Stolen Nights with the Single Dad Read online

  Her smile widened. ‘I’ll start. I’m Jenna Armstrong, a critical care paramedic. I live not far from this station in south London and I’m here because I’m passionate about this course. I started developing it quite a few years ago and I’ve been all over the country getting it up and running. It’s been going long enough now for statistics to confirm that it’s one of the most effective strategies we’ve put in place to save lives in more remote areas. It’s something I’m very proud of. And it’s something that I can promise has the potential to make an important difference to you—and to the communities that you care for.’

  There was a moment’s silence when she finished speaking. Had she sounded a bit over the top? Too passionate? But it was hard not to, when this had been the total focus of her life for so long.

  The only thing that had really mattered for so long.

  It didn’t take long to get around the group. Jenna ticked names off her list as they introduced themselves. Melanie, Ravi and Judith had come from as far away as rural areas near Basingstoke and Brighton. There were older doctors, like Peter and Jack, who felt they were getting rusty on emergency procedures and young GPs, like Susie and Indira, who were nervous about being so far away from major hospitals and advanced ambulance services. It wasn’t deliberate, but the man at the back was the last person to introduce himself.

  ‘I’m Mitch,’ he said, quietly. ‘I’m one of four GPs in the only medical centre in Allensbury, which is a small town in Surrey.’

  Jenna was frowning at the sheet of paper in front of her. Mitch? The only person who wasn’t ticked off was an Andrew. Then she noticed his surname and almost smiled because it fitted him so well to go by a shortened version of Mitchell.

  Because it was just that bit different?

  ‘I’m here because I think we get so caught up in the ordinary busyness of general practice that we can miss opportunities to keep up to date,’ Mitch said. ‘And...you never know—that one skill we got rusty in might be the one skill we absolutely need to save someone’s life.’

  His voice was deep enough to be a bit like his body language and how he looked. Unusually attractive. Calm and confident but...somehow contradictory? Was it Jenna’s imagination or was there something he wasn’t saying, here?

  It had only been polite to look up from the paper that listed the expected attendees for the course and meet this man’s gaze as he continued speaking but it was suddenly difficult to break that eye contact.

  Because she felt like she recognised what was different about him.

  He was searching for something.

  Something of personal significance.

  And...disturbingly enough to send a tiny chill down Jenna’s spine, it felt like she might have been singled out as the only person who could help him find what it was he was searching for.

  CHAPTER TWO

  JENNA ARMSTRONG WASN’T someone that would stand out in a crowd.

  She wasn’t tall—Mitch guessed a few inches over five feet, which would mean the top of her head wouldn’t even reach his shoulder. She was also slim and fine-featured, which probably made her look a lot younger than she actually was. Or maybe that was partly due to the very short hairstyle, which made him think of a curly version of Ollie’s soft spikes that had a mind of their own when it came to being tamed.

  Any ability to vanish into a crowd physically, however, was more than compensated for by an astonishing...what was it, exactly? Her presence? There was a confidence about her. He might have put that down to the crisp uniform she was wearing but, in fact, you could actually feel the passion that she had, not only for her work as a highly skilled paramedic but for sharing her knowledge and skills by teaching. She was a natural teacher, too. She had this entire class in the palm of her hand within minutes of completing the introductory hoops of learning each other’s names and the overview of the course they were enrolled in.

  There was a sense of drama as Jenna rolled down the blinds on the windows and dimmed the lights in the room to show a short video on a large screen. A dramatic footage that had to be a clip from a movie. An historical setting, judging by the clothing worn, so it had little relevance to contemporary life but it still made Mitch’s blood run cold. Because it had someone riding a horse. Flying through an idyllic countryside, galloping over flower-studded fields and jumping rustic wooden gates and... he knew what was coming.

  He was braced for the moment the music changed to become far more sinister and the filming went into slow motion as the horse caught its leg on a fallen log and both horse and rider somersaulted through the air before the shocking collisions with the ground that made everybody watching wince. It made Mitch close his eyes and take a slow breath in. By the time he opened his eyes again, the camera was panning out from above the scene. The horse got to its feet, stood still for a moment and then took off at a gallop.

  The rider remained completely motionless and there was no sign of life as the image got smaller and smaller, until that lifeless looking person was no more than a speck in an endless—and apparently deserted—rural landscape.

  There was a long moment’s silence before Jenna began speaking and it was then that Mitch really heard her voice for the first time. He could hear the faint accent that might be a touch of Welsh background but, more than that, he could hear the tone of someone who knew exactly what they were doing and why.

  ‘The horse jumps another fence and gets onto a road. Someone has the sense to go looking for the rider and then calls for help as soon as they see them lying in the field. The call taker in the emergency response centre looks up the co-ordinates and pinpoints the location of the accident on a map. They look for the nearest ambulance that might be available in the area but it’s miles away—being used to transport a patient to the nearest hospital big enough to have a catheter laboratory that can deal with an evolving myocardial infarction. There’s no helicopter immediately available, either, but the system flags that there’s is a FRAME doctor in a nearby village medical centre, so they activate that call first.’

  Jenna’s voice was soft but as clear as a bell and just as captivating.

  ‘Your pager goes off,’ she tells them. ‘You apologise to the patients in your waiting rooms who’ll have to wait a while longer, grab your backpack kit and jump into your car. You’re at the scene within minutes. And—’ the pause was dramatic ‘—right now, you’re the only medically qualified person there and you’ve got the gear in your pack that could tip the balance between life and death. You need to identify the critical actions that are needed urgently to prevent someone’s condition from deteriorating to the point of them becoming a fatality. It’s up to you to do whatever you can to save this life.’

  Mitch didn’t have to imagine what that would be like. He knew, only too well, how huge that sense of responsibility seemed. How powerful the determination to win was and how crushing the weight of failure could be. He also knew that their instructor couldn’t possibly have deliberately chosen a scenario that was so close to the bone for him that it felt like a physical blow but that didn’t help. He could feel his fingers tightening into fists as he took another deep, slow breath and fought the urge to head outside for some fresh air to clear his head as the blinds on the windows were lifting again.

  This was what he’d come here for, after all. A way to revisit that nightmare and find answers to some of those ‘what ifs’ that might stop the fear of it happening again haunting him for the rest of his life. And he was clearly in the right place.

  It almost felt as if this course had been designed specifically for him.

  Maybe he wasn’t hiding his reaction as well as he thought he was because Jenna turned her head to catch his gaze at that moment and there was a tiny frown between her eyes.

  Brown eyes, he noticed, as the light from the windows caught them. But not as dark as his own. More a golden, hazel kind of brown. Warm eyes. Empathetic. They only held h
is gaze for a heartbeat and, while he had the odd feeling that she could see far more than he would have chosen to show, he didn’t mind.

  Because it felt like he was being understood rather than judged. As if Jenna Armstrong knew what it was like to fight that kind of battle.

  And lose...

  * * *

  Wow...

  A dramatic opening to a session on critical interventions for a FRAME doctor on scene always got everybody on board but that expression on Mitch’s face meant that Jenna was the one being sucked into this scenario now—as if she could see what was happening from the point of view of the injured person and Mitch was the hero who was about to do whatever it took to save her life.

  And he would, wouldn’t he? Even in a split second of eye contact, she could sense just how hard he would try. How important it was to him to care for others and...she had to suck in a quick breath as she broke that contact. There was a pull here that was inexplicable and too strong to feel remotely comfortable.

  ‘Okay...’ She kept her tone brisk. Urgent, even. ‘What’s the first thing that’s going to kill someone the fastest?’

  ‘An occluded airway,’ Ravi offered.

  Jenna nodded. ‘Absolutely.’ She tapped the keyboard in front of her and the first slide of a presentation filled the screen. ‘One of our sessions tomorrow is going to cover identifying and managing risks on scene and whether a major incident activation is warranted but, for the moment, we’re going to assume that our scene is safe and risks are controlled so we can focus on the immediate threats to life. And yes, it goes back to the basic ABCs that you will all be very familiar with. The occluded airway could be as simple as someone who’s unconscious and unable to lift their chin off their chest.’

  The picture on the screen now was of a car accident, the deeply unconscious driver still held upright by the safety belt but with his head flopped forward far enough to easily cut off any air entry. Jenna clicked again and this time the image was a more confronting illustration of a serious face and neck injury. ‘It could also be as complex as this kind of blunt force or crush injury to the face and/or the neck that has distorted the anatomy and rapidly continues to deteriorate due to bleeding and swelling.’

  She could feel the focus with which Mitch was listening to her speak. The way he was watching her. It could have come across as creepy but it didn’t. If anything, it was giving her a strange sort of internal tingle—as if he might be interested in her rather than what she was saying? She shook the sensation off. ‘Indicators of airway compromise?’

  The responses came quickly.

  ‘Stridor.’

  ‘Cyanosis. Or pallor.’

  ‘No chest wall movement to be seen. Or felt.’

  Mitch was the last to contribute. ‘Accessory muscle use,’ he said. ‘Like intercostal retractions or a tracheal tug. And agitation,’ he added quietly. ‘Fear, even...’

  There was a collective pause. This had just become rather more significant than simply discussing the theory of a medical examination. This was about people. Possibly terrified people. Somehow, it came as no surprise that it was Mitch who had made signs and symptoms something they could all relate to on a human level rather than reciting a paragraph from a medical textbook.

  Jenna spoke into that moment’s silence. ‘You all know the list. And you all know what we need to do. Which is?’

  ‘Open the airway,’ Judith said.

  ‘Head tilt, chin lift.’ One of the younger doctors, Indira, nodded. ‘And then we can move on to reassessing the respiratory efforts.’

  ‘You’re not going to do that if there’s any suspicion of a spinal injury,’ Jack said. ‘And, if we’re using that example of the horse-riding accident, that would be top of my list.’

  ‘In that case, of course we’d use a modified jaw thrust.’ Indira shook her head. ‘Basic first aid, isn’t it? And an occluded airway is going to kill someone faster than a potential spinal injury, isn’t it? I believe it’s only about ten percent of unconscious trauma patients that do have a C spine injury.’

  Jenna intervened before the discussion could go off track.

  ‘Basic first aid can very well be life-saving,’ she said calmly. ‘A lot of what this course is about is reminding us of things we might not have used in a long time. I think Mitch hit the nail on the head with what he said about why he had come to this course—that one skill that we’re a bit rusty in might be the one that we need, if not to save a life, then possibly to prevent making an injury a whole lot worse. I agree with you, Indira, in that making sure there’s a patent airway can take precedence over anything else depending on circumstances, but I also agree with you, Jack—in the mechanism of injury like coming off a horse at high speed, a spinal injury would be well up my list as well.’ She glanced around the group. ‘Out of interest, who has done a modified jaw thrust recently?’

  Nobody put their hand up or nodded their head. Jenna walked a few steps to the full-body mannequin that was lying on the floor at the front of the classroom.

  ‘Let’s have a quick demo.’ She looked around the room but she already knew where her glance was going to stop this time. ‘Mitch? You up for it?’

  ‘Sure.’

  He was taller than she’d realised. By the time he’d joined her at the front of the room, Jenna could tell that the top of her head would barely reach his shoulder. She noticed the faded, denim jeans that clung to his long legs and the soft shirt with the top buttons casually open and the sleeves rolled up almost to his elbows to reveal well-defined muscles beneath tanned skin. It was impossible not to notice the way he moved, too—with a grace that belied his height and muscle mass. The errant thought that he was probably an excellent dancer came from nowhere and was entirely inappropriate.

  Without looking directly at Jenna, Mitch knelt in front of the mannequin’s head. He put his hands on each side of the face, with his thumbs on the cheekbones and his fingers hooked under the angle of the jawbone. Pressing down with his thumbs and pulling up with his fingers moved the jaw without changing the line of the head or neck.

  ‘Perfect,’ Jenna announced.

  Mitch got to his feet in another fluid movement and, this time, he did catch Jenna’s gaze for a moment before heading back to his seat, his lips tilting into an embryonic smile as he acknowledged her commendation. The corners of a pair of very dark brown eyes crinkled a little at the same time, which made the almost smile as genuine as a wide grin might have been.

  For just another moment, Jenna watched him walk away, aware of that tingle she’d dismissed not long ago. But this time it was even stronger and she could recognise it for exactly what it was.

  Attraction.

  The kind of attraction she hadn’t felt in for ever.

  Well, not exactly for ever but certainly not since she’d lost Stefan and eight years could definitely feel like for ever. She’d never expected to feel it again, either, but there it was.

  Very much alive and kicking.

  Nobody could have the faintest idea what had just flashed through her head but Jenna took a sharp inward breath and lifted her chin, anyway. This might be totally unexpected but it wasn’t anything she couldn’t deal with. She dealt with far more difficult things on a regular basis, after all.

  ‘Right...’ Her smile was bright. ‘We’ve got that airway open. What are some of the adjuncts we might use to secure it?’

  Jenna picked up a tray of items that included a hard, plastic oropharyngeal airway, a soft nasopharyngeal tube, a laryngeal mask airway and kits for more invasive airway management like tracheal intubation, needle cricothyroidotomy and surgical airways. She deliberately turned to the opposite side of the classroom from where Mitch had just taken his seat again and offered the tray to Jack.

  ‘Pick one,’ she invited. ‘Tell us what it is, the indications for using it and whether it’s something you carry in your own f
irst response kit. Later today, we’ll be using all of them in a practical session but, if you’ve used one recently yourself, tell us about that case.’

  It was going to take some time to get to Mitch’s side of the classroom and, by then, Jenna was quite confident she would be able to interact with him in exactly the same way she had interacted with hundreds and hundreds of students over the last few years. There was no real reason why Andrew Mitchell should be any different.

  No reason at all.

  * * *

  The last session of the first day was a workshop. The large classroom had been rearranged to provide stations equipped with mannequins and all the gear needed to refresh skills that hadn’t been used recently enough or to learn new ones. Jenna moved between where class members were working alone or in pairs, helping them to smooth over rough points or challenging them to try new techniques. Voices were quiet and the atmosphere one of intense concentration, despite a background weariness after a long and intense day of both academic and practical instruction.

  This was the highlight of Mitch’s day. He had a video laryngoscope in his hands for the first time in years and he could see an impressive improvement in the technology. There was a light source and a digital camera built into the tip of the laryngoscope blade and a small screen attached to the side of the sleek, easy-to-hold handle. This screen provided an enlarged view of the larynx and all the anatomical landmarks you were looking for in order to pass a breathing tube into the trachea and secure an airway. With his other hand, he was following the angle of the blade to slip the tip of the stylet, loaded with the endotracheal tube, through the vocal cords and into the trachea. He then needed to advance the tube and remove the stylet.

  That was when the process stopped going so smoothly.

  Mitch could feel the hairs on the back of his neck prickle as he felt the resistance beneath his fingers. It was all too easy to imagine that this was a real emergency situation—maybe even the last chance to secure an airway before his patient ran into the life-threatening complications that came from a prolonged lack of oxygen. He tried again but still couldn’t advance the tube.