Their First Family Christmas
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Alison Roberts
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Chapter One
‘ALMOST HOME TIME, EMMA.’
‘I know.’ Emma Matthews beamed at the triage nurse behind the central desk of Glasgow’s Eastern Infirmary. ‘I’m so excited. What is it about Christmas Eve that can make you feel so much like a kid again?’
She hadn’t felt like this in so long. In all honesty, she hadn’t ever expected to be able to feel like this again, let alone today of all days. These moments of joy that had surprised her in the odd quiet moments of this long shift were something to be treasured—rare jewels in a landscape that, by rights, should have been the bleakest ever.
‘Presents,’ Caroline offered. ‘And being able to go out for drinks knowing that you’ve got a day off to recover. Are you coming to the pub with us after work?’
‘No.’ Emma shook her head. ‘I’ve got a date.’
‘No way...’ A registrar paused as he reached for a set of case notes on the desk. ‘Did I hear you say you had a date?’
‘With my daughter, Alistair,’ Emma said. ‘Don’t you go spreading ridiculous rumours.’
As if she had time to go on any other kind of date.
Or the inclination, for that matter.
‘It’s a date to decorate the tree and hang up our stockings,’ she added. ‘And put carrots out for the reindeer. And some of the shortbread Mum will have been baking has to go out for Santa. You know...the really exciting stuff...’
Alistair rolled his eyes, tucked the notes under his arm as he glanced up at the board and then headed for one of the curtained cubicles that lined the side walls of this area.
Caroline was far more impressed with the date Emma had lined up. ‘Aww...cute,’ she sighed. ‘Lily’s, what...eighteen months old now? Old enough to get excited.’
‘She calls it Kissmas.’ Emma smiled. ‘And yeah...it’s the cutest thing ever.’ A new family tradition had been born—kisses for Kissmas—and Lily was only too happy to oblige. She couldn’t wait to get home and have those small arms wound around her neck as Lily plastered her face with more of the festive affection.
She reached up to erase the name in the space for Curtain Seven. ‘Guess what three-year-old Colin had jammed up his nose?’
Caroline shuddered as she reached for one of the phones on the desk that had started ringing. ‘Do I want to know?’
‘It was a little ball from the top of a Christmas decoration. Like one of those...’ Emma waved at the brightly coloured miniature tree on the end of the desk where some tiny Santas dangled with white bobbles on the top of their hats.
Not that Caroline was listening anymore. ‘But I told you we need a bed urgently,’ she was saying. ‘Now. We’re short-staffed in ED as it is, with this flu going around, and we’re filling up. We don’t have room to hang on to patients who need admission. I don’t care how you do it—just find us some space—’
She ended the call as the radio behind her crackled into life.
‘Rescue Three to Eastern Infirmary. How do you read, over?’
Caroline grabbed the microphone. ‘Go ahead, Rescue Three.’
‘We’re coming to you with a six-year-old, status epilepticus... Vital signs as follows...’
Emma was only half listening to the transmission, her gaze sweeping the department. Thanks to the flu that had been felling staff in the last few days, she had been the only consultant on today. She had two registrars and three junior doctors along with the nursing staff and technicians but many of them were due to finish their shifts when she was—in thirty minutes—at six o’clock. She needed to check how many medics would be here to work with Stuart Cameron, the head of this ED, when he came in to relieve her. As usual, he’d put up his hand to work the Christmas Eve night shift so that as many of his staff as possible could be at home with their families.
Emma’s heart squeezed with another moment of warmth that gave her a lump in her throat. Stuart was not only the best ED specialist she knew, he was also the kindest man in the world. She wouldn’t have got through this last year without him, that was for sure...
And she needed to make sure she was on top of everything going on in here at the moment so she could give him a competent handover. Oh, and she needed to remember to fetch his gift from her locker—that very expensive bottle of aged Scotch whisky that she knew he would love. She’d wrapped it last night and given it a gorgeous, tartan bow.
‘What’s the ambulance ETA?’ she asked Caroline.
‘Ten minutes. And you should know that they haven’t been able to get IV access.’
‘Okay. Thanks.’
Would the child with the uncontrollable seizures arrive before Stuart did? If so, Emma would have to handle this case. At least both the resus rooms were empty at the moment. She walked towards one of them, catching Alistair’s eye as he emerged from behind a curtain.
‘Might need you in a few minutes,’ she warned. ‘Six-year-old incoming with status epilepticus. No IV in. I’ll get an intraosseous kit out in case we have problems, too. He’ll need IV meds asap.’
She glanced over her shoulder as she heard the distinctive whoosh of the automatic doors that led to the ambulance bay. Was the paediatric emergency arriving early?
No. Emma breathed a sigh of relief. It was Stuart Cameron, who would have parked in the ‘Consultant On Call’ space beside hers at one side of the ambulance bay. He was bundled up in a thick coat, scarf and hat, looking like he’d come in from Arctic temperatures, and Emma felt another beat of excitement. Was it possible they’d actually get some snow for Christmas?
Not in the city, of course—that never happened these days. But out in the countryside a bit, where she lived with her mother in her tiny whitewashed cottage—well...they might just get lucky...
Stuart was unwinding his scarf and then unbuttoning his coat as he came further into the department. As he got closer, and took off his hat, alarm bells began ringing for Emma.
‘You don’t look so good, Stuart.’
‘I’m fine.’
‘Come with me,’ Emma ordered. She led him into the resus room and pointed to a chair. ‘Sit.’
Stuart shook his head, peeling off his coat. ‘I don’t need to sit. I need you to give me a handover so you can get home to Lily and—’
He stopped talking abruptly and Emma could see the way his features froze as he closed his eyes.
Her tone was gentle now, almost a whisper. ‘What’s hurting, Stu?’
He raised his right hand as if to fend her off. ‘It’s nothing. A touch of the flu coming on, maybe.’
But then his hand went to his other arm and gripped it.
‘You’ve got pain in your left arm? Any in your chest?’
Stuart didn’t respond. Emma stared at him, a knot of fear taking root in her belly as she took in the way the colour was fading from his face to leave it looking grey and the beads of perspiration appearing on his forehead.
‘On the bed,’ she said. ‘You’re not going anywhere until I’ve done a twelve lead ECG.’
‘There’s no need to fuss...I’ll just sit for a moment.’ He perched on the side of the bed. Was it her imagination or was Stuart sounding slightly out of breath? ‘There was an ambulance pulling up as I came in...you’ll be needed...’
‘I’m needed here.’ Emma took a step towards the door and leaned out. ‘Alistair?’
His head appeared through a gap in a nearby curtain. Behind him, Emma could see the doors sliding open again as paramedics wheeled in a stretcher.
‘You take the lead on the boy in status epilepticus. I’m going to be busy in here for a few minutes. Call if you need me.’
Turning back, she was relieved to see that Stuart was now properly on the bed, lying back on the pillows.
‘Sorry about this, lass,’ he murmured. ‘It’s the last thing you need when you’re due to go off shift.’
‘The last thing I need,’ Emma said quietly, ‘is for you to be unwell. I’m not leaving until we find out what’s going on.’ She reached for a plastic mask and tubing that she attached to the overhead port. ‘Here...let’s give you some oxygen.’
A nurse came into the room, clearly on a mission to find something, and stopped in her tracks. ‘Oh, no...what’s happened to Dr Cameron?’
‘Help him off with his shirt,’ Emma said calmly. ‘I want to get some monitoring dots on. And then get me the twelve lead ECG machine.’
The nurse’s eyes widened. ‘Okay.’
‘What did you come in for?’
‘An intraosseous needle. It looks like it’s going to be a mission to get a line into the little boy that’s just come in.’
‘You get that, then. I’ll do this.’ Emma took over unbuttoning Stuart’s shirt. He had his eyes closed but she could tell by the look on his face how much he was hating this. ‘It’s in the top drawer of the IV cupboard,’ she added. ‘And don’t go telling everybody that Dr Cameron’s in here. Until I say otherwise, this is private.’
‘It’s probably a fuss about nothing,’ Stuart muttered. ‘Bit of indigestion, that’s all...’
Emma had sticky dots on his shoulders and just above his hips. She waited for the interference to clear on the overhead monitor. And then her heart sank.
Stuart opened his eyes. And then shut them again.
‘Guess it’s not indigestion, then...’
‘No.’ Emma swallowed hard. ‘You’ve got significant ST elevation in leads two and three. We’ll know more when I do a twelve lead but this looks like an inferior infarct. Have you had any aspirin today?’
Stuart shook his head.
‘And you probably need some morphine, don’t you?’
This time it was a slow nod.
‘We’ll do that first, then. And bloods. And I’ll get someone to page Cardiology and make sure the catheter laboratory is available.’
Angioplasty was the definitive treatment to unblock the coronary arteries causing this heart attack. It could prevent Stuart being left with any lasting damage. It could also save his life. Emma didn’t want to leave his side. What if he went into cardiac arrest?
But there was a whole raft of things that needed to be done immediately and Emma wasn’t about to let someone else take the lead role in caring for this man.
Stuart Cameron probably should have retired years ago—before Emma had arrived to follow her passion in emergency medicine—but she would be grateful forever that he’d loved his work too much to leave. He was the closest thing she’d had to a father since she’d lost her own when she’d been only sixteen. A father figure, mentor and close friend all rolled into one. He was one of the most important people in her life—the people she truly loved—and that was a group small enough to be counted on the fingers of one hand. Lily, her mum, Jack...and Sarah...
Maybe it was that fleeting thought of Sarah that made the fear kick up a notch. Was history repeating itself? Was she going to lose someone so special that it would feel like the end of the world—on the eve of the day that was all about celebrating exactly those people?
Like she had last year?
No...she couldn’t let that happen.
Maybe it was a blessing that Stuart had ignored any warning signs and come into work. He was in the best place possible to deal with this and she was going to make sure that nothing got in the way of his treatment.
There was no point in trying to keep the news of this crisis away from the staff here now and Emma knew that she was far from the only person who would be desperately worried about Stuart. Within minutes, she had people falling over themselves wanting to help. A nurse was rushing blood samples away to be tested and a technician was capturing a twelve lead ECG trace. She had given Stuart pain relief herself and had also made the call to the cardiology department. It was no surprise that a cardiology consultant came down to the department herself, instead of sending her registrar.
‘Goodness me, Stuart. What kind of Christmas surprise is this?’
‘Not the best kind.’ Stuart’s smile was apologetic and his gaze included Emma. ‘You’ll have to call someone in, lass. Doesn’t look like I’ll be taking over this shift.’
‘Don’t even think about it,’ Emma told him. ‘It’s all under control.’
It was a white lie. The senior staffing issue for the night was far from under control. Knowing that they were off, most of the doctors had headed out of town for family gatherings. Caroline had been making call after call with no success.
‘Here’s the latest twelve lead.’ She handed a series of graphs to the cardiology consultant. ‘Looks like it’s evolving to include a lateral extension.’
‘Enzymes back yet?’
Emma nodded. She handed over the result sheet, reluctant to voice the figures that would tell Stuart just how serious this heart attack was looking.
‘We’re all ready for you upstairs,’ the consultant told Stuart. ‘And I’m going to do your angioplasty myself.’
‘I’ll bet you were supposed to be heading home by now, too.’
She just smiled at her colleague. ‘Consider this my Christmas gift to you, my friend. I’ve never forgotten how kind you were to my father when he came in here with his stroke all those years ago.’
Emma took hold of Stuart’s hand and squeezed it for a moment as the orderly unlocked the brakes on the bed and prepared to start moving him.
‘It’ll be okay,’ she told him. ‘I’ll come up and see you as soon as you’re in CCU.’
‘No you won’t. You’ll be home with your Lily by then.’ He gave her fingers a return squeeze. ‘You need to be away from this place tonight, love. I know how hard it must be...’
Emma had to blink against the sudden sting of tears.
‘I’m doing fine,’ she whispered. ‘Thanks to you...’
There was so much more she could have said. So much she would want to say—just in case this was the last chance she would ever have—but the bed was moving already.
‘I’ll call you when we’re through,’ the consultant said as she left. ‘Try not to worry—he’s going to get our platinum service.’
Emma was left standing in the empty space where the bed had been. Littered around her were the plastic wrappers from syringes and IV supplies. The top of a glass drug ampoule was still spinning after being knocked and an ECG electrode was stuck to the floor where it had been dropped. There were no Christmas decorations in here because it had been deemed inappropriate for patients—and their families—who might be facing an unsuccessful conclusion to a life-threatening crisis.
She could hear the sounds of a busy—and very well decorated—department just through the doors. Clearly, the first of the alcohol-related injuries were arriving, judging by the raised voices and the loud, tuneless singing of a Christmas carol that was happening out there.
It was only then that she realised she was standing in the same resus area that she’d been in last Christmas Eve. Where she’d had to sit and hold the hand of her best friend as Sarah had taken her last breaths.
She couldn’t hold back the tears by blinking now. Turning, she ripped some paper towels from the dispenser by the sink and pressed them to her face.
Only a few minutes ago, she’d been blessed by one of those jewels of excitement but now she was teetering on the edge of that dark space she never wanted to enter again.
It was all going wrong.
There would be no decorating the Christmas tree tonight and attaching those very special ornaments to the top. How many tears had been quietly shed as she’d crafted those two little felt angels—a mummy one and a daddy one—in memory of Lily’s parents? Putting them in pride of place at the top of the tree and sharing a moment of remembrance was going to be a new, private Christmas tradition just for her special little family.
Like kisses for Kissmas.
She wouldn’t be hanging up the stocking that she had embroidered Lily’s name on, either. No putting carrots out for the reindeer. No squeezy cuddles or sticky kisses to make everything seem worthwhile.
And no Jack, either.
Had she really thought that this anniversary might be the one thing that would persuade him to come back?
To see Lily, at least?
She’d been hoping for far too much. But right now, it didn’t seem to matter. She needed to refocus those hopes and give them all to Stuart for the next few hours. Knowing that he was going to be all right was the only Christmas magic she needed now.
‘You okay, Emma?’
‘Mmm.’ A quick swipe with the paper towels and Emma was ready to turn around. ‘How’s it going, Caroline?’
‘Not good, I’m sorry. I can’t find anyone to come in. Alistair’s going to stay on, though, and I can probably find an extra registrar from somewhere. We’ve cancelled our drinks. Nobody’s really in the mood anymore...’
‘I’ll stay,’ Emma told her.
‘But—’
‘There’s no way I’m going home until I hear how Stuart’s doing and by then Lily will be fast asleep, so I may as well stay until the morning crew gets here.’
‘Are you sure?’
‘I’m sure. I just need to ring Mum and let her know what’s happening.’
She was getting good at these white lies, wasn’t she? Emma wasn’t at all sure about this. It would mean she would still be in the department late this evening and how hard was it going to be not to remember every agonising detail about last year?
But she didn’t have a choice.
Any more than she had had a year ago, when she’d given that solemn promise to Sarah.
She’d coped since then. And she would cope now.
Because that was how things had to be.
* * *
Man, it was cold...
Despite the full leather gear and a state-of-the-art helmet, Jack Reynolds was beginning to feel like he was frozen to the seat of the powerful motorbike beneath him.
It was time he took a break but he was so close now. In less than an hour he’d be hitting the outskirts of Glasgow and then he could find his motel and thaw out with a long, hot shower.
And tomorrow, he’d do something he’d sworn he’d never do.
He would celebrate Christmas.
Well...maybe celebrate wasn’t exactly the right word. This journey was more like the world’s biggest apology.
He just happened to have a brightly wrapped gift in the pannier of his bike that the sales assistant in Hamleys—London’s best toy shop—had assured him would be perfect for an eighteen-month-old child. The little girl he hadn’t seen in nearly a year.
His goddaughter.
And his niece...
A wave of the sensation that had grown from a flicker, that had been all too easy to bury months ago, to its current unpleasant burn generated a warmth that Jack would rather not be feeling right now, despite the chill of the wind seeping into his bones.
An unfamiliar feeling that he could only identify as shame.
Who knew that grief could mess with your head enough to turn you into someone you couldn’t even recognise?
How painful was it to start realising how much that could have hurt others?
At least Lily was too young to have been affected by it, but what on earth was he going to say to Emma to try and start mending bridges?
He’d been unbelievably selfish, hadn’t he?
It had been all about him. He’d lost his twin brother, Ben, in that dreadful accident and it had felt as if more than half of himself had died that night.
But Emma had lost Sarah, who’d been her best friend forever, and they’d been as close as sisters. Closer than most sisters, probably. What had given him the right to think his loss had been greater?
The traffic was building up as the M74 into Glasgow bypassed the township of Uddingston. Somewhere in the darkness to the left the river Clyde was shadowing his route into the city he’d never really expected to see again. He’d turned his back on everything there—and everyone—when he’d walked out all those months ago.
The rain spattering his visor felt different now. There was a sludgy edge to it that was making visibility worse than it had been and the lights of the vehicles around him were blurred and fragmented. Signposts warned of the major road changes ahead where the M73 joined the M74.
That was where it had happened, wasn’t it?
Where Ben and Sarah had had the accident that had claimed their lives exactly a year ago today?
Almost to the minute...
There was a new burning sensation now, behind his eyes this time, and he recognised that feeling.
It had been only a couple of weeks ago. In the burning heat of an African summer, when one of his colleagues had started reminiscing about English winters. About Christmas...
He could have sworn that Ben was right beside him, giving him one of those none-too-gentle elbow nudges in his ribs. Saying the words that had been the last thing his brother had ever said to him.
‘See you tomorrow, bro. For once, you’re going to enjoy Christmas. Me and Sarah and Lily...we’re going to show you what Christmas is all about. Family...’
It hadn’t been the first time he’d found a private spot with the view of nothing but desert but it had been the first time in forever that he’d cried. Gut-wrenching sobs that had been torn from his soul. And that was why he recognised this painful stinging sensation at the back of his eyes.
It couldn’t happen now. Not in heavy traffic and with what looked like sleet getting thicker by the second. There was an exit lane ahead and he needed to change lanes and make sure he was well clear of any idiot who might decide to take the exit unexpectedly.
Like that dodgy-looking small truck that was crossing the line directly in front of him.
Tilting his body weight, after checking there was a gap in the lane beside him, Jack flipped on his indicator and glanced over his shoulder again to check the lane was still clear.
Where the hell had that car come from? And what did it think it was doing?
No-o-o...
* * *
Text messages had been frequent over the last hour, including one that accompanied an adorable photo of Lily, bundled up like a little Eskimo in her puffy, pink jacket, with tinsel in her dark curls, crouching down to put an enormous carrot beside a bucket of water. Emma could see the ropes of the swing hanging from the branch of the old oak tree in the garden in the background so she knew exactly where the bucket had been placed.
Exactly where she should have been, too.
Just as well she was too busy to dwell on the unexpected turn her evening had taken.
The waiting room was crowded but the curtained cubicles were all full right now. Every doctor had several patients to cover and Emma was trying to keep herself mobile so she could help wherever she was needed. She just had to decide on the priority as she looked at the list on the glass board.
It wouldn’t be the drunk in Curtain Eight who’d been punched in the nose and had a septal haematoma that needed draining. Or the teenager that had downed enough alcohol at a work Christmas party to collapse. Someone else could supervise the administration of activated charcoal there. Was it the young woman with epigastric pain in Curtain Four? The dislocated shoulder in Curtain Two that needed sedation and relocation? That was a task that needed quite a lot of physical strength sometimes so she might need to wait until Alistair had a free moment, and he was busy sorting pain relief for that nasty foot fracture that had come in a little while ago when an elderly man had fallen from the ladder he was using to hang twinkly lights in a garden tree.
The X-rays were up on the screen beside her and Emma couldn’t help leaning in for a closer look. A Lisfranc fracture and a fracture/dislocation of at least two other joints. This patient was going to need some urgent orthopaedic management as soon as pain relief was on board and a plaster back-slab applied. He’d need to be kept nil by mouth, too, in case a theatre slot became available.
The baby, Emma decided. The one with the rash that looked like a bad reaction to antibiotics. She’d just pop her head into the side room and check that something had been given to settle the miserable infant and calm its mother.
And she wouldn’t look at the clock on the way.
It was getting too close to that time.
The moment her world had started to fall apart this time last year. When those sliding doors had opened for two stretchers to be rolled in amongst a team of paramedics that all had the grim faces that advertised how bad this accident had been. With the policeman behind them carrying a baby in its car seat.
Not that she had had any idea of how bad this really was. Neither had Jack, who was standing in one of the resus rooms, having been summoned as the orthopaedic component of the major trauma team that had gathered to receive the victims of the MVA out on the M74.
The injuries had been so bad, he hadn’t even recognised his twin brother in those first minutes. It had been Emma who recognised Sarah on the second stretcher. Still conscious. Asking over and over whether Lily was all right and where was Ben?
She’d had to go into Resus One. Just as Stuart was shaking his head before he glanced up at the clock.
‘Time of death, twenty-two thirty-five...’
‘Jack?’ It had been so hard to get the words out. ‘Jack...? I think...I think this might be Ben...I’m so, so sorry...’
Later, she’d wondered if he’d already guessed but had been too shocked to process the information. You’d think that the kind of connection between twins would make it plausible but Jack and Ben had been opposite sides of the same coin, hadn’t they? Ben was the quiet one. The responsible one. The perfect husband and father material that Sarah couldn’t believe how lucky she’d been to find.
Jack might have mirrored his brother’s career in medicine and achieved even greater popularity and success but he was the wild one of the pair.
She’d been warned by Sarah to stay away from him.
Jack had been warned by Ben to stay away from her.
Not that their disobedience had mattered in the end, because any connection as far as Jack was concerned had evaporated in the instant she’d passed on that devastating news.
It was another thing she’d lost that night...
* * *
Emma sucked in a deep breath. The noises around her seem to be amplified for a moment as she dragged herself back to the present. People shouting. Babies crying. A shriek of pain. Phones ringing. An ambulance call coming through on the radio. Caroline should have gone home ages ago but she was still there, fielding the calls.
‘Go ahead, Rescue Seven. Reading you loud and clear. Over...’
‘We’re coming to you with a thirty-six-year-old male, result of a motorbike accident on the M74. Query chest injury. Multiple contusions. Query fracture left tib/fib. Vital signs as follows: GCS fifteen, heart rate one-twenty...’
Breathe, Emma told herself. Without thinking, she reached up to touch her hair, finding the inevitable tight curl that had sprung free from its clip and making sure it was trapped again. It was an action that always made her feel that little bit more in control.
This was just another accident. Not even a particularly serious one, by the sound of things, but she wasn’t going to take anything for granted.
‘I’ll be in Resus One,’ she told Caroline.
‘Want me to activate the trauma team?’
A GCS of fifteen meant that the victim was conscious and alert. Okay, he might have a chest injury but he was breathing well enough for the moment. Part of her job in charge of this department was to make sure she used potentially limited extra resources as wisely as possible.
‘Not yet. I’ll take a look at him first. How far away are they?’
‘About five minutes.’
Emma couldn’t help glancing up at the clock as she walked into Resus One and pulled on a disposable gown and some gloves.
Twenty-two thirty. It would probably be twenty-two thirty-five as they rolled the stretcher in.
Breathe, she reminded herself again, as she heard the whoosh of the ambulance bay doors.
Alistair came in and grabbed a gown, closely followed by a nurse. And then the stretcher arrived. Nothing could have prompted Emma to take a breath when she saw who was on the stretcher. The opposite happened as her body and brain both froze. There was just enough breath left to utter a single, horrified word.
‘Jack...?’
