Logan had the phone in his hand and was dialling. He made two calls—one to the air ambulance and one to Jim—and Evanna gave a swift nod of understanding. Jim owned the land they were walking on. The sheep in the field were his sheep and he owned a four-wheel-drive vehicle. Travelling cross-country, they could be in the surgery in less than five minutes.
Still holding Kirsty on one arm, Logan made the calls while Evanna glanced nervously around her. She’d lived on the island virtually all her life and she’d never seen a snake.
‘What if it bites someone else? Should we look for it?’
‘It will have gone. Adders are shy. They’ve been spotted on the island occasionally but they don’t normally bother people. They feel the vibration of approaching walkers and slide away.’
‘I think it must have been lying in the sun, warming itself,’ the man muttered, dropping to his knees beside his wife. ‘She trod on it and she was wearing sandals. It’s summer. We didn’t even bother with walking boots. We heard this terrific hiss and then she felt a really sharp stinging in her leg.’
‘Can’t breathe properly,’ the woman gasped, lifting her hands to her throat, and Logan glanced across the fields.
‘We’re going to have you in the surgery in a couple of minutes,’ he said easily, standing up and shielding his eyes from the sun. ‘There’s Jim now. I’m going to help you up, Alison, and we’re going to get you into the car.’
Evanna looked at the woman’s face, saw her increasing struggle for breath and wondered if they’d make it. Panic, with its sharp, deadly claws, stabbed through her and she looked at Logan, taking reassurance from the fact that he was so calm.
He was watching Alison and clearly working out a plan in his head. As Jim pulled up in his four-wheel-drive vehicle, Logan handed Kirsty to Evanna and lifted Alison inside. The rest of them clambered into the vehicle and Logan slammed the door shut.
‘Drive,’ he said to Jim, without wasting time on conversation or niceties and, to his credit, Jim rose to the challenge, covering the distance to the surgery in record time.
‘I’ll keep Kirsty with me,’ Jim volunteered, and Logan gave a brief nod of thanks as he and Pete helped Alison out of the car.
Evanna unlocked the door and sprinted through to the consulting room. Without hesitating, she unlocked the drug cupboard and removed the adrenaline.
‘Can you do a pulse and blood pressure, please? And let’s give her some oxygen.’
Without hesitation, Logan helped Alison onto the couch, jabbed the injection straight into the muscle and depressed the plunger. ‘Her pulse is a hundred and forty. I’m going to need more adrenaline, Evanna, and I want to do an ECG.’
‘Her blood pressure is ninety over fifty.’ Evanna quickly fastened a mask over the woman’s mouth and nose and adjusted the flow of oxygen. Then she reached for the ECG machine and swiftly attached the leads.
‘Ninety over fifty? That’s low, isn’t it? Is she going to be OK?’ The woman’s husband was pacing the floor, his hands clasping his head. ‘I can’t believe this has happened. I didn’t even know that we had poisonous snakes in the UK. If I’d known, I wouldn’t have let her walk in sandals. But it was hot and—’
‘They rarely show themselves and the bite doesn’t always cause such an extreme reaction. She was unlucky.’ Logan took the second syringe from Evanna and injected the contents into his patient. ‘Let’s give her some antihistamine and hydrocortisone and I’m going to put a line in, just as a precaution.’
Evanna reached for the IV tray that she kept ready. ‘Do you think she needs antivenin?’ She knew nothing about antivenin but she knew that it existed.
‘Possibly. She’s obviously absorbed some venom.’
Evanna watched the ECG trace carefully but could see nothing amiss. ‘That seems all right. What exactly are you looking for?’
‘Non
specific changes—ST depression or T-wave inversion.’ Logan frowned and leaned closer. ‘That seems all right. Leave it on until we transfer her to the helicopter. I want to keep an eye on it.’
‘You’re sending her to the mainland?’ Evanna knew that Logan never requested a helicopter transfer unless he was absolutely confident that the patient needed hospital help fast. In his years as the island GP, he’d shown himself to have an uncanny instinct for exactly when to call in the air ambulance.
‘Yes.’ His eyes were still on the ECG trace. ‘Can you get the poisons unit on the phone for me? I want to talk to them.’
‘Her blood pressure is coming up,’ Evanna said, recording the reading and then reaching for the phone. She looked up the number and dialled swiftly, aware that Logan was examining his patient.
It was impossible to work with him and not admire him, she thought as she waited for someone on the other end to pick up the phone. In all the years that he’d been the doctor on Glenmore Island, she’d never seen him panic. Even that awful night with Catherine, he’d been in control. He was incredibly skilled and his confidence had a soothing effect on patients who were often anxious at finding themselves ill or injured so far from what they considered to be civilisation.
Logan removed the ad hoc dressing that they’d applied. ‘Her leg is swelling up,’ he said quietly, ‘and I can see fang marks on her foot. So it was definitely a venomous bite. Do you know if her tetanus is up to date?’
‘I have the poisons unit on the phone for you.’ Evanna held out the phone and Logan stepped towards her and took the receiver.
‘Can you clean and dress it, Evanna?’ He lifted the phone to his ear. ‘It’s Logan MacNeil here.’ His voice deep and steady, he swiftly outlined what had happened and discussed the best management with the person on the other end.
‘Her colour looks better,’ Pete said, and Evanna nodded as she checked her pulse again.