Rivals in Practice Read online

  Two women stood in the waiting room. The younger woman looked anxious. ‘Mum’s had a fall, Dr Tremaine.’

  ‘I couldn’t see a thing when the lights went out!’ The older woman sounded annoyed. ‘I tripped over the coffee-table.’

  ‘Were you knocked out?’

  ‘No, but I’ve cut my leg and you know what my skin’s like.’

  Jennifer nodded. Edith Turner had been on steroids for years to treat her lung condition. Even a slight knock could tear her papery skin badly. Judging by the blood-soaked towel around her lower leg, this accident had been more than a slight knock. She touched the towel to find the stain almost dry.

  ‘It’s stopped bleeding, anyway. Take a seat in the consulting room and I’ll be with you in a couple of minutes. I’ve just got a few stitches and a dressing to take care of.’ Jennifer was debating whether to open the internal door from the waiting room to call for Wendy’s assistance when the outside door opened again.

  ‘The front driveway is completely blocked!’ a cheerful voice informed Jennifer. ‘So I had to come in this way.’

  ‘Margaret!’ Jennifer was delighted to see another of her senior nurses. The uniform the older woman was wearing was a surprise. ‘You’re on night duty. You’re not due in for hours yet.’

  ‘Thought you might need some extra help what with this weather.’ Margaret Coates pulled a clear plastic hood clear of her grey hair.

  ‘You’re an angel,’ Jennifer told her. ‘Can you take Edith in to the consulting room and have a look at her leg? You might need to soak that towel off. I’ve got a bit of stitching to finish in the treatment room.’

  The last stitch in John’s palm was being tied when Wendy came into the room. ‘Contractions are back to ten minutes apart,’ she reported to Jennifer. ‘Liz is asking for some pain relief.’

  ‘I’ll go and see her. Could you dress John’s hand? Put a plastic bag over it all when you’ve finished so it doesn’t get wet. John wants to go and have another look at his boat.’ Jennifer stripped off her gloves and stood up. ‘Did you get hold of Saskia?’

  ‘Sorry, the phone lines seem to be out.’ Wendy was ripping the covering off a crêpe bandage. ‘I’ll try again later.’

  Margaret signalled to Jennifer as she stepped into the hallway. ‘Edith’s got a nasty avulsion,’ she said. ‘And the skin flap’s all scrunched up and torn.’

  ‘Put a moist dressing on it,’ Jennifer directed. ‘I’ll come and sort it out in a few minutes.’ She moved quickly towards the door further down the hallway as the surgery bell sounded again. Jennifer paused for a second, not wanting to enter the maternity suite until she was able to focus completely on her patient. Her level of tension needed lowering.

  If the phones were out there was no way of ringing home, but Saskia was far more responsible than most girls her age. If there had been any problem getting all the children home safely, she would have found some way to contact Jennifer on her mobile. She could reach Brian on his own cellphone if absolutely necessary but calling him in to help deal with a stressful influx of casualties was the last thing Jennifer wanted to do. Wendy and Margaret were both very capable nurses. Surely even this storm couldn’t throw anything at them more than the three medical staff could deal with. There was nothing life-threatening about the injuries arriving so far and as long as Liz’s labour was straightforward, they should be fine. Jennifer took a deep breath and entered the maternity suite.

  ‘Sorry to have been gone so long, Liz,’ she told her patient cheerfully. ‘Let’s have a look at you and see what’s happening.’

  Ten minutes later, Jennifer headed back to the treatment room. Wendy and Margaret now had Edith on the bed.

  ‘I’ve had a go at straightening this flap.’ Wendy looked up, the tweezers poised in her gloved hand. ‘What do you think?’

  Jennifer eyed the wound. ‘Couldn’t have done better myself. Could you dress that, please, Margaret?’ She waited until Wendy had dropped her gloves into the rubbish bin near the door. ‘Liz is about six centimetres dilated so she’s definitely in labour. I’ve set up the Entonox for her to use for pain relief but it’s better if she keeps moving at the moment. Can you stay with her?’

  ‘Sure.’ Wendy nodded. ‘Sam McIntosh is in the consulting room with his mother. He needs looking at.’

  ‘What happened?’

  ‘Apparently the wind caught the garage door and it hit him on the head. Possibly unconscious but only very briefly. He seemed fine but rather quiet. Jill got worried when he vomited about half an hour ago. Looks like concussion.’

  Jennifer knew Sam well. Six years old, he was the same age as the twins. Sam lived just down the valley from Jennifer’s property and often came to play after school. He looked pale and unusually subdued at present.

  ‘I’m going to shine a bright light in your eyes,’ Jennifer told the small boy. ‘Try and keep them open for me.’

  She managed to complete a full neurological check and reassure Sam’s mother before another interruption occurred. This time it was her cellphone. The flash of panic that something had happened at home intensified when the caller identified himself as Robert Manson, one of the local fire officers.

  ‘We’ve got an accident near Barry’s Bay.’ Robert’s voice was difficult to hear over the crackle of static and the background noise of the weather and people shouting. ‘We need you on scene, Jennifer.’

  ‘How bad is it?’ Barry’s Bay was well away from the route the children would have taken and they had probably been home for hours by now.

  ‘We’ve got one of the drivers trapped. He’s unconscious. He’s the worst but we’ve got a couple more patients.’

  ‘I’m on my way.’ Jennifer moved fast. She was donning over-trousers and her oilskin parka by the time Wendy found her.

  ‘What’s happened?’

  ‘Car accident. We’re going to need some help, Wendy. Do any of the other nursing staff have cell-phones?’

  ‘Not that I know of.’

  ‘Get hold of Tom Bartlett, then, if you can. Let him know what the situation is.’ If he wasn’t already on the accident scene, their local police officer should be able to use his four-wheel-drive vehicle to round up some extra staff.

  ‘Do you want Brian called back?’

  ‘Not yet.’ Jennifer was determined to keep her partner as a last resort. She picked up the large tackle box that contained her resuscitation kit. ‘We need a bed made up for Sam. I want to keep an eye on him overnight. Run a neurological check every twenty minutes or so for now.’ She gave her nurse an anxious glance. ‘I hope I won’t be too long.’

  ‘Don’t worry. We’ll hold the fort,’ Wendy assured her confidently. ‘Rather you than me out in that lot. It’s not going to be pleasant.’

  Pleasant was an adjective almost as far removed as possible from anything that could describe the conditions Jennifer found herself in. It was now only 5.30 p.m. but it felt like the middle of the night. The wind was strong enough to rock the solid four-by-four vehicle she was driving and the rain heavy enough to virtually obliterate visibility, even with the windscreen wipers on full speed. Waves crashed against the sea wall as she crawled slowly along the foreshore on the far side of the road. The force of the sea was enough to send a river of foamy water across the tarmac. Jennifer tried to dampen her alarm but her thoughts tumbled wildly.

  She could imagine a newspaper headline. LOCAL DOCTOR WASHED OUT TO SEA IN STORM. What would the article say? ‘Thirty-two-year-old Dr Jennifer Tremaine is missing, presumed drowned, having been swept from the road by a fatal combination of a southerly storm and a high tide.’

  Jennifer changed gears as she reached the first hill past the township. The water level was well below her now but her imagination had been caught by the notion of the article. ‘Dr Tremaine had been practising in her home town of Akaroa for nearly six years and was well used to attending emergency call-outs in any type of weather.’ That would be true enough. They could even go to town on some of the
more dramatic rescues she had been involved in. Like that one on the fishing trawler right out in the headwaters of the harbour. They could probably find the photographs that had been published on the front page of the newspaper a few years back, where the bus full of tourists had gone over the bank thanks to the snowdrifts which had obscured the side of the road. Jennifer had had her share of drama over the years but she had never encountered weather quite this vicious.

  Her progress was slowed even more as she passed Duvauchelle by the hail that clogged the windscreen wipers and bounced off the bonnet of the vehicle. She smiled wryly. ‘Dr Tremaine had never intended to practise medicine in a small rural hospital,’ she invented aloud. ‘After a highly commendable record at medical school, she had every intention of moving overseas. She planned to become a specialist surgeon, attached to a world-renowned unit—probably in the United States—and become famous for her incredibly brilliant skills and the unparalleled depth of knowledge in her field.’

  Jennifer snorted and abandoned the mental game. She could see the flashing lights of the rescue vehicles ahead of her as the hail changed to sleet. She was about to get very wet and very cold, working under miserable conditions to save a life that could well belong to someone that she had known since childhood. The battles she fought were often personal and victory gave a level of satisfaction she would never had found anywhere else. Certainly not in the States and probably not even as a specialist surgeon. The fates that had delivered her home were probably a lot wiser than she had been. This was where she belonged and exactly where she was needed.

  Robert Manson was directing a small but dedicated team of volunteers. They were using heavy cutting equipment on a badly crumpled car jammed against the bank. Another car was further up the hill, its windscreen broken and one side badly dented. The doors hung open and Jennifer could see a woman sitting sideways on the front passenger seat, her head cradled in her hands. Another person, presumably the woman’s companion, stood motionless beside her, watching the activity down the hill. Jennifer left her own vehicle’s engine running, with the heater on a high setting and the headlights helping to illuminate the rescue scene. She pulled her resuscitation kit from the back and joined the group of men between the fire engine and the car.

  ‘Hi, Jenny!’ Robert had to shout over the noise of the cutting gear. ‘Sorry to drag you out in this. We shouldn’t be much longer.’

  ‘What’s the patient’s condition?’

  ‘Still not conscious but he’s got a good pulse and he’s breathing OK. There’s a doctor in there, stabilising his neck. We’re just putting a neck collar on him.’

  ‘A doctor?’ Jennifer was taken aback, her position as the first medic on scene removed. ‘Not Brian, is it?’

  Robert shook his head. ‘Don’t know who he is. Said he was a doctor and he seems to know what he’s doing. He arrived a few minutes after we did. He’s got a camper van.’

  Jennifer’s gaze followed the direction of Robert’s arm. The rain had eased to a steady downpour and she could see the shadowy outline of the large van in the intermittent glow of the flashing rescue lights. Someone on holiday, then. Jennifer would need some reassurance of their qualifications but if they checked out she would be only too glad to accept some assistance.

  ‘Has anyone checked the other victims?’

  ‘Not properly.’ Robert looked back towards the second vehicle. ‘Damn. I told them to stay inside the car, out of the rain. That chap’s not even wearing a coat. He’ll be frozen.’

  ‘Get them into my truck,’ Jennifer suggested. ‘The heater’s on.’ She stepped back as the noise of the cutting equipment slowed and the fire officers pulled the mangled car door clear.

  ‘We’re ready for the backboard,’ someone shouted. ‘And the oxygen.’

  Jennifer moved forward. The wind caught her hood, pushing it back and driving heavy rain into her face. She pushed her fringe back from her eyes, able to see the accident victim clearly for the first time. A young man, his face was injured and bloody but not enough to disguise his features. Jennifer felt a familiar twist of her gut. She knew the patient. He was Liam Bellamy—the son of the fisherman who had just had the hook removed from his hand.

  ‘Liam?’ Jennifer leaned closer and raised her voice. ‘Liam? It’s Jenny Tremaine. Open your eyes for me.’

  ‘He’s not responsive.’ The deep male voice came from the back seat of the car. ‘Except to painful stimuli. I’d put his GCS at about 8.’

  ‘Airway clear?’

  ‘It is now.’

  Jennifer nodded. Liam’s mouth was closed around the end of the plastic oropharyngeal airway.

  ‘Here’s the oxygen.’ A mask was passed in beside Jennifer. ‘It’s running on 15 litres.’

  Jennifer fitted the mask to Liam’s face. As she pulled the elastic strap behind his head her hands brushed the arms of the man still supporting Liam’s head. She glanced up, registering the stranger’s appearance for the first time. She blinked and stared, her jaw dropping. The man smiled without amusement.

  ‘Hello, Jennifer. Fancy meeting you here.’

  ‘Andrew!’ The name came out as an astonished gasp.

  ‘Here’s the backboard.’ Robert’s voice was right beside Jennifer’s ear. ‘How do you want to do this, Doc?’

  ‘Slide the end of the board onto the seat. I’ll look after his head and you take the legs. Let’s keep him as straight as possible.’ Jennifer nodded at the man in the back seat as he let go of Liam’s head. She supported the weight on her shoulder, her arms around the young man’s body as they turned and lifted their patient onto the backboard. The other members of the local rescue team crowded in to help lift the board onto the waiting stretcher and transfer it to the back of the modified Land Rover that served as an ambulance. Jennifer had her kit open and IV equipment already out by the time she was joined by her unexpected colleague. She didn’t glance up until she had inserted the IV cannula and flicked the tourniquet open again.

  ‘Andrew Stephenson,’ she said softly. ‘I just don’t believe this.’ Her gaze shifted. ‘Is that saline ready to go, Mickey?’

  The young fire officer nodded. He handed the end of the tubing to Jennifer who connected it to the line in Liam’s forearm. She checked the flow as the bag was suspended, then reached for her penlight torch.

  ‘Have you got a spare dressing?’ Andrew was still standing outside the back of the vehicle. ‘I’ve managed to cut my leg on some metal.’

  Jennifer nodded. ‘Find one for him, Mickey.’ She was still focussed on her patient. She pulled Liam’s eyelids open and shone the torch on his pupils. ‘Liam, can you hear me?’

  The response was an incoherent mumble of words but Liam’s arms moved. Jennifer caught the one with the IV line in.

  ‘Try and keep still, Liam,’ she said firmly. ‘You’ve been in a car accident.’

  ‘He’s lightening up a bit.’ Andrew took a package from Mickey. ‘Thanks, mate.’

  ‘Why don’t you get in out of the rain?’ Jennifer suggested. ‘I’ll have a look at your leg.’

  ‘I’m all right.’ Andrew had his foot on the first step of the Land Rover. He enlarged the rip on the leg of his jeans.

  ‘That’s one hell of a cut.’ Mickey sounded impressed. ‘I think you’d better let the doc take a look.’

  Andrew had already folded a large gauze pad and pressed it to his leg as Jennifer looked up. ‘Andrew is a doctor, Mickey. We went through medical school together.’

  Not precisely together, she amended silently, fitting her stethoscope to her ears. More like at the same time. Competing fiercely for the top spot of their intake. Alternating their positions at the head of the class and taking intense satisfaction in proving themselves superior to the other in whatever field they were competing. Academic, practical or even social—the struggle had blurred the boundaries of all aspects of those years. Looking back, the antagonism had provided a memorable background to Jennifer’s tertiary education. It had been a fight she had
revelled in. And the enemy had been Andrew Stephenson.

  ‘You sound like an American tourist,’ Mickey told Andrew.

  ‘I’ve been living in the States for a few years,’ Andrew responded. His tone was weary. ‘I suppose I’ve picked up a bit of an accent.’

  ‘Liam’s got a flail chest but breath sounds are equal at present.’ Jennifer’s attention shifted briefly to Andrew. ‘You’re a general surgeon, aren’t you?’

  ‘Not any more.’

  ‘What?’ Jennifer’s brow furrowed. ‘Have you specialised in something, then?’

  ‘Not exactly.’ Jennifer’s stare at Andrew wasn’t productive. His head was bent, his attention on the dressing he was holding to his calf. A dressing that was already soaked with blood.

  ‘Is that an arterial bleed?’ Jennifer snapped.

  A figure appeared beside Andrew before he had time to respond. Tom Bartlett glanced at Andrew’s leg, then towards Jennifer.

  ‘I’ve got one of the boys to take your truck back to the hospital with the two people from the other vehicle, Jenny. They don’t seem to be injured badly but they’ll need checking. How’s Liam?’

  ‘He’s pretty seriously injured. Under normal circumstances I’d be calling for a helicopter to get him to Christchurch. We’ll have to get an ambulance in by road.’

  ‘No go, sorry.’ Tom’s face was grim. ‘There’s been a massive slip on the other side of the hilltop. Our access is completely cut off.’

  Jennifer marshalled her thoughts rapidly. ‘You’ll have to come with me,’ she told Andrew. ‘I’m going to need some help.’

  ‘I can’t.’ Andrew shook his head. ‘I’m on holiday. My camper van’s over there.’

  ‘I don’t give a damn about your holiday.’ Jennifer couldn’t believe Andrew’s casual attitude to this situation. ‘This is serious,’ she told him coldly. ‘Liam’s life might depend on you sacrificing a few hours of your precious leisure time.’

  ‘What I meant was, I don’t have a current practising certificate for New Zealand.’ Andrew met her furious glare without blinking. ‘I’m not licensed to treat patients here.’