by Ann Mcintosh
Prolonged abstinence—that’s all it was! In the three years since Nick’s death she’d had only one relationship and although occasional sex had been involved in it, it had been more comfort than physical fulfilment that she’d wanted.
But Andy?
She’d met him and Nick together, and although it had been Nick who’d asked her out then courted her into a whirlwind marriage, she’d always liked Andy, had felt a kind of kinship with him. There’d always been something steady and reliable about Andy, though she’d seen less of him after her marriage.
Now he marched away after handing her the twine, and she had to hurry to catch up with him, falling in almost beside him, just a half-step back.
Deference to the boss, or fear that being closer might disturb her in some way?
Nonsense. It was simply because of the past that she was feeling uneasy...
He used a card to access what was obviously a staff elevator and punched the number for the fourth floor.
‘You’ll get one of these with your information pack,’ he told her, ‘and sometime today you’ll need to have a photo taken to put on your ID—it only takes a few minutes.’
End of conversation, the elevator doors opened and they stepped into a corridor, Andy turning left and pushing through pneumatic doors.
They’d barely entered when a nurse appeared.
‘Andy, they need someone down in the ED, eighteen-month-old with a temp of thirty-nine C, listless, flushed, unresponsive.’
‘Come with me,’ Andy said to Sam as he turned on his heel and headed back to the elevator.
‘These two elevators are staff only. Well, they’re used for moving patients as well, but the hospital is fairly new and the design is really brilliant, which makes working here a dream.’
He paused, then added, ‘How often have you stood in an elevator and known there are at least three people in it who’d like to ask you a question about a patient?’
‘And often did,’ she added as she nodded her agreement.
This was good, this was work. She could not only handle working with Andy but she would enjoy it, aware that he was extremely good at what he did.
If she locked the past away where it belonged, treated Andy like any other colleague, and just concentrated on work...
He led the way into the ED, which was strangely quiet early in the morning, and a nurse hailed him as he walked in.
‘We’ve put her in an isolation room—she’s pink but that could just be the fever,’ she explained.
‘Or measles,’ Andy ground out savagely.
He walked into the room and leant over the child, Sam slipping around to the other side of the bed, the small girl on it staring blankly at the ceiling. Her eyes were red, her nose oozing mucus, and flat red spots covered her forehead and were appearing as they watched, down her face and neck and onto her torso.
Speaking quietly to the child, Andy eased her mouth open and peered inside, finding tell-tale signs of measles in there as well.
‘We need to check with her parents if she’s been vaccinated, although somehow I doubt it as the measles vaccine provides almost one hundred percent protection.
‘What checks have you done so far?’ he asked the nurse.
‘We’ve removed her clothes and sponged her down, given her twenty milligrams of paracetamol, tried to get some water into her but she’s so unresponsive I was afraid she’d choke.’
Andy nodded.
‘We’ll admit her, take her up to PICU and isolate her up there. We can use IV fluids and add ibuprofen six hourly via her drip.’ He paused, drew a deep breath, then said, ‘I’d better talk to the parents. Who brought her in?’
‘The father, but he had to leave. Both parents are lawyers apparently, but I have a phone number for him.’
Sam followed, trying to thrust images of the sick child from her mind, wondering just how this had happened in this day and age of preventative measures. But as Andy used the card for the elevator, another thought struck her.
‘You’ve just come off duty, haven’t you? Why are you following up on this infant?’
‘You’ve never worked a few hours after your shift ended?’ he asked, and she shrugged because, of course, she, and probably thousands of other doctors, had.
‘Thought not,’ he said. ‘But I’ve not just come off night shift—it’s one of the few perks of the job that I don’t do night shifts. I came in earlier and then again at about four to see a child on the ward who was having breathing problems.’
He smiled, and although it was a tired smile, it affected her, deep inside, in a way she certainly didn’t want to think about.
Andy had been Nick’s friend, and for all the irritations she might have felt in her marriage, the difficulties and disappointments, she still felt loyalty to Nick’s memory, and somehow being attracted to his best friend was surely the ultimate disloyalty...
And, anyway, it was just a smile!
Andy had always had a nice smile.
They left the elevator, and Andy led her to the main monitoring desk, pointing out the way all the rooms could be monitored at once and introducing her to Karen, who was the head nurse on duty that morning.
She watched as his eyes scanned the monitors, and knew he’d been taking a mental note of every patient, even leaning over the desk and picking up a paper file to check on something he’d seen.
He explained the new admission to Karen, adding, ‘Keep trying the number they have for the father in case the ED didn’t get hold of him. Let him know where we are at and how to find us.’
A short discussion on their other patients, then Andy turned away, leading Sam along a corridor and returning to the conversation they’d been having.
‘Actually, it was my last shift on call, and I’d worked my schedule so I could be here for your orientation before heading off this afternoon for a rest and to try to get my biorhythms back into sync.’
‘I thought biorhythms had been totally debunked,’ she said as the elevator doors slid open.
‘Not totally and anyway it always seems to me that it’s a better word to use because it’s more than the physical side of yourself—well, myself anyway—that has to sort itself out after being on call, but the emotional and intellectual sides as well. I don’t know about you, but I don’t think well after a change of shifts—not until the sleep thing is sorted.’
‘And the emotional side?’ Sam asked as she followed him along the corridor.
‘Oh, that’s been totally stuffed for years,’ he said. ‘Unless you’re involved with someone else who works ridiculous hours and often has to dash off at two in the morning for an emergency, a normal relationship is impossible.’
‘Is there such a thing as a normal relationship?’ she couldn’t resist asking, thinking of the trials and anxiety she’d often felt in her marriage to Nick. But they’d reached the room where the little girl was already up from the ED and was being intubated by a nurse in full sterile covering, while Andy was looking intently at the chart he’d collected from the door.
* * *
With ninety-nine percent of his attention on the child in front of him, that tiny one percent had been caught by something in Sam’s voice as she’d asked that question. The one about relationships...
Had her and Nick’s marriage not been the one of connubial bliss he and everyone else had always thought it?
Nick had certainly painted it that way.
‘We’ll need to find out about her family,’ he said, dragging that errant one percent back into place. ‘Siblings, parents and grandparents, children she might mix with in day care or kindy.’
‘I know most kindergartens won’t accept unimmunised children. I’m not certain whether family day care is covered by it,’ Sam told him, although he’d been speaking to the nurse.
‘Her family—or at least one of th
em—should be with her,’ the nurse muttered, but Andy ignored them both.
‘There’s a phone number for the father. When you speak to him just check out all you can about anyone she’s been in contact with. If she has siblings who haven’t been vaccinated, we need to get them in—or get them to their local doctor—for vaccination now. If she’s been with other children at risk, we need to find them and get them vaccinated too.’
‘Within seventy-two hours,’ Sam finished for him. ‘I could do that.’
He frowned at her.
‘You’re here for orientation,’ he reminded her, a little too sharply because what he could only put down to lack of sleep was making him overly aware of Sam by his side. Reminding him he’d been foolish enough to ask her to stay with him at his apartment.
He stepped aside and wrote up the protocols for the day, handed the chart to the nurse, saying, ‘I’d have liked to speak to a family member before admitting her, but I couldn’t leave her in the ED. We’ll have to explain that to someone later.’
He left the room, Sam on his heels.
‘Why Intensive Care not the children’s ward?’ she asked, and he seized on the question to shake off the weirdness going on with this woman’s reappearance in his life. Dear God, he’d known she was coming—had been looking forward to working with her again, given the experience she’d gained—and stupidest of all, he’d thought that long-ago attraction would surely have burnt out...
He banished the distracting thoughts, put them down to tiredness. This was work, a child’s life was at stake.
‘We can isolate her better here, watch for any signs of complication.’
‘Pneumonia, encephalitis?’
‘Ear infections,’ he added, shaking his own head as if that might dislodge the softness of her voice.
Forcing his mind back to work, he led her towards the nurses’ station, situated in the centre of the ward where a team of five nurses monitored the live feeds from all the PICU beds while two clerical staff handled phones and paperwork.
‘This is Dr Sam Reilly,’ he said as several of them looked up. ‘She starts here tomorrow and I’m showing her around.’
He waved Sam forward before adding, ‘No point in introducing you all now, she’ll meet you in time.’
He turned to one of the clerical workers.
‘I’ve just admitted a three-year-old girl with measles and put her in Isolation Room Two. Could you chase up the electronic file from the ED and make sure the room’s online for monitoring?’
‘We use paper files that stay with the patient, as well as electronic,’ he said to Sam as he whisked away, aware she was just a step behind him—aware, too, that he should slow, they should walk together, as colleagues did.
But although he’d been prepared for her arrival, even looked forward to seeing her again, having her on his team, the fact that her physical presence still perturbed him had thrown his mind into chaos.
It was only temporary, this reaction. They hadn’t parted on the best of terms—no, they’d parted on the worst of terms, he’d hurt her badly—so this would pass.
Soon, he hoped...
He thought back to that day in shame, but he’d seen her there in the hospital bed, so pale she’d have disappeared against the white pillow case if the scattering of freckles across her nose and the tangled red hair hadn’t stood out so clearly.
She’d been injured, but just the sight of her—the pain he’d read on her face—had knotted something in his gut, something that he’d tried to burn away with anger.
And now?
Now she was a colleague, and he had to think of her that way, because that was surely the only way she thought of him, She’d certainly never given the slightest indication that she was interested in him—in anyone but Nick, in fact...
‘Abby has encephalitis,’ he said, forcing his mind back to work as he led Sam into another room.
The young girl in the bed opened her eyes and smiled wanly at them.
‘We’ve no idea what brought it on, have we, Abs?’ he added, coming closer to take Abby’s hand, ‘but we do know she’s on the mend.’
He motioned Sam forward.
‘This is Sam, Abby, a new doctor and a very good one. We’ll let her have a go at your records and see what she can sniff out, eh?’
Abby smiled again, then her eyes closed and she drifted back to sleep.
Andy handed the file he’d picked up from the back of the door to Sam, but kept his eyes on the sleeping girl.
Abby was thirteen, the same age Sarah had been when she’d died—Sarah, his beautiful, loving, always happy sister...
* * *
Sam flipped through the pages, noting the myriad tests that had been carried out on the sick child, realising that nothing had shown up as a possible trigger.
‘Had she had a sore throat—could it have been as simple as a cold virus that triggered the swelling in her brain?’ she asked as she slotted the file back in its place on the door, knowing she could read up on it on the computer later.
‘Or some autoimmune thing, we’ve been thinking,’ Andy replied, obviously still puzzled over the case. ‘In fact, we did the regular tests, then stopped worrying what might have caused it and simply treated her. She’s a little more alert every day, so I’m hopeful, given time and rest, she’ll make a full recovery.’
‘So much of what we do in PICU is rest and monitoring, isn’t it?’ Sam said, hoping she sounded rational and professional, although this being with Andy, trying to pretend he was nothing more than a colleague, was tying her stomach in knots.
And then he grinned at her.
‘Ah, but the monitoring needs to be constant,’ he said, while her head whirled. But Andy had always had that teasing grin so why...?
She dragged her mind back into gear and caught up with the conversation.
‘Which is why the children are here and not down in the normal kids’ wards. Come and meet Ryan—he’s one of our frequent flyers.’
Sam laughed at the familiar phrase, reminding herself that this was work.
‘Premmie?’ she asked, and Andy nodded.
‘He’s two years old now, but still susceptible to any damn virus floating past in the air.’
‘Usually RSV?’ Sam asked, aware that respiratory syncytial virus, with its respiratory and breathing difficulties, was common in premature children.
Andy nodded.
‘It’s bronchiolitis this time. All the small passages in his lungs are inflamed, but six months ago it was pneumonia.’
‘Poor kid,’ Sam said, entering the room and peering down at the small form in the small cot. The little boy was probably only two thirds the size of a normal two-year-old, though what was really ‘normal’ with any child?
But she was intrigued by the small mask taped to the little boy’s face and the tube from it leading back to a tiny CPAP machine.
‘Non-invasive positive air pressure?’ she said, intrigued why the usual nasal prongs weren’t delivering oxygen to the little body.
‘We’re finding, particularly with smaller children, that it’s easier to get them off the oxygen when we use the continuous pressure air pump. There’ve been various small trials on it, and no definitive data as yet, but it works for young Ryan here, so we stick to it.’
Aware there was no treatment apart from oxygen to help their battling lungs, fluid to keep them hydrated, and paracetamol to keep the child’s temperature down, Sam followed Andy out the door. Studying him, thinking...
He would have had the final decision on her employment, yet he’d employed her anyway—even though he obviously blamed her for Nick’s death.
She shut the box in her mind that held memories of that day. This was now a new life, and Andy would be, inevitably, a big part of it so sometime soon that box had to be opened and some of the contents discussed. T
heir last encounter especially needed some explanations and she knew they couldn’t go forward with it in both their minds, blocking out any proper conversation or even, possibly, friendship.
But in the meantime, Andy was right here—her boss—and she had to prove herself to him.
He was tall—taller than Nick had been—and he carried himself well, except for stooping slightly to hide his height as he was wont to do. He was good looking, too, with his dark hair and blue eyes.
But not married—well, apparently not—there was no ring on his finger.
And why would you be checking that out? she asked herself. He doesn’t even like you.
‘We talked about monitoring earlier.’
The words brought her mind back to the job. It was probably a bit of jet lag that had it wandering so far and so fast.
‘And though it seems such a simple thing, it’s paramount. It means we can see when they’re about to crash and need resuscitation, or stop breathing and need urgent intubation, or have a seizure and need protective care and medication to ease it.’
He frowned slightly, turning to look directly at her, before adding, ‘Though why I’m justifying our work to someone who is as experienced as you I don’t know!’
Blue eyes looked steadily into her wishy-washy green ones, and about a million synapses in her brain fired to chaotic life.
Breathe!
‘You forget I’ve just come from a hospital that’s barely more than a shed with some beds, and the most sophisticated medical machinery was an X-ray machine that we couldn’t work because of a lack of electricity.’
Andy stared at her. ‘Seriously?’ he said, and she smiled, relaxing as she talked about the place she’d grown to love. A place where her mother, a nurse, had worked for so many years it had become her home.
‘Well, we did have a generator and when we had fuel for it, and it actually decided to work for a while, we could get the occasional X-ray. Whoever had donated the X-ray machine to the clinic had included plenty of film, so from time to time it was very handy. Mind you, I wasn’t there for long enough to get totally frustrated by the lack of technology, but it was very educational in its own way!’