Sarah Morgan - Wish Upon A Star

What if she couldn’t remember what to do?

A blood-stained Father Christmas outfit lay in a pile and the patient was groaning with pain. Alessandro stood at the head of the trolley, co-ordinating the medical team as he assessed the patient. ‘There’s some bruising over the anterior chest wall,’ he murmured as his eyes slid over the patient, conducting a visual examination. ‘No evidence of open wounds or penetrating trauma.’

Christy walked towards the trolley, momentarily distracted by the sight of him in action. She’d forgotten what an exceptionally gifted doctor he was. Slick, competent and a natural leader. Nothing ever fazed him.

He lifted his eyes from the patient and saw her. His expression didn’t change. ‘You need protective clothing before you handle the patient,’ he said coldly. ‘At the very least, latex gloves and an apron.’ He turned his attention back to his patient and Christy felt the colour flood into her cheeks. Of course she knew that the first thing she should have done was to reach for protective clothing. All blood and body fluids had to be assumed to carry HIV and the hepatitis virus. She knew that. It was just that seeing him had rattled her. Affected her confidence.

Determined not to let him get to her, she quickly donned the clothing that she needed and walked back to the trolley.

Her hands were shaking and her heart was banging against her ribs. She’d done this before, she reminded herself firmly. Many times.

Alessandro was listening to the patient’s chest, his face blank of expression as he concentrated. When he was satisfied, he looped the stethoscope round his neck and turned to the circulation doctor, a pretty blonde girl who was examining the patient’s femur. ‘Blood loss?’

‘I’m keeping pressure on that wound and it’s under control.’

‘OK, I want two peripheral lines in and take some blood for cross-matching, full blood count, U and Es, and let’s get an arterial sample. I want blood gas and pH analysis. What’s his blood pressure doing? I need an ECG here.’ His instructions were smooth and seamless and swiftly Christy took over from one of the other nurses, who was clearly struggling and whom she presumed to be Donna.

Instinctively her eyes flicked to the monitor as she reached for the adhesive electrode pads and attached the patient to the ECG monitor. ‘It’s dropping. Ninety over fifty.’

Suddenly her hands weren’t shaking any more. Her movements were smooth, confident and almost automatic. She knew what she was doing and it was as if she’d never been away.

‘We’ll start with a litre of Hartmann’s,’ Alessandro said immediately, and Christy busied herself with her patient while he made a rapid assessment of brain and spinal-cord function.

‘Put your tongue out for me,’ he instructed the patient. ‘Wiggle your toes.’

‘His blood pressure is still dropping,’ Christy said quietly, and Alessandro’s gaze flickered to hers.

‘Increase the flow rate and let’s give him some analgesia.’

‘First line is in,’ the blonde doctor said as she slid a wide-bore cannula into a vein and Christy pulled the IV stand towards her so that she could attach the giving set and start the infusion.

‘Get that second line in straight away, Katya,’ Alessandro instructed, and the blonde doctor reached for the second cannula and moved round the trolley to the other side of the patient.

The man gave a groan of pain and Alessandro immediately switched his attention back to his patient. ‘We’re going to give you something for the pain now, Derek,’ he said calmly and Christy reached for the drugs that she knew would be on the trolley. ‘Morphine and cyclizine?’

With speed and efficiency she drew up the drug and handed it to Alessandro, along with the ampoule to check. Then she moved closer to the trolley and closed her hand over the patient’s, offering comfort.

‘We’ll soon have you more comfortable, Derek,’ she said quietly, and felt the man’s fingers tighten over hers.

This was the bit that the doctors often forgot or ignored, she thought to herself as she felt the man’s grip. They forgot the importance of touch. They forgot that as well as being injured, the patient was anxious and scared.

It was another thing that she’d always admired about Alessandro. No matter how tense the situation, he never forgot his patient. He wasn’t a touchy-feely doctor, but he understood the importance of communication in lowering stress levels.

Her eyes flickered to the machines next to her. ‘His blood pressure is stable,’ she said quietly, and Alessandro gave a nod.

‘Good. He’s still in pain so I’m going to give him a femoral nerve block before we splint and X-ray.’

Immediately Christy reached for the needle she knew he was going to need and an ampoule of lignocaine.

Alessandro felt for the femoral artery and cleaned the skin. Then he held out his hand for the local anaesthetic that Christy had prepared.

She watched while he inserted the needle perpendicular to the skin and then aspirated to check for blood. ‘That’s fine,’ he murmured, moving the needle up and down as he injected the local anaesthetic.

Katya moved forward, standing close to Alessandro. ‘What happens if you puncture the artery?’

‘I resign.’ Sounding impossibly Spanish, Alessandro dropped the syringe back on the tray that Christy was holding and gave a brief smile. ‘But before I resign, I compress it for five to ten minutes or until the bleeding stops. Then I carry on with the femoral nerve block.’ He turned his attention back to his patient. ‘That should give you some relief very quickly, Derek.’

Katya turned away but not before Christy had seen the flirtatious glance.

She wanted Alessandro.

Christy’s stomach lurched and she swallowed hard.

She was used to women staring at Alessandro. It had always happened and perhaps it always would because he was a man who inevitably attracted the attention of the female sex. But this was the first time she’d seen it happen when their marriage was in trouble.

Had he done something about it?

She bit her lip. Katya was very pretty. Alessandro was a hot-blooded Spaniard with a high sex drive, she knew that better than anyone. With their marriage in its current state, it was hard not to worry.

Had something happened between them?

The man closed his eyes and shook his head. ‘We were on our way to a school—delivering presents.’

‘Don’t worry about that now.’ Pushing aside disturbing thoughts of Katya with her arms wrapped around Alessandro, Christy gave a reassuring smile as the man gripped her hand tightly.

‘Will you get someone to phone the school and explain? These kids believe in Father Christmas. What will they think if I don’t turn up?’

Alessandro looked taken aback but Christy squeezed the man’s hand. ‘I’ll talk to one of the nurses outside see if one of your elves can make a call.’

Alessandro looked at her blankly and she just smiled and turned to Donna, who was hovering nervously. ‘Can you speak to Nicky?’ she said quietly. ‘Ask her to talk to one of the elves and call the school.’

Visibly relieved to be given an excuse to leave, Donna backed out of the room.

Alessandro watched her go with an ominous frown in his dark eyes. ‘She’s nervous.’

‘She’s learning and you can be scary,’ Christy said calmly. ‘Do you want to immobilise the limb now?’

He looked at her. ‘I’m scary?’

‘Not everyone is born with your confidence. Derek, we’re going to splint this leg of yours and for that I need to take some measurements on your uninjured leg.’ Having offered an explanation, Christy moved the blanket and measured the uppermost part of the patient’s thigh.