Desert Doctor, Secret Sheikh
Jen, meanwhile, was wondering where to begin.
‘Pain relief before we start to examine him, I think.’ Her colleague answered her unspoken question, kneeling on the other side of the man but looking across him at Jen. ‘What do you have?’
Jen did a quick mental scan of her precious drugs.
‘I’ve a small supply of pethidine but we should run it through fluid in an IV for it to work faster.’
Fluid—she had so little in the way of fluid replacement, a couple of bags of isotonic saline solution and a couple of bags of five percent dextrose in water, which was also isotonic. The man had bled a lot and both would help restore plasma levels and though she hated using up what few supplies she had, she knew she would.
Was she frowning that her colleague, who’d been taking stock of the patient’s injuries, now turned his attention to her?
‘You do have some fluid?’ he asked, and she nodded and stood up, asking one her assistants, Aisha, to bring a basin of water and cloths to bathe the man, before heading for the little partitioned-off section of the tent that was her bedroom and digging into the sand in one corner where she’d buried this treasure.
‘You bury it?’
She turned to see Kam standing near the rug she’d hung to provide a little privacy to this area, and now he was frowning, although she was the one disturbed to have him in her space.
‘To keep it safe from thieves.’
He shook his head and walked away.
Tubing, cannulas and catheters were buried in another part of the area she looked on as her room, and she dug them up and dusted sand off the plastic bags in which she’d buried them.
‘I don’t have much IV fluid replacement,’ she said, when she joined him by the patient. She was angry with herself for sounding apologetic, but he merely shook his head, though he frowned again as he saw the sand dropping from the bundle she was unwrapping.
If frowns were any indication, he was one angry man…
‘And what you have you must hide? Isn’t that overdoing things? Do you feel you can’t trust these people? How can you help them if distrust is in the air all the time?’
Anger sharpened the demands.
‘I don’t hide things from the people in the camp,’ Jen told him, defending the refugees, although she knew some of them might steal from need. ‘But raiders come from time to time. Even if they don’t need medicines themselves, they can sell them. It’s one of the reasons drug-resistant TB has spread so widely. People steal the medicine, sell it to unsuspecting locals in the souk, and never tell the buyers they need to take far more than one box of tablets in order to be cured.’
She knelt beside the patient, opening the small trunk that held their most used medical needs, like antiseptic and swabs and small sutures. She found what she needed and first bathed the man’s left hand then swabbed it, before bringing up a vein and inserting a cannula into it.
Marij, Jen’s other assistant, had passed a blood-pressure cuff and small monitor to Kam, who was now checking the man’s BP and pulse, while Marij and Aisha were cutting off the tattered remnants of the man’s robe, leaving pieces that were stuck to open wounds, which would be removed later.
Jen set up a drip, pulling a wooden box that had once contained TB drugs close to the man so she could sit the bag of fluid on it, then she broke open the ampoule of pethidine, drew the contents into a syringe and injected it into the fluid, adjusting the flow so their patient would receive it slowly over a prolonged period of time.
But as more and more of the man’s clothing was cut away and Jen saw the depth of some of the wounds, she began to wonder if they would be able to help him.
‘How could anyone do this to someone else?’ she whispered, awed by the ferocity of the attack.
‘They must have taken him for a thief or, worse, a spy,’ Kam said, his voice grim.
‘But—’
Once glance at his stern, set face stopped further protest and she reminded herself she was there to help, not to judge. She concentrated on their patient.
‘I suppose we can only do what we can,’ she said, thinking how little that might be—what if there were internal wounds they wouldn’t know about until too late? Although now she had someone with whom she could work, maybe they could save this patient.
The visitor nodded.
‘I know you’re a TB clinic but would you have surgical instruments? I think if we can debride some of the damaged skin, there’ll be less likelihood of infection.’
Jen thought of the odds and ends of instruments she’d acquired over the last three years, now packed in among her underwear in the battered suitcase in her makeshift bedroom.
‘I’ll get what I have,’ she said, but as she rose to her feet she wondered why Kam Rahman didn’t have all this equipment himself. If he was from Aid for All and coming here to run a medical clinic in conjunction with the TB clinic, surely he’d have brought supplies and equipment with him.
She glanced his way but the badge he’d shown her was now tucked inside the T-shirt. Later she’d take a closer look at the logo on his vehicle—better by far than thinking about digging under the T-shirt for his ID…
CHAPTER TWO
WHY was she suspicious of him? Because he was far too good-looking to be an aid worker? Did she have preconceived ideas that they all had to be long-haired and wear sandals and not speak like an English prince? As she considered these questions, she stacked all the instruments, sterilised by boiling and now wrapped in paper, on a battered metal tray and carried it out to put it beside the stranger, then suggested Marij empty the bowls of water and bring fresh.
‘That’s some collection,’ Kam said, as Jen unwrapped her treasured instruments and set them on the tray where they could both reach them.
‘Three years of humble begging,’ she joked, but from the way his lips tightened he didn’t think it was at all funny.
Which it probably wasn’t but, then, there wasn’t much to laugh about here, so the man had better loosen up and get used to feeble humour or he’d frown his way into a deep depression.
‘Sutures?’ he asked.
They were in the chest with the dressings—and fortunately she had plenty of them, mainly because they were the first things people pressed on her back at home when she visited hospitals or surgeries, asking for donations.
‘Now, how are we going to work this? Do you want to cut and swab and I’ll stitch or would you prefer to stitch?’
Jen stared in horror at the damage that had been done, not only to the man’s back but to his chest as well. In places the lash, or whatever had been used, had bitten so deeply into his flesh she could see the grey-white bone beneath it.
‘I’ll cut and clean,’ she said, and heard something of the horror she was feeling in the tightly squeezed-out words.
‘He’ll be all right,’ her colleague said, his voice gentle as if he knew she was upset. ‘It looks far, far worse than it really is. And with me to stitch him up, there’ll barely be a scar.’
‘Surgeon, are you?’ Jen teased, though it was unlikely a specialist would be deployed to somewhere like this camp.
‘And why not?’ he parried, leaving Jen to wonder…
He spoke again, but this time to the patient, the slightly guttural words of the local language rolling off his tongue. The man opened bleary eyes then closed them again, and Kam nodded as if satisfied the drug was working.
‘Let’s go,’ he said, and Jen started at the neck and began to cut away the cloth that was embedded in the wounds, preserving what skin she could but needing to debride it where it was too torn to take a suture. Desert sand encrusted the wounds and the blood-hardened fabric, so the job was slow, but piece by piece she removed the foreign material, leaving a clean wound for Kam to stitch.
From there she moved to the wounds just above his buttocks, so she and Kam weren’t jostling each other as they worked, and slowly, painstakingly, they cleansed and cut and stitched until the man’s back resembled a piece of patchwork, sutures criss-crossing it in all directions.
Jen squatted back on her heels and Kam raised his head, tilting it from side to side, shrugging impressively broad shoulders to relieve tension in his neck. For a minute the green eyes met hers but she couldn’t read whatever message they might hold. Pity? Horror? Regret?
Emotion certainly, and she felt a little more kindly towards him. So many doctors, surgeons in particular—and she was pretty sure he must be one—could remain detached from the work they did, believing it was better for all concerned for them to be emotionally uninvolved.
‘Do you want to swap jobs?’ Jen suggested, as Kam roughly taped a huge dressing to the man’s back then tilted him so he was lying on it. They both watched the patient to see if there was any reaction, but as he remained seemingly asleep, they assumed the pethidine was working and he couldn’t feel the pain of the wounds on his back.
‘You’ve been bent over there for over an hour. I can at least move around,’ Jen added.
He glanced at her again.
‘You like sewing?’ he asked.
‘Not really,’ Jen said, wondering how he could make her feel so uncomfortable. He was, after all, just a colleague.
Problem was, of course, she’d never had a colleague who looked like this one…
Or felt any physical reaction to a man for a long time…
She hauled her attention back to the subject under discussion. ‘But I’ve done most of my hospital work in A and E, so I’ve had plenty of practice.’
She was sounding snappish again and knew it was because it niggled her that this man could get so easily under her skin.
Because she was physically attracted to him?
Balderdash! Of course she wasn’t.
‘I’m sure you’d do as good a job as I, but now I’ve begun I’ll finish it.’
And finish it he did, Jen cutting and cleaning, Kam sewing, until all the deepest wounds on the man’s back, chest and legs were stitched, while the less deep ones were neatly dressed.
Jen, finishing first, checked their patient’s blood pressure and pulse again, then studied the readout with trepidation.
‘His blood pressure’s dropping. I saw you examining him all over earlier—there were no deep wounds we’ve missed?’
Kam shook his head.
‘But there’s extensive bruising to his lower back and abdomen, which suggests he might have been kicked. There could be damage to his spleen or kidneys and internal bleeding, which we won’t find without an X-ray or ultrasound.’
‘Do you have a radio in your car? Do you know enough about the health services available locally to know if we could radio for a helicopter to take him out?’
Kam shook his head.
‘I imagine you drove in, camping out in the desert for one night on the way. That’s not because we—I mean the locals—want to put aid workers to as much hardship as they can, but because of the mountains around here. They have temperamental updraughts and downdraughts that can cause tremendous problems to the rotors on a helicopter, so they don’t fly here. Fixed-wing aircraft are a different matter, they fly higher so aren’t affected, but, of course, there’s no handy airfield for even a light plane to use!’
He studied her as if to gauge her reaction to his explanation, but when he spoke again she realised he’d gone back further than the helicopters.
‘You asked about a radio in my car—yes, I do have one, but so should you. One in the car and one for your office or wherever you want to keep it—they’re listed on the inventory you’re given with your supplies.’
Jen smiled at him.
‘The one in the car disappeared within two days of our arrival and the other one a couple of days after that. You can’t dig a hole and bury radios. No matter how well you wrap them, you can’t seal them completely and they tend to stop working when sand gets into their bits.’
She was smiling at him, but Kam couldn’t return the smile, too angered by the artless conversation. He couldn’t believe that things had got so bad people were stealing from an aid organisation, although he imagined these refugees had so little, he could hardly blame them for the thefts.
But how to fix this? How to redress the balance in his country? Could he and his twin achieve what needed to be done in a lifetime? Arun was working in the city, talking to the people there, seeking information about the government and whether, as their father’s influence slipped, corruption had crept in.
Or had the people elected into positions of power only seen the city as their responsibility, ignoring what was happening in the country, ignorant of this camp on the border?
As he and Arun had been, he reminded himself with a feeling of deep shame. He couldn’t speak for his twin, but nothing—neither work and study programmes, nor his father’s orders to keep his nose out of the ruler’s business—excused the way he, as heir, had allowed neglect to hurt his people. And nothing would stop his drive to fix this hurt.
Nothing!
Their patient groaned and Kam brought his mind sharply back to the job in hand.
‘A drop in blood pressure certainly suggests he’s bleeding somewhere. If you’re short of fluid, we should consider whole blood.’
The woman he’d been surprised to find in this place nodded. He’d known she was here, of course, but he’d expected…
What?
Some dowdy female?
OK, not some dowdy female, but definitely not a beauty like this golden woman was. He checked the dusting of freckles again and even in the dimmer light of the tent saw the colour of them.
‘Sorry?’ Checking out her freckles, he’d seen her lips moving and realised she was talking to him.
‘I was just offering to take some blood from him and test it, then maybe find some volunteers willing to be tested,’ Jen suggested.
‘His friends will surely volunteer. Take some blood. You can test it here? You have a kit?’
She nodded.
‘Good,’ Kam said, pleased his mind was back on the job, though the greater job still awaited him. ‘We’ve got him this far, let’s see if we can finish the job. Internal bleeding will sometimes stop, leaking vessels sealing themselves off, but if it doesn’t, without an ultrasound I’d have to open him up and have a look. He’s suffered so much already I wouldn’t like to risk it until he’s much stronger, so let’s wait and see. We’ll have to monitor him closely, of course.’
We’ll have to monitor him? The words echoed in Jen’s head.
The stranger intended staying?
Here?
In her tent?
Of course he intended staying—he was another aid worker, one who was sorely needed, and right now there wasn’t another tent to house him or his clinic.
Unease fluttered like panicking moths in her stomach—or maybe that was hunger, it was well past lunchtime.
She turned her attention back to the job she was supposed to be doing—taking blood.
Marij had returned, having belatedly finished the morning’s TB testing.
‘Can I help?’ she asked, in her soft, gentle voice.
‘Would you type this blood for me?’ Jen asked her, handing her the vial.
‘Of course,’ Marij replied, adding, ‘And then you’ll want volunteers—I will ask around and begin typing them as well.’
Jen turned her attention back to the patient.
‘Shall we ease him back onto his side? And what about antibiotics? I have some but they’re in tablet form. For a start at least, he should be getting them through his drip. And tetanus? Who knows if he’s ever had a tetanus shot, but if it was a horse whip he was hit with, he’ll need one.’
He helped her move the patient back onto his side, propping cushions gently against his injured back to keep him from rolling over.
‘I’ve stuff like that in the car,’ Kam said. ‘Not much because this visit was more a recce to see what was needed, but I’ll go and get what I have.’
Once again suspicion fluttered in Jen’s chest. Would he really undertake a two-day drive just to see what was happening? And then drive back to the city to get what was needed and drive up here again? Six days going back and forth across desert roads that could swallow a car whole?
Or was the flutter discomfort at the thought of the man moving his things in here—moving in himself?
So close that if she woke in the night she might hear him shifting in his sleep, hear him breathing?
But where else could he stay? Until they had another tent, and she’d believe he could muster one when she saw it, he’d have to live and work here. If she put up another rug across the far corner…
She shook her head at her own folly. Whatever it was about this man that was affecting her, it wasn’t going to be stopped by a brightly woven rug hung down between them. The way they blew when the tent sides were rolled up to allow cool air in, another rug would barely provide privacy.
She checked her patient, then looked up as a shadow fell across them. The cause of her concern was standing over them, a large cardboard box in his hands.
Was she staring that he offered a half smile?
The flutters she felt were definitely not suspicion, and all the more worrying because of that.
‘I have some more pethidine,’ he said, such an ordinary conversation, ‘and antibiotics. The blood test?’
‘Marij is checking now.’
Jen climbed carefully to her feet, but even with care she stumbled when she put her weight on a foot that had gone to sleep.
Kam’s hand reached out to steady her, his grip surprisingly strong. She turned to thank him, but the words wouldn’t come, held captive in her throat by something she couldn’t explain.
She stamped her unresponsive foot, and caught his lips curving into a smile.
‘That’s not a sign of a tantrum,’ she assured him, with a tentative smile of her own. ‘The darned thing’s gone to sleep. And so’s my brain. I know you introduced yourself earlier, but did I? My name’s Jenny.’
She held out her hand and watched him take it—saw the tanned skin of his fingers against her own pale flesh, felt warmth and something else—something she didn’t want to put a name to.
‘I knew the Jennifer part, but wondered if you shortened it.’
Jenny removed her hand from his, and tucked it in the pocket of her tunic, out of danger’s way.
‘Jen, Jenny, even, hey, you—I answer to them all,’ she said, trying desperately to sound casual and light-hearted, although her arm where he had touched it, and the fingers he’d briefly held, burned as if they’d been branded.
The patient’s name, they learned, was Akbar, and his blood group was B.
‘Mine’s B,’ Jenny told Kam, who was sitting, cross-legged, by their patient, talking quietly to Lia, Akbar’s wife. ‘Let’s do a cross-match and see if it’s OK for him to have mine.’
Kam studied her for a moment, wondering about this woman he’d found on the border of his country. Wondering if she was the first fair-haired Westerner to ever tread these particular desert sands.
Wondering if he should take her blood…
Take her, as his ancestors might have…
The sudden heat in his body shocked him back to the matter in hand. Of all the times to be distracted by a woman…
‘You need your strength for your job,’ he objected.
It was a token protest and she took it that way.
‘The loss of a couple of pints of blood won’t hurt me,’ she insisted, handing him a syringe with a needle attached so he could draw blood from her forearm for cross-matching. She had pulled off her soiled tunic and now rolled up the sleeve of her shirt so he could access a vein, yet he felt strangely reluctant to move closer to her—to touch her.
He had to move closer—how else could he withdraw some blood?—and if their patient was bleeding internally, and his blood pressure drop suggested he was, he would need blood.
Kam crossed the distance between them in one long stride and took her arm, seeing as he did so pale scars like snail tracks, paler than the lightly tanned skin and puckered here and there.
Without regard to the intrusiveness of the gesture, he ran his forefinger lightly down the longest of them, then looked up into her eyes, knowing she’d read the question in his own.
Defiance was his answer, as clear as if it was written on a whiteboard. Ask me if you dare, she was saying, and though Kam knew he shouldn’t, he couldn’t help himself.
‘Accident?’
She nodded briefly then swabbed the spot where a vein showed blue beneath the fine skin of her inner elbow.
Take the blood, she was saying with the gesture—take the blood and mind your own business. But Kam’s mind was already racing off along a tangent—did the scars explain why such a beautiful woman, and she was beautiful in her golden, glowing way, would hide herself away in a refugee camp on the edge of a little-known country?
Was she hiding only these surface scars or were there deeper ones?
Had she lost someone she loved, leaving scars on her heart?
‘Was it bad?’
She stared at him as if she didn’t understand his question, but a shadow had crossed her face and he had his answer.
Very bad, that shadow told him, while the set of her lips again warned him off further questions.
But his sympathy for her made him gentle as he held her arm and eased the needle into the vein. He watched the vial fill with dark blood, trying to keep his mind on the job—on their patient and what might lie ahead for him, and for himself and Jenny as his doctors—not on snail-track-like scars on a woman’s arm, or the dark shadow that had crossed her face.
Fortunately, the woman—Jenny—recovered her composure and her sensible conversation brought him back to the present.
‘If it works in a cross-match, you can take it directly from me to him, although you’ll have to keep an eye on him for any transfusion reaction because I’ll be lying beside him.’
She smiled as if this were a little joke at her expense, but Kam couldn’t return the smile, his thoughts veering back to the puzzle of why this woman was willing to do so much for people she didn’t know, in an inhospitable place, and with no friends or family to support her.
Had she come to escape her memories?
Her pain?
‘Well?’ she prompted. ‘Are you going to do a cross-match or should I?’
With his mind back on the job, Kam took another vial and drew a little blood from their patient, Jenny acting as nurse, tightening the tourniquet on the man’s arm to bring up a vein then taping a dressing over the small wound. Kam mixed the contents of the two vials, watching anxiously for any sign of clotting, which would tell them the blood samples were not compatible. But the blood didn’t clot and the intrepid woman who puzzled him now produced a cannula and loop of tubing.
‘Let’s go,’ she said, sitting down beside Akbar while one of the nurses who worked with her explained to Akbar’s wife what was happening.
Lia shifted to sit beside Jenny and hold her hand, babbling her thanks for the gift of blood—the gift of life.
‘You need to be higher,’ Kam told the unexpected donor. ‘Are you all right to sit up if we stack pillows behind you?’
‘I’ve two bedrolls behind the partition,’ Jenny told him. ‘I can sit with those behind me to prop me up and that way my arm is higher than Akbar’s and it will feed down into him.’
She half smiled, while the nurse, Aisha, fetched the bedrolls.
‘It will be up to you to check the blood’s going the right way. I don’t want to be taking more of it from the poor man.’
Not only was she here in this desperate situation but she was joking about it. Kam thought back to the women he had studied with, both women from his own land and Western women, but none of them had been anything like this particular female doctor. No fuss, no nonsense, just get on with the job.
Although there was one problem now he thought about it…
‘I don’t think we should run it direct into Akbar. We should measure the amount—both for your sake as a donor and his as the recipient,’ he said, trying to be as efficient as she was at getting on with the job. ‘Do you have a container?’