Needed: Full-Time Father

‘You know this is one of the proudest days of my life.’

‘There’d be a lot of proud moments in a life like yours, Gerard,’ Madison said warmly, and if it sounded gushing she didn’t care. Gerard Dalton was quite simply the finest doctor and the most honourable man she had ever met. A devoted husband and father, he had somehow managed to squeeze in a career that would have anyone reeling. As well as being an esteemed emergency doctor, he was also a tireless AID worker for developing countries. The long list of letters after his name had been extremely well earned and, always thrilled to work alongside him, Madison had been honoured when he’d hand-picked her to join him in the daunting task of getting the accident and emergency department of the brand new Heatherton Hospital up and hopefully running successfully.

‘There have been a lot of proud moments,’ Gerard agreed. ‘But this is something really special. I don’t know how many times I’ve said in my career that if only things were different, if only we had the right equipment, if only someone had thought to put that here or this there…’ He gave an apologetic smile. ‘I’m waffling.’

‘No, you’re not,’ Madison said. ‘I’ve been thinking exactly the same thing—all this wonderful new equipment, consultations with the designers, hand-picking the staff, it’s going to be wonderful.’

‘If you like that sort of thing.’ Gerard smiled and Madison did, too. ‘You either love hospitals or you hate them, I guess. What time do you think the staff will start getting here?’

‘Well, no one’s actually due to start until seven, but everyone was so enthusiastic when they came for orientation, I’m sure they’ll start trickling in after six.’

‘And the department officially opens at nine?’ Gerard checked his paperwork and Madison smothered a smile—they’d been over and over the details a thousand times, but despite Gerard’s amazing ability to retain anything remotely medical, when it came to trivial matters such as clocks, budgets or even where he’d put down his glasses, he was the original absent-minded professor.

‘We open at nine for patients making their own way in, but we’re closed to ambulances until eleven a.m., which will give us a couple of hours to iron out any minor hiccups that might arise.’

‘Good idea,’ Gerard agreed.

‘It was your idea, Gerard,’ Madison said, not bothering to hide her smile this time.

‘So it was,’ Gerard said. ‘Right, it looks like all we need now is a patient.’

‘And a consultant,’ Madison added, instantly regretting the slight edge to her voice. Because she’d worked alongside Gerard for so many years now, naturally he picked up on it.

‘You’re going to like him, Madison. Guy Boyd is the finest doctor I’ve had the privilege to work with.’ Which, coming from Gerard, was high praise indeed, but still Madison remained hesitant.

‘I just wish I’d met him. From what you’ve described, he’s not exactly…’ Her voice trailed off, not wanting to be rude, not wanting to judge before she’d even laid eyes on the man, but Gerard spoke for her.

‘Guy’s a bit of a free spirit,’ Gerard said, and no doubt he meant well, but the description of the new consultant brought absolutely no comfort to Madison, the words ‘free spirit’ searing through her like dental pain as she gritted her teeth. ‘He just doesn’t like to be tied down in one place for too long.’

‘He doesn’t like responsibility, you mean?’ Madison responded. ‘Look, I’ll reserve judgement till I’ve met him, Gerard, but we’ve known each other long enough to be honest, and the truth of the matter is I’m not particularly keen on “free spirits” wandering around my department. I want fully grounded, on-the-ball, committed workers.’

‘I know,’ Gerard answered, smiling placidly at Madison’s frown. ‘And I know we’ve both been in on every interview, that we’ve both agreed on every member of the team, but in Guy’s case he simply couldn’t get here because he was overseas. When I emailed him about the new department I couldn’t believe my luck—our luck—when he said that he was keen to be a part of it.’

‘But he’s only prepared to commit to a six-month contract,’ Madison pointed out. ‘We’re aiming for continuity, Gerard, staff who will follow the vision…’

‘We are.’ Gerard nodded. ‘And if it was anyone else I’d have said no but, believe me, six months with Guy Boyd on board is too good to pass up. You’re just going to have to trust me, Madison.’

‘Which I do,’ Madison said, forcing a smile, determined to let nothing mar this day. ‘I’m probably overreacting. I’m sure that he’ll turn out to be great.’

‘Once you get used to him,’ Gerard added, and Madison wished he hadn’t! ‘Guy’s not exactly into hospital politics. He’s not exactly politically correct—very much his own man,’ Gerard explained, but seeing Madison’s tight expression hastily turned his back and spooned sugar into a mug. ‘I’d best take this out to Vic. I noticed the sign diverting patients has been taken down. We ought to put it back up until the department officially opens.’

‘Gerard, when you say he’s not into hospital politics…’ Madison didn’t even finish her sentence, her audience lost as Gerard headed off for an extended chat with Vic. Madison headed through the department towards the entrance, picking up the sign the cleaners must have taken down when they’d polished the doors. She pressed it back against the glass, and jumped as a looming shadow appeared out of the darkness.

‘We’re closed,’ Madison mouthed, pointing to the sign, but perhaps in the subdued light she couldn’t be seen. It was either a patient who needed help or a member of staff, so Madison tapped the window and gestured to Reception. ‘Go that way,’ she said, exaggerating the words to make herself understood, peering into the bleak ambulance bay.

He didn’t look like a patient. Certainly, from his relaxed stance he wasn’t in any pain, although admittedly all she could really see was a white T-shirt. But there wasn’t any urgency in his actions.

‘Problem?’ Gerard asked, coming behind her and flicking on the light, which reduced Madison’s visibility to zero.

‘Either an eager patient or a keen member of staff.’

‘We can deal with both.’ Gerard gave a half laugh and, cupping his hands, pressed them against the window.

‘Why, it’s Guy!’ The delight in his voice forced Madison’s attention and she watched as Gerard fiddled with the door. ‘Can’t we open it?’

‘Not without Security,’ Madison answered, resisting the urge to cup her own hands against the glass and have a good look at the new, politically incorrect consultant, but curiosity got the better of her and, cupping her own hand against the glass, she peered out into the pre-dawn darkness. Her eyes squinted to focus then she stepped back as a smiling, utterly laid-back face greeted hers. Inexplicably she felt as if he was way, way too close to her, his presence definitely felt even though he was safely on the other side of a thick glass door. In that split second a shooting flame of something she couldn’t quite define rippled through her—and had Madison pulling away rapidly, catching her breath as if she’d been stung.

‘Are you OK?’

‘Fine,’ Madison answered briskly. ‘He’ll have to walk round to Reception. We should go and meet him…’ She headed off, expecting Gerard to follow her. After all, despite her own misgivings about his employment, it was the new consultant that was arriving and he deserved to be greeted. But as she walked back through the sterile waiting room it took a moment to realise she was walking alone.

‘Gerard?’ Turning with a smile, Madison stared back to where she’d just come from and froze. She stood fixed to the spot. Vaguely aware of the coffee from her cup splashing onto the new blue carpet, followed in a split second by the sound of the cheap, china mug thudding to the ground, the world moved in slow motion for a moment. A tiny, useless croak came from her throat and then she was running, running towards her boss, her friend, her confidant, running as fast as her legs would carry her, as Gerard slowly slid down the length of the glass door, his face in the fluorescent light a hideous purple. Then the world was speeding up again, seemingly stuck on fast-forward, and Madison begged it to slow back down as she reached her boss, broke his leaden fall a touch and lowered Gerard to the floor.

Madison crouched on her knees, willing herself to hold it together, drawing on her professionalism, almost reading off the chart that was tattooed in her mind, through the ABC—airway, breathing, circulation—trying, trying to treat him as a patient, desperate to give back to this amazing, talented man some of what he’d so readily delivered to others in the course of his career.

‘It’s OK, Gerard,’ Madison soothed him, her voice amazingly assured. She checked his airway, watching, praying to see the rise and fall of his chest as her fingers desperately fought to locate a pulse in his neck.

‘Gerard.’ Her voice was sharper now, tears muffling her words as she called out his name, but even as she pinched his nose, tried to keep her breathing even enough to drag in some air to exhale, clamped trembling fingers into position over his chest, Madison knew he had gone, knew in that moment the vital, eloquent, disarming man had already gone for ever.

But that knowledge didn’t stop her from trying to bring him back to them all—to his family that needed him, to his friends and colleagues that adored him, to the department he had created from the first blueprint.

Barely looking up as footsteps thudded towards her, she noted with relief that the new consultant had picked up vital emergency equipment on his way—an ambubag to reinflate Gerard’s lungs and a mini oxygen cylinder, even the red bag that contained a self-administering defibrillator. She moved aside as the man she’d briefly glimpsed ripped open the packages, connected the tubing and took over Gerard’s airway with an ambu-bag. She concentrated instead on cardiac compressions as Vic arrived, shouting into his walkie-talkie for assistance, dragged an oxygen cylinder over and connected it to the bag Guy was squeezing.

‘What happened?’ Guy’s voice was deep but urgent—no introduction, no niceties, because there was nothing nice about this.

‘You saw what happened,’ Madison answered, leaning in as she pummelled Gerard’s chest. ‘He just collapsed.’

‘Did he complain of chest pain?’

‘No.’

‘Headache, dizziness, shortness of breath?’

‘Nothing!’ She almost shouted it. ‘I thought he was walking behind me.’

‘Is there anything else I can do?’ It was Vic speaking now, Vic desperate to help, to do something, anything. ‘I let Switchboard know on my walkie-talkie as I was running over. The nursing supervisor was just pulling up in the car park when it happened, they’re going to send for her.’

‘We need to get him to Resus—get a trolley,’ Guy shouted, but Vic was already picking up Gerard’s shoulders, and Guy assisted him, somehow carrying the leaden weight. Madison raced ahead, turning on machines that had so far only been used in practice runs, completely unable to comprehend that the patient they’d so eagerly anticipated, had so long awaited, had trained and practiced for, had, in fact, turned out to be Gerard himself.

As Madison ripped open chest pads, Guy tore at Gerard’s suit then picked up the chest paddles and placed them over Gerard’s chest to give a reading of his heart rate.

‘Asystole,’ Madison said, seeing the flat line appear on the monitor. She plugged in the ambu-bag to the walled oxygen and commenced the breathing for Gerard, but Guy shook his head.

‘It could be fine VF,’ he said, hoping that the reading that was showing on the monitor wasn’t a true one—asystole was the worse kind of cardiac arrest, but there was a chance, a tiny one, that his heart was fibrillating and that the reading was so fine the machine couldn’t pick it up, a tiny chance that he had a type of cardiac arrhythmia that could be reverted and Madison stood back as Guy gave Gerard the benefit of the doubt and delivered a shock to his lifeless body.

‘Still asystole.’ Guy’s voice was hoarse. ‘Keep up the massage.’ They needed more hands, needed help here now, and thankfully it arrived. Shirley, the nursing supervisor, racing into Resus, her expression appalled when she took in the scene.

‘Bag him, Shirley,’ Madison ordered, clipping a tourniquet to Gerard’s flaccid arm and getting IV access as Guy continued to pound Guy’s chest. ‘Vic, call for an ambulance, tell them we need the MICA.’