The Magic of Christmas (2 page)

Lara allowed herself the luxury of a brief glance at his athletic physique and then she looked away.

He was the senior consultant.
A colleague.

And he was also—

‘Why does he have to be married?' Jane muttered in an undertone, and Lara gave an exaggerated sigh of regret.

‘Because the world is a cruel, hard place,' she muttered back. ‘And, anyway, it doesn't make any difference in my case, because men like him always trample over me as they rush to embrace the tall, blonde stick with the perfect hair who just happens to be standing behind me. And, if by some strange chance he did happen to notice me, it would take me less than a minute to start finding his faults because that's what I do.' With a fatalistic shrug she let the door swing shut behind her and walked into the room.

A strong, handsome man who is sexier than sin.

For some reason, the psychic's words played on her mind and Lara's heart performed a series of strange rhythms. Well, they certainly didn't come any sexier than Christian. Ever since he'd taken up his post as senior consultant in the ED two months earlier, all the women in the hospital had been hoping and dreaming.

Except her.

She was about to embark on the trip of a lifetime.

Even if Christian hadn't been married, she wouldn't have been interested. But that didn't stop her admiring him.

‘If you're looking for perfection, I think you've just found it,' Jane murmured, and Lara frowned at her as she slid past her into the room.

‘He's married. If I want pain, I'll just go ahead and remove my heart with a blunt scalpel and have done with it.' She walked briskly across the resuscitation room. ‘Good afternoon, Dr Blake.'

He looked up, his gaze cool and assessing. ‘Lara, this is Ellen Bates.' He spoke with characteristic brevity, delivering the necessary facts and nothing more. ‘She's thirty-two years of
age and complaining of chest pain and shortness of breath.'

He never showed the slightest flicker of emotion
, Lara mused as she smiled at the patient and reached for a blood-pressure cuff. He gave nothing away. He'd been working in the emergency department for two months and during that time he'd shown no inclination to socialise with the staff or reveal intimate facts about himself. On one occasion his daughter had phoned the department, and that had been how they'd discovered that he was married with children. Apart from that one incident, nothing. He worked. He went home—no doubt, to his beautiful wife.
Because Lara had absolutely no doubt that a man this impossibly handsome would have an equally impossibly beautiful wife.

The patient's eyes were fixed on Christian's face. ‘I was at the office Christmas lunch and then all of a sudden I started to feel terrible. Typical. The first time for ages I actually get to eat lunch and I'm ill. Usually I'm too busy working to bother.'

‘Has anything like this ever happened before?'

‘I do get palpitations occasionally,' Ellen murmured, her face screwed up as she rubbed the flat of her hand against her chest. ‘But I've always assumed they're caused by the amount of coffee and diet cola I consume. I'm a lawyer. I spend whole days in boring meetings and caffeine is the only thing that keeps me conscious.'

Lara quickly attached her to the machine and checked her observations. Seeing that Ellen's pulse was two hundred, she glanced at Christian and he nodded to indicate that he'd seen the reading.

‘I want to get a line in and take some bloods.'

Knowing that they needed to check the patient's blood oxygen level, Lara swiftly attached the necessary probe to Ellen's finger and then picked up the IV tray. ‘Is there anyone you'd like me to call, Ellen?'

‘No one.' Ellen didn't look in her direction. Her eyes were occupied with studying the dark stubble that shaded Christian's hard, angular jaw.

‘Can we check her sats, please, Lara?' Christian slid the venflon into the vein and released the tourniquet.

‘Just doing it now.' Lara adjusted the probe and
watched the machine. ‘Sats are ninety-eight per cent.'

‘Good. These can go to the lab.' He dropped the blood bottles onto the tray. ‘I'll do the forms in a minute.'

Lara handed him some tape so that he could secure the venflon, her eyes still watching the pulse and blood-pressure readings. ‘She's still tachycardic.'

Christian's gaze followed hers and he moved the IV tray, reached for his stethoscope and hooked it into his ears.

‘I'm just going to listen to your chest, Ellen.'

Ellen lowered her eyelashes in an unmistakably flirtatious gesture. ‘Anytime. I suppose the one good thing about all this is having you leaning over me. I thought doctors as good-looking and sexy as you only appeared on television. Are you real or have they flown you in from Hollywood to perk up everyone's Christmas?'

In the process of labelling blood bottles, Lara winced slightly at the patient's less than subtle approach and glanced towards Christian, anticipating a cool putdown.

But he chose not to respond to the comment.
He was probably used to female adulation,
Lara thought to herself as she dropped the bottles into the bag and handed them to another nurse to take to the lab. He was so impossibly attractive he had to have been fending off desperately hopeful women all of his adult life.

She pulled the ECG machine closer to the trolley and tried to ignore the fact that Ellen was still flirting with Christian.

‘Do you play poker?' Her voice was husky. ‘I bet you do. You have one of those faces that gives nothing away. Inscrutable. You must win millions. Oh, dear.' She closed her eyes. ‘I feel horribly, horribly dizzy. And sadly I don't think it's anything to do with the fact that a gorgeous man is listening to my chest.'

Wondering whether she'd even noticed anyone other than Christian, Lara ripped open some pads. ‘I just need to attach these to your chest, Ellen, so that we can get a reading of your heart rate.'

Ellen didn't look at her.

‘Pulse is two hundred and twenty,' Lara said, her eyes flickering to the monitor as she swiftly and
competently attached the electrodes to the patient. ‘Do you want me to call the cardiologists?'

Christian looped the stethoscope back around his neck and gave a swift nod. ‘Please.'

Ellen clutched his arm, her outward appearance of calm slipping. ‘Am I having a heart attack?'

‘We need to perform some tests before we make a diagnosis, but I don't think you're having a heart attack, Ellen.' His gaze flickered to Lara just as she switched on the machine. ‘Are you ready to do a trace?'

‘Coming right up.'

Ellen gave a whimper and shifted on the trolley. ‘I feel all sweaty and clammy. Oh, God, something awful is happening, isn't it? I knew I'd been working too hard lately.'

‘Try not to panic,' Lara murmured, but Ellen didn't even look in her direction. It was clear that all her hope for the future was fixed on Christian, who was studying the ECG machine. It purred softly as it produced a trace and he watched for a moment, his eyes narrowed. ‘Her ECG is showing regular narrow complex tachycardia with retrograde P waves.'

Interested, Lara leaned forward to take a closer look. ‘Mmm. There's a shortened PR interval and a delta wave.'

Christian glanced at her in astonishment. ‘Yes,' he murmured, ‘there is.'

‘So…'
Why was he staring at her?
‘Do you want to try adenosine or go straight for cardioversion?' She knew that some doctors were reluctant to give adenosine in the emergency setting.

He was still staring. ‘We'll give her 6 milligrams of adenosine by rapid IV push and see if we can get her back into sinus rhythm.' He paused and she nodded to indicate that she understood that there was always the chance that the patient might develop a life-threatening arrhythmia.

‘So we'll just have this within grabbing distance,' she said quietly, moving the defibrillator next to the trolley.

Then she prepared the drug and handed it to Christian, who checked it and inserted the syringe into the venflon.

‘What's happening?' Ellen moaned, rubbing her hand over her chest. ‘What's happening?'

‘Ellen, the conduction system of your heart isn't
working properly and your heart is being overstimulated. That's why you're feeling the way you are. The drug I'm giving you should prevent some of the electrical impulses getting through and slow the heart.' Christian depressed the syringe to push the drug into the vein then dropped the empty syringe onto the tray next to him.

‘I'll do you a rhythm strip,' Lara said, programming the ECG machine and then standing to one side so that he could see the printout.

Ellen gave a sigh. ‘I'm feeling a bit better. But my face feels really hot.'

‘That's a side effect of the drug we just gave you. Nothing to worry about.' Christian's gaze flickered to the monitor. ‘I'm going to refer you to the cardiologists, Ellen. They'll want to do some more tests.'

‘Do you know what's wrong?'

He looped the stethoscope back around his neck. ‘The electric currents that control your heart aren't working properly. Put simply, they're taking a short cut.'

‘I'm a lawyer. I don't need the simple version.'

Christian studied her for a moment. ‘All right.
Do you know anything about normal conduction pathways in the heart?'

‘No, but I'm a fast learner.'

Christian pulled a piece of paper and a pen out of his pocket and swiftly drew a diagram. ‘In the normal heart, electrical impulses start in the sinoatrial node in the right atrium—the atria are the chambers at the top of your heart—' his pen flew over the page to illustrate his point ‘—and pass through the atrioventricular node to the ventricles in the bottom of your heart. The atrioventricular node limits the electrical activity that passes through to the ventricles and acts as a break on the heart rate. That's what happens in the normal heart.'

Ellen looked at the drawing and gave a hollow laugh. ‘And that's not me, right?'

‘Sometimes there's an extra electrical pathway that bypasses the normal process and conducts electricity at a higher rate—there's no filter, if you like. The result is that the heart can beat very quickly and that causes the symptoms you felt today.'

Lara studied the ECG again. ‘If she has an accessory pathway, why does the QRS complex look normal?'

‘Because ventricular depolarisation can occur through the normal pathway. It's a combination of pre-excitation and normal conduction.'

‘You've lost me.' Ellen sighed. ‘So how did I get this extra pathway? Was I born with it?'

‘Yes, it's congenital. Some people have more than one. Basically it happens when the atria and the ventricles fail to separate completely.'

‘But why hasn't it been picked up before?'

‘Because the majority of the time the normal pathway is used.'

‘And can it be fixed?'

‘Extremely successfully.' Christian folded the ECG strip and attached it to the notes. ‘We'll refer you to the cardiologists and they'll carry out electrophysiological studies—basically, looking at the conduction of your heart.'

Ellen frowned. ‘And then?'

‘If they think you're an appropriate candidate, then they may do something called radiofrequency ablation—to put it simply, they destroy the extra electrical pathway by sending an electric current through it.'

‘Sounds scary.'

‘Actually, it's a very successful procedure. It takes a few hours and requires an overnight stay in hospital, but no more than that.'

Ellen gave a wan smile. ‘I'm not allowed time off in my job. Even sleeping is banned.'

‘Sounds familiar,' Lara murmured, watching as Christian scribbled on the notes. Over the past two months, she'd developed enormous respect for him. No matter what the situation, he never lost his cool. He was focused and skilled and didn't let emotion cloud his judgement.

Lara studied him for a moment, wondering whether he was even aware of Ellen's advances.

As if to test the theory, the woman gave him a smile that was pure invitation. ‘If I'm in hospital, will you visit me? I never get to meet anyone except boring lawyers in my job. I bet you only ever meet boring nurses.'

‘That's me,' Lara said lightly, slipping the tourniquet back into her pocket. ‘Boring nurse.'

Ellen turned her head and looked at her, as if only now noticing that there was someone else in the room with Christian. Her eyes widened as she stared at Lara. ‘Boring maybe, but beautiful,' she
muttered with a faint smile. ‘How do you manage to look so good in that shapeless blue thing? I dress in designer wear from head to foot and I don't manage to look as good as you. Who does your hair? It's fabulous.'

‘My hair?' Taken aback by the question, it took Lara a moment to answer. ‘No one. Most of the time
I
don't even do it. I mean, I wake up with it looking like this. That's when my job allows me the luxury of sleep, which isn't often.'

Ellen gave a wry smile. ‘Your job sounds a lot like mine. Except that I don't look a fraction as beautiful as you even after eleven undisturbed hours of sleep. Someone must do your colour. Those blonde streaks are gorgeous. So natural.'

‘That's because they
are
natural,' Lara muttered, wondering why she was discussing her hair with a patient. In the circumstances it seemed utterly bizarre. Any moment now they'd be talking about shoes. Bracing herself for a sharp comment from Christian about her lack of professionalism, her eyes slid in his direction and she found him studying her with a curiously intent look in his eyes.

As if it was the first time he'd seen her.

Awareness shimmered between them, as powerful as it was unexpected, and then he turned back to his patient, leaving Lara to cope with a frantically pumping heart and shaky knees.