LITMIR.BIZ

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be there in a minute. I’ll have a quick look at her usual medications first.’

      ‘My, you’re eager for work this morning. How strange,’ she said over her shoulder as she walked away. ‘I’ll go and put the coffee-jug on as no one needs me.’

      What was wrong with Julia? She wasn’t usually this moody. Theo frowned at her back and flicked through the patient’s notes.

      Elsie Reddy. Last admission a month ago, also for breathlessness.

      She’d been given home oxygen, a Ventolin nebuliser, fluid tablets, potassium supplement to replace what the fluid tablet took out, digoxin for heart rhythm, quinine for leg cramps—all the usuals.

      He particularly remembered that she had bad veins for getting blood. But it was time for a look. He walked onto the ward.

      ‘Good morning, Mrs Reddy. I’m Dr McWilliam.’

      ‘I know.’ Elsie Reddy’s face was pale except for two spots of unhealthy colour in her cheeks, but the soft wheezing voice still held a smile. ‘Big virile man like an out-of-work stuntman.’ She took a breath. ‘Got yourself a woman yet?’ She laboured to catch her breath again.

      Theo looked at Savannah who was standing by the old lady’s bed, and glared at the suppressed amusement he saw in her face. He looked back at the older woman. ‘How about you try to not talk and I’ll have a listen to your chest?’

      ‘When I’m not talking I’ll be dead,’ she said, but sank wearily back against the high pillows and closed her eyes.

      Savannah smiled at the old lady’s dry comment. ‘Mrs Reddy’s temperature isn’t elevated but it’s pretty cold outside this morning. Her respirations are thirty-two and blood pressure’s up.’

      ‘You think she’s got an infection?’ He raised his head and looked at Savannah. When she nodded her hair bounced. He frowned and concentrated. ‘I’ll put a line in, get some blood gas analysis from Pathology and we’ll start some Ventolin via nebuliser and maybe antibiotics later.’

      They both heard the sound of another ambulance pulling up outside.

      Savannah tilted her head. ‘Leave me a quick written order and I’ll put the cannula in and get a Ventolin nebuliser going while you see to that one.’

      Theo raised his eyebrows. ‘You’ll put the cannula in? The winds of change are obviously blowing.’ He shrugged. ‘But that’ll certainly make my job easier.’ He scribbled on the notes, patted Mrs Reddy’s arm and left.

      Savannah smiled at the old lady. ‘Did you catch all that?’

      ‘Most of it.’

      ‘I’ll pop a drip in this arm, take some blood, then we’ll put something into the bag of fluid to help your lungs work better.’

      ‘My veins are bad.’ The memories of past jabs shone in wary eyes.

      Savannah lifted the frail arm and ran her fingers lightly over the papery skin. ‘Yours look better than the veins they’ve been showing me in the city lately.’

      Five minutes later, Theo poked his head around the curtain. Savannah was cleaning up after completing the tasks quickly and competently.

      He nodded. ‘I’m impressed. Can I borrow you?’

      She barely glanced at him. ‘Sure, but check these ampoules first, please, and I’ll start this infusion.’

      ‘Bossy little thing, aren’t you?’ She certainly hadn’t been bossy fifteen years ago and Theo wasn’t quite sure he appreciated her lack of deference now!

      She raised her own eyebrows and this time met his eyes. ‘You have no idea.’

      Savannah turned back to her patient and lifted the mask over Elsie’s face, then slid the nurse-call button into her hand. ‘Ring me if you’re worried, but you should start to feel better soon. I’ll be back as quick as I can.’

      Theo watched her gentleness with the old lady and forgave her assertiveness. He sighed. He’d probably have to get used to it.

      The sound of another ambulance, this one with the siren wailing, made Savannah and Theo look at each other. ‘The all-or-nothing law of country hospitals,’ he said with resignation. They moved towards the entrance.

      Savannah shrugged. ‘Well, the city ones don’t have a quiet time except maybe at four o’clock on a Sunday morning—so we’ll manage.’

      The new patient had all their attention after one glance.

      The ambulance officer passed the history over quickly. ‘Mr Grey was found almost unconscious under his house. He’d been doing some dusting for fleas.’

      The white-haired man on the stretcher was pale and saturated with sweat. His nose was running and his chest gurgled with fluid. Savannah felt the leap in her own pulse rate at the sight of the gravely ill man.

      His clothes were covered with a fine powder and he lay limp on the trolley except for the twitches he had no control over.

      ‘Wear some gloves and get his clothes off. Looks like organophosphate poisoning.’

      Savannah did a double-take. This was a different Theo. This doctor was fast, sure and determined to keep his patient alive until the intravenous line he’d quickly inserted could be used to inject the atropine he was drawing up. They had a chance.

      Savannah snatched a pair of disposable gloves from the box and started to strip the shorts and T-shirt from the man.

      “It’s a parasympathetic nervous system reaction from the pesticides, isn’t it?’ she asked quietly.

      ‘Right. Not wearing full-length clothes wouldn’t help. The poison is absorbed through the lungs, gut and skin. So until you get his skin washed he’s still absorbing the poison into his system. All I can do is keep giving atropine, which has the opposite effect on the body. Hopefully it will override his nervous system response, which is to produce so much in the way of secretions he could drown in them.’

      The man was gasping for breath and Savannah could well believe Theo’s worst-case scenario. Savannah swiftly applied the cardiac leads and began to sponge the man’s body. Julia arrived to help and kept replacing the water dish and washers with fresh ones.

      ‘Pinpoint pupils and respirations are faster and shallower.’ Savannah dried him and pulled a warm blanket over his twitching body. Her voice was steady. ‘Blood pressure’s falling, he looks like he might fit.’

      Theo was calm but intense. ‘Pump the intravenous fluid into his veins—it’s hypovolaemic shock from the fluid shift. Pupils are beginning to dilate so the atropine is starting to take effect. He should improve soon. It’s usually quite dramatic. Looks like they got him here just in time.’ They both glanced at the monitors and nodded.

      ‘Vital signs are stabilising, and his twitching has decreased. Stop pumping the fluid in and we’ll just run it normally now.’ Savannah removed her hand from the manual pump bulb on the IV line and flexed her fingers.

      That had been close. Any doubts she’d had about Theo’s skill were gone.

      Theo was looking down at the patient when the man opened his eyes.

      ‘Hello, old son.’ He squeezed the man’s shoulder and Savannah blinked at the kindness in Theo’s eyes. ‘You gave us a scare for a while there. You should be on the mend now but we need to move you up to Intensive Care for at least seventy-two hours.’ He turned away to write up the notes on Mr Grey. ‘Speed his transfer to the unit, Sister. I’ll go out and see his wife.’

      Two broken legs, a toddler with a temperature and a teenage boy’s three-day-old burn that needed redressing saw them through to morning tea.

      Theo was off home at ten, Mrs Reddy and the two orthopaedic patients had been transferred to the wards and the toddler sent home with a script.

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