any of that vague, reluctant awareness of her as a single, eligible woman have translated into signals?
The possibility weighed on him, even in the midst of this medical crisis, and it was a huge relief to hear Lucy say, 'He must have some mobility. He's not always in the wheelchair. I've just looked at the soles of his shoes, and there's dried mud in the treads.'
'That's consistent with the position of the scarring,' Heather was saying. 'His neural tube must have been open quite low down. Then I'm guessing he had surgery for spinal cord tethering at some stage.'
Then it clicked, just as Lucy said, 'What's happening to his face?'
'Get me the drill and the adrenaline, now,' Malcolm said urgently. 'I've just remembered who he is.'
The activity around the patient went into overdrive. Lucy had gone for the adrenaline, and they could all see now how the man's mouth was swelling and his breathing was becoming more laboured. His throat would be swelling rapidly as well, and his blood pressure would be plummeting. He was in full anaphylactic shock, and Heather said aloud what they all understood.
'He must be allergic to latex!' Her wide dark eyes were still fixed on Malcolm, as Nurse Sandra Corman ran for the drill.
'Severely,' Malcolm said. 'But that's not the only thing threatening his life at the moment.'
He didn't wait to watch as Heather prepared a syringe of adrenaline and injected it in the man's upper arm, into the fatty layer beneath the skin. Instead, he took the drill and positioned it on the patient's skull. If he didn't release the cerebrospinal fluid that was building to acute pressure at the brain stem, causing this unconscious state...
It was a spine-chilling sound, that high-pitched metallic whine, and Heather wasn't the only one to wince and hiss at it. It did the trick, though, and the clear fluid that had been building up inside Sam's skull—yes, his name was definitely Sam, Sam Ackland—began to drain through the two holes Malcolm had made.
Meanwhile, the symptoms of anaphylactic shock had subsided, and Lucy had hunted up a box of plastic gloves to replace the latex ones which had triggered the dramatic reaction. For the moment, the tension could ease a little.
'His name is Sam Ackland,' Malcolm said as he continued to work, setting up a drip so that a rapid infusion of fluids could correct the patient's dangerously lowered blood pressure. 'And he was in here with bronchitis and pneumonia and acute respiratory failure a couple of years ago. He had a dangerous weight problem then, and was very unfit, but he looks like he's in far better shape now.'
'Yes, look at his shoulders,' Heather said.
'That's one of the reasons I didn't recognise him at first,' Malcolm said, nodding. 'Hell, I feel angry with him! He's obviously done really well with the weight and exercise, but he must have been having symptoms of fluid pressure on the brain. He has a shunt, and it looks as if it must have failed for some reason. Why did he ignore the symptoms? He'd have been having some pretty uncomfortable ones—headaches, sleepiness, maybe even vomiting. Possibly other things like swallowing difficulties, neck pain, weakness in the arms. And he's by no means out of the woods yet.'
'You mean permanent impairment to the brain?' Heather Woodley frowned.
'Unfortunately, yes.' Malcolm nodded. 'We'll send him along to Radiology for a CAT scan, and then he'll be admitted to one of the neurosurgeons. Nick Blethyn, probably. Ultimately, he'll need to have that shunt checked out thoroughly, and probably replaced. We won't know for a few days whether he's escaped permanent damage or not For that matter, we won't know if he's going to survive...'
He heard Lucy give a shocked hiss.
'Does he have family we can contact?' she asked at once, and Malcolm thought that it was typical of the Lucy he'd known six years ago, who'd always been so quick to think of family and how other people felt. In those essentials, she obviously hadn't
The possibility weighed on him, even in the midst of this medical crisis, and it was a huge relief to hear Lucy say, 'He must have some mobility. He's not always in the wheelchair. I've just looked at the soles of his shoes, and there's dried mud in the treads.'
'That's consistent with the position of the scarring,' Heather was saying. 'His neural tube must have been open quite low down. Then I'm guessing he had surgery for spinal cord tethering at some stage.'
Then it clicked, just as Lucy said, 'What's happening to his face?'
'Get me the drill and the adrenaline, now,' Malcolm said urgently. 'I've just remembered who he is.'
The activity around the patient went into overdrive. Lucy had gone for the adrenaline, and they could all see now how the man's mouth was swelling and his breathing was becoming more laboured. His throat would be swelling rapidly as well, and his blood pressure would be plummeting. He was in full anaphylactic shock, and Heather said aloud what they all understood.
'He must be allergic to latex!' Her wide dark eyes were still fixed on Malcolm, as Nurse Sandra Corman ran for the drill.
'Severely,' Malcolm said. 'But that's not the only thing threatening his life at the moment.'
He didn't wait to watch as Heather prepared a syringe of adrenaline and injected it in the man's upper arm, into the fatty layer beneath the skin. Instead, he took the drill and positioned it on the patient's skull. If he didn't release the cerebrospinal fluid that was building to acute pressure at the brain stem, causing this unconscious state...
It was a spine-chilling sound, that high-pitched metallic whine, and Heather wasn't the only one to wince and hiss at it. It did the trick, though, and the clear fluid that had been building up inside Sam's skull—yes, his name was definitely Sam, Sam Ackland—began to drain through the two holes Malcolm had made.
Meanwhile, the symptoms of anaphylactic shock had subsided, and Lucy had hunted up a box of plastic gloves to replace the latex ones which had triggered the dramatic reaction. For the moment, the tension could ease a little.
'His name is Sam Ackland,' Malcolm said as he continued to work, setting up a drip so that a rapid infusion of fluids could correct the patient's dangerously lowered blood pressure. 'And he was in here with bronchitis and pneumonia and acute respiratory failure a couple of years ago. He had a dangerous weight problem then, and was very unfit, but he looks like he's in far better shape now.'
'Yes, look at his shoulders,' Heather said.
'That's one of the reasons I didn't recognise him at first,' Malcolm said, nodding. 'Hell, I feel angry with him! He's obviously done really well with the weight and exercise, but he must have been having symptoms of fluid pressure on the brain. He has a shunt, and it looks as if it must have failed for some reason. Why did he ignore the symptoms? He'd have been having some pretty uncomfortable ones—headaches, sleepiness, maybe even vomiting. Possibly other things like swallowing difficulties, neck pain, weakness in the arms. And he's by no means out of the woods yet.'
'You mean permanent impairment to the brain?' Heather Woodley frowned.
'Unfortunately, yes.' Malcolm nodded. 'We'll send him along to Radiology for a CAT scan, and then he'll be admitted to one of the neurosurgeons. Nick Blethyn, probably. Ultimately, he'll need to have that shunt checked out thoroughly, and probably replaced. We won't know for a few days whether he's escaped permanent damage or not For that matter, we won't know if he's going to survive...'
He heard Lucy give a shocked hiss.
'Does he have family we can contact?' she asked at once, and Malcolm thought that it was typical of the Lucy he'd known six years ago, who'd always been so quick to think of family and how other people felt. In those essentials, she obviously hadn't
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