A Vet to Heal His Heart
Auteur·e
Caroline Anderson
Lectures
18,1K
Chapitres
11
CHAPTER ONE
FINALLY!
Ellie turned onto the drive with a sigh of relief and stared at her little house for a long moment.
She’d saved hard for a deposit and since she’d bought it three years ago as an investment she’d let it to tenants to cover the mortgage. She’d never lived in it herself because she hadn’t needed to, but she did now, so thank goodness it was available.
It shouldn’t have been. Wouldn’t have been, if it hadn’t been for her tenant doing a midnight flit a few weeks ago. She’d been furious at the time, but now she was grateful that it was empty, even if, in the words of the agent, it needed ‘a little attention’. But that was fine. Thanks to Craig she had time on her hands now, if nothing else. Certainly no job security, that was gone and the rent-free flat that went with it...
No. She wasn’t going down that rabbit hole again. Time to find out what ‘a little attention’ actually meant.
She sucked in a deep breath, then turned to look at Lola in the back seat. After six horrendous hours in heavy traffic, it wasn’t just Ellie who was more than ready to get out of the car. Her little black Lab was sitting up now, her face expectant, tail wagging, and Ellie dredged up a smile.
‘This is our new home, Lola. It’s going to be great!’
Maybe her voice had been more convincing than she thought, or maybe the dog was just as relieved as she was, but she jumped up, and Ellie got stiffly out of the car, let her out and led her to the front door.
The paint was a little chipped and faded now, but that was hardly a major issue. She slipped her key in the lock, turned it and stepped inside.
And stopped.
A little attention? It smelt stale and unpleasant, and she wouldn’t feel happy until she’d scrubbed it from top to bottom and cleaned all the carpets. Lola was busy sniffing, and she led her through the sitting room to the kitchen at the back and peered out of the window.
The light was fading, but she could see the once-tidy garden was a mess and heaven knows when the grass was last cut. Well, her agent had warned her, and it wouldn’t take long to get it in order. Like the house, it was only tiny and easily manageable. She let Lola out for a wee and a sniff and left the door open while she went to check out the rest of the house.
She’d furnished it sparsely when she’d bought it three years ago, but everything was tired and dirty now, the mattress grubby, the bathroom filthy, and her optimism hit a brick wall. She came back down and sat with a plonk on the bottom step, her usually relentless optimism crushed.
What had she been thinking? Yes, she owned the house, but she knew nobody in Yoxburgh, and her rose-tinted family holidays here seemed worlds away. And the house was awful now. Beyond awful, really. ‘A little attention’ didn’t even scratch the surface.
She sat up straight. No. She just needed to clean it, get the paintbrush out and—
The loud yelp made her turn her head sharply, and she ran out through the kitchen and found Lola limping towards the door. Even in the fading light she could see the thin spurt of blood from her right hind leg, and her heart went into overdrive.
‘Lola! Oh, sweetheart...’
She needed a vet fast, but how to get her there before she bled out? She laid Lola down on her side, pressed her thumb firmly over the femoral artery high up in her groin above the wound to stop the bleeding, and studied it carefully. Whatever Lola had slashed herself on, she was pretty sure it wasn’t glass. The cut wasn’t clean enough for that, more a jagged tear, and it was just above her knee on the inside of her thigh, so she could get a pressure pad on it. If she had one...
She held her fingers on the artery while Lola whined and struggled to get free, stripping off her sweater and thin vest-top, swapping thumbs, then she balled the top up into as firm a wad as she could manage one-handed and wrapped her scarf tightly around it to hold it in place over the wound.
Lola did her best to resist, and at one point she put her teeth on Ellie’s hand, not hard, just a gentle protest, but Ellie knew it must be very painful for her.
‘Good girl, it’s OK, I’ve got you, sweetheart, it’s going to be all right,’ she murmured, but she wasn’t sure if it was. Tying it tight enough to stop the bleeding was next to impossible, and Lola wasn’t helping, but it was as tight as she could get it and at least it had slowed the blood flow down.
So now what?
Back to the car and head to the nearest vet. She’d been scoping out the practices online this morning with the intention of visiting them to ask about locum work, and the closest by miles was just three streets away in a big old Victorian house. She’d driven past it on the way here, and they had excellent reviews. She tugged her sweater back on hurriedly, carried Lola to the car and set off, praying that the makeshift tourniquet would stay put until she’d got there.
Please be open, please be open, please be open...
There! Yoxburgh Veterinary Practice. She swung through the open gates into the empty car park in front of the building, jumped out and ran to the door. She could see lights on at the back, but the entrance was in darkness, and her heart sank. She rang the bell and pounded on the heavy old door.
Please be open...
Nothing. She fumbled for her phone and rang the practice, and was automatically transferred to the night service. It was miles away, but she’d been watching the wound as she’d phoned, and she could see the blood slowly seeping through the wadded-up top and her scarf every time she took her hand off the pad.
If she didn’t get help soon, Lola was going to die.
She felt a sob rise in her throat as she hung up and pressed hard on the pad, and Lola whined and licked her hand.
‘Oh, baby. I can’t lose you, not like this, not now after everything else...’
She fought down the sobs, kneeling on the edge of the back seat and stroking her sweet, gentle dog with her other hand while she tried to work out what she could do. Move her to the front seat so she could reach to press on the pad as she drove? No, the front seat and footwell were packed to window height and it would take too long.
So—leave her in the back and drive fast? She couldn’t, not that fast. If she took the pressure off she’d bleed out in minutes, and the tourniquet, such as it was, had already been on nearly ten minutes.
Five more minutes and the leg would be compromised...
Stay there all night pressing on it until the surgery opened again, and resign herself to Lola losing her leg?
Or just pray for a miracle?
So much for their new start. If only she’d stayed put—but she couldn’t have, not after what had happened, and now everything was falling apart and Lola was going to die. She’d never felt so helpless in her life.
She went back to the door and pounded on it again.
‘Where are you?’ she wailed. ‘Why won’t you open the door?’
But they didn’t. Whoever was in there was ignoring her, and she went back to Lola, leant on the pressure pad again and stroked her head gently with a hand that shook with grief and guilt and horror.
‘I’m sorry, sweetheart. I’m so, so sorry...’
The pounding on the door seemed frantic, and Hugo hesitated another few seconds and gave in.
He went out through the staff entrance, Rufus at his heels, and saw a car in the car park, the back door hanging open. A woman was half in, half out of it, giving him a distractingly tempting view of a gently rounded bottom in snug jeans.
He ignored the inappropriate urge and was gearing up to explain that the practice was closed when he heard a wrenching sob that made his heart sink. So much for his quiet Friday evening walk with Rufus...
He peered in at her. ‘Can I help you?’
She turned her head, her face streaked with blood and tears, a strand of dark hair clinging damply to her cheek. He didn’t wait for a reply, just told Rufus to stay and ran round to the other side of the car and opened the door.
A dog, a black Labrador by the look of it, still alive but bloodied and whimpering, and the woman was leaning on some kind of makeshift bandage on her hind leg.
‘What happened?’
‘No idea. I let Lola out into the garden and heard a yelp and she was hosing blood—’
‘OK, let’s get her inside. I’m Hugo, by the way. And you are?’
‘Ellie.’ Her eyes held his and he could see hope in them. ‘You’re the vet?’
‘Yes.’
Another wrenching sob made her whole body convulse, and he took over, lifting the injured dog into his arms and carrying her swiftly round to the side door. He opened it with his elbow and went inside, Rufus beside him, and he sent him to his bed and headed straight through to the prep room, putting the dog down on the table.
‘It’s OK, Lola, I’ve got you, sweetheart,’ he said gently, and the dog licked his hand and gave a quiet whimper. A trembling, bloodied hand reached out and stroked the dog’s head, and he leant on the makeshift pressure pad and looked up and met Ellie’s distraught eyes.
‘Right, tell me everything you know.’
Her voice had a tremor, but her words were calm and concise. ‘It’s her femoral artery. No idea what she tore it on, I’d just let her out for a wee, but it’s a jagged cut, so most likely not glass. I did what I could to contain it, but she’s probably lost two hundred mils, maybe more?’
He gave an inward eyeroll. She’d probably spent her life watching vet programmes. ‘That’s a wild guess,’ he said, but she cut that off with her next words.
‘It’s an educated wild guess. I’m a vet.’
He met her eyes again. ‘Seriously?’
She rolled her eyes, echoing his thoughts, which under normal circumstances he would have found funny, but this wasn’t exactly normal. But if she really was a vet...
‘Do I look as if I’m joking? My dog is bleeding out, and that pressure has been on for about twelve minutes now! Can you please just give her a GA and clamp the artery before she bleeds to death or you have to amputate her leg?’ Her voice cracked on that, and he frowned.
‘I’ll call my nurse—’
‘You don’t need a nurse, Hugo, I’m a vet! I’ve got all my paperwork in the car, or you could call my old boss James Harkness, but we don’t have time for that now. Please—before it’s too late?’
His mouth opened, but then he clamped it shut and held her eyes.
Come on, come on...
‘You know Jim?’
‘Yes. He owned my old practice. I worked with him for eight years.’
Another pause, then, ‘OK,’ he said at last, and her shoulders sagged with relief. ‘Right,’ he went on, stepping up a gear. ‘You hold this while I get everything ready, and once I’ve got her under I can clamp that artery and get a proper look at it. Meanwhile tell me a bit more about her, please.’
She watched him, heart pounding, itching to do it herself, hoping he’d do things the way she would, and while he prepped at lightning speed, she filled him in.
‘She’s got no pre-existing conditions that I know of, no contra-indications, she weighs twenty kg. I gave her a general anaesthetic to drain an abscess at the back of her mouth three and a half weeks ago, she was fine for that and it’s healed well. She hasn’t eaten since this morning, she had a drink about three hours ago.’
‘Good.’ He was moving briskly and efficiently, doing what she would have done. Warming a bag of Hartmann’s in hot water because Lola would need the compound sodium lactate solution to replace her lost blood volume, pulling up the induction agent, checking the anaesthetic gas in the vaporiser, selecting an ET tube, and she began to think they might after all be able to save Lola and her leg.
He clipped the hair on the front leg that hadn’t been recently cannulated, asked her to hold it while he slid the needle in, and moments later Lola was asleep, intubated and out of pain. ‘OK, let’s move her into Theatre,’ he said, and they carried her through and he connected her up to the gas. He was setting up fluids, injecting pain relief and antibiotics, checking Lola’s stats, moving reassuringly swiftly. Then he looked up and met her eyes again.
‘Right, we’re good to go,’ he said, then added, ‘Which end do you want?’ which surprised her.
The leg, because she wanted to know exactly what was going on in there, but she didn’t know where anything was in his theatre, and anyway, her hands were shaking too much and vascular surgery needed steady hands. And she realised she trusted him.
Not that she had a choice...
‘You do the leg, I’ll monitor her.’
To her relief, he did exactly what she would have done.
Keeping his thumb on the artery, he removed the makeshift pressure pad, then released the pressure carefully.
Blood welled in the wound, but at least it didn’t spurt.
‘It might have closed up a bit,’ she said hopefully, but as soon as she said that it started again, a thin stream streaking out across the room, and he shook his head and clamped the artery.
‘OK, let’s clean this up and get a better look. Up the fluids, please. We need to boost her circulation now.’
She’d already done it as soon as the artery forceps were on, and she watched as he filled the wound with sterile gel to protect it from the clipped hair, ran the clippers over the inside of Lola’s thigh, scrubbed the skin with chlorhexidine, sucked out the gel and irrigated the wound thoroughly.
Just what she would have done. She heaved an inward sigh of relief.
‘How’s she doing?’ he asked without looking up.
‘She’s fine. All good.’
He nodded, laid out all the instruments he’d need, then while he scrubbed she opened the outer packets ready for him.
‘OK, let’s get a good look at this.’
He laid a sterile drape over the leg, blotted the wound with a swab, and she leaned over and studied it with him. The artery was punctured, but it was also grazed, not extensively but enough that it would need a skilled vascular surgeon to fix it.
‘That’s a nasty graze. Can you repair it?’ she asked without any real hope, but he shook his head.
‘No. If it was just the tiny hole, I’d give it a go, but the graze has damaged the vessel wall and I don’t have the equipment or skills for fine vascular surgery. It needs a graft.’
‘So what do we do?’
‘Tie it off and hope? The artery’s been clamped for a few minutes but her foot’s still warm, she has good perfusion of the tissues, so I reckon she’s got a good enough supply from the other vessels. She should be fine, but realistically, we have no other options.’ He looked up and met her eyes. ‘Unless you want her to go to a specialist? We can probably get her stable enough. Up to you.’
She shook her head. ‘No. I’ve tied it off in a similar case, and frankly, if she’s got enough of a blood supply to that leg for it to survive the journey, it’s probably fine anyway.’
He nodded, and his gloved fingers explored the wound carefully.
‘Nothing in there that I can feel. You’ve got no idea at all what she cut it on?’
‘No, none. I’d literally just got the keys off the rental agent and walked in, and I’d got no idea what’s in the garden, so I should have been more careful.’
He raised an eyebrow. ‘X-ray?’
She nodded. ‘Might be an idea, as I haven’t got a clue what it was. She was probably racing round like a mad thing. She’d been in the car for six hours.’
He winced, and she pulled a face.
‘Yeah. Long story. I’ll tell you later.’
He wondered what the story was, but it would keep.
He X-rayed the leg, studied the images closely and tried not to think about the scent of something delicate and delicious drifting from her hair as she leant close to look at the screen.
‘I can’t see anything,’ she said.
‘No, nor can I.’ He straightened up and told himself to focus. ‘OK, let’s close it.’
He tidied up the wound, debriding the edges so they’d come together in a clean line, tied off the artery and then hesitated.
‘Does it need a drain in the dead space so she doesn’t get a seroma?’ she asked, echoing his thoughts, and he nodded.
‘I’d rather put it in and take it out if it’s not needed than have to do it later. Negative pressure drain?’
‘I would.’
He made a tiny hole through the skin to the centre of the wound, slid in the fine flexible tube and taped the drain in place, then repaired the muscle damage before he drew the edges of the wound together and closed it with a continuous soluble suture. Then he squeezed the empty drain bottle and attached it to create suction in the wound and watched as a thin trickle of pink-tinted serum filled the fine tube. He gave a satisfied nod and looked up. ‘How’s she doing?’
‘Fine. Stable.’
‘Good. I’ll get some local into that so it’s not too sore when she wakes up, and then let’s bring her round and see how she is.’
He stepped away from the table, pulled off his gloves and gown and binned them while she monitored Lola.
She was slowly coming to, but still sleeping, her breathing slow but steady, and together they put her into a mesh vest, tucked the suction bottle into it up against her tummy and then Hugo carefully moved her into a kennel and covered her with a warm blanket.
Ellie sat down onto the floor beside the kennel, her legs suddenly too weak to hold her. Lola was alive, her foot was warm, and she wasn’t going to die. She realised she was shaking uncontrollably, and she felt a gentle hand on her shoulder.
‘Hey, it’s OK. She’s going to be all right.’
Hugo hunkered down beside her, his hand still on her shoulder, warm and reassuring, and she turned her head and met his eyes. They were the kindest eyes she’d ever seen, and she couldn’t hold that gentle, understanding gaze. She turned her head away again and blinked back tears.
‘Have you had anything to eat or drink recently?’
Recently? Hardly. She shook her head. ‘Not since this morning. I had a bit of water when I stopped to let Lola out, but—no, not really.’
‘I’ll knock something up. You OK with pasta and pesto?’
‘Um—yes, fine. Sounds lovely. Thank you.’
‘Good. I might even have some parmesan.’
She dredged up a smile, suddenly realising how hungry she was. ‘Even better.’
He went through a door into what she assumed was a staff room. She could hear him talking to his dog, the sound of a food bowl being chased around the floor, and he came back a couple of minutes later with a large mug full of steaming tea.
‘It’s got sugar in it—and don’t argue, just drink it,’ he said over his shoulder as he walked away again.
She didn’t argue. She was beyond arguing, and his kindness suddenly overwhelmed her. She put the tea down, buried her face in her hands and gave in to the tears.
She was crying. He could hear her as he ran back downstairs from his flat with the ingredients from his fridge, the quiet sobs tugging at his overused heartstrings.
He wondered again what the ‘long story’ was. Something that had taken her alone on a six-hour journey, ending up in a rental place with a garden that was clearly unsuitable for a young, energetic dog like Lola. Or any dog, really, by the sound of it.
He dumped the fresh pasta into boiling water, drained it, stirred a hefty dollop of pesto into it, grated the parmesan generously over their brimming bowls and carried them through.
‘Here you go,’ he said, and sat down cross-legged beside her.
She’d stopped crying now, and he could see why. Rufus was curled up in her lap, and she was stroking him with one hand and nursing her mug with the other. He called the dog over to his side, and he lay down between them, sharing the love. She got the head end, he noted wryly.
He handed her a bowl, and she put the tea down and took it with a smile and a hand that was still shaking. Low blood sugar? Shock? Exhaustion?
All of the above, probably.
They ate in silence.
She was glad of that. She was too tired, stressed and hungry to engage in polite conversation, and it seemed he was, too.
But then it was done, her bowl scraped clean, and she put it down and met his eyes. They were slate blue, and she thought they could see to the bottom of her soul, but that kindness was still there in them and she felt oddly safe. ‘Thank you. That was amazing. I really needed it.’
‘Yeah, me, too.’ He smiled, his mouth tipping up a little on one side. ‘You’ll feel better soon.’
‘I do already,’ she told him honestly. ‘I can’t believe how kind you’ve been. It’s restored my faith in human nature.’
‘I haven’t billed you yet,’ he reminded her with a wry smile, and she gave a fractured little laugh.
‘No, you haven’t, but I’m sure you will.’
He chuckled, then held out his hand. ‘It’s probably time we introduced ourselves properly,’ he said. ‘I’m Hugo Alexander, and this is my practice.’
She knew that already from her research last night, but she took his hand—the warm, strong and yet gentle hand that had squeezed her shoulder and reduced her to tears, that had saved Lola’s life and leg with quiet competence—and she smiled at him.
‘Eleanor Radcliffe. Ellie to my friends,’ she added, and he cocked his head on one side, a smile playing around his lips.
‘So, Ellie,’ he said with quiet emphasis, ‘this long story...’
She looked away from those kind yet piercing eyes that would see too much and gave a little shrug. ‘Oh. That. I’m sure you’ve heard it before. I was working in Jim’s practice in the Cotswolds. He was a brilliant boss, but he was getting on and he wanted to retire, so he stepped back and made me senior vet, which was great for a while, but things had moved on, some of the equipment needed upgrading, and he didn’t want to invest any more in it, so he decided to sell it to a corporate.’
‘Was that a problem?’
‘Not initially. The building needed investment, and it was going to get it, which had to be a good thing. And then within a year the corporate sent in a new senior vet over me.’
‘Ah...’
She threw him a wry smile. ‘It’s not what you think. He was an ex from uni days. We’d had a brief relationship, I’d dumped him when I realised he was a lying, cheating snake, then he’d said stuff about me that wasn’t true that caused a rift with my best friend—and then he reappeared in my life and got his revenge.’
‘How?’
‘Oh, picking fault here and there, snide remarks, trying to undermine me with my colleagues—it went on for months, then we had a row over Lola, and I lost it.’
He frowned. ‘What kind of a row?’
She sighed and looked over her shoulder at Lola. ‘Her owner brought her in. She’d been off her food for a day or so, could barely open her mouth and her eye was being pushed out of the socket by something—a tumour, an abscess—I didn’t know and I couldn’t see without an anaesthetic, but her owner said she couldn’t afford it, didn’t have insurance because it was too expensive—she was heartbroken.
‘She loved Lola to bits but she wasn’t well herself, she was struggling to look after her properly, and she was utterly distraught. She’d tried every rescue place she could find without success, and now, with this issue, she thought it would be better for Lola if she was dead than facing an uncertain future, so she asked me to put her to sleep. And she’s three. There was nothing wrong with her apart from whatever was going on in her mouth, she’s a beautiful dog and she didn’t deserve to die. I couldn’t let that happen.’
‘So you treated her for nothing?’
She shook her head. ‘No, because that wouldn’t have solved the problem going forward, but I said I’d take her on, keep her myself, give her a home for life and she signed her over to me on the spot. It turned out to be a massive abscess at the back of her jaw. She’d yelped when she’d been chewing a stick in the woods a few days before, her owner had said, so it was probably blackthorn or hawthorn, but I drained the abscess and flushed it, it healed up really quickly, and I paid the bill.’
‘So what was his problem?’
She sucked in a breath. ‘I’d used my staff discount for her treatment, and then Craig refused to give it to me, billed me in full for the initial consult, the op, the drugs, the dispensing fee, the kennel time, the overnight care, even though I’d done all that myself while I was off duty... He said it was company policy, which was a crock of nonsense. A staff discount was in my contract and he knew it, but he said the dog hadn’t been mine at the time of the first consultation, so technically it was down to the previous owner, and if I didn’t pay up he’d bill her.’
He frowned. ‘That’s horrendous. So what did you do?’
‘I paid it, because I didn’t want her being hassled and I don’t want a bad credit rating, so I told him exactly what I thought of him, finished my shift, wrote a stinking letter to the company, went up to my flat over the practice, packed up all my stuff, put it in the car and drove away with Lola. I spent last night in a dog-friendly motel, got up this morning, spoke to the rental agent and drove here.’
His eyes widened. ‘So this was only yesterday? You were lucky to find a house to rent so quickly.’
‘Oh, no, I didn’t, it’s mine. I’ve been letting it, but a few weeks ago the tenant did a flit and left it in a bit of a state, so I thought—well, I don’t know what I thought, really, but maybe I’d been naïve imagining I could just drive up here and move in, but I can’t live in it, not like it is. Maybe I should have been less impulsive and stayed, but I just—I couldn’t even look at Craig any more I was so angry.’
‘I can see that. So when was her op?’
‘Three and a half weeks ago. The Monday.’
‘And he’s only just now decided to bill you?’
‘Yes. He didn’t know anything about it. He started a three-week holiday the day Lola came in, so he didn’t know. Then someone said something about Lola, and he looked at the accounts yesterday afternoon, and it all hit the fan.’
Hugo leant back against the wall, taking it all in.
‘Wow. That’s quite a twenty-four hours you’ve had.’
She laughed, but it ended on a tiny sob. ‘Tell me about it. And now my poor little house turns out to be lethal, filthy and—I can’t take her back there, not with a wound, and I have nowhere else to go.’
‘No family?’
‘No, my mother’s in Spain.’
No mention of a father. He wondered why. ‘No boyfriend, partner, significant other?’ he asked, realising as he’d said it that he was blatantly fishing.
‘No other at all. Just me and Lola.’
She shot him a smile, but it didn’t look convincing. ‘So there you are. I’m jobless and unemployable, I have a broken dog, and my house is bordering on uninhabitable.’
He frowned again. ‘Why?’
She stared at him. ‘I just told you why. The tenant—’
‘No, I mean why are you unemployable?’
‘Are you serious?’ She gave a tiny huff of laughter without a trace of humour. ‘You didn’t see my letter! And I’m in breach of contract because I didn’t give three months’ notice, so who’s going to employ me with a record like that? And I didn’t hold back when I talked to him, so I wouldn’t fancy his reference,’ she added with a wry smile.
He grunted. ‘Yeah, I can imagine.’ He studied her face. It was still streaked with blood, her sweater was on inside out, her tired green eyes were red-rimmed and exhausted, but she still had fight in her. Impressive.
He took a deep breath, let it out again, and said, ‘I have an idea. Feel free to say no, if you want to, but I’m short-staffed tomorrow.’ He rolled his eyes. ‘That’s nothing new, I’m permanently short-staffed, but the locum who was doing tomorrow morning is sick. If you can show me all the appropriate certification, how do you fancy covering the shift?’
‘But what about Lola?’ she asked without missing a beat, and he smiled. He wasn’t in the slightest bit surprised that the dog was her first thought.
‘Lola needs to stay in overnight, probably for at least two nights, and we have a bed in the office that the night vets used before the staffing situation got ridiculous. You’re welcome to stay and look after her tonight, do the shift tomorrow, and when that finishes we can go over to your house and blitz it together.’
She stared at him. ‘You’d do all that for me? For a perfect stranger you know nothing about?’
Her eyes were welling with tears, and he had to stifle the urge to wrap his arms around her and kiss the tears away. He gave himself a mental kick and stuck to the facts.
‘I know quite a lot about you. I know you’re a competent vet, I know your dog comes first, I know you did exactly what I would have done under the circumstances, and I’m not being entirely altruistic. I do need a vet for tomorrow. I need another vet, full stop, so you could look on it as an interview, if you like?’
‘An interview?’
‘That’s what I said.’
She looked away, then looked back at him, her face awash with a whole raft of conflicting emotions, and he held his breath.
Ellie, please say yes...
