A Courageous Doctor Read online

  ‘I’m sure you’ve got better things to do with your afternoon than taking me sightseeing.’

  Hugo appeared to give the statement serious consideration. ‘Sadly, no.’

  ‘Why sadly?’

  ‘Because telling you that my idea of a perfect winter afternoon is sitting by the fire catching up on some journals might just confirm your opinion of how boring my life is. How boring I am, in fact.’

  ‘Oh, you’re not boring, Hugh,’ Maggie assured him. She hung her jacket up and then pulled the woollen cap off her head, releasing tendrils of hair that spiralled gleefully into disarray. ‘Safe, yes, but never boring.’

  ‘So you won’t try and make me try bungy-jumping or extreme skiing if we go somewhere this afternoon?’

  ‘Perish the thought.’ Maggie raised an eyebrow. ‘Can you ski?’

  ‘Not very well,’ Hugo admitted. ‘Can you?’

  ‘Haven’t really tried,’ Maggie said. Her eyes gleamed. ‘Yet. I guess that’s a whole new adventure waiting for me. Hey, I could sign up for some lessons if we go up to the ski field.’ The gleam intensified. ‘I wonder if I can find some hunky Swedish ski instructor who’d take me on?’

  Hugo closed his eyes as he shook his head sorrowfully. He had no doubt at all that any available male would be happy to take Maggie on, given half a chance. ‘Wasn’t your date with Donald Hamilton exciting enough, then?’

  ‘It wasn’t a date.’ Maggie was in front of the woodburner now. She crouched to open the door. ‘I think he just wanted company for dinner. There’s a conference on this weekend and he arrived early. I declined to go to the cocktail session they had later. I was home well before you,’ she reminded Hugo. She poked another log into the burner and her lips twitched mischievously. ‘I guess Joan has exciting depths to her personality that I have yet to discover.’

  ‘I wouldn’t know.’ Hugo was astonished at himself for making such an admission. ‘At this point in time we’re just good friends.’

  Maggie rocked back on her heels. ‘Don’t tell me you’re a born-again virgin, too?’

  ‘I have no intention of telling you any such thing,’ Hugo said grimly. ‘Mainly because it’s none of your business.’

  ‘Sorry.’ Maggie bit her lip. She was horrified at having asked but it had just popped out. And now she was dead curious. According to the hints Joan dropped at frequent intervals, she and Hugo were practically engaged. Maybe she was holding out to make sure she got a ring on her finger. The thought was uncharitable but Maggie wasn’t happy with Hugo’s choice of woman and the more she saw of Joan Pringle the less happy she became.

  If Hugo married someone like Joan, they would both sit around reading on a winter’s afternoon. They’d probably have a string of well-behaved blond children who would also keep their little noses buried in books or paint lots of pictures of trains and hills. He might find the idea attractive but it would definitely be the way to step from safe into boring. What Hugo Patterson needed was someone to show him how much fun there was to be had out of life.

  Someone like herself.

  The thought was far more shocking than her personal question about Hugo’s sex life had been. Even in the throes of her teenage crush Maggie had never considered herself a potential partner for Hugo. He was way out of her league. Far older, far more clever and far too good-looking. He was a role model for the man she was looking for, not the man himself. Was it just the intervening years that now made the age gap seem so insignificant? Or made her feel as though they discussed things both professional and personal on an almost equal footing? Maggie could feel the colour creeping back into her face and suspected she could pass for a good imitation of Rudolf the red-nosed reindeer. She’d been firmly put into her place again, hadn’t she? It was none of her business.

  Hugo noted the embarrassment Maggie was trying to disguise by stuffing the woodburner with as many logs as she could fit in but, hell, he was just as embarrassed. The very thought of discussing his sex life, or rather the lack of it, with Maggie was decidedly shocking. The silence in the room was just becoming unmistakeably awkward when the telephone rang.

  ‘I’ll get it.’ Hugo sounded relieved. A moment later, however, he was frowning tensely. ‘Try and calm down, Betty. When did his pain come on? Has he used his GTN spray? How many times?’ He was still frowning and already dark brown eyes looked almost black with concern. ‘He needs to come in to the hospital straight away, Betty.’ He listened again. ‘Well, that’s certainly going to be the quickest way if you think you can manage. We can send an ambulance out if you need it. Tell you what, you start driving and I’ll send the ambulance to meet you. That’s going to be the fastest. I’ll meet you in at the hospital.’

  Hugo hung up and found Maggie standing right behind him. ‘Someone with chest pain?’

  ‘Charlie Barker. One of my patients.’

  ‘Cardiac history?’

  ‘A long one. Previous MI and on the waiting list for bypass surgery.’ Hugo was still holding the telephone. ‘I’d better despatch an ambulance.’

  ‘There’s only volunteer staff on at the weekend. I’ll go.’

  ‘You’re not on duty. Why should you go?’

  ‘Because they’re not qualified to give him anything more than oxygen or GTN or aspirin. They won’t even be able to get an IV line in and if you’re looking this worried he probably needs one. How far out of town does Charlie live?’

  ‘About twenty minutes. Past Arrowtown on the way to Wanaka.’

  Maggie was already heading for the door. ‘What are we waiting for, then? If he’s having an MI, every minute counts, Hugh. Time is muscle, as they say.’

  ‘You’re right.’ Hugo grabbed his mobile phone and his coat. ‘We’ll take the Jeep. It’ll be faster than your car.’

  It took only a few minutes to reach the ambulance station but Maggie used the time to quiz Hugo thoroughly. She wanted to know how old Charlie was, his full medical history, what medications he was on, whether he was allergic to anything and whether this chest pain differed from the angina he usually suffered. Hugo had to interrupt the flow of queries to answer his mobile phone.

  ‘Don’t panic, Betty. We’re on our way.’ He glanced at Maggie. ‘She can’t find her car keys and Charlie’s been sick.’

  ‘How long is it since the pain came on?’

  ‘Just over twenty minutes now.’ Hugo slammed the Jeep to a halt and they both leapt out, startling the volunteer ambulance officers sitting inside the station building.

  ‘What’s happened?’

  ‘Patient of Hugh’s might be having an MI,’ Maggie told them. ‘I’m just going to grab my paramedic kit and we’ll head out to get him. Are the life-pack batteries fully charged?’

  ‘Yes. Do you want us to come with you?’ The older woman who spoke looked anxious.

  ‘I think we’ll manage,’ Hugo told her.

  Maggie was heaving her kit into the back of the ambulance. ‘You’d better stay in case another job comes in,’ she directed. ‘We’ll call if we need back-up.’

  Hugo had to make two attempts to fasten his seat belt as Maggie put her foot flat to the floor. He’d been in an ambulance before with the beacons and siren blazing but he was sure he’d never reached this kind of speed so quickly. And Maggie wasn’t even wearing a seat belt! Hugo opened his mouth, which felt unusually dry, but one look at the intense concentration on Maggie’s face made him close it again. This probably wasn’t the moment to mention her oversight with the seat belt. She looked as though she knew exactly what she was doing and in the interests of self-preservation Hugo didn’t want to distract her.

  Passing two long tourist buses, Maggie then aimed for what seemed a narrow gap between a car that hadn’t pulled over or slowed noticeably and oncoming traffic that was also being slow to respond to the emergency vehicle’s right of way. Hugo shut his eyes as they screamed through the gap. He held his breath as they took a curve in a road bordered by drifts of old, icy snow but Maggie seemed to know exactly
how far she could push the speed of the ambulance. They rocketed through the narrow streets of Arrowtown and then speeded up even more.

  ‘I need directions.’ Maggie had been totally silent until now.

  ‘Keep going. Over the next hill it’ll be the second…no, third turning on the right.’

  Maggie switched off the siren as they turned off the main road. She turned off the beacons as they reached the Barkers’ driveway.

  ‘No point in scaring anybody,’ she murmured. ‘Poor old Betty might really think it was an emergency.’

  Maggie backed the ambulance swiftly to the back door of the house, which was framing the anxious figure of Mrs Barker. With a graceful economy of movement Maggie was out of the driver’s seat and into the back where she unclipped the strap holding the life pack into position.

  ‘What can I bring?’ Hugo climbed through into the saloon with far less grace than Maggie had.

  ‘You take this.’ Maggie handed him the heavy life pack. ‘I’ll get my kit and the oxygen.’

  Betty Barker’s eyebrows rose as Maggie threw the back doors open and jumped lightly to the ground, swivelling to pick up the bulky paramedic kit with one hand and the portable oxygen cylinder with the other.

  ‘This is Maggie Johnston, Betty,’ Hugo told her. ‘She’s our new paramedic.’

  ‘I’m so glad you’re here, Hugo.’

  If Maggie felt at all offended by Betty’s preference she showed no sign of it and Hugo deliberately hung back a little, curious to see Maggie in action. After that hair-raising driving experience he was already viewing her with a rather different perspective. This focussed and professional calm she was exuding was an aspect of her personality he wouldn’t have guessed even existed.

  Their elderly patient was sitting at the kitchen table and looked distressingly like a classic presentation for a heart attack. His face was grey and beads of perspiration stood out on his forehead. Maggie put down her kit and smiled at him as she ripped open the plastic bag containing an oxygen mask.

  ‘Hi,’ she said warmly. ‘I’m Maggie. I’m a paramedic. You’re Mr Barker, aren’t you?’

  ‘Charlie.’

  ‘Is it OK if I call you Charlie?’ Maggie had uncoiled the plastic tubing and attached it to the cylinder. She twisted the metal handle to open the valve and then the knob to adjust the flow. ‘We’ll start some oxygen for you, Charlie, and then we’ll do something about that pain you’re in.’ She glanced up at Hugo. ‘Can you put the leads on and get an ECG trace?’

  ‘Sure.’ Hugo unzipped the pouch and took out a cable that split into three wires with electrodes on their tips. It took him a moment to find the connection port for the cable and switch the machine on, and as he did so he listened to Maggie’s rapid but calm questioning of her patient as she took his blood pressure.

  ‘Where is the pain at the moment, Charlie?’

  ‘Right here.’ Charlie pressed his hand to his sternum.

  ‘Just in the one place?’

  ‘I can feel it in my left arm. And my jaw.’

  ‘Pain score on a scale of ten, with zero being no pain and ten being the worst you can imagine?’

  ‘Bloody fifteen,’ Charlie grunted from beneath the oxygen mask.

  ‘Blood pressure’s 140 over 70 and he’s bradycardic at 55.’ Maggie had her kit open now and was moving impressively fast. A tourniquet went around Charlie’s arm to replace the blood-pressure cuff before she scooped out the other items she needed. She ripped open an IV cannula packet, then a luer plug, then a dressing. Maggie drew up a small syringe full of saline as a flush, but she appeared to be keeping an eye on Hugo at the same time.

  ‘The white electrode goes on the right just under the clavicle. Black on the left and red on the left side below umbilical level. You could put that oxygen saturation probe on a finger as well, if you like.’

  ‘Thanks. It’s a bit different to the gear I’m used to.’ Hugo peeled off the coverings to expose the sticky side of the electrodes and positioned them on Charlie’s chest. By the time he had the second in place he noted that Maggie had swabbed a vein on Charlie’s forearm and slipped a cannula in. She released the tourniquet, tamponaded the vein just beyond the end of the cannula, attached the luer plug and taped it into place before covering the site with a clear plastic dressing. Her actions were smooth, polished and incredibly efficient.

  By the time Hugo had a trace showing on the screen of the life pack, Maggie was snapping the top off a glass phial. She inserted the needle of a syringe and drew up the drug. Then she handed the empty phial to Hugo.

  ‘Morphine, 10 milligrams, expiry date April next year,’ he confirmed.

  ‘Thanks. And this one?’

  ‘Metaclopromide, 10 milligrams. Expiry May.’

  ‘Happy for me to administer them?’

  ‘Sure.’

  ‘Hugh tells me you’re not allergic to any medications, Charlie? Is that right?’

  ‘Not that I know of.’

  ‘Cool. This first one is to make sure that the morphine doesn’t make you feel sick.’ Maggie injected the dose of metaclopromide. ‘And this should help that pain.’ She injected the morphine slowly, keeping her gaze fixed on Charlie’s face. ‘How’s the rhythm looking?’ she asked Hugo over her shoulder.

  ‘Sinus bradycardia.’

  Maggie turned her head. ‘And ST elevation,’ she murmured as she caught Hugo’s eye. He knew she was as aware as he was that Charlie was in trouble. The evidence that a heart attack was in progress was fairly conclusive and the slow heart rate could easily herald serious complications like a cardiac arrest. Hugo unclipped his mobile phone from his belt and excused himself to make a phone call out of earshot of the Barkers. It took only seconds to request priority transport to get his patient to the cardiac team in Dunedin and he returned to the kitchen to find Maggie busy packing up her gear.

  ‘Have you had an aspirin today, Charlie?’

  ‘Yes, he has.’ Betty had been standing, silently watching until now. ‘I line up all his pills first thing in the morning beside his orange juice. And I make sure he takes them all.’ Her smile at her husband was a valiant effort but still distinctly watery. ‘Don’t I, love?’

  ‘The Gestapo’s got nothing on my Betty.’ Charlie returned his wife’s smile and Maggie could see the reassurance that he was trying to give her.

  ‘I’ll grab a stretcher,’ she told Hugo quietly. ‘Let’s get moving, shall we?’

  ‘I can walk,’ Charlie protested. ‘I’m far too heavy for a slip of a girl like you to carry. And the pain’s a lot better now.’

  ‘No way.’ Maggie grinned at Charlie. ‘I need the exercise. Imagine how floppy my arms would get if all my patients insisted on walking.’

  ‘Need a hand?’ Hugo queried.

  ‘No. You keep Charlie company.’ Maggie’s glance informed Hugo that she wanted their patient’s condition monitored carefully. ‘Betty, can you throw a couple of things in a bag for Charlie? Pyjamas and a toothbrush and so on?’

  ‘It’s all packed,’ Betty said. ‘I’ve kept a bag ready in the hot-water closet ever since that first heart attack.’

  Maggie wasted no time in bringing a stretcher into the kitchen. She raised the head end and then opened a blanket to cover the mattress. Together, she and Hugo lifted Charlie despite his protests and then Maggie tucked the blanket around him, pulled up the side of the stretcher and clipped the safety belt into place.

  ‘You’ll need that,’ Hugo said with a smile. ‘Wait till you see Maggie’s driving, Charlie.’

  ‘I’m sure she’s as good at that as everything else,’ Betty said stoutly.

  Maggie’s glance at Hugo was amused as she fitted the hook of the oxygen cylinder onto the back of the stretcher. ‘Unplug the life pack for a minute,’ she said. ‘We’ll connect up again once we get Charlie on board.’

  It took only a minute to install Charlie in the back of the ambulance, connect his mask to the main oxygen supply and reattach the cardiac monitoring equ
ipment. Betty sat in the back on the spare stretcher, close enough to hold Charlie’s hand.

  ‘You happy in the back, Hugh?’ Maggie peered into the saloon. ‘You’re welcome to drive if you want.’ There was just a hint of amusement in her bland tone and Hugo’s lips twitched. He’d deserved that.

  ‘I’m happy,’ he said. ‘Let’s get going. The helicopter should be well on the way by now so we shouldn’t have too long to wait at the airfield.’

  Maggie started the engine and eased slowly over the pot holes in the Barker’s driveway. She could hear Hugo talking to Charlie.

  ‘We’ll have you in the catheter laboratory in Dunedin in no time, Charlie. With a bit of luck they’ll be able to slot you in for a bypass while you’re up there.’ Maggie could hear a smile in his voice. ‘I wouldn’t have recommended this course of action but it’s certainly the most effective way to bump yourself to the top of the waiting list.’

  ‘Hate waiting,’ Charlie said. ‘Always have.’

  Maggie drove fast but without the spine-chilling speed with which she had responded to the call. They had a fifteen-minute wait at the airfield until the rescue helicopter arrived from Dunedin and they used the time to give Charlie another thorough assessment and complete the paperwork. Maggie helped the paramedic crew transfer Charlie to their own stretcher and load him into the chopper. Then she moved back, surprised to find Hugo with his arm around Betty.

  ‘You OK, Betty?’

  ‘I’m worried sick. Is he going to make it through this time, Hugo?’

  ‘He’s certainly not going to give in without a good fight,’ Hugo said with a gentle smile. ‘And he’s going to the best place possible.’ He pulled Betty closer and gave her a warm hug. ‘Hang in there and ring me later to let me know what’s happening.’

  ‘I’ll do that.’ Betty pulled away from Hugo’s embrace. ‘Thanks, Hugo…for everything.’ The older woman sniffed hard as she noticed Maggie standing beside them. ‘Thanks to you as well, dear, for taking such good care of Charlie. I think we’re lucky to have you here.’