stethoscope and doing a fast visual assessment. Marilyn looked ashen, and there was no movement. Her eyes were wide and she was staring straight upward, seeing nothing.
‘How long?’ she snapped, and the male nurse fought to answer.
‘Four…five minutes. Leonie was watching her but she went to the bathroom. I was on supper break. I just stepped out.’
‘History of heart condition?’
‘Yes. Two…two minor heart attacks and angina. Heart pain tonight.’
Why the hell wasn’t the monitor attached, then? ‘Get that monitor working-fast.’ She glanced around the room. It was tiny-Tambrine Creek’s answer to Intensive Care was a far cry from a big city hospital’s set-up-but there was everything she needed.
But first…
‘Marilyn,’ she said strongly, taking the older woman’s shoulders and giving her an urgent shake. ‘Marilyn, can you hear me?’ It was a remote hope that this was a temporary loss of consciousness that she could snap out of, but patients had woken before, and Marilyn wouldn’t thank her for broken ribs if this wasn’t a cardiac arrest.
There was no response.
Airway.
She rolled Marilyn onto her side, not waiting for one of the nurses to help her. The older nurse was actually wringing her hands. Of all the useless actions. But she didn’t have time to complain.
What she was doing now was almost intuitive, drilled into her over and over again. ABC. Airways. Breathing. Circulation.
Her mouth was clear. Her tongue wasn’t blocking her throat. Airway fine.
Breathing.
She put her hand on Marilyn’s breast. Her chest wasn’t moving.
‘Mask,’ she snapped, and held out a hand. Her other hand was searching for a pulse. Nothing. ‘Get that monitor hooked up fast.’
The younger nurse-his label said his name was Paul-was fighting to connect it. He at least seemed vaguely competent.
‘Mask,’ she snapped again, and the older nurse finally managed to turn to the trolley and fetch it. Ally still had to snatch the mask from her hands. She fitted it with lightning precision, inserting the Guedel airway with a speed learned from scores of practise sessions on dummies and a few more on the real thing.
She fitted the bag and squeezed, then stared down at Marilyn’s chest. Damn, she couldn’t see. Marilyn was wearing some sort of frilly nightgown.
She put her hand in the neckline and ripped the frills to the waist.
She pushed the bag again.
Marilyn’s chest heaved-and fell.
The airway was clear. That meant this really was heart and not obstruction caused by swallowing.
Ally started rolling her, but Paul was with her now, helping. ‘Monitor’s up,’ he told her, and Ally’s eyes flicked to the cabinet where the tiny screen was located.
The line wasn’t absolutely straight. It was a faint vibration, hardly going above the horizontal, but it was definitely moving.
Ventricular fibrillation.
‘We have a chance,’ she breathed. ‘Paul…’
He knew what to do. He was a competent nurse, Ally decided, just somehow thrown off course by what had been happening. His hands were already linked as she said his name, and before it was completely uttered he was starting the rhythmic thump of cardiac pulmonary resuscitation. She heard a crack and winced. A rib. No matter. It couldn’t be allowed to matter.
‘Breathe for me,’ she snapped to the other nurse.
‘But…you’re the masseuse,’ the woman floundered.
‘I’m a doctor. Take the bag, damn you.’ Then, as the nurse still didn’t respond, she reached over and slapped her. Not hard, but hard enough to wake her up out of the trance. ‘Move!’
The woman jolted into action. She didn’t have a choice. She took the bag and started the pushing that would keep oxygen entering Marilyn’s body.
Ally was fitting electrodes, working around Paul’s hands. Everything she needed was there, thank God. She grabbed the paddles and smeared them with jelly.
Right.
She lifted the paddles and placed them just off Marilyn’s chest.
‘Back,’ she ordered.
Paul lifted his hands clear and Ally let the paddles contact Marilyn’s bare skin.
Her body gave a convulsive heave.
All eyes went to the monitor.
Nothing.
Paul thumped again and the other nurse-Leonie?-went back to bagging air in. They were in rhythm now, doing what they were trained to do.
‘Back.’
The paddles moved into position again.
Another heave.
Nothing.
Again.
Again.
Still the heart monitor told them there was hope. It wasn’t the flat line of a completely dead heart. It was still ventricular fibrillation.
‘Again!’
Another heave.
The line moved.
Ally was scarcely breathing herself. This so seldom worked. But… The blue line on the monitor was jerking upward. Over and over. Rhythmically.
‘We have a beat,’ she whispered.
It was time to take a deep breath herself. How long since she’d breathed?
They weren’t out of the woods yet.
‘Get that oxygen up to maximum,’ she snapped as Paul started to speak. How long had the brain been starved?
Marilyn. She stared down at the elderly lady and here came the prayer that seemed to be with her all her working life. Please.
Please.
And, as if in answer, a visible shudder through the old lady’s body. Another. And then…
A rasping breath.
Dear God.
Marilyn was breathing in earnest now, her chest moving all by itself. It was the best sight. Her breathing sounded dreadful, a ragged rasping as if it was being torn from her body, but to Ally it was a fantastic sound.
And then the elderly lady’s eyes flickered open. They were pain-filled and confused. She attempted to shake her head, trying to rid herself of a mask she didn’t understand, gagging a little on the airway, but Ally took her hand and held it, lifting the airway clear but replacing the mask so the oxygen still flowed.
‘Marilyn, lie still. It’s Ally. You’ve had a heart attack. You’re OK, but you need to lie still.’
Marilyn’s eyes focussed. And then, unbelievably, she tried to smile. Her mouth moved beneath the mask.
‘Ally.’
‘It’s me.’ Then, as Marilyn’s face contorted in pain, Ally looked up at the nurses.
‘Get me five milligrams of morphine.’
Silence.
She looked up again and the nurses were glancing at each other in confusion.
