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This book is dedicated to all those health care
workers, agencies and volunteers who help with
society’s poor and disadvantaged. Thank you.
CONTENTS
CHAPTER ONE
CHAPTER TWO
CHAPTER THREE
CHAPTER FOUR
CHAPTER FIVE
CHAPTER SIX
CHAPTER SEVEN
CHAPTER EIGHT
CHAPTER NINE
EPILOGUE
CHAPTER ONE
TWO more weeks. Two more weeks. Two more weeks. The words reverberated around Charlie Wentworth’s head in time with the squeak in his back wheel. Two more weeks until he could start living again. The regular Sunday visit with his parents had left him with that familiar bitter taste in his mouth. Between his family’s overt disapproval, the uncertainty over his health and tomorrow’s invasion from the hospital administrator, he had a lot on his mind.
All he had to do was get through the next fortnight. Go through the motions. Co-operate with the hospital hatchet-wielder. See his patients. Take his meds. Keep focused. Go get the blood test. Wait for the results. Then he could get on with living.
Unless the test results were bad. Then what the hell was he going to do? He stepped on the accelerator out of pure frustration. He felt like his life had been on hold for years. The separation, the divorce and now this. The ancient Datsun strained and protested, gaining steadily on the car in front, and Charlie eased his foot off the pedal. Blowing the gearbox wouldn’t bring the next fortnight to a close any faster.
Carrie Douglas flicked her gaze to the rear-view mirror and tensed as the car behind surged closer. Her headlights stabbed into the darkness and she prepared to dip her high beam. She could see Dana’s blonde head slumped to one side, her cute face relaxed in a deep sleep, her ancient blanky snuggled against her cheek.
The other car fell back to a safe distance again and she relaxed. Driving at night on an unfamiliar road made her nervous. Carrying such precious cargo intensified the feeling. It was at times like these one realised that there was only so much as a mother you could do to protect your children. So much more was out of your control.
Thoughts about the job she was starting tomorrow turned over and over in her mind. The hospital was sending her in to sort out the financial mess of one of their inner-city outreach programmes. As far as projects went it looked pretty tedious but with her business and medical degree, she was perfect for the job.
And it wouldn’t be long now until her hard work paid dividends. There were rumours she was being considered for promotion to department head. Both Anaesthetics and Paediatrics were coming up for renewal. From there it would be an easy springboard into the real management hierarchy. In five years she was hoping to make Deputy Medical Director. Glass ceiling be damned!
It was the only thing in her life that mattered other than Dana. She needed financial security for her daughter and herself and to show everyone that her unplanned career diversion had been successful. Losing sight of her goal was not an option. She’d even left her sister’s wedding before the bride and groom so she could catch a decent eight hours’ sleep to ensure she was in good condition for tomorrow’s job.
Carrie saw the headlights of an approaching car illuminate the horizon and adjusted her headlights in preparation. She chewed at her bottom lip, going over everything in her head as the approaching car grew bigger. She glanced in the rear-view mirror again. The car behind was keeping a respectful distance.
Charlie was pulled out of his brooding thoughts in an instant as he noticed the drift of the oncoming car into the path of the car in front of him. Into his path. He became instantly alert, braking reflexively and at the same time noticing the brake lights of the car in front. Great, just the way his luck was running!
He swore as the car crossed the middle line, putting it on a collision course with the car in front.
Letting out an expletive, Carrie stomped on the brake pedal as the fancy red vehicle bore down on her. Her entire life flashed before her eyes. For a split second the world stopped. Her heart beat so loudly in her ears that nothing else registered. It pounded so frantically in her chest her whole body shook with its agitated rhythm. And then panic and instinct took over and she pulled hard on the steering-wheel. Please, God, don’t take me away from Dana.
Carrie held her breath as the red car passed in a blur. For a split second she thought she was safe. But then the red car clipped the rear of hers and she felt her head snap forward, her seatbelt snap tight and her head fling back again, slamming into her headrest as her vehicle spun wildly round and round in the centre of the road.
Charlie swore again as the red car’s trajectory changed on contact with the car in front.
It flipped, rising up over his Datsun, narrowly missing him. He looked in his rear-view mirror as it made contact with the road behind him, smashing into the bitumen and rolling several more times before coming to rest on its wheels in a mass of mangled metal and shattered glass. The remaining headlight shone brokenly on the unmoving form lying in the middle of the road.
‘Dana,’ Carrie called, turning frantically, ignoring the pain in her neck as they came to a stop in the middle of the road. Her daughter’s eyes fluttered open briefly and then she stuck her thumb in her mouth and stroked her blanky against her cheek. Carrie’s mother had always said Dana could sleep through an explosion.
Carrie felt a surge of relief so intense she almost floated out of the car. Dana was fine. Dana was fine. Her baby was fine. Thank you. Thank you. Thank you. Carrie felt an overwhelming urge to sink to her knees on the road and kiss the ground. She laid her forehead against the steering-wheel and took some deep calming breaths, the immediate shock giving away to the euphoric feeling of having just dodged a bullet.
It took a few seconds for the doctor in Charlie to respond to the inert form lying on the road, shock blunting his reactions. He opened his door, knowing he had to get to the victim lying on the road. But his eyes flicked to the other car that had come to a standstill in the centre of the road not far from him. The person inside was sitting at the steering-wheel, unmoving. Was this person also injured? Two potential victims.
The golden rule of triage—the most critical first. He looked back at the person on the road. Was he even alive? Could he have survived being flung out of a vehicle at high speed? He doubted it. He ran to the first vehicle and wrenched open the door.
‘Are you OK?’
Carrie startled at the brisk demand coming back from the quagmire of her shock. Her heart was hammering like a runaway train, her hands still gripping the steering-wheel. Was she OK? She’d been too concerned with Dana to notice. Her neck hurt a little.
She blinked at the question. ‘I’m f-fine.’
Charlie gave her a quick visual once-over. She didn’t seem to have any obvious injuries. He nodded. ‘I have to go see to the other driver.’ He indicated with his head.
Carrie nodded, noticing the very still person lying on the road for the first time. ‘Yes,’ she said.
And then the man was gone. She lifted her head, gingerly tested the range of movement of her neck. It was tender when she twisted it to the very limit of its capabilities but otherwise it seemed OK. Probably some minor whiplash. Still, Carrie knew how debilitating such an injury could be. She’d get an X-ray some time tomorrow to be sure.
Charlie popped the boot of his car and pulled out his medical kit, complete with oxygen and suction. In his line of work he needed a fully stocked kit ready to go in his car at a moment’s notice, and tonight he was grateful that he’d decided to irritate his father and drive the Datsun. If he’d been driving the BMW, he’d have been up the creek without a paddle.
He sprinted to the inert form, his heart pounding, his pupils dilating as his brain processed all the possibilities. It was a man. A middle-aged man. Had he fallen asleep at the wheel or had there been a medical emergency like a heart attack or a stroke that had caused him to veer into their path?
Charlie donned a pair of gloves and assessed the man methodically as drilled into him during his student years. D. R. A. B. C. H. Danger. Response. Airway. Breathing. Circulation. Haemorrhage.
The man was unresponsive. Unconscious. His airway was compromised, his gurgling respirations concerning. He was breathing. Just. He had a pulse. But it was rapid and weak.
His face was covered in blood. Charlie looked at the car and noticed the massive hole in the windscreen. The man must have been catapulted out through the glass, sustaining numerous lacerations. A quick head-to-toe check revealed multiple contusions, bilateral fractured tibias and what appeared to be an arterial bleed from the femoral artery if the bright, pulsing blood from the man’s groin was any indication.
Great! He tore the fabric of the man’s jeans, pulled a wad of gauze out of his kit and placed it over the bleeding site, applying firm, even pressure. He needed help. He flipped open his phone and dialed triple zero with one hand and prayed for service in an area that was generally sketchy at best. The nearest ambulance was twenty minutes away.
‘Hey, lady, I could use a hand here,’ he shouted into the stillness of the night while he waited for the operator.
Carrie jumped, snapped out of her daze by the urgency of his voice. Of course. She was a doctor, for goodness’ sake. But the thought of getting out of the car, of assisting the stranger, paralysed her with fear. The familiar dread descended on her and her heart was hammering madly again. He didn’t know what he was asking. And anyway…she couldn’t leave Dana.
Carrie watched him working as he spoke into the phone as if she was watching it on a television screen. Like it wasn’t really happening. He obviously had a medical background. He was calm and capable, with a huge boxful of medical supplies at his side.
She had a strange feeling of disconnectedness. Maybe it was the residual effects of shock. Maybe his appeal for help had tipped her over. Her hands shook as she thought about getting out of the car and lending a hand. She couldn’t do it. The mere thought was enough to make her hyperventilate. It terrified her more than the near collision had.
Charlie cursed as he hung up. They were coming, sending two road units and a chopper and alerting the nearby local rural fire brigade, but would it be soon enough? The man’s obstructive breathing sounded loud in the night filled otherwise only by insect song. Hell! The driver needed his airway managed as well as his haemorrhage, and he couldn’t do both.
‘Lady! Get your butt here now,’ he shouted, turning his head so he could pierce her with a look that was a cross between commanding and desperate. ‘I’m trying to save this guy’s life!’
Carrie felt the man’s demand slice through her panic and touch the doctor she had shut away for too many years. Despite her shaking, despite the dryness of her mouth and the pounding of her heart, something inside responded to the stranger’s urgent appeal. She checked on Dana. Still asleep. Almost against her will her hand reached for the door.
Charlie looked up as the woman approached. Oh, hell. She was pale and visibly shaking, looking at the unconscious bleeding patient as if she’d never seen blood before. She looked horrified, as if she was going to either faint or vomit. Or both. Great. She was going to be as useless as a screen door on a submarine.
She’s all you’ve got, Charlie boy.
‘Gloves top drawer of the kit,’ he barked. If she didn’t snap out of this stupor they were both in trouble. Yes, she’d been through a lot tonight. No doubt she’d thought she’d been a goner at one stage but there was a life hanging in the balance and time was of the essence. He didn’t have time to baby her. He only hoped she would respond automatically to his demands.
Carrie crouched and pulled out a pair of gloves. Her movements were stiff, robotic, as if someone else was controlling her. Pushing her buttons.
‘Down here. I need you to put your hand here,’ he said. She didn’t move and he almost lost it.
‘I…c-can’t.’ Carrie’s teeth chattered violently.
Charlie bit his tongue and took a deep calming breath. ‘Look, lady, I know you’ve had a shock tonight but this is really, really important.’
Carrie felt herself responding to the softness in his voice. To his calm appeal. ‘I c-can’t.’
‘Yes, you can,’ he said encouragingly. ‘I need firm, even pressure.’
His kept his voice quiet and composed despite the well of frustration rising inside him. Of all the people in the entire world he was stuck with a neurotic female who would probably faint before much longer.
He looked at her for confirmation and breathed a sigh of relief as she reached out a shaking hand to cover his. He removed his slowly. ‘Firm. Even. Do you understand?’
She didn’t answer him, just stared with a look of horror at the blood covering her glove. She was looking at it as if she’d never seen the substance before.
‘Y-yes,’ she stuttered.
Charlie looked down at her technique, pleasantly surprised to find that she had quickly mastered it. As long as she kept the pressure applied she could prevent this man from bleeding to death, and it freed him up to manage the airway.
Carrie didn’t feel the bite of the bitumen into her knees through the thin fabric of her hand-made cotton tie-dyed trousers. She didn’t hear the hum of insects or the stutter of her own panicked breath. She didn’t even hear the stranger rooting around in his medical kit. The injured man’s blood totally consumed her.
She could feel its warmth though the thin barrier of latex. She could smell its pungent metallic aroma heavy on the warm night air. Knew that it would be sticky as it clotted around her hands. Don’t die. Don’t die. Don’t die. The chant helped her keep her mind off the roar of her own blood in her ears, the sweat beading her forehead, the nausea rolling through her intestines. She was breathing fast. Too fast.
Charlie cursed under his breath as he applied an oxygen mask to the man’s face. She was going to hyperventilate at any moment.
‘Hey,’ he said, forcing himself to minister to her needs for a few seconds while the patient’s life hung in the balance. ‘You’re doing great, OK? Just slow your breathing down. Can you do that?’
Carrie shook her head, feeling everything around her spinning out of control. Her lips were tingling. Her gloved fingers, covered in blood, were tingling. ‘I can’t…b-breathe,’ she gasped.
Charlie bit back an expletive. ‘Yes, you can. Look at me.’
Carrie couldn’t move. She could only see the blood. Her mind started to play tricks. She was getting flashes of another place and time. Another patient. Another life-and-death situation. So much blood. She squeezed her eyes shut and shook her head to expel them.
‘Look at me!’
His command ricocheted across the space between them and Carrie’s head snapped up.
He saw the sheer panic in her eyes. ‘You’re doing really well,’ he said gently, lifting his hand and squeezing her shoulder. ‘The ambulance should be here soon.’
Carrie felt the warmth of his hand anchoring her in the suddenly spinning world and her panicked thoughts eased momentarily.
‘What’s your name?’ he asked.
‘C-Carrie,’ she said.
‘Hi, Carrie. I’m Charlie,’ he replied, and smiled. ‘I need you to slow your breathing down, OK? Do you think you can do that?’
Carrie nodded mutely.
‘Come on, Carrie, like this,’ he said, breathing deeply in and out himself. ‘Breathe with me, like this.’
Carrie forced herself to slow her breathing. It was hard at first, she didn’t feel like she was getting enough air into her oxygen-starved lungs. But following Charlie’s calm voice, mimicking his deep steady breathing—in and out, in and out—had an affect. His hand on her shoulder was immeasurably comforting. The tingling slowly subsided.
‘OK, now. Good. This is good. Much better. Well done.’
He smiled encouragingly at her. Carrie was aware somewhere inside her jumbled thoughts that he was talking to her like she was a frightened child, the way she spoke to Dana during a thunderstorm. And she was also aware that behind his calm façade his eyes kept flicking down to check the inert man on the ground. Their patient was in bad shape and she had to pull herself together.
‘I need to keep going here. Will you be OK? Just keep breathing, OK? In and out. All right?’
‘I’m sorry. I’m g-good now. I’ll breathe.’
Charlie searched her face. She still looked scared but the panic was gone. ‘OK.’ He nodded and turned his attention back to his patient.
What first? He needed a collar to stabilise the patient’s neck before he manipulated it to improve the airway. He didn’t have one. He made a mental note to put a collar in the kit for future use and moved to plan B. He knelt so that the patient’s head was between his legs, his knees and thighs providing support for the head and neck.
He experimented with some gentle jaw support and chin extension and was relieved to hear the breathing become much less noisy. He reached for his portable suction unit, pushed the mask aside and placed the sucker inside the man’s mouth. Blood slurped into the tubing.
Carrie startled at the loud mechanical noise. She saw the red fluid track down the tubing and looked away quickly. Nausea roiled through her intestines again and for an awful moment she thought she was going to vomit. Her heartbeat surged and she coughed on a rising surge of bile.
Charlie looked up quickly. ‘You OK?’ The look on her face was worrying. He could hear her fear in her tortured breathing as she struggled to get herself back under control. ‘In and out, Carrie. This is nearly over.’
Carrie nodded, not trusting herself to speak.
Charlie felt his conscience prick at what this experience was doing to her. First she’d nearly lost her life and second he was forcing her to do something she was clearly unsuited to. She was obviously one of those squeamish people who didn’t like the sight of blood, who flicked the channel over when a medical show came on television. It had to be hard for her. This sort of scene could be difficult for even hardened professionals.
She nodded, still not trusting herself to speak. ‘Do…do you think he’s going to d-die?’
Charlie was surprised to hear her talk. She looked mute with fear and her teeth were chattering loudly. Maybe she needed conversation to distract her from the grim reality of the situation? He had two choices. Truth or gloss.
‘Probably.’ He’d never much been one for gloss.
Carrie shut her eyes again.
‘He’s got a significant head injury and multiple fractures, including probable facial, which is compromising his airway. His pupils are fixed and dilated. He has a major arterial haemorrhage.’
Carrie nodded. Through the fog of her seized thought processes she knew these were significant, life-threatening injuries.
‘But it’s OK, I’m a doctor.’ He grinned despite the circumstances, knowing she needed assurance. ‘I’m not giving up yet.’
Carrie felt relief wash through her system. Maybe his confidence was wrong in the face of the severity of the situation but it helped calm her a little.
The wail of a distant siren interrupted their conversation. They both cocked their heads.
‘See? Not much longer.’ Charlie smiled.
A fire engine arrived a minute later. It wasn’t quite what Charlie was after but it meant more hands. ‘What happened?’ asked a thin young man, jumping out of the truck.
Charlie filled them in. Within a minute the car was being dealt with, a road block was being set up to manage any traffic and Charlie’s request for light had been efficiently dealt with. He even commandeered someone to assist.
Second rule of triage—the most experienced person on scene managed the airway. But Charlie needed to get a line in and he couldn’t do that from the head of the patient. He let one of the crew take his place, stressing the importance of neck stability while he quickly placed an IV in the crook of the patient’s elbow. He hooked some fluid up to it and ran it wide open as another fireman held the bag aloft.
‘She OK, Doc?’ The human IV pole nudged Charlie.
Charlie looked down at Carrie, who had her eyes closed and was rocking her body slightly. Not really.
‘She’s fine,’ he assured the fireman. The ambulance would be here soon and she could be relieved, but in the meantime she was doing a great job with the arterial bleed.
‘OK?’ he asked as he crouched down beside Carrie, squeezing her shoulder. She looked very pale. ‘You’re doing really well. I couldn’t have done this without your help. I’m proud of you.’
Carrie looked at him, stunned by his praise. Amazed even more that it seemed to matter so much. She was a mess and she shouldn’t have been. She should have been a professional. She could have been really useful. Formed a vibrant partnership to save the man’s life. Been an asset instead of a liability. But he was complimenting her nonetheless and in this nightmare it really meant something.
Charlie contemplated splinting the man’s fractured legs but discarded the idea instantly. He knew they’d probably want to put some special haemorrhage control trousers on the patient for his trip to hospital and splints would only hamper that process. He went back to managing the airway and keeping an eye on his unwilling assistant.
The road ambulances arrived five minutes later, one carrying an intensive-care paramedic, and the chopper thundered overhead minutes after that, landing on the road nearby. Carrie was relieved of her duty, her fingers numb from applying constant pressure. Someone took over and she felt several arms lifting her up and out of the way.
A paramedic shepherded her away but she refused to be looked at until she’d checked on Dana. Surely she wasn’t still asleep? But she was. Soundly. Her cherubic pout slack, her blonde locks in disarray.
Carrie allowed the paramedic to give her a once-over by her car. Someone thrust a warm drink at her and someone else draped a blanket around her shoulders. She was grateful to be away from it all, her heart rate settling but the feeling of unreality persisting. Her neck ached and she rubbed each side absently. Her knees ached also. She looked down at her ruined trousers, torn and frayed at the knees.
She watched Charlie work in tandem with the paramedics to help stabilise the patient. She admired his confidence. His self-assuredness. She had practically fallen apart, almost vomited all over the patient. But not him. He had saved the man’s life. His insistence that she help, while difficult beyond words for her, had been the right call. Not that she’d been capable of much.
Thirty minutes later the patient was gone. Dana finally woke up as the chopper lifted noisily. Carrie got her out of her car seat and snuggled her against her chest, wrapping the blanket around both of them.
‘What happened, Mummy?’
‘There was a car accident, sweetie.’
Dana yawned. ‘It looks like a disco, Mummy. Can I dance?’
Carrie smiled. Dana was right. The scene did look like a roadside discotheque. Flashing lights from the multiple emergency vehicles strobed across the scene, reflecting the pieces of broken glass scattered like diamonds across the road surface. ‘No, sweetie, no dancing tonight.’