New Surgeon at Ashvale A&E (11 page)

He shrugged. ‘It was a long time ago, and generally my grandparents lived some distance away from the family home. I don’t see a lot of them, even now, though we get together for family occasions. As to my brother, he lives up in Scotland, so my parents go to see him whenever they can, but of course they’re away a lot.’

‘I can’t imagine that kind of lifestyle,’ she said. ‘My family have always been reasonably close by, and we’re always in touch one way or another. My grandparents are moving to live near the coast, but they won’t be too far away even then…an hour or so by car. We often spend weekends together as a family, and I can’t see that changing.’

They walked into the restaurant, and Sam picked up a couple of trays, handing one to her. ‘It has still been a problem for you with Becky, though, hasn’t it, even with close family to help. How have they all reacted to Sophie’s disappearance?’

She winced. ‘They’re very worried. They tend to think that she was ill as a result of her pregnancy, and maybe because of the shock of discovering that Becky’s father wasn’t going to be around for her. They want to support her in any way they can, and both my parents and grandparents have suggested that she might go to live with them once she comes home.’

She grimaced faintly. ‘I think Sophie felt that she ought to be able to manage on her own, but of course it didn’t work out. Now all we can do is hope that we manage to find her. I think the police tend to take the view that she’s an adult who made her own decision to leave. They suggested we involve social services to take care of Becky, but we declined that offer.’

Sam asked the woman behind the counter to add meat pie, potatoes and vegetables to his plate. ‘Sophie lived with you for a time, didn’t she?’ he said, throwing Ruby a sideways glance. ‘Was that your own house, or were you renting?’

‘It was mine. I can’t make up my mind whether to let it out or put it up for sale. I think I’m waiting to find out what happens with Sophie first of all, in case she comes back and needs to find a place of her own.’

She chose beef and vegetable casserole for her own lunch and added a cup of tea and a dessert of fruit and ice cream.

Sam was frowning as they went to find a table by the window. ‘So you’re definitely thinking of moving into your grandparents’ place, then? I thought perhaps you might find it a bit too much to handle, now that you’ve decided to come back to work.’

‘I didn’t realise that you knew about that.’ She sat down at the table and took a sip from her tea.

He made a half smile. ‘I know the general consensus is that I don’t mix too well or have any idea of what’s going on, apart from on the work front, but I do tend to absorb all the chatter that goes on around me. Just because I don’t always join in, it doesn’t mean I don’t know what’s happening.’

‘Ah…so you do have an idea about what people are thinking? They would really like for you to open up to them a bit more, you know.’

‘Yes, well, maybe I will, as soon as I’ve manoeuvred the department into its new, lean, less costly shape.’ He lifted his fork and slid it into a mound of creamy potato. ‘So, how are you planning to make things work if you take over your grandparents’ place?’

‘That,’ she answered, scooping up a forkful of succulent vegetables, ‘is what I still have to work out. It’s just that the opportunity was too good to miss, and it’s a beautiful old house, rambling, large, full of light, and with masses of land
where children can run and play…so it would be good for the future—if ever I get as far as having a husband and children, that is.’

He sent her a thoughtful look. ‘How would you feel if your prospective husband doesn’t share your love of the place?’

Her brows drew together, and she wavered for a moment, her fork poised in the air as she pondered that. ‘He’d obviously be the wrong man for me. What’s not to like about that lovely farmhouse?’

She grinned. ‘Of course, coming from your background, you’d probably find lots that was unsuitable…all that clutter and mess. Even the stream and the pond are haphazard and meandering, and as to the meadows—all those broken-down fences and ancient stiles must offend your sense of order. The trees are old and gnarled, and the apple orchard tends to be filled with fallen fruit in the autumn. I expect your country estate is all manicured lawns and neat gravelled drives, with not a weed to be seen anywhere.’

He raised a dark brow. ‘Weeds? With all those gardeners employed to tend to the grounds week in and week out, I should think not.’ His mouth made a crooked shape, and soft light glimmered in his eyes. ‘Anyway, the house is a charming example of fine Georgian architecture, beautifully symmetrical in style, and it has certainly stood the test of time. I’m really quite taken with it. It isn’t mine, of course, though it has been in the family for generations.’

‘No. I understand that.’ She frowned. ‘Have you never thought of getting a place of your own?’

He gave a negligent shrug. ‘Not really. Up to now I’ve usually rented apartments because I’ve been on the move, going wherever promotion took me. I suppose now that I’m on the board of the hospitals trust, I ought to consider finding somewhere, but it seems a waste when my parents are away so much and I already have a wing to myself in the family home.’

‘Will your parents object to you setting up a fund-raising event on the estate? That is what you plan to do, isn’t it?’

‘That’s right. No, I don’t see them having a problem with that. The grounds are extensive enough for us to take over one of the fields, maybe a second one for the car parking, and we should be able to provide everything we want within that area.’

‘What did you have in mind?’

‘Well, that’s the question.’ He leaned back in his chair and gestured with his hands to show a wide-open expanse. ‘I’m open to suggestions. I thought a few stalls—cakes, bric-a-brac, plants and a raffle. Maybe some horse riding experiences for the youngsters…I haven’t really thought much beyond that.’

She finished off her last forkful of carrots and sent him a questioning look. ‘Where would you find the horses?’

‘In our stables. We have several thoroughbreds that run regularly on the racing circuits, and there are grooms to attend to them, but we also have other horses that are gentle enough for untrained riders.’

She raised her eyes heavenward. ‘It’s another world out there, isn’t it? How on earth did you ever come into medicine with that background?’

He chuckled. ‘I think I was impressed by the medical profession from an early age. My parents set up facilities abroad, and sometimes they took me with them, so I was able to see how they were progressing. I was very taken with how people valued the chance to receive medical help, and I was touched by how much difference a doctor’s intervention could make in someone’s life. The actual decision to take up medicine as a profession, though, came while I was away at school.’

‘You put me to shame,’ she said. ‘My medical career had quite mundane beginnings. I stuck plasters on my dolls and bandaged up my teddy bears, and they always miraculously recovered from whatever ailed them, so I was convinced from a very young age that I had the healing touch.’

He laughed. ‘And I’m sure you do. You’re very good at your job.’

‘Thanks. I just hope we can keep this department going so that I still have a job to come to in a few months’ time.’ She drew the dish of fruit towards her and picked up her spoon. ‘So what are we going to do about this fund-raiser? I suppose we could have a dog show. Those sorts of things tend to bring in a good crowd, don’t they? Unless you have any objections to something like that?’

‘Not at all. And, thinking about events that people can watch, I could ask the local tae kwon do team if they’d like to do an exhibition. They would be glad to take part, I think, to drum up support for their club and gain new members.’

‘There you are…we’ve practically sorted it, haven’t we? Shall I print out some posters? We could ask for volunteers at the village institute.’

‘Yes, that would be good.’ He began to eat his pudding, a stodgy treacle sponge that made her feel full up just looking at it.

‘Do you want a taste?’ he asked, picking up a fork and getting ready to offer her a sample.

‘Uh…no thanks,’ she murmured hastily. ‘I’m fine with what I have. In fact, I’m already wondering if I haven’t overdone it. My waistband feels as though it’s expanded a couple of inches.’

‘I’m sure that won’t matter at all,’ he said, his gaze travelling over her in appreciation. ‘You look gorgeous: all soft, womanly curves, enough to make a man’s pulse shoot into orbit. It’s just as well that you’re a paediatrician because if you were to give your tender loving care to the adult males who are brought in here, they’d probably keel over from their hearts going into overdrive.’

‘Oh,’ she said, looking at him in astonishment, her lips parting a fraction.

He groaned. ‘Please don’t look at me like that. It’s difficult enough to keep my distance as it is, but when you give me that wide-eyed look, it pushes everything else out of my head and just makes me want to kiss you. That’s not good at all, not when I have to go back to work and concentrate on the job in hand.’

‘Oh,’ she said again, her eyes growing even wider, so that he pushed his dish away and got to his feet.

‘If you’ve finished,’ he murmured, ‘perhaps we should go before things run out of control. I need to collect some files, and then I have to drive over to the Heritage and do my stint there.’

He held out a hand to her, and she slid her palm into his, allowing him to draw her to her feet. His grasp was warm and firm, and it was just as well that he was holding her because for a moment or two the world seemed to be out of kilter, and she had no idea why she was experiencing such a heady rush of heat from her toes to her face. She was sure her cheeks must be burning, and all she wanted right then was to get out of there, away from the restaurant and prying eyes.

Not that anyone would have noticed, she realised as she went with him out into the corridor. They were all far too busy refuelling themselves after a busy morning, and any feelings of embarrassment were entirely her own.

She walked with him back to A&E, and all the time he retained his hold on her hand, and she did nothing whatever to change that. He keyed the security code into the door panel and ushered her into the unit, draping his free arm around her waist, as though he knew she might crumple to the floor if he was to let go of her.

‘Okay, then,’ he murmured. ‘I’ll go and find those files.’ They reached the door of his office, and he hesitated for a moment, pushing the door open and glancing at her as though he was going to invite her in.

‘Yes, of course.’ She looked at him, all too conscious of his
palm still resting in the small of her back, aware of the subtle pressure that was gently coaxing her to come and join him.

‘I should go back to work,’ she said, and he gazed at her for a second or two, reading her indecision, and waiting hopefully for her to give in to his tender persuasion.

Instead, she took a small step backwards, and he reluctantly let his arm fall to his side, allowing her to go. Released, she finally began to breathe more easily. It would not have done for her to take him up on that unspoken invitation. She was far from immune to his masculine vibes, and just being near him was playing havoc with her senses. How did he manage to do this to her, to make her feel as though her whole body was yearning to have him hold her close?

She turned and walked away from him, pulling in a slow, deep breath, trying desperately to get herself together once more.

‘Are you all right?’ Michelle asked, her gaze following her as Ruby went to rummage through the stack of lab reports at the desk.

Ruby nodded. ‘Of course. Why do you ask?’

‘I saw you coming back from lunch,’ the nurse said. ‘You looked as though you’d been hit by the aftershock from a quake.’

‘Did I?’ Ruby blinked. ‘We don’t get those around here, do we?’

Michelle gave a short laugh. ‘We do if Sam Boyd is around. I think it’s known in some circles as the Boyd effect. Women have been known to fall for him, big time, according to the gossip in the nurses’ quarters, but it never pays to think that you’ll be the one to crack the code. They say he always moves on, especially if things start getting too serious.’

‘Do they?’ Even as she asked the question, Ruby had to accept that she knew it was true. Hadn’t Sam told her as much himself? He had warned her that he didn’t have time for commitment, for long-term relationships with strings attached, and perhaps there was more behind that than simply a desire
to put all his energy into his chosen career. Maybe he was afraid of becoming emotionally involved. Why else would he steer clear of any deep and lasting attachment? ‘Are some of the nurses suffering from broken hearts?’

‘Not as far as I can tell, but you know how these things are bandied about. There are people who know people…and then the rumours start.’

‘Well, thanks for telling me, but I wasn’t actually planning on getting involved.’

‘Maybe not.’ Michelle’s expression became serious. ‘But it happens sometimes, and I wouldn’t like to see you get hurt.’

Ruby sent her a quick, rueful smile. ‘Thanks, Michelle, but I’m sure you’re worrying unnecessarily. I don’t have the time or energy for romance right now. I have enough on my plate at the moment with all the worry about my sister and having to look after Becky while at the same time trying to hold down a job. Besides, Sam and I have nothing whatever in common.’ She went back to studying the lab reports.

It was true what she’d said, wasn’t it? Sam was attracted to her, and he was more than ready to explore the various places where that could lead, but he lived in a different world from Ruby, and even if she’d been tempted by the lure of his sensual magnetism, she was far too sensible to allow herself to be pulled into his force field, wasn’t she?

‘W
HY
can’t people take the time and trouble to refill the coffee pot when they see it’s running empty?’ Ruby said grumpily as she contemplated the dregs of coffee grounds in the filter. She picked up the filter paper and tossed it into the nearby bin.

The staff lounge was empty right now, except for herself and Sam, because there had been an influx of patients in A&E, and everyone was working at full tilt. Ruby had already been on duty for several hours, dealing with the usual crop of accidental injuries, respiratory difficulties and acute illness that brought people here during the weekend. Now, as this Saturday afternoon wore on, they were dealing with the aftermath of all-day drinking and injuries from fights that had broken out. The waiting room was full to overflowing, and there were a number of intoxicated, garrulous people waiting to be seen.

‘Because it takes time and trouble, I would guess,’ Sam said, throwing her a quick, assessing glance. ‘What’s wrong? You’re not yourself today, are you? I’ve noticed you’ve had a tendency to be quite short-tempered at times. Is it the drunks taking over A&E? Are they beginning to get to you?’

Ruby shook her head. ‘I’m used to them by now.’ She put fresh coffee into a new filter, filled the jug with water and set it on the base to heat. ‘I’m just tired because Becky had a bad
night. I think she caught sight of one of her mother’s sweaters when I was sorting through the wardrobe, and it must have triggered something in her mind. After that she was inconsolable. Nothing I did would put matters right.’

She sighed. ‘And she’s teething again, so that didn’t help. She kept waking up and putting a finger in her mouth, and then she would start to sob and dribble, and it was just too awful. I ended up nursing her in my arms each time until she fell asleep. I didn’t know what to do. I tried teething gel. I tried a nice bottle of warm milk, but she was very fractious.’

She made a brief grimace. ‘Of course, this morning, when I took her over to my mother’s house to be looked after, she was sleeping serenely like a little angel.’ She pulled down a cup from the rack and sent him a taut glance. ‘So all in all I’m not in the best of moods. Be warned.’

He pressed his lips together to hide a smile. ‘What you need is doughnuts,’ he murmured. ‘Didn’t you once tell me that they were the very thing that would put a smile on the face of everyone here?’ He walked over to the fridge and drew out a box. Then he held it out to her. ‘Here you are. Help yourself to something delicious.’

She lifted the lid and stared down at an assortment of doughnuts and cream cakes. ‘Oh, bliss. Oh, joy,’ she said. She looked up at him. ‘Where did these come from? I mean, who brought them?’

‘I did.’ He smiled. ‘Haven’t you noticed that the snack trolley has been filled with goodies every day? I thought you were giving out extremely good advice, so I decided to act on it. And today, since it’s the weekend, I reckoned we all needed an extra boost.’

‘Mmm. I think I could kiss you,’ she said, glancing up at him and taking a bun from the selection. ‘I’m in more of an iced bun kind of a mood today, I think.’ She bit into it, savoured the sweet flavours, licking the cream from her lips,
and then looked at him with deep affection. ‘I’m pretty sure you’re my favourite person in all the world,’ she murmured. She took another bite and then nodded. ‘Yes, I’m sure of it. I’m in love, definitely.’

‘With me or the bun?’ He laughed and went over to the coffee machine. ‘Sit down and I’ll pour your coffee,’ he said. ‘Relish it for as long as you can because, as we both know, it’s hell out there.’

She sat down and scoffed the rest of the bun while he made coffee and came to put a cup down on the table beside her. He waited until she had finished eating, watching in fascination as she licked her fingers clean slowly, one by one, and then he leaned over and planted a kiss firmly on her mouth.

‘Mmm,’ he said, drawing back eventually. ‘Delightful. Sweet as sugar and absolutely delicious, you taste like perfection to me, grumpy or not.’

She stared up at him, a dazed look coming over her face, her senses dazzled by the swiftness of that sensual onslaught, her lips on fire where he had touched them, and he laughed again. ‘I have to go,’ he said. ‘Back into the fray. Don’t let your coffee get cold.’

She drank it in a bemused state, her mind whirling in a wonderland of overwhelming sensation. She wanted to savour the memory of that kiss for as long as she could, but after he’d left the room and reality slowly began to sink in once more, she realised that life had to go on, and she had no choice but to get back out there and join the frantic race to deliver health care to the endless queue of people who were waiting outside.

Her nerves were in a chaotic state after that unexpected, delicious kiss. Sam was beginning to get to her, and she wasn’t at all sure how she was going to cope with all the frantic emotions that suddenly besieged her. Didn’t she have enough to contend with right now?

She went to the sink and splashed water over her face, then
dried herself on a paper towel and ran a comb through the burnished chestnut of her hair. Feeling a little more in control of herself, she walked back into A&E and started to work her way through the list of patients still to be seen.

It was a thankless task. Noise from the waiting room erupted into the treatment rooms, and she had to battle a headache as she dealt with a succession of head and face wounds caused by various fracas, pavement falls and general wild and wanton behaviour.

She felt like shouting, ‘Enough!’ but of course that wouldn’t do at all.

In the end, it was Sam who declared ‘enough’. He looked at the ever-growing list of patients and called the nurses over to the central desk. ‘We have some people who are seriously injured coming in by ambulance,’ he told them, ‘and they have to take priority, which means these people already here will be in for a long wait. I want to set up a nurse-based treatment centre in the annexe next door, so that you can work through those who have minor injuries and send them on their way. Michelle will be in charge. We’ll divide the more senior nurses into two groups—one group to work here, the rest in the annexe. The triage nurse on duty will decide which patients go to the annexe for treatment.’

He looked around. ‘Is that clear? Grab what you need from stores and take it with you, those of you who are going.’

There was shock on the faces of some of the assembled group. ‘You can’t do that,’ one of them said. ‘You’re not in charge of the nurses’ schedule. You can’t just arbitrarily decide who goes where.’

‘I’ve just done it,’ he said. ‘Take it up with your nursing manager later if you like, but right now we need you to be dealing with patients.’

‘And who’s going to deal with all the drunks and the aggressive
patients, or even with their relatives? I’m certainly not doing it,’ another nurse said.

He nodded. ‘Call security if there’s a problem.’

‘A doctor should sign off on treatment,’ yet another said. ‘I’m not prepared to take responsibility if anything goes wrong. We’re not covered legally.’

Sam made a short, exasperated sound. ‘Yes, of course, that’s true. Send all the charts to me at the end of treatment, and I’ll sign them off. If there are any problems or queries, put a phone call through to Ruby or me, and if there’s a patient that you think needs to be seen by a doctor, or one who rejects nurse-based treatment, refer them back here. Anybody who really doesn’t want to take part should say so, but as to the rest, we need to start doing this now, otherwise we’ll be over-running the waiting times, and that will put our on-going status as an A&E unit in jeopardy.’

There were murmurs of dissent, but Michelle stepped forward and started sorting out which nurses would stay and which would go to the annexe. Sam began to walk away, heading towards the ambulance bay, and Ruby hurried after him.

‘That nurse was right, you know,’ she said. ‘You can’t just decide on a whim who goes where. It isn’t your place to do that.’

‘And do you really think the nursing manager is going to object?’ His tone was curt. ‘When she comes in on Monday and understands the situation, she’ll okay the measures I’ve taken.’

‘When you’ve had a chance to talk her round, you mean?’

He shrugged. ‘Maybe. We can’t stand around debating the issue when there’s a job to be done. Some patients don’t need to be seen by a doctor. They turn up at A&E with sprains or cuts that can be treated by nurses. We’re wasting resources if we insist that a doctor sees each one of them. Each of the senior nurses is trained to practitioner level. I don’t see a problem with that.’

‘The trust board might object.’

‘So let them sack me.’

She glanced at him. ‘You really don’t care, do you?’ She made a face. ‘I suppose that’s because you’re confident they won’t do that…but you could have handled the situation with a little more tact, you know, instead of upsetting the staff. You won’t endear yourself to anyone by taking a do-it-or-else stance.’

‘That’s not a problem for me. I don’t need to be universally liked. I just want to get the job done.’

She gave a sigh of frustration. ‘And you’ll succeed, I’m sure…but there are ways of doing it, Sam…more diplomatic ways.’

He sent her a rueful look. ‘So you’re standing in as my popularity gauge, are you? And it looks as though you’ve also set yourself up to assess the way I handle the running of the unit. Why do you want to do that? Don’t you have enough to contend with already with the job and everything that’s going on at home?’

‘I don’t want to see you at loggerheads with everyone,’ she said, frowning. ‘You deserve better than that. I know you’re trying to do a difficult job here, but you could make life much easier on yourself if you would just manage to tone your attitude down a little. We aren’t all here to jump through hoops that admin throw our way. We’re here because we want to do a good job, and at the same time we want to get along with the people who work alongside us.’

‘I’ll bear it in mind,’ he said. ‘But I do think you probably have other, more important, things to worry about rather than my popularity. I’m glad you came back to work, but I still haven’t worked out how you manage to do this job, with all its frustrations, and keep relatively good-natured and still cope with running things back at the farm.’

‘Why wouldn’t I manage it?’

‘Well, for instance, you didn’t take me up on my offer to send people over to help out with your crops and your animals. How on earth are you able to keep going?’

‘My father is helping out by calling in every morning and evening, and Mary from next door said she’d keep an eye on things each day to make sure that everything was secure and the animals were safe. She’s been great with Becky too. I suspect she likes looking after her once in a while.’

‘Hmm. Well, the offer still stands for me to send people over if you change your mind.’

‘Thanks.’

She worked with him over the next hour or so, helping to stabilise a teenager who had been brought in after a fall from a bridge. He had suffered several broken bones and internal injuries, along with a hairline fracture to the skull.

‘We’ve done all we can for him for now,’ Sam said, writing up the medication chart and then checking the monitors and intravenous lines. ‘He needs to be transferred to Intensive Care.’

Ruby made all the arrangements and explained to the boy’s parents what was happening. Then she accompanied the boy to ICU, stopping there to give details of his condition and the care he had received to Jenny, the nurse in charge.

‘It sounds as though things have been hectic in A&E today,’ Jenny said, ‘more so, perhaps, than usual.’

‘Well, we’ve been having some fine weather,’ Ruby answered, ‘possibly the best we’ll get before autumn sets in. I think people are making the most of it while it lasts, so the pubs are full, and people are in high spirits in more ways than one.’

‘It always happens, doesn’t it? Still, maybe next week we can relax a bit. Sam’s holding the fund-raiser then, isn’t he?’

‘That’s right. I’ll look forward to seeing you there, Jen.’

She took a final look at the injured boy before she left. She knew she was leaving him in good hands, but she was sad to think of how much damage the fall had done to him.

Back in A&E, the relatives of the walking wounded were becoming restless. ‘Your Mr Dryden is back again,’ Olivia said as Ruby glanced in at the waiting room.

‘My
Mr Dryden?’ Ruby echoed. ‘What makes you call him that?’

‘Because I suspect he’s only here because he wants to see you. He’s been asking for you to treat him.’

Ruby gave a frown. ‘What’s wrong with him?’

Olivia glanced at the triage chart. ‘A sprained wrist.’

Ruby shook her head. ‘I can’t deal with that right now. I need to go back to Sam to help with the people in resus. Say I’m not available and send him over to the annexe, will you?’

‘I will.’

They both moved off in different directions to go on with their work, but a gang of youths spilled out of the waiting room just then, arguing with the triage nurse and pushing people out of their way. Ruby went to intervene, and Olivia said hastily, ‘I’ll call security.’

Ruby nodded. ‘Yes, do that. Thanks.’

She went to stand in front of a young man who was staggering towards the resuscitation room, blocking his way. ‘You need to go back to the waiting room,’ she said.

He glowered at her. ‘I’m not going back there. You can’t make me. My mate needs to see a doctor. Look at him.’ He draped an arm around his friend, who stared at her in a blearyeyed fashion. ‘He’s bleeding from a cut on his arm, and his hand’s in a right state. He’s weak from all the blood he’s lost, and it’s messed with his head.’ He lurched towards her and grabbed at the name badge she wore on her green scrubs. ‘You’re a doctor. You see to him.’

Ruby twisted out of his grasp and turned to look at his companion. ‘Let me see your arm, please.’

The youth stuck his arm under her nose, narrowly missing her face, and then swayed with the movement, so that a waft of alcohol-drenched breath fanned her face.

She studied both the arm and the hand. His knuckles were raw from where he had been in a fist fight, and the
cut on his arm was not too deep. ‘The wounds aren’t that bad,’ she said. ‘The nurse has put a temporary dressing on your arm, and you should put it back in place to keep the wound from becoming infected. Please go back into the waiting room and take a seat until a doctor’s free to see you.’