She opened the curtain to reveal a young man on a trolley, the cot sides up and a drip running in. He was lying motionless, his face pale and clammy, and he looked very shocked.
The staff nurse eased off the thick gauze pad covering the wound on the outside of his left foot, and Frankie’s mouth tightened slightly. It was very badly mangled, bent in at an unnatural angle and with extensive soft tissue injuries. There was a great deal of grit and tarmac ground into the exposed bones, and she winced.
‘Not nice, is it?’ the staff nurse agreed. ‘His X-rays are here.’
Frankie studied them thoughtfully. The bones were nearly all intact, amazingly, but one or two were broken through the ends and would need fixing. The main damage, she could see, was to the soft tissues.
‘Do you know what happened?’ she asked the nurse.
‘He was knocked off his bike and dragged along the ground for a few yards by a car. Luckily for him he had a helmet and leather jacket and gloves on, or he’d be a lot worse off. His little finger’s broken as well, by the way—just a minor fracture. We’ve put a garter strapping on to support it. We’ve done chest X-rays but there didn’t seem to be anything on them. He’s complaining of pain in the left shoulder, though.’
‘May I see?’ she asked, and, studying the plate, she ran her finger lightly along the left collar-bone to the outer end. ‘The clavicle’s partially dislocated,’ she said quietly. ‘Must have happened as he landed on that shoulder. We’ll have to support that for a while as well. OK, thanks—can I take the plates up to Theatre to show Mr Ryder?’
‘Sure. What do you want to do with the patient?’
She turned back to the foot and studied it again. The soft tissue injuries were nasty, infection was likely and the toes were looking discoloured. ‘I’m inclined to think he’ll want this one next. Is the consent form signed?’
‘Yes—his wife’s here. Do you want to talk to her?’
She shook her head. ‘Not until I’ve spoken to Mr Ryder. I think I’ll ring him and ask him to come down.’
She contacted him on the phone, explained the situation and then had to defend her suggestion that he go in next.
‘The soft tissues look awful. I think the circulation could be compromised,’ she told him.
‘The other man’s soft tissues look awful.’
‘Is the circulation affected?’
She heard him sigh. ‘Apparently not. So you want me to come down?’
‘I think you should.’
The phone clicked and she replaced it thoughtfully. Was he cross with her? Perhaps she should have just tacked the man on the end of the list, but she wasn’t even officially working and the last thing she wanted to do was blow her chances at this job by fouling up in the first few hours!
She needn’t have worried. He came down, took one look at the foot and nodded.
‘Let’s do him next,’ he agreed, and Frankie’s fragile ego heaved an enormous sigh of relief. The relief quickly turned to horror, however, when he told her that if she liked jigsaws so much she could do this one.
‘Me?’ she squeaked.
He rolled his eyes above the mask. ‘Sure, you. Why not? Don’t worry, I’ll tell you blow by blow what I want you to do.’
And so she did her first orthopaedic jigsaw, carefully reinstating the circulation by reconnecting the damaged blood vessels as well as possible. When the foot turned pink again she could have wept with delight.
Ryder, however, kept her feet firmly on the ground and her optimism in the dirt—literally.
‘Right,’ he said, ‘now you can set about picking all those bits of tarmac out of the bone-ends and cleaning up the field before closing the skin.’
It took ages, with both of them working although the area was quite small, and finally it was cleaned up to his satisfaction.
‘Right, we need to screw back that small chip of bone with its ligament attached and we’re done,’ he told her. ‘We won’t close it because of the danger of infection. It was a very dirty wound.’
It was indeed, and once the healing was under way it would need skin grafts to cover the area. In the meantime it would be covered with a non-adherent dressing.
Finally he declared the operation finished, and Frankie sagged against the wall outside and looked at the clock in disbelief. It had taken nearly two hours, but she was very pleased with herself—until her boss pointed out that it could and should have been done in half the time.
‘Still,’ he added with a slight smile that softened his weary eyes, ‘you did a good job. Well done.’
High praise. She could have hugged him, but thought better of it and concentrated instead on pouring them another cup of coffee and this time drinking hers quickly before the phone could ring again.
They were lucky. His bleeper didn’t squawk until later, when they were back on the ward following up the post-ops, all of whom were doing well.
Mary O’Brien, the ward sister, handed him the phone and he spoke to the switchboard briefly before being connected.
Frankie wasn’t really listening, but it was impossible not to hear what he was saying, and anyway she was fascinated.
‘What do you mean you’re at the station? Jane, you can’t do this to me! I’m at work—yes, I know it’s a bank holiday. It just means that we’re even busier—no, I didn’t get the day off; my senior registrar did. He worked Christmas, remember?
‘You’ll have to get a taxi to the house—what do you mean you haven’t got any money? Get a taxi here, then. What about your train fare? Oh, Jane, for heaven’s sake!’
He looked at Frankie doubtfully. ‘Can you hold the fort? Just for half an hour? My daughter’s got herself in a mess.’
‘Of course,’ Frankie assured him, far from confident. She didn’t know the hospital, she didn’t know all she felt she should about orthopaedics, even though she’d spent the past month reading solidly on the subject, and she felt totally at sea. In, as they said, at the deep end.
‘Mary, look after her for me,’ he said to the kindly ward sister, and then, with a wry smile and a weary shake of his head, he strode quickly off the ward and away to his errant daughter.
At least, Frankie assumed she was errant. It certainly sounded as if she was, at least a little.
‘Can’t his wife drive?’ she found herself asking.
Mary O’Brien snorted. ‘Oh, yes—but she’s in London and it’s her the child’s run away from yet again. They’re divorced—have been for years.’
Frankie blinked, part of her mind registering with interest the fact that his wife no longer lived with him. Then her mind belatedly latched onto the information about the child. ‘Run away?’ she queried.
‘I expect so. I should think there was a wild party last night and she hates it. Nice kid. I expect you’ll meet her in a while; he often has to bring her in when she does something like this, poor little scrap.’
Poor little scrap? ‘How old is she?’ Frankie ventured, suddenly concerned for a little girl torn in the war between irresponsible adults.
‘Oh, thirteen or so. Twelve, perhaps?’
So, not a little girl at all but quite a big girl—which meant either that Robert Ryder was wearing better than he had any right to or that he had started a family somewhat younger than was prudent.
Remembering the warmth of his body and the intoxicating