Intensive Care: Escape to the Country (19 page)

Richard laid his head on the pillow beside Meredith’s own bald shiny head. They were both oblivious to Kate trying to remove the remainder of the leads and wires from her tired body. Too weak to speak, Meredith squeezed Richard’s hand from time to time, as though trying to find the final words to say.

Kate watched as he pulled a piece of string over his head. Attached to the black leather band was a silver wedding ring. He held the ring in his hand and placed it over Meredith’s heart, laying his hand on top of the ring.

“I have your ring here, my darling. I will wear it next to my heart forever.”

Meredith brought her own hands up to meet his and he joined their fingers together across her chest. The wedding band remained hidden beneath their hands.

Sadness anchored Kate’s feet to the floor and she was unable to pull her eyes away from the scene unfolding before her. The tears welled up and she awkwardly brushed them away, wondering what it would be like to love someone so deeply and to be loved so much in return. She sensed other movement and saw Richard and Meredith’s four young children, their eyes red from crying, peeking their heads around the curtain, unsure of whether to come in. The oldest child was carrying the baby. Richard beckoned them all toward the bed. Meredith turned her head toward them and opened her eyes long enough to gaze steadfastly into each of their eyes, one by one. The effort exhausted her and she closed her eyes again but her mouth moved silently. Kate could clearly make out the words she was trying to say.

“I love you all.”

“It’s okay, my love,” Richard whispered. “We’re all here and you can go home now. You’re going to a better place and we will see you again soon. We love you.”

And with those words of love, Meredith Jackman took her last breath. Her grip on her husband’s hands across her chest relaxed and her eyes remained closed.

Tears began to roll down Kate’s face in earnest and she let them fall, not stopping to wipe them away and not caring about the mascara that she knew would be leaving trails down her cheeks. Transfixed, Kate watched as Richard again laid his head beside his wife’s. Then, silently at first, he began to sob as the full realization of the truth hit him. He wiped the tears from each eye with his thumb. His children gathered around him and he drew them toward him. Kate slipped unnoticed from the room, allowing them the opportunity to grieve in privacy and peace.

The sound of their crying etched itself in Kate’s memory and as she made her way to the tea room, her own tears fell freely out of the well of emotional overload. Amanda and Laura were both sitting at the table in the tea room, heads down, silently staring into their cups of tea. Amanda was the first to stand and put her arms around Kate and she allowed herself to cry awkwardly on Amanda’s shoulder.

“I’m here for you, Kate. If you need to talk anytime, just call me, okay?”

Laura stood and placed her hand across Kate’s shoulders. “That goes for me too, Kate. Anything you need, let me know.”

Kate nodded, unable to speak, the constriction in her throat painful as she realized that in the midst of this tragic situation she had just made her first two friends in the unit.

When Kate arrived home from work later that day, she checked the mail that was delivered each day into the rusty metal container at the end of her driveway. Not expecting anything other than the usual bills, she was surprised to see a letter, her name handwritten in cursive script on the thick cream envelope. Turning it over, she checked for a return address but there was none. As she approached the house, the sound of a dog’s cheerful bark of greeting could be heard through her open car window. She grinned, knowing exactly what she was about to find.

Leaving the mail on the front passenger seat, Kate stepped out of the car and went around to the side of her house where the barking was coming from. As she opened the gate, a large black and white border collie came bolting toward her, a huge bright blue ribbon tied around his neck. As soon as he saw Kate, he plonked himself down at her feet, his liquid brown eyes looking lovingly up into hers. Kate rubbed the dog’s ears and undid the bow, surprised that he hadn’t managed to remove it himself.

“Well, what’s
your
name?” she asked him.

Not expecting an answer, Kate was surprised when he gave a little bark. She reached for his collar and saw a small tag attached to the leather band around his neck with his name engraved on it.

“Baxter? Your name is Baxter?” The dog barked again. “I like it. It suits you,” Kate exclaimed.

The dog immediately tore around in circles, trying to impress her. Acting like a puppy, he continued to tear backward and forward, his long black tail flaring out behind him, the white tip pointing upward toward the sky. Kate let him run free while she unlocked the back door and went inside. Kate watched the dog out the kitchen window for a while and he soon calmed down when he realized no one was paying him any attention, and he lay down in the late afternoon sun, all his bundled-up energy spent for the time being.

“Hello, Miss Kate,” Joel answered his phone on the first ring and she could hear the lilt in his voice.

“A bit of warning would have been good,” Kate joked.

“I told you weeks ago you needed a dog,” Joel teased. “How much more warning did you need?”

“What would you have done if I was scared of dogs?” Kate asked.

“I knew you weren’t.” Joel sounded smug.

“But what if he’d dug up all the veggies while I was at work?” She was trying to come up with excuses.

“Have you actually checked your veggies, Kate?” Joel asked her.

“No.”

“Well, love, I suggest you go for a little walk in that backyard of yours.”

Kate kept the phone to her ear as she stepped out the back door, curious as to what Joel was talking about this time. Baxter greeted her enthusiastically again and immediately sat at her side, tongue lolling out to one side, eyes glowing, waiting for her to play with him. A tennis ball was at his feet where he had dropped it, hoping Kate would take the hint.

“He’s kind of cute,” Kate said as she rubbed the dog’s soft ears.

“Isn’t he though?” his reply came. “So are you in the backyard yet?”

“I’m walking across the grass now …” She froze mid-sentence. “Joel! You’re amazing!” Kate yelled into the phone.

While she had been at work Joel had been at her house and erected a new fence to separate the garden from the veggie patch and chook run.

“Do you like it?” he asked.

“I love it! It’s absolutely perfect. How on earth do you have time to do these things for me?”

“I get Emma to look after the café one day a week so I can work on my farm. Today I just chose to do some work on yours.”

“You are the most perfect guy ever!” Kate gushed. “Now I won’t have to worry about the dog getting into the chooks or veggies.”

“The dog has a name,” Joel said, ignoring the comment about himself.

“Yes, I saw that. Baxter. It totally suits him. What’s his story?”

“Handed in to an animal shelter by some young guy in a big BMW. Probably someone from the city realizing that working dogs need more than a postage-stamp-sized backyard. He’s a purebred and very well trained.”

“That’s an awful story. Why would someone dump a dog as beautiful as him?” Kate hugged him tightly around his neck and the dog licked her cheek.

“Ah, I can hear it in your voice already,” Joel chuckled. “You’re falling in love!”

If only you knew
.

As Kate was getting ready for bed that night, something reminded her of the mail she had left in her car. She slipped her feet into her brown knee-high Ugg boots, pulled on her dressing gown, wrapped the cord tightly around her waist, and opened the front door. The cool air chilled her and Baxter looked up from his temporary bed and eyed her strangely, as if wondering what she was doing outside so late at night. Kate retrieved the mail from the car and closed and locked the front door behind her. Back in the warmth of the house, she flicked off all the lights again and climbed back into bed.

The hand-addressed envelope was made from expensive-looking paper and she wondered who would write to her here on the farm. As she opened the envelope and pulled out the stiff cream-colored paper inside, she stifled a shocked cry.

Dear Catherine and partner,

Marcus Antony Thornton

and

Cindy Lee Collins

together with their families

request the pleasure of your company at their upcoming wedding.

Saturday 6th December

Kate didn’t read any further. For goodness sake, they hadn’t even spelled her name correctly!

“Well, he clearly didn’t waste any time moving on!” Kate spoke out loud and Baxter looked up at her with an expression she couldn’t read. She rubbed his ears while deciding what to do, then reached for her phone.

“Kate?” Joel’s voice sounded a bit groggy. “Twice in one night. What’s up?” Kate heard rustling sounds on his end of the phone.

“Sorry Joel, did I wake you?” Kate looked at the clock beside her bed but it was only just after eight o’clock.

“It’s okay, I haven’t been in bed long. It’s been a busy day and I thought I’d try to get to sleep before midnight. All that hard manual labor today has stuffed me and I’m not feeling all that well. I think I’m coming down with something.”

As if to prove his point, he coughed. Kate heard rustling again and imagined it to be the sound of Joel’s sheets as he got comfortable in bed. She tried to remove the mental image but found that she failed miserably.

“Marcus is getting married,” she blurted out.

“You’re joking! When?”

“In December,” Kate answered. “December
this
year!”

“Wow. He sure didn’t waste time moving on.”

“That’s exactly what I said. And no prizes for guessing who he’s marrying.”

“No way. His secretary?” Joel sounded as stunned as Kate felt.

“Yep,” she replied, “the one he apparently
wasn’t
having an affair with!”

“Are you okay, Kate?” he asked before he started coughing again. Poor guy. He sounded terrible.

“I’m actually numb. It’s just come as a massive shock.”

“I’m sorry, Kate. I know how much you wanted to get married.”

“It’s just he was always so dead set against marriage – said it was just a piece of paper.”

“I wish I knew what to say.”

“Oh my gosh!” Kate cried all of a sudden, a sick feeling in her stomach.

“What? What’s wrong?”

“I’ll bet she’s pregnant.” Kate’s heart felt heavy as though someone was squeezing the life from her.

Joel coughed again and Kate heard more crackling through the phone and she figured he was changing position in bed again.

“And guess what else?” Kate asked him.

“What?”

“We’re invited!”

“What do you mean? He’s invited both of us to his wedding? Is the guy stupid?” Joel replied.

“Well technically he hasn’t invited both of us. He’s invited me and a
partner
.” Kate emphasized the word. “You could be my plus one.”

“Oh.”

She couldn’t detect the tone in Joel’s voice but as soon as she had spoken Kate realized her mistake of making an assumption about their relationship.

“Of course, I’m not going to go,” she backpedaled quickly.

“If you want to go, I’m happy to accompany you, Kate.” Joel’s voice sounded slightly strained. He coughed again.

“No. No. It’s all right. I don’t even want to go. That would be just too weird anyway. I don’t even know why I suggested it.”

“Okay.”

“Well, I’ll let you go then,” Kate said. The phone call felt awkward now and she was regretting calling him. “I might drop by tomorrow and grab a coffee on my way to work. Will you be there early?”

“If you let me get some sleep I will.” The teasing voice Kate was more familiar with came across the phone. “Unless this cold develops into man-flu.”

She laughed. “Well, good night, Joel. Take care.”

“Good night, Miss Kate. Sweet dreams.”

“Yep. You too.” She hit the end button and stared at the phone for a moment. Baxter looked up at her and then tucked his head back around his body, curling himself into a tight ball and closing his eyes.

“That’s a good idea, Baxter. I think I’m going to try to do the same.”

An hour later Kate was still tossing and turning. She couldn’t stop thinking about Marcus marrying Cindy. Perhaps at the time there hadn’t been anything between them and the text message she’d found was one big mistake like everyone had suggested. But now, no matter which way she thought about it, even if Marcus kept trying to declare his innocence, one thing was certain to Kate. If Cindy truly
was
pregnant, then Marcus wasn’t just a cheat. He was also a liar.

Almost ten days later, Kate was sitting in her office working her way through an inbox full of paperwork when her work phone rang. She looked down at the screen, hoping to see Joel’s number, but it was a number she didn’t recognize.

“Kate speaking.”

“Is that Kate Kennedy?”

“Yes. Who is this?”

“It’s Emma. Joel’s sister.”

Kate immediately sensed something in Emma’s voice.

“Is Joel okay?”

She hadn’t seen or heard from him since she’d made the stupid assumption about their relationship status. She figured he hadn’t wanted to speak to her again. She still couldn’t believe she’d said he could be her plus one at Marcus’s wedding! She probably should have called him to apologize, but stubbornness and pride kept stopping her. Then, out of embarrassment and uncertainty, she had kept her distance, not even going into the café for her usual daily coffee and chat. The longer she went without seeing him, the more awkward it had become.

She had tried to tell herself his silence meant nothing. He was probably just busy getting Eagles Ridge Farm ready for the upcoming opening. When he hadn’t shown up for their usual Saturday morning run and hadn’t bothered to send a message explaining where he was, Kate had been slightly miffed, but not worried enough to find out why. She figured he was backing off because he didn’t feel the same way about her as she was starting to feel for him. Clearly she’d read their possible relationship completely wrong.

“Emma?” she repeated. “Is Joel okay?”

Emma’s words came out in staccato beat. “I’m not sure, Kate. No. I don’t think so. He asked me to call you.”

On high alert now, Kate asked, “What’s wrong?”

“He’s been unwell for the last week or so and each time he goes to the doctor, he gets seen by a different doctor and given another lot of antibiotics. But he’s not getting any better. He’s really sick, Kate. And I’m worried about him.”

Kate didn’t want to pry, but she needed more information, and wondered if Emma would want to share the details of Joel’s personal medical history with her.

“Do you know what the doctor said, Emma?”

“Yeah. He says it’s just a really bad case of the flu but Joel says he’s having trouble breathing today. He’s saying his chest is killing him. He’s never sick and he never complains. He asked me to call you. He looks awful. His lips are really blue.”

Worry shot through Kate’s heart like an arrow and her own chest felt tight.

“And Kate? I’m really worried that he’s been drinking again.” Emma’s voice was almost a whisper and Kate had to push the phone against her ear to catch her words.

Had something happened? Why would Joel be drinking again? Kate shuffled dates around in her mind, struggling to recall when Rebecca had died. It was only November. The anniversary was still another month away. Maybe it was her birthday or some other special event that had tipped him over the edge.

“Are you with him now, Emma? Can I speak to him?” Kate asked, trying to keep the urgency from her voice.

“Yeah. Sure. Hang on.”

Kate heard the sound of muffled voices and then Joel came on the line. The voice was raspy and she barely recognized it as Joel’s, it was so laced with the sound of pain and fear.

“Katie?” He had never called her by that name and she was momentarily taken aback, surprised by how nice the accent made it sound coming from him. Immediately, she switched her mind into a more professional mode.

“Joel, tell me what’s happening.”

“I. Can’t. Breathe.”

“Do you ever get asthma, Joel?”

“No.”

“Have you ever felt like this before?”

“Never.”

“Does it hurt anywhere else?”

“My chest. It hurts to breathe in.”

“Have you been drinking?”

“No!” His reply was emphatic and Kate instantly regretted doubting him.

“Can you put Emma back on the phone for me?” Kate tried to keep her voice calm.

“Kate, he can’t even talk. I’m really scared.” Emma’s voice was almost a whisper.

“Emma. Listen to me carefully. Hang up and call an ambulance immediately. I’m calling the emergency department to let them know he’s coming in. Okay? Will you do that now?”

“Okay. Yes. Yes. I’ll call them.” Emma now sounded frantic with worry and Kate was sorry she had alarmed her. Disconnecting the call, Kate dialed the emergency department as she started walking in the direction of the nurses’ station.

“Emergency. Can I help you?” The phone was finally answered on the tenth ring.

“This is Kate Kennedy from ICU. You’re going to be getting an admission, a friend of mine. From the sound of it he’s in some sort of respiratory distress. I’ve told his sister to call triple O. I’ll come down to meet the ambulance as soon as it gets there. Can you call me when it arrives, please? Also, I’ve got a bed up here if you need it.” Kate disconnected the call and hoped that the ambulance would get to Joel quickly.

“What’s going on?” Debbie had overheard Kate’s end of the conversation.

Briefly Kate filled the ward receptionist in. By now some of the other staff had gathered around and Kate remained tense as she retold the story, waiting for her phone to ring. Most people knew of Joel and his family and Kate was also sure most of them assumed that the two of them were a couple. Their faces reflected the concern that she was feeling.

Amanda approached Kate and pulled her off to the side, her usual cheery disposition looking grim. She pushed her red glasses up to the top of her head and looked intently at her. “Kate, I know Joel’s family very well. I also know you two have become good friends since you arrived, so I’ll cover things up here for you for as long as you need. Go and take care of Joel. He needs you.”

“Thanks, Amanda. That means so much to me.” Kate reached out and touched her arm. “Really. Thank you.”

“Go!”

Just then Kate’s phone rang and, recognizing the caller ID, she started walking in the direction of the elevators as she answered. “Kate here.”

“Ambulance is pulling into the bay now. He’s not in a good way. I reckon we’re going to need that bed.” She didn’t recognize the voice of the emergency doctor but she was glad he had taken her phone call seriously. She turned away from the elevators and ran for the stairs, knowing the elevator would be too slow.

The adrenaline kicked in and her stomach was churning by the time she waved her swipe card across the security pad to allow her access into the emergency department. She met the paramedics as they were wheeling Joel into one of the resuscitation bays. While she desperately wanted to help, she also knew that it wasn’t her place to get involved. She let the emergency staff do their job and stood to the side, watching them work.

A few minutes later Emma was brought into the resuscitation bay by a nurse and surprised Kate when she greeted her with a tight hug.

“Oh Kate. I’m so glad you are here. He can’t die.” The tears were already threatening to fall and she was pale with worry.

“Shh! It’s okay. He’s going to be okay. He’s in good hands here.” Kate hugged her in return. “We won’t let him die. I promise.”

Hearing the voices of Kate and his sister, Joel tried to lift his head from the trolley but his breathing was so labored that the effort exhausted him and he collapsed back onto the pillow.

“Stay still, Joel.” Kate got up close to him and spoke calmly. “Everything’s going to be okay. Emma is here with me. When things have settled down a bit I’ll call your parents. You’re in good hands.”

“Kate, can you tell me what’s happening?” Emma asked, her eyes wide and frightened.

Kate didn’t want to leave the resuscitation area so she pulled Emma farther away from the action and spoke quietly to her. “It looks to me like oxygen just isn’t getting into the blood from his lungs for some reason. He might have pneumonia or even a collapsed lung. We won’t know until they run some tests. They’ll take an x-ray and maybe a CT scan. It actually doesn’t matter what the underlying cause is, if the tissues aren’t getting enough oxygen, this will trigger his shortness of breath. The other issue is that his heart may not be pumping the blood properly so they have to rule out a heart attack too. He said he was having some chest pain.”

“But he’s too young to have a heart attack!”

Emma began to look even more worried and although Kate tried to reassure her, she was getting more anxious every minute and Kate didn’t want to have two patients to deal with. She spied Lou, the friendly nurse who had looked after her when she was ill, and told her where they would be if needed, then led Emma into one of the small waiting rooms near the entrance to the department.

“How about I go and grab you a drink while you give your parents a call? What can I get you?”

“Anything. I don’t care. Diet Coke. Sprite. Whatever. Thanks Kate.”

Leaving Emma in the room, Kate went back and checked with the staff caring for Joel.

“What can you tell me?” Kate asked the doctor.

“Chest x-ray shows that he’s developed a pneumothorax on top of pneumonia. With every breath he’s taking, air is being delivered into the pleural space causing pressure inside his lungs to build.”

“I know what a pneumothorax is.”

The doctor looked at Kate as though just noticing her scrubs and hospital identification for the first time. He raised his eyebrows in question.

“I’m Kate Kennedy. I was the one that called to say he was coming in. I’m the new NUM of ICU. We haven’t met before.” She extended her hand which he shook warmly.

“I’m sorry. I had no idea. G’day, I’m Damien. Damo. Anyway, as you know, the pneumothorax is severely compromising the ability of his lungs to expand and ultimately one of his lungs has completely collapsed.”

Kate pictured Joel’s lung, folded in on itself like a deflated balloon.

Damien continued to speak. “Unfortunately, what’s complicating this case is that his other lung is showing signs of the chest infection and pneumonia he has obviously been battling for the past few weeks.”

Kate peeked her head back into the resuscitation bay, hoping to see an improvement in Joel’s condition, however he was looking even more distressed than earlier and she was certain he looked as though he was about to go into respiratory arrest. He was blue, almost cyanotic, and tachycardic, his heart racing far too quickly. She was worried enough to express her concerns out loud to the doctor.

“Are you thinking tension pneumothorax?” Kate asked.

If the pressures within Joel’s chest continued to rise, his lungs would be squashed to the point that there would be no air entry on the affected side. This would result in a displacement of his heart, kinking off the vessels in the heart, preventing blood from returning to the heart. It would be fatal if not treated immediately. The only way to treat a tension pneumothorax was to release pressure from the pleura by using a large needle and placing it into a patient’s chest. As pressure is immediately released, the heart is able to resume its normal position and blood can continue to circulate.

“No.” Damien’s answer was brief but Kate saw the look in his eyes and heard the words he wasn’t saying out loud.
Not yet.
“I think he’s going to be okay but we’re going to tube him now then get a chest drain in. Once we’re done, we’ll bring him upstairs to you guys.”

“Thanks, Damien.”

Kate appreciated that this was not her department and although she wanted to remain with Joel, she knew that she also needed to be with Emma. Kate was glad Lou was working and she left the staff to administer the drugs that would sedate and paralyze Joel before they intubated him and placed him on the ventilator that would breathe on his behalf, allowing his lungs the chance to rest and recover. At the same time Kate knew they would place a large chest drain into the lung cavity to release the air that was causing the pneumothorax.

Kate found Emma still in the waiting room, on the phone. She looked up as Kate walked in the door, searching Kate’s face for clues to Joel’s condition. Kate realized she’d forgotten to get Emma a drink.

“Hang on, Liam, Kate’s just walked in.”

Not bothering to put her hand over the mouthpiece of the phone, Emma spoke to Kate.

“It’s Liam on the phone. He’s in Sydney. I’ve already called Mum and Dad and they’re on their way here. Liam wants to know what’s happening. Can you tell him?”

Kate took the phone from Emma’s hand. “Hi Liam. This is Kate Kennedy.”

“Hi Kate. What can you tell me?” Liam’s voice sounded identical to Joel’s and Kate had to stop and consciously force herself to remember she wasn’t talking to Joel on the phone.

“How much has Emma told you?”

“She’s not making much sense, to be honest. And it doesn’t help that I’m wanting more information than she can give me. I’m a paramedic, Kate, so please explain it to me in medical terms.”

Kate filled Liam in on Joel’s condition and just as she was explaining that Joel would be taken to the ICU shortly, an older couple walked into the room. As Emma hugged them, it was apparent that these were her parents. “Your parents are here now, Liam. Do you want to speak to them?”

“No, it’s okay Kate. Fill them in and let them know I’ll be on my way when my shift’s over. I’ll be there really late tonight or early tomorrow. Tell them not to wait up for me – I’ve still got my old front door key. Oh, and Kate – look after him for me, will ya? He may be me brother but he’s also me best mate.”

“I will, I promise. Drive safely, Liam.” Kate hit the end button and handed Emma her phone back. She paused, realizing everyone’s eyes were on her. There was an awkward silence for a moment before anyone spoke.

“You must be Kate, then.” Lorraine O’Connor was pleasantly plump and not much taller than five feet. She had a face that was obviously more used to smiling than frowning. She extended her arms and pulled Kate into a hug. “We have heard so much about you, dear.”

Kate raised her eyebrows, wondering what Joel had told them.

“Love, we are so sorry to meet you under these circumstances.” Sean looked like an older version of Joel and he too gave Kate a warm hug.

“Thank you so much for being here for our Em too,” Lorraine spoke again.