so maybe he’s not been pulling his weight lately—’
‘Seth, he’s never here. If he’s not off to some conference, he’s away at a seminar. He wants out of A and E. You know it, and so do I.’
Seth did, but it didn’t make him feel any better. In fact, it made him feel worse. He gazed round the examination room, at the peeling paint, the tattered cubicle curtains, and bit his lip. ‘Jerry, do you ever feel like you’re stuck in a rut?’
‘Can’t say I do. I get the blues occasionally—everybody does—but there’s far too much variety in A and E for me ever to get bored.’
Once Seth would have agreed with him, but just lately he’d had the worrying feeling that their patients were beginning to merge, to blend, into faceless, nameless anonymity. ‘I think I’m getting too old for this job.’
‘Seth, you’re thirty-six,’ Jerry protested. ‘You don’t get burn-out in A and E until you’re fifty.’
‘Maybe I should sign up as a doctor on one of those luxury cruise liners,’ Seth continued as though his specialist registrar hadn’t spoken. ‘The ones that sail the Mediterranean or the Caribbean.’
‘Dispensing sea-sickness pills and fighting off the advances of the blue-rinse brigade?’ Jerry grinned. ‘I’d give you a month, and you’d be bored out of your skull.’
‘Médicins sans Frontiéres, then,’ Seth murmured. ‘They’re always looking for new doctors.’
Jerry started to laugh, then stopped when he saw his boss was in earnest. ‘Okay, let’s forget all this crap about Dr Mackenzie, cruise ships, and Médicins sans Frontiéres. What’s wrong, Seth—and I mean really wrong?’
The consultant picked up the whiteboard eraser from the table, stared at it for a second, then tossed it down again. ‘I don’t know—and that’s the honest truth. All I do know is nothing seems fun any more. Not my job, not dating, not even sex.’ He frowned. ‘Especially not sex.’
‘I don’t see how changing your job is going to make your sex life any better,’ Jerry pointed out. ‘Look, who are you dating at the moment?’
Seth looked over his shoulder, then lowered his voice. ‘Nobody. I haven’t been out on a date since June.’
‘You haven’t had sex for three months? Seth—’
‘I’m losing it, aren’t I?’ the consultant exclaimed. ‘If I can’t even be bothered to have sex any more, I’m definitely losing it.’
Jerry stared thoughtfully at him. ‘No, you’re not. I think you’re just beginning to realise there’s more to life than work and a string of casual relationships. I think what you need is to settle down with just one woman.’
‘Are you crazy?’ Seth spluttered. ‘The minute a bloke settles down, he’s brain dead.’
‘Hey, I take great exception to that,’ Jerry exclaimed. ‘Carol and I have been married for a year, and I’m certainly not brain dead.’
‘Not yet, but you soon will be,’ Seth said darkly. ‘In a couple of years’ time your idea of a sparkling evening’s entertainment will be sitting in front of the television, poring over some DIY magazines. And when the kids start arriving…’ He shuddered. ‘I’ll ask how they are—just to be polite—and you’ll whip out their latest photographs and start telling me all about little Isolde’s first tooth and Tristram’s first step.’
‘That isn’t being brain dead,’ Jerry said uncertainly. ‘It’s…it’s being proud of your family, loving them, being committed to them.’
It also meant waving goodbye to any exciting foreign holidays because little Isolde didn’t like travelling, Seth thought glumly. Goodbye to any visits to a restaurant or to the movies because little Tristram got upset if he was left with a babysitter. And it wasn’t just the kids who made you brain dead. It was living with the same woman for the rest of your life, having to see the same face over the breakfast table every morning.
‘Seth, listen—’
The consultant couldn’t have, even if he’d wanted to. The examination-room doors clattered open and the paramedics who’d attended the multiple car crash appeared, each clamouring for attention.
‘Twenty-six-year-old male, Doc. Open leg wound, Glascow coma scale 3-3-4. Blood loss extensive, definite class 11 shock. His saturation levels are falling and he’s hardly moving any air.’
‘My bloke’s in really bad shape, too, Doc,’ another paramedic declared. ‘Chest and head injuries. GCS 2-2-4. We’ve tubed him and set up an IV line, but his BP’s been falling steadily since we lifted him.’
‘Tony—where’s Tony?’ Seth demanded, and to his relief the junior doctor appeared. He looked as though he’d been dragged out of bed, but at least he was there.
‘Seth, the child with the burns needs attention, and fast,’ Babs declared, casting her professional eye quickly over the trolleys. ‘He’s cyanotic for sure.’
The child was. Even from where he was standing Seth could see the characteristic blue tinge of the boy’s face which indicated his blood wasn’t receiving enough oxygen.
‘Jerry, you take the bloke with the head and chest injuries, I’ll take the child. Tony, the guy with the open leg wound is yours. Tube him, but keep a careful watch for any signs of a tension pneumothorax or major rupture of his diaphragm.’
‘Right,’ the junior doctor replied, looking anything but happy.
‘What about my patient, Doc?’ one of the paramedics protested. ‘Diane Lennox, late thirties. She’s fractured both her femurs, and I think she could be bleeding internally.’
Seth stared indecisively at the badly burnt child, then across at the female casualty, and exploded. ‘This is ridiculous! We need another pair of qualified hands. We need another doctor—any kind of doctor!’
‘Will I do?’
Seth spun round to see a tall, slender woman wearing a pair of baggy tracksuit bottoms and a sweatshirt emblazoned with the words MAKE MY DAY, gazing back at him, and shot a fulminating glance at Madge from Reception who was hovering beside her. ‘Madge, could you escort this lady through to the relatives’ waiting room? She shouldn’t be—’
‘Seth, she’s not a relative,’ the receptionist interrupted. ‘She’s a bona fide doctor. I’ve seen her ID, and Admin have verified it. She starts work tomorrow, and she’s actually—’
‘Boss, I’ve got the tube in, but this bloke’s trachea has definitely shifted to the left,’ Tony Melville exclaimed, panic plain in his voice.
‘Then he obviously needs a needle thoracotomy,’ Seth retorted, more caustically than he’d intended, and the junior doctor flushed.
‘I know, but I’ve never done one before, and…’
Impatiently Seth snapped on a pair of surgical gloves, strode across the examination room and deftly thrust a needle into the patient’s chest.
‘I’ll insert a thoracotomy tube for you in a minute,’ he declared when a satisfying hiss of air came from the patient’s lungs, ‘but in the meantime start him on a two-litre infusion of Ringer’s lactate and then get a sterile pad over his leg and apply pressure to stop that bleeding.’
The junior doctor nodded, and Seth swung round to discover that Madge had disappeared and Dr Sweatshirt had not only donned the spare white coat they kept hanging on the back of the examination room door but she’d also slipped an IV line into the badly burnt child’s arm and was in the process of inserting a catheter into his bladder.
‘What the hell do you think you’re doing?’ he exclaimed, shooting back across the examination room and elbowing her roughly aside.
‘What