‘It doesn’t matter, I’m used to it. It happens all the time in A and E.’
‘That’s what you did before, isn’t it? Work in A and E?’
‘Yes.’ She didn’t elaborate, but as she’d expected he didn’t let it go.
‘Tell me about it,’ he said, and, although it was a question and not an order, she felt she had no choice.
‘I was a specialist trauma nurse. I did it for a couple of years.’
‘And then?’ he pressed, and she swallowed hard and straightened up.
‘Then I gave up. I finished ten days ago.’
Even thinking about it made her feel sick, it was all still so raw and fresh, like an open wound. She hugged her arms round herself and hoped he’d give up, but he didn’t. He couldn’t, of course, because he had to find out about her. That was what her interview was all about, and she’d known it was coming, so she just braced herself and waited.
‘So recently? Forgive me for saying this, but it seems strange that you should leave when you had no other job lined up. Was it a sudden decision?’
‘Pretty much.’
He paused, then said cautiously, ‘May I ask why?’
No, she wanted to scream, but she couldn’t. Instead she shrugged. He had to know, in case it happened again. ‘It just happened one day. I just froze up,’ she said bluntly. ‘I suppose if you want a technical term for it, you could call it burnout. Whatever, I couldn’t do it any more, and after a few days, I had to stop.’
He nodded his understanding. ‘I’m sorry, that’s tough. It does happen, though. In all branches of medicine, I suppose, but especially on the front line. Sometimes it just gets too much, doesn’t it?’ he said, and suddenly she found herself telling him all about it, about the blood and the waste of life and the endless failures, day after day, even though it was never their fault.
‘We had a run of fatalities,’ she told him. ‘One after another, all young, all foolish, all so unnecessary. I just realised between one patient and the next that I couldn’t go and talk to another set of bereaved parents and try and make sense of it for them where none could be made. I just couldn’t do it any more.’
‘So what happened?’
‘My boss sent me home, but the next day wasn’t any better, or the one after that, so he told me to go away and think about it, and he’d have me back when I was sorted, if ever. I don’t know if I’ll ever be ready to go back, though. It’s only ten days ago, but it feels like a lifetime, and I don’t think I’ll ever be able to do it again. And now I just feel so lost. I thought I knew what I was doing with my life, and now suddenly I don’t, and I don’t know what’s going to happen.’
She shrugged again, just a tiny shift of her shoulders, but he must have caught the movement out of the corner of his eye because he shot her an understanding smile.
‘It’s hard when everything seems to be going smoothly and then fate throws a spanner in the works. I know all about that and the effect it can have on you.’
She closed her eyes and groaned inwardly. Oh, what an idiot! ‘I’m so sorry,’ she said. ‘I didn’t mean it to come out like that. It’s nothing like as bad as what’s happened to you and your children, and I didn’t mean to imply—’
‘You didn’t. It was me that drew the parallel, and it does exist. In my case it was a bit more dramatic, but yours is no less valid. Life-changing moments are usually pretty drastic, by definition. Let’s just hope we aren’t going to find one here.’
He swung into a driveway and cut the engine, and Fran followed him up the path of a neat little bungalow. The front door was open by the time they reached it, and the elderly woman waiting for them was wringing her hands with worry.
‘Oh, Dr Giraud,’ she said, clutching his arm. ‘Oh, he’s worse. He looks all grey and waxy—come in.’
Fran followed them down the hall to a bedroom at the back. An elderly man was lying in bed, his skin every bit as grey and waxy as Mrs Donaldson had said, and Fran took one look at him and her heart sank. He was obviously hypovolaemic and shocky, and his condition was all too familiar.
Please, no, she thought. Don’t let him bleed to death. Not the first patient I’m involved with.
‘Mr Donaldson, tell me about the pain,’ Dr Giraud said, quickly taking his blood pressure and pulse, scanning him with eyes that Fran sensed missed nothing.
‘It’s just here,’ he said, pointing to his midsection. ‘So sore. It’s been getting worse for days.’
‘Any change in bowel habits? Change of colour of stools?’
‘Black,’ he said weakly. ‘I read about that somewhere. That’s blood, isn’t it?’
Xavier nodded. ‘Could well be. I think you’ve got a little bleed going on in there. Fran, could you get a line in for me?’ he asked, turning towards her and giving her a reassuring smile. ‘A large-bore cannula and saline to start. I’m going to phone the ambulance station and bring the oxygen in from the car. Are you OK to do that?’
‘Sure,’ she said, quelling her doubts, and found the necessary equipment in his bag. Part of her interview, or just another pair of qualified hands? Whatever, within moments the line was in, she was running in the saline almost flat out and checking his blood pressure again with the portable electronic monitor.
‘What is it?’ Xavier asked, coming back in just as the cuff sighed and deflated automatically.
‘Ninety over fifty-two.’ It had been ninety over fifty-six before, she’d noticed, so it was falling too fast for comfort.
He frowned. ‘OK, I’ve told them to have some O-neg standing by. We’d better take some blood for cross-matching and a whole battery of other tests while we wait for the ambulance, because once they start the transfusion it’ll be useless. Could you do that for me? There are bottles in my bag.’
He turned to the patient. ‘Right, Mr Donaldson, let’s put this mask on your face and give you some oxygen, it’ll help you breathe more easily.’
Once that was done he sat on the edge of the bed and explained to them what was happening and what Fran was doing.
‘The ambulance is on its way—Mrs Donaldson, could you find him some pyjamas and wash things to take with him? They’ll be here in a minute and you don’t want to hold them up.’
‘Of course not. I’ll get everything ready.’
She started going through drawers, clearly flustered and panicked, and Mr Donaldson watched her worriedly.
‘Betty, not those, the blue ones,’ he said as she pulled out his pyjamas, and while he was distracted Fran caught Xavier’s eye.
‘I’ll check his BP again,’ he murmured, and while she labelled her blood bottles he repeated the test. It was eighty-seven over forty-eight, and he winced almost imperceptibly. Only a slight drop, but in a very short time, she thought, so the fluids weren’t holding him stable.
‘Open it right up,’ he said quietly, indicating the saline with a slight movement of his head. ‘I’ll call the ambulance station again, ask them to hurry. I’ve spoken to the surgical reg on call and told him to stand by, but there’s not much else we can do here.’
An endless five minutes later the ambulance arrived, and Mr Donaldson and his worried wife were whisked away, leaving Fran and Xavier standing on the drive watching them go.
They didn’t speak. There was nothing much to say. They both knew it was touch and go, and Mr Donaldson was already