lord. She needed to get her thoughts under control. Fast. Joel wasn’t free and she didn’t do relationships anyway. And fantasising about the man who was practically her boss would definitely end in tears.
‘Just call me if you need me,’ Joel said.
Down, girl, Lisa scolded her libido silently. She wasn’t going to make a move on Joel Mortimer. Even if he did have the most beautiful eyes in the world and a sensual mouth that made her quiver. ‘Thanks,’ she said, in the most professional tones she could muster, and went to book Sam’s X-ray before she said something really stupid to Joel.
She cleaned all the grit out of Sam’s arm while they were waiting for the slot in Radiology and immobilised his arm in a sling. She asked for two films—one lateral and one antero-posterior, both including the joints and covering the entire radius and ulna so she didn’t miss any problems—and was just checking them against a lightbox when Joel came up beside her. ‘How’s it looking?’
‘Greenstick,’ she said, showing him the section on the X-ray where it was clear that one side of the ulna shaft had bent while the other side had broken. ‘I’m just checking in case there’s an ephiphysal injury. It looks normal, but…’
‘Worried about a Salter-Harris type V?’ Joel asked.
She nodded. With a Salter-Harris Type V injury—also known as a crush injury to the growing plate—the X-ray could look absolutely normal. It was notoriously difficult to diagnose the injury, but it had the greatest risk of causing the growth plates to fuse prematurely so the limb would always be too short.
‘It’s very rare,’ Joel reassured her, his eyes narrowing as he looked at the films. ‘And it’s more common on the distal tibia. It’s much more likely you’d find a Salter-Harris II fracture—’ this was where the epiphysis separated from the bone, with a shape almost like a reverse tick ‘—but it looks as if he’s been lucky.’ He traced the outline of the cortex: a procedure Lisa had been taught to do as a house officer to make sure she didn’t miss a subtle fracture by mistaking it for an ossification centre on the growing bone. ‘Anything else you’d be worried about?’
‘With an ulnar fracture, you need to check for a Monteggia fracture-dislocation,’ she said. If you fell onto your ulna, as Sam had done, you could dislocate the head of the radius, the other main bone of the forearm, and the dislocation needed to be treated as well as the fracture. ‘But there aren’t any signs of it on the X-rays.’
‘Agreed. This looks like a pretty straightforward case. What’s your treatment plan?’ Joel asked.
She didn’t mind the questions, because she knew he was doing his job. She was his junior, he hadn’t worked with her much, and he needed to know how competent she was—how far he could trust her to deal with patients on her own or whether she needed closer supervision. ‘It’s an angulated fracture, so I’ll refer him to the orthopods for manipulation under a general anaesthetic. He’ll have a cast on for a while, and I assume you have fracture clinics here in Paeds so I can get him booked in there for a follow-up.’
‘Yup. Obviously you know what you’re doing and you’re sensible enough to ask if you need help. Carry on just as you are,’ he said with a smile.
‘Cheers.’ Before she could stop herself, she added, ‘Are you coming out with the team for the Chinese meal tonight?’
‘No.’ His voice was noticeably cooler. And he didn’t offer an explanation, she noticed.
Not that she should expect one. He was a colleague—a senior colleague; he was barely an acquaintance, let alone a friend, and he didn’t have to explain himself to her. Really, she shouldn’t even have asked. It was none of her business.
‘Um, I’ll get back to my patient,’ she said, and escaped back into the cubicle to show Sam his X-rays, as promised, and explain to him and his mother what was going to happen next.
Lisa didn’t see Joel to speak to for the rest of the afternoon, and she’d put it out of her mind when she met the others at the local Chinese restaurant that evening.
‘So how are you settling in?’ Nell, the other registrar in their ward, asked Lisa.
‘Fine.’ Lisa smiled back at her. ‘Everyone’s really friendly, and I love my job.’
‘So much that you volunteer for extra duties on your day off,’ Julie said. ‘On the air ambulance.’
Lisa blinked. ‘Blimey. The hospital grapevine here’s pretty fast, isn’t it?’ She hadn’t said anything to anyone in the department, not wanting to sound…well…boastful. Setting herself up either as a heroine or a martyr. That wasn’t where she was coming from at all. She had her own reasons for doing her rescue work—reasons she didn’t want to share. And she enjoyed doing it, too.
Julie chuckled. ‘My boyfriend Marty’s one of the full-time paramedics with the air ambulance. He saw your name on the list and asked me if I knew you. Your first duty’s next week, isn’t it?’
Lisa couldn’t help smiling. ‘Yes. I’m doing two slots a month. I’m really glad they accepted me, because I was on secondment to HEMS in London, and I loved every second of it. Though we could only do a six-month stint so we weren’t over-exposed to trauma.’
‘Rather you than me. I don’t know how you do it.’ Julie shivered. ‘Winching out of a helicopter into thin air…No way would you get me doing that!’
‘It’s fine, once you get used to the idea,’ Lisa said. ‘You’re perfectly safe.You’re clipped into a harness, and when you go up with a stretcher, it’s pretty smooth—you don’t spin around on a rope and you don’t even feel the downdraught from the blades. It’s not like these action movies where you see someone hanging onto a ladder and blowing around madly in the wind.’ She grinned. ‘Oh, and you don’t have all the baddies firing at you or have to dive through plate glass into a skyscraper, run out the other side and leap onto the rope ladder from several hundred feet up feet up.’
Julie laughed. ‘Nope, you still haven’t convinced me. I’d rather keep my feet firmly on the ground in the department!’
‘If you’re working with the air ambulance, you’ll end up doing a rescue with the coastguard team at some point, then,’ Ben, one of the other house officers, said to her.
‘Not necessarily. You know as well as I do most of the work of the air ambulance is with RTCs or falls,’ Julie said.
Not surprising, Lisa thought. Road traffic collisions, falls and suspected heart attacks were the most common reason for callouts in all the air ambulance services, usually in cases where it would take too long for a land ambulance to get through or the access to an accident site was poor.
‘But Ben’s right, we do get a few rescues on the cliffs and sea rescues. Joel’ll introduce you to the coastguard team, if you ask him,’ Nell suggested.
Lisa remembered what Joel had told her earlier. ‘It’s a bit unusual, a doctor being a volunteer coastguard.’
‘It probably makes him feel he’s giving something back,’ Ben said quietly.
Lisa frowned. ‘I’m not with you.’
‘His wife died in an accident on the cliffs,’ Nell explained.
It took a moment for it to sink in.
Joel wasn’t committed elsewhere.
But he was so young to be a widower—he couldn’t be more than in his early thirties. Obviously with his work on the coastguard team he was trying to make sure someone else didn’t have to suffer the same kind of loss—just as she was, with the air ambulance.
Then she became aware that Nell was continuing. ‘That’s why he doesn’t work nights or weekends.’
‘Sorry, Nell. I didn’t catch what you said. Joel doesn’t do nights or weekends?’ Lisa prompted.
‘Childminders