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While Marcus talked she restlessly went back over to the window to stand partially behind a curtain and watch the street, trying to get the registration number of the car.

'Marcus,' she called in a soft voice, 'it's leaving.'

'See if you can get the number.'

'No.. .no, I couldn't.' She turned to him as he came to her. 'Thank God it's gone. What did Mr Davinsky say?'

'She's been using hired cars. Never the same one twice, apparently. She doesn't own a car,' Marcus said tensely. 'They've been watching her apartment. She doesn't park the hired cars there so it's possible that she could have slipped out.. .maybe the back way. But they don't think so because they've been watching that, too.'

Lisa sighed. 'What are we going to do?'

'I'll spend the night here on the sofa. If you don't mind, that is. I would feel happier. Just in case it was her.' He passed a hand tiredly over his face, pressing the tips of his fingers against his eyelids for a moment. 'I doubt that it was her, but we won't take any chances. I'll feel happier if I'm here.'

'All right, So will I,' she agreed, knowing that he was trying to reassure her, probably convinced that it was Miss Damero. 'I'll get you a pillow and a duvet.'

'We'd both better get some sleep,' he said. 'I'll see myself out in the morning.'

Later in the night Lisa woke, stirring restlessly in the bed as she remembered that Marcus was there a few yards away from her. The fluorescent hands of the bedside clock pointed to 2 a.m. There was no sound from Emma Kate, who sometimes still woke in the middle of the night.

Lisa got up, and padded on bare feet downstairs to the sitting room. Marcus lay on his back, the duvet pulled down to reveal his naked chest. In the dim light from the street she could see the dark hair that covered the centre part of it. His head, with its dark, unruly hair, was turned away from her. Slowly her eyes travelled over his firm jaw and sensuous mouth, down over the full length of his body. At that moment she longed to pull aside the cover and crawl in beside him, feel his arms coming round her...

Frustrated, she turned away from him to check on Emma. Marcus had to be up early, as did she.

The
. emergency department was as busy as it could be during the next week, with a rash of minor accidents. The weather had turned decisively warmer, from quite cold to quite hot, over a few days. There was little time during working hours for Lisa to dwell on her private life and problems.

'How you doing, Lisa?' Diane Crane queried as they passed each other at great speed in the corridor. The orientation period for both of them was now over—they were part of the team.

'Trying to keep a low profile.' Lisa smiled at her friend as she followed a stretcher case that had just come in by ambulance. 'No good, though.'

With a wave of her hand she indicated to the ambulance attendants that they should turn into an examination cubicle. They in turn gave her some quick background information. The patient on the stretcher was a girl of about seventeen, accompanied by her distraught parents.

As Lisa stood back, waiting for the ambulance attendants to make the transfer, Diane came back to speak to her. 'Listen,' she whispered, grasping Lisa's arm, 'I've heard something about that gorgeous Dr Blair, a bit of gossip. Try to get your coffee-break with mine. I'll tell you all the details. Apparently, he was engaged to be married—to Dr Lydia Grenville, no less. I've worked with her. She ought to have been in films, not in medicine... absolutely stunning.'

'There won't be anything left to tell,' Lisa grinned, trying to keep her face neutral as her heart gave an uncom
fortable little jump at the mention of Marcus. Her interest was captured, in spite of her basic aversion to gossip.

'There's more,' Diane muttered. 'She wouldn't wait for him when he had to go to Africa for three months, so the story goes. What a dingbat, eh? I'd sure wait for him.' Her eyes were dreamy. 'Or that cute Nathan Hanks.'

'I've got to go, Diane. This is my patient.'

'OK, Liz. See you in the coffee room later. Bye.'

'Tell me what happened, and when,' Lisa said to the girl's parents in the examination cubicle, a folder of papers ready in her hand with forms for laboratory tests that might have to be done. This appeared to be a change from the usual accidents. 'This is your daughter, Susan, seventeen years old? And you are Mr and Mrs Bowlder?'

'Yes.' The father nodded. He was a tired-looking, middle-aged man, thin and stooped and going bald. Lisa felt a wave of compassion for him and his wife, getting the impression that this was their only child. 'Last night she started throwing up, real bad.'

'Couldn't keep anything down,' his wife, who was equally thin, chipped in. She looked exhausted.

'Then she started behaving strange,' the father continued. 'Like getting mad with us when we asked her what was wrong, and how she felt. She wouldn't let us touch her, like take her temperature, or anything.'

'She's very irritable, just wanting to sleep all the time. I think there's something really wrong with her. She's been thrashing out at us when all we want to do is find out how she's feeling.' Mrs Bowlder took up the story, tears in her eyes.

'She sort of looks at us as though she doesn't know who we are,' Mr Bowlder said. 'She has this sort of glassy-eyed look. .. See for yourself. She just mumbles when we speak to her.'

The girl, Susan, was staring up at the ceiling, her eyes wide, as though she wasn't really focusing on anything. From where Lisa stood, next to the bed, she could see that the girl's pupils were dilated. She took her penlight torch from her pocket and shone the beam of light into the girl's eyes, noting that the pupils contracted very slightly but still remained abnormally expanded. There was definitely a cerebral problem.

'I'm going to take her temperature,' Lisa said, 'then I'll get our doctor to see her.'

As Lisa felt for Susan's pulse she noted that the girl's hands were cold and clammy. Carefully, quickly, she charted her findings. Later she would enter all this into a computer.

'Susan?' Lisa said, bending over the girl. Susan said nothing, just continuing to stare at the ceiling. Then, as they watched, her body twitched slightly.

'Has that happened before?' Lisa asked urgently.

'Yes, this morning,' the mother said. 'That's why we called the ambulance. Didn't bother to call the doctor. We figured we ought to come straight here.'

'You did the right thing. Tell me,' Lisa said urgently, 'has she been sick in the last week or so? Flu? A viral infection of some sort?'

'Well.. .yes,' the mother confirmed, half-fearfully. 'Last week she stayed home from school for four days... didn't feel well. Sort of like flu, but not as bad. We did call the doctor. He said to come in to the office but she didn't go because she was so tired. We all figured it would get better on its own. And she did seem better for a couple of days... Started eating again.'

'Then the vomiting started?' Lisa queried as she stood beside the bed in her neat white pants suit, her pen poised to make notes of anything that might be important and to take the main points of the history.

'Yes.'

'Her temperature's a little below normal,' Lisa confirmed, after checking. A suspicion had formed in her mind, and was growing stronger, that the girl might have Reye's syndrome, an often deadly syndrome that could come on after a viral infection. The glassy, staring eyes were one indicator. The irritability her parents had described could be a manifestation of swelling of the brain tissue.

'I'll call the doctor now. We'll soon get this sorted out,' she said reassuringly to the parents. 'Have a seat just here.'

Picking up the internal telephone, she put a call through to the triage station. 'Dr Blair to cubicle eight, please,' she said to the nurse who answered.

While she waited for Marcus to
₍
come she got together the equipment that she knew would be needed—the intravenous lines and bags of fluid, syringes and tubes for the blood samples that they would have to take to send to the laboratory. With the glass tubes, she lined up the appropriate request forms for the lab.

'Hi.' Marcus arrived, coming into the small room like a whirlwind, his white coat flapping over his green scrubsuit. 'What can I do for you here?'

'Mr and Mrs Bowlder.' Lisa introduced the parents in her best professional voice, determined that her private interaction with Marcus would not affect her working skills in any way. 'And this is Susan, their daughter.'

Marcus smiled, inclining his head to the parents. Quickly Lisa gave him a summary of the symptoms then, while he questioned Mr and Mrs Bowlder further, she made sure that everything was on hand for an examination. The girl herself seemed unable to answer or fully understand the questions that they put to her, an alarming sign.

'Shall I call the intern, Dr Blair?' Lisa asked.

'Yes. I want three IV lines put up. Start on that yourself,
would you? Get the intern to help with that,' Marcus said, sizing up the situation quickly as he began a systematic physical examination of the patient. 'But before you do that, Liz, get on to the blood bank and order three units of fresh frozen plasma, stat.'

'Could this be Reye's?' she said quietly.

'Very likely,' he said tersely, 'so I want those IV fluids up right away—one litre of dextrose to start. These patients are hypoglycaemic and there's liver damage so the sooner we get some sugar into them, the better.'

'Right,' Lisa said, going to the telephone to call the blood bank. Then she put on a pair of rubber gloves to insert the first cannula into a vein for the IV fluid, while Marcus continued with the examination as he talked. Susan responded only sluggishly to neurological stimuli.

'I also want IV mannitol put up,' Marcus instructed her, 'to reduce the cerebral swelling. We'll put saline through the third IV line until we get the plasma from the lab. Also, please have the neurology resident paged right away—we'll get him to order an emergency CAT scan, just to rule out anything else.'

'OK.'

At the telephone again, she called the locating service.

'Neurology resident to Emergency right away, please. Cubicle eight. Patient Susan Bowlder. Thanks.'

Quickly she and Marcus worked side by side, involving the anxious parents in their explanations. The mother was openly crying now, while the father looked desperately pale and worn.

When the intern, Abby Gibson, arrived she silently stripped off her white coat and waited for instructions.

'Abby, take some blood, would you?' Marcus said, looking up from his task with a stethoscope dangling from his ears. 'I want tests for blood-sugar, prothrombin time, liver function, serum aminotransferases. This could be a Reye's syndrome—they get liver and renal damage, as well as cerebral oedema.'

'Generally following a viral infection, right? Exacerbated by the taking of aspirin?' Abby Gibson said, putting a needle on a syringe preparatory to taking blood.

'That's right,' Marcus said. 'Then, when you've done that, help Liz with the I Vs. The patient's dehydrated so we want to get that fluid into her as quickly as possible. No doubt her blood-sugar's way down.'

What Marcus did
not
say, in front of the parents, was that there was no specific cure for Reye's syndrome. All they could do was treat the symptoms and hope that the treatment had been started in time before the brain damage, as well as the liver and kidney damage, had gone too far to be reversed.

The three of them worked on her while the fearful parents watched in silence. Within minutes there were three IV lines functioning—two in the backs of Susan's hands and one in a vein at her ankle.

Marcus straightened. 'Definitely looks like Reye's syndrome to me. There's definitely neurological involvement,' he said quietly to Abby and Lisa. 'I'm going to arrange to have her admitted right away to the critical care unit. They may prefer to have an IV line in her neck— we'll let the neurology resident do that up there.'

The two women exchanged glances, both knowing that this cluster of symptoms they were witnessing—which generally followed a viral infection for no known reason— had a fifty per cent chance of being fatal. Perhaps they had got Susan just in time; perhaps the IV mannitol they were giving her would sufficiently reduce the cerebral swelling before permanent brain damage ensued.

'This syndrome is generally seen in kids of fifteen and under, isn't it?' Abby Gibson asked Marcus.

'Yes, but it can affect older teenagers, as you see. Cases have been described. I'll get one of the medical staff-men to see her as well when she gets up to the unit. Maybe they'll do the CAT scan on the way up,' Marcus went on. 'We'll keep her here until we get the fresh plasma delivered. If it's not here in the next five minutes, Liz, maybe you could get on to the lab again. They are going to deliver it here, I take it?'

'Yes, that's the usual procedure,' Lisa confirmed.

While Marcus made a few telephone calls Lisa and the intern carefully labelled the blood samples and filled in the request forms, marking each one 'stat'. 'The guy who brings the plasma can take these tubes back to the lab with him,' Abby said.

Marcus sat down with the parents and unhurriedly began to explain the situation to them and discuss the planned treatment. Again, Lisa marvelled at his skill in dealing with people. He seemed to understand instinctively just what they were feeling and the kind of questions they would want answered, never rushing them.

The three units of plasma arrived, brought by a lab runner, just as Lisa was about to call them again. While Abby replaced a bag of IV saline with one of plasma for their patient Lisa handed over the blood samples.

'She'll be going to Critical Care,' she explained to the lab runner. 'Could you put the results on the computer to us, and to them, please?'

'Sure.'

Busying herself with clearing up the debris, Lisa considered that they had done all they could do for the moment.

Susan was a pretty girl, about average in height and weight, with long, soft, fair hair and large blue eyes. Now that the immediate crisis was over they could talk to her parents to fill in details of the family background and medical history. The intern would do a great deal of that.