‘Sarah supplements her income by doing internet work,’ James put in. ‘She writes a medical advice column for a website, and one for a newspaper, too.’
How had he known that? She looked up at him in surprise, and his mouth made a wry shape. ‘I came across your advice column when I was browsing one day, and there was mention there of your work for the newspaper.’ He frowned. ‘I’m not sure it’s wise to make diagnoses without seeing the patient.’
‘That isn’t what I do, as I’m sure you’re aware if you’ve read my columns.’ Perhaps he was testing her, playing devil’s advocate, to see what kind of a doctor she really was, but she wasn’t going to let him get away with implying she might not be up to the job. Neither was she going to tell him about her personal circumstances and give him further reason for doubting her suitability for the post. She needed to work part time so that she could be there for Sam and Rosie whenever possible, and the writing had provided an excellent solution in that respect. Working from home was a good compromise.
‘I mostly work with a team of doctors,’ she said, ‘and we pick out letters from people who have conditions that would be of interest to a lot of others. We give the best advice we can in the circumstances, and point out other possible diagnoses and remedies.’
‘Hmm. You don’t think the best advice would be for your correspondents to go and see their own GP, or ask to see a specialist?’
‘I think a good many people have already done that and are still confused. Besides, patients are much better informed these days. They like to visit the doctor with some inkling of what his responses might be, or what treatment options might be available to them,’ she responded calmly.
He nodded. ‘I guess you could be right.’ He might have said more, but the red phone started to ring and he lifted the receiver without hesitation. He listened for a while and then said, ‘What’s the location? And his condition? Okay. We’re on our way.’
Food and coffee were abandoned as they hurried out to the helicopter. ‘A young man has been injured in a multiple-collision road-traffic accident,’ James told them. ‘He has a broken leg, but he’s some thirty miles away from here, and the paramedics on scene feel they need a doctor present. He needs to go to hospital as soon as possible.’
They were airborne within a minute or two, and soon Sarah was gazing down at lush green fields bordering a sparse network of ribbon-like roads. James sat next to her, commenting briefly on the landmarks they flew over.
‘There’s the hospital,’ he said, pointing out the helipad on top of the building. ‘We’ll be landing there when we have our patient secured.’
A little further on, they passed over a sprawling country estate, which had at its centre a large house built from grey, Cornish stone. It was an imposing, rectangular building, with lots of narrow, Georgian windows.
‘Your family’s place,’ Sarah mused. ‘Do you still live there?’ It was large enough for him to have the whole of the north wing to himself. That’s how things had been when she’d lived in the area, though he’d been away at medical school a good deal of the time, or working away at the hospital in Penzance. His younger brother had taken over the east wing, leaving the rest of the house to their parents.
He shook his head. ‘I have my own place now. It seemed for the best once I settled for working permanently in Truro. It’s closer to the hospital. Jonathan still lives on the estate, though he has a family of his own now. He has a boy and a girl.’
‘I wondered if he might stay on. He was always happy to live and work on the family farm, wasn’t he?’
James nodded. ‘So you decided to come back to your roots. What persuaded you to leave Devon? I have friends who worked there from time to time and, from what I heard on the grapevine, you were pretty much settled there. Rumour had it your mind was set on staying with the trauma unit.’
‘That’s pretty much the way it was to begin with … I was hoping I might get a permanent staff job but then I was passed over for promotion—a young male doctor pipped me at the post, and after that I started to look around for something else.’
He winced. ‘That must have hurt.’ He studied her briefly. ‘Knowing you, I guess his appointment must have made you restless. You wouldn’t have let the grass grow under your feet after that.’
‘No, I wouldn’t, that’s true.’ She wasn’t going to tell him about her situation—although it hadn’t been voiced at the time, she was fairly certain that she’d lost the promotion because of her family ties, and now she had to do everything she could to find secure, permanent work. This job promised all of that, but she was on three months’ probation to see how things worked out on both sides, and she didn’t need him to go looking for excuses to be rid of her before she signed a final contract.
By now they had reached their destination, and as the pilot came in to land, she could see the wreckage below. It looked as though a couple of motorcyclists had been involved in a collision with a saloon and a four-wheel-drive vehicle, and there were a number of casualties. A fire crew was in attendance, and from the blackened appearance of the saloon, it seemed that a blaze had erupted at some point. She could only hope the occupants of the car had escaped before the fire had taken hold.
‘You’ll be shadowing me,’ James said, unclipping his seat belt as the helicopter came to a standstill, ‘so don’t worry about getting involved with the other patients. We’ll take them in strict order of triage.’
Sarah bit her lip. She had no objection to following his lead and learning the ins and outs of this particular job, but surely she’d be of more use helping with the other victims of the crash?
‘Okay, whatever you say. Though I do feel I could be of help with the rest of the injured.’
He was already on his way to the door of the helicopter, his medical kit strapped to his back in readiness. ‘Let’s see how it goes, shall we? According to the paramedics, our primary patient is in a bad way. He needs to be our main concern right now.’
Sarah followed him to the side of the road where a paramedic was tending an injured youth. There were police vehicles nearby and a young officer was directing traffic while another was setting up a road block.
She knelt down beside the casualty. He couldn’t be much more than eighteen years old. He lay on the grass verge, well away from the traffic, and his face was white, blanched by shock and loss of blood. The paramedic was giving him oxygen through a mask.
‘There are two people suffering from whiplash and sprains,’ the paramedic told them. ‘They’re being looked after by my colleague, along with another man who has chest injuries—broken ribs and collarbone, from what we can tell so far. This lad is Daniel Henderson, motorcyclist. He and his friend were on their way to the coast when they ran into trouble. The two motor vehicles crashed at a road junction and the lads had no way of avoiding them.’
James was already assessing the extent of the boy’s injuries. ‘His lower leg’s grossly deformed,’ he said in a quiet voice. ‘It looks like a fracture of both the tibia and fibula. That degree of distortion has to be affecting the blood supply.’
The paramedic nodded. ‘He’s in severe pain, he’s very cold and his circulation is shutting down. We can’t give him pain relief because we can’t find a vein.’
It was a bad situation, because if there was an inadequate supply of blood to Daniel’s foot there was the possibility that gangrene would set in and he might lose his leg.
‘Thanks, Colin. I’ll do an intraosseous injection,’ James said, reaching into his medical bag for a bone injection gun. He spoke directly to the boy. ‘I’m going to give you something to take away the pain, Daniel. It’s a strong anaesthetic, so after a minute or two you’ll be feeling much better. There’ll be a sharp sting and soon after that you’ll start to feel drowsy. Are you okay with