No, Katy had definitely changed. She’d dropped the innocent act—and they both knew that it had been nothing more than an act—and she was showing a level of courage that frankly surprised him. There were still hints of the feminine fragility that she’d shown at eighteen, but he sensed a strength and determination that hadn’t been there before.
Suddenly he was intrigued.
And he was also impressed. He’d seen numerous colleagues make the mistake of dismissing a patient who was drunk. She hadn’t made that mistake. Even when the patient had vomited on what he assumed to be a frighteningly expensive pair of shoes, she hadn’t allowed it to cloud her decision-making.
She was a good doctor.
And he had to face the fact that the reason he was being so hard on her had absolutely nothing to do with her clinical abilities and everything to do with his own emotions.
Katy was nearly at the end of her shift the following day when a call came through requesting a medical team to attend an accident.
‘They’ve got a man trapped in a car and they’re worried about his leg. I’m the duty consultant so it’s mine,’ Jago said immediately, reaching for high-visibility jackets and the equipment they’d need at the roadside. ‘I’ll take Charlotte and Katy.’
Katy felt the adrenaline rush through her veins.
She knew that immediate care—tending to the patient at the scene of the accident—was very different from looking after someone in the A and E department where they were surrounded by equipment.
Was he expecting her to take the lead as he had with the drunken head-injury patient the previous day?
‘I’m taking you as an observer,’ he said smoothly, evidently reading her mind, ‘and an extra pair of hands if we need one. I’ll be right by your side all the time.’
And she was supposed to find that reassuring?
But Katy didn’t have time to reflect on Jago’s reasons for taking her because they were soon in the car, travelling at high speed towards the scene of the accident.
The roads were slick with rain and Jago drove fast but carefully, the powerful headlights cutting through the darkness.
They arrived to find the fire crew cutting one of the occupants of the car out of the vehicle.
Jago retrieved several rucksacks from the car and checked that she was wearing the correct protective clothing.
The darkness and the foul weather were clearly hampering the rescue efforts.
Responding to a shout from one of the paramedics, Katy hurried across to one of the stretchers.
‘We’ve got him on a spinal board and he’s conscious but his leg’s a mess. It needs attention before we transfer him.’ The paramedics addressed her directly and Katy looked frantically around for Jago but he was speaking to a member of the fire crew.
Which meant it was up to her.
A blanket was covering the injured man and Katy lifted it gently, feeling the colour drain out of her face as she saw the extent of the man’s injuries. The leg was severely deformed and she felt a cold rush of panic in her chest. Where should she start? She could see that there was an open fracture, with part of the bone exposed to the air, as well as a severe laceration. She knew that it was important to cover it to try and prevent infection but the leg was so badly damaged that she was afraid of making the damage worse.
Aware that she was well outside her own realms of experience, she looked over her shoulder for Jago and to her relief he was there, his powerful presence reassuring in the chaos of the accident.
‘What have we got?’
Unlike her, his expression didn’t flicker as he saw the state of the man’s leg. He merely pulled on a pair of sterile gloves, and turned to the nearest paramedic and quietly listed the equipment he needed.
Katy took a deep breath to steady her stomach and those sharp dark eyes settled on her face.
‘Are you OK?’ He frowned sharply as he scanned her pale face. ‘You can wait in the car if you like.’
And give him more ammunition for accusing her of not being able to cope? No way!
‘I’m fine,’ Katy replied sickly, hoping that he couldn’t see just how much she was shaking.
‘As long as you’re sure.’ His voice was surprisingly gentle. ‘If you change your mind, let me know.’
The rain had plastered his jet-black hair to his face and trickled off the dark stubble on his hard jaw.
He was breathtakingly handsome and very much in control of the situation.
Which was a relief because she felt completely and totally out of her depth.
He kept his voice low, explaining what he was doing as he worked. And he worked quickly.
‘Normally we wouldn’t handle the injured part without splinting,’ he told her after they’d given the man drugs to control the pain, ‘but in this case there’s severe deformity and the blood supply is compromised.’
‘So that could damage the soft tissues?’
‘Exactly. A good blood supply is vital to limb survival. So in this case I’m going to apply gentle traction to restore the alignment of the bones. Then we’ll splint.’
Katy blinked in surprise as one of the paramedics took a Polaroid photograph of the wound before covering it with a sterile dressing.
‘Why did he do that?’ She spoke in a low voice even though the patient was drifting in and out of consciousness, barely aware of what was happening.
‘Because exposing the wound again in the A and E department will increase the risk of infection, so if we can we take a photo at the roadside before we cover it,’ Jago explained. ‘No one will disturb the dressing now until this chap reaches Theatre.’
Katy watched while he reduced the fracture and then checked the pulses in the limb.
‘OK.’ He glanced up at the paramedics and ran a hand over his face to clear his vision, his thick, dark lashes clumped together in the rain. ‘I need a long leg splint.’
They produced one immediately and Jago immobilised the leg with help from Katy and one of the paramedics.
‘Splinting the leg will help control the pain but we need to get him to hospital fast. Blood loss from limb wounds and internal bleeding from fractures contribute to shock so we need to resuscitate him carefully.’ His eyes flickered to Katy. ‘Don’t forget that blood loss from open fractures can be two or three times greater than that from closed fractures.’
Katy listened, taking in everything he was saying, totally in awe of his amazing calm and the amount of knowledge he displayed.
He seemed totally indifferent to the rain and darkness, acting with the same degree of supreme self-confidence that he displayed in the well-equipped A and E department.
He was talking again. ‘One of the advantages of attending the scene of the accident is that you get a real picture of what happened and that helps you assess the possible injuries.’
She was eager to learn from him and for a brief moment their past history was forgotten, the tension between them easing as they concentrated on the patient. ‘And that’s why you always question the paramedics about whether the patient was a passenger or the driver?’
Jago nodded, his attention fixed on the patient. ‘It’s important to know whether they were in the vehicle or a pedestrian. Whether they were restrained by a seat belt. The direction of impact and the degree of damage to the car.’
‘So if you know that someone was thrown from a vehicle—’