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He now knew that Finn hated peas, liked chicken in all forms, was also partial to sausages and tomato ketchup, and loved a kids’ TV show with spacemen. He had seven DVDs of it and Riley had watched them all with him.
The whirlwind that was Riley’s mother was a whole other matter. Thank goodness he hadn’t seen her in the flesh when he’d told her about Finn. He was pretty sure she’d had a heart attack at the other end of the phone. Of course she was driving right down. She wanted to meet her grandchild straight away. She’d asked a million questions that Riley didn’t know the answers to.
Eventually he’d told her a white lie. He told her that the social worker had recommended that he and Finn spend the first week together on their own to get used to each other. Not to overwhelm him with things. In fact, the social worker had recommended routine as soon as possible. So he’d registered Finn at school and taken him in to say hello. The headmistress had been great, suggesting he bring Finn in for a few hours in the first instance to let him find his feet.
Riley had finally managed to placate his mother by sending the picture that April had taken of them both together. She’d cried at that point. But at least it had given him some time.
What he couldn’t work out right now was how to be around April.
Since they’d picked up Finn together, she’d retreated right into herself again. She’d spoken to him about a few funeral arrangements she’d helped put together after talking to Isabel’s friends. She’d asked him to speak to Finn about a few things too. But that was it.
No closeness. No real glimmer of friendship.
Maybe it was his fault? If she’d planned her sister’s funeral, had she had to deal with other things too? Maybe empty her house, or deal with all her financial affairs. She’d seemed so knowledgeable in Isabel’s house—a place he’d felt entirely uncomfortable. She’d seemed to know exactly what Finn needed—even though she said she had no more experience of children than he had. The visit might have revived memories for her that he hadn’t considered. Was it any wonder she was keeping her distance?
The rest of the staff had been great. They’d been surprised he was still there. But the news had spread quickly, and everyone was supportive.
Finn had asked to stay at school today until lunchtime. That meant he had three hours. Hours best spent in the hospital.
He’d barely got across the doorway before someone gave him a shout. April.
‘Dr Callaghan? Can you come and assess Robert Black for me, please?’ He could see the concern on her face straight away.
He nodded and walked over quickly. Robert had been caught in an explosion. His spinal injury was severe and he was currently in neurogenic shock. This was always a crucial time for patients. Neurogenic shock happened in almost half of patients with a spinal injury above T6 in the first twenty-four hours and didn’t go away for between one to three weeks. Patients in neurogenic shock needed continual assessment of their circulation, senses and breathing abilities. Neurogenic shock could lead to organ failure.
Robert Black’s blood pressure was low, his heart rate bradycardic. His limbs were flaccid, his skin warm and flushed due to the vasodilation caused by the neurogenic shock.
Riley signalled to the nurse. ‘Connie, can you get me some atropine?’
She nodded and handed him a vial from the emergency trolley. April moved automatically to the head of the bed to keep assessing Robert’s breathing. The staff here were used to emergencies and good at recognising the symptoms.
Riley kept his voice calm and even as he flushed the atropine through the Venflon in Robert’s arm. ‘Robert, I’m just giving you something to speed up your heart rate a little. I’m also going to give you something to help your blood pressure.’
He nodded at Connie again. ‘Get me some dopamine.’ He turned to April. ‘Can you put some oxygen on for me, please?’
April nodded and slipped the mask over Robert’s face, lowering her head to the bed to monitor the rise and fall of his chest and keeping her eyes on the numbers on the oximeter.
Teamwork was crucial. Neurogenic shock was difficult. It was different from spinal shock or the most common type of shock with injuries—hypovolemic—and had to be treated differently. Often patients could have a respiratory arrest.
Right on cue, April waved her hand. ‘Can we call an anaesthetist?’
‘No time,’ said Riley as he finished administering the dopamine and moved to the head of the bed. It only took a few seconds to tilt Robert’s head back, using the laryngoscope to insert an endotracheal tube.
He glanced towards the doorway. ‘We need to transfer him to high dependency. Does anyone know if they have a bed?’
April took his cue and ran over to the phone. Riley kept bagging the patient. At this stage, Robert needed to be ventilated. He could only pray this was a temporary setback.
Robert’s regular doctor appeared at the door. His eyes widened. ‘What the—?’
He stopped himself and held open the ward doors. ‘High dependency?’
April put the phone down and nodded. ‘They’ll be waiting.’
He moved over and grabbed a side of the bed. Between the other doctor, April and the nurse, the transfer was smooth. Riley concentrated on the airway, bagging the whole way, then setting up the ventilators and pressures when they arrived.
‘Need anything else?’ he asked his colleague.
The doctor shook his head. ‘I take it he had just had a rapid deterioration?’
Riley nodded. ‘April was working with him. She picked up on it straight away.’
‘Thank goodness. This could have been a disaster.’
Riley gave a thoughtful nod and stared back towards the door. April had stopped in the corridor. He gave a brief smile. ‘Give me a page if you need any help.’
The other doctor nodded and he headed out into the corridor.
April was dressed in her usual attire of the physios, white tunic and navy trousers, with her hair pulled back in a ponytail. She had her eyes closed and was resting her head and body against the wall.
He touched her arm and her eyes jerked open. ‘April, are you okay?’
Their eyes connected for a few moments. Hers were bluer than ever. Maybe it was the bright hospital lights. Or maybe it was the fact he was noticing so much more about her. April had always looked away quickly before, but this time she didn’t. This time it felt as if there was more to their gaze.
But she pulled her arm away. ‘Of course, I’m fine.’ She gave her head a little shake. ‘I just got a fright when R
obert deteriorated so quickly.’
He nodded. As a doctor, he was used to dealing with emergencies, but other staff didn’t have the same exposure as he did. Quite often they did a debrief after things like this.
‘Come with me.’
Her eyes widened. ‘What?’ She shook her head fiercely. ‘No, I’ve got work to do. I need to get back to the ward.’
‘Actually, you don’t.’
She glared at him and folded her arms across her chest. ‘I can’t.’
He spoke firmly. ‘You can. Get your jacket. I have to pick up Finn at twelve. But we have time for a coffee before I go get him.’
April shifted on her feet. ‘I have work to do.’
‘You must be due a break, and we need a chance to debrief—to talk about what just happened. We usually do it as a team after any emergency. Let’s take some time out.’
She hesitated and took a few breaths. He gestured towards the locker room. ‘Go and get your jacket.’ He wasn’t going to let this go. There was something in that glance. Some kind of connection.
She gave the briefest nod then disappeared for a few seconds while his stomach gave a little roll.
No getting away from it. April Henderson had definitely been avoiding him. He just had to figure out why.
* * *
Her hands were still shaking as she opened her locker and grabbed her jacket. The canteen and coffee shop were across the main courtyard. She slid her hands into her puffy winter jacket. Riley was waiting for her at the door.
This was nothing. It was a simple chat. A debrief. She had heard of them before—she’d just never needed one.
So why was her stomach flip flopping around?
She’d spent the last few days avoiding Riley. She’d done the things she’d been asked to do. The funeral arrangements were sorted. She’d arranged the undertaker, the church, the minister and the plot at the cemetery. According to Isabel’s friends, she’d been a little unconventional. One had offered to speak. Another had offered to say a poem. She just had to find out what Riley would think appropriate for Finn. She figured he’d want to give Finn the chance to say goodbye to his mum. She just wasn’t quite sure how a kid did that.
