him all the time, and it could have been any of his boys lying there, all skinny limbs and ribcage with only the pelvic binder left to hold his pelvis stable.
Don’t let him die. Please, God, don’t let him die…
‘OK, let’s cross-match for ten units and get five units of O-neg to start with, and some packed cells, and let’s get some X-rays—a full trauma series, starting with head, spine and pelvis. What about pain relief?’ Ben asked. ‘What’s he had already?’
‘Three milligrams of morphine IV, but his blood pressure’s dropping. Want to try—?’
The voices washed around Nick, only two things really registering. One was the bruised little face scarcely visible under the mask, most of Jem’s head concealed by the padding of the neck brace; the other was Kate, sodden and bedraggled, standing a few feet away watching as they worked on her little son, her eyes wide with fear, her lips moving soundlessly.
Praying?
Probably. There was little else to do. He crossed over to her, and she gripped his hand and gave a tiny sob.
He squeezed back. He wanted to hug her, to say, ‘It’s OK, it’s going to be all right,’ but he wasn’t sure it was, wasn’t sure she’d want him to hold her, wasn’t sure she’d believe him—and anyway his tongue was glued to the roof of his mouth.
He freed it with effort and concentrated on the facts. ‘Have you done a FAST exam?’ he asked, sticking to something safe, and Ben shook his head.
‘No, we’re just about to.’
‘Fast?’ Kate murmured.
‘Ultrasound, basically,’ Ben said. ‘It might show what’s going on.’
Such as free fluid in the abdomen. Blood, most particularly, from torn arteries, sheered bone ends…
Nick felt the bile welling again, and dragged his free hand over his face.
The radiographer was setting up the X-ray machine as Ben quickly ran the head of the ultrasound wand over Jeremiah’s thin, slightly distended abdomen, and Nick watched the screen, wincing at the image. Free fluid. Lots of it. Damn.
They were handed lead aprons. Ben must have realised they wouldn’t leave, and as the X-rays appeared on the computer screen a few moments later, Nick sucked in a breath.
Even across the room, he could see the fractures on the left side of Jeremiah’s pelvis, the bony ends displaced, the damage they’d caused all too easily imaginable.
‘OK, this needs fixation before he goes anywhere,’ Ben was saying. ‘Are the orthos free?’
‘No. They’re just finishing off so they’re ready for him,’ the charge nurse said. ‘Want me to get Josh?’
‘Please—and fast-bleep the anaesthetist, we need to get on with this.’
‘Who’s Josh?’ Kate asked, her face white.
‘New guy,’ Ben said. ‘He’s good—don’t worry, I’ve known him for years. He’s done a lot of this—he’s a bit of a trauma specialist. But we need to get this pelvis rigid before we move Jem and he needs to go straight up to Theatre if we can’t stop the bleeding here. You need to sign a consent form for that. Why don’t you do that and then get a cup of tea—?’
‘His pressure’s dropping.’
Ben frowned and bent over the boy. ‘OK, Jem, stay with us, come on, you’re doing really well. Let’s give him a 250-mil bolus of O-neg and we’ll see if he stabilises. Kate, I don’t suppose you know his blood group, do you?’
She shook her head, her face terrified. ‘No. No idea. I’m O-positive, if that helps.’
‘Cross-match results are up,’ someone said. ‘He’s B-negative.’
B-negative? Through the roaring in his head, Nick heard Ben sigh harshly. ‘Damn. We used all our stock this morning. I don’t know if it’s been replaced yet.’ Ben’s eyes flicked questioningly to Nick’s, and he swallowed.
‘I’m B-negative,’ he confirmed, the last traces of doubt obliterated from his mind with this one small fact. ‘So’s Jack. We’re both regular donors.’
Ben didn’t miss a beat. ‘OK. Nick, contact Jack and ask him if he’s able to donate today, then we’ll get Haematology to sort it. That’ll give us two units, and we’ll salvage his own in Theatre and recycle it and give it back to him, and we can use O-neg if necessary until we get more, but if we get the ex-fix on, the bleeding may well stop anyway.’
Or it might not. ‘You can take two units from me,’ Nick said, and he saw Kate turn towards him, heard the hitch in her breath as she waited for what he was going to say. Not that. Not out loud, but he met his son-in-law’s eyes squarely, and Ben gave a brief, imperceptible nod of understanding.
A door flapped shut behind him, and Nick turned and looked straight into Jack’s eyes.
‘Kate, Dad—hi. What’s going on?’ he asked. ‘I was out in cubicles—they said Jem was in here.’
‘He is,’ Nick said, and Jack looked at the X-rays, winced and glanced down at the child on the trolley.
‘Hell,’ he said softly. ‘Poor little chap. What’s the damage?’ he asked Ben.
‘Pelvis, for sure, and maybe abdominal and head injuries. We were about to contact you,’ Ben told him. ‘We’re short of B-negative. Have you given blood recently?’
‘Um—about three months ago? No—just before Christmas, so nearly four.’ Jack sighed harshly and glanced at the clock. ‘I’ve got a meeting I should be at and I’m already late. Can you call me if you definitely need me?’
‘We definitely need you,’ Nick said, his voice deliberately low so that only Jack could hear. ‘He’s your brother, Jack,’ he added, and watched the disbelief like a shockwave on his firstborn son’s face.
‘Jeremiah? Kate’s son? He’s—?’
‘My son,’ Nick said softly, voicing the words in public for the first time, and beside him he felt Kate squeeze his hand. His words hung in the air between them for a moment, and Jack’s face was suddenly expressionless.
‘Well, we’d better roll our sleeves up, then, hadn’t we?’ he said after a long pause, and Nick let out his breath on a shuddering little sigh.
‘Thanks,’ he said, but Jack turned to him, his blue eyes like chips of ice.
‘Don’t thank me,’ he said, his voice deadly quiet. ‘I’m not doing it for you.’ He turned back to Ben. ‘Give me five minutes. I just want to make a couple of calls.’
‘That’s fine, we’re using O-neg for now. You’ve got a little while. We’ll save cross-matched blood until he’s stable.’
He nodded curtly and walked out, slapping the door out of the way with his hand, and Nick closed his eyes and swallowed. He’d known it would come out at some time, he’d known it would be hard, but like this, with Jeremiah’s life hanging in the balance—
‘OK, what have we got?’ a new voice asked, and a man strode in, a man they’d never seen before, with a soft, lilting Irish brogue and that dangerous blend of rakish charm and lethal good looks that would leave trouble in his wake.
Nick knew all about that. He’d been like that in his youth; it had gone to his head, and look where it had got him. He almost felt sorry for Josh O’Hara, the new A and E consultant, but maybe this man wouldn’t make the same mistakes he had. He’d have to try hard to do worse.
He was bending over Jeremiah now, smiling at him. ‘Hello, Jem, I’m Josh. I’m just going to have a quick look at your X-rays, and then we’re going to send you to sleep and fix you, OK? That’ll take away a lot of the pain for when you wake up.’