The Consultant's Adopted Son

CHAPTER TWO

OWEN had never fully appreciated before what the saying about being pole-axed had meant, but he understood it now. It felt as though he’d been riveted to the spot as he stared at Rose Tremayne. What was she doing here? he wondered dazedly. However, before he could attempt to work out the answer, the doors crashed open as the next patient was rushed in.

‘Bed two. Suzanne, you take charge. I’ll be with you once I’ve checked this one out.’ Owen snapped back into action, feeling his heart thundering as he strode over to the bed. He didn’t look at Rose as he bent over the young man because he couldn’t afford to let himself get distracted. ‘What do we know so far?’

‘Motorcyclist with severe injuries to both legs. GCS of ten on admission.’

It was Rose who answered, and he felt his skin prickle with awareness when he recognised the sweetly husky tones. His mouth thinned as she continued updating him on the patient’s status. There was no way on earth that he was prepared to think of her as an attractive woman. She was a threat to his son and that was all there was to it.

‘He needs intubating and I want another line put in, stat! And can someone get rid of those clothes? How the hell can I examine him properly when he’s trussed up in those?’

He quickly set about intubating the patient, ignoring the fact that everyone had fallen silent. So maybe it wasn’t usual for him to order people around like that, but this wasn’t a usual day, was it? Having Rose Tremayne turn up in his department was something he had never allowed for. He wasn’t sure what she’d hoped to achieve by it, but there was no way he was letting her get anywhere near Daniel if that was what she’d been planning.

The thought of her duplicity was very hard to swallow and he swore under his breath as he eased the endoctracheal tube down the young man’s throat. Rob Lomax, one of the two registrars who were on duty that day, looked at him in surprise.

‘Are you OK, Owen?’

‘Fine. I suggest you concentrate on what you’re supposed to be doing instead of worrying about me.’

Owen ignored the looks the team exchanged at yet another example of his strange mood that day. He would make his peace with them later, after he’d calmed down—if he calmed down, he amended as Rose Tremayne moved around the bed and into his line of sight. What the hell was she doing here?

The only person who could answer that question was Rose herself, and there was no way he could ask her it at the present moment. He finished intubating while she cut away the young man’s leather jacket and then carried on with his examination, logging up a couple of broken ribs as well as a dislocated shoulder.

‘X-rays,’ he rapped out, moving to the bottom of the bed so he could examine the man’s legs, which were a mess. The right tibia was sticking through the flesh and the left foot was twisted at such an odd angle that the ligaments had to be ruptured. It was going to take the orthopaedic team several hours to put this jigsaw back together, he thought grimly as he turned to Beth Humphreys, the senior radiologist.

‘Both legs need doing as well as the usual—lateral cervical spine and anteroposterior views of the chest and pelvis. And can you send a copy through to the orthopaedic department so they know what they’ll be dealing with?’

He moved away after Beth had assured him that she would get straight onto it and went to see how Suzanne was faring. Although the registrar was extremely capable, she tended to doubt her own ability and needed a bit of gentle encouragement at times.

‘So what have we got here?’ he asked, standing beside Suzanne because it meant that he had his back to Rose Tremayne. The less he saw of her the better, he thought darkly, then deliberately erased the thought from his mind. If she’d hoped to upset him by turning up here then she was going to be disappointed.

‘Jane Robinson, aged fifty-five, presented with severe chest pain. She was a rear-seat passenger in the second vehicle that crashed.’ Suzanne frowned as she looped her stethoscope around her neck. ‘GCS fifteen on admission. Blood gases normal for both oxygenation and acid-base status, and both lungs are clear. There’s no history of cardiac problems, but there’s extensive bruising down the centre of her chest.’

‘Right.’ Owen turned to the woman. ‘I’m Owen Gallagher, the consultant in charge of the trauma unit. Were you wearing a seat belt when the accident happened?’

‘Yes. My daughter insisted I should wear it…Where is she? Has she been brought in yet? I want to see her…!’

‘I’ll get one of the nurses to check,’ he said soothingly. He looked around but everyone appeared to be busy at that moment apart from Rose. He steeled himself and beckoned her over. ‘Can you find out if this lady’s daughter has been admitted yet?’

‘Of course.’ She turned to the woman and smiled, and Owen felt his breath catch. Rose Tremayne had the most beautiful smile he’d ever seen, so warm and caring that it felt as though it could melt away any problems one might have had. It obviously had a comforting effect on Mrs Robinson because she immediately calmed down.

‘Can you tell me your daughter’s name?’ Rose asked quietly, but he’d prepared himself and the sound of her voice caused only the most minimal reaction this time.

‘Shelley…Michelle, I mean. Michelle Robinson.’

‘I’ll see what I can find out for you.’

Rose gave the woman’s hand a gentle squeeze then hurried away. Owen breathed a sigh of relief as she left the resuscitation room. Now that she’d gone he should be able to function on all cylinders again.

It was alarming to realise the effect she had on him. He tried not to think about it as he turned to the patient. ‘I need to examine you, so try not to worry. I’m sure there will be news of your daughter very shortly.’

Mrs Robinson didn’t demur as he set about the familiar routine. He frowned when he saw the full extent of the bruising down the centre of her chest. ‘How did this happen? I can see the marks from your seat belt, but I can’t understand where you got these bruises from.’

‘It was my own fault,’ Jane Robinson admitted guiltily. ‘Shelley told me to put it in the boot but I didn’t want it getting damaged.’

‘Were you holding something on your knee?’ he guessed, gently exploring the area. The bruising extended from just below her collar-bones right down to her waist—following the line of her sternum, in fact. It was possible that she’d broken a rib or two but he wasn’t convinced it was that which was causing her so much pain.

‘Well, not on my knee, exactly. It was too heavy for that. I had it propped in the footwell in front of me.’ She sighed. ‘It was a table, you see, with a marble top, and I didn’t want it getting chipped.’

‘And when the car crashed you slammed into it?’ Owen said, rapidly putting two and two together.

‘Yes. There wasn’t much room with the table in front of me, so even though I was wearing my seat belt, it still rammed right into my chest…’

She broke off and gulped. Owen frowned when he saw her start struggling for breath. ‘Can you tell me how severe the pain is at this moment?’

‘It’s really bad, Doctor, and I can’t seem to breathe properly…’ She suddenly stopped talking and her eyes rolled up into her head. The cardiac monitor started beeping to warn them that there was no output from her heart.

‘She’s in VF.’ Owen turned to his registrar. ‘I think it’s a cardiac tamponade—the heart is being compressed because blood is collecting in the pericardium. I’ll need to draw it off to relieve the pressure.’

‘You think it’s a fractured rib that’s caused it?’ Suzanne queried, hurrying round the bed.

‘More likely to be the sternum. That would explain the severe pain she’s been in. If the sternum has fractured, it could have pierced the pericardium, which is why there’s blood collecting around her heart. She’ll need to go straight to Theatre once we’ve finished. Shock her and give her a shot of adrenaline, but don’t apply external cardiac compression—it will only make matters worse.’

He left it to Suzanne to resuscitate the woman, knowing that the registrar was perfectly capable of following his instructions. His main concern was to deal with the cause of the patient’s arrest. It took him just a few moments to insert a hollow needle into the woman’s chest and he nodded as he watched the blood gush back into the syringe.

‘Just as I thought—cardiac tamponade. The sternum will need wiring up and the pericardium will need repairing, so the cardio team will have to crack open her chest.’

He drew off another syringe full of blood before Suzanne told him the patient’s heart was beating and they had established sinus rhythm. ‘Good. Get onto the cardio reg and tell him what’s happened,’ he instructed, peeling off his gloves. ‘Make sure he understands how urgent it is. This is one occasion when queue-jumping is absolutely essential.’

Suzanne made the call, then came back to him. ‘I wouldn’t have known what to do if you hadn’t been here. It never occurred to me that it could be a tamponade. I always associate that with a penetrating chest injury. I never considered the possibility that the sternum had fractured and pierced the pericardium even though I could see all that bruising.’

‘Don’t be so hard on yourself, Suzanne. There’s a dozen different reasons why she could have arrested. You know that as well as I do.’

‘Maybe. But you still managed to come up with the correct diagnosis.’

Suzanne looked downhearted as she went to meet the paramedics who’d arrived with another casualty. Owen made a note to have a word with her later and went to check on the young man with the leg injuries. Beth had the X-rays on the computer screen and he sighed when he saw the extent of the damage that had been done to the man’s ankle.

‘That’s going to take some sorting out. It will be a while before he’ll be able to walk on it. It causes a major problem when ligaments are torn like that.’

‘What about his leg?’ Rob queried, coming over to have a look. ‘It’s a real mess.’

‘That’s going to take time, too, and it will need external fixation from the look of it. The bone’s in bits just here,’ he explained, pointing to the screen. ‘It will take several weeks to lay down new bone and the biggest problem will be to ensure that the tibia doesn’t shorten in the meantime. That’s why external fixation is the best option.’

He looked round when he sensed that someone was standing behind him and stiffened when he saw Rose. ‘Yes?’

‘Mrs Robinson’s daughter is on her way in. ETA three minutes,’ she told him quietly, then moved away.

Owen watched her walk over to the bed and it was all he could do not to go after her and demand to know what she was doing there. He’d barely slept since the night he’d met her in the pub. He knew that he’d handled the situation badly by offering her money, but it had been his last resort after everything else had failed. Now he had no idea what she was up to, but he couldn’t accept that it was coincidence that had brought her to his department that day. She was planning something and, whatever it was it would have an impact on Daniel.

The thought of the damage she might cause was too much to deal with. Owen knew that he had to put some distance between himself and Rose Tremayne, otherwise he couldn’t be held responsible for his actions. Spinning round on his heel, he strode out of the room, ignoring the startled looks from his staff as they watched him leave. He needed a couple of minutes on his own to think things through. If Rose did have a plan, he intended to be one step ahead of her!

Rose bit her lip as she watched the doors swing shut after Owen Gallagher had left. She knew he was furious about her being there but it wasn’t her fault. She’d had no idea that he worked at St Anne’s when she’d accepted this job, otherwise she wouldn’t have taken it. Now she couldn’t decide what to do. Should she go after him and explain that she hadn’t intended to make life difficult for him by turning up in his department? Or would it be better if she left well alone?

‘I wonder what’s up with His Highness today.’

Rose summoned a smile when Rob Lomax came over to her. Instinct told her that it would be a mistake to let anyone know about her link to Owen Gallagher so she feigned ignorance. ‘Do you mean Dr Gallagher?’

‘Uh-huh. He’s like a cat on a hot tin roof today and it isn’t like him. That guy is the epitome of cool normally. Isn’t that right, Suzie?’

‘Isn’t what right? And don’t call me Suzie. You know I don’t like it.’

‘I know how you feel.’ Rose smiled as the other registrar joined them. ‘I hate it when people call me Rosie.’

Suzanne grimaced. ‘Then my advice to you is to make sure that certain members of this staff are fully acquainted with your views.’ She shot a speaking look at Rob, who tried to look hurt.

‘Do you mean me?’

‘If the cap fits…’ Suzanne sniffed loftily and walked away.

Rose chuckled. ‘That put you in your place, didn’t it?’

‘She loves me really,’ Rob assured her, grinning. ‘So, I know that your name is Rose but I don’t know much else. How about filling me in over a cup of coffee after we finish up here?’

‘Sorry, but I think I’d better stick to what I’m getting paid for.’

Rose smiled to take the sting out of her refusal, but nowadays she made a point of not getting involved with the male members of staff wherever she was sent to work. The few times she’d been out with a man in the past it had usually ended badly—her date had expected more from her than she’d been prepared to give. But she had made up her mind after Daniel had been adopted that she would never put herself in the position of being hurt like that again. It was much easier if she kept things on a strictly friendly footing.

‘That makes a change,’ Rob declared, unfazed by her refusal. ‘Most of the agency staff seem to think they’re here to socialise. Angie—that’s the charge nurse—keeps threatening to padlock the staffroom door. Usually they spend more time in there drinking coffee than doing any work!’

‘You must have been using the wrong agency,’ she said lightly, not wanting to be drawn into a discussion about the merits—or pitfalls—of employing agency nurses. There was enough ill feeling as it was, without her encouraging people to think badly of all agency staff.

The porters arrived just then, to take the motorcyclist up to Theatre. Rose checked that his notes were up to date and handed him over, then went to help with the patient who’d been brought in. It was Michelle Robinson, the daughter of the woman who had suffered the heart attack, and she was in a very bad way.

Owen reappeared, and he and the team did all they could for her, but it was a losing battle from the outset. The young woman’s injuries were just too extensive and she died thirty minutes later. Rose nodded when Angie asked her to remove all the leads and tubes before her family came to identify her. It would be distressing enough for them without them having to see all the unpleasant details.

Another couple of patients were brought into Resus, but Rose was asked to work the cubicles and didn’t deal with them. She was glad of the change because dealing with the most severely injured was always harrowing. As she went to report to the triage nurse, she found herself remembering what Rob had said about Owen Gallagher’s mood that day and sighed.

It didn’t take a genius to work out why he was out of sorts. Seeing her there must have been as big a shock for him as it had been for her. All she could hope was that it wouldn’t make a difficult situation any worse. No matter what he believed, she only had Daniel’s best interests at heart, and if getting in touch with her would help Daniel then she most certainly wasn’t going to refuse to see him.

The day wore on, the usual mix of high drama and the mundane. Overcrowded GP surgeries meant that a lot of people who came to the department didn’t actually need to be treated there. Rose dealt with half a dozen minor injuries ranging from a deeply embedded splinter to a sore throat then, at Angie’s behest, went for a break.

There were a couple of other nurses in the staffroom when she went in and she tried not to take it personally when they ignored her. She never stayed in one place long enough to make friends, so she was used to being ignored. She made herself a cup of coffee and had just sat down to drink it when the door opened and Owen Gallagher appeared.

She had managed to keep out of his way since she’d left Resus. With her working the cubicles, it hadn’t been that difficult to avoid him and she’d been glad of the respite. Knowing that she was an object of loathing in his eyes wasn’t the most pleasant experience she’d ever had. Now she stiffened as his gaze skimmed over the other nurses and landed on her. Even from that distance she could see the chill in his grey eyes. He strode towards her and his face was like thunder when he stopped in front of her.

‘There is a waiting-room full of people out there. I suggest you attend to what you’re being paid for, Ms Tremayne. And, to my knowledge, that doesn’t include sitting here, drinking coffee.’

His tone was icy with contempt and Rose flushed. She didn’t say a word as she got up, took her mug to the sink and emptied the coffee down the drain. Nobody said anything as she left the staffroom but she could feel the other nurses watching her and it was galling to know what they must be thinking.

They probably thought she wasn’t pulling her weight after what Owen Gallagher had said, and the unfairness of being labelled as lazy was very hard to take. She did a good job wherever she worked and put one hundred per cent effort into it, too. That was why she’d been offered so many permanent posts—every hospital she’d worked at had asked her if she would like to join their staff, but she’d had to refuse.

It wasn’t that she didn’t like the idea of working in one place, because she would have loved to do so. It was the fact that she wouldn’t earn her current salary that stopped her. As her father had sunk deeper into the grip of Alzheimer’s disease she’d had to move him into a nursing-home, and the fees were extortionate. Agency work paid far more than she could earn by working for the NHS, plus she could top up her income by working nights if the nursing-home’s fees increased. Maybe she should have explained all that to Owen—only what would have been the point? He wasn’t interested in her problems, he was only interested in keeping her away from Daniel.

Rose went back to the unit and took a fresh file out of the tray, determined that she wouldn’t give him the opportunity to accuse her of wasting time again. The waiting-room was packed and she had to shout to make herself heard above the din.

‘Vicky Smith.’

A girl in her twenties stood up, clutching her left hand. Rose grimaced when she saw the state of her ring finger. ‘That looks very nasty,’ she said, leading the young woman to a cubicle. ‘How did it happen?’

‘I was bringing my horse in from the field when he tried to bolt. The lead rope must have got wrapped around my finger somehow because I heard it make this horrible popping sound.’ Vicky sat down on the bed, looking very pale as she studied her swollen hand. ‘Do you think it’s broken?’

‘It could be, but I’ll have to get one of the doctors to take a look at it before we can be sure.’ Rose smiled at her. ‘It will probably need X-raying so there’ll be a bit of wait. Did you come here on your own or did someone bring you?’

‘I came on my own.’ Vicky looked close to tears. ‘I was going to phone my boyfriend but Oliver—that’s my horse—trampled on my mobile phone and broke it.’

‘I can phone him for you,’ Rose assured her. She jotted down the boyfriend’s phone number then went to find Suzanne and asked her to take a look at the girl’s hand. As she had predicted, Suzanne wanted X-rays to be done so Rose ushered the young woman to the radiology unit and left her there while she made the telephone call. Angie was using the phone on the desk, so rather than waste time waiting until it was free Rose found some change in her pocket and used the public phone in the foyer. She was just hanging up after telling Vicky’s boyfriend what had happened when Owen Gallagher came out of the department and he stopped dead when he saw her.

‘I’ve warned you once today about getting on with your work, Ms Tremayne, and I don’t intend to warn you again about flagrantly wasting time. You’re paid to work, not to organise your social life.’

‘Do you always speak to staff this way or have you singled me out for special treatment because of Daniel?’ Rose was incensed. She had never been spoken to in such a fashion before and she refused to stand there and meekly accept it.

‘This has nothing to do with my son!’ Gallagher glared at her. ‘I will not tolerate incompetence in any way, shape or form.’

‘Of course it has to do with your son!’ Rose spat the accusation back at him. ‘You’ve got it into your head that I am a threat to Daniel’s well-being and that’s why you are behaving this way.’

‘And can you blame me?’ He took a step towards her so that, instinctively, she tried to retreat. However, with the wall at her back there was nowhere to go. Her heart began to pound as he bent and stared into her eyes. She had never seen such dislike on anyone’s face before. It was all she could do to stand there as he continued in the same relentless tone when what she wanted to do was to run away and hide.

‘I don’t know what kind of a game you’re playing, Ms Tremayne, but one thing I do know: it won’t work. I won’t let you ruin Daniel’s life.’

‘I have no intention of ruining his life,’ she protested.

‘No? Then what are you doing here? What exactly do you hope to achieve by harassing me?’

‘I didn’t know that you worked here! I was just as shocked as you were when I saw you this morning.’

‘And you really expect me to believe that?’ He laughed shortly, his deep voice devoid of humour. ‘I’m sorry but I don’t believe in coincidences, so you’ll have to come up with a better story than that.’

‘It’s the truth! I’m here because the agency I work for sent me here. That’s it. There’s no other reason.’

Just for a moment a flicker of uncertainty showed in his eyes before he shook his head. ‘No, it’s just too convenient. You turn up in my department and expect me to believe that you didn’t plan this—’