An Unexpected Proposal

She traced her fingers over his face. So he wasn’t skater boy but he had a nice smile and despite everything she still loved him. They’d been together for ever—since they’d been twenty. You couldn’t just wipe that love out overnight. And she’d be damned if she’d let some inexplicable attraction to a bit of rough derail her conviction that the split with Simon was just temporary.

She heard the bell ding over the door and was pleased at the distraction. She thought it would probably be George back from his house call so she was surprised to see young Brett Sanders looking as white as a ghost, supporting his very grey, very sweaty mother.

Madeline hurried over. ‘Mrs Sanders, what’s wrong?’ she demanded, quickly assessing the woman’s cool, clammy skin, breathlessness and racing pulse.

‘It’s her indigestion,’ said Brett. ‘I wanted to take her to the hospital but she said she was fine and that you were closer. But she got worse in the car…’ He trailed off, his voice cracking with fear and unshed tears.

‘It’s OK,’ Madeline soothed, sitting Mrs Sanders down next to the emergency trolley near the front desk. It was basic, holding just oxygen, an ambubag, some adrenaline mini-jets and a portable defib unit. She quickly assembled a face mask and placed it on her patient’s face, cranking up the oxygen. She hoped it wasn’t too little too late. Mrs Sanders was in a lot of pain and it was extending down her left arm.

‘Brett, go and ring the ambulance on the phone at the desk. Triple zero.’

Even at seventeen, people in a panic could forget the number that had been drummed into them since they could talk. And Brett Sanders was about as panicked as she’d ever seen anyone.

‘Tell them that your mum is having a heart attack. OK, Brett? Do you understand?’

He looked at Madeline, alarmed, and she thought he was about to cry. ‘Brett.’ Madeline shook him. ‘I can’t leave your mother. You must do it now.

You’ve done so well. I need you to do this.’ Her voice was calm but firm.

He got up and made the call, while Madeline took Mrs Sanders’s blood pressure. Suddenly, the woman let out a pained moan, clutched at her chest and lost consciousness. Madeline knew immediately without having to feel for a carotid pulse that the woman was in cardiac arrest. With Brett’s help she dragged the obese Mrs Sanders onto the floor, rolled her on her side and cleared her airway.

‘Brett, run next door. There is a doctor there called Dr Hunt—get him. Go now, Brett—now.’ Madeline knew from experience that CPR was much easier with two people. She just hoped he’d be able to see past their earlier confrontation. The youth took one look at his mother and fled.

Madeline dragged the recently purchased semi-automatic external defibrillator off the trolley, switched it on and followed the electronic voice prompts. She ripped open Mrs Sanders’s blouse, buttons flying everywhere, cut open her bra with scissors from the trolley and slapped the two defib pads in the right positions on her chest.

While the machine analysed her patient’s heart rhythm, Madeline assembled the mask-bag apparatus and hooked it up to the oxygen to deliver mechanical breaths to Mrs Sanders as soon as the machine had analysed the heat rhythm.

‘Shock not recommended,’ the electronic voice announced. ‘Commence CPR.’

Madeline was in the middle of chest compressions when Marcus and Brett came through the door.

‘What happened?’ he demanded, shirt flapping wide.

‘Fourteen, fifteen,’ Madeline counted out loud with each downward compression of the sternum. She passed him the bag-mask and was grateful that he expertly took over the respirations, holding the mask and the patient’s jaw with the practised ease of an anaesthetist.

‘Myocardial infarction. She’s arrested. The ambulance is on its way.’

They worked together as a team. Marcus gave one breath to Madeline’s five compressions, stopping every two minutes for the defib to analyse the rhythm again.

‘Shock recommended,’ the voice said after nearly ten minutes.

Madeline almost cheered. They’d gone from an unshockable rhythm to one the defib deemed it could help. Had she moved from asystole into VF? Were they making real headway with their CPR?

Madeline checked they were well clear of Mrs Sanders’s body before she pushed the shock button.

‘Brett,’ she said, ‘why don’t you go and wait for the ambulance outside? They’ll be here soon.’ The poor kid had seen enough today and was barely holding it all together. He didn’t need to see how his mother’s body would jump as the current arced through her chest.

‘I don’t want to leave her.’ The boy’s voice cracked with emotion he was desperately trying to keep in check.

‘Brett,’ Marcus said calmly, ‘we have everything under control here.’ He gave a reassuring smile. ‘You can be a bigger help by greeting the ambulance and guiding them to us.’

Brett nodded miserably and left reluctantly.

‘Stand clear,’ said Madeline in a loud voice as they both backed away from the patient, making sure no part of them was touching Mrs Sanders in any way.

Madeline hit the green ‘deliver shock’ button and they both watched as the patient’s chest bucked with the electricity. The machine told them to wait as it reanalysed.

‘We need IV access,’ Madeline said, slightly puffed from the exertion of depressing the patient’s sternum. Her arms were beginning to ache.

‘Shock not recommended,’ the defib pronounced.

‘Intubation gear, too,’ said Marcus, as he resumed his position at Mrs Sanders’s head.

She admired his skill but found herself wishing he’d do up his buttons. ‘What? No eye of toad or wing of bat, Dr Hunt? No magic wand?’ she taunted unreasonably, going back to her compressions. It was bitchy and uncalled for, given his willingness to help after she had called him a quack, but puh-lease! How could she even be thinking about his barely dressed body at such a time?

‘Too late for that now, Maddy,’ he stated, his lips tightening. Her gibe might have been amusing at another time but he too was way more distracted than he should have been by how her skirt had ridden up, exposing a generous length of thigh, and the way the silk of her blouse pulled tautly, sliding seductively over her pert breasts with each downward compression. There was a time and a place and this was definitely not it!

Madeline heard the sirens wailing somewhere close by and breathed a sigh of relief. Locked in this battle with Marcus to save Mrs Sanders’s life seemed deeply intimate and she was pleased that other health-care professionals would soon join them and break the connection.

The two ambulance officers were there within the minute and Madeline explained what she knew and the four of them worked together. One of the ambulance team worked on intravenous access while Madeline and Marcus continued CPR. The other drew up first-line drugs.

‘We need to intubate,’ said Marcus when the machine recommended no shock again.

The officer handed him a laryngoscope and Marcus inserted the cold heavy metal into the patient’s mouth as he manoeuvred her head with his other hand. The light on the instrument shone down her throat and Marcus angled it around slightly until he could visualise the white vocal cords.

‘Size eight endotracheal tube, please.’

Marcus skilfully inserted the plastic airway into the trachea and removed the mask from the bag-mask apparatus, connecting the bag to the top of the tube and squeezing oxygenated air into the lungs. The paramedic tied the tube in place.

The machine reanalysed again and everyone moved back as it recommended a shock and Madeline pushed the green button. They moved back in and Marcus felt for a pulse.

‘Got one,’ he said.

There was no time for congratulations. ‘Let’s load her and go,’ said the paramedic who had established the intravenous access. They swapped the defibs for one of theirs, which had a full-screen cardiac monitor attached, and Madeline helped load their patient onto the trolley as Marcus continued to administer breaths.

Madeline noted the tachycardia, relieved that they had got Mrs Sanders back, but she was having runs of VT and Madeline knew that her condition was still critical and unstable. They had her ready for transport quickly and Madeline put her arm around Brett who was silent and pale, obviously shocked by everything that had just happened.

‘Come on, son,’ Marcus said gently, passing over the bag to the paramedic. ‘You can ride up front.’ Brett nodded absently, following his stretchered mother like a zombie.

‘I’d like to ride in the back with her—is that all right?’ Madeline asked the paramedics, who gave her a nod. If she arrested again, another pair of hands would be helpful.

‘I’ll follow in my car,’ said Marcus.

She turned to face him and took an abrupt step back, not realising how close behind her he was.

‘There’s no need,’ she said, trying not to sound ungrateful. After all, she couldn’t have done it without him. Now the immediate emergency was over, the ebb of the adrenaline that had surged through her system was making her nauseous. Combined with her jet lag, she was shaking badly.

He put his hands gently on her shoulders and frowned at their trembling. ‘Are you OK?’ he asked, applying slight pressure to her shoulders.