Marion Lennox - Prescription-One Bride

‘Cellulitis,’ Niall said grimly. He was holding Frank’s chart in his free hand and glanced at the line of figures. Sarah had filled in temperature and blood pressure readings with neat, precise figures. It was one thing she was good at.

The nurse was taking a tiny fingerprick blood sample now for a blood-sugar reading and her hand trembled.

‘He’s been running a temp of over thirty-eight for seven days,’ Niall said incredulously. ‘There’s no drip up? Has Dr Hurd discontinued intravenous antibiotics?’

Sarah was placing the blood sample on the stick. She nearly dropped it in her fright.

‘He’s had antibiotics orally, Doctor,’ she whispered. ‘And his diabetic tablets…’

‘So he’s not on insulin?’

‘Tablet only.’ Sarah was sure of her ground here.

‘And you haven’t taken a blood-sugar reading?’

‘I don’t…’ Sarah looked wildly across at Jessie. ‘Maybe the night nurse did-or Dr Hurd himself-’

‘Pigs might fly,’ Niall snapped. He laid the chart on the bed and lifted Frank’s wrist. ‘I need a drip set up fast,’ he told Jess. ‘Can you arrange it…?’

‘Dr Harvey’s a vet,’ the nurse said, shocked.

‘Yes, she’s a vet,’ Niall growled. ‘And she wouldn’t treat a dog like this man’s been treated. What’s the blood sugar, Nurse?’

He waited.

Sarah stared at the tiny chart. It was as much as she could do to keep her hands from trembling too much to read it.

‘Th-thirty-two…’

‘Thirty-two.’ Niall sighed. His voice was dangerously quiet. ‘A blood sugar of sixteen should be sending danger signals. Thirty-two, and you haven’t been testing…’

His face set into grim lines. ‘Someone’s been criminally negligent here,’ he snapped. ‘But we’ll worry about that later.

‘I want his urine tested for ketones as soon as possible but I won’t wait on the result. He has to be suffering from diabetic ketacidosis and I’ll work on that assumption. I want insulin-now-and I want saline intravenously at maximum flow. We’ll also need blood for electrolytes.’

‘H-how much insulin do we give him?’

‘Twenty units to begin with.’

‘And saline?’ The nurse was practically weeping and Niall winced.

‘As much as we can get aboard,’ he said icily. He was taking Frank’s blood pressure as he spoke. ‘Ninety on fifty…And you ask me how much…?’

‘Can I help?’ Jess asked quietly.

‘I need equipment for an IV line…’

Jessie had already found it. She’d moved swiftly next door to the small theatre and brought back what was needed. Before Dr Hurd’s arrival, her presence had been welcome in the hospital-as the island doctors’ presence had been welcome in her vet’s clinic. Two halves of a medical team…

Not now. Not with Dr Hurd…

Maybe she could again with Niall Mountmarche. He seemed to have accepted her completely as a medical equal. Niall accepted the syringe Jess handed him without comment.

‘I want insulin in now and the first litre of saline through within the hour. Then keep right on going-if we’re in time,’ he told Sarah. He was swabbing the back of Frank’s hand and sliding the catheter into place ready for the IV line, taking the blood sample for elecrolytes in the process.

‘The insulin can go in with the first litre. You don’t stop the flow until I tell you and I’ll tell you when to stop. You’re not taking instructions from Dr Hurd for this patient, Nurse, but from me. Move…’

‘But Dr Hurd…’

The nurse stared wildly with frightened eyes. She clearly had no idea who this strange man was-to be marching into her ward and giving orders.

‘Dr Mountmarche is a qualified doctor,’ Jess said quickly, but the nurse’s unease didn’t diminish.

‘I don’t know…’

Then her face cleared at the sound of footsteps in the hospital corridor.

‘Oh, here comes Dr Hurd now,’ she said in relief. ‘He’ll give me orders.’

‘You will do as I say. Now!’ Niall snapped. ‘There’s no time for argument. If you don’t then this man will be dead within an hour. Jessie, stay here and see she does what I’ve asked. Brain her and do it yourself if necessary.’ His mouth tightened in a grim line.

‘But Dr Hurd won’t let me,’ the nurse sobbed.

‘Leave me to deal with Dr Hurd.’

He hesitated, clearly unsure whether to stop Lionel Hurd in the corridor or stay and risk an altercation in Frank’s room. Jess saw his dilemma. A shouting match by his bedside was the last thing that Frank needed.

‘We’ll be right here,’ she said swiftly, and Niall’s eyes met hers in a fleeting moment of comprehension.

‘You’re in charge then, Dr Harvey. OK?’

‘OK.’

He nodded, a trace of a smile curving the sides of his mouth. ‘Rather medicine than Dr Hurd?’

‘Any day.’

The smile deepened. ‘So you’re sending me to battle. Well, they don’t call me the Ogre of Barega for nothing,’ he told her, and let his hand drop to touch the back of hers in a fleeting gesture of reassurance.

Then he handed the tray of equipment across to Jessie and walked out of the room.

JESSIE tried hard not to listen. The voices in the corridor were muted. One doctor discussing a case with another?

Not likely.

If Frank wasn’t so desperately ill she’d have no compunction in putting her ear to the door but there was enough to do in the ward for Jessie’s attention to be fully occupied. She worked swiftly with Sarah to set up the drip, trying to dispel the nurse’s doubts as she went but aware all the time that the most important thing was to get the drip going and the fluid and insulin into Frank’s dehydrated body.

Sarah was like a frightened rabbit.

The nurse sobbed as she worked and Jess came close to strangling her. Finally, as Sarah dropped a bag of saline, Jess paused.

‘Sarah, pull yourself together,’ she told her. ‘Immediately.’

The nurse gulped on a sob. ‘I c-can’t. I’m so scared.’

‘Why?’ Jessie lifted the saline bag and hooked it to the stand, then fitted it to the needle in the back of Frank’s hand. She gave Frank’s arm a reassuring squeeze as she did so.

‘You’ll be OK now, Frank,’ she said gently, with more assurance than she was feeling. The elderly farmer seemed beyond hearing but she could hope…‘The insulin’s going in. Just try and relax and let it take over.’

Relax…

She looked across at Sarah. Sarah was a crumpled mess.

‘I should have insisted,’ Sarah said harshly, self-blame starting to show through her fear. ‘I should have stood my ground and insisted Dr Hurd come back. I knew something was wrong-but Dr Hurd made me feel like a fool. I should have…’

‘Trusted your own judgement?’ Jessie bit back irritation, trying to imagine how she’d feel coming back to veterinary medicine after a twenty-year absence. She crossed to take the woman’s hands and gave them a swift squeeze. It was either that or give in to anger-and anger here would help no one.

‘Sarah, you’ve been a fine nurse in the past and you’re a sensible woman,’ she said roundly. ‘Coming back after an absence of twenty years must make you nervous-but technology hasn’t changed so much that you can’t tell when a man’s sick. You have to trust what your common sense tells you.’

‘But Dr Hurd wouldn’t come and I didn’t think past that,’ Sarah gulped. ‘I hardly thought about the diabetes. I just knew Frank’s leg was infected and maybe the poison had spread.’ She took a deep breath.

‘Well, maybe it was my own insecurity working there, too. If I was sure of myself I would have thought things through-thought of the diabetes-instead of blindly waiting for orders.’ She looked doubtfully down at the bed. ‘Oh, Jess, do you think we’re in time?’