‘Hmm.’ He absorbed that. ‘Wouldn’t it have been better to have a garage mechanic look over your car? What if your neighbour can’t fix it for you?’
She started towards the door. ‘Well, then I suppose I’ll have to do that.’ She guessed he was trying to make sure that her lateness wasn’t going to be a frequent occurrence. ‘It would be unfortunate, though, because it will probably cost me an arm and a leg if I have to go to a garage, whereas this way I can give Tom a realistic amount of money for his time and trouble—that will give him a boost and help him to get back on his feet, and I’ll benefit at the same time.’
‘Does he need a boost?’ They walked together towards A&E. ‘Is your neighbour in trouble of some sort?’ Josh’s brows had come together in a dark line. Clearly he was having a problem coming to terms with her lifestyle.
‘I’d say so. He’s an engineer, but he found himself out of work when the company he worked for folded, and then he’s had difficulty getting another job…which in turn means that he can’t afford to pay the mortgage, and now the building society is beginning to make nasty rumbling noises about repossession. None of that bodes very well for a happy Christmas, does it?’
‘It doesn’t bode very well at any time of the year,’ he commented.
They had only just set foot inside the A&E unit when his bleeper went off. He glanced briefly at the displayed message. ‘That doesn’t sound like good news,’ he murmured. ‘There’s been an accident on the motorway. I guess things are going to become hectic around here very soon. Alison—I want you to stay with me.’
He moved away then, and went to organise the rest of the staff, directing who was to do what before striding towards the ambulance bay. Alison quickly followed him.
‘Twenty-five-year-old male,’ the paramedic reported, wheeling a casualty towards the resuscitation room. ‘Had to be extricated from his car. His blood pressure’s low and he has a broken leg and arm. He also has chest and abdominal pain.’
‘Thanks.’ Josh took control as the patient’s condition deteriorated even further. He began to insert a tube into the patient’s throat, connecting it to the oxygen delivery system. ‘Okay, let’s get an intravenous line in and hook him up to the monitors.’ He made a hasty but thorough examination of the patient, and then ordered a chest X-ray, skeletal survey and a CT scan of the head, thorax and abdomen.
‘We’ve multiple injuries here,’ he said, showing Alison the results a short time later. ‘Apart from the chest injury he has fractures to his right arm and leg and a liver laceration. The broken bones have been splinted, so we’ll concentrate on checking for abdominal injury.’
‘His abdomen is slowly enlarging,’ Alison pointed out. ‘That means there must be some internal bleeding. We need to get him up to Theatre.’
He nodded. ‘Make the arrangements. I’ll do an emergency laparotomy to see what’s going on in there.’
Just a few minutes later, after they had both scrubbed in, Josh began to operate on the patient. Alison assisted by retracting the edges of the incision he made into the patient’s abdomen. ‘He’s bleeding from the hepatic vein,’ she said urgently.
Josh was already tending to it. ‘I’ll do a resection of the liver, but I’m afraid I’ll have to remove the gall bladder.’ All the time he was speaking he was cauterising the tissues that were bleeding and checking for other damage. Alison was in awe of the way he worked. Every action was careful, precise, and no time was wasted. After a while, though, he let out a deep breath and said, ‘That’s it, I believe. We can close him up now. Would you do that for me, Alison?’
She nodded and prepared to suture the wound. This man had opened her eyes to what a skilled surgeon was capable of. ‘What are we going to do about his chest injury?’
‘Nothing for the moment. We’ll keep an eye on things, but let’s make sure his condition is stabilised before we do anything else.’ He thanked the team who had assisted him and pulled off his surgical gloves, dropping them into a bin. ‘I’ll go and see how the other casualties are doing.’
It was some time later, after the mayhem finally subsided in A&E, that she was able to go along to the minor injuries treatment room to see the teenager who had hurt his hand.
He was a pale-looking youth, around sixteen years of age, she guessed, and even though he was lying on a bed, leaning back against the pillows, she could see that he was tall and lanky, with a shock of dark hair and strangely haunted, unhappy grey eyes. There was a bruise beginning to form around the lower edge of his jaw, as though he had been punched.
‘Rees, I’m so sorry you’ve had to wait for such a long time,’ she told him. ‘We’ve been busy looking after some people who were injured in a road traffic accident.’
‘That’s all right,’ the youngster said. ‘The nurse let me know what was happening. I didn’t mind waiting.’
‘That’s good.’ She smiled at him. ‘There aren’t many people around here who say that.’ She glanced around the empty room. ‘Are your parents waiting for you somewhere?’
‘No.’ He looked anxious for a moment, and then started to cough—a deep, chesty cough that racked his whole body for a second or two. ‘Someone who was passing by brought me in. I said I’d be all right, but she insisted on bringing me here. She said she wanted to wait with me, but she had to go to work.’
‘Would you like me to get in touch with your parents?’
‘No…thanks. They don’t need to know I’m here.’ The words came out abruptly, in a staccato manner, causing Alison to wonder why he was so anxious at the mention of them. She sat down beside his bed and began to carefully inspect his hand. There was a ragged, deep gash across his palm. ‘So how did this happen?’
‘I stumbled over some rough ground. I was a bit dizzy and I wasn’t really looking where I was going. I started to fall and put out a hand to protect myself, but there was broken glass on the verge and that’s how I cut myself.’
She nodded, not quite sure whether or not she believed him. The edges of the wound were deep, as though his hand had been rammed by a broken bottle. According to his notes, the woman who had brought him in had said she’d found him wandering in the street, looking dazed. ‘It looks nasty, doesn’t it? Have you any idea what caused the dizziness?’
He shrugged. ‘No, not really.’ He coughed again.
‘Everything all right in here?’ Josh put his head around the door, and Alison wondered if he had come to check up on her. Perhaps he was looking in on all the A&E staff?
‘We’re fine,’ she said.
Josh nodded, and looked as though he intended to hang around for a while. She would have preferred he didn’t do that. How was Rees going to open up to her with Josh watching over them?
‘Your trauma patient is still in recovery,’ she told him. ‘Last I heard, he wasn’t doing too well.’
‘I know. I’m going to do an aortogram. I suspect there’s something wrong with the heart vessel.’
Perhaps he realised that she didn’t want him around. His glance went from her to Rees, and then he nodded towards the boy and said, ‘You’re in good hands.’
Josh left, and Alison let out a slow, soft breath. She went back to checking Rees’s neurological reflexes.
‘Everything seems to be okay on that score,’ she said quietly, ‘although your blood pressure is a bit low. Did you have anything to eat before you went out this morning?’
He shook his head, and was overcome once more by a bout of chesty coughing that left him exhausted. No wonder he hadn’t complained about being kept waiting. She guessed he was probably glad of the chance to sit and rest somewhere warm and comfortable for a few hours.
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