A Consultant Beyond Compare

CHAPTER TWO

KATIE turned the car on to the north road, heading towards Ambleside. She barely noticed the bracken-covered hills and heather-clad knolls, or the wide, U-shaped valleys that had been carved out by ice all those aeons ago. Her thoughts were taken up with the events of the day.

She still carried with her the brooding, dark image of Jessica’s rescuer, and it was troubling that he seemed to have misgivings about her ability to care for her sister. She had always thought of herself as a capable, independent individual, but lately her confidence had taken a battering. How could any of this be happening to her?

‘You will let me stay with you, won’t you, Katie?’ Her younger sister turned earnest, pleading eyes on her and Katie felt her heart give a painful twist. ‘I promise I won’t be any trouble, but I can’t go back home, I can’t. You won’t send me back there, will you?’

‘But you’re only thirteen, Jess,’ Katie answered, in what she hoped was a soothing voice, ‘and you’re a long way from home. Mum and Dad will be worried about you.’

‘No, they won’t. They don’t care about me as long as I’m out of their hair. They’ll just go on arguing, and shouting at one another like they always do. It’s horrible. I won’t go back.’

‘Of course they care about you.’ Katie frowned as she glanced at the road ahead. Perhaps she shouldn’t have taken this route. She had hoped to avoid problems, but traffic was building up, and it was beginning to occur to her that whatever had delayed her earlier on the journey to Windermere had merely been the overspill from what was happening up ahead. There must have been an accident of some sort, because in the distance she could see the flashing lights from ambulances that were parked by the roadside. A couple of police vehicles were stationed nearby.

Jessica made a face. ‘No, they don’t. They’re not going to miss me at all. They hardly ever notice I’m around, unless it’s because they think I’m getting in their way. Dad’s never had any time for me. He’s always at work or off out somewhere and as for Mum…well, she’s too busy worrying about her own problems, so she’ll be glad there’s one less person to bother about.’ She sighed. ‘You know how they are. They’re always arguing about something or other. Isn’t that why you left home and went off to medical school? You were glad to get away, weren’t you?’

Katie’s mouth made a wry shape. ‘It was a bit different for me. After all, Mum divorced my father when I was just a bit younger than you are now, and when she married again—well, it felt a bit odd. Things were never quite the same.’ She smiled at Jessica. ‘But then you came along, and it was lovely for me to have a baby sister.’

Jessica’s expression relaxed a little. ‘You’ve always been my very best friend,’ she said. ‘That’s why I came here to the Lake District to find you. I didn’t know what else to do, but I felt sure you would find a way to help me somehow.’

‘I wish it were that simple.’ Katie quickly ran her mind over all her options. ‘Whatever happens, I’ll have to ring them and let them know that you’re safe. They weren’t answering their mobiles when I tried earlier, but I’ve left a message for them on the answering machine at home.’

‘No, they’ve gone into town for the day. I said I was going to be at my friend’s house.’

Katie shook her head, shooting Jessica a quick glance. ‘I’m amazed that you managed to find your way here at all without getting into trouble of some sort.’

‘It was easy,’ Jessica said, with an air of unconcern. ‘I emptied my money box and went to the train station and asked for a ticket to Windermere. The man in the booth gave me a funny look, and I guessed he was a bit suspicious, so I told him I was going to visit my sister in the Lake District for the summer holidays and he said, “Oh, I see.”’

Katie frowned. ‘What did you plan on doing when you arrived at my house? I was out at work and the place is locked up.’

Jessica appeared crestfallen, but only for a moment. ‘I would have hung around until you came home.’ She gave Katie a contrite look and said quickly, ‘I won’t get in the way, I promise, and it’ll be cool if you let me live here with you, because I’d do everything to make things easier for you. I could tidy up and help you with meals and stuff. I know how hard you have to work and how tired you used to be after being in A and E all day, but with me around, things will be much better for you, honest.’

Katie couldn’t help but smile at her sister’s sincere expression. ‘I’m sure you would do everything you possibly could to help out, but that isn’t really what’s important right now, is it? We have to think about you, and what we can do to sort out your problems. It isn’t just a question of you coming to live here. There would be all sorts of arrangements to be made. How could I make sure that you would be properly looked after while I’m out at work?’

Jessica pulled in a quick breath. ‘I’m old enough to look after myself.’

Katie shook her head. ‘But you’re not, that’s the whole point. And then there’s school to think about. The holidays aren’t going to last for ever.’

Jessica’s mouth wavered as she struggled to keep her emotions in check. ‘I could go to school here, couldn’t I? You have to let me stay, Katie. Please, say you will, please, please? Things will work out all right, I know they will.’

‘Maybe. I left a message to say that I’d take care of you for a few days, whatever happens. We’ll talk it through properly when we get home.’ Katie slowed the car to a halt as the traffic came to a standstill. ‘If we ever get home…I thought we would avoid this hold-up by coming this way,’ she murmured distractedly. ‘It looks as though we’re going to be stuck here for a while, though.’

Jessica nodded and peered out of the window at the trouble up ahead. ‘It looks as though everything’s more or less sorted now. They’re closing the ambulance doors and getting ready to move away.’ She gave Katie a sideways glance. ‘You know, the man who helped me—Alex, he said his name was—took this road as well. I bet he’s wishing he’d gone another way. He’s still following us, just a few cars behind.’

‘Yes, I’d noticed.’ Katie glanced in her rear-view mirror and caught sight of the gleaming blue car slowing to a halt at a bend in the road. ‘Perhaps he’ll turn off before we get anywhere near Ambleside.’

It was wishful thinking, a vaguely consoling thought that she had clung on to as the journey had progressed. There was something about him that made her flustered and set her pulses racing, and it was all very disturbing. His calm, quietly perceptive manner ought to have encouraged her to feel that everything was under control, but instead he had stirred up all kinds of doubt and confusion within her.

She was left feeling unnerved and edgy, but of course that might have been as a result of all that had happened. All day long she had been active, rushing about, trying to resolve one problem after another, but now that she was stuck in traffic she was forced to be still, and it was an odd feeling. She tapped her fingers on the steering-wheel, beating out a restless rhythm.

Jessica dug her in the ribs. ‘Katie, look—there are skid marks on the road, right back here. Can you see them?’

Katie followed her sister’s pointing finger. ‘Yes, you’re right. It looks as though someone took the bend too fast, hit the barrier at the side of the road and then tried to stop further on.’

‘But he must have smashed into the car up front.’ Jessica’s eyes widened. ‘That must be one of the cars that they’re loading on to the retrieval truck right now.’

‘I hope the people who were hurt manage to come through this safely in the end,’ Katie murmured. She tried to gauge what was happening in the distance, but Jessica was jabbing her in the ribs again.

‘Something’s not right—look over there, in the bushes. I can see something. Come on, we have to go and find out what’s going on.’ Already, Jessica had released herself from her seat belt and was pushing at the passenger door.

‘Jess, come back here,’ Katie called out, but her sister wasn’t listening. She had jumped down onto the verge at the side of the road and now she was headed for the trees.

‘I don’t believe this,’ Katie muttered under her breath. ‘Will this nightmare never end?’ She manoeuvred the car onto the grass verge so that others could pass her, and then she switched off the ignition, sliding out of the driver’s seat to go in search of Jessica.

‘Over here,’ Jessica shouted. ‘There’s a man—Katie, I don’t think he’s breathing.’

Katie made her way through the thicket of brushwood that lined the hedgerow and saw that her sister was kneeling beside a man who was lying crumpled on his side on the meadow grass.

‘I saw his shoe through a break in the hedge,’ Jessica said, ‘so I guessed there might be someone here. Do you think he might have been thrown out of the car?’

Katie nodded. ‘It looks that way. I suppose the car door might have been flung open if it hit a post, and perhaps he wasn’t strapped in.’ She crouched down and was busy checking the young man for signs of life. He was in his early twenties, she guessed, and from the looks of things his jaw was broken. That would make it virtually impossible for anyone to insert an airway, and that could be disastrous, because he was already struggling for air, making strange gurgling sounds.

He wasn’t responding to Katie’s urgent attempts to talk to him and find out if he was aware of what was going on, and she knew that he was in a bad way. ‘His pulse is rapid and faint,’ Katie murmured, glancing up at Jessica, who was looking shocked and pale. ‘I need to help him to breathe. Do you think you could look in the glove compartment of my car for a pen or maybe a plastic drink straw, while I do what I can to clear the obstruction in his throat? And bring me the first-aid kit from the boot?’ She handed over the keys.

Jessica nodded, and hurried away. Katie was relieved. At least if the child had something to do, it would stop her from dwelling on the awfulness of the situation.

She rummaged in her bag, spilling some of the contents out onto the grass as she hastily searched for her phone. Finding it, she called for an ambulance. If only the paramedics who had attended the accident up ahead had stayed around for a few moments longer…but they hadn’t, and she had to deal with this calamity all by herself.

That thought barely had time to sink in before Jessica came back, and Katie’s eyes widened when she saw that her sister wasn’t alone. The man from the café was with her, his face taut with concern, a line indenting his brow. He came to kneel down beside her, so close that they were almost touching one another. Katie felt her senses swim.

‘Have you managed to clear his airway?’ he asked.

She gave herself a mental shake. ‘Not really. I’ve brought his tongue forward and done what I can, but he’s bleeding heavily and I can’t manoeuvre him properly to resuscitate him because his jaw is broken.’

‘Let me see what I can do.’

He made as though he would move her to one side but she resisted, saying quietly, ‘No, thank you. I believe I’ll manage.’ She gave him a determined blue stare. She couldn’t imagine why he thought he would know any better than she did about what needed to be done. ‘I’m going to improvise an airway. There’s no way he can be intubated in the usual way, even if there was any time to wait.’

He frowned, his eyes narrowing, as Jessica leaned over to hand her a plastic straw and then placed the first-aid kit down on the ground beside her.

Jessica’s jaw dropped as Katie opened up the box and took out a small sharp knife. ‘What are you going to do?’ she asked breathlessly.

‘I’m going to make a small incision in his throat and put the straw in place so that he can get air into his lungs.’ She looked up at her sister. ‘Perhaps you should turn away for a while. You might not want to see this.’

Jessica swallowed hard but steadfastly continued to watch what was going on. Beside her, Katie felt the man stiffen.

She sent him a quick glance. ‘Maybe you should look away, too,’ she said. The last thing she needed was for him to pass out through squeamishness. Anyway, it was unsettling, having him watch her every movement.

He shook his head. ‘Do you know what you’re doing?’ His whole body was poised as though he was ready to intervene at any second. Katie could feel the warmth emanating from him, almost as though he was touching her, and her skin began to tingle in response.

‘Yes, it’s all right.’ Her voice was husky and she cleared her throat. ‘I’m a doctor.’ As she spoke, she was already feeling for the thyroid cartilage, and within seconds she began to make the incision. Once she had established that she had managed to puncture the cricothyroid membrane she opened up the fissure with a finger and inserted the drinking straw a little way into the trachea. Breathing into the tube, she was relieved to see that the man’s chest began to rise.

‘Is he going to be all right?’ Jessica’s eyes were wide.

‘I hope so. I think he has some broken ribs, and there may be a skull fracture, but at least he’s breathing now, and we’ve managed to buy some time for him. We can’t do much more until the paramedics get here with proper equipment.’

She eased back a fraction and saw that Alex was checking the man’s pulse. ‘There’s a strong possibility he’ll go into shock,’ he said. ‘We don’t know for sure how long he might have been lying here. His heart rate is rapid, but the pulse is weak, and I suspect his blood pressure is way down. He must be bleeding internally.’ He was already getting to his feet. ‘I’ll go and get my medical bag from the car. We can at least put in an IV line and try to get some initial fluids into him.’

Katie stared up at him. ‘You’re a doctor?’

He nodded briefly, but he was already moving away from her, and after a moment Katie released a long breath. She hadn’t realised how keyed up she had been, having him so close beside her that his shoulder had almost brushed against hers. It had been like being surrounded by an electric force field strong enough to make the air crackle.

She blinked. So he was a doctor, too? No wonder he had tried to intervene. She tried to absorb this new revelation and at the same time keep a check on her patient. Alex seemed to think they had met before, but surely she would have remembered him if they had been at medical school together? After all, he wasn’t the kind of man you would easily forget. He was incredibly good-looking, with strong features and grey-blue eyes that seemed to penetrate deep into her soul. Just being around him had the power to stop her in her tracks.

He came back as she was taping the makeshift breathing tube securely in place. He sank down next to her on the grass and opened up his black leather case, but this time she was prepared, and with an effort she managed to keep her pulse rate under control.

‘I don’t carry a lot with me,’ he said in an undertone, ‘but I have some lactated Ringer’s solution, which will help until we can get him to hospital. They talk about the golden hour, but we’re fast losing ground there.’

Jessica was puzzled. ‘What’s the golden hour?’

Alex was attempting to find a vein, and Katie realised that it was going to be difficult if the man’s circulation was shutting down.

‘It’s the maximum time lapse from when the trauma happened to arrival at hospital, if the patient is to stand a good chance of survival.’ He slid the needle into place. ‘I’m in.’ Quickly he set up the IV line and hooked up the Ringer’s solution, using an overhead branch to keep the bag above the level of the patient.

‘At least…’ Jessica’s voice broke, becoming thready. ‘At least he has you and Katie to look after him.’

Alex gave her a brief smile, and perhaps he realised that she was very young and vulnerable because he said softly, ‘We’re doing everything we can for him.’

Jessica nodded, and watched as Alex drew up a syringe. ‘What’s that you’re giving him?’

‘It’s an antibiotic. We haven’t been able to use sterile equipment out here, so this should help to ward off any infection.’ He sent her a thoughtful glance. ‘You seem very keen to know what’s going on. Are you thinking of going into medicine like your sister? I suppose she must be a great influence in your life, working as a doctor?’

Jessica gave an awkward shrug. ‘I’m not sure what I want to do. I used to go and see Katie sometimes when she worked in A and E and she explained some of it to me, but she doesn’t work there now, and I’m not sure I’d be able to do that kind of job. I know Katie gave it up. She doesn’t work as a doctor any more, and I don’t know if I’m cut out for it either.’

Alex turned his gaze on Katie, his brows meeting in a dark line. ‘Is that true? You’re not working in medicine now?’

Katie nodded. ‘It isn’t easy to find placements these days, as you probably know. Anyway I wanted a change, so I found myself a job in a rehabilitation centre. It was good. I enjoyed working there.’ She grimaced wryly. ‘Unfortunately, the place closed down this afternoon, so it looks as though I’ll be looking through the situations vacant columns for something else first thing tomorrow.’

He opened his mouth as though to say something, but in the distance a siren sounded, growing nearer. They both checked their patient, relieved to find that his condition was reasonably stable for the moment. Alex began to gather up the equipment they had used, closing his medical bag and handing the first-aid kit to Jessica as the ambulance arrived.

The paramedics oversaw the patient’s transfer to the waiting ambulance, and Alex gave the team a rundown of the man’s injuries. ‘We’ll need to get a CT scan and move him to Theatre as soon as possible,’ he said. ‘I’ll follow you to the hospital and help with the handover to A and E. Martin’s on duty today, isn’t he?’

The paramedic nodded. ‘We’ll get in touch with him and tell him to stand by.’

‘Good.’ He stood back and waited while the men made sure their patient was securely strapped in place in the vehicle. Turning to Katie, he said, ‘There’s a place for you on my team if you want it. I’m in charge of the A and E department at South Lake Hospital. I’ve been advertising for a senior house officer for a few weeks now, and so far I haven’t managed to fill the position. None of the candidates have been right for the job. If you drop by the department some time tomorrow, we could go through the application forms together.’

Was he actually offering her a job? Katie’s mouth dropped open, but she quickly attempted to recover herself. ‘I don’t think so,’ she murmured. ‘I mean…thanks all the same, but I think I’ll take some time and look around.’

He was frowning again. ‘I don’t understand why you’re hesitating. Didn’t you say that you were out of work and posts were hard to find?’ His grey-blue eyes homed in on her with laser-like precision. ‘I’ve seen you in action and I’ve no doubt that you know what you’re doing. You acted promptly in an emergency and you probably brought this man back from the brink. Is there a problem of some sort, a reason why you won’t consider the offer?’

She shook her head. ‘There’s no problem. I just prefer to give it some thought, that’s all.’ Her chin tilted. She didn’t see why she had to lay her life bare for this man. He had dropped into her life from out of nowhere, and he could just as easily disappear into nothingness once more. Out of sight, out of mind—wasn’t that what people said? And that being the case, the spectre of working in A and E once more would disappear along with him, wouldn’t it?

‘I can’t stay and debate the matter with you,’ he said on a brisk note, ‘but I think you’re making a mistake.’ He pressed his lips together in a straight line. ‘I have to go.’

He glanced at Jessica, who had gone to stand a short distance away from the ambulance, watching the paramedics make their preparations to leave. Then he turned his attention back to Katie.

‘How are you going to manage? Don’t you owe it to that young girl to keep a roof over her head?’ His grey eyes darkened. ‘Or maybe she comes a long way down on your list of priorities? I suppose that could explain a lot.’

Katie straightened her back. ‘You don’t know anything about me, or my sister,’ she said. ‘How can you presume to judge me when we’ve only just met?’

He inclined his head a fraction. ‘That’s true,’ he murmured, and his mouth indented in a vestige of a smile. ‘You’re definitely something of an enigma, Katie Sorenson…but I dare say I’ll fathom the puzzle somehow.’

He moved swiftly away from her and headed towards his car, stopping only to say a quick goodbye to Jessica. Then he slid behind the wheel and sped away in the wake of the ambulance.

Jessica came over to where Katie was standing. ‘Did I hear him offer you a job?’

Katie nodded. ‘Yes. He seems to think I could find a place in his A and E department, but I told him I wanted to look around for something else. That’s why I moved here, so that I could put all that behind me and make a fresh start.’

Jessica nodded. ‘Yes, I know, but you’ll be going to work in another A and E department at some point, won’t you? You have to, surely? You’re a good doctor, and you’re needed out there. Anyway, you weren’t ever going to stay at the rehab centre for very long, were you?’

Katie started to walk towards her car. ‘Actually I found that it was far more rewarding than I expected. It was certainly less frantic than what I was doing at the hospital, and I wasn’t planning on making a change yet.’