In Dr Darling's Care

Marion Lennox | Harlequin | 2004

On her way to a locum job, Dr Lizzie Darling runs into her new boss. Unfortunately she's in her car at the time, leaving Dr Harry McKay with a broken leg!

Lizzie doesn't want to be a family doctor, or to get involved in the tiny community of Birrini. She doesn't want to get involved with Harry either, no matter how attractive and likeable he is. But, as the only available doctor, she has to stay. And, slowly but surely. Lizzie finds her heart going out to Birrini and its dangerously charming doctor...

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In Dr Darling's Care

by Marion Lennox

Memo:

Tell Emily: Doctors are not trained to tie pew ribbons.

Tell Emily: Doctors should not even need to admire pew ribbons. It’s not written in the wedding contract. Is it?

Remember to admire the bridesmaids. Don’t tell anyone I detest pink chiffon.

Do not slug Mrs. Smythe when she asks me yet again when we can expect the patter of tiny feet.

Run. Run until I forget how many people are intending to watch me get married tomorrow...

She’d hit him.

Dear God, she’d hit him. Dr. Lizzie Darling pushed Phoebe aside and shoved open the car door, her heart sprawled somewhere around her boots.

Where was he? There. Oh, no...

The man was face down in the mud right beside her car. Lizzie hadn’t been going fast – this was a blind bend on an unmade road and it was raining. She’d crawled around the bend, but Phoebe had snapped her dog-belt at just the wrong time. The vast basset hound had launched herself joyously at her new mistress and Lizzie had been momentarily distracted. Or maybe distracted was too mild a description for the sensation of a basset tongue slurping straight down your forehead.

Whatever.

What had she done?

He must have been jogging; but what was someone doing jogging in this wilderness? He was in his late twenties or early thirties, Lizzie guessed. She’d reached him now. The sick dread in her heart was almost overwhelming. What damage had she caused?

Stay calm, she told herself. Look. Think. Triage. Sort priorities and the first priority had to be to get herself calm enough to be professional.

Was he an athlete? With this build he surely could be. He was wearing shorts. His too small t-shirt revealed every muscle. On his feet were running shoes and he wore nothing else. Lying in the mud he looked like some discarded Rodin sculpture. A wounded Rodin sculpture.

But... not dead? Please?

How hard had she hit him? She’d practically crawled around the corner on the blind bend. He must have run into her as much as she’d run into him.

She knelt in the mud beside him and put a hand to the side of his neck. Beneath her fingers his pulse beat strongly. That was good. There wasn’t any blood. That was good, too.

But he wasn’t moving. Why?

Her momentary calm was receding as panic built in waves. Lizzie might be a qualified medical practitioner but she was accustomed to her emergencies coming through the front entrance of her nicely equipped emergency department – not lying in the mud at her feet. She looked wildly around her, taking in her surrounds. She truly was in the middle of nowhere.

Birrini was a tiny fishing town on the south coast of Australia. The road through the forest into this town was one of the wildest in Australia. Scenic, they called it, but no tourists ever came here at this time of the year. Especially now, when the road surface had been ripped up for road works. Local traffic only, the sign had said, and for good reason. The road was a series of hair pin loops around a jagged coastline. On one side was a sheer cliff face; the other side dropped straight to the sea.

And what a sea! From here the ocean fifty feet down was a churning maelstrom of foam, with jagged shards of rock reaching up like suppliant fingers in the foam.

Suppliant fingers... Hands raised in prayer. The analogy was a good one, she thought bitterly. Help was what she needed.

Action was what she needed. Here she was staring out to sea when she should be figuring out what to do with this guy.

She was figuring out how alone she was.

At least his breathing was fine. Her fingers had been moving over his face even as she looked about her, searching for what was most important. The stranger was face down but as her hand came over his mouth she felt the soft whisper of breathing. Thank God. She adjusted the position of his head a tiny bit – not enough to hurt if his neck was broken but a tiny sideways shift so his mouth and nose were clear of the mud.

So why wasn’t he moving?

`What’s wrong?’ she whispered, but there was no answer.

Had he hit his head? He must have. Her fingers kept searching and found what they were seeking – an ugly haematoma on the side of his forehead. There was a little blood. Not much.

Maybe this was momentary. Maybe she’d just stunned him.

What else? She sat back, her trained eyes running over his body. What...

His left leg.

She winced. It was all wrong. Just below the knee it twisted and was lying at a grotesque angle. She moved so that she was kneeling by it and winced again.

He’d snapped the bones beneath the knee. The tibia and the fibula must both be broken. She stared at it – at the position it was lying in. The position meant that there was a huge risk it’d be cutting blood circulation. In fact... With fingers that seemed numbed – horror had made her whole body seem numb - she edged off one of the guy’s boots and stared down. There was no mistaking the blue-white tinge to his toes.

No blood. She winced again, her mind racing. She was a good five miles out of Birrini . The way those toes had lost colour... Maybe he’d torn an artery.

No. Probably not. There didn’t seem enough swelling to indicate that level of internal bleeding. But the blood vessels must be kinked, and the speed that his foot had lost colour told her that he’d lose his leg before she could get help.

He needed X-rays, she told herself frantically. He needed careful manipulation under anaesthetic.

He had Lizzie and nothing and nowhere.

But at least she knew what had to be done, and as for anaesthetic... well, he was stunned now. He was temporarily – hopefully temporarily - out to it. What she needed to do would have him screaming in agony if he was conscious. She had morphine in the car but even so... It’d be far better to do this while he was unconscious and worry about pain relief if... when... he came around. So... `Move, Lizzie,’ she told herself. Any minute now he could gain consciousness and she’d have lost her chance.

But if only she had x-rays. She gave one last despairing glance at the road ahead. Nothing. She glanced up at the cliff and then down to the sea below. There was nothing there to help her either.

She took a deep breath, then moved so that she was kneeling beside the leg. Another breath. She stared down, figuring which way she should move. She may well do more damage with this manoeuvre – without x-rays she was flying blind. But the choice was to do nothing and watch his leg die, or try to move it into position. No choice at all.

She took hold of his left ankle in one hand and his knee in the other. It was harder than she thought. She was applying manual traction, easing the leg long and to the side. Trying – slowly and gently but with still with strength – to move it.

It wouldn’t go.

She wasn’t brave enough. She must be. More traction. She pulled and it moved. Just.

More traction. Twist...

And she heard it. Crepitus. The grating sound that fractured bones make as they move against each other. Crepitus was an awful name for an awful sound but now she almost welcomed it.

Had she done it?

Maybe.

Her fingers were on his leg and she felt – she was sure she felt? - the pulse return. She stared down, willing the colour to change. And in moments she was sure she wasn’t imagining it. There was a definite improvement in the skin tone of the toes.

He stirred and groaned. Little wonder. If someone had done to her what she’d just done to him, she’d have screamed so hard she’d have been heard back in Melbourne.

`Don’t try and move,’ she said urgently, her voice really, really unsteady - but he didn’t respond.

`Can you hear me?’

Nothing.

Okay. What next? She’d saved him from a dead leg. Well done, Lizzie. Now she just had to save him from cerebral haemorrhage, or internal bleeding or by being run over by another car as he lay in the road.

Her thoughts were cut off by another moan. The guy stirred and moaned some more and then shifted. He was finally coming round.

`You mustn’t move,’ she said again and he appeared to think about it. `Why not?’ His voice was a faint slur but it sounded really good to her. Not only was he gaining consciousness, he was gaining sense.

`You’ve been hit by a car.’ She moved again so that she could see his face, stooping so her nose was parallel to his nose. `You’ve broken your leg.’

He thought about that for a while longer. She’d laid her face in the mud beside his so that he could see her and she could see one of his eyes. She knew that he’d desperately need human contact and reassurance but she daren’t move him further.

It was a crazy position to be in, but panic could make him move. He mustn’t panic. So she lay in the mud so that he could focus.

He did. `Whose car?’ he managed and she winced.

`My car.’

That was another cause for some long, hard thinking.

`My leg hurts,’ he conceded at last. `What else?’

`You tell me,’ she said cautiously. `Where else hurts?’

`My head.’

`I think you hit your head on the road.’

`How fast were you going?’

`Not fast at all,’ she told him, a tiny bit of indignation entering her voice. He was making sense. No brain damage, then. `You ran straight into me.’

`Yeah, like you were stopped and I just smashed into your car. You’ll be suing me next.’ Amazingly there was a hint of laughter in the man’s voice. Laughter laced with pain.

But Lizzie wasn’t up to laughter. Not yet. No brain damage, she was thinking. He had enough strength left to give her cheek. She found she was breathing again but she hadn’t remembered stopping.

`I might sue you,’ she said cautiously, still nose to nose with him in the mud. `But not yet. I think we should consider scraping you off the road before we consult with our lawyers.’ She placed her hand on his head in a gesture of warmth and comfort. Strong as this man sounded, he was badly hurt and shock must be taking a toll. His hair was nice, she thought inconsequentially. Thick and wavy and deep, deep black. What she could see of his face was strong boned and tanned. Her initial impression was really, really nice.

Which was a silly thing to think, given the circumstances. `I’ll get you something for the pain and ring for an ambulance,’ she told him and decided that shock was affecting her too. Her voice was decidedly wobbly. She couldn’t make it sound efficient and clinical. Efficient and clinical was the last thing she felt like.

And his next words made her feel even less efficient. `There’s no phone reception out here,’ the man muttered.

`No reception?’

`No.’

`But...’ Leaving her hand resting on his head – he’d need touch, she knew – she rose and sat back on her heels and stared blankly down at him. `But... why not?’

`Because we’re in the middle of nowhere.’ Stupid, he might have added, but he didn’t. `Why do you think I run out here?’

`Because you’re stupid?’ Lizzie whispered, trying to disguise her overwhelming sensation of sick dismay. No reception. Help!

`A man has to have peace sometime.’

`Yeah, well it should be really peaceful in hospital,’ she snapped. This was a crazy conversation. He was lying face down in the road; she didn’t even know what was wrong with him yet and he was giving her cheek?

`Who said anything about hospital?’

`I did.’ Her voice was starting to sound a bit desperate. She was feeling more out of control by the minute. `That’s where you’re going.’ She took a deep breath, searching for control. `Now shut up while I examine you. And stay still!’

`Yes, ma’am.’

Silence. More silence. Lizzie started running her fingers over his body, searching for any lumps of bumps or obvious contusions. She could still only see his back but she was reluctant to roll him over. For a start that leg would hurt like hell. Second, if he’d hurt his back or his neck...

`I can wiggle my fingers and my left toes,’ he told her. `I’m not game to try my right toes.’

`I don’t blame you. You’ve got a horrible break. I just had to straighten it to get circulation back.’

`Circulation...’ He stirred and she placed a warning hand on his shoulder. `Who the hell are you?’

`Lizzie Darling.’ Her hands kept moving. One good thing about the scant clothes he was wearing, her examination wasn’t impeded. She put her hands under him and felt his ribs. His chest was broad and muscled and the ribs didn’t seem damaged at all.

`Lizzie Darling.’ He sounded bemused. `Darling. As in not Lizzie Sweetheart but Lizzie Darling, daughter of Mr. and Mrs. Darling? Or wife of Mr. Darling?’

She could afford to be magnanimous about her stupid name. Almost. If she hadn’t been so fond of her mum and dad and her grandma she would have changed it years ago. But by deed poll. Not by marriage. `Daughter will do,’ she told him. `That’s the one.’

You’re the new locum, then?’ he demanded, his voice incredulous and she sat back and surveyed him some more. And worried some more. She had more to concentrate on now than her entirely inappropriate name.

`I’ll find something to splint that leg and then we’ll try and roll you over.’

`But you are the doctor we’re expecting?’

`I am.’ She was searching the roadside. A branch had fallen from the cliff-top and it had crashed down, splintering into what she needed – a mass of wood of various lengths and thickness. Something here would do. She needed to roll him to check for further injuries but she wanted that leg immobile first.

At least the man was sensible. His voice was strong enough. With no blood, ease of breathing and fully conscious... she hadn’t killed him and it didn’t look like she was going to.

Locum. He’d said locum. He’d recognised her name?

`You knew I was coming?’ She left him for a moment to think about it while she fetched her doctor’s bag from the back of the car. Returning to kneel beside him, she located a syringe from the bag and fitted it with a morphine vial. By the time she had the needle ready, he had his answer ready. He might be conscious but he was still dazed.

`Yeah, I knew you were coming. Of course I did.’

`I’m just giving you something for the pain.’

`Morphine?’

`Mm.’

`Five mg.’

`I thought ten,’ she told him. `I need to move you and it’s going to hurt.’

`Five.’

`Hey, who’s the doctor here?’

`I am,’ he told her and she paused, her syringe held to the light, and stared at the head in the mud.

`You?’

`Me,’ he told her, his face still muffled. `That’s who you just ran over. Your boss. I’m Harry McKay, Birrini’s doctor. You’re here to replace me while I go on my honeymoon.’

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