ She laughed.
‘Too true,’ he teased with a wickedly handsome grin. ‘So your mother warned you about men like me, did she?’
Her smile became a little crooked. ‘My mother died when I was born so she didn’t have time to warn me about anything.’
His own laughter died instantly. ‘Hannah, I’m sorry…I didn’t know—’
‘It’s OK,’ she interrupted. ‘I never knew her, and people keep telling me you don’t miss what you’ve never had.’
‘And people who make observations like that deserve to be hung, drawn and quartered,’ he declared, putting his arms around her and giving her a hug. ‘Extremely slowly.’
She chuckled but she didn’t move out of his arms. He was hugging her with sympathy and understanding, and she accepted the gesture in the spirit it was given.
Robert clearly didn’t. In fact, judging from his thunderous expression when he emerged from cubicle 3 and saw them, he didn’t appreciate the gesture at all.
‘I think we’d better get back to work,’ she murmured, quickly extricating herself from Elliot’s arms. ‘The boss doesn’t look too happy about us wasting time.’
Elliot glanced over his shoulder at Robert and an amused smile curved his lips. ‘Oh, I don’t think that’s what’s bugging him, sweetheart.’
‘You don’t?’ she said, puzzled, and he shook his head.
‘It’s jealousy, love,’ he whispered. ‘Pure, unadulterated, green-eyed jealousy.’
A splutter of laughter came from her as Elliot strolled away. Robert Cunningham jealous? If Elliot believed that then insanity wasn’t simply common in A and E, it was endemic, but, judging by Robert’s grim expression as he began walking towards her, now wasn’t the time to discuss it. Now was the time for a very swift retreat, and Paul Weston in cubicle 6, with ac
ute back pain according to the white board, fitted the bill perfectly.
‘I feel so stupid, Doctor,’ the young man declared the moment he saw her. ‘I was helping my sister move some furniture yesterday, and now I can hardly move.’
‘Which part of your back actually hurts?’ Hannah asked, pulling up a chair to sit level with him.
‘Down near the bottom—sort of to the left. And I’m feeling a bit sick, too.’
Warning bells went off in her head immediately. Nausea coupled with back pain could mean pyelonephritis—an inflammation of the kidneys—or even chronic kidney failure.
Robert had said she should always think the worst, she remembered, and she fully intended to.
‘Have you been passing less urine recently, Mr Weston?’ she asked, quickly taking his pulse.
‘Yes, but—’
‘Felt feverish at all—lethargic—as though you were coming down with flu?’
‘Doctor, I only came in because I pulled a muscle in my back,’ he protested.
Maybe he had. His pulse rate wasn’t high, and his temperature and blood pressure were near normal, too, and yet…
‘I’d like to do a few tests, Mr Weston,’ she declared, getting quickly to her feet. ‘Just as a precaution.’
‘If you say so,’ he murmured reluctantly, ‘but could you give me something for this pain while I wait? I’m in absolute agony.’
A painkilling injection wouldn’t affect the results of any tests she performed so swiftly she administered one, then went to phone the lab. Speed was of the essence if Paul Weston was suffering from chronic kidney failure, and she wanted to ensure there’d be no delay over any samples she took.
‘Something wrong?’ Jane asked, seeing Hannah frown as she put down the phone.
‘Could be. Look, are you free right now, Jane? I need to take some blood and urine samples.’
‘No problem.’ The sister nodded. ‘Where’s your patient?’
‘Cubicle 6.’
Jane stopped in mid-stride. ‘Cubicle 6’s empty. The guy who was in there left a couple of minutes ago.’
‘But he can’t have left,’ Hannah protested, bewildered. ‘He could hardly walk!’
A Wife for Dr. Cunningham Page 3