MORE VICTIMS were brought onto the coastguard vessel, blankets quickly wrapped around them then they were passed along for her or Sam to check.
The divers had first offered oxygen from their own tanks to those trapped below, then had taken tanks down for the victims to share until they could be helped out. Some with the confidence a few gulps of oxygen had given them had even made their own way up to the surface, where willing hands had hauled them aboard.
‘I’m going down, there’s someone trapped.’
Meg turned from a woman she was tending—bandaging a badly scraped shin—to see Sam struggling into a wetsuit much too small for him.
‘It’s a man in the galley of the trimaran. I might have to amputate his foot to get him out. You’re OK here?’
Meg looked in horror at Sam. He was going down into the dark waters of the bay to cut off someone’s foot, and he made it sound…normal?
Or was he speaking that way not to panic her?
She reached out and touched his leg—well, the cold, clammy rubber of the wetsuit on his leg—and said, ‘Take care,’ hoping her voice didn’t quaver enough to give away her horror.
He bent and pressed a hand against her hair.
‘I will,’ he said, and it sounded like a promise.
But was it a promise he could keep? If the man was trapped, whatever was trapping him could fall on Sam. Trap him! And who would cut him free?
She worked on, hoping to escape the thoughts chasing through her head, but although she worked efficiently and spoke cheerfully to all the patients as she tended them, her heart was with Sam while her mind made little bargains with uncaring fate—promising her soul for his safe return.
At last the final passenger had been shipped back to shore—or last but one. Sam and the two divers were still down below, still trying to rescue the trapped man.
How badly was he hurt? Would shock and lack of treatment kill him before they got him out?
Meg walked into the cabin of the coastguard cabin where the captain was talking to someone on his radio.
‘How bad are things back on shore?’ she asked, as he turned it off and acknowledged her with a nod and an offer of coffee.
She answered with a nod herself, and followed him to a table with an urn on it. A litter of dirty cups and teaspoons showed coffee had been much in demand all evening.
‘The most badly injured have been taken straight through to the city,’ he told her. ‘The Bay hospital has been treating people for shock, keeping a few for observation but on the whole sending home those people who have family or friends to watch over them.’
‘How many were there? Did they all survive?’
The man made her coffee then waved his hand towards sugar in a paper bag and milk in its carton.
‘We have two fatalities,’ he said quietly. ‘I’m thinking they were in the speedboat that hit the trimaran. Teenagers, both of them. They were the first taken ashore—one of our blokes went with them on a trawler that was coming in from netting the shallow banks.’
‘Did you know them?’ Meg asked gently, hoping the pain in his voice was for a different reason. He turned away but not before she saw him swallow hard.
‘One young bloke’s a neighbour,’ he said. ‘His mother’s had a rough time as it is. Her husband left her a couple of years ago—just took off without a thought for how she’d cope with four young kids. We’ve all helped out but Josh—the one who died—he…I guess he resented his dad leaving him like that and he’s taken it out on the whole world. Angry—that’s how he was, all the time. He’d have been speeding across the water, probably with no lights. All that anger…’
Meg hadn’t thought her heart could ache so much for someone else, but right now it was aching for Josh’s mother.
As much as it had ached for Lucy.
And suddenly she was fiercely glad she’d told Sam she wouldn’t marry him. Marriage was too hard. There were too many stresses and strains and bad stuff that could happen—too many heartaches waiting to strike when you least expected them.
Sam! Was Sam all right?
She sipped her coffee and went back to worrying, although her chest still throbbed with the referred pain of a woman she didn’t know.
Sam breathed in and out, checking from time to time the dial that showed how much oxygen he had left in his tank.
The two divers were working with pinch bars to try to prise the refrigerated cold room off the man’s foot, but the weightlessness of water meant they couldn’t get the leverage they needed, and steel plating used in the decking of the trimaran meant they couldn’t bash away the deck to free him that way.
Sam held the oxygen mask to the man’s nose and supported him, but he guessed there was injury to the foot already, for the man’s pallor suggested he was losing blood, though the shadowy water didn’t show it.
Unable to communicate apart from basic hand signals, he had no idea of knowing if the divers’ work was meeting with success. He hoped so—the idea of amputating the man’s foot in such circumstances was making him feel physically ill. Although in his head he was rehearsing it. The first thing the divers had done had been cut away the man’s slip-on shoe, thinking to pull his foot out of it, but the foot wouldn’t move.
The ankle was clear, which was good, and he thought the tarsal bones, the ones closest to the ankle, could probably be saved. But with the metatarsals and the phalanges trapped by such a weight, the chances were they were crushed and worthless anyway.
But cutting through? Getting through the bones. No, around the bones—cut through the sinews and ligaments of the joints but keep as much skin as possible so the wound can be closed over neatly.
Would half a foot ever be neat?
No, think positive. The man had already been given a sedating injection—just enough to relax him—and Sam had put a nerve block in his leg so he was feeling nothing below the knee. Everything was ready—should it be necessary.
Pray it would not be!
The divers straightened and gave the signal he’d been dreading. No can do!
OK, it was up to him. Up to him, and speed was essential. Hard to bandage a cut-off foot underwater!
He signalled to the divers to hold the patient and slid lower in the water, first securing a ligature around the man’s leg, just above the ankle, hoping it would stop enough blood flow to save the man bleeding to death while he operated. Then with concentrated effort he unsheathed the first of the scalpels he’d tucked into his weight-belt and more by feel than from the feeble light penetrating the churned-up water, he began to cut, starting right against the steel container that pressed against the foot, delving deeper as he felt each bone, using his hands to find the joints before pressing hard between them, remembering as he pressed just how tough nerves and sinews and ligaments were.
It was taking for ever.
The man would surely die.
He was running out of oxygen.
They all must be.
Then a movement—an involuntary spasm of the man’s calf or thigh muscle—and the foot moved. Sam wrapped a sodden towel around it and held on tightly, signalling to the divers at the same time to take them up.
They rose swiftly, not deep enough to be concerned about the bends, willing hands reaching out to take his patient. Sam tore away his own mask to yell at Meg, whose pale face hung above him.
‘Pad and bind his foot then loosen the ligature just slightly, give him oxygen and start fluid IV.’
The man was already gone, and so was Meg. Now all Sam had to do was haul his weary body aboard the vessel and tend his patient.
The twin motors of the coastguard vessel roared as the driver took off, heading back to shore the moment he had Sam and the divers on board.
‘He’s being well looked after,’ one of the crew told Sam as he lifted the oxygen tank from his back, taking its weight while he undid the straps and eased it off his shoulders.
How long had it been since he’d last dived?
He’d certainly been fitter then. His shoulders ached with strain, and getting out of the wetsuit and into his dry trousers and shirt all but exhausted him.
‘Hot sweet coffee, mate.’
Another crewman handed him the cup and wrapped a blanket around his shoulders. Just how many blankets did the coastguard carry?
Then, still sipping, he made his way to where Meg had his patient, also blanket-wrapped. The damaged foot was already padded and Meg was tightening the ligature again.
‘He’s too cold. The crew are heating a fluid bag in their kitchen, but he’s shaking with shock and hypothermia.’
‘Body heat—it’s not for long,’ Sam suggested, whipping off his blanket to lie on the deck beside the man. Meg understood and lay down on the other side, cuddling up to the cold, unresponsive body.
But he was breathing, and that, Sam knew, was as good as it would get, until they got him ashore where warming pads in the ambulance would start the process of bringing him back to normal.
Or his temperature back to normal.
Any other normal would be difficult for him for a while.
A crewman approached, a bag of fluid held tentatively aloft. Meg spotted him as well and sprang up.
‘You lie here,’ she told the crewman, taking the fluid, feeling the temperature of it against her cheek and reaching for the bag already hooked up to the IV access.
She double-checked the label then switched bags. Another crewman came with more blankets.
‘Put these on the bilge pump—they mightn’t be clean but they’re warm. And I haven’t been in the water, so my body’s warmer than yours.’
He took Sam’s place beside the man, while Meg spread the blankets over their patient, tucking them tight across all three of them to trap the two men’s body heat around their patient.
The motors revved then stopped. They were back at the wharf. Sam sat back and let the ambulance attendants who scrambled on board shift the man onto a stretcher, then carry him away.
‘I’ll go with them—you take my car home,’ he said to Meg, whose T-shirt was wet and stained with blood and grease.
‘No, you go with him but I’ll follow,’ she said, taking the keys. ‘Whatever staff’s on duty will need to be relieved—there’ll be work for both of us.’
Sam was too tired to argue—too tired even to think about where they’d been when all of this had begun, but he saw the strain in Meg’s white face and the bluish shadows beneath her eyes and though he wanted to argue—to order her home to bed—he knew he wouldn’t.
She wouldn’t be Meg if she didn’t insist on being at the hospital.
‘How are you feeling? Up to an hour or so in Theatre?’
Meg was settling the woman with the collapsed lung into a single room where she could be monitored when Sam came through the door.
‘The man with the foot?’
Sam nodded.
‘I can’t send him anywhere until he’s stable, and that won’t happen until we’ve done something with his foot. I’ve got him in Theatre. Kristianne will assist but I’ll need a couple of nurses.’
‘I’ll come, and I’ll grab someone else with theatre experience off a ward. I don’t particularly want to call in any off-duty staff as we’ll be just as busy tomorrow with the patients we’ve kept here.’
The man’s body had been gradually warmed back to within acceptable limits, but he was shocked and had fluid in his lungs—not an ideal patient for surgery, but until the blood vessels in his foot were tied off, he was in danger of haemorrhaging to death.
Meg was glad to see Andy, their most experienced anaesthetist, already in Theatre, watching over the man, checking his sedation, keeping an eye on his breathing and heart rate while Sam and Kristianne worked on his foot.
‘We’ve got to make sure the sutures will hold,’ Sam was telling Kristianne, as one by one they tied off bleeding vessels, cauterising the smaller ones so the smell of burning hung in the air. The theatre was quiet, apart from the clatter of instruments and the demands of the two surgeons.
‘If we can reattach this strand of muscle to one of these small bones, it might give him some movement later,’ Sam added. ‘Enough to make prosthetic toes work.’
The pair worked swiftly, Meg enjoying the rhythm of theatre work as she slapped instruments into waiting hands and dropped soiled swabs into the bin.
Finally, Sam tucked the skin he’d managed to save around the man’s truncated foot and sewed it neatly, leaving Kristianne and Meg to dress it.
‘Your car keys are in my jeans pocket in the changing room,’ Meg called after him, thinking he might now—it was four in the morning—be going home.
He turned back and shook his head.
‘You take the car. I’m staying.’
As he walked away, Meg could feel Kristianne’s eyes on her and looked up to see questions in them.
‘He lives next door—we went to the wharf in his car,’ she explained briefly, and the woman’s blue eyes brightened perceptibly.
‘That’s all?’ she persisted, as Andrew and an orderly wheeled their patient away.
‘Pretty much. He grew up here, so I knew him from before.’
‘Hmm!’
‘You interested?’ Meg had to ask, and Kristianne laughed.
‘What woman under a hundred wouldn’t be?’
‘But you’re leaving in a month or so,’ Meg protested, aware she was liking this conversation less and less.
‘So? I can’t have some fun for a month? Actually, it’s six weeks. Six weeks with sexy Sam! Has a good ring to it, don’t you think?’
Actually, Meg didn’t, and she wasn’t entirely sure that now she’d turned down Sam’s ridiculous proposal he wouldn’t take Kristianne up on whatever she might offer.
It was another example of how little they knew of each other.
Just thinking about it made her feel sick! But as soon as she’d helped the other nurse clean up the theatre and had the instruments in the autoclave, she grabbed her grubby clothes and, still in her scrub suit, drove Sam’s car home so she could shower and change.
Pride?
She didn’t want to think about it, any more than she wanted to think about Kristianne making moves on Sam. She was back within three quarters of an hour, showered and in uniform, and if she was wearing just a touch more make-up than usual, who was to know?
Leaving Sam’s car in the car park, she walked through the hospital, starting with the A and E rooms, checking who was still held there, checking staff numbers and who should be sent off duty, who called in to deal with the extra patients.
Doing her job and doing it well—she had been promoted to DON last year—were the things that had brought her satisfaction in the last four years, but today a little devil in some dark corner of her mind was prodding her with his pitchfork and asking if it would be enough for ever.
Of course not, but medicine will be, she told him firmly.
‘Lips still moving when you read?’
Sam’s voice startled her as she bent over the duty roster in the A and E office. She glanced up and saw the gleam in his eyes. Appreciation that she’d changed?
Or something else?
She didn’t have to wait long for clarification. A smile made the gleam seem brighter as he asked, ‘Did you have a particular storeroom in mind?’
She had to laugh but the excitement that zoomed through her body and sprinted along her nerves wasn’t a laughing matter, but she hid her reaction and said calmly, ‘There’s a nice one in the corridor next to where the crash cart is kept, but I thought you’d put the kibosh on an affair.’
Had she spoken loudly, that Sam looked around to see if anyone had heard?
But when he said, ‘It will not be an affair,’ in a very firm voice, she realised he’d looked around to protect his words, not hers. ‘That discussion is not finished.’
A squawk from the radio suggested it was—an ambulance was calling in to say they had a young woman in labour on board. ‘No obstetrician, no regular doctor, no check-ups along the way, thinks she might be about six or seven months. ETA seven minutes,’ the driver finished, and Meg reached for the phone, calling the consultant obstetrician and checking she had a midwife on duty in the labour ward, warning staff there of the new arrival.
‘Do you handle most local births?’ Sam asked.
‘Nearly all of them,’ Meg told him. ‘Some young women who haven’t lived here long might go home to where they grew up to have their first baby, but after that—and with all the locals—they come here. We’ve good staff, and fathers can live in if the wife needs to stay for more than one night. We’ve a good home follow-up routine going as well, hospital staff doing home visits for the first three months.’
The patient was little more than a girl—undernourished and grubby-looking—with, to Meg’s horror, needle tracks and keloid scarring from needles up both arms.
She was also totally spaced out.
‘Was anyone with her? Who called you guys?’ Meg asked the attendant who wheeled her in.
‘We got a triple zero call from a mobile phone that’s got a number block on it, and she was alone when we got there. She was in that old guest house building at the southern end of the Esplanade—the one the developers are pulling down shortly to build the big hotel.’
Meg knew the building and knew it was used as a squat for young people drifting into the Bay, finding life on the streets more comfortable in a place that was both warm and had any number of derelict buildings.
‘And a ready supply of drugs apparently!’ Meg muttered to herself as Sam followed the patient into the trauma room.
Sam was talking gently to her, asking how far apart the contractions were.
She lifted her thin wrist to show she wasn’t wearing a watch and shook her head. Meg nodded to the nurse to start timing them and asked her to strap a foetal heart monitor around the girl’s belly. Then, while Sam talked on, inserting a catheter and taking blood for testing, Meg began to take note of the young woman’s status.
‘Everything up,’ she was able to tell Matt when he arrived. ‘Pulse 110 beats a minute, respirations 22 a minute, temperature 99.8, blood pressure 140 over 95. The foetal heart rate is good—158 beats a minute—and she’s having contractions…’
Meg looked across at the nurse.
‘Seven minutes between them.’
‘Do you know when the baby is supposed to be due?’ Matt asked, his voice so gentle Meg knew why women loved him as a doctor.
‘I think at Christmas. Or some time then,’ the young woman said. ‘But if it comes now, it’ll die, won’t it?’
‘Not necessarily,’ Matt told her, while the medical staff in the room all mentally computed the woman must be about thirty weeks pregnant.
‘Better it dies,’ the woman said. ‘It’ll be all screwed up with drug addiction. Not much chance for the poor little thing.’
Meg stared at the young woman, at the good bones in her face that showed she had been pretty before drugs and disease had taken their toll.
‘There’s no such thing as no chance,’ she protested, while Matt explained he was going to give her something that might stop the pre-term labour.
‘The longer you can go in your pregnancy, the more chance the baby will have of survival.’
‘But I don’t want the baby!’ the girl, Melody, protested. ‘Who’ll look after it?’
Matt, ignoring her protests, was hooking up a drip to the cannula the ambos had inserted in her arm.
‘You need fluid anyway, and maybe some methadone. Have you been on a programme?’
Melody nodded.
‘Got hooked on that just as easy, and with the fuss you have to go through to get it, might just as well stick to H.’
‘Do you want to get off it? Want us to help you?’
Sam spoke so gently tears filled the girl’s eyes.
‘It’s no use,’ she said. ‘My mum tried to help, and if she couldn’t do it, why should you be able to?’
‘We could try,’ Meg offered. ‘And if you like, we could contact your mum. Maybe she’d like to be with you.’
The tears spilled over then and rolled in steady streams down the emaciated cheeks.
‘She doesn’t know about this,’ Melody finally managed, but the careful way she cupped her hand around her swollen belly and rubbed it gently suggested she wasn’t nearly as uncaring about this unborn babe as her tough talk had suggested.
Sam wheedled her mum’s phone number out of her and left the cubicle, while Meg waited until Matt had finished his examination then arranged for Melody to be shifted to a single room.
‘I think she’s had a shot recently—you might have trouble as she’s coming off,’ Matt told Meg as the girl was wheeled away.
‘We’ve handled it before. We’ll manage,’ Meg said, sure that if Sam had had A and E experience in a big Sydney hospital he’d know even more than they did about heroin addiction and how to handle it in a hospitalised patient.
‘Her mum’s in Brisbane. She’ll drive up and, giving her time to pack and get the cat to the cattery, she should be here in about six hours.’
‘Mum sounds like a very efficient woman,’ Meg said, smiling at Sam because she was relieved Melody would have family support—and also because he was Sam!
She asked him about his experience with drug-addicted patients, explaining they’d had a doctor at the hospital who knew a lot but he’d gone back to England, and since then they’d gone on textbooks and help from the drugs hotline in Brisbane.
‘I’ve seen more of it than I would have thought possible,’ Sam said, his face looking tired and drawn. The memory of kids he hadn’t been able to help or the result of a night without sleep? Or both? ‘I’ll keep a special eye on her.’
Meg told him where Melody was and returned to the rosters she’d been checking. It was nearly change of shift for those working a split shift and she still had no idea what nursing staff members were on duty or how many she might need for the rest of the day.
By five o’clock the hospital had settled down. The man with the amputated foot had been transferred to Brisbane as he came from there and had family support, as well as specialists who could help his rehabilitation.
Melody’s mother had arrived so Melody was now clean and clad in a beautiful silk nightdress while the tocolytic drug—to prevent the premature labour—seemed to be working. She couldn’t be said to be stable but she was talking more positively about kicking her habit and was responding to the drug regime recommended by addiction specialists Sam had contacted in Sydney.
So when the man in question poked his head into the office and said, ‘Come on, let’s go home,’ Meg didn’t argue, although she knew the ‘going home’ thing would be taken literally. They were both too tired to think of anything but sleep.
‘We’ll catch up,’ Sam said, as if he’d read her mind. He slung an arm around her shoulder and guided her out of the hospital towards the car park.
‘Will we?’ she said, too tired to stop her thoughts becoming words, worrying that the more physical contact she had with Sam—more physical pleasure and delight—the harder it would be to keep saying no.
Though he mightn’t ask her again…
‘Of course. For a start, there’s a whole conversation of yours I must have missed, looking at the way your hair fell, and your eyes sparkled in the moonlight. I’m not taking your no for an answer without hearing the reason.’
So what was the reason?
It was to do with love. Not her love for she did love him, and she was pretty sure it was the grown-up Sam she loved and not a hangover from the past.
More to do with Sam and love…
And telling him she loved him would give him too much power—way too much—on top of all he already had with his ability to make her bones go weak and her nerves tingle whenever he was in her vicinity.
She climbed into the car and asked if he’d put down the top then drive the long way home so the wind could blow in her hair all the way along the Esplanade.