Emergency: Wife Lost and Found

‘We’re on bypass,’ May immediately interrupted, because her staff needed this break. The accident had meant that for a few hours North London Regional Hospital was closed to new admissions, the ambulances automatically diverted to other hospitals, and though it was a tough call to make, it was one that had to be made if safe working levels were to be maintained. The department was struggling at the moment in any case. Two junior doctors had left in the middle of their six-month rotations and they had not filled the vacancies. Abby was good, but new, and one of the registrars had just gone on extended sick leave. Everyone was working beyond their limits and even more so today. They would come off bypass soon. May had, in consultation with James and the nursing supervisor, decided they would call it off in the next half an hour, but for now her staff needed to restock, not just on food and drink but the depleted store shelves, and also get a few more patients up to the wards.

But the voice was crackling on.

‘She’s just been found a little way from the accident scene, trapped in her car… Jane Doe, in her twenties, hypothermic, full cardiac arrest…’

James was already standing up, grabbing a handful of sandwiches and heading for the door, appalled at the thought of a patient left behind and what she must have been through.

‘Accept,’ he and May said together.

The late staff were already setting up for the expected new arrival as James and May rushed around. Rolling out the warming unit, which was like a large duvet that would be inflated with warm air and placed over her, IVs were being run through warmers and the anaesthetist had been paged and was running down from a no doubt frantic ICU. ‘What else do we know?’

‘Not much!’ Lavinia, the crackling voice on the intercom, who was pretty in the flesh, brought them swiftly up to date. ‘The car was found in a field a few hundred yards from the accident scene, the windscreen was shattered so she’s been exposed for a while. She had a blanket around her, so it would seem she was conscious after the accident. She arrested as they freed her from the wreckage.’

‘Do we have a name?’

‘Not yet. She’s been intubated and is on her way. ETA nine minutes.’

‘Come on,’ James said to May, ‘let’s go and meet the ambulance.’

They stood in the ambulance bay, James only in his theatre scrubs. It seemed rather inappropriate to moan about the weather—still, it was freezing.

He glanced at his watch and willed the ambulance to hurry up. ‘Four hours in this.’ He wasn’t making small talk, his head was frantically trying to do the maths. Four hours exposed to freezing temperatures, and no doubt already injured from the accident. In hypothermia, patients often arrested when moved and, though it was never good news, the fact it had been a witnessed arrest was positive. ‘This is going to be a long one.’

It would—her body temperature would need to be gradually raised and until her temperature was normal the resuscitation would continue. When the body was hypothermic the brain required little oxygen and there was a chance that despite being trapped for hours, despite being in full cardiac arrest, this patient might make a full recovery—and given her age, she would be afforded every benefit of the doubt.

‘The poor pet, stuck out there in this blessed weather all these hours,’ May said, shivering into her cardigan as they stood in the ambulance bay. She wished nurses still wore capes!

‘I knew it wasn’t over,’ James said. ‘There were so many cars involved, just so much chaos, we’re going to have to review this.’

‘We will,’ May sighed. ‘But it was already getting dark by four, and with the snow and everything…’ Her voice trailed off. Security was having a row with a driver who had insisted on parking his car in the ambulance bay. His wife would only be two minutes, he was arguing loudly and, no, he wasn’t moving his car, but James had already heard enough. May watched as he strode over, an imposing man at the best of times, but when someone compromised his patients’ care, woe betide them. May cringed as James not too politely told the driver where he could put his car, but she smiled as he strode back.

‘He thinks it’s a bloody car park.’

‘He doesn’t now,’ May pointed out, watching as the driver reversed angrily out of the ambulance bay, but her smile soon faded. ‘That’s all we need!’

A television news team, which was setting up a little way down to do a live cross on the evening news about the earlier incident, had got wind of the ‘forgotten patient’ story. They dashed over with their cameras and talked excitedly into their microphones as James told Security to bring out the screens to shield the incoming patient from prying eyes. The last thing he wanted was some kid eating their tea, seeing their mother being brought into hospital at death’s door. He was taut with suppressed rage as he shooed the journalists back and helped Security to erect the screens quickly.

Oh, the joys of being an emergency consultant!

‘Where the hell’s the ambulance?’ James demanded of May, and she glanced at her watch.

‘It will be a couple more minutes yet. Are you okay, James?’ May couldn’t help but ask. He was like a coiled spring this afternoon. Okay, he was often brusque but there was just something about him now that May couldn’t put her finger on.

He was about to give his usual dismissive ‘Fine,’ only this was May who was asking and he respected her more than anyone in the department, looked out for her in the same way that she looked out for him, and because of that he was honest.

‘I don’t know, May.’ He could just hear the ambulance siren, which meant it was still a minute or two away. He turned to her wise, familiar face and even if it sounded evasive he answered with the truth. ‘I really don’t know.’

‘Are you not feeling well?’ She asked.

‘It’s not that…’ He blew out a breath, long and white in the freezing early evening sky, and tried to find the right word to describe how he felt. Nervous? Anxious? Neither really fitted. He just felt uneasy, that was the best word he could come up with, but he was hardly going to offer that to May.

‘I know that it’s hell in the department at the moment, we’re so many staff down, but…’ she offered.

‘It’s not that either. I hate it that we missed someone. I knew it wasn’t over…’ His words were drowned out by the sirens and the noise of the camera crews. Security opened the back of the ambulance door before it had even halted, the driver jumped into the back and, seeing the greedy cameras, pulled the blanket over the patient’s face, which was acceptable as she was already intubated, while the other paramedic pushed on her chest. The stretcher was unclipped and James took over the cardiac massage as May bagged the patient. They bumped the stretcher out of the ambulance, raised it and then set off to the resuscitation area in a skilled, practised motion.

But midway there, James lost his stride, the whole party halting for less than a second as James caught up, or seemed to.

She’d always had pretty feet.

Despite her plain clothes and serious, unmade-up face, Lorna had always worn pretty pink nail varnish just as this patient was, and Lorna had a mole just on the dorsum of her right foot too. James could feel the chest beneath his hand as he massaged the heart and he had, for that stupid second, wanted to stop the stretcher, wanted to rip the blanket from her face and find out that it wasn’t her.

Except James knew with dread that it was.

A coil of wet dark auburn hair had escaped the blanket, and as they whooshed into Resus and prepared to lift her onto the hard resuscitation bed, the blanket covering her was whipped off. Then he finally got confirmation, but he’d already known for a good fifteen seconds that it was Lorna.

He’d always wondered if she’d changed. Up in Glasgow for a conference a couple of years ago, he’d scanned the shops and bars for a woman with auburn hair and huge amber eyes. He’d told himself it was futile, that it had been so long ago she might have dyed her hair by now, she’d always hated that it was red after all—or maybe she’d have put on weight. Or, worse, he might bump into her pushing a stroller containing twins. He was being ridiculous, he had told himself that day, because even if she walked towards him, stood in front of him, he probably wouldn’t even recognise her.

He’d known at the time he was kidding himself and he’d had that confirmed today.

Ten years on and he’d recognised her in an instant by her pretty feet alone.

CHAPTER TWO

‘SHE WAS UNRESPONSIVE when they found her, but she had did have a pulse. She arrested when we moved her from the vehicle,’ the paramedic informed them as they raced into Resus.

‘Do we have an ID?’

As she transferred the patient over to the resuscitation bed it was May who asked the question when James didn’t—he was still massaging the chest, even though Lavinia had offered to take over.

‘From the driving licence in the car we have a Lorna McClelland, thirty-two years of age, from Scotland; she’s a doctor apparently…’

‘How was she missed?’ It was the first time James had spoken since her arrival, and it was an irrelevant question really. She had been found, she was ill, for now all they could deal with was what presented, and May frowned as James persisted with the pointless. ‘How could she have been missed?’

‘I’m not sure,’ the paramedic answered. ‘We just got a callout twenty-five minutes ago. Mind you, it’s been chaos out there.’

Instead of the emergency consultant it was Khan, the anaesthetist, who was running the show, flashing lights in the patient’s eyes, frowning up at James as he checked the airway, calling for drugs, and at that moment May stepped in. She had no idea what was wrong with James, but she would find out later. He was standing there, massaging the chest, as grey as sheet metal and instead of assessing the patient and commencing active treatment, still there he stood. It happened now and then, May knew that well, where staff just hit a wall. But maybe it was another peril of working in Emergency that was occurring here, May thought as she watched the beads form on his brow. He knew this patient!

‘Abby.’ Pressing the intercom, she summoned the registrar from her break. ‘We need you in Resus. Lavinia,’ May ordered, ‘take over the massage.’

He stood and watched, half heard May say to Abby something about James not feeling too good, but all he could really hear was the sound of gushing in his ears, and the blip, blip, blip of the cardiac monitor as Lavinia delivered cardiac massage.

Lorna’s blouse was already undone, her bra cut and pushed to the side. Her boots or shoes had already been taken off, where they had attempted IV access. They were slicing through her soaked clothes with scissors, sheering through her torn stockings and underwear. He could see the scars from her operation and it made him want to weep, but instead he just stood there, watching them lift her pale knees and insert a catheter, knowing how much she would hate all this, tempted to tell them to just leave her alone, tempted to pick her up and run, but wanting them to carry on as well.

‘Go to the on-call room,’ May said to him. ‘James, go to the on-call room, you look as if you’re about to pass out.’

‘I’m staying…’

He’d never felt more useless in his life. As an emergency consultant he was accustomed to crises, but to have her slam back into his life like this, he was literally paralysed. She was so white. Lorna had always been pale, yet now she was as white as the sheet she was lying on. Even her lips were white. The only colour on the bed was her hair, thick, long and red still, so she hadn’t dyed it after all. In fact, she hadn’t changed at all. This fragile, slender little thing was just as he remembered her, and the Lorna he’d known was such a private person she would loathe the intrusion on her body very much. The warming unit had been pushed aside as full access to her body was needed. Abby was here now, taking over, asking for peritoneal lavage—where a bag of warmed fluids would be run into her abdominal cavity. The anaesthetist called for an oesophageal warming tube, but then Abby checked the monitor, the fine VF required Lorna be defibrillated. As the first shock was delivered to the frail body, James truly thought he would vomit as her chest lifted off the resus bed.