Earthquake Baby

Her heart went out to him. If it wasn’t enough that he lost his mother last year, his father obviously wasn’t coping. How alone and sad he must be at the moment.

She watched as his young face crumpled and tears spilled from his eyes. The boy turned away from his father and ran blindly towards the front doors.

Laura gave chase, not wanting him to be alone at a time like this or end up lost somewhere in the hospital because he wasn’t paying any attention to where he was going.

She rounded the corner in time to witness the boy running smack bang into Jack.

‘Whoa there, matey,’ he said holding the boy gently by the shoulders. ‘What’s your rush, Andrew?’

‘Let me go. Let me go,’ Andrew sobbed, pushing ineffectually against Jack’s hold.

‘Come on, mate,’ Jack said quietly as Laura approached. ‘Why don’t I buy you a soft drink from the machine and we can have a talk?’

The boy’s shoulders sagged as his struggle died and he nodded his head miserably. He walked back to the unit with Laura and she showed him into the ‘quiet’ room.

It was a small but comfortably appointed room generally used as a place for relatives of new admissions to wait, as well as a place for doctors to talk to relatives about their loved ones. More often than not it was the place where bad news was given.

She tried to engage Andrew in conversation but he sat tight-lipped and head bowed. Laura felt a little inadequate. She had a son about his age, surely she could think of something to say to help Andrew to open up?

Jack arrived with a can of lemonade. He cracked the lid and handed it to the boy.

‘Thanks,’ he said quietly, and took a small sip.

Jack weighed up the situation as Andrew continued to stare at the floor, hoping he was up to the challenge. Children weren’t exactly his forte. Would he be able to reach the boy?

‘Tough time, huh?’ asked Jack tentatively, initiating dialogue.

‘I guess.’ Andrew shrugged.

‘Want to talk about it?’

Jack held his breath as Andrew stared solemnly into his lemonade can. Just when Jack thought he’d have to try a different tack, Andrew raised his head slowly and fixed him with a stare that belied his young years.

‘Why did he do it?’

Laura’s heart lurched at the directness of this eleven-year-old boy.

‘Your dad’s very sad at the moment. He’s finding it really hard since your mum died.’

‘But he’s got me. Why does he want to leave me as well?’ Andrew’s voice broke.

Jack felt helpless in the face of such earnestness. How did you explain the complexities of adult emotions to children when they dealt in simplistics?

‘Andrew, mate, he doesn’t want to leave you. It’s not about that. He loves you. He loves you with all his heart and all his soul and all his mind. He’s just so sad at the moment he’s not thinking properly. He just wanted to stop feeling so sad. It’s not about leaving you, I promise.’

The boy was quiet as he mulled over Jack’s words. ‘Can you help him?’

There was that directness again!

‘I reckon I can. I reckon we both can. What do you say? Partners?’ Jack held out his hand palm up and waited.

Andrew sat unmoving for a moment and then a slight smile tugged at his lips as he raised his hands and gave Jack a high five.

Laura left them chatting about the latest video games, incredibly moved by what she had just witnessed. And this was a man who didn’t want children? He had been amazing with Andrew. OK, he was a psychiatrist, he knew the right techniques, but it had been more than that.

He had connected with Andrew, had got down to his level. She thought about how he would be with Isaac. Something told her he would be a fantastic father. Unfortunately he seemed so opposed to the idea, even worse than ten years ago, he couldn’t see what was blindingly obvious. He was a natural with kids.

Fortunately the business of the day didn’t give her any time to dwell over the conundrum. There were three discharges to organise and for the first time in weeks there was no one to take their places. The tide appeared to have ebbed.

After lunch it was Laura’s pleasure to say goodbye to one of their long-term patients, Bill, who after fifty-two days was finally well enough to go to a general ward. He had been in a car accident, sustaining major chest trauma that had developed into severe respiratory collapse. But he’d hung in there and today he was being awarded his get-out-of-jail-free card.

Bill had a tear in his eye as he squeezed Laura’s hand.

‘Sister, thank you so much. Thank you. You saved my life, you all did. I don’t know how I’m ever going to be able to thank you enough.’

‘It was a pleasure, Bill.’ Laura smiled. ‘Our pleasure. Seeing you well again is all the thanks we need.’

As Laura waved him off she reflected on the truth of her words. It was as she had told Jack yesterday. This was why she did the job, for moments just like these. This was what made her job so special.

Despite the busy workload, Laura was constantly aware of Jack’s presence. He was spending a considerable amount of time at Simon’s bedside, talking to his patient and spending time with Andrew. This was significant given that, as head of the department, he would have a killer schedule. She guessed that now he had built a rapport with the boy he would be reluctant to blow the tenuous relationship by passing the case off to another member of his team.

Jack approached her as she was at Jason Smith’s bedside. His nurse had called her over to discuss his deteriorating condition. Jason had been involved in a teenage pub brawl, sustaining several blows to the head. He had a moderate closed head injury that hadn’t required surgical intervention, but he hadn’t regained consciousness yet. His heart rate was slowing and his blood pressure was rising.

‘Laura, can I talk to you about Simon?’

‘Not right now, Jack,’ she said distractedly. ‘I just need to—’

Her words were cut short by Jason’s monitor suddenly blaring loudly. She looked over and saw the young man’s arms and legs jerking rhythmically. He was fitting.

‘Give him a bolus of sedation,’ she instructed the bedside nurse. ‘Jack, help me get him on his side.’

Jack assisted as the nurse held her finger on the purge button of the syringe driver that delivered a standard mix of sedative drugs.

‘How much?’ she asked.

‘Until he stops,’ Laura said.

‘He needs some mannitol to reduce the swelling in his brain and we should load him with an anti-epileptic, too,’ said Jack, reaching for the suction tubing and inserting the plastic head into Jason’s mouth to clear the secretions from his oropharynx. ‘Phenytoin,’ he ordered.

Laura stared at Jack over the top of their patient’s head. He had taken the words right out of her mouth. She felt admiration for him mix with her satisfaction that they were working together as a team.

Jason’s movements slowly subsided. Laura handed Jack an airway and watched as he deftly inserted the curved hollow device into Jason’s mouth to prevent his tongue from falling back and occluding his airway.

‘He needs a CAT scan,’ he said, and her admiration grew a little more.

A flurry of activity ensued, the bedspace becoming quite crowded, so Jack excused himself to write in Simon’s notes. He watched Laura surreptitiously in the middle of the action, discussing the developments concerning Jason with the rest of the medical team. She was so in control, so focussed. He hoped there wouldn’t come a time when an emergency triggered a different response. How would she ever cope with feeling out of her depth?

Laura worked with Steve quickly to get Jason prepared for another CAT scan. The team felt he had probably extended his head injury by having a further bleed, causing an increase in his intracranial pressure. The scan would confirm this.

Everything attached to Jason had to be switched to a portable alternative. Portable oxygen, portable monitor, portable pumps. The process took fifteen minutes. Steve accompanied the bedside nurse to the radiology department, along with the registrar and two wardsmen. Scanning an intensely monitored person was involved and required many hands.

Laura finally got a chance to grab a quick break so she took it gratefully. She sank into the tearoom chair, her mind abuzz with the things still to do.

‘Taking a breather?’ asked Jack, sitting beside her.

‘Jack. Thanks so much for earlier, with Jason. It was good having someone who knew what they were doing by my side.’

Jack smiled and felt the pleasure at her compliment warm his insides. ‘I like being at your side.’

Laura smiled back, their closeness of a decade ago returning. She took a deep breath and blinked. This was neither the time nor the place.

‘Oh,’ she said, ‘I’m sorry. You wanted to see me earlier?’

‘Doesn’t matter. I sorted it, thanks.’ He quelled the disappointment he felt as she distanced herself. ‘You’ve had a busy day.’

‘No worse than most. Better than some.’ She smiled.

He smiled back and Laura felt her stomach flip-flop. Damn the man. It had been ten years and she could still remember how good he had felt inside her.

‘This is a normal work day?’

‘Pretty much.’

‘Laura.’ He shook his head. ‘Do you know anything about post-traumatic stress disorder?’

The glow from distant memories faded as wariness took over. ‘Probably more than most.’

‘So you know that with the traumatic events of Newvalley, you are in the highest risk group.’

‘I think we’ve been through this already. I can handle it, Jack. I’ve been doing this for a long time. I’m OK.’

‘Just hear me out, Laura, that’s all I’m asking,’ he said, holding up his hands to emphasise the import of his words. ‘I do know what I’m talking about here. You trusted me with Jason, right? Please, trust me on this one.’

Laura shut her eyes and sighed. He was right. She owed it to him to at least listen to what he had to say. His professionalism with Jason and his invaluable help with the emergency compelled her to give his words some thought.

‘OK, I’ll listen.’

‘Thank you,’ he murmured, grateful for the chance to sway her to his way of thinking. But where to start? Now he had his opportunity he didn’t want to blow it.

‘See, the funny thing about PTSD is its ability to rear its ugly head when people least expect it. Sufferers can cruise along for years and then something will happen—doesn’t even have to be very big—and wham! They’re losing it. Big time.’

‘I know that, Jack. But it won’t happen to me.’

‘No.’ He nodded knowingly, ‘Of course, you’re OK. You’ve dealt with it.’

‘I have,’ she sighed, rubbing her eyes.

‘Well, if that was true, going to the memorial service wouldn’t be a problem for you. But it obviously is. I suspect that’s because there are still some demons lurking. The effects of PTSD can be quite debilitating. Some people can’t even get out of bed, let alone hold down a job. Who was the Einstein that recommended you take up this kind of nursing?’

‘I didn’t ask anyone’s permission, Jack. I kind of just stumbled into it and loved it and stayed.’

‘Didn’t your therapist advise you not to?’

‘I didn’t start working here until after my therapy finished.’

‘Well, that’s just as well because anyone worth their salt would know there are two important factors to decrease the risk of PTSD. One…’ he held up his finger ‘…deal with your issues. Two…’ he held up another finger ‘…reduce life stressors. Not hold hands with them, Laura. Reduce them. But you…’ he jabbed his finger at her ‘…go and choose the world’s most stressful job!’

‘Actually, I think air traffic controller holds that honour.’

‘Laura,’ he groaned, exasperated. He had to make her see that she could be setting herself up for a real fall.

‘Jack.’ She sprang up, a frustrated laugh escaping. I’ve given you a fair hearing but enough already! I am not going to crack up on the job! I’m fine. I’ve been fine for a long time now and you dragging it all up again is not going to help me. Obviously this is more your issue than mine!’

‘Laura—’

‘Butt…out…Jack,’ she whispered loudly, emphasising each word, and left the room without a backward glance.

Great, he thought, contemplating the empty room. That went well!

CHAPTER THREE

TWO days later, Laura was on her seventh day of a nine-day stretch. It was Saturday. She loved weekends in hospitals. Even though it wasn’t necessarily quieter on the unit, there was still less hierarchy floating around making life miserable for those at the coalface. The entire atmosphere was relaxed.

She yawned as she came back from lunch. It was almost two o’clock. Today she was the runner and Marie was team leader. Marie didn’t usually work weekends, but when they were this short-staffed she did what she could.

So much for the spare beds! Two had filled by the next day. Miraculously one bed still remained empty and it was Laura’s fervent hope that it would still be so at the end of her shift. Only an hour and a half to go!

Thankfully Jack had backed off. In fact, she hadn’t seen him at all after their tearoom conversation. It did surprise her, however. The memorial service was on Monday and he had seemed so determined to get her there. Hopefully he had heeded her words.

Jenny Dexter put down the phone as Laura approached.

‘I’m going down to Casualty. They want me to look at a guy who’s just come in. Sounds serious. I’ll let you know.’

‘Sure,’ said Laura. So much for the empty bed!

Ten minutes later the consultant was on the phone. She gave Laura a brief rundown on the patient, who she’d be bringing up immediately. Mr Gordon was a forty-year-old with a rapidly deteriorating condition. Suspected meningococcal septicaemia.

Marie and Laura prepared the bedspace for the man’s arrival in record time. They’d just finished when the stretcher pushed through the heavy swing doors of the unit. Laura took one look and knew that the situation was grave. Two women accompanied the stretcher.

While the medical team took over, Laura ushered the reluctant women into the quiet room.

‘My husband’s going to die, isn’t he?’ his frantic wife demanded as the other woman placed a comforting hand on her arm.

Choosing her words carefully, Laura said gently, ‘Your husband is gravely ill.’

‘Don’t let them give up on him. Please, don’t let them. Don’t let him die.’ She clutched at Laura’s arm.

She searched for a shred of hope to give to the woman.

‘Those doctors out there are the best there is, Mrs Gordon. I know they’ll do everything they can.’

When she returned to the bedspace Mr Gordon was already intubated and had a central line inserted. Fluids and drugs were being poured into him. His blood pressure was dangerously low and his heart rate very fast, with multiple erratic beats. The area was littered with discarded packaging and used equipment. It looked chaotic but was actually very controlled.

Laura pitched in, passing things hastily requested, often even before they were asked for. The heart trace on the monitor changed to a life-threatening rhythm and what blood pressure there was totally collapsed.

‘Start cardiac massage,’ Jenny commanded. Marie climbed up on the bed and began compressing Mr Gordon’s sternum. One of the doctors disconnected the ventilator and commenced hand-bagging.

Laura charged the defibrillator. She quickly assembled an ampoule of lignocaine. The machine pinged its readiness and she handed the paddles to Jenny, sending up a quick prayer. All eyes watched his chest jump as the joules of electricity tried to jolt the erratic rhythm back to normality. The trace remained the same. Lignocaine was administered as the machine was charged again.

Mr Gordon had been in full cardiac arrest for twenty long minutes when the futility of the situation called for a reluctant end to the proceedings. The atmosphere, which had been charged with pure adrenaline only moments before, was suddenly hollow and heavy. Solemn introspection replaced frenetic activity.

Laura, who had taken over the cardiac massage, stilled. Her shoulders ached from the effort of compressing such a big man’s sternum. And her heart ached for another life they couldn’t save. She stared down at the gloved hands that formed a barrier between her and the bright purple rash covering the patient’s body—the hallmark of the presence of meningococcus.

‘Laura? You’ve been dealing with the family?’ asked Jenny.

‘Yes,’ said Laura.

‘Shall we?’

They de-gloved solemnly and washed their hands at the sink. Jack approached as they were drying their hands.

‘What are you doing here?’ asked Laura, not even her surprise at seeing him managing to shake the gloom from her voice.

‘I was paged. The social worker is dealing with a crisis on another ward and it was felt that Mr Gordon’s family might need some grief counselling. Has he passed away?’

‘Yes,’ said Laura

‘Oh, dear. How awful.’ Jack voice was quiet as he watched Laura intently. He saw the sadness and disbelief etched on her face and had an inkling of how she was feeling.

He had felt similar emotions at Newvalley. How quickly someone could die was always startling. And it didn’t matter how many times you’d seen it before, it was always shocking.

The fact that Mr Gordon was a complete stranger to Laura would only make it harder. It just wasn’t right that people died among strangers. Surely, in the most desperately dire time of his life, Mr Gordon should have been surrounded by people who knew and loved him?

Such was the nature of the work on an intensive care unit. But Jack knew it didn’t make it any easier and as he continued to watch Laura he could see she was having trouble reining in her emotions. Perhaps she wasn’t the best candidate to be present when the dreadful news was given to the family. Maybe she’d had enough emotion for one day?

Jenny excused herself to answer a page and Laura found herself waiting for Jenny’s return with Jack beside her.

‘Do you think it’s a good idea that you be the one to break the news to Mrs Gordon?’

‘Jenny will do that,’ she said, staring straight ahead.

‘Yes, but do you really need to be there, too?’

‘I’m the only one here who the family vaguely know. Her husband is dead. I think that she deserves to have at least one familiar face around when she’s told. Don’t you?’ Laura’s voice was terse. Her body tense.

‘You’re looking a little shaky at the moment. You’re going to need to be a lot more detached than this,’ Jack pushed.

‘Don’t tell me how to do my job,’ she snarled, turning to look at him. ‘I am a professional. I’ve been sitting in on awful conversations for years. I haven’t broken down in front of a client ever. Ever! And I’m not about to start. When I go into that room I will be perfectly in control.’

‘OK, OK. Calm down. I didn’t mean to upset you.’

‘When you question my professionalism it upsets me!’ she said in an angry whisper. ‘You think I want to be part of what’s going to be said in that room? Because I don’t. Every part of me rebels against the idea.’

Laura took a breath and tried to calm her racing pulse and seesawing emotions. Yes, the swiftness of Mr Gordon’s deterioration was having an effect on her, but she had to make Jack understand why he was wrong.

She softened her voice. ‘But I am a nurse, I don’t have a choice here. I am compelled to be there because it’s the right thing to do. The only thing to do. I’ve made a connection with them. I can’t just break that connection in their neediest hour because it’s emotionally challenging.’

Jack nodded. He understood what she was telling him but was worried about her nonetheless. At least he would be present during the talk. He had been paged for Mrs Gordon’s emotional journey but as Jenny rejoined them he knew that Laura’s needs took first place.

‘Mrs Gordon.’ Jenny addressed the woman, her face grim, introducing herself and Laura and Jack.

‘No.’ Mrs Gordon shook her head wildly, looking from one to the other, knowing from their faces what they were about to say.

‘I’m sorry, Mrs Gordon. We did all we could but…your husband died a few minutes ago.’

‘No,’ she whispered fiercely. ‘He can’t be dead. He was fine four hours ago.’

Jenny nodded solemnly. ‘Mrs Gordon, what we think your husband had, meningococcal septicaemia, it probably got into his bloodstream. Its onset is very quick…’

The woman wasn’t listening. She came closer to Laura and grabbed her by the forearms, her eyes accusing. ‘You said they were the best. You said they’d do everything they could.’ Her voice rose hysterically and she began to shake Laura.

Laura looked into the woman’s eyes, wild with grief, and was paralysed by her disbelief and anger. Even the bite of the woman’s fingers as they dug into her skin didn’t register. She opened her mouth to say something but the words just didn’t come.

She had witnessed many emotional moments, working in this field, comforted many grieving people, but most were surprisingly quiet, reserved in their mourning. To feel the full force of such raw emotion directed right in her face was shocking.

Laura could feel the neutral mask she had slipped on start to fall away. She blinked. Anything to shut out those strangely compelling anguished eyes. Mrs Gordon’s friend was trying to drag her away and Jenny was talking calmly so Laura could be released.

‘OK, now. Come along, Mrs Gordon.’ Jack’s soothing but authoritative voice broke through the woman’s hysteria. He gently prised her fingers from Laura’s arms and held her as she sobbed.

‘Go to the staffroom, Laura,’ he commanded.

‘Wh-what?’ She looked at him, puzzled. She stared at him like she’d never seen him before, her mind refusing to function.

‘Jenny, get her out of here,’ he ordered.

Laura followed Jenny blankly, sitting in the indicated chair in the staffroom, her body on autopilot as she accepted the cup of tea Jenny placed in her cold fingers.

Laura’s brain tumbled over and over, like a clothes dryer. The staff television prattled as she stared at the images on the screen before her, but all she could see was Mrs Gordon’s utter wretchedness and hear her accusing words.

She felt…overwhelmed. Helpless. Just like those immediate months following the building collapse. Laura tried not to panic. She couldn’t go there again. It had taken too long to claw her way back to a semblance of normalcy. What was happening to her? She’d told Jack she was over it and, damn it all, she was!

She drew in a ragged breath and tried to calm her galloping thoughts. I am a professional. I am a professional. The chant helped her retreat from the edge. She felt she’d gained back some control when Jack found her half an hour later.

‘Laura,’ he said gently. ‘Are you OK?’

Laura dragged her gaze to his face. She felt her control teeter and stumble at the concern written there and echoed in his words. She shook her head and he pulled her into his arms.

‘It’s OK. I’m here.’

‘Just like always, huh?’ His chest muffled her whisper as he slowly rocked her.

Before she could stop it, her mental proximity to the past had her back in his apartment ten years ago, being rocked and comforted. Smelling him, feeling him. Wanting him.

She felt the beginnings of an awareness, similar to the one that had possessed her back then. The one that had led to her kissing him and touching him and tearing his clothes off.

Laura broke away, putting some distance between them.

‘That poor woman, that was awful.’ She shuddered. ‘Really awful.’

‘It was what I was worried about before we went in.’

‘What? That she would attack me?’

‘No. That emotionally you were a little too raw still. I mean, you were speechless in there. That’s not normal, I hope?’