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Allegra introduced the laryngoscope and attempted intubation but the patient had only been extubated forty-eight hours before and the larynx was red and swollen. To make matters worse, he had a short, bullish neck. She couldn’t see the cords and reverted to bag and mask, but could hardly keep a seal on the face with the mask because the insufflation pressure needed was so high.
She muttered a curse under her breath, conscious of Joel watching her every move. ‘I’ll have to try again. We’re in real trouble here.’
‘I can see that, but you’re the most skilled here at airway management,’ Joel said calmly. ‘Just tell me how you want me to assist.’
Allegra threw him a quick grateful glance and tried the laryngoscope again but still could not intubate the patient. Mr Munsfield’s sats were now 70 per cent and he was looking deeply cyanosed.
‘We need to get an airway, Dr Tallis. He’s badly hypoxic and throwing off VEBs,’ Joel said.
‘I can’t get a tube in,’ she said, her brow beading with perspiration. ‘I’ll have to do a surgical airway. Open the tray, Dr Addison, stat.’
Joel opened the surgical airway pack on the top of the trolley. Allegra put on sterile gloves and made a transverse incision over the cricothyroid membrane with a disposable scalpel. Taking a pair of artery forceps, she widened the hole, and passed in a cuffed tracheostomy tube and inflated the cuff, then connected the tube to the oxygen bag. The chest rose and fell with each pump on the bag, though the insufflation pressure was high.
Allegra flicked her gaze to the sats monitor, which showed the patient’s sats coming up into the 90s. She connected the ventilator and set the dials to cope with the high pressure and poor oxygen exchange.
‘Well done, Dr Tallis,’ Joel said, briefly placing a hand on her shoulder to steady her. ‘That was a top-notch surgical airway under pressure. Things look back under control here. I’ll leave you to fill Harry in—he’s just arrived.’
He moved off towards the A and E area before Allegra could thank him for his help. She frowned as he went through the swing doors, her feelings towards him undergoing a confusing change which she couldn’t quite explain.
The surgical registrar arrived with the consultant, Harry Upton, and was briefed by Allegra.
‘He needs to be opened, I agree. The pancreatic anastomosis has probably leaked, and on top of that he’s got pancreatitis. Thanks for salvaging the situation, Allegra.’
Danielle filled Harry in on the rest of the patient’s details before he turned back to speak to Allegra. ‘You look like you could do with a break.’
Allegra blew a wisp of damp hair off her face. ‘I’m off for a break right now. It’s been one of those mornings.’
‘So you’ve finally met our new director,’ Harry said with a twinkle in his eyes. ‘I didn’t see you at his welcome function last week.’
‘I was on nights,’ she explained, her mouth tightening a fraction.
Harry grinned at her sour expression. ‘So what gives, Allegra? You don’t like his … er … aura?’
She gave him a mock reproving look. ‘Don’t you start, Harry. He totally rubbished my project as if it was a load of pseudoscience. “Can’t afford alternative therapies in his science-based unit”, I think was how he put it.’
‘Yeah, well, I guess he’s under a lot of pressure to make this place work,’ he said. ‘There’s a lot of cash been poured into it, and there are a few irate unit directors who think they should have got the funds instead. If it doesn’t shape up fast, his head will roll.’ He grimaced as his pager went off. ‘I’m due in Theatre. I’ll see you around. Good work on Mr Munsfield, by the way. You and Joel Addison make quite an impressive team.’
She gave him another mock reproving glance but a small smile softened it. ‘Thanks, Harry.’
Allegra was using the staff restroom to freshen up when Kellie Wilton, one of her colleagues, came in.
‘I was hoping I’d run into you,’ Kellie said as she washed her hands at the basin. ‘I heard about your meeting with Dr Addison.’
Allegra frowned as she twisted her light brown hair back into its clip. ‘The hospital grapevine is running rampant again, I see,’ she said, turning to look at her friend. ‘Who told you about it?’
‘Louise mentioned it at morning tea,’ Kellie said, leaning back against the basin. ‘It certainly sounds as if you got off on the wrong foot. What’s his problem with your project? I thought Patrick Naylor was touting it as a unique study.’
‘He did, but apparently Dr Addison is under the impression that his decisions bear more weight than those of the chief executive officer. I hate men with overblown egos and closed minds.’
‘How is your relationship going with Patrick, by the way?’
Allegra put her hands on her hips and gave her friend a frustrated grimace. ‘Listen, Kellie, I had dinner with him—once. It wasn’t even in a posh restaurant and I ended up paying because his credit card wouldn’t swipe. We had pizza and a bottle of awful red wine, which I was still paying for with a headache the next morning. He spent the whole time complaining about his soon-to-be-ex-wife. Hardly what I’d call a date.’
‘Yeah, I’d heard his separation had hit him hard,’ Kellie reflected. ‘You do need to get out more, Allegra, with some fresh talent. Have you ever thought about using a dating service? My sister did and got a real honey.’
‘I don’t believe what I’m hearing, Kellie. What do you think—I’m desperate or something?’ Allegra gaped at her. ‘I can find my own dates without the help of a computer, thanks very much.’
‘One bad dinner in two years is not a good track record,’ Kellie pointed out.
‘Eighteen months,’ Allegra corrected her swiftly.
‘Look, Allegra, you’re twenty-eight years old. We’ve known each other a while now, and as far as I can tell the only fun you’ve had lately is sharing tubs of chocolate-chip ice cream with me while watching soppy movies at my place.’
Allegra sucked in her stomach and groaned. ‘Don’t remind me. It’s taken me four weeks to get my jeans to do up again after the last time.’
Kellie smiled. ‘Some of us are going to go out for drinks this evening after work. Why don’t you join us?’
‘Where are you going?’
‘Just down to the pub on Elgin Street. It won’t be a late night. You’re not on call, are you?’
Allegra shook her head in relief. ‘No, thank God.’
‘So will you come?’ Kellie urged. ‘You never know, you might pick up.’
‘What? A cold sore or a strep throat?’
Kellie laughed. ‘You are a sad case, Allegra. You’ve been hanging around unconscious people way too long.’
‘Maybe,’ Allegra said with a wry smile. ‘But they don’t break your hearts and they’re not unfaithful.’
Kellie’s expression softened. ‘And they don’t always live, no matter how hard you try.’ She placed a gentle hand on her friend’s arm. ‘Alice Greeson didn’t have a chance, Allegra. You did your best.’
‘I know …’ Her shoulders slumped a little. ‘But telling the family is always so hard. She was just twenty-one. I thought she was responding …’
‘She was brain dead, Allegra,’ Kellie said. ‘It was hopeless right from the start. You did what you could but the brain injury she sustained in that car accident was beyond anything medical science could repair.’
Allegra gave a long sigh. ‘I know, but I guess I was hoping for a miracle. They happen occasionally, I just so wanted one for Alice and her family.’
‘You’ll get your miracle one day,’ Kellie said. ‘We all do. It’s what keeps us going. Why else would we work the hours we do if there were no miracles?’
Allegra smiled. ‘You’re right. Thanks, Kel. What time did you say drinks are on?’
‘Just come when you’ve finished your shift. The place will be rocking by the time you get there so come no matter what time you finish. You need some chill-out time.’
‘You sound like my mother.’
‘Yes, well, mothers often know best, although I’m not sure mine would approve of the date I have lined up for the weekend.’
‘Don’t tell me you’re doing that internet dating thing, like your sister?’
Kellie grinned. ‘Why not? Look at her, six months on and she’s married and pregnant to a gorgeous guy. It could happen to any of us.’
Allegra rolled her eyes. ‘My mother would have a coronary if I told her I was dating someone I’d met on-line. My father would be even worse. They’d be doing a personality inventory and an astrology and numerology profile on the guy, and checking out his background with a private investigator. I think I’ll have to do it the old-fashioned way, you know, boy meets girl, that sort of thing.’
‘That sort of thing usually ends in divorce,’ Kellie pointed out. ‘Physical attraction is one thing but finding someone you can relate to is the stuff that really counts. You need to be friends first, lovers second.’
‘Yeah … I guess you’re right, but with the sort of hours I work, how am I going to find the time to make friends with anyone halfway decent? Most men expect you to sleep with them on the second or third date these days. They’re not interested in friendship, they’re interested in getting laid as soon as they can.’
‘That’s why the dating service is so useful,’ Kellie said. ‘It cuts corners for you by weeding out the weirdos and the ones who have no interests in common with you. Think about it. I can get Jessica to do a preliminary printout for you to show you how it works.’
‘I’ll think about it,’ Allegra said, as she shouldered open the door. ‘I’ll see you tonight.’
The door swung shut behind her but halfway along the corridor she came face to face with Patrick.
‘Hello, gorgeous,’ he said, planting a moist kiss to her mouth before she could turn her head away in time.
‘Patrick … I …’ She tried to push herself away but his hands were heavy on her shoulders.
‘Have dinner with me tonight?’ he asked, his tone pleading.
She opened her mouth to respond when just past his right shoulder she caught sight of Joel, coming out of one of the smaller meeting rooms used for conferencing with the relatives of patients. His dark eyes were cynical and there was a hint of something that looked very much like a smirk at the corners of his mouth.
‘Sorry, Patrick, but I promised Kellie I’d join some of the others for drinks later this evening,’ she said. ‘Maybe some other time.’
‘I’ll hold you to it,’ he said, and, pressing another quick kiss to her mouth before she could avoid it, went on his way in the opposite direction.
Joel stepped away from the doorjamb he’d been leaning against and walked towards her, his eyes very dark as they held hers. ‘Dr Tallis, no doubt you will disagree with me on principle, but perhaps it might be prudent to refrain from fraternising with members of staff in the corridors of the unit. I wouldn’t want any of our patients’ relatives to think that you’re acting unprofessionally.’
‘I wasn’t acting unprofessionally, I was just—’
‘Dr Tallis.’ His low deep tone brooked no resistance as he pointed to the room he had left a short time ago. ‘In that conference room are the parents of a young man who was admitted to ICTU a short time ago. He fell from a building site and has suspected spinal injuries. I do not think that they need to see right now two members of staff going for it in the corridor.’
She glared at him in affront. ‘We were not going for—’ But she cut herself short when out of the corner of her eye she saw the conference-room door open down the corridor. She watched in silence as a middle-aged couple came out with the head neurosurgeon, Anthony Pardle, in attendance, their faces ravaged by the emotion they were going through on hearing of the extent of their son’s injuries.
As much as Allegra wanted the last word, she knew it would be pointless. Joel had yet again stripped her of her professional dignity, and the last thing she wanted was for anyone else to witness it. She didn’t understand why he had to be so obstructive. He had been so helpful with Mr Munsfield earlier, but now it looked as if the momentary truce was at an end.
She waited until the patient’s parents and Anthony Pardle had passed before lowering her gaze and briefly apologising, even though the words felt like acid in her throat. ‘I’m sorry. It won’t happen again, Dr Addison.’
‘Fine.’
Allegra felt the silent magnetic pull of his dark brown gaze, her breath stalling somewhere in the middle of her chest as their eyes locked. The silence was so thick she felt as if it was going to choke her. Her heart began to thump a little irregularly as his gaze slipped to her mouth for a nanosecond before returning to her wide green eyes.
‘Fine …’ he said again, running a hand through the thickness of his hair in a manner that appeared to Allegra to be slightly agitated. ‘I’ll … er … let you get back to work.’
She watched as he turned and walked with long purposeful strides up the length of the corridor, before disappearing from sight through the swing doors at the end.
She blew out a little uneven breath and gave herself a mental shake.
Don’t even think about it, she scolded herself sternly. Dr Joel Addison was definitely in the ‘too hard’ basket. And for the sake of her heart he had better stay there.
CHAPTER THREE
THE pub was noisy and crowded by the time Allegra made her way there, but she wove her way through the clots of people to the table where some of the other Melbourne Memorial staff were sitting, chatting volubly over their drinks.
Kellie waved to her as she approached. ‘Come and sit here, Allegra.’ She made room for her on the booth seat. ‘What will you have to drink?’
‘I’d better start with something soft,’ she said. ‘After five nights of on-call my head for alcohol gets a little wonky. I’ll have a lemon, lime and bitters, but you sit down—I’ll get it. Do you want a top-up?’
‘Thanks. Vodka and orange,’ Kellie said.
Allegra made her way to the bar, saying a quick hello to two of the surgical registrars who’d been on call with her the last week. After a short exchange with them she carried the drinks back to the table where Kellie was and sat down with a sigh of relief marking the end of a stressful day.
‘How’s your coma study going, Allegra?’ Margaret Hoffman, an anaesthetic registrar, asked.
Allegra exchanged a quick glance with Kellie before responding. ‘The new director doesn’t think it’s scientific enough for his exacting standards. He’s giving me a month to prove it’s worthwhile.’
‘Oh?’ Margaret looked surprised. ‘But it’s all been approved and your work on the Greeson girl was worthwhile, I thought.’
‘The Greeson girl died,’ Allegra said with a despondent sigh.
‘I know, but what you might not have realised at the time was how much it meant to her parents, having you there. I saw the way they drew comfort from you massaging their daughter’s legs and arms, touching her like a real person, instead of someone who’d been written off as a vegetable. You gave them a lot of comfort in a tragic situation, Allegra. Even if the study achieves nothing for the patient, it sure as hell gives the relatives comfort—shows that the staff are treating their loved one with dignity, like a real person.’
‘She’s right, Allegra,’ Kellie said. ‘That’s what’s missing from medicine these days. The staff are all run off their feet, no one has time any more for simple things, like holding a patient’s hand or listening to their worries or giving them a soothing back rub.’
‘I guess you’re right. But if I’m going to show anything from the study, I’m going to need the support of the director,’ Allegra said, reaching for her drink. ‘He seems against it on principle, and we haven’t exactly had the best start to a working relationship.’
‘I thought he was lovely when I met him at the welcome function,’ Margaret said with a twinkle in her eye, ‘and good-looking, too, which of course always helps.’
‘I wouldn’t care if he looked like the hunchback of Notre Dame as long as he lets me do my project—it’s really important to me,’ Allegra growled.
‘Ah, but your involvement with Patrick Naylor gives you the trump card, surely,’ Margaret said. ‘I say, why not aim for the top if you can.’
Allegra frowned as she put down her drink. ‘I’m not involved with Patrick. Not in any way. Who on earth starts these rumours?’
It was Margaret’s turn to frown. ‘But I heard him tell everyone in the doctors’ room the other day how you had dinner together. He’s really into you, Allegra. He made that very clear.’
‘He’s still officially married, for God’s sake,’ Allegra said. ‘Besides, I’m not the slightest bit attracted to him.’
‘Well, someone’s definitely got their lines crossed,’ Margaret said, as she leaned back in her seat. ‘The way Patrick tells it, it sounds as if you are the reason his marriage split up in the first place.’
‘No!’ Allegra gasped. ‘That’s not true! I only went out with him as he seemed so down. It was more of a goodwill gesture. I was worried about him. He told me his wife had left him and he started to cry. I’m hopeless when men do that, it really gets to me. I just can’t help going into rescue mode.’
‘Uh-oh,’ Kellie said, glancing towards the bar. ‘Don’t look now but guess who just walked in?’
Allegra groaned and put her head in her hands. ‘Please, don’t let it be Patrick Naylor. I just couldn’t bear it.’
‘It’s not Patrick.’
Allegra lifted her head out of her hands and swivelled in her chair to see Joel looking straight at her. She turned back to her drink, her face feeling hot all of a sudden.
‘Guess who’s blushing,’ Kellie teased, and, leaning closer, whispered, ‘Go on, admit it, Allegra, he’s hot. Look at those biceps—he must be lifting bulldozers in the gym.’
‘Shut up—he’ll hear you,’ she muttered hoarsely.
‘He’s coming over,’ Kellie said. ‘Hello, Dr Addison. There’s a spare seat over here opposite Allegra.’
Allegra stifled a groan and sent her friend a blistering glare.
‘Thanks,’ Joel said, taking the seat facing Allegra. ‘Can I get anyone a fresh drink?’
‘I’m fine, thanks,’ Margaret said with a friendly smile.
‘Me, too,’ Kellie said. Giving Margaret a surreptitious nudge, she got to her feet. ‘We’re calling it a night anyway. We’re on early, aren’t we, Margi?’
‘Are we? Oh, yes … silly me.’ Margaret grinned sheepishly and wriggled out of the booth. ‘See you later.’
Allegra would have sent another scorching glare her friend’s way but Joel’s dark gaze had already searched for and located hers.
‘What about you, Dr Tallis?’ he asked, once the girls had left. ‘What’s your poison?’
‘I’m only drinking soft this evening,’ she said, her eyes falling away from his.
‘On call?’
‘No.’
A small silence tightened the air.
‘I hope I didn’t frighten your friends away,’ he said after a moment. ‘They seemed in a hurry to leave once I arrived.’
Her eyes came back to his, her expression taut with resentment. ‘They were trying to set us up. Surely you could see that?’
He frowned in puzzlement. ‘Set us up? What do you mean?’
She resisted the urge to roll her eyes. What planet had he just come down from?
‘Set up as in matchmake,’ she explained with a disapproving grimace. ‘Kellie does it all the time. It drives me nuts.’
Joel took a leisurely sip of his lime and soda as he studied her expression. She had a wry twist to her mouth, as if the thought of being connected to him in any way was impossible.
‘I take it she doesn’t approve of your relationship with the CEO?’ he inserted into the silence.
‘I am not having a relationship with the CEO.’ She bit out each word with determination.
‘So that little tableau I witnessed earlier today was an aberration of some sort?’
‘Patrick and I are friends … sort of …’ she said. ‘He’s going through a particularly acrimonious separation. I found myself lending an ear one day and now it seems the hospital is rife with the rumours of us being involved. Nothing could be further from the truth.’
‘Hospitals are like that. Members of staff have only to stop and talk in the corridor and everyone thinks something’s going on,’ he commented. ‘But perhaps you should be straight with him. He seems to think you’re his for the taking.’
Allegra frowned. ‘I know … but I don’t know how to avoid hurting his feelings.’
Joel finished his drink. ‘He’ll get over it. Tell him you’re involved with someone else.’
‘Yeah, right, like who?’ she said, with another rueful twist to her mouth. ‘I work thirteen-hour shifts. I don’t even have time to do my own laundry and shopping, let alone find a date.’
‘I know what you mean,’ he said with a wry smile. ‘I haven’t had a date in a year and a half. My mother is threatening to register me on an internet dating service.’
Allegra stared at him.
‘What’s wrong?’ he asked. ‘What did I say?’
She gave her head a little shake and picked up her almost empty glass for something to do to occupy her hands. ‘Nothing … It’s just that Kellie was suggesting I do the same.’
‘When you think about it, it sounds good in theory.’
She scrunched up her face in scepticism. ‘You think so?’
‘Yeah.’ He leaned back in his seat, one arm lying casually along the back of the booth. ‘It cuts the chaff from the wheat, if you know what I mean.’
Allegra couldn’t stop a bubble of laughter escaping her lips. ‘Chaff and wheat? Is that how guys these days refer to women?’
He gave her an answering smile. ‘I guess it’s not the best metaphor, but I thought sheep and goats would probably be worse.’
‘You could be right,’ she said, still smiling.
Joel ran his eyes over her features, taking in the light brown slightly wavy hair that seemed to be protesting about being restrained at the back of her head with a clip of some sort; loose tendrils were falling out around her small ears, and one long strand was over one of her rainforest green eyes. He watched as she tucked it behind her ear with her small slim fingers, her nails short but neat. Her face was faintly shadowed with residual tiredness but he knew if he looked in a mirror right now, his would look very much the same. Her mouth was soft and full, and her skin creamy white, as if she hadn’t seen much of Melbourne’s hot summer.
She looked like she worked hard and he felt a little uncomfortable with how he had spoken to her earlier. She had a good reputation among the staff, everyone spoke highly of her dedication to patients, but he couldn’t help feeling her project had all the potential to provoke criticism and crackpot commentary as the new ICTU was evaluated by those who had backed its funding and those who had lost out on their own funding as a result. From what he’d heard so far, her study was time-consuming, had little theoretical basis and it would be hard to show results. And he of all people knew how important results were. His parents’ situation was living proof of how the wrong results could change everything—for ever.
‘So …’Allegra said, moistening her lips as she searched for something to fill the silence. ‘How are you enjoying things so far at Melbourne Memorial?’
‘It’s a great facility,’ he answered, ‘the first of its kind in Australia. Having Trauma Reception on the same floor as ICU means that ICU staff are at close hand to be involved with trauma management. It’s a very innovative concept, even for a level-3 trauma centre.’
‘Yes, it makes a lot of sense. Less handing over of patients from one group to another, involvement of ICU staff right from the start of resus, and less movement of patients, too,’ Allegra agreed. ‘Wheeling patients twenty metres straight into ICU, instead of the old arrangement of up two floors and the opposite end of the hospital is a huge plus in itself.’
‘And having the two fully equipped operating theatres in Trauma Reception is real cutting edge,’ Joel said, ‘although some of the surgeons and theatre staff I’ve spoken to haven’t been too keen on it, actually. They don’t like splitting the staff and equipment between the main theatre and us.’