Gary muttered something unintelligible, and Frankie pulled down his lower eyelid to look at his pupils. ‘No reaction,’ she murmured. ‘He’s sweating and his heart rate’s up.’ She looked up at Corey, frowning. ‘But something doesn’t add up here. Did you see where he was hit?’ she asked the landlord, who was now standing over her with folded arms and pursed lips.
‘It didn’t look a full-blooded punch,’ he admitted, ‘more a swipe that glanced against his chin, but he went down like a felled tree.’
‘It’s possible he’s got concussion from hitting his head on the floor,’ pondered Frankie, ‘But it’s a carpeted area here. I wouldn’t have thought…’ She bent forward and smelt the man’s breath, then looked up at Corey with a slightly triumphant smile. ‘I think I’ve got it, Corey. Not sure if I’m right, though. What do you think?’
Corey knelt next to Gary and put her face close to his. ‘He smells of alcohol, that’s for sure…but there is something else on his breath, too, which reminds me of nail polish. It’s acetone, isn’t it?’
Frankie nodded. ‘My guess is he’s diabetic, and he’s got alcohol-induced hypoglycaemia. It probably didn’t help when he was involved in a fight. At least we know what we’re trying to cope with when the ambulancemen get here.’
A man from the watching crowd called out, ‘That’s right, Doc—he’s diabetic. Has to inject himself every day.’
‘Ah, yes, look at that, Corey—a pinprick on his thumb.’
Frankie turned the man’s hand towards Corey, who put a cushion from one of the chairs under Gary’s head and covered him with a rug the barman handed to her.
‘Is he in danger?’ asked the landlord looking anxiously at the figure on the floor.
‘If he’s not treated, he could be,’ admitted Frankie.
‘In what way? What can it do to him?’ asked the landlord. ‘I thought he’d just had a skinful.’
‘A diabetic who takes alcohol can suffer an unnatural surge of insulin, and that can absorb too much of the glucose in his blood. That affects the nervous system, which in turn could lead to brain damage,’ she explained.
‘Bloody hell,’ said the landlord. He gazed nervously at the youth and wiped his brow with a handkerchief. ‘Will he be all right, then?’
The sound of a siren whining down to silence came from outside and two policemen and a paramedic appeared at the door. The two girls exchanged relieved looks and Corey murmured, ‘The cavalry’s arrived, thank God. Once we’ve got some glucose into him he’ll improve.’
The paramedic strode over to the injured man and then looked at Frankie and Corey in surprise. ‘I thought I’d said goodbye to you two about an hour ago—after we brought in those RTA victims. Don’t you have a home to go to?’ He knelt down beside Frankie. ‘What’s happened to this gentleman?’
‘I’m pretty sure it’s alcohol-induced hypolglycaemia,’ said Frankie. ‘I suggest you give him fifty grams of glucose intravenously, and then you can take him back to hospital and get him in balance again. His name’s Gary Hemp.’
‘I’ll do a quick blood test with a Haemastix strip,’ said the paramedic, opening his medical bag. He withdrew a little blood from the patient’s arm and put a blob on the strip. ‘Yup—his blood sugar’s way down,’ he remarked. ‘Better get some glucagen into him.’
He took out a prepacked needle and phial of glucose, which he swiftly injected into the man. ‘Involved in a fight, was he? He’s got a cut lip…’
‘It wasn’t my fault,’ shouted the other youth, now held by one of the policemen. ‘I told you, he suddenly went beserk—tried to kill me with a broken bottle, he did! I wasn’t doing anything to him at all, just talking about football,’ he added in an aggrieved voice.
‘He could very well have got aggressive just before he went down,’ murmured Frankie to the other policeman. ‘People who are out of balance with their insulin can sometimes become very hostile—change their character completely.’
Gradually the young man’s eyes flickered open and he looked in a bewildered way at the faces above him.
‘You’re all right, Gary—just had some imbalance with your insulin,’ said the paramedic. ‘Forget to take it today, did you? Don’t worry, son, we’re just going to take you to hospital to check you out.’
The youth moaned faintly. ‘What’s happened?’ he croaked as he was being stretchered out of the pub. The other youth’s details were taken down by the policeman. Gradually the onlookers drifted back to the bar, and the paramedic turned to Frankie and Corey as he picked up his medical bag.
‘I know you’re off duty,’ he said pleadingly, ‘but you couldn’t come back with us, could you? Just heard that there’s been a general call for more staff—a wall’s collapsed in the high street and there’s several people trapped. Some of the A and E staff have gone out to the scene.’
Corey groaned. ‘I was going to have a lovely bath, watch telly all evening and eat really unhealthy food…’
She looked enquiringly at Frankie, who shrugged and nodded. ‘Go on, then, tell them we’ll be there in a minute.’ After all, she thought bleakly, she wasn’t going to be doing anything else when she went home—not even making plans for a wedding any more.
* * *
Denniston Vale Infirmary was a sprawling Victorian Hospital with modern additional wings tacked onto it in random fashion, their pockmarked walls contrasting oddly with the magnificent stonework of the original building. It stood on a hill at the edge of Denniston town, an imposing clock tower rising from the centre of the building and impressive stone steps leading up to the front entrance, although the ambulances went round the back where the casualty department was situated.
As Frankie’s car swung round the corner to the staff car park, they could see three ambulances lined up, with patients being lifted out on trolleys then being pushed through to the unit. Two police cars were parked to the side of the ambulances, their blue lights still flashing, and a harassed-looking plump nurse with a clipboard was watching the proceedings.
‘Looks a biggy,’ groaned Corey. ‘My feet are killing me already at the thought of it.’
‘Come on,’ said Frankie. ‘You won’t notice your feet once you get going.’
‘Don’t you believe it,’ retorted Corey. ‘And look who’s on duty—fusspot Sister Kenney. That’s going to make my day.’
She jumped out of the car and they began to trot towards the entrance.
‘What did I tell you?’ she murmured, as the nurse stepped towards them and wrote something on the clipboard. ‘Evening, Sister Kenney.’
The woman nodded to her, a brief smile replacing her worried frown for a minute. ‘Thank you for coming in—I’m really grateful.’ She waved vaguely towards the bustle of ambulances and stretchers. ‘As you can see, we’re very much stretched at the moment. We’ve got Mr Burton from Orthopaedics helping to deal with the injuries from the collapsed wall and I’ve managed to persuade the senior nursing officer to loan us some nurses from Medical.’
‘That must have taken some doing,’ murmured Frankie.
Sister Kenney allowed herself a small triumphant grin. ‘It’s about time they helped us out. Now, please, would you look at a woman with chest pains in the end cubicle? She’s a Mrs Jepson, just come in while all this brouhaha was going on, and all three theatres and the emergency room are in use. She needs her vital signs monitored—I’ll leave you to do that, Dr Lovatt.’
It took just a few minutes to scramble into their hospital greens and make their way to the large central area surrounded by cubicles.