Intensive Care: Escape to the Country (18 page)

“Hutch?” He turned to her, shaking his head in mock dismay. “Ah, Miss City Chick, you’ve still got a lot to learn. Try calling it a chicken coop or a chicken run and you won’t sound like such a citiot! Hutches are for rabbits.”

Kate laughed at his good-natured teasing. “Whatever! Just don’t tell me the next animal I need is a rabbit!”

“No. You’re safe on that account,” Joel replied.

“Well thanks again. You’re a great friend.”

They stood at the door and everything within Kate wanted to reach up and plant another kiss on his cheek. She moved toward him to do so when she saw a fleeting shadow cross his eyes and it caused her to step back uncertainly. With a wave and a tired-looking smile, Joel shoved his hands into his pockets and walked out the door, closing it behind him and leaving her still completely baffled by his reactions to her.

Kate returned to work and was welcomed with a warmth she didn’t expect. In her office was a large indoor plant and a card that had been signed by all the staff. She was thrilled.

“Good morning everyone,” Kate greeted those sitting around the table ready for the morning handover.

Voices welcomed her pleasantly in return.

“Thank you to everyone who covered me while I was on sick leave. And also for the lovely plant. Hopefully it won’t end up in the ICU – I’m not known for my green thumb.” Kate laughed and several of the others joined in.

“We’re just glad you’re okay, Kate.” It was Amanda who spoke up first.

“It could have ended an entirely different way,” Stephanie added. “It can get bloody cold out there.”

“What were you thinking though, going out in the snow wearing jeans?” Laura asked, with her usual bluntness.

Before Kate had a chance to reply, Mitch spoke up. “It’s not like it was her fault, Laura,” he said, defending her. Kate remained silent. “I heard Joel O’Connor took her out and he didn’t tell her to wear snow gear.” Kate frowned and wondered what else Mitch had heard and from whom. She was once again reminded of what it was like to live in a place where everyone knew everyone else’s business.

“We hadn’t planned on being out as long as we were,” Kate explained, wondering if she was going to have to put any rumors to rest. “Until last week I’d never seen snow so Joel offered to take me out to build a snowman. I had no idea how wet it was and I didn’t realize how cold I’d become until it was too late.”

“Will you still be okay for the run?” Amanda asked.

“I don’t see why I wouldn’t be,” Kate replied. “It was only a very mild case of hypothermia. Anyway, how’s everyone else been going with their training?”

“Well I’m not sure many of us are aiming to do the whole twenty-one k like you are!” Mitch answered.

Kate laughed. “I’m not even sure I’ll make the distance yet, but I intend to try, even if I have to crawl over the finish line!” Kate glanced at the clock on the wall. Conscious of time, she turned to Stephanie.

“Sorry Stephanie, I’ll let you start handover. I know you’ll be wanting to get home.”

“It’s all good, mate,” Stephanie replied warmly, her almost black eyes twinkling. “We’re all just glad you’re okay.”

There was a murmur of agreement from the nurses gathered around the table and inside Kate’s heart leaped. Maybe she was beginning to be accepted at last.

“You’re obviously over your little misadventure,” Belinda said, later that morning, as she handed Kate the coffee she’d purchased.

Kate smiled, looking up at the taller woman. “Yes, I’m fine. I feel like such a fool though.”

“Oh don’t be silly,” Belinda said as she plonked herself into one of the chairs in Kate’s office. “You weren’t to know how cold it gets. Sometimes the snow just seems to come out of nowhere and even takes us locals by surprise. Anyway, how’s the training coming along? You’re still okay to do the fun run, aren’t you?” Belinda’s brows furrowed in concern as she leaned forward.

“Of course. It’s all good. I’m fine. I have no idea how I’m going to complete the whole distance, but I’m certainly going to try. I don’t want to let people down.”

“And the sponsorship? How’s that coming along?”

“Really well. I’ve got all my friends from the Royal Sydney ICU sponsoring me. They love the whole idea of a fun run raising money for the special care nursery. If they didn’t live so far away I think some of them would have registered as well.”

Belinda nodded. “That’s terrific, Kate. Anyway, how are you settling in here?”

“Here at work or Birrangulla?”

“Both.”

“It certainly hasn’t been as easy as I expected, but things are definitely improving.”

“You thought it was going to be easy being a unit manager?” Belinda scoffed.

“I don’t mean the job – I always knew it was going to be a steep learning curve taking on the position, but it’s more than that. It’s taken me a lot longer to feel accepted by everyone than I thought it would. I feel like I’m always going to be the new girl. The one from the city.”

“You’re lonely.”

Kate remembered how offended she had been when Joel suggested the same thing. This time she didn’t snap. “Yeah, I guess I am a bit.”

“Ah, it takes time, Kate. Living in the country is very different from living in the city. Everyone knows everyone else – most of them are usually related in some way. And when it’s a tight-knit community like it is here in Birrangulla, they’re just waiting to see if you’re going to stay and put down roots before they befriend you.”

“You sound like you speak from experience.”

“I do. Like you, I came from Sydney and moved to Birrangulla as the new city girl. That was fifteen years ago. As soon as I met you, I knew this job would be perfect for you. You remind me a bit of me when I was younger. My advice is to keep getting involved in the community like you’re already doing with the fun run. And remember, it takes time.”

It takes time. 
Kate wondered how many more times she was going to have to hear that same advice before it sank in.

“I realize it’s hard for people to accept someone new, especially someone from out of town. I get it that some people don’t like change. I’m someone new, and I brought change. I think a few people were threatened by me because they have this perception that city nurses are better than country nurses. And of course that is far from the truth,” Kate said.

“Well I’m hearing some good and positive reports coming out of the unit. There seems to be a shift in the atmosphere,” Belinda replied.

“Thanks. I’m glad to hear that, because I agree,” Kate said. “I guess they’ll eventually accept me when they realize I’m not going anywhere.”

“So, speaking of that – we haven’t really discussed your contract, Kate. I know we are well past the three-month probation period but I guess I just want to ask how you’re 
really 
doing. Do you see yourself staying in Birrangulla long term? Have you made any friends outside of work? You know – met anyone special?”

Kate felt herself blush, wondering what Belinda had heard. She figured everyone obviously knew all about her incident up on the mountain in the snow. Heck, they probably all knew Joel had undressed her and driven her naked to the hospital!

“I’ve met some lovely people and I have every intention of hanging around for a very long time,” she answered. That was as much as she was willing to say.

“I’m pleased to hear that, Kate. I think you’ll find there are some top people here. Especially a certain cute Irish barista.” Belinda winked at Kate. “You never know, you may find yourself living here for the rest of your life.”

“I think that would be pretty easy to cope with.” Kate smiled.

Especially if it involves a cute Irish barista.

*

Walking back into the unit one afternoon after lunch a few weeks later, Kate immediately sensed something was wrong. The tension was so high Kate felt as though she were sitting inside a circus tent watching a tightrope walker balance on a wire without anything to support him if he fell.

The crash cart stood near bed five and Kate groaned as she ran toward the cubicle. Meredith Jackman was in that bed. She was a forty-two-year-old mother of four young children with metastatic breast cancer. The cancer had been discovered only ten months earlier in her left breast when she was breastfeeding her youngest child. It had now spread like wildfire throughout her whole body. Despite a double mastectomy and multiple treatments with radiation and chemotherapy, her prognosis was grim, right from diagnosis. Each of the nurses who had cared for her over the past few days since her ICU admission had acknowledged to Kate that they knew her death was imminent. Unfortunately Meredith’s family were not ready to sign the “not for resuscitation” paperwork as they thought this meant they were giving up. Her family wanted to feel like they had done everything for her and given her every chance to recover.

They were doing everything in their power as nurses to keep Meredith alive, but they also knew it was futile. In the battle of dying there was often the dilemma of how much pain was worth it in the struggle to keep someone alive for just one more day or one moment longer. She had said all of this to Meredith’s husband Richard, explaining that they could delay her death, but only for a short time. On the other hand, they could make her comfortable, allow her family to gather around her and let them watch her peacefully slip away rather than die during the chaotic ordeal of any invasive resuscitation procedures. Kate had tried desperately and so far unsuccessfully to explain this to Richard and Meredith’s parents, but they were all unable to see the facts the way the nursing staff saw them. In some ways Kate couldn’t blame them and wondered if she would feel the same if the situation were reversed.

As Kate pulled the curtain aside she saw Ewan standing beside the bed performing chest compressions and her own heart plummeted to her feet. With the rise and fall of his arms Kate winced as she pictured each of Meredith’s frail, cancer-ridden ribs. Surely they must be breaking with each compression Ewan made. She watched him stand back as the pads were applied and the first shock was delivered.

“Still in VF,” Kate heard Laura call out. Ewan recommenced compressions.

“What’s the time, please?” Ewan called out, his face red from the exertion of doing CPR.

“Draw up the adrenaline,” Simon said calmly.

“Adrenaline. One milligram,” Laura answered. She handed the syringe of transparent fluid to Simon and he administered the dose into the line in Meredith’s chest.

“We need to shock her again.” Ewan sounded slightly breathless.

“Stand by everyone. All clear.” Simon’s voice, clearly in charge of the situation, could be heard. Kate saw him press the button on the defibrillator.

“We’ve got a rhythm,” Laura called out, sounding jubilant.

Meredith was conscious and breathing spontaneously again. Almost as quickly as it started, the emergency ended as a normal heart pattern smoothly slid across the monitors. Everyone breathed a collective sigh. Whether or not it was a sigh of relief, Kate wasn’t sure.

Kate looked around and realized that no one was looking at Meredith, the scared, dying woman. No one except her husband. He stood in the hallway, far enough away from the bed that he wasn’t in anyone’s way, but clearly he had been close enough to watch the whole scenario unfold. Kate wanted to close the curtains completely, to close off this scene that he was unwittingly being forced to watch. Right then he didn’t look scared or upset, he just looked sad and tired. She watched him for a brief moment and then looked around at the faces of the others in the room. There was no joy anywhere.

Kate remembered reading once that nurses sometimes forget that each body is made up of a soul and a brain; that each patient is a person with a past and a life lived. They forget to see the patient as someone’s mother, father, daughter or son, or simply as a valued, and valuable, human being. The pathology collector sees the patient in terms of how good their veins are. The pharmacist sees the body as a certain weight for proper drug dose calculation. The physiotherapist sees the person for their potential for rehabilitation. The doctors and nurses see the patient as someone to try to heal.

She looked down at Meredith Jackman in the bed and imagined her laughing as she ran down a beach, chasing her children into the waves. Kate pictured her sitting in her car waiting to collect them from school at the end of the day. Or pushing her shopping trolley around the supermarket, juggling her phone in one hand while she spoke to her boss at work. She was a woman who had lived life to the full, loving all those around her. She had walked in the rain with her sweetheart, eaten chocolate ice cream in waffle cones with her best friends, worried about putting on weight. She had stood beside her family and comforted them in their own times of need. She had probably had moments of being angry, scared and sad. She would have spent many hours in tears. She had given everything, but cancer had taken it all away. All her hopes and dreams quashed with one awful diagnosis.

Kate went to her side then and the eyes that looked up at her were scared. Recognizing Kate, Meredith groped for and found Kate’s hand and squeezed her fingers tightly with a strength that surprised her.

“I want to die, Kate. Please, please, let me go.” Meredith gripped Kate’s hand as though holding onto life itself for one last brief moment. Kate was unable to find the words to reply. “Where’s Rich?” Meredith’s voice was weak and Kate had to lean in close in order to hear her.

“I’ll get him for you,” she assured Meredith.

Time seemed to stop for everyone as Kate beckoned for Richard to come closer.

“I want to go home.”

Kate could barely hear Meredith, but Richard heard. With tears in his eyes, he moved silently closer toward his wife and squeezed her hand, nodding his head.

Looking up at the room full of people and equipment, he spoke clearly.

“No more.”

When he stared back at his wife, his face was drawn and pale. He closed his eyes in prayer and simply said, “God. Please help me.”

The confusion in the room slowly slid away as the pads were removed from Meredith’s chest and the resuscitation trolley was wheeled from the room. No one spoke as each person got on with their job of removing superfluous equipment from the room. Richard had made his decision. A decision made from a place of deepest love from one person to another.

Kate turned the monitors off and began to pull the sticky dots from Meredith’s pale, flat chest. Meredith frowned in obvious pain and Kate glanced at Simon but he had already seen the look and was administering the morphine that would ease her discomfort.

Richard hadn’t moved and Kate lowered the bed and directed him to sit on a chair at her side. Someone turned off the overhead fluorescent lights and within minutes the space was almost empty, the curtains drawn around the bed. The emergency was over and Meredith would finally be allowed to die now without any interference from them.