Love Without Measure

He headed off towards the waiting-room, X-rays and forms in hand, and Anna watched him go. Another gorgeous hunk, one that half the hospital were apparently in love with, including most specifically his wife Cassie, the only scrub-nurse he would tolerate and who would tolerate him, so rumour had it.

His temper in Theatre was legendary, but his results were astonishing and he was tipped for stardom. It made her laugh that Mr James had queried his competence. He was probably the most skilful and intuitive orthopaedic surgeon in the hospital, bar none.

And yet he left her cold. No, not cold, she acknowledged, just warmed with admiration and a genuine liking.

Whereas Patrick—!

How had he managed to break through her reserve and reach that part of her so carefully guarded that even she scarcely knew it existed?

But break through it he had, and now her skin shivered when he approached, her heart beat faster, and when he looked at her with those melting brown eyes her insides turned to mush.

And when he touched her …! Even an accidental brushing of his hand against hers made her heart race and her skin heat. She was like a teenager, anticipating her first kiss. Her breath caught in her throat at the image that provoked, and she rolled her eyes in self-disgust. If it hadn’t been so worrying it would have been laughable.

But she was worried. She was too vulnerable, too inexperienced to deal with a sexy, meaningless flirtation—or, worse still, a casual affair with a married man.

Her heart thumped at the thought, and her mind recalled with absolute clarity the vivid dream she had had the night before.

Her cheeks heated at the memory, and she quickly busied herself with the admission details for Nick’s patient, Clive Ronson. How she had managed such a provocative dream anyway, she didn’t know. She had no experience of any of the moves he had made, or any of the feelings she had quite definitely felt!

She cobbled up the form and tried again.

Patrick was cross with himself. He was trying to write up notes and all he could think about was the feel of Anna’s body beside his as they had worked together on Clive Ronson. She was too thin, he thought critically, but still she managed to stir him. The jut of her hip was still unmistakeably feminine, the brush of her thigh like the soft stroke of fire against his leg as she had leant across to cut away the patient’s trousers. He had been in her way, and yet a perverse part of him had refused to move.

He wanted her.

It shocked him, the realisation that she was capable of getting past the ice around his heart and setting his body on fire like this.

It was only physical, he knew that. It could never be anything more meaningful, but that didn’t diminish its power. Oh, no. Almost the reverse. Because it was just sex, just meaningless, hot, physical lust, his mind could allow it.

His body was helpless. He shifted uncomfortably, embarrassingly aware of the heavy heat that suffused him, the very present evidence of his desire.

He glanced down at the notes, at his hands lying on the desk, and saw the scar.

Deliberately, enduring the pain, he dragged his mind back. Heat, noise, clouds of choking dust clogging his pores and making it difficult to breathe, and the screams. Always the screams.

Desire drained away, as he had known it would, leaving him empty and shaken.

He stood up and went out of the office to the staff-room, pouring himself a cup of coffee with hands that were not quite steady.

‘Hi. Any left?’

The voice behind him was soft, and his breath jammed in his throat again. He let it out consciously.

‘Just about enough,’ he said, and his voice sounded harsh, scrapy.

He was conscious of her eyes on him, mellow with concern. ‘Are you OK?’

‘Yes, I’m fine. Just a bit preoccupied.’

It was clearly a dismissal, and he felt a kick of self-disgust as rejection flickered over her gentle face and she withdrew into herself.

He made himself smile. ‘Sorry. Clive Ronson. He was a bit of a mess. I was just writing up the notes.’

‘Nick will sort him out if anyone can.’

She sounded very confident.

He felt he ought to warn her, just in case the worst happened. Ridiculous. She was a professional. If the man died, she would take it in her stride. Even so… ‘He’s bad,’ Patrick warned. ‘It’ll be a few days before he’s out of the woods, you know.’

‘I know, but Nick’s good,’ she replied. ‘Too good for the likes of Mr James and his private ankle. Pompous idiot. I gather he’s still on the phone.’

Patrick felt the tension ease as they shared a smile. He noticed again how thin she was, how fine-drawn the skin over her delicate jawline.

‘How about lunch?’ he suggested into the ensuing silence.

‘Lunch?’ She said the word as if she had forgotten what it meant. He reminded her, and she laughed. ‘I know what lunch is, silly. I just didn’t realise it was time yet.’

He snorted softly. ‘It’s nearly one.’

‘Oh. Right.’

‘Shall I go and find a few sandwiches again?’

‘That really isn’t necessary—’

‘What did you have for lunch yesterday?’

She shook her head. ‘Nothing. I was too busy.’

‘And Tuesday?’

She sighed, recognising defeat when it stared her in the face. ‘Lunch would be lovely, but let me pay for it.’

He growled softly under his breath, and she suppressed a smile. ‘I mean it.’

‘Stubborn woman. All right, you can pay for your share. OK?’

She nodded.

Sensible woman. She knew when to give up, he thought with an inward chuckle.

He headed for the door, but as he got there a phone rang in the office.

Kathleen stuck her head out. ‘That was ambulance control. A lorry’s embedded in the front of a house, and the driver’s trapped. He’s still alive, but he’s bad, and it’ll be hours before they can get him out. They want a team.’

Anna joined him at the door. ‘Do you want us to go?’ she asked.

‘Will you?’

She nodded. ‘OK. Patrick?’

‘Sure. Let me speak to them, find out what they know so we’re prepared.’

He left Anna finding the emergency bag used for attending such accidents, and quickly established what else they would need.

His stomach rumbled, but he ignored it. He could eat later. Just now he had to get back on the merry-go-round.

Anna was appalled. The lorry was buried right inside the house, the cab almost invisible. As they arrived a fireman crawled out of a tiny hole near the left of the cab and shook his head.

‘I can’t really reach him. There just isn’t enough room—oh, hi, Doc. Want to try and get through? He can talk, but not a lot else. I haven’t got a glimpse of him yet.’

Anna took a breath. ‘I could try and get closer. I’m smaller than you two.’

Out of the question; it’s too dangerous,’ the fireman said bluntly.

‘For who?’ she asked him, her voice quiet. ‘For you, for me, or for the driver?’

‘He’s right, Anna,’ Patrick said slowly. ‘That whole lot looks very unstable.’

‘And what about the man inside it? How stable is he?’

The fireman shifted awkwardly. ‘We don’t know. He says his head’s bleeding, and the steering-wheel’s stuck in his abdomen, but we haven’t been able to get anyone in there.’

‘Well, you can now,’ Anna said with quiet determination. She took his hat off his head, plonked it on her own and headed for the little gap. Taking a steadying breath, she squeezed into the hole and wriggled forward, feeling her way towards the front. She could see a heavy beam of some sort lying across the front of the cab, and the door had burst open, jamming across her path. The hat was in the way, so she took it off and dropped it behind her.

‘Anna?’

Patrick’s voice. ‘I’m OK,’ she called back.

Squeezing out her breath, she wriggled through the narrow gap and up into the side of the cab. Her right hand went into a pool of something sticky, and she sniffed. Blood. Lots of it.

‘Hi, there,’ she said, squeezing as much reassurance as possible into her voice.

A grunt of pain came out of the dim cab, and she ducked her head beneath the beam that was lying above her head and peered up towards his face. Blood was oozing steadily down his cheek from a wound high up on his temple. His eyes were bright, though, and alert. That was a good sign.

‘What’s your name?’ she asked, knowing that it might be vital in ensuring his co-operation later in the rescue.

‘Nigel—Nigel Ward.’

‘OK, Nigel, let’s find out how you are. Where do you hurt?’

‘Everywhere. Head, chest, legs—especially my right leg.’

She was relieved about that. ‘Hang on to the pain,’ she told him. ‘As long as you can feel, you’re alive.’

He grinned, a surprising flash of white in the dark cab. ‘I’ll bear it in mind.’ His voice was wry and filled with pain. She reached out and touched his hand, offering comfort.

‘I’m Anna,’ she told him. ‘I’m a nurse at the hospital. There’s a doctor outside but he’s too big to get in here at the moment. I just want to find out how you’re doing, and then they can start making plans to get you out. I’m going to have to go again, to get some equipment. I need to take some blood so we can cross-match and replace what you’ve lost, and I’ll need to measure your blood pressure and bring you some pain relief, and maybe some supports for this beam before they can start shifting things. OK?’

‘Will you be long?’ he asked, and she felt rather than heard the fear in his voice.

‘No,’ she said firmly. ‘Just a minute or two. I’ll talk to you as I go, and I can talk to you from outside as well ——’

‘Anna?’

Patrick’s voice was muffled but audible.

‘See?’ she told Nigel. ‘You can hear people outside. OK, Patrick,’ she called towards the door. Tm coming out. I need to do his BP, and I’ll need an IV set and Haemacel, a syringe for bloods, Entonox and some bandages—oh, and saline for cleaning a head-wound. I’m coming out.’

She squeezed Nigel’s hand, glad to feel the pressure returned, and then wriggled out backwards. She was beginning to feel like a worm stuck in a tunnel.

Her dress caught on a sharp bit of metal jutting out and she heard it tear.

Still, she was free. She squirmed slowly backwards, and then there were hands on her waist and she was being pulled out and up into the fresh air.

‘OK?’

It was Patrick, his face concerned, his voice gruff and scratchy.

She nodded, relieved to be out in the sunlight. ‘He’s alive, but his right arm’s gone—it’s lying at a funny angle. His back hurts, and his legs.’

‘Thank God for that. At least he can still feel them.’

‘That’s what I thought. He’s got a head-wound, and the steering-wheel’s rammed firmly in under his ribs. I can just about see his face, but there’s a beam lying right in front of it across the top of the cab.’

‘Could I get in to him?’

She shook her head. ‘Not a chance. If we’d had lunch I don’t think I’d get in either.’

His face was grim. ‘You’ll have to do it all yourself, then.’

‘Mmm. Can I have all the stuff? The first thing I want to do is take some blood for cross-matching. I can get to his left arm, so I should be able to get a line in and then we can start transfusing him. I want to keep a close eye on his BP, as well. He’s got the steering-wheel in his abdomen and that’s going to mess up his venous return, I expect. I think the wheel’s intact. If it’s broken, and penetrated through the wall, he’s in much more serious trouble.’

Patrick nodded, assembling the things she’d requested while she stuck her head back in the hole and talked to Nigel for a moment.

‘How is he?’ Patrick asked.

‘Still talking. I don’t want to mess about, though. I wonder what’s the best way to get that stuff in there?’

‘I’ll crawl in behind you as far as I can and pass things through to you, OK?’ Patrick suggested. ‘You can hand me back the syringe and I’ll deal with the bottles. A police car can take the blood to haematology for cross-matching. Then I can be on hand to tell you what to do.’

‘Just what I need, a bossy-boots up my tail,’ she quipped, but she was reassured to know he was going to be there, just in case.

She took a steadying breath and crawled back into the hole, then, with Patrick behind her, she squirmed back into the cab.

‘Hello, Nigel, I’m back,’ she told him. ‘How are things?’

‘Better now you’re here again,’ he said quietly. She could feel the fear again, and squeezed his hand.

‘There’s a doctor behind me. He can’t get in, but he can pass me things and we can talk to him. OK?’

‘OK.’

His voice was getting weaker, she thought, and, turning with difficulty, she asked for the IV set.

Patrick reached up to her, the packaged set already in his hand.

There was an elastic strap in her pocket—when was she ever without one?—and she pulled it tight around Nigel’s upper arm and turned his arm over carefully. The vein on the back of his forearm just above his wrist looked good, considering the amount of blood he had probably lost, and she prepared the site with an alcohol swab, wiping away the brick-dust and sweat that had clogged on the skin.

‘OK, I’m going to put this into your arm now, Nigel. You’ll just feel a little scratch coming up now…’

It was incredibly awkward doing it with her left hand, but she couldn’t turn either of them round enough to do it with her right. Still, the needle slipped home on the first try and she heaved a quiet sigh of relief as she taped the tubes in place on his arm and plugged the syringe into the end.

Having filled it, she passed it back to Patrick and then held out her hand for the Haemacel.

He put it in her hand, his fingers warm and hard against hers, and she took comfort from the small contact.

The only place to hang the bag was from the rearview mirror, but there it dangled right in her way so she had to dodge even further to see him.

She did so now, and managed a grim-lipped smile.

‘OK?’ she checked.

‘I’ll do.’

She slipped the blood pressure cuff on to his arm and checked his pressure. Low, as she had known it would be. Hopefully he wouldn’t understand the significance of the numbers when she told Patrick. She opened up the drip so it ran in steadily.

‘I’m just going to report to the doctor so he doesn’t feel totally redundant,’ she said with a smile, and then, squirming round, she bent over and stuck her head out of the gap.

‘BP 90 over 40,’ she told him quietly.

He swore under his breath. ‘Internal?’

She shrugged. ‘We need to get him out, Patrick, but there’s this big beam over the cab, and if you tried to pull it out it would crush him. God knows what’s holding it up as it is.’

His jaw muscle jerked, his mouth a harsh line. ‘Are you sure I couldn’t fit?’

She snorted softly. ‘Don’t be crazy. There’s hardly room for me in here. You’ll just have to tell me what to do.’

‘Get out. I want to come in there.’

‘No. You’re being absurd. You’ll just have to trust me.’

‘It isn’t a case of trust,’ he muttered. ‘You shouldn’t be in there. It’s no place for a woman ——’

‘Cut the heroism, Patrick,’ she told him brusquely. ‘Nigel doesn’t have time for all that stuff.’

His mouth tightened, but he had no choice. ‘Find out as much as you can about his condition,’ he grunted. ‘I’ll get the Entonox.’

He backed out and went to confer with the firemen while she turned round and ducked back down to see her patient. She would have to deal with his head-wound, but she could see it had stopped bleeding now. She wiped it with cotton wool squeezed out in saline, and dabbed it dry, talking to him all the while. She had to find out as much as possible, and like this she could watch his eyes. ‘Tell me more about your injuries,’ she coaxed. ‘Can you be specific about where you hurt?’

He thought for a moment. ‘My right knee,’ he said slowly. ‘That’s bloody sore. And my chest—right at the bottom. My stomach really.’

She turned her head and looked down at where the steering-wheel disappeared under the jut of his ribs. ‘I’d like to feel it, see what I can find out about where that steering-wheel’s pressing on you. Tell me if I hurt you,’ she added, and then, slipping her fingers under the edge of his shirt, she ran her hand carefully over his ribs. Several were sticking out at a strange angle, but the skin seemed intact.

She worked her way down, her fingers tracing his hipbone on the far side. So far so good. Her hand explored the rim of the steering-wheel, and she could feel something warm and wet on his abdomen. It didn’t feel sticky, so it was probably urine. Certainly she could smell it. The question was, had his bladder been punctured or had he simply wet himself?

She asked, and he didn’t seem to know. Still, there was no evidence of blood on her hand, which was a good sign. She continued her search, her fingers gentle but thorough, and found the full sweep of the steering-wheel, distorted but intact. So far, so good. She moved on.

His right femur seemed all right, lying awkwardly but unbroken, as far as she could tell. His knee, though, was a different matter. She approached it with caution, but the really painful part was embedded in the remains of the dashboard. The area below his knee was out of reach, but she could see in the light from the torch Patrick had passed her that it was trapped in the distorted footwell.

His left leg seemed to have fared better, and he said he could wriggle the toes of that one although she couldn’t see them because of the bent and twisted metal in the way.

His voice was growing weaker, and she checked his blood pressure again. It was falling still, but whether because he was losing blood internally or because the steering-wheel was digging into his abdomen so hard it interferred with his venous flow she couldn’t tell.

She squeezed the bag of Haemacel for a minute, to boost his circulation, and then turned her attention back to Patrick, who was calling her from the tunnel.

‘They want to know about this beam. They’re going to send in the smallest man they’ve got to check it out and put in supports and airbags, if necessary, to protect him while they remove the rubble from around the cab. OK? So you have to come out.’

Just then she sensed rather than heard a change in Nigel. ‘Hang on,’ she muttered, and, turning, she wriggled back towards him. ‘Nigel?’

‘It’s getting bloody hard to breathe,’ he muttered.

She flashed the torch at his face, noting the blue line round his lips and the bulging veins in the side of his neck.

‘I’m just going to check your ribs,’ she told him, and tapped the side of his chest nearest to her.

Sure enough, it sounded hollow and unduly loud.

She wriggled back to Patrick. ‘I don’t like to rock the boat,’ she said quietly, ‘but our patient’s got a tension pneumothorax—I think his right lung’s collapsed.’

Patrick’s language deteriorated rapidly. ‘You’ll have to come out and let me in.’

‘Don’t be ridiculous. Get me a cannula and I’ll do it.’

‘With or without anaesthetic?’

‘We don’t have time to wait for the lignocaine to work. Just give me the stuff and talk me through it. If it hurts, no doubt he’ll be grateful later.’

Muttering, clearly reluctant, he handed her the cannula. ‘Between the fourth and fifth ribs, to the side and just below his nipple. And for God’s sake mind the intercostal nerve and blood vessels—they run just below each rib.’

‘Fine. Got that.’ Cutting away Nigel’s shirt, she cleaned the area quickly and opened the packet containing the cannula.

‘Right, Nigel, I’m going to make a hole through into your ribcage and let out the air that’s trapped outside your lung stopping you from breathing—OK? I’m sorry, it may hurt a bit.’

Nigel, now desperate for air, nodded. She guessed the other side of his chest might have similar problems, or perhaps a haemothorax. Whatever, if she didn’t move soon, he was going to die.

Taking a steadying breath, and with Patrick’s calm voice instructing her from behind, she slid the thick, solid trocar instrument through the intercostal muscle, which filled the space between the ribs, and into the pleural cavity, then slid the cannula over it and withdrew the trocar. There was a rush of air, and within seconds Nigel’s colour changed back to a healthier pink.

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