An Inescapable Temptation
Scarlet Wilson
Nurse Francesca Cruz has taken a job on a cruise ship bound for the Mediterranean – the perfect retreat from her break-up – except she finds herself trapped with gorgeous, arrogant doctor Gabriel Russo.She knows his type well, and won’t be tempted twice. But with nowhere to escape – except overboard – and her delicious boss lying in the next cabin, it’s easier said than done!
Dear Reader
My family and I had the pleasure of cruising around the Mediterranean last year and visiting some wonderful places. It was a great experience and there was nothing like waking up in a new port every day. We visited the ruins of Pompeii and the Château D’If—the prison that inspired The Count of Monte Cristo.
Imagine living that life every day. The crew we met were all hardworking, dedicated professionals, and I couldn’t think of a better setting for a medical romance.
Gabriel is a gorgeous Venetian doctor. He’s returned home to be closer to his family as his father is unwell. He comes from wealthy background and has a poor experience of women, who have frequently been more interested in his money than his heart.
Francesca is using the cruise ship as a safe haven while she waits for her visa to Australia. But what is she really running from?
These two had to work hard for their happy-ever-after, and I’m so glad that they get it in such a beautiful setting.
Please come and say hi at my website:
www.scarlet-wilson.com
Scarlet
Praise for
Scarlet Wilson:
‘Stirring, emotional and wonderfully absorbing,
IT STARTED WITH A PREGNANCY is an
impressive debut novel from a fabulous new voice
in category romance: Scarlet Wilson!’
—www.cataromance.com on
IT STARTED WITH A PREGNANCY
An Inescapable
Temptation
Scarlet Wilson
www.millsandboon.co.uk (http://www.millsandboon.co.uk)
DEDICATION
My family are so lucky to have been blessed
with three beautiful babies in the last year.
Welcome to the world, Taylor Jennifer Hyndman,
Oliver Edward Nyack and Noah Alexander Dickson.
Wishing you lives filled with love, health and happiness.
CHAPTER ONE
‘HELP!’
Gabriel turned his head, trying to figure out where the cry had come from amongst the bustling bodies at the port side. The Venezia Passegeri was packed—mainly with crew and harbour staff. Carts packed with passengers’ luggage and an obscene amount of fresh food were being piled aboard the cruise ship in front of him, all blocking his view.
‘Help! Over here. Someone help!’
The cry rippled through the crowd as heads turned and focused towards the shout. It only took Gabriel a few seconds to realise the cry was coming from the edge of the quay. He dropped his bag and pushed his way through the crowd. A woman was standing near the edge, her face pale, her breathing coming in rapid, shallow breaths. Her trembling hand was pointing towards the water.
Gabriel’s eyes followed her finger. There, in the water, was a child—a teenager—struggling in the waves that already seemed to have a grip of him. He must have only just fallen in, but this part of the marina was right on the outskirts of Venice, nearest the sea, and the waves were picking him up and down as he coughed and spluttered, pulling him out to sea.
Gabriel didn’t even think. He just dived in. Straight into the murky waters of Venice.
By now a few crew members had noticed the commotion and were shouting in rapid Italian. Gabriel swam quickly towards the boy. It only took a few seconds to wish he’d taken the time to remove his shoes and dress uniform jacket. They weighed him down almost instantly. His white uniform would never look the same again.
The boy kept sinking before his eyes, the waves sweeping over his head as he struggled for breath. Gabriel powered forward, anxious to reach him before he disappeared from sight again.
He got there in less than a minute but the boy had sunk under the waves. Gabriel took a deep breath and dived underwater, reaching down into the darkness. It was amazing how the strong Italian sun penetrated so little through the murky waters. Venice was renowned for its dirty canals. The cruise ship terminal was situated on the outskirts near the edge of the Adriatic Sea, where the deep-keeled ships could dock. And although the waters were marginally better here, they still looked nothing like the clear blue seas depicted in the travel brochures. His fingers brushed against something and he tried fruitlessly to grasp it. Nothing.
Frustration swept over him. His face broke the surface of the water and he gasped for air, trying to fill his lungs. Beneath the waves he shucked one foot against the other. It was a move he did every night in the comfort of his penthouse flat while sitting on the sofa, but struggling to stay afloat it was so much more awkward. Finally he felt a release as the five-hundred-euro hand-made leather shoes floated down into the murky depths. Now he would find the boy.
He dived beneath the waves again, reaching out, trying to circle the area beneath him. This time he felt something bump against his hand and he grabbed tightly before kicking his burning legs to the surface. The two of them burst above the waves, the teenager’s flailing legs and arms landing a panicked punch on the side of Gabriel’s head.
He flinched. His brain switching into gear. The woman at the quayside had shouted in English.
‘Stay still,’ he hissed at the boy. The sun was temporarily blinding him as the water streamed down his face.
He could see the jetty. Figures shouted towards him but he couldn’t hear a word. The current was strong here and he could hardly believe how quickly they’d moved away from the quay.
The glistening hull of the luxury cruise ship seemed so far away. He’d been standing before it only a few minutes earlier.
He put both hands around the boy’s chest and pulled him backwards against his own chest, trying to swim for both of them in his version of the classic lifesaving manoeuvre.
But the boy couldn’t stop panicking. The waves were fierce, the water still sweeping over the top of them, causing the boy to writhe in Gabriel’s arms as he struggled for breath. A shadow loomed behind them.
His arms were aching as he fought to keep their heads above the water. How on earth was he going to get them back to the quay? Again he could hear the boy coughing and spluttering, choking on the waves that kept crashing over their heads.
He’d never done a sea rescue before. Last time he’d seen one he’d been watching TV. It had all looked so much easier then. Didn’t the lifeguards on TV always put people on their backs and pull them towards shore? It didn’t seem to be working for him. And they had that strange red plastic thing to help them. Where were the lifebelts here? Shouldn’t every port have them?
What on earth was he doing? This was madness. Being a cruise ship doctor was supposed to be easy. It wasn’t supposed to kill you the first day on the job.
The irony of this wasn’t lost on him. He’d known this job was a bad idea right from the start. A cruise ship doctor was hardly the ideal role for a paediatrician.
But family came first.
And this had been the first job he’d been able to find at short notice. Close enough to Venice to be here when needed but far enough away not to attract any unwanted media attention.
His father’s health was slowly but surely deteriorating. And the call to the family business—the one he’d never wanted to be part of—was getting louder and louder. Being a fourteen-hour flight away was no longer feasible. Then again, finding a position locally in his specialist field hadn’t been feasible, either.
Timing was everything. If he’d applied for a paediatric post six months previously, with his background and experience he could almost have guaranteed his success. But all the desirable posts had been filled and it would be another six months before slots were available again.
This was a compromise. Only the compromise wasn’t meant to kill him.
He saw a small boat in the distance. It seemed to be moving very slowly, creeping around the huge hull of the cruise ship as if it was crawling towards them like a tortoise. Every muscle in his body was starting to burn. His arms were like blocks of lead. The figures on the jetty were still shouting towards them and the shadow appeared again.
Gabriel struggled to turn his head as the brick wall loomed above them. All at once the danger became apparent. The sweeping current was taking them straight towards it and with Gabriel’s hands caught tightly around the teenager’s chest there was no opportunity to lift his hands and protect his head.
So much for being here to support his family.
And then everything went black.
Francesca was bored. Bored witless. Her mother’s favourite British expression.
She smiled and nodded as someone walked past, shifting uncomfortably in the dress uniform. This was the one part of her job she hated. All the staff hated it. So much so, they drew straws each time the captain insisted one of the medical staff stand near the check-in desks in the terminal.
Standing in front of a pull-up banner of the Silver Whisper was not her idea of fun. The captain thought it made the medical staff look ‘accessible’. She was going to have to talk to him about that.
She watched the passengers wandering in and looking in awe at the side view of the ship. As soon as they appeared the crew entertainment staff were all over them, thrusting brochures of trips the cruise ran at every port they stopped at. Francesca sighed and looked at her watch. This was going to be long day.
She glanced over her shoulder. None of the other senior staff were around. Who would notice if she slipped out for a few minutes? A smile danced across her lips. She crossed the terminal building in long strides, slipping out through a side door that took her down to the dock where the ship was moored.
The dock was jammed with suitcases and sweating crewmen struggling to load them on board. Her brain automatically switched into work mode—ticking off in her head who hadn’t attended for their required medicals. She was going to have to crack the whip with the crew. Huge delivery crates of food were being wheeled up one of the gangways. It was amazing the amount of fresh food that was loaded at every port.
She wandered along the walkway, nodding greetings at several of the familiar crewmen, relishing the feel of the sun on her skin. Today, as every day, she’d applied sunscreen. But her Mediterranean skin rarely burned and the slightest touch of sun just seemed to enhance her glow.
This was the life. Working on a cruise ship had sounded like a dream at the time and a good sideways move. A chance to use all the skills she’d learned working in Coronary Care and A and E, along with the ability to use her advanced nurse practitioner status, and all in a relatively calm and safe environment.
But the long hours and constant nights on call were starting to wear her down. Thankfully she had a good supportive team to work with. A team that was slowly but surely helping her rebuild her confidence. The ship was a safe place to try and learn to trust her nursing instincts again. She’d once thought those instincts were good, but personal experience had taught her differently. It was time to start over and the ship seemed a good—if a little boring—place to start.
At the end of the day this was only supposed to be a temporary arrangement while she waited for her work visa for Australia to come through. But there had been delay after delay, with two months turning into three and then four. It seemed as if she’d been waiting for ever for the chance to spread her wings and go further afield. A chance to escape the memories of home.
‘Nurse! Nurse!’
She turned swiftly towards the shout. It was at the end of the dock where a small crowd was gathered, pointing and looking out towards the sea. Francesca started running towards the shouts—one of the crew had obviously recognised her.
She could feel the adrenaline start to course through her veins. When had been the last time she’d dealt with an emergency? Would she be able to deal with one again? She’d started her staffing in a coronary care unit where cardiac arrests had been a daily occurrence. Then she’d moved to A and E to increase her skills. Expect the unexpected. That’s what the sister she’d worked with had told her.
And she’d been right. From toddlers with a variety of household objects stuffed up their noses to RTA victims, she’d never known what would come through the door. Up until now she’d enjoyed the relative calm of the cruise ship. It could be a little mundane at times, dispensing seasickness tablets, dealing with upset stomachs and advising on sunburn. Maybe things were about to liven up?
She reached the edge of the dock and followed the pointing fingers to the two figures in the water. One looked like a child. She felt her stomach sink. The last thing she wanted was an injured child. A motorboat was approaching them and not before time. She winced as she watched the strong waves barrel them both into the port wall. Even though it was hundreds of yards away she could almost hear the crack.
The boat was almost on top of them and she watched as they dragged the child on board then struggled to reach the man, who had slipped beneath the waves. One crewman jumped into the water to help. Her heart thudded in her chest. Were they going to find him? The child was older than she’d first thought—probably a teenager—but the man?
Yes! They’d found him.
Oh, no. He was dressed from top to toe in white—an officer’s uniform—and they were dragging his lifeless body out of the waves.
She started pushing the others aside. ‘Let me through.’ The boat was heading towards them. She turned to one of the crewmen, ‘Go on board to the medical centre. Tell Dr Marsh I need some help. Tell them to bring a trolley and some resus equipment.’ The crewman nodded and ran off.
Francesca noticed a woman sobbing near her and elbowed her way through the crowd. ‘Are you okay?’ she asked.
‘My son Ryan. He was running along the walkway and he slipped. I got such a fright.’ She gestured around about her. ‘I couldn’t find anything to throw to him. I couldn’t find any lifebelts. And he can barely swim. Only a few lengths in a pool.’ She shook her head furiously. ‘Never in the sea.’
Francesca nodded, trying to take in all she’d heard. ‘Who’s the man?’ she asked gingerly, dreading the answer she was about to hear.
The woman shook her head again. ‘I’ve no idea. He appeared out of nowhere and dived straight in. Ryan was swept away so quickly, then he disappeared under the waves.’ She was starting to sound frantic again. ‘That man had to dive a few times before he finally found him.’ The woman turned to face Francesca, her voice trembling. ‘But what if he hadn’t? What if he hadn’t found my son…?’ Her voice drifted off and her legs were starting to shake.
Francesca put a firm arm around her shoulders. ‘Just hold on for a few minutes longer. Your son will probably be in shock when the boat reaches us. The sun may be shining but the water out there is pretty cold. How old is he?’
‘He’s thirteen.’
Francesca’s brain was rapidly calculating the drugs she might need for an adolescent. It was always tricky to calculate for kids—everything was generally based on their weight as children came in all different shapes and sizes. And from her experience, at a time of emergency the last thing a parent remembered was their child’s weight. It didn’t matter. It was worth a try.
‘Do you know how much Ryan weighs?’
The woman shook her head. Just as she’d suspected. If necessary, she’d have to make an educated guess when she saw him. Hopefully by then the rest of the team would have arrived.
Please don’t let her have to resuscitate a child. She’d done it a few times in A and E and had been haunted by every occasion.
The motorboat was getting closer. Francesca recognised a few crewmen who must have commandeered some poor unsuspecting local’s boat. Fear crept through her. The teenager was sitting at one side, a blanket flung around his shoulders, his face pale and water dripping from his hair. But the officer lay unmoving in the bottom of the boat—never a good sign. One of the other crewmen was leaning over him, so she couldn’t see clearly what was going on.
The boat bobbed alongside them and she leapt over the gap to the other craft. She took a few seconds to check Ryan over. He was conscious, he was breathing and his pulse was strong. How he looked was another matter entirely. ‘Get him onshore and get one of the medical team to assess him,’ she instructed, before pushing the others out of her way to get to the man.
She glanced at his face and noted the three gold stripes on his shoulders. Not only an officer—but a senior officer. The uniform was familiar but the face wasn’t. Maybe he wasn’t one of theirs?
She was on autopilot now, the adrenaline bringing back all the things she’d thought she’d forgotten. She knelt by him, putting her head down next to his, her eyes level with his chest looking for the rise and fall that was distinctly lacking. Her fingers went to the side of his neck, checking for a carotid pulse. Nothing. She tipped his head back and had a quick check of his airway. Clear.
She didn’t hesitate. She could do this in her sleep. On some occasions she almost had done this in her sleep. Some skills were never forgotten.
She took two deep breaths, forming a tight seal around his mouth with her own, and breathed into him, watching for the rise of his chest. She pulled at the white jacket, ripping down the front, and gold buttons pinged off and scattered around the bottom of the boat, revealing a plain white T-shirt underneath. She wasn’t going to waste time trying to remove it. The firm muscles of his chest were clearly outlined and she had all the definition she needed.
She positioned her hands on his chest and started cardiac massage, counting in her head as she went. She was frantically trying to remember everything she could about drowning victims—an area she had little experience in. It seemed almost absurd when she was working on a cruise ship—but most passengers never came into contact with the sea. Didn’t they have quite a good chance of survival if they were found quickly enough? She knew that there had been newspaper stories about children with hypothermia being pulled from frozen lakes and resuscitated successfully. But although this man’s skin was cold, he wasn’t hypothermic. There wasn’t going to be any amazing news story here.
She kept going, conscious of voices behind her and shouted instructions. There was a thud as the boat rocked and a pair of black shiny shoes landed next to her. Her heart gave a sigh of relief. David Marsh was here to help her but she didn’t stop what she was doing, leaning over and giving two long breaths again.
‘Throw me over a defib and a bag and mask,’ came the shout next to her.
Francesca kept going, the muscles in her arms straining as she started cardiac massage again. David was more than capable of organising everything around them.
She was counting again in her head. Twenty-two, twenty-three, twenty-four… Come on. She willed him to show some sign of recovery.
The handsome Italian features weren’t lost on her. The dark brown hair, long eyelashes, strong chin, wide-framed body and muscled limbs. This man could be very impressive—if he was standing up.
David was pulling up the T-shirt that had been underneath his officer’s jacket. ‘I don’t recognise him.’ He squinted. ‘Who on earth is he?’
She shook her head, ‘I have no idea. Somehow I think I would have remembered this one.’
He slapped the pads on the muscular brown chest that Francesca was desperately trying not to notice and turned to switch on the machine. Then, before her eyes, the lean stomach muscles twitched. ‘Wait!’ she shouted.
She held her breath for a few seconds and then he did it again. Twitched. And then coughed and spluttered everywhere. The Venetian water erupted from his lungs all over the deck around them and she hurried to help him on his side.
The monitor kicked into life, picking up his heart rate. His breathing was laboured and shallow. David read her thoughts and handed her over a cylinder of oxygen with a mask as he slipped a pulse oximeter on the man’s finger.
Francesca bent over the man, blocking out the bright sunlight and shading his face from the nosy bystanders. She spoke in a low, calm voice. ‘I’m holding an oxygen mask next to your face to help your breathing,’ she said, praying he would understand because right now she had no idea if he spoke English. He opened his eyes. They were brown. Deep dark brown.
Wow.
But she must think purely as a professional. She must ignore everything about the Italian hunk they’d just pulled from the water. All the little things that would normally have sent shivers skittering down her spine.
She pulled her penlight from her pocket. This man probably had a head injury. She’d seen him being bounced off the port wall. She lifted his groggy eyelids and shone the light first in one eye and then the other. He gave the smallest flinch.
Pupils equal and reactive. She turned to David. ‘We need to start proper neuro obs on this guy.’
He nodded. ‘What happened?’
‘He went in to rescue the boy. Once he’d got him the current carried them to the port wall and he was knocked unconscious. I think he was under the water for just over a minute.’ Her hand reached around to the back of his head. His dark brown hair was wet but she could feel some abrasions at the back of his head. She pulled her hand back—blood.
‘Can you give me something to patch this before we move him, please, David?’
David nodded and handed her some latex gloves and a dressing pad. ‘Stretcher will be here in a minute. We’ll get him onto the trolley and see if we can find some ID.’
Francesca hadn’t lifted her head. He was still groggy. In all the TV shows she’d ever watched, victims of a near-drowning seemed to get up almost as soon as they were revived and walk off down the beach into the sunset. Usually hand in hand with their rescuer.
The thought of walking off into the sunset with this guy was definitely appealing. Like something out a fairy-tale. If only he would come round.
As a child she’d always loved the childhood fairy-tales Cinderella, Rapunzel, Snow White and Little Red Riding Hood. Her father had read them to her over and over again. Those were some of her fondest memories of him.
She leaned in a little closer to the man. If she really wanted to do a set of neurological observations on this guy then she needed to try and elicit some kind of response from him, a response to a painful stimulus.
‘Wake up, Sleeping Beauty,’ she whispered.
CHAPTER TWO
GABRIEL was in a dark place. Nothing. Nothingness. Then a sharp pain in his chest and the need to be sick. He coughed and spluttered, conscious that he was being pushed on his side but totally unable to assist. His head was thudding. His lungs felt as if they were burning. He heard a little hissing noise and felt a gentle, cool breeze on his face. What was that?
Someone tugged his eye open and shone a bright light at him. How dared they? Couldn’t they see he just wanted to sleep? To be left alone for a few moments in this fuzzy place?
He felt a little pinch on his hand. Then another, more insistent.
‘Ouch!’ He was annoyed, irritated. Then he heard a soft, lilting voice with the strangest accent he’d heard in a while. ‘Wake up, Sleeping Beauty. Are you with us?’ Warm, soft breath tickled his cheek.
His eyelids flickered open. The sun was too bright.
Someone was trying to block the sunlight out.
Rats. It must be a dream. She was far too pretty for real life.
She was every guy’s dream. A real-life modern-day princess. Mediterranean skin and dark eyes with tumbling brown curls. But something in this fairy-tale still wasn’t working.
She spoke again. ‘There we go, that’s better.’
It was that accent. It didn’t fit with his Mediterranean dream princess.
It confused him. Made his brain hurt. No—that wasn’t his brain, that was his head.
He blinked again. The smell of the Adriatic Sea assaulting his senses. His skin was prickling. All of a sudden he felt uncomfortable. Something wasn’t right. He was wet. Not just damp but soaked all over.
In the space of a few seconds the jigsaw puzzle pieces all fell into place. The young boy drowning, his attempt at saving him and the almighty crack to his head. He pushed himself up.
‘Whoa, sailor. Take it easy there. You’ve had a bump on the head.’
‘You can say that again,’ he mumbled, squinting in the sunlight. ‘And it’s Doctor, not sailor.’
The princess’s face broke into a wide perfect-toothed smile. ‘Actually, I’ll correct you there. On board, you’re a sailor first, doctor second.’
David Marsh leaned forward, clutching some wet credentials in his hand. He held out his other hand. ‘Well, this is an interesting way to meet our new boss. Gabriel Russo, I’m Dr David Marsh, your partner in crime. And this…’ he nodded towards Francesca ‘… is Francesca Cruz, one of our nurse practitioners. But as you’ve just been mouth to mouth with each other, introductions seem a little late.’ He signalled to the nearby crewmen. ‘We’re just going to get you on this stretcher and take you to the medical centre to check you over.’
Francesca felt a chill go down her spine at the name. She recognised it but couldn’t for the life of her think why. She stared at him again. Was he vaguely familiar? She was sure she’d never met him, and with features like those he wasn’t the kind of man you’d forget.
Gabriel looked horrified and shook his head, water flying everywhere. ‘No stretcher. I’m fine. I can walk.’ He pushed his hands on the bottom of the boat and stood up, standing still for a few seconds to make sure his balance was steady.
His eyes found the thick rope securing the small boat to the quay before he stepped over the gap and back to the safety of solid ground. He spun round to face Francesca. ‘How’s the boy? Is he all right?’ But he’d turned too quickly and he swayed.
She caught hold of his arm and gave him a cautious smile. ‘He’s on his way to the medical centre to be checked out. He was conscious, breathing but distinctly pale when he arrived. Now, how about I get you a wheelchair?’
‘I don’t do wheelchairs.’
She signalled over his shoulder. ‘I can be very bossy when I want to be.’
Dr Marsh cut in, ‘I can testify to that. Particularly if you think you’re going to get the last chocolate. I should warn you in advance that’s criminal activity in the medical centre.’
Gabriel felt pressure at the back of his legs as he thudded down into a wheelchair that had appeared out of thin air. ‘I said I don’t do chairs,’ he growled.
‘Let’s argue about that later,’ said Francesca as she swept the wheelchair along the dock.
The hairs on his arms were standing on end and he started to shiver—an involuntary action—a sign of shock. A few seconds later a space blanket was placed around his shoulders.
He grudgingly pulled it around him, noting the efficiency of his new staff and the easy rapport and teamwork—all good signs. Within a few seconds his nurse appeared to have walked the hundreds of yards along the dock and was pushing him up the gangway.
This was a nightmare. The worst way possible to meet your new staff. Yet another reason he should never have taken this job.
She seemed to turn automatically to her left, heading toward the service elevators. Gabriel felt mild panic start to build in his chest. Could this day get any worse?
Then she quickly veered off to the right. ‘Where are we going?’ he growled.
‘To the medical centre. We’re already on Deck Four so it will only take a couple of minutes.’ If she was annoyed by his tone there was no sign.
Gabriel heaved a sigh of relief and settled back in the chair. He’d be fine once he got something for this headache and was out of these wet clothes. Then he could get started.
The chair turned sharply into the modern medical centre. Consulting rooms, treatment rooms, in-patient beds and state-of-the-art diagnostics and emergency equipment. He knew the spec for this place off by heart—it was impressive, even by his exacting standards.
She wheeled him through to one of the rooms and pulled the curtains around the bed, pushing the brake on the wheelchair. She disappeared for a second and came back with a towel and set of scrubs.
Francesca’s brain was whirring. Gabriel Russo. Why was that name so familiar? Then it hit her like a ton of bricks falling from the sky. She had seen him before. Only last time he’d been wearing a pair of white designer swimming trunks and been perched on the edge of a multi-million-pound yacht, his arm lazily flung around the shoulders of her bikini-clad friend Jill.
The Italian stallion, Jill had called him and that picture had adorned her flatmate’s bedside cabinet until one night when a sobbing Jill had phoned Francesca at 3:00 a.m. to come and pick her up.
Francesca would never forget the sight of Jill in her sodden green designer gown, her hair plastered around her face and tears running like rivulets down her cheeks after Gabriel had flung her out of his penthouse flat.
Jill had been broken-hearted over his treatment of her and had taken a good few weeks to get over him—a long time for Jill.
And Francesca had waited a long time, too—to tell this man exactly what she thought of him. He was alive. He was breathing. His heart rate was sound. After a few general observations for head injuries he should be fine. There was a determined edge to her chin; it would be criminal to waste this opportunity. And she had absolutely no intention of doing so.
Something was wrong. Something had changed. He could sense it immediately; the tension in the air was palpable. Right now, all he wanted to do was climb into that pristine white bed, close his eyes and lose this thumping headache.
But the soft side of his Mediterranean princess had vanished and she was staring at him as if he were something she’d just trodden on.
Or maybe he was imagining it? Maybe the resuscitation and head knock had affected him more than he’d thought?
‘You’re Gabriel Russo.’
Gabriel’s pounding head jerked in response to the sharp tone in her voice. He wasn’t imagining it. ‘I thought we had established that.’
‘No, you’re Gabriel Russo, Italian stallion.’ She lifted her fingers in the air, making the quotation mark signs, wrinkled her nose and then continued, ‘Stinking love rat. You used to date my friend Jill—until you threw her out of your apartment in London at 3:00 a.m. in the pouring rain.’
‘No one’s ever called me Italian stallion to my face before.’ He felt almost amused. The nickname had been plastered across the press often enough. He wasn’t used to being blindsided. Then again, he wasn’t used to being resuscitated.
Jill. The name flickered through his brain. He’d certainly dated more than his fair share of beautiful women and he’d worked all over the world. Something fell into place. London. No. Let’s hope she wasn’t talking about that Jill. Just what he needed—a misguided, loyal friend. If his head wasn’t thumping so much this could almost be funny. Not only that—Ms Misguided was a knockout. A beautiful work colleague would never be a problem. But an angry, venomous one would be. This was a small team. They had to work together. It could be badly affected by two people who didn’t get on.
She wasn’t finished. ‘But I bet plenty of women have called you a heartbreaker before.’
‘Have we met?’ His eyes ran up and down her body and she felt a prickle of disgust—he’d almost mirrored her thoughts from earlier. ‘I think I’d remember.’
A few minutes before she’d had nice thoughts drifting about her head about their new doctor. She’d thought he was handsome. She’d thought he was fit. She’d even thought… No. She hadn’t. She couldn’t possibly have.
He frowned. ‘Jill? Who was she again? Remind me.’
Francesca felt rage build inside her. Arrogant so-and-so. The palm of her hand itched—she wanted it to come into contact with his perfect cheek.
‘Six years ago. London. Blonde model. You took her on your yacht for the weekend.’
‘Oh, that Jill.’ His frown deepened, puckering little lines around his eyes. He turned away, pulling his muddied jacket and T-shirt over his head, and she sensed it was on purpose. She tossed the scrubs and towel onto the bed beside him.
‘Yes, that Jill.’ The volume of her voice increased in proportion to her rage. ‘The one you dumped in the middle of the night in the pouring rain outside your flat. What kind of a man does that?’
He whipped around, the muddied jacket and T-shirt clenched in his fists, leaving his wide brown chest right in front of her eyes. The fury in her voice couldn’t match the venom in his eyes. ‘What kind of a man does that?’ he growled.
She gulped. He was half-dressed, his shoulder muscles tense, his bare abdomen rigid. If they were shooting an action movie right now he would be the perfect poster-boy hero.
All of a sudden the room felt much smaller. Maybe it was the six-foot-four presence. All trembling muscle and eyes shooting fireballs in her direction.
She could feel every hair on her body stand on end. And she hated it.
Because amongst the repulsion there was something else she was feeling—something more—and it went against every principle she had.
She pushed all those thoughts aside. If she ignored them then they weren’t actually there.
He still hadn’t answered. Probably because he was incoherent with rage.
‘What are you doing here anyway? Aren’t you supposed to be some billionaire-type doctor? You don’t actually have to work for a living, do you? Why on earth would you be working on a cruise ship?’
He shook his head, almost imperceptibly. What a surprise. All the usual assumptions, misunderstandings and wrong conclusions. All the things he went to pains to shake off. Normally he wouldn’t care what some stranger thought of him. But this stranger was part of his team and she was going to have to learn who was boss around here—hardly an ideal start. ‘Some things you wouldn’t understand.’ He leaned against the side of the bed, and could feel the pressure inside his head increase.
‘Try me.’
Something flashed across his face. He took a deep breath. ‘How well do you know Jill?’
‘She is my friend. She was my flatmate in London. We lived together for six months.’
‘Six years ago?’ There was an edge to his voice—almost as if he couldn’t believe someone had been friends with Jill that long.
‘Yes. We don’t live together any more but we keep in touch.’ She scanned her brain, trying to think of the last time she’d heard from Jill—maybe a week or more?
‘And how many times did you have to pick her up heartbroken in the middle of the night?’
‘Once.’ Not strictly true. But he was beginning to look too smug. There was a lot not to like. He was too handsome and too sure of himself. And she didn’t like that look on his face—as if he knew something she didn’t.
‘Jill is a really good friend of mine. She helped me when I needed it most. Make no mistake about where my loyalty lies, Gabriel.’
Those words didn’t even touch what Jill had done for her. When her father had died, Jill had dropped everything and flown straight up from London to Glasgow. She’d organised the funeral, dealt with the post-mortem, sorted out the insurance and the contents of the house—all things that Francesca couldn’t possibly have dealt with. Jill had been her rock.
In the past their relationship had always felt uneven, as if Francesca was constantly running after Jill and taking care of her. But when the chips had been down Jill had more than risen to the challenge. Francesca couldn’t have got through it without her.
‘How long are you here for?’
‘I haven’t even done my first shift and you’re trying to get rid of me?’
She shrugged.
‘As long as I want. I took this job at short notice—someone had broken their contract—so I was pretty much offered what I wanted. It’s up to me to decide how long I want to stay.’
Great. Who knew how long she would be stuck with him? ‘You didn’t answer the original question. Why would a billionaire doc like you want to be working on a cruise ship?’
He waved his hand dismissively. ‘Family stuff.’
It was the first interesting thing he’d said.
Yip. The walls in the room were definitely closing in on her. This was her worst nightmare. Working with this man every day was going to play havoc with her senses and her principles. She hated the fact that under other circumstances she might like him. She hated the fact she’d almost flirted with him.
‘I know you’ll have some clean uniforms in your quarters but how about putting these on right now?’ She pointed to the scrubs. She wrinkled her nose at the ruined jacket and T-shirt, still in his hand. ‘I don’t care how good the laundry staff are here, they’re not going to be able to save those.’
Gabriel stood up, his legs feeling firmer than before. He hadn’t even considered his appearance. The pristine white uniform he was holding was covered in remnants of brown sludge. His body hadn’t fared much better. From the port wall perhaps? She was right, no matter what the TV adverts pretended to show, no washing powder on the planet could sort this out.
He grabbed the towel to rub his hair, momentarily forgetting the reason he was there and wincing as the edge of the towel caught his wound.
‘Easy, tiger.’ Francesca pushed him down onto the edge of the bed. ‘Let me do that.’ She took the towel from his hands and gently dried around the edges.
‘Stop fussing,’ he muttered, trying to swat her hand away. ‘I need a shower.’
Francesca was doing her best to push her anger aside. She had a job to do. Whether she liked him or not, he was a patient—one she’d just resuscitated and with a head injury. She was a good nurse. This was straightforward. She could do this. ‘Right now I’m in charge—not you. You can go in the shower when I say so.’ She stuck a tympanic thermometer in his ear. ‘I’m going to do a full set of neurological observations on you, then clean that head wound and either glue or stitch it.’ She glanced at the reading on the thermometer. ‘You’re still cold. We’re going to heat you up a bit first.’ She pulled a blanket from one of the nearby cupboards.
Gabriel sighed. At least she was an efficient nurse, even if she was smart-mouthed and hated his guts. ‘Where’s Dr Marsh?’
She peered around the edge of the door. ‘He and Katherine are dealing with the teenager. Children get priority. I’m sure you’d agree with that.’
The child, of course. What was he thinking? There was a child to be attended to. ‘I should go and check him over.’ He tried to push his blanket off, but she laid her hand firmly on his shoulder.
The constricting feeling across his chest was almost instant. Paediatrics—children were his whole reason for being a doctor. There was no way he’d watch a child suffer. He couldn’t stand the thought that there was a child in the next room requiring attention while he was being pushed onto a bed.
It made him feel useless. It pushed him into dark places imprinted on his mind. Memories of long ago. Of a child with a scream that sent shivers down his spine. Feelings he’d spent his whole professional career trying to avert.
He pushed himself off the bed again.
‘Gabriel.’
Her face was right in front of his, her large brown eyes looking him straight on and her voice firm.
‘Ryan is fine. David Marsh is more than capable of looking after a shocked teenager. Maybe—just maybe—if we were resuscitating him, like we did with you, I might let you go and assist. But this isn’t an emergency situation. You’re not needed. You’re not even officially on duty. Right now you’re a patient, not a doctor. And a cranky one at that. You’d better hope that your head injury is making you cranky because if that’s your normal temperament you won’t last five minutes in here.
She was right. The rational part of his brain that was still functioning knew she was right. But his heart was ruling his head. He was cursing himself for not paying more attention to the port wall. He shouldn’t have dived straight in, he should have taken a few more seconds to get his bearings. Then maybe he could have protected Ryan and stopped him from slipping from his arms.
They could hear rapid chatter next door. She obviously didn’t realise his background in paediatrics. It was hardly surprising. Six years ago he’d been just about to pick his speciality and he’d dumped Jill before he’d made his final choice.
‘You should stay where you are. I’m going to attach you to a monitor for a few hours. You, sir, are going to do exactly as I say—whether you like it or not.’ She pulled the wires from the nearby monitor. ‘I’m not the pushover Jill was,’ she murmured.
Gabriel felt a weight settle on his chest again. For a second he’d seen a little glimpse of humour from her. For a second he’d thought maybe she didn’t hate him quite as much as it seemed. This was the last thing he needed—some smart-mouthed nurse with a load of preconceived ideas him. How close was she to Jill? Hopefully she didn’t have any of the same tendencies—that could be disastrous.
Every part of his body was beginning to ache and if he didn’t get something for this headache soon he was going to erupt.
It was almost as if she’d read his mind. ‘I’ll give you something for your headache in a few moments. I want to have a clear baseline set of neuro obs and I can’t give you anything too strong—I don’t want to dull your senses.’ There was a hint of humour in her voice, the implication that his senses were already dulled crystal clear.
It was just about as much as he could take.
‘Enough about me. What about you?’ he snapped. ‘What’s with the accent? Where are you from?’
The unexpected question caught her unawares and she jolted. She put the unattached wires down and her brow wrinkled. She bent to shine her penlight in his eyes again, satisfying herself that his pupils were equal and reactive.
‘I’m from Scotland.’ She straightened up.
‘You don’t look like you’re from Scotland,’ he mumbled as he dropped the towel he’d been using to dry himself, revealing the taut abdominal muscles, and pulled the scrub top over his head. ‘You look like a native. And what were you doing in London?’
‘I could be offended by that,’ she said quickly, placing one hand on her hip as she tried to drag her eyes away from his stomach. Was this his natural response? Was he normally so blunt? Or was this an altered response that she should be concerned about? She had no background knowledge on which to base a judgment. Should she just take for granted that he could be quite rude?
He’d paused, half-dressed, and was watching her. Watching the way her eyes were looking at his taut abdomen. She felt the colour flooding into her cheeks. There was no point averting her eyes, she’d been well and truly caught. She could be cheeky, too.
‘Put those away. You’ll give a girl a complex. And they’ll need to go, too.’ She pointed at his muddied underwear and handed him the scrub bottoms, averting her eyes for a few seconds to allow him some privacy. She slid her hand up inside his scrub top to attach the leads to his chest. His brown, muscled chest.
Time to change the subject. ‘My parents were from Trapetto, a fishing village in Sicily. But I was brought up in Scotland. I’m a Glasgow girl through and through.’ She waved her hand. ‘And don’t even try to speak to me in Italian. I’m not fluent at all—I know enough for emergencies and how to order dinner but that’s it.’
‘Didn’t you speak Italian at home?’
His voice brought her back to reality. ‘Rarely. There wasn’t much call for it in Glasgow.’
Her eyelids had lowered, as if this wasn’t a conversation she wanted to get into. Why was that?
Francesca picked up his dirty clothes. ‘I take it you’re okay if I dump these?’
He nodded and shifted on the bed, frowning at his attached leads. ‘So what are you doing here, Francesca?’
She froze, a little shocked by the bluntness of the question. This guy was going to take a bit of getting used to.
She frowned at him, knowing her brow was wrinkled and it wasn’t the most flattering of looks. ‘What on earth are you talking about?’
There it was again, that little hint of something—but not quite obvious.
‘I would have thought that was obvious. I’m here working as an ANP. Maybe I should check that head knock of yours again.’
His eyebrows lifted. ‘I’m curious what a young, well-qualified nurse like you is doing here.’ His hand swept outwards to the surrounding area.
She felt a little shiver steal down her spine. Nosy parker.
She kept her voice steady. ‘You mean here…’ she spread her arms out and spun round ‘… in this state-of-the-art medical complex, in the middle of the Mediterranean, with a different port every day and a chance to see the world?’
She planted her hands on her hips and looked at him as defiantly as she could. She was stating the obvious. The thing that any website would quote for prospective job-seekers. It was a cop-out and she knew it. But she didn’t like the way he’d asked the question. It was as if he’d already peered deep inside her and knew things she didn’t want anyone else to know.
‘I’m just curious. Your family is in Glasgow. And yet, you’re here…’ His voice tailed off. Almost as if he was contemplating the thought himself.
Something inside her snapped. Were all Italians as old-fashioned as him?
‘My family isn’t in Glasgow any more. Get a life, Gabriel. Isn’t a girl allowed to spread her wings and get a job elsewhere? Maybe I’m trying to connect with my roots in Sicily. Maybe I was just bored in Glasgow. Maybe I want to see the world. Or it could just be that I’m killing time until I get my visa to Australia. I thought cruise ships would be fun. Truth be told, so far I’ve found it all a bit boring.’ The words were out before she’d thought about it. Out before she had a chance to take them back.
She cringed. He was her boss. He was her brand-new boss, who had no idea about her skills, experience and competency level—probably the only things that could be her saving grace right now. How to win friends and influence people. Not.
She pushed the dirty clothes inside a plastic disposal bag, ‘I’ll get rid of these,’ she muttered as she turned to leave.
This was going to be nightmare. This ship was huge. Big enough for two thousand, six hundred passengers and five hundred staff. But this medical centre? Not so big. And the staff worked very closely together. Some days the medical centre felt positively crowded.
And the last thing she needed was to be stuck with some playboy doc. A pain shot through her chest. The last time she’d been distracted by a playboy doc it had had a devastating effect on her family life, causing irreparable damage. She could not allow that to happen again, no matter what the circumstances.
Every part of her body was buzzing. She hadn’t even had a chance to think about what had happened today. She’d resuscitated someone.
Someone who could, potentially, have died if she hadn’t taken those actions.
The thought of dealing with a death again horrified her. It didn’t matter that she was a nurse. Her circumstances had changed. Everything had changed.
Deaths weren’t supposed to happen on cruise ships. Working here was part of her safety net—keeping her away from the aspects of her job she couldn’t deal with any more.
And now him.
On top of everything else.
She leaned back against the wall. There was no two ways about it.
This ship wasn’t big enough for the two of them.
CHAPTER THREE
FRANCESCA’S fingers thumped furiously on the keyboard.
Hey babe!
You’ll never believe who I’m working with right now—Gabriel Russo. Yes, the very one. And he’s every bit the conceited billionaire boy that he was six years ago. It took me a few minutes to work out who he was—probably because I had to resuscitate him first—but needless to say, once I’d reminded him I was your flatmate you could cut the atmosphere in here with a knife.
Cruise ships might look huge in real life but the reality is, when you can’t stand to be around someone, they seem very small.
Haven’t seen you in a while, so hope you’re doing well.
In the meantime living in hope he’ll fall overboard,
Fran xx
‘Busy?’
The voice, cutting through the dark medical centre in the dead of night, made her jump. Couldn’t she get any peace from this man?
She could barely tolerate being in the same room as him. What’s more, he constantly appeared at her shoulder, checking over what she’d done. And for someone whose confidence was already at rock bottom it was more than a little irritating.
There were always two crew members on call at night—one for the passengers and one for the crew. One week had passed and this was Gabriel’s first official night on call and Francesca had drawn the short straw of babysitting him.
She spun around in her chair to face him. He had his black medical bag in his hand. ‘I’m waiting for one of the crew members to meet me,’ she said. ‘She’s complaining of abdominal pain.’
‘Need a hand?’
Francesca bit her tongue to stop her saying the words that were dancing around her head right now. Over my dead body probably wouldn’t go down that well with her boss.
‘No, I’m fine, thanks.’ She pasted a smile on her face and gestured towards his bag. ‘You look busy enough anyway. Lots of passenger callouts?’
He nodded, rubbing his hand across his eyes. ‘Three in the last hour. All for really ridiculous things. Please tell me this isn’t a normal night.’
Francesca smiled. If it had been anyone else she would have told him about the ‘cougar list’ currently taped inside one of the cupboard doors in the treatment room.
The list of well-known passengers—mainly women in their forties and fifties—who developed symptoms requiring a cabin call whenever a new, young doctor came on board. She could bet in the last hour Gabriel had seen a lot of skin and satin negligees.
Not all the passengers changed every week or every fortnight. A certain select group seemed to spend a large part of their life cruising. It was not unusual to have the same passengers on board for four to six weeks at a time. Sometimes they swapped to another ship for a month and then came back to the Silver Whisper again.
The ‘cougar list’ had been started by Kevin, one of the nurses, after he’d noticed a sharp rise in callouts whenever a new doctor started. It was really just a warning list to give the person on call the opportunity to decide if they wanted to take the other crew member on duty with them. She would tell him about the list—really, she would—just not yet.
Francesca was sure that Gabriel could handle a few coy looks. After all, hadn’t he spent his life chasing women, collecting them like trophies and then unceremoniously dumping them? This should be a breeze for him.
‘Here, have a look at this.’ She handed him the communiqué she’d been given requesting details about the rescue at Venezia Passegeri. Apparently the media were keen to run a story. ‘They’re a little late but maybe they were short of news.’
A dark shadow passed over his face as his eyes flew over the page. ‘Absolutely not. No names. I don’t want to talk about last week. Make sure the communications officer understands.’
She shrugged, a little surprised by his reaction. ‘The cruise line probably wants the publicity,’ she suggested. ‘What’s the problem? You’re used to being in the news.’
‘No!’ He looked furious. He crumpled the piece of paper in his hand and threw it deftly into the wastepaper bin. She smirked. Message received, loud and clear.
Was this man temperamental? Maybe his snappiness after his head injury hadn’t been the result of the accident. His questions to her had been a little blunt. He certainly wasn’t exhibiting all the traits Jill had told her about of the flirtatious, playboy doctor. Gabriel Russo seemed to be a wolf in doctor’s clothing. And the thought intrigued her.
Katherine had complained bitterly last week that Gabriel wasn’t the best of patients—apparently she’d had to practically pin him to the bed to monitor his neuro obs overnight after his head injury. He’d been furious when Dr Marsh had insisted he be monitored overnight and it had been a relief to them all when he’d been given a clean bill of health the following morning and allowed to take on normal duties.
His pager sounded again and he sighed, picking up his medical bag and heading for the door. ‘If I’m not back in an hour page me.’ He hesitated for a second, his brown eyes connecting with hers. ‘Please.’
Francesca couldn’t help but smile. Maybe he was finally catching onto the cougar brigade.
She turned back to the computer and pulled up the file for the crew member she was about to meet.
The notes were limited. Elena Portiss, twenty-seven, from Spain, working on board as a bartender, with a declared past medical history of endometriosis.
She’d phoned ten minutes earlier saying her abdominal pain was worse than usual—bad abdominal pain was not uncommon in a woman with a history of endometriosis.
There was a noise behind her and Francesca stood up and flicked the switch, lighting up the medical unit.
‘Elena?’
The young woman nodded.
Francesca was immediately struck by how pale the girl was. Her pale blue eyes were dull and lifeless, her normally tanned skin pallid and slightly waxy.
‘Come in here.’ Francesca walked into the nearby room and gestured Elena towards one of the examination trolleys. She worked quickly, checking her temperature, blood pressure and pulse. ‘You have endometriosis?’ Francesca spoke slowly, taking care in case there was any difficulty in language.
Elena nodded. Francesca noted that her hands were positioned carefully over her stomach, obviously trying to keep her pain in check. ‘It was diagnosed last year after I had very painful periods.’ She lifted her shirt and pointed to a little scar next to her belly button. ‘I had a camera in there.’
Francesca nodded. If Elena had had a laparoscopy done and the diagnosis confirmed then it was likely that her symptoms were related to her endometriosis.
‘Do you normally use painkillers?’ Elena nodded and fumbled in her bag, pulling out a battered box with the name written in Spanish. Francesca took the box, looking at it and writing the name down in the notes. It was a commonly used non-steroidal anti-inflammatory drug that was effective in treating endometriosis.
‘We will be able to give you something similar,’ she reassured Elena, ‘but the box may look a little different. Have you tried anything else?’
Elena pulled a second, slightly more battered cardboard box from her bag. ‘I stopped taking these,’ she said, ‘as they made me feel unwell.’ As she didn’t recognise the name on the box Francesca opened it and pulled out the foil strip with the twenty-eight tablets enclosed. Around half were missing and she realised immediately what they were. Oral contraceptives were commonly used to treat endometriosis in women who weren’t trying to start a family. They worked by regulating the hormone levels to stop the production of oestrogen in the body. Without exposure to oestrogen, the endometrial tissue could be reduced and this helped to ease symptoms.
‘Do you remember when your last period was?’ Francesca asked.
‘I’m not sure. I had some bleeding yesterday and a little this morning, but it wasn’t much.’
‘I’m so sorry, but I’m going to have to get a urine specimen from you. Do you think you can manage to go to the toilet for me?’
Elena grimaced as Francesca helped her to the toilet. It only took a few minutes before she was back on the couch and Francesca reattached her to the blood-pressure cuff. BP was ninety over sixty. Hypotensive. Colour poor. Alarm bells started to go off inside Francesca’s head.
The amount of pain that Elena was exhibiting was more than would be expected. Elena nodded, still clutching her stomach.
Francesca’s spider sense was tingling. Her instinct—the thing she’d thought she’d lost.
This wasn’t right. This didn’t feel right. Elena’s pain seemed too severe and too localised to be endometriosis. Francesca knew that endometriosis was a painful condition in which the endometrial cells that would normally be present within the lining of the womb could be deposited in other areas around the body. These cells were still influenced by the female hormones and could cause pain in various areas, particularly around the pelvis.
And she knew how painful it could be—one of her friends spent a few days every month doubled up in bed. But this just didn’t add up.
She checked the urine sample for infection and it was clear. Francesca opened the nearby cupboard and pulled out another test. It was only a hunch and she could be wrong. Using a little pipette she dropped a few drops of urine onto the test and checked her watch. A little line appeared.
Her heart gave a flutter in her chest. She hadn’t been wrong and for a second she felt almost elated. Then common sense pulled her back to reality.
She needed help. And no matter how much he irritated her, she knew who to call.
The pager sounded again.
Gabriel was annoyed. What would be the reason for this ridiculous callout? A stubbed toe? A grazed elbow? He was going to have serious words with the team in the morning if this was what they normally dealt with.
He glanced at the number on the pager. The medical centre. Francesca. Now, that was a surprise. She’d looked as if she’d rather set her hair on fire than ask him for help earlier.
And as for the media request…
It made his blood boil. His family were constantly in the paper—particularly in Italy. With the words ‘tragic’ usually appearing in the second sentence. Twenty-five years ago the media had been all over them and their ‘tragic’ loss. Every time they were mentioned in the press it was all raked over again.
The last thing they needed was more painful reminders.
Didn’t they get that the loss of Dante was imprinted on them for life, seared on their very souls?
Gabriel had never once given an interview to a journalist.
Correction. Gabriel had never knowingly given an interview to a journalist. The ugly remnants of a faked past relationship by an aspiring reporter burned hard. That, and his experience with Jill and a few others like her, told him that women weren’t to be trusted. Under any circumstances.
It only took him a few moments to reach the medical centre.
‘What’s wrong?’
Francesca was waiting at the door for him, some notes in her hands and a worried expression on her face.
She thrust the notes towards him. ‘Elena Portiss, twenty-seven, severe abdominal pain, past history of endometriosis.’
‘Have you given her some analgesics?’
‘Not yet.’
‘Why not?’
She hesitated just for a second. ‘Because she’s pregnant and she doesn’t know it. I think it may be an ectopic pregnancy,’ she said tentatively.
Gabriel’s eyes skimmed over the notes in front of him. He’d no idea why she looked like a deer currently caught in the headlights. She’d done everything he would have expected. ‘Let’s find out.’
Francesca caught his arm as he walked past her. ‘I haven’t given her any indication about what I think may be wrong.’ Gabriel caught the worried expression in her eyes. He understood completely. Endometriosis was frequently associated with infertility. To tell the patient that she was pregnant but that the pregnancy was ectopic would be a devastating blow. He strode through to the treatment room and spoke to Elena, who was lying on the examination couch, her face still racked in pain.
‘Hello, Elena,’ he said confidently, ‘my name is Dr Russo. I’m one of the ship’s doctors. Nurse Cruz has asked that I take a little look at you.’ He shook Elena’s trembling hand. As he placed his hands very gently on her stomach he noticed her visibly flinching. ‘I promise you, I will be very gentle.’
He moved lightly across her abdomen, pressing gently with his fingertips from one side to the other. ‘Where is the pain worse? Here? Here?’
Elena shook her head tensely, and then grimaced again in pain as his fingers reached her right side. The clinical signs were all present. She was pale, hypotensive, with lower abdominal tenderness and distension. That, together with a positive pregnancy test, gave an almost conclusive picture.
Francesca watched him from the corner of the room. Had she been wrong to mention her tentative diagnosis? Other doctors might have thought she was stepping on their toes to make such a suggestion.
But Gabriel hadn’t even blinked. He didn’t seem offended or annoyed with her suggestion. His only concern seemed to be for the patient.
Given the hostility between them it could have been a perfect opportunity for him to take her to task.
But apparently not. This man wasn’t exactly how she’d imagined him to be.
‘Okay, that’s me finished.’ He took his hands from Elena’s abdomen and stood next to her.
‘Do you know the date of your last period, Elena?’
She shook her head miserably. ‘I have been bleeding on and off for several months. I can’t say for sure. I was taking the Pill, too, but it made me feel unwell, so I stopped. Then I had some light bleeding yesterday. I’m not sure when my last period was.’
Gabriel nodded, ‘That’s okay’. He turned to Francesca. ‘Can you check her BP and pulse again for me, please, and draw some bloods? I’ll need her urea and electrolytes, but more importantly a full blood count, please.’
Francesca nodded and set the monitor to retake Elena’s blood pressure while she opened the nearby drawer to find the blood bottles. Once the blood pressure had been recorded she removed the cuff and replaced it with a tourniquet to facilite taking some blood. It only took her a matter of seconds to locate a vein. ‘Just a little prick,’ she said to Elena as she gently slid the needle into the vein and attached the bottle to collect the blood samples. Francesca released the clip on the tourniquet, letting it spring apart, relieving the pressure on Elena’s arm. She placed the needle in the nearby sharps box and gave Gabriel a quick glance as she left the room. ‘I’ll phone Kevin and get him to do the blood results for us.’
She wondered if he realised how quickly her heart was beating in her chest. Elena’s blood count would be a good indicator of whether her diagnosis was correct or not.
It could also prove that her instincts were still completely off.
The medical centre was equipped with a wide range of laboratory equipment that allowed the staff to carry out many diagnostic tests that were essential to diagnosing and treating patients. Kevin arrived a few minutes later, hair mussed, took the blood samples and prepared them for testing. When she returned to the room Gabriel was sitting next to the examination trolley, talking to Elena. Francesca could see the serious expression on his face and watched as he gently took Elena’s hand to explain her condition. Gabriel was surprising her. He was taking time to talk to Elena, to hold her hand and explain clearly what was happening. For some reason she found it almost the opposite of what she’d expected. This was a man who’d flung her friend out on the street at three o’clock in the morning yet here he was as a doctor, doing everything he should and showing empathy for his patient. In her head that just didn’t fit. Her curiosity was piqued.
She listened quietly in the background.
‘Elena,’ he said gently, ‘I think it is likely that you’re having an ectopic pregnancy.’ He noticed the complete confusion on her face, and realised she hadn’t really understood. ‘Your urine test shows that you are pregnant—but this is not a normal pregnancy.’
‘But I can’t be pregnant—I have endometriosis—it’s not possible for me to be pregnant.’ Her face was filled with shock.
‘It is possible,’ Gabriel continued carefully. ‘Have you had sex in the last six weeks?’
Elena nodded numbly.
‘Although your condition makes it difficult to conceive, it is not impossible. It is likely that because you were taking the contraceptive pill you’ve become unclear about when your next period was due. Your urine test is definitely positive. However, the pain and discomfort that you are feeling makes it likely that, instead of implanting in the womb, the fertilised egg has implanted in your Fallopian tube.’ He picked up a nearby book with pictures of the female reproductive system and pointed to the various areas, showing her where the fertilised ovum had likely reached.
The medical staff often used these clear diagrammatic books to explain conditions to crew members of different nationalities. ‘The embryo can’t develop within this confined space and causes bleeding and pain. Sometimes the tube can rupture and that can be very serious. But in all cases the pregnancy can’t continue.’
He waited for a moment, until he could tell that Elena had processed the information he had given her. Elena started sobbing uncontrollably. Gabriel had been right. The news of a pregnancy, followed by the news that it was ectopic and couldn’t produce a baby, had devastated her.
‘What happens now?’ she asked.
Gabriel stood up from the chair. ‘We have to watch you very closely so we are going to admit you to our intensive care unit. I’ll put up some fluids and give you some pain relief. One of our nurses will come and take some more bloods from you in the next few hours. I will have to arrange for you to go to hospital at the next port.’
Kevin appeared and handed Gabriel the blood results. Haemoglobin eight point seven. Gabriel glanced in Francesca’s direction. No words were needed. They both knew that was much lower than normal for a woman of her age and more than likely an indicator of some internal bleeding.
Francesca felt the flush of relief rush through her system. She’d been right. For once her instincts had been good. If things weren’t so serious for their patient right now she would run outside and breathe a big sigh of relief.
When had been the last time she’d felt like this? The last time she’d had real confidence in her abilities as a nurse?
After her initial meeting with Gabriel, she couldn’t have blamed him if he’d ignored her instincts at all. But he hadn’t.
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