The Secret Doctor (9 page)

‘Is it bad?' Rob asked. ‘What's happened?'

‘I think he's probably suffering from the bends. He may have been in the water too long, or perhaps he surfaced too quickly. Either way, he's in trouble.'

He was already on the move, heading for the door,
and Lacey followed him. ‘Do you work for the rescue services?' she asked. She was puzzled. ‘I thought you had given up medicine.'

‘I only go out if it's local, or if there's a major disaster like a hurricane…which is a rare occurrence, thankfully. It helps that I have the boats. It gives me better access when there's a problem out at sea.'

‘Could I come with you? I'd like to help.'

‘Yes, of course.'

‘Good luck,' Rob said. ‘I hope things go well.'

They left him to go on with his work plans, while they hurried out to the dock.

Jake had the boat running within a minute. He was very quiet, and Lacey wondered if he was concerned for the diver, or whether he had other things on his mind.

As they sped out across the bay, though, she asked him, ‘What happens when someone has the bends? I've never come across it before.'

He checked the co-ordinates he had been given and turned the boat in the direction of a nearby reef. ‘It's to do with the way the body tissues absorb nitrogen from the breathing gas in proportion to the surrounding pressure. If the pressure is reduced too quickly, the nitrogen comes out of solution and forms bubbles in the body tissues. This causes the classic pain in the joints, but if the air bubbles enter the circulation as well, they might enter the lungs and cause congestive symptoms and even circulatory shock through an arterial gas embolism.'

‘So that's why we need to get to him fast, to try to prevent that from happening?'

‘Yes. If decompression sickness isn't treated quickly, the diver could end up suffering from brain damage, or he may not even survive.'

‘But you told them to give him oxygen. Won't that help? Won't that stop any of those symptoms developing?'

‘Not necessarily. It will help, but people can seemingly recover and then collapse later. He needs decompression treatment if he's to be safe, but the nearest hyperbaric chamber is at Key Largo.'

‘Will you be taking him there?'

‘No. The rescue services will scramble a launch to take him there, but it will take a while to reach him. That's why we need to make sure that his condition is stabilised before he starts the journey.'

When they reached the mooring buoy some five minutes later, it was clear that their patient was in a bad way. Jake and Lacey clambered aboard the diver's boat.

‘He's not been making much sense at all,' a man told them. ‘I know he's in pain,' he added in a low voice, ‘and that's worrying, because Martin's not one to complain. He's finding it hard to get his breath as well. That means it's bad, doesn't it?'

‘At least he's still conscious,' Jake murmured, kneeling down beside the patient, who was lying on the deck.

‘Martin,' he said, ‘I'm Jake Randall… I'm a doctor…Can you hear me?'

Martin mumbled a reply, but it was indistinct, and Jake tried again. ‘You've been in a diving accident,' he said. ‘You're suffering from decompression sickness…Do you understand what I'm saying?'

Martin's whole body was suddenly racked with tremors. He tried to answer, but clearly he was confused, and then he started to cough, an unhealthy sound, as though his lungs were filling up with fluid.

Jake turned to Lacey, who had come to kneel beside him. ‘Will you go on giving him oxygen while I set up an intravenous line?' he asked. ‘I'm going to give him isotonic fluids without dextrose to correct any dehydration and maintain blood pressure. I think we're going to have to put a urinary catheter in place as well.'

He glanced around at the people who were waiting anxiously on deck. ‘Do you want to go into the cabin and give Martin some privacy while we do that? It would be helpful if you would call the Divers Alert Network—their number's on my phone.' He handed his mobile to the man who had been helping Martin. ‘Tell them he definitely needs treatment in a hyperbaric chamber. They'll start making the necessary arrangements.'

‘Okay, leave it with me.'

‘Good…and keep the line open so they can get back in touch.'

‘Will do.'

Lacey and Jake continued to work on their patient until they were satisfied they had done all they could for him, but just as they were beginning to feel it might be safe to sit back and wait for the rescue launch, Martin slipped into unconsciousness.

Jake examined him once more and then looked up at Lacey, his face grim. ‘He's not breathing, and I can't find a pulse,' he said, his voice taut. ‘We need
to start CPR. Will you do chest compressions while I intubate him?'

Lacey nodded, and positioned herself so that she could press down on Martin's chest. Jake put a tube down his throat to help with his breathing, and as soon as that was in place he brought out the defibrillator.

Jake quickly fixed the pads in place on Martin's chest and switched on the machine. The man's heart had slipped into a dangerous rhythm.

‘Charging,' Jake said, and then, ‘Stand clear.' The defibrillator delivered an electric shock that was meant to restore Martin's heart rhythm to normal, but it failed. The heart monitor showed that he was still in a hazardous condition.

‘I'll try again,' Jake said. His expression was bleak. His face was pale, his features grimly etched, and Lacey realised that she had never seen him this way before.

A second shock, but there was still nothing…no change.

Jake was doing everything he could for this man, but if this dangerous rhythm continued any longer, Martin could go into cardiac arrest. If he flat-lined, that would be the end. Jake knew it and Lacey knew it. She wished there was something she could do that would change the course of events, but she was helpless.

‘Stand clear.' Another shock, and this time the heart trace began to show a sinus rhythm and Lacey breathed a sigh of relief. Martin was out of danger for the moment, at least.

Jake, though, was rigid with tension. He appeared to
be completely drained of energy, his face shadowed, his clamped lips making it seem as though he was under great stress. It was clear that he was badly disturbed by everything that had gone on.

Lacey looked at him in concern. ‘Jake, are you all right?'

‘I'm okay,' he said.

She frowned. He wasn't okay at all. That was plain to see. Something was definitely wrong, and he was in denial. She desperately wanted to find out what was causing his tension so that she could find a way of helping him.

‘Y
OU
saved Martin's life, and yet you look as though you've gone into shock.' Lacey watched Jake as he eased himself away from the patient and checked the man's vital signs. ‘I know something's wrong. Can you tell me about it? What's troubling you, Jake?'

‘Nothing. And we can't waste time talking about it now.' He kept his voice low. ‘We have to get Martin off this boat and on his way to Key Largo.' He looked at his watch. Every movement he made was stiff, as though it took a great effort. ‘The launch should have been here by now…every second counts. The sooner he goes into decompression, the better his chances.'

‘It's only been a few minutes,' Lacey said in a soothing tone. ‘He's stable for the moment, and he'll be at the hospital within the hour. That's all anyone can ask. Don't beat yourself up about it.'

‘I'm not.' He made a ragged sigh. ‘I just can't get used to the way life can be snatched away from people in a sudden accident or by a freak of nature. It's unfair. There's no coming to terms with it.' He gazed
at her. ‘But you already know that. You've been through it.'

‘Yes, but you do come to terms with it in the end. You look back on the way people lived their lives and you celebrate the good times that live on in your memory.'

She watched his expression, but his features were still frozen into a taut mask. ‘Are you feeling this way because of what happened to your parents? You said they had passed on…is that what troubles you?'

He shook his head. ‘No. Obviously, yes, in part, it's unbearably sad, but they each had illnesses that gave them time to say their goodbyes. They loved one another to the end and shared a good life together. There were no regrets, no things left undone or words not said… In a way, they made it easier for my brother and me.'

‘Then what—?' Lacey broke off as the engine of a motor launch sounded in the distance. It was coming nearer at speed.

Jake straightened up and checked his patient once more. ‘His vital signs are holding steady,' he said.

‘That's something, at least.' Lacey stood up. Much as she wanted to talk to Jake, she realised that he was right, and this was not the time to pursue things any further. Their priority had to be the patient, and so she went to talk to the anxious group of divers who were waiting to hear what was happening.

‘He'll be given hyperbaric oxygen therapy,' she told them. ‘That means oxygen will get to any damaged tissue and help with the healing process. Any bubbles
of gas will be eliminated from his system, and he should slowly begin to recover.'

‘How long will he be in there?'

‘I don't know the answer to that, I'm afraid. You'll have to ask the doctor doing the hyperbaric treatment for his opinion…but usually treatment takes between several hours and a few days.' She sent the man a reassuring glance. ‘He'll be all right in the hyperbaric chamber. Patients can talk to their therapist while they're in there, and in some instances they can even watch TV. So you needn't be concerned from that point of view.'

‘No. You're probably right. Thanks.'

Lacey went to help supervise Martin's transfer to the launch. There was a doctor on board who was familiar with diving illnesses, and she felt confident that they were leaving him in good hands.

‘I'll let you know how he gets on,' the doctor said as the launch started to move away.

Jake nodded. ‘Thanks.'

Their job was done, and after a few minutes more they said goodbye to the people left behind on the boat. ‘Make sure your equipment is up to date,' Jake advised them. ‘You can buy gadgets that warn you if you're spending too long under water, or if you're coming up to the surface too fast. It's well worth spending the money on them if it saves a life.'

‘We'll look into it.' The divers were subdued. Their friend had been in mortal danger and now a pall hung over the whole expedition.

‘We should start back,' Jake said. His face was devoid
of expression, as though he was getting by on automatic reflexes. ‘Rob will be wondering what's happening, and I imagine your sister will be on her way to see you.'

‘Yes.' Lacey went aboard the boat with him once more, and they watched as the divers set off for Key Largo. ‘Perhaps we should take a few minutes to relax first, though,' she murmured. ‘Come into the cabin and I'll make some tea. Having a hot drink might make you feel better.'

He didn't argue with her, and she guessed that was a measure of how low he was feeling. He seemed uptight, pacing up and down the small cabin like a caged animal, until she said quietly, ‘Jake, you need to sit down… Take a seat and try to drink your tea while it's hot.'

He gazed at her blankly, then as she placed a hand on his shoulder and gently pressured him towards the bench, he gave in and did as she suggested. He rubbed a hand over his forehead.

‘I'm sorry if I worried you,' he said. ‘I wasn't really prepared for what happened today and it threw me for a while. I've been out to accidents before, but not to a case of decompression sickness…not in the last year, anyway.'

She was puzzled. ‘I thought you handled everything perfectly.' She studied him carefully, taking in his braced, upright stance. He looked as though he was struggling to hold everything together.

She slid into the seat beside him. ‘What more could you have done? As it is, he'll probably be back to full fitness within a couple of weeks, and that's all thanks to your swift actions.'

She frowned. ‘You're a good doctor, Jake. I've seen it for myself, and I've heard other people say the same. I just don't understand how you could doubt yourself or turn your back on the profession you trained for.' She ran a hand over his arm, gently persuading him to look at her. ‘What happened, Jake? Can you tell me? Is there something about this particular accident that bothers you?'

He sighed heavily and then nodded. ‘My cousin had the same illness—decompression sickness. He was diving at one of our wreck sites, about eighteen months ago, and he must have stayed down there too long. When his fellow divers realised he was in difficulty, they hurried to bring him out of the water as soon as possible, but he was already unconscious. They tried everything they could to resuscitate him, but it was no use. He died.'

She made a soft gasp. ‘Oh, Jake, I'm so sorry. That must have been awful for you.' She reached for him, putting her arms around him as his shoulders slumped. ‘Were you there when it happened?'

He shook his head. ‘I was at work, at the hospital, but as soon as I heard he was in trouble I took the boat out to the wreck site. They were still working on him when I arrived there, but I could see it was too late. His heart had stopped and the doctors tried everything they could to revive him, but it was impossible. There was nothing anyone could do.'

She wrapped her arms more firmly around him, drawing him close, so that his cheek was next to hers and the warmth of her body would comfort him. She felt the heavy thud of his heartbeat next to hers, and for just
a few minutes they stayed like that, locked together in each other's arms.

‘You must have been very close to him,' she said softly. ‘Did you ever go on dives with him?'

He nodded. ‘We were practically inseparable as youngsters, and that carried on into adulthood. He loved diving, and he always felt that he was contributing to the family's fortunes by unearthing artefacts from the wrecks.' He made a brief smile. ‘Once he found a beautiful gold cross, encrusted with emeralds… There was some talk of selling it, but we didn't…we'd already made millions, and it wasn't necessary… So now it's part of our collection, and I'm just thankful that we have it as a physical memento of the work he put in at the wrecks.'

‘Did you dive on a regular basis?'

‘Only when I wasn't working at the hospital. I made a number of finds, and they were added to the collection, but I value them more for their history than anything else. This whole area is steeped in history…the era of sailing ships, their crews, and pirates. My grandfather was excited by all that, and his enthusiasm was infectious. It was passed down through our family.' His mouth flattened. ‘I shared his feelings to begin with, and I have a lot to be grateful for, but now I simply want to preserve his legacy. I want to make sure that the company he set up thrives, so that my cousin's death won't have been in vain.'

He frowned. ‘I was never wholly involved in the venture. I moved away from the family business and went into medicine.'

‘And yet you gave that up.'

‘Yes.' He straightened and Lacey let her arms fall to her sides. She felt bereft for a moment, feeling the loss of his warmth, of his strong male body next to hers.

He took her hand in his. ‘I know you'll find this hard to understand…but after my cousin died everything seemed pointless. You work hard, you do your best for your family, for other people, and yet life can be plucked away from you in a second. Why put in all that effort if it's not going to do any good? We might as well enjoy life while we can, because you never know what's around the corner.'

‘I do understand.' She looked up at him, her gaze troubled as she studied his bleak expression. ‘It's just that I think life is all about helping one another, and if you have a skill that can make someone else's life better, then it doesn't seem right not to use it.'

He leaned towards her and kissed her gently on the mouth. ‘You're very sweet. I'm glad that you came to live next door.' His glance moved over her, lingering on the soft fullness of her lips, and it was just as though he had kissed her again. Lacey felt the lasting impression of that kiss as though he had seared her with his touch.

‘I'll take you home,' he said. ‘It'll be good for you to have your family with you…and it'll keep Rob from making any untoward moves in your direction.' His eyes glinted in the soft light of the cabin.

She stared at him, her mouth dropping open a little. ‘You men,' she said in protest. ‘You're unbelievable. All
this sniping at one another, when I've made it quite clear I've no intention of dating any man right now. You should take a break, the pair of you.'

He laughed softly. ‘I'm fine with that. Because I'm sure that eventually I'll be able to persuade you to change your mind.'

She shook her head and stood up, sliding out from the bench and going to take the air outside on deck. It was impossible to deal with him. Just a few minutes ago he had shown her another side to him, the part of him that could be hurt, the part that grieved for what he could not bring back, and yet now he was teasing her, making a play for her as if nothing had happened.

She didn't know what to make of him. Was it bravado, a reckless attempt to gloss over the worries that lay beneath the surface? Was his laid-back style, his live-for-the-moment attitude, just a front?

They set off, heading back over the water for the secluded dock that was shared by both properties. Jake secured the boat and then saw her to her door, saying lightly, ‘Thanks for helping me out with Martin. You'd make a good first-on-the-scene doctor if you ever consider a career change.'

She smiled. ‘Thanks, but I'm happy as I am.'

He left her, and she let herself into the house, going to find Rob to tell him about the incident. ‘I think he'll be all right,' she said. ‘We were there in minutes, so he had the best treatment available.'

Rob nodded. ‘I suppose I have to hand it to Jake. He hasn't entirely stopped practising medicine, and from
what you told me about the reef accident the other day, he seems to be well up on his skills.'

‘I never thought the day would come when you and he were behaving in a reasonable manner towards one another. Wonders will never cease.' She smiled. ‘Still, I imagine it must be good news for you with this film project he has in mind?'

‘It is. It came completely out of the blue…I wasn't expecting that. I've been working on ideas all afternoon…there are just a few details I need to think about.'

‘I'll leave you to it, then. I'm expecting Grace and the children to arrive within the next couple of hours, and I want to have supper ready for them.'

She went into the kitchen to start preparations. The sun was setting as she laid the table, out on the deck, lighting up the sky with a huge golden orb. Grace arrived just in time to see it, and the children ran excitedly into the garden to take it all in. Their dog, a black border collie, followed them, barking in ecstasy at his new surroundings and wagging his tail to signal that everything in his world was great.

‘Everything's red and gold,' Cassie said. ‘It's beautiful, Lacey.'

‘I think the sky's on fire,' Tom decided. ‘The sun's caught the trees and it's 'sploded all over the place.'

‘It certainly looks that way, doesn't it?' Lacey put an arm around her nephew and together they looked up at the sky.

Grace laughed. ‘I don't think we need call the fire service just yet,' she said. ‘Why don't you children go
and explore the garden for a bit while Lacey and I talk? Don't go too far, mind…the orange grove will be far enough. And your supper's ready, so don't be long.'

They ran off, with the dog, Toby, following them, running round in circles, darting this way and that until he was sure where Tom was headed. Tom went to investigate the undergrowth at the far end of the garden, where tree branches hung down and made a convenient den.

Lacey sat with Grace on the deck. They sipped iced drinks, and shared the food that Lacey had set out on the table. There was melon, corn cakes with a variety of meat and vegetable fillings, southern fried chicken and salad.

‘Isn't Rob joining us?' Grace asked, savouring the chicken and washing it down with chilled white wine.