New Surgeon at Ashvale A&E (10 page)

‘How is the boy?’ His brows drew together as he watched her mouth flatten.

‘He’s on life support, and we need to get him into Intensive Care. I’ve done everything I can for him. I repaired a massive tear in the bronchus, and I’m hoping the chest drainage tubes will gradually ease the pressure in the chest cavity and elsewhere. Air has even collected under his skin, so that you can hear the crackles when you touch him. That poor child…’

‘He was fortunate that he had you here to look after him.’ Sam’s voice was matter of fact, not allowing any shred of wasteful emotion. ‘I doubt anyone else would have thought to look for a ruptured bronchus in such quick time. That’s where skill and experience come into play.’

She sent him a weary look. ‘That, and the fact that this A&E department is still in existence. Though that could end any time soon, couldn’t it?’ She sighed. ‘How’s his father bearing up? Did you find out the cause of his trouble?’

He nodded. ‘There was a laceration in his liver. I managed to repair it. He should pull through all right, with any luck.’

She smiled at that. ‘I don’t think luck comes into it. You’re a good surgeon, one of the best, from what I’ve seen and heard.’ She straightened up. ‘I really hope this family come out of this disaster safe and sound. I want to think of them having a future together, a wonderful family unit, sharing good times, supporting one another through all of life’s ups and downs. That’s what families are all about, isn’t it?’

Her eyes misted a little as she thought back to her own past. ‘I remember when I was Jason’s age, we all went to spend a long weekend at the seaside. Sophie was two years old, like Jason’s little sister, and she spent the days telling everyone who would listen that she was going to make a huge sandcastle on the beach and when it was finished she would decorate it to make it fit for a princess. Little as she was, she made everyone hunt along the water’s edge for shells, and they had to be just right, the perfect shape and colour, or she would reject them.’

She might have expected him to smile at that, but his gaze was solemn, smoke grey, with a brooding quality that made her wonder what kind of experiences he’d had in life. He made no comment.

‘She told me that she wanted to take Becky to that same place when she was a little older, and she was going to show her where she built the castle. She wanted her to have the same glorious memories that she did.’

‘And yet she walked out on her daughter and left you to pick up the pieces. That doesn’t say a great deal for the family spirit, does it?’ He gave her that same no-nonsense look that he had given her before.

She sent him a long, thoughtful glance. He had such a practical, straightforward way of looking at things, and he was so dismissive of sentiment, of emotional ties. How could she begin to understand a man like him?

‘It says that people have their ups and downs, and you need to stick together in order to get over them. I know that my sister loves her daughter, and that it must have taken something disastrous to make her stay away. It grieves me that I can’t find her or do anything to help her.’ She hesitated. ‘You have a younger brother, don’t you? Didn’t you have good times together…or weren’t there occasions when you helped each other out?’

‘We enjoyed long breaks by the sea,’ he said, ‘sometimes with our parents, and other times with our grandparents.’

His expression sobered, a bleak quality coming into his eyes. ‘As to helping each other out, it’s probably best not to think too deeply about that. We had to rely on each other a good deal because we were at boarding school together for the major part of the year.’

He leaned back against the wall, his long legs crossed over at the ankles, his hands thrust into the pockets of his scrubs. ‘My brother had a hard time settling, and since I had been
there for a couple of years before him, I did what I could to make him feel that he wasn’t alone. Up until then he’d been with our grandparents.’

He looked at her, sensing her frown. ‘It wasn’t that our parents wanted to leave us…it was more that they had the pressure of international business interests swamping them. Alongside that, they were trying to bring medical facilities to countries that wouldn’t otherwise have the benefit. Who am I to argue with that kind of altruism?’

‘But they did it at the expense of their children’s happiness, didn’t they?’

‘I don’t see it that way, and nor did they. They wanted us to have a good education, the best, and they succeeded in that. We both went on to carve out satisfying careers for ourselves. My brother has done well. He set up his own financial consultancy in Scotland. His wife works with him, and his boys enjoy living in a beautiful house surrounded by moorland and lochs.’

‘It sounds idyllic.’ She slanted him a questioning glance. ‘Didn’t you ever feel that you wanted to have that kind of life for yourself?’

‘With a wife and family, you mean?’ He shook his head. ‘It isn’t something I’ve ever really thought about—or wanted, for that matter. I don’t have time for that sort of commitment, or any long-term, all-or-nothing kind of relationship with strings attached. I know it’s not easy for any woman to settle for what I would be prepared to offer, but that’s how it is. I have too much still to do getting to where I want to be.’

He looked around. ‘This is just the start—I want to be there in the setting up of state-of-the-art units. It means everything to me to see to it that people have the best care we can give them…and that includes keeping this place going. It doesn’t have to be new, just working at full capacity, bringing the best we have in people and resources to serve the local area.’

She gave a wry smile. ‘And there’s no room in all that for meaningful relationships?’ It seemed strange to her that he could rule out the prospect of finding and appreciating enduring love. ‘Don’t you feel you’re missing out in some way?’

His dark brows shot up. ‘I’m not missing out. What makes you think that?’ He straightened up, moving to face her, closing in and winding an arm around her waist. ‘I’m here with you,’ he said softly, ‘and that has to be good, doesn’t it? You’re beautiful, lovely to hold…and alongside all that you have a glorious, laid-back attitude to life, and you’re not afraid to speak your mind.’ His mouth curved, his long body shielding hers, blocking her escape by the simple means of an outstretched arm, palm flat against the wall at the side of her neck. ‘How much better could it be?’

‘Um…I should tell you,’ she said, gazing up at him and feeling the lure of those eyes that were blue-grey like the depths of the ocean, ‘that from the sound of it, I’m really not your type. I’m an all-or-nothing kind of girl. I wouldn’t like you to get the wrong idea.’

‘I won’t,’ he murmured, his head lowering, his lips moving ever closer to hers. ‘I’m just glad that you came here today.’

By now his lips had settled on hers, nudging them softly so that they parted in a gentle sigh of delicious response, and the heart-melting kiss that followed took her breath away. He captivated her with his sensuous demand, drawing from her every drop of sweet, feverish yearning that was pent up inside her.

How was it that he could make her feel this way? The question came to her through the mists of warm, heady sensation. They had nothing in common except for a deep, abiding sense of commitment to their patients. Even in that she had fallen by the wayside, but it was as if none of that mattered now. All she cared about was that he was kissing her, and her entire body was on fire, the blood pulsing through her veins in ecstatic, hectic response.

She couldn’t think straight any more. His hands stroked along the length of her spine, drawing her to him, so that her breasts were crushed against the solid wall of his chest, and she felt the thunder of her heartbeat so strongly that she felt sure he must feel it too. He bent his head and began to nuzzle the delicate column of her throat.

She ran her hand lightly over his rib cage, expecting to feel the fine linen of his shirt, and encountered instead the thin cotton of his scrubs. A faint sense of shock ran through her. Scrubs meant that they were in the hospital…how could she have forgotten that?

Through the thin material, she absorbed the warmth of his skin, and everything in her wanted to lean in closer, to revel in the sheer heaven of being in his arms…only by now reality had stepped in, reminding her of where they were…and of what he had said. He didn’t believe in long-term relationships, and from her point of view it would be madness to even think about getting involved with any man right now. She’d been hurt once before, and why would she want to set herself up for more unhappiness?

Her palm flattened, gently pushing against his chest, and at the same time she shifted a little, moving out of reach of his seeking mouth.

He looked at her, his eyes still smoky with passion, but he registered her withdrawal and gazed at her questioningly.

‘I can’t do this,’ she said.

He took a slow step away from her, giving her breathing space, and she stayed very still for a moment, allowing herself time to think.

‘I’m sorry,’ he said. ‘I didn’t mean to step out of line. I don’t know what came over me. It’s just that from the moment you walked into A&E this morning, it felt as though the world was putting itself right. It’s odd, I know. But it feels good having you around, and whenever you’re near me, lately, I get this urge to kiss you and hold you.’

She gave a rueful smile. ‘Perhaps you should try to overcome it,’ she said. ‘Like I said, I’m an old-fashioned kind of woman. I may hanker after the warmth and delight of a wonderful relationship and all that goes along with it, but I also want love and commitment, and I don’t think I’m prepared to give up on that dream. Not that you were offering any of that, of course…but just so that you know…I have enough to deal with right now. I’m not sure I’m ready for any of this.’ Her life was chaotic as she juggled so many different roles. How could she even think of getting tangled up in a relationship with a man who admitted his career took precedence over everything?

‘Of course. I’m totally out of order.’ He pressed his lips together in an expression of regret. ‘I don’t usually behave like this, you know…but then again, I’ve never met a woman quite like you before.’

‘You haven’t?’ She wasn’t at all sure whether she could believe him. Didn’t all the women who had fallen for him in the past believe that they were the one and only woman for him? What good had it done them when he had eventually moved on?

He shook his head. ‘You’re one of a kind, Ruby. Which makes me all the more keen not to upset you in any way.’

He took another step backwards, emphasising his point by his actions, and then studied her intently. ‘Would you give some more thought to coming back to work on a formal basis?’

She marvelled at the way he morphed smoothly into business mode, but didn’t that just go to show how accomplished he was at separating his emotions from his physical desires?

‘I’ve already made arrangements to set on a couple of nurses,’ he said, ‘and I’m having meetings with the maintenance contractors to see if we can sort out some different kind of set up.’

She raised her brows. ‘You are?’

He nodded. ‘And that’s not all. I’ve worked out a plan
for making huge savings on the drugs bill for the whole of the hospital.’

She sent him a cautious glance. ‘Isn’t that a bit risky? Surely we need all the medicines that we currently use—not only that, we should be certain that we have the right quality of drug.’

‘That’s true in all respects. But I’ve spoken to the board members about it, and they’ve agreed that we will arrange for competing suppliers to bid for our custom in an online auction. That way we bring in offers of lower prices—we’ve already tested it out, and the savings will be tremendous.’

‘You have been busy,’ she said. ‘I can see you’re a force to be reckoned with. No wonder the board set you on.’

He gave a short laugh. ‘You’re never going to forgive me for that, are you?’

Ruby shrugged. ‘I’m getting there,’ she said. ‘Slowly.’

He tilted his head slightly to one side. ‘So does that mean you’ll come back? We really need you here working alongside us.’

She thought about it. This morning’s events had shown her just how important her work was to her, and surely it would be madness to give it up? The fact that she had done everything she could to save that little boy’s life meant more to her than anything. Besides, putting all other more professional and philanthropic considerations to one side, she had come to realise that if she wanted to buy the farm off her grandparents, the money would definitely come in handy.

‘I suppose I’ll have to come back,’ she murmured, ‘or you’ll be forever nagging me, won’t you?’

He gave her a beaming smile and draped an arm around her shoulders. ‘Now, would I do that?’ he asked.

‘Oh yes,’ she said as they started to walk towards the lift that would take them back down to A&E. ‘I’m becoming quite convinced you’ll stop at nothing to get your own way.’

‘I’m wounded you should think so,’ he murmured, ‘but
since we’re on the subject, I’ve been trying to work out how I can persuade you to come over to visit my family estate at the weekend.’

She blinked. ‘I thought we just had a conversation about you mending your ways?’

‘So we did…but this is work related, you see. I’ve arranged to hold a fund-raising event in aid of the A&E department, and I think I need some input from you—it being your idea in the first place, of course.’

She sent him a narrowed glance. ‘Why is it I get the feeling you’re railroading me into doing things I wouldn’t normally contemplate?’

‘I can’t begin to imagine the reason,’ he said, assuming an air of innocence. ‘Beats me.’

‘I
F
anybody needs me, I’ll be over in Intensive Care, checking up on young Jason. It’s been a couple of days since he was brought in, and I want to see how he’s doing.’ Ruby added her signature to the patient’s chart and handed it to Michelle. ‘Everything’s reasonably under control here, so I’m going to slip away while I have the chance to grab a few minutes. I’ve sent Olivia to the staff lounge to take a well-earned break, but James is around if anything should crop up. I’ve no idea where Sam is this morning, but you can page either of us if there’s a problem.’

‘Will do.’ Michelle quickly ran her gaze over the prescribed medication outlined on the chart and then lifted her head to look back at Ruby, her silky black hair swinging lightly with the motion. ‘That’s the thing about Sam, isn’t it? He’s always busy, either with patients or in admin, but he never bothers to tell anyone what he’s doing. He’s a workaholic, forever on the move.’

The nurse placed the chart at the end of their young patient’s bed. ‘I used to think he didn’t care much for mixing with staff, but it isn’t that at all…he’s fine when you do manage to collar him…it’s just that he always seems to have a thousand and one things to do and doesn’t feel it necessary to explain himself to anyone.’

‘He’s a complicated man, that’s for sure,’ Ruby said as they walked towards the central desk, ‘but he appears to be coping well under a lot of pressure. He has a lot of new systems to put in place if we’re to avoid closure, and they’re taking up a lot of his time. Eventually, when things settle down, I expect he’ll be more available, but in the meantime the trainees will have to come to me, or page him if they find they are having difficulties.’

‘I’m sure that’s what he expects them to do. If there’s a problem, he wants the junior doctors to come and find him, or sometimes he’ll already have stepped in and be there dealing with it…and he doesn’t see the point in making a fuss over anything. He just believes in getting on with the job.’

‘That’s true, though he ought to stop and take a few minutes for himself every now and again. It doesn’t do anyone any good to work at full pelt the whole time.’ Ruby had her suspicions that Sam had an inbuilt ‘on’ switch, and that he didn’t have it in him to wind down. This constant busy, busy, busy attitude drove her to distraction.

She hurried to Intensive Care, which was along the corridor from the A&E department, and spent a few minutes there talking to the sister in charge.

‘All being well, we’ll take Jason off the ventilator later on today,’ the nurse told her. ‘The consultant wants to make sure first of all that there have been no setbacks overnight, but from what we’ve observed he’s still making good progress. He’s looking altogether much better now, and his heart rhythm and respiration have both improved. The drainage tubes will most likely stay in place for another twenty-four hours, though. We have him on antibiotics because of the risk of infection, but all in all he seems to be going along very well.’

‘That’s brilliant news, Jen.’ Ruby smiled at her. ‘I’ll go and take a peek at him, if I may?’

‘Of course. He’s still under sedation, so he won’t know
much about what’s going on, but his mother’s been sitting with him a lot of the time. She isn’t here at the moment because the doctor on her ward wants to check her over, but the nurses bring her here from women’s surgical each day.’

‘I thought they might. What about his father? Is there any news of him?’

‘He’s in the adult intensive care unit. Last I heard, he was still experiencing some abnormal heart rhythms, but, considering the injuries he received, that’s not really surprising. It’ll take a while for him to heal.’

Ruby nodded and a few moments later went to stand by the boy’s bed, looking at the monitors that registered his heart rate, respiration and temperature, along with blood oxygen levels.

The child appeared to be sleeping peacefully, his brown hair spiky against the white of the pillow, and someone had placed a teddy bear against the side bars of his bed, so that it would be the first thing he saw when he woke up. He was still pale, but there was faint colour in his cheeks, and he looked to be in a much better state than he had when she had last seen him.

‘Thanks for letting me look in on him, Jen,’ she told the nurse as she was about to leave. ‘I feel much happier for knowing that he’s doing all right.’

‘You’re welcome, any time.’

Ruby made her way back to A&E feeling much lighter in spirit. Some things, at least, seemed to be going along well enough. Now all she needed was for her sister to come back home and repair the broken bond with her baby daughter.

‘I’ve been looking for you,’ Sam said, meeting up with her in the corridor as she was about to go back to work. There was a hint of exasperation in his voice. ‘I wanted to talk to you about one of your patients—a girl who fell off her bike—but I couldn’t find you anywhere in A&E.’

‘That’s because I was in ICU, checking up on my thoracotomy patient.’

He frowned. ‘The little boy? But you treated him two days ago, didn’t you? He’s not our patient any more.’

‘Maybe not, but I wanted to know how he was doing.’

‘Couldn’t you have given the unit a ring to find out how he was?’

‘I could, but it wouldn’t have been the same. I preferred to go and look in on him.’

‘Whatever for?’

She stared at him, raising her brows in an expression of astonishment. ‘Do you really need to ask?’

‘Yes, I think I do. What is it with all this touchy-feely stuff that goes on around here? You treat the patients, you do what you can for them, and then you need to move on. There are always other people waiting to be seen.’

‘That might be your way of doing the job,’ she said, tapping the security code into the main door of the A&E unit, ‘but it isn’t mine. I do what I can to make sure that I stabilise the patients who are brought in here as emergencies, but when I have a free moment, I like to follow up on them.’ She pushed open the door and walked into the department, leaving him to trail in her wake. ‘And I’m sure, if you give it a little more thought, you’ll realise that you’re misguided somewhere along the line. We do this job because we care. We’re dealing with people, children and individuals, not numbers or statistics that make up targets to be met.’

She sent him a sharp glance. ‘And while I’m on the subject, if you think you’ll get me to change my ways, you’re very much mistaken. If I wanted to become another version of you, I’d have taken a course in robotics or virtual medicine.’

Now it was his turn to raise his brows. ‘I’m shocked. Whatever did I do to merit that tongue-lashing? All I’m saying is that if you get too involved with your patients, you’ll come shuddering to a stop when anything bad happens to them, and then you won’t be fit for anything. It doesn’t do to have all
this deep compassion and empathy for everyone you come into contact with.’

Her gaze narrowed on him. ‘I think you should stop digging yourself deeper in the mire while you still have the chance to escape. I don’t much care what your opinion is on the matter. I’ll do as I think fit.’ She made a brief, falsely sweet smile. ‘Now, what was it you wanted to ask about the girl who fell off the bike? Much as I felt compassionate about what happened to her, I didn’t offer to have the bike fixed. I simply treated her for a dislocated elbow and arranged for follow-up care.’

His mouth turned down at the corners in a crooked grimace. ‘Sarcasm doesn’t become you at all, Ruby. I thought you were above all that. I was just interested to know if you’d found any other injuries or problems when you examined her—only, her mother was asking about her being feverish. She told me she thought that might have led to the fall.’

‘There was no fever. I checked the girl’s temperature and asked about dizziness or faintness, but when she was alone with me briefly, the child said she came off the bike when she swerved to avoid her young brother, who ran into her path. I have the
feeling
that she didn’t want to get him into trouble, so she invented a story about being headachy…if I’m allowed to use the word
feeling,
that is?’

‘All right, all right. You win.’ He put up his hands in submission. ‘Let’s call a truce, shall we?’

She gave a soft laugh and walked over to the central desk, where she began to check on new arrivals. Sam went to the computer and started to access information.

‘There’s a baby who needs to be seen right away,’ the desk clerk said. ‘He has a nasty case of diarrhoea, and the family doctor sent him here.’

‘I’ll go and look at him.’ Ruby took the baby’s chart from the rack and checked the details the triage nurse had written
down. As she looked up, she saw a familiar figure coming towards her, a man that she had treated some time ago.

‘Hello there,’ Nick Dryden said. ‘Remember me? You treated me a few weeks ago, and I had to go to the operating theatre to have my spleen removed.’

‘Oh…yes, that’s right.’ Ruby gave him a quick glance. ‘How are things with you? You’re not here because you’ve done some more damage to yourself, are you?’

‘No, nothing like that.’ He smiled, his thin face lighting up a fraction. ‘I had to come into the hospital for my check-up with the consultant, and I thought while I’m here I would see if you were around. I just wanted to say thanks for what you did, for listening to me. The nurse said it would be all right to come and find you.’

‘I was glad to help,’ Ruby told him. ‘I hope things are going well for you.’

He nodded. ‘Actually, it occurred to me that I must have seen you here before that day. It was when I came about the pain in my back one time. You didn’t treat me, but I remember you because you were talking to a young woman over by the desk. She was having some problem with her hair, and you fixed a clip for her.’

Ruby frowned, thinking back. ‘Oh, yes, that was probably my sister. She came to see me at work one day…I think she’d caught her hair clip on something, and she was in a bit of a tangle.’

Sophie had been for her first post-natal check that day, she recalled, while their mother was looking after Becky.

Beside her, Sam made a restless movement, and Ruby collected her thoughts. Too much touchy-feely interchange going on, was there? Sam was clearly restless and on fighting form today. He had achieved his objective of bringing her back into work, and now he wanted things to move smoothly on, without interruption.

‘Well, it’s good to see that you’re feeling better,’ she told the man. ‘I can’t stop and chat, I’m afraid…I have to go and see another patient.’

‘That’s okay. I understand.’ He gave a slight waving motion with his hand and started to walk away.

The baby, who was a little younger than Becky, was suffering from a nasty tummy upset, Ruby discovered when she carefully examined him. Not only that but he was lethargic, with parched and cracked mucous membranes, had a very fast heart rate, and his breathing was disturbed.

‘It looks as though the diarrhoea has caused him to become dehydrated,’ she gently told the baby’s mother. ‘His fontanelle, this soft spot on the top of his head, is sunken, and he generally appears to be quite poorly.’

‘I’ve tried to get him to drink,’ the mother said, ‘but he keeps vomiting; he can’t keep anything down. That’s why I took him to my doctor, but he said to bring him here.’

Ruby nodded. ‘I’ll do some tests to find out if it’s a bug that we can treat with antibiotics, but usually these things are caused by a virus, and so that kind of treatment won’t be of much use. What we’ll do is admit him, and I’ll make sure he gets fluids and the correct balance of rehydration salts through an intravenous line.’

‘Thank you.’ The woman seemed to relax a little. ‘How long will he need to stay in hospital—do you know?’

‘It could be a few days. Children usually respond very well to the treatment.’ Ruby smiled at her. ‘I’ll leave you to talk to the nurse, and she will be able to explain anything you want to know and make any arrangements for you to be with your baby on our children’s ward.’

The woman inclined her head in acknowledgement and cuddled her baby to her while Ruby made preparations to set up the drip.

Some time later, when she had seen to it that the infant was
settled and the treatment started, Ruby made her way back to the main area of A&E. Sam was there, arranging for a cardiac specialist to come and see one of his patients, but as soon as he finished dealing with that, he came over to her.

‘I was hoping we might get together some time to discuss plans for the fund-raiser,’ he said. ‘How are you fixed?’

‘Oh…I’m glad you’re going ahead with that.’ She glanced at her watch. ‘How about we do it now? I haven’t taken a proper lunch break yet, so I dare say we could go and have something to eat and talk it through. Or were you about to go off duty? You have to go over to the Heritage this afternoon, don’t you?’

‘That’s right, I do.’ He gave her a fleeting, assessing glance. ’There’s not much that escapes you, is there?’

‘Not a great deal. It’s all part of the job.’ She smiled at him. ‘So what shall we do? I know you’re always in a hurry, but even you have to eat sometimes.’

He gently cupped her elbow with his hand and turned her towards the door. ‘We’ll go and eat,’ he said. ‘You can tell me how things are working out for you with young Becky.’

‘Oh, she’s not doing too badly,’ Ruby told him. ‘She had another tooth come through, so she’s a little more settled now that’s over and done with. Of course, she’s missing her mum, and that’s a bit upsetting. She looks around for her every now and again, as though she knows something precious is missing, and then there are times when she’s fractious for no apparent reason…mainly when she’s tired.’

They left the department and headed towards the hospital restaurant. ‘You seem to be coping well enough,’ he commented. ‘Is she being looked after in the crèche at the moment?’

She shook her head. ‘My mother is looking after her today.’ Her mouth curved. ‘She likes to get in her granny time when she can—lots of cuddles and masses of spoiling.’

He looked at her oddly, and she tilted her head to one side,
looking at him and trying to fathom his reaction. ‘Do you not find that your parents are the same with your brother’s children,’ she asked, ‘or even that your grandparents were like that with you when you were small? You said that they looked after your brother for a while, didn’t you, so I imagine they must have cared for you as well?’