Doctor's Orders (14 page)

“Will you be here long?” she asked Sarah. It was something to say more than anything else. Someone had to break the uneasy silence. “I believe you're a model. It must be very exciting.”

“It's boring,” said Sarah, with an air of tedium, as she lit a cigarette in a long black holder. “The only good thing about it is the money.”

Isabel laughed. “I wouldn't mind being bored if I got paid for it,” she said. “Nurses don't get paid much, you know.”

“You get paid what you're worth, I imagine,” replied Sarah in a disinterested voice. She looked at Isabel, her glance raking her from top to toe. “If you did something with yourself, you could look quite decent. You're tall, you could probably even get the odd job with a small modelling agency.”

Perhaps she did intend it as a compliment. Isabel tried to tell herself charitably that it was, even though Sarah's tone wasn't complimentary. Somehow she had managed to convey in those few words that Isabel was a small-town frump, and not for the first time that evening Isabel wished she had worn something different.

“I think Isabel looks perfect the way she is,” said Cliff gallantly, “don't you, Mike?”

“Yes,” said Mike quietly, “I much prefer the dress you are wearing to the theatre dresses.”

“Anything
would been improvement on
those,”
said Sarah sarcastically, flicking the ash carelessly from her cigarette towards the ash tray. “I'll have another drink, darling. Make it a double Scotch.”

“Let me,” said Cliff, standing quickly, “Mike, anything for you?”

Mike shook his head. “I'm driving,” he said shortly. Then as Cliff disappeared in the direction of the bar, he turned to Isabel, “Would you care for this dance?”

“Well…er, I,” Isabel was embarrassed. Sarah was obviously sulking, and she didn't want to be the cause of further friction. However, her deliberations were cut short, as he leaned down, and grasping her wrist drew her up to face him. There was no choice but to follow him meekly on to the dance floor. “Sarah might be offended,” she muttered as they started dancing.

“Sarah?” Mike stared at her, surprise written all over his face. “She couldn't care less who I dance with. She didn't want to come at all this evening, I made her. Hence her bad temper!” Without waiting for any further comment he swept her masterfully into the middle of the dance floor.

So that accounts for it, thought Isabel miserably. He is using me to make her jealous, I'm a pawn in their game. But as he held her close, the same old magnetism of his presence began to work. Stubbornly Isabel resisted it, as the surge of anger at the thought of being used, grew within her. Involuntarily she stiffened in his arms, resisting the seductive magic of his body.

“You didn't tell me the truth, did you?” his voice cut through her anger and misery. “Remember? You told me that there was nothing interesting about you.” He laughed. To Isabel's ears it sounded harsh. “Being able to keep two men dangling helplessly on a string makes you interesting in my book. In fact it puts you in a class of your own!”

“What do you mean?” demanded Isabel, glaring at him, although his next words came as no surprise to her. They merely confirmed her suspicions that he had hopelessly misjudged the whole situation.

“Why, Hugh and Cliff, of course,” he answered lightly. “There is my poor friend Hugh drinking too much because his fiancée jilted him, and then there is the eligible surgeon, Cliff.” Isabel opened her mouth to protest but he continued in a cutting voice. “I gather you are doing a splendid job where he is concerned, even getting him to move you into your new flat.”

“It's none of your damned business what I do,” flashed Isabel, an irrepressible rage swamping her. Pride forbade her to explain, to tell him that he had everything wrong, that she hadn't jilted Hugh, it had been the other way round. Let him think what he wanted! But her rage made her reckless, and she couldn't resist adding, “Talking about being in a class of your own, I think that description fits you very aptly!” She spat the words out angrily.

“Oh?” If he had been about to say anything else Isabel didn't give him the opportunity.

“I despise a man who lives with his brother's wife,” she hissed in a low voice. “But I should have known that a man who can ask a girl to go to bed after
one
meal, is capable of
anything!”
Impatiently she twisted out of his arms, angry with him, and, more over, angry with herself for still being attracted to him in spite of everything. “I'm going,” she flung back the words over her shoulder.

“I can see that,” came his dry reply, “I don't know why I ever bothered to rescue you from your drunken fiancé.”

“Ex-fiancé,” hissed Isabel. “Anyway, nobody asked you to.” She paused momentarily as they were nearly back to the table, “Just stay away from me altogether.”

“That will be rather difficult, we work together,” he pointed out smoothly. To her fury, his voice even sounded faintly amused.

“It can be very easy,” replied Isabel icily. “You can behave like a robot, the way you did when I first met you. I prefer you that way!” There was a choking noise behind her which she ignored as she marched back to the table and sat down.

“Quick dance?” said Sally, a questioning note in her voice.

“Too crowded,” lied Isabel coolly, flashing Mike a look, daring him to comment. He didn't, just reached across and picked up his beer.

Sarah stood up. “I'm ready to go, Mike,” she said. “Goodbye everyone, it's been lovely meeting you.” Without waiting, she started to walk away, and Isabel noticed, with resentment tinged with sadness, how quickly Mike got up and followed her.

“It's been lovely meeting you,” Sally mimicked her voice. “What a liar, she couldn't care less, poisonous bitch! I can't think what Mike sees in her.”

“She's very lovely,” said Isabel miserably watching their retreating backs as they were swallowed up in the crowd. She noticed that Hugh joined them. “My poor friend Hugh” Mike's words came back to her. If only he knew. Not that he would have believed her, even if she had told him the truth. The unjustness of it all made Isabel see red. Trust Hugh to play on his friend's sympathy. Men, she thought bitterly, I'm better off without them!

As if by tacit agreement, no mention was made again of Sarah and Mike, and the rest of the evening passed by pleasantly. At least, Isabel made a pretence of enjoying herself, everyone else obviously was, and she didn't want to be a wet blanket. But in reality Mike's accusing words were ringing round and round in her head, and although she tried to tell herself it didn't matter a jot what he thought of her, it did. It mattered more than anything else in the world. Even if he can't love me, she thought dully, I wish he could think well of me. She had spoilt any chance of that, she had let fly at him a salvo of verbal darts, each one with a deadly poisoned tip!

Chapter Eight

Isabel dreaded Monday. In spite of her defiant words to Mike, telling him she didn't care, she was filled with apprehension at the thought of seeing him. All day Sunday her mind had wandered back to thoughts of him, she had wondered what he and Sarah had been doing. Imagining them settling their difference of opinion, sitting cosily together in his kitchen at breakfast, looking out on to his beautifully neat garden. She supposed Sarah would get a divorce and eventually marry Mike. The thought was like a physical pain, bringing home the realisation that she had fallen even harder for Mike Blakeney than she had at first imagined.

However, Monday duly arrived, there was no putting it off and Isabel started the weekly routine in the anaesthetic room. Subconsciously, in order to keep her edgy thoughts from straying, Isabel paid extra meticulous attention to everything, working like a demon, as if her life depended on it.

Steve Holden came in and looked at her curiously. “I know you're a perfectionist,” he said, “but this morning you are verging on the point of the ridiculous.”

“There's nothing ridiculous about being careful,” snapped Isabel, “someone's life may depend on it.”

“You don't have to tell me that,” he replied, pulling a face, “don't you think I know how hazardous anaesthesia is? Even if the surgeons do think it's just a case of giving a quick whiff!” He came across to Isabel, “What I should have said was, you look a bit tense. Had a bad weekend? I know how it feels,” he continued morosely, “I had several pints too many last night, my head feels as if it's filled with cotton wool.” He groaned dramatically.

“I've no sympathy for you,” said Isabel severely, “you'd best get yourself a strong cup of coffee before we start.”

Steve grinned irrepressibly, Isabel's bad humour bouncing off of him like water off of a duck's back. “Yes, perhaps I had, don't want to upset our lord and master by making a mistake!”

However, he never had the chance for a coffee because at that moment the tall figure of the senior anaesthetist strode through the doors. “Everything ready?” he barked tersely.

“Yes,” Isabel looked up as she spoke. She hadn't expected him to be exactly friendly after the harsh words they had exchanged at the dance, but then neither had she expected him to come charging in as if disaster was about to strike any moment.

“Good,” he said briefly. “Forget the published theatre list. We're starting with an emergency, an RTA, in casualty now. A nineteen-year-old girl, severe internal injuries. I've already cross-matched 12 units of whole blood, but we'll have to use the O-negative in the fridge to start with, until the cross-matched blood gets here from transfusion.”

The moment his words were out, Isabel switched on to the matter in hand. At times like this all personal thoughts flew out of the window, there was only one thought in everyone's mind, the patient. “I'll get the O-negative out of the fridge now,” said Isabel moving swiftly towards the door, “Steve, will you get the blood warmer ready please.” Outwardly she was calm, but inwardly her mind was racing ahead, trying to anticipate any other needs. How long would the cross-matched blood take to arrive? Should she get some plasma expander ready just in case?

Mike followed her through the swing doors into the corridor outside the anaesthetic room. “Get some plasma expander, as much as you can,” he said, as if he had been reading her mind. “I've a horrible feeling we're going to need it all.”

Isabel smiled briefly at him as she went on her way; he hadn't read her mind. The fact that they both worked in theatre, meant their minds were closely attuned, running on the same wavelength. That was always a comforting thought when faced with an emergency situation.

Isabel had only just finished the preparation for major traumatic surgery when the girl was wheeled in. She had already been resuscitated once in casualty, and was in a severely shocked condition. Intravenous therapy had already been started.

Mike came into the anaesthetic room and Isabel noticed he was scrubbed. “I'm going to put in a cannula, using the cut-down technique,” he said, seeing her surprised glance at his rubber gloved hands. “If she survives she is going to need massive blood replacement, and this will be her best chance.”

Without a word Isabel deftly put all the items he needed on a sterile trolley. Everything was already prepacked and autoclaved, so not a moment was lost. Carefully, she tore open the packets, taking care not to touch any of the contents. Soon the girl was on the table in theatre, Bill Goldsmith peering over her, the brilliant lights of the operating lamps shining down on the tense team. Without a need for words, everyone sensed that this was no ordinary trauma case, but a very serious one indeed. It was strange, Isabel reflected, in a way everyone felt easier when they could actually see blood, but internal injuries were another thing. It was a fear of the unknown, how bad was it going to be?

Carefully the surgeon made his incision, then he let out a long sigh. “Liver ripped to shreds,” he muttered.

“Situation retrievable?” asked Mike curtly, watching his monitors closely.

“I'm going to have a damned good try,” replied Bill Goldsmith grimly, “get plenty of blood ready, Mike.”

“It's ready,” replied the anaesthetist, “we've already got it going.” He looked up at the transfusion set, the dark red O-negative blood dripping steadily down the tubing. “Even so, I'm having difficulty in maintaining a decent blood pressure, be as quick as you can.”

After that there was silence. Bill Goldsmith and his team worked on, cutting, stitching, cutting, stitching, while Mike, Isabel and Steve monitored and changed the blood bags when they were empty. They used the six units of O-negative, and then the cross-matched blood. Isabel had thought twelve units rather excessive to start with, but now she could see they would probably use it all, plus the plasma expander. She glanced at her watch. They had been in theatre four hours already. No one had stopped, the thought of coffee or lunch hadn't even crossed their minds. She looked at the face of the girl on the table, pale, slightly cyanosed, the tubing from her mouth connecting her to the life-giving oxygen. She's too young to die, thought Isabel, willing her to live. Please, oh please, let Mr Goldsmith stop the bleeding, she thought fervently, but it was no use. After eight solid hours in theatre the girl died quietly on the operating table. All the blood and plasma they had poured into her had merely poured out again through the many injuries she had sustained.

It was the second death on the table that Isabel had witnessed since working at the County General. First the tiny baby and now a teenage girl. Both times it seemed like a nightmare, a bad unreal dream. Death came so silently, as if it had been patiently waiting all the time in the dark shadows outside the fringe of the bright ring of theatre lights. We wasted our time, thought Isabel, fate had already decided the outcome before we started. Her heart flooded with sorrow at the thought of the young life lost, and the anguish it would cause for her family.

“Such a waste of life,” said Mike savagely, flicking the switch viciously as he turned everything off. “All because some bloody maniac was driving too damned fast.” He looked at Isabel's pale face. “You go,” he said quietly, “you've been here long enough. Steve and I will see to the formalities.”

Isabel hesitated. She had had a long day, but so had he and everyone else. His face was taut and drawn, drained of emotion. He looked vulnerable and unhappy, quite different from the usual taciturn face he presented to the world. Impulsively she reached out and touched his arm. “Go on,” he snapped irritably, turning away, “the other girls have already gone.”

So she left, feeling hurt at his abrupt rejection of her impulsive gesture. Slowly she walked down the corridor, her gait exhausted and weary. When she reached the changing room, Sally and Susie were already there, flopped out in the armchairs.

“I wouldn't like too many days like this one,” said Sally, voicing the thoughts of all of them. “Poor kid, riding her bike to University.” The three of them were silent, thinking of the nineteen-year-old whose life had been so suddenly cut short. As she showered, Isabel wondered about the girl's parents. How awful it must be to lose a daughter. One moment a girl full of life, the next day dead. Sally and Susie were quiet, each one changing and leaving the room with a brief goodbye, none of the cheery chatter and gossip that usually took place. Isabel finished changing last, and collected the bike to ride back to her flat.

Slowly she cycled along in the warm evening air. Normally she would have enjoyed such a perfect late summer evening, the sunlight filtering through the thickly leafed trees, forging intricate patterns on the roadway, but that evening her heart was heavy. The summer beauty passed by unnoticed, the face of the dead teenager blotting out everything else. Once she was back in her flat, it was no better. She just didn't feel in the mood to cook herself anything to eat. Half-heartedly she toyed with the idea of ringing Cliff, but then decided the sensible thing to do was to walk her depression away. After all, she reasoned, you've seen death before, you will see it again, it has to be kept in perspective. So, setting off determinedly, she decided to walk to the pub by the river.

Walking was a pastime Isabel had always enjoyed. As a child she used to walk over the Scottish hills, and had never minded the weather. It had not mattered whether it was sunny or raining. In fact, she remembered as she thought back to those far off days, in a way she had always preferred the rain. Perhaps that was because when she returned, her grandmother always had a kettle boiling ready for some tea, and fresh homemade scones that melted in the mouth. For the first time, Isabel suddenly felt homesick for Scotland. Now that she had seen Hugh again, and knew she had nothing to fear where he was concerned, there was nothing to stop her going back. Perhaps I ought to, she pondered, that way I need never see Dr Mike Blakeney again. Need never argue with him again, never feel that inexplicable feeling of exhilaration when he comes near me, or the sadness when he makes it quite plain he doesn't want, or need, my sympathy.

But once she was seated comfortably by the smoothly flowing river, munching a cheese sandwich and sipping a mellow red wine, she changed her mind again. It
was
a lovely part of the country, and already she had made many good friends. Why leave them just because you have been stupid enough to fall for a bad-tempered, two-timing anaesthetist, she told herself firmly.

Relishing her sandwich, Isabel watched the clear water of the river slide silently past. No mother duck and ducklings now, but there were some adult ducks swimming about, hopefully eyeing her sandwich with interest. Isabel threw them some pieces of crust. Perhaps they are the babies that ate my crisps on that very first evening, she thought, watching them dabble for the crusts in the water. It seemed such a long time ago since she had sat in the very same place with Mike Blakeney, after her first day at the County General.

“I find slow flowing rivers soothing too,” Mike's voice sliced through her thoughts.

Isabel turned, sandwich in hand to find Mike and Sarah standing behind her. “I just had to get out this evening,” she muttered lamely, wishing that Mike had been standing there alone, and not accompanied by the beautiful Sarah.

“So did Mike,” said Sarah coming to perch beside Isabel. “He was like a bear with a sore head when he came in this evening, so I demanded that he take me out.”

“We had a bad day,” said Isabel slowly, “did Mike tell you?”

“No, and I don't want to know,” said Sarah quickly. “I can't bear anything to do with hospitals. I had enough of that as a child. My father always used to bring his work home with him.”

Of course, Isabel suddenly remembered that Sally had mentioned that Sarah's father was some important surgeon. It puzzled her slightly, however. If Sarah hated hospitals that much, Mike Blakeney was hardly the right man for her. She could never imagine him giving up his hospital work for anyone.

Mike made a move towards the pub to collect their drinks. “Another glass of wine for you?” he asked Isabel, smiling at her. It was a distant but friendly smile, or so it seemed to Isabel.

She found herself smiling back, echoing the friendly light flickering in his eyes as she nodded, “Thanks.”

Sarah watched him walking away. “Don't tell me,” she said. “I know something dreadful has happened today. I always know where Mike is concerned, but I don't want to hear about it,” she added hastily, “I'm only thinking about tomorrow.”

“Tomorrow?” asked Isabel politely.

“I'm flying to New York,” replied Sarah, “a modelling assignment,” she added by way of explanation.

“Oh, how I envy you,” said Isabel wistfully, wishing she could just get on a plane and fly off to an exciting city like New York the next day. Instead of laying out the anaesthetic room as usual. “Will you be gone long?”

Sarah lit a cigarette and inhaled slowly. “I don't know,” she said quietly, and for the first time Isabel saw her really smile, a smile that reached her eyes as well as her lips. “It all depends on what Mike can arrange.”

“I see,” said Isabel politely, trying to ignore the hard lump in her throat. That was it, of course, Mike must be going to arrange a divorce for Sarah in the United States. She remembered reading somewhere that it was possible to get a divorce easily in the States, no waiting. Not like in England. Then they would be free to marry. That must be why Sarah was looking happy for the first time since she had met her. It was with difficulty that she forced herself to smile brightly, and take the drink Mike proffered when he returned. “Sarah has told me she is going to the States tomorrow,” she said.

“Yes,” he replied, but his tone of voice didn't invite further comment.