HANNAH pulled the door of her flat firmly shut. It wasn’t a good fit against the frame, and she made a face, struggling with the lock, but she wasn’t going to let it deter her from making certain that everything was secure. There wasn’t all that much to recommend the accommodation, but at least it was a place to stay while she was going to be working in London for the next few months.
‘Is you going out?’ a small voice piped up from the bottom of the stairs, and Hannah glanced to where the sound was coming from.
‘Hello, Ellie,’ she said, peering down to see the little girl from the ground-floor flat. ‘Yes, I’m on my way to work at the hospital. Are you waiting to go off to nursery school?’ Hannah started down the stairs, her mouth curving as she came closer to the child.
The three-year-old was sitting on the bottom step, cuddling a soft toy to her chest, but now she twisted around and looked up at Hannah once more. She nodded solemnly, her bright golden curls quivering. ‘We was s’posed to be going ages ago, but Mummy’s late. She couldn’t get up this morning. She sleeped and sleeped and I had to keep nudging her.’
‘She’s awake now, though, isn’t she?’ Hannah frowned momentarily. After the disturbed night they had just gone through, she wasn’t really surprised that Ellie’s mother wasn’t firing on all cylinders this morning, but at least Ellie had slept through everything.
It had taken Hannah all that she had to get herself ready for work this morning, but this was her first day in a new job and she was determined to be there in good time. It didn’t bode too well that she was feeling drained of energy before she even started, though.
Ellie nodded, dancing the teddy bear on her knees. ‘She forgetted something. She’s gone back to get it.’
Hannah came to the last step and sat down beside the little girl. ‘He’s a lovely teddy bear, isn’t he?’ she murmured, lightly stroking the silky fur. ‘What’s his name?’
Ellie’s gaze met hers in an unwavering blue stare. ‘His name’s Teddy,’ she said.
‘Oh, well, yes, of course, it would be, wouldn’t it?’ Hannah chuckled softly. ‘Is he going to nursery school with you?’
‘Yes.’ Ellie looked surprised. ‘He goes everywhere with me.’
Just then Ellie’s mother emerged from her flat, looking harassed. ‘Hi, Hannah,’ she said, throwing her a quick, friendly glance. She had the same blue eyes as her daughter, but she was a brunette, her hair glossy and shoulder length, pinned back with two gold clips. ‘We’re running late today. All that upheaval with Dean upstairs meant that it took me ages to get to sleep afterwards. I kept worrying about what might have happened if we hadn’t gone in and helped out.’
‘It was a good thing that his smoke alarm was working,’ Hannah agreed, ‘otherwise things might have been much worse. He’s obviously having trouble getting about since his knee operation, and we all had a lucky escape. I dread to think what might have happened—the chip-pan fire could have set light to the whole building if we hadn’t gone in when we did.’
‘Do you think he’ll be all right?’ Abby asked. ‘He’s seemed depressed lately and I can’t help feeling that we ought to do something to help out. I have to go to the office this morning, though, so he’ll be on his own here.’
‘I’m not sure what more we can do, just at the moment. He was half-asleep when I went to look in on him this morning, but he said that his knee was troubling him and that he was going to take some painkillers and go back to bed for a while. He’s supposed to be going for a check-up at the hospital later on today—around two o’clock, he said.’
‘I’ll be home by then. I’ll have a word with him at lunchtime, and make sure that he’s up and about. He’ll need a hand with cleaning up some of the smoke damage, anyway.’
‘Thanks, Abby. I’ll feel better knowing that we’re both going to keep an eye on him from now on.’ It shouldn’t be too difficult to do that—Dean’s flat occupied half of the second floor, opposite Hannah’s, while Abby and her daughter had a two-bedroomed flat taking up the whole of the ground floor.
Abby glanced at her watch. ‘I must go—I have to drop Ellie off at nursery school before I go in to work.’
‘Me, too…I want to get in to work early so that I can familiarise myself with everything before I have to make a start.’
Hannah said her goodbyes and left the house, hurriedly making her way to the tube station. With any luck, her journey would only take around half an hour and then she would have just a two-minute walk to the City Hospital. Once there, she was hoping to have time to find her bearings and adjust herself to her new role as senior house officer in A and E.
She wasn’t sure what to expect. Everyone had said that this was the best teaching hospital around, and she was lucky to have landed a post here, even though it was only for a six-month stretch. Her nerves were already beginning to get the better of her, though, and when she finally arrived at her destination, the hospital seemed to loom up in front of her. It was an imposing building. It was a huge, sprawling, impersonal place, like the city, and she faltered, wondering whether she might have made a mistake in coming here.
After a moment, she went inside. At least she had made friends with her neighbours, the people who shared the house with her. Getting to know Abby and her daughter had been good. It went part way to making the cramped living conditions seem more bearable. Dean, the young man who lived in the flat across the hallway from Hannah, was a bit of an unknown quantity as yet, but he seemed sociable enough.
‘So, you’re the new SHO?’ Mr Tremayne, the consultant, was a tall man, in his mid-forties, she guessed, and he had black hair, silvering a little around the edges, giving him a distinguished look.
She nodded, and he said, ‘Good. Grab yourself some protective covering and you can help out over here. We’ve had an influx of patients from a road traffic accident, and we need every pair of hands we can get hold of.’
He was clearly not going to waste any time on preliminaries. ‘I was going to put you with our specialist registrar, but he has his hands full right now, and Colin could do with some help in the meantime. He’s trying to save a man’s leg. Compound shaft of femur fracture—as well as tibial fracture. The circulation could be compromised. When you’ve finished there, you can go and look for our registrar.’
He paused, then threw back, almost as an afterthought, ‘He’s from the same neck of the woods as you, I believe—the Chilterns, isn’t it? Even the same area, I think.’
Hannah was puzzled. It sounded as though he thought she might know the man, but she didn’t know anyone who worked in London. As it was, she was more than a little distracted by being thrown in at the deep end. She didn’t have time right now to worry about who the specialist registrar might be.
No matter how edgy she might be feeling, Colin, the doctor she had temporarily been assigned to, appeared to be even more so. He looked worried. His dark hair fell in a haphazard way across his brow, giving him a youthful look.
‘The analgesia isn’t adequate,’ he said, assessing his patient who was groaning and clearly suffering. ‘I’m going to have to try a femoral nerve block.’ He glanced at the nurse who was assisting. ‘Sarah, have you had any luck finding the orthopaedic surgeon yet?’
‘He’s on his way.’
He sent Hannah a quick look. ‘Check the dosage of lignocaine with me, will you? He’s going to need the maximum.’
Hannah did as she was asked, then cleaned the patient’s skin in preparation for the insertion of the needle. Colin started the procedure, inserting the needle perpendicular to the skin and lateral to the artery, then aspirated and checked for blood, before starting to inject the local anaesthetic. He moved the needle, fanning it in and out laterally. After a moment, he sucked in his breath and, though he didn’t say anything, Hannah guessed that he had punctured the artery.
‘I’ll have to start again, as soon as the bleeding stops,’ he muttered. He apologised to his patient, who screwed up his eyes and clenched his hands.
‘Do you want me to compress the area?’ Hannah asked. It wasn’t his fault. It happened sometimes, and she felt sorry for both Colin and the patient.
He nodded. ‘Give it five minutes, and then I’ll try again. I’ll take a wound swab while we’re waiting. We’re giving him cefuroxime in case of infection, but I may need to add metronidazole.’
The next time, when he tried the nerve block, he was successful. Hannah hurried to prepare the backslab in order to immobilise the limb and Colin covered the wound with povidone-iodine soaks.
‘That should hold things until he goes for surgery,’ he said. He sent Hannah a quick look. ‘You’ve not come to us on the best of days. It feels as though all hell’s been let loose round here.’
‘So it seems.’ She gave a weak smile. ‘I was supposed to be working with the specialist registrar when I’ve finished helping you—do you know where he is?’
‘He was with a patient in cubicle three last time I saw him, but he could be anywhere by now. Adam’s one of those quicksilver figures—you never know with him. He might be working on a cardiac patient, or he could be supervising a student. It always seems as though he’s in three places at once.’
‘I saw him going over to the coffee machine a while back,’ Sarah put in. She was a pretty young woman, a brunette, with grey eyes that reflected an outgoing personality. She waved a hand in the direction of a bay that was set back from the main area of A and E. ‘You can grab something to drink from there any time you like, while you’re on the move, in between breaks.’
‘Thanks. That’s useful to know.’
She sent Hannah a querying look. ‘I heard you were from somewhere around the West Wycombe area. Perhaps you know Adam already? His father’s Monroe Driscoll—you know, the Driscoll import-export conglomerate? He has a big country estate round about where you come from. Perhaps you’ve seen it?’
Hannah felt a prickling sensation run down the back of her neck. ‘Yes, I know the estate.’ Her voice sounded hollow in her ears.
Sarah was looking at a point beyond her. ‘Adam,’ she said, ‘we were just talking about you.’ She directed a hand towards Hannah. ‘This is Hannah, our new SHO. Perhaps you two already know each other?’
Hannah half turned as the specialist registrar approached. She looked him over, her gaze transfixed. Adam Driscoll was every bit the man she remembered…long and lean, rangy and confident in his stride, his features perfectly sculpted, his hair as black as jet. Her heart tripped into a thudding, erratic beat in response to his nearness, and it bothered her that he still had the power to enthral her, to make her go weak at the knees.
She stared at him and all the memories came flooding back in full force. Their last meeting had not been a happy one. Harsh words had been said, and recriminations left to hang in the air. The same brooding tension rose up between them now as though the years had dropped away in an instant.
Adam’s gaze travelled over her steadily, with cool intent. ‘Oh, yes,’ he said. ‘We’ve met before, haven’t we, Hannah?’
He said it with a wry inflection, his deep voice gritty, his grey eyes dark and glittering, giving nothing away, but he remembered, just as she did, she was sure of it.
He flicked a glance towards Sarah and Colin. ‘In fact, we’ve known each other since Hannah was in her teens and came to live in the village. At one time, she and her foster-brother were frequent visitors to my father’s estate…in fact, they even worked there sometimes in the summer holidays.’
‘Oh, that must have been something special,’ Sarah murmured. ‘I’ve seen the place in the brochures. It looks lovely, set in all that sprawling, beautiful countryside.’
Hannah’s mouth made an awkward twist. ‘Yes, you’re right. It’s just as wonderful as it looks from the photographs.’
Adam said calmly, ‘Perhaps we should find a quiet corner where we can go and talk. I need to show you around the department and fill you in on how we organise things here.’
He turned and she went after him, her steps trailing, almost reluctant, yet drawn to follow him as though by some magnetic impulse. Hadn’t it always been that way? As a young girl, she had been mesmerised by him, had needed him, wanted him, but in the end all her dreams had turned to ashes.
‘It must be all of five or six years,’ he said, opening the door to an office and going in there, pausing to glance down at a file on the desk. ‘Even longer, perhaps, since we last saw each other.’
He was probably right. Although he had come back to his family estate since then, on fleeting visits during breaks from his work, she had always been careful to keep away, after that last bitter parting.
Adam pushed the file to one side and cleared a space, half leaning, half sitting on the edge of the table, facing her, his long legs thrust out in front of him. ‘I suppose you were busy with your medical training in all that time…at a medical school close to where your adoptive mother lived, wasn’t it? And various other places since, I imagine. I didn’t think you would ever stray this far afield—not to London, at least. Cities aren’t really your style, are they? You’re a country girl at heart.’
‘Is there something wrong with that?’ Her blue eyes challenged him.
He shook his head. ‘Nothing at all. It just surprises me to see you here, away from your home territory.’
‘I heard that this was the best teaching hospital around. It was an opportunity I couldn’t miss.’
‘Maybe.’ He looked at her thoughtfully, and she could see that he wasn’t convinced. He was too perceptive by far, and it made her deeply uncomfortable to know that he might guess what was her driving force. She wasn’t ready to share her true reason for coming here with anyone, yet. Her self-confidence was too fragile, too easily shattered, and she was afraid that if she admitted too much, everything would fall through.
He frowned. ‘So, how’s your foster-brother these days? Is he managing to stay out of trouble?’
‘You don’t think that’s possible, do you?’ It was her turn to study him, her gaze clear and direct. He had brought up the source of their hostility towards one another, and she wasn’t going to back down from that. ‘He wasn’t guilty of any wrongdoing, but your father wouldn’t listen to reason, would he? Ryan didn’t take that money. He isn’t a thief. You all blamed him, and treated him despicably, but he was innocent.’
Adam shrugged. ‘That’s all water under the bridge now, isn’t it? We’ve all moved on from there.’
‘Have we? How can we move on when those things are still unsettled? Those accusations were hurtful, and the sting lingers on, even years after the event.’
‘Hasn’t your brother moved on? I thought he might have become less restless over the years…that he might be less easily roused to anger. He was always quicktempered and ready to fly off the handle at the slightest provocation. You can hardly blame my father if he had his doubts about him. There was gossip. People talked and they always had something to say about the kids from Calder Close.’
Hannah glowered at him. ‘And that was always the gospel truth, was it? We were all part of a foster-family, and children came and went, and we had no solid foundation—that meant we were bound to be up to no good, did it? What was it that made us a target—that we were all misfits from a bad gene pool?’
‘I didn’t say that.’ His jaw tightened. ‘I’m just pointing out that people had their doubts, and Ryan didn’t do anything to convince them otherwise.’ His glance flicked over her, taking in her slender figure, coming to linger on the mass of her shimmering, honey-gold curls, but she had no way of knowing what he was thinking. The air sparked between them. ‘Anyway, you and your foster-brother didn’t come and go, like the other children, did you? You stayed. You, for one, were adopted and you didn’t go back to your parents.’
Her gaze faltered. It hurt to remember those childhood years. ‘Ryan did, from time to time. His parents managed to unscramble themselves on occasion, as I recall, but he was happy with our foster-mum. She gave him stability of sorts.’
‘That’s true, I suppose.’An ambulance siren sounded in the distance and he got to his feet in one fluid movement. ‘We should get back to work. There might just be time for me to show you around before we get caught up in the melee once more.’
He left her to meet up with the paramedics a few minutes later, and she worked steadily through the rest of the morning, trying to keep her mind firmly on the job in hand. It had been a shock, meeting up with him like this, and she wasn’t at all sure what was the best way to handle the situation. It looked as though he was going to be supervising her work for a good deal of the time, and things were by no means settled between them. Perhaps they never would be.
His father had dismissed Ryan from his job on the estate, and that knowledge still rankled. No one had actually ever labelled Ryan a thief, but the implication had been there, and her foster-brother had never come to terms with that. It had hurt him to be branded a ne’er-do-well, and Hannah recognised that and had been fiercely loyal to him to the last.
He wasn’t a blood relation to her, but they had been brought up together for a good many years, and she treated him as though he was her brother. Adam’s part in the whole sorry episode had unsettled her and had destroyed their tenuous relationship. He had sided with his father, and Hannah felt bad about that.
Colin came and found her after the lunch break. ‘How are you holding up?’ he asked. ‘You look as though you’re a bit out of your depth. Can I help at all?’
‘Thanks. I might need propping up before too long.’ Her mouth made an odd quirk. ‘Everything’s so immediate, and there’s hardly a moment where you can stop and think. I still haven’t quite found my bearings. The whole place is like a warren, and I’ve lost my way on more than one occasion.’
She grimaced, recalling how Adam had sharply intervened when she had nearly taken a patient down to the basement instead of up to Theatre, and she was still smarting from his cool admonition when she had been about to start treatment on a patient before waiting for lab results to come back. It had appeared to her to be totally necessary, but how could she have known that the man was a drug user who was known to the department for his wily subterfuges?
She hurried over to the paramedics as they brought in another patient. The man on the trolley was semiconscious, with an oxygen mask over his face, and Hannah gave him a cursory glance, anxious to examine him and find out what needed to be done. She could see that his breathing was shallow and barely perceptible. He was slipping deeper into oblivion.
‘What happened to him?’ she asked.
‘It looks like a co-proxamol overdose,’ the paramedic said. ‘There was a bottle of tablets on his bedside table and, judging by the date they were prescribed, there are a lot missing. His neighbour found him.’
‘OK, thanks.’ Hannah supervised the patient’s transfer to a cubicle, and prepared to intubate him, but as she removed the mask from his face, she drew back in sudden alarm. ‘I know this man,’ she said, throwing Sarah a quick glance. ‘He lives in the flat opposite mine.’
Dean looked in a bad way, and she had to quickly overcome the jolt to her system to make sure that she did whatever was possible to save him.
‘I’m going to put in an intravenous line and give him naxolone to try to reverse any cardiorespiratory effects,’ she told Sarah. ‘I’ll add N-acetylcysteine in dextrose as well, but we’ll need to check the prothrombin time and repeat the infusion accordingly.’
‘Are you going to do a gastric lavage?’ Sarah asked.
Hannah nodded. ‘Yes, I’m going to put in a nasogastric tube. Let’s get him into a head-down position, and I’ll need two litres of warm water.’
Inside, Hannah was feeling shaky. She ought to have known that something was wrong when she had spoken to Dean this morning. If anything happened to him, she would feel responsible. Guilt washed over her. She had to save him…she had to…
She glanced up as her friend Abby appeared in the doorway. She looked fraught, concerned, as though she was in shock.
‘They said he was in here,’ Abby managed. ‘Is it all right if I stay? I need to know that he’s going to be all right. I had to get the landlord to come and open his door so that we could get in, and it took ages. I felt sure that something was wrong.’
‘Yes, of course you can stay,’ Hannah said. ‘It won’t be pleasant, though. You might want to look away. As soon as I’ve washed out his stomach, I’m going to give him charcoal to prevent any more absorption of the drug he’s taken.’
‘Is it very dangerous, what he’s taken?’Abby asked. ‘I mean, how bad is it?’
‘The drug contains paracetamol,’ Hannah explained as she worked. ‘It can cause irreparable liver damage, or even liver failure, if the overdose is large enough and we don’t clear it from his system.’
She turned to Sarah and said anxiously, ‘I need to find out why he took so many tablets.’
‘Should we get a psychiatric consultation?’
‘Possibly. I’ll wait until I know more.’ She glanced at Abby. ‘Do we know if there are any relatives we should contact?’
Abby grimaced. ‘I’m not sure. He said something to me about his parents—I think they live somewhere in Kent. I’ll see if I can find out exactly where.’
‘Thanks. I think that would be a good idea.’
Abby stayed for a while, but she was increasingly restless, and after an hour had passed, she looked at her watch and said, ‘I can’t wait any longer. I have to go and fetch Ellie from nursery school or she’ll wonder where I am.’ She bit her lip. ‘There’s been no change in his condition, has there? Is he going to get through this?’
Hannah glanced at her. ‘We’re doing everything we can, Abby, but it could take several hours before we can say for certain that he’s out of danger. I’ll let you know what’s happening, I promise.’
‘Thanks.’ Abby left, looking worried, and after a minute or two, Adam put his head round the door.
‘You’re still keeping watch over him, I see. Perhaps you should take a break, and then go and see to some of your other patients. There are a lot of people out there who need your attention, and the queue is getting longer by the minute.’
She looked at him, her face pale. ‘But I know him. He lives in the same building as me, and I have to see him through this.’
‘You’re doing everything that you can. When Sarah comes back from suturing her patient, she’ll observe him and let you know if there’s any change.’
He was right, of course, but it tore her to pieces to leave Dean like this. She said anxiously, ‘Are you sure there’s nothing more that I can do for him? I’ve been trying to think of alternatives that I might have missed.’
He glanced at Dean’s chart. ‘It looks as though you may have found out why he took so many painkillers. He has an infected wound on his knee…is that right?’
She nodded. ‘Yes, he does. He had an operation recently to repair the ligament, and somehow it became infected. I’ve taken a swab for the lab and I’m giving him antibiotic cover in the meantime.’
‘Then you’ve done enough for now. When you get the results back from the lab you’ll be able to choose a more specific treatment.’
She didn’t have any more arguments to put forward, and there was no denying he was right when he said that she had other patients to attend to. Reluctantly, she followed Adam out of the cubicle as Sarah came back to check Dean’s blood pressure and pulse.
‘You know, you’re going to have to find a way of distancing yourself from your patients,’ Adam said. ‘If you get too deeply involved with them like this, you’ll be nothing but a shadow of yourself by the time you finish your stint here. You can’t afford to expend all that emotional energy.’
‘I don’t suppose you ever let that happen to you, do you?’ she remarked flatly. ‘You make it sound as though it’s easy to let go.’
‘I realise that it must be hard for you, but it’s something we all have to learn. Emotionally, we’re all vulnerable and you have to find a way to keep part of yourself detached, or you simply won’t be able to do your job.’
‘And you manage yours perfectly, don’t you?’ Her gaze challenged him. ‘You don’t let things bother you. You don’t worry about what happens afterwards, when the damage has been done. You simply let go and you move on as though it’s none of your concern.’
Wasn’t that what he had done when Ryan had been in trouble? It had hurt all the more because she had idolised Adam, worshipped him from afar, compelled by his strength and firm character, and it had been as though he had let her down when she’d most needed his support.
He frowned. ‘This isn’t a little cottage hospital where you get to know your patients and probably even live near them. This is the city, and our intake runs into the thousands. You can’t afford to let yourself care so much about everyone who comes through here.’
She lifted her head, her mouth straightening. ‘No, I suppose you can’t. That wouldn’t do at all, would it?’
His gaze ran over her. ‘I said that you don’t belong in the city, and it’s true, isn’t it? I’m not sure that you’re anywhere near tough enough to stand the pace—and it will overwhelm you, unless you manage to build up your confidence somehow, so that you’re better able to cope with everything that comes your way.’ He grimaced. ‘Perhaps you’d have done better to stay in the countryside, where you could work in a close-knit, rural community.’
She looked into his eyes. ‘But I’m here now, and I plan to stay. I’m sorry if that doesn’t fit in with your plans.’
He watched her, his expression cloaked, but she moved away from him and went in search of her next patient. No matter what he said, or thought, she wasn’t going to back down. She was here for a special reason…she was here to find her natural mother, and there was no going back. It was something she needed to do. If he didn’t like it that she was here, that was too bad.
Hannah just didn’t know, right now, how exactly she was going to cope, working alongside him day after day. Once she had held a torch for him, and the flame had burned brightly, fiercely, until a cold, harsh wind had blown it out. Now their differences were too deeply ingrained for things to be easily resolved.