Stormbound Surgeon

CHAPTER ONE

‘IF IT doesn’t stop raining soon I’ll brain someone.’ Amy put her nose against the window and groaned. Outside it was raining so hard she could barely see waves breaking on the shoreline fifty yards away.

‘Great idea. Brain Mrs Craddock first.’ Kitty, Amy’s receptionist, was entirely sympathetic. ‘If I hear “Silver Threads” one more time I’ll do the deed myself.’

It was too late. From the sitting room came the sound of the piano, badly played, and Mrs Craddock’s warbling old voice drowned out the television.

‘Darling, we are getting old,

Silver threads among the gold…’

Murder was looking distinctly appealing, Amy decided. ‘Can you taste arsenic in cocoa?’ she muttered. ‘And just what are the grounds for justifiable homicide?’

‘Whatever they are, it can’t be more justifiable than this. A week of rain and this lot…’

It was the limit. Nothing ever happened in Iluka, and this week even less than nothing was happening. The locals jokingly called Iluka God’s Waiting Room and at times like this Amy could only agree.

It did have some things going for it. Iluka was a beautiful seaside promontory with a climate that was second to none-apart from this week, of course, when the heavens were threatening another Great Flood. It had two golf courses, three bowling greens, magnificent beaches and wonderful walking trails.

On the cliff out of town was Millionaire’s Row-a strip of outlandishly expensive real estate. At the height of summer the town buzzed with ostentatious wealth.

But the rest of the time it didn’t buzz at all. Iluka was a retiree’s dream. The average age of Iluka’s residents seemed about ninety, and when the rain set in there was nothing to do at all.

Nothing, nothing and nothing.

Card games. Scrabble. Hobbies.

Lionel Waveny had made five kites this month and he hadn’t flown any of them. The sitting room was crowded at the best of times, and if he made one more kite they’d have to sit on them.

From the sitting room came excited twittering. ‘Amy… Bert’s won.’

Great. Excitement plus! Summoning a smile Amy headed into the sitting room to congratulate Bert on his latest triumph in mah-jong. She stepped over Lionel’s kites and sighed. She really should stop him making them but she didn’t have the heart. They were making him happy. Someone should be happy. So…

‘Great kite,’ she told Lionel, and added, ‘Hooray,’ to the mah-jong winner. ‘Bert, if you win any more matchsticks you can start a bushfire.’

Despite her smile, her bleak mood stayed.

Oh, for heaven’s sake, what was wrong with her? she wondered. What was a little rain? This was a decent sort of life-wasn’t it? The nursing home she’d set up was second to none. Her geriatric residents were more than content with the care she provided. She could start a cottage industry in knitwear and kites, she had a fantastic home-and she had Malcolm.

What more could a girl want?

Shops, she thought suddenly, and a decent salary so she could enjoy them. She stared down in distaste at the dress she’d had for years. What else? Restaurants. A cinema or two, and maybe a florist where she could buy herself a huge bunch of flowers to cheer herself up.

Yeah, right. As if she’d ever have any money to buy such things.

She looked out the window at the driving rain and thought…

What?

Anything. Please…

Amy wasn’t the only one to be criticizing Iluka. Five miles out of town Joss Braden was headed for the highway and he couldn’t escape the town fast enough.

‘It’s the most fantastic place,’ his father had told him over the phone. ‘There’s three separate bowling greens. Can you believe that?’

‘Yes, but-’

‘Now, I know bowling doesn’t interest you, boy, but the beaches are wonderful. You’ll be able to swim, catch lobster right off the beach and sail that new windsurfer of yours. Go on, Joss-give us a few days. Get to know your new stepmother and have a break from your damned high-powered medicine into the bargain.’

He’d needed a break, Joss thought, but five days of rain had been enough to drive him back to Sydney so fast you couldn’t see him for mud. For the whole week his windsurfer had stayed roped to the car roof. The seas had been huge-it would have been suicidal to try windsurfing. His father and Daisy had wanted him to spend every waking minute with them; they’d been blissfully and nauseatingly in love, and medicine was starting to look very, very good in comparison.

So this morning, when the newsreaders were warning of floods and road blockage, his decision to leave had bordered on panic. Now he steered his little sports car carefully through the rain and crossed his fingers that the flooding wasn’t as severe as predicted.

‘Ten minutes and we’re on the highway and out of here,’ he told his dog. His ancient red setter, Bertram the Magnificent, was belted into the passenger seat beside him, staring through the windscreen with an expression that was almost as worried as his master’s. If they were stuck here…

‘We’ll be right.’

They weren’t.

‘Amy, love, we need a fourth at bridge.’

‘I’m sorry, Mrs Cooper, but I’m busy.’

‘Nonsense, child. We know you always go for a walk on the beach mid-morning. You can’t walk anywhere now, so come and join us.’

‘But I can’t play.’

‘We’ll give you hints as we go along. You’ll be an expert in no time.’

Aargh…

Once they reached the highway it’d be easier.

The road into Iluka from the highway twisted around cliffs along the river. It was a breathtakingly scenic route but it was dangerous at the best of times, and now was the worst possible time to be driving.

Joss’s hands gripped white on the steering-wheel. He leaned forward, trying to see through the driving rain, and his dog leaned forward with him. Bertram’s breath fogged the windscreen and Joss hauled him back.

‘There’s no need for both of us to see.’

It’d be better once they were on the highway, he told himself. Just around this bend and across the bridge and…

His foot slammed hard on the brake.

Luckily he was travelling at a snail’s pace and the car’s brakes responded magnificently. He came to a halt with inches to spare. But inches to what? Joss stared ahead in disbelief. He had to be seeing things.

He wasn’t. Ahead lay the bridge. The water was up over the timbers in a foaming, litter-filled torrent, and the middle pylon was swaying as if it had no base.

And as Joss stared, there was a screech of tortured metal, a splintering of timber and the entire bridge crumbled and buckled into the torrent beneath.

‘I can’t play bridge. I’ve promised to help Cook make scones.’

‘Oh, Amy…’

Beam me up, someone. Please beam me up…

Joss opened the car door with caution. He was safe enough where he was but seeing a bridge disappear like that made a man unsure of his own footing. Thankfully the ground underneath felt good and solid, even if a relentless stream of water began to pour down his neck the minute he opened the door.

Before him was a mess. The entire bridge was gone. In the passenger seat Bertram whimpered the unease of a dog in unfamiliar territory, and Joss leaned in to click the seat belt free.

They weren’t going anywhere fast, Joss thought grimly. Bertram was a water dog at heart, and if Joss was going to drown out here at least he’d have happy company.

‘Stupid dog. You can’t possibly like weather like this.’

He was wrong. Joss even managed a grin as Bertram put his nose skywards, opened his mouth and drank.

But his humour was short-lived. How was he to get back to Sydney now?

First things first, he told himself. Before he started to panic about escape routes, he needed to do something about oncoming traffic. He didn’t want anyone plunging unaware into that torrent.

He bent into the car again and flicked his lights to high beam. The river wasn’t so wide that oncoming cars wouldn’t see his warning. Then he flicked on his hazard lights.

But his warning was too late. A truck came hurtling around the bend behind him and it was travelling far too fast. Above the roar of the river Joss hardly heard it coming, and when he did he barely had time to jump clear.

The smash of tearing metal sounded above the roar of the water. There was a crashing of broken glass, a ripping, tearing metallic hell, and then the sounds of hissing steam.

Joss backed away fast and Bertram came with him.

What the…?

His car had been totalled. Just like that.

He swallowed a few times and laid a hand on his dog’s shaggy head, saying a swift thank you to the powers who looked after stupid doctors who ventured out in sports cars that were far too small. In a world where there were trucks that were far too big. In weather that was far too bad.

Then he took in the damage.

The other vehicle looked like an ancient farm truck-a dilapidated one-tonner. If Joss’s sports car had been bigger it would have fared better, but now… His rear wheels were almost underneath his steering-wheel. The passenger compartment where Joss and his dog had sat not a minute before was a mangled mess.

Hell!

‘Stay,’ he told Bertram, and thanked the heavens that his dog was well trained. He didn’t want him any closer to the wreck than he already was. The smell of petrol was starting to be overpowering…

He had to reach the driver.

Damage aside, it was just as well his car had been where it was, Joss thought grimly. Coming with the speed it had, if Joss’s car hadn’t been blocking the way the truck would now be at the bottom of the river.

If anyone else came…

There was another car now on the other side of the river, and it also had its lights on high beam. Joss’s lights were still working-somehow. The lights merged eerily through the rain and there was someone on the opposite bank, waving wildly.

They’d all been lucky, Joss thought grimly. Except-maybe the driver of the truck.

The smell of petrol was building by the minute and the driver of the truck wasn’t moving. Hell, the truck’s engine was still turning over. It only needed a spark…

The truck door wouldn’t budge.

He hesitated for only a second, then lifted a rock and smashed it down on the driver’s window. Reaching in, he switched off the ignition. The engine died. That’d fix the sparks, he thought. It should prevent a fire. Please…

Were there injuries to cope with? The driver was absolutely still. Joss grabbed the handle of the crumpled door from the inside and tried to wrench it open. As he worked, he lifted his phone and hit the code for emergency.

‘The Iluka bridge is down,’ he said curtly as someone answered, still hauling at the door as he spoke. ‘There’s been a crash on the Iluka side. I need help-warning signs and flashing lights, powerful ones. We need police, tow trucks and an ambulance. I’m trying to get to the driver now. Stand by.’

‘If you won’t play bridge how about carpet bowls?’

‘That’s a good idea.’ At least it was active. Amy was climbing walls. ‘Let’s set it up.’

‘But you’ll play bridge with us tomorrow, won’t you, dear? If it doesn’t stop raining…’

Please, let it stop raining.

‘You’re wanted on the phone, Amy.’ It was Kitty calling from the office. ‘It’s Chris and she says it’s urgent.’

Hooray! Anything to get away from the carpet bowls-but the local telephonist was waiting and at the sound of her voice, Amy’s relief disappeared in an instant. ‘What’s wrong?’

‘I don’t know.’ Chris was breathless with worry. ‘All I got was that the bridge is down. There’s been a crash and they want an ambulance. But, Amy, the ambulance has to come from Bowra on the other side of the river. If the bridge is down… If there’s a medical emergency here…’

Amy’s heart sank. Oh, no…

Iluka wasn’t equipped for acute medical needs. The nearest acute-care hospital was at Bowra. The nearest doctor was at Bowra! Bowra was only twenty miles down the road but if the bridge was down it might just as well be twenty thousand.

‘I don’t know any more,’ Chris told her. ‘There was just the one brief message and the caller disconnected. I’ve alerted Sergeant Packer but I thought…well, there’s nowhere else to take casualties. You might want to stand by.’

It was a woman and she was in trouble.

Joss managed to wrench the door open to find the driver slumped forward on the steering-wheel. Her hair was a mass of tangled curls, completely blocking his view. She was youngish, he thought, but he couldn’t see more, and when he placed a hand on her shoulder there was no response.

‘Can you hear me?’

Nothing. She seemed deeply unconscious.

Why?

He needed to check breathing-to establish she had an airway. He stooped, wanting to see but afraid to pull her head back. He needed a neck brace. If there was a fracture with compression and he moved her…

He didn’t have a neck brace and he had no choice. Carefully he lifted the curls away and placed his hands on the sides of her head. Then, with painstaking care, he lifted her face an inch from the wheel.

With one hand holding her head, cupping her chin with his splayed fingers, he used the other to brush away the hair from her mouth. Apart from a ragged slash above her ear he could feel no bleeding. Swiftly his fingers checked nose and throat. There was no blood at all, and he could feel her breath on his hand.

What was wrong?

The door must have caught her as it crumpled, he thought as he checked the cut above her ear. Maybe that had been enough to knock her out.

Had it been enough to kill her? Who knew? If there was internal bleeding from a skull compression then maybe…

She was twisted away from him in the truck, so all he could see was her back. He was examining blind. His hands travelled further, examining gently, feeling for trauma. Her neck seemed OK-her pulse was rapid but strong. Her hands were intact. Her body…

His hands moved to her abdomen-and stiffened in shock. He paused in disbelief but he hadn’t been mistaken. The woman’s body was vast, swollen to full-term pregnancy, and what he’d felt was unmistakable.

A contraction was running right through her, and her body was rigid in spasm.

The woman was in labour. She was having a baby!

‘Amy?’

‘Jeff.’ Jeff Packer was the town’s police sergeant-the town’s only policeman, if it came to that. He was solid and dependable but he was well into his sixties. In any other town he’d have been pensioned off but in Iluka he seemed almost young.

‘There’s a casualty.’ He said the word ‘casualty’ like he might have said ‘disaster’ and Jeff didn’t shake easily. Unconsciously Amy braced herself for the worst.

‘Yes?’

‘It’s a young woman. We’re bringing her in to you now.’

‘You’re bringing her here?’

‘There’s nowhere else to take her, Amy. The bridge is down. We’d never get a helicopter landed in these conditions and Doc here says her need is urgent.’

‘Doc?’

‘The bloke she ran into says he’s a doctor.’

A doctor… Well, thank heaven for small mercies. Amy let her breath out in something close to a sob of relief.

‘How badly is she hurt?’

‘Dunno. She’s unconscious and her head’s bleeding. We’re putting her into the back of my van now.’

‘Should you move her?’

‘Doc says we don’t have a choice. There’s a baby on the way.’

A baby.

Amy replaced the receiver and stood stunned. This was a nursing home! They didn’t have the staff to deliver babies. They didn’t have the skills or the facilities or…

She was wasting time. Get a grip, she told herself. An unconscious patient with a baby on the way was arriving any minute. What would she need?

She’d need staff. Skilled staff. And in Iluka… What was the chance of finding anyone? There were two other trained nurses in town but she knew Mary was out at her mother’s and she didn’t have the phone on, and Sue-Ellen had been on duty all night. She’d only just be asleep.

She took three deep breaths, forcing herself to think as she walked back out to the sitting room.

Thinking, thinking, thinking.

The vast sitting room was built to look out to sea. Mid-morning, with no one able to go outside, it held almost all the home’s inhabitants. And they were all looking at her. They’d heard Kitty say the call was urgent and in Iluka urgent meant excitement.

Excitement was something that was sadly lacking in this town. These old people didn’t play carpet bowls from choice.

Hmm. As Amy looked at them, her idea solidified. This was the only plan possible.

‘I think,’ she said slowly, the solution to this mess turning over and over in her mind, ‘that I need to interrupt your carpet bowls. I think I need all hands on deck. Now.’

Fifteen minutes later, when the police van turned into the nursing home entrance, they were ready.

Jeff had his hand on his horn. Any of the home’s inhabitants who hadn’t known this was an emergency would know it now, but they were already well aware of it. They were waiting, so when the back of the van was flung wide, Joss was met by something that approached the reception he might have met at the emergency ward of the hospital he worked in.

There was a stretcher trolley rolled out, waiting, made up with mattress and crisp white linen. There were three men-one at each side of the trolley and one at the end. There was a woman with blankets, and another pushing something that looked blessedly-amazingly-like a crash cart. There was another woman behind…

Each and every one of them wore a crisp white coat and they looked exceedingly professional.

Except they also all looked over eighty.

‘What the…?’

He had barely time to register before things were taken out of his hands.

‘Charles, slide the trolley off the wheels-that’s right, it lifts off. Ian, that’s great. Push it right into the van. Push it alongside her so she can be lifted… Ted, hold the wheels steady…’

Joss glanced up from his patient. The efficient tones he was hearing weren’t coming from a geriatric. They came from the only one in the group who didn’t qualify.

She was a young woman, nearing thirty, he thought, but compared to her companions she was almost a baby. And she was stunning! She was tall and willow slim. Her finely boned face was tanned, with wide grey eyes that spoke of intelligence, and laughter lines crinkled around the edges that spoke of humour. Her glossy black hair was braided smoothly into a long line down her back. Dressed in a soft print dress with a white coat covering it, she oozed efficiency and starch and competence. And…

Something? It wasn’t just beauty, he thought. It was more…

‘I’m Amy Freye,’ she said briefly. ‘I’m in charge here. Can we move her?’

‘I… Yes.’ Somehow he turned his attention back to his patient. They’d thrown a rug onto the van floor for her to lie on. It wasn’t enough but it was the best they could do as there’d been no time to wait for better transport. The thought of delivering a distressed baby in the driving rain was impossible.

‘Wait for me.’ Amy leaped lightly into the van beside Joss. Her calm grey eyes saw and assessed, and she moved into action. She went to the woman’s hips and slid her hands underneath in a gesture that told Joss she’d done this many times before. Then she glanced at Joss, and her glance said she was expecting matching professionalism. ‘Lift with me. One, two, three…’

They moved as one and the woman slid limply onto the stretcher.

‘OK, fit the wheels to the base,’ the girl ordered of the two old men standing at the van door. ‘Lock it into place and then slide it forward.’

In one swift movement it was done. The stretcher was on its wheels and the girl was out of the van.

‘Take care of the dog, Lionel,’ she told an old man standing nearby, and Joss blinked in astonishment. The top triage nurses in city casualty departments couldn’t have handled things any better-and to even notice the dog… He opened his mouth to tell Bertram things were OK, but someone was handing towels to the man called Lionel, the old man was clicking his fingers and someone else was bringing a biscuit.

Bertram was in doggy heaven. Joss could concentrate on the woman.

‘This way,’ Amy was saying, and the stretcher started moving. Doors opened magically before her. The old men beside the stretcher pushed it with a nimbleness which would have been admirable in men half their age, and Joss was left to follow.

Where was he? As soon as the door opened, the impression of a bustling hospital ended. Here was a vast living room, fabulously sited with three-sixty-degree views of the sea. Clusters of leather settees were dotted with squashy cushions, shelves were crammed with books, someone was building a kite that was the size of a small room, there were rich Persian carpets…

There were old people.

‘Do we know who she is?’ Amy asked, and Joss hauled his attention back where it was needed.

‘No. There was nothing on her-or nothing that we could find. Sergeant Packer’s called in the plates-he should be able to get identification from the licence plates of the truck she was driving-but he hasn’t heard back yet.’

She nodded. She was stopping for nothing, pushing doors wide, ushering the stretcher down a wide corridor to open a final door…

‘This is our procedures room,’ she told Joss as she stood aside to let them past. ‘It’s the best we can do.’

Joss stopped in amazement.

When the police sergeant had told him the only place available was the nursing home he’d felt ill. To treat this woman without facilities seemed impossible.

But here… The room was set up as a small theatre. Scrupulously clean, it was gleaming with stainless-steel fittings and overhead lights. It was perfect for minor surgery, he realised, and his breath came out in a rush of relief. What lay before him started looking just faintly possible.

‘What-?’

But she was ahead of him. ‘Are you really a doctor?’ she asked, and he nodded, still stunned.

‘Yes. I’m a surgeon at Sydney Central.’ But he was focussed solely on the pregnant woman, checking her pupils and frowning. There didn’t seem a reason for her to be so deeply unconscious.

He wanted X-rays.

He needed to check the baby first, he thought. He had two patients-not one.

‘You can scrub through here.’ Amy’s face had mirrored his concern and she’d followed his gaze as he’d watched the last contraction ripple though her swollen abdomen. ‘Or…do you want an X-ray first?’

‘I have to check the baby.’ She was right. He needed to scrub before he did an internal examination.

‘I’ll check the heartbeat. The sink’s through here. Marie will help.’

A bright little lady about four feet high and about a hundred years old appeared at his elbow.

‘This way, Doctor.’

He was led to the sink by his elderly helper-who wasn’t acting elderly at all.

There was no time for questions. Joss was holding his scrubbed hands for Marie to slip on his gloves when Amy called him back.

‘We’re in trouble,’ she said briefly, and her face was puckered in concern. She’d cut away the woman’s smock. ‘Hold the stethoscope here, Marie.’ Then, with Marie holding the stethoscope in position over the swollen belly, she held the earpieces for Joss to listen.

His face set in grim lines as he heard what she’d heard. ‘Hell.’ The baby’s heartbeat was faltering. He did a fast examination. The baby’s head was engaged but she’d hardly dilated at all. A forceps delivery was still impossible. Which meant…

A Caesarean.

A Caesarean here?

‘We don’t have identification,’ Amy was saying. ‘Will you…?’

That was the least of their worries, he thought. Operating without consent was a legal minefield, but in an emergency like this he had no choice.

‘Of course I will. But-’

‘We have drugs and equipment for general anaesthetic,’ she finished, moving right on, efficient and entirely professional in her apology. ‘The Bowra doctor does minor surgery here, but I’m afraid epidural is out of the question. I…I don’t have the skills.’

After that one last revealing falter her eyes met his and held firm. They were cool, calm, and once again he thought that she was one in a million in a crisis.

‘What’s your training?’ he started, hesitating at the thought of how impossible it would be to act as anaesthetist and surgeon at the same time-but she was before him there, too.

‘Don’t get the wrong idea. I’m not a doctor,’ she said flatly. ‘I’m a nurse. But I’m qualified in intensive care and I spent years as a theatre nurse. With only one doctor in the district, I’ve performed an emergency general anaesthetic before. That’s why we have the drugs. For emergencies. So if you guide me, I’m prepared to try.’

He stared at her, dumbfounded by her acceptance of such a demand. She was a nurse, offering to do what was a specialist job. This was a specialist job for a qualified doctor!

But she’d said that she could do it. Should he trust her? Or not?

He hardly had a choice. He’d done a brief visual examination on the way here. The baby was still some way away-the head wasn’t near to crowning-and now the baby’s heartbeat was telling its own grim story. If they waited, the baby risked death.

He couldn’t do a Caesarean without an anaesthetic. The woman was unconscious but the shock of an incision would probably wake her.

He needed a doctor to do the anaesthetic, but for him to perform the Caesarean and give the anaesthetic at the same time was impossible.

Amy wasn’t a doctor. And she was offering to do what needed years of medical training.

But… ‘I can do this,’ she said, and her grey eyes were fearless.

He met her gaze and held it.

‘You’re sure?’

‘Yes.’

‘You realise insurance…’

‘Insurance-or the lack of it-is a nightmare for both of us.’ She nodded, a decisive little movement of her head as though she was convincing herself. ‘But I don’t see that we can let that worry us. If we don’t try, the baby dies.’

It went against everything he’d ever been taught. To let a nurse give an anaesthetic…

But she was right. There was no decision to be made.

‘OK. Let’s move.’

It was the strangest operation he’d ever performed. He had a full theatre staff, but the only two under eighty years old were Amy and himself.

Marie stayed on. The old lady had scrubbed and gowned and was handing him implements as needed. Her background wasn’t explained but it was assumed she knew what she was doing, and she handled the surgical tray with the precision of an expert.

And she had back-up. Another woman was sorting implements, moving things in and out of a steriliser. A man stood beside her, ready with a warmed blanket. Every couple of minutes the door opened a fraction and the blanket was replaced with another, so if-when-the baby arrived there’d be warmth. There was a team outside working in tandem, ferrying blankets, hot water, information that there was no chance of helicopter evacuation…

Joss took everything in. He checked the tray of instruments, the steriliser, the anaesthetic. He measured what was needed, then sized Amy up.

‘Ready?’

‘As ready as I’ll ever be.’ Still that rigid control.

He looked at her more closely and saw she was holding herself in a grip of iron. There was fear…

It would help nothing to delay or probe more deeply into her fear, he decided. She’d made a decision that she could do it and she had no choice. There was no choice!

‘Let’s go, then.’

Amy nodded. Silently she held her prepared syringe up so he could check the dose. He nodded in turn and then watched as she inserted it into the IV line.

He watched and waited-saw her eyes move to the monitor, saw her skilfully intubating and inflating the cuff of the endrotracheal tube, saw her eyes lose their fear and become intent on what they were doing.

He felt the patient’s muscles relax under his hand.

She was good, he thought exultantly. Nurse or not, she knew what she was doing, which left him to get on with what he had to do.

He prepped the woman’s swollen abdomen, lifted the scalpel and proceeded to deliver one baby.