Would Beth have turned her face up toward his like that if she hadn’t wanted him to kiss her?

Would he have wanted to kiss her if he’d known what it would be like? If he’d known that the lock would disintegrate on that part of his heart that had been so well protected for so long? That all the old feelings would still be there so completely?

Except they hadn’t been complete, had they? Because now he could add the painfully gained wisdom of so many years. And the forgiveness, and understanding of why it had happened.

His hands held her close; his lips moved over hers gently. This wasn’t about passion—though that was only a heartbeat away. It was about finding a connection again, and asking whether that connection could ever mean enough to make it worth exploring further.

Dear Reader,

Stories can begin to grow from an amazing variety of starting points. A character or a place or a conflict can all provide a flash point. Sometimes, as happened with The Surgeon’s Engagement Wish, something comes from way out in left field. I was leafing through a motoring magazine, of all things, when I saw a picture of a whale rescue.

We get a few mass strandings of whales in New Zealand so it’s not that unusual, but it got me thinking about how emotional such an experience would be, and how much depth it could add for a pair of central characters that were already having problems.

Not that I’ve ever helped with a whale rescue, but I have a friend who works in the Department of Conservation and she was able to help with the research. Thank you, Sandra!

My stranded whales and their rescue became very real for me and the story of Luke and Beth grew in both directions from that point.

I wonder what my next starting point will be?

Happy reading!

Love,

Alison

The Surgeon’s Engagement Wish
Alison Roberts

www.millsandboon.co.uk

MILLS & BOON

Before you start reading, why not sign up?

Thank you for downloading this Mills & Boon book. If you want to hear about exclusive discounts, special offers and competitions, sign up to our email newsletter today!

SIGN ME UP!

Or simply visit

signup.millsandboon.co.uk

Mills & Boon emails are completely free to receive and you can unsubscribe at any time via the link in any email we send you.

CONTENTS

Cover

Excerpt

Dear Reader

Title Page

CHAPTER ONE

CHAPTER TWO

CHAPTER THREE

CHAPTER FOUR

CHAPTER FIVE

CHAPTER SIX

CHAPTER SEVEN

CHAPTER EIGHT

CHAPTER NINE

CHAPTER TEN

Extract

Copyright

CHAPTER ONE

THE car should not have been there.

In the small car park adjacent to the emergency department of Ocean View hospital, yes. In the space reserved for the ambulance, even, if the emergency was dire enough.

But three quarters of the way through the wide electronic doors that led into the reception and triage area?

No way!

Nurse Elizabeth Dawson’s astonishment rapidly gave way to alarm. The car would have been suspicious enough tucked neatly into an acceptable car-parking slot. An ancient, rusting hulk of a V8. A status symbol amongst the elements of society who preferred to simply ignore any restrictions the law might impose on their lifestyle.

The man climbing out of the driver’s seat was even more intimidating. Clad in battered leathers with the ‘patch’ of his gang emblazoned on the back of the jacket, the heavily tattooed and menacing figure would have alarmed even the most confident of any emergency department staff.

And Beth Dawson was far from the most confident right now. She had started a new job in a new town only a couple of hours ago, for heaven’s sake, and everything was still completely unfamiliar.

No. Not quite everything. The aggression emanating from the gang member she was watching was all too familiar.

An unexpected flash of anger cut through her fear. This type of scenario was precisely why she’d left her job in a huge south Auckland hospital so recently. She’d had a gutsful of dealing with violent and uncooperative patients who took any pleasure or even satisfaction out of demonstrating the level of skill she had attained in her chosen profession.

The anger couldn’t last long enough to fuel courage, however, given the fact that she was alone in this part of the department. At 1 a.m. in a semi-rural area you wouldn’t expect a full waiting room, and the only patient who had come in since midnight was now having his chest pain investigated in one of the two resuscitation rooms.

Beth’s finger was pressed firmly against the button summoning assistance and any trace of saliva vanished from her mouth as she watched another two figures emerge from the vehicle. The bizarre sight of the car under the bright lights and filthy tyres on the spotless linoleum had already become just a background to an unpleasant drama unfolding. So had the rhythmic and futile attempts the electronic doors were making to close the small gap left around the obstacle. They touched the rear of the car and then bounced open again. And again.

The movement of the doors did not impede two of the men dragging the final occupant from the rear seat of the car. Little care was afforded the potential injuries of an apparently unconscious victim and a large smear of blood appeared on the pale floor as his feet dragged.

Two more nurses rushed into the space behind Beth, closely followed by the only doctor on duty, Mike Harris. Beth could feel all three of them virtually skidding to a halt as they caught sight of the car inside the building, but she didn’t turn her head. Her gaze was fixed on the slumped figure being held up by the armpits. She drew back instinctively as the gang member who had been driving the car started walking towards them.

‘Jackal’s been shot.’

Beth was aware of broken teeth and the smell of alcohol as the man spoke. She was also quite well aware that the incongruously casual tone of voice was no insurance against the level of implied threat in his next succinct words.

‘You’d better do something.’

They would be armed, Beth had no doubts about that. There would be knives tucked inside those commando-style boots. At least one of the men was wearing knuckle-dusters and she was quite certain there would be more than one sawn-off shotgun easily accessible in that vehicle.

Her breath escaped in something like a strangled laugh. She had left a big city hospital that had protocols for dealing with precisely this type of incident. Any number of security personnel would be available within seconds and a well-rehearsed police squad only minutes away. And even that kind of back-up hadn’t been enough to prevent her best friend, Neroli, giving up her nursing career, having been held at knife point in Beth’s old emergency department.

Beth had come to a small-town hospital near the tip of the south island of New Zealand to find a peaceful place to settle and refocus her life. She had barely begun her first night duty in this tiny emergency department and here she was, facing one of her worst nightmares. A recurrent one, thanks to the trauma she had unsuccessfully tried to help Neroli overcome.

Did Ocean View hospital even have security?

How far away were any police? The closest large town was Nelson and that would be at least ninety minutes away by road.

The tension escalated several more notches as the spokesmen for the gang members moved. His shoulders hunched and the fingers of one hand flexed and then clenched. The fist was thrust towards the only male member staff member present.

‘Now!’

Just do what he says, Mike, Beth urged silently. Please! But Dr Harris hadn’t even flinched.

‘Sure.’ Mike’s face was impassive and Beth found herself suddenly feeling slightly more confident. Well into his fifties now, Ocean View hospital’s emergency department consultant probably had more than enough experience to cope with situations such as this. ‘But I’m not going to tolerate my staff—or anyone else—being intimidated.’

There was a tiny silence as each side weighed up the implications of non-cooperation. It was broken by a groan from the injured gang member and the attention of everybody present was instantly diverted.

‘What’s happened exactly?’

‘He’s been shot, man. I told you.’

‘Yes, but where? And how long ago? How much blood has he lost?’ Mike was moving calmly towards the victim. Beth looked at her nursing colleagues. Should they all follow him? Chelsea was looking as nervous as she felt herself, and Maureen looked grim. The older nurse tilted her head.

‘Chelsea, why don’t you and Beth go and get a stretcher? I’ll stay and help Mike.’ She turned as she spoke so that her back was towards the gang members. ‘Call the police,’ she whispered faintly, her lips barely moving. ‘Fast.’

Chelsea’s nervousness seemed to wear off the moment she was assigned a task. She even grinned at Beth as they hurried from the triage area.

‘Here we go,’ she said almost cheerfully. ‘Again!’

Beth’s heart sank to a new low. ‘You mean you get this type of incident on a regular basis?’

‘We do get bit of trouble from gangs now and then.’ Chelsea paused as they entered the main section of the emergency department and she reached for the wall phone. ‘You’d be used to it, though, wouldn’t you? Didn’t you say you’ve been working in south Auckland?’

‘Yes, but I didn’t expect…’ Beth’s words trailed off as Chelsea started speaking to whoever was on the other end of the phone.

‘We seem to have a code yellow in ED,’ she said briskly. She listened for only a few seconds. ‘Cool…thanks.’

Beth grabbed the tail end of the stretcher and she and Chelsea headed back the moment the phone was replaced.

‘What’s a code yellow?’

‘Trouble with gangs.’

Good grief! So it happened often enough to have its own code?

‘What happens on a code yellow?’

‘Sid will get here first. He’s our night orderly cum security guard. Then one of the local cops who lives just down the road will come in.’ Chelsea was looking almost excited now as she glanced back at Beth. ‘If he thinks it’s necessary, he’ll call Nelson and they’ll chopper in the armed offender squad to help out.’

‘But there’s only one patient!’

‘So far.’ Chelsea gave Beth a questioning glance now. ‘This really bothers you, doesn’t it?’

‘I’m OK.’ Beth wasn’t about to demonstrate any inadequacy on her first shift. ‘Like you said, I’m used to it. A bit too used to it, maybe. A friend of mine had a knife held to her throat by a gang member not so long ago.’

Chelsea looked horrified. ‘Was she hurt?’

‘Not physically. She’s given up nursing, though, and gone to work in her sister’s coffee-shop in Melbourne.’

‘Was that why you decided to move as well?’

‘Partly.’ Beth smiled wryly as they turned the corner. ‘I was rather hoping I’d be getting away from this kind of thing by moving down here.’

Chelsea’s quick smile was sympathetic. ‘I hope it wasn’t the main incentive for the shift, then.’

‘It wasn’t.’

Beth’s words were lost as they entered the front of the department to find the stretcher was now superfluous. The injured man’s colleagues had dragged or lifted him as far as the bed in the empty resuscitation area.

‘I said don’t cut his leathers, man!’

‘We’ve got to get his jacket off so I can assess his breathing.’ Mike was still managing to sound calm but Beth could see that his frown lines had deepened perceptibly.

Maureen was plugging the tubing attached to an oxygen mask onto the overhead outlet. ‘I’m just going to put this on your face,’ she warned their patient.

The stream of obscene language made Maureen look even grimmer than she had on first spotting this patient.

‘Airway appears clear,’ she told Mike dryly. Stepping back as two silent gang members unceremoniously stripped the leather jacket off the now groaning man, she noticed the return of the younger nurses.

‘Perhaps you two could clear Resus 2.’ She and Mike seemed practised in trying to keep the atmosphere as casual as possible, but the undercurrent of urgency was easy enough for Beth to detect.

And no wonder. The man in the adjacent resuscitation area was looking alarmed and his wife was terrified. It was just as well that the chest pain he was having investigated had been deemed to be angina rather than a heart attack because otherwise the anxiety caused by the arrival of the new patient might have made his condition a lot worse. He probably didn’t need admission but he certainly needed to be moved.

It took a minute or two to disentangle the patient from the ECG electrodes and other monitoring equipment anchoring him to the area. Beth looked over her shoulder as she pushed the foot end of the bed clear of Resus 2. The injured man in Resus 1 was alone with his medical attendants now. The other gang members had vanished. A second later they all heard the roar of an unmuffled engine as the car blocking the doors was restarted.

‘Our first job is to clear the department of any other patients if it’s possible,’ Chelsea told Beth as they manoeuvred the bed along the corridor separating the emergency department from the rest of the hospital. ‘We close the department to any arrivals that could be seen by a GP as well.’ She shook her head. ‘There was a major riot in the department a few years back apparently, and a bystander in the waiting room got stabbed. That was when code yellow came into force.’

Their patient’s wife was clutching her handbag in both hands as she trotted beside the swiftly moving bed. ‘Did you hear them say they were going to deal with whoever did the shooting? Where’s it going to end?’

‘At least most of them are out of the department for a while,’ Chelsea responded. ‘It’ll give the police time to deal with them before there’s any real trouble here.’

There was a curious calm in the emergency department when Beth and Chelsea returned. Mike was doing an ultrasound on the exposed, tattooed belly of their patient. Maureen was setting up a new bag of IV fluids.

A burly man wearing an orderly’s uniform was standing with his arms folded by the head of the bed, and an equally solid man in police uniform stood in an identical pose at the foot. They both gave Beth a curious stare.

‘Gidday,’ the orderly said. ‘You’re new here, aren’t you?’

‘This is Beth,’ Chelsea told them. ‘It’s her first shift tonight. Beth, this is Sid and that’s Dennis.’

The nods and smiles from the two men were both welcoming and sympathetic. Not a great way to start a new job, they conveyed, but they were pleased to meet her and would make sure she was safe. And Beth smiled back. Suddenly things didn’t seem nearly so disheartening. She would never have been introduced to members of security back-up in her old department and they certainly wouldn’t have made any non-verbal promises about making sure she was looked after. Working in a small community was going to be different.

Better.

‘Who’s on call for surgery tonight?’ Mike’s query broke an almost companionable silence.

‘Luke,’ Maureen told him.

‘Good. He won’t mind being woken up.’

‘Can you call him in, please, Chelsea?’

‘Sure.’

Beth watched as Chelsea headed for the wall phone. She knew there were five surgeons associated with Ocean View hospital. Three general and two orthopaedic. What were the odds that one of them would end up being called Luke?

And how many other reminders would there be for her tonight to let her know that you could never really escape the past and make a brand-new start? Beth shook herself mentally, bending over to pick up packaging from dressings and IV gear that littered the floor.

For heaven’s sake. It had been six years ago. It was pathetic that hearing that particular name could still have any effect on her. And it was weird that it was so much stronger tonight than it had been for a very long time. Maybe that was just because she was displaced. Feeling a little lost in a new environment and seeking links with her past to anchor herself.

‘He’s on his way,’ Chelsea reported. ‘Do you need theatre staff called in?’

Mike angled the ultrasound probe in a new direction, still peering at the screen. Then he nodded. ‘Yes, thanks, Chels. I reckon Jackal here is going to need more of an inside look than I’m getting.’

The gang member’s nickname suddenly seemed quite appropriate. The flash of fear as the comprehension of what was being organised on his behalf filtered through was swiftly followed by an aggressive snarl.

‘No way! You’re not cutting me, man! I’m outta here.’

‘Oi!’ The barked response from both Sid and Dennis was not enough to stop Jackal making an unexpectedly vigorous move to sit up, ripping the IV line from his arm in the process and actually managing to swing both legs over the side of the bed.

Restrained by the larger men, who latched onto both arms, he subsided instantly. In fact, he looked decidedly green within seconds and then, much to Sid’s obvious disgust, he vomited. Sid gamely kept hold of the arm but the restraint was no longer needed. Sitting up had been enough to cut an already diminished blood supply to Jackal’s brain and his level of consciousness was dropping fast.

‘Lay him down.’ Mike sounded almost weary. ‘And watch out for that blood, Sid.’ The orderly was wearing gloves but Jackal’s IV site was bleeding quite heavily. He leaned closer to their patient. ‘Listen, mate. You’re sick. You’ve had a bullet go through your belly. You’re lucky it hasn’t killed you but it’s still done a lot of damage to your spleen. You’re losing blood. Jump up now and you might make things a whole lot worse in a hurry.’

The response was not incoherent enough to disguise the obscenities but Mike simply straightened and reached for a fresh pair of gloves.

‘I’ll get that IV line back in. I don’t think he’s going to put up much of a fight with his blood pressure in his boots.’

Beth looked at the monitor. The pressure reading was 85 over 40. Jackal had to be losing a significant amount of blood. The glance that passed between Sid and Dennis was significant. If this became a homicide, they could all be in for a lot more drama.

Maybe they would be anyway.

Beth handed Mike a new wide-bore cannula and was ready with the luer plug and flush moments later.

‘Any word from Sally?’

‘Sorry.’ Beth shook her head. This was the kind of thing she hated about starting a new job. ‘I don’t know who Sally is.’

‘She’s one of our paramedics,’ Maureen supplied. ‘The ambulance got called not long after Jackal’s mates took off from here.’ Her brief smile was intended to be reassuring for Beth. ‘Police back-up got activated at the same time.’

Beth nodded, pleased to find her hands steady as she completed the fiddly task of screwing the luer plug into place on the cannula hub. She was injecting a bolus of saline to check that the IV line was patent when the radio on the main desk crackled.

‘Ambulance to ED. Do you copy?’

‘Shall I get that?’ Chelsea queried.

‘I’ll do it.’ Mike stripped off his gloves and then glanced at Beth. ‘Can you get some more fluids up?’

‘Sure.’

Beth taped the cannula securely in place, having flushed the line. Then she reached for a giving set and a new bag of saline. The task was automatic enough not to distract her from listening to Mike as he reached for the microphone next to the radio set.

‘Mike here, Sally. Receiving you loud and clear. What have you got?’

‘Status one patient. Car vs pedestrian.’

‘Roger.’ Mike shook his head slowly as he pulled a pen from his shirt pocket. They all knew how unlikely this was to have been any accident. ‘Vital signs?’

‘Heart rate of 130. Respiration rate 36. Oxygen saturation down and blood pressure unrecordable at present. GCS of 8. Head and chest injuries. Multiple fractures.’

Sid and Dennis looked at each other again. They didn’t need medical training to know that this patient was seriously unwell. Neither did they need the ambulance officer’s confirmation that this was another code yellow patient.

The ETA of the ambulance was ten to fifteen minutes and any calm in the small emergency department vanished.

Extra staff began arriving as Beth and Chelsea were assigned the task of setting up Resus 2 in preparation for the new arrival.

‘Have an intubation trolley ready,’ Mike instructed. ‘And a chest decompression kit.’

‘What happens with serious chest injuries here?’ Beth queried, pulling the crumpled sheet from the bed. ‘We don’t have a cardiothoracic surgeon, do we?’

Chelsea shook her head. ‘We stabilise them and then chopper them to Wellington.’ She flapped the clean sheet to spread it over the mattress. ‘Same with head injuries. We don’t run to a neurosurgeon either.’

Chelsea told Beth who the staff members were as the level of activity in the department steadily increased.

‘That’s Kelly—she’s a radiographer. Seth is the house surgeon on call. Looks like Rowena’s coming in to help as well. She’s a midwife.’

The names flowed right over Beth’s head. These people were all still strangers and this was no time to start even trying to remember names.

‘And there’s Luke.’

Beth flicked the laryngoscope she was checking shut to turn off its light. Despite herself, her head turned sharply at that familiar name but any view of the latest newcomer was blocked by the large figure of Dennis, the police officer.

‘The ambulance is here,’ he told them. ‘I’m going to see if they need any help.’

Two other members of the local police force had accompanied the ambulance but the paramedics had been in no danger from the hit-and-run victim they were transporting.

‘Breath sounds absent on the left side now.’ A blonde woman had her stethoscope on the exposed chest, between ECG electrodes. ‘GCS has been dropping steadily. I’ve already done a decompression on the right side.’

‘Bring him straight in here.’ Mike pointed to the available resuscitation area and Beth stepped back as the stretcher moved swiftly towards her. Then she reached to help transfer the patient to the bed.

‘On the count of three,’ Mike directed, holding the patient’s head and neck still by supporting the cervical collar. ‘One…two…three!’

‘We think he was hit at a speed of at least sixty kilometres an hour,’ the paramedic informed Mike. Apparently he was airborne for twenty to thirty metres.’

Maureen handed Beth a pair of shears. ‘See what you can do to get rid of the clothing.’

Beth was aware of more people pressing into the resus area to assist. ‘Tension pneumothorax on the left,’ Mike confirmed tersely. ‘Someone get me a decompression kit, please?’

‘I can do that.’

The calm voice should have eased some of the tension but the shears in Beth’s hands closed with an uncontrolled snap. Her gaze shifted just as emphatically to the speaker and for a split second she actually forgot what she was supposed to be doing.

Luke.

It couldn’t be.

But it was.

Luke Savage.

At Ocean View hospital?

If Beth had tried to think of the last possible place on earth she would expect to see this man again, a smalltown hospital would have been way up on the list. A prison cell might have beaten it to top spot, of course, but not by much.

He hadn’t noticed her. The surgeon was completely focussed on the task of inserting a needle between the victim’s ribs to release air trapped in his chest, which was preventing his lungs from functioning.

‘Pelvis is unstable.’ Mike was doing a survey for other major injuries while Luke was attempting to establish adequate breathing.

The consultant’s statement was enough to start Beth’s hands moving again, her momentary lapse unnoticed. She peeled leather trousers clear of the deformity on the right thigh.

‘Open fracture of the femur,’ she advised.

‘Cover it,’ Mike responded. ‘We can’t deal with that just yet.’

Beth reached for a large gauze dressing and tried to concentrate on squeezing a sachet of saline onto the pad to dampen it, but she simply couldn’t help glancing back towards Luke.

Had Luke recognised her voice as easily as she had recognised his?

Apparently not.

‘Oxygen sats aren’t climbing.’ Luke was staring at the monitor above the bed. ‘We’ll have to intubate.’

‘I’ll get another IV line going,’ Mike said. ‘We need to speed up this fluid resus.’

A new face peered in through the curtain. ‘Luke? They just called to say they’re ready for you in Theatre.’

His glance seemed to bypass Beth effortlessly as she used the damp dressing to cover the gaping wound on their patient’s leg. ‘Thanks. I’ll be up as soon as I can.’

Mike took the cannula Beth was holding out for him. ‘Could you help Sid take Jackal upstairs, please?’

‘Sure.’ The prospect of making an exit was appealing.

Was Luke simply being professional, ignoring her—quite properly—due to the emergency treatment of a patient? It was possible that he had not yet recognised or even noticed her.

It was also quite possible that he just didn’t give a damn.

And why, in God’s name, should that bother her so much anyway?

Beth turned her back on Luke but she wasn’t going to escape quite so easily. The sound of breaking glass made everybody pause.

‘What the hell was that?’

‘We locked the doors when we came in.’ The male ambulance officer had abandoned his paperwork to step closer. ‘Sounds like someone really wants to get in.’

A police officer appeared behind him. ‘ETA for the chopper is only two minutes. We’ve got a bit of a skirmish going on in the car park right now, though.’

The sound of a shotgun being fired was unmistakable.

So was the alarm that sounded on the new patient’s monitor in the tiny silence that followed.

‘He’s in VF,’ Luke warned.

Mike was already reaching for the defibrillator paddles. ‘Everyone stand clear.’

‘I don’t want anyone moving from here until we get some back-up,’ the police officer ordered.

‘Stand clear,’ Mike ordered.

Beth stood clear. In fact, she was quickly penned into the corner of the area, along with the paramedic and Chelsea, and couldn’t escape the awareness of how appalling the situation was.

They watched as Maureen squeezed air into the patient’s lungs and Luke readied himself to do compressions when the initial series of shocks was completed. Mike pressed the paddles into position and pressed the buttons to deliver the second shock and then the third.

Beth closed her eyes for a moment. This was all so bizarre it was almost a joke. Some huge, cosmic joke. And whoever decided which way the winds of fate were going to blow was laughing at her right now.

She had come here to get away from the stress of dealing with violence and was now up to her neck in the most major incident she had ever encountered.

And she had also come to get away from the lingering effect Luke Savage had branded on her life. She had just ended her extremely brief engagement to Brent, for heaven’s sake, because she had recognised that the only qualities he had that were attractive had been the ones that reminded her of Luke.

The prospect of actually crossing paths with Luke Savage had haunted Beth for far longer than the fear of finding herself living Neroli’s nightmare, and coming to a small town like Hereford had seemed like the perfect way to escape that particular ghost.

And here she was, only a few feet away from the man. And it felt like the first time she had seen him all over again. He was just as physically attractive, but it hadn’t been simply his looks that had drawn her so convincingly at that first meeting. It had been his presence. The feeling she’d got that this man would be able to handle any situation he found himself in, no matter what it was. And she could feel that again right now. Luke was just…exactly the same.

It was so bizarre. It went way beyond being a disappointing start to a new beginning. This was gutting. Maybe she should have taken up Neroli’s invitation to go to Australia with her. Melbourne would be a nice place to live and Neroli’s sister was always short of waitresses in that coffee-shop.

The static cleared from the monitor screen after the third shock to show a pattern that settled over several seconds into normal sinus rhythm. The quiet was broken by the steadying beeps of the monitor, loud but muffled shouting from somewhere outside and then the crescendo of an approaching helicopter’s rotors.

Relieved glances were exchanged between staff members and it was only then that Beth’s gaze met that of Luke. The, oh, so familiar dark grey eyes beneath that shaggy mop of black hair widened and Beth realised that he hadn’t been ignoring her.

He couldn’t look this shocked if he had known she was so close.

Her presence was a surprise. And it wasn’t a pleasant one.

It shouldn’t have hurt but it did. Any fantasies she’d ever had of looking into those eyes again and seeing the love that had once been there were crushed in an instant, and Beth could hear echoes of that cosmic laughter.

She wanted nothing more than to get away, and Mike’s repeated instruction to help shift Jackal up to Theatre seemed timely.

It wasn’t until Beth pulled the curtain back and stepped outside the resuscitation area that they realised the move had been premature.

Black-clad, helmeted and armed offender squad members were filing rapidly into the emergency department of Ocean View hospital, but the skirmish that had been taking place outside had also moved in. Somehow one of Jackal’s mates had gained access and was now standing outside Resus 1 with a knife in his hand as a member of an obviously rival gang advanced rapidly towards him.

And Beth had inadvertently stepped right between them.

Was this the punchline of the joke?

There was nobody close enough to help but the fear that should have swamped and immobilised Beth simply wasn’t there.

‘Don’t even think about it!’ she snapped.

Beth drew herself up to her full height of a not very impressive five feet four inches. Her lack of height was irrelevant because the misery over the personal disaster she had engineered for herself in coming here had just morphed into pure fury.

‘You!’ She jabbed her finger at the leather-clad chest of the man whose progress towards Resus 1 she had just blocked. He was at least six feet tall and his bearded, tattooed face was bleeding heavily from a jagged laceration. ‘Go and sit down and behave yourself.’

Whirling to confront Jackal’s mate, Beth was dimly aware that the police officers rushing to her assistance had slowed involuntarily, their jaws drooping.

‘Drop the knife,’ she commanded.

‘No!’ she yelled as both men made a move to close her further into the middle of the potentially very dangerous human sandwich. Her voice remained at a furious shout. ‘Do as you’re bloody well told! I am just so not in the mood for this.’

Amazingly, the gang members froze. The hand holding the lethal-looking knife began to drop and suddenly the police were right there. As fast as the incident had occurred, it was defused and the space cleared.

Beth was aware of a curious shaking sensation in her knees. She turned her head slowly to see the occupants of Resus 2 staring at her.

‘Woo-hoo!’ Chelsea called softly. ‘You go, girl!’

Mike had an astonished grin on his face but it was Luke who drew Beth’s gaze. He was staring at her as well, of course. Who wouldn’t be? He wasn’t looking shocked any more. He was looking as though Beth were a complete stranger.

A rather impressive stranger, in fact.

Straightening her back made that weak-kneed sensation subside almost completely. The calm, confident smile Beth was aiming for probably came out more like an embarrassed grin, but it didn’t seem to dull the respect she could detect from her small audience.

An audience that included Luke Savage.

How cool was that?

CHAPTER TWO

GOOD grief!

Luke was still shaking his head in disbelief as he scrubbed up for Jackal’s emergency laparotomy ten minutes later.

Seeing Beth again after all these years was unbelievable enough. Seeing her doing that warrior princess act with the gang members had been…

The sexiest damn thing Luke had ever seen in his life.

He scrubbed beneath his nails hard enough to cause real pain.

Beth was the only woman who had ever made him seriously consider marriage.

And she was the only woman who had ever dumped him.

The hurt and the ensuing anger that had caused should have been rendered inconsequential by the blows life had meted out since then, so it was incredibly disturbing to find how easily the years could be peeled back.

One good look into those bright blue eyes and there he was again. Not measuring up. Just not being good enough, no matter how much love he had to offer.

What the hell was Beth doing in Hereford of all places?

Luke took his foot off the water control and reached for a sterile towel. She’d probably come here to give her kids a nice, healthy rural upbringing or something. Snapping on gloves, Luke turned abruptly to let the scrub nurse tie up his gown. That flash of something astonishingly like jealousy at the thought of the father of those children was ridiculous.

So she was still an attractive woman. So what?

So she had grown up a bit and become brave about confronting things she didn’t like. Again, so what?

Luke had more than enough to deal with in his life right now, without complicating things by renewing any kind of relationship with Beth. The last thing he needed was to try poking an old scarred area when the potential to find a tender spot was so clearly possible.

A deep breath was called for here. And rational thinking. This disturbance was probably just part of the surprise factor of seeing Beth again. All he needed to do was ride it through and there would be no shortage of distractions if that proved in any way difficult. It was a relief to use the one immediately available.

‘Let’s get this show on the road, shall we?’

With his hands held carefully crossed in front of his chest, Luke used his shoulder to push open the swing doors into Theatre.

At just after 3 a.m. on a Tuesday morning, Ocean View’s emergency department was stretched to slightly over its full capacity.

One of the high-tech resuscitation areas was still occupied by a seriously injured patient, the other one having just been vacated by the hit-and-run victim, who had gone up to Theatre 2 for the attention of an orthopaedic surgeon. All the beds in the cubicled area were also full and half of those patients were still waiting to have bones X-rayed or lacerations sutured. The treatment rooms were full and there were no spare seats in the waiting area either.

A few people with minor injuries were in Reception but most of them were simply there to offer solidarity to their mates, and they included some of the loudest and most unpleasant women Beth had ever encountered.

They were all unkempt, tattooed, pierced in multiple places and inebriated, and only too happy to demonstrate their contempt of any authority figures or lack of appreciation for any medical assistance. But the police presence was strong enough to ensure the safety of staff and the background noise of obscene language and shouting was so constant Beth could tune it out now.

It had already become automatic to seek the company of a police officer before approaching or treating a patient, and all the nurses remembered to wait until a member of one gang had left the X-ray department before escorting a member from the rival gang down the corridor.

Hopefully, the stab victim who was currently in Resus 1 would also be sent up to Theatre soon. When the doctors could be freed from attending the critically injured patients they should be able to deal with the minor injuries rapidly. They would be able to clear the department and then they could all have a well-deserved break.

Oddly enough, the chaos and unpleasantness of her current environment had been quite enjoyable over the last hour or so. Not the patients, of course, but their uniform lack of co-operation or appreciation had provided a bond of camaraderie amongst the staff members that had only increased under pressure.

And Beth was very firmly one of them. Thanks to that inadvertent episode of venting her tension, having stepped into the path of the converging gang members, Beth had not only been welcomed into the ranks of Ocean View’s emergency department staff, she was currently being used as a lynchpin.

Even though it had only taken a few seconds and could quite easily have been a huge mistake, the fact that Beth had taken control had become a kind of emotional bank in which snippets of humour or stamina were being deposited and could be withdrawn whenever someone needed the lift of a shared smile or a pat on the back.

‘I’m just so not in the mood for this’ had become the catch-phrase of the night and never failed to produce a smile.

Dennis, the local cop, had claimed Beth as one of their own with a hint of pride.

‘Keep your eyes open,’ he had told one of the Nelson police officers about to accompany Beth when she needed an escort to Radiology. ‘You might learn something from our Beth they never thought to teach you at police college.’

How ironic that Beth could feel so at home in a new place so quickly when she was still having serious doubts about the wisdom of having come here at all. She even knew her way around the storeroom now, having gone in there so often to fetch new supplies, and she was there again now, checking the fridge, as requested, to see how much O-negative blood they had on hand. Then she moved towards the shelves supporting boxes of dressings.

A number of extra-large gauze pads had been needed to staunch the arterial flow from the blood vessel severed by a knife wound in the car-park skirmish. And a fresh intubation pack was needed to restock Resus 2. Searching for the location of cuffed endotracheal tubes, Beth’s eye was caught by the sterilised, draped rolls of surgical gear.

The obstetric pack was probably useful, but how often would they have the need for a thoracotomy kit here? Beth had only ever seen someone’s chest opened in an emergency department once, and that had only been done because it had been in a big hospital and they’d had a cardiothoracic surgeon available for back-up.

Luke had had ambitions in cardiothoracic surgery so why on earth was he working here? And how could Beth hope to start a new life when there would be such constant reminders of the past?

If she didn’t stay at Ocean View, though, would she end up being back in some emergency department large enough for the triage staff to wear headsets and microphones? Beth’s sigh was heartfelt. She had really been looking forward to the change of working in a much smaller and potentially friendlier environment. And what on earth was she going to say to the nurse manager?

Sorry. This is a great place to work but I can’t possibly stay because the man I was passionately in love with years ago happens to be working here as well, and I’m not sure if I could handle seeing him every day.

How pathetic was that?

Especially when it had been her that had broken up the relationship.

Beth added some other sizes of gauze dressings to the load she was carrying and wondered how the supplies of lignocaine were holding up. A lot of local anaesthetic was being used in the repair of lacerations. The thought was only fleeting, however, and Beth did not reach for any ampoules. She was too busy thinking about something else.

It hadn’t been her that had broken things up, though, had it? Not really. Ending it had been the last thing Beth had wanted. And having her nose rubbed in the puddle of her lost dreams by living in the same small town as Luke Savage was just unthinkable.

And finding him beside the bed of the stabbing victim in Resus 1 was unexpected enough to add considerably to those doubts about her new job. She had thought Luke would be tied up in Theatre for the rest of the night and that maybe encounters with the surgeon would be the exception rather than the rule. Beth averted her gaze hurriedly to avoid renewed eye contact but the surgeon was listening too intently to Mike to notice the arrival of a nurse carrying supplies.

‘…femoral artery,’ Mike was saying. ‘Class III haemorrhage. Estimated blood loss of around two litres, but we’ve finally got it under control with the pressure bandage.’

‘Blood pressure?’

‘Coming up finally. Ninety-five on fifty now. We’ve run in two litres of saline and I’m just waiting for blood results.’

Beth was behind Luke now. It was quite safe to risk a glance. Not that she needed to confirm the impressions gained earlier, but it was tempting to add to them.

The shaggy black hair was a little longer than it used to be and there was just a hint of silver at his temples. Thirty-six seemed a bit young to be going grey, but Beth had found the odd white hair amongst her own recently and she was two years younger than Luke.

His face was browner and leaner, which made him look more serious somehow. Judging by the arms and the smooth V of chest visible around the baggy scrub suit, the rest of Luke’s body was browner and leaner than it used to be as well.

Beth had to take a rather deep breath all of a sudden. No. Luke Savage had not lost his looks in the last ten years. Quite the reverse, really…damn it!

‘Beth?’

‘Sorry, were you talking to me?’

‘I just wondered how the supplies of O-neg were looking.’

‘There’s two units. Plus some packed cells.’ Beth continued putting the dressings into the drawer of the trolley but it would have been rude not to look up again. Mike was nodding. Luke was looking at the patient.

‘How are you feeling?’ he queried.

The gang member gave a noncommittal grunt.

‘We’re going to have to take you up to Theatre and repair that gash in your leg,’ Luke explained. ‘Have you had anything to eat or drink in the last four hours?’

‘Yeah. I had a feed.’

‘How long ago was that?’

‘Dunno.’

‘And you’ve been drinking?’ The question was superfluous, given the smell of alcohol that hung over most of their patients that night, but Luke managed to sound nonjudgmental.

‘Yeah. Had a few beers, man.’

The gang member actually smiled at Luke. ‘You going to fix up my leg, then?’

Beth was slipping out of the cubicle as Luke turned towards Mike. ‘Looks stable enough to go upstairs. We should be ready in twenty minutes or so, I guess. What about…?’

Beth was now far enough away for Luke’s voice to be covered by the general noise in the department. Or maybe it was because the noise level had suddenly increased out here. A wave of weariness hit as Beth wondered if she needed to call for more police assistance.

But it was a police officer who was doing the calling.

‘Help! We need some help here.’

Beth moved fast towards the reception area. She could see a woman lying on the floor near the seats in the waiting room. Another woman was struggling to get away from the grip the police officer had on her arm.

‘I told you Stella was sick,’ the woman shouted. ‘And you wouldn’t listen, you bastard!’ She kicked at the officer, who winced but held on.

Beth dropped to a crouch, reaching to shake the apparently unconscious woman’s shoulder.

‘Stella? Can you hear me?’ With no response to the shaking, Beth pinched the woman’s ear lobe. ‘Open your eyes.’

The woman groaned and rolled her head from side to side. Beth could see her chest rising and the groans were loud enough to suggest that her airway was clear. She was feeling for a pulse on the woman’s wrist as she heard a deep voice behind her.

‘What’s happened?’

‘She fainted or something,’ the police officer said. ‘One minute she was sitting on that chair and the next she was on the floor.’

‘She’s been bloody hurt, that’s why!’ The second woman was clearly furious. ‘She’s been feeling like crap but nobody would listen!’ With the stream of obscenities that followed this statement, it didn’t surprise Beth that nobody had wanted to listen. Still, there was no excuse for missing a potentially serious injury.

Luke was frowning as though he’d had the same thought. He crouched down close to Beth and put his fingers on the woman’s neck, feeling for a carotid pulse.

‘There’s no radial pulse,’ Beth told him quietly.

Luke nodded, acknowledging the information that the woman’s blood pressure had to be very low. He glanced up at the people standing nearby. ‘Can somebody tell us what happened to her?’

‘She got hit in the chest,’ the second woman spat. ‘With a bloody softball bat, that’s what happened.’

‘How long ago?’

But Luke’s query was ignored.

‘And it was that bitch over there that did it. And I’m going to do something about it.’

Fortunately, two more police officers arrived to deal with the woman who was making a new and more frenzied attempt to get free.

‘It must have happened in the car park,’ the first officer told Luke. ‘Probably well over an hour ago.’

‘Thanks.’ Luke slid an arm beneath the woman’s back, the other under her legs, standing up with apparent ease despite the weight of his burden. ‘Let’s go,’ he said to Beth. ‘What’s free?’

‘Resus 2.’ Beth led the way, relieved to move away from the tension in the waiting area, which was now escalating thanks to the screams of their new patient’s friend.

‘Let me go! Where are you taking her? She’s bloody dead, isn’t she?’

Stella wasn’t dead but she wasn’t looking at all well. Mike came into Resus 2 as Luke gently deposited the woman on the bed.

‘What’s happened?’

‘Collapse,’ Luke told him succinctly. ‘Possible blunt chest trauma from a softball bat more than an hour ago.’

Beth slipped an oxygen mask over the woman’s face and turned the flow up to 10 litres a minute, before swiftly turning her attention to pulling open Stella’s shirt. Then she grabbed a pair of shears to cut through the singlet top beneath the shirt.

‘She’s tachycardic,’ Luke told his colleague. ‘And she’s got JVD.’

Beth hadn’t noticed the distension of the jugular veins on the woman’s neck but she recognised the significance of the sign, reaching for the ECG leads as she dropped the shears.

‘Chest-wall contusion,’ she reported.

Stella groaned loudly, swore incoherently and tried to move as Mike put his hands on the obviously bruised area on the left side of her chest.

‘It’s all right,’ he reassured their patient. ‘We’re just checking you out.’ He looked up. ‘Do we know her name?’

‘Stella,’ Beth supplied.

‘I know it hurts, Stella. Hang in there.’ He looked up again. ‘Fractured ribs,’ he said. ‘But she seems to be moving air all right.’

Luke had wrapped a BP cuff just below the tattoo encircling Stella’s upper arm. ‘Hypotensive,’ he noted. ‘Systolic’s barely 80. Let’s get an IV started.’

‘Make it two,’ Mike said. ‘Beth, can you get a line in on your side, please?’

‘Sure.’ Beth stuck the last ECG electrode in place and turned to grab a tourniquet. Mike was watching the screen of the cardiac monitor.

‘Sinus tachycardia,’ he said. ‘And…yes, we’ve got electrical alternans.’

Luke’s grunt sounded almost satisfied as he pulled the cap off a cannula. ‘Thought so. Pericardial tamponade.’

Beth glanced up at the screen, noting the way the spikes of the QRS changed direction every few beats, indicating a change in the cardiac axis. She knew the first line of treatment for an acute pericardial tamponade was a rapid infusion of saline. Bleeding around the heart, trapped by the membrane encasing the organ, was interfering with its ability to pump blood. By increasing the fluid volume of the patient, the output of the heart could be improved.

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.’

Конец ознакомительного фрагмента.

Текст предоставлен ООО «ЛитРес».

Прочитайте эту книгу целиком, купив полную легальную версию на ЛитРес.

Безопасно оплатить книгу можно банковской картой Visa, MasterCard, Maestro, со счета мобильного телефона, с платежного терминала, в салоне МТС или Связной, через PayPal, WebMoney, Яндекс.Деньги, QIWI Кошелек, бонусными картами или другим удобным Вам способом.