moved into action. She went to the woman’s hips and slid her hands underneath in a gesture that told Joss she’d done this many times before. Then she glanced at Joss, and her glance said she was expecting matching professionalism. ‘Lift with me. One, two, three…’
They moved as one and the woman slid limply onto the stretcher.
‘OK, fit the wheels to the base,’ the girl ordered of the two old men standing at the van door. ‘Lock it into place and then slide it forward.’
In one swift movement it was done. The stretcher was on its wheels and the girl was out of the van.
‘Take care of the dog, Lionel,’ she told an old man standing nearby, and Joss blinked in astonishment. The top triage nurses in city casualty departments couldn’t have handled things any better-and to even notice the dog… He opened his mouth to tell Bertram things were OK, but someone was handing towels to the man called Lionel, the old man was clicking his fingers and someone else was bringing a biscuit.
Bertram was in doggy heaven. Joss could concentrate on the woman.
‘This way,’ Amy was saying, and the stretcher started moving. Doors opened magically before her. The old men beside the stretcher pushed it with a nimbleness which would have been admirable in men half their age, and Joss was left to follow.
Where was he? As soon as the door opened, the impression of a bustling hospital ended. Here was a vast living room, fabulously sited with three-sixty-degree views of the sea. Clusters of leather settees were dotted with squashy cushions, shelves were crammed with books, someone was building a kite that was the size of a small room, there were rich Persian carpets…
There were old people.
‘Do we know who she is?’ Amy asked, and Joss hauled his attention back where it was needed.
‘No. There was nothing on her-or nothing that we could find. Sergeant Packer’s called in the plates-he should be able to get identification from the licence plates of the truck she was driving-but he hasn’t heard back yet.’
She nodded. She was stopping for nothing, pushing doors wide, ushering the stretcher down a wide corridor to open a final door…
‘This is our procedures room,’ she told Joss as she stood aside to let them past. ‘It’s the best we can do.’
Joss stopped in amazement.
When the police sergeant had told him the only place available was the nursing home he’d felt ill. To treat this woman without facilities seemed impossible.
But here… The room was set up as a small theatre. Scrupulously clean, it was gleaming with stainless-steel fittings and overhead lights. It was perfect for minor surgery, he realised, and his breath came out in a rush of relief. What lay before him started looking just faintly possible.
‘What-?’
But she was ahead of him. ‘Are you really a doctor?’ she asked, and he nodded, still stunned.
‘Yes. I’m a surgeon at Sydney Central.’ But he was focussed solely on the pregnant woman, checking her pupils and frowning. There didn’t seem a reason for her to be so deeply unconscious.
He wanted X-rays.
He needed to check the baby first, he thought. He had two patients-not one.
‘You can scrub through here.’ Amy’s face had mirrored his concern and she’d followed his gaze as he’d watched the last contraction ripple though her swollen abdomen. ‘Or…do you want an X-ray first?’
‘I have to check the baby.’ She was right. He needed to scrub before he did an internal examination.
‘I’ll check the heartbeat. The sink’s through here. Marie will help.’
A bright little lady about four feet high and about a hundred years old appeared at his elbow.
‘This way, Doctor.’
He was led to the sink by his elderly helper-who wasn’t acting elderly at all.
There was no time for questions. Joss was holding his scrubbed hands for Marie to slip on his gloves when Amy called him back.
‘We’re in trouble,’ she said briefly, and her face was puckered in concern. She’d cut away the woman’s smock. ‘Hold the stethoscope here, Marie.’ Then, with Marie holding the stethoscope in position over the swollen belly, she held the earpieces for Joss to listen.
His face set in grim lines as he heard what she’d heard. ‘Hell.’ The baby’s heartbeat was faltering. He did a fast examination. The baby’s head was engaged but she’d hardly dilated at all. A forceps delivery was still impossible. Which meant…
A Caesarean.
A Caesarean here?
‘We don’t have identification,’ Amy was saying. ‘Will you…?’
That was the least of their worries, he thought. Operating without consent was a legal minefield, but in an emergency like this he had no choice.
‘Of course I will. But-’
‘We have drugs and equipment for general anaesthetic,’ she finished, moving right on, efficient and entirely professional in her apology. ‘The Bowra doctor does minor surgery here, but I’m afraid epidural is out of the question. I…I don’t have the skills.’
After that one last revealing falter her eyes met his and held firm. They were cool, calm, and once again he thought that she was one in a million in a crisis.
‘What’s your training?’ he started, hesitating at the thought of how impossible it would be to act as anaesthetist and surgeon at the same time-but she was before him there, too.
‘Don’t get the wrong idea. I’m not a doctor,’ she said flatly. ‘I’m a nurse. But I’m qualified in intensive care and I spent years as a theatre nurse. With only one doctor in the district, I’ve performed an emergency general anaesthetic before. That’s why we have the drugs. For emergencies. So if you guide me, I’m prepared to try.’
He stared at her, dumbfounded by her acceptance of such a demand. She was a nurse, offering to do what was a specialist job. This was a specialist job for a qualified doctor!
But she’d said that she could do it. Should he trust her? Or not?
He hardly had a choice. He’d done a brief visual examination on the way here. The baby was still some way away-the head wasn’t near to crowning-and now the baby’s heartbeat was telling its own grim story. If they waited, the baby risked death.
He couldn’t do a Caesarean without an anaesthetic. The woman was unconscious but the shock of an incision would probably wake her.
He needed a doctor to do the anaesthetic, but for him to perform the Caesarean and give the anaesthetic at the same time was impossible.
Amy wasn’t a doctor. And she was offering to do what needed years of medical training.
But… ‘I can do this,’ she said, and her grey eyes were fearless.
He met her gaze and held it.
‘You’re sure?’
‘Yes.’
‘You realise insurance…’
‘Insurance-or the lack of it-is a nightmare for both of us.’ She nodded, a decisive little movement of her head as though she was convincing herself. ‘But I don’t see that we can let that worry us. If we don’t try, the baby dies.’
It went against everything he’d ever been taught. To let a nurse give an anaesthetic…
But she was right. There was no decision to be made.
‘OK. Let’s move.’
It was the strangest operation he’d ever performed. He had a full theatre staff, but the only two under eighty years old were Amy and himself.
Marie stayed on. The old lady had scrubbed and gowned and was handing him implements as needed. Her background wasn’t explained but it was assumed she knew what she was doing, and she handled the surgical tray with the precision of an expert.
