Dr. Right for the Single Mom
Autor:in
Alison Roberts
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CHAPTER ONE
‘HAS ANYONE HEARD what’s happening?’ Laura McKenzie slowed down as she pushed an IV trolley past the central desk of Wellington’s Royal Hospital’s emergency department and then she stopped. ‘Has the baby arrived yet?’
One of the department’s consultants, Fizz Wilson, was in front of a computer screen, studying the lab results on blood samples. ‘Last I heard, it’s not far away. Maggie was almost fully dilated. When Cooper brings Harley in for his feed later, I’m hoping we can use my break to go and meet the new arrival.’
‘Yes... I’m due for my break at the same time.’ Laura nodded. ‘I’ll come with you.’ Maggie was a close friend and ex-flatmate and Laura couldn’t wait to meet her baby.
‘Where are you off to?’ Tom Chapman, the senior consultant in this emergency department, dropped a patient file on the desk.
‘To see Joe and Maggie’s baby.’
Tom’s eyebrows rose. ‘Maggie’s in labour?’ He was already scanning the board that provided the update of all the patients currently in the department, whose care they were under and at what stage of their assessment or treatment they were. ‘I was working with Joe at the rescue base yesterday and he thought it was still a week or two away.’
‘Nope. Today’s the day. They headed into Maternity at about four this morning.’
But Tom didn’t seem to be remotely excited and Laura could feel a slightly puzzled frown line appearing between her eyebrows as she let her gaze rest on his profile for a moment longer. She’d worked with this man for more than two years now but sometimes she had absolutely no idea what was going on in his head. He was a brilliant doctor, was warm and kind and completely trustworthy but, at the same time, he could be oddly reserved. Like now, when you might expect him to share at least some of the excitement of imminent parenthood to people he knew well.
Maybe he just had other things on his mind. Like how his emergency department was coping with the patient numbers and the levels of attention they needed. Laura brushed off an urge to reassure him in some way that, as always, he had everything as under control as it was possible to have it but a couple of seconds later she thought that it had been just as well that she hadn’t said anything because someone would have blamed her for tempting fate as potential chaos broke out. An ambulance crew was rushing through the automatic doors leading to the vehicle bay, someone was calling for assistance from one of the cubicles and a cardiac arrest alarm was sounding.
Tom was the first person to put his hands on the trolley that contained a lifepack, airway and IV equipment and the drugs that could be needed to manage a major cardiac event.
‘Where’s the arrest?’ he demanded.
‘Waiting room,’ someone responded.
Tom started moving. ‘Fizz, take over here for a minute. Laura? Come with me. We can get there before the arrest team arrives.’
Abandoning the IV trolley, Laura was almost running to keep up with Tom’s long stride. Expecting to see an elderly patient who had collapsed in the waiting room, it was a shock to find that the cardiac arrest button had been pushed for someone who looked like a child.
‘Help...please...she’s not breathing...’ The distraught woman who had her arms around the young girl had to be her mother and Laura’s heart immediately went out to her. She’d be this terrified, as well, if she was holding her son, Harrison, and he’d just stopped breathing.
‘What’s happened?’ Tom eased the girl from her mother’s arms to lay her flat on the floor and then he tilted her head back to open the airway. He put his fingers on the side of her neck as he leaned closer.
Laura was peeling open the pack that contained the defibrillator pads. She cut the neck of the girl’s T-shirt and ripped it open to give her access to the point below her right collarbone and then lifted the hem to press the second pad on her left side. She noted the dramatic rash on the child’s skin and caught Tom’s gaze to make sure he was aware of it, as well. He was. Of course he was.
‘She’s allergic,’ the mother was saying. ‘To dairy. She was eating chips in the car and I thought they were the plain ones and they were safe but they weren’t...someone had given her some flavoured ones. Ketchup. She thought that was fine but we could already see the hives starting to come up.’
‘We’ve got a pulse,’ Tom told Laura. ‘But she’s bradycardic. Not breathing.’
He reached for a bag mask, fitted the mask over the girl’s face and delivered a breath. And then another. But he was frowning and Laura knew why. This had to be an anaphylactic reaction to an allergen and the child’s airways were swelling up and making it harder to deliver oxygen. They needed to move fast or it could become impossible to intubate and secure the airway. The fact that the heart rate was already too slow meant that they could be dealing with a cardiac arrest as well as a respiratory arrest in a very short time.
Tom glanced up and this time it was him who was catching Laura’s gaze. It was another moment of silent communication and something they were both so used to now it took only a split second to have a question asked and answered. This was a critical situation and every second counted. They would be losing quite a few of those seconds to take the girl into one of the resuscitation areas on the other side of the swing doors but it was entirely possible that they would need more equipment than they had in this trolley—like a surgical kit to perform a cricothyroidotomy if a tracheal intubation proved impossible.
With no more than a subtle nod, Tom broke the glance, scooped the child into his arms and took off.
‘Follow us,’ Laura told the mother. She had picked up the lifepack as Tom had started moving and she really was running this time to keep up with him and not break the connection between the pads and the defibrillator.
People in the emergency department stepped hurriedly out of their way. Laura saw the startled expression on Fizz’s face and the way she signalled junior doctors to take over what she was doing. She was right on their heels by the time Tom put the girl down on the bed.
‘Respiratory arrest,’ he told Fizz. ‘Anaphylaxis. Known allergy to dairy.’
‘Has she had any adrenaline?’
‘Yes...’ The girl’s mother was near the foot of the bed, her arms held tightly across her body as if she needed physical support. ‘We used her auto-injector but...but it didn’t seem to be working. When she started getting wheezy I just drove straight here.’
She was used to coping, Laura thought. Used to providing her own support. Was she a single parent, like herself?
‘Laura? Draw up some adrenaline, please.’
‘Onto it.’ The personal connection Laura was feeling to this patient and her mother had to be put firmly aside as she focused on what she needed to do.
Other staff members were arriving now, including the two medic arrest team. Laura was pleased to see a new nurse beside their patient’s mother, easing her to one side of the room, out of the way, but staying with her as she endured the terrifying sight of a medical team fighting to save the life of her daughter.
There was so much happening. Tom was intubating the girl, using a video laryngoscope so that he could actually see what he was doing amongst the swelling tissues. An anaesthetist who’d been on call for the arrest team was setting up the ventilator that would be attached as soon as the intubation had been successfully completed. He had a kit on standby for creating a surgical airway if the intubation was not possible due to the amount of swelling.
Fizz was working to gain IV access and someone else was setting up the bags of saline and the giving sets that they would need for a fluid challenge to combat anaphylactic shock. Laura administered the first dose of intramuscular adrenaline and then began sorting the other drugs that she knew would be needed. More adrenaline, to set up as an infusion if there wasn’t enough response to the first doses, along with an antihistamine and steroids. She filled syringes and taped the ampoules to the barrel of the syringes to identify them. She was keeping an eye on the screen above the bed, too, so that she could warn Tom of any changes that could be significant, like a further drop in blood pressure or heart rate. This would become even more of a challenge if the heart stopped in the wake of the lack of oxygen from the respiratory arrest.
The tension was palpable and, at one point, Laura heard the stifled sob of the girl’s mother behind her. She could feel a lump in her own throat. This was every parent’s nightmare, wasn’t it? She was going to hug Harry so hard when she went to pick him up after work today that she knew he would squeak and wriggle free, probably giggling or groaning at the same time, the way six-year-old boys did. In the meantime, she was going to do everything she could to help save this young life in front of them. The alternative was simply unimaginable.
‘We’re in...’ Tom gave a satisfied nod as he hooked his stethoscope back around his neck after checking the placement of the airway. ‘Now, let’s get this oxygen saturation looking a bit better.’
‘Heart rate’s picking up.’ Like Laura, Fizz was watching the screen above them. ‘And I’ve got wide-bore access on both sides.’
‘Let’s start the fluid challenge.’ Tom turned his head to where the child’s mother was standing. ‘How much does she weigh?’
‘Um...she was about twenty-six kilos the last time it was checked.’
‘And how old is she?’
‘Nine. Nearly ten...she’s always been small...’
Like Harry, Laura thought. He’d always been small for his age and a bit underweight, as well. It made them seem younger than they were. More vulnerable. She wanted to give this young mother a hug. To try and reassure her. She could actually sense the same empathy coming from Tom, whose face creased in an almost smile.
‘What’s her name?’
‘Elizabeth. We call her Lizzie...’
‘She’s going to be fine. The immediate danger is over.’
‘But she’s in Intensive Care...’
‘This is the best place to monitor Lizzie for a few hours. Just to make sure that everything’s under control and the medications are doing their job.’
The woman closed her eyes as she nodded slowly. ‘I can’t thank you enough, Dr Chapman.’ She pressed her fingers against her mouth. ‘I feel like it was my fault. How could I not have noticed that the auto-injector was past its expiry date?’
‘I’m sure that’s something that will never happen again. And you did exactly the right thing, bringing her straight to Emergency.’
‘I could have lost her. I... I thought I had...’ She had her hand over her eyes now.
The urge to touch this woman’s shoulder, or hug her even, to provide comfort was so strong that Tom had to curl his fingers into a fist.
He didn’t get personally involved with his patients. Or their families. If he did, he’d never be able to do his job well enough and doing his job to the very best of his ability was the most important thing in Tom Chapman’s world.
The only thing, pretty much...
‘Go and sit with her now,’ he told Lizzie’s mother. ‘Or take a break? You probably need one after all that drama.’
‘I won’t be leaving her side for a while yet. It’s you that needs a break, I reckon. You worked so hard to save my little girl.’
‘It’s my job. And my privilege.’ Tom glanced at his watch. ‘I am on a late lunch break now. That’s why I popped up to see that Lizzie was settled well.’
‘I hope you’ve already had your lunch?’
‘Not yet. That’s next.’
But he wasn’t really hungry at all, Tom decided as he walked towards the café in the Royal’s entrance foyer. It was often like that, in the aftermath of the adrenaline rush that came from treating someone so critically ill—even more so when that fight for life was on behalf of a child. All life was precious, of course, but children and especially babies were so vulnerable you couldn’t help becoming emotionally involved to some extent. For some reason, the feeling of connection was harder to shake off after this case. Maybe that was why Tom gave in to the impulse to turn into the gift shop beside the café.
Ten minutes later he was standing in front of a door in the maternity suite of the Royal.
Hesitating...
He didn’t actually have to go in, did he? He could leave his gifts with one of the nurses. He didn’t have to prod that no-go area of his heart any more than it had already been prodded today.
But visiting Joe and Maggie as they basked in the glow of new parenthood was a friendly thing to do. A polite thing, and Tom Chapman was always polite. Manners that had been developed as a form of self-protection had evolved to be useful under even the most extreme circumstances and he’d learned that there was truth in the old adage to “fake it till you make it”. Tom had faked it for long enough to have made it long ago.
So, with the string of the pink “It’s a girl!” balloon in one hand and the softest baby toy the gift shop had had available, Tom tapped on the door and poked his head through the gap.
‘I can come back later,’ he offered. ‘If you’ve had too many visitors already.’
‘No, come in, Tom.’
‘Just for a minute, then.’ Tom shook the outstretched hand of the paramedic who had become a trusted colleague in recent months. ‘Congratulations, Joe. And there you were telling me only yesterday that you thought this was a week or two away.’
‘Bella had other ideas.’ It was Maggie who spoke. ‘I have a feeling we’re going to be scrambling to keep up with this little one.’
Tom smiled at Maggie, another paramedic who worked at the Aratika Rescue Base. Her blonde curls looked a little tangled and she looked exhausted but the glow of joy in her eyes nearly blinded Tom.
He’d seen that look before.
He’d worn it on his own face, once.
And yes...it was hard to drop his gaze to the bundle in Maggie’s arms. To the tiny, slightly scrunched-up face of a baby who’d been born within the last few hours. The pain never really went away, did it? You’d think it had faded or been safely locked away somewhere but sometimes all it took was something like seeing that tiny starfish hand poking up from out of the blanket folds and there it was again. So sharp, it could have been yesterday.
So poignant, it could have brought the sting of tears if he’d allowed it. But, of course, that was never going to happen.
‘Would you like to hold her?’ Maggie offered.
‘Ah...no...’ Tom actually took a step backwards. ‘I really can’t stay. We’re pretty busy in Emergency.’
He knew Joe was watching him. He also realised that Joe had respected the confidence of a personal discussion they’d had a while back now. That he hadn’t even told Maggie that he’d learned something about Tom that he never told others. And Tom could feel the understanding in that gaze he was under. Joe knew that this was tough. That being with a couple who were so much in love and welcoming their first child had to be a painfully sharp reminder that he’d lost his own wife and son.
He didn’t want that understanding. Or rather, he didn’t want anybody feeling sorry for him because he had no desire to start feeling sorry for himself.
But Joe was nodding as he spoke. ‘We heard about the anaphylactic shock you guys had to deal with. Fizz said it was touch and go for a while there.’
‘It was. I’ve left her in charge, too, and it’s about time she went home.’
‘Did Laura come back? With Harry?’
Tom had his hand on the door already, but he turned back. ‘Harry? Her little boy?’ He was frowning. ‘I didn’t realise she’d gone anywhere.’
‘She got a call from Harry’s school and she had to go and pick him up because he was feeling sick. It’s been happening quite a bit lately. If you see her, tell her to text me? She said she’d take him to the GP but if she was really worried, she said she might bring him in to see you.’
‘Oh?’ Tom shook his head. ‘I’m not a paediatrician. I’m sure her GP can handle it. Or refer her. Laura knows that Emergency is just for emergencies.’
Laura knew she was bending the rules.
Okay, so a lot of people came to the emergency department when they had problems that could—and should—be dealt with by a general practitioner. And the fact that people did turn up when they had a minor injury or illness could mean that the department could get overloaded and the patients that really needed the attention of the staff might have to wait too long or even miss getting a critical treatment in time.
But this was Harrison—Laura’s precious little boy.
And something wasn’t right.
He’d had tummy aches before. He’d been sick at school more than once in recent months but there’d been something about him, when Laura had arrived at the sick bay to collect Harry today, that had sent a chill trickling down her spine. Maybe it was his skin colour. Or the air of listlessness about him. Or perhaps it was just the expression in those dark brown eyes he’d inherited from her. A sad look, as if he couldn’t understand why life was so miserable right now.
Anyway, it was done. Laura was back at the Royal and had Harry in her arms, balanced on her hip. She was still in her scrubs with her official lanyard on so nobody would question her presence in the department and, technically, she was still on duty so she could tell people she’d come back to finish her shift and Harry was just going to wait quietly for her in the staffroom.
But the first person she encountered was Tom and the way he held her gaze for a moment or two longer than you would with a normal acquaintance provided one of those lightning-fast, telepathic conversations.
You’re worried about your boy, aren’t you?
Yes.
Too worried to go to your GP?
Yes.
Okay, then...that’s fine...you’ve done the right thing bringing him in.
The lines around Tom’s eyes softened and Laura felt herself relax just a little thanks to that understanding and trust in her judgement she could see in Tom’s face.
She trusted him just as much and it was a trust that was rock solid because it had grown slowly to begin with when Tom had begun working in this emergency department. On both sides.
Laura was always wary around men she didn’t know, especially when they were single and as good looking as Tom Chapman was. She had to make sure they got very clear signals that she wasn’t interested in being anything more than a colleague. That she didn’t want anyone trying to get close. It hadn’t taken long to realise that the new consultant was giving off exactly the same signals but that hadn’t stopped almost every other single woman she’d seen him interact with trying to catch his attention. A sympathetic glance on one occasion had cemented the unspoken knowledge that, for whatever reason, they had both built solid barriers to protect themselves.
Maybe that was what had given the level of trust between them such a solid foundation—that they both recognised those barriers and knew that neither was going to attempt breaking through them. They were workmates. Not quite friends, because they didn’t choose to spend any time away from work together, like Laura did with Maggie and Joe and Fizz and Cooper, but they were more than simply workmates because there was that trust on both sides. That confidence that it was totally safe to be near each other. And that meant they didn’t have to be on their guard on any level, which was probably why it was so easy to communicate, even without any words.
‘Let’s find him a cubicle,’ Tom said. ‘You fill in the paperwork and I’ll come and check on him as soon as I can.’
He smiled at Harry before he turned away. ‘Hey, buddy...who have you got there? T Rex?’
Harry clutched his plastic dinosaur more tightly to his chest and curled closer to his mother. Laura could feel the sudden tension in his small body from being too close for comfort to a man he didn’t know. But her heart squeezed hard when her son was brave enough to say something back to Tom.
‘His real name is Tyrannosaurus Rex,’ Harry whispered.
‘It is,’ Tom agreed. ‘Did you know that he had sixty teeth? And they were all razor sharp and could be this big?’ He held his hands with a large gap between them.
Harry’s eyes widened and his jaw dropped. Laura grinned at Tom. Way to go, she told him silently. He had just won the heart of a six-year-old who was passionate about dinosaurs and he might have even erased much of the fear that this small boy had of men he didn’t know well.
She headed towards the central desk, to pick up the forms she needed to fill in and to check the board to see what cubicle might be free.
Fizz was on her way out of the department. ‘Oh, no... Harry... Are you still feeling sick, sweetheart?’
Harry nodded.
Fizz caught Laura’s gaze. ‘Want me to stay? Cooper’s just gone with Harley to get the car but we could come back.’
‘No...we’re good.’
Fizz raised an eyebrow. She knew that Harry was shy with men he didn’t know. She also knew that her husband had won Harry’s trust very early on, when he’d been one of Laura’s flatmates.
‘You remember Cooper, don’t you, Harry? He helped you when you broke your arm last year.’
Harry nodded.
‘It’s all better now, isn’t it? Your arm?’
Harry nodded again.
‘Well, Doctor Tom will help make whatever it is that’s making you feel sick all better, too.’
‘He will,’ Laura agreed. ‘And who knew that he knew so much about dinosaurs?’
Fizz chuckled. ‘There you go. A match made in heaven.’ But her smile faded as she looked back at Laura. ‘Text me,’ she said, ‘if there’s anything I can do to help.’
‘I’m sure we’ll be fine,’ Laura told her. ‘You go and enjoy the rest of your day with your boys. I’m probably overreacting.’
‘I’d be exactly the same with Harley. And we both know that you need to listen when a mum’s feeling worried. Instinct should never be ignored.’
‘Mmm...’ But Laura didn’t want to think about a mother’s instinct. Because hers was trying to send messages that were too scary.
She just knew too much. She’d seen too much in this department. People that came in, occasionally, with symptoms that should be of no great significance but turned out to be something really awful.
Laura collected the paperwork and settled Harry onto the bed in a spare cubicle. She left the curtain open enough to be able to see what was happening in the department because she wanted to see the moment Tom started heading in their direction.
She wanted him to come and make her feel safe.
More than anything, she needed the reassurance that Harry was safe.
Tom collected the new patient file from the central desk and was reading through the information Laura had provided about Harry as he walked to their cubicle. Perhaps that was why it came as a bit of a shock to look up and see Laura and Harry through the gap in the curtains.
He saw Laura McKenzie almost every day he was at work but he’d never seen her looking like this. She was normally on her feet and always busy, caring for her patients or fully involved in an assessment or resuscitation scene. Even if she was taking a break, she’d be reading while she ate a sandwich, or chatting to one of her friends like Fizz.
Right now, however, she was half on the bed with her son, perched on one side and lying across the pillows so that Harry was tucked under the shelter of her arm. She was gently smoothing the dark spikes of his hair, quietly watching as Harry made his plastic dinosaur hop slowly across the blanket she had tucked around him.
Tom had never seen Laura staying this still, her body language shouting its focus on only one thing—her precious son. Or with an expression like that on her face. That mix of tenderness and concern—the picture of a mother’s love—hit him like a punch in the gut and Tom found himself swallowing hard. To get a flashback twice in one day was more than a little disturbing when he’d been so sure he was well past that part of his life. Or perhaps this was simply an aftershock of how he’d felt seeing Maggie and Joe with their newborn baby and getting dragged back into the past like that.
It felt like longing, this sharp twinge of discomfort.
Or a renewed flash of grief for a future that was never going to happen.
Whatever it was, he knew he could handle it but it was certainly giving him a new perspective on this woman he’d worked with for so long. Someone he had learned to trust because she’d never attempted to get past the guardrails he had in place in his personal life. And, in this moment, he felt closer to her than he ever allowed himself to get to a colleague or a member of a patient’s family, for that matter. It was already under his skin. That note of tenderness. The knowledge that Laura was very vulnerable right now. All he could do was try and contain it. To make sure it didn’t grow any stronger.
‘Hey...’ Tom pasted a smile on his face as he pulled the curtain shut behind him. ‘How’s it going in here? Is Tyrannosaurus Rex finding enough to eat?’
Harry hid his toy under the blanket. ‘He’s not hungry.’
‘Oh...’ Tom pulled out a chair and perched on the edge of it, so that he wasn’t looming over the bed. ‘How ’bout you, Harry? Are you hungry?’
Harry shook his head. ‘I was sick,’ he told Tom. ‘At school. I was sick on the mat at story time.’
‘Oh, no...’ Tom could feel Laura’s gaze on his face but he kept his gaze on his young patient. ‘And you’ve got a sore tummy, too, I hear.’
Harry was silent. His chin was going down and his head tilting further into the crook of Laura’s elbow.
Tom raised his glance. ‘How long has the cream been on his arm?’
Laura touched the clear plastic cover that was keeping the generous blob of anaesthetic cream in place over the easiest vein to get a blood sample from. ‘Needs another ten minutes or so.’
‘Okay. So, tell me about what’s been happening. This isn’t the first time for a sore tummy, is it?’
Laura shook her head. ‘It’s been happening off and on for a long time. Almost since he started school, which made me think it was an anxiety thing, you know? Not wanting to go to school? The vomiting is more recent, though.’
‘What’s vomiting?’
‘Being sick, sweetheart. It’s what we call it here.’
Tom was watching closely as Harry looked up at his mother when he asked the question. Was that a tinge of yellow he could see in the whites of Harry’s eyes?
‘Can I have a look at your tummy, Harry? Is that okay?’
He could see the visible shrinking back further into his mother’s arms but, with Laura’s encouragement and reassurance, Harry let the blanket get pushed back and his tummy exposed.
‘I won’t hurt you,’ Tom promised. ‘If it’s really sore, you tell me and I’ll stop.’ He eyed the dinosaur in Harry’s hand. ‘Or T Rex can bite me on my arm, okay?’
Big, brown eyes looked up at him. Exactly like his mother’s eyes, Tom thought. Harry hadn’t inherited Laura’s auburn hair, though. The ruffled spikes of Harry’s hair were very dark, almost black, which could be contributing to how pale that little face was. There was a hint of a smile there now, however.
‘’Kay.’ He lay back but kept the toy dinosaur in a raised hand, ready to strike if it became necessary.
Tom was as gentle as possible. His hand looked so large against Harry’s abdomen as he carefully palpated each quadrant. He left the upper right quadrant till last, probably because he had that suspicion of possible jaundice at the back of his mind.
‘Can you take a big breath in for me, Harry? Like this?’ Tom demonstrated and Harry complied.
And there it was...
A firm, irregular edge to this little boy’s liver as he could feel it coming down with the lungs filling.
‘Ow...’ The plastic dinosaur tapped against Tom’s arm.
‘Sorry, buddy.’ Tom lifted his hand but his heart was sinking. That prickle at the back of his neck was something he recognised all too easily and it came from the instinct that there was something significantly wrong here. That Harry could be in trouble and it might be impossible to protect him from painful things to come. Pain that would be felt by his mother, as well.
Tom didn’t dare catch Laura’s gaze just then. He didn’t want to scare her. Not until he was sure about what his instincts were telling him. Maybe he just wanted to put that moment off for as long as possible because he knew, all too well, how it could turn your world inside out and upside down.
Destroy it even...
Or maybe it was because he was suddenly aware of a desire to protect Laura McKenzie.
Where on earth had that come from...?
