‘All righty,’ he said, looking taken aback by her dismissive response to his apology.
Jessica immediately felt terrible, suddenly worried that she was now the one overreacting. It was ridiculous that she cared what he thought but she did again. It was all beyond her comprehension and confusing and yet she felt compelled to step in and save it.
‘Now it’s my turn to apologise. I’m sorry. I—’
Their pagers both went off at the same time, cutting short her words. They looked down simultaneously and saw they were being called to the ER.
‘Dr Wainwright, Dr Ayers—’ a young ER nurse rushed into the room ‘—I know you’ve been paged but I thought I could brief you on the way down. There’s been an accident on the New England Highway. A school bus left the road. Four ambulances are on their way here now. Nine seriously injured, eleven others with minor injuries and an unspecified number with cuts and abrasions that are being treated at the scene but may be transported here later. ETA eight minutes.’
‘The driver?’ Harrison asked as he and Jessica followed the nurse to the lift.
‘Pronounced dead at the scene.’
Jessica sighed and closed her eyes for the briefest moment as they all stepped into the lift. ‘From injuries sustained in the accident?’
‘No, it appears he suffered a heart attack and died at the wheel; that’s why the bus left the road,’ the nurse continued as the lift reached the ground floor and they all stepped out in unison and headed to the ER. ‘He called out to both the teachers as he clasped his chest and tried to keep control of the bus. In the statement to police, the paramedics overheard one teacher say the driver had done his absolute best to slow the bus, but at such a high speed he couldn’t prevent them leaving the road. The teachers were at the rear of the bus and couldn’t get to the driver in time to take the wheel.’
‘What a tragic set of circumstances,’ Jessica said solemnly as they entered the doors of the ER.
‘Do you have an idea of the age range of the children?’ Harrison asked as he scrubbed and donned surgical gloves and gown.
‘It was two year five classes on an excursion, so the students are all around nine to ten years of age.’
Jessica followed suit and scrubbed and gowned. ‘And the extent of the injuries?’
‘Two suspected spinal cord injuries, multiple fractures, lacerations and all are being monitored for internal bleeding.’
‘Any fatalities other than the driver?’
‘Not yet.’
‘Let’s make sure we have all bays emptied if possible,’ Harrison called out to the ER staff. ‘Any non-life-threatening can be triaged to a waiting room. Stat. We have less than two minutes to ETA.’
Jessica watched as four patients were wheeled on their beds out of ER and other beds were quickly wheeled in by orderlies. She suspected that the experienced ER staff had already made that decision and the triaging was well underway before she and Harrison arrived. It was like clockwork and far too quick to have been arranged on his command. They just knew what they needed to do. It was a well-oiled machine that Harrison ran.
One minute later, and one minute ahead of schedule, two stretchers were rushed into the ER. Jessica could see immediately these were two of the serious injuries. Both were in neck braces and bandages had been applied to their heads and one had both legs in splints. A man in his early forties was walking beside one of them. Jessica assumed he was one of the children’s teachers. She walked into bay five with the first and Harrison took the second stretcher into bay four.
‘Nine-year-old male. Suspected fractures to both legs, potential neck injury and blunt head trauma from hitting the seat in front and being thrown to the ground on impact. No seat belt. We inserted an IV en route and administered pain relief as he was experiencing pain while conscious. While his injuries are extensive, there’s no sign of internal bleeding and the pain would indicate no C1-C2 vertebrae damage. He’s on a board and we braced him as a precaution.’
‘Great job and it does sound promising,’ Jessica replied. ‘Let’s transfer him onto the bed.’
The paramedics and the nurses worked swiftly and carefully to execute the transfer, keeping the board in place before they handed over their notes and exited the bay with the stretcher.
‘His name is Trevor Saunders,’ the man added. ‘I’m his teacher, Gavin Watson. We were on an excursion to Armidale from the Tamworth Elementary School.’
Moments later, two more stretchers arrived with paramedics and they were taken into the adjacent bays, with a third stretcher and two more paramedics following closely behind and being parked in the final empty bay. All nurses and ER staff were engaged and Jessica was aware there were four more serious cases en route.
‘Have you been assessed by the paramedics, Mr Watson?’ Jessica asked before she donned a surgical mask and approached the child.
‘I was assessed at the accident site by paramedics and cleared. My seat belt was in place, just as I thought the students’ belts were because we have a school travel policy and strict rules. Unfortunately, the boys thought they knew better and I had no way to see they had undone their seat belts just before the accident.’
‘Would you be able to help identify the students we are treating? If you make your way over to the desk and explain what you have been asked to do, one of the nurses at the desk will help you. Please stay close so we can call on you if we need anything further,’ Jessica said in short staccato sentences. ‘I assume the parents have been contacted?’
The teacher nodded. ‘My colleague, Ms Forbes, is still at the accident scene with those students not hurt in the accident and the school has called all of the parents,’ he said before following her instructions and making his way to the ER desk.
Quickly Jessica turned her attention back to the young patient, who was unconscious but breathing steadily. ‘Trevor,’ she began in a soft and soothing voice. ‘My name is Jessica and I’m a doctor. While you cannot see me, you may be able to hear me. You were in an accident and you’ve been brought to the Armidale Hospital, about an hour and a half from your school in Tamworth.’
There was no visible reaction to her words.
‘We are going to put some monitors on you. If you can hear me, you need to stay very still. You hurt your back and your legs when the bus left the road so we don’t want you trying to move.’
The nurses worked quickly to ensure the boy’s heart, temperature and breathing were all monitored.
‘BP is rising—it’s now ninety over forty-five,’ the nurse announced, then continued as she looked over the paramedic’s notes. ‘En route it was eighty over forty.’
The boy’s eyelids began to flicker. Jessica could see he was regaining consciousness.
‘Welcome back, Trevor.’
His eyes closed again and the flickering stopped for a moment.
‘The patient is drifting in and out of consciousness. I need a portal X-ray machine to assess the damage to the lower limbs,’ she told one of the nurses in the same calm but lowered voice. ‘According to the notes, we have a suspected fracture of right tibia and left femur but the issue for me is the potential for spinal cord injury.’
‘BP’s a little higher again and oxygen saturation is improving,’ the nurse reported.
‘Good, his pain must be under control but there’s still a risk of lumbar spinal cord damage if he moves so let’s not get ahead of ourselves.’
Jessica confirmed the reading on the monitor out of habit and felt silently pleased and confident that she was not dealing with a quadriplegia diagnosis.
The young boy began to open his eyes and they remained open for a few seconds.
‘Trevor, I know you are feeling confused and maybe a little scared but you’re safe. You’re in a hospital and your parents are on their way now to be with you. I’m not sure if you could hear me when you first arrived b
ut my name is Jessica and I’m a doctor.’
The nurse leant in to Jessica and said in a low whisper, ‘They left Tamworth twenty minutes ago so their ETA is around an hour.’
‘Your parents should be here by the time we’ve finished these tests, Trevor. Your neck is in a brace so you have limited movement but I need you to keep your body still too. If you can keep your eyes open please do, but if that is difficult then close and rest them as you need. I’ll tell you what’s happening but again we need you to remain very still. You are flat on a board on a stretcher, as you hit your head on something hard in the bus. You may have also hurt your neck and your back. We’re about to take X-rays of your legs. I’ll be stepping away for a moment and then I’ll come right back. You’re not alone.’
Jessica and the nurses stepped away momentarily while the radiologist took the images and then they all returned to find the boy’s eyes wide open but staring straight ahead.
‘You’re doing so well, Trevor,’ Jessica continued. ‘I know I’m now upside down to you but I need to stand here at your head, so I can check your response to light. I will shine a small torch into your eyes; it won’t hurt but I want you to keep looking at my nose.’ The nurse handed Jessica the small torch and she shone it in sideways movements across Trevor’s line of vision and then slowly in a circular motion. ‘I’m going to cover one of your eyes and shine the light in the uncovered eye, then I will do the same to the other eye.’
Jessica completed the examination before turning to the nurse. ‘The pupils are equal in size and responsive to light, which is a good sign, but the right eye is a little sluggish, which may be an issue. I just apologise that I don’t know all of the consultants at the hospital; is there a neurologist on staff?’
‘No, however, our ICU Consultant is on his way down now. A neurologist in Sydney was contacted by Dr Wainwright as his patient is suspected C1-C2 vertebrae damage. The neurologist is flying over tomorrow to assess the boy as he may need airlifting to the Sydney General Memorial Hospital for treatment.’
Jessica nodded her understanding of the situation in the adjacent bay and her appreciation of the ER team’s initiative in sending for the ICU Consultant. She quickly returned her attention to her patient.
‘You’ve been very good, Trevor,’ Jessica told him and, casting a glance at the nurses’ names, she turned back to him, adding, ‘Nurse Jan and Nurse Gayle will stay with you and I will check back in a little while. If you have any questions, please ask them. And if you have any pain let them know. We’re waiting for another special doctor to come and look at you and, in the meantime, I’m going to help one of your classmates who’s been hurt too.’
Jessica discarded her gloves and rushed into the next bay, where an intern was attending another young victim. She had no idea where Harrison was but she could hear his voice and knew he was moving from one bay to the next, doing his best to keep each and every little patient alive.
It was going to be a long day and night for them all and Jessica hoped that no parent would be without their precious child by the end of it.
* * *
‘Thank you,’ Harrison said as he observed Jessica sign off on the last patient and release the young girl into the care of her very relieved and grateful parents.
His words were few but heartfelt. Jessica could see in his face that the pressure of the previous hours, constantly triaging patients and managing staff, had taken its toll. He was exhausted, mentally and physically.
‘You don’t need to thank me,’ Jessica replied, pulling off her disposable surgical cap and gown, which was splattered with fine spots of her last patient’s blood. The young girl had sustained lacerations to her forearm as fragments of plate glass window had cut through her sweater and lodged in her skin, but fortunately not compromised any blood supply. With one of the senior ER nurses assisting, Jessica had painstakingly removed the fine glass and stitched the wounds. It was one of the least serious injuries and, as such, had been left until last to ensure the patients with life-threatening injuries had been treated first.
* * *
It had been a long day and night for the ER team and the other medical staff called in from across the hospital as required. They had pulled together professionally and worked tirelessly to save the lives of all the children. While some of the injured students would spend an extended amount of time in hospital with their injuries, they had at least all pulled through. The less seriously injured patients would be transferred to the Tamworth General Hospital the following day to make it easier on family and friends visiting them, but at least two young boys would have to remain in Armidale for an indefinite period. They had not been wearing their seat belts and had, as a result, sustained neck and back injuries that required ongoing monitoring in the ICU as unnecessary travel would not be permitted.
‘It’s one a.m.,’ Harrison commented in passing to the staff who had worked past the end of their shifts to treat the patients. ‘Great job—please go home and if you’re rostered on tomorrow, don’t show up. We’ll move staff around the hospital to cover for you. And if any of you usually catch public transport across the New England area, please get a cab and the hospital will reimburse you.’
All the staff thanked Harrison and left for the day. Weary but satisfied with the outcome of the horrific accident. They were all saddened to know the bus driver had lost his life but relieved that the children had not.
‘How about you, Dr Ayers? Do you have transport?’ Harrison asked Jessica as she made her way to leave.
‘Yes,’ she said as she turned to face him. ‘But thank you for asking. I have my rental in the doctors’ car park.’
‘If you’d like to get your things from your office, I’m more than happy to walk you to your car. It’s a bit isolated out the back, especially at this hour, and not particularly well lit in some places.’
Jessica nodded. ‘Thank you; that’s very kind of you.’
‘It’s settled then. I’ll grab my jacket and meet you back here in ten minutes.’
Jessica returned to her office and collected her overcoat and handbag. On the way out she called in and caught up with the night staff in Paediatrics and was brought up to speed on her patients. Thankfully, there was nothing to report; all were progressing well with their treatment and Jessica told them she would be back for morning rounds. She returned to the ER to find Harrison waiting, just as he’d said he would. An unexpected warm feeling washed over her. It felt good to have someone looking out for her. She had been doing it alone for the best part of a year and it hadn’t bothered her, but seeing Harrison there made her feel unexpectedly safe for the first time in a long time.
And she didn’t want to run from that feeling.
* * *
‘I can’t believe how freezing cold it can get in this town. I don’t think I’ve lived anywhere that drops down this low,’ Jessica remarked as she dug her hands into the deep pockets of her heavy woollen coat. Her breath was fogging the still night air as she spoke.
‘Heads up, Dr Ayers—one in the morning, slap bang in the middle of winter, isn’t the best time to get out and about in many places around here!’ Harrison laughed as they picked up speed and headed to the doctors’ car park at the rear of the hospital. ‘And if you didn’t already know, Armidale has the highest altitude of any city in Australia.’
‘So now I know why almost every house I drive past has a stockpile of wood. They know what they’re in for in winter.’
‘Yes, and nothing beats an open fire,’ he returned, rubbing his hands together as if over the flames.
Jessica smiled and kept walking. The conversation was flowing and she felt at ease...but that was almost making her uneasy.
‘At least it’s not raining and you don’t have far to drive,’ Harrison continued.
‘That’s the joy of not being in a big city. You can drive for what seems like hours in Sydney or Melbourne to g
et home after a long shift, which isn’t pleasant and the last thing you need when all you want is to put your feet up and collapse on the sofa because you have an early start the next morning.’
‘So, you’re not a lover of big cities then?’
‘I’m not averse to living in large cities. I mean it has its advantages but there’s the downside too, and I don’t have to deal with that here, which is a bonus. I’ll be home in five minutes and that’s a big plus—particularly at one in the morning, slap-bang in the middle of winter!’
Another bonus was being walked to her car by a handsome medical colleague and that hadn’t happened in any city placements, but Jessica wasn’t about to mention that to Harrison. She was still coming to terms with how her feelings were developing for the man, no matter how hard she fought to remind herself that men were not permitted within a mile of her or her heart. But the more she spent time with Harrison, the more difficult it became to ignore the respect she had for him as a doctor, a godfather and a colleague.
And a chivalrous man.
‘So, is Armidale winning over the city girl?’
‘I’m not sure,’ she replied as she reached inside her handbag for her keys. ‘I haven’t been here long enough yet...but, from what I’ve seen of the town over the last few days, it’s a lovely lifestyle and such a supportive community spirit.’
Mending the Single Dad's Heart Page 9