THE LAND OF the Midnight Sun. Hayley had been stunned by the sheer quality of the light from the moment she’d arrived at the airport; everything seemed brighter in Reykjavik.
Evan would’ve loved this, she thought with a pang. Especially the whale-watching trip she’d chosen to do this morning. Now the boat was out in the middle of the open sea, the temperature had dropped quite sharply, but the sun was bright and she leaned against the railing at the side of the boat, listening to the guide and trying to spot the tiny puffins with their bright orange beaks.
‘There are lots of birds just above the water ahead of us, and that often indicates cetacean activity—they’ll be picking up bits of fish the whales have left behind,’ the guide said. And then, a couple of minutes later, she called, ‘Spout at nine o’clock!’
Hayley could actually see the spout of warm, moist air blown up by the whale; to her amazement, it really was like you saw in TV documentaries. A perfect misty funnel.
‘And here’s our minke!’ the guide said.
The ship drew to a standstill, and Hayley could see just the dark back of the whale, like a slight hump above the surface of the sea. And then a fin appeared, bright white against the sea and the sky, almost as if the whale was waving to them.
This was magical.
She took a few shots on her camera, hoping they’d come out. And then, to her sheer joy, the whale breached, its snout coming up out of the water and then its body performing a perfect arc, revealing its white belly before the whale splashed back into the sea.
She’d never seen anything so awe-inspiring. The whale’s snout came up again, and then a fin; then she saw the divided end of the tail as the whale dived down again.
‘I’m sure you could all see the flukes then—that’s the whale’s tail—and this usually indicates that the whale’s diving more deeply,’ the guide said. ‘So we’re going to move on.’
This was a truly humbling experience, Hayley thought; it made her feel glad to be alive.
But then, a few minutes later, the guide called, ‘Do we have a doctor on board?’
Her heart skipped a beat. When a tour guide put out that kind of call, it could mean a true emergency, and right now they were almost an hour’s sail away from Reykjavik. She had no idea how the emergency services worked here. Would they send out a helicopter to the ship, or would the tour guide have to cut the trip short and they’d have to sail straight back to the city?
She made her way to the guide’s post. ‘I’m Hayley Clark, a doctor from England. Can I help?’
‘My husband’s having an asthma attack,’ an American woman said, looking anxious and wringing her hands. ‘And we don’t have his inhaler with us.’
Just as well she worked in the emergency department, Hayley thought. ‘Can you put out a call to see if anyone has a reliever inhaler we could borrow, please?’ she asked the guide. ‘Even a preventer inhaler would help.’
‘Will do,’ the guide said.
She turned to the woman. ‘Would you like to take me to your husband? My name’s Hayley and I work in the emergency department of a London hospital.’
‘I’m Lulu Adams and thank God you’re on board,’ the woman said, leading her towards the next deck down. ‘I can’t believe Milton’s having an attack out here. Normally it’s pollen and cat hair that sets him off.’
‘Cold can set off asthma, too, and the air’s quite cool out here,’ Hayley said, ‘so it’s always a good idea to keep a reliever inhaler with you—even if you don’t think you’re going to come across your usual triggers. Does your husband take his preventer inhaler regularly?’
‘He’s a man. You can’t tell him anything,’ the woman said with a sigh.
So this was probably an attack that had been brewing for a while, Hayley thought, with a patient who didn’t bother taking his preventer inhaler that often. Milton Adams’s doctor definitely needed to talk to him about the importance of asthma control. She just hoped she could keep him stable until they managed to get some proper bronchodilator medication for him. ‘Does he have any other medical conditions?’ she asked.
‘Just the asthma.’
Which was tricky enough to deal with, by the sound of things. ‘OK. Thanks.’
* * *
Do we have a doctor on board?
There were maybe a couple of hundred other people on the boat. The chances were, Sam was the only doctor. Plus this would be a test. Had he done the right thing in accepting the job at a London hospital, or had his experience in Manchester soured his love affair with medicine to the point where he really didn’t want to go back to it?
He made his way to the bridge to talk to the guide, and on the way he heard her ask if anyone had an asthma inhaler that another passenger could borrow.
‘My name’s Sam Price, and I’m an emergency doctor from England. It sounds as if you have a passenger who’s having an asthma attack and doesn’t have an inhaler. Can I help?’ he asked.
‘There’s another doctor gone to see him already, if you want to join her,’ the guide said. ‘You’ll see her on the deck below. She’s wearing a yellow raincoat.’
‘OK. Thanks. Has anyone come up with an inhaler?’
‘Not yet, but I’m going to put another call out,’ she said.
Asthma attacks could be tricky. If nothing else, Sam thought, he could help calm down whoever was with the patient, so the other doctor could get on with treating the patient. He headed down to the next deck, and saw a woman wearing a yellow raincoat. She was talking to a man who was clearly panicking and wheezing, and the woman with them was wringing her hands and looking equally panicky.
‘Hello. I’m Sam Price, and I’m an emergency doctor,’ he said as he joined them. ‘Can I help?’
‘Hayley Clark—also an emergency doctor, from London,’ the woman in the yellow raincoat said.
He noticed how blue her eyes were—like an Icelandic summer sky—and her sun-streaked blonde hair was caught back at the nape of her neck, with soft tendrils framing a perfect oval face.
What the hell was he doing, noticing the colour of her eyes when there was a sick patient who needed their attention? Besides, even if he was looking for a relationship—which he wasn’t, after Lynda—she was probably already spoken for. Cross with himself for getting distracted, he paid attention to what she was saying.
‘This is Milton Adams and his wife Lulu,’ Hayley continued. ‘He doesn’t have his reliever or preventer inhaler with him, and we think the cold air probably brought on his asthma attack. He doesn’t have any other medical conditions.’
‘The guide’s putting out a second call to see if anyone on board has an inhaler with them,’ Sam said. ‘But even if there isn’t anyone, we can help you, Mr Adams.’
The man continued to wheeze, fighting for air, clearly panicked by the tightness in his chest.
Really, they needed to get him away from the cold air that had triggered the attack and into a warm place. But, given the state of his breathing right now and the fact that he was quite overweight, no way would Mr Adams be able to cope with the steep stairs to go back inside the ship. First, Sam thought, they needed to get Mr Adams stabilised so he was calm, and breathing more slowly. Anxiety released cortisol in the body, constricting the bronchial tubes even further, and panicking that you couldn’t breathe caused a vicious circle: it tightened the chest muscles, which made it harder to breathe, which in turn made the patient panic more and then the chest muscles tightened even further.
‘Mr