Life Support: Escape to the Country (4 page)

“Oh, love.”

“I was so angry because I’d confronted him only six months earlier. We were talking about starting a family – well, I was at least – and he didn’t seem that excited about being a dad. When I asked him why, he hesitated. Wouldn’t give me an answer. So I asked him then if there was someone else. He denied it and I believed him. I took his word for it. I assumed he just wasn’t ready to have kids yet.”

“And you never suspected anything?” Lorraine asked gently.

Emma shrugged. She honestly had no idea, which meant she was either blind or stupid. “He was always busy with work. At least that’s what he told me.”

“What did Mary-Margaret and Winston say?”

“They don’t know.”

She heard her mum’s sharp intake of breath. “What? When are you going to tell them?”

Emma lifted one shoulder and sighed in exasperation. “Who knows. Lleyton is the master when it comes to keeping secrets. That’s why we’re still living in the house together.”

“So you don’t think his parents know any of this?”

Emma laughed, but the sound caught in the back of her throat. “There’s lots of things Lleyton’s parents don’t know.” It felt nice finally having someone to talk to, but she wasn’t going to divulge
all
of Lleyton’s secrets, even to her mum.

“You know you can always come home.”

Emma leaned forward, picked up the bowl and took another spoonful of near-melted ice cream. Now she remembered why she hadn’t wanted to have this conversation. “I know Mum, thank you, but I can’t. My life is in Melbourne now.”

When Lleyton had come along and swept her off her feet, she’d clung to him like moss to a tree. Lleyton, with his handsome looks, money, family connections and imminent medical degree, had distracted her from Tom and the country town life that had begun to stifle her. Becoming a Chirnside had exposed Emma to a whole new world and all too soon she found herself spinning like a mouse in a wheel, unable to escape. Now she was further trapped, and escaping back to the country, as much as it sounded ideal at that moment, wasn’t going to happen. Besides, she was a city girl now.

“So what are you going to do?”

She sighed. “Avoid him. You know how big this house is. We can both live here and never see one another.”

They employed a gardener, though they rarely used the backyard, someone to clean the pool once a week, though no one ever swam in it, and a cleaner, though the house was always spotless because they were rarely home.

“Who asked for the divorce?”

“I did.”

“You’ll need a good lawyer.”

“Probably.”

“I’m serious, Emma. Get yourself a lawyer or you could end up with nothing.”

“I could also end up with everything.” Emma paused and stared out the window into the blackness of the backyard as realization struck. “I could get my life back and start again,” she murmured more to herself than her mum.

“I hope he doesn’t try to do the dirty on you and leave you with nothing.”

“He won’t. Deep down, Lleyton isn’t a bad man.”

And Emma truly believed that. Lleyton was trapped. He’d spent his entire life keeping up appearances, and now he had a massive secret to keep. A secret which could see him disowned by his parents and cut off from his allowance and inheritance if they found out. A secret she was not about to divulge to her mum. Or anyone for that matter. Lleyton would have to play this one out very carefully. And so would she.

“Where is he now?” Lorraine asked.

“I have absolutely no idea.”

“I’m going to need some help here.”

Emma’s pulse quickened and her heart punched against her chest wall. If Helen Patterson was calling for help, it
must
be serious. With over twenty years’ experience working triage, Helen was the most capable nurse Emma knew.

Another nurse, balancing a bedpan in one hand and a bag of intravenous fluids in the other, rushed past, scowling. “Is it a full moon?”

Emma rolled her eyes and tucked a strand of hair behind one ear. “Do you even need to ask?” Driving to work earlier that night, the large super moon had glowed orange, low on the horizon.

It was a few minutes after midnight, and since the start of her shift, the revolving doors hadn’t stopped spinning as patients poured in. Emma refused to be convinced that research said the effects of a full moon on emergency departments was a myth. Except for an unexpected birth, tonight had been one with the lot – accidents, injuries, assaults, self-harm attempts, overdoses. Almost every cubicle in the department was full and the waiting room was overflowing with people and noise.

If the past three hours were any indication, they were in for a long and hectic shift, but Emma didn’t care. The busy night was keeping her mind off her own troubles. It was her first shift back after her two-week break and she was thanking the roster gods. While she adored her job, she was glad she wasn’t working at triage or in one of the busy resuscitation bays. She had so much going on in her head she was having difficulty concentrating.

“Emma.”

With her ebony-dyed hair, tattoos, gruff tone and surly looks, Emma had learned from experience that Helen wasn’t nicknamed “Hell” for no reason. She’d also learned Helen’s bark was big but her bite was little more than a scratch. Still, Emma jumped.

“What do you need?”

Helen pointed to a middle-aged man stumbling and weaving his way between the conga lines of people waiting for triage. Ghostly gray, his marble-like skin had a waxy glow about it. Sweat trailed down his wrinkled face and his dazed eyes slowly regarded everyone in the room as if he was trying to work out where he was. If it wasn’t such a cliché, Emma would have described him as a dead man walking.

His eyes flicked up and met Helen and Emma’s gaze through the thick glass window. “Is this the emergency department?” Every breath took an effort.

Helen nodded, pointed toward the closed doors and pressed a button to release the automatic doors.

“Go Emma. Get him.” Helen turned her attention to the next person in line.

Emma’s pulse raced at a staccato beat. Grabbing a wheelchair, she sprinted toward the man. She barely noticed the noise, the smells, the sounds of the waiting room. Barely noticed the way people stopped talking to watch the unfolding scene. Barely noticed the way the man staggered and swayed. Curling her fingers around his fleshy forearm, she captured his attention, indicating the wheelchair. A whoosh of air escaped his pursed lips as he flopped into it like a marionette with severed strings. Emma pushed him through the open doors and straight into the last remaining empty cubicle. Where was everyone? At the very moment she needed help, the department appeared to have entirely emptied itself of staff.

She touched his shoulder as she wheeled him to an available cubicle. “I’m Emma, one of the nurses. What’s your name?”

“Jeff,” he said, panting as if he’d run a hundred-meter sprint, which she doubted he’d ever done in his life, judging by the look of him.

“I need to assess you, Jeff. Do you think you can get up onto this bed?” Emma patted the starched white sheet on the narrow bed.

Jeff huffed and puffed his way out of the wheelchair. Could he move any slower? Emma yanked the curtain closed and tamped down her impatience. Did he not comprehend how sick he was? Maybe his brain wasn’t getting enough oxygen. She indicated the bed again.

He shot her a suspicious look before bending to remove his shoes. By the time he’d unlaced them and placed them side by side next to the chair, Emma’s frustration had gone up another few notches. Evidently, Jeff’s priorities were different from her own. It took him two complete 360-degree turns and four attempts to get his bum properly onto the bed. She clenched her fists at her side and struggled to stop herself from telling him to hurry up. Every second was a delay in her valuable assessment time. In the end, she couldn’t help herself.

“Jeff, I need to get your clothes off
now.
”

Unmoved by the urgency in her tone, or ignoring it – she couldn’t tell which – he slowly removed his jumper. He started to fold it before Emma yanked it from his hands and threw it under the bed. He clearly didn’t comprehend how unwell he was. Puffy fingers fumbled at the buttons on his shirt and at that point Emma couldn’t wait any longer. He looked as if he was about to pass out. Or die. Neither of which was going to happen on
her
shift.

She yanked his shirt up and over his head, gently pushed him by the shoulders until he was lying back against the pillow and attached ECG dots to his clammy chest, arms and legs.

Cath Reid stuck her head around the curtain. “Do you need help?”

Emma looked up at her colleague. Cath towered above everyone, even most of the men. Known for her blunt and bossy approach, she was the perfect nurse to have around when a patient was misbehaving.

“Perfect timing. While I hook him up to the monitor and finish doing the ECG, can you check his BP and sats please?”

Cath glanced at Jeff and her frown deepened. “He looks like he’s about to crash.” Her movements hurried, she wrapped a blood pressure cuff around Jeff’s upper arm and attached an oxygen saturation probe to his finger.

Emma shot questions at him, trying to gain vital information about his medical history. He met every question with the same answer. “You’ll have to ask my wife.”

“Sats seventy-eight percent on room air. Heart rate fifty.” Cath felt for Jeff’s pulse with one hand while with the other she grabbed an oxygen mask out of a box on the wall. “Pulse is thready.”

“Blood pressure?”

“One-ninety-five on seventy.”

Cath attached the oxygen tubing to the nipple on the wall and slipped the mask over Jeff’s face. Shoving her stethoscope in her ears, she listened to Jeff’s chest, her face serious. She glanced at Emma. “Decreased air entry. Widespread crackles to the bases.”

“You think APO?” Emma asked.

Yanking her stethoscope from her ears and wrapping it back around her neck, Cath nodded and pulled a face. “I’d say so.”

Acute Pulmonary Oedema.
Not good. Emma wiped sweaty palms down the front of her scrubs as she stared at the green lines tracing across the screen on the ECG machine.

“Hold still Jeff,” she instructed.

Seconds later she stabbed at the button on the machine and waited for it to spew out the printed page. She stared at it for a second then sucked in her breath before handing it to Cath. Cath’s eyes widened. Neither nurse needed a cardiologist to interpret the squiggles running across the red graph paper. The waveform wasn’t called a “tombstone” for no reason. As well as potentially having APO, it looked like Jeff was having a STEMI – an ST-elevation myocardial infarct – a heart attack – right in front of their eyes.

Cath snatched the ECG from Emma’s hands and tore off to find a doctor. Emma dragged an IV trolley into the cubicle. Wrapping a tourniquet around Jeff’s upper arm, she pulled it tight with shaky hands.

“I’m going to take some blood and put a drip in,” she said.

Laying out her equipment on a plastic sheet, she prayed for a vein to pop up. She swabbed Jeff’s arm with alcohol solution and waited for it to air dry before sliding the large bore cannula straight into the cubital fossa vein. She let out a quiet sigh of relief that she had hit the vein on her first attempt. She drew off a set of bloods for pathology before attaching a bung to the end of the needle and flushing it with normal saline.

“Do you have any pain in your chest?”

He squeezed his right hand into a balled fist and touched his sternum. “No pain, but it feels like someone’s sitting right here and it’s hard to breathe.”

Emma’s own breathing and pulse quickened.

Jeff was still a pasty color and becoming drowsier. His oxygen saturation levels were dropping despite the oxygen he was receiving. Emma turned the flow up as high as it would go. She checked the time on the wall. Although it felt like ages, Jeff had been in the department for less than ten minutes. He needed aspirin, GTN, morphine. And she needed a doctor. Now.

Bridget Russell burst into the cubicle, eyes flashing. She shot Emma a questioning look. “Who have we got here?”

Emma told the doctor what she knew. Which was practically nothing. “I thought he was going to be trouble the minute Helen called for help.”

“I’ve seen worse,” Bridget said with a grin.

Emma chuckled. “I suppose that’s meant to be reassuring, but it’s not.”

Bridget laughed in return. “He actually looks like sh—”

Jeff grimaced, took a deep breath, closed his eyes and lay back on the bed.

Unconscious.

Emma and Bridget exchanged a look of disbelief.

Bridget swore. “I’ll go get the defib.”

Fear crawled up Emma’s spine but she shook it off and went straight into action.
A, B, C,
she reminded herself. Airway, breathing, circulation. She began her checks. Jeff’s airway was clear. Tick. She bent closer, looked and listened, but she couldn’t tell if he was still breathing. Dammit. She smacked the emergency buzzer on the wall to alert more staff to come and assist. She was laying the head of the bed down ready to start CPR when Bridget returned with the trolley and defibrillator. Emma ripped open the packages and positioned the defibrillation pads on Jeff’s chest, breathing a thankful sigh he had no chest hairs and the pads stuck properly.

They stared at the machine as the waveform finally traced across the screen.

VT.
Ventricular Tachycardia.
Wide and shockable.

“Charge it,” Bridget said.

With shaking hands, Emma pressed a button. “Stand clear.” she shouted.

The machine delivered the defibrillation joules, causing Jeff to arch his back and lift his head before his body thumped back onto the bed, limbs bouncing in an uncoordinated way. Within seconds, he was conscious. He sat bolt upright and stared at them, his eyes wild and glazed, like a crazed animal. He clearly had no idea where he was or what had happened.

Bridget’s eyes sparkled. “Well that was fun.”

Emma didn’t say anything because the truth was, she didn’t share Bridget’s sentiment. Emma had four years’ experience in ED, but was embarrassed to admit she had yet to perform CPR on a real patient. And she did not want tonight to be the first time.

“I’ll go and let the in-charge doc know,” Bridget said. Without waiting for an answer, she bounced down the corridor, her ponytail swinging.

“I didn’t see that coming.” Cath said.

“Me either,” Emma replied. “And I can’t believe Bridge thought that was fun.”

Jeff didn’t see the humor in it either. He let out a soft grunt and projectile vomited. Both nurses jumped back in time. Emma gagged.

“I’ll grab towels,” Cath said, sprinting off.

Growling, Jeff pulled at the ECG leads on his chest. Yanking on gloves, Emma tried to restrain him. For an unwell man, he was incredibly strong. He grabbed at the mask hanging loosely around his neck and pulled tight. The elastic stretched before he released the mask and it slapped with a thwack back against his neck. He then yanked at the plastic tube until it disconnected from the wall. Oxygen hissed like a rattlesnake. Emma reached behind the bed to reconnect the tubing as Jeff went straight for the IV cannula in his arm.

“No.” she wailed, launching herself across the bed at him. It was too late. He pulled it out in one swift movement.

Blood dripped, splattering everywhere and mixing with the vomit on the floor. Emma leaned over and pressed against the bleeding IV site with two gloved fingers. Jeff thrashed around on the bed. “I need a hand in here,” she cried out.

Two more nurses appeared immediately, followed by an orderly a moment later, then Cath with an armload of towels. It took five of them to hold Jeff down. He was breathing hard, but at least he was still conscious.

“Where’s Bridge now?” Cath asked with a grin. “She’s missing all the fun.”

Eventually he settled and while he lay quietly with his eyes closed, Emma and Cath cleaned up the blood and vomit and washed his sweat-covered body. They re-attached the ECG monitoring leads and Cath inserted another IV bung in the opposite arm. His oxygen levels remained low and a new mask was slid over his mouth and nose.

“Nothing like a bit of night duty drama,” Cath said, fifteen minutes later.

Emma yanked off her gloves and tossed them in the trash. She went to the sink and scrubbed her hands and arms. “I am totally
over
drama.”

Cath chuckled. “Then you’ve picked the wrong place to work.”

Cath was right. Emma rolled her shoulders forward and backward in an attempt to relieve the tension. The stress of the last few months had caused a chronic pain in her neck. A wave of dizziness hit her and she had to place her hand on the wall to steady herself.

“You okay?” Cath asked, tilting her head to one side. “You haven’t been your usual chirpy self lately.”

“I’m fine.” She wasn’t, but she and Cath weren’t close friends, and Emma wasn’t one to talk about her personal life with her colleagues.

“Maybe you need to take time off. Take a mental health day.”

“I’ve just had two weeks off,” Emma said. “Tonight’s my first shift back.”

“What happened?” Jeff asked. It was the first time he’d spoken.

Emma was grateful for the interruption. “You had a heart attack and we had to shock you to get your heart started again.”

“I thought I must have fainted. Everything went black.”

Emma shook her head. “No, you didn’t faint. You were unconscious because your heart stopped beating properly.”

Jeff went quiet, taking this in. “I wondered why I wasn’t feeling very well.”