The Emergency Specialist. Barbara Hart

      CHAPTER TWO

      THE following week, Anna changed from the day shift to the night shift. Although it played havoc with her sleep pattern, in some ways she preferred the night shift. The atmosphere in the hospital was completely different—a strange mixture of cosiness and danger.

      During the long hours of the night shift, Anna was frequently reminded of why she’d chosen to specialise in A and E. It made her feel as if she was right in the centre of everything, with her finger on the pulse of life.

      As she strode through the swing doors that led into the accident and emergency department, a small knot of tension formed in her stomach. It happened every time, particularly when she was on the night shift. She knew it would only be temporary and would disappear within a couple of minutes. It told her that the adrenalin rush had begun and that she was ready to swing into action without a moment’s delay.

      She hadn’t taken more than a dozen steps when one of the nurses grabbed her.

      ‘Dr Craven, you’re needed in Resus One,’ she said. ‘Patient just admitted…young child…rescued from a house fire…extensive burns to his legs. Mr Harvey is in charge.’

      She put on a sterile gown and walked briskly towards the resuscitation room. A light over the entrance was signalling a code blue. She quickened her pace. A code blue meant that a life-threatening crisis was on hand.

      Resus One was a hive of activity. Several people in theatre blues and surgical gowns were circling the trolley and on it was the small, motionless figure of a child. The bottom half of his body was covered with the special wet dressings used for burns. Through the antiseptic-smelling air drifted another smell, the nauseating, never-to-be-forgotten smell of burnt flesh.

      Jack looked up. Once again he experienced a chilling moment as the woman who so resembled his late wife walked into the resus room.

      ‘Glad to have your assistance, Dr Craven,’ he said, keeping his voice on an even keel, though his heartbeat had gone into overdrive. He’d get used to it, he told himself, working with her on a daily basis—and the shock waves would become less each time they met. Or maybe not…because these particular shock waves were becoming very pleasurable, he had to admit.

      ‘We’re prepping this young patent for a transfusion,’ he told her. ‘The burns are so bad that he needs blood as soon as possible or there’s a good chance he’ll die of shock.’

      ‘What’s his blood pressure?’ she asked.

      ‘Eighty over sixty,’ a nurse replied. ‘He’s showing signs of shock.’

      ‘How old is he?’

      ‘About six, we think,’ replied Jack. ‘We don’t know for sure because he was alone in the house when the fire started. His parents haven’t been contacted yet.’ He gave this information factually but Anna could see the rage in his eyes.

      At that moment, the monitors surrounding the boy began to bleep erratically as the lines on the screens became jagged and irregular.

      ‘Get the defibrillator over here,’ Jack shouted. ‘He’s arrested!’

      Anna and the rest of the team went to work. The boy’s oxygen level was increased and Anna moved forward, holding the defibrillator paddles.

      ‘One, two, three—clear!’ she called. Down went the paddles onto the boy’s chest. There was a loud buzzing and the boy’s small body was practically lifted off the operating trolley.

      Everyone turned their attention to the monitor. The boy’s heart was beating regularly again but the rate was weak, the green lines barely moving up and down.

      ‘I think you should try again,’ said Jack. ‘Two hundred and forty joules again.’

      Anna recharged the paddles and waited.

      ‘One, two, three—clear!’ she called, before again applying the defibrillator.

      The team waited anxiously, all eyes on the monitor as the oxygen mask was clamped over the boy’s face. The green lines on the screen settled into a regular rhythm, this time stronger than before.

      ‘He’s stabilising,’ said Jack. ‘Good. Keep the oxygen at ninety-five per cent. Well done, everyone!’

      He looked at Anna as he said this. He would have liked to have said more. He’d have liked to have said, You are terrific, Dr Craven, one of the best registrars I’ve ever worked with. But instead he just kept on looking at her, his eyes dancing—and even though he was wearing a surgical mask she must have known he was smiling at her.

      Now that they’d stabilised the boy’s heart, the team turned their attention to his legs. Jack gently pulled back the wet dressings, revealing the young boy’s mottled, bleeding legs which had pieces of charred material stuck to them. The smell of burnt flesh intensified. But while his legs were very badly burned, the rest of his small body was mainly unaffected.

      ‘He must have been wearing just pyjama bottoms,’ said Jack as he set up the line for the blood transfusion, ‘and they must have been made of untreated cotton. That’s why they burst into flame with such tragic results.’

      A nurse wheeled an intravenous pole across the room to the head of the trolley. ‘I thought pyjamas had to be made of flame-retardant material,’ she said. ‘I thought it was the law.’

      ‘It is,’ said Jack bitterly, ‘but this kid’s pyjamas were certainly not flame-retardant. Any news of his parents yet?’ He looked towards the door but no one was waiting outside.

      ‘I’ll go and find out, shall I?’ asked Tammy, one of the nurses whom Anna recognised from the triage desk—the reception area where patients were sorted into categories depending on medical priority.

      ‘Yes, please,’ said Jack. ‘There may be decisions to make about operating and we may need parental permission. Though what kind of parents must they be? People who leave a young kid alone in a house at night, while they, most likely, go out on the town! The police have been informed, I do know that.’

      He watched as the first bag of blood was hooked onto the intravenous pole and the line attached to the patient. ‘Now we need to set up the intravenous antibiotics,’ he instructed.

      Jack and Anna worked together smoothly and silently, each anticipating the other’s actions. He was good to work with, Anna thought. He was quick and efficient and he exuded a calmness and confidence that she found mentally stimulating and physically reassuring. He was the ideal surgeon for the kind of situations they constantly faced in A and E.

      ‘I wasn’t expecting to find you on the night shift,’ she said.

      ‘I’m not,’ he said wryly. ‘I’m on the day shift but was asked to stay on when we got the call from the emergency services.’

      Tammy came back into the resuscitation room, followed by a distraught man.

      ‘This is the boy’s father,’ she said.

      ‘How’s my son? How’s Jamie?’ he asked anxiously. The medical team parted slightly, leaving a small gap through which the boy’s father was confronted by the gory sight on the surgical trolley.

      ‘Oh, my God!’ he said. ‘He’s not dead, is he? Tell me he isn’t dead!’

      ‘He’s alive but he isn’t out of danger by any means,’ said Jack, not wishing to soften the blow. His eyes were blazing. He was so mad that he wanted to put his blood-stained hands round the throat of the