The Consultant's Italian Knight Page 8

‘I was about to say would you take care of the IV lines, and attach him to the heart monitor while I intubate him?’ she said pointedly, and for a second Mario looked bemused but—to his credit—he nodded quickly and did what she’d said.

  ‘BP now, Terri?’ Kate asked after she had gently eased the endotracheal tube past the man’s vocal cords and into his trachea.

  ‘Still 60 over 40,’ the sister replied, and Kate frowned.

  It should have been going up, not remaining stationary.

  ‘IV lines?’ she said.

  ‘Open and running,’ Mario replied, checking the drip bags containing the saline solution which was providing a temporary substitute for the blood the man was losing.

  Quickly, Kate placed her stethoscope on the man’s chest. Damn, but she could hear no breath sounds at all on the left side. Ewan Fraser’s left lung must have collapsed, sending blood and air seeping into his chest cavity.

  ‘Chest and…’ She came to a halt as she realised that Mario was already holding out a chest drain and a scalpel to her. ‘You know, you’re going to make someone a wonderful wife,’ she said lightly, and he laughed, but Terri, she noticed, didn’t.

  In fact, the sister was staring at Mario with a thoughtful, puzzled expression, and Kate bit her lip. She really was going to have to have a long talk with Mario, but not now. Now she needed to concentrate on making an incision into the upper right hand side of Ewan Fraser’s chest, then carefully inserting a plastic tube directly into his chest cavity.

  ‘BP now?’ she asked after she’d checked with her stethoscope that the chest drain was in the right place.

  ‘No change,’ Terri replied, drawing blood out of a vein in the man’s arm, and putting it into separate colour-coded vials to send off to the lab for analysis.

  Damn it, but the blood pressure should be going up, not remaining static. Why wasn’t it going up?

  ‘OK, I want neck, chest and pelvis X-rays, and a CAT scan,’ Kate declared. ‘He could be bleeding inside his head, so we’d better—’

  ‘Run the O-negative fast,’ Mario declared.

  He was doing it again, Kate thought, but this time she didn’t have time to shoot him a warning glance. She simply nodded to Terri who swiftly inserted another IV line to take the O-negative blood they would use until they’d made a cross-match.

  ‘I also want a chem-7,’ Kate ordered. ‘Low potassium can cause irregular heartbeats and—’

  ‘No pulse, Kate!’ Terri exclaimed.

  For a second they all froze, then Kate raced round the examination trolley.

  ‘OK, get me epi, and a blood gas. Mario…’

  He hadn’t needed any instructions. He’d already started CPR, but neither the CPR nor the blood they pumped in, two units wide open, helped. Every time Mario stopped the CPR, and they all looked at the monitor, hoping to see some kind of rhythm being established, there was none.

  ‘Paddles, Terri,’ Kate demanded.

  Swiftly, the sister picked them up, and Kate gritted her teeth. This was going to be a tough one. Ewan Fraser must have weighed well over 230 lbs so she was going to have to press down really hard with her full weight to kick-start his heart. OK, so she was no size 10, but right at this moment she couldn’t help but wish she was a lot heavier, and a good deal taller.

  ‘Let me do it,’ Mario said, clearly reading her mind.

  If Paul had suggested such a thing he would have been lying flat on his back, nursing a bloody nose, but as Mario gazed at her, his blue eyes steady and intent, she found herself wavering.

  ‘You’re sure?’ she said uncertainly, and he nodded.

  ‘There are some things you never forget, Kate.’

  For a second she hesitated, then murmured, ‘OK,’ and tried hard not to notice that Terri was gaping at her like a startled fish.

  Quickly, Mario rubbed the defibrillating paddles together with electrical conducting gel, shouted an urgent, ‘Stand clear everyone,’ then pressed the paddles hard on either side of Ewan Fraser’s chest.

  ‘Nothing,’ Terri said, her eyes fixed on the monitor.

  ‘Up the power,’ he ordered, and Terri glanced across at Kate, who nodded her agreement, but it made no difference.

  No matter how often Mario placed the paddles on Ewan Fraser’s chest, the heart monitor remained resolutely flat, and after fifteen minutes Kate held up her hand.

  ‘I’m calling it unless anybody has any other ideas?’ she said, and both Terri and Mario shook their heads.

  ‘Time of death, 15.45,’ Terri murmured, then cleared her throat. ‘His wife and son are outside in the family room, Kate.’

  She wished they weren’t, but breaking bad news to relatives was part of her job, and gently she touched Ewan Fraser’s forehead with her fingers, murmured a farewell, then walked, stiff-backed, out of the cubicle.

  ‘Do you always do that?’ Marco asked curiously as he followed her. ‘Say goodbye to a patient who’s died?’

  She coloured. ‘I know it’s stupid, but I always want them to know that I did my very best, that I didn’t want to lose them, and I guess…I guess I also want to wish them godspeed. I know it makes no sense—’

  ‘It makes perfect sense to me,’ he interrupted, his voice husky, ‘and I think it’s nice.’

  ‘In that case, do you want to hear something that really is stupid?’ she said, fighting to keep her voice steady. ‘I hate this moment—the moment before I go outside and break the bad news to the relatives. I always feel that if I stay in here—’

  ‘His family will be able to hope for just a little bit longer,’ he finished for her. ‘Right now, they don’t know that they’re never going to hear his voice again, or see him smile, and you feel that if you stay in here they can keep on hoping—just for a little while longer—that everything will be all right whereas the minute you go out there you extinguish that hope and their lives are changed for ever.’

  ‘How did you know that?’ she said in surprise, and he smiled.

  ‘Because I used to feel the same myself.’

  ‘Did you?’ she said, and when he nodded, her own lips curved into a lopsided smile. ‘You’re not as tough as you pretend, are you, Mario Volante?’

  ‘Dammit, but I’ve been rumbled,’ he replied in his usual, casual, jesting way, then quirked an eyebrow at her. ‘You aren’t, either, are you?’

  ‘No. No, I’m not,’ she murmured. ‘I guess…I guess we’re both frauds, deep down.’

  He stretched out his hand and gently touched her cheek.

  ‘At least you’re a nice fraud, Kate. A kind fraud.’

  And you don’t know me at all, she thought, feeling her heart twist inside her as she gazed up at him. I’m not a nice person, not really. I get bad-tempered, and bitchy, and, when I do, I take it out on the people who love me, and then they walk away.

  ‘What’s wrong?’ he asked, his eyes searching her face, and she shook her head.

  ‘I just wish I was half as nice as you seem to think I am,’ she replied, and his eyes gleamed.

  ‘Of course you are. You’re also crabby, and argumentative, and a downright pain in the butt at times, but then you wouldn’t be Kate Elizabeth Kennedy if you weren’t.’

  She gazed at him uncertainly. ‘Have you just paid me a compliment, or deeply insulted me?’ she said and he grinned.

  ‘Let me know when you’ve figured it out, and then I’ll know when to duck.’

  And she laughed properly this time but, as he strode across the treatment room in answer to one of the unit nurses’ beckoning wave, her laughter slowly faded. What did he want from her? She was damned if she knew. She thought he liked her, and she knew she liked him, but all this teasing, all this trying to make her laugh…Was he just an incorrigible flirt who couldn’t resist trying it on with any woman, or did it mean more?

  Do you want it to mean more? her mind whispered, and she sighed.

  Part of her said, yes, that it would be fun to go out with a man like Mario Volante, but the other part, the h
urt part, the bewildered part that John had left behind when he’d walked away, warned that Mario could hurt her a lot more than her ex-husband ever had.

  ‘I’ve cleared away all the equipment,’ Terri declared as she joined her, ‘and made Mr Fraser look as unmarked as I can.’

  ‘Thanks, Terri.’ Kate nodded, and stiffened her spine.

  She couldn’t put off breaking the bad news to Ewan Fraser’s family any longer. It had to be done, she knew it had, just as she also had a niggling suspicion that this was going to turn out to be a spectacularly rotten day.

  She was right. They had two MVAs in quick succession, and Terri collared her just before the end of her shift.

  ‘OK, I want the truth about Mario Volante,’ the sister declared, her bespectacled face determined, ‘and I want it now.’

  ‘I don’t know what you mean,’ Kate replied, all too aware that the wash of bright colour she could feel staining her cheeks was totally belying her words. ‘He’s an old friend from med school who’s been nursing overseas—’

  ‘Kate, if that guy is a nurse, I’m the Sugar Plum Fairy,’ Terri interrupted. ‘Who is he? What is he?’

  Paul was watching them curiously from outside one of the cubicles, and Kate drew Terri further down the treatment room.

  ‘OK, all right,’ she began, wishing with all her heart that Mario hadn’t been quite so insistent that nobody must know who he was. ‘He’s not an auxiliary nurse, he’s a doctor.’

  ‘Ah-hah!’ Terri exclaimed, then her face creased in bewilderment. ‘But if he’s a doctor, what he’s doing here as an auxiliary nurse?’

  Good question.

  ‘He hasn’t practised as a doctor for eight years,’ Kate replied. ‘Because…um…There was an illness in his family, but now…now he wants to return to medicine, and Admin…’ Oh, lord, but she hated lying to her friend, and she wasn’t even making a very good job of it if Terri’s raised eyebrows were anything to go by. ‘Admin has agreed that he can work in A and E as an auxiliary nurse to see if…if that’s really what he wants to do.’

  It sounded lame. It sounded completely unbelievable, and Terri clearly thought so, too.

  ‘But why is he pretending to be a nurse?’ she demanded. ‘Why can’t he just tell everyone he used to be a doctor?’

  Another good question.

  ‘Because he…he’s…’ Got a criminal record for GBH? Because he’s an idiot who didn’t realise that any experienced A and E sister would suss him out in a week? ‘Because—’

  ‘Attempted suicide on the way in,’ Colin interrupted. ‘Seventeen-year-old female, ETA five minutes.’

  Which was all she needed at the end of a long and weary shift, Kate thought as Terri raced away, but at least it had put an end to Terri’s questions, though one glance at the sister’s face had told her she was merely postponing the inevitable.

  ‘Her mother found her fifteen minutes ago with an empty paracetamol bottle and a half full bottle of vodka by her side,’ the paramedic declared when Terri and Mario had carefully lifted the teenager onto the examination trolley.

  ‘Did her mother say when she last spoke to her?’ Kate asked.

  ‘An hour ago—maybe a little longer.’

  Which meant, with luck, the paracetamol should still be in the girl’s stomach and they’d be able to pump it out using gastric lavage. It wasn’t a pleasant procedure, but if the pills weren’t extracted from the girl’s stomach her liver would be irreparably damaged.

  ‘Kate, look at this,’ Terri muttered after they’d cut off the teenager’s blouse and trousers.

  The girl’s arms and legs were covered with old scars and abrasions, and Kate groaned. Not only had the girl tried to commit suicide, she was also a self-cutter into the bargain.

  ‘Why does anybody do that?’ she said as Mario held the girl down while she inserted a large tube down her throat. ‘I know people can become suicidal, but to physically cut yourself…’

  ‘Some kids do it because they’re being bullied at school, or because they’re suffering physical and sexual abuse at home,’ he replied. ‘Others simply want to find out if anyone loves them, or to punish themselves for some perceived wrong-doing on their part.’

  Kate shook her head. ‘It’s so sad—so very sad. At seventeen she should be going to parties, having fun, and to feel at that age your life is worth nothing…’

  ‘A lot of people do,’ Mario said, and something about his voice made her look up at him.

  He was reliving some moment in his past. She didn’t know how she knew that, but she did. There was raw pain in his face, the kind of pain she had never—thank God—experienced, but she couldn’t say anything, not with Terri standing there.

  ‘At least she’s not a user,’ she said tentatively instead. ‘There are no track lines on her arms.’

  ‘No,’ he said tightly. ‘Do you want sorbitol added to the charcoal?’

  ‘IC will cut up rough if we use sorbitol,’ Terri pointed out. ‘You know how they prefer everything scrubbed and cleaned and sterile, and if we give this girl sorbitol she’ll be anything but.’

  ‘IC can whistle Dixie,’ Kate declared firmly. ‘Our job is to get as many of the pills out of her stomach as we can, so add the sorbitol.’

  And they did, and the girl fought them all the way, so that by the time she had been transferred to IC not only was she covered in charcoal and sorbitol, Mario and Kate were, too.

  ‘IC are definitely not going to be happy,’ Mario observed as Kate threw her stained white coat into the laundry basket.

  ‘IC are never happy with us,’ Kate replied. ‘As Terri said, they prefer everything clean and neat, and we…we…’

  ‘We what?’ he demanded as her voice trailed away into silence.

  He’d peeled off his tunic top whilst she’d been talking and, oh, lord, but he had a beautiful chest. Broad, heavy muscled, and olive coloured with a slight sheen of sweat left from his attempts to keep the teenage girl from choking during the gastric lavage, it was the kind of chest that just cried out to be touched. The kind of chest that…

  ‘Kate, we what?’

  Quickly she tore her gaze away from his chest and stared fixedly at the laundry basket as though it was the most riveting thing in the world.

  ‘W-we keep sending them all these messy, dirty, difficult patients,’ she managed to say, and heard him exhale with exasperation.

  ‘Dammit, it’s their job—what they’re paid for!’ he exclaimed.

  ‘I know, but…’ She shot him a quick, uncertain glance only to immediately wish she hadn’t.

  He really did have a chest to die for. The sort of chest a girl could cling to. The sort of chest that was just asking to be caressed and kissed, and she wanted to be the one doing the caressing and kissing.

  ‘Kate…?’

  Damn, but he’d noticed her staring, and she waited for him to make some smart comment, but to her surprise he didn’t. Instead he suddenly seemed to find the laundry basket just as interesting as she had done.

  ‘You’ll make sure the psychiatric staff talk to the girl once she’s recovered?’ he said, yanking a still-buttoned shirt quickly over his head. ‘She’ll probably need one-to-one monitoring for quite a while. And before you say it,’ he added. ‘I know that’s an infringement of her personal liberty, but to hell with personal liberty if she does this again and kills herself.’

  ‘I…um…I—I wasn’t going to say it was an infringement,’ she stammered. Don’t think about his chest, forget he has a chest, pull yourself together. ‘In cases like this, somebody’s safety is more important than their civil liberties.’

  ‘Yes.’

  ‘Kids—young people,’ she said tentatively. ‘They really push your buttons, don’t they?’

  His face darkened. ‘I don’t like bad things happening to anybody.’

  ‘No, but you especially don’t like it when it happens to young people,’ she pressed.

  For a moment she thought he wasn’t going to answer
, then he nodded.

  ‘Too many of them fall through the net, Kate!’ he exclaimed. ‘Too many of them die when if only somebody had listened to them, seen the warning signs, they might have pulled through.’

  ‘Is that why you went into the drugs squad?’ she asked. ‘Did somebody you know fall through the net?’

  ‘Madre di Dio, must you stick your damned nose into everything?

  His words had come out like a whiplash, and her mouth fell open with surprise.

  ‘I wasn’t sticking my nose in,’ she protested. ‘I was just concerned because that girl obviously upset you, and I thought—’

  ‘I don’t give a damn what you thought,’ he flared. ‘My private life is none of your business, so back off.’

  ‘Back off?’ she repeated. ‘Back off? So, what you’re saying is that it’s OK for you to know every small, personal detail about my private life, but not for me to know anything about yours, is that it?’

  ‘I have to know about your private life,’ he replied impatiently. ‘You’re a witness in a case I’m working on.’

  ‘But I thought…’ She cleared her throat. ‘I thought we were friends, too.’

  ‘Even if we were friends,’ he exclaimed, ‘that doesn’t give you the right to poke and prod about in my private life!’

  Even if they were friends?

  ‘I wasn’t poking and prodding!’ she exclaimed. ‘I just thought that as you’re clearly upset, if you wanted to talk about it…I might be able to help.’

  ‘I don’t need any help,’ he retorted.

  ‘But it might help me to understand—’

  ‘You don’t need to understand anything about me.’

  His face was cold, closed, and he couldn’t have hurt her more if he’d actually slapped her.

  ‘I see,’ she said slowly, and she stared at him for a long moment, then nodded. ‘Right. Fine.’

  But it wasn’t fine, she thought as she walked out of the treatment room, feeling both stupid and quite ridiculously close to tears at the same time. She was a fool, such a fool. Of course he was only here because he was working on a case, and she should have realised that all his flirting and teasing meant nothing. He probably flirted with every woman he met, and she’d been an idiot to think—hope?—that it might mean something, might lead somewhere.