Page 34 of Stranded with the Surgeon

His tanned, lean chest had just a faint cover of dark hair in a V that pointed to an admirably flat belly.

Professor Jennifer Allen had yet another one of those momentary lapses, but it was easy enough to recover this time. Guy’s shoulders had been much broader and this man was on the skinny side of lean. His ribs were prominent rather than overlaid with a firm layer of muscle.

It was ridiculous to be still experiencing these lapses anyway. Despite the intensity of their time together, Guy was still a stranger. She would never see him again so it was high time she stopped thinking about him so often.

Missing him.

A registrar was giving Jennifer a curious look, so she smiled reassuringly, introduced herself to the patient and then caught the younger doctor’s eye again.

‘This is Peter Cowl,’ she was informed. ‘He’s twenty-six and has a history of spontaneous pneumothorax. He came in with sudden onset, unilateral, localised chest pain and shortness of breath.’

The patient did not appear to be in a state of respiratory distress that might indicate the development of a tension pneumothorax. ‘What’s the oxygen saturation?’

‘He came in at eighty-six. It’s gone up to ninety-two on high-flow oxygen.’

‘How are you feeling, Peter?’

‘Bit puffed. Not too bad.’

‘How many times has this happened before?’

‘Three or four.’

‘Have you needed aspiration with a needle or tube before?’

‘Twice.’ The young man grimaced. ‘Would prefer not to… do it again.’

‘Sure. We’ll keep an eye on you and run a few tests, then we’ll decide how we’re going to manage this.’

Jennifer turned back to the registrar. ‘Get chest X-rays, both inspiratory and expiratory. And we’ll need an arterial blood-gas sample. Have you done one of those yet?’ She smiled again at the nervous head shake.

‘Get one of the senior registrars to assist you then. I’ll help if I can, but it’s a bit busy out there.’

Jennifer was already moving away from the cubicle. Busy was the kind of understatement that made light of their workload – a coping mechanism. The emergency department of Auckland Central was currently stretched to its limit. It would fit right into Jennifer’s day if Peter Cowl did develop a tension pneumothorax that required urgent decompression – probably when she was tied up with another critical intervention.

At least there were a dozen or so other people somewhere in this department qualified to perform such a procedure, plus all the equipment and backup they could possibly need. None of these doctors were ever likely to have to try and manage an emergency perched on top of a mountain in a makeshift tent, with only limited gear and no hope of assistance. Or success, in the long run.

They had no idea how spoilt they all were.

‘Dr Allen, can you spare a minute?’

‘What is it, Doug?’ The senior registrar was competent enough for his anxious expression to ring an alarm bell.

‘I’ve got a sixty-nine-year-old chap with sepsis from a urinary tract infection. He’s as flat as a pancake and I can’t get any peripheral IV access. He needs fluid resus, stat, and it’s going to take too long to do a surgical cutdown.’

‘Try a central venous line then.’ Jennifer caught the message in the glance she received and remembered that Doug had had major difficulties the last time he’d tried the procedure, but if this patient was in septic shock, this was hardly the best situation for a teaching session.

‘Are you set up?’

‘Yes.’

‘Okay, I’m all yours.’

‘Are you sure?’ Doug eyed the cast on her arm, but Jennifer nodded decisively. ‘It’s not a problem anymore. See?’ She waggled her fingers at him. ‘I’ve got full mobility in my hand.’

Doug led the way towards one of the curtained resuscitation areas past the central desk.

‘MVA coming in,’ the triage nurse warned Jennifer. ‘Three patients. Two status one. ETA five minutes.’

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