Twins for Christmas
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Alison Roberts
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32
Chapter 1
As an omen, this wasn’t good.
It could have been the opening scene to a horror movie, in fact.
Grace Forbes, in her crisp, clean set of scrubs—her stethoscope slung around her neck along with the lanyard holding her new Manhattan Mercy ID card—walking towards Charles Davenport who, as chief of Emergency Services, was about to give her an official welcome to her new job.
An enormous clap of thunder rolled overhead from a storm that had to be directly on top of central New York and big enough for the sound to carry into every corner of this huge building.
And then the lights went out.
Unexpectedly, the moment Grace had been bracing herself for became an anti-climax. It was no longer important that this was the first time in more than a decade that her path was about to cross with that of the man who’d rocked her world back in the days of Harvard Medical School. Taking control of a potential crisis in a crowded emergency room was the only thing that mattered.
In the brief, shocked silence that followed both the clap of thunder, a terrified scream from a child and the startling contrast of a virtually windowless area bathed in bright, neon lighting being transformed instantly into the shadowed gloom of a deep cave, Charles Davenport did exactly that.
‘It’s just a power outage, folks.’ He raised his voice but still sounded calm. ‘Stay where you are. The emergency generators will kick in any minute.’
Torch apps on mobile phones flickered on like stars appearing in a night sky and beams of light began to sweep the area as people tried to see what was going on. The noise level rose and rapidly got louder and louder. Telephones were ringing against the backdrop of the buzz of agitated conversations. Alarms sounded to warn of the power disruption to medical equipment. Staff, including the administrative clerks from the waiting area, triage nurses and technicians were moving towards the central desk to await instructions and their movements triggered shouts from people desperate for attention.
‘Hey, come back...where are you going?’
‘Help... I need help.’
‘Nurse...over here...please?’
‘I’m scared, Mommy... I want to go home...’
Grace stayed where she was, her gaze fixed on Charles. The dramatic change in the lighting had softened the differences that time had inevitably produced and, for a heartbeat, he looked exactly as he had that night. Exactly like the haunting figure that had walked through her mind and her heart so often when sleep had opened portals to another time.
Tall and commanding. Caring enough to come after her and find out what was wrong so he could do something about making it better...
Which was pretty much what he was doing right now. She could see him assessing the situation and dealing with the most urgent priorities, even as he took in information that was coming at him from numerous directions.
‘Miranda—check any alarms coming from cardiac monitors.’
‘Get ready to put us on bypass for incoming patients. If we don’t get power back on fast, we’ll have a problem.’
‘Put the trauma team on standby. If this outage is widespread, we could be in for a spate of accidents.’
Sure enough, people manning the telephones and radio links with the ambulance service were already taking calls.
‘Traffic lights out at an intersection on Riverside Drive. Multi-vehicle pile-up. Fire service called for trapped patients. Cyclist versus truck incoming, stat.’
‘Fall down stairs only two blocks away. Possible spinal injury. ETA two minutes.’
‘Estates need to talk to you, Dr Davenport. Apparently there’s some issue with the generators and they’re prioritising Theatres and ICU...’
Charles nodded tersely and began issuing orders rapidly. Staff dispersed swiftly to cover designated areas and calm patients. A technician was dispatched to find extra batteries that might be needed for backup for equipment like portable ultrasound and X-ray machines. Flashlights were found and given to orderlies, security personnel and even patients’ relatives to hold. Finally, Charles had an instruction specifically directed to Grace.
‘Come with me,’ he said. ‘I need someone to head the trauma team if I have to troubleshoot other stuff.’ He noticed heads turning in his direction. ‘This is Dr Grace Forbes,’ he announced briskly. ‘Old colleague of mine who’s come from running her own emergency department in outback Australia. She probably feels right at home in primitive conditions like this.’
A smile or two flashed in Grace’s direction as her new workmates rushed past to follow their own orders. The smile Charles gave her was distinctly wry. Because of the unusual situation she was being thrown into? Or was it because he knew that describing her as an old colleague was stretching the truth more than a little? It was true that she and Charles had worked in the same hospital more than once in that final year of medical school but their real relationship had been that of fierce but amicable rivals for the position of being the top student of their year. The fact that Charles knew where she’d been recently, when he hadn’t been present for the interview she’d had for this job, was another indication that he was on top of his position of being head of this department. No wonder he’d won that final battle of the marks, even though it had only been by a small margin.
‘Welcome to Manhattan Mercy, Grace... Trauma One is this way...’
It was hardly the best way to welcome a new member of staff but maybe it was better this way, with so many things to think about that Charles couldn’t allow any flashes of memory to do more than float past the edges of his conscious mind.
He hadn’t seen Grace since he’d noticed her in the audience when he’d walked onto the stage to accept the trophy for being the top student of their graduation party from medical school.
He hadn’t spoken to her since...since that night...
‘Warn people that waiting times are going to go through the roof for anything non-urgent,’ he told the senior member of the administrative team as he passed her. ‘But don’t push them out the door. By the sound of this storm, it’s not safe out there.’
A flicker in the ambient light filtering into the department suggested a flash of lightning outside and another roll of thunder could be heard only a second later so they were still right underneath it. Fingers crossed that the worst of the storm would cross the central city quickly but how long would it be before the power disruption was sorted? And how many problems would it cause?
The weather alone would give them a huge spike in traffic accidents. A sudden plunge into darkness could cause all sorts of trauma like that fall down stairs already on its way. And what about the people on home oxygen who could find themselves in severe respiratory distress with the power outage cutting off their support? They needed to be ready for anything in the ER and he needed to clear space for the potential battleground of dodging unexpected missiles of incoming cases and whatever ambush could be in store with equipment that might not be functioning until power came back on.
He hadn’t faced a challenge like this for a long time but he had learned way back how to multi-task when the proverbial was hitting the fan and Charles knew he could function effectively on different levels at the same time.
Like knowing which patients could be sidelined for observation well away from centre-stage and directing staff members to transfer them as he passed their ed cubicles at the same time as fending off a request from a television crew who happened to be in the area and wanted to cover the fallout from what was apparently a record-breaking storm.
‘Keep them out of here,’ he growled. ‘We’re going to have more than enough to deal with.’
It never took long for the media to get their teeth into something, did it? Memories of how much damage had been done to his own family all those years ago had left Charles with a mistrust bordering on paranoia. It was a time of his life he had no desire to revisit so it was perhaps unfortunate that the arrival of Grace Forbes in his department had the ability to stir those memories.
And others...
A glance over his shoulder showed him that Grace was following his slightly circuitous route to Trauma One as he made sure he knew what was happening everywhere at the moment. The expression on her face was serious and the focus in those dark grey eyes reminded him of how capable he knew she was. And how intelligent. He’d had to fight hard back at medical school to keep his marks on the same level as Grace and, while they’d never moved in the same social circles, he’d had enormous respect for her. A respect that had tipped into something very different when he’d discovered that she had a vulnerable side, mind you, but he wasn’t going to allow the memory of that night to surface.
No way. Even if this situation wasn’t making it completely unacceptable to allow such a personal distraction, he wouldn’t go there. It was in the same, forbidden territory that housed flirting and he had never been tempted to respond to opportunities that were only becoming more blatant as time crept on.
No. He couldn’t go there. It would still feel like he was being unfaithful...
Nobody could ever accuse Charles Davenport of being less than totally loyal. To his family and to his work.
And that was exactly where his entire focus had to be right now. It didn’t matter a damn that this was a less than ideal welcome to a new staff member. Grace would have to jump into the deep end and do her bit to get Manhattan Mercy’s ER through this unexpected crisis.
Just as he was doing.
Other staff members were already in the area assigned to deal with major trauma, preparing it for the accident victims they had been warned were on their way. A nurse handed Grace a gown to cover her scrubs and then a face mask that had the plastic eye shield attached.
‘Gloves are on the wall there. Choose your size.’
Someone helpfully shone a torch beam over the bench at the side of the area so that Grace could see the ‘M’ for medium on the front of the box she needed. She also caught a glimpse of an airway cart ready for business, an IV cart, a cardiac monitor, ventilator and portable ultrasound machine.
Okay. She could work with this. Even in semi-darkness she had what she needed to assess an airway, breathing and circulation and to do her best to handle whatever emergencies needed to be treated to stabilise a critically injured patient. And she wasn’t alone. As the shadowy figures of paramedics surrounding a gurney came rapidly towards them, Charles was already standing at the head of the bed, ready to take on the most important role of managing an airway.
‘Male approximately forty years old,’ one of the paramedics told them. He was wearing wet weather gear but his hair was soaked and he had to wipe away the water that was still trickling into his eyes. ‘Hit by a truck and thrown about thirty feet to land on the hood of an approaching car. GCS of twelve, blood pressure ninety on palp, tachycardic at one-thirty. Major trauma to left arm and leg.’
The man was semi-conscious and clearly in pain. Despite wearing a neck collar and being strapped to a back board, he was trying to move and groaning loudly.
‘On my count,’ Charles directed. ‘One, two...three...’
The patient was smoothly transferred to the bed.
‘I need light here, please,’ Charles said. He leaned close to their patient’s head as someone shone a beam of light in his direction. ‘Can you hear me?’ He seemed to understand the muffled change to the groan coming from beneath an oxygen mask. ‘You’re in hospital, buddy. We’re going to take care of you.’
A nurse was cutting away clothing. Another was wrapping a blood pressure cuff around an arm and a young, resident doctor was swapping the leads from an ambulance monitor to their own. Grace was watching, assessing the injuries that were becoming apparent. A mangled right arm and a huge wound on the left thigh where a snapped femur had probably gone through the skin and then been pulled back again. The heavy blood loss was an immediate priority. She grabbed a wad of dressing material and put it on the wound to apply direct pressure.
‘We need to get back out there,’ the lead paramedic told them. ‘It’s gone crazy. Raining cats and dogs and visibility is almost zero.’
‘How widespread is the power cut?’
‘At least sixteen blocks from what we’ve heard. Lightning strike on a power station, apparently. Nobody knows how long it’s gonna be before it’s back on.’
Charles nodded. ‘Thanks, guys.’ But his attention was on assessing his patient’s breathing. He had crouched to put his line of sight just over head level and Grace knew he was watching the rise and fall of the man’s chest to see whether it was symmetrical. If it wasn’t, it could indicate a collapsed lung or another problem affecting his breathing.
She was also in a direct line for the steady glance and she saw the shift, when Charles was satisfied with chest movement and had taken on board what she was doing to control haemorrhage and his gaze flicked up to meet her own. For a split second, he held the eye contact and there was something in his gaze that made her feel...what? That he had confidence in her abilities? That she was already a part of the team?
That he was pleased to see her again?
Behind that emotional frisson, there was something else, too. An awareness of how different Charles looked. It shouldn’t be a surprise. Thirteen years was a very long time and, even then, they had been young people who were products of their very different backgrounds. But everyone had known that Charles Davenport had the perfect life mapped out for him so why did Grace get the fleeting impression that he looked older than she would have expected? That he had lines in his face that suggested a profound weariness. Sadness, even...
‘Blood pressure eighty on forty.’ The resident looked up at the overhead monitor. ‘And heart rate is one-thirty. Oxygen saturation ninety-four percent.’
‘Is that bleeding under control, Grace?’
‘Almost. I’d like to get a traction splint on asap for definitive control. It’s a mid-shaft femoral fracture.’
Another nod from Charles. ‘As soon as you’ve done that, we need a second line in and more fluids running. And I want an abdominal ultrasound as soon as I’ve intubated. Can someone ring through to Theatre and see what the situation is up there?’
The buzz of activity around the patient picked up pace and the noise level rose so much that Grace barely noticed the arrival of more paramedics and another patient being delivered to the adjoining trauma room, separated only by curtains. Working conditions were difficult, especially when some of the staff members were directed to the new arrival, but they were by no means impossible. Even with the murky half-light when a torch wasn’t being directed at the arm she was working on, Grace managed to get a wide-bore IV line inserted and secured, attaching more fluids to try and stabilise this patient’s blood pressure.
With the airway and breathing secured by intubation and ventilation, Charles was able to step back and oversee everything else being done here. He could also watch what was happening on the neighbouring bed, as the curtain had been pulled halfway open. As Grace picked up the ultrasound transducer and squeezed some jelly onto her patient’s abdomen, she got a glimpse of what was happening next door.
Judging by the spinal board and the neck collar immobilising the Spanish-looking woman, this was the ‘fall down stairs’ patient they had been alerted to. What was more of a surprise was that Charles was already in position at the head of this new patient. And he looked...fresher, somehow. Younger...?
No... Grace blinked. It wasn’t Charles.
And then she remembered. He’d had a twin brother who’d gone to a different medical school. Elijah? And hadn’t their father been the chief of emergency services at a prestigious New York hospital?
This hospital. Of course it was.
Waiting for the image to become readable on her screen as she angled the transducer, Grace allowed herself a moment to think about that. The dynasty was clearly continuing with the Davenport family front and centre in Manhattan Mercy’s ER. Hadn’t there been a younger sister who was expected to go into medicine as well? It wouldn’t surprise her if there was yet another Davenport on the staff here. That was how rich and powerful families worked, wasn’t it—sticking together to become even more powerful?
A beat of something like resentment appeared. Or was it an old disappointment that she’d been so insignificant compared to the importance of family for Charles? That she’d become instantly invisible the moment that scandal had erupted?
Whatever. It was easy to push aside. Part of a past that had absolutely nothing to do with the present. Or the future.
‘We’ve got free fluid in the abdomen and pelvis,’ she announced. ‘Looks like it’s coming from the spleen.’
‘Let’s get him to Theatre,’ Charles ordered. ‘They’ve got power and they’ve been cleared to only take emergencies. He’s stable enough for transfer but he needs a medical escort. Grace, can you go with him, please?’
The metallic sounds of brakes being released and sidebars being raised and locked were almost instant. Grace only had time to ensure that IV lines were safe from snagging before the bed began moving. This was an efficient team who were well used to working together and following the directions of their chief. Even in the thick of what had to be an unusually stressful shift for this department, Grace could feel the respect with which Charles was regarded.
Behind her, as she stayed close to the head of the bed to monitor her patient’s airway and breathing en route to Theatre, Grace could hear Charles moving onto a new task without missing a beat.
‘Any signs of spinal injury, Elijah? Want me to see if the CT lab is clear?’
And then she heard his voice change. ‘Oh, my God... Maria?’
He must know this patient, she realised. And he was clearly horrified. She could still hear him even though she was some distance on the other side of the curtain now.
‘What happened? Where are the boys?’
A break from the barely controlled chaos in a badly lit emergency department was exactly what Grace needed to catch her breath but it was a worry how crowded the corridors were. And a glimpse into the main waiting area as they rushed past on their way to the only elevators being run on a generator suggested that the workload wasn’t going to diminish any time soon.
This was a different planet from the kind of environment Grace had been working in for the last few years and the overall impression was initially overwhelming. Why on earth had she thought she could thrive with a volume of work that was so fast-paced? In a totally new place and in a huge city that was at the opposite end of the spectrum from where she’d chosen to be for such a long time.
Because her friend Helena had convinced her that it was time to reconnect with the real world? Because she had become exhausted by relying solely on personal resources to fight every battle that presented itself? Because the isolation of the places she had chosen to practise medicine had finally tipped the balance from being a welcome escape to a bone-deep loneliness that couldn’t be ignored for ever?
Like another omen, lights flickered overhead as neon strips came alive with a renewed supply of power. Everybody, including the porters and nurses guiding this bed towards Theatre, looked up and Grace could hear a collective sigh of relief. Normal life would be resumed as soon as the aftermath of this unexpected challenge was dealt with.
And she could cope, too. Possibly even thrive, which had been the plan when she’d signed the contract to begin work in Manhattan Mercy’s ER. This was a new beginning and Grace knew better than most that to get the best out of new beginnings you had to draw a line under the past and move on. And yes...some things needed more time to heal but she had taken that time. A lot more time than she had anticipated needing, in fact.
She was ready.
Having stayed longer than the rest of the transfer team so that she could give the anaesthetist and surgeons a comprehensive handover, Grace found that she needed to find her own way back to the ER and it turned out to be a slightly more circuitous route than before. Instead of passing the main reception area, she went past an orthopaedic room where casts were being applied, what looked like a small operating theatre that was labelled for minor surgery and seemed to have someone having a major laceration stitched and then a couple of smaller rooms that looked as if they had been designed for privacy. Were these rooms used for family consultations, perhaps? Or a space where people could be with a loved one who was dying?
A nurse was peering out of one of the doors.
‘Oh, thank goodness,’ she said, when she saw Grace approaching. ‘I’m about to burst... Could you please, please stay with the boys in here for two minutes while I dash to the bathroom?’
The young nurse, whose name badge introduced her as ‘Jackie’, certainly looked desperate. Having had to grab a bathroom stop herself on her way back from Theatre, Grace could sympathise with the urgency. She was probably already later in her return to the ER than might have been expected so another minute or two wouldn’t make any difference, would it?
‘Sure,’ she said. ‘But be as quick as you can?’
Jackie sped off with a grateful smile and vigorous nod without giving Grace the chance to ask anything else—like why these ‘boys’ were in a side room and whether they needed any medical management.
She turned to go through the door and then froze.
Two small faces were filling the space. Identical faces.
These two children had to be the most adorable little boys she had ever seen. They were about three years old, with tousled mops of dark hair, huge curious eyes and small button noses.
There was something about twins...
For someone who’d had to let go of the dream of even having a single baby, the magic of twins could pack a punch that left a very physical ache somewhere deep inside Grace.
Maybe she wasn’t as ready as she’d thought she was to step back into the real world and a new future...
