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Bushfire Bride
They watched her go, Hugo with laughter in his eyes and Michael with his jaw somewhere around his ankles.
She didn’t care. If she didn’t see any one of them again she’d be delighted. She was getting out of here.
She didn’t make it.
She stalked out of the pavilion, took a couple of deep breaths and regrouped for a moment to try and figure out the location of the main entrance to the showgrounds—and a dogfight broke out just behind her.
CHAPTER TWO
SHE stopped.
Of course she stopped. The sound of the dogfight was unmistakable, the vicious, ear-splitting snarls breaking through everything else.
And then a high-pitched scream of human terror.
She’d have to have been less than human to ignore it. She turned and stared, as did everyone else close enough to hear.
The dogfight was at the entrance of the pavilion she’d just left and it wasn’t a fight—it was a massacre. A faded old cocker spaniel, black and white turned to grey, had been held on its lead by his teenage owner but the pit bull terrier had no restraint and it was intent on killing. The dogs were locked in mortal combat, though the cocker clearly had no idea about fighting—no idea about how to defend himself.
The spaniel’s owner—a girl of maybe fifteen or so—was the one who’d screamed in terror. She was no longer screaming. She was trying desperately to separate them. As Rachel started forward—no!—the girl grabbed the pit bull’s collar and hauled. The dog snarled and twisted away from the spaniel—and bit.
‘No!’
Rachel was screaming at her to stop—to let go. She was running, but it was a good fifty yards back to the entrance to the pavilion.
The man—Hugo—was before her. The dogs were everywhere—a mass of writhing bodies with the girl beneath …
She had to get them apart. The girl would be killed. Rachel dived to grab a collar to pull the pit bull from the girl, but her arm was caught.
‘Keep back!’ Hugo’s harsh command had the power to make her pause. He was reaching for a hose snaking across the entrance and he hauled it forward. ‘Turn it on.’
She saw instantly what he wanted and dived for the tap. Two seconds later the tap was turned to full power. The massive hose, used to blast out the mess in the pavilion after showtime, was directed full at the dogs.
Nothing else could have separated them. The blast hit the pit bull square on the muzzle and drove him back. The hose turned to the spaniel, but he was already whimpering in retreat, badly bitten by the pit bull, while Rachel launched herself at the prone body of the girl.
‘Her leg …’ she breathed.
The girl’s leg was spurting bright arterial blood, a vast pulsating stream. Oh, God, had the dog torn the femoral artery? She’d die in minutes.
The dog had lunged at her upper leg and the girl had been wearing shorts! Dear heaven …
‘Someone, get my bag. Fast! Run!’ Hugo was shouting with urgency. ‘The car’s by the kiosk.’ Car keys were tossed into the crowd—swiftly, because Hugo’s hands were already trying to exert pressure. Rachel was hauling her T-shirt over her head. They needed something for a pressure pad—anything—and decency came a very poor second to lifesaving.
She shoved the shirt into Hugo’s hands and Hugo wasn’t asking questions. He grabbed the T-shirt and pushed.
‘Kim, don’t move,’ Hugo was saying, and with a jolt Rachel realised he was talking to the girl. He was good, this man. Even in extremis he found time to tell his patient what was happening. ‘Your leg’s been badly bitten and we need to stop the bleeding. I know it hurts like hell but someone’s gone for painkillers. Just a few short minutes before we can ease the pain for you, Kim. I promise.’
Could she hear? Rachel didn’t know and she had to concentrate on her own role. Hugo would want a more solid pad than one T-shirt could provide. She stared up into the crowd. ‘Michael,’ she yelled. Hugo was too busy applying pressure to haul off his shirt and he needed something to make a pad. And Michael could help with more than a shirt. He had the skills.
But Michael was gone.
It couldn’t matter. ‘Take mine.’ A burly farmer had seen her need and was hauling off his shirt. She accepted with gratitude, coiling it into a pad.
Out of the corner of her eye she saw her overnight bag, sprawled and open in the dust where she’d dropped it as she’d lunged for the tap. More clothes. Great. As Hugo looked up, searching for whatever she had, she handed him a pad. She made another with what was in the bag. Then she shoved the pad hard down over his and pressed. He pressed with her. Even their combined effort wasn’t enough to stop the flow.
‘I need forceps,’ he said grimly. ‘My bag …’
‘Clive’s gone to fetch it,’ the farmer told them, hovering over both doctors as they worked, his face ashen with concern. ‘He’ll be back any minute. He’s the fastest runner.’
‘Good.’ They were working together, their hands in tandem. Hugo was breathing fast, using all his strength to push tighter, and Rachel realised that she was hardly breathing at all. Live. Please. It was a prayer she’d learned early on in her medical training, and had used over and over. Skills were good but sometimes more was needed.
Luck?
Still the blood oozed. ‘Push down harder,’ Hugo told her. ‘Don’t move off the wound.’
‘I’m not moving,’ she said through gritted teeth. The bite resembled a shark bite—a huge, gaping wound that, left untended, would release all the body’s blood in minutes.
Even if tended …
She was pushing down so hard it hurt.
‘I need forceps.’ Hugo’s voice was growing more urgent as the situation became more desperate. ‘Damn, where’s my bag?’
‘Here.’ A youngster, a boy of about sixteen, was bursting through the crowd, carting a bag that was three times the size of any doctor’s bag that Rachel had ever seen. A country doctor’s bag.
‘Haul it open.’
The boy flicked the bag open and Rachel’s eyes widened. Forceps. There were several and they were sitting on the top as if prepared for just this emergency. She lifted a hand from the wound and grabbed the first pair.
‘We’re not going to stop this without clamping,’ she muttered. ‘The femoral artery has to have been torn to explain this.’
He accepted her medical knowledge without a blink. ‘I agree. Clive, take a shirt and clear as much blood as you can while we work. Let’s go.’ He grabbed forceps himself and then looked across at her. ‘Ready?’
She took a deep breath. This was a huge risk. They needed the pad to stop the spurting, but the only way to stop the bleeding altogether was to remove the pad and locate the source. They had only seconds to do it or the girl would die beneath their hands.
‘OK.’ She took two deep breaths. ‘Now.’
They lifted the pad away from the wound. The blood spurted out and they were working blind, searching in the mess that was the girl’s leg.
Where in this mess was the artery? Dear God, they had to stop it.
‘Take the swab right away, Clive. Just for the moment,’ Hugo said. ‘Be ready to replace it.’
And in the tiny millisecond before the wound refilled with blood …’There!’ Rachel pushed in and grasped, and the forceps linked to the torn artery. She clicked them shut—and the pumping died.
Not enough.
There were more. As well as the femoral artery, two or three minor vessels had been torn. They could kill all by themselves.
Hugo’s forceps clamped shut on another blood vessel and the flow abated still further. Another pair of forceps was in Rachel’s hands and Hugo had another.
She was working like lightning. Without the pads there was no pressure—the blood simply pumped out.
‘Gotcha.’ Another one was under Hugo’s forceps. He clamped.
And another.
And that was it.
The blood was still oozing, but slowly now. The pumping had stopped. It’d be flowing from the ripped veins but they’d done what they had to do. For now.
‘We need to continue with pressure,’ she said, and sat back as Hugo set to work with another shirt, forming another pad. They’d been lucky. Trying to find the blood vessels in these conditions …
Yeah, they’d been lucky—but this man was good!
Hugo was tying the pad firmly around the leg. He gave her a curious glance. There was still urgency but they were working with minutes now rather than seconds. They’d blocked off the blood supply. Now they needed to prevent shock setting in. They needed to replace fluids and they needed to save a leg that no longer had a blood supply.
‘Pete, ring the ambulance,’ Hugo snapped into the crowd. ‘Tell them I want plasma and saline on board and if they’re not here in thirty seconds I’ll have their hides. Dave, can you and a couple of the men find those damned dogs and deal with them before we have another disaster? Toby … Where’s Toby?’ He looked out into the crowd, searching for his little boy. ‘Myra, can you take him?’
‘The first two are already being looked after,’ someone said. ‘The vet’s got the cocker and a couple of guys have gone after the pit bull. The ambulance is on its way.’
Which left Toby.
A middle-aged woman stepped from the crowd of horrified onlookers and took Toby’s hand. The child had been standing white-faced and shocked as Hugo and Rachel had worked. ‘Come on, love,’ she told him. ‘Come with me while Daddy looks after Kim.’
Kim …
Rachel looked up to the girl’s deathly white face. Kim’s eyes were open but it wasn’t clear whether she was conscious or not.
‘You’ll be OK, Kim,’ she told her, taking the opportunity to take the girl’s hand in hers. What she’d most need now would be reassurance. Not panic. ‘We needed to hurt you a bit to stop the bleeding but we’re both doctors. We know what we’re doing. The bleeding’s stopped now.’
The girl’s eyes widened. She was conscious.
‘Mum … Knickers …’
‘Someone find the Sandersons,’ Hugo ordered. ‘It’s OK, Kim. We’ll find your mum and dad now, and Knickers is with the vet. You know Rob will look after Knickers just as I’ll look after you.’
The flaring panic in the girl’s eyes subsided. They were winning. Kind of. For now.
But … was one of the reasons the bleeding had eased because the blood pressure itself had dropped?
‘She hasn’t lost too much,’ Hugo muttered, and Rachel realised he was thinking the same as she was.
Too much blood …
There was certainly a lot. Rachel herself was covered with a spray of gore. She was wearing only a bra above the waist and she looked like something out of a vampire movie. Paramedics were supposed to wear protective clothing, she thought ruefully. If Kim had any sort of blood-borne disease, then she and Hugo were now also infected.
They couldn’t care. Not now.
Hugo was swabbing the girl’s arm and Rachel moved to get a syringe. By the time Hugo had the line ready she was prepared.
‘Five milligrams morphine?’
‘Yeah, and then saline. We need plasma. Hell, where’s the ambulance?’
It was here. There was a shout and then someone was pushing through the crowd. A couple of ambulance officers.
Rachel almost wept with relief. They’d have plasma, saline—everything Hugo needed.
They’d take over. This wasn’t her place. She could go back to being a horrified onlooker.
But …
‘Your husband’s a cardiologist?’ She’d gone back to applying pressure as Hugo inserted an IV line.
Her husband? She stared blankly and then realised who he was talking about. Michael, her husband. What a thought! But now wasn’t the time for fixing misconceptions. ‘Yes.’
‘Thank God for that.’
‘Sorry?’
‘I’m the only doctor in town,’ he told her. ‘Can you ask someone to find him? He’ll be able to help.’
‘He was catching the helicopter back to Sydney,’ Rachel said blankly.
‘There’s a helicopter’s taking off now,’ a voice said helpfully. ‘You can hear it.’
He’d left? Michael had left?
Maybe he hadn’t even noticed what had happened. Rachel had stalked out and it’d be just like Michael to have left as well. He’d have heard the dogfight but he wouldn’t have turned to investigate. She knew him well enough after this weekend to know he wouldn’t deviate from his chosen plan for anyone.
‘He’s taken the helicopter?’ Hugo searched the crowd to find the farmer who’d been the first to offer his shirt. ‘OK, it’ll have to come back. Matt, get onto the radio. Get the chopper returned here. Tell the pilot we need priority. Kim needs emergency surgery if we’re to save this leg. She needs vascular surgeons. We need to evacuate her—now!’
‘Will do,’ Matt muttered, and ran.
There was a crowd of about twenty onlookers around them now, but it wasn’t the sort of crowd you saw in city accidents, Rachel thought. There was horror on everyone’s faces. They all knew Kim. They were all desperate to help.
Rachel was the only woman who’d stripped to her bra but she knew without asking that each and every one of these women would do the same and more if they needed to. Their care and concern were palpable.
Then Kim’s parents were there, running toward their daughter across the showgrounds. Their fear reached the group on the ground before they did, but Kim had drifted into unconsciousness. The combination of shock, blood loss and painkillers had sent her under. Good, Rachel thought as her mother disintegrated into tears, sobbing onto her chest. The horror on her parents’ faces would only have made things worse.
Enough. There was nothing more she could do now. One of the paramedics had taken her position, keeping pressure on the wound. She rose. A buxom woman in floral Crimplene put her arm around her and held. Rachel wasn’t complaining. She was grateful for the support.
‘Who are you?’ Hugo asked. He was adjusting a bag of plasma, the ambulance officers were helping. Rachel wasn’t needed.
‘Rachel. Rachel Harper.’
‘You’re a doctor?’
‘Yes.’
‘You’re not a vascular surgeon, I suppose?’
‘I wish.’ She knew exactly what he was thinking. A vascular surgeon was what they needed, urgently. The chances of saving Kim’s leg were incredibly slim. ‘But Michael has the skills. And he’s still in range.’
He’d be upset at being called back but he had no choice.
‘OK.’ He stared up at her for a moment longer, his intelligent eyes assessing. Each knew what the other was thinking. They couldn’t voice it here—not in front of Kim’s parents—but if the femoral artery wasn’t repaired fast, Kim would lose the leg if not her life.
They needed the helicopter. They needed Michael. Kim’s future depended on it.
There was nothing Rachel could do, though.
For now she was no longer needed.
Mrs Keen, the lady in the Crimplene, ushered Rachel into the showground caretaker’s residence. As the ambulance screamed its way to the hospital she was already under hot water while Mrs Keen tut-tutted about the state of her clothes.
‘And the clothes in your bag are no better,’ she told Rachel through the bathroom door. ‘One of the men brought your bag over but you’ve dropped it, and then used everything to stop the bleeding. Oh, my dear, there’s blood on everything.’
That was a minor worry. For now Rachel couldn’t care. She let the hot water steam away the gore and she worried about the girl. Worried about the leg.
Michael would be really angry at being recalled. He’d hate to miss out on the Witherspoon case.
It couldn’t matter. He wouldn’t have heard the dogfight, she decided. Michael Levering saw only the things that affected him. He was needed in Sydney for a prestigious patient and Rachel wasn’t doing what he wanted. He’d have simply turned on his heel and stalked away. As for Rachel and Penelope—others could pick up the pieces. If Rachel didn’t take his expensive dog and his expensive car back to Sydney, well, Michael had the money to send a lackey to the country to collect them later in the week. Dog-show organisers were hardly likely to let Penelope starve and even if they did …
Penelope was just a possession.
‘Damn the man.’
She was shaking, a combination of anger and reaction to the whole situation. They’d been really, really lucky to save Kim’s life.
Michael would be back. The helicopter would have returned by now and, dislike Michael as she did, she had to concede he possessed the skills she didn’t. He was an incredibly competent vascular surgeon. He might not have noticed the dog fight but if they planned to evacuate Kim on his helicopter, he would, of course, treat her. And with Hugo as back-up …
She washed the last trace of blood from her arms as Mrs Keen’s face appeared around the door. Her cheeks were crimson with embarrassment and distress.
‘My dear, I’m sorry to disturb you but you’re needed back at the hospital. Dr McInnes has just rung. The helicopter’s refused to turn around,’ she told her. ‘Dr McInnes says he has to operate now or she’ll lose the leg, and you’re all the help he has.’
‘It’s not a publicly owned chopper.’ Harold Keen, the showground caretaker, drove her to the hospital in grim-faced anger. ‘It seems it belongs to the chap that had the heart attack—Hubert Witherspoon. His man’s the pilot. He’s under instructions to take your young man to Sydney and there’s no way he’s turning back.’
‘But Michael’s on board. Surely he can overrule.’
‘I don’t think he has any say in the matter.’
Rachel stared straight ahead. She was wearing one of Doris Keen’s Crimplene dresses. She’d hauled a comb through her hair, but her curls were still dripping. She was wearing a pair of Doris’s sandals. She was heading to a tiny country hospital where they were facing surgery that was a nightmare.
Help!
‘I suppose someone’s looking after Penelope,’ she said in a small voice, and Harold looked her over with evident approval.
‘Your dog’s fine,’ he told her. ‘There’s any amount of folk looking after her. You look after Kim and we’ll look after you.’
‘Thank you.’ She felt like she was about to cry. Damn Michael. Damn him. He had the skills she didn’t. He had the helicopter she needed.
He was gone.
‘It’s no use being angry. We just have to get on with it.’
Hugo was already kitted out for surgery in green theatre gown, cap and slippers. The nurse had ushered Rachel straight through to the theatre. She glanced around and her heart sank. This was a tiny surgery, set up for minor procedures. Not the major trauma that was facing them now.
She swallowed and looked up, and some of her panic must have shown in her face.
‘What’s your background?’ he asked, his voice gentling a little.
‘I’m a registrar at Sydney Central. Emergency medicine. I don’t … I don’t have the surgical skills to cope with this.’
‘But you’re the reason we were able to clamp the arteries so fast,’ he told her. ‘So you saved Kim’s life in the first place. It’s just a matter of finishing what we started.’
Yeah, right. ‘You’re planning on rejoining the femoral artery?’
‘If we can—yes.’ He shook his head. ‘It may be unlikely we’ll succeed but we have to try. I’ve been on the phone to specialists in Sydney and we don’t have a choice. By the time we get her evacuated to Sydney the leg will be dead. If we don’t try then she loses the leg. It’s as simple as that. I’m assuming you can give an anaesthetic?’
He wasn’t expecting her to operate. That was such a relief her knees almost buckled right then.
‘Yes.’ If he was prepared to be heroic then so was she. This was heroic surgery, she thought. Damn fool surgery. The outcome seemed almost inevitable but he was right. They had to try.
‘It’s not as bad as it seems,’ he told her. ‘We have a video link to Sydney. Joe Cartier, one of the country’s leading vascular surgeons, has agreed to help us every step of the way. I’ve hauled in Jane Cross, a local who plays at being a film-maker. She’s setting up computer equipment and she’ll video while we operate. She can do really intricate close-up stuff so everything I do goes straight down the line to Sydney and I get immediate feedback.’
He’d organised all this while she’d been in the shower?
‘I … You’re not a surgeon?’
‘I’m a family doctor,’ he told her. ‘I’m two hours away from back-up. I’m everything. If you weren’t here—if I didn’t have an anaesthetist—then I’d count this impossible. But we have enough going for us now to hope. So what are we waiting for? Let’s go.’
Afterwards, when Rachel was asked to describe what had been done, she’d simply shake her head. How they did it … It was impossible. All she could describe were the technicalities, and they were impressive enough.
They had a speaker-phone mounted just beside the table. Every sound they made went straight down the wire to Sydney.
Jane Cross, a woman in her forties, looking crazily incongruous with theatre garb covering a purple caftan and a mass of jangling earrings dangling beneath her theatre cap, directed a video camera straight at the wound.
‘You promise you won’t faint?’ Hugo had asked the middle-aged woman as she’d set up the equipment, and Jane had regarded Hugo and Rachel with incredulity. Even with a hint of laughter.
‘What, faint? Me? When I’ve got a captive audience? I intend to faint at least three times and I’ll probably throw up too, but later. Not until I’ve done my job.’
She was wonderful, Rachel decided. She was right there behind Hugo’s hands, but somehow she had the skill and the sensitivity to stay clear enough for his fingers to do their work.
The pictures she took were via a digital video camera linked to video conferencing equipment. In Sydney Joe Cartier had a clear view—and Hugo was asking questions every step of the way.
Rachel couldn’t help him at all. She had her own battles. She wasn’t a trained anaesthetist—she’d done basic training but that was all—and Kim was so severely shocked that just keeping her alive was a major battle.
She worked with a phone link, too. They’d run out of phone lines but Jane’s partner, a dumpy little woman in jeans and sweatshirt, sat in a corner of the theatre where she didn’t have to see—her stomach was evidently not as strong as Jane’s—and relayed Rachel’s questions down the line to an anaesthetist in Sydney.
‘Minimal anaesthesia for such a shocked patient,’ the specialist told her, working her through a careful, haemody-namically neutral induction method. He worked through her needs with her and Rachel wondered that such a small hospital could meet the requirements he snapped down the phone.
It could. For a tiny hospital Hugo had brilliant equipment. It was stunning that they had sufficient blood supplies on hand, but there was so much more. Rachel had blood on request, she had plasma, she had saline and a team outside the theatre was warming all the fluids before she even saw them.
The fluids weren’t the only thing being heated.
‘Keep the patient warm at all costs,’ the anaesthetist barked down the phone, and warmed blankets appeared like magic to cover every part of Kim’s body that Hugo didn’t need to work on. After that one instruction Rachel didn’t need to worry about warming—the blankets were replaced every few minutes by freshly warmed ones handed through the door. There must be a hive of industry out there.
It was an amazing scene. As well as the unseen industry outside, they had two nurses working with them in the theatre.
Elly was a competent middle-aged woman, white-faced and shocked because she was best friends with Kim’s mum, but that fact wasn’t allowed to get in the way of her professionalism. Then there was David, a ginger-headed kid who looked like he was hardly old enough to be qualified—but was magnificent under pressure.
They were all magnificent under pressure, Rachel thought. The whole town.
And Hugo …
What was being asked of him was unthinkable. His concentration was fierce—he didn’t lift his head. He concentrated as she guessed he’d never concentrated in his life.