And Daughter Makes Three

And Daughter

Makes Three

Caroline Anderson

www.millsandboon.co.uk

Table of Contents

Cover

Title Page

Chapter One

Chapter Two

Chapter Three

Chapter Four

Chapter Five

Chapter Six

Chapter Seven

Chapter Eight

Chapter Nine

Chapter Ten

Copyright

CHAPTER ONE

‘YOU aren’t taking this interview seriously, are you?’

Robert blinked in astonishment. ‘I beg your pardon?’

The girl sighed and rammed the long fingers of her right hand through once tidy mousy hair. Well, not really mousy. There were actually some rather beautiful gold lights lurking in it, he noted absently, just waiting for a stray sunbeam to bring them to life—

‘I’m just your statutory woman interviewee, aren’t I? Why can’t you admit it? I’m only here because you have to appear unbiased, but I can tell by your questions that you think I should be curled up somewhere behind a desk chatting to pregnant mothers and peering down children’s throats!’

Robert shifted uncomfortably and cleared his throat, embarrassed at being so easily read by the young woman in front of him.

‘Not at all,’ he demurred, but her fine dark brows shot up sceptically and he ‘sighed. ‘All right, perhaps a little. I’ve got nothing against women doctors; I think they’re a necessary—’

‘Evil?’ she supplied helpfully.

He sighed. ‘I was going to say balance. The problem isn’t so much your gender as your physique. Orthopaedic surgery is physically demanding—’

‘So is general practice. The point is, I don’t want to do general practice, I want to do orthopaedics, and I want you to give me the chance.’

Stubborn little cuss. Robert eyed her with fresh interest. ‘So what makes you think you’d be any good?’

‘I can spot fractures on X-ray plates that other people miss—’

‘So you can diagnose. But can you treat those fractures? Have you got the strength to reduce them, to realign the bones and reduce dislocations?’ He studied the slender hands lying on the edge of the desk, palms down, the long, fine fingers outspread as if she was ready to spring up and dash off. ‘Look at your hands. I doubt if you could even wring a chicken’s neck.’

She smiled wryly. ‘I doubt if I could, but that’s probably because I’m vegetarian and nothing to do with brute force and ignorance.’

‘I never mentioned ignorance.’

‘You didn’t mention skill, either. Or patience and persistence. You need those too, and on that score I’m definitely your man—so to speak.’

Robert was beginning to think that her patience and persistence would be the death of him. ‘What evidence have you got to support that extravagant claim?’ he asked drily.

‘I can do jigsaws,’ she told him.

His jaw sagged slightly. Jigsaws? She could do jigsaws? He could play badminton, but it was hardly relevant—

‘You know, the double-sided baked bean variety that nobody has the patience for? I don’t give up. I persist until whatever I’m doing is done to my satisfaction. I’m a perfectionist, but I know how to compromise. I’m strong, I’m fit and I’m prepared to go to any lengths to do the job well. I won’t let you down.’

‘Won’t’, please note, not wouldn’t, he thought wearily. As if he’d offered her the job.

‘It’s physically punishing,’ he warned. ‘Long hours in Theatre, bending over shattered limbs, piecing them together—’

‘Like jigsaws. Exactly.’

‘Can you bang a nail in straight? Saw straight? Drill and screw with total accuracy?’

‘Yes,’ she said. Just like that, without any hesitation.

‘Yes?’ he pushed.

‘Yes. I’ve been practising. My brother’s got a Victorian house. I’ve been helping him do it up. I’m a dab hand with an electric drill, and I can hammer and chisel and paint in straight lines—’

‘How useful,’ he said drily.

‘Well, if I can paint in straight lines I can cut in straight lines, which might be relevant, I suppose?’ she replied, just as drily.

He sighed. ‘Look, Ms—’

‘Bradley. Frances—Frankie, for preference—and it’s Miss but Dr will do. Please, Mr Ryder, give me a chance. I won’t let you down.’

‘Won’t’ again. Damn her. He rammed his own fingers through his own hair and sighed again. ‘Look, Dr Bradley, I won’t lie to you. I’ve seen another applicant who looks ideal—’

‘A man?’

Robert groaned inwardly. ‘As it happens. As I was saying, I’ve seen him, he’s right for the job, and I was simply waiting until I’d interviewed you to offer it to him. He’s got more surgical experience than you—’

‘I can learn. I loved my time in surgery—check my references. I was good at it.’

‘Slow, it says. Good, but slow.’

She swallowed, but, damn her, she didn’t give up. ‘That’s because I’m thorough. The SR I was working with missed a thrombosis in a mesenteric artery, and the patient would have died if I hadn’t pointed it out. He’d just removed her perfectly healthy appendix and said that must be the trouble, and some people didn’t know what pain was. He was so busy flirting with the scrub nurse they could have sewn up the rest of the surgical team inside the woman and not noticed. A loop of necrotic bowel was far too subtle!’

He bent over her references again, cupping his chin in his hand and using his fingers to cover the little smile that wouldn’t be suppressed.

‘What if I gave you the chance and you couldn’t do the job in the end?’

‘You’d face that possibility with anyone,’ she said fairly. ‘I was good on fractures in my time in A and E, and God knows I saw enough of them. It frustrated me to bits not to be able to follow them up to Theatre and finish the job. What if you got someone whose only asset was his strength? What about the jigsaws?’

He looked up at her again and her eyes trapped his, mesmerising him. He cleared his throat and tried again. ‘As you haven’t met the other applicant I can’t see how you can make that judgement—’

‘I’m not making any judgements, just putting forward for instances.’ She leant towards him, resting on those long, elegant fingers, her energy vibrating in her voice. ‘Look, I’m prepared to do it on a trial basis. If you give me three months, I’ll do everything I can to justify your faith in me.’

He stared at her in amazement. ‘You’re prepared to do it on a trial basis?’ he repeated, unable to believe the brass neck of the woman. ‘You want me to turn away a perfectly good applicant so I can give you a trial?’ He was stunned. Justify his faith, indeed! What faith? He had no faith in her, none at all!

She surged to her feet, nearly six feet of willowy, tormenting woman, and paced to the window. She was so slender he could have snapped her in half with his bare hands, he thought disgustedly. How did she imagine she could cope?

The sunshine caught her hair and for a moment she looked like an angel, the gold strands surrounding her enthusiastic, lovely face like a shimmering halo. Then she turned, a coil of energy that made him feel exhausted just to watch her, and came back to the desk, bracing those beautiful, slender hands on it and leaning towards him, her eyes earnest.

‘That’s right. It will give us both long enough to see if it could work. If it doesn’t, then I’ll give up and go quietly.’

He couldn’t stop the little snort. The very idea of this young woman giving up and going anywhere quietly was laughable.

She jerked up straight and glared down at him. ‘You don’t believe me, do you?’

He met her eyes, serious now. The last time he had believed a woman had been his wedding day. He wouldn’t make that mistake again.

‘Why should I?’

‘Because I’m honest. I’ll try, and try hard. If it doesn’t work, I’ll admit it. What I won’t accept is not being given a chance just because you think I won’t stick at it or won’t be strong enough to do it.’

‘And will you?’

‘Of course. Give me your hand.’

Warily, a little bemused, he held out his hand and her warm, slender fingers curled softly round it and gripped with surprising strength. She settled herself into the chair again, said, ‘Ready?’ and at his nod he felt the power in her arm challenge his own strength.

She wanted to arm-wrestle? Far be it from him to spoil her fun, but he didn’t believe in hurting women—

‘Damn! How did you do that?’

She laughed. ‘You weren’t taking me seriously. You keep doing that, don’t you?’ She shook her head and laughed again. ‘Big mistake.’

He didn’t doubt it for a minute! He extricated his hand from her warm and enticing grip and leant back in the chair, regarding her steadily.

‘I let you win,’ he lied.

She snorted. ‘Fiddlesticks. You underestimated me, Mr Ryder. My point is this—I’m strong. I take care of myself—probably better than you do. I won’t let you down—I promise.’

Her eyes were grey, not the blue-grey of his but a soft, slightly greeny grey, wide and clear, and they locked with his and wouldn’t let go. He could still feel the strength of her grip, the warmth of her hand and he was achingly aware of the soft rise and fall of her very feminine curves under her fine wool sweater as she waited for his answer.

‘Please?’ she coaxed, and her voice whispered over his senses and did unbidden things to his normally ordered mind.

He felt himself crumble under that misty gaze, and the rigid set of his shoulders sagged slightly under the weight of his foolishness. ‘I’ll probably regret it,’ he found himself saying, ‘but yes, Dr Bradley, I’ll give you your chance.’

For a moment he thought she was going to jump over the desk and hug him, but with a massive effort she pulled herself together and smiled, and the smile set off little fires in her eyes that warmed the cold recesses of his heart.

‘Thank you,’ she said, with commendable control, and leant against the chair-back as if sheer will-power had been holding her up. ‘So—when do I start?’

He shuffled paper on his desk, still unable to believe what he had done. Was he quite mad? ‘The beginning of January? I’ll get my secretary to sort out all the details of your salary and so on—she might be able to help you with accommodation as well.’

He pushed his chair back and rose to his feet, going round the desk to usher her out, and as she stood and smiled at him with her megawatt smile a shock of heat coursed through his body.

He crushed it ruthlessly and forced a smile. ‘Welcome to the team, Dr Bradley. I’ll see you in the new year.’

Her eyes were dancing and a subtle hint of perfume, sensuous and filled with promise, drifted over him as she moved. ‘Thank you. I’ll look forward to it. Happy Christmas.’

‘Thank you. And to you.’

Her strong, warm fingers curled round his again, familiar now and somehow enticing, and with a mumbled goodbye he closed the door behind her and leant against it with a groan, grateful for the long white coat which disguised his body’s betrayal.

A knot of tension gripped his chest and he rubbed it absently. What had he done?

Ah, well, it was only three months. Hopefully he could survive.

He wasn’t convinced. Her perfume lingered on the air, conjuring a memory of her smiling eyes and soft, lush figure. Frances Bradley, he realised with a sinking feeling in his gut, was one complication he could frankly have done without …

She found him in the sister’s office, dressed in green theatre pyjamas, his feet, in white anti-static boots, up on the desk, a file open on his lap. The remains of a cup of coffee lurked beside him, and she could see by his shadowed jaw that he had been up all night.

He looked forbidding and rather cross, she thought, and her heart sank. Oh, well, it was all her own fault, and if he proved a pig to work with she had only herself to blame. After all, he hadn’t wanted her.

Frankie approached him cautiously.

‘Happy New Year,’ she ventured.

He lifted his head and stared at her, then gave a tiny snort of disbelief. ‘Is it?’

‘I hope so. So, what’s on the menu today?’ she said brightly.

Robert Ryder scowled, his blue-grey eyes as chilly as the January wind that sliced across the Suffolk countryside. ‘Emergency theatre work, mainly. Several casualties after last night’s festive stupidity—I thought you weren’t coming in until tomorrow? It’s a bank holiday today.’

She shrugged and smiled. ‘Thought I’d come and find out where everything was, see if I could help.’

She could see he wasn’t convinced. The scowl lurked in the back of his eyes, and her heart sank even further.

‘It’s all under control,’ he said shortly, snapping the file shut. ‘You should have stayed in bed while the going was good.’

‘It wasn’t that good—the bed. Cold and lumpy, really. Most unappealing. It was no hardship to get out of it.’

His scowl worsened. Oh, damn, she thought, he regretted his impulse. She stifled the sigh and let her smile slip a little. ‘Well, then, if there’s nothing else I can do, do you mind if I watch you operate?’

He shrugged his broad shoulders slightly, and a cynical little smile touched his lips. ‘Oh, I think you can scrub—you never know, I might find a use for you since you’re here. We might as well find out sooner rather than later if you aren’t going to be able to cope.’

Oh, hell. Frankie dredged up a smile. ‘Oh, I’ll cope, Mr Ryder; don’t you worry.’

‘I’m not worried, Dr Bradley—just unconvinced.’

‘Then give me a chance to convince you. What’s the first case?’

He dropped his feet to the floor and stood up, stretching wearily and kneading the back of his neck with one large, long-fingered hand. ‘Here.’ He snapped some X-rays up onto the light box and stood back. ‘What can you tell me about this?’

‘Ouch,’ she murmured.

‘Would you care to be more specific?’ he said drily.

‘Sure.’ She pointed to the radiograph of the right thigh and indicated a long, diagonal fracture of the shaft of the femur. ‘This, obviously, and also here.’ She moved her finger up to the femoral neck, where it angled across to the pelvis. ‘There’s a slightly impacted fracture here, and the hip joint’s gone on the other side, I think,’ she murmured, looking at the other plate of the left side. She peered more closely at it, and frowned. ‘Is there another view of this?’

He snapped it up onto the screen and she nodded. ‘Yes. The pelvis has a slight fracture across the acetabulum, here—’ she pointed out the fine line across the socket of the hip joint ‘—and the whole joint has probably destabilised a little in the collision.’

‘Collision?’

‘Oh, yes, I think so—hasn’t the patient been involved in a car accident? Looks like a telescoped front end, with the bulkhead pushing up against the knees and transmitting the force of the impact through into the thighs and pelvis. I expect she was on the left side of the car and the pelvic fracture resulted from her being slammed against the door or the door slammed against her by another vehicle, perhaps? Were there any other injuries?’

‘Such as?’

She shrugged. ‘Foot or lower leg? Facial? Whiplash to the neck and upper spine? Ribs, maybe, if she was the driver, but I don’t think she was.’

‘She?’

‘Yes, it’s a woman,’ Frankie said confidently. ‘You can tell from the pelvis—and the name on the X-ray plate!’

His mouth twitched and she felt a ripple of relief. At least he appeared to have a sense of humour in there somewhere!

He nodded thoughtfully and answered her previous question. ‘Yes, there were some minor facial and cervical spinal injuries and bruising from the seat belt. The other leg was all right. She was a passenger, travelling on the left of the car in a front right quarter impact. The car then slewed round and hit a wall. The driver was killed outright; so was the rear-seat passenger behind him who wasn’t wearing a seat belt. She was lucky to get away with it so lightly.

‘So,’ he said, leaning back against the desk and bracing his hands on the edge at each side, ‘how would you deal with her?’

Frankie chewed her lip slightly. ‘I’d fix the femur internally, both because it’s a spiral fracture and unstable with traction alone and because the neck of the femur looks stable and I wouldn’t want to go and tug on it. At the moment it isn’t displaced so I’d want to manage it conservatively if possible and just watch it.

‘Also I’d put the other leg in traction to relieve pressure on that acetabulum and rest the damaged tissues in the hip joint.’

‘Just like that.’

‘If the skin’s intact or in good enough condition for the operation and if the soft tissues aren’t too badly damaged. I can’t tell that, of course, from the X-rays.’

‘No. Right, well, she’s our first customer.’

‘And?’

He raised an eyebrow. ‘And what?’

‘Was I right with the treatment?’

A grudging smile touched his eyes. ‘Yes, you were.’

She had to stop herself forcibly from heaving a sigh of relief. Instead she turned to the pile of X-ray envelopes on the desk. ‘What’s next?’

He took down the woman’s X-rays and put them away, then snapped another set up onto the screen. ‘This man.’

He sat back on the edge of the desk again, and Frankie could feel his eyes boring into her. ‘Um—he’s got lower leg fractures—ah—is that an old one?’

She swivelled round to look at him and he shrugged nonchalantly. ‘You tell me—you’re the diagnostician.’

She stifled her retort, turned back to the plates and nodded, running her fingertip down the shin bone and the finer bone—the fibula—beside it. ‘Yes—there’s an old non-union of the tibia, a mal-union of the fibula and another fracture of the tibia and fibula higher up, a new one this time. Looks like a fracture from a direct blow, and as one end of the tib’s free it’s probably caused havoc in the soft tissue.’

‘“Havoc” is putting it mildly,’ he told her, shrugging away from the desk and coming to stand behind her. ‘He was a pedestrian. He was hit by a car bumper at this point—’ His arm reached round her and as he carried on describing the result of the impact his finger pointed out the area of soft tissue damage, invisible on the X-ray.

It would have been invisible to Frankie anyway, because she was suddenly, chokingly aware of him, of the enticing smell of his skin lurking under the smell of antiseptic, the warmth of his arm against her shoulder, the lean, sinuous forearm dusted with dark curls so very, very close to her face …

He muttered something under his breath and moved away, and she released the block of air trapped in her lungs, letting it out on a long, silent sigh, and focused on the X-ray again.

‘So what are you intending to do with him?’ she asked in what she hoped was a normal voice.

‘Open up the leg at the sight of the old fracture, repair the soft tissue damage and realign the old break, pack it with slivers of bone and put an external fixator on to hold the whole thing. I can’t fix it internally because of the risk of infection with the soft tissue injuries, so we’ll put screws into all the various fragments, pull them out into line with a little judicious twiddling, and fasten the whole lot onto a rod outside his leg and let it get on with it.

‘Hopefully the old one’ll heal this time, and the new one’s got two chances. I’m not so worried about the fibula; I want to sort the tibia out once and for all.’

He flicked off the light, returned the plates to the envelope and gestured towards the door. ‘Shall we go? They’re all prepped up and ready for us.’

Watching him operate was a joy. He was careful, precise and meticulous, and Frankie realised with a surge of humility how much she had to learn. Oh, she knew the theory—she’d studied it endlessly—but it was nothing compared to watching the real thing.

And he made it look so easy! Fixing the femur with an intramedullary nail driven down inside the bone had always sounded fairly brutal. In his hands it became a skilled procedure, using imaging techniques to see the nail slowly descending through the femur until it reached the fracture, then the ends aligned so that the nail continued on down the second section.

Finally they were fixed in place with screws through the bone into the nail, and so the bone was held, unable to rotate or slip, with the ends in perfect alignment, and all without disturbing the break in the neck of the femur.

He checked on the image intensifier to ensure that all was as he wanted it, then closed the wound on the thigh and at the top of the femur and straightened up with a sigh.

‘Thank you, everyone,’ he murmured, and turned to Frankie, peeling off his gloves and dropping the mask down off his face. ‘How about a cup of coffee while they prepare the operating room for the next onslaught?’

‘Sounds good.’

She followed him out, accepted the cup and listened as he talked to the anaesthetist, Peter Graham. From the conversation she gathered that this was far from the first operation they had performed in the last few hours, and there were at least two more ahead—the man with the fractured lower leg and another new admission from A and E.

Robert Ryder turned to her. ‘I don’t suppose you’d like to pop down there and have a look at the plates, would you, and report back? Perhaps bring the plates back here and we can study them together.’

‘Sure.’ She put down her untouched coffee and stood up. ‘Um—where is A and E?’

Peter grinned. ‘Out the door, turn left, down the corridor to the end and turn left again. You can’t miss it.’

She followed his directions and found herself in the busy bustle of a typical accident and emergency department. She found the desk in the middle, collared a staff nurse and introduced herself.

‘Oh, you’ve come about the cyclist. He’s in here—it’s a nasty mess.’

She opened the curtain to reveal a young man on a trolley, the cot sides up and a drip running in. He was lying motionless, his face pale and clammy, and he looked very shocked.

The staff nurse eased off the thick gauze pad covering the wound on the outside of his left foot, and Frankie’s mouth tightened slightly. It was very badly mangled, bent in at an unnatural angle and with extensive soft tissue injuries. There was a great deal of grit and tarmac ground into the exposed bones, and she winced.

‘Not nice, is it?’ the staff nurse agreed. ‘His X-rays are here.’

Frankie studied them thoughtfully. The bones were nearly all intact, amazingly, but one or two were broken through the ends and would need fixing. The main damage, she could see, was to the soft tissues.

‘Do you know what happened?’ she asked the nurse.

‘He was knocked off his bike and dragged along the ground for a few yards by a car. Luckily for him he had a helmet and leather jacket and gloves on, or he’d be a lot worse off. His little finger’s broken as well, by the way—just a minor fracture. We’ve put a garter strapping on to support it. We’ve done chest X-rays but there didn’t seem to be anything on them. He’s complaining of pain in the left shoulder, though.’

‘May I see?’ she asked, and, studying the plate, she ran her finger lightly along the left collar-bone to the outer end. ‘The clavicle’s partially dislocated,’ she said quietly. ‘Must have happened as he landed on that shoulder. We’ll have to support that for a while as well. OK, thanks—can I take the plates up to Theatre to show Mr Ryder?’

‘Sure. What do you want to do with the patient?’