The Magic of Christmas (6 page)

Gritting her teeth, she reached for the equipment that was mandatory for dealing with trauma patients. Swiftly she sorted out a gown, gloves and eye protection, all the time reminding herself that Christian Blake might be a hotshot in the resuscitation room, a fabulous father and indecently good-looking, but that didn't mean that he was perfect.

The trauma team was assembling, each member occupied with preparing for the arrival of the patient.

Christian was prowling around the room, checking that everything was in place and that everyone understood their responsibilities. ‘Jane? Have you bleeped the trauma consultant?'

‘He's on his way.'

The trauma registrar hurried into the room and then the doors to Resus flew open again and the paramedics surged into the room with the patient on a stretcher and ED staff alongside.

Everyone moved swiftly into position, carefully transferring the patient but maintaining silence while the paramedics described the mechanism of injury, the patient's signs and what treatment had been given.

Christian's gaze flickered to the whiteboard at the head of the trolley, which had already been covered in black, scrawling notes by the person who had taken the call from Ambulance Control.

Another doctor moved to the head of the trolley to clear and secure the airway and Lara reached for a pair of more robust gloves so that she could help remove the patient's clothes.

How did Christian do it?

How did he hold down such a busy job and look after two lively daughters on his own?

But she knew the answer to that, of course, thanks to Aggie's innocent declaration. He was living in a house with boxes still unpacked and he
relied on nannies. He was doing the job and being a father to his children, but not much else.

By now the patient's airway was secure, the clothes had been removed from the patient's body and two peripheral lines were in place. The radiographer had moved the X-ray machine into position on the patient's left side and someone pulled a unit of O-negative blood out of the warmer.

‘Chest and AP pelvis to start with,' Christian ordered, ‘and then I want to do a FAST test. Her systolic pressure is less than 90 so she's bleeding from somewhere. The question is whether it's just the pelvis. Keep the pelvic splint in place and don't move her around.'

Lara moved the machine closer to the trolley. ‘You don't want to send her straight for a laparotomy and packing?'

‘I might still do that but I want to see the result of the FAST test first. She's haemodynamically unstable so if it's negative then she's going straight to the angio suite for embolisation.'

He was examining the patient's chest now, checking for signs of life-threatening thoracic conditions. ‘She has a seat-belt mark on her chest.
But her lungs seem clear and there's no evidence of tension pneumothorax or haemothorax.'

‘You're not going to spring the iliac crests?' Penny, one of the casualty officers, asked the question and Lara frowned.

Christian glanced in her direction and gave a faint smile. ‘I think Staff Nurse King has the answer to that question.'

‘Her veins and arteries are trying to clot,' Lara said immediately, wondering whether Penny ever bothered to read a textbook or a medical journal. Despite four months in the ED, she had yet to make much of a favourable impression. ‘If you spring the iliac crests, you risk disturbing the clot and increasing the bleeding.'

‘Lara is right.' Christian dragged the ultrasound machine closer to the patient. ‘Protect the clot. No springing. No log-rolling. I don't need to tell you how serious an unstable pelvic fracture can be.'

Lara's eyes were on the machine. ‘Her blood pressure is dropping.'

‘Give her another unit of warmed blood through the rapid infuser.' Christian was still checking the patient. ‘Are those blood results back yet? If we just
pour fluid into her, she'll have coagulation problems. Now, let's have a look at her abdomen. I want to know if there's any intraperitoneal bleeding. Jane, can you ring through to the angio suite and fill them in? I have a feeling we're going to need their help and it takes them a while to set up.'

‘Will do.' Jane hurried over to the phone and Lara stepped a little closer so that she could watch Christian do the FAST test.

He placed the transducer on the patient's abdomen, just above the pubic bone, and studied the screen, a frown on his face. ‘Penny?You can't see from over there—come closer. I'm looking for free intraperitoneal fluid—fluid collects in the pouch of Douglas and you can visualise that with the scan.' He paused for a moment, staring at the screen with total concentration. ‘It's negative but that doesn't exclude intra-abdominal injury.'

The anaesthetist adjusted the oxygen flow and glanced at the monitor. ‘They don't like having patients this unstable in the angio suite, Christian. It's not a good place to resuscitate a patient.'

‘Interventional angio is the best way to stop the bleeding.' Cool and unflustered, Christian
checked a set of blood results and shook his head. ‘Give her FFP and cryoprecipitate. Let's take a look at that X-ray, Maria.'

‘I have it here.'

He studied the screen. ‘Well, that's fairly obvious, isn't it? Penny? Take a look at this X-ray.'

Lara recorded the patient's observations again and glanced towards the screen, hoping that Penny would spot whatever it was she was supposed to spot.

The girl needed a boost to her confidence.

‘She has an antero-posterior compression fracture.' Penny leaned closer to the screen and touched it with her finger. ‘It's causing separation of the pubic symphysis and widening of both sacroiliac joints.'

Lara breathed a sigh of relief and slipped her pen back into her pocket.

‘Well done.' Christian nodded. ‘Also known as an “open-book” fracture. Significant opening of the sacroiliac joints is associated with tearing of the major blood vessels that overlie the joint. So what we're looking at here is potential for serious vascular damage.'

‘And major blood loss.' Lara grimaced as she looked at the blood-pressure reading. ‘Christian?'

‘I've seen it.'

Penny frowned. ‘But the X-ray doesn't look that bad.'

Lara handed Christian a set of results. ‘With every pelvic fracture it's important to think about the mechanism of injury because the damage on the X-ray may not actually reflect the degree to which the bones were separated during the actual injury. So you need to be alert for major soft-tissue damage.'

Christian scanned the results. ‘I want to take her straight to angio. Everything else can wait.'

Derek adjusted the oxygen. ‘You don't want to examine her back?'

‘That can wait, too. I don't want to risk dislodging the clot in her pelvis.'

Lara watched him, envying the ease and confidence with which he tackled every case that came his way. In two months, working alongside him in the ED, she'd never seen him remotely rattled and she loved working with him.

‘Penny, what do you know about interventional radiology?'

‘Very little,' the junior doctor admitted frankly, and he gave a nod.

‘Perhaps you should go along and observe.'

‘Oh, yes, please.' She nodded immediately and then fell silent as one of the nurses drew his attention to the monitor.

‘Her blood pressure is dropping into her boots.'

They worked swiftly, using the rapid infuser to push blood into the critically ill patient.

‘Her pressure is coming up a little.' Christian looked at Lara. ‘Let's do another FAST test, just in case things have changed.'

He performed the test, satisfied himself that interventional angiography offered the best chance for the patient and the team transferred her to the angio suite.

Left alone in Resus, Lara started clearing up and restocking, ready for the next patient.

She worked methodically, following the agreed protocol, and she had just started on the intubation tray when Christian came back into the room. She glanced at him expectantly. ‘How's our patient doing?'

‘Well, she didn't die in the corridor, if that's
what you're asking me.' His eyes were tired. ‘It's too soon to say. Can I ask you a question?'

‘Of course.' She picked up a laryngoscope and snapped it open, checking the bulb. ‘Ask away.'

‘Why didn't you do medicine? You're easily the brightest nurse I've ever worked with.'

‘You think nursing is a career for those too thick to become doctors?' Lara's eyes twinkled. ‘Be careful where you voice that opinion, Dr Blake. You might just find yourself with a compound orbital fracture.'

‘You're threatening to black my eye?'He strolled into the room. ‘I never would have suspected that you have such a violent nature. For the record, that wasn't what I was suggesting. Obviously nursing is a distinct career choice. The reason I wondered about you is because you're so obviously interested in the diagnostic side of things.'

‘I'm not sure that I am.' Lara wrinkled her nose thoughtfully. ‘I think I probably just have a naturally interfering nature. And a big mouth. If I think I know what's going on, I have to speak up.'

‘Did you consider becoming a doctor?'

‘No, not really. I suppose I'm more interested
in the person than the disease.' She smiled. ‘And I'm not serious enough to be a doctor. I'd crack a joke at the wrong moment.'

‘You're serious enough when you need to be.'

She found his gaze distinctly unsettling. ‘I don't have the necessary cool to do the job you do. When you're with a patient, you're very emotionally detached.'

‘My job is to deal with the immediate physical trauma.'

‘And you do it brilliantly. You're a clever man, Dr Blake.' She put the laryngoscope back on the tray, trying to understand the sudden tension in the atmosphere. They were just colleagues—nothing more. ‘So you should be relieved that you didn't try and see Father Christmas in his grotto yesterday, because the queues were enough to make a grown man sob. How are your girls?'

He hesitated, as if he wasn't entirely comfortable with the topic of conversation. ‘Excited about Christmas. We have a new nanny installed in our house so hopefully a few of those boxes might get unpacked soon.'

His oblique reference to Aggie's impulsive confession
in the grotto made her wonder if he was concerned about his privacy.

‘Listen, Christian, I hope you don't feel awkward about last week. A little girl's chat with Father Christmas should always be kept private. Just in case you're worrying, I never repeat anything I hear in the grotto.'

He watched her. ‘I'm not worrying. It's hard to keep anything private with Aggie around, as you've probably gathered.'

‘She's adorable. You're so lucky.' Faint colour touched her cheeks. ‘Sorry. I mean, it's obviously a very difficult time for you and—'

‘I know I'm lucky, Lara,' he said softly. ‘I love my girls.'

‘Yes, that's obvious.' She gave a wistful sigh and then smiled at him. ‘It must be hard, moving house just before Christmas.'

‘We moved three months ago, just before I started this job. But with the demands of a new job and the endless nightmare of nannies, I haven't had time to finish unpacking the boxes.' He gave a self-deprecating smile. ‘But clearly it has to be a priority now that emptying boxes is on Aggie's Christmas list.'

‘And what's on your Christmas list, Dr Blake?'

‘Top of my list is a decent nanny. The current one has turned up to work five days in succession so that's a start. If she turns out to be Mary Poppins then I'm going to have a happy Christmas.'

‘That doesn't seem like a very exciting Christmas present for you.'

He studied her face for a long moment. ‘I don't need exciting. What I need is to not worry about my children when I'm working.'

‘Yes. I can see that must be a worry. In fact, the whole thing must be a worry. ‘Do you know what you need, Christian?'

‘What's that?'

‘Fun.' She tilted her head and looked at him with laughter in her eyes. ‘You look like a man who is taking life much too seriously at the moment. What you need is fun.'

F
UN
?

Why was everyone suddenly so obsessed with him having fun?

First Chloe, now Lara. Only, coming from Lara, the word
fun
took on an entirely different meaning.

When Chloe had used the word, he'd immediately thought of rowdy games of catch in the park, sledging in the snow on Hampstead Heath, playing Monopoly in front of the fire, with Aggie cheating. When Lara had used it, entirely different images had filled his brain.

Dangerous images
.

He remembered her legs in the fairy costume, long and slim, her body slender but with curves in all the right places.

She was getting under his skin, Christian
thought grimly, struggling against the hot burn of lust that threatened to devour him.

It wasn't going to happen
.

His girls had been through hell and they'd only just started to show signs of settling down. There was no way he was going to do anything that might threaten their new-found security. They needed life to be stable and predictable. They didn't need their father involved with another woman.

Christian strode back to the comparative sanctuary of his office, wondering what was happening to him. He'd never had any trouble focusing on his work and since the divorce he'd had no trouble in
not
noticing women. But that had changed when he'd moved hospitals and met Lara King.

No man could fail to notice Lara.

She had a vibrant, energetic personality and her sense of humour infected the whole department. And as for the way she looked—well, her appearance matched her personality. Her hair flicked cheekily up at the edges, she wore an almost permanent smile on her face and her deep blue eyes always seemed to be twinkling with humour.