Anne Fraser - Top-Notch Men!

‘I don’t suppose he wants you to work on his wife,’ Bethany said cynically.

‘No, but that doesn’t mean I can’t.’ Allegra looked towards the isolation room where Kate was being monitored, a tiny frown bringing her brows together. ‘Has anyone been in to see her yet?’

‘No one at all. I guess she either doesn’t have any relatives or if she does, they’re all too angry with her to visit—not that you could blame them after what she tried to do.’

‘Surely there must be someone close to her, a friend or sister or cousin, if not her parents. She can’t possibly be all alone in the world. Someone must care about her.’

‘Doesn’t look like it,’ Bethany said, ‘Unless the husband has deliberately not told them.’

‘It’s been in the papers though …’

‘Not everyone reads the paper every day,’ Bethany said.

‘True, but news has a habit of travelling anyhow so you’d think someone would have at least called to ask after her by now.’

‘I guess you’re right,’ Bethany said. ‘And when you think about it, Tommy hasn’t had too many visitors either.’

‘Has anyone apart from his father been in?’

‘Mr Lowe’s sister, Tommy’s aunt, has come in a couple of times.’

‘What was she like?’

Bethany screwed up her face. ‘Exactly like her brother, cold and distant. She was dressed to the nines—you know the type, the cloying perfume and the coiffed hair and designer gear and heavy jewellery. She barely sat by Tommy’s bed for more than a minute or two before leaving.’

‘Does Tommy have grandparents?’

‘I heard one of the nurses ask Mr Lowe that earlier,’ Bethany said. ‘He made no mention of Kate’s parents but he said his were travelling somewhere interstate and couldn’t be contacted.’

Allegra’s frown increased. ‘Which probably means he doesn’t want them to be contacted. I wonder why?’

‘Beats me,’ Bethany said. Changing the subject, she asked, ‘What are you going to do with Tommy?’

‘His father said he loves Harry Potter movies. I’d like to set one up playing next to his bed—it might trigger memories, stir some neurological activity. It’s part of the coma recovery protocol, using familiar auditory stimuli as triggers.’

‘What are you going to play it on? This place is pretty cluttered as it is.’

‘I’ve got a portable DVD player and stereo earpieces,’ Allegra said as she reached for a piece of equipment. ‘I’ll set it up on the side shelf out of the way. Also, I want to put on a BIS monitor to record any sort of cerebral activity. This strip sticks on his forehead, and the lead plugs into the monitor. This one’s got an eight-hour recorder. I’ll set it going now, and take a baseline record. In an hour, can you plug in the earpieces and start the DVD? When it’s finished, just take out the earpieces. Leave the BIS going till I come in later tonight, OK?’

‘Sure’ said Bethany. ‘Got that. What time will you be back in?’

‘About eight-thirty tonight, I think. I’ve just got one social engagement, and then I’ll come in and collect the stuff and go home.’

‘I didn’t know you even had a home,’ Bethany said with a wry grin. ‘You seem to spend most of your time here.’

Allegra sent her a rolled eyed look as she left. ‘Don’t remind me.’

ALLEGRA had not long completed the pre-admission clinic for Harry Upton’s list for the following week when her mobile phone buzzed with an incoming text. She looked down at it and saw it was from Tony Ringer, the night duty intensivist, informing her that Joel was in the high-dependency unit with Harry Upton, assessing the patient who’d had the complication after surgery that morning and that Joel needed anaesthetic information urgently.

Allegra remembered the case well. Gaile Donovan was a forty-eight-year-old woman with ovarian cancer that had invaded the pelvic wall and sigmoid colon. Harry had helped the gynaecologist with the pelvic exploration. The gynaecologist had been keen to get the tumour out but after five litres of blood loss, the normally calm-under-pressure Harry had broken out in a sweat trying to control the bleeding and had insisted they pull the plug before the patient expired on the table. They had packed the pelvis and temporarily closed the abdomen, with the intention of a second-look laparotomy the next day.

When Allegra arrived in HDU, she could hear Harry and Joel discussing the plan of action.

‘The patient’s BP has hit the floor, Harry,’ Joel said. ‘She’s obviously bleeding again—you have no choice but to operate again now.’

‘It was a nightmare the first time around,’ Harry said. ‘I think an angiogram and embolisation would be a better choice for controlling the bleeding.’

‘Listen, Harry,’ Joel said. ‘She’s pouring blood and wouldn’t survive the trip to X-Ray, let alone a couple of hours on the X-ray table, having films done. The blood loss has got to be stopped or at least slowed a hell of a lot first. Maybe embolisation, then.’

‘Damn it! I wish I’d never become involved in this case,’ Harry grumbled. ‘I could see it was trouble as soon as we opened.’

‘Use the theatre here,’ Joel suggested. ‘It’s on site, it’s staffed and it’s got angiography capability. Why don’t you talk to Radiology now so they come in and set up in case you want to do on-table embolisation?’ He turned as he saw Allegra, his expression visibly hardening. ‘I thought Tony called for the anaesthetist on duty.’

‘I’m the one he called, but if you’d prefer someone else, fine—go ahead,’ she said with a flash of her green eyes.

He shifted his mouth in what was clearly reluctant resignation and turned back to Harry. ‘Dr Tallis can anaesthetise for you. I’ve got to get a new central line in quickly to catch up with volume.’

‘Right.’ Harry nodded in agreement and with a quick grimace in Allegra’s direction headed towards Radiology and the ICTU theatre.

Once Harry had left, Joel turned to fill Allegra in on the patient’s condition. ‘Mrs Donovan’s MAP’s 50, pulse 160, sats 80—not good. I’ve got a norad infusion up and fresh blood pouring in, but she needs surgical control of the bleeding. I’m replacing your central line from this morning—it seems to be kinked or compressed somewhere and I just can’t get enough volume through it. Harry’s using the theatre here.’

Allegra had to force aside her personal issues with him to maintain professional calm. ‘I’ll head down now and set up. Will you bring her down?’

‘Yes, in about ten minutes. How much blood altogether did she have in Theatre this morning? I haven’t had time to familiarise myself with the anaesthetic charts here—it would take me ten minutes to add it all up.’

‘Yes, they are confusing. Fifteen units of packed cells and four units of whole blood. She also had four packs of albumin volume expander and three fresh-frozen plasmas. How many have you crossed-matched now?’

‘Twenty packed cells—that’s the current hospital supply of B at the moment. Red Cross are bleeding call-ins tonight to replenish supplies,’ he answered.

‘Good. I’d better get going,’ Allegra said, and left the unit.

Joel turned back to the patient, his brow tightening with tension as he called on all his intensive care skills to work to salvage the rapidly developing disaster in front of him.

Gaile Donovan had two young teenage daughters and a loving husband waiting anxiously in the waiting room for news of their loved one’s condition. Gaile’s cancer diagnosis had been bad enough, but to suffer this complication during surgery added an element of potential tragedy that would be very hard to announce to the family if things didn’t go well.