The Nurse's Christmas Wish Read online

  ‘I don’t do relationships, Louisa.’ He had to be honest with her even though he knew he’d be hurting her. ‘Not any more.’

  There was a long silence.

  Then she gave a brave smile. ‘No.’ Her tone was wistful. ‘Of course you don’t. I understand.’

  No, she didn’t. She didn’t understand anything.

  For a brief, frustrating moment Mac wanted to smash his fist into the wall.

  ‘Louisa—’

  ‘Oh, no!’ She stood up suddenly, almost tipping the chair in the process, her eyes sliding round the kitchen.

  He frowned. Now what? ‘What’s the matter?’

  ‘Where’s Hopeful?’ She raked tangled dark curls out of her eyes, her expression anxious as she searched under the table and behind the curtains. ‘We left him in here last night. I thought we shut the door.’

  Mac thought for a moment and then groaned. ‘He rushed past me when I opened the door this morning.’

  He hadn’t been concentrating. He’d other things on his mind.

  Like the way she’d given all of herself to him. No holding back.

  ‘I hope he hasn’t been up to mischief.’ She hurried out of the kitchen and Mac followed her, biting his lip to prevent himself from pointing out that Hopeful’s entire life consisted of mischief.

  She saw the best in everyone. Even the dog.

  They found Hopeful in the sitting room, coughing up pieces of coloured paper over the polished floor, the Christmas tree lying full length across the room.

  ‘Oh, no, he’s knocked the tree over.’ In a second she was on her knees by the dog. ‘Did you have a fright, darling? Are you hurt?’

  Mac looked at the debris over his sitting room and shook his head in disbelief. ‘Nothing would hurt that dog,’ he said dryly. ‘He’s indestructible.’

  ‘He’s eaten something, Mac.’ Louisa picked up some bits of shiny paper and then glanced at the tree. ‘He’s eaten the chocolate decorations. Including the paper.’

  ‘Not very discriminating, then.’

  Louisa stuck her fingers in the dog’s mouth. ‘Spit it out, Hopeful,’ she urged. ‘Come on, darling, you can’t eat that.’

  Mac looked at the mess on his floor. ‘I think he has already spat it out. All over my living room.’

  Louisa didn’t even look up. ‘We need to take him to the vet again. All that paper might upset his insides.’

  ‘My credit card hasn’t recovered from the last visit.’

  ‘Don’t joke.’ Louisa scrambled to her feet, dragging Hopeful with her. ‘Let’s get him in the car. Quick, Mac.’

  ‘Louisa.’ Mac tried to keep his tone patient, ‘the dog will be fine. Whatever he’s swallowed will come out again. That dog looks totally healthy. Just a little sick from too much chocolate.’

  She bit her lip, her arms still wrapped round the dog. ‘You don’t know that. You’re not a vet.’

  Realising that nothing short of a big bill was going to reassure her, Mac gave a sigh and reached for his coat.

  ‘All right, we’ll go. But you’d better put some clothes on or you’ll shock the vet.’

  CHAPTER NINE

  THE vet was suitably reassuring. ‘Don’t give him any more chocolate,’ he said as he finished examining Hopeful, ‘and don’t worry about the paper. It will work its way out.’

  ‘Probably over my carpets,’ Mac said wearily as he proffered his credit card again.

  They walked back to the car, leading a chastened Hopeful.

  ‘There, darling,’ Louisa said gently, ‘you sit in the back.’

  ‘And if you’re sick in my car, you’re going back in the ditch,’ Mac muttered, and Louisa smiled at him.

  ‘I know you don’t mean that.’

  Mac slid into the driver’s seat next to her. ‘Louisa, that dog has cost me a fortune! Vet’s bills are outrageous. Do you realise how much I just paid him for the privilege of being told not to give him any more chocolate? Chocolate that I didn’t want him to eat in the first place.’

  Louisa chuckled. The truth was she was grateful to Hopeful for offering a distraction.

  When she’d woken that morning and found Mac gone, she’d felt as though she’d been showered with cold water. Nothing had prepared her for waking up alone.

  The night they’d spent together had been intense, frantic, passionate and totally honest.

  He’d held nothing back from her. And she’d held nothing back from him.

  So she hadn’t expected the chill she’d experienced when she’d walked into the kitchen.

  It was like going from the tropics to the Arctic without a suitable change of clothes.

  How could he be prepared to walk away from what they’d shared? How could he pretend that it had meant nothing?

  Louisa bit her lip and stared out of the window. Anything rather than look at him. It was time to accept some truths. She had to accept that, for Mac, no one would ever replace his wife. Clearly she had left a gap that no one could ever fill, she thought miserably, watching as the snowy countryside flashed past.

  And one night of passion, however breathtaking, wasn’t going to change that.

  She could force him to accept people into his life, but she couldn’t force him to accept her into his heart.

  * * *

  Christmas Eve turned out to be the busiest day of the year in the A and E department.

  Louisa found herself working alongside Josh as they struggled to cope with the steady influx of patients.

  ‘Fifty-year-old man coming in with chest pain,’ she called out to him as she replaced the receiver of the ambulance hotline. ‘They’ll be here in five minutes. Shall I see if there’s room in Resus?’

  Josh shook his head. ‘Mac’s already in there with two patients and there’s an RTA coming in—the guy will be safer in one of the side rooms where the equipment hasn’t been stripped. Let’s get an ECG ready and prepare some drugs. And run through an IV.’

  Louisa nodded, seeing the sense in what he was saying. They were still working on two patients in Resus and they hadn’t yet had time to restock the equipment.

  ‘So much for spending the day eating mince pies and singing Christmas carols,’ she said dryly, and Josh looked at her.

  ‘Are you all right? You look tired.’

  She was exhausted. Thanks to the bedroom skills of his brother.

  ‘I’m fine.’

  Josh cast her a speculative glance. ‘You’re far from fine. What’s happened?’

  Louisa felt the colour seep into her cheeks and Josh gave a sigh.

  ‘OK, I know that look. You’d better tell me everything.’

  ‘There’s nothing to tell.’ She gave a tiny shrug. ‘Your brother is so in love with his wife that he can’t see another woman and perhaps he never will.’

  ‘Is that what he told you?’ Josh stared at her in shock and then gave a little shake of his head. ‘No, Louisa, that isn’t—’

  The shriek of a siren interrupted them and Louisa glanced towards the doorway, pleased for the excuse to change the subject. She didn’t really want to talk about it. The discovery that she’d finally fallen in love with a man who couldn’t love her back left her hollow inside. She’d waited so long to meet a man she knew she could be happy with, could make a family with. ‘We can’t talk about this now. That’s our patient. I’ll get the side room ready.’ She gathered together all the things she anticipated that they’d need just as the ambulance arrived.

  She recognised the paramedic from the accident the night before. ‘Hi.’

  His face brightened as he recognised her. ‘Well, if it isn’t our little heroine. Those kids are doing really well, thanks to you and Mac.’ He pushed the stretcher alongside the trolley. ‘This is Tom Parker. He was at his firm’s Christmas party when he started getting central chest pains radiating down the arm.’

  ‘It’s just indigestion,’ the man groaned, screwing up his face as the pain hit again. ‘Too many sausage rolls. And I should never have dan
ced with the girl from Accounts.’

  ‘Sounds like a good party,’ Josh drawled. ‘We just need to transfer you onto our trolley and then we can take a look at you.’

  Louisa and the paramedics helped the man across onto the A and E trolley. ‘Have you ever had these pains before?’

  Her eyes scanned the patient, noticing that he was very pale and sweaty. Alarm bells rang in her head. This had nothing to do with sausage rolls.

  She glanced at Josh. ‘Right with you,’ he said softly, as he reached for a cannula. ‘We’ve called the coronary care team. They’re on their way. Give him a puff of GTN spray, Louisa,’ he ordered as he slid the cannula into the vein. Then his blue eyes lifted to hers. ‘And when we’re done here, you and I need to have a talk.’

  What was there to talk about?

  She was in love with his brother and talking about it wasn’t going to change the facts. That he didn’t love her.

  Louisa checked the patient’s observations while Josh carried out his examination and checked the ECG trace.

  ‘He has ST elevation and pathological Q waves,’ he muttered, his eyes fixed on the trace. He turned to the SHO who was working with him. ‘Let’s get a line in, take bloods for urgent U and E, glucose, CK, FBC and baseline cholesterol. And let’s give him something for the pain. Louisa?’

  Louisa handed him a syringe of morphine and cyclizine for sickness. ‘Is there anyone you’d like me to phone, Tom?’ She checked his blood-pressure reading again. ‘Is your family expecting you home?’

  He nodded, his face contorted with the pain. ‘My wife. But not until later. I was expecting to stay at the party until mid-afternoon. I left the car at home. She was going to pick me up.’

  ‘Sensible man,’ Louisa said, thinking of the two teenagers. ‘I’ll call her,’ she promised. ‘Do you have a number?’

  At that moment the coronary care team arrived and Louisa wrote down the number that Tom gave her and made the call, choosing her words carefully so that she didn’t worry his wife.

  Tom was transferred quickly to Coronary Care and Louisa found herself helping out in the treatment room, dressing the arm of a child who had cut herself.

  ‘Her brother threw a snowball and it must have had a stone in it,’ the mother told her helplessly, looking completely fraught. ‘Can you imagine? For the first time in years it snows and we all think we’re going to have a fairy-tale Christmas and here we are in A and E! We were supposed to be sitting by the fire, watching the repeats on the television and arguing.’

  Louisa laughed. ‘Isn’t that life, though? It never quite works out the way you expect.’

  Hers certainly didn’t.

  She finished bandaging the child’s arm and wished her concentration was better. All she could think about was Mac.

  She’d arrived just for Christmas and suddenly all she wanted to do was stay for ever.

  Her hands stilled on the bandage and for a moment her need for him was so severe that she could hardly breathe. Was this what he’d felt for Melissa? If so, no wonder he couldn’t move on. No wonder he couldn’t fully give himself to anyone else. She couldn’t imagine ever having this depth of feeling again.

  He was right when he said that she wanted happy ever after. It was all she’d ever wanted—with the right man. But sadly Mac didn’t think he was the right man.

  ‘Nurse?’ The mother was watching her closely. ‘Are you all right?’

  Louisa made a supreme effort and managed a smile. ‘I’m fine, thanks. Just a little tired. We’ve been terribly busy. A white Christmas is pretty but it creates havoc in A and E. Come back in three days to have the dressing changed. And have a lovely Christmas.’

  ‘Can we go home now?’ The little girl looked at her, her eyes shining with excitement. ‘Santa is coming tonight. I have to be asleep or he doesn’t come.’

  Louisa felt her heart twist. ‘That’s right. So you do.’ She brushed the child’s hair out of her eyes. ‘Did you write him a letter?’

  The little girl nodded her head solemnly. ‘I asked for a doll. The one that wets her nappy and drinks from a bottle.’

  Louisa nodded. ‘Sounds great.’

  She watched them go with a wistful expression on her face, wondering whether she’d ever know what it was like to be part of a family.

  It had been her dream for as long as she could remember.

  And it looked as though that was where it was going to stay. In her dreams.

  Mother and child left just as Mac put his head round the door. ‘There you are. I’ve been looking for you.’

  Her heart leapt and danced in her chest and suddenly she felt light-headed. ‘Did you need me for something?’

  He gave a brief nod. ‘A woman just wrapped her car round a tree. She’ll be here in five minutes. I need the trauma team in Resus.’ He looked drawn and tired. ‘Louisa, will you bleep the surgeons and make arrangements for a CT scan just in case...?’

  Work.

  With him it was always work.

  And he didn’t need her for anything except his trauma team.

  She gave a nod and turned her back for a moment to hide the pain in her eyes. ‘I’ll be there in just a moment.’ She tipped the debris from the dressing into the bin, keeping her back to him until she heard the door swing shut behind him. Then she turned her head and glanced towards the place he’d been standing, her eyes glistening with tears.

  ‘You don’t need me for anything, Mac Sullivan,’ she said softly. ‘Nothing at all.’

  * * *

  The woman was in bad shape.

  ‘She’s local and her husband is on the way in.’ The paramedics transferred her across to the trolley and everyone swung into action.

  From the start, Mac was white-faced and tense. ‘Hannah, start the clock. Get a central line in but hold fluids until we know where she’s bleeding from. She has distended neck veins.’

  Josh administered oxygen. ‘You think she has a cardiac tamponade?’

  ‘I don’t know.’ Mac’s face was grim. ‘And until I know I’m not going to give indiscriminate fluid replacement. The aim is to restore circulatory status to the point of critical organ perfusion. If we raise arterial and intracardiac pressures we could cause fatal haemorrhage. Let’s do a chest X-ray and a FAST examination.’

  Hannah finished cutting off the patient’s clothes. ‘But this was blunt injury. Isn’t cardiac tamponade usually a result of penetrating injury? Stabbings and so forth?’

  ‘Usually but not always.’

  Louisa let her gaze slip to Mac. He didn’t take his eyes off his patient. He was constantly monitoring, examining, looking for minute changes that might give clues as to the patient’s condition.

  He was a very talented doctor.

  Now he was listening to the patient’s heart, a frown on his handsome face. ‘Can we keep the noise down, folks?’ he growled, his eyes shut as he tried to concentrate. Moments later he ripped the stethoscope out of his ears. ‘Muffled heart sounds and hypotension. I’m guessing she has cardiac tamponade. Let’s do a scan. Are those X-rays ready?’

  Sue put the films into the light box and Mac studied them carefully.

  ‘Her pressure is falling,’ Josh murmured, and Mac nodded as he scanned the patient.

  Louisa watched as he placed the transducer just to the left of the xiphisternum and angled upwards under the coastal margin.

  ‘I haven’t seen that done before.’

  Mac had his eyes on the screen. ‘It’s just an ultrasound that you can perform by the bedside.’ He moved the transducer. ‘Helps to identify intraperitoneal haemorrhage or, in this case, pericardial tamponade.’

  Josh looked at his brother. ‘Her pressure is still falling.’

  ‘She’s not responding. Hannah, emergency bleep the cardiothoracic surgeons and let’s attach the patient to an ECG. We’re going to have to do an emergency pericardiocentesis—I want to see if I can draw some blood from the pericardial space. Louisa—get me a pack. Let’s move, everyone.
I won’t lose her.’

  There was something in his tone that made Louisa glance at his face. It was a mask, not one flicker of emotion showing on his features. She caught Josh’s eye and he gave a brief shake of his head, indicating that she shouldn’t interfere.

  Reminding herself that she had a job to do, Louisa quickly grabbed the equipment he needed while Mac scrubbed and donned gloves and an apron.

  He prepared the skin surgically and then held out a hand. ‘Local anaesthetic—and then I’m going to need a wide-bore, plastic-sheathed needle.’

  Louisa handed him the syringe and watched while he infiltrated the area and then inserted the needle. As the needle advanced Mac aspirated. ‘This doesn’t always work,’ he murmured for the benefit of the more junior doctors who were watching in awed silence. ‘In about a quarter of cases the blood around the pericardium has clotted and it isn’t possible to aspirate.’

  His eyes flickering to the ECG and then back to the syringe as it filled with blood. ‘But in this case that hasn’t happened. She’s going to need a surgical exploration.’

  ‘Her pressure is still falling,’ Josh said, his eyes on the monitors, and Mac’s mouth tightened.

  ‘Someone get the surgeons up here now!’

  His tone was harsh and unusually impatient, and Louisa knew that to Mac this case had become personal.

  He was thinking of his wife.

  * * *

  ‘Her husband is still in the relatives’ room,’ Josh said wearily, after they’d handed the patient over to the cardiothoracic team and transferred her to Theatre. ‘Do you want me to talk to him?’

  Mac breathed out slowly and shook his head. ‘No, I’ll go and talk to him. But thanks.’ He gave a wintry smile as he ripped off his gloves and dropped them in the bin. ‘Louisa, will you come with me?’

  They walked in silence to the relatives’ room and Louisa felt Mac’s tension grow with every step.

  She could almost feel his pain.

  Was he remembering another winter’s evening when he’d been the one waiting to hear news?

  Suddenly it didn’t seem right that he was the one to do this, and she put a hand on his arm and stopped him. ‘Wait.’ Her tone was soft, and she pulled him to one side, conscious of the other members of staff hurrying past. ‘You don’t have to do this, Mac. Josh could do it. Or one of the others.’