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‘That means,’ Mark replied slowly, ‘that there is no electrical communication between the atria and the ventricles.’
Holly stared. ‘But that would make him dead.’
‘No. Not necessarily.’ Mark shook his head. ‘In his case ventricular activity is stimulated by an independent focus arising within the ventricles. It’s an escape rhythm and it produces abnormal wide complexes on the ECG—look.’
Holly leaned forward, frowning slightly as he explained the ECG trace. ‘I can’t understand why he hasn’t collapsed.’
‘He did collapse,’ Mark reminded her grimly, ‘but on this occasion he was lucky. Now we need to treat it. Urgently.’
He picked up the phone and dialled the hospital, talking quickly to one of the cardiology team while she hovered.
‘OK.’ He replaced the phone and let out a long breath. ‘I’m going to give him some atropine here and transfer him to hospital. They’re going to have an infusion of isoprenaline ready.’
‘And then what?’
Mark shrugged. ‘He’ll almost certainly need a permanent pacemaker, but they’ll assess that when he arrives. Do you want to send him back to me and then arrange an ambulance?’
Holly asked Tina to arrange for an ambulance and returned to Mr Fox, taking him back to Mark, staying close while Mark explained the seriousness of the condition.
Then she went back to her own list of patients which had grown in her absence.
By the time she’d seen the last of them it was well into lunchtime and she slipped quickly into the staffroom to make herself a cup of coffee.
‘What a morning.’ Tina was lounging in one of the armchairs, her eyes closed, and Ian was munching his way through a packet of sandwiches. ‘I’d swear that some people come on holiday just to get a second opinion from another doctor. How can so many tourists develop ailments the minute they arrive here?’
Ian laughed and tossed his sandwich wrapper in the bin. ‘It does seem to have been unusually busy. Is it your turn to do the lifestyle clinic tonight, Holly?’
Holly nodded and settled herself in one of the chairs, relaxing slightly now that she realised that there was no sign of Mark.
‘Has anyone heard anything of Jack Finn?’ she asked, taking a sip of coffee and then wincing as she burnt her tongue.
‘I popped in on him last night actually,’ Ian told her. ‘The cardiologists are very pleased with him.’
‘That’s good.’ Holly took another sip of coffee and then spilt a large portion as Mark strode into the room.
‘What a morning.’ He looked tense and harassed, fine lines of tiredness around his dark eyes. But, then, he hadn’t had any sleep last night either, Holly reminded herself, springing to her feet and fetching a cloth to mop up her coffee.
Blushing self-consciously she dabbed at the mess on the carpet, casting an apologetic look at Ian who was watching her thoughtfully.
‘Sorry. Not concentrating,’ she mumbled, putting the cloth back on the draining board and making for the door. ‘I need to get on. See you later.’
Ian frowned. ‘Holly...’
But she slipped quickly away, pretending not to have heard him, too agitated by Mark’s presence to stay in the same room as him a moment longer.
Her afternoon vaccination clinic seemed to drag and the children were more fractious than usual.
‘It’s the heat,’ Caroline murmured, dishing out sweets to a howling four-year-old who’d just been given her pre-school booster. ‘It’s making us all cross.’
Only Caroline didn’t seem cross at all, and Holly realised that she hadn’t given Greg’s whereabouts a thought.
‘Did you have a nice evening?’ She took advantage of a break in the stream of babies to ask Caroline about her date.
‘Perfect.’ Caroline gave her a soft smile that left no room for doubt. ‘Greg’s fantastic. He came back to my place last night. I suppose we should have called you—did you wonder where he was?’
‘No.’ Holly managed a wan smile. ‘We guessed.’
‘I owe you an apology, Holly,’ Caroline said quietly. ‘I was less than welcoming when you arrived and you were so nice to me. I’m really sorry.’
