It was alarming to realise the effect she had on him. He tried not to think about it as he turned to the patient. ‘I need to examine you, so try not to worry. I’m sure there will be news of your daughter very shortly.’
Mrs Robinson didn’t demur as he set about the familiar routine. He frowned when he saw the full extent of the bruising down the centre of her chest. ‘How did this happen? I can see the marks from your seat belt, but I can’t understand where you got these bruises from.’
‘It was my own fault,’ Jane Robinson admitted guiltily. ‘Shelley told me to put it in the boot but I didn’t want it getting damaged.’
‘Were you holding something on your knee?’ he guessed, gently exploring the area. The bruising extended from just below her collar-bones right down to her waist—following the line of her sternum, in fact. It was possible that she’d broken a rib or two but he wasn’t convinced it was that which was causing her so much pain.
‘Well, not on my knee, exactly. It was too heavy for that. I had it propped in the footwell in front of me.’ She sighed. ‘It was a table, you see, with a marble top, and I didn’t want it getting chipped.’
‘And when the car crashed you slammed into it?’ Owen said, rapidly putting two and two together.
‘Yes. There wasn’t much room with the table in front of me, so even though I was wearing my seat belt, it still rammed right into my chest…’
She broke off and gulped. Owen frowned when he saw her start struggling for breath. ‘Can you tell me how severe the pain is at this moment?’
‘It’s really bad, Doctor, and I can’t seem to breathe properly…’ She suddenly stopped talking and her eyes rolled up into her head. The cardiac monitor started beeping to warn them that there was no output from her heart.
‘She’s in VF.’ Owen turned to his registrar. ‘I think it’s a cardiac tamponade—the heart is being compressed because blood is collecting in the pericardium. I’ll need to draw it off to relieve the pressure.’
‘You think it’s a fractured rib that’s caused it?’ Suzanne queried, hurrying round the bed.
‘More likely to be the sternum. That would explain the severe pain she’s been in. If the sternum has fractured, it could have pierced the pericardium, which is why there’s blood collecting around her heart. She’ll need to go straight to Theatre once we’ve finished. Shock her and give her a shot of adrenaline, but don’t apply external cardiac compression—it will only make matters worse.’
He left it to Suzanne to resuscitate the woman, knowing that the registrar was perfectly capable of following his instructions. His main concern was to deal with the cause of the patient’s arrest. It took him just a few moments to insert a hollow needle into the woman’s chest and he nodded as he watched the blood gush back into the syringe.
‘Just as I thought—cardiac tamponade. The sternum will need wiring up and the pericardium will need repairing, so the cardio team will have to crack open her chest.’
He drew off another syringe full of blood before Suzanne told him the patient’s heart was beating and they had established sinus rhythm. ‘Good. Get onto the cardio reg and tell him what’s happened,’ he instructed, peeling off his gloves. ‘Make sure he understands how urgent it is. This is one occasion when queue-jumping is absolutely essential.’
Suzanne made the call, then came back to him. ‘I wouldn’t have known what to do if you hadn’t been here. It never occurred to me that it could be a tamponade. I always associate that with a penetrating chest injury. I never considered the possibility that the sternum had fractured and pierced the pericardium even though I could see all that bruising.’
‘Don’t be so hard on yourself, Suzanne. There’s a dozen different reasons why she could have arrested. You know that as well as I do.’
‘Maybe. But you still managed to come up with the correct diagnosis.’
Suzanne looked downhearted as she went to meet the paramedics who’d arrived with another casualty. Owen made a note to have a word with her later and went to check on the young man with the leg injuries. Beth had the X-rays on the computer screen and he sighed when he saw the extent of the damage that had been done to the man’s ankle.
‘That’s going to take some sorting out. It will be a while before he’ll be able to walk on it. It causes a major problem when ligaments are torn like that.’
‘What about his leg?’ Rob queried, coming over to have a look. ‘It’s a real mess.’
‘That’s going to take time, too, and it will need external fixation from the look of it. The bone’s in bits just here,’ he explained, pointing to the screen. ‘It will take several weeks to lay down new bone and the biggest problem will be to ensure that the tibia doesn’t shorten in the meantime. That’s why external fixation is the best option.’
He looked round when he sensed that someone was standing behind him and stiffened when he saw Rose. ‘Yes?’
‘Mrs Robinson’s daughter is on her way in. ETA three minutes,’ she told him quietly, then moved away.
Owen watched her walk over to the bed and it was all he could do not to go after her and demand to know what she was doing there. He’d barely slept since the night he’d met her in the pub. He knew that he’d handled the situation badly by offering her money, but it had been his last resort after everything else had failed. Now he had no idea what she was up to, but he couldn’t accept that it was coincidence that had brought her to his department that day. She was planning something and, whatever it was it would have an impact on Daniel.
The thought of the damage she might cause was too much to deal with. Owen knew that he had to put some distance between himself and Rose Tremayne, otherwise he couldn’t be held responsible for his actions. Spinning round on his heel, he strode out of the room, ignoring the startled looks from his staff as they watched him leave. He needed a couple of minutes on his own to think things through. If Rose did have a plan, he intended to be one step ahead of her!
Rose bit her lip as she watched the doors swing shut after Owen Gallagher had left. She knew he was furious about her being there but it wasn’t her fault. She’d had no idea that he worked at St Anne’s when she’d accepted this job, otherwise she wouldn’t have taken it. Now she couldn’t decide what to do. Should she go after him and explain that she hadn’t intended to make life difficult for him by turning up in his department? Or would it be better if she left well alone?
‘I wonder what’s up with His Highness today.’
Rose summoned a smile when Rob Lomax came over to her. Instinct told her that it would be a mistake to let anyone know about her link to Owen Gallagher so she feigned ignorance. ‘Do you mean Dr Gallagher?’
‘Uh-huh. He’s like a cat on a hot tin roof today and it isn’t like him. That guy is the epitome of cool normally. Isn’t that right, Suzie?’
‘Isn’t what right? And don’t call me Suzie. You know I don’t like it.’
‘I know how you feel.’ Rose smiled as the other registrar joined them. ‘I hate it when people call me Rosie.’
Suzanne grimaced. ‘Then my advice to you is to make sure that certain members of this staff are fully acquainted with your views.’ She shot a speaking look at Rob, who tried to look hurt.
‘Do you mean me?’
‘If the cap fits…’ Suzanne sniffed loftily and walked away.
Rose chuckled. ‘That put you in your place, didn’t it?’
‘She loves me really,’ Rob assured her, grinning. ‘So, I know that your name is Rose but I don’t know much else.