Their marriage was on a slow downhill slide and she didn’t seem able to stop it.
The next morning, Christy scraped a thick layer of ice from her windscreen, dropped the children with her mother and arrived at A and E to find the department in chaos. The waiting room was full to bursting and the triage nurse looked unusually stressed as she tried to calm everyone and maintain order, filtering the urgent from the non-urgent.
‘A bus carrying Father Christmas and a bunch of elves hit a patch of black ice at the head of the Kirkstone pass,’ Nicky told her as she hurried past, carrying an armful of equipment. ‘Mostly walking wounded but they’ve just brought the driver in and he’s badly injured. Can you go into Resus and help? Alessandro is in there and they’re short of a circulation nurse. Donna is there but she’s newly qualified and I’m worried that your husband might take her head off if she’s less than perfect. I need you to give her some help. I’m helping to stave off a riot out here. Apparently even elves don’t respond well to four-hour waiting times.’
Without arguing or asking any further questions, Christy pushed open the doors of Resus and felt her heart hammer hard against her chest.
She hated to admit it, but the prospect of working with Alessandro made her nervous. She didn’t need Nicky’s reminder that he was capable of removing someone’s head if he wasn’t happy. It was one of the things she’d always respected about him. He cared deeply about each patient and wasn’t willing to settle for anything other than best practice. She knew him to be an exacting taskmaster with a zero tolerance for anything other than perfection.
It was all very well for Nicky to tell her to keep an eye on Donna, but who was going to keep an eye on her?
What if she couldn’t remember what to do?
A blood-stained Father Christmas outfit lay in a pile and the patient was groaning with pain. Alessandro stood at the head of the trolley, co-ordinating the medical team as he assessed the patient. ‘There’s some bruising over the anterior chest wall,’ he murmured as his eyes slid over the patient, conducting a visual examination. ‘No evidence of open wounds or penetrating trauma.’
Christy walked towards the trolley, momentarily distracted by the sight of him in action. She’d forgotten what an exceptionally gifted doctor he was. Slick, competent and a natural leader. Nothing ever fazed him.
He lifted his eyes from the patient and saw her. His expression didn’t change. ‘You need protective clothing before you handle the patient,’ he said coldly. ‘At the very least, latex gloves and an apron.’ He turned his attention back to his patient and Christy felt the colour flood into her cheeks. Of course she knew that the first thing she should have done was to reach for protective clothing. All blood and body fluids had to be assumed to carry HIV and the hepatitis virus. She knew that. It was just that seeing him had rattled her. Affected her confidence.
Determined not to let him get to her, she quickly donned the clothing that she needed and walked back to the trolley.
Her hands were shaking and her heart was banging against her ribs. She’d done this before, she reminded herself firmly. Many times.
Alessandro was listening to the patient’s chest, his face blank of expression as he concentrated. When he was satisfied, he looped the stethoscope round his neck and turned to the circulation doctor, a pretty blonde girl who was examining the patient’s femur. ‘Blood loss?’
‘I’m keeping pressure on that wound and it’s under control.’
‘OK, I want two peripheral lines in and take some blood for cross-matching, full blood count, U and Es, and let’s get an arterial sample. I want blood gas and pH analysis. What’s his blood pressure doing? I need an ECG here.’ His instructions were smooth and seamless and swiftly Christy took over from one of the other nurses, who was clearly struggling and whom she pr
esumed to be Donna.
Instinctively her eyes flicked to the monitor as she reached for the adhesive electrode pads and attached the patient to the ECG monitor. ‘It’s dropping. Ninety over fifty.’
Suddenly her hands weren’t shaking any more. Her movements were smooth, confident and almost automatic. She knew what she was doing and it was as if she’d never been away.
‘We’ll start with a litre of Hartmann’s,’ Alessandro said immediately, and Christy busied herself with her patient while he made a rapid assessment of brain and spinal-cord function.
‘Put your tongue out for me,’ he instructed the patient. ‘Wiggle your toes.’
‘His blood pressure is still dropping,’ Christy said quietly, and Alessandro’s gaze flickered to hers.
‘Increase the flow rate and let’s give him some analgesia.’
‘First line is in,’ the blonde doctor said as she slid a wide-bore cannula into a vein and Christy pulled the IV stand towards her so that she could attach the giving set and start the infusion.
‘Get that second line in straight away, Katya,’ Alessandro instructed, and the blonde doctor reached for the second cannula and moved round the trolley to the other side of the patient.
The man gave a groan of pain and Alessandro immediately switched his attention back to his patient. ‘We’re going to give you something for the pain now, Derek,’ he said calmly and Christy reached for the drugs that she knew would be on the trolley. ‘Morphine and cyclizine?’
With speed and efficiency she drew up the drug and handed it to Alessandro, along with the ampoule to check. Then she moved closer to the trolley and closed her hand over the patient’s, offering comfort.
‘We’ll soon have you more comfortable, Derek,’ she said quietly, and felt the man’s fingers tighten over hers.
This was the bit that the doctors often forgot or ignored, she thought to herself as she felt the man’s grip. They forgot the importance of touch. They forgot that as well as being injured, the patient was anxious and scared.
It was another thing that she’d always admired about Alessandro. No matter how tense the situation, he never forgot his patient. He wasn’t a touchy-feely doctor, but he understood the importance of communication in lowering stress levels.
Her eyes flickered to the machines next to her. ‘His blood pressure is stable,’ she said quietly, and Alessandro gave a nod.