Marion Lennox: Midwives On Call: Stealing The Surgeon's Heart

Handover was rapid. Judith was unusually subdued and the rest of the day staff were no doubt keen to escape for the last few hours of Saturday night. When it was over Harriet took a few moments to allocate the staff beneath her, first asking if anyone had any preferences.

‘Resus,’ Charlotte immediately asked, and Harriet gave a small grin at her enthusiasm.

‘You can work in there, with Susan,’ Harriet agreed, keen to give the grad nurse the experience she needed, but ever mindful of staff-patient ratios. ‘But when it’s quiet, you’ll need to give a hand out in A bay.’

‘Louise.’ Harriet gave an apologetic grimace, knowing that most emergency nurses wanted to be in where the action was, not watching from a glass booth in the waiting room. ‘Do you mind covering Triage for the first part of the night? I’ll make sure that I rotate staff.’

‘Fine,’ Louise agreed with a not too thinly disguised sigh, which Harriet chose to ignore. As the senior nurse on duty she needed to be on the floor and needed to delegate the staff appropriately, and Triage was important. As the first port of call for patients it needed a perceptive, experienced nurse to assess the patients and categorise them. As much as most nurses hated being in there, it was one of the most important roles in a well-run emergency department and a leaf or two out of Judith’s book wouldn’t go amiss.

Judith!

After a quick check to make sure everything was in order, Harriet headed for the changing room and, sure enough, there Judith was, slowly emptying her locker, filling her wicker basket with her Thermos and sandwich container, her proud face not even looking over as Harriet slipped in quietly.

‘Judith?’

‘I’m fine.’

‘I know you are,’ Harriet started, not quite sure how to broach this difficult, proud woman but knowing she was hurting. Knowing that, unlike the rest of the mob who had scampered off after handover to the pub or their families, Judith would be going home to an empty house and that the only part of the shift she would remember was the final part. ‘Look, in a couple of weeks you two will probably be friends,’ Harriet ventured, and Judith gave a tired nod.

‘Probably. Oh, Harriet, I didn’t mean to imply that he was giving her preferential treatment just because she was a dancer.’

‘No, you probably didn’t.’ Harriet gave a half-smile. ‘But that was what you said, Judith, and, given it’s his first shift in Emergency in this country and English isn’t his first language, and given that your sense of humour doesn’t come with a user manual, he’d be forgiven for thinking that you meant it.’

After the longest time Judith nodded, even managed a watery smile. ‘Should I apologise?’

‘Heavens, no!’ Harriet gave a far wider grin this time. ‘Never apologise to a doctor, Judith, you know that better than me.’

Heading back to the department, happy that Judith wasn’t if exactly cheered at least feeling a bit better, Harriet eyed the whiteboard, planning her next move. She wasn’t sure what reached her senses first, the deep voice or the heady scent of his aftershave, but for reasons she couldn’t even begin to fathom, every sense was on high alert as an all-too-familiar request met her ears.

‘Who is in charge?’

Harriet felt her confident introduction dissipate into a croak.

‘That would be me,’ she somehow managed, dragging her eyes upwards. Incredibly tall, he was easily a good few inches taller than Drew who stood at six-one, but there was nothing remotely slender about him. Ciro was an absolute brute of a man, impossibly wide shoulders, the short-sleeved theatre blues displaying muscular forearms, dusted with dark hairs. Even his hands, holding out a casualty card towards her, were somehow sexy—olive-skinned and long-fingered. Harriet immediately felt incredibly guilty for even noticing they were utterly devoid of a wedding ring.

‘The sister who was on before was very dismissive, but I am preocupado…’ Ciro hesitated. ‘Worried,’ he corrected, and even though she’d already guessed what he was alluding to she gave a small appreciative nod when he translated his word effectively. ‘Very worried and concerned about this patient.’

Grateful for something to concentrate on other than this divine specimen, she took the casualty card and skimmed through the notes written by the evening doctor Ciro had taken over from, cutting through the medical jargon in a moment and summing up the bare facts. ‘Alyssa Harrison, fifteen years old. Fell at a ballet rehearsal, lacerated scalp, sutured, neuro obs stable, ready for discharge. What’s concerning you, Doctor?’

‘A lot, I think.’ His voice was serious, and he gestured to an empty cubicle. ‘Can I speak with you for a moment?’

‘Of course!’ Harriet agreed, but nothing was that simple in Emergency. Before heading off, she flagged down a passing RN with the words, ‘I won’t be long,’ and, handing the drug keys to Susan, she added, ‘Dr Delgato wants a word in private.’

‘Lucky thing.’ Susan grinned. ‘Take as long as you need—I would.’

Thankfully the short walk allowed her blush to fade. No man had even come close to causing such a reaction in her and Harriet didn’t even need to glance at the ring that adorned her own finger to know that whatever she was feeling was inappropriate.

‘It would appear straightforward.’ Ciro wasted no time getting to the point. ‘Alyssa was seen and stitched before I arrived on duty—she had no neurological signs, etcetera, but the doctor who saw her suggested we keep her in for a few hours for head-injury observations, which have all been normal. Now her mother is very keen to get her home.’

‘But?’ Harriet asked, because clearly there was one.

‘I don’t think this young girl is well at all, I’m not happy to discharge her, yet she doesn’t want to get undressed for a full examination,’ Ciro said grimly.

‘A lot of fifteen-year-olds wouldn’t,’ Harriet ventured, ‘especially…’ Her voice trailed off, but in the interests of patient care she cleared her throat and boldly continued, ‘Well, you’re a young man, good-looking—’

‘I have taken that into consideration,’ Ciro broke in, apparently not remotely embarrassed by Harriet’s rather personal observation. ‘She is swathed in legwarmers and a cardigan. All I have managed is to roll up her sleeve, check her blood pressure and take a small look at her ankles while I checked her reflexes. That was enough for me to see that this girl is not just thin, but I would say anorexic and severely malnourished. Her ankles are swollen and oedematous, which would suggest severe malnutrition, and her arms are very thin. Now, usually you would have the parent helping, telling the child not to worry, that it is a doctor examining her and this needs to be done, but instead the mother is agreeing with the daughter when she says that she doesn’t want to get undressed and loudly insisting that any further investigations are unnecessary and that she wants to take her home.’

‘OK.’ Harriet chewed her bottom lip as she realised the possible gravity of the situation, listening intently as Ciro continued.

‘I took her pulse for a full five minutes and she is having arrhythmias. I suggested that we put her on a monitor and do an ECG and some bloods, but the mother again refused. She said that she would take her to the family doctor tomorrow. It is my belief that the mother knows her daughter is grossly underweight, knows that if she is examined properly she will be kept in hospital, and is trying to avoid it.’

‘Have you managed to speak to Alyssa alone?’

‘No.’ Ciro shrugged, his shoulders moving just a fraction. ‘Sister…’

‘Harriet,’ she corrected automatically.