The Doctor's Family Secret

‘Like your father, you’ll believe what you want to believe.’

Frowning, she looked up at Nick. Was he right? No matter what her reservations were about him, she had to respect him as a doctor. He was doing everything in his power to save Tom. He worked quickly and efficiently and he was very clear thinking. But, then, as he’d said, he’d seen this coming, hadn’t he?

She said quietly, ‘What about fibrinolytics?’

‘That’s probably a good idea,’ he said in a low voice. ‘We’ll get the test results first, but there’s no history of ulcer or recent surgery so they’re probably advisable in this instance. We need to do whatever we can to unclog these arteries.’

As soon as they had Tom stabilised, Nick arranged for him to be transferred to the cardiac unit. Laura watched Tom being wheeled away a little later, and hoped fervently that he would be all right.

‘At least we were on hand to treat him,’ Nick said. ‘If he had been on his own, I doubt whether he would have survived. As it is, he’s in the best place.’

She had the feeling that he was trying to comfort her. ‘I know. I haven’t known him for very long but, even so, I get on very well with him. He’s so kind and thoughtful, and he always has time for other people. He was very good to me when I started here.’

‘He’s good to everyone. His problem has always been that he works too hard, and doesn’t pay enough attention to his own health. If he had done, he might have heeded some of the signs that things were going wrong. Perhaps now he will begin to listen.’

Laura bit her lip. She felt as though she was losing a friend and ally. In the few months that she had known him, Tom had always been steadfast in his concern for his colleagues and his patients, and now he was the one who needed support. What had happened to him this morning was serious and life-threatening, and now he must be feeling vulnerable and frightened.

‘He’s in good hands. Our cardiac unit is one of the best in the country.’

She nodded. ‘I know. We deal with these kinds of incidents all the time, and that should make it easier for us to cope, but Tom is one of our own. He’s not all that much older than my father. It sort of brings things home to you, and makes you think of how these things affect families.’

‘That’s true.’ He was silent for a moment, then said in a musing tone, ‘Talking of families, that was a nasty gash your brother had. Is he keen on DIY?’

‘Not especially, but it makes a change from sitting behind a desk all day. He likes to dabble in all sorts of things that involve keeping busy, like gardening, decorating, sport.’

‘What work does he do?’

‘He works in a bank. He enjoys what he does, but he says that having a desk job means he doesn’t get enough exercise.’

‘Then he wasn’t interested in following family tradition and going into medicine?’

‘No, not really.’

‘He’s very much like your father, physically. Has his lack of interest in medicine caused any friction? I know that David was particularly pleased when you decided to go to medical school.’

‘Perhaps he was, but all he really wants is for us to be happy, whatever we decide to do.’

Nick looked at her curiously. ‘I still think it’s strange that you and your brother are so very different in appearance. I met your mother once, when she came to a function at the hospital, but you don’t seem to take after her either.’

Laura gave a faint, wry smile. She had to give him full points for observation. ‘You’re perfectly right,’ she said softly. ‘The truth is, Matthew is their natural son, but I was adopted. It doesn’t matter to me, because I don’t really remember it being any other way. I love my father dearly, and I miss my mother more than words can say.’

She lowered her head slightly, remembering her adoptive mother. ‘It was a great shock to all of us when she died.’

Nick frowned. ‘I’m sorry. I didn’t mean to upset you.’

She lifted her head and braced herself. ‘That’s all right, I’m fine. I’ve had more than a few years to get over the fact that she’s gone. It’s just that it was so unexpected. She was a good driver, but it was a foggy night and there were patches of ice on the road. That particular bend in the road was an accident black spot. At least now they’ve made it safer by putting warning signs up.’

‘She would have been proud to know that you passed your medical exams, and that you became a fully fledged doctor.’

‘Yes, I believe she would…even though I may still have a lot to learn.’ Remembering his comments on her junior status from a few days ago, she threw him a hooded glance, and perhaps her gibe hit home because his mouth twisted at the corners.

He didn’t follow it up, though, because an emergency admission dragged them both back to work.

The thought still rankled in her mind, though. Whenever she was on duty at the same time as Nick, she felt that he was keeping an eye on her, and she often wondered if he was expecting her to fall flat on her face. A and E was a challenging speciality, and she was doing her level best to master it. You never knew what to expect, but she wanted to do her utmost for her patients, and she knew that she would go on learning for quite some time. She just didn’t need Nick to remind her of that.

When she went back home that evening, Matthew was there with Connor. Her father was showing Connor how to colour pictures on the computer, and he looked up and smiled as she walked into the living room.

‘Matthew tells me that you had to stitch his hand for him this morning. You’d think a doctor’s son would be more careful, wouldn’t you?’

Laura chuckled. ‘You would, but this is Matthew we’re talking about. He’s always been slightly accident-prone. He gets absorbed in what he’s doing, to the exclusion of everything else.’ She sent Matthew a smiling glance. ‘I take it that Catherine’s not back from her shopping trip yet?’

He nodded. ‘She phoned to say that she met up with a friend, and they’re having a meal together to celebrate the friend’s birthday. She’ll be back later on this evening.’

‘Would you like to stay for dinner with us?’

‘That would be great. I’m sure Connor will enjoy spending some more time with both of you.’

Over dinner, she told her father what had happened to Tom.

‘I heard about it,’ her father said. ‘It’s a bad business. I like Tom. We’ve worked together for years, and he’s always been a good friend to me.’

Matthew frowned. ‘Is this the same Tom who goes fishing with you in the summer?’

‘That’s right. I’m sorry to see him brought down by something like this.’ He sent Laura a quick glance. ‘I’m glad that you and Nick were there to take care of him.’

‘I think Nick was expecting it, to be honest. I knew that Tom had been unwell for some time, but I didn’t know how bad it was.’

‘Nick’s more observant than most, I’ll give him that. He’s a very clear-headed young man, but he’s very forthright in his views, too. He doesn’t pull his punches, and he forgets that there is more than one side to most situations.’ He frowned, his mouth tightening in a spasm of anger. ‘We’ve had more than a few arguments over this very subject. He didn’t think Tom should have still been working in A and E.’

‘I know.’

‘Sometimes it seems as though Nick is totally insensitive to what other people are going through. I can understand how Tom must have felt, faced with the thought of giving up his work. I know what it’s like to have to give up a career in medicine. It isn’t an easy thing to accept that your way of life, everything that you’ve worked for, has to come to an end. It can be a brutal blow, but Nick will never appreciate that.’ There was a bitter edge to his words. ‘For him it seems like a simple enough decision, but for Tom it was something he couldn’t even bear to consider.’

‘It’s been forced on him now.’

‘Yes. He’ll have a lot of thinking to do over these next few months while he recovers his strength.’

He reached for the coffee-pot and filled his cup. ‘Actually, I called in to see Tom before I came home this evening. He said that you’d been in to see him, too, and I think it’s made him feel a lot more cheerful to know that he’s surrounded by friends. He seemed resigned to the fact that he’s not going to be able to avoid surgery.’

‘A triple bypass would give him a new lease of life.’

‘That’s true enough.’ He shook his head in grim reflection. ‘It’s a sad fact, but I can’t see him being able to come back to work. He’s only a year or so off retirement, and I think in the end he’ll come around to the fact that he will have to accept his limitations.’

‘That’s probably true, but at least he’ll have his family around him. That will be something for him to look forward to.’

Her father nodded. ‘I’m sure he’ll be glad of their support.’ His expression was sombre. ‘On the other hand, as far as we’re concerned, this whole sorry business leaves us with something of a predicament.’

Laura looked at him curiously. ‘What do you mean?’

‘I mean that the A and E department has been left with no consultant in charge.’

‘Yes, I had thought of that. I suppose, if Tom is ill for any length of time, which seems likely, the hospital will have to appoint an acting consultant, a locum perhaps.’

‘I don’t imagine it will be easy to get someone suitable as a matter of urgency. What’s most likely to happen is that Nick will be asked to stand in temporarily.’ His features darkened. ‘I expect he’ll be glad enough to step into Tom’s shoes. With nobody standing in his way, he’ll have free rein, won’t he? What is there to stop him from going after what he wants?’

Laura’s eyes widened. ‘You mean that he will be in charge?’

‘Unfortunately, I think that’s a strong possibility.’

Laura struggled to absorb that. Nick, in charge? While she respected him as a doctor, there was no way she would be happy for him to have overall control of her daily work situation. It was bad enough at the moment, when there seemed to be constant friction between them. She was forever having to bite her tongue when their sometimes heated disagreements threatened to get out of control. How would it be when he was the acting consultant?

And that was without even beginning to consider the damaging effect his sudden promotion would have on his working relationship with her father. The result would be calamitous and didn’t bear thinking about.

CHAPTER THREE

LAURA wiped yet another name from the board. That was one more patient she had treated and discharged that night. How many more were there likely to be before her shift ended? It seemed as though she had already dealt with hundreds. Flexing her tired muscles, she reached for another treatment chart.

Wayne Golding was waiting in cubicle number four, and she went there now, drawing back the curtains.

‘Hello, Mr Golding,’ she greeted him. ‘I’m Dr Brett.’ She glanced at the chart, and added, ‘I understand you’ve had a nasty gash to your hand. Perhaps I could have a look at it.’

‘Oh, so you’re finally ready for me, are you?’ he snarled disagreeably. ‘How long does it take for you doctors to get around to looking at your patients around here? I could have bled to death by now.’

Taken aback, Laura viewed him warily. He was a big man in his forties, with ruddy cheeks and nose in a well-worn face that made him look as though he had lived life to the full. He also reeked of alcohol.

‘I’m sorry that you’ve been kept waiting. We’ve been very busy dealing with emergency patients elsewhere in the department.’

He glared at her, his body stiff and threatening, so that she surreptitiously looked towards the alarm button. ‘I haven’t seen any emergency activity around here. I think you’re just making excuses. I’ve got better things to do than sit around for hours on end.’

‘I’m sure you have,’ Laura said, hanging onto her patience by a thin thread. ‘No one enjoys having to wait, but I can assure you that if we had made our road accident patients wait, they certainly wouldn’t have lived to see the day out.’ Her chin lifted in a determined and businesslike way. ‘Perhaps if you let me take a look at your hand I’ll be able to see what needs to be done and send you on your way.’

He thrust his hand towards her face so that she took a step backwards. ‘It’s obvious what needs to be done, isn’t it?’ He spoke to her as though he thought she was an idiot. ‘It needs stitching up.’

She inspected the wound. His knuckles were lacerated, the skin split in several places. She probed gently, searching for any injury to the underlying tendons and ligaments. Growling, he pulled his hand away.

‘Watch what you’re doing. You don’t need to maul it like that,’ he snarled. ‘For all you know, it could be broken.’

‘I’m sorry if I hurt you,’ Laura said quietly. ‘Have you been in a fight?’

‘Someone came at me and I let him have it. If my hand’s broken, he’s going to pay for this.’

‘Fortunately the X-rays don’t show any broken bones,’ Laura murmured. ‘The downside is that there is a nasty infection in there, possibly from an old wound.’

His eyes narrowed on her suspiciously. ‘So what does that mean?’

‘It means that I’ll need to wash the wound out with a medicated solution, and then I’ll put a dressing on your hand so that it stays clean. I’ll prescribe an antibiotic as well to clear up the infection.’

‘You mean you’re not going to stitch it up?’ Angrily, he got to his feet, and Laura quickly drew back, startled.

‘I’m afraid I can’t, not while there’s an infection present. You’ll need to come back the day after tomorrow so that we can look at it again.’

‘You’re doing this to wind me up.’ He lunged towards her, his face a mask of aggression.

‘I’m not, I promise you.’ She tried to stay calm, but his anger was making her feel uncomfortable. ‘If you’ll excuse me for just a moment, I’ll go and get some supplies.’

Without giving him any chance to object, she walked out of the cubicle and drew the curtains behind her. Pulling in a sharp breath, she went to the desk at the far end of the room and began to count soundlessly to ten.

‘Is there a problem?’ Nick flicked a glance over her, appraising her carefully from head to toe.

‘None at all.’ The last thing she needed was to admit to Nick that she was having difficulty treating a patient. He placed a lot of emphasis on treating patients with respect. Pain sometimes made people unreasonable, he had said, and it was their job in A and E to look beyond a person’s critical or tetchy comments.

‘Really?’ he said drily. ‘I heard someone shouting. Are you having trouble with a patient?’

‘It’s nothing that I can’t handle,’ she said tersely.

‘I’d still prefer it if you’d told me what’s going on,’ he persisted. ‘It’s late at night, and we’re busy in the department. Tempers get frayed, and things can easily get out of hand.’

Laura grimaced. He thought she was going to mess things up, didn’t he? That wouldn’t go down well. Tom Edwards had been easygoing and tolerant, but Nick was a different animal altogether. Over these last few weeks, while he’d been in charge of A and E, he had made it clear that he liked things to run smoothly, and he was keen on keeping the department up to full speed.

‘I won’t let that happen.’

‘You came on duty tonight to help out because we were short-handed, didn’t you? This isn’t your usual shift.’

‘That’s right.’ She looked at him steadily. ‘What difference does that make?’

‘It means that you haven’t had much of a break between shifts, and I know that you haven’t had a coffee-break for some time. I think you should go and get one now.’

‘I’m in the middle of treating a patient, or had you forgotten?’

‘I’ll deal with him.’

Laura shook her head. ‘I would prefer to do that myself. It’s a matter of professional pride.’

His mouth crooked in a half-smile. ‘You can be a very stubborn woman at times, can’t you?’

‘I prefer to use the word independent.’ She moved away from him towards a cupboard. ‘If you’ll excuse me, I need to get some supplies.’

He watched her go, and Laura turned her attention to getting the irrigation equipment. It took her a few minutes to find what she needed, and when she returned to the cubicle where she had left Wayne Golding, she was startled to see that Nick was already in there.

‘I hope you understand what I’ve been saying,’ Nick murmured, giving Wayne a narrow-eyed look. ‘That’s a nasty infection, but Dr Brett will clean it up for you and make arrangements for a follow-up appointment. Now I have other patients to attend to. Goodbye, Mr Golding.’

Wayne looked uncomfortable, and Laura wondered what on earth had been going on. She sent Nick a questioning glance, but he simply swept determinedly past her and went to check on another patient.

Wayne was subdued as she washed out the wound on his hand, and he made no murmur when she carefully taped a dressing in place. The change in his attitude was remarkable, and Laura had no idea what had brought about the transformation. He even thanked her when she passed him on to a nurse who would arrange his follow-up appointment.

The whole episode puzzled her so much that she went in search of Nick. He was treating a pneumothorax, and she assisted him until they were both sure that their patient was out of danger.

‘Would you like to tell me what you said to Wayne Golding?’ she asked as they cleaned up afterwards. ‘He was a different man when I went back to treat him.’

‘I heard what he had been saying to you, so I simply told him that his behaviour wouldn’t be tolerated. The doctors and nurses in A and E have a difficult enough job to do, and they deserve respect. I made it clear to him that if he couldn’t control his temper and behave in a reasonable fashion, I would ask Security to remove him from the premises.’

Her jaw dropped. ‘You really said that? But I thought you would blame me for not handling the situation efficiently and sending him on his way.’

He frowned. ‘Why on earth would you think that?’

‘Things have been so different around here since Tom was taken ill, and I’m not always sure that I’m doing the right thing. The triage system is different, and the working rotas have changed. We assess patients, treat them and mostly we send them on their away more quickly than before, but it isn’t always possible.’

‘Don’t you think it’s a good thing that we’ve made the department more efficient?’

‘Yes, I do, but the changes have happened so quickly, and I’m not sure whether you expect one hundred per cent efficiency. I’m not certain that that’s attainable.’

‘Then perhaps we should get one thing straight at the outset. I value the co-operation of all the staff in A and E. Everyone has worked tremendously hard to make the department function efficiently, but it could be that I’ve been concentrating so hard on getting things off the ground that I haven’t made it clear to everyone how much I appreciate what they have done. I need to remedy that.’

Nick frowned. ‘I still don’t understand why you didn’t come to me with any of your doubts.’

She made a wry smile. ‘I’m just a junior doctor here, remember. I value my job and I don’t want to rock the boat unnecessarily.’

‘Laura,’ he said in a dry tone, ‘I’m here to support you in what you do. If you have any problems, you should bring them to me. You’re not expected to manage things on your own. We work as a team. That’s one of the fundamental characteristics of working in A and E.’

‘Maybe, but you always seem to expect perfection. It’s sometimes hard to live up to the standards that you set.’

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