Intensive Care: Escape to the Country (10 page)

Kate’s knees gave out and she collapsed on the bed, her heavy limbs protesting at having had to stand upright for so many hours. She kicked off her shoes and crawled beneath the covers, not even bothering to undress. It wasn’t long before Matilda joined her. The cat purred and walked in circles for a moment before marching on the spot until she found a perfect position and snuggled down, curling into a tight ball. Kate stared at the ceiling, thinking back over the previous few hours. She stroked the cat’s fur, willing her mind to slow down and switch off.

John and Heather had made the brave decision to allow their son’s organs to be donated. Thankfully, Pete had made his wishes clearly known to his parents and they loved their son enough to want to honor his request. They seemed to understand that Pete was brain dead and no recovery was possible.

Their decision quickly set the wheels in motion for the Donate Life team to fly in, and an organ donor co-ordinator had arrived within hours to provide much needed support. The medical team had arrived soon after and two senior doctors independently conducted the same set of clinical tests on Pete at the bedside. 

It was around ten o’clock when Pete was taken to theater for the organ retrieval surgery. Kate was allowed to watch the procedure, and was astounded with the care that was taken, and the way Pete was treated with respect and dignity. She felt privileged to be part of this process.

Over a five-hour period, specialist doctors and their teams arrived and left the hospital. All of them had flown in from various parts of the country and would return to their own hospitals to perform life-giving transplantation surgery within the next few hours. Just thinking of it again brought tears to Kate’s eyes.

John and Heather had remained in the ICU waiting room and this was where Kate had found them when the surgery was finally over. The hospital chaplain had sat with the family all night. Other family members had arrived, as well as many of Pete’s friends. They looked up as she walked into the room but none of them rose from their seats. Their eyes were red from crying and their faces were pale and washed out.
How is it people manage to look as though they have aged twenty years overnight after a tragic event?

Someone eventually made way for her to sit beside Heather on the couch. Kate went to her side, and Heather held Kate’s hands in her own and said two words that Kate never expected to hear.

“Thank you.”

Wrapping her arms around Heather, the dam burst and it was Kate who cried uncontrollably.

A week later the gentle patter of rain on the tin roof woke Kate. She was groggy and disorientated from another bad night’s sleep. She wondered if she’d been dreaming of Marcus again. Rolling over, she noted the red digital numbers on her clock read eleven-fifteen. Surprised, she realized she had slept longer than she had in months. She lay still, relishing the sound of the rain, listening as it slowly grew heavier. She pictured it bouncing off the roof like drumsticks bouncing off a snare drum. Judging by the sound, it had settled in for the day and she was glad. According to the farmers, they needed the rain.

Living in the city, Kate was used to the inconvenience of rain, but in Birrangulla it was good news for the farmers, and she knew there would be lots of smiles among the locals in the coming weeks if the forecast wet weather continued. She was told that many farmers had watched their crops wither year after year when the rain didn’t come, their souls crumbling a little more each time the clouds passed them by.

The hidden underside to living in the country was that too many farmers and their sons had taken their own lives because of the years of drought, their cups of optimism as dry as the clouds that passed overhead. Just thinking about it broke Kate’s heart.

Kate pulled aside her bedroom curtains and looked out at the heavy dark clouds hanging so low they seemed to scrape the tops of the trees. The heaviness of the clouds over the distant hills matched her mood.

She dragged herself off to work just after two o’clock with the beginnings of a headache. The unit was disturbingly quiet. Kate leaned back in her chair, watching the bank of cardiac monitors in front of her. She yawned and folded her arms across her chest.

There were only three patients in the unit and all of them were planned discharges the following day. One of the patients had been stented two days earlier and the others had been sent to hospital by their local GP. All they had needed was some offloading of fluid and tweaking of their medications. Kate was beginning to understand that they saw a lot of patients like this in the unit.

Welcome to living in a small town.

The phone rang and Mitch answered cheerfully, his loud voice echoing in the deserted unit. “ICU. You’re talking to Mitch.”

Kate closed her eyes, imagining who might be on the other end of the line.

Mitch nudged Kate’s chair with his foot and mouthed, “It’s the co-ordinator.”

She held her hand out, indicating that she would take the call, but Mitch ignored her. From time to time he nodded and scribbled some information on the back of his hand. Kate was more alert now and she narrowed her eyes at Mitch but he swiveled in his chair, turning his back on her. Kate pushed a notepad toward him, but again, he ignored her. Finally he hung up the phone and turned to Kate with his trademark cheeky grin.

“Got a good one for you! Her name is Penelope Cartwright-Jones. Chest pain for investigation.”

“And?” Kate asked, eyebrows raised.

“Well, seems it’s a bit of a weird admission.”

“How so?”

“She was brought into emergency by her partner about an hour ago. They were out having lunch and he says she was having trouble breathing.”

“Cut to the chase, Mitch. What’s so weird?” Kate rubbed her forehead. She felt her headache worsening and Mitch’s attitude wasn’t helping.

“Ah. Well you see, it’s not what’s weird, it’s
who
is weird.” Mitch paused for melodramatic effect. “Penelope Cartwright-Jones is well known here in town. She’s the local socialite I guess you could say. She used to just be plain old Penny Jones but when she hooked up with the mayor she upgraded her name too.”

“I still don’t get your point.”

“Oh, wait ’til you see her. Then you’ll know what I’m talking about.” Mitch winked at Kate as he got up from his chair to set up the room for the new admission. Kate was none the wiser about the patient’s diagnosis. She followed him and watched as he checked that the oxygen and suction on the wall were working. He found an extra pillow from the cupboard and placed it on the bed and then began preparing some paperwork for her arrival.

“Well, what’s her diagnosis, Mitch? She can’t be admitted here without a proper diagnosis,” Kate argued.

“The ED doctor diagnosed her with shortness of breath,” Mitch replied.

“Well
is
she short of breath?” Kate was beginning to get exasperated with Mitch’s nonchalance. It was as if he was deliberately goading her. “You just told me it was a chest pain for investigation. Which is it?”

“I guess you’ll just have to wait and see. They’re bringing her up in ten minutes.”

Wondering if the patient was being admitted to the unit because there were no spare beds at the private hospital, Kate was beginning to think it was what was referred to as a “soft” admission. She wasn’t happy because she had a budget to consider and these types of admissions took up beds and made poor use of valuable nursing time and skills. In addition, every now and again one of these sorts of patients would be demanding and disruptive. Kate was about to call the hospital co-ordinator to get more information when the woman arrived.

She knew immediately upon seeing Penelope that this was going to be a soft admission of the very worst kind
–
the pillow-fluffing kind. Sometimes the wealthier members of society insisted on one-to-one nursing care, private rooms and special diets. Over the years Kate had heard many a nurse exclaim, out of the patient’s earshot, “Who do they think they are? Some Hollywood celebrity? Seriously, this is not the Hilton!” The problem was, these patients were often viewed by management as a valuable financial asset. The understanding was that if nurses looked after them, when the time came they might contribute financially to the hospital.

“Good afternoon,” Kate tersely greeted the woman who was sitting ramrod-straight in the wheelchair. “My name is Kate Kennedy and I’m the nurse in charge of this unit.” She indicated Mitch. “And this is Mitch. He’s one of the nurses working with me today.”

Kate’s headache was now full-blown and spots swam in front of her eyes. She clenched her jaw and pressed her lips together to stop herself from saying anything that she might later regret.

Penelope handed Kate her toiletry bag as one of the orderlies helped her out of the wheelchair and onto the bed Mitch had prepared. Kate was surprised that Mitch hadn’t laid chocolates on her pillow, he was being so effusive in his care. So far Kate wasn’t seeing any signs of shortness of breath or chest pain. She rolled her eyes, hoping no one had seen her do so. She’d been lied to about this admission! There was no way this woman needed looking after in the intensive care unit.

“Perhaps before you settle onto the bed, Ms. Jones, we can weigh you and get you into one of our hospital gowns,” Kate suggested with a friendly but firm tone.

“It’s
Cartwright
-
Jones. And that won’t be necessary. I weigh fifty-two kilograms. I weighed myself just this morning. And a gown won’t be required. Hugh will bring me one of my own nightshirts from home later this evening. When he
eventually
gets here.”

She waved her hands in the air and flicked her bottle blonde hair back as she spoke. Kate caught a glimpse of bright red polish. Penelope’s voice suggested she’d spent years in a European finishing school yet there was also something about it that didn’t quite ring true. It was as though she were playing a part in a high school theater production. Everything about her was just a little bit over the top.

Kate raised her eyebrows. She had no idea how to respond. Still wondering what this woman was doing in her unit, Kate continued trying to make her assessment. The orderly left, pushing the wheelchair, and Kate caught the wink he shared with Mitch. Clearly she was being left out of the loop again. Was this another test to see how she’d cope?

Penelope allowed Kate to take her blood pressure – which was normal, and her temperature – also normal. She then inquired what time dinner would be arriving. Kate was totally perplexed. Next thing she expected Penelope would be ordering a bottle of red wine with her dinner.

Leaving Penelope with Mitch, Kate stalked off in search of the doctor on duty, hoping Mitch would take a proper history from the patient. Kate found the doctor in the lounge. She knocked on the open door and then leaned against the doorway, waiting for Pippa to look up from her computer.

Philippa Tierney, or, as she’d told Kate, “Please call me Pippa,” was one of the newer doctors and Kate wasn’t sure why, but she sometimes felt intimidated by her. It didn’t help that she was stunningly gorgeous and somehow always managed to look like she’d just stepped out of the pages of an R.M. Williams catalog. Today her floral Liberty print shirt perfectly matched her sleeveless pink puffer jacket and the navy pants she wore hugged long slim legs. The obligatory pearls were in each earlobe and Kate had no doubt they were real. Pippa was a long-time local, and had only recently returned to Birrangulla as part of the government’s push to see more doctors take on positions in regional and rural parts of the country. Kate wondered what her story was. She’d have to ask Joel – they were about the same age and would probably know each other.

“Hey Pippa. We’ve got a patient here by the name of Penelope Cartwright-Jones. Admitted from ED with shortness of breath or maybe chest pain. Details are pretty sketchy. She looks completely normal to me. Can you come and assess her for me please?”

“Penny Jones, eh?” Pippa said the name as though it tasted bitter in her mouth. “The mayor’s
partner
.” Pippa emphasized the word sarcastically. She tucked a strand of blonde hair behind her ear and fidgeted in her seat. “They’re not even married, and she’s taken his name and made hers double-barreled, as though she’s someone important.”

“You know her?”

“No, not personally, but we’re the same age. You’ll see her photo in every edition of the local newspaper. She’s at the opening of an envelope. The mayor is over twice her age – parades her around like a trophy. She’s usually draped all over him, covered in leopard spots or zebra stripes. It’s quite sad because his wife Sandra and children still live in town and you won’t meet nicer people. His wife is one of Mum’s best friends.”

Pippa must have seen Kate’s expression or sensed what she was thinking.

“Sorry. That was very judgmental of me. They used to attend the same church as our family until he had some sort of mid-life crisis and left his family after having an affair with a woman half his age. It really rocked the church and people didn’t know whose side to choose. Sandra and the kids stayed for a while but couldn’t cope with the gossip so they ended up leaving too. Penny is a piece of work, that’s for sure.”

“Oh. That’s awful.” Kate wasn’t sure what else to say.

Pippa just rolled her eyes and shrugged her shoulders before heading off to see the patient.

Back in the room, Penelope had moved from the bed and taken a seat in one of the recliner chairs, sitting up as though she were in a hotel. Her afternoon tea of dry crackers and cheese was on the table in front of her. Pippa squatted beside Penelope’s chair, trying to convince her to allow Kate to withdraw some blood to be sent for testing.

“I will wait until Hugh gets here, thank you very much,” Penelope spoke politely although with a defiance that surprised Kate.

“Would you at least allow me to do an ECG?” Kate asked. “Just routine of course,” she assured Penelope.

“No thank you,” Penelope replied, as if there was an option.

Pippa shook her head at Kate. “Don’t even bother.” It was clear she was equally perplexed.

Hugh Cartwright arrived around an hour later. Kate was surprised at how old he looked. He was neatly dressed, as befitting a local mayor Kate supposed, but looked more like Penelope’s father than partner. He was lugging a large brown Louis Vuitton suitcase behind him, and in his other hand, a matching overnight bag. Kate suspected they were probably the real thing. The zippers were straining on both bags.
How long does she think she’s staying?
 He was dressed in casual navy blue pants and a pale pink polo shirt that was at least one size too small for his portly figure, and Kate had to stifle a giggle at the bulge of his man-boobs. Draped over his arm was a camel-colored woolen coat.

“Hello. Mr. Cartwright I assume?” Kate greeted him politely. “My name is Kate Kennedy. I’m the unit manager here.”

“Hugh Cartwright.” His voice had a commanding tone to it as he set one of the bags down to pump Kate’s offered hand. Kate had to stop herself from wiping her hand on the front of her pants. His was damp with perspiration. “I’m here to see my partner.”

“Mr. Cartwright, as you know, Penelope
is
here, but can you tell me why you brought her into hospital today? You were out at lunch, is that right? And she became short of breath? Did she have any chest pain?” Kate asked each question with a small pause, allowing him time to process what she was asking and answer her questions.

He eventually cleared his throat. Kate expected to hear him speak in the same imposing authoritative voice he had just used to greet her and was surprised when the words he spoke came out softly. He glanced around and Kate recognized the look of fear in his eyes. He was worried someone would eavesdrop.

“We had a small disagreement over lunch, you see. Penelope becomes quite, um, how shall I say, slightly argumentative and a little aggressive toward me at times. I could tell she was getting all worked up over something someone said at lunch and well, er, sometimes it’s best if she just comes into hospital for a few days when she gets like this. She’s on medication you see and, um, sometimes she forgets to take it so we have to get it sorted out again.” He looked furtively around him again and was unable to meet Kate’s gaze.

The picture was getting a little clearer so Kate pushed for more information. “Does she have a mental illness?” She tilted her head to the side while she looked at him.

Surreptitiously Hugh Cartwright looked around again to ensure no one had overheard her question before he replied, “Yes. She’s bipolar. But we can’t let anyone in the community know. She has a high public profile, you see. So I bring her in here and get her tablets changed from time to time when we need to. It only takes a couple of days to get it all sorted out and then she goes home again.”