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Surgeon On Call
Alison Roberts
Brilliant surgeon – baffled dad!Joe Petersen is a skilled surgeon, unfortunately, when it comes to being a dad, he's a complete amateur. Fliss Munroe, consultant, quickly finds Joe and little Sam creeping into her heart – except she starts to think that Joe is looking more for a nanny than a wife!
Felicity traced her forefinger through a dollop of the chocolate icing on the edge of the platter.
‘It was far too soft. I’ll have to watch that next time.’ She licked the icing off her finger. ‘Tastes good, though.’
The gaze from Joe’s brown eyes made her acutely aware of the effect her action had had. Silently and deliberately, Felicity traced her finger through the chocolate for a second time before slowly raising it to her lips, her gaze never leaving Joe’s. Her hand was caught well before it made contact. The chocolate-covered finger touched Joe’s lips rather than her own. His mouth closed softly around the digit and Felicity felt the firm caress of his tongue as he sucked the icing clear.
‘You’re right,’ Joe murmured. ‘It tastes very good.’
Felicity couldn’t say a word. She could only watch, stunned, as Joe used his own finger to scoop up another droplet of icing. He painted the soft chocolate on her lower lip. Felicity’s breath caught and held as he bent his head towards hers…
Alison Roberts was born in Dunedin, New Zealand. Her father’s medical career took her overseas as a child, but she returned to Dunedin and trained there as a primary school teacher. A teaching position led to a whirlwind romance and marriage to Mark—a young doctor who is now a professor and even more attractive than he was twenty years ago! Alison is currently residing in Christchurch with her husband, daughter and various pets, and her writing companion is an Irish wolfhound called Ryan. Apart from home, family and her writing, Alison’s passion is her involvement with the ambulance service. Having fallen in love with the job while researching a book, she is now avidly training as an ambulance officer and spends as much time as possible on active duty.
Recent titles by the same author:
EMERGENCY: CHRISTMAS
RIVALS IN PRACTICE (Medics Down Under) DOCTOR IN DANGER (Medics Down Under)
Surgeon on Call
Alison Roberts
www.millsandboon.co.uk (http://www.millsandboon.co.uk)
CONTENTS
Chapter One (#u75289ff4-6eee-52b1-a094-357d55fd97cc)
Chapter Two (#u970e4e5b-ac4e-53ef-849b-2f219a7080fa)
Chapter Three (#u77fd91db-6f22-5301-932f-657fba331ce6)
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)
CHAPTER ONE
SEVEN-THIRTY a.m.
Far too early to be starting work. A job like this might be OK in summer but below zero temperatures weren’t much fun. Not when the first rays of sunshine only made up for their lack of warmth by the uncomfortably blinding glare they could produce. Jeff Simms shaded his eyes from the glare with his hand. He could see the group of men congregating around the prefabricated shed that served as headquarters for the building site. He could also see his mate, Lou, climbing out of Tommo’s truck just ahead of him.
At least they’d made it to work on time today. The boss should be looking a lot happier than he appeared to be. Maybe he hadn’t had his coffee yet. The thought of coffee was enticing. Jeff and Lou had downed quite a few beers during their session at the pub last night.
‘Hey!’
‘How’s it going, mate?’ Jeff grinned at Lou.
‘Have you spoken to the boss yet?’
‘No. I just got here. Bloody cold, eh?’ Jeff blew on his knuckles and rubbed his hands together vigorously.
‘Tommo reckons you’re in trouble, mate.’
‘What for?’ Jeff caught Lou’s eye. Maybe they shouldn’t have taken off to the pub yesterday with such alacrity.
‘Boss couldn’t find his skill saw last night,’ Tommo reported gloomily. ‘He reckons you’d been using it.’
‘I was,’ Jeff admitted. ‘I had to go up and tidy that framing on the second floor.’
‘Where’d you put the saw, then?’
Jeff’s gaze roamed the scaffolding on the apartment block. He traced the route on the corner that he’d used to climb down from the wooden planks, trying to remember just what he had been carrying. The oath that escaped his lips was enough to impress even Tommo.
‘It’s still up there.’
Tommo unleashed an even better oath. ‘It’ll be frozen solid. Man, are you in trouble!’
‘It’ll still be dry. I put it under a tarpaulin. That’s why I forgot about it. I’ll go and get it now.’
‘You can’t.’ Lou shook his head. ‘Scaffolding’s out of bounds until it thaws. The boss’ll go mental if he sees you.’
‘He won’t see me. It’s on the road side. I’ll be quick.’
‘You’d better be careful, mate.’ Lou sounded doubtful. ‘It’s solid ice up there.’
* * *
Seven thirty-five a.m.
It was just as well he’d set off this early. Joe Petersen drummed his fingers on the steering-wheel as he waited in the line of traffic for the lights to change. He needed to get right across town and it was going to take a long time at this rate. He’d promised to be there at 8 a.m. to help get the kids off to school and then take Samantha to kindergarten for the morning. Dayna wouldn’t be very impressed if he arrived late, and he wasn’t about to give her any new ammunition regarding his lack of elementary parenting skills.
Joe glanced sideways to give his eyes a rest from the glare of the rising sun. The building site to his left was impressively large. This part of Christchurch city had changed beyond recognition since he’d last driven past but that was hardly surprising. It had been nearly five years since he’d had a visit lasting more than a few days. The trend seemed to be towards building these large inner-city apartment blocks now and this one looked fairly upmarket. Joe’s idle gaze roamed the side of the well-formed building. He could see the ice coating the scaffolding. Cold job, being a builder at this time of year. He wondered idly what the young chap was doing, scrambling up the side of the steel skeleton. He seemed to be in rather a hurry.
The toot from behind indicated that Joe’s attention should be back on the traffic. He slid the car back into gear but the movement he caught in his peripheral vision jerked his gaze back to the left. Had the lad’s foot slipped on that wooden platform? He’d managed to catch hold of one of the steel pipes but the grip held only momentarily. Joe watched the fall with horror. He could almost feel the impact as the victim’s back contacted the next steel bar several feet below before the graceful arc that completed the fall.
The sensation of horror was dismissed instantly and replaced with a clinical detachment. The impact mid-fall had been enough to cause a lumbar spinal injury. The distraction to the cervical vertebrae which the impact of landing on his head might have caused was even more serious. Joe pulled his steering-wheel decisively and put his foot down on the accelerator to gain just enough momentum for the wheels to mount the kerb. He pushed the hazard light control on the dashboard.
* * *
Seven thirty-eight a.m.
Felicity Munroe shaded her eyes from the glare of the sun. It was hard to see what was going on ahead but the traffic appeared to be even slower than normal for this time of day. At least she wasn’t too far from the hospital now. With a bit of luck she could still make the 8 a.m. meeting with members of the cardiology department. The interface between Cardiology and Emergency needed some urgent attention. Only yesterday they’d had a patient with a major heart attack taking an unacceptable length of time to clear the emergency department.
Her scrutiny revealed the cause of the hold-up. A car had pulled off the road onto the footpath but was still creating enough of an obstacle to cause problems. The vehicle’s hazard lights were flashing and a man was attempting to get out on the driver’s side. Passing traffic was making this difficult, however, and the man was being subjected to irate blasts of car horns as he tried to open his door.
Traffic ground to a complete halt again with one car close enough to provide an impassable barrier to the man in the stalled vehicle. Felicity could see him moving to exit from the passenger side with some urgency. Her own car was still well away from the disruption, level with the entrance to a building site on her left. Felicity glanced sideways briefly, hoping to distract herself from a mounting irritation with the delay. She’d been watching the huge apartment block take shape for months now and the site looked busy again this morning. Extraordinarily busy, in fact. There were people running from all directions. Felicity’s casual glance focused on the scene sharply. On the supine figure that the men were running towards.
The wisdom gleaned from years of experience was not needed to let Felicity know that a significant incident had occurred. It took only a second to ease her vehicle from the line of traffic and cruise onto the building site. A few seconds more and she was at the side of the victim. She could see that the young man was conscious and breathing. She picked up his wrist to check the radial pulse as she crouched down beside him.
‘Can anyone tell me what’s happened?’
‘Don’t touch that man! Stand back!’
The command was vehement enough to distract Felicity from her visual examination of her patient. The sharp tone made the man crouching beside her stand up hurriedly, stunning him into silence, though he had barely begun to answer Felicity’s query.
‘I’m sure you all have the best intentions,’ the man told the group. ‘But people who don’t know what they’re doing can actually do more harm than good in a situation like this. I’m a doctor,’ he continued. ‘And I witnessed the accident.’ He glared at Felicity, his gaze flicking over her well-dressed slight figure dismissively. ‘You haven’t tried to move him, have you?’
‘Of course not.’ Felicity might not have witnessed the accident at first hand but it didn’t take much common sense to realise that someone lying motionless beneath scaffolding could well have suffered a significant fall. And it didn’t take anything like her training to suggest that such a fall carried a high index of suspicion of a spinal injury. Felicity opened her mouth to inform this man that as an emergency department consultant she was hardly likely to risk an exacerbation of such an injury by moving an unstabilised patient. She was also tempted to say something snappy regarding the assumptions this man had clearly made based on what she looked like. What did he think she did for a job? Work as a beauty therapist perhaps? Not that she was given a chance to say anything at all.
‘Move over here.’ The stranger draped the stethoscope he was holding around his neck with a casual movement that suggested long familiarity. ‘You can do something useful and hold this chap’s head still. It’s very important that he doesn’t move his neck.’
Felicity surprised herself by doing as she was asked. Or, rather, told. There was something about this man’s attitude that indicated it wouldn’t be in anyone’s best interests to get in his way right now and it certainly wasn’t an appropriate time to voice her resentment at the way he was treating her. Felicity took a mental step backwards. She would only intervene if she needed to and so far she had no complaints.
The doctor had gently moved the young man’s head and neck into a neutral position. As soon as Felicity’s hands took over providing support he conducted a rapid examination of the head and neck. Felicity relaxed a little as she noted that his movements appeared to indicate that he knew what he was doing. From the gentle palpation of the front of the neck he was clearly checking for tracheal deviation. As he carefully felt the back of the victim’s neck, the young man groaned and Felicity watched the doctor’s face register a focused concern.
‘I need some sandbags,’ he stated. ‘Or cushions. Or some rolled-up clothing. Anything. We need to pad the neck to protect it. And someone call an ambulance.’ He leaned over his patient, seemingly oblivious to how close this brought his face to Felicity’s. ‘What’s your name?’ he queried briskly.
‘Jeff.’
‘I’m Joe. Joe Petersen. I’m a neurosurgeon.’
Felicity blinked. Perhaps the stranger was more qualified to deal with a spinal injury than she was. The fact that she’d never heard the name associated with the specialised spinal injuries unit on the other side of town didn’t mean he wasn’t an expert. He could be visiting from overseas. His deep voice did have the hint of an unusual accent.
‘I can’t feel my legs.’ Jeff’s words held an edge of panic. ‘Am I going to be paralysed?’
‘Are you having any trouble breathing?’
‘No.’
Felicity tightened her grip at the attempt to shake his head. ‘Keep very still, Jeff,’ she told him. ‘It’s important.’
‘He hasn’t told me.’ Jeff caught Felicity’s gaze. ‘I want to know how bad this is.’
‘We don’t know yet.’ Joe placed the earpieces of his stethoscope into position. He pulled up the thick jersey Jeff was wearing. ‘I’m just going to listen to your chest.’
Felicity could feel the slower than normal heart rate under her fingertips. She considered suggesting that neurogenic shock could be producing a bradycardia as she watched Joe conduct a rapid assessment of Jeff’s chest, abdomen and pelvic area. He pressed his hands on each side of Jeff’s hips to check the stability of the pelvis. Glancing up, he noticed Felicity’s studied gaze.
‘I’m looking for what we call ‘‘silent’’ lesions,’ he informed her. ‘Injuries, that is.’
Felicity kept her face neutral. She was perfectly well aware what lesions were. It was quite interesting, being treated as a layperson. Or it would have been if this man’s tone didn’t suggest that her level of intelligence might not be up to scratch. She decided not to raise the subject of neurogenic shock.
‘If there’s a significant level of paralysis then injuries could be hidden.’ Joe was palpating Jeff’s abdomen with obvious skill. ‘That means they won’t be causing any pain. I’m particularly concerned with a chest injury that might affect breathing or something that could cause internal bleeding. Can you feel me touching you, Jeff?’
‘No, I can’t feel anything. Have I broken my back?’
‘You’ve certainly injured your spine.’ The assessment for major associated injuries had taken less than a minute. Joe moved swiftly into a neurological check that Felicity could also make no complaints about.
‘Can you move your hands, Jeff?’
‘I think so.’ Jeff’s fingers wiggled weakly. ‘They feel weird, though.’
‘What sort of weird?’
‘Kind of pins and needles.’
‘Can you feel me touching them?’ Joe went from a light touch to a distinct pinch before Jeff responded.
‘Kind of.’
‘Which finger am I touching?’ Joe was pinching Jeff’s thumb.
‘I’m not sure. The middle one?’
Felicity saw the frown of concentration as Joe assimilated the information of lowered sensation. He took hold of Jeff’s hands. ‘Squeeze my hands,’ he ordered. ‘As hard as you can.’
The pulses on both wrists were checked and then Joe moved to check Jeff’s legs. As he elicited the assistance of Jeff’s friend, Lou, to remove the laces of the steel-capped boots and ease the heavy footwear clear, Felicity found she was still focused on Joe Petersen’s face. It was a very intelligent face with rugged features and dark brown eyes that seemed almost grim in their intensity. Straight brown hair revealed distinct auburn tints as the early morning sunshine bathed the group of people. What a strange thing to notice at a time like this, Felicity thought. She transferred her gaze to the knot of anxious-faced men surrounding them. They were still standing well back, except for one younger man who pushed through the group.
‘I’ve found some sandbags.’
‘Good for you, Tommo.’ The men made way for him.
‘Excellent,’ Joe added. ‘Well done.’ Felicity noticed the pleased expression on the young man’s face as Joe rose swiftly from his crouched position. Joe clearly had the ability to lead people. Tommo’s face became eager.
‘Where would you like me to put the bags?’
‘Give them to me,’ Joe ordered. ‘I need to put them in exactly the right place.’
Felicity saw the disappointment that accompanied the handover of the sandbags. Joe Petersen might have leadership qualities but he would never hold the loyalty of the people he led if he dismissed their potential so abruptly. There wasn’t anything highly technical about the placement of support materials for a neck and head. Tommo could easily have been directed to accomplish the task. He would have had the satisfaction of knowing he was really helping and Joe would have had a loyal assistant for anything else he might require. The sandbags were cold against Felicity’s hands as Joe snuggled them along the side of Jeff’s head.
‘Don’t let go of his head,’ Joe instructed her firmly. ‘These supports will help but they’re not enough. You’re doing a great job,’ he added.
It was the first direct eye contact Felicity had had with this man. It was also the first appreciative comment. She noted that the dark brown eyes were rather attractive but she couldn’t detect any hint of personal warmth being directed at her. In fact, in the few minutes so far of his management of this incident, Felicity had not seen even a hint of a smile. Joe was focused on this task with an intensity that was definitely grim. The people around him were merely tools. His praise of Felicity’s ability to stabilise his patient’s head and his appreciation of Tommo’s success in locating sandbags was automatic, an acknowledgment that they had both performed as he had expected. How totally ridiculous that she should feel as pleased by the acknowledgement as Tommo had been.
Felicity gave herself a mental shake. She could hear the wail of the approaching siren advertising the imminent arrival of the ambulance service. The emergency vehicle was likely to be crewed by paramedics who would know who she was. It was going to be extremely interesting to see how Joe reacted to finding out her qualifications. Felicity was also curious to observe how he would relate to the ambulance officers. Doctors who had no direct contact with the service were sometimes inclined towards an arrogant assumption that the paramedics were no more than drivers. Given Joe’s treatment of the people around him so far, Felicity would be surprised if he gave the paramedics any credit for the skills she knew they possessed.
The first surprise came when Joe stood up to greet Stanley Ferris, the paramedic leading the crew.
‘I’m Joe Petersen. I’m a neurosurgeon,’ Joe told Stanley crisply. ‘This is Jeff. He’s nineteen years old and has fallen approximately fifteen metres from this scaffolding.’
Stanley glanced up at the platform well above them as he took in the mechanism of injury.
‘He hit a rail about halfway down which caught his back in the lumbar region. Then he landed on his head, causing a distraction injury to his neck. He wasn’t KO’d and his GCS has remained at 15.’ Joe cast a brief glance at the second ambulance officer. ‘Can you get a cervical collar on Jeff? Thanks. And some oxygen. A high-concentration mask.’ His attention turned back to Stanley.
‘Jeff has pain at C5 to C7 and I’d query an increased interspinous gap. He has a moderate contusion in the occipital area. He has paralysis to both legs and paraesthesia and paresis in both arms and hands. Chest and abdomen are clear, breathing is diaphragmatic. He’s bradycardic at 55 and I’m concerned about hypothermia. This ground is frozen solid and it’s been nearly ten minutes since the accident.’
Felicity watched as Stanley nodded to show he had absorbed the information. She was impressed at Joe’s professional summary of their patient’s condition, but she was even more impressed at his attitude towards Stanley. Assuming he now had assistance of medical merit, Joe was treating the paramedic as a colleague and an intelligent one at that.
‘We need some blankets,’ Joe continued. ‘A foil sheet if you have one. Jeff will be poikilothermic with a spinal injury.’
Felicity’s raised eyebrow mirrored Stanley’s expression. Perhaps Joe wasn’t treating Stanley as a colleague after all. Did the paramedic know that poikilothermic meant that a body would assume the temperature of the environment? Maybe Joe was deliberately using terms even medical staff might not recognise easily in order to show superiority and demonstrate his command of the situation.
‘We need to get him off the ground as quickly as possible,’ Joe continued. ‘Do you carry backboards or scoop stretchers?’
‘Both.’ Stanley’s glance at Jeff’s position made him notice Felicity for the first time. His eyes widened dramatically. Felicity’s smile was intended to indicate that this wasn’t the moment for Stanley to be distracted by her presence, and the paramedic took the hint with his customary astuteness. ‘A scoop stretcher will let us pick him up with minimal disruption but they are cold. If we log-roll him onto a backboard it would also give you the chance to check his lower back.’
‘What’s going to be quicker?’
‘Probably the scoop.’
‘We’ll do that, then.’ Joe watched as Stanley and his partner, Ray, introduced themselves to Jeff and explained what they were about to do. They moved the sandbags and eased a cervical collar into place.
‘Grab a towel,’ Stanley directed Ray. ‘We want that under his head to maintain neutral alignment. You can get the scoop out as well. I’ll take some vitals while you set it up.’
Stanley wrapped a blood-pressure cuff around Jeff’s arm. Ray brought the metal scoop stretcher from the back of the ambulance. When Joe moved to take over unfolding and setting out the stretcher, Stanley caught Felicity’s gaze.
‘Does he have any idea who you are?’
‘No.’ Felicity couldn’t help a quick grin. ‘I haven’t exactly had the opportunity to introduce myself.’
‘Hmm.’ Stanley’s noncommittal grunt acknowledged the level of authority Joe had assumed. ‘At least he seems to know what he’s talking about.’
Felicity nodded. She rubbed her hands together. They were cold and stiff after the long minutes of stabilising Jeff’s head and neck. ‘I think I’ll leave you guys to it,’ she told Stanley. ‘I’m late for a meeting and I’m sure Mr Petersen can give you any medical assistance you need.’
Stanley was taking some IV supplies from his kit. He had the line in Jeff’s hand within seconds. Joe frowned as he noticed the action that had been taken without his direction. He laid down the half of the scoop stretcher he was carrying.
‘Blood pressure’s 85 over 60,’ Stanley told him. ‘I won’t run any IV fluids unless the systolic drops below 80.’
Joe nodded and Felicity could sense his satisfaction. The low blood pressure with a spinal injury was likely to be due to vasodilation below the level of injury rather than blood loss. As long as the systolic blood pressure remained above renal filtration pressure of 80 mm mercury it was not advisable to give extra IV fluids, which could cause complications from over-hydration.
Joe was eyeing the drug supplies in Stanley’s kit. ‘Are you able to give a loading dose of methyl prednisolone?’
‘No.’ Stanley shook his head. ‘That’s not in our procedures.’
‘We do it in some parts of the States.’ Joe frowned again. ‘Have you got a specialist spinal unit we can transfer him to directly?’
‘We go through the emergency department at the main hospital. It’s only five minutes away. They’ll stabilise him and then transfer. It takes nearly an hour for a slow transport of an acute case to the spinal unit.’ Stanley’s glance at Felicity suggested that it was time she introduced herself but Felicity was quite happy with the management of their patient.
‘I’d better go,’ she announced. ‘Unless I can help in some other way?’
‘No, of course not.’ Joe looked vaguely surprised at the offer. ‘We’ve got plenty of extra hands here. Thanks for your help.’
‘My pleasure.’ Felicity threw a glance over her shoulder as she walked back towards her car. The blades of the scoop stretcher had been eased, one side at a time, beneath Jeff. The halves had been clicked into place and Jeff was now being strapped into position. The scene had been well managed and any injury Jeff had sustained had been in no way exacerbated. No doubt she would see the young fall victim later on in the emergency department. He would probably still be accompanied by the neurosurgeon, who seemed determined to take complete control of his management.
Felicity shook her head as she joined the line of traffic again. Maybe she should have asserted herself and let him know that she wasn’t simply a useful pair of extra hands. It had been a little immature to take offence at the suggestion that she didn’t know what she was doing. It wasn’t as if he could have had any idea she was remotely qualified to act as a colleague, but his attitude had rankled. She had worked long and hard to get where she was now. His dismissal of her, based presumably on what she looked like, had got right up her nose. She was regretting the decision to stay anonymous now, however. It would have been more interesting to have had a professional discussion. She’d like to know where in the States they were doing methyl prednisolone protocols in the field and whether it had been going on long enough to have results on any improvement in long-term outcome. The lights changed and Felicity moved off with a sigh. It was too late now. Best she forget about the whole encounter.
The intention to forget wasn’t easily acted upon. The encounter had left an impression that lasted well past the meeting with the cardiology department. It was still ready to jump into prominence later that morning when Felicity noticed Stanley and Ray handing over another patient to the sorting nurse. She waited until they had transferred their patient to a bed.
‘You guys did a good job with that spinal patient this morning.’
‘Thanks,’ Stanley responded warmly. ‘It was a surprise to see you there, Fliss.’
‘I was just passing. I became rapidly redundant.’ Felicity’s smile gave no hint of her persistent dissatisfaction with the incident. ‘How did the transport go? Did Mr Petersen go with you?’
‘No, thank goodness.’ Stanley grinned. ‘He probably would have complained about every bump on the road. He was a bit over the top, wasn’t he?’
‘He knew what he was doing. I think he was just determined to manage things as well as possible.’ Felicity was surprised to find herself defending Joe, but it would have been unprofessional to complain about another doctor to Stanley despite their long association and Felicity’s appreciation of the paramedic’s level of skill. ‘Jeff was lucky to have someone that experienced on the scene. I imagine that Mr Petersen is only visiting. It sounded as though he’s come from the States.’
‘He’s been in the States but he’s just moved back to New Zealand.’ Stanley fished in his pocket and extracted a slip of paper. ‘He gave me his phone number. He said he’d like to hear some follow-up if I had the chance.’
‘Oh.’ Felicity dismissed the errant thought that she could do the follow-up and contact Joe herself. Why on earth would she want to do that?
‘He’s looking for a job,’ Stanley told her. ‘We had a quick chat while he was giving me his number. Apparently he’s just finished some postgraduate specialist training and he’s come back here for family reasons. He’s hoping to get a position here or at the spinal unit.’
‘Unusual to move countries without a position to go to,’ Felicity observed. ‘Rather a big risk, especially for a consultant. Did he say what the family reasons were?’
‘No. But they must have been compelling. He was dead keen to get away as soon as we’d loaded Jeff. Said he didn’t want to let his daughter down.’ Stanley’s pager sounded at the same instant that Felicity’s beeper went off. They both grinned.
‘No rest for the wicked. See you later, Fliss.’
‘No doubt. Bye, Stan.’ Felicity moved towards the telephone on the sorting desk. This morning’s incident had simply been an interesting and somewhat different start to the day. Now it was time to get on with the many and varied challenges the emergency department could throw at her. She was bound to see Stan again in the near future. She was not likely, however, to see Joe Petersen again, and that was fine. It might have been satisfying to tell him who she was, but if she’d wanted to see him again she could have offered to take that phone number from Stan and use the excuse of a patient follow-up as a reason for contact. The choice had been there and it hadn’t been difficult to make. She had no desire to renew her acquaintance with Joe Petersen. The incident and the man were history.
In fact, she would probably have trouble recognising him if she did see him again.
CHAPTER TWO
THE recognition was instantaneous.
Felicity spotted Joe in the emergency department from as far away as it was possible to get. She was entering the double doors that led from the end of the corridor dividing the department into the main area of Queen Mary Hospital. Joe was standing beside the bed in cubicle 3. On top of the bed sat a small girl with curly red hair. Even from that distance Felicity could recognise a struggle to keep on top of the fear, confusion and probably pain the child was experiencing.
The characteristic decisiveness in Felicity’s forward movement took her swiftly towards the sorting desk.
‘Who’s in cubicle 3, Mike?’
The nurse manager had been talking to senior consultant Gareth Harvey as he was entering information into a computer program. ‘Samantha Petersen. Four years old. Query greenstick fracture of the left radius.’
Felicity nodded. Joe Petersen’s daughter, then. Part of the family whose circumstances had somehow brought Joe to Christchurch. ‘Did she come in by ambulance?’
‘No. Her father brought her in a couple of minutes ago. He’s some sort of medic, apparently.’ Mike raised an eyebrow as he glanced up from the computer screen, clearly puzzled by the interest shown by a consultant in such a minor case.
‘Do you know him?’ Gareth also looked curious.
‘We’ve met.’ Felicity’s gaze flicked to the whiteboard. The spaces beside cubicle 3 had yet to be filled in.
Mike had followed her line of query. ‘I’m giving her to Mary. Colin White can see her later.’
Felicity’s gaze shifted again. The nurse, Mary, was pushing an IV trolley out of cubicle 6 so she hadn’t caught up on her new case assignment. She knew that Colin, one of the registrars, was still busy in the observation ward she had just come from herself. Nobody had attended to the Petersens yet.
‘I’ll deal with it, Mike. I’ve got a clear space unless there’s something urgent on the way.’
‘Nothing major. Possible infarct coming from out of town but they’re twenty minutes or so away yet.’
‘OK.’ Felicity’s nod was brisk. ‘This shouldn’t take long.’ She was already moving towards cubicle 3. It might not take very long but, boy, was she going to enjoy it! She pulled the curtain closed around the cubicle to create a more private examination area.
‘Hi, there, sweetheart.’ Felicity smiled at the child whose right arm was clutching a soft toy that looked like some kind of floppy dog. ‘What’s your name?’
Small lips pressed together tightly but the movement was not enough to stop a noticeable chin wobble. Large, frightened brown eyes were fixed on Felicity.
‘Tell the nurse your name, Samantha.’ The order was given in a kindly voice but the only effect was to make the child’s eyes swim with tears.
Felicity flicked Joe a brief glance. Nurse indeed. This was going to be even better than she had anticipated. She smiled at Joe’s daughter again.
‘My name’s Fliss,’ she told the child. ‘Do you go to school, Samantha?’
‘She’s not old enough for school. She goes to kindergarten.’ Joe’s tone was wary. Felicity knew he had recognised her now. His brain was ticking over, probably remembering their encounter with the spinal injury patient. Maybe he was wondering if he might have insulted her by not knowing she was a nurse. Nurse, ha! Felicity bit back a tiny smile. Joe would keep for the moment.
‘Do they call you Samantha at kindy, sweetheart?’
This time Felicity was rewarded with an almost imperceptible head shake.
‘What do they call you? Sam? Sammie?’
The slight movement changed to an affirmative direction. Felicity mirrored the nod as she perched casually on the bed beside the small girl.
‘Which do you like better? Sam or Sammie?’
‘Sam.’ The response was a whisper.
Felicity lowered her own voice to a similarly conspiratorial level. ‘Can I call you Sam?’
‘OK.’
‘Cool.’ Felicity winked at Samantha. ‘I’ll call you Sam and you can call me Fliss. Is that a deal?’
The smile was worth winning. It brightened up a pale little face which was dusted with freckles that matched the luxurious reddish blonde curls. Felicity’s visual impression had included more than the skin colour of her patient, however. She had, by now, assessed the level of the child’s responsiveness and distress, noted her respiration rate and seen the slight but obvious deformity of the left forearm that lay limply on the child’s lap. The right arm still clutched the tattered toy dog.
‘How did you hurt your arm, Sam?’
‘I...I fell out of the swing.’ The child’s glance towards her father made Felicity blink. Was Samantha afraid of giving the wrong answer? Was she afraid of her father? The continuation of the hesitant response raised Felicity’s suspicions another notch.
‘I...I didn’t hang on tight enough.’ A huge tear escaped and rolled down a freckled cheek.
‘It was an accident.’ Was Joe Petersen annoyed with the child or the inconvenience of a trip to the emergency department? Whatever the reason, the tone was inappropriate and not the normal interaction between a parent and child in such a situation. Felicity had already noted the lack of physical contact between the pair. What was going on here?
‘It doesn’t matter how it happened,’ she told Samantha gently. ‘What matters is that we fix up your arm. Does it hurt at the moment?’
Samantha nodded.
‘Did you hit your head when you fell out of the swing?’
‘She wasn’t KO’d,’ Joe said.
Felicity ignored him. ‘Does anything else hurt you, Sam?’
‘No.’ Again Joe answered on behalf of his daughter.
Felicity drew in a deep breath. She spoke calmly. ‘I think Samantha might be better qualified to answer that question than you, Mr Petersen.’
The muscular twitch in the man’s face gave away the incredulity his tone managed to conceal. ‘I believe my daughter has a greenstick fracture of the left radius. Perhaps you could do whatever baseline measurements your protocols dictate and then find a doctor who can authorise the necessary pain relief and treatment this injury requires.’
Felicity met the stare with equal directness. ‘I am a doctor, as a matter of fact. I’m one of the consultants in this emergency department.’ She allowed only a moment to let the implications sink in before adding a punchline she couldn’t quite resist. ‘And don’t worry, Mr Petersen. I may not be a neurosurgeon but I do know what I’m doing.’
She turned back to Samantha, satisfied that the stunned and distinctly discomfited expression on Joe’s face would take some time to dissipate.
‘I know your arm is sore, sweetheart, but I want you to try and wiggle your fingers for me. Can you do that?’
The movement produced was tentative but reassuring. ‘Good girl, Sam. That’s fantastic. Now, I’m going to hold your hand—just gently. Can you feel me touching your fingers?’ Felicity noted the temperature and colour of Samantha’s hand as she responded affirmatively. ‘OK, see if you can squeeze my fingers.’
Felicity compared the responses with Samantha’s uninjured limb. She could still feel Joe’s stare. She checked the radial pulses on both wrists before glancing up. ‘No neurological or circulatory deficit. That’s good.’
‘Why didn’t you tell me before?’
‘I hadn’t done the necessary examination.’ Felicity gave in to the temptation to be deliberately obtuse.
‘I meant, why didn’t you tell me that you were a doctor?’
‘I’ve only been in here a few minutes.’
‘I’m not talking about now. I’m talking about last week.’ Joe Petersen’s tone suggested he was unamused by this verbal sparring.
Felicity shrugged as though it was a matter of little importance. ‘I don’t remember having the opportunity,’ she said thoughtfully. ‘You had the situation well controlled—and, anyway,’ she added mischievously, ‘stabilising the head and neck of a spinal injury patient is a pretty useful thing to do.’ She turned back to Samantha.
‘We’re going to get a special picture taken of your arm,’ she told the child. ‘An X-ray. It looks at the inside of your arm. Do you know what there is inside there?’
Samantha shook her head. The fearful look returned to the large, brown eyes.
‘It’s nothing to worry about,’ Felicity reassured her. ‘An X-ray doesn’t hurt. It’s just a special camera that can see what we can’t see. Bones. They’re the hard bits inside your arms and legs.’ She was debating whether the trauma of inserting an IV line to give some narcotic pain relief was justified, given how easily Samantha could be distracted from her injury. She still looked ready to cry again so Felicity decided to test the distraction level once more.
‘Does your dog have a name?’
‘Snowy.’ The firm response came from Joe.
Felicity saw the expression on Samantha’s face and sighed inwardly. The little girl might be distracted from the pain but upsetting her wasn’t going to help. Maybe she needed to push a little harder and find out what was going on in this relationship. The vibes she was getting were making her distinctly uneasy now.
‘He looks pretty special,’ she told Samantha quietly. ‘Is his name really Snowy?’
Samantha shook her head slowly and dislodged another tear. Then another. ‘His name’s not Snowy,’ she sobbed. ‘His name is Woof Woof Snowball.’
Felicity bit her lip. Her peripheral vision caught the wince on Joe’s face and it was extremely hard not to laugh aloud. The neurosurgeon was acutely embarrassed by the childish name for the toy.
‘‘‘Woof Woof Snowball’’,’ Felicity repeated with some relish. ‘That’s a great name.’ She peered more closely at the toy. ‘He’s a rather grubby snowball right now, though. Did he fall out of the swing, too?’
Samantha nodded.
‘Did he hurt himself, do you think?’
The head shook this time. The tears were gone again and Samantha tried to smile. ‘I think he just got dirty.’
‘Maybe he needs a bath.’
‘I’m not allowed to have squashy toys in the bath. Mum says they take too long to dry.’
‘Ah.’ Felicity digested the information offhandedly as she began to record her medical observations on Samantha’s chart. So there was a mother. Joe’s wife, presumably. Maybe there were brothers and sisters as well. A whole family, in fact, including some cute, fluffy dog. ‘Have you got a real dog at home, too, Sam?’
‘No. Mum doesn’t like dogs.’
‘Oh.’ Felicity continued her rapid note-taking. ‘Does Daddy like dogs?’
‘I don’t know.’
Felicity’s glance was too automatic and too quick to hide her astonishment. How could Samantha not know whether her father liked dogs? Joe was frowning.
‘Of course I like dogs, Sam.’
Felicity tried to dismiss the notions that flitted through her head as she charted some oral analgesics for Samantha and filled in a requisition form for an X-ray. She needed a bit of time to think about this one. Standing up, she smiled brightly at Samantha.
‘I like dogs, too,’ she told her. ‘In fact, I’ve got a real dog. He’s an Irish setter called Rusty.’ Her smile widened. ‘Maybe I should have called him ‘‘Woof Woof Rusty’’.’
Samantha giggled. It was a delightful chortle that prompted Felicity to reach out and gently ruffle the child’s curls. ‘Rusty is a lovely dark auburn colour,’ she continued. ‘But he has long hair on his tail which is much lighter. On the ends it’s exactly the same colour as your hair.’
Samantha looked delighted with the information. ‘Sometimes Daddy calls me Nas—Nas...’ She struggled with the word. ‘Nastagmus,’ she managed triumphantly. ‘He says that’s what my hair reminds him of.’
‘Really?’ A nystagmus was a word used to refer to an abnormal and rapid type of involuntary eye movement. She caught Joe’s gaze and a lopsided smile appeared on his face.
‘She means ‘‘nasturtium’’.’
‘Oh!’ Felicity grinned. She loved the amusing verbal errors children often made, though she was usually careful not to show her amusement in front of them. It was difficult to hide her delight at present, however, and Felicity knew quite well that Samantha’s mistake had only provided part of the pleasure she was experiencing.
That lopsided twist of his lips was the first time she had seen anything like a smile on Joe’s face, and its effect was dramatic. His features softened and crinkles appeared around his eyes. The dark brown eyes were exactly the same colour as Samantha’s. In fact, Samantha looked very much like her father, and while their relationship was oddly formal for a parent and child there was really no doubt about their genetic bond.
Maybe there wasn’t anything too odd about their interaction either. Samantha’s face lit up at the sight of her father’s smile and the look that passed between the pair suggested a genuine closeness. Warmth, even. Felicity had the fleeting and rather disturbing thought that she would like just such a look directed at her from this man.
She excused herself hurriedly. She had no time to ponder the intricacies of this particular family’s relationships with each other and she certainly didn’t want to be distracted by any peculiar reactions to Joe. There were other patients waiting to be seen.
The potential heart-attack patient from out of town had arrived in the department. Felicity accompanied the man during his rapid transfer to a resus area. Geoffrey Pinnington was a forty-year-old farmer from a rural area well north of the city.
‘I’d been feeling a few niggles all morning,’ he told Felicity in response to her first query. ‘I thought I must have pulled a muscle, heaving hay bales around. I’d just finished my lunch when I started feeling really terrible. I went all sweaty and lost my lunch and this awful pain started up.’
‘Where was the pain?’
‘Right here.’ Geoffrey slapped a hand on the centre of his chest. The nurse attending to the 12-lead ECG hastily reattached a dislodged electrode.
‘Try and keep still for a moment, please, Mr Pinnington,’ the nurse requested.
‘Was the pain just in the one spot?’ Felicity asked.
‘No. It went into my neck and then all the way down my left arm.’
‘Given a scale of zero to ten, with zero being no pain and ten being the worst you could imagine, what score would you have given it?’
‘Twelve.’ Geoffrey smiled wryly. ‘I’ve never felt so bad in my life. I really thought I was about to die.’
Felicity nodded sympathetically. A feeling of impending doom was a common symptom of a heart attack. ‘What time did the pain come on?’
‘One o’clock or thereabouts. Maybe a quarter past.’
‘OK.’ Felicity glanced at her watch. Nearly three hours ago. They were still well within the therapeutic window for an angioplasty procedure which could abort the damage being caused by the lack of coronary blood flow.
‘Give Cardiology a call,’ she directed the registrar beside her. Felicity picked up the ECG trace and scanned it rapidly. The changes were abnormal and clear-cut. ‘Tell them we have a probable anterior infarct in progress here.’ She turned to the junior doctor who was drawing blood from the IV line already in Geoffrey’s arm. ‘We need cardiac enzymes, CBC, electrolytes and lipids done, Sarah.’ Her attention returned to her patient. ‘How’s the pain at the moment?’
‘Not too bad. The stuff the GP gave me was good.’
Felicity nodded. She’d read the ambulance patient report form as she’d walked into the resuscitation area. After a half-hour drive to the local doctor, Geoffrey had been given treatment consisting of oxygen, pain relief, an anti-nausea agent, aspirin and GTN. The GP had then called for an ambulance for urgent transfer to hospital. All the right things had been done and the GP’s note included baseline measurements and a brief medical history that didn’t indicate any risk factors for heart disease. But Felicity wanted to double-check.
‘So you’ve never had any problems with your heart before this, Geoffrey?’
‘No.’
‘No other medical conditions you’re treated for?’
‘No, nothing.’
‘Blood pressure’s always been OK?’
‘As far as I know.’
‘Have you ever had your cholesterol levels checked?’
Geoffrey nodded. ‘Always been fine. I’m fit and healthy, Doctor, and I’m far too young to be having a heart attack, aren’t I?’
‘Unfortunately there are always exceptions to the general rules. Is there any history of heart disease in your family?’
‘My dad gets chest pain sometimes, I reckon. He’s one of the old school and wouldn’t admit to it, but I’ve seen him rubbing his chest and looking a bit grey sometimes.’
‘Do you smoke?’
‘Used to. I knocked it on the head a couple of years ago.’
‘Good for you.’ Felicity had enough information to transfer this patient directly to Cardiology. Baseline measurements and recordings had all been completed by the team in the resus area. When the curtain was drawn back behind her she expected the new arrival to be the cardiology registrar. Instead, it was a woman with two young children beside her.
‘Sorry, Geoff. I couldn’t drive as fast as the ambulance. How are you feeling?’
‘Not too bad, love. Don’t worry.’ Geoffrey smiled at his wife. He winked at his son who was about ten years old but the boy was staring, wide-eyed, at the screens of the monitoring equipment. The younger child, a girl, was clutching her mother’s hand, staring at her father and crying quietly.
‘It’s OK, chicken,’ Geoffrey said gently. ‘Dad’s going to be just fine.’ He held out the arm that wasn’t encumbered by IV tubing and the girl ducked behind a nurse and rushed into the inviting circle, burying her face against her father’s chest. Mrs Pinnington also moved closer and laid her hand on Geoffrey’s leg. Felicity watched as the family drew themselves into a unit again, preparing to cope with whatever was coming next. She answered the querying look Geoffrey’s wife was directing towards her.
‘It looks as though Geoffrey may be having a heart attack,’ Felicity explained. ‘There’s a cardiologist on the way to see him now and they’ll decide what the best course of treatment will be. You’ve done exactly the right thing in getting Geoffrey to the doctor and into hospital as quickly as possible. That means the treatment has much more chance of being successful and that any damage that is occurring can be minimised.’
The cardiology registrar arrived while Felicity was talking. She took over the management of the patient but Felicity stayed in the resus area, listening and watching, for a few minutes. The registrar assimilated the available information quickly. She explained the mechanics of the life-threatening condition Geoffrey was experiencing and outlined the treatment options. Felicity watched as he listened carefully. His daughter was still tucked within his arm and he was stroking her hair. Blonde, straight hair. Not at all like Samantha Petersen’s.
Given the choice between drug therapy and the more invasive but faster and probably more effective procedure of angioplasty, the Pinningtons had no difficulty making a choice, and the staff prepared to move Geoffrey upstairs to the catheter laboratory. It was time for Felicity to move as well. With no urgent cases awaiting her attention, she collected a cup of cold water and stood observing the department for a minute from her position beside the water dispenser. She wasn’t really registering the activity in the department, however. She was still thinking about Geoffrey and his daughter. Or, more specifically, the interaction between them and the contrast it had presented to the way Joe and Samantha had appeared. That easy affection and physical closeness had been non-existent.
Sometimes the frightening environment of an emergency department made people act differently to what they might have done normally, but Joe was a surgeon. He should have been as much at home here as anywhere, and more capable of reassuring his daughter than most people. On reflection, it was hard to believe that the pair were father and daughter. The atmosphere of awkwardness was more like that of a relative or care-giver being thrown into dealing with an unfortunate and unexpected incident. A care-giver who only had limited contact with children, perhaps.
Felicity crumpled the polystyrene cup and threw it away. Maybe Joe was just a father who couldn’t be bothered and left the upbringing of his children entirely to his wife. Or maybe he had been missing an important appointment because of the accident. What did it matter anyway? It was really none of her business. Instinct had already told her that the unusual atmosphere was highly unlikely to be due to some dysfunctional or abusive relationship that needed further investigation so Felicity was slightly annoyed at her continuing level of interest.
No distractions were immediately available in the department.
‘I’ll be in my office,’ she told Mike. ‘I’ve got some paperwork to catch up on. Beep me if you need me.’
The left turn at the doors into the main part of the hospital took Felicity past the store cupboards, the sluice room and the relatives’ room on her right. The bed coming from the observation ward on the other side of the corridor slowed her decisive walk for only a few moments, but it was long enough to recognise the voices coming from the area set aside for relatives. One of the voices, at least.
* * *
‘For God’s sake, Joe. I just can’t understand how it could have happened!’
Joe had had almost enough. The day had already been a disaster and Dayna was just making things worse.
‘I told you, Dayna. It was an accident. She missed her footing when she jumped off the swing. She fell over. Accidents happen.’
‘I would have thought you could manage a simple trip to the park without some sort of disaster.’ Dayna’s tone was scathing. ‘This is just typical of you, Joe. How bad is it?’
Joe sighed. It was typical. Dayna expected any time he spent with Samantha to cause problems and no matter how hard he tried her expectation always seemed to be justified. Usually it was something minor like stained clothing from a spilled drink or a damaged toy—things that Dayna could have ignored easily enough if she chose to. He had to concede that a broken arm wasn’t something to dismiss lightly.
‘It’s a greenstick fracture.’
‘What on earth is that?’
‘It’s where the bone doesn’t break completely. One side breaks and the other side gets bent. It happens commonly with children.’ Joe frowned. ‘For heaven’s sake, Dayna. It’s exactly what Scott did to his arm a couple of years ago.’
‘He’s a boy.’ Dayna clearly dismissed the reference to her older son’s injury as unimportant. ‘Where is Samantha, Joe? I hope you haven’t left her sitting somewhere by herself.’
‘Of course I haven’t. She has a nurse with her.’
‘Well, I want to see her. Now.’
‘Of course.’ Joe stood back to let his sister-in-law exit the small room first. He followed, edging past the bed being manoeuvred awkwardly in the corridor outside. Another sigh escaped him. Just how much of Dayna’s rather heated conversation had been overheard by Dr Felicity Munroe? And why was she standing there at this particular moment anyway?
Joe led Dayna towards the emergency department. He was still appalled at having discovered Felicity’s qualifications and position. The fleeting memories of things he had said to her on the building site had made him cringe inwardly. Fancy suggesting that a consultant in emergency medicine might not know what she was doing and cause further damage. Or suggesting that if she wanted to be useful she could hold the head still. Of course, she could have told him she was a doctor but Joe had a sneaking suspicion that she had been right in saying she hadn’t been given much of an opportunity. The scene had reminded him too strongly of Catherine’s accident and the ghastly aftermath of a mismanaged spinal injury. He hadn’t been about to allow anyone to interfere with what he knew to be expert leadership.
Joe pulled back the curtain to cubicle 3. If only he hadn’t compounded the error by assuming that Felicity Munroe was a nurse when she’d arrived to look after Samantha. If he hadn’t been so worried about his daughter he might have noticed that she hadn’t been wearing a uniform. He might have taken the trouble to read the identity badge pinned to the waistband of her skirt.
‘Hello, Mum.’ Samantha was smiling. ‘Look at my arm plaster. It’s pink!’
‘Very pretty.’ The nurse beside the bed stepped back as Dayna leaned over to kiss Samantha. ‘Does it hurt a lot, darling?’
‘Not any more. I had some medicine. I’m hungry now.’
Joe smiled at Samantha. She was looking a lot happier. All that he needed now was some more time with her and he could probably wipe out the unpleasant aspects of their outing. ‘Maybe we could go out for a hamburger.’
‘No,’ Dayna said firmly. ‘It’s time to go home.’
Samantha looked disappointed enough to prompt Joe to try again. ‘I could drop Sam home a bit later.’
‘I’ve come into the hospital now, Joe. I’ve left the boys with Nigel and he’s busy at work. We’ve got grocery shopping to do and Scott’s due at his piano lesson at 4:30. I haven’t got time to chop and change arrangements. I’ll take Samantha home with me now.’
Joe gave in. It wasn’t worth the stress of trying to talk Dayna out of a decision. Not this time anyway, when Samantha was probably tired. He watched Dayna help his daughter off the bed.
‘Mum?’
Dayna was folding up Samantha’s cardigan, which had been abandoned on the end of the bed. She didn’t appear to have heard.
‘Mum?’
Joe gritted his teeth at the repetition. Dayna wasn’t Samantha’s mother. She was her aunt. Samantha had started calling her ‘Mum’ because of the example set by Dayna’s two sons. And Dayna certainly hadn’t discouraged her.
‘Mum?’ Samantha was trying again. ‘Can I give Woof Woof Snowball a bath with me tonight? He’s really dirty.’
‘He can go in the washing machine.’ Dayna turned her attention to the nurse who required a signature on the discharge papers. Joe bent down towards his daughter and spoke quietly.
‘When you come and stay with me you can give Woof Woof Snowball a real bath.’
Samantha’s grin at the private suggestion was worth a lot. The one-armed hug was worth even more, despite the obstacle the soft toy presented. It almost restored the pleasure Joe had anticipated from the afternoon’s outing. He could watch Dayna lead Samantha briskly away without the usual heartache. He even found himself smiling. Using that awful name for the toy hadn’t been that difficult at all. Maybe he just needed to relax. He just hadn’t had enough time with his daughter and that wasn’t entirely his fault.
He could learn. Look at how easily Felicity had established such an easy rapport with his child. Instead of being resentful at the way she’d effortlessly gained what he was having such difficulty achieving, he should follow her example. He could be relaxed and confident like that. And friendly. Felicity was obviously a friendly person, good with children, and she clearly knew what she was doing if she was a consultant emergency physician. She looked far too young for the position. She couldn’t be much over thirty, surely?
It seemed, by now, typical that Joe should encounter Felicity as he left the emergency department. This woman had a knack of appearing when least expected. He paused and directed a smile at her.
‘Thanks very much for your help, Dr Munroe.’
‘A pleasure, Mr Petersen.’
The formality was ridiculous. It made them both smile.
‘The name’s Joe.’
‘And mine’s Fliss.’
They both held their hands out simultaneously. The shake was brief but firm. Not so brief that Joe didn’t notice that Felicity wasn’t wearing a wedding ring, however. His mind was turning rapidly. No, she couldn’t be much over thirty and she really was an incredibly attractive woman. Those large hazel eyes were rather difficult to look away from. They weren’t looking as friendly as they had when Samantha had been around but that was hardly surprising.
‘I’d like to apologise,’ he found himself saying hurriedly.
‘What for?’ Felicity’s tone was cool. Disinterested, perhaps?
What for, indeed. There was too much to choose from. Joe had insulted her on more than one occasion already by making erroneous assumptions about her qualifications. He’d also displayed his lack of confident parenting in an embarrassing manner. He should have known better than to answer Samantha’s questions for her. Or upset her about the dog’s name. Felicity probably thought he was an idiot. A rude idiot, at that.
‘Our acquaintance didn’t get off to the best start. I’m sorry I didn’t enlist your expertise at that accident scene.’
‘You didn’t know I had any.’ Felicity dismissed the apology.
‘I wasn’t much of a help with Samantha today either.’
‘It’s often harder to cope with one’s own family than patients.’
‘The thing is, I...’ Joe hesitated. The only hope he had of repairing this woman’s opinion of him would require her to have at least some understanding of the complicated background his actions sprang from. However, any explanation of the reasons for his behaviour on the two occasions they’d met was likely to be time-consuming, and Felicity was looking past Joe’s shoulder at present as though she wanted to escape. ‘I’d just like a chance to explain,’ Joe finished. ‘An opportunity to redeem myself, perhaps.’
‘There’s absolutely no need.’
‘Maybe a coffee?’ Joe couldn’t quite accept the brush-off. He didn’t want to be brushed off. ‘When you have the time, that is.’
‘I don’t think so.’ Felicity’s smile was polite. ‘But thanks for the invitation. Nice meeting you again, Joe.’
Joe watched Felicity walk into the emergency department and kicked himself mentally. Surely he could have handled that a bit better. He had really wanted that coffee. It would have provided the opportunity to spend time with the young consultant and gain more than the initial impression he was being left with. It was an impression he was not going to forget in a hurry. One that he would very much have liked to have built on.
Not that he was going to get the chance. Felicity had spelt that out fairly convincingly. Of course, there was always that appointment Joe had tomorrow. If that interview was successful it was just possible he might get another opportunity to persuade Felicity that he was worth spending some time with. He hadn’t been all that bothered about whether it was going to be successful because he hadn’t been sure it was what he really wanted. Now Joe was quite sure it was what he wanted.
He wanted it rather a lot.
CHAPTER THREE
‘WHAT on earth is taking so long?’
‘I have no idea.’
Felicity frowned at her watch. ‘How long is it since you put in the call for the neurosurgical registrar?’
‘Must be nearly ten minutes.’ Emergency Department Registrar Colin White looked worried. ‘They said he was just finishing a case in Theatre and would be here directly.’
‘Ten minutes is a long way from ‘‘directly’’.’ Felicity’s glance raked the monitor screens surrounding the trauma room bed. ‘I think we’ll just transfer her to CT scanning now. We’ve got two multi-trauma patients from an MVA coming in by helicopter with an ETA of eight minutes. We need to get this room cleared.’
Felicity’s gaze was on the unconscious woman on the bed as the door to the trauma room swung open. She didn’t waver from her visual reassessment and mental review of the patient as the newcomer joined the team at the bedside.
‘Hi. I’m the neurosurgical registrar. Joe Petersen.’
Felicity had never looked up so quickly in her life. For a split second she was totally distracted from the case she was managing. Her patient could have been on another planet. It had been three weeks since Joe had appeared in the emergency department with his daughter. She had forgotten about him...almost. Not only had he stepped back into her world, he was now standing on the other side of a critically ill patient whose care they needed to co-operate over professionally. Felicity snapped the lid closed on her stunned reaction.
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Alison Roberts
Brilliant surgeon – baffled dad!Joe Petersen is a skilled surgeon, unfortunately, when it comes to being a dad, he's a complete amateur. Fliss Munroe, consultant, quickly finds Joe and little Sam creeping into her heart – except she starts to think that Joe is looking more for a nanny than a wife!
Felicity traced her forefinger through a dollop of the chocolate icing on the edge of the platter.
‘It was far too soft. I’ll have to watch that next time.’ She licked the icing off her finger. ‘Tastes good, though.’
The gaze from Joe’s brown eyes made her acutely aware of the effect her action had had. Silently and deliberately, Felicity traced her finger through the chocolate for a second time before slowly raising it to her lips, her gaze never leaving Joe’s. Her hand was caught well before it made contact. The chocolate-covered finger touched Joe’s lips rather than her own. His mouth closed softly around the digit and Felicity felt the firm caress of his tongue as he sucked the icing clear.
‘You’re right,’ Joe murmured. ‘It tastes very good.’
Felicity couldn’t say a word. She could only watch, stunned, as Joe used his own finger to scoop up another droplet of icing. He painted the soft chocolate on her lower lip. Felicity’s breath caught and held as he bent his head towards hers…
Alison Roberts was born in Dunedin, New Zealand. Her father’s medical career took her overseas as a child, but she returned to Dunedin and trained there as a primary school teacher. A teaching position led to a whirlwind romance and marriage to Mark—a young doctor who is now a professor and even more attractive than he was twenty years ago! Alison is currently residing in Christchurch with her husband, daughter and various pets, and her writing companion is an Irish wolfhound called Ryan. Apart from home, family and her writing, Alison’s passion is her involvement with the ambulance service. Having fallen in love with the job while researching a book, she is now avidly training as an ambulance officer and spends as much time as possible on active duty.
Recent titles by the same author:
EMERGENCY: CHRISTMAS
RIVALS IN PRACTICE (Medics Down Under) DOCTOR IN DANGER (Medics Down Under)
Surgeon on Call
Alison Roberts
www.millsandboon.co.uk (http://www.millsandboon.co.uk)
CONTENTS
Chapter One (#u75289ff4-6eee-52b1-a094-357d55fd97cc)
Chapter Two (#u970e4e5b-ac4e-53ef-849b-2f219a7080fa)
Chapter Three (#u77fd91db-6f22-5301-932f-657fba331ce6)
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)
CHAPTER ONE
SEVEN-THIRTY a.m.
Far too early to be starting work. A job like this might be OK in summer but below zero temperatures weren’t much fun. Not when the first rays of sunshine only made up for their lack of warmth by the uncomfortably blinding glare they could produce. Jeff Simms shaded his eyes from the glare with his hand. He could see the group of men congregating around the prefabricated shed that served as headquarters for the building site. He could also see his mate, Lou, climbing out of Tommo’s truck just ahead of him.
At least they’d made it to work on time today. The boss should be looking a lot happier than he appeared to be. Maybe he hadn’t had his coffee yet. The thought of coffee was enticing. Jeff and Lou had downed quite a few beers during their session at the pub last night.
‘Hey!’
‘How’s it going, mate?’ Jeff grinned at Lou.
‘Have you spoken to the boss yet?’
‘No. I just got here. Bloody cold, eh?’ Jeff blew on his knuckles and rubbed his hands together vigorously.
‘Tommo reckons you’re in trouble, mate.’
‘What for?’ Jeff caught Lou’s eye. Maybe they shouldn’t have taken off to the pub yesterday with such alacrity.
‘Boss couldn’t find his skill saw last night,’ Tommo reported gloomily. ‘He reckons you’d been using it.’
‘I was,’ Jeff admitted. ‘I had to go up and tidy that framing on the second floor.’
‘Where’d you put the saw, then?’
Jeff’s gaze roamed the scaffolding on the apartment block. He traced the route on the corner that he’d used to climb down from the wooden planks, trying to remember just what he had been carrying. The oath that escaped his lips was enough to impress even Tommo.
‘It’s still up there.’
Tommo unleashed an even better oath. ‘It’ll be frozen solid. Man, are you in trouble!’
‘It’ll still be dry. I put it under a tarpaulin. That’s why I forgot about it. I’ll go and get it now.’
‘You can’t.’ Lou shook his head. ‘Scaffolding’s out of bounds until it thaws. The boss’ll go mental if he sees you.’
‘He won’t see me. It’s on the road side. I’ll be quick.’
‘You’d better be careful, mate.’ Lou sounded doubtful. ‘It’s solid ice up there.’
* * *
Seven thirty-five a.m.
It was just as well he’d set off this early. Joe Petersen drummed his fingers on the steering-wheel as he waited in the line of traffic for the lights to change. He needed to get right across town and it was going to take a long time at this rate. He’d promised to be there at 8 a.m. to help get the kids off to school and then take Samantha to kindergarten for the morning. Dayna wouldn’t be very impressed if he arrived late, and he wasn’t about to give her any new ammunition regarding his lack of elementary parenting skills.
Joe glanced sideways to give his eyes a rest from the glare of the rising sun. The building site to his left was impressively large. This part of Christchurch city had changed beyond recognition since he’d last driven past but that was hardly surprising. It had been nearly five years since he’d had a visit lasting more than a few days. The trend seemed to be towards building these large inner-city apartment blocks now and this one looked fairly upmarket. Joe’s idle gaze roamed the side of the well-formed building. He could see the ice coating the scaffolding. Cold job, being a builder at this time of year. He wondered idly what the young chap was doing, scrambling up the side of the steel skeleton. He seemed to be in rather a hurry.
The toot from behind indicated that Joe’s attention should be back on the traffic. He slid the car back into gear but the movement he caught in his peripheral vision jerked his gaze back to the left. Had the lad’s foot slipped on that wooden platform? He’d managed to catch hold of one of the steel pipes but the grip held only momentarily. Joe watched the fall with horror. He could almost feel the impact as the victim’s back contacted the next steel bar several feet below before the graceful arc that completed the fall.
The sensation of horror was dismissed instantly and replaced with a clinical detachment. The impact mid-fall had been enough to cause a lumbar spinal injury. The distraction to the cervical vertebrae which the impact of landing on his head might have caused was even more serious. Joe pulled his steering-wheel decisively and put his foot down on the accelerator to gain just enough momentum for the wheels to mount the kerb. He pushed the hazard light control on the dashboard.
* * *
Seven thirty-eight a.m.
Felicity Munroe shaded her eyes from the glare of the sun. It was hard to see what was going on ahead but the traffic appeared to be even slower than normal for this time of day. At least she wasn’t too far from the hospital now. With a bit of luck she could still make the 8 a.m. meeting with members of the cardiology department. The interface between Cardiology and Emergency needed some urgent attention. Only yesterday they’d had a patient with a major heart attack taking an unacceptable length of time to clear the emergency department.
Her scrutiny revealed the cause of the hold-up. A car had pulled off the road onto the footpath but was still creating enough of an obstacle to cause problems. The vehicle’s hazard lights were flashing and a man was attempting to get out on the driver’s side. Passing traffic was making this difficult, however, and the man was being subjected to irate blasts of car horns as he tried to open his door.
Traffic ground to a complete halt again with one car close enough to provide an impassable barrier to the man in the stalled vehicle. Felicity could see him moving to exit from the passenger side with some urgency. Her own car was still well away from the disruption, level with the entrance to a building site on her left. Felicity glanced sideways briefly, hoping to distract herself from a mounting irritation with the delay. She’d been watching the huge apartment block take shape for months now and the site looked busy again this morning. Extraordinarily busy, in fact. There were people running from all directions. Felicity’s casual glance focused on the scene sharply. On the supine figure that the men were running towards.
The wisdom gleaned from years of experience was not needed to let Felicity know that a significant incident had occurred. It took only a second to ease her vehicle from the line of traffic and cruise onto the building site. A few seconds more and she was at the side of the victim. She could see that the young man was conscious and breathing. She picked up his wrist to check the radial pulse as she crouched down beside him.
‘Can anyone tell me what’s happened?’
‘Don’t touch that man! Stand back!’
The command was vehement enough to distract Felicity from her visual examination of her patient. The sharp tone made the man crouching beside her stand up hurriedly, stunning him into silence, though he had barely begun to answer Felicity’s query.
‘I’m sure you all have the best intentions,’ the man told the group. ‘But people who don’t know what they’re doing can actually do more harm than good in a situation like this. I’m a doctor,’ he continued. ‘And I witnessed the accident.’ He glared at Felicity, his gaze flicking over her well-dressed slight figure dismissively. ‘You haven’t tried to move him, have you?’
‘Of course not.’ Felicity might not have witnessed the accident at first hand but it didn’t take much common sense to realise that someone lying motionless beneath scaffolding could well have suffered a significant fall. And it didn’t take anything like her training to suggest that such a fall carried a high index of suspicion of a spinal injury. Felicity opened her mouth to inform this man that as an emergency department consultant she was hardly likely to risk an exacerbation of such an injury by moving an unstabilised patient. She was also tempted to say something snappy regarding the assumptions this man had clearly made based on what she looked like. What did he think she did for a job? Work as a beauty therapist perhaps? Not that she was given a chance to say anything at all.
‘Move over here.’ The stranger draped the stethoscope he was holding around his neck with a casual movement that suggested long familiarity. ‘You can do something useful and hold this chap’s head still. It’s very important that he doesn’t move his neck.’
Felicity surprised herself by doing as she was asked. Or, rather, told. There was something about this man’s attitude that indicated it wouldn’t be in anyone’s best interests to get in his way right now and it certainly wasn’t an appropriate time to voice her resentment at the way he was treating her. Felicity took a mental step backwards. She would only intervene if she needed to and so far she had no complaints.
The doctor had gently moved the young man’s head and neck into a neutral position. As soon as Felicity’s hands took over providing support he conducted a rapid examination of the head and neck. Felicity relaxed a little as she noted that his movements appeared to indicate that he knew what he was doing. From the gentle palpation of the front of the neck he was clearly checking for tracheal deviation. As he carefully felt the back of the victim’s neck, the young man groaned and Felicity watched the doctor’s face register a focused concern.
‘I need some sandbags,’ he stated. ‘Or cushions. Or some rolled-up clothing. Anything. We need to pad the neck to protect it. And someone call an ambulance.’ He leaned over his patient, seemingly oblivious to how close this brought his face to Felicity’s. ‘What’s your name?’ he queried briskly.
‘Jeff.’
‘I’m Joe. Joe Petersen. I’m a neurosurgeon.’
Felicity blinked. Perhaps the stranger was more qualified to deal with a spinal injury than she was. The fact that she’d never heard the name associated with the specialised spinal injuries unit on the other side of town didn’t mean he wasn’t an expert. He could be visiting from overseas. His deep voice did have the hint of an unusual accent.
‘I can’t feel my legs.’ Jeff’s words held an edge of panic. ‘Am I going to be paralysed?’
‘Are you having any trouble breathing?’
‘No.’
Felicity tightened her grip at the attempt to shake his head. ‘Keep very still, Jeff,’ she told him. ‘It’s important.’
‘He hasn’t told me.’ Jeff caught Felicity’s gaze. ‘I want to know how bad this is.’
‘We don’t know yet.’ Joe placed the earpieces of his stethoscope into position. He pulled up the thick jersey Jeff was wearing. ‘I’m just going to listen to your chest.’
Felicity could feel the slower than normal heart rate under her fingertips. She considered suggesting that neurogenic shock could be producing a bradycardia as she watched Joe conduct a rapid assessment of Jeff’s chest, abdomen and pelvic area. He pressed his hands on each side of Jeff’s hips to check the stability of the pelvis. Glancing up, he noticed Felicity’s studied gaze.
‘I’m looking for what we call ‘‘silent’’ lesions,’ he informed her. ‘Injuries, that is.’
Felicity kept her face neutral. She was perfectly well aware what lesions were. It was quite interesting, being treated as a layperson. Or it would have been if this man’s tone didn’t suggest that her level of intelligence might not be up to scratch. She decided not to raise the subject of neurogenic shock.
‘If there’s a significant level of paralysis then injuries could be hidden.’ Joe was palpating Jeff’s abdomen with obvious skill. ‘That means they won’t be causing any pain. I’m particularly concerned with a chest injury that might affect breathing or something that could cause internal bleeding. Can you feel me touching you, Jeff?’
‘No, I can’t feel anything. Have I broken my back?’
‘You’ve certainly injured your spine.’ The assessment for major associated injuries had taken less than a minute. Joe moved swiftly into a neurological check that Felicity could also make no complaints about.
‘Can you move your hands, Jeff?’
‘I think so.’ Jeff’s fingers wiggled weakly. ‘They feel weird, though.’
‘What sort of weird?’
‘Kind of pins and needles.’
‘Can you feel me touching them?’ Joe went from a light touch to a distinct pinch before Jeff responded.
‘Kind of.’
‘Which finger am I touching?’ Joe was pinching Jeff’s thumb.
‘I’m not sure. The middle one?’
Felicity saw the frown of concentration as Joe assimilated the information of lowered sensation. He took hold of Jeff’s hands. ‘Squeeze my hands,’ he ordered. ‘As hard as you can.’
The pulses on both wrists were checked and then Joe moved to check Jeff’s legs. As he elicited the assistance of Jeff’s friend, Lou, to remove the laces of the steel-capped boots and ease the heavy footwear clear, Felicity found she was still focused on Joe Petersen’s face. It was a very intelligent face with rugged features and dark brown eyes that seemed almost grim in their intensity. Straight brown hair revealed distinct auburn tints as the early morning sunshine bathed the group of people. What a strange thing to notice at a time like this, Felicity thought. She transferred her gaze to the knot of anxious-faced men surrounding them. They were still standing well back, except for one younger man who pushed through the group.
‘I’ve found some sandbags.’
‘Good for you, Tommo.’ The men made way for him.
‘Excellent,’ Joe added. ‘Well done.’ Felicity noticed the pleased expression on the young man’s face as Joe rose swiftly from his crouched position. Joe clearly had the ability to lead people. Tommo’s face became eager.
‘Where would you like me to put the bags?’
‘Give them to me,’ Joe ordered. ‘I need to put them in exactly the right place.’
Felicity saw the disappointment that accompanied the handover of the sandbags. Joe Petersen might have leadership qualities but he would never hold the loyalty of the people he led if he dismissed their potential so abruptly. There wasn’t anything highly technical about the placement of support materials for a neck and head. Tommo could easily have been directed to accomplish the task. He would have had the satisfaction of knowing he was really helping and Joe would have had a loyal assistant for anything else he might require. The sandbags were cold against Felicity’s hands as Joe snuggled them along the side of Jeff’s head.
‘Don’t let go of his head,’ Joe instructed her firmly. ‘These supports will help but they’re not enough. You’re doing a great job,’ he added.
It was the first direct eye contact Felicity had had with this man. It was also the first appreciative comment. She noted that the dark brown eyes were rather attractive but she couldn’t detect any hint of personal warmth being directed at her. In fact, in the few minutes so far of his management of this incident, Felicity had not seen even a hint of a smile. Joe was focused on this task with an intensity that was definitely grim. The people around him were merely tools. His praise of Felicity’s ability to stabilise his patient’s head and his appreciation of Tommo’s success in locating sandbags was automatic, an acknowledgment that they had both performed as he had expected. How totally ridiculous that she should feel as pleased by the acknowledgement as Tommo had been.
Felicity gave herself a mental shake. She could hear the wail of the approaching siren advertising the imminent arrival of the ambulance service. The emergency vehicle was likely to be crewed by paramedics who would know who she was. It was going to be extremely interesting to see how Joe reacted to finding out her qualifications. Felicity was also curious to observe how he would relate to the ambulance officers. Doctors who had no direct contact with the service were sometimes inclined towards an arrogant assumption that the paramedics were no more than drivers. Given Joe’s treatment of the people around him so far, Felicity would be surprised if he gave the paramedics any credit for the skills she knew they possessed.
The first surprise came when Joe stood up to greet Stanley Ferris, the paramedic leading the crew.
‘I’m Joe Petersen. I’m a neurosurgeon,’ Joe told Stanley crisply. ‘This is Jeff. He’s nineteen years old and has fallen approximately fifteen metres from this scaffolding.’
Stanley glanced up at the platform well above them as he took in the mechanism of injury.
‘He hit a rail about halfway down which caught his back in the lumbar region. Then he landed on his head, causing a distraction injury to his neck. He wasn’t KO’d and his GCS has remained at 15.’ Joe cast a brief glance at the second ambulance officer. ‘Can you get a cervical collar on Jeff? Thanks. And some oxygen. A high-concentration mask.’ His attention turned back to Stanley.
‘Jeff has pain at C5 to C7 and I’d query an increased interspinous gap. He has a moderate contusion in the occipital area. He has paralysis to both legs and paraesthesia and paresis in both arms and hands. Chest and abdomen are clear, breathing is diaphragmatic. He’s bradycardic at 55 and I’m concerned about hypothermia. This ground is frozen solid and it’s been nearly ten minutes since the accident.’
Felicity watched as Stanley nodded to show he had absorbed the information. She was impressed at Joe’s professional summary of their patient’s condition, but she was even more impressed at his attitude towards Stanley. Assuming he now had assistance of medical merit, Joe was treating the paramedic as a colleague and an intelligent one at that.
‘We need some blankets,’ Joe continued. ‘A foil sheet if you have one. Jeff will be poikilothermic with a spinal injury.’
Felicity’s raised eyebrow mirrored Stanley’s expression. Perhaps Joe wasn’t treating Stanley as a colleague after all. Did the paramedic know that poikilothermic meant that a body would assume the temperature of the environment? Maybe Joe was deliberately using terms even medical staff might not recognise easily in order to show superiority and demonstrate his command of the situation.
‘We need to get him off the ground as quickly as possible,’ Joe continued. ‘Do you carry backboards or scoop stretchers?’
‘Both.’ Stanley’s glance at Jeff’s position made him notice Felicity for the first time. His eyes widened dramatically. Felicity’s smile was intended to indicate that this wasn’t the moment for Stanley to be distracted by her presence, and the paramedic took the hint with his customary astuteness. ‘A scoop stretcher will let us pick him up with minimal disruption but they are cold. If we log-roll him onto a backboard it would also give you the chance to check his lower back.’
‘What’s going to be quicker?’
‘Probably the scoop.’
‘We’ll do that, then.’ Joe watched as Stanley and his partner, Ray, introduced themselves to Jeff and explained what they were about to do. They moved the sandbags and eased a cervical collar into place.
‘Grab a towel,’ Stanley directed Ray. ‘We want that under his head to maintain neutral alignment. You can get the scoop out as well. I’ll take some vitals while you set it up.’
Stanley wrapped a blood-pressure cuff around Jeff’s arm. Ray brought the metal scoop stretcher from the back of the ambulance. When Joe moved to take over unfolding and setting out the stretcher, Stanley caught Felicity’s gaze.
‘Does he have any idea who you are?’
‘No.’ Felicity couldn’t help a quick grin. ‘I haven’t exactly had the opportunity to introduce myself.’
‘Hmm.’ Stanley’s noncommittal grunt acknowledged the level of authority Joe had assumed. ‘At least he seems to know what he’s talking about.’
Felicity nodded. She rubbed her hands together. They were cold and stiff after the long minutes of stabilising Jeff’s head and neck. ‘I think I’ll leave you guys to it,’ she told Stanley. ‘I’m late for a meeting and I’m sure Mr Petersen can give you any medical assistance you need.’
Stanley was taking some IV supplies from his kit. He had the line in Jeff’s hand within seconds. Joe frowned as he noticed the action that had been taken without his direction. He laid down the half of the scoop stretcher he was carrying.
‘Blood pressure’s 85 over 60,’ Stanley told him. ‘I won’t run any IV fluids unless the systolic drops below 80.’
Joe nodded and Felicity could sense his satisfaction. The low blood pressure with a spinal injury was likely to be due to vasodilation below the level of injury rather than blood loss. As long as the systolic blood pressure remained above renal filtration pressure of 80 mm mercury it was not advisable to give extra IV fluids, which could cause complications from over-hydration.
Joe was eyeing the drug supplies in Stanley’s kit. ‘Are you able to give a loading dose of methyl prednisolone?’
‘No.’ Stanley shook his head. ‘That’s not in our procedures.’
‘We do it in some parts of the States.’ Joe frowned again. ‘Have you got a specialist spinal unit we can transfer him to directly?’
‘We go through the emergency department at the main hospital. It’s only five minutes away. They’ll stabilise him and then transfer. It takes nearly an hour for a slow transport of an acute case to the spinal unit.’ Stanley’s glance at Felicity suggested that it was time she introduced herself but Felicity was quite happy with the management of their patient.
‘I’d better go,’ she announced. ‘Unless I can help in some other way?’
‘No, of course not.’ Joe looked vaguely surprised at the offer. ‘We’ve got plenty of extra hands here. Thanks for your help.’
‘My pleasure.’ Felicity threw a glance over her shoulder as she walked back towards her car. The blades of the scoop stretcher had been eased, one side at a time, beneath Jeff. The halves had been clicked into place and Jeff was now being strapped into position. The scene had been well managed and any injury Jeff had sustained had been in no way exacerbated. No doubt she would see the young fall victim later on in the emergency department. He would probably still be accompanied by the neurosurgeon, who seemed determined to take complete control of his management.
Felicity shook her head as she joined the line of traffic again. Maybe she should have asserted herself and let him know that she wasn’t simply a useful pair of extra hands. It had been a little immature to take offence at the suggestion that she didn’t know what she was doing. It wasn’t as if he could have had any idea she was remotely qualified to act as a colleague, but his attitude had rankled. She had worked long and hard to get where she was now. His dismissal of her, based presumably on what she looked like, had got right up her nose. She was regretting the decision to stay anonymous now, however. It would have been more interesting to have had a professional discussion. She’d like to know where in the States they were doing methyl prednisolone protocols in the field and whether it had been going on long enough to have results on any improvement in long-term outcome. The lights changed and Felicity moved off with a sigh. It was too late now. Best she forget about the whole encounter.
The intention to forget wasn’t easily acted upon. The encounter had left an impression that lasted well past the meeting with the cardiology department. It was still ready to jump into prominence later that morning when Felicity noticed Stanley and Ray handing over another patient to the sorting nurse. She waited until they had transferred their patient to a bed.
‘You guys did a good job with that spinal patient this morning.’
‘Thanks,’ Stanley responded warmly. ‘It was a surprise to see you there, Fliss.’
‘I was just passing. I became rapidly redundant.’ Felicity’s smile gave no hint of her persistent dissatisfaction with the incident. ‘How did the transport go? Did Mr Petersen go with you?’
‘No, thank goodness.’ Stanley grinned. ‘He probably would have complained about every bump on the road. He was a bit over the top, wasn’t he?’
‘He knew what he was doing. I think he was just determined to manage things as well as possible.’ Felicity was surprised to find herself defending Joe, but it would have been unprofessional to complain about another doctor to Stanley despite their long association and Felicity’s appreciation of the paramedic’s level of skill. ‘Jeff was lucky to have someone that experienced on the scene. I imagine that Mr Petersen is only visiting. It sounded as though he’s come from the States.’
‘He’s been in the States but he’s just moved back to New Zealand.’ Stanley fished in his pocket and extracted a slip of paper. ‘He gave me his phone number. He said he’d like to hear some follow-up if I had the chance.’
‘Oh.’ Felicity dismissed the errant thought that she could do the follow-up and contact Joe herself. Why on earth would she want to do that?
‘He’s looking for a job,’ Stanley told her. ‘We had a quick chat while he was giving me his number. Apparently he’s just finished some postgraduate specialist training and he’s come back here for family reasons. He’s hoping to get a position here or at the spinal unit.’
‘Unusual to move countries without a position to go to,’ Felicity observed. ‘Rather a big risk, especially for a consultant. Did he say what the family reasons were?’
‘No. But they must have been compelling. He was dead keen to get away as soon as we’d loaded Jeff. Said he didn’t want to let his daughter down.’ Stanley’s pager sounded at the same instant that Felicity’s beeper went off. They both grinned.
‘No rest for the wicked. See you later, Fliss.’
‘No doubt. Bye, Stan.’ Felicity moved towards the telephone on the sorting desk. This morning’s incident had simply been an interesting and somewhat different start to the day. Now it was time to get on with the many and varied challenges the emergency department could throw at her. She was bound to see Stan again in the near future. She was not likely, however, to see Joe Petersen again, and that was fine. It might have been satisfying to tell him who she was, but if she’d wanted to see him again she could have offered to take that phone number from Stan and use the excuse of a patient follow-up as a reason for contact. The choice had been there and it hadn’t been difficult to make. She had no desire to renew her acquaintance with Joe Petersen. The incident and the man were history.
In fact, she would probably have trouble recognising him if she did see him again.
CHAPTER TWO
THE recognition was instantaneous.
Felicity spotted Joe in the emergency department from as far away as it was possible to get. She was entering the double doors that led from the end of the corridor dividing the department into the main area of Queen Mary Hospital. Joe was standing beside the bed in cubicle 3. On top of the bed sat a small girl with curly red hair. Even from that distance Felicity could recognise a struggle to keep on top of the fear, confusion and probably pain the child was experiencing.
The characteristic decisiveness in Felicity’s forward movement took her swiftly towards the sorting desk.
‘Who’s in cubicle 3, Mike?’
The nurse manager had been talking to senior consultant Gareth Harvey as he was entering information into a computer program. ‘Samantha Petersen. Four years old. Query greenstick fracture of the left radius.’
Felicity nodded. Joe Petersen’s daughter, then. Part of the family whose circumstances had somehow brought Joe to Christchurch. ‘Did she come in by ambulance?’
‘No. Her father brought her in a couple of minutes ago. He’s some sort of medic, apparently.’ Mike raised an eyebrow as he glanced up from the computer screen, clearly puzzled by the interest shown by a consultant in such a minor case.
‘Do you know him?’ Gareth also looked curious.
‘We’ve met.’ Felicity’s gaze flicked to the whiteboard. The spaces beside cubicle 3 had yet to be filled in.
Mike had followed her line of query. ‘I’m giving her to Mary. Colin White can see her later.’
Felicity’s gaze shifted again. The nurse, Mary, was pushing an IV trolley out of cubicle 6 so she hadn’t caught up on her new case assignment. She knew that Colin, one of the registrars, was still busy in the observation ward she had just come from herself. Nobody had attended to the Petersens yet.
‘I’ll deal with it, Mike. I’ve got a clear space unless there’s something urgent on the way.’
‘Nothing major. Possible infarct coming from out of town but they’re twenty minutes or so away yet.’
‘OK.’ Felicity’s nod was brisk. ‘This shouldn’t take long.’ She was already moving towards cubicle 3. It might not take very long but, boy, was she going to enjoy it! She pulled the curtain closed around the cubicle to create a more private examination area.
‘Hi, there, sweetheart.’ Felicity smiled at the child whose right arm was clutching a soft toy that looked like some kind of floppy dog. ‘What’s your name?’
Small lips pressed together tightly but the movement was not enough to stop a noticeable chin wobble. Large, frightened brown eyes were fixed on Felicity.
‘Tell the nurse your name, Samantha.’ The order was given in a kindly voice but the only effect was to make the child’s eyes swim with tears.
Felicity flicked Joe a brief glance. Nurse indeed. This was going to be even better than she had anticipated. She smiled at Joe’s daughter again.
‘My name’s Fliss,’ she told the child. ‘Do you go to school, Samantha?’
‘She’s not old enough for school. She goes to kindergarten.’ Joe’s tone was wary. Felicity knew he had recognised her now. His brain was ticking over, probably remembering their encounter with the spinal injury patient. Maybe he was wondering if he might have insulted her by not knowing she was a nurse. Nurse, ha! Felicity bit back a tiny smile. Joe would keep for the moment.
‘Do they call you Samantha at kindy, sweetheart?’
This time Felicity was rewarded with an almost imperceptible head shake.
‘What do they call you? Sam? Sammie?’
The slight movement changed to an affirmative direction. Felicity mirrored the nod as she perched casually on the bed beside the small girl.
‘Which do you like better? Sam or Sammie?’
‘Sam.’ The response was a whisper.
Felicity lowered her own voice to a similarly conspiratorial level. ‘Can I call you Sam?’
‘OK.’
‘Cool.’ Felicity winked at Samantha. ‘I’ll call you Sam and you can call me Fliss. Is that a deal?’
The smile was worth winning. It brightened up a pale little face which was dusted with freckles that matched the luxurious reddish blonde curls. Felicity’s visual impression had included more than the skin colour of her patient, however. She had, by now, assessed the level of the child’s responsiveness and distress, noted her respiration rate and seen the slight but obvious deformity of the left forearm that lay limply on the child’s lap. The right arm still clutched the tattered toy dog.
‘How did you hurt your arm, Sam?’
‘I...I fell out of the swing.’ The child’s glance towards her father made Felicity blink. Was Samantha afraid of giving the wrong answer? Was she afraid of her father? The continuation of the hesitant response raised Felicity’s suspicions another notch.
‘I...I didn’t hang on tight enough.’ A huge tear escaped and rolled down a freckled cheek.
‘It was an accident.’ Was Joe Petersen annoyed with the child or the inconvenience of a trip to the emergency department? Whatever the reason, the tone was inappropriate and not the normal interaction between a parent and child in such a situation. Felicity had already noted the lack of physical contact between the pair. What was going on here?
‘It doesn’t matter how it happened,’ she told Samantha gently. ‘What matters is that we fix up your arm. Does it hurt at the moment?’
Samantha nodded.
‘Did you hit your head when you fell out of the swing?’
‘She wasn’t KO’d,’ Joe said.
Felicity ignored him. ‘Does anything else hurt you, Sam?’
‘No.’ Again Joe answered on behalf of his daughter.
Felicity drew in a deep breath. She spoke calmly. ‘I think Samantha might be better qualified to answer that question than you, Mr Petersen.’
The muscular twitch in the man’s face gave away the incredulity his tone managed to conceal. ‘I believe my daughter has a greenstick fracture of the left radius. Perhaps you could do whatever baseline measurements your protocols dictate and then find a doctor who can authorise the necessary pain relief and treatment this injury requires.’
Felicity met the stare with equal directness. ‘I am a doctor, as a matter of fact. I’m one of the consultants in this emergency department.’ She allowed only a moment to let the implications sink in before adding a punchline she couldn’t quite resist. ‘And don’t worry, Mr Petersen. I may not be a neurosurgeon but I do know what I’m doing.’
She turned back to Samantha, satisfied that the stunned and distinctly discomfited expression on Joe’s face would take some time to dissipate.
‘I know your arm is sore, sweetheart, but I want you to try and wiggle your fingers for me. Can you do that?’
The movement produced was tentative but reassuring. ‘Good girl, Sam. That’s fantastic. Now, I’m going to hold your hand—just gently. Can you feel me touching your fingers?’ Felicity noted the temperature and colour of Samantha’s hand as she responded affirmatively. ‘OK, see if you can squeeze my fingers.’
Felicity compared the responses with Samantha’s uninjured limb. She could still feel Joe’s stare. She checked the radial pulses on both wrists before glancing up. ‘No neurological or circulatory deficit. That’s good.’
‘Why didn’t you tell me before?’
‘I hadn’t done the necessary examination.’ Felicity gave in to the temptation to be deliberately obtuse.
‘I meant, why didn’t you tell me that you were a doctor?’
‘I’ve only been in here a few minutes.’
‘I’m not talking about now. I’m talking about last week.’ Joe Petersen’s tone suggested he was unamused by this verbal sparring.
Felicity shrugged as though it was a matter of little importance. ‘I don’t remember having the opportunity,’ she said thoughtfully. ‘You had the situation well controlled—and, anyway,’ she added mischievously, ‘stabilising the head and neck of a spinal injury patient is a pretty useful thing to do.’ She turned back to Samantha.
‘We’re going to get a special picture taken of your arm,’ she told the child. ‘An X-ray. It looks at the inside of your arm. Do you know what there is inside there?’
Samantha shook her head. The fearful look returned to the large, brown eyes.
‘It’s nothing to worry about,’ Felicity reassured her. ‘An X-ray doesn’t hurt. It’s just a special camera that can see what we can’t see. Bones. They’re the hard bits inside your arms and legs.’ She was debating whether the trauma of inserting an IV line to give some narcotic pain relief was justified, given how easily Samantha could be distracted from her injury. She still looked ready to cry again so Felicity decided to test the distraction level once more.
‘Does your dog have a name?’
‘Snowy.’ The firm response came from Joe.
Felicity saw the expression on Samantha’s face and sighed inwardly. The little girl might be distracted from the pain but upsetting her wasn’t going to help. Maybe she needed to push a little harder and find out what was going on in this relationship. The vibes she was getting were making her distinctly uneasy now.
‘He looks pretty special,’ she told Samantha quietly. ‘Is his name really Snowy?’
Samantha shook her head slowly and dislodged another tear. Then another. ‘His name’s not Snowy,’ she sobbed. ‘His name is Woof Woof Snowball.’
Felicity bit her lip. Her peripheral vision caught the wince on Joe’s face and it was extremely hard not to laugh aloud. The neurosurgeon was acutely embarrassed by the childish name for the toy.
‘‘‘Woof Woof Snowball’’,’ Felicity repeated with some relish. ‘That’s a great name.’ She peered more closely at the toy. ‘He’s a rather grubby snowball right now, though. Did he fall out of the swing, too?’
Samantha nodded.
‘Did he hurt himself, do you think?’
The head shook this time. The tears were gone again and Samantha tried to smile. ‘I think he just got dirty.’
‘Maybe he needs a bath.’
‘I’m not allowed to have squashy toys in the bath. Mum says they take too long to dry.’
‘Ah.’ Felicity digested the information offhandedly as she began to record her medical observations on Samantha’s chart. So there was a mother. Joe’s wife, presumably. Maybe there were brothers and sisters as well. A whole family, in fact, including some cute, fluffy dog. ‘Have you got a real dog at home, too, Sam?’
‘No. Mum doesn’t like dogs.’
‘Oh.’ Felicity continued her rapid note-taking. ‘Does Daddy like dogs?’
‘I don’t know.’
Felicity’s glance was too automatic and too quick to hide her astonishment. How could Samantha not know whether her father liked dogs? Joe was frowning.
‘Of course I like dogs, Sam.’
Felicity tried to dismiss the notions that flitted through her head as she charted some oral analgesics for Samantha and filled in a requisition form for an X-ray. She needed a bit of time to think about this one. Standing up, she smiled brightly at Samantha.
‘I like dogs, too,’ she told her. ‘In fact, I’ve got a real dog. He’s an Irish setter called Rusty.’ Her smile widened. ‘Maybe I should have called him ‘‘Woof Woof Rusty’’.’
Samantha giggled. It was a delightful chortle that prompted Felicity to reach out and gently ruffle the child’s curls. ‘Rusty is a lovely dark auburn colour,’ she continued. ‘But he has long hair on his tail which is much lighter. On the ends it’s exactly the same colour as your hair.’
Samantha looked delighted with the information. ‘Sometimes Daddy calls me Nas—Nas...’ She struggled with the word. ‘Nastagmus,’ she managed triumphantly. ‘He says that’s what my hair reminds him of.’
‘Really?’ A nystagmus was a word used to refer to an abnormal and rapid type of involuntary eye movement. She caught Joe’s gaze and a lopsided smile appeared on his face.
‘She means ‘‘nasturtium’’.’
‘Oh!’ Felicity grinned. She loved the amusing verbal errors children often made, though she was usually careful not to show her amusement in front of them. It was difficult to hide her delight at present, however, and Felicity knew quite well that Samantha’s mistake had only provided part of the pleasure she was experiencing.
That lopsided twist of his lips was the first time she had seen anything like a smile on Joe’s face, and its effect was dramatic. His features softened and crinkles appeared around his eyes. The dark brown eyes were exactly the same colour as Samantha’s. In fact, Samantha looked very much like her father, and while their relationship was oddly formal for a parent and child there was really no doubt about their genetic bond.
Maybe there wasn’t anything too odd about their interaction either. Samantha’s face lit up at the sight of her father’s smile and the look that passed between the pair suggested a genuine closeness. Warmth, even. Felicity had the fleeting and rather disturbing thought that she would like just such a look directed at her from this man.
She excused herself hurriedly. She had no time to ponder the intricacies of this particular family’s relationships with each other and she certainly didn’t want to be distracted by any peculiar reactions to Joe. There were other patients waiting to be seen.
The potential heart-attack patient from out of town had arrived in the department. Felicity accompanied the man during his rapid transfer to a resus area. Geoffrey Pinnington was a forty-year-old farmer from a rural area well north of the city.
‘I’d been feeling a few niggles all morning,’ he told Felicity in response to her first query. ‘I thought I must have pulled a muscle, heaving hay bales around. I’d just finished my lunch when I started feeling really terrible. I went all sweaty and lost my lunch and this awful pain started up.’
‘Where was the pain?’
‘Right here.’ Geoffrey slapped a hand on the centre of his chest. The nurse attending to the 12-lead ECG hastily reattached a dislodged electrode.
‘Try and keep still for a moment, please, Mr Pinnington,’ the nurse requested.
‘Was the pain just in the one spot?’ Felicity asked.
‘No. It went into my neck and then all the way down my left arm.’
‘Given a scale of zero to ten, with zero being no pain and ten being the worst you could imagine, what score would you have given it?’
‘Twelve.’ Geoffrey smiled wryly. ‘I’ve never felt so bad in my life. I really thought I was about to die.’
Felicity nodded sympathetically. A feeling of impending doom was a common symptom of a heart attack. ‘What time did the pain come on?’
‘One o’clock or thereabouts. Maybe a quarter past.’
‘OK.’ Felicity glanced at her watch. Nearly three hours ago. They were still well within the therapeutic window for an angioplasty procedure which could abort the damage being caused by the lack of coronary blood flow.
‘Give Cardiology a call,’ she directed the registrar beside her. Felicity picked up the ECG trace and scanned it rapidly. The changes were abnormal and clear-cut. ‘Tell them we have a probable anterior infarct in progress here.’ She turned to the junior doctor who was drawing blood from the IV line already in Geoffrey’s arm. ‘We need cardiac enzymes, CBC, electrolytes and lipids done, Sarah.’ Her attention returned to her patient. ‘How’s the pain at the moment?’
‘Not too bad. The stuff the GP gave me was good.’
Felicity nodded. She’d read the ambulance patient report form as she’d walked into the resuscitation area. After a half-hour drive to the local doctor, Geoffrey had been given treatment consisting of oxygen, pain relief, an anti-nausea agent, aspirin and GTN. The GP had then called for an ambulance for urgent transfer to hospital. All the right things had been done and the GP’s note included baseline measurements and a brief medical history that didn’t indicate any risk factors for heart disease. But Felicity wanted to double-check.
‘So you’ve never had any problems with your heart before this, Geoffrey?’
‘No.’
‘No other medical conditions you’re treated for?’
‘No, nothing.’
‘Blood pressure’s always been OK?’
‘As far as I know.’
‘Have you ever had your cholesterol levels checked?’
Geoffrey nodded. ‘Always been fine. I’m fit and healthy, Doctor, and I’m far too young to be having a heart attack, aren’t I?’
‘Unfortunately there are always exceptions to the general rules. Is there any history of heart disease in your family?’
‘My dad gets chest pain sometimes, I reckon. He’s one of the old school and wouldn’t admit to it, but I’ve seen him rubbing his chest and looking a bit grey sometimes.’
‘Do you smoke?’
‘Used to. I knocked it on the head a couple of years ago.’
‘Good for you.’ Felicity had enough information to transfer this patient directly to Cardiology. Baseline measurements and recordings had all been completed by the team in the resus area. When the curtain was drawn back behind her she expected the new arrival to be the cardiology registrar. Instead, it was a woman with two young children beside her.
‘Sorry, Geoff. I couldn’t drive as fast as the ambulance. How are you feeling?’
‘Not too bad, love. Don’t worry.’ Geoffrey smiled at his wife. He winked at his son who was about ten years old but the boy was staring, wide-eyed, at the screens of the monitoring equipment. The younger child, a girl, was clutching her mother’s hand, staring at her father and crying quietly.
‘It’s OK, chicken,’ Geoffrey said gently. ‘Dad’s going to be just fine.’ He held out the arm that wasn’t encumbered by IV tubing and the girl ducked behind a nurse and rushed into the inviting circle, burying her face against her father’s chest. Mrs Pinnington also moved closer and laid her hand on Geoffrey’s leg. Felicity watched as the family drew themselves into a unit again, preparing to cope with whatever was coming next. She answered the querying look Geoffrey’s wife was directing towards her.
‘It looks as though Geoffrey may be having a heart attack,’ Felicity explained. ‘There’s a cardiologist on the way to see him now and they’ll decide what the best course of treatment will be. You’ve done exactly the right thing in getting Geoffrey to the doctor and into hospital as quickly as possible. That means the treatment has much more chance of being successful and that any damage that is occurring can be minimised.’
The cardiology registrar arrived while Felicity was talking. She took over the management of the patient but Felicity stayed in the resus area, listening and watching, for a few minutes. The registrar assimilated the available information quickly. She explained the mechanics of the life-threatening condition Geoffrey was experiencing and outlined the treatment options. Felicity watched as he listened carefully. His daughter was still tucked within his arm and he was stroking her hair. Blonde, straight hair. Not at all like Samantha Petersen’s.
Given the choice between drug therapy and the more invasive but faster and probably more effective procedure of angioplasty, the Pinningtons had no difficulty making a choice, and the staff prepared to move Geoffrey upstairs to the catheter laboratory. It was time for Felicity to move as well. With no urgent cases awaiting her attention, she collected a cup of cold water and stood observing the department for a minute from her position beside the water dispenser. She wasn’t really registering the activity in the department, however. She was still thinking about Geoffrey and his daughter. Or, more specifically, the interaction between them and the contrast it had presented to the way Joe and Samantha had appeared. That easy affection and physical closeness had been non-existent.
Sometimes the frightening environment of an emergency department made people act differently to what they might have done normally, but Joe was a surgeon. He should have been as much at home here as anywhere, and more capable of reassuring his daughter than most people. On reflection, it was hard to believe that the pair were father and daughter. The atmosphere of awkwardness was more like that of a relative or care-giver being thrown into dealing with an unfortunate and unexpected incident. A care-giver who only had limited contact with children, perhaps.
Felicity crumpled the polystyrene cup and threw it away. Maybe Joe was just a father who couldn’t be bothered and left the upbringing of his children entirely to his wife. Or maybe he had been missing an important appointment because of the accident. What did it matter anyway? It was really none of her business. Instinct had already told her that the unusual atmosphere was highly unlikely to be due to some dysfunctional or abusive relationship that needed further investigation so Felicity was slightly annoyed at her continuing level of interest.
No distractions were immediately available in the department.
‘I’ll be in my office,’ she told Mike. ‘I’ve got some paperwork to catch up on. Beep me if you need me.’
The left turn at the doors into the main part of the hospital took Felicity past the store cupboards, the sluice room and the relatives’ room on her right. The bed coming from the observation ward on the other side of the corridor slowed her decisive walk for only a few moments, but it was long enough to recognise the voices coming from the area set aside for relatives. One of the voices, at least.
* * *
‘For God’s sake, Joe. I just can’t understand how it could have happened!’
Joe had had almost enough. The day had already been a disaster and Dayna was just making things worse.
‘I told you, Dayna. It was an accident. She missed her footing when she jumped off the swing. She fell over. Accidents happen.’
‘I would have thought you could manage a simple trip to the park without some sort of disaster.’ Dayna’s tone was scathing. ‘This is just typical of you, Joe. How bad is it?’
Joe sighed. It was typical. Dayna expected any time he spent with Samantha to cause problems and no matter how hard he tried her expectation always seemed to be justified. Usually it was something minor like stained clothing from a spilled drink or a damaged toy—things that Dayna could have ignored easily enough if she chose to. He had to concede that a broken arm wasn’t something to dismiss lightly.
‘It’s a greenstick fracture.’
‘What on earth is that?’
‘It’s where the bone doesn’t break completely. One side breaks and the other side gets bent. It happens commonly with children.’ Joe frowned. ‘For heaven’s sake, Dayna. It’s exactly what Scott did to his arm a couple of years ago.’
‘He’s a boy.’ Dayna clearly dismissed the reference to her older son’s injury as unimportant. ‘Where is Samantha, Joe? I hope you haven’t left her sitting somewhere by herself.’
‘Of course I haven’t. She has a nurse with her.’
‘Well, I want to see her. Now.’
‘Of course.’ Joe stood back to let his sister-in-law exit the small room first. He followed, edging past the bed being manoeuvred awkwardly in the corridor outside. Another sigh escaped him. Just how much of Dayna’s rather heated conversation had been overheard by Dr Felicity Munroe? And why was she standing there at this particular moment anyway?
Joe led Dayna towards the emergency department. He was still appalled at having discovered Felicity’s qualifications and position. The fleeting memories of things he had said to her on the building site had made him cringe inwardly. Fancy suggesting that a consultant in emergency medicine might not know what she was doing and cause further damage. Or suggesting that if she wanted to be useful she could hold the head still. Of course, she could have told him she was a doctor but Joe had a sneaking suspicion that she had been right in saying she hadn’t been given much of an opportunity. The scene had reminded him too strongly of Catherine’s accident and the ghastly aftermath of a mismanaged spinal injury. He hadn’t been about to allow anyone to interfere with what he knew to be expert leadership.
Joe pulled back the curtain to cubicle 3. If only he hadn’t compounded the error by assuming that Felicity Munroe was a nurse when she’d arrived to look after Samantha. If he hadn’t been so worried about his daughter he might have noticed that she hadn’t been wearing a uniform. He might have taken the trouble to read the identity badge pinned to the waistband of her skirt.
‘Hello, Mum.’ Samantha was smiling. ‘Look at my arm plaster. It’s pink!’
‘Very pretty.’ The nurse beside the bed stepped back as Dayna leaned over to kiss Samantha. ‘Does it hurt a lot, darling?’
‘Not any more. I had some medicine. I’m hungry now.’
Joe smiled at Samantha. She was looking a lot happier. All that he needed now was some more time with her and he could probably wipe out the unpleasant aspects of their outing. ‘Maybe we could go out for a hamburger.’
‘No,’ Dayna said firmly. ‘It’s time to go home.’
Samantha looked disappointed enough to prompt Joe to try again. ‘I could drop Sam home a bit later.’
‘I’ve come into the hospital now, Joe. I’ve left the boys with Nigel and he’s busy at work. We’ve got grocery shopping to do and Scott’s due at his piano lesson at 4:30. I haven’t got time to chop and change arrangements. I’ll take Samantha home with me now.’
Joe gave in. It wasn’t worth the stress of trying to talk Dayna out of a decision. Not this time anyway, when Samantha was probably tired. He watched Dayna help his daughter off the bed.
‘Mum?’
Dayna was folding up Samantha’s cardigan, which had been abandoned on the end of the bed. She didn’t appear to have heard.
‘Mum?’
Joe gritted his teeth at the repetition. Dayna wasn’t Samantha’s mother. She was her aunt. Samantha had started calling her ‘Mum’ because of the example set by Dayna’s two sons. And Dayna certainly hadn’t discouraged her.
‘Mum?’ Samantha was trying again. ‘Can I give Woof Woof Snowball a bath with me tonight? He’s really dirty.’
‘He can go in the washing machine.’ Dayna turned her attention to the nurse who required a signature on the discharge papers. Joe bent down towards his daughter and spoke quietly.
‘When you come and stay with me you can give Woof Woof Snowball a real bath.’
Samantha’s grin at the private suggestion was worth a lot. The one-armed hug was worth even more, despite the obstacle the soft toy presented. It almost restored the pleasure Joe had anticipated from the afternoon’s outing. He could watch Dayna lead Samantha briskly away without the usual heartache. He even found himself smiling. Using that awful name for the toy hadn’t been that difficult at all. Maybe he just needed to relax. He just hadn’t had enough time with his daughter and that wasn’t entirely his fault.
He could learn. Look at how easily Felicity had established such an easy rapport with his child. Instead of being resentful at the way she’d effortlessly gained what he was having such difficulty achieving, he should follow her example. He could be relaxed and confident like that. And friendly. Felicity was obviously a friendly person, good with children, and she clearly knew what she was doing if she was a consultant emergency physician. She looked far too young for the position. She couldn’t be much over thirty, surely?
It seemed, by now, typical that Joe should encounter Felicity as he left the emergency department. This woman had a knack of appearing when least expected. He paused and directed a smile at her.
‘Thanks very much for your help, Dr Munroe.’
‘A pleasure, Mr Petersen.’
The formality was ridiculous. It made them both smile.
‘The name’s Joe.’
‘And mine’s Fliss.’
They both held their hands out simultaneously. The shake was brief but firm. Not so brief that Joe didn’t notice that Felicity wasn’t wearing a wedding ring, however. His mind was turning rapidly. No, she couldn’t be much over thirty and she really was an incredibly attractive woman. Those large hazel eyes were rather difficult to look away from. They weren’t looking as friendly as they had when Samantha had been around but that was hardly surprising.
‘I’d like to apologise,’ he found himself saying hurriedly.
‘What for?’ Felicity’s tone was cool. Disinterested, perhaps?
What for, indeed. There was too much to choose from. Joe had insulted her on more than one occasion already by making erroneous assumptions about her qualifications. He’d also displayed his lack of confident parenting in an embarrassing manner. He should have known better than to answer Samantha’s questions for her. Or upset her about the dog’s name. Felicity probably thought he was an idiot. A rude idiot, at that.
‘Our acquaintance didn’t get off to the best start. I’m sorry I didn’t enlist your expertise at that accident scene.’
‘You didn’t know I had any.’ Felicity dismissed the apology.
‘I wasn’t much of a help with Samantha today either.’
‘It’s often harder to cope with one’s own family than patients.’
‘The thing is, I...’ Joe hesitated. The only hope he had of repairing this woman’s opinion of him would require her to have at least some understanding of the complicated background his actions sprang from. However, any explanation of the reasons for his behaviour on the two occasions they’d met was likely to be time-consuming, and Felicity was looking past Joe’s shoulder at present as though she wanted to escape. ‘I’d just like a chance to explain,’ Joe finished. ‘An opportunity to redeem myself, perhaps.’
‘There’s absolutely no need.’
‘Maybe a coffee?’ Joe couldn’t quite accept the brush-off. He didn’t want to be brushed off. ‘When you have the time, that is.’
‘I don’t think so.’ Felicity’s smile was polite. ‘But thanks for the invitation. Nice meeting you again, Joe.’
Joe watched Felicity walk into the emergency department and kicked himself mentally. Surely he could have handled that a bit better. He had really wanted that coffee. It would have provided the opportunity to spend time with the young consultant and gain more than the initial impression he was being left with. It was an impression he was not going to forget in a hurry. One that he would very much have liked to have built on.
Not that he was going to get the chance. Felicity had spelt that out fairly convincingly. Of course, there was always that appointment Joe had tomorrow. If that interview was successful it was just possible he might get another opportunity to persuade Felicity that he was worth spending some time with. He hadn’t been all that bothered about whether it was going to be successful because he hadn’t been sure it was what he really wanted. Now Joe was quite sure it was what he wanted.
He wanted it rather a lot.
CHAPTER THREE
‘WHAT on earth is taking so long?’
‘I have no idea.’
Felicity frowned at her watch. ‘How long is it since you put in the call for the neurosurgical registrar?’
‘Must be nearly ten minutes.’ Emergency Department Registrar Colin White looked worried. ‘They said he was just finishing a case in Theatre and would be here directly.’
‘Ten minutes is a long way from ‘‘directly’’.’ Felicity’s glance raked the monitor screens surrounding the trauma room bed. ‘I think we’ll just transfer her to CT scanning now. We’ve got two multi-trauma patients from an MVA coming in by helicopter with an ETA of eight minutes. We need to get this room cleared.’
Felicity’s gaze was on the unconscious woman on the bed as the door to the trauma room swung open. She didn’t waver from her visual reassessment and mental review of the patient as the newcomer joined the team at the bedside.
‘Hi. I’m the neurosurgical registrar. Joe Petersen.’
Felicity had never looked up so quickly in her life. For a split second she was totally distracted from the case she was managing. Her patient could have been on another planet. It had been three weeks since Joe had appeared in the emergency department with his daughter. She had forgotten about him...almost. Not only had he stepped back into her world, he was now standing on the other side of a critically ill patient whose care they needed to co-operate over professionally. Felicity snapped the lid closed on her stunned reaction.
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