‘Patrick, you take the injured female with lacerations on her face in Theatre One and the status 3 patient will go into the big theatre.’
‘I’ll take the status 3 patient,’ said Dr Vernon. ‘Bob—you come with me.’
‘That’s three patients for urgent X-rays. John Cooper can take the suspect broken leg with Tilly. Max—make sure we’ve got enough oxygen cylinders and dripstands in that big theatre. Jandy, can you be on hand to help where necessary?’
Jandy felt the familiar ripple of adrenalin kicking through her body as they waited for the ambulances to arrive. It was peculiar to Casualty—that tremor of excitement mixed with apprehension in dealing with absolutely any injury or illness thrown at them, and often time was not on their side. Split-second decisions had to be made and the staff in the department were the first line of defence.
Tilly nibbled at her nails nervously. ‘It’s nerveracking, not knowing what you’ll get. I hate these horrible accidents. I’m frightened I’ll faint or something.’
Jandy placed a reassuring hand on Tilly’s arm—the young nurse had only been in the department a few weeks and it was a very fast learning curve for all the students.
‘It’s always a bit scary—knowing that how we deal with patients here can determine the outcome of their eventual recovery. And every case is different,’ she admitted. ‘But once we’re in the thick of it, there’s no time to think. You put everything else out of your head.’
Patrick stood near the door, looking down the drive where the ambulances would come from. He turned and smiled at the young nurse. ‘But this is what it’s all about, isn’t it? Being able to turn your hand to anything. In the end it becomes instinctive. It’s exciting!’
He grinned at Jandy, eyes dancing with anticipation, confidently looking forward to the challenge of the unknown. Everyone’s idea of the perfect doctor, she thought wryly, his hospital greens seeming to emphasise his athletic physique. She was uneasily aware that she was just a little too conscious of Patrick’s attraction and that devastating easy smile of his, but he was just an ordinary married guy, wasn’t he? Not her type at all. She bit her lip. This man was getting too much under her skin.
She glanced at Bob Thoms—what a contrast! His brow was furrowed with anxiety as usual. He was a good doctor, painstaking and thorough, but always racked by worries that his best might not be good enough—what a pity she couldn’t find someone like him attractive. Bob was free and single with no hint of arrogance or over-confidence about him—but incredibly dull!
She forced herself to concentrate on the moment, to push out of her mind the distracting fact that Patrick was standing close to her. Then the flashing blue lights of the ambulances appeared as they came up the drive, and gradually the whine of the sirens died down as they reached the entrance. In a few minutes the doors swished open and three trolleys were being pushed through into the wide passage. A plump woman clutching a large handbag was running beside one of the trolleys, tears streaming down her face. Jandy took her arm gently but firmly and steered her to the side of the passage.
‘Come with me for a minute,’ she said gently. ‘Just let the doctors see to the patient…Are you a relative?’
‘I’m her mother…Mrs Thorpe…’ The woman clung to Jandy hysterically, hiccuping sobs shaking her, as the shock of the incident she’d just witnessed set in. ‘She…she’s having a baby. Please help her. She mustn’t lose this one—she’s had two miscarriages already.’
‘Come with me to the desk and let’s take her details. First, what’s her name?’
‘Brenda Evans…she’s twenty-five. She’s been longing for this baby…’
Mrs Thorpe’s voice started to rise in panic again and Jandy quickly said, ‘Tell me what happened…take it slowly.’
Gradually the woman started to calm down, and in the telling of the story her mind was forced to concentrate on something other than what was now happening to her daughter.
‘This motorbike…it came towards us with no warning. It was going that fast. I saw it coming, and I screamed to Brenda, but it hit her and sent her sprawling on the ground.’ Mrs Thorpe paused for a second to control her tears. ‘Will…will she lose the baby?’
With the skill born of much practice in calming worried relatives, Jandy led her to a chair and said comfortingly, ‘She’s in very good hands, Mrs Thorpe, and I know they will be monitoring her very closely—especially now they know her medical history. I’m going to get you a cup of tea and then I’ll go and find out just what’s happening to her. You try and calm down—she’ll need you to look after her when she goes home.’
A paramedic was wheeling Mrs Thorpe’s daughter briskly into one of the small theatres. ‘This is Brenda Evans,’ he said. ‘She’s in a lot of pain, but superficially at least she only seems to have lacerations. BP 100 over 70, pulse 120. Reasonably stable. She’s also seven and a half months pregnant.’
‘What happened?’ asked Patrick, bending over the supine figure on the trolley.
‘It looks like a motorcycle tried to take a corner at speed and hit this lady a glancing blow—she fell forward onto her face.’
Jandy had come into the cubicle to see what was happening so that she could update the patient’s mother on the latest information. She was watching the girl’s face—there was a large graze on her chin, covered with grit.
‘She’s very pale…’ she murmured to Patrick. ‘Obviously she’s in shock, but she’s blinking her eyes all the time. What’s causing that?’
He frowned and looked at Brenda’s face closely. ‘Rapid blinking is often a sign of a sharp pain. I wonder…Can you speak, Brenda?’
Brenda grimaced and mumbled something through stiff lips.
‘I reckon it’s something to do with her jaw—see how stiffly she’s holding it,’ Patrick said. ‘Moving it seems to cause her extreme discomfort.’
He ran his hands lightly over her face, watching her reactions carefully. Brenda sucked in her breath and groaned.
‘I’m sorry, Brenda,’ he said gently. ‘That’s all I’m going to do at the moment. We’ll give you something for the pain, don’t worry. You’ll be all right—just try and relax and don’t do anything that might move your jaw.’
He patted her arm, trying to reassure her and with his calm voice showing her that he was very much in charge. You got to know people’s skills quite quickly when you worked with them in Casualty, reflected Jandy. Patrick had a sure touch with patients, knowing that the familiar platitudes would soothe Brenda. He knew that physical and aural contact with a frightened patient could reduce the effects of shock.
It was one of Karen’s repeated adages to her team: ‘Remember that reassurance is one of the most powerful clinical tools you’ve got.’ When it came to medicine, Dr Sinclair was ticking quite a few boxes so far, admitted Jandy.
‘Can you arrange to have Brenda X-rayed ASAP?’ Patrick asked Jandy.
‘But she’s pregnant,’ she pointed out.
Patrick shook his head. ‘She’s going to need surgery on her jaw, I’m afraid, and we’ve got to know exactly what the damage is. The X-ray won’t be over the baby—fortunately she’s late on in her pregnancy.’
‘Do you think she’s broken her jaw?’
‘The first thing to hit the floor was her chin I reckon—like that!’ Patrick demonstrated this by smacking his fist into his other hand. ‘That’s where the cut is. I’ll bet what’s happened is that the force of the impact has snapped off her left condyle—the part of the bone that forms the hinge of the jaw.’
‘She hit her chin just at the wrong point, then.’
Patrick nodded. ‘Every time she moves her jaw, bone