At His Service: Her Boss the Hero: One Night With Her Boss / Her Very Special Boss / The Surgeon's Marriage Proposal

Mikki nodded. Her head felt heavy with the unfamiliar helmet and her nod was probably over-eager. She became still again. This was her first opportunity to show Tama what she was capable of professionally and she was determined not to mess it up.

‘Take a look around in the back here.’

They had their helmet radios on a different channel to the one Josh and Steve were using as they discussed navigation. Tama’s voice, inside the helmet, was so clear and close it was disturbingly intimate. As though he had his mouth right beside her ear, his lips close enough to touch her skin.

And that gave Mikki a shiver to add to the strange physical sensations this ride was already clocking up.

‘We haven’t had a chance to go through the gear in here.’ Tama’s voice continued to caress her ear. ‘Might be a good idea if you at least knew where the basics were.’

She was ready for the weight of the helmet this time. Her nod was carefully controlled.

‘You can talk, you know,’ Tama said drily. ‘You’ve got a mike as well as earphones in there.’

‘OK.’

‘See where the portable oxygen is?’

‘Yes.’

‘There’s adult and child masks, acute and nebuliser, plus a non-rebreather in the pouch.’

‘What’s in that big pack?’

‘It’s called a Thomas pack. It’s got pretty well everything and it’s what we take from the chopper for a job like this. Blood-pressure cuffs and a stethoscope, chest decompression sets, intubation gear, bag mask unit, IV gear, fluids and drugs. We’ll go through it properly when we’re back at base.’

Mikki had a sudden inkling of what this was like from Tama’s viewpoint. She was being allowed out on a job before she really had any idea about resources and protocols. Before he had any idea what her level of skill was. He was probably thinking—quite rightly—that she could be a hindrance rather than any help.

Mikki took a deep breath and tried to quell her rush of nerves but they came back with a vengeance when they slowly circled the scene and came in to land. The view from up high was spectacular but getting the big picture with such clarity made this all seem almost overwhelming.

Traffic was backed up for miles in both directions, with police cars blocking the road well away from the accident site, so that even before Mikki could glimpse what they were heading for, she already had the impression it was major.

More police cars. Fire engines and two ambulances and so many people made up the inner circle and there—in its centre—were two horribly mangled vehicles. A car and a small truck. Mikki could see someone lying on the ground and another sitting with ambulance officers in attendance. And, judging by the cluster of rescue workers, someone else was still trapped in the car.

Multiple patients, potentially critically injured, but it shouldn’t be throwing her into this kind of a spin. She dealt with the aftermath of MVAs all the time in Emergency and she was good at it. They often had more than one victim arrive from a single incident.

But this was very, very different.

These people hadn’t already been triaged and stabilised by competent paramedics. Removed from a scene of carnage to arrive neatly packaged on a stretcher into a department that was well prepared with equipment and personnel. This was frontline stuff with an emotional element Mikki hadn’t expected, thanks to seeing the lines of traffic and the scope of the rescue effort and being there—in real time—to imagine the shock of having one’s life so unexpectedly thrown into chaos.

You know what to do, Mikki reminded herself as the helicopter touched down in a paddock beside the road, far enough away for the rotor wash not to create havoc. It’s basic. Airway, breathing, circulation. Assess each one and deal with it if it’s not adequate before moving on to the next. It may be more difficult and messier out here in the field but the priorities were the same.

And this was exactly where she wanted to be, wasn’t it? Frontline. Dealing with all the complications any kind of environment could create. Relying on her own skills and resources that would be far less than those an emergency department could offer. She wasn’t being thrown into this alone, in any case. She was with someone who was the top of their field. She was here to learn.

Confidence was available after all. She had Tama by her side. Mikki gathered all she could find as she followed him towards the car. Josh peeled off, after a brief, almost non-verbal communication with his senior partner, to go to the ambulance officers attending the people already out of the vehicles. Two more ambulance officers were right beside the car. The rear door had been cut away and a woman perched on the back seat, holding the driver’s head in a position that would keep his airway open and protect his neck.

Another straightened from where the front door had also been cut away.

‘He’s unresponsive,’ the paramedic informed Tama. ‘They’ve only just pulled the truck clear and got these doors off for us so I haven’t even completed my assessment, sorry.’

Tama leaned in. ‘Hey, mate,’ he called. ‘Can you hear me? Can you open your eyes?’ His fingers were on the man’s wrist, and then his neck. ‘Carotid pulse,’ he said aloud. ‘No radial. BP’s well down.’

‘He’s bleeding heavily,’ the paramedic noted. ‘His leg’s trapped under the dash.’

A fireman moved in from the crumpled bonnet of the car. ‘We’re about to do a dash roll. You’ll be able to get him out then.’

Mikki had to move as a thick hose was pulled past her feet, a piece of equipment attached to its end that looked like a modified pneumatic drill. She was trying to concentrate on the continuing communication between Tama and the road-based paramedic but this was no emergency department handover.

The pneumatic gear the fire service were using was loud enough to mean people had to shout to communicate and everyone seemed to have urgent tasks that other people were being ordered to carry out. The woman on the ground a short distance away was screaming and a new, approaching siren added to the cacophony.

It smelt of hot metal and petrol and blood and everything looked deformed and sharp. Dangerous.

‘Can you move?’ A fireman requested curtly. He was holding the heavy-looking cutting gear. ‘I need to get in here.’

‘Give us a minute,’ Tama ordered. ‘I want to get an IV in and some oxygen on before we do anything more.’ He slid the Thomas pack off his back and, magically, enough clear space opened beside him to allow the pack to be opened out. ‘Mikki? You want to get the IV in?’

‘Sure.’

She hoped she sounded sure. An eagerness to show Tama what she could do—please him, even—bubbled inside her, and he’d handed her what should be an easy way to begin. Apart from having to step around the crumpled driver’s door on the ground, access wasn’t a problem. The paramedic unhooked a pair of shears from his belt and cut through the jersey and shirt covering her patient’s arm. Mikki slid a tourniquet on and pulled it tight.

Tama leaned past to slip an oxygen mask over the man’s face, then he hooked the stethoscope hanging around his neck into his ears and leaned in to listen to the man’s chest. The paramedic was waiting his turn to get close, a stiff neck collar in his hands.

‘Chest and neck injuries,’ Tama informed Mikki succinctly. ‘I’m not happy with his airway but an OP will have to do until we get him out. BP’s well down so I want to get fluids started stat.’

Mikki just nodded, concentrating on gaining access to a forearm vein with the wide-bore cannula she held. It wasn’t easy. Their patient was a very large man and she was having to go on touch rather than a visual target. To her relief, blood flowed into the chamber instantly. She advanced the needle a little further, slid the cannula home and withdrew the mechanism.

‘Got a luer plug?’

‘Here.’ The paramedic had a dressing and tape ready to secure the line as well and then a giving set and bag of fluids appeared with commendable swiftness, but if Mikki had expected any praise for succeeding in her task, she would have been disappointed. Not that there was time to think of it because things were moving very rapidly now.

Josh joined them.

‘Truck driver’s only got minor injuries and the female passenger from the car is stable. They’re both being transported by road. Where are we here?’

They were at the point of being able to move their patient. Mikki stood back, letting the more experienced and stronger men put on an impressive display of peeling back crumpled metal and then using a body splint and backboard to turn and slide the victim free with minimal disruption to his spinal alignment.

The unconscious driver was on a stretcher within a very short period of time, moved clear of the wreckage, but securing him in the helicopter was still some way off, it appeared. The man’s breathing was deteriorating and Tama clearly wanted to try and stabilise his condition prior to transport. He opened pockets of the Thomas pack and took out a large, tightly rolled package.

Mikki was using the stethoscope as Tama untied the package and opened it up to reveal an intubation kit. She nodded her agreement.

‘He’s got some bleeding going on in his trachea,’ she said. ‘And I don’t like this swelling in his neck. If we don’t secure his airway now, we might lose it completely.’

‘Absolutely.’ Tama was holding up a pair of gloves that looked far too small for his hands. ‘Go for it, Doc.’

Mikki couldn’t help her jaw dropping in astonishment.

Technically, she had higher qualifications than either of the paramedic air rescue crew. She had intubated dozens of people in emergency departments and Theatre but these guys had the huge advantage of experience in working under precisely these conditions.

Rescue crews were still busy around them. It was noisy and dirty and … foreign. And this was an obese patient who could be difficult to intubate even under ideal circumstances. Tama was throwing her in the deep end here but she had breezed through that cannulation, hadn’t she?

She could do this, too.

Except it was harder than she had feared. With blood in the airway and bright sunlight negating the effect of the laryngoscope’s light, it was impossible.

‘I can’t see a thing,’ Mikki had to admit.

‘Here. I’ll shade you.’ Tama loomed close over Mikki and the man’s head, blocking the light from falling directly on them.

Mikki still couldn’t visualise the vocal cords. It was hard to keep a note of desperation from her voice.

‘I need suction.’

‘It’s here.’ Tama managed to slip the handle of the suction unit inside their patient’s mouth without dislodging the laryngoscope Mikki held in place. She reached for an ET tube.

‘Here goes,’ she muttered hopefully.

Her first attempt failed.

‘Oxygen saturation is dropping.’ Josh was right beside her. ‘I’ll bag mask him for a sec.’

Mikki sat back on her heels, looking for a replacement tube in the kit. She caught Tama’s steady gaze. ‘Maybe you should do this,’ she suggested. Or Josh could. Except that Josh was now responding to a signal from a fire officer. It looked as though one of the rescue workers had injured himself.

‘Have another go,’ Tama directed.

So she did and again it proved impossible.

‘The trachea’s swelling,’ she said in despair. ‘I can’t get this past the cords even with a guide wire.’

‘I’ll have a go.’

They swapped places. Tama handed her the bag-mask unit and she held the mask over the man’s face, squeezing the bag to try and get a high concentration of oxygen into the man’s lungs. She could feel it becoming more difficult as the airway closed further. Tama was pulling on gloves. As he picked up the laryngoscope, Mikki could hear the deterioration in the man’s breathing. A nasty stridor that suggested they might be about to lose this challenge.

Tama positioned himself and the patient’s head. He inserted the laryngoscope.

‘Give me some cricoid pressure,’ he instructed seconds later.

Mikki pressed on an Adam’s apple that was actually hard to locate in an already thick neck that had severe swelling going on as well. If things were this hard from the outside, what hope did Tama have of slipping a tube through the airway internally?

Very little, but he managed. Almost instantly, he slipped the tube into place and then straightened to secure it and attach the bag mask to the end of the tube. Mikki picked up the unit as Tama placed his stethoscope on the chest. She squeezed the bag as he listened for lung sounds and then placed the disc below the ribs to exclude air going into the epigastrium.

‘We’re in,’ he announced calmly. ‘Let’s get this guy on board and get moving.’

The packing up and preparation for take off were practised and smooth. Josh returned and again Mikki was left on the outskirts of the routine, simply watching.

No wonder. She had messed up, hadn’t she? Failed on the first real medical challenge that had been thrown her way.

She was a liability. Tama hadn’t wanted her on his crew in the first place and now he had good reason to resent her inclusion.

No wonder he was so focussed on his patient he didn’t spare her even a glance on the homeward journey. No surprise she wasn’t asked to assist in any medical capacity either. These guys had it sorted. Intensive monitoring, another IV line, fluids going in under pressure, a badly broken leg dressed and splinted.

She was just a passenger. An unwanted one. Present but not included, and it stirred memories Mikki had thought long buried.

They came in to land on the hospital helipad with their patient still stable and breathing well. The two paramedics were clearly satisfied with the way the job had gone. Tama seemed to have forgotten the debacle with intubation but Mikki couldn’t. She had to bite her lip and blink away a very unexpected prickle in her eyes that suggested the possibility of tears.

She was about to cry?

No way!

Mikki clenched her jaw tight as she climbed out of the helicopter to follow the stretcher. She wasn’t going to let it matter that Tama didn’t want her. That she had played into his hands by begging to go on a job and then demonstrating a very uncharacteristic lack of ability.

He’d give her another chance.

He had to.

CHAPTER FOUR

‘HAPPY?’

‘Yeah … sure,’ Tama replied.

Josh quirked an eyebrow. ‘You should be. You don’t have to carry on with the incredibly boring stocktake.’

This was true. If it remained quiet on station he could carry on with Mikki’s training. She needed to learn how to load and unload the stretchers. How to secure sliding doors and all the medical gear and what to check before telling the pilot that ‘all was secure in the rear’.

‘Do you know how many individual components we have in IV gear alone?’

‘No.’ And Tama didn’t know why he wasn’t as happy as he claimed to be either.

‘Fourteen,’ Josh said in disgust. ‘Five different gauges of cannula, wipes, luer plugs, giving sets, Tegaderm, tape …’

Tama pushed open the door of the men’s changing room, barely registering the list. Mikki wasn’t in the kitchen end of the messroom and it was well past time they had some lunch. Where was she?

‘Then there’s four sizes of syringes and six sizes of needles on top of that,’ Josh continued, ‘and I have to count every single one of them.’ He, too, looked around the room. ‘Where’s the mouse?’

‘Dunno.’

‘She was kind of quiet when we got to the hospital. If the job had been a bit much for her, I would have expected her to feel happy to be on familiar turf, even if it wasn’t an ED she’s worked in. She didn’t look happy, though, did she?’

‘No.’

‘Maybe she doesn’t like it as much as she thought she would. She looked pretty excited when we headed off.’

‘Yeah.’ That glow had been well and truly snuffed out, hadn’t it? And Tama knew why. Having been called to check that fire officer, Josh hadn’t seen Tama take over the intubation of that difficult patient. He had no idea how tense it had been. How lucky Tama had been to succeed on his first try and how it must have made Mikki feel like she’d messed up and shown herself to be less than competent.

The wind had been taken out of the royal sails all right. Tama had demonstrated his own prowess at her expense. He should be pleased with himself. Experiencing the kind of satisfaction that had once been a dream—to prove that someone like him was just as good, if not better, than someone like her. He should be happy, dammit!

‘Coffee?’

‘Sure.’ Maybe she was still in the tiny bathroom area kept for visitors that was now deemed the female locker room. That would be it. She probably needed to touch up her mascara or nail polish or something after working rough.

I don’t do manicures.

Josh turned from where he was fossicking in the fridge. ‘And how about I nuke the leftover chow mein we put in the freezer last week?’

Tama nodded. He wasn’t bothered about what they ate. He was more bothered by how clearly he could hear Mikki’s words echoing in his head. She wasn’t into nail polish. Her hair colour was natural and she liked the size of her breasts. So there!

Tama could feel a corner of his mouth pulling sideways. Spirit like that was something he could approve of. Like the way she had punished herself keeping up with him during those pre-requisite challenges. She had been so determined to make the grade, hadn’t she? To prove she was up to the job.

Had that spirit been snuffed out, along with the glow?

OK, the glow had been irritating but that was partly because he understood it. Not that he’d ever let it show on his face like that. At least, he hoped he hadn’t, but he knew what it was like to get a shot at something you wanted badly enough to get so excited about. And he also knew what it was like to want something that badly and have it all turn to custard. To blame yourself for whatever was going wrong. He hoped Mikki wasn’t into beating herself up too thoroughly. While it might be good to have tarnished the glow a little, crushing that spirit entirely would not only be unnecessary, it could lead to repercussions. What if the boss learned that the princess was unhappy? Who would be held accountable? Him, that’s who.

Josh was pushing buttons on the microwave and Tama should have been looking forward to the food, not standing here, worrying about the mental state of an extra crew member.

The faint growling sound he emitted did not come from his empty stomach.

Josh looked over his shoulder. ‘What’s up?’

‘Just need a bit a fresh air. Be back in a minute. Don’t eat it all.’

Patting his pocket as he strode through the hangar on his way outside was automatic. Remembering that he’d packed in smoking a long time ago didn’t help alleviate the odd tension. Neither did spotting Mikki.

She’d hung her overalls back on the peg and she was just standing there, her back towards Tama. She probably had no idea how the slump of her shoulders was advertising her state of mind as clearly as her expressions did.

Tama’s need for a bit of solitude went head to head with the knowledge that he could—and should—do something to debrief their new recruit. She hadn’t seen him, however. He could slip out the back door and find a quiet spot in the sun for a minute or two.

There would be plenty of time later for some reassurance and encouragement, but Tama had hesitated and then he was lost. With a sigh, he gave in to the pull that led him away from the back door.

‘What do you think you’re doing?’

Mikki jumped.

Oh, God! What had she done wrong now?

This day had started with such promise and excitement and now it was going from bad to worse, but she wasn’t about to let Tama know how crushed she was feeling. She really didn’t want to give him the satisfaction of having his doubts affirmed.

No. She knew that when the going got tough, that was when the tough had to get going. Mikki straightened her shoulders and lifted her chin before she turned to face Tama. She held his gaze and waited for whatever reprimand was coming. Ready to fight back, if necessary.

Her resolve to hold that eye contact wavered with the horrible thought that Tama could see way too much. There was something about those dark eyes that made her feel curiously defenceless. Whatever he saw, however, didn’t seem to displease him because his mouth pulled to one side in a half-smile that was distinctly disconcerting. People didn’t usually smile at you when they were about to tear you to shreds.

‘We tend to leave our overalls on for the rest of the shift after the first callout,’ he said. ‘You never know what’s coming next.’

‘We’. He’d said ‘we’ as though he considered her to be one of the crew. Mikki took a careful inward breath and dampened the flash of hope that tiny word had created. Was he patronising her in some way? Did he really expect her to believe he didn’t consider her an incompetent encumbrance after this morning’s efforts?

Employing the benefit of the doubt would have been the wise thing to do but insecurity was deeprooted. She did do her best to sound offhand, to try and pretend it didn’t matter. ‘I thought you might prefer to leave me behind next time.’

‘Why?’

‘Well …’ He knew, dammit. She could see it in his eyes. Did he expect her to describe her inability to perform a lifesaving procedure? Spell it out in excruciating detail? Mikki could feel heat creeping up from her neck and heading towards her cheeks. ‘I didn’t exactly—’

‘You did great,’ Tama interrupted, sounding as casual as Mikki had been striving for. As though it was no big deal. ‘It was a pretty full-on scene for your first callout.’

He was smiling with both sides of his mouth now and it connected to his eyes in a way that made them … warmer. It gave the impression he was being genuine but kindness seemed too much to expect. Inappropriate, somehow. Mikki could feel herself frowning as she tried to remember what had seemed so important a moment ago.

‘I’d like to have done a better job with that intubation.’

The big man actually shrugged. ‘We got there in the end.’

‘You got there.’

‘I got lucky.’ Unexpectedly, Tama’s eyes danced for a heartbeat. ‘Plus, I knew it was a pig of a job. I went down two sizes in the ET tube.’

Mikki shut her eyes for a moment, both as a distraction from that disconcerting twinkle and to berate herself. Why hadn’t she thought of that for her second attempt? With all the swelling and bleeding going on, it made perfect sense to downsize from what a patient of that build would normally need.

‘Nice job with that IV,’ Tama added. ‘We could have lost that guy if we hadn’t got fluids started soon enough. Tip someone into irreversible shock and it doesn’t matter what fancy techniques you throw in later. They’re still going to go into multi-organ failure and die.’

Mikki couldn’t help staring. He was being nice to her. But why? If she had done outstandingly well the first time they had worked together in the field she might have understood. He hadn’t been thrilled to have her on the team but if she had proved herself a valuable addition then at least acceptance, if not respect, might have been reasonable, but she hadn’t done outstandingly well. Anyone could put in an IV.

Tama was still talking about it. ‘Bit different for you, to say the least. You don’t have someone trapped in awkward positions in ED and a dozen impatient firemen breathing down your neck.’

Her mind was racing at a million miles an hour. Tama was being kind. Glossing over something he could have used to her disadvantage, even to the point of refusing to take her on missions for the foreseeable future. Instead, he was glossing over the failure and focussing on what she had achieved. It came across a bit like someone patting a child on the head and telling them they’d done well just because you could see they’d done their best.