Summer With Love: The Spanish Consultant
‘Very probably, but there isn’t much we can do about it except mop up the blood afterwards.’
Jago was prowling around Resus, checking that the right equipment was ready and everything was where he wanted it.
Moments later the doors crashed open and the paramedics hurried in with the stretcher.
‘This is Dan Walker. He’s a warehouse supervisor. He was caught under the ribs by a forklift truck. No obvious injury but he’s shocked and his pulse is thready. We’ve given him high-flow oxygen and we managed to get a line in at the scene …’
The paramedic outlined the care they’d given and Jago moved to the head of the trolley.
‘OK, let’s move him across, on my count—one two three.’
They lifted the man carefully and he groaned slightly, his skin pale and clammy.
Katy’s blood was pounding in her veins. This was her first real trauma case. What if she did something wrong?
But it soon became clear to her that she couldn’t possibly do anything wrong because Jago was directing the entire operation with an air of cool command which left no doubt in anyone’s mind who was in charge.
Having secured the man’s airway and satisfied himself that there was no damage to the cervical spine, he turned his attention to the work of the rest of the team.
‘Get another line in. I want vital signs recorded every five minutes and get his clothes off fast—I want every inch of him examined.’
Using sharp scissors, they cut off his clothes and Katy reached for the man’s wrist to insert another line. One of the nurses handed her a swab and venflon and she searched frantically for a vein.
‘Everything’s shutting down,’ she murmured, her fingers slipping on the man’s skin as she nervously tried to find a vein.
‘Let Harry try,’ Jago said sharply, and she gritted her teeth and felt around again for a vein.
‘Give me one more go—I think I felt something then.’
Please—please …
Something moved under her fingers. Was that it?
She slid the needle through the skin and breathed a sigh of relief as blood came back into the venflon.
‘I’ve done it. I’m in.’
‘Well done.’ Harry gave her an encouraging smile but Jago merely barked out more instructions.
‘Take blood for group and cross-match, full blood count, urea and electrolytes, and get a catheter in so that we can assess his fluid output. What’s his blood pressure doing?’
‘It’s falling.’ Annie checked the reading and recorded it on the chart.
‘Remember that there is a consistent fall in the systolic blood pressure only after 30 per cent of blood volume is lost,’ Jago said, his tone cool. ‘Get him attached to an ECG monitor and let’s give him a bolus of fluid. Start with a litre of warm colloid and then we’ll reassess.’
There were so many questions that Katy wanted to ask but she knew they were going to have to wait until the patient was stable.
She watched while Jago examined the patient’s abdomen, his hands moving skilfully as he looked for signs of tenderness.
‘There’s bruising and tenderness under the ribs,’ he murmured, and then glanced at Annie. ‘Phone down and see if they’ve confirmed the blood group yet. It’s been ten minutes so they should have. Once they have, get some blood up here,’ he ordered sharply, and Annie hurried to the phone just as another nurse popped her head round the door.
‘His wife is in the relatives’ room. Is there someone who can see her?’
Jago glanced at Charlotte. ‘Can one of your team go to her until we’ve stabilised him? Tell her we’ll be with her as soon as we have some news.’
Charlotte moved towards the door. ‘And if she wants to come and see him?’
Jago didn’t hesitate. ‘Then let her.’
Katy frowned and Jago raised an eyebrow in her direction. ‘Something wrong, Katy?’
At least he was calling her by her first name now, instead of referring to her as ‘Dr Westerling’. ‘I just thought it might be distressing for her to see him like this.’
‘It is distressing …’ Jago glanced across to check the ECG and the blood-pressure reading ‘… but studies have shown that on balance it’s probably better for the relatives to see the patient in Resus than not to see them.’
Annie looked up. ‘His blood pressure is falling, Jago.’
‘He needs blood and we need to call the surgeons and warn them that he’s likely to need a laparotomy.’
Jago looked impatiently towards the door and at that moment one of the nurses came hurrying in, carrying the blood bags.
‘At last.’ Jago reached out a hand and took one of the blood bags, attaching it quickly to the giving set. ‘Open the tap and let’s see if that helps.’
They worked to stabilise the man but the blood transfusion seemed to have no effect.
‘Still no improvement. OK, that tells us one of two things.’ Jago’s expression was grim. ‘Either the shock isn’t caused by bleeding, or he’s bleeding faster than we can infuse the blood—my money’s on the latter. He needs urgent surgical intervention. Has someone bleeped the surgeons?’
Charlotte nodded. ‘Mr Hart is on his way.’
‘Well, he’d better be quick.’ Jago turned his attention back to the patient, who was deteriorating by the minute.
‘His blood pressure is still falling.’ Annie looked at Jago expectantly and his mouth tightened.
‘Push that blood through faster.’
At that moment the door swung open and a tall, blond man strode into the room. ‘Jago?’
Jago gave a succinct report on the man’s condition and the surgeon examined him briefly.
‘You’re right. He’s bleeding. Let’s take him straight to Theatre.’
There was a flurry of activity and the man was transferred to the operating theatre for a laparotomy which would allow the surgeons to assess any internal damage.
Katy found herself alone in Resus with Charlotte. ‘Phew, what a mess!’ She glanced around the room, taking in the discarded blood bags, needles and other equipment.
‘What happens now?’
‘We clear it up ready for the next patient,’ Charlotte said immediately, thrusting needles into the sharps bin and scooping up soiled dressings. ‘Jago’s gone to talk to the relatives with Annie. Can I ask you something?’
‘Of course.’ Katy checked the intubation tray and ran another bag of saline through a giving set.
‘How do you two know each other?’
Katy’s eyes flew to hers and she thought about denying their past acquaintance, but Charlotte’s next words made her realise the futility of that approach.
‘When you were brought in here two weeks ago, he was the one who identified you.’
‘Oh.’ Katy concentrated on the equipment she was checking, wondering what Jago had felt when he’d seen her lying on the ambulance stretcher. Had he felt any guilt at all? ‘We knew each other years ago. He used to work for my father.’
‘In the bank?’ Charlotte’s eyes widened. ‘He’s filthy rich and we’ve all been dying to know how he made his money. I suppose that answers the question.’
‘I suppose so.’
Katy moved away, hoping that was the end of it. She hated gossiping about people.
Charlotte was still looking at her in fascination. ‘Did you know him well?’
Katy shook her head and avoided eye contact. ‘Not that well.’
She’d thought that there had been gentleness under the strength but she’d been wrong.
Charlotte gave a wistful sigh. ‘He’s the hospital heartthrob.’
Katy kept her eyes fixed on the intubation tray. Of course he was. Jago Rodriguez was seriously rich, stunningly good-looking and single. A prime target for every woman on the planet.
Except her.
She’d learned her lesson the hard way eleven years ago and she wasn’t that innocent, naïve girl anymore.
Charlotte sighed. ‘Every available woman in the hospital dreams of being the one to tame him and marry him.’
Katy looked up at that, unable to hide her incredulous expression. ‘Marry him?’ Well that showed how well they knew Jago. I don’t do commitment, Katy. ‘If you know him then you’ll know he isn’t the marrying kind.’
Charlotte shrugged. ‘Everyone’s the marrying kind if they meet the right person.’
‘I don’t think so.’ Katy’s voice was soft and thoughtful. ‘I think some people just can’t allow themselves to be that vulnerable.’
And Jago didn’t have a vulnerable part to his make-up.
At one point she’d thought he had. He’d fooled her with a display of gentleness that had turned her insides to jelly but she knew now that that was just part of his superior bedroom technique.
‘You’ve obviously thought about it a lot.’ Charlotte hung the giving set over the stand and looked at her quizzically. ‘But you’re getting married so you must believe in love and commitment.’
Did she?
Katy turned her attention back to the intubation tray, not wanting to shatter Charlotte’s romantic illusions.
She certainly wasn’t in love with Freddie.
And she didn’t feel guilty about it because she knew that Freddie wasn’t in love with her either. He was marrying her because she was the right sort of girl with the right sort of connections and that suited her fine. She didn’t want love.
Her one experience of love had been a shattering, all-consuming experience that had threatened her very existence.
I don’t do commitment, Katy.
‘Not that we hospital staff really get a look in,’ Charlotte said gloomily, tearing off her plastic apron and lobbing it in the bin. ‘He’s dating a stunning Brazilian model at the moment. The real woman type. Legs up to her armpits and boobs to make a man drool. She’s a very lucky woman.’
Katy clenched her fists and told herself firmly that she didn’t care who Jago was dating. It was none of her business.
And she wanted to end the conversation.
‘I’d better get back to the main area and see some more patients,’ she said quickly, anxious to get away from Charlotte. She was nice but she didn’t need to talk about Jago. Working with him and seeing him every day was bad enough without talking about him as well.
CHAPTER FOUR
KATY’S first week passed quickly and every time she looked up Jago seemed to be there, challenging her, asking questions, his handsome face inscrutable.
Determined not to make a mistake, she examined every patient meticulously, made sure that her questions were detailed, never took anything at face value. And in her opinion she’d performed well. But Jago hadn’t uttered a single word of praise and she was starting to feel the strain.
Was he going to keep this up indefinitely?
Did he really think that she wasn’t up to the pressures of A and E or did he have another reason for not wanting her in his department.
A more personal reason perhaps?
On her first Saturday night working on A and E a fight broke out in the street behind the hospital. They heard the sound of police sirens and a few minutes later a group of drunks staggered through the door that led to the ambulance bay, half-supporting a man who seemed barely conscious.
‘Hey, you!’ One of the drunks waved a hand at Charlotte who frowned with distaste.
‘You can’t come in through that entrance,’ she said tightly. ‘It’s reserved for emergency vehicles. You need to—’
‘Don’t tell me what I can and can’t do,’ the man slurred, his eyes flashing angrily at Charlotte as he struggled to remain upright and focus. ‘Get me a bloody doctor. Now!’
Charlotte stiffened and turned to Jago expectantly.
‘This is one for Katy,’ he delivered softly, his dark eyes connecting with Katy’s in unmistakable challenge.
There was no missing the message in his gaze. This was one of the situations he was convinced she’d never be able to deal with, and he was testing her.
She almost laughed. She’d probably had more experience with drunk, violent men than he had.
Ignoring Charlotte’s shocked murmur of protest, Katy stepped forward, her manner calm and professional.
‘That looks like a nasty cut.’
She addressed her remarks directly to the injured man, who barely acknowledged her presence.
His head rolled onto his chest and his expression was glazed.
Was he drunk or was he suffering the consequences of a head injury?
She’d read enough to be aware of the potential pitfalls of dismissing someone as drunk. There were plenty of horror stories about people who’d been discharged from Casualty only to die the next day as a result of a head injury that no one had taken seriously. Drink could mask a number of symptoms and she had no intention of missing anything.
She turned to his friend, who was clearly having trouble staying upright. ‘What’s his name?’
‘James.’
‘And what happened?’
The man swayed slightly. ‘He fell over and banged his head.’
He was slurring his words so badly that it was difficult to understand him, but Katy knew how important it was to obtain some sort of history. ‘And did he knock himself out?’
The man shrugged, his eyes glazed. ‘Dunno.’
Great. Some history.
‘All right.’ Katy’s tone was brisk. ‘Well, I need to take a look at his head. Why don’t you sit him over there and then go and give his details to Reception?’
The man didn’t answer, his body swaying as he watched her. ‘I asked for a doctor. You’re never a doctor.’
Katy gave a calm smile. The same smile she’d used on her father time and time again.
Don’t antagonise him, Katy.
‘I’m a doctor.’ She spoke quietly, knowing better than to joke or argue with him or enter into any conversation that wasn’t necessary. She could see that the man was very drunk and suspected that he was only too keen to pick a fight. ‘Now, if you’ll just sit him over here, I can take a look at his head.’
Without giving the man time to argue, she took charge and helped the injured man onto the couch in the first cubicle, half-drawing the curtain around him.
She looked at Charlotte. ‘Would you mind showing his friend the way to Reception so that he can give some details, please?’
Charlotte nodded, her eyes wide with admiration. ‘Of course.’
Jago said nothing. He just leaned broad shoulders against the wall, his eyes narrowed as he watched Katy.
Trying to hide how much his presence affected her, Katy reached for an ophthalmoscope to examine the patient’s eyes, but as she put a hand on the man’s head, he gave a groan and lurched towards her. She sidestepped neatly and he vomited over the floor.
Katy reached for a bowl and held it for the man while he retched and mumbled incoherently.
Charlotte, back from Reception, rolled her eyes in disgust. ‘It’s on your shoes,’ she muttered, and Katy shook her head dismissively.
‘I’ll sort that out later.’ She didn’t care about her shoes but she was seriously worried about her patient. Were the symptoms he was displaying the result of alcohol or the bang on the head he’d received? It was such a difficult decision.
If she admitted a patient who was perfectly healthy, she’d be wasting precious hospital resources. On the other hand, if she discharged him and his symptoms were the result of a serious head injury, she would have failed in her duty as a doctor.
Medicine had never seemed so complicated.
She knew that she could ask Jago for advice but she didn’t want to. He might take it as a sign of weakness on her part and she was determined to prove to him that she was more than capable of doing the job without constant supervision.
‘Can you hear me? Can you tell me your name?’
She spoke clearly and the man groaned and mumbled something unintelligible.
‘Do you know what day it is?’
She continued to question the man but was far from satisfied by the results.
Jago stepped closer to her. ‘He could just be very drunk,’ he said coolly, and she knew he was testing her again.
‘Or his symptoms could be the result of his head injury.’ She tried to ignore the explosion of heat that consumed her body as he moved closer still. Breathing in his warm, familiar, male scent, she felt her head swim.
‘So which is it, Dr Westerling?’
She made the mistake of looking at him and his eyes locked onto hers with the power and force of a missile attack.
The mood was suddenly electric and Katy found herself mesmerised by the look of raw, sexual intimacy in his eyes.
Suddenly her breathing was suspended and she struggled to find her voice.
‘I—I need to finish my examination before I can answer that question.’
He dealt her a slanting smile. The same smile that she’d found totally irresistible at the age of eighteen. ‘Then finish it, Doctor.’
Cursing her own weakness and the effect he had on her, Katy turned her attention back to the patient.
She asked more questions, checked the patient’s reflexes and only after completing an exhaustive examination did she make her decision.
‘I’m sending him for a CT scan and then I’m admitting him,’ she said firmly, and Jago lifted an eyebrow.
‘And why is that?’
‘He’s showing symptoms of a serious head injury. Headache, vomiting, disorientation. I’m not prepared to discharge him.’
Confident in her decision, Katy looked straight at him, her heart lifting as she saw the glimmer of respect in his dark eyes.
Finally.
After a week of concentrated hard work.
‘Good decision,’ he said smoothly. ‘Make the arrangements and then come to my office and we can talk about it further.’
Light-headed with relief that she’d done the right thing, Katy suddenly wanted to smile. He’d praised her. He thought she’d done a good job.
But there was no way she was going to his office.
The effect he had on her was just too powerful and if she couldn’t control her reactions she needed to avoid him.
She lifted her chin, her confidence increasing by the moment. She’d done a good job. ‘Can we talk about it tomorrow, please? I was supposed to be off duty an hour ago and I’m going out so I need to go and clean the vomit off my shoes and—’ her eyes challenged his and a small smile touched her mouth ‘—file my nails.’
And remind herself that dreaming of Jago was a fast route to a miserable life.
Jago looked taken aback. Then to her surprise he threw back his dark head and laughed. ‘Tomorrow will be fine.’ He turned to Charlotte, who was gaping at the scene being played out before her. ‘I’m out of here. If you need me, call my mobile.’
Charlotte watched him stride away and looked at her with awe. ‘Would someone mind telling me what’s going on here? You answered him back and he just laughed,’ she muttered, reaching for the notes so that she could make the arrangements for the CT scan. ‘And I can’t believe he let you deal with those drunks. I’ve never known him to act like that before. Normally he’s very protective of the female staff, to the point of chauvinism. I mean, we all ought to deal with the same patients but the truth is when you’re built like Jago you stand more chance with a violent drunk than someone who is built like you. I don’t know what he was playing at.’
Katy gave a weak smile. She knew exactly what he’d been playing at. He’d been waiting for her to fail.
He’d wanted her to fail since the day she’d started.
What she didn’t understand was why.
A pleasant warmth spread through her veins. His reasons didn’t really matter. She hadn’t failed. She’d managed fine, she knew she had. She’d made all the right clinical decisions and she hadn’t needed his help.
She straightened her slim shoulders and gave a small smile, suddenly feeling more confident.
He’d tested her and she’d passed with flying colours.
So now what would happen?
Jago closed the door of his office and ran long fingers through his cropped hair.
What the hell was the matter with him?
He’d sent a woman to deal with a bunch of drunks.
And not just any woman, he’d sent Katy. Katy, who was about as robust as a spring flower.
What had he been thinking of?
But he knew the answer to that, of course.
He’d been trying to prove that she couldn’t cope with the rigours of practising medicine in the A and E department. He’d been trying to scare her away.
Because he didn’t want her here, on his territory, looking at him with those wide violet-blue eyes.
Just thinking of her exceptionally beautiful, heart-shaped face made him harden in an instinctive and powerful male reaction, and he gave an exclamation of disgust.
Hadn’t he learned anything? Was he really that basic that he could forget everything just to satisfy the most primitive of male urges?
What was it about Katy Westerling? True, she was astonishingly beautiful but he met beautiful women all the time and they didn’t make him abandon his usual caution towards members of the opposite sex.
He had to keep reminding himself that she wasn’t what she seemed.
That the innocent aura that aroused a man’s most fiercely protective instincts was actually just an act.
His hands tightened into fists and his hard jaw clenched as he remembered the photographs her father had shown him.
She might have been a virgin when he’d first slept with her, but less than four weeks later she’d slept with another man.
I love you, Jago.
Remembering the incredibly intimate pictures he’d seen, he growled low in his throat and strolled across to the window of his office which looked out on the ambulance bay.
It was eleven years ago, he reminded himself. And eleven years was a long time. Enough to change a person, and Katy had obviously changed.
The old Katy had been deliciously shy and tongue-tied but the Katy he’d seen in action today was very different from the girl he’d made love to so long ago. Far from buckling under the challenge he’d set her, she’d coped well.
In fact, she’d handled those drunks with an admirable level of skill and tact. There had been every sign that they could have become violent at any minute but she’d reacted with textbook efficiency and had successfully defused any suggestion of aggression on the part of the patient and his friends.
She’d behaved as though she’d been operating totally within her comfort zone, which didn’t make a scrap of sense. When would Katy Westerling, with her over-privileged, protected upbringing, ever have been exposed to drunk, violent men?
His dark brows locked in a frown as he puzzled over her complete lack of concern. She hadn’t even seemed to notice the danger. But some deep-seated instinct told him that she had been all too aware and had known exactly how to cope with it. She’d stood up to them and she’d stood up to him.
He allowed himself a brief smile of admiration as he remembered her gutsy response to his command that she meet him in his office.
She’d remembered his caustic remark about her filing her nails and she’d thrown it back at him.
No, Katy had definitely changed. She’d dropped the innocent act—and they both knew that it had been nothing more than an act—and she was showing a level of courage that frankly surprised him. There were still hints of the feminine fragility that she’d shown at eighteen, but he sensed a strength and determination that hadn’t been there before.
Suddenly he was intrigued.
And he was also impressed. He’d seen numerous colleagues make the mistake of dismissing a patient who was drunk. She hadn’t made that mistake. Even when the patient had vomited on what he assumed to be a frighteningly expensive pair of shoes, she hadn’t allowed it to cloud her decision-making.
She was a good doctor.
And he had to face the fact that the reason he was being so hard on her had absolutely nothing to do with her clinical abilities and everything to do with his own emotions.