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Pleased to have known to choose a wide-bore cannula without being told, Beth had also gone for easy venous access inside the left elbow. The cannula slid into place and she occluded the vein at the end of the tubing as she withdrew the needle and reached for a luer plug.
Luke was reaching for a luer plug as well. For a split second they caught each other’s gaze and there was a hint of a smile lurking on the surgeon’s face.
‘Snap,’ he murmured. ‘Guess we’ll have to call that one a draw.’
Mike watched them both as they finished attaching giving sets and started the fluids running. ‘Definitely a draw.’ He smiled. ‘Nice work.’ Then his face settled into a frown of concentration as he placed his stethoscope on Stella’s chest.
‘Heart sounds are pretty muffled.’
‘Jugular veins are more distended now.’
‘Stella!’ Mike raised his voice. ‘Open your eyes for me.’
There was no response. Mike pinched her ear lobe but her level of consciousness had dropped enough for the pain to be ignored. ‘GCS is dropping,’ he warned.
‘Beck’s triad.’
Beth wasn’t aware she spoken aloud until she caught Mike’s glance. ‘You know your stuff, don’t you?’ The older consultant sounded impressed. ‘What do we do next, then?’
‘Pericardiocentesis?’ Beth was aware that Luke was watching her. She’d been little more than a student nurse when they had worked together all those years ago. Would he also be impressed at the level of knowledge and the skills she had acquired since then? ‘Removal of as little as 20 mils of blood can improve cardiac output and patient condition considerably, can’t it?’
‘Spot on.’ Mike nodded. ‘You’ll find the kit on the shelf above the IV cannulas.’
Luke drew up the local anaesthetic while Beth swabbed the skin on Stella’s chest. Mike inserted the six-inch, plastic-sheathed needle, aiming towards the base of the heart, and they all watched the monitor screen carefully for ECG changes.
‘QRS complex is widening,’ Luke warned at one point. ‘Draw back a little, Mike.’
Beth held her breath. If it wasn’t blood around Stella’s heart that was causing the problem then their patient was in serious trouble. She relaxed slightly as she saw the needle fill with blood.
‘Here we go.’ Mike drew back on the syringe. ‘Five mils,’ he noted. ‘Ten…fifteen…’
Then the flow stopped. It seemed that enough blood should have been removed to help, but there was no improvement in Stella’s condition. In fact, it got worse. The ECG began to change, with the heart speeding up and missing beats. Stella wasn’t moving or even groaning any longer.
And then Chelsea called out from the adjoining resuscitation area.
‘Mike? He’s bleeding again. I can’t seem to find the right spot to apply manual pressure. Shall I take the bandage off?’
‘Coming.’ Mike glanced up at Luke. ‘Can you manage?’
Luke glanced at Beth. ‘Sure.’
The management of the femoral artery bleed next door was obviously difficult and the rest of the department was still humming. Nobody could be spared to assist in Resus 2 even when Stella’s heart gave up the struggle of trying to pump against constriction.
The electrical stimulus was still there but their patient was pulseless and Luke’s attempt to draw more blood from the pericardium with the needle proved fruitless.
‘Start CPR,’ he instructed Beth.
She worked hard to make her chest compressions as effective as possible, but Luke shook his head as he felt for a carotid pulse moments later.
‘We’re still not getting a pulse.’ He raised his voice. ‘Mike? I’m going to have to go for a thoracotomy here.’
Beth’s jaw dropped but Mike sounded perfectly calm. ‘That’s fine,’ he called back. ‘I’ll come and intubate for you in a second.’
Luke had caught Beth’s astonished expression and his tone suggested he had taken her reaction as a personal criticism. ‘You’ll find a thoracotomy kit in the storeroom, Beth.’
She was pleased to be able to turn away. ‘I know where it is.’
He was a surgeon after all, and maybe Luke had had experience with opening people’s chests. He certainly seemed confident enough, and it was probably the only procedure that was going to save a life here, but it was still horrific to watch him divide Stella’s sternum with a saw in what seemed like only a few minutes later.
It was just as well she’d had theatre experience in the past, Beth decided, handing instruments and wound towels to Luke. It was how they’d met in the first place. Luke had been a surgical registrar and Beth had just been starting work as a theatre nurse. She’d transferred, of course, when their relationship had hit the rocks and the fascination and pressure of working in the emergency department had gone from being a welcome distraction to a real passion.
And here they were again. The bizarre impression of being in a time warp was heightened after Luke took a scalpel and carefully incised the membrane of the pericardium. The rush of blood wasn’t enough to suggest a fatal cardiac injury and there was a collective sigh of relief as the vigorous pumping of Stella’s heart could be actually seen.
Mike had his fingers on the side of Stella’s neck. ‘Great output,’ he said delightedly. ‘Fantastic!’
His voice startled Beth. The feeling that she and Luke had been a single—and isolated—unit had been so strong she had actually forgotten Mike was there in the last few minutes. She had been standing so close to Luke. Their hands had touched more than once when she had handed him instruments, and that closeness—that touch—had wrapped them into a space that had been theirs alone. Luke merely nodded in response to Mike’s delight. ‘We’re not out of the woods quite yet,’ he warned. ‘Let’s cover everything with dressings and sterile drapes and get her up to Theatre to finish.’
But he paused fractionally when he caught Beth’s gaze and for the third time that night she was trapped by the expression in those dark grey eyes.
There was no hint of displeasure in them this time. Or the suggestion that she had changed beyond recognition. And, very oddly, the flicker of warmth that she saw was far more of a shock than Luke’s earlier reactions to seeing her had been.
His voice touched exactly the same tender place as that fleeting glance had.
‘Thanks, Beth,’ Luke said softly. ‘You were brilliant.’
CHAPTER THREE
IT WOULDN’T go away.
That flash of warmth in Luke’s gaze had been contagious, and Beth could still feel it, hours later, when she was finally able to follow Chelsea to the staffroom where Maureen was making a pot of tea.
She could still abandon her new job and leave Hereford, she reminded herself as she sank gratefully onto a chair. Her head was telling her that in no uncertain terms again and again. Her heart, on the other hand, was insufferably smug in the knowledge of how difficult it would be her to talk herself into walking away. From this place. From the new job.
From Luke Savage.
And all it had taken had been that one little spark from the warmth in those grey eyes and the tone of his voice when he’d said she’d been brilliant.
Brilliant!
Beth’s toes actually curled inside her shoes as a new wash of the glow spread through her.
‘You’re looking happy.’ Maureen placed a steaming mug on the table in front of Beth. ‘Sugar?’
‘No, thanks.’
‘I reckon she’s just relieved it’s all over.’ Chelsea reached for the sugar bowl. ‘What a night!’
Beth smiled wryly. ‘It’ll certainly go down in history as the most memorable first shift I’ve ever had at work, that’s for sure.’
And the major incident with the gang members had only been the half of it.
‘You did an amazing job out there.’ Maureen pushed a plate of chocolate biscuits closer to Beth. ‘Well done.’
‘Yeah…’ Chelsea was eyeing Beth curiously. ‘You were brilliant.’
Beth hadn’t blushed like that since she’d been a teenager. She reached for a biscuit to cover an embarrassment that had little to do with any modesty concerning her professional skills.
It hadn’t been the first time she had been a key player in a dramatic life-and-death scenario in an emergency department. Not that she’d assisted with a thoracotomy, of course—in a big department there was always a queue of more senior staff eager to participate in something that big, but there had been that emergency Caesarean that time. And the puncture wound in a carotid artery and…
And none of that history mattered a damn because any praise that had come her way had been strictly professional.
As the comment that Chelsea appeared to have overheard from Luke had been, she reminded herself firmly.
But it hadn’t felt like that, had it? The approbation from Luke had touched a place that hadn’t been touched since…since…
Since she had been Luke’s lover.
Beth crushed the thought relentlessly because Chelsea was still giving her an odd look. As though she was determined to read her mind.
So was Maureen, come to that. Beth’s eyebrows rose sharply.
‘What?’ she asked. ‘Have I got chocolate all over my nose or something?’
‘We’re just curious,’ Maureen explained.
‘About the thoracotomy?’
Chelsea laughed. ‘No. About whether you’re going to ask or not.’
Beth was mystified. ‘Ask what?’
‘What every new female staff member always asks.’
So the interest had to concern a male staff member, and Beth suddenly knew exactly whom Chelsea had in mind. She could stop this conversation right now. Change the subject. Pretend that an urgent trip to the bathroom was called for. But her mouth had other ideas. It smiled.
‘Which is?’
Chelsea exchanged another significant glance with Maureen. ‘Whether Luke Savage is married or not, of course.’
The fact that the answer was expected did not stop Beth’s heart stumbling over the next beat or two, but she actually laughed and shook her head in a valiant attempt to feign indifference. She picked up her mug of tea with a remarkably steady hand and took a sip.
Her lack of any verbal response did not faze Chelsea but she did seem puzzled.
‘Well, that’s a first, then.’
‘What? A woman not throwing herself at Luke Savage?’
‘Yep.’
Beth couldn’t pretend to be all that surprised. She’d had a vivid reminder tonight of what it had been like the first time she had clapped eyes on Luke. There must be countless women out there who would feel that same level of attraction. What was surprising was the distinct impression she was getting that Luke was, in fact, still single.
‘Not that any of them succeed,’ Chelsea added wistfully enough for Beth to wonder if she had been one of those women herself. ‘Maureen and I have a kind of running bet to guess how long it will take for them to realise he’s not interested.’
That explained the significant glances but it left rather a lot still not explained.
Like why was Luke not interested in the women who clearly made themselves easily available?
Why was he here? In a medical backwater that lacked so much of the resources a larger hospital would have in the way of specialty expertise and facilities?
And why was she experiencing such an overwhelming level of curiosity?
The need to escape took on greater urgency and Beth glanced up at the wall clock.
‘Nearly time to go home,’ she said in relief. ‘Is there anything I should be doing before the day shift arrives?’
‘No.’ Maureen smiled at Beth. ‘You go and get some sleep. You’ve done more than enough on your first shift. We’ll take care of the paperwork and handover.’ She waved aside the protest Beth was clearly about to make. ‘Go on,’ she ordered. ‘And if you see Mike out there, tell him his cup of tea’s getting cold. I don’t know why he hasn’t come in yet.’
Beth soon found out. Mike was leaning against the central desk, in a now deserted department, talking to Luke. Both men looked exhausted but Beth could sense their satisfaction.
‘How’s Stella?’ she queried.
‘Stable,’ Luke answered. ‘We’ll be transferring her to Wellington pretty soon.’
‘Thanks to you two,’ Mike added. ‘You’re a pretty good team, aren’t you?’
Beth gritted her teeth. The old wound must have opened more than she had realised for Mike’s words to have the effect of rubbing salt into it. This wasn’t good.
‘Runs in the blood for Beth, mind you,’ Luke told Mike lightly. ‘Did you know that her father is Nigel Dawson?’
Beth could barely suppress her groan. Of course Mike didn’t know. It was the last thing she’d be pointing out to any new colleagues.
‘Not the Nigel Dawson of heart-transplant fame?’
‘That’s the one.’
Mike’s glance towards Beth was openly interested but it was Luke he directed his comment to. ‘How on earth did you know that?’
‘Beth and I worked together for a while, years ago.’ Luke made it sound completely impersonal. ‘She did a stint as a theatre nurse.’
‘Lucky for Stella that you did.’ Mike was smiling warmly at Beth but it was almost impossible to return the gesture.
Not only had Luke dismissed their past relationship as not rating a mention, he had revealed a large chunk of Beth’s personal history that had been the other major part of her past she had been hoping to leave behind in coming to Hereford. It was the last straw and the balance finally tipped. No. Thanks to Luke, there was no way she could envisage the future she’d hoped to find here.
‘I’d better go,’ she said aloud.
Of course, her new colleagues couldn’t detect any undertones to her statement. They both smiled understandingly.
‘I’ll walk you out to your car,’ Luke offered.
‘No need, thanks. I’m walking.’
‘I’ll come anyway,’ Luke said infuriatingly. ‘I need to grab my shaving gear from my car. Besides, we haven’t even said hello properly, Beth.’
Beth ignored the quirk of Mike’s eyebrow but she could feel her shoulders slump as she turned away. On top of discussing her famous father, she could just imagine how interested Chelsea and Maureen would be to hear that Luke was insisting on escorting her out of the building.
Her first shift at Ocean View hospital was ending with just as much of a disaster as it had begun with. Beth was in no mood to give a polite response to Luke’s query about how she was.
‘I would have been a lot better if you hadn’t told Mike who my father was.’
Luke looked justifiably taken aback by her sharp tone. ‘What’s the problem? He is your father.’
Beth couldn’t deny it, however much she would have preferred to. ‘I came to Hereford to make a new start,’ she said curtly. ‘My family was one of the things I was more than happy to leave behind. Now I’m going to have everybody I meet asking questions.’
The calm, early morning sunshine that they emerged into made the drama of the last six hours seem totally unreal. This conversation with Luke seemed just as unreal. How crazy that they could slip back into an argument the first time they got to talk to each other.
‘Well, I’m sorry.’ Luke didn’t sound sorry at all. ‘But what’s so wrong with your family? If he was my father I’d be proud of what he’s achieved in his career.’
‘Yeah…you would.’
‘What’s that supposed to mean?’
The tone was enough to force Beth to slow her pace and turn to face Luke. He looked so tired, she thought. And annoyed. And genuinely puzzled.
‘Your opinion of my father was always higher than mine.’
‘I only met the man once. If you remember, you kept me away from your family for so long I thought you were an orphan.’ Luke shook his head. ‘For heaven’s sake, Beth. When did you start hating your father?’
‘I don’t hate him. I don’t hate any of my family. They’re strangers.’ Beth’s anger was more than ready to spill out. Gone were the days when she had responded to a conflict by bottling things up. ‘We were just an item to add to our parents’ CVs. Our son, the cardiologist. Our daughter, the paediatrician. Oh, there’s Beth, of course, but the only thing she ever did that we really approved of was to produce Luke Savage as a potential son-in-law.’
Luke had stopped walking completely now. He was staring at Beth with that look she had seen earlier. The one that implied she was a total stranger.
He opened his mouth but Beth didn’t give him a chance to say anything.
‘I wanted to escape from that “not living up to the family tradition” rubbish. Now, thanks to you, that’s going to be impossible.’
Luke merely blinked. ‘Was that all you came to Hereford to escape from?’
‘What?’
‘Is there anything else I should know about so I don’t put my foot in my mouth and make your new start any more difficult for you?’ Luke didn’t actually sound as though he was trying to be helpful. His polite tone had a distinct edge of sarcasm. ‘Have you left a boyfriend behind as well perhaps? Or a husband maybe?’
The tone pushed a button Beth had almost forgotten about. As if he cared about any answer she might supply!
‘A fiancé, actually.’
The effect on Luke was quite satisfying. His jaw dropped. ‘You’re engaged?’
‘Not any more.’
Luke’s expression became carefully blank, as though a switch had been thrown. ‘Who finished it?’ he asked quietly. ‘You…or him?’
‘Me.’ Beth glared at Luke. Just how much of her past was going to be dragged up before she could even find some time alone to come to terms with it all? It had gone beyond any kind of joke, however unfunny. Right now, it felt like her entire life was unravelling.
Luke met Beth’s glare without moving a muscle. ‘Not good enough for you, huh?’ he suggested casually.
Beth could feel the heat leaving her gaze but she couldn’t drag her eyes away from Luke. What would he say if he knew that her fiancé hadn’t measured up because it was Luke who had set the standard? Staying in a relationship with Brent would have been settling for second best. No, not even that close. It would have been stepping onto another emotional planet.
The thought was gone as quickly as it had come and Beth could feel her anger draining, but it was Luke who looked away first.
‘Maybe I should start a club,’ he muttered. He turned towards a black Jeep parked nearby. He took a step away from Beth then stopped again. Luke looked more than tired now. He looked…sad.
‘You’ve changed, Beth. I would never have thought you could stand up to trouble with gang members like that. Or start hating your family. Or go around dumping fiancés. I don’t feel like I even know you any more.’
The sadness in Luke’s expression was enough to bring the sting of tears to Beth’s eyes and she turned away quickly to hide them.
‘You never did, Luke,’ she said softly. ‘That was the problem, wasn’t it?’
The walk to the motel unit the hospital was providing until she found somewhere to live was not long enough to calm the spin-cycle effect Beth’s brain was having on her thoughts, and despite her exhaustion she knew she had no hope of sleeping yet. A walk on the deserted beach over the road from the motel seemed the perfect way to wait out the cycle.
Somewhere beneath the emotional roller-coaster the night had provided was a quiet pride in the fact that she had actually coped with it all. And the knowledge that she could cope again, if she had to. She wasn’t going to follow Neroli’s path and give up the work she loved because of intimidating patients.
Seeing Luke again had been just as much of a shock. But she had coped with that, too. Or had she? Somehow, it was crushingly disappointing that their conversation in the car park had ended up feeling just like one of the arguments that had marked the disintegration of their relationship. Nothing had changed.
But everything had changed. There was something different about Luke. A mystery that was never going to be solved if Beth didn’t stay in Hereford long enough to find out why Luke had chosen this quiet place to live and work.
And the tension created in the car park was never going to be resolved the way the old arguments had been. Until that last, horrible conflict, they had always made up their differences…in bed.
Any lingering tension would have been channelled into love-making that had made anything else totally insignificant. The world could have stopped turning as far as Beth was concerned when she had been in Luke’s arms like that. She wouldn’t have cared. She probably wouldn’t have even noticed.
An echo of Luke’s touch reached through the years and surfaced strongly enough for a spiral of desire to clutch something deep within Beth. A sound like a strangled groan escaped her lips and she sank onto a sun-warmed boulder.
How could she cope with this?
It was the ultimate reason to leave, wasn’t it? A very clear alarm sounding. If her body and heart were going to rebel against her head and decide they still wanted Luke, then she was going to be vulnerable. She could get hurt.
Again.
The thought was terrifying.
And exhilarating.
The spark was still there. Even if the result was a negative tension, it was better than indifference would have been, wasn’t it? When Beth had thought Luke had been ignoring her because he didn’t give a damn, she had felt astonishingly let down.
But it hadn’t been entirely negative.
He’d told her she’d been brilliant. He had looked at her—for just a fraction of a second—with an expression that had spoken of appreciation. Pride even.
And for the briefest pinpoint of time Beth had felt the sensation of pure joy that had always come from Luke being proud of her. Turning her face up to the sun, Beth closed her eyes and sighed softly. That sensation, however brief, was unforgettable. It was precisely what had been missing from her life for far too long. It was that elusive ‘x’ factor she had been searching for in all her attempts at other relationships. She had thought she might have found it more than once, only to gather enough doubts to ruin things.
And she’d been so right. Because now that she’d experienced the genuine article again, Beth knew she’d never found anything comparable. The craving to feel it again was undeniably powerful. The fear that she couldn’t protect herself if she did was equally strong.
The chance of experiencing it again if she stayed was minimal in any case. Luke hated her now. She was a stranger to him. An angry stranger who confronted people and hated her family. He was clearly bitter about their past. Did he really think that Beth had ended things because she’d thought he Luke ‘wasn’t good enough’? And how many fiancés did he think she might have had in the intervening years?
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