Her Brooding Italian Surgeon. Fiona Lowe
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you’re on walking wounded. Get a nurse from the floor to help you stat, and get someone to ring all the nursing staff and tell them to come in. I want a list of all names and all injuries. Prioritise, treat and be aware of anyone who blacked out. Any concerns, consult me or Jason.’
‘Will do.’ The experienced nurse headed to the chairs as Abbie grabbed the emergency radio.
‘Bandarra Base Hospital to Bandarra Police, over.’
Daniel Ruston’s voice crackled down the line. ‘Abbie, a bus and a truck collided. The paramedics are on their way with the first of the seriously injured passengers. It’s not pretty.’
‘How many are there?’
‘Two at least, probably more.’
‘Thanks, over and out.’ She headed straight into the resuss room, which was technically always set up ready for any emergency but she always liked to double-check. She glanced at the brand-new Virtual Trauma and Critical Care Service – a video conferencing screen on wheels. With its camera that used superfast broadband technology to transfer images from the country to the city, GPs in small towns could teleconference with specialists if need be. It was an extra medical lifeline in the tyranny of distance. Everything was ready. She didn’t have to wait long.
The paramedics barrelled through the doors, their stretchers bringing in two patients, both wearing oxygen masks. Paul, the senior paramedic, his face grim, started talking. ‘First patient is Jenny, a thirty-year-old woman, conscious with pneumothorax and suspected abdominal internal injuries. Chest tube and IV inserted in the field but BP continuing to drop. Second patient is Emma, a seventeen-year-old female with suspected spinal injuries, currently on spinal board and immobilised with a collar. Complaining of not feeling legs. IV inserted in the field and observations stable.’
Abbie bit her lip. ‘What else is coming?’
Paul looked sombre. ‘There’s a forty-five-year-old male with a fractured pelvis and multiple lacerations, and a sixty-year-old woman whose leg has gone into the wall of the bus. Jaws of life are on hand.’
Adrenaline poured through her, making her shake. She had at least four seriously ill patients, a minimum of thirty walking wounded and only four staff until the other nurses arrived. The ratio of staff to patients totally sucked.
‘It hurts.’ Jenny’s muffled sob came from behind the oxygen mask.
Abbie put her hand reassuringly on the woman’s shoulder as the trolley was wheeled into the resuss room. ‘I’m Abbie McFarlane and I’ll give you something for pain as soon as I’ve examined you.’
Justin appeared. ‘Lisa’s got it under control out there and I’ve given the hysterical woman a sedative and will stitch her forehead later. If you’re right here, I’ll examine the other stretcher patient.’
‘Great. Thanks.’ Abbie wrapped the automatic blood pressure cuff around Jenny’s arm and attached the electrodes to the ECG dots that the paramedics had applied. The reassuring beat of a regular heart rate traced across the screen.
The blood pressure machine beeped. Eighty on fifty.
Not good. ‘I just have to feel your tummy, Jenny.’
‘Will it hurt?’ Fear lit the woman’s eyes.
‘It might.’ Abbie gently palpated the woman’s abdomen and her fingers met a rigid and guarded upper left quadrant.
Jenny flinched. ‘Do you have to do that?’
‘I’m sorry.’ She’s bleeding somewhere.
‘What do you need? Catheter, plasma expander, abdominal ultrasound?’ Erin walked into the room, lack-of-sleep-induced black smudges under her eyes but as competent as ever.
‘All of the above, Erin.’ And more.
Despite what Leo Costa thought of her, Abbie knew her medicine, knew her strengths and was well aware of her short comings. She was a bloody good GP but she wasn’t a surgeon.
A patient with internal bleeding needed a surgeon.
She glanced hopefully at the Virtual Trauma and Critical Care Service but knew in her heart that this time a ‘virtual’ surgeon wasn’t going to meet her needs. She needed a real live hands-on surgeon and she had one down the hall.
One who thought she was incompetent. One she wanted to avoid at all costs, not work with side by side. But her breath shuddered out of her lungs, the sound telling. No matter how much she wanted to avoid the charismatic and opinionated Leo Costa, patients’ needs and lives came first.
The BP machine screamed incessantly, telling its undeniable message in no uncertain terms. Jenny was bleeding into her abdominal cavity. It was just a matter of time before she had more blood there than in her arteries.
She grabbed the plasma expander and plunged the sharp tip of the IV into it, piercing the seal, and then hung the bag onto the hook, opening the flow to full bore. Her choice was no choice at all. Jenny needed surgery and Abbie had to ask for help.
‘Erin, find Leo Costa and get him in here. Now!’
Chapter Three
ABBIE had just finished catheterising Jenny when Leo strode into the room, instantly filling it with vibrating energy and command.
‘You want me?’
His onyx eyes held hers with a hypnotic gaze and a sharp pang akin to hunger shook her so hard her fingers almost dropped the forceps. It had been years since she’d experienced anything like it. She cleared her throat, finding her in-charge voice. ‘Jenny sustained a blunt trauma to the abdomen, is haemodynamically unstable and transfer to Melbourne at this point is risky. She needs a surgeon.’ She pulled the ultrasound machine in close and turned it on, handing the transducer to him as Erin returned with a set of charts.
Leo put his hand gently on the terrified patient’s arm and, using the velvet tone she’d heard him use with everyone except herself, he reassured their patient.
‘Jenny, I’m Leo Costa and I’m a surgeon. Dr McFarlane’s pretty concerned about you so I’m just going to see what’s going on using the ultrasound.’
‘OK.’ Jenny gazed up at Leo as if he’d mesmerised her and all the resistance she’d used with Abbie melted away.
Abbie’s jaw clenched as memories of her father and Greg swamped her but she reminded herself it didn’t matter a jot if Leo Costa charmed every woman he ever met as long as he saved Jenny in a professional manner.
‘It will feel cold.’ He squirted the gel onto her abdomen and gently moved it across her distended belly. Black and white flickered on the screen until the image came into focus. He let out a low grunt. ‘Good catch.’
Abbie followed the trace of his finger against the screen, making out the black mass that was darker than intact liver and splenic tissue. It was everywhere – between the left kidney and the spleen, behind the spleen and ultimately pooling in the pelvis, the blood having travelled via the paracolic gutter. Her diagnosis was correct, not that it made her feel at all happy because Jenny wasn’t out of the woods yet.
Leo wiped the transducer and stowed it in its holder on the machine and returned his undivided attention to the patient. ‘Jenny, I’m fairly certain the impact of the accident has ruptured your spleen and I’m going to have to operate.’
The already pale woman blanched even more, a tremble of fear on her lips. ‘You’re good at this, aren’t you?’
Leo grinned, his smile streaking across his clean-shaven cheeks. ‘Jenny, I’m more than good; I’m one of the best.’ Then, as impossible as it was to imagine, his voice suddenly dropped even deeper, its timbre completely sincere. ‘Most importantly for you, I’ve done this operation many times in Melbourne. Erin’s going to get you ready for Theatre and I’ll see you there very soon.’