The Nurse's Reunion Wish
Autor
Carol Marinelli
Lecturas
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14
CHAPTER ONE
SOME WOULD SAY that Rachel Walker had a superpower.
She was an emergency nurse, slight of build, and looked younger than her thirty-two years, which wasn’t much of an advantage. With her fiery red hair and porcelain skin it might be expected that she would blush easily. But Rachel’s pale skin rarely flushed. As well as that, her huge green eyes revealed little of her thoughts even as she held someone’s gaze.
And while that might not sound like much of a superpower, when a patient was critically ill and terrified, or revealing his innermost troubles, it rather helped that the emergency nurse remained outwardly calm and seemingly unfazed.
Rachel had long ago learnt to hide her deepest feelings.
Growing up in Sheffield, in a loud, happy family, with gregarious parents and four older brothers, she had found it necessary, from an early age, to retain a neutral expression and not let anyone reap the effects of their persistent, albeit good-natured, teasing.
But then, aged six, Rachel had come home from school to a house full of aunts and uncles, neighbours and family friends and found out that her mother had suddenly died. The teasing had stopped and the laughter had faded from the Walker home, and the little girl had quickly discovered that her dad and her brothers could not deal with her grief and tears.
‘Take her to the park,’ Dad would say when she cried for her mum.
Rachel had duly been taken to the park and pushed on a swing, or spun on a roundabout, or bumped up and down on a seesaw until her brothers had been satisfied that she’d return home smiling, at least for a little while.
The tears would soon start again, of course.
Especially at night, when she’d missed her mum tucking her up in bed and reading her bedtime stories, or when she would wake from a dream calling out for her.
‘Come on now, Rachel,’ her dad would tell her. ‘You’re upsetting our Phil with your carry-on.’
When she’d cried one day at school, and they’d had to call her dad to come from work to pick her up again, she’d known her tears were causing real problems. Her dad owned his own removal company and, as he’d explained that afternoon, people relied on him to get the job done.
‘It’s their moving day, Rachel,’ he said as she sat in the front of his lorry. ‘If I have to be called away, who’s going to move them into their new house? And what about the family that are waiting to move in to theirs? You’ve got them thinking they’ll have nowhere to sleep tonight. Now, stop with them tears and be a good girl.’
Then one day it had been ‘our Phil’ himself who had warned her. ‘Enough now, Rachel! Dad doesn’t need to hear it. He’s upset enough and missing Mum too. You’re just making things worse.’
Finally Rachel had stopped with the tears and the questions about her mum. Her emotions hadn’t stopped, of course—she’d just learnt to hide them.
This superpower she now possessed hadn’t done much for her relationships, but on this cold February morning, in the Emergency Department of London’s Primary Hospital, even though Rachel had only worked there for a week, her particular skill had been recognised.
She had been assigned to the minor injuries unit and was helping a young man with crutches when the intercom buzzed and she heard her name being called by May, the unit manager.
‘Excuse me a moment,’ Rachel said. But, reluctant to leave the man wobbling, she just went and stood by the curtains, so she could keep an eye on him as she answered the call.
‘Yes?’
‘Can I ask you to come down to Resus?’
‘Sure,’ Rachel said. ‘I’ll just—’
‘Immediately.’
As May summoned her, the chimes went off and the request for an anaesthetist to go to the ED went out.
Rachel called over her shoulder to a colleague to come and take over with the young man. Then she made her way through the department, via Reception and the central waiting room, which was particularly full, and through to the main section of the unit, where she could see May standing outside the resuscitation area looking in.
Rachel liked her new unit manager. She was caring in the way of a mother hen, but also wise and sharp.
May gestured for Rachel to stand with her and observe as she told her about the patient. ‘Thomas Jennings, eighteen-month-old with query epiglottitis, just arrived in the department. Mother drove him here...thought he had croup.’
Even from this distance Rachel could see that Thomas was a very sick little boy indeed. He sat on his mother’s knee, leaning forward and drooling, his breathing noisy and laboured. She could hear the stridor—a high-pitched wheezing—from outside the room.
‘Where is everyone?’ Rachel asked, because she could only see Tara, a fellow RN, in there.
‘Jordan the paediatrician is here,’ May explained. ‘He’s on the phone, out of earshot of Mum, trying to get hold of an anaesthetist. But the on-call team are up on ITU and the second team is in Theatre.’
Sure enough, as soon as May said that the chimes went off again, summoning an anaesthetist to the resuscitation area of the ED.
Epiglottitis could quickly turn life-threatening. It was an inflammation of the flap of cartilage and mucous membrane at the back of the throat that guarded the windpipe. Thanks to immunisation, it was now rarely seen. Still, at any moment little Thomas’s airway could become obstructed—hence the need for an anaesthetist to be present.
‘Mum’s getting upset that we’re not doing anything and Tara’s getting a bit flustered,’ May explained, and then glanced at Rachel, who stood there unruffled, taking it all in.
She must have looked so calm that May felt she had to double-check that she understood the precariousness of the situation.
‘You do know how quickly a patient with epiglottitis can deteriorate?’
‘Yes, May,’ Rachel answered calmly. ‘Has everything been set up for a tracheostomy?’
‘That’s why I called for you to come down,’ May admitted. ‘I’ll leave you to it. I’m staying back, so as not to distress the little man with too many people around him, but I’ll be hovering should you need me.’
‘Thanks,’ Rachel said, glad to know that May was near as she walked into the room.
‘Morning.’ Rachel smiled at both Tara and the mother, but she didn’t fuss over the little boy.
His blond hair was dark with sweat and plastered to his head, and he buried his face in his mum’s chest at the sight of a new arrival.
The monitors were all turned up and bleeping loudly. Rachel turned the volume down—given all the staff who were close by—doing what she could to make the surroundings less scary.
‘He’s never been in hospital before,’ Mrs Jennings said.
‘It’s very overwhelming.’ Rachel nodded. ‘But you’re doing great. I know it looks as if we’re not doing much, but the most important thing right now is to keep Thomas from getting upset.’
‘Where’s the anaesthetist?’ Mrs Jennings asked, her voice rising in panic.
‘On the way,’ Rachel said, privately hoping that was the case.
Tara spoke then. ‘I was just explaining to Mum that if we can get a couple of local anaesthetic patches onto Thomas it would be a great help when we cannulate him.’
‘Good idea—but perhaps Mum could do it,’ Rachel suggested, and then looked over to Mrs Jennings. ‘I’ll show you how.’
There probably wouldn’t be time for the cream to take effect before he was cannulated, but hopefully it would save him a little pain and distress, which was the main goal here.
Thomas didn’t flinch as his mother copied Rachel’s instructions and the patches were applied, which concerned Rachel greatly.
She glanced over to Tara. ‘Has everything been set up for the transfer?’
‘I was just about to do that,’ Tara said.
Thomas had only been in the department for ten minutes, but things had to be moved along speedily, as the situation could change at any minute. And it was starting to. He was becoming increasingly exhausted, and Rachel knew she had to get everything they might possibly need on a trolley as quickly as possible.
‘I’m going to get things ready for Thomas’s transfer,’ Rachel said to the mum, ‘but I’ll be right here.’
All seemed calm.
All was not.
Outside the room there was a flurry of activity taking place. The paediatrician was alerting the operating theatre, and the anaesthetist, who had just arrived in the hospital and collected his pager, was sprinting down the long corridor towards the ED. Rachel was preparing the trolley, and outside May was calling Security to clear the corridor and hold the lifts while the transfer was made.
It was imperative that the little boy did not become distressed, so the staff were hands-off, leaving it to his mother to comfort him as they hovered discreetly and prepared for the worst.
Rachel started to collect the equipment they would need for the transfer while keeping an eye on Thomas. She glanced out and saw Jordan on the phone, running a worried hand through his hair, but he plastered on a smile when he returned from his call and gave Rachel a nod, then made small talk with Mrs Jennings about his own three children while keeping a very close eye on Thomas.
‘There’s Nicholas, who is Thomas’s age,’ Jordan said, ‘and the twins are three—’
His words halted as the doors slid open.
‘Ah, the anaesthetist is here, Mrs Jennings. This is Dr Hadley.’
Hadley?
Rachel glanced over towards the doors at the sound of the familiar name. And the world as she knew it changed as Dominic Hadley stepped in.
Rachel quickly turned back to the trolley she was preparing, drawing in a deep breath when she suddenly felt giddy.
Dominic Hadley worked at The Primary?
Dominic was a doctor?
An anaesthetist?
How?
When?
Though his voice was slightly breathless from running, it was a deeper and more assured voice than the one she had known. As he spoke with Jordan, Rachel screwed her eyes tightly shut, for she did not know how to face him. How to turn around and deal with this situation?
Because it really was a situation.
Dominic Hadley had hurt her badly.
So badly that it had taken her more than a decade to recover her heart enough to try to love again.
So badly that as she stood there anger, hurt and recrimination fought for first place in the order of her feelings.
But she could not think of that here, so she focused on the soft bleeps of Thomas’s monitors and forced the surge of animosity within her to settle. She wondered about Dominic’s reaction when he saw her.
Dominic had not a clue.
Yet.
‘I’m just going to let Richard know,’ Dominic told Jordan. ‘Though I’m not sure if he’s in ye—’
His voice halted as a flash of red hair caught his eye and he couldn’t help but check the profile of the nurse who was preparing to transfer Thomas up to Theatre.
It happened every now and then—a glimpse of red hair would make him turn his head, or the sound of laughter in a bar would have him scanning the crowd—but then he would remind himself that there hadn’t been much laughter at the end of their relationship.
But it couldn’t be Rachel, Dominic thought, and dismissed her from his mind as Jordan continued to bring him up to speed.
‘Mrs Jennings understands that we won’t examine Thomas until we’re safely in Theatre, and she’s consented to a tracheostomy, should it be necessary.’
Dominic looked over to the anxious woman, who was doing all she could to hold it together for the sake of her son.
‘Hello, I’m Dominic Hadley—the anaesthetic registrar.’ He gave her a smile, but noted that the little boy whimpered at the rather imposing sight of him so halted his approach. He stood a couple of inches over six foot and, sharply dressed in a navy suit, he was aware he might look rather imposing, so he sat down on the resuscitation bed a little further away from Thomas. ‘What would you like me to call you?’ he asked.
‘Please,’ Mrs Jennings said, ‘call me Haylee.’
‘And do you understand what’s happening, Haylee?’
She gave a helpless shrug. ‘Not really. The children’s doctor said he might need to be put on a breathing machine, and an airway made in his neck...’
‘It’s called a tracheostomy.’ Dominic nodded.
Time was of the essence, but so was explanation. He drew a rudimentary picture of a throat on the pad he carried in his pocket.
‘The epiglottis is a flap of tissue at the back of the throat. If that swells so much that we can’t get a tube past it, then an incision would need to be made here.’ He pointed to the picture he’d drawn and then to the same spot on his own throat. ‘That way we can bypass the swelling.’
‘But he might not have to have one?’
‘We won’t know till we look at Thomas’s throat. I’d prefer to do that in Theatre, where we can examine him properly and get treatment underway. I’ll attempt to secure his airway, though a tracheostomy might well be the only course available to us.’
Haylee looked down at the picture and then to her son, who was working very hard to breathe.
Dominic was deeply concerned and he would feel a lot better if they were in Theatre. ‘Thomas really needs antibiotics and IV fluids,’ he said. ‘But putting in a cannula is only going to upset him, so the very best thing we can do is get him up to Theatre and take care of everything there.’
‘I understand that,’ said Haylee Jennings as she cuddled her son.
‘Have you got anyone here with you?’
‘My husband’s on his way.’
‘Good,’ Dominic said. ‘I’m just going to let my senior know what’s happening and...’
He glanced up to let the nurse know they’d be heading up to Theatre imminently, and it was then that Dominic realised he hadn’t been wrong at all.
The nurse was Rachel.
It helped, as an anaesthetist, to have nerves of steel. For Dominic, it was an acquired trait. Some called him arrogant, but those nerves of steel were invaluable now that he was faced with this unlikely situation.
Dominic looked through Rachel, rather than at her.
In fact, Dominic barely blinked.
‘We’ll head up shortly,’ he informed her. ‘I’m going to make a quick call first.’
‘Ready when you are,’ Rachel replied, in a voice that was both measured and calm.
Yes, a superpower indeed!
As Dominic Hadley selected some drugs and syringes from the cart and stalked off, there was a moment when Rachel wondered if he’d even recognised her.
After all, she’d barely recognised him!
There was little about this polished, suave man who commanded the room that compared with the awkward physics geek she had fallen in love with.
Although his thick black hair was the same, still damp from his morning shower, and the soapy male scent of him was familiar. His dark eyes were the same gorgeous velvet brown as they had always been too. He had always towered above her, but he seemed taller now, if that were possible. And he had definitely broadened out, and looked immaculate in his sharp navy suit, pale blue shirt and lilac tie.
Her dad, if he were here, would probably say it was pink...
What sort of man wears a pink tie? Rachel could almost hear her father’s thick Yorkshire accent.
With the phone pressed between his ear and his shoulder, Dominic pulled up the drugs he might need, should there be an emergency en route, as he let his boss know the situation.
‘Any history?’ asked Richard Lewis, the consultant anaesthetist.
‘Unvaccinated.’ Dominic clipped back his response. But his voice faltered as he glanced over to Resus, where Rachel still stood. There was a whole lot of history right there...
‘Healthy little boy until this morning, nil allergies...’ He went through the case, and it was agreed that Richard, who was currently on ITU, would meet him up in Theatre.
‘We’re heading straight up,’ Dominic told May as he replaced the phone.
‘They’re ready for you. Rachel will come up to Theatre with you.’
Dominic felt as if his heart might pump its way up to his throat and wondered if it would be better to object to Rachel escorting him.
‘She’s new. I need someone who knows what they’re doing.’
‘Which is why I’m sending Rachel. She might be new but she’s worked in Paediatric Emergency up in Sheffield and is very competent.’
‘Fine.’ He walked over to the cooler and filled a little plastic cup with water, drained it, filled it again, drained it again, and told himself to remove Rachel from his mind entirely. He headed back in, determined to ignore the fact that Rachel had just dropped back into his life.
For now.
‘We’re going to get Thomas up to Theatre now,’ Dominic informed Haylee. ‘We’ll put you in a wheelchair, with Thomas on your knee, but if there’s an emergency on the way, then we’ve got everything we need to deal with it.’
Rachel—or rather, he told himself, the nurse—helped mother and child into the wheelchair as he ran a knowing eye along the equipment she had prepared for the journey.
‘Ready?’ Dominic checked as Rachel wrapped a blanket around Thomas and his mum.
‘Ready,’ the nurse agreed and gave the mother a smile...
Except it was Rachel’s smile, and to Dominic it felt like a punch in the guts. It was summer and spring all rolled into one. It was the memory of Saturday nights watching a movie while eating a curry in bed. It was a forgotten ten-pound note found in her jeans that she’d waved over her head before taking him for breakfast in the café across the street.
But he was determined that her smile would not be his undoing.
‘Ready,’ Jordan said.
There was a blast of cold air as they left the department and he tried not to notice Rachel briefly rub her bare arms.
It was a reminder for Dominic that Rachel was always cold—and not just in body temperature. He’d never been allowed inside that head of hers, so he did all he could to put her out of his now.
It was a very long walk up the corridor. Rachel’s eyes never left Thomas’s face as Haylee nervously chatted away. ‘I thought he had croup,’ she admitted. ‘But he was blue when I went to him...’
‘Well, he’s in the right place now,’ Rachel said, doing her level best to keep Haylee as calm as she could.
‘Have you worked here long?’ Haylee asked.
‘I’ve only been here a week,’ Rachel admitted. ‘Before that I worked in a paediatric emergency department in Sheffield.’
‘I thought I heard a northern accent.’ Haylee nodded and looked up at Rachel. ‘Do you have any children?’
‘No,’ Rachel said.
To her utter, aching regret, the answer was no, even if it wasn’t strictly true. But it was much easier just to say no and deny her son’s existence than to walk along a corridor with someone she didn’t know and admit to the agony.
‘No, I don’t.’
The porters were holding the lift for them, and as the group got in, Rachel gave them a nod of thanks, relieved that attention could be diverted from her answer to Haylee’s question.
The lift doors closed and Haylee looked up at Jordan. ‘So, you’ve got three children?’
‘I do,’ Jordan said. ‘All boys.’
Rachel held her breath as Haylee asked Dominic the same question. ‘What about you, Doctor?’
How would Dominic respond?
For Rachel, worse than having him reveal their past would be hearing about his present. Was she about to learn that he was married with two little ones or one on the way?
As she awaited his response, Rachel found she was holding her breath. Was she going to have to hide her reaction to hearing about a Mrs Hadley? Or a soon-to-be Mrs Hadley? And how would she react to that?
Dominic wasn’t about to enlighten anyone.
He would rather be anywhere than in this lift right now. And this morning, of all mornings, it was imperative that he keep his private and professional worlds firmly separated.
‘I try not to bring my personal life to work, Haylee,’ he said, and let out a steadying breath. ‘It makes it easier for me to focus.’
Haylee nodded and gave a small smile, not offended in the least at the slight rebuff, and he saw Rachel let go of the breath she’d been holding.
The lift swished them to the second floor, and they were soon gliding along the highly polished corridor and into the controlled world of the operating theatre, where more medical staff awaited them.
‘Stay with him,’ Dominic ordered Rachel. ‘A familiar face might help.’
But Rachel’s familiar face most certainly wasn’t helping Dominic, so it was Thomas Jennings he kept on his mind as he went off to change into scrubs.
As the theatre nurses checked Thomas’s ID, and ran through questions with his mum, Richard Lewis came in and introduced himself.
Jordan was ordering an IV and drugs, but the efficient theatre staff were taking care of that, and Rachel again found that she felt a little giddy.
Not in an about-to-faint way. Just giddy from the heat of Theatre, she tried to convince herself. Of course she was worried about Thomas, but mostly she was overwhelmed by seeing Dominic again—but she never let it show, not even for a second. Even when Dominic returned, dressed in scrubs and a theatre cap, she gave him as banal a look as she could muster.
‘Let’s get a line in,’ Dominic said, and then added to Rachel, ‘Can you try to distract him?’
The numbing gel had only recently been applied, but she hoped it would take the edge off the cannula going in. More important, Thomas was increasingly cyanosed and becoming rather listless, so it was imperative they moved quickly.
Haylee cuddled her son while Dominic eased a cannula into his little vein.
‘Good boy,’ Dominic said when it was all done and hooked up.
Now that IV access had been secured, it was time for Rachel to escort Thomas’s mum out of the operating theatre. But before she left, Dominic caught the tearful woman’s eye. ‘I won’t leave his side,’ he said.
‘Thank you,’ Haylee said.
She turned and waved as her son let out a raspy cry, but allowed Rachel to lead her out.
‘They’ll take the very best care of him,’ Rachel said.
‘That anaesthetist—he seems to know what he’s doing,’ Haylee said as Rachel led her to the relatives’ room. ‘Thomas will be safe with him.’
‘Yes,’ Rachel said. ‘Dr Hadley will take the very best care.’
It was a difficult intubation. Thomas’s throat was swollen, and the vocal cords were hard to visualise, but with Richard’s quiet and reassuring presence, Dominic got the tube in and thankfully a tracheostomy wasn’t necessary. Swabs and bloods were taken, and antibiotics and IV fluids were started.
Thomas was moved over to the ITU, where, sedated and ventilated, his little body could finally start to fight the infection, and it wasn’t long before Haylee was allowed to return to her son’s side. Only then did Dominic leave him.
‘Well done,’ Richard said as Dominic took a seat at the nurses’ station that looked out over the whole of ITU and pulled up Thomas’s incoming blood work on the computer.
‘Thanks.’
Richard turned his head at this rather muted response from Dominic. He noted the pallor on his colleague’s face, and saw that his usually suave registrar was suddenly anything but.
‘Is everything okay?’ Richard checked.
‘Not really,’ he admitted, and ran a hand over his forehead now that the surprising turn of events had begun to sink in. ‘There’s a nurse down in Emergency...’
Richard rolled his eyes. This happened all too often where Dominic was concerned. ‘You need to learn to let them down more gently,’ Richard suggested.
But Dominic was silent.
He knew it would be far more sensible to say nothing. To just let it go.
After all, what had happened between him and Rachel had been more than a decade ago.
Way more than a decade.
It had been thirteen years, in fact.
Yes, better to stay silent, Dominic decided.
Except the shock of the morning had been so great—or maybe it was just that he couldn’t hold it in any longer—that he told his senior the truth.
‘It’s not like that,’ Dominic said, for it wasn’t a little glitch with an ex or some disgruntled lover that was troubling him.
Rachel had been way more than that.
‘I just ran into my ex-wife.’
