him because his jaw is broken.’
‘Let me see what I can do.’
He made as though he would move her to one side but she resisted, saying quietly, ‘No, thank you. I believe I’ll manage.’ She gave him a determined blue stare. She couldn’t imagine why he thought he would know any better than she did about what needed to be done. ‘I’m going to improvise an airway. There’s no way he can be intubated in the usual way, even if there was any time to wait.’
He frowned, his eyes narrowing, as Jessica leaned over to hand her a plastic straw and then placed the first-aid kit down on the ground beside her.
Jessica’s jaw dropped as Katie opened up the box and took out a small sharp knife. ‘What are you going to do?’ she asked breathlessly.
‘I’m going to make a small incision in his throat and put the straw in place so that he can get air into his lungs.’ She looked up at her sister. ‘Perhaps you should turn away for a while. You might not want to see this.’
Jessica swallowed hard but steadfastly continued to watch what was going on. Beside her, Katie felt the man stiffen.
She sent him a quick glance. ‘Maybe you should look away, too,’ she said. The last thing she needed was for him to pass out through squeamishness. Anyway, it was unsettling, having him watch her every movement.
He shook his head. ‘Do you know what you’re doing?’ His whole body was poised as though he was ready to intervene at any second. Katie could feel the warmth emanating from him, almost as though he was touching her, and her skin began to tingle in response.
‘Yes, it’s all right.’ Her voice was husky and she cleared her throat. ‘I’m a doctor.’ As she spoke, she was already feeling for the thyroid cartilage, and within seconds she began to make the incision. Once she had established that she had managed to puncture the cricothyroid membrane she opened up the fissure with a finger and inserted the drinking straw a little way into the trachea. Breathing into the tube, she was relieved to see that the man’s chest began to rise.
‘Is he going to be all right?’ Jessica’s eyes were wide.
‘I hope so. I think he has some broken ribs, and there may be a skull fracture, but at least he’s breathing now, and we’ve managed to buy some time for him. We can’t do much more until the paramedics get here with proper equipment.’
She eased back a fraction and saw that Alex was checking the man’s pulse. ‘There’s a strong possibility he’ll go into shock,’ he said. ‘We don’t know for sure how long he might have been lying here. His heart rate is rapid, but the pulse is weak, and I suspect his blood pressure is way down. He must be bleeding internally.’ He was already getting to his feet. ‘I’ll go and get my medical bag from the car. We can at least put in an IV line and try to get some initial fluids into him.’
Katie stared up at him. ‘You’re a doctor?’
He nodded briefly, but he was already moving away from her, and after a moment Katie released a long breath. She hadn’t realised how keyed up she had been, having him so close beside her that his shoulder had almost brushed against hers. It had been like being surrounded by an electric force field strong enough to make the air crackle.
She blinked. So he was a doctor, too? No wonder he had tried to intervene. She tried to absorb this new revelation and at the same time keep a check on her patient. Alex seemed to think they had met before, but surely she would have remembered him if they had been at medical school together? After all, he wasn’t the kind of man you would easily forget. He was incredibly good-looking, with strong features and grey-blue eyes that seemed to penetrate deep into her soul. Just being around him had the power to stop her in her tracks.
He came back as she was taping the makeshift breathing tube securely in place. He sank down next to her on the grass and opened up his black leather case, but this time she was prepared, and with an effort she managed to keep her pulse rate under control.
‘I don’t carry a lot with me,’ he said in an undertone, ‘but I have some lactated Ringer’s solution, which will help until we can get him to hospital. They talk about the golden hour, but we’re fast losing ground there.’
Jessica was puzzled. ‘What’s the golden hour?’
Alex was attempting to find a vein, and Katie realised that it was going to be difficult if the man’s circulation was shutting down.
‘It’s the maximum time lapse from when the trauma happened to arrival at hospital, if the patient is to stand a good chance of survival.’ He slid the needle into place. ‘I’m in.’ Quickly he set up the IV line and hooked up the Ringer’s solution, using an overhead branch to keep the bag above the level of the patient.
‘At least…’ Jessica’s voice broke, becoming thready. ‘At least he has you and Katie to look after him.’
Alex gave her a brief smile, and perhaps he realised that she was very young and vulnerable because he said softly, ‘We’re doing everything we can for him.’
Jessica nodded, and watched as Alex drew up a syringe. ‘What’s that you’re giving him?’
‘It’s an antibiotic. We haven’t been able to use sterile equipment out here, so this should help to ward off any infection.’ He sent her a thoughtful glance. ‘You seem very keen to know what’s going on. Are you thinking of going into medicine like your sister? I suppose she must be a great influence in your life, working as a doctor?’
Jessica gave an awkward shrug. ‘I’m not sure what I want to do. I used to go and see Katie sometimes when she worked in A and E and she explained some of it to me, but she doesn’t work there now, and I’m not sure I’d be able to do that kind of job. I know Katie gave it up. She doesn’t work as a doctor any more, and I don’t know if I’m cut out for it either.’
Alex turned his gaze on Katie, his brows meeting in a dark line. ‘Is that true? You’re not working in medicine now?’
Katie nodded. ‘It isn’t easy to find placements these days, as you probably know. Anyway I wanted a change, so I found myself a job in a rehabilitation centre. It was good. I enjoyed working there.’ She grimaced wryly. ‘Unfortunately, the place closed down this afternoon, so it looks as though I’ll be looking through the situations vacant columns for something else first thing tomorrow.’
He opened his mouth as though to say something, but in the distance a siren sounded, growing nearer. They both checked their patient, relieved to find that his condition was reasonably stable for the moment. Alex began to gather up the equipment they had used, closing his medical bag and handing the first-aid kit to Jessica as the ambulance arrived.
The paramedics oversaw the patient’s transfer to the waiting ambulance, and Alex gave the team a rundown of the man’s injuries. ‘We’ll need to get a CT scan and move him to Theatre as soon as possible,’ he said. ‘I’ll follow you to the hospital and help with the handover to A and E. Martin’s on duty today, isn’t he?’
The paramedic nodded. ‘We’ll get in touch with him and tell him to stand by.’
‘Good.’ He stood back and waited while the men made sure their patient was securely strapped in place in the vehicle. Turning to Katie, he said, ‘There’s a place for you on my team if you want it. I’m in charge of the A and E department at South Lake Hospital. I’ve been advertising for a senior house officer for a few weeks now, and so far I haven’t managed to fill the position. None of the candidates have been right for the job. If you drop by the department some time tomorrow, we could go through the application forms together.’
Was he actually offering her a job? Katie’s mouth dropped open, but she quickly attempted to recover herself. ‘I don’t think so,’ she murmured. ‘I mean…thanks all the same, but I think I’ll take some time and look around.’
He was frowning again. ‘I don’t understand why you’re hesitating. Didn’t you say that you were out of work and