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Love Without Measure
Caroline Anderson


IT’S COMPLICATED…Staff Nurse Anna Jarvis adores her work in Audley memorial Hospital’s Emergency Department,, even though combining a full-time job with looking after her adorable four-year-old daughter Flissy has its complications! However, breathtakingly handsome Patrick Haddon—the new senior registrar—is a complication that Anna doesn’t need. She might not have announced Flissy’s existence to all and sundry, but by the look of the ring on his finger it’s clear that Patrick’s keeping a few secrets of his own . . .THE AUDLEY—where love is the best medicine of all…












Love Without Measure

Caroline Anderson





www.millsandboon.co.uk (http://www.millsandboon.co.uk)




Table of Contents


Cover (#u4d7d48f0-cacc-55c8-9474-b3d1226a46f7)

Title Page (#u0a3e1360-a326-5ee2-908d-4dadc11c5772)

Chapter One (#udb9f60fe-c6bc-5c7f-ad31-cd9adca44176)

Chapter Two (#ub1c2ae70-e17f-5dd2-bb8e-e640ef2de559)

Chapter Three (#litres_trial_promo)

Chapter Four (#litres_trial_promo)

Chapter Five (#litres_trial_promo)

Chapter Six (#litres_trial_promo)

Chapter Seven (#litres_trial_promo)

Chapter Eight (#litres_trial_promo)

Chapter Nine (#litres_trial_promo)

Chapter Ten (#litres_trial_promo)

Copyright (#litres_trial_promo)




CHAPTER ONE (#ulink_f5058a9b-01f4-5cba-b897-4bfc662694b4)


ANNA heard his laugh first, a deep, rich chuckle that made the corners of her mouth curl involuntarily and softened the lines of tiredness around her eyes.

Laughter could convey many things, she thought—happiness, amusement, joy, even scorn and derision. This man’s laugh was sheer enjoyment, full of warmth and humour. It was the laugh of a man glad to be alive, and she sensed he was also comfortable, a man at ease with himself and the world.

It was also a big laugh, and she knew before she turned the corner that his body would match it. Even so, her first sight of him made her breath catch, and she faltered.

He was tall, his body lean and rangy, with wide, square shoulders and long legs; he was leaning against the wall, his white coat held back by the hands thrust deep into his trouser pockets, amply displaying his narrow hips and taut, flat stomach. One knee was bent and the sole of his shoe was propped casually against the wall at mid-calf.

He was deep in conversation with Jack Lawrence, the A and E unit consultant, and as she watched his mouth opened again and his head tipped back. The laugh rippled round her again, and she felt a shiver start deep inside. Who was he?

The new senior registrar, she realised. Patrick something. At least he looked confident. They had been plagued by a recent houseman who had been a total pain, and losing their previous and excellent SR Ben Bradshaw to an unknown quantity could have been very bad news. Hopefully this guy would pass muster, as a doctor anyway. As a man, there was no question.

She forced herself to walk towards them, confused by the sudden speeding of her heart. This was crazy—he was just a colleague! Probably, please, God, safely married like Ben.

He looked completely relaxed and thoroughly at home, which was quite remarkable considering he had only started on the unit ten minutes ago. That laugh found its way up from his throat again, teasing the air with its joyful sound. Anna’s mouth curved involuntarily.

As she approached Jack looked up with a smile and held out his arm towards her, drawing her into their circle.

‘Anna, I want you to meet Patrick Haddon, our new SR. Patrick, this is Staff Nurse Anna Jarvis, Kathleen’s second in command.’

He shrugged away from the wall, standing straight at last, so she could see how large he really was, and took his hands out of his pockets as he turned towards her.

The light caught the dull gleam of a gold band on the ring-finger of his left hand, and her breath eased out in a sigh of relief—relief that felt curiously like disappointment. He was married. She was conscious of the silly smile still lurking round her mouth, and forced it into a smile of welcome. His own mouth tipped into an answering grin, and she felt something kick under her ribs. ‘Hi,’ she managed, a touch breathlessly.

She took the proferred hand, noting almost absently its dry warmth and firm grip. It was his eyes which had her attention, though; they were a warm, deep brown, rich and full of humour, and yet still gentle. She had the feeling he could see into her soul. It was a most uncomfortable sensation, and yet curiously she didn’t feel threatened. It was only uncomfortable because it was so unexpected.

‘Hello, Anna,’ he said quietly, and his voice seemed to resonate deep inside her, rippling out into the cold, quiet reaches of her loneliness.

No! He was married! She dropped his hand, the contact suddenly too much to cope with. ‘Welcome aboard, Dr Haddon,’ she replied, managing to find the social niceties despite the strange sensations in the pit of her stomach. She turned towards the other man. ‘Jack, have you seen Kathleen?’

‘She’s in the end cubicle with a fracture. If you go and give her a hand I’ll be along in a minute, once I’ve sorted Patrick out.’

‘Thanks.’ She turned and walked away, conscious of those searching eyes following her. The hair on the back of her neck prickled, and she had to force herself not to run.

As she turned into the cubicle she risked a glance back. He was still watching her, his eyes steady, a thoughtful look on his face.

She went behind the curtain, her heart thumping. Not a flirt, she prayed. Please, God, not a flirt. Sexual harassment was the one thing Anna hated above all else, particularly when it came in the form of a flirting playboy, and most especially when he was married. She found herself feeling suddenly sorry for the wife she had dreamed up for him.

How must it feel to catch a man like that just to discover he was a will-o-the-wisp? She dismissed the memory of those eyes, far from flirting, just gently assessing, and seeing far too much for her peace of mind. She would think of him as a flirt. That way he would be easily dismissed, pushed to the back of her mind, not worth the time of day.

Kathleen looked up from the trousers she was easing off and smiled. ‘Good morning, Staff.’

‘Morning, Sister. Do you need a hand?’

‘Oh, yes, please. This is Mr James. He fell off the kerb, didn’t you?’

The man nodded and winced. ‘Right down a pothole. Teach me to look where I’m going, won’t it? Are you sure you shouldn’t cut those trousers?’

Kathleen laughed. ‘And have you sueing me for a new pair? Don’t worry, I’ll be careful.’

‘You’d better be,’ he muttered, grim-lipped, and subsided on to the pillow with a groan. Together Anna and Kathleen eased the trousers down, slipped his good foot out, and carefully removed them from the damaged one without even making him wince.

Perversely he looked disappointed, and Anna almost laughed.

The skin was very scraped, and Anna could see his foot was lying at a strange angle. Kathleen straightened up and smiled.

‘I’ll get a doctor to come and have a look at you, Mr James, while Staff Nurse Jarvis cleans you up a bit more.’

‘They’re in the corridor. Jack’s just coming,’ Anna told her, and Kathleen nodded and went out quietly through the curtain.

‘This looks very sore,’ Anna said as she pulled on gloves and cleaned the skin a little. ‘Am I hurting you?’

‘It is rather tender,’ he said a bit stiffly, and Anna stopped as soon as she had wiped away the worst of the blood and dirt from around his graze. It was obvious that the fibula was broken, so he would probably need an anaesthetic to set the bone and there was no point in torturing him for the hell of it. Whoever examined him could see enough now.

The curtain swished beside her, and she felt a shiver run over her skin. She didn’t need to look to know it wasn’t Jack Lawrence. Gorgeous though he was, his magnetism was strictly limited to Kathleen. This man, though …

‘Mr James? I’m Dr Haddon. I gather you’ve hurt you leg—mind if I have a look?’

‘Be my guest.’

He bent his head over the leg, checked the foot for warmth and sensation, and then tutted quietly. ‘It looks a bit nasty, doesn’t it? I think we need an X-ray first, to assess the extent of the damage, but I’m pretty sure you’ve just broken the bone at the side of your leg—the fibula. You may have damaged some of the bones in your foot as well, but the X-ray will pick that up. Whatever, you’ll need an operation to fix that bone properly, I’m afraid.’

The man sighed heavily. ‘Can’t you just put a plaster on it?’

Patrick shook his head. ‘Sorry. It won’t heal unless we can pull the bone-ends into alignment, and that will need surgery, I’m almost sure.’

‘Damn. I’m supposed to be flying to America tomorrow.’

‘Well, I’m sorry, you won’t be going—not for a good while.’

He swore, softly but fluently. ‘I have to go,’ he repeated.

‘Sorry, old chap, that’s the way it goes,’ Patrick told him calmly.

It didn’t calm him noticeably. ‘I’ve got my mobile phone here—do you mind if I make some calls while I wait?’ he asked, already flicking up the aerial.

‘Be our guest,’ Patrick told him, and, making sure the sides were up on the examination couch, Anna followed him out to fill in the X-ray request forms and get Patrick to authorise them.

Behind them they could hear Mr James’s voice on the phone.

Tallen off the pavement and broken my goddamn leg—what? I said I fell off the bloody pavement!’ he yelled.

Patrick grinned at Anna. Oops. I think our business executive’s heading for a mid-life crisis,’ he said softly, and she chuckled despite her intentions to have nothing to do with him.

He followed her into the office, perched on the edge of the desk so that his lean, well-muscled thigh was just inches from her hand, and watched as she made a total foul up of the first form.

‘Damn,’ she muttered, and, screwing it up, she lobbed it towards the bin and missed.

‘Calm down. You’re getting like Alan James.’

She snorted, but tackled the next form slowly. ‘There—could you sign, please?’

His hands were fascinating—tanned, the backs lightly scattered with dark hair, the fingers strong and straight. She forced herself to look at the ring on his left hand, to remind herself that he was married.

That was when she saw the scar, a jagged white line that ran from thumb to wrist. She found herself touching it before she knew what she was doing.

‘What happened?’ she asked.

He glanced at it dismissively. ‘I don’t know. I was helping at an earthquake, pulling rubble off the remains of a school.’

‘An earthquake?’

‘Mmm. Here, he can go through now.’

She took the form, clearly dismissed, and went and wheeled Mr James through to X-ray, trying not to let idle curiosity distract her from her job. Except that earthquakes in this country were rarer than hen’s teeth …

Mr James was still on the phone. Grudgingly he put it down and subsided to a steady grumble for the X-ray. Sure enough, it was a clean fracture of the fibula with no other damage to the foot, but it would need plating to draw it back into alignment.

As she wheeled him back to the cubicle Nick Davidson, the orthopaedic SR on take, appeared and walked towards them with a grin.

‘Is this my patient?’

‘Yup—here are the plates, and this is Mr James.’

Nick introduced himself and shook the man’s hand. ‘My name’s Davidson. I’m the orthopaedic surgeon who’s going to be fixing this. Shall we have a look?’

He thrust the plates up into the light-box and grunted, then pointed to the broken ends of the bone, explaining to Mr James what he was going to do. ‘When did you last eat?’

‘Last night.’

‘No breakfast?’

‘I never have time.’

‘Good—this once. When did you drink last?’

‘Coffee at eight before I left home.’

Nick glanced at his watch. ‘Nine thirty-five. OK, we’ll take you up to the ward and prep you, and I’ll tack you on the end of my list. You’ll go to Theatre just before lunch, OK?’

‘If it’s really necessary,’ he grumbled.

‘It’s really necessary.’

He snorted. ‘I’ve got more calls to make—can I have a private room?’

‘Only if there’s a single room free at the time. Ask the staff on the ward.’

He left, and Mr James stared after him. ‘Is that it?’

Anna was astonished. ‘What did you want him to say?’

‘I want to know when I’ll be up and about—when can I leave hospital?’

She stuck her head out of the curtains and called after Nick. ‘Mr James wants to know when he can leave hospital.’

Nick turned, walking backwards down the corridor as he spoke. ‘Whenever he feels ready,’ he called back. ‘I suspect about a week. Then he’ll need two weeks at least with it up, and another week or two slowly mobilising. Five to six before he’s walking regularly with crutches. And no, he can’t fly tomorrow.’

She went back into the cubicle. ‘Did you hear that?’

‘Bloody ridiculous,’ he growled. ‘Is he a consultant?’

Anna took a steadying breath. ‘No, he’s a senior registrar.’

‘I want to see the big cheese—I’m not going to be fobbed off with some incompetent junior doctor.’

She hung on to her temper with difficulty. ‘I can assure you, Mr Davidson isn’t a junior doctor, nor is he incompetent! His next post will be a consultancy—probably in the fairly near future. And he’s more than qualified to mend your ankle!’

Mr James was stubbornly unrepentant. ‘I want it done privately,’ he stated. ‘I don’t have time to mess about like this.’

She eyed him with disfavour. ‘Could you explain something to me? Would you tell me how paying for it is going to make your leg heal any quicker?’

‘I might get better treatment,’ he grumbled. ‘At least a real specialist. I can’t afford to take weeks off,’ he added petulantly.

‘You should have thought of that when you weren’t looking where you were going, shouldn’t you?’ she said sweetly, and with that she swished out into the corridor smack into a laughing Patrick Haddon.

She glared at him, but he winked and took her arm, leading her away.

‘Calm down,’ he soothed, and led her into the staff-room, pressing a cup of coffee into her hand. ‘Drink this. There’s nothing requiring your immediate attention, so take a little time out and relax.’

She snorted. ‘Pompous ass. I don’t suppose there’s the slightest chance he’ll get pneumonia from the anaesthetic?’

Patrick laughed again, his eyes creased with delight. ‘You’re a wicked woman.’

‘Only when provoked, and boy, did that man provoke me!’ She sipped her coffee, then sighed. ‘Oh, this is luxury. What a nasty shock, coming back to that after a wonderful weekend!’

‘What do you expect—gratitude? This is the great British public. We’re here to serve them, and do it on time, regardless of what might have just gone on behind the scenes.’

She stared at him. ‘You sound really bitter.’

‘Do I?’ He gave a quick grin. ‘Sorry. I’ve been in Africa for the last two years. They queue up there for days to see you, and never complain. Mostly they’re too weak, but they’re pathetically grateful for any slight kindness. It’s very humbling.’

The weary smile didn’t reach his eyes. ‘Sorry. Don’t let me get on my hobby-horse. I’m back here now, and I should just accept the absurd plethora of medical equipment and facilities instead of begrudging it to these miserable ingrates.’

His smile robbed his words of any offence, and Anna found herself even more curious about him. If he felt so passionately about Africa, why come home? Now was not the time to ask him, though, because he was still speaking, asking for her help.

‘Sit down for a minute,’ he suggested. ‘I could do with being filled in on procedure, names, places—that sort of thing. Who do I call, who do I avoid, who’s got a tetchy temper?—apart from you, of course.’

His smile took the criticism out of his words, and she found herself smiling back.

‘I’m normally very calm, but when someone questions a colleague’s competence, and says they’d get better treatment if they paid for it, I get very, very cross.’

‘Let him pay. It relieves the stress on the hospital’s funds. Anyway, you shouldn’t get so worked up. You’ll get ulcers.’

‘No, I won’t. Not if I haven’t got Helicobacter pylori.’

‘Smart-mouth.’

There was no malice in his remark, and they shared a smile.

‘Thanks for the coffee.’

She dropped into a chair and sighed. The weekend had been hectic, and already seemed a long way away. Flissy had been dancing in her ballet class, and Anna had had to dress her and pile her wispy hair up into a bun, and then watch the tiny little scrap trip and dither her way across the room, pretending to be a butterfly.

A virtuoso performance it wasn’t, but it had reduced Anna to a sniffling, pink-eyed heap. Pride was a ridiculous thing, she thought.

‘What are you thinking about?’

She blinked. Oh—nothing. Something that happened at the weekend, that’s all.’

‘It must have been pretty good—you were all misty-eyed.’

She laughed self-consciously, not ready to tell this stranger about her little Flissy. Men had a way of judging a single mother, and Anna wasn’t ready to be judged by this man. Not judged and found wanting.

‘It was good,’ she said, and deliberately changed the subject. ‘So, tell me about Africa. Was that where the earthquake was?’

A shadow crossed his eyes. ‘No,’ he said, effectively cutting off the conversation.

She blinked. So he, too, had things he wasn’t prepared to talk about.

She studied her cup, swirling the dregs of her coffee round and wondering why he was suddenly so remote and cut off. Had someone he loved died in the earthquake? Perhaps a wife or child? Oh, God, not a child! He’d said it was a school …

‘You didn’t lose someone—not your child?’ she asked, unable to help herself.

He met her eyes, his own revealing a flash of pain. ‘No,’ he agreed quietly. ‘Not my child.’

But someone. What was the saying about fools rushing in? Her shoulders drooped. ‘Look, I’m sorry I dragged the whole thing up—’

She jerked to her feet, almost dropping her cup back on the table, and fled.

She heard him call her name, but she didn’t stop. She went out to the front desk, glanced round, and picked up the notes for a patient who had just arrived.

‘Mrs Lucas? Would you like to come with me, please?’

He caught up with her at lunchtime, when she was just grabbing ten minutes for another coffee and a biscuit.

‘Is that all you’re having?’ he asked in disbelief.

‘I don’t eat much during the day,’ she told him, unprepared to get into discussion about it.

‘You can’t work as hard as you have been on that. Come and have some lunch with me—we never did have that conversation. I’ll offend someone mortally, and it will be your fault. Do you really want that on your conscience?’

His smile was warm and teasing. He was clearly quite unbothered about offending anyone. He wasn’t the offensive sort. He also wasn’t the sort to be thwarted.

‘Come on, while it’s quiet.’

She shook her head, reminding herself that he was married. ‘No. I really don’t want to go to the canteen.’

‘Then it will come to you. Wait here.’

He left the room, his long legs eating up the corridor. She heard the quiet swish of the door as he left the department, and, shutting her eyes, she leant her head back with a sigh. She felt like King Canute—totally helpless in the face of such stubborn determination. It would be easier to give in, but she didn’t want to. That would give him the upper hand, and absolutely the last thing she needed was to be bullied by a man, especially somebody else’s husband …

‘You sound tired.’

She opened her eyes. ‘Hello, Kath. No, I’m not tired, I’m saving my energy. Our Dr Haddon has decided I need to eat more. I think I’m about to be force-fed.’

Kath laughed, the action declaring her on Patrick’s side. ‘Good job, too,’ she retorted. ‘You’re far too skinny.’ She helped herself to coffee and dropped into a chair next to Anna, kicking off her shoes and rubbing her toes. ‘So, what do you think of him?’

Anna shrugged non-committally. ‘He seems very competent.’

Kath laughed. ‘Competent? He’s big, Anna—B-I-G. Just what we need to sit on all the drunks while we wrestle them into submission. Ben was fine, but he just didn’t have Patrick’s weight, and Jack’s not always here.’

Anna swallowed. Patrick was big, true, but size wasn’t everything. There was something else about him, a deep and intrinsic kindness that matched his bulk. He would be useful for sitting on drunks, but she could see he would have far greater uses dealing with the ordinary run-of-the-mill tragedies that passed through their department. It was the sort of intuitive, bone-deep sensitivity that would make him a wonderful lover, too, she thought, and yanked herself up hard.

No. No, no, no! Why should she think of that? She knew nothing about what made a man a lover, good or otherwise! She drank her coffee, wondering if she would have time to finish it and escape before Patrick got back. It was a long way to the canteen. If he had to queue …

She had reckoned without his long legs. She heard a door swish, a firm stride approaching, and her escape was cut off.

She sank back with a sigh, and Kath chuckled.

‘She was going to bolt—you feed her, Patrick. God knows someone needs to take care of the silly girl; she won’t do it herself.’ She stood up, slipped her feet back into her shoes and stretched. ‘You two take half an hour, crises permitting, and then Jack and I will go for lunch. OK?’

She left them, and Anna had no choice but to turn her attention back to Patrick. Her eyes settled on the mountain of sandwiches, buns and fruit he was putting on the table, and widened in amazement.

‘I hope you don’t expect me to eat all that?’ she asked, her voice rising to a squeak.

He chuckled. ‘It would probably do you good, but no. I had rather hoped you’d leave me a little. Of course, if you feel that hungry, I can always go and get more—’

‘No! Heavens, no. If I get through one sandwich I’ll be doing well.’

He snorted rudely, snapping open the plastic containers and tipping the contents out on to plates.

‘Cottage cheese and tomato, ham and lettuce, egg and cress, tandoori chicken, prawn cocktail—take your pick.’

She blinked. ‘Um—prawn?’ she ventured, finding her voice. Lord, it must have cost a fortune. She ought to offer to pay for her share …

He put two sandwiches on a plate and pushed it into her hand, then took her cup and refilled it. ‘Eat—come on,’ he nagged. ‘They’ll curl up before you get to them.’

She bit obediently into the deliciously moist sandwich, and groaned.

‘All right?’

‘Gorgeous,’ she mumbled round the prawns. It was. She took another bite, and another, unaware of Patrick’s searching gaze on her as she demolished the sandwich and started on the second half. A slow smile of satisfaction touched his eyes, then he turned his attention to his own lunch, biting deeply into his sandwich but monitoring her progress over the top. She finished, and he lowered his plate.

‘Good?’

Anna stared down at her empty plate, surprised.

‘It was—wonderful.’

‘Have another.’

She opened her mouth to refuse, but his face was implacable. Instead she gave a rueful smile, and reached for the spicy chicken.

‘That’s my favourite,’ he grumbled.

She made to put it back but he laughed. ‘I’m teasing. I like anything. You go ahead and have it.’

He picked up the other half, though, and winked at her across it. ‘You can take your pick of the rest.’

She ate it silently, pondering on her knight in shining armour. He looked about thirty-five, she thought, maybe younger, but his face had that lived-in look that had seen many sides of life, not all of them kind. The earthquake? Perhaps that had aged him. He was good-looking, though. Good bone-structure, his body broad and strong without being overly heavy. There wasn’t an ounce of fat on him, she thought, despite his prodigious appetite. He bit into another sandwich and glanced up, meeting her eyes. His mouth occupied, he waved instead at the food.

‘More,’ he mumbled.

‘I couldn’t.’

‘Fruit, then—or a doughnut.’

She felt herself weaken. ‘You’ve got doughnuts?’ she asked hopefully. ‘Are they warm?’

He nodded, his mouth busy again.

‘Jam?’

He nodded, the corners of his eyes crinkled with understanding.

She heard her stomach rumble. Oh, what the heck? He clearly intended to feed her till she split. She couldn’t disappoint him.

The doughnut was wonderful, light and fluffy, the jam still warm. It squirted down her chin and she laughed and reached for a tissue.

He was there first, a napkin at the ready, steadying her jaw with his other hand as he wiped the jam away. Their eyes met, and for a long and almost unbearable second she thought he was going to kiss her.

Then he sat back, cobbling up the napkin and lobbing it neatly into the bin.

Her breath eased slowly out. Had she imagined it? Oh, God.

She finished the doughnut and then wiped her fingers, reaching for her coffee with hands that were not quite steady. She cast about for another topic for her mind, and came up with money as the safest option.

‘What do I owe you for that lot?’ she asked.

He looked astonished. Owe me? Nothing.’

‘Don’t be silly, it must have cost a fortune.’

‘I think I can just about run to a few sandwiches for our first date,’ he said drily, and drained his coffee-cup while she tried to ignore the funny hiccup in her heartbeat at his use of the word ‘date’. Ridiculous. ‘However,’ he continued, ‘if you insist on going Dutch you can refill my cup, bring me a banana, and tell me everything I need to know to keep out of trouble.’

Clearly it was as far as she was going to get. ‘Are you always this stubborn and bossy?’ she asked mildly as she did as she was told.

‘Always. Thank you.’ He took the cup and set it down. ‘Now, the trade-off. Who do I have to avoid, who do I have to crawl to, what are the internal politics?’

She groaned. ‘Internal politics? I try and stay out of it. Funding, of course, is always a hassle. So far they haven’t threatened to close us down, but funding for our emergency teams going out to incidents is always a bit of a fraught issue. They say it’s very expensive, and I’m sure it is, but it’s absolutely vital that we continue to keep the service available and I’m sure in the long run we actually save money.’

He nodded. ‘Who usually goes?’

‘The most senior members of staff available to a small incident. To a major incident with multiple casualties we usually keep several senior staff here to deal with the casualties as they come in, but others, of course, go out for on-the-spot surgery and emergency resuscitation. The first job in major incidents is Triage, really, sorting the patients into priority for transfer to hospital, and that’s something we’re all very used to.’

‘Do you have a Triage system operating in the unit all the time?’ he asked.

Anna nodded. ‘Yes—it’s often me doing that. We only bother if it gets busy, but the reception staff are excellent and keep us in touch all the time with what’s coming through the door.’

Patrick stretched out, his long legs crossed at the ankle, and balanced his coffee-cup on his chest. ‘What’s the usual waiting-time?’

She laughed softly. ‘You tell me. Certainly less than several days, unlike your Africa. We try and keep it down to under half an hour, and patients are always seen by the Triage nurse within a few minutes of arrival in any case, unless we’re so quiet that they’re virtually straight in. Sometimes, though, it can be up to an hour before they get seen and that really bothers me. It’s the malingerers that mess up the system—the people that won’t go to their GP because they don’t like to bother him, or because they have to wait in the surgery, or because this is more convenient than trying to get an appointment. Last week we had a man who came in with piles.’

‘They can be very painful,’ Patrick said reasonably. ‘He might well have been worried, especially if they were bleeding.’

‘They weren’t,’ she retorted, ‘and he’d had them twenty years!’

Patrick chuckled. ‘So who had the pleasure of telling him where to go?’

‘Kathleen—and very effective she was, too! She has a pet thing about people who abuse the system. She asked him if he’d left his glasses behind, and pointed out the sign. “Have you had an accident?” she asked. “Is it an emergency?” He left quite quickly.’

‘I’ll bet. She’s a little fire-cracker, I should think.’

Anna smiled indulgently. ‘She can be. She’s also very gentle and kind.’

‘And married to the boss, of course.’

‘Oh, yes. They can be quite nauseating.’

He chuckled. ‘Really?’

‘Really, although you’d think they’d have grown out of it by now. They’ve been married nearly eighteen months.’

‘Nah, they’re still newly-weds,’ he said with another of his infectious chuckles. He tipped his coffee-cup and she watched his very masculine throat work as he swallowed. Then he stretched luxuriously, totally unselfconscious, and hauled himself to his feet.

‘I suppose we ought to let the love-birds go to lunch and do some work,’ he said with a smile. ‘There’s still some food left—want another doughnut?’

She shook her head. ‘No. I won’t need to eat again for days.’

He snorted rudely, grabbed a sandwich as they passed the table, and headed towards the cubicles.

Stifling a smile, Anna followed.

A few minutes later she lost all urge to smile.

A message came from ambulance control to say that a young boy, Simeon Wilding, was being brought in direct from school with a severe asthma attack, and he was reported to be in a serious condition.

‘OK,’ Patrick said calmly. ‘We’ll take him straight into Crash. Can someone clear it, please, and get it ready? We may need to ventilate him. Any information on drugs?’

Anna shook her head. ‘No, nothing. He’s a known asthmatic; we may have the notes. Julie’s searching for them.’

Julie was the receptionist, and, having checked for notes held in the unit, would then check with the asthma clinic. If they were in the hospital, Julie would track them down in the next few minutes.

Until then, they just had to play it by ear. They prepared the nebuliser with salbutamol, cleared the decks and waited.

They heard the ambulance coming and went to the door in time to see it sweep in very rapidly. The doors were flung open and the boy was out, heading for the department, with Patrick running beside the trolley and examining the lad as they came.

Anna could see that his lips were blue, his eyes wide, and he was clearly fighting for breath. Then, as she watched, his eyes closed and he stopped breathing.

Patrick swore, very softly, and yanked down the blanket, slapping the stethoscope on his chest as they manoeuvred through the doors.

‘Damn. He’s arrested. Get him into Crash.’

They ran, leaving him on the trolley for speed as they all went automatically into action as soon as the trolley was stationary.

Feeling for the breastbone, Patrick crossed his hands and pumped hard on the boy’s chest.

Anna heard a dull creak and winced. A rib had gone. Oh, well, it was better than dying. She didn’t have time to think about it, though, because she had to take over from Patrick while he inserted the cuffed tube and blew it up, sealing the airway. Then he connected it to the humidified air from the ventilator unit on the wall and watched as the boy’s chest rose and fell.

They alternated cardiac massage with positive ventilation, to allow the air to be forced into his lungs, together with a measured dose of a bronchodilator to combat the swollen tubes in his lungs that were preventing him from breathing.

While Anna worked another nurse was putting monitor leads on his chest, and then he was connected up and they could see the flat trace that indicated the heart was still not beating.

‘Damn you, don’t you dare die,’ Patrick muttered, and, pushing Anna out of the way, he thumped the boy’s chest hard.

The line wiggled, then settled into an erratic rhythm. ‘He’s fibrillating—I’ll give him a jolt. Stand back, everyone, please.’

They took a pace back while Patrick held the paddles to the boy’s chest. ‘Shock, please,’ Patrick said.

The boy’s body arched and flopped, and the trace suddenly corrected itself. As it did, the boy’s lips turned less blue and he started to fidget.

‘I’ll give him a minute and then we’ll try him off the ventilator,’ Patrick told them, and bent over the boy.

‘Simeon, it’s OK, you’re going to be fine,’ he said calmly, his voice reassuring.

The boy’s eyelids fluttered up and he started to fight the ventilator. Patrick disconnected him from the machine and watched to see if he could breathe alone. To their relief his chest rose and fell gently. ‘Good,’ Patrick said, and, letting down the cuff, he withdrew the endotracheal tube from the boy’s mouth.

He coughed, his breath rasping, and Anna replaced the tube with a mask connected to a nebuliser. Warm, damp air flowed into his lungs, and within minutes he looked much better.

‘My chest hurts—I want my mum,’ he said in a small voice, and beside her Anna felt Patrick almost sag with relief. He was all right; the fight for air had been won before it was too late. Another few seconds and he could have suffered irreversible brain damage.

Even so, Patrick was worried about him.

‘I think he ought to go into ITU for a day or so, if the paediatrician agrees,’ he said quietly to Anna.

She nodded. It was standard procedure to overprotect their young asthmatic patients, because attacks of that severity rarely happened in isolation and in ITU everything necessary was there at hand.

The paediatric consultant, Andrew Barrett, arrived then and took over, examining the boy and chatting quietly to him.

It seemed they were old friends—the boy a frequent visitor to the paediatric ward. This time, though, Andrew agreed with Patrick. It had been a little too close for comfort, and they were erring on the safe side.

Just as he left the department Jack and Kathleen Lawrence came back in, staring at the trolley in surprise.

‘Was that Simeon Wilding?’

‘Yes—asthma attack. He arrested,’ Patrick told them economically.

‘What?’ Jack looked shocked.

Patrick smiled slightly. ‘He’s OK—well, apart from a rib I may have cracked. He’s going to Paediatric ITU for a couple of days, just to be on the safe side. He stopped breathing, but he’s spoken to us and he’s OK—at least for now.’

Jack’s mouth tipped into a cynical curve. ‘Of course he is—after all, it’s only asthma.’

Anna heard the bitterness in his voice and understood it. Asthma was so common that it tended to be ignored, underestimated, almost brushed aside until a crisis forced it into view.

An event like this brought you up hard against reality, she thought. Most of their critical asthmatics made it, but every now and again they would lose a patient to it, even though it was ‘only asthma’.

They all felt so helpless then, and Jack hated being helpless. Patrick, too, she realised, looking at them as they shared a frustrated smile.

‘Oh, well, we do what we can. Well done for saving him,’ Jack said, and rested his hand on Patrick’s shoulder.

‘I’ve been meaning to give you a guided tour of the department all morning—but I guess you’ve seen Crash now?’

Patrick laughed. ‘Yes—thank you.’

‘How about a coffee?’ Kathleen suggested.

Just then the phone rang, and as one they all turned to look at it, then shrugged.

‘So who needed coffee anyway?’ Kathleen said philosophically, and picked up the phone.




CHAPTER TWO (#ulink_602b1a55-8c4a-5571-bcd6-ccf2cff43be3)


PATRICK stood up to leave. The elderly man in the chair by the window regarded him without curiosity.

‘Are you going now?’ he asked.

‘Yes. I’ll see you tomorrow.’

The old boy shook his head. ‘Very kind of you, I’m sure, but I can’t see why you should want to.’

Patrick quelled the pain. ‘Would you rather I didn’t come?’ he asked quietly.

‘Oh, no. I enjoy your company, young fella. Too many old girls in this place for my liking. No, I was thinking of you. I just can’t see the attraction in talking to an old codger like me.’

Patrick smiled, a sad half-smile that didn’t reach his eyes.

‘I find you very interesting. You’ve had a fascinating life.’

The man snorted. ‘You must have a very boring life, young man, if you find mine fascinating. Very boring.’

Patrick thought back over the last few years, and gave a wry, quiet laugh. ‘It’s quite exciting enough for me. I’ll see you tomorrow.’

They shook hands formally, and Patrick turned to leave. As he did so the man called him back.

‘Patrick?’ he said.

He turned towards him again. ‘Yes?’

‘I don’t know who you are, young man, but I’d be proud if you were my son.’

Patrick’s face twisted slightly. ‘Thank you,’ he said softly. ‘Thank you very much. Goodnight.’

He went out, waving a greeting at the sister who was busy wheeling another resident through the grounds, and slipped behind the wheel of his car—his father’s car, in fact.

For a moment he remained motionless, letting the pain ease away, giving himself time. Then he started the car and drove back to the lovely Tudor house where he had grown up, and where he was now staying with his mother.

She was in the front garden when he pulled up, and she straightened and went to greet him with a kiss. ‘How was he?’ she asked.

Patrick shrugged. The same.’

‘Still doesn’t know you?’

He shook his head. His eyes blurred, fogging his vision, and he blinked hard. ‘I miss him,’ he said unevenly.

‘So do I,’ his mother said sadly. Oh, Patrick, I’m so glad you’re home.’

They hugged each other, drawing comfort from the contact, sharing their sorrow. The lump in Patrick’s throat grew, and he eased away.

‘I’ll put the car in the garage, then I need to change.’

‘Don’t be long. I want to hear all about your day.’

He didn’t doubt it. He put the car away and went in through the side door into the converted stable-block that had been turned into a self-contained annexe for guests. He had refused to stay in the house with his mother, preferring instead to maintain his independence and privacy while still being close at hand.

Now, as he stripped in the airy bedroom and wandered through to the little bathroom to shower, he was glad he had insisted. He needed room to himself, a little time and space to be quiet and recharge his batteries.

And God knows they were flat enough. This sudden deterioration of his father’s was the last straw, the Alzheimer’s that had been creeping up now claiming his memory and distancing him from the son who had travelled back across half the world to be near him.

A heavy sadness settled in Patrick’s chest, joining the other weight that lay there at all times, ignored for the most part but omnipresent, a constant anchor round his heart.

He turned on the shower and stood under the hot, stinging spray, his eyes closed, letting the water pelt over him and wash away the smell of the nursing-home.

Ideally he would like to bring his father home, but his mother couldn’t cope alone now her husband was incontinent. Perhaps, with Patrick’s help and the services of an agency nurse, it would be possible.

He would consider it, talk it over with his mother.

Half an hour later he joined her in the conservatory overlooking the garden that had been his father’s pride and joy. It was a mess, the weeds forming a mat between the perennials, the vegetable patch untended. Patrick had cut the grass at the weekend but already it seemed to be growing. His mother did what she could, but there was too much for one person to look after. They needed a gardener.

He sighed and picked up the wine his mother had poured him, raising it to his lips. It was cold and crisp, rinsing away the strain of the day.

‘So—tell me about your new job,’ his mother began, tucking her feet under her bottom like a girl and leaning eagerly towards him. ‘What are the rest of the staff like? Are you going to be happy working there?’

He thought of Jack Lawrence, his boss—apparently casual and yet with a mind like a steel trap, decisive and efficient. Kathleen, his wife, a softly-spoken little Irishwoman with a spark in her eye and a core of iron.

And Anna.

Something unfamiliar and forgotten happened in his chest, a sort of tightening, a feeling of anticipation.

She was no oil-painting, their little staff nurse. Not that little, really, unless she was beside him, then she seemed unbelievably fragile, with her wide grey eyes and clear, almost transparent skin. Her hair was long, he guessed. It was hard to tell with it twisted up under her cap, but certainly shoulder-length at least, and a wonderful dark brown, like polished mahogany. She wasn’t really pretty, but there was a life in her, an inner beauty that transcended her slightly uneven features and made her if anything even more attractive.

She was too thin, of course. Kathleen had implied that no one took care of her. Certainly she didn’t take care of herself. The way she had fallen on those sandwiches ——

‘Well?’

He blinked. ‘Um…’

‘I asked about your colleagues, and you went into a trance.’

He grinned easily at his mother. ‘Sorry, I was thinking about the day. Yes, they’re fine. A good bunch of people. I think I’m going to enjoy working there.’

His mother sipped her wine and regarded him steadily. ‘Are you going to tell me about the woman who put that look in your eye, or are you going to keep me guessing?’

He could feel the flush on the back of his neck. ‘Woman?’ he said casually.

His mother sighed. ‘You’re going to keep me guessing. OK.’

‘Whatever makes you think there’s a woman?’ he asked with feigned amusement.

‘Patrick!’ The gently teasing reproof undid him. He never could hide anything from his mother.

He laughed awkwardly. ‘Her name’s Anna Jarvis. She’s single, about twenty-five, a staff nurse.’

‘And you like her?’

He nodded. ‘Yes, I like her. She’s a good colleague.’

‘And you find her attractive.’

‘She’s all right. Nothing special.’

His mother snorted softly. ‘Patrick, you’re a lousy liar. She’s lit a fire under you, I can tell. Why don’t you let it burn, for a change?’

‘For what? Casual sex? I thought you didn’t approve.’ His voice was deliberately light, but his mother wasn’t fooled.

‘I don’t. There are other relationships ‘

‘Mother, I am not getting married again!’

Patrick smacked his glass down too hard and stood up, ramming his hands into his trouser pockets and glaring down the darkening garden.

His mother’s hand was gentle on his shoulder. ‘Patrick, I’m sorry. It just hurts me to see you so alone. You’re like a caged lion without a mate. You need a partner, someone to share things with.’

‘I had a partner.’

‘I know.’

Her hand fell away and Patrick heard her chair creak as she sat down again. ‘Tell me about the set-up in the department.’

He forced his feelings back down, the grief, the rage, the frustration, and lowered himself into the chair again.

‘Only if you’ll promise not to needle me.’

‘I promise.’

Patrick snorted. She might as well have promised not to breathe.

Anna smoothed back the tumbled curls from the little face and smiled. ‘You go to sleep now, my darling.’

‘Night-night,’ the little cherub mumbled round her thumb.

‘Sleep tight,’ Anna whispered, bending to kiss the warm, smooth skin of her daughter’s cheek. Her lashes fluttered down, the busy day catching up with her, and Anna eased away from her and stood up, stretching her aching muscles.

She had been crouched over the bed reading to Flissy for nearly an hour, she realised in astonishment. She left the room quietly and went back into the sitting-room. Her coffee was cold, so she made another and curled up in front of the television.

It couldn’t hold her attention, though. Instead her mind strayed to a tall, smiling man with gentle hands and a stubborn streak about a mile wide. She reminded herself that he was married, and then allowed herself to admit that nothing he had done could be construed as flirting. Not unless you counted feeding her until she groaned.

Anna’s mouth tipped again, remembering the lunch. It had been wonderful, a real feast. She had eaten far too much, but it was just as well. The contents of her fridge had been scant to say the least. She had given Flissy the last egg and a bit of cheese in an omelette, but there had been nothing left for her apart from a couple of slices of stale bread. She’d had toast, smeared with a little honey, and was thankful that she wasn’t hungry.

Kathleen was right; she ought to take better care of herself, and Flissy too. Their diet was woefully inadequate. She made a vow to get to the shops tomorrow on her way home.

Ouch.’

‘Hmm.’ Anna, standing beside Patrick looking at the X-rays, couldn’t understand how their patient was still in such comparatively good condition. He’d been trapped by several tons of steel across his chest and pelvis, and when they had lifted it away his leg had been lying beside his arm, bent up courtesy of his shattered pelvis.

And shattered it most certainly was. A large part of his hipbone was detached and lying oddly, and the bones which formed the bowl of the pelvis were broken on both sides at the front and on the right at the back. As a result his whole pelvis was grossly unstable.

As if that wasn’t enough, both femurs were fractured, the right in two places, and his left hip was dislocated. In short, he was a mess.

Nick Davidson was on his way down from Theatre to see the plates, and it was likely the man would go straight there for emergency surgery to fix his pelvis and femurs. In preparation for such an event they had taken blood for cross-matching already, and were running in Haemacel to replace the massive blood-loss caused by his fractures. Whether there was any other damage was unclear as yet, but he was being closely watched. It was hard to tell from the circulatory loss alone, because fractures of that order caused such massive blood-loss that abdominal injuries could easily go undetected.

Nick wandered in as they stood frowning at the X-rays, and rested a hand on each of their shoulders. ‘Hi, folks. This my customer?’

‘Yup.’ Patrick filled him in, and Nick winced.

‘Sounds nasty.’

‘It is.’

He studied the plates quietly, then pursed his lips.

‘We can’t do it all at once. I’ll get a fixator on to hold it all a bit steady, but he’ll need plating and pinning once the bleeding has settled at the fracture sites. I’ll have to do the femurs today, though. Any abdominal damage apart from the pelvis?’

‘No evidence of any. He’s in very good shape really—in pain, of course. We’ve given him Entonox gas, because his circulation is too close to collapse to risk diamorphine, but it isn’t really anything like enough.’

‘It won’t be,’ Nick agreed. ‘We’ll soon knock him out. What about blood?’

‘He’s been cross-matched and we’re boosting his circulation as fast as we can. We’ll be able to do more when we get the whole blood.’

Nick nodded. ‘OK, I’ll have a word with him and then we’ll get him up to Theatre. Has he signed the consent form?’

‘He’s not in that good shape,’ Anna said drily. ‘His wife’s here—I’ll get her to do that.’

‘Thanks. Right, where is he?’

Anna left them with the patient and went into the office.

Nick joined her a few minutes later. ‘All done?’

She nodded. ‘His wife’s signed. She’d like to see him before he goes up to Theatre.’

‘I’ll go and find her. Give me the forms, I’ll take them with me.’

He headed off towards the waiting-room, X-rays and forms in hand, and Anna watched him go. Another gorgeous hunk, one that half the hospital were apparently in love with, including most specifically his wife Cassie, the only scrub-nurse he would tolerate and who would tolerate him, so rumour had it.

His temper in Theatre was legendary, but his results were astonishing and he was tipped for stardom. It made her laugh that Mr James had queried his competence. He was probably the most skilful and intuitive orthopaedic surgeon in the hospital, bar none.

And yet he left her cold. No, not cold, she acknowledged, just warmed with admiration and a genuine liking.

Whereas Patrick—!

How had he managed to break through her reserve and reach that part of her so carefully guarded that even she scarcely knew it existed?

But break through it he had, and now her skin shivered when he approached, her heart beat faster, and when he looked at her with those melting brown eyes her insides turned to mush.

And when he touched her …! Even an accidental brushing of his hand against hers made her heart race and her skin heat. She was like a teenager, anticipating her first kiss. Her breath caught in her throat at the image that provoked, and she rolled her eyes in self-disgust. If it hadn’t been so worrying it would have been laughable.

But she was worried. She was too vulnerable, too inexperienced to deal with a sexy, meaningless flirtation—or, worse still, a casual affair with a married man.

Her heart thumped at the thought, and her mind recalled with absolute clarity the vivid dream she had had the night before.

Her cheeks heated at the memory, and she quickly busied herself with the admission details for Nick’s patient, Clive Ronson. How she had managed such a provocative dream anyway, she didn’t know. She had no experience of any of the moves he had made, or any of the feelings she had quite definitely felt!

She cobbled up the form and tried again.

Patrick was cross with himself. He was trying to write up notes and all he could think about was the feel of Anna’s body beside his as they had worked together on Clive Ronson. She was too thin, he thought critically, but still she managed to stir him. The jut of her hip was still unmistakeably feminine, the brush of her thigh like the soft stroke of fire against his leg as she had leant across to cut away the patient’s trousers. He had been in her way, and yet a perverse part of him had refused to move.

He wanted her.

It shocked him, the realisation that she was capable of getting past the ice around his heart and setting his body on fire like this.

It was only physical, he knew that. It could never be anything more meaningful, but that didn’t diminish its power. Oh, no. Almost the reverse. Because it was just sex, just meaningless, hot, physical lust, his mind could allow it.

His body was helpless. He shifted uncomfortably, embarrassingly aware of the heavy heat that suffused him, the very present evidence of his desire.

He glanced down at the notes, at his hands lying on the desk, and saw the scar.

Deliberately, enduring the pain, he dragged his mind back. Heat, noise, clouds of choking dust clogging his pores and making it difficult to breathe, and the screams. Always the screams.

Desire drained away, as he had known it would, leaving him empty and shaken.

He stood up and went out of the office to the staff-room, pouring himself a cup of coffee with hands that were not quite steady.

‘Hi. Any left?’

The voice behind him was soft, and his breath jammed in his throat again. He let it out consciously.

‘Just about enough,’ he said, and his voice sounded harsh, scrapy.

He was conscious of her eyes on him, mellow with concern. ‘Are you OK?’

‘Yes, I’m fine. Just a bit preoccupied.’

It was clearly a dismissal, and he felt a kick of self-disgust as rejection flickered over her gentle face and she withdrew into herself.

He made himself smile. ‘Sorry. Clive Ronson. He was a bit of a mess. I was just writing up the notes.’

‘Nick will sort him out if anyone can.’

She sounded very confident.

He felt he ought to warn her, just in case the worst happened. Ridiculous. She was a professional. If the man died, she would take it in her stride. Even so… ‘He’s bad,’ Patrick warned. ‘It’ll be a few days before he’s out of the woods, you know.’

‘I know, but Nick’s good,’ she replied. ‘Too good for the likes of Mr James and his private ankle. Pompous idiot. I gather he’s still on the phone.’

Patrick felt the tension ease as they shared a smile. He noticed again how thin she was, how fine-drawn the skin over her delicate jawline.

‘How about lunch?’ he suggested into the ensuing silence.

‘Lunch?’ She said the word as if she had forgotten what it meant. He reminded her, and she laughed. ‘I know what lunch is, silly. I just didn’t realise it was time yet.’

He snorted softly. ‘It’s nearly one.’

‘Oh. Right.’

‘Shall I go and find a few sandwiches again?’

‘That really isn’t necessary—’

‘What did you have for lunch yesterday?’

She shook her head. ‘Nothing. I was too busy.’

‘And Tuesday?’

She sighed, recognising defeat when it stared her in the face. ‘Lunch would be lovely, but let me pay for it.’

He growled softly under his breath, and she suppressed a smile. ‘I mean it.’

‘Stubborn woman. All right, you can pay for your share. OK?’

She nodded.

Sensible woman. She knew when to give up, he thought with an inward chuckle.

He headed for the door, but as he got there a phone rang in the office.

Kathleen stuck her head out. ‘That was ambulance control. A lorry’s embedded in the front of a house, and the driver’s trapped. He’s still alive, but he’s bad, and it’ll be hours before they can get him out. They want a team.’

Anna joined him at the door. ‘Do you want us to go?’ she asked.

‘Will you?’

She nodded. ‘OK. Patrick?’

‘Sure. Let me speak to them, find out what they know so we’re prepared.’

He left Anna finding the emergency bag used for attending such accidents, and quickly established what else they would need.

His stomach rumbled, but he ignored it. He could eat later. Just now he had to get back on the merry-go-round.

Anna was appalled. The lorry was buried right inside the house, the cab almost invisible. As they arrived a fireman crawled out of a tiny hole near the left of the cab and shook his head.

‘I can’t really reach him. There just isn’t enough room—oh, hi, Doc. Want to try and get through? He can talk, but not a lot else. I haven’t got a glimpse of him yet.’

Anna took a breath. ‘I could try and get closer. I’m smaller than you two.’

Out of the question; it’s too dangerous,’ the fireman said bluntly.

‘For who?’ she asked him, her voice quiet. ‘For you, for me, or for the driver?’

‘He’s right, Anna,’ Patrick said slowly. ‘That whole lot looks very unstable.’

‘And what about the man inside it? How stable is he?’

The fireman shifted awkwardly. ‘We don’t know. He says his head’s bleeding, and the steering-wheel’s stuck in his abdomen, but we haven’t been able to get anyone in there.’

‘Well, you can now,’ Anna said with quiet determination. She took his hat off his head, plonked it on her own and headed for the little gap. Taking a steadying breath, she squeezed into the hole and wriggled forward, feeling her way towards the front. She could see a heavy beam of some sort lying across the front of the cab, and the door had burst open, jamming across her path. The hat was in the way, so she took it off and dropped it behind her.

‘Anna?’

Patrick’s voice. ‘I’m OK,’ she called back.

Squeezing out her breath, she wriggled through the narrow gap and up into the side of the cab. Her right hand went into a pool of something sticky, and she sniffed. Blood. Lots of it.

‘Hi, there,’ she said, squeezing as much reassurance as possible into her voice.

A grunt of pain came out of the dim cab, and she ducked her head beneath the beam that was lying above her head and peered up towards his face. Blood was oozing steadily down his cheek from a wound high up on his temple. His eyes were bright, though, and alert. That was a good sign.

‘What’s your name?’ she asked, knowing that it might be vital in ensuring his co-operation later in the rescue.

‘Nigel—Nigel Ward.’

‘OK, Nigel, let’s find out how you are. Where do you hurt?’

‘Everywhere. Head, chest, legs—especially my right leg.’

She was relieved about that. ‘Hang on to the pain,’ she told him. ‘As long as you can feel, you’re alive.’

He grinned, a surprising flash of white in the dark cab. ‘I’ll bear it in mind.’ His voice was wry and filled with pain. She reached out and touched his hand, offering comfort.

‘I’m Anna,’ she told him. ‘I’m a nurse at the hospital. There’s a doctor outside but he’s too big to get in here at the moment. I just want to find out how you’re doing, and then they can start making plans to get you out. I’m going to have to go again, to get some equipment. I need to take some blood so we can cross-match and replace what you’ve lost, and I’ll need to measure your blood pressure and bring you some pain relief, and maybe some supports for this beam before they can start shifting things. OK?’

‘Will you be long?’ he asked, and she felt rather than heard the fear in his voice.

‘No,’ she said firmly. ‘Just a minute or two. I’ll talk to you as I go, and I can talk to you from outside as well ——’

‘Anna?’

Patrick’s voice was muffled but audible.

‘See?’ she told Nigel. ‘You can hear people outside. OK, Patrick,’ she called towards the door. Tm coming out. I need to do his BP, and I’ll need an IV set and Haemacel, a syringe for bloods, Entonox and some bandages—oh, and saline for cleaning a head-wound. I’m coming out.’

She squeezed Nigel’s hand, glad to feel the pressure returned, and then wriggled out backwards. She was beginning to feel like a worm stuck in a tunnel.

Her dress caught on a sharp bit of metal jutting out and she heard it tear.

Still, she was free. She squirmed slowly backwards, and then there were hands on her waist and she was being pulled out and up into the fresh air.

‘OK?’

It was Patrick, his face concerned, his voice gruff and scratchy.

She nodded, relieved to be out in the sunlight. ‘He’s alive, but his right arm’s gone—it’s lying at a funny angle. His back hurts, and his legs.’

‘Thank God for that. At least he can still feel them.’

‘That’s what I thought. He’s got a head-wound, and the steering-wheel’s rammed firmly in under his ribs. I can just about see his face, but there’s a beam lying right in front of it across the top of the cab.’

‘Could I get in to him?’

She shook her head. ‘Not a chance. If we’d had lunch I don’t think I’d get in either.’

His face was grim. ‘You’ll have to do it all yourself, then.’

‘Mmm. Can I have all the stuff? The first thing I want to do is take some blood for cross-matching. I can get to his left arm, so I should be able to get a line in and then we can start transfusing him. I want to keep a close eye on his BP, as well. He’s got the steering-wheel in his abdomen and that’s going to mess up his venous return, I expect. I think the wheel’s intact. If it’s broken, and penetrated through the wall, he’s in much more serious trouble.’

Patrick nodded, assembling the things she’d requested while she stuck her head back in the hole and talked to Nigel for a moment.

‘How is he?’ Patrick asked.

‘Still talking. I don’t want to mess about, though. I wonder what’s the best way to get that stuff in there?’

‘I’ll crawl in behind you as far as I can and pass things through to you, OK?’ Patrick suggested. ‘You can hand me back the syringe and I’ll deal with the bottles. A police car can take the blood to haematology for cross-matching. Then I can be on hand to tell you what to do.’

‘Just what I need, a bossy-boots up my tail,’ she quipped, but she was reassured to know he was going to be there, just in case.

She took a steadying breath and crawled back into the hole, then, with Patrick behind her, she squirmed back into the cab.

‘Hello, Nigel, I’m back,’ she told him. ‘How are things?’

‘Better now you’re here again,’ he said quietly. She could feel the fear again, and squeezed his hand.

‘There’s a doctor behind me. He can’t get in, but he can pass me things and we can talk to him. OK?’

‘OK.’

His voice was getting weaker, she thought, and, turning with difficulty, she asked for the IV set.

Patrick reached up to her, the packaged set already in his hand.

There was an elastic strap in her pocket—when was she ever without one?—and she pulled it tight around Nigel’s upper arm and turned his arm over carefully. The vein on the back of his forearm just above his wrist looked good, considering the amount of blood he had probably lost, and she prepared the site with an alcohol swab, wiping away the brick-dust and sweat that had clogged on the skin.

‘OK, I’m going to put this into your arm now, Nigel. You’ll just feel a little scratch coming up now…’

It was incredibly awkward doing it with her left hand, but she couldn’t turn either of them round enough to do it with her right. Still, the needle slipped home on the first try and she heaved a quiet sigh of relief as she taped the tubes in place on his arm and plugged the syringe into the end.

Having filled it, she passed it back to Patrick and then held out her hand for the Haemacel.

He put it in her hand, his fingers warm and hard against hers, and she took comfort from the small contact.

The only place to hang the bag was from the rearview mirror, but there it dangled right in her way so she had to dodge even further to see him.

She did so now, and managed a grim-lipped smile.

‘OK?’ she checked.

‘I’ll do.’

She slipped the blood pressure cuff on to his arm and checked his pressure. Low, as she had known it would be. Hopefully he wouldn’t understand the significance of the numbers when she told Patrick. She opened up the drip so it ran in steadily.

‘I’m just going to report to the doctor so he doesn’t feel totally redundant,’ she said with a smile, and then, squirming round, she bent over and stuck her head out of the gap.

‘BP 90 over 40,’ she told him quietly.

He swore under his breath. ‘Internal?’

She shrugged. ‘We need to get him out, Patrick, but there’s this big beam over the cab, and if you tried to pull it out it would crush him. God knows what’s holding it up as it is.’

His jaw muscle jerked, his mouth a harsh line. ‘Are you sure I couldn’t fit?’

She snorted softly. ‘Don’t be crazy. There’s hardly room for me in here. You’ll just have to tell me what to do.’

‘Get out. I want to come in there.’

‘No. You’re being absurd. You’ll just have to trust me.’

‘It isn’t a case of trust,’ he muttered. ‘You shouldn’t be in there. It’s no place for a woman ——’

‘Cut the heroism, Patrick,’ she told him brusquely. ‘Nigel doesn’t have time for all that stuff.’

His mouth tightened, but he had no choice. ‘Find out as much as you can about his condition,’ he grunted. ‘I’ll get the Entonox.’

He backed out and went to confer with the firemen while she turned round and ducked back down to see her patient. She would have to deal with his head-wound, but she could see it had stopped bleeding now. She wiped it with cotton wool squeezed out in saline, and dabbed it dry, talking to him all the while. She had to find out as much as possible, and like this she could watch his eyes. ‘Tell me more about your injuries,’ she coaxed. ‘Can you be specific about where you hurt?’

He thought for a moment. ‘My right knee,’ he said slowly. ‘That’s bloody sore. And my chest—right at the bottom. My stomach really.’

She turned her head and looked down at where the steering-wheel disappeared under the jut of his ribs. ‘I’d like to feel it, see what I can find out about where that steering-wheel’s pressing on you. Tell me if I hurt you,’ she added, and then, slipping her fingers under the edge of his shirt, she ran her hand carefully over his ribs. Several were sticking out at a strange angle, but the skin seemed intact.

She worked her way down, her fingers tracing his hipbone on the far side. So far so good. Her hand explored the rim of the steering-wheel, and she could feel something warm and wet on his abdomen. It didn’t feel sticky, so it was probably urine. Certainly she could smell it. The question was, had his bladder been punctured or had he simply wet himself?

She asked, and he didn’t seem to know. Still, there was no evidence of blood on her hand, which was a good sign. She continued her search, her fingers gentle but thorough, and found the full sweep of the steering-wheel, distorted but intact. So far, so good. She moved on.

His right femur seemed all right, lying awkwardly but unbroken, as far as she could tell. His knee, though, was a different matter. She approached it with caution, but the really painful part was embedded in the remains of the dashboard. The area below his knee was out of reach, but she could see in the light from the torch Patrick had passed her that it was trapped in the distorted footwell.

His left leg seemed to have fared better, and he said he could wriggle the toes of that one although she couldn’t see them because of the bent and twisted metal in the way.

His voice was growing weaker, and she checked his blood pressure again. It was falling still, but whether because he was losing blood internally or because the steering-wheel was digging into his abdomen so hard it interferred with his venous flow she couldn’t tell.

She squeezed the bag of Haemacel for a minute, to boost his circulation, and then turned her attention back to Patrick, who was calling her from the tunnel.

‘They want to know about this beam. They’re going to send in the smallest man they’ve got to check it out and put in supports and airbags, if necessary, to protect him while they remove the rubble from around the cab. OK? So you have to come out.’

Just then she sensed rather than heard a change in Nigel. ‘Hang on,’ she muttered, and, turning, she wriggled back towards him. ‘Nigel?’

‘It’s getting bloody hard to breathe,’ he muttered.

She flashed the torch at his face, noting the blue line round his lips and the bulging veins in the side of his neck.

‘I’m just going to check your ribs,’ she told him, and tapped the side of his chest nearest to her.

Sure enough, it sounded hollow and unduly loud.

She wriggled back to Patrick. ‘I don’t like to rock the boat,’ she said quietly, ‘but our patient’s got a tension pneumothorax—I think his right lung’s collapsed.’

Patrick’s language deteriorated rapidly. ‘You’ll have to come out and let me in.’

‘Don’t be ridiculous. Get me a cannula and I’ll do it.’

‘With or without anaesthetic?’

‘We don’t have time to wait for the lignocaine to work. Just give me the stuff and talk me through it. If it hurts, no doubt he’ll be grateful later.’

Muttering, clearly reluctant, he handed her the cannula. ‘Between the fourth and fifth ribs, to the side and just below his nipple. And for God’s sake mind the intercostal nerve and blood vessels—they run just below each rib.’

‘Fine. Got that.’ Cutting away Nigel’s shirt, she cleaned the area quickly and opened the packet containing the cannula.

‘Right, Nigel, I’m going to make a hole through into your ribcage and let out the air that’s trapped outside your lung stopping you from breathing—OK? I’m sorry, it may hurt a bit.’

Nigel, now desperate for air, nodded. She guessed the other side of his chest might have similar problems, or perhaps a haemothorax. Whatever, if she didn’t move soon, he was going to die.

Taking a steadying breath, and with Patrick’s calm voice instructing her from behind, she slid the thick, solid trocar instrument through the intercostal muscle, which filled the space between the ribs, and into the pleural cavity, then slid the cannula over it and withdrew the trocar. There was a rush of air, and within seconds Nigel’s colour changed back to a healthier pink.




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