‘He’s still shifting some air but it’s not enough.’
Lisa checked that the clip on Alex’s finger was secure and looked at the screen of the monitor, below the overly rapid spikes of the ECG. ‘Oxygen saturation is down to seventy five percent,’ she told Hugh. The automatic blood pressure cuff was deflating at the same time. ‘His BPs dropping again. Seventy-five over forty.’
‘Come and take over here. We’ll swap the nebuliser mask and use an Ambu bag and a hundred percent oxygen. I’ll get another IV line in and start an adrenaline infusion. I’m not going to wait if things deteriorate any more, though. We’ll go for a rapid sequence intubation.’
Lisa could feel the fierce concentration when Hugh took her place by Alex’s head a minute or two later to try and insert a breathing tube through the swollen tissues in their patient’s mouth and throat. A lot of doctors might have panicked when not only the first but the second attempt failed. Hugh only looked more focused. He caught Lisa’s gaze as she moved back in with the bag mask and tried to deliver oxygen to Alex’s lungs.
‘Oxygen saturation’s down to seventy percent,’ he said quietly. ‘We’re in a “can’t intubate, can’t oxygenate” situation. Have you ever assisted with a surgical cricothyroidotomy?’
‘No.’ Lisa held his gaze. ‘Do you want me to find Tim? Or Peter?’
‘There’s no time.’ Hugh hadn’t broken the gaze either. ‘You can do this. I’ll talk you through it.’
And, within what felt like seconds, when they were both gloved and Hugh had unrolled another kit, that was exactly what he was doing as he palpated the front of Alex’s neck around his Adam’s apple after swabbing it with antiseptic.
‘I can feel the thyroid cartilage here and this is the cricoid cartilage. I’m aiming for the space between them, where the membrane is, and I’ve got a good grip on it all so nothing moves.’
With his free hand, Hugh picked up a scalpel and made first a vertical incision and then a horizontal one. Because Alex was now deeply unconscious and this was such an urgent situation, there was no time or need for local anaesthesia but Lisa found herself holding her breath at Hugh’s confident, swift movements.
‘I can feel the “pop” so I know I’m in the trachea now.’ Even his voice sounded calm. ‘I’m going to put my finger in when I take the scalpel out but what I need you to do is pick up that tracheal hook, put it at the top end of the incision and retract everything for me.’
Lisa had never been this hands on in such a dramatic invasion procedure but, amazingly, her hand wasn’t shaking and she had no problem following Hugh’s clear instructions. She watched as he widened the incision, inserted a bougie as a guide for the endotracheal tube that followed and then inflated the balloon around the end of the tube that would help secure it. He attached the Ambu bag to the tube and squeezed it.
‘Good chest rise,’ he said quietly. ‘I’ll have a listen to be sure and then we can take that hook out and secure the tube properly.’
Lisa could tell that the tube had been correctly placed because the concentration of oxygen in Alex’s blood was already increasing and his heart rate slowing a little. They had got through a crisis that could have killed an otherwise healthy young person and, when Hugh looked up and smiled at Lisa, while he was still listening to lung sounds with his stethoscope, she knew that he was just as happy as she was.
They had done this together. She could hear other people arriving in the medical centre now, with rapid footsteps coming towards the treatment room, but it was Lisa and Hugh who had done the hard work here. They were the only ones to have shared that rising tension, background alarm of the ticking clock of a limited amount of time available and the nail-biting stress of a dramatic procedure to deal with it. So they were the only ones who got to share this moment of relief. Joy, even.
Along with something else. A knowledge that they could work together this closely under extreme circumstances. That they could trust each other. That they were in exactly the same place when it came to how much they cared about their patients and how hard they were prepared for a fight for something that really mattered. The moment of connection was only a heartbeat before others rushed into the room but the effect lingered as Lisa stepped back to let Peter and Tim close to their patient. It was Tim who was tasked with securing the tube and Peter assisted Hugh in setting up the portable ventilator.
‘We’ll need transport to the nearest hospital. He’ll need intensive care monitoring for a while.’
‘Chopper?’
‘Possibly. We might be close enough to shore for a coastguard vessel. I’ll get hold of the captain.’
‘I can go with him, if he needs an escort,’ Tim offered.
Hugh nodded his acknowledgment of the offer but his gaze shifted to Lisa, one eyebrow raised. Was he asking if she wanted that drama? Maybe he was even suggesting that they both go to look after the man who had been a patient they had both been so invested in saving. Suddenly, it felt like the connection they had just forged was strong enough to make Lisa feel flustered. Unsure of which way to jump and it was a well-practised habit to find a safe option as quickly as possible. Ignoring the unspoken invitation was a first step. Removing herself from the situation was the second.
‘We’ll need more details, won’t we?’ she said. ‘I could go back up to the Lido deck where we found him. They might have found his clothes and his medication. He’ll need something more than a swimming suit when they discharge him.’
‘Good thinking, Lisa.’ It was Peter who was nodding now. ‘We can get Housekeeping to go to his cabin and pack a few things for him as well. I’ll get someone to meet you.’
By the time Lisa got back to the medical centre with Alex’s suitcase, she found the entire team were ready to escort their patient up to helipad at the very bow of the ship.
‘None of us need to go with him.’ Hugh had a clipboard in his hands and must have been working fast to have written up what looked like a very detailed report. ‘They’re sending an intensive care doctor and a paramedic to take him back.’
‘Come and watch,’ Janet said. ‘It doesn’t happen that often and it’s pretty exciting, especially in the middle of the night.’
‘Does the ship have to stop?’
‘It’s already slowing down but I’ve seen them land even in fairly big seas when the ship is going fast. If it’s too dangerous to land, they’ll winch the patient up. They’re amazing.’
It was an opportunity not to be missed. Lisa followed the entourage and waited with them to watch as the helicopter got close enough to glow in the floodlit area of the helipad located right at the bow of the ship, overlooked by the bridge, as it hovered and very slowly sank until its skids were on the deck. Two of the French crew ducked their heads beneath the still whirring blades of the aircraft and came to meet Hugh, who was standing at the head of Alex’s stretcher, holding the clipboard, raising his voice to give a verbal handover to the new health professionals in charge.
‘Bonjour, messieurs. Voici Alex, qui a eu une réaction anaphylactique sévère...’
The fact that Hugh was doing the handover in French was not only astonishing, it completely took Lisa’s breath away. That he was already such a charming and good-looking man had been quite enough to deal with in terms of being happy to keep herself at a safe distance. That he seemed to be at ease speaking what had to be the most beautiful language on earth took his attractiveness to another level and, on top of that, there was now that moment of connection they’d shared tonight that made Lisa think that the social planets they inhabited might not be that far apart after all.
Minutes later, she also had to wonder whether the butterflies that had taken over her stomach were due solely to the excitement of standing here as the helicopter lifted off and swung away right in front of her, the beat of its rotors vibrating right through her body. It was quite possible that these unfamiliar sensation
s had even more to do with the man who was standing right beside her.
It was no wonder that Lisa found it impossible to go back to bed and try to sleep after the tension and excitement of the last few hours. Even though it was nearly three a.m. she decided she needed to go and walk off the adrenaline or whatever it was that was still bubbling in her veins and making her brain race in an endless loop of reliving those fraught minutes of working to save Alex’s life. The beat of fear when she’d believed she was facing the challenge alone. The relief when Hugh had arrived. That feeling of someone moving close enough to touch her soul when they’d shared the joy of success and, possibly the most disconcerting recurrent thought, how she’d felt when she’d heard him speaking French so fluently.
Yes...that very odd, melting sensation that was happening every time that part of the loop resurfaced was the best reason of all to go for a brisk walk and get some fresh air outside.
Lisa headed for the stairs that would take her to the deck she wanted that had a running track available. They were right beside a set of elevators and the doors on one slid open as she walked past. She heard the giggle of an obviously inebriated woman and she probably would have heard her voice even if she was halfway up the stairs.
‘But you are coming to my cabin, aren’t you, darling? You promised...’
‘Yes, I did. And I will. Oops-a-daisy... I think you’d better hang on a bit more tightly...’
It was the sound of the male voice that made Lisa turn her head and slow her feet enough to count as a long pause. A deep, sexy voice with that note of muted amusement she was rather familiar with. She knew she was staring. She knew her mouth was gaping and she was probably looking as appalled as she was feeling.
For one long, horrified moment she held Hugh Patterson’s gaze. And then she all but fled up the stairs because, quite honestly, she couldn’t get away fast enough. Not that she had any intention of trying to analyse why she felt so...disappointed? Because she suspected that there might be a corner of her mind that could justifiably taunt her with the notion that she was jealous.
* * *
Oh...man...
It had been all too obvious what Lisa Phillips had been thinking when she’d seen him holding up that drunk woman in the lift. She probably wouldn’t believe him if he told her that he’d found the woman rather too worse for wear when he’d gone back to the bar on the Lido deck to reassure the staff who’d been so worried about Alex, and he’d offered to make sure she got safely back to her own cabin. What was his nurse still doing up, anyway? He had the excuse of having been waiting for an update from the hospital that had taken their patient and then spending time with the staff on the Lido deck, but Lisa should have been in bed long before now.
As if he’d ever take advantage of an inebriated passenger. Or any passenger, for that matter. Okay, it was not unpleasant to have an endlessly changing number of beautiful women who were often remarkably uninhibited in advertising that they’d like to add to their holiday pleasures by including a dalliance with him but he very rarely had any desire to do more than a bit of harmless flirting.
He’d practically been a monk, for heaven’s sake—apart from that first cruise when he’d been a passenger and not a crew member, of course, and when he’d needed a lot more than the on-board entertainment to distract himself from the betrayal of the woman he’d believed had loved him as much as he’d loved her. A woman he’d been on the verge of committing to for the rest of his life, in fact.
His friendship with Carlotta, in Barcelona, was the closest he’d come to in any kind of relationship since then and they both knew that it was no more than a friendship with occasional benefits.
It seemed a bit ironic that the first time he’d seen Lisa she’d been watching him kiss Carlotta and he’d been well aware that she’d been somewhat shocked. Well...she’d looked more than shocked when she’d seen him in the elevator tonight. She’d looked positively disgusted, and the worst thing about that was that a part of Hugh’s brain could see himself through her eyes only too easily and...he had to admit, it looked shallow.
He looked like a pleasure-seeker with a job that might provide the occasional medical challenge, as tonight had done, but was mostly delivering a kind of private general practice, catering for an elite group of people who were wealthy enough to take luxury holidays. It was also a job that could obviously provide a playground for unlimited sexual adventures.
Hugh didn’t like the thought that Lisa would think so little of him. But, then again, he didn’t like the idea that she was judging him either. She knew nothing about why he was here or how much satisfaction this job could deliver on a regular basis. She was only here for a couple of weeks anyway, so why the hell should it matter what she thought?
But it seemed that it did. Having found a female crew member who had helped him get the passenger back to her cabin and taken over the responsibility of getting her into bed and checking on her later, Hugh didn’t go straight back to his own cabin. He needed a bit of fresh air, he decided. A moment to take a breath and dismiss whatever unpleasant vibe that look on Lisa’s face had left him with.
It was unfortunate that he chose that particular deck to go out onto. Or that his new colleague had still not retired to her cabin and was looking over the railing at the stern of the ship, watching the moonlight sparkle on the impressive foam of the wake stretching back into the inky darkness of the sea. It was even more unfortunate that, when she finally noticed him walking in her direction, she chose to try and make some sort of negative comment about his sexual prowess.
‘That was quick,’ she said. She sounded surprised but there was a smile tugging at the corners of her mouth, as if the idea of him being terrible in bed was somehow unexpected but amusing.
‘Excuse me?’ Hugh stopped. He took a breath, trying to put a lid on how defensive he was feeling, but the lid didn’t quite fit. ‘I take it that you’re assuming I jumped into bed with the passenger you saw me with?’
‘The invitation was obviously there.’
‘And you think I would have been unable to resist? That I sleep with every woman who offers invitations for sex even if they’re not sober or if it might jeopardise the position I hold here?’
Her gaze slid away from his. ‘It’s none of my business,’ she said. At least she had the grace to sound uncomfortable. She might even be blushing, although it was hard to tell in this light, but Hugh wasn’t about to let her off that lightly. For some inexplicable reason this mattered.
Maybe that was because he was feeling something other than defensive. Something like disappointment? Working with Lisa tonight and especially that moment when they’d both acknowledged how amazing it was to know that you’d saved someone’s life had given Hugh a feeling of connection with a woman that was different from anything he’d ever experienced before.
A chink in his armour even, where he could feel what it must be like to be with someone you could really trust. Someone who could share the important things of life—for either celebration or encouragement to conquer. And maybe he had felt that way because he’d seen himself in a big brother role, which gave Lisa the status of family—someone it was safe to care about.
But she was judging him and his lifestyle now and any glimmer from that chink in his protective armour was nowhere to be seen. Lisa wasn’t family. She was a stranger and, while she might be damned good at her job, she was uptight to the point of being a prude.
‘At least I know how to relax occasionally and enjoy myself,’ he heard himself saying. ‘What’s your problem, Lisa?’
‘I haven’t got one.’
She sounded as defensive as he had been feeling and Hugh could see that her hands were gripping the railing so tightly her knuckles were white. Was she scared of something? Hugh contemplated the ship’s wake for a long moment and he could actually feel his negative thoughts getting washed away and disappearing into the night. Ther
e was something vulnerable about Lisa. She was the one who needed encouragement right now, even if she didn’t realise it. He injected a teasing note into his voice as he turned to lean his back against the railing so he could watch Lisa’s reaction.
‘Are you a virgin?’ he asked.
That shocked expression he’d seen on her face when she’d seen him propping up that passenger in the lift was back again.
‘No... Of course I’m not.’
‘But I’m guessing you don’t like sex that much?’
Her breath came out in such an incredulous huff he could hear it over the hum of the engines and the sound of the churning water far below them.
‘Just because I don’t approve of jumping into bed with total strangers?’ Her chin came up. ‘I think sex is an important part of a relationship, if you must know. But I also happen to think there are more important things.’
‘I’m not talking about a relationship.’ Hugh was keeping his tone light. He was curious about how far down the list sex would come on the list of important things in a relationship for her but that could wait for another conversation. Right now, all he wanted to find out was just how tightly this woman kept herself under control.
‘I’m just talking about sex,’ he added. ‘Enjoying a physical activity. Like dancing.’ This seemed inspired. Did Lisa ever let herself go enough to dance? ‘Do you dance?’
‘No.’ Lisa was resolutely keeping her gaze on the endless wake, although he had the feeling that she knew how closely he was watching her.
Hugh could feel a frown line appearing between his eyebrows as he leaned a little closer so that he could lower his voice. ‘What about eating some amazing meal? Or drinking champagne? Do you like drinking champagne, Lisa?’
She shrugged. ‘I’ve never tasted real champagne.’
Wow...she’d never tasted a lot of things, it seemed. Hugh’s annoyance had long since vanished. He was watching Lisa’s profile—the way the wind was playing with that short tumble of waves, the freckles he could see dusting her pale cheeks and that delicious curve at the corners of her mouth that looked like an embryonic smile, even though she was clearly not that happy at the moment.
Awakening the Shy Nurse Page 5