‘No worries. I think my Vietnamese is up to this.’ Tom smiled at the youth, greeting him before examining the wound. ‘It’s deep. He’s cut into muscle.’
‘I thought so.’ Bec opened the dressing pack and drew up some local anaesthetic, pre-empting his request. As usual, she was organised and efficient.
Tom changed to Vietnamese. ‘How did you cut your hand, Trang?’ He sat down and applied more pressure to the wound.
‘I don’t know. I didn’t feel it. I just saw the cut.’ Beads of sweat clustered on his forehead.
‘A sharp knife is a dangerous thing.’ Tom checked the edges of the wound.
‘But it isn’t very sharp. It wasn’t cutting well.’
Bec leaned over his shoulder, her chest brushing his back. ‘It’s a pretty jagged cut. How did it happen?’
Tom peered more closely at the gash. ‘He said the knife wasn’t sharp and he didn’t feel the cut which really doesn’t make a lot of sense.’
Trang’s face paled as he suddenly leaned forward, heaving.
Bec grabbed a bucket and pushed it into his hands just as he started to vomit.
‘Lucky save.’ Tom smiled his thanks. Her quick actions had just prevented him being covered in Trang’s stomach contents.
A dreamy look crossed her face. ‘It’s my lucky day.’
The softly spoken words wafted around him warmly, but settled on him uncomfortably. He shrugged the feeling away. Pressing a finger around the wound, he asked Trang, ‘Does it hurt here … here … here?’
The patient shook his head. ‘No, it doesn’t really feel.’
‘Pass me a needle please, Bec.’ This didn’t make sense. He should have a throbbing hand. He should have felt the cut.
‘Here you go. What are you thinking? Some sort of paraesthesia? Perhaps he cut a nerve.’
Tom unsheathed the needle and pressed it around the hand. ‘Tell me when you feel a sharp jab.’
‘No, I don’t feel. My feet are tingling, too.’ Trang slumped at the table as he heaved again.
Bec passed the young man water to rinse his mouth and then mopped his brow with a cool cloth. ‘I know he could be vomiting from shock but do you think he might have cut his hand because he was feeling unwell and lost concentration?’
Tom shrugged. ‘The symptoms are pretty confusing. I’m going to stitch the hand first. That might turn out to be the easy bit. Can you do a set of observations?’
‘Sure.’ Bec picked up the sphygmomanometer and wrapped it around Trang’s upper arm.
As Tom injected the local anaesthetic into Trang’s already numb hand he started to sort the symptoms in his head. Nausea, vomiting, sweating, numb hand, tingling feet. On the surface it could be, as Bec had said, a vaso-vagal reaction. But he had a nagging feeling that if he went with that, it would be the easy diagnosis. ‘Now I am going to stitch your hand.’
Trang gave a feeble nod. ‘Jus doit.’ His words ran together in a slur.
‘Tom, his blood pressure is really low.’ Bec’s questioning and concerned gaze fixed on him. ‘Food poisoning?’
Tom threaded the curved needle and started to bind the muscle layers of the hand together in a series of small stitches. ‘Maybe.’ Without looking up, he asked the other crew. ‘Does anyone feel sick or dizzy?’
‘I don’t know what you just asked them, Tom, but they’re all shaking their heads.’
‘I think we just ruled out food poisoning.’ He changed over to the finer thread for the skin closure stitches.
Bec encouraged Trang to drink some more water. ‘Not necessarily. Trang’s the cook. He could have tasted dinner as he prepared it and the contamination could be from that. We’re well because we haven’t eaten that meal yet.’
He smiled at her logic as he snipped the thread. ‘Very perceptive.’ Keen intelligence wrapped up in a delicious body. It was a powerful combination. One he couldn’t wait to explore again. And he would as soon as he’d solved the Trang puzzle.
The sick man took a sip of water but most of it dribbled out of his mouth.
‘He’s dribbling, Tom.’ Apprehension clung to her words.
‘And he’s slurring his speech.’ He quickly finished the last stitch, his brain frantically searching his memory for clues. ‘Trang, is your mouth feeling numb?’
‘My mouf an’ my tong.’ The words sounded thick.
‘Squeeze my hand as hard as you can.’ Tom placed his hand against Trang’s uninjured hand.
The pressure was weak. Far too weak for a young man of twenty.
Bec’s words about tasting a meal rang in his head. ‘What were you cooking?’
The young man’s gaze slid away. ‘Soup.’
A red flag hoisted itself in his mind. ‘What sort of soup? It’s important you tell me. You could be very, very sick.’
Trang threw an imploring look at his captain and then dropped his head. ‘Puffer fish.’
All the symptoms dropped into place. He’d been cooking the delicacy that the Vietnamese government was actively discouraging. Discouraging because fugu was deadly. ‘Bec, you were right. He’s poisoned himself with his cooking. He’s got tetrodotoxin poisoning.’
A stunned look passed across her face. ‘But that’s a neurotoxin and it will slowly paralyse his respiratory system. We’re hours from the mainland. Hours from a respirator.’
‘I know, but he said he was making soup. Let’s hope the fish had been gutted and that there were only traces of toxin heavily diluted by water.’ He turned to the now frightened young man. ‘How did you prepare the fish?’
‘I took out the guts. I know these are where the poison is.’
Tom sighed. ‘Did you boil the heads and skin?’
Trang sobbed. ‘I did.’
‘There’s no antidote, is there?’ Bec bit her bottom lip.
‘No. None. It paralyses the victim, leaving them fully conscious. A living death.’ He stood up and gave Trang’s shoulder a squeeze. ‘He cooked the eyes of the puffer fish, which are full of the toxin. But we’ve got charcoal to absorb it and if we can give him a gastric lavage and empty his stomach we have a fighting chance.’
Bec started rummaging through the medical kit. ‘I guess we can use the IV tubing as a lavage tube.’
‘Good thinking. All we can do is address the symptoms. Let’s hope that this is as bad as he gets.’ He touched her arm. ‘I’ll tell the captain to head the boat back to Halong City.’
She nodded, a flash of regret streaking across her face. He knew exactly how she felt. It was going to be a long night but not the type of long night they’d both imagined.
* * *
Bec woke with a start. Rain pounded the porthole as the boat rocked violently. Her stomach lurched and she dragged in a deep breath, trying to calm the seasickness. Tom had sent her to bed. His bed. Only problem was, he wasn’t in it.
Just as she’d finished the gastric lavage and charcoal treatment, the storm had hit. The tranquil sea she’d swum in only a few hours before had become a roiling, churning mass of white-capped waves, thudding hard against the hull of the boat, making it roll back and forth. Making her stomach roll. Just like on the motorbike when she’d succumbed to motion sickness.