Читать книгу: «Doctor at Risk»

CHAPTER ONE

HE COULD smell the danger.

Mountain rescues could be dangerous enough but they never smelt like this. Of thick dust and heat. Of unwashed and exhausted people. He could smell the sudden fear that kicked in when their hazardous environment reminded them of precisely where they were. Sometimes he could smell the incongruous aroma of foodstuffs or perfume. And sometimes he could smell blood and the dreadful stench of death.

Dr Ross Turnball would have picked a mountain rescue in preference any time. Clean, cold air or the relatively safe smell of wood smoke. The scent of the carpet of decomposing vegetation that might be released by the tread of heavy boots or the far less pleasant aroma of a long-dead possum. He would be hearing the moan of a southerly storm brewing or the rattle of scree dislodged by a careless step to go cascading down a barren slope. Or perhaps he would be listening to the welcome chop of helicopter rotors as back-up arrived.

He wouldn’t be listening to the alien sound of people trying to communicate through dust masks against an almost constant background of crackling radio transmissions, the staccato intrusion of pneumatic tools or the dull roar of heavy machinery shifting rubble. He wouldn’t see the kind of bewildered fear and pain on the faces of the victims they found either. These people hadn’t chosen to enter an environment with inherent risks. They had had no protective clothing and absolutely no warning of imminent disaster.

Yes, he would have picked a mountain rescue in preference but there was no way he would choose to be anywhere else at this point in time. These people needed him and Ross knew he was precisely where he was supposed to be.

Not that any of them had anticipated being in a situation like this so soon. Or of ever being in a situation of this magnitude. At 15.38 hours yesterday, on a sunny Friday afternoon, a massive explosion had occurred in Westgate, a popular suburban shopping mall in Christchurch. Its unprecedented level of destruction made it the largest multi-casualty incident ever seen in the small country of New Zealand, and had resulted in the first full-scale deployment of personnel trained in urban search and rescue.

Including the most recent graduates of the USAR training course held in Christchurch, Dr Turnball among them. Given his medical qualifications, his presence on the course had been welcomed. His years of experience as part of a mountain search and rescue team had put him right at the top of the class but Ross had been eager to add to his knowledge base. He’d wanted to add skills that would enable him to respond to any kind of emergency situation. To reinforce the quiet confidence he already possessed that he could assist or, if need be, lead the kind of people who were willing to risk their own safety to save the lives of others.

That risk was starting to feel familiar enough to make the fear of personal danger seem almost irrelevant. Ross turned to speak to a man standing to one side and well below his own position.

‘If you hold a rope I can tie it round my waist and lean over far enough to reach her.’

‘I could climb down there.’

‘No way.’ Ross swung his gaze back to the small figure in blue overalls perched close to him on the mound of debris. It might be easy to dismiss the fear for his own safety, but Wendy Watson’s was a completely different matter. ‘We have no idea how stable this side of the void really is. You could end up being buried as well.’

‘I’m smaller,’ Wendy protested. Her bright orange safety helmet tilted as she lifted her face to look directly at her senior colleague. ‘And lighter. I’d be less likely to make anything collapse.’

‘We don’t even know if she’s alive yet.’ Ross peered over the concrete slab obscuring the lower half of the woman lying just out of reach below them. The discovery of the woman had been made in Sector 3, when the pile of debris had shifted following the removal of a large beam obstructing the path of rescue workers nearby in Sector 2. USAR Squad 4 had been on their way to a new deployment on the second level of the shopping centre but they had been quickly diverted by news of the discovery. A rapid survey by members of a civil defence team, in consultation with an engineer, had allowed permission to be given for USAR 4’s medics to move close enough to try and assess the victim’s condition.

‘She doesn’t look dead.’ Wendy sounded hopeful as Ross turned his attention to securing the rope around his waist. Her optimism was contagious, despite his exhaustion, but it was probably no more than wishful thinking. The few victims they had found on their last tour of duty had been well beyond their assistance.

‘Ross!’ Wendy’s voice was excited. ‘She moved. Look!’

Sure enough, the woman’s hand was moving, her fingers curling slowly into a fist. A rush of adrenaline surged through the whole squad.

‘I could climb around to the back. Maybe there’s access to the void from that direction.’

‘Stay right where you are, Kyle.’ The squad leader, Tony Calder, had been one of the instructors on the USAR course. He was well used to containing the youngest class member’s enthusiasm when necessary. ‘We’re not going to risk making this situation any more unstable than it already is. You and Matt can hang on to this rope. And be ready to pull Ross clear fast if I give you the signal.’

Making a primary survey of a multi-trauma victim whilst hanging head down was not a skill Ross had previously discovered he possessed. His hands felt heavy and his head was pounding gently as gravity affected his own circulation.

‘She’s breathing,’ he reported a short time later, ‘but the chest movement looks unilateral.’

Wendy was leaning as far as she could without a rope. ‘Possible pneumothorax, then,’ she suggested. ‘Do you want a stethoscope?’

‘Not just yet.’ Ross was rubbing a knuckle on the woman’s sternum. ‘Hello, can you hear me? Hello?’ His voice rose as the woman made an inarticulate sound. ‘It’s all right,’ he reassured her. ‘I’m a doctor. We’re here to help you.’

His hands continued moving. ‘Good carotid pulse,’ he called back to Wendy. An air hammer had started up in the vicinity and it was difficult to know whether she could hear him. ‘Trachea’s midline. There’s no obvious cervical deformity and no sign of a major head injury.’

Wendy had heard. She had a cervical collar and was reaching forward to dangle the Velcro strap within his reach.

‘I’ve just guessed the neck size,’ she said. ‘She looks like a medium from here.’

‘I’m sure you’re right,’ Ross responded. ‘You’ve dealt with a lot more spinal injuries than I’ve ever seen.’ He had to wriggle forward a few extra inches to give him room to manoeuvre the collar into position. A shower of plaster dust seemed to come from nowhere and too much of it settled over the victim’s face. The demonstration that she was not unconscious enough to have lost her cough reflex should have been a relief, but Ross was not alone in the alarm he felt at the tiny movement of the concrete slab he was lying on.

Tony raised his hand and dropped it in a sharp cutting motion. Matt and Kyle hauled on the rope to help pull Ross clear quickly. He slid down from the pile of debris and staggered slightly as he tried to catch his balance.

‘You can stop pulling now, Kyle,’ he said drily. ‘I’m out now.’

Wendy was still perched above them to one side of the slab that Ross had been leaning over. ‘We need to get an oxygen mask on her,’ she called. ‘And to listen to her breathing. If she’s got a tension pneumothorax she’ll need decompression.’ Wendy was clearly frustrated by the delay.

‘It’s too dangerous for me to keep leaning over that ledge. My weight and movement could send it right down on top of her head.’

‘There’s room for me to stand down here, I’m sure of it. And I’m only forty-five kilos. If it hasn’t moved too much with Ross’s weight, I could easily get past that slab.’

Ross had to admire her courage. She had weighed the risks—almost literally—and she was determined to carry on. He would probably have chosen to assess the situation a lot more thoroughly before taking action but Wendy’s enthusiasm was contagious. So was her confidence. It was a package Ross couldn’t help responding to and it had been that way from the first moment he’d seen this woman. He recognised all her qualities as being the ones he nurtured in himself but she had a glow that illuminated shadows he’d never known he harboured. Like conservatism and prudence and maybe too much of a professional distance. It was no wonder he’d fallen head over heels in love with this pint-sized powerhouse of a personality, and he wasn’t the only one affected. Poor old Kyle was staring at her with an expression of hero-worship as Wendy put her case. And the squad leader, Tony, was actually grinning—albeit ruefully.

‘If you’re sure you want to try, it’s OK by me.’

‘I’m sure.’ Wendy looked serious now. The hint of mischief that usually lurked in that elfin face was nowhere to be seen. She was far too intelligent not to understand what she was letting herself in for and while Ross felt an almost overwhelming urge to protect her by protesting the decision, he knew his only real option was to offer his support.

And Wendy needed him. Ross took her previous and more secure position, well away from being able to touch the victim but close enough to pass supplies and advice to his medical partner.

‘Breath sounds are absent on the left and it’s difficult to hear the heart.’ Wendy pulled the earpieces of the stethoscope free as she looked up at Ross. ‘I can’t see the trachea or neck veins now with the collar on but her colour’s getting worse and she’s on a hundred per cent oxygen.’

‘I’d say a tension pneumothorax is highly likely. You’ll have to do a needle decompression.’

A look of alarm crossed Wendy’s features. ‘I’m not qualified to do that! The only thing I do with cannulae is put IVs in. We’ll have to get her out so that you can do it.’

‘There’s no time.’

‘But I don’t think she’s actually trapped under that slab. There’s other stuff holding it up and I’m pretty sure I could shift some of it. We could get a harness on her and lift her out.’

‘There’s still not enough time. If it is a tension pneumothorax and she’s deteriorating this quickly you’ll have a respiratory arrest on your hands within the next couple of minutes if you don’t release the air in the chest cavity. You can do it, Wendy.’ Ross was already sorting the gear she would need into a pouch. ‘I’ll talk you through it.’

‘OK.’ Wendy’s tone advertised her trust in his judgement. She still looked scared, however. ‘But I’m depending on you here, Ross.’

Ross had every confidence in his dependability. And in Wendy’s ability.

‘Find the second intercostal space in the mid-clavicular line,’ he instructed calmly. ‘That’s the point for the needle insertion.’

Wendy put clean gloves on, swabbed the skin with an alcohol wipe and ripped open the sterile package containing the cannula. The tiny shake Ross could see in her hands was gone the moment the needle penetrated the skin.

‘Keep the pressure on. It’s tougher than getting into a vein.’

‘I’ve got it, Ross. I can hear the hissing.’

‘Good girl. Well done.’ It was a small miracle that the noise in the surrounding area had dropped with such good timing. The reason for the sudden quiet became apparent as Ross finished his directions for Wendy to secure the cannula. He could hear the faint shout from another USAR squad working nearby.

‘Rescue team here. Can you hear me?’

Wendy had also heard the call. ‘That sounded like Fletch.’ She was reassessing her patient as she spoke. ‘Colour’s improving,’ she reported happily. ‘What next, Ross?’

‘IV access,’ Ross said promptly. ‘We’ll get some fluids running. Then we’ll see what we can do about getting her out. We might try getting her into a body splint, too. There’s no way we’re going to get a backboard down there.’

It took careful management and the skills of more than one rescue team to extricate the survivor but their success made the extraordinary effort worthwhile. By the time the woman was securely strapped into a Stokes basket for transport, her blood pressure had risen thanks to the fluid load, her respiratory distress was only mild and she had regained consciousness enough to tell them her name and thank her rescuers. A life had been saved. Wendy and Ross were congratulated as being the tight single unit everyone knew them to be.

And Ross was walking on air.

He laughed aloud when Wendy rolled her eyes at him to communicate her exasperation with Kyle’s impatience to get back to some action.

‘We’re supposed to be searching Level 2. What’s taking so bloody long?’

Wendy looked tired and Ross knew just how drained she would be feeling as they watched the stretcher carrying their patient pass into the hands of the paramedics waiting at the triage tent. An ambulance was also ready, its beacons flashing. USAR Squad 4 turned back to the mall to continue their shift. Kyle led the way alongside Tony. Ross walked at the back, his arm resting lightly on Wendy’s shoulders.

‘You did a fantastic job in there,’ he told her. ‘I’m really proud of you.’

The smile he received in response temporarily wiped out any hint of exhaustion or discomfort. The rub of grimy overalls, the gritty, sore eyes, the various bruises and scrapes were forgotten. The fact that they were crunching through broken glass and walking into a dark and threatening environment with only the beams from their headlamps to illuminate the hazards did nothing to dim the joy Ross felt. He wanted to say more to Wendy. To tell her just how much he loved her. He wanted to stop and pull her into his arms and kiss her senseless. Of course, he would do nothing that inappropriate. He would just return the smile and hope that something of what he was feeling would be communicated by the pressure of his arm around her shoulders and the sincere tone of the words he had spoken.

‘Thanks.’ Reading the expression in eyes partially obscured by dusty goggles was unreliable but Wendy’s smile broadened into the impish grin he loved. She spoke loudly enough to make it plain she didn’t share the inhibition Ross found their situation imposed. ‘Love you.’

And suddenly Ross didn’t care where he was or who might overhear either. Or even that it could be considered unprofessional.

‘Love you, too.’

He was still walking on air. And it felt like flying. This kind of joy was so new to Ross. It had been in his life for only a matter of weeks. Since he had met Wendy Watson, in fact, and discovered the unimagined pleasure of being with someone who could only be considered a soul mate.

He could hear Kyle’s voice rising with excitement ahead of the rest of the squad. ‘I heard something. There’s someone here—calling for help!’

Ross moved into position as the team made a line to begin a systematic search of the Level 2 area. A hairdressing salon had partially collapsed into a shop on the ground floor. More internal walls had fallen upstairs and there were piles of debris and voids to search. The signal of three short blasts on a whistle called for silence, and gradually the sounds coming from beneath and around them faded.

Ross started the calls. ‘Rescue team here. Can you hear me?’

He waited. Five seconds. Ten. Fifteen. ‘Nothing heard.’

‘Rescue team here. Can you hear me?’ Wendy’s small frame could produce a remarkably loud voice and Ross found himself smiling.

It was so much a part of her. That energy...and strength. Making love to her had been a revelation all of its own. Touching that lithe, fine body that defied any attempt to be treated as fragile, because Wendy’s enthusiasm and generosity affected her love-making as much as every other aspect of her personality. Ross had the sudden wish that this incident was over with. That he and Wendy could be somewhere by themselves and negate the horror of the last twenty-four hours by a very private celebration of life...and their love.

He could hear Kyle again but the young firefighter wasn’t using the well-rehearsed calling system. He wasn’t using any words at all. The call rose in pitch and volume. A dreadful scream. And then a cry for help.

‘Help! Someone, help me!’

A figure writhed in the shadows. Ross could see him more clearly as he moved closer. The beam from his headlamp jerked and then steadied and he could see what the problem was. A thin rod of reinforcing steel protruded from a broken concrete slab. The end of the rod was bent into a right angle that Kyle hadn’t seen in the darkness. He couldn’t see the tip of the rod because it had penetrated the thick fabric of Kyle’s overalls and was now lodged in the soft flesh of his calf muscle.

‘Don’t touch my leg, man! It hurts!’

Kyle was still writhing. Was he trying to pull himself clear or push Ross out of reach? Ross could feel the shove. It felt like a blow and it made reality intrude, much as a slap in the face might have affected someone as hysterical as Kyle now appeared to be. The blow was a wake-up call, and in a dreadful moment of truth Ross knew that he was dreaming.

Again.

And he couldn’t escape.

The flying sensation continued, as part of his brain acknowledged that it had to. Any joy, however, had been replaced by a dark and terrible fear. He wasn’t flying.

He was falling.

Spiralling through space, towards the pain and destruction waiting in the unforgiving rubble below. Life as he had always known it was about to end. Ross could feel his heart pounding, his stomach knotting painfully with fear. He tried to cry out but he couldn’t compete with the echoes of Kyle’s screams, and anyway there was no time to force any sound from his uncooperative vocal cords. No time to—

The soft touch distracted him from the effort of attempting the impossible. Wendy was there. He could feel her touch. In another moment he would hear her voice as it reassured and encouraged him. He would be able to look at those elfin features with the mop of blonde spikes and see the love and concern blazing from dark blue eyes. And she would still be there as he learned the worst about his injuries. As he pulled himself from the oblivion of anaesthesia and as he struggled through the dark hours of fighting to breathe...and live.

The gentle shaking continued for just another second but it was long enough to pull Ross back from the brink. To escape. He forced his eyelids to lift and concentrated on trying to slow his breathing as he looked into a face that was nothing like Wendy’s.

‘Another nightmare?’ The nurse on night duty, Megan Leggett, was sympathetic. ‘Are you OK?’

Ross closed his eyes again. The dream was already fading and although the relief was overwhelming, Ross knew there were parts of that dream he didn’t want to relinquish. A tiny sliver of the satisfaction in rescuing that woman surfaced. And a brief snatch of the joy of making love to Wendy. Another split second and they were both gone. Part of the past. Sensations that he would never experience again in anything other than a dream.

‘I’m OK,’ he told Megan curtly. ‘Sorry if I’ve woken anyone.’

Thanks to the incoherent but distressed sounds he had been heard to make, the disturbance to his sleep in recent nights was no longer private. The nightmares hadn’t started until after his transfer from ICU to the ward but they were increasing in frequency. They served to underscore the importance Ross knew he should be giving to sorting out the emotional as well as the physical aftermath of his accident.

‘Sam would sleep through Armageddon.’ Megan smiled. ‘One advantage to having hearing aids that can be switched off, I suppose. And Aaron went home today, remember? I was the only person who heard anything.’ Her eyebrows lifted. ‘Can I get you anything? A drink maybe?’

‘No. I’m fine, thanks.’

‘Want some company for a bit? Or would you rather just go back to sleep?’

‘I won’t sleep for a while.’ Ross had no intention of inviting a return of that dream. He would be doing his best to stay awake for the next few hours and he had learned how lonely that could be. ‘Some company would be great if you’re not busy.’

Megan pulled up the chair and sat down. ‘I know I shouldn’t tempt fate by mentioning the ‘‘Q’’ word but it is dead quiet at the moment. I’ve caught up on all the paperwork and read the newspaper. If I hadn’t heard you I might have been desperate enough to have a go at the cryptic crossword.’

Ross smiled. ‘Crosswords don’t do much for me either.’

‘What does?’

‘Cycling,’ Ross said wryly. ‘And tramping and rock-climbing.’ His snort of laughter lacked any trace of amusement. ‘Maybe I ought to revisit crosswords after all.’

‘Bit early for that,’ Megan said firmly. ‘According to your notes you’re doing really well. You had four spinal fractures, didn’t you?’

‘Yep—C7, T8, T10 and L5.’

‘But the only unstable ones were T8 and T10?’

‘Yeah. I’ve got a bit of hardware taking care of them now. I’ll set off the metal detectors in the airport from now on.’

‘A Harrington rod.’ Megan nodded. ‘So they’ll be looking at fitting you with a brace and mobilising you into a wheelchair pretty soon, then.’

‘I guess.’ Ross was not prepared to look forward to the prospect of a wheelchair.

‘But that’s great,’ Megan encouraged. ‘You’ll be amazed how much better you’ll feel, getting mobile.’

Maybe having company hadn’t been such a good idea after all. Ross wasn’t in the mood to be encouraged. He knew he was lucky compared to many people these nurses cared for. He knew he should be thankful for what he still had in the way of movement. And he knew that the jury was still out as far as a final outcome—but he had to come to terms with the worst prognosis. That way he could accept any improvement as a bonus, and the agony of grieving for what was lost would not be too prolonged.

Megan clearly sensed that the topic was not welcome. ‘You’re from the Coast, aren’t you? I had an uncle I used to visit over there—in Hokitika.’

‘I grew up in Hoki.’ Ross was happy to accept the change of subject. ‘But I live just outside Charleston now. I built my own house out in the bush.’

‘Really?’

‘Well, not exactly. But I had a lot of input into its design and I cleared the site. A patient of mine was a builder in Greymouth and he helped me with the building in his spare time. It took five years to complete and I feel like I built it myself.’

‘Sounds special.’ Megan rested an elbow on the side of the bed and propped her chin on her hand. ‘My fiancé and I are saving for a section at the moment. I’ve got a few ideas for a house design I’d love to try out.’

‘I tried to make mine blend in with its setting. It’s made of logs with a cedar shingle roof. I use solar panels as the main form of heating and there’s slate floors and lots of internal brickwork to soak up the heat and then release it slowly.’ Ross was unaware of the note of longing in his voice as he described his home. ‘For winter, I’ve got an open fireplace you could roast an ox in.’

‘You must be missing it,’ Megan said gently. ‘I’ll bet you can’t wait for a visit home.’

‘Not much point visiting. It’s not as though I’ll be able to live there again.’

‘Why not?’

‘It’s isolated,’ Ross said flatly. ‘And the grounds aren’t exactly manicured. I’ve put paths in to make sure I didn’t fall down any undiscovered gold-mining shafts but they wouldn’t be wheelchair-friendly. And the house is two-storeyed. The bedrooms and main bathroom are upstairs. There’s only a small shower and loo downstairs unless you count the outside bath, and that’s miles away on the edge of the bush.’

‘You’ve got a bath in the bush?’

‘Yeah.’ Ross smiled at Megan’s expression. ‘An old claw-foot, cast-iron model. It’s got a water supply from the creek and it gets heated by a gas burner. You can sit and have a soak under the stars with just a few ancient rimu trees and the occasional morepork for company.’

‘Sounds romantic.’

‘Yeah.’ Ross let his eyelids drift shut for a few seconds. It hadn’t been intended as a romantic setting but that had been before Wendy had been introduced to the property’s unusual outdoor feature. She had loved it as much as she had loved his house. She had also revelled in the exciting hint of danger from uncovered mining shafts and had been enchanted by the limestone cave in the base of the hill behind the house. It had been in that cave, sheltering from some of the rainfall that made the West Coast famous, that Ross had declared his love.

Wendy must have understood how difficult it had been to describe emotions he was experiencing for the first time in his life. She had listened, holding both his hands in her own, and she had looked more solemn than he would have believed she was capable of looking. Then she had simply nodded.

‘We’re soul mates, Ross. I love you, too. I always will.’

Megan misinterpreted the silence. ‘There’s lots of help available to get past things that can seem like big problems, you know. Even with a complete lesion around T10 people often only need a wheelchair for part of the day. Walking can be fully functional.’

‘Yeah.’ The agreement was bitter. ‘With callipers and crutches. And incomplete lesions like mine can leave people severely disabled, despite neurological recovery.’

‘Do you have any family in Hokitika?’

‘No.’ His response was curt.

The arrival of the extra staff on turning duties for the night seemed well timed. Megan was needed to do the rounds of the other patients due for a change of position and Ross was grateful that any further discussion had to be abandoned. He was in enough emotional turmoil without dredging up memories of his childhood and family. Maybe that was what was making the whole business with Wendy such agony. Nobody had ever offered him such unconditional love before. Or matched him so perfectly in his outlook on life. And now he had to take that precious gift and return it virtually unopened.

The grief of losing what he and Wendy had found together was going to be greater than losing the use of his legs, but he had no choice. His recovery, to whatever extent he could make it, was going to require total focus. It would be the biggest physical challenge Ross had ever faced. It would need all the strength he could muster and it was something he had to do alone.

Pride would not allow Ross to offer Wendy an empty shell of the man she had fallen in love with so convincingly. Their shared love of physical pursuits had brought them together and Ross could even pinpoint the moment he had known he was in love with her. Wendy had been below him on a rock-face, laughing at the sheer exhilaration of the difficulty and danger she had been faced with. He had been holding the rope, making sure that if she slipped she would still be safe. He would only hold her back now. His physical disability would be another rope—preventing her from doing what she loved to do so much. And Ross could understand better than anyone how essential doing such things could be for nurturing one’s soul.

He wouldn’t even be able to make love to her again, and the pain of losing something he’d never dreamed could be so fulfilling was unbearable. He hated Wendy touching him now because it was such an instant and searing reminder of that loss.