‘As Jen will have explained, I need you to anaesthetise Sam Dennison.’
Long, lean fingers on his right hand crossed his wide and casually clad chest, flicking at the sleeve band of his white T-shirt. ‘This is my department and I need to examine my patient before any decisions are made.’ He turned and walked towards the cubicle.
Poppy matched his stride. ‘And as Bundallagong’s resident surgeon for the next ninety days or less, it’s my considered opinion that—’
‘You’ve had time to examine Sam and now you need to extend that courtesy to me.’
He didn’t alter his pace and before she could reply, Matt Albright stepped through the curtains and closed them in her face.
CHAPTER TWO
MATT could hear the new surgeon pacing, her black heels clicking an impatient rhythm against the linoleum floor. Well, she could just wait. He wasn’t a stickler for protocol but Jen had overstepped the mark by not calling him in to examine Sam first. God, he was sick of the town walking on eggshells around him and trying to protect him when all he wanted was normality. Yeah, and what exactly is that these days?
‘You OK, Doc?’ The young miner lay propped up against a bank of pillows, his eyes slightly glazed from the opiate pain relief.
Hell, if a spaced-out patient noticed he was shaking with frustration then things were really spinning out.
Matt, how can you always be so calm? Lisa’s slightly accusing voice sounded faintly in his head. But that conversation had taken place in another lifetime, before everything he’d held dear had been brutally stolen from him. He hadn’t known calm in over a year.
‘I’m fine.’ Pull the other one. ‘But you’re not. That appendix rumbling again?’
‘Yeah, although whatever that other doctor gave me is good stuff.’ Sam grinned happily.
Matt smiled as he examined him. ‘Have you got any family up here?’
Sam shook his head. ‘Nah, came for the job and the money.’
‘I’ll arrange for a phone so you can talk to your mum because there’s a very high chance you’ll be parting with your appendix. We’ll fast you from midnight and observe you overnight.’
‘OK.’
‘Any questions?’
‘Nah, you explained it all last time and then it got better.’ Sam’s eyes fluttered closed as the drugs really kicked in, tempering any concern over the surgery that he might have.
Matt decided he’d explain it all again to him later. He pulled the curtains open and the new surgeon immediately ceased pacing, but she held her wide shoulders square and tight. It struck him that there was nothing soft about this woman except for her name.
And her mouth.
Guilt kicked him hard. His initial top-to-toe glance of her had stalled unexpectedly on her mouth and a flash of lust-filled heat had sparked momentarily, shocking him deeply. There’d only ever been one woman for him, and until ten minutes ago no one else had ever registered on his radar, let alone elicited such a response. But there’d been something about Poppy Stanfield’s plump mouth that had held him mesmerised. Lips that peaked in an inviting bow were the colour of crushed strawberries and hinted at tasting like an explosion of seductive sweetness. He’d almost licked his own in response.
It was a totally ridiculous and over-the-top reaction given the contrast between the softness of the lips and the precise and no-nonsense words they formed. Everything else about Poppy Stanfield was sharp angles and harsh lines. Her long black hair was pulled straight back exposing a high and intelligent forehead. Black hair, black brows, black suit, black shoes; the monotone was only broken by her lush mouth and the most unexpectedly vivid blue eyes.
Eyes that were fixed on him, full of questions and backlit with steely determination.
He deliberately sat on the desk and put a foot up on a chair, the position screaming casual in stark contrast to her starchy demeanour. For some crazy reason he had to concentrate really hard to get her name correct because, apart from being the colour of her lips, Poppy didn’t suit her at all.
Her fingers tugged sharply at the bottom of her suit jacket, which was ludicrously formal attire for Bundallagong, and she seemed to rise slightly on her toes so she wasn’t much shorter than him. ‘Dr Albright.’
‘You’re in the bush now, Poppy.’
Her gaze drifted to the red dust on his boots before moving up to his face. ‘Oh, I’m very well aware of that.’
Her tone oozed urban superiority and for the first time in months something other than anger and despair penetrated his permanent sadness—the buzz of impending verbal sparring. No one had faced up to him or even questioned him since Lisa. Hell, half the time his friends and colleagues had trouble meeting his gaze and, like Jen, their well-meaning attempts to help only stifled him. But he had a citified stranger in front of him who knew nothing about him and he realised with unexpected relish that he was looking forward to this upcoming tussle.
He met Poppy’s baby-blue eyes with a deadpan ex-pression. ‘Excellent. Oh, and by the way, we use first names here even when we’re ticked off.’
Her eyes flashed but her mouth pursed as if she was working hard not to smile. It was the first sign that a sense of humour might lurk under all the superficial blackness.
‘Thank you for that tip, Matt. So you agree with my diagnosis that Sam has appendicitis?’
‘I do.’ He tilted his head ever so slightly in acquiescence. He didn’t have any problem with her diagnosis, just her modus operandi. ‘The pain he was presented with last month has intensified.’
Poppy schooled her face not to show the sweet victory that spun inside her. ‘So we’re in agreement. He’s been fasting due to his nausea so Jen can prep him for Theatre and—’
‘I said I agreed with your diagnosis.’ He raised one brow. ‘That doesn’t translate into agreeing with your treatment plan.’
The coolness of his tone didn’t come close to soothing the hot and prickly frustration that bristled inside her, and she silently cursed William for sending her to the middle of nowhere where men ruled and women had no choice but to follow. ‘So you’re going to sit on it until his appendix bursts and we’re faced with dealing with peritonitis?’
Emotionless molasses-coloured eyes bored into her. ‘Not at all. He requires surgery and he’ll have it—tomorrow.’
So this is a power play: my turf versus your turf. ‘But he could deteriorate overnight and we’d have to come in anyway. Tomorrow is an unknown quantity, whereas right now it’s quiet, we’re both here, so why wait?’
‘Technically you don’t even start work until 8:00 a.m. tomorrow.’ ‘That’s semantics.’
He lowered his gaze and stared at her bright red suitcase stowed by the desk and then he moved the stare to her. ‘Is it? It’s Sunday and I would have thought seeing as you’ve only just arrived, you’d want to get settled in the house, hit the supermarket and fill your fridge.’
Something about his unflinching gaze made her feel like he saw not just the persona she showed the world but way beyond it and down deep into the depths she hadn’t allowed anyone to enter since Steven.
But he really didn’t want to—
I am so not doing this now!
She shut the voice up, hating that her hand had crept to the pendant that sat just below her throat. She forced her arm back by her side and her voice came out stiff and authoritative. ‘You don’t have to concern yourself with my domestic arrangements.’
‘Very true.’ He radiated a controlled aura that was an odd mix of dark and light, although the dark dominated. ‘But I do concern myself with my staff’s. They have lives outside work, Poppy.’ His expression intimated that he thought perhaps she didn’t. ‘This is not an emergency and therefore we are not interrupting their family time, their fishing and sailing time, and, for some, their afternoon naps.’
‘Afternoon naps?’ Her voice rose in disbelief as her brain tried unsuccessfully to wrap itself around such a foreign concept. ‘You’re joking.’
Matt gave a snort that sounded like a rusty laugh as his face creased stiffly into lines that bracketed his mouth and for a moment his lips broke their tight line. A streak of something close to warmth followed, giving life and character to his face, which up until this point had been almost a caricature of unmarred features.
Her gut lurched as a flicker of delicious shimmers moved through her and she wished he’d stop. Perfection she could resist. Deep life lines around those dark and empty eyes, not so much.
His expression neutralised as the shadows returned. ‘Life is slower here and, as you’ll discover, the humidity at this time of year really saps your energy.’
She thought of the chief of surgery job back in Perth and went back into battle. She knew this game and she didn’t plan to give an inch. ‘Nothing saps my energy. I’m here to work, not to relax.’ She reached for her briefcase and pulled out a folder. ‘In regard to staff, I have a surgical budget and my own staffing ratios, and it’s my call when to operate, not yours.’
‘It is, and come tomorrow, your first official day, when David, the anaesthetic registrar, is back on duty, you can order him about to your heart’s content. Today, as the ED doctor and the back-up anaesthetist, it’s my call. We’re not operating on Sam just so you can rush in, set a precedent and get some runs on the board.’
‘This has nothing to do with me and everything to do with patient care.’ She protested too quickly as his words hit far too close to home. Sam’s case technically wasn’t an emergency but it wasn’t strictly elective surgery either. She hated that he’d guessed at her need to operate so she could stake her claim as the incumbent surgeon, competent and in charge.
He slid to his feet, the movement as graceful as a gazelle’s but with the calculation of a panther. Everything about him screamed, I don’t believe you.
‘Should Sam’s condition change, I’ll call you straight away. Meanwhile, go stock your fridge and turn on the air-conditioning so you can sleep tonight.’
Her body vibrated with rage. ‘Don’t patronise me.’
Genuine surprise raced across his face and he gave a sigh filled with fatigue. ‘I’m not. I’m actually trying to help. Your life here will be a lot easier if you don’t get the staff off-side before you’ve officially started.’
She wanted to stay furious with him, she wanted to cast him in the role of obstructive male, but his gaze wasn’t combative and amid the darkness that hovered around him, she detected a sliver of goodwill. It totally confused her.
‘I see. Well, we may not agree about Sam but I take on board what you’re saying.’ She made herself say, ‘Thank you.’
‘No problem.’ His fingers pushed through his straight hair, the strands sliding over them like water on rocks.
With a shock she caught the glint of gold on his ring finger. How had she missed that? But it didn’t matter how or why—what was important was now she knew. Married men didn’t interest her.
It’s been a long time since an unmarried one interested you.
Get off my case!
She had a gut feeling that she and Matt Albright would probably spend the next ninety days disagreeing but now it would be without fear of those strange and unwanted shimmers. Working with Matt would be uncomplicated and all about the job, and that was what she did best.
She pulled out a business card and held it towards him.
‘This is my mobile number should Sam deteriorate, and meanwhile I’ll let you get back to your Sunday afternoon and your family.’
The goodwill vanished from his eyes as his lean body ceased all movement, and an eerie stillness hovered around him.
So much for her attempt at being polite. She couldn’t work him out.
The card hung between them for a moment and then he slowly raised his arm and plucked it from her fingers. ‘Right. See you around.’
‘I guess you will.’ What else was there to say?
‘Wait!’ Jen hurried over as two bloodied men supported and half dragged another man into the de partment.
‘What happened?’ Matt hauled his way back from the black despair Poppy’s innocent comment had plunged him into, hating that it had, and was glad to be able to focus on the patient.
‘Patient involved in a brawl, suspected head injury and possible fractures.’
He grabbed a gown and stifled a groan. In years gone by, drunken brawls had been exclusively Saturday night’s domain but the mining boom had brought more people into the town and some of them had more money than sense. This patient could have anything from a broken toe to a subdural haematoma, with a million possibilities in between.
He threw Poppy a gown. ‘I think you just got a reprieve from filling your fridge but just so we’re clear, this is my emergency and you’re assisting.’
‘Oh, absolutely.’ But deep sapphire blue shards scudded across her enormous baby-blue eyes, making a mockery of her supposed compliance. ‘It’s your emergency right up to the point when you realise he needs surgery and you’re totally out of your depth.’
No one had been that blunt with him in a long time. A noise rumbled up from deep down inside him and for a moment he didn’t recognise the sound. With a shock of surprise he realised that for the first time in months he’d just laughed.
Matt moved into action, work being one of the few things in his life he didn’t question. He called out to the two men, ‘Help me get him onto this trolley.’
They half hauled and half dropped the injured man onto the mattress and as soon as the sides had been pulled up, Matt asked, ‘Do either of you have any injuries or is that your mate’s blood?’
‘We’re OK.’
Matt wasn’t convinced. ‘Sit over there and wait. As soon as we’ve checked out your mate, someone will examine you both. No one is to leave until you’ve been examined, do you understand?’
Both men looked sheepish. ‘Yeah, Doc.’
He pushed the trolley into the resus room. ‘What’s his pulse ox?’
Poppy slid the peg-like device onto the end of the patient’s finger. ‘Eight-five.’ She unravelled green plastic tubing and turned on the oxygen. ‘Mr …?’
‘Daryl Jameson.’ Jen supplied the information.
‘Mr Jameson. I’m Poppy Stanfield, this is Jen Smithers, and on your left is Dr Matt Albright. You’re in good hands. We’re just going to give you some oxygen and help you to sit up.’
Matt tried not to show his surprise that Poppy had failed to mention her qualifications and that unlike many surgeons she was actually quite personable with an awake patient. ‘Daryl, how’s the breathing, mate?’
‘Hurts.’
‘Where does it hurt?’ Poppy adjusted the elastic to hold the nasal prongs in place.
‘It’s me chest and arm that’s killing me.’
‘Do you know what day it is?’ Matt flicked on his penlight.
‘Sunday. I remember everything up to the moment the idiot hit me.’
Matt flashed the light into his patient’s eyes. ‘Pupils equal and reacting.’
Jen tried to ease Daryl’s shirt off but resorted to scissors when Daryl couldn’t move his arm without flinching. The soft material separated, revealing purple bruising all over the thin man’s chest. The nurse gasped.
Matt looked up from the IV he was inserting, hating that he knew exactly what would have caused such trauma. ‘Steel-capped boots. Welcome to the seedier side of Bundallagong, Poppy.’
She attached electrodes to Daryl’s chest, and at the same time Matt knew she was examining the rise and fall of his chest given the complaint about pain on breathing. ‘Sinus tachycardia. Jen, organise for a chest and arm X-ray.’
‘On it.’ The nurse started to manoeuvre the portable X-ray machine into position.
While Poppy wrapped a blood-pressure cuff around their patient’s uninjured arm to enable automatic readings, Matt swung his stethoscope into his ears and listened to Daryl’s breathing. He could hear creps and he palpated a paradoxical movement of the chest wall. ‘Flail chest. I’ll insert prophylactic chest tubes.’
A frown furrowed her smooth, white brow. ‘Good idea but it’s the damage under the fractured ribs that worries me.’
Matt nodded. ‘We’re in agreement, then.’
‘There’s a first time for everything.’
The words sounded precise and clipped, but her plump, berry-red lips twitched. Like the siren’s call, he felt his gaze tugged towards them again and wondered what they’d feel like to kiss.
The blood-pressure machine beeped loudly, ripping into his traitorous thoughts and grounding him instantly. He pulled his shame-ridden gaze away, reminding himself that he loved Lisa and he had a patient who needed his total concentration. ‘Pressure’s dropping.’
‘He’s bleeding somewhere.’ Poppy’s hands went direct to Daryl’s abdomen, her alabaster fingers, with their neatly trimmed nails devoid of polish, palpating expertly. ‘Any pain here?’
Daryl barely managed a negative movement of his head.
‘No guarding. It’s not his abdomen.’ Poppy’s frown deepened, making a sharp V between her expressive black brows. ‘His O2 sats aren’t improving. What about a haemothorax?’
‘If he does have that, it’s not massive because there’s no mediastinal shift or tracheal deviation.’
But the blood-pressure machine kept beeping out its worrying sound as Daryl’s heart rate soared and his conscious state started to fade. Matt stared at the green lines racing across the screen. PQRST waves scrawled the heartbeat but he thought he saw something unusual. He hit the printout button and studied the paper strips, detecting a change in the ST segment. Combining it with Poppy’s musings, he had a sudden idea. ‘Check his jugular vein.’
Matt shoved his stethoscope back in his ears and listened carefully to Daryl’s heart beat. Instead of a loud and clear lub-dub, the sound was muffled.
‘Cardiac tamponade.’
They spoke in unison, their thoughts and words meshing together for the very first time. ‘He’s bleeding into the pericardial sac.’
Poppy ran the ultrasound doppler over his chest, locating the heart. ‘There you go.’ She pointed to the dark shadow around the heart that squeezed the vital muscle.
Matt snapped on gloves and primed a syringe, knowing exactly what he had to do. Under ultrasound guidance, he withdrew the fluid from around the heart. ‘Hopefully that will stabilise him until you work your magic.’
Her teeth scraped quickly over her bottom lip; the slightest of hesitations. ‘A pericardial sac repair without the back-up of bypass isn’t quite what I’d expected.’
He understood her concerns and he had some of his own. ‘The anaesthetic will stretch me too.’
‘It’s going to be touch and go.’
‘I know.’ He met her direct and steady gaze, one devoid of any grandstanding or combative qualities, and wondered not for the first time about the many facets of Ms Poppy Stanfield.
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