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She gave him a brief smile. 'I'm hoping that they're sorted out for the time being,' she returned. 'I did my very best to be here on time. What's on the agenda for today?'

'Go and take a seat and you'll find out. We're just about to begin.'

She did as he'd suggested, sipping appreciatively at her coffee. Most of the meeting was taken up with a discussion of ways and means that they could use to improve throughput in the emergency room. There was obviously a need for change because patient numbers were rising steadily and the doctors and nurses were under pressure most of the time. It didn't help that they were short-staffed.

Mark had been brought in to the department to shake things up, and Sarah had no doubt that he would achieve his objective. He was energetic, on the ball, decisive, and she could see why management had chosen him instead of Owen.

Owen, on the other hand, was good at his job, calm and tranquil, and far more easygoing. Those qualities didn't necessarily make for good management, though, and Mark certainly didn't suffer from any such handicap.

'Did you have anything to add to that, Sarah?'

She looked up as the sudden query caught her unawares, and she tried to collect her scattered thoughts. She stared at Mark. Was he talking to her? She had no idea what direction the discussion had taken. For some minutes her thoughts had drifted off, and now Mark was looking at her with laser-like interest, one dark brow, raised in query.

He knew that she had not been listening. Drawing herself up in her chair, she said quietly, 'I'm not sure. Would you mind running that by me again?'

His mouth made a faint twist. 'Certainly. Dr Blake was suggesting that we could use a competitive system, with each doctor attempting to deal with as many cases as possible at each session. At the end of the month we could decide who was the overall winner and make that person A and E doctor of the month.'

Sarah swallowed. 'I don't think I could agree with that. Firstly, it does nothing to encourage the nurses, and could even alienate them, and, secondly, I don't think it would be a fair system.'

Mark was standing by a table at the far end of the room, and now he came around to the front of it and leaned back against the edge, his long legs thrust out before him. It was distracting, and she was far too aware of the strength of his taut thighs, firmly encased in beautifully tailored dark trousers.

He was studying her with a quizzical expression. 'Why do you think it wouldn't be fair? After all, this way everyone has an equal chance to compete. It would certainly help us to improve output.'

She glanced towards Dr Blake. He was young and lively, a senior house officer, on an equal footing with herself, and she recognised that he was very good at his job. He was clever, quick thinking and exceptionally skilled as a doctor. He would have little trouble making swift decisions over the treatment of his patients, and she had no doubt that he could send them on their way, knowing that they had been given the care they needed. She felt totally inadequate alongside him.

'I agree with you that it would be a positive solution, and we would most likely see results if it was put into practice,' she said. She turned her gaze towards Mark. 'I just think that there would be too many problems if we do that. Who is to say that the doctor who treats the most patients has had a similar workload to anyone else? Some cases are more troublesome than others. It may take more time to deal with their particular problems, or it may be necessary to spend a while working out how best to help in particular circumstances.'

Mark was not impressed. 'Surely, over the course of the month, these inequalities would be evened out? Everyone has to take on cases with varying levels of difficulty.'

That might be true, but Sarah wasn't about to back down. 'Maybe, but to go down this route would be to encourage snap decisions and speed for the sake of speed, and it could lead to carelessness. With all due respect to Dr Blake, I think it would be a bad idea.'

Shaun Blake frowned. He didn't look at all happy that she had disagreed with him.

Mark gave a faint grimace. 'Thank you for your observations,' he said. To Sarah's ears, it didn't sound as though he had appreciated them very much.

Addressing the meeting, he added, 'I'll take into account everything that has been said here today. I'm not going to make a decision here and now, but I'll let you know what course we'll be taking in a day or so.' He gave a brief smile. 'That's all for now. Thanks for your time, everyone, and now you're free to go.'

Sarah didn't move along with everyone else. She and Mark were scheduled to meet up with the ambulance crew once again and she was feeling faintly apprehensive about that. It hadn't been a good start to the day, one way and another. First the problem with Hannah not coming home, and now she had to contend with the fact that Mark was unimpressed by her participation in the meeting. She gave an inward sigh. There was nothing she could do about that.

'You don't appear to be too enthused about the day ahead,' Mark said, coming to stand beside her. 'Are you still uneasy about going along with the ambulance crew?'

She looked up at him. 'I don't recall saying that I was uneasy about it.'

'No, but I sense that you have reservations.'

'It isn't a problem,' she murmured.

He raised a dark brow. 'No? Then it must be something to do with the meeting that's troubling you. Am I right?'

'Not necessarily.' She pulled in a deep breath. If he would insist on goading her, then she would be straight with him. 'If I have a problem at all, it's with your management style. I don't go along with competitive practices or staff having to earn bonus points to score off one another. I prefer to work in an atmosphere of camaraderie, where everyone counts just as much as everyone else. I know that I haven't been here long, but I've been used to a more relaxed, inclusive style of leadership.'

'Like Owen's, you mean.' His mouth twisted. 'Sorry to disappoint you. I've been brought in to shake things up, and that's what I intend to do.'

'That's your prerogative.'

'I'm glad you realise it.' He gestured towards the exit door. 'Are you ready to go? We should leave now.'

'Yes, I'm ready.'

Their first callout was to a house where a woman had collapsed after suffering a suspected heart attack. They managed to relieve her pain and restore her circulation, and with any luck she would survive, given good care in the coronary unit.

Back in the ambulance, on their way to assist at another location, Mark leaned back in his seat and asked, 'What was the problem this morning when you first came in?'

She looked at him in surprise. 'What makes you think there was a problem? I wasn't late. You hadn't started the meeting.'

'Maybe so, but I could tell from the way that you came into the room. You had that distracted look about you. I'm beginning to recognise it.'

She shot him a hooded glance. There was a wry look about his mouth, and she thought she detected a faint gleam in the depths of his grey eyes.

'I had to do something about Hannah's dog. He was on his way to tearing up my upholstery and generally wrecking the place, so I had to make sure that he was going to be looked after today.'

'Hannah wasn't there?'

'No. I've been trying to get in touch with her, but she just sent me a text message to say that she was sorry and something had come up.'

'Is she often unreliable like that?'

'Not usually. Sometimes she'll forget the time if she's caught up in something, but she doesn't go out of her way to let people down. I think she's unsure of herself at the moment. She has a lot on her mind, and she tries to fit things in between looking after Jamie and doing her part-time job.'

'What kind of work is she doing?'

'She's working in an office at the moment—not today, but for several hours a week. It's not what she's used to, but she did some secretarial training before she started work as a buyer for one of the big stores. She used to have a really good job and she used to travel, but all that's come to an end.'

'I suppose it would be difficult to cope with a job like that now that she has a child. It's one thing to travel and work long hours when you're footloose and fancy-free, but it's not as simple when you have dependants.'

She nodded. 'You're right.' She was pensive for a moment or two. 'That was how she met Ryan—she was working abroad, and he was out there doing some engineering work for his company. They were both staying in the same hotel.'

'Didn't you say that Ryan had managed to keep his job?'

'Yes, I did. I'm not sure for how much longer he can do that, though. He has a problem with drink, and it can't be helping.'

'It doesn't sound as though that's his only problem. There must be a reason for him to keep getting himself in the state he was in the other night.'

Sarah shrugged. 'I dare say, but I don't know what that is.'

The ambulance had now arrived at their destination, a factory where bottles were labelled and packaged, and the crew jumped out and went to attend to their patient. He was a young man who had trapped his hand in a roller mechanism. The fire brigade team was already there, attempting to free him.

I don't think you've done any irreparable damage,' Mark said, examining the man's hand. 'It looks worse than it is, but we'll take you to hospital and get it X-rayed, just in case.'

Sarah felt sorry for the young man. He looked faint from shock, and although there was no dreadful damage he was suffering from severe bruising, and it would be a while before he would be able to use the hand again properly.

They waited at the hospital until their next call came through. 'We might as well grab some lunch while we have the chance,' Mark said.

'How can we do that?' Sarah asked. 'We could be called out at any moment.'

'I know that, but we'll get something to take out with us. Even if it's just a pack of sandwiches and some coffee, it will keep us going.' He sent her a long look. 'I don't suppose you thought to bring anything with you, did you?'

Sarah shook her head. 'I did pack some lunch, but it's still sitting on the kitchen table at home. I forgot all about it when I saw what Kingston had done to my sitting room.' She flicked him a sideways glance. 'Anyway, you can hardly talk—I don't see you with a lunch pack.'

'That's because I was called away to help one of the junior doctors. I was on call at the hospital overnight, and I meant to drop by the cafe and pick up something, but I didn't get the chance.'

Her mouth curved. 'You mean you forgot.' She stared at him for a moment. 'Perhaps you're not infallible after all.'

His dark brows met. 'Did I say that I was?'

'That's the impression I had. I'm the one who suffers from constant lapses. You made that clear enough this morning.'

'I don't recall doing that.' There it was again, that quizzical expression, his head tilted a little, as though he had his doubts about her, as though he would like to find out exactly what it was that made her tick.

'Weren't you annoyed because I was almost late for the meeting? I thought you were scathing towards me when I disagreed with Dr Blake's suggestion. You might not like it, but I'm entitled to my opinion.'

His eyes glinted. 'I think you have the wrong impression of me. You were perfectly justified in saying what you thought.'

She sent him a narrowed glance. He wasn't saying that he agreed with her, but it was a concession of sorts.

They queued up in the cafe, and made their purchases. Sarah began to eat, savouring her hot Cornish pasty, and Mark was demolishing his sandwiches at a rate of knots. It wasn't long, though, before they were called back to the ambulance.

'It's a multiple road traffic accident,' the paramedic told them. 'There's been a pile-up at one of the accident black spots. Three cars were involved, from what we've heard. One driver hit a patch of ice and spun into the path of an oncoming vehicle. A car behind ran into both of them. There are multiple injuries.'

All thoughts of food were forgotten now. Sarah was keyed up, wondering what they were about to face. These kinds of accidents were serious. She had to be on the ball and decisions that she made could determine life or death. She hoped she was up to it.

Mark made a swift check of the casualties when they arrived at the scene of the accident. Another ambulance had gone along with them and the police were already there, setting up roadblocks. The paramedics went to attend to a woman and an older man, leaving Mark to tend the driver of the car involved in the initial skid. Sarah saw a woman, lying on the grass verge. She appeared to be conscious and a paramedic was by her side.

'There's a man in the other car suffering from breathing difficulties,' Mark told Sarah. 'He needs oxygen. He may have a pneumothorax.'

Sarah went to take care of her patient. He was in a bad way and one lung had collapsed, but she managed to inflate it once more, inserting a chest drain and taping it in place. 'How does that feel?' she asked. 'Do you feel more comfortable now?'

The man nodded. 'How is my wife? I tried to avoid the other two cars, but I lost control on the ice. I heard my wife scream.'

'One of the paramedics is attending to her. I'll find out for you.' The man's wife had been thrown from the car onto a grass verge, and Sarah guessed that she hadn't been wearing a safety belt. Her initial thought was that she might have escaped major injury when the car door had been flung open, but she couldn't be sure.

Sarah looked over to the verge. 'I can see her,' she told the man. 'She's sitting up and the paramedic is trying to put her arm in a sling. I don't think you need to worry too much.' It could be that the woman had sustained a fracture, but she was breathing and talking, and that was what mattered.

The man slumped back in his seat. 'Thank heaven,' he muttered.

'I need some help over here,' one of the paramedics called to her, and Sarah hurried towards the mangled car across the road.

'What is it?' She could see that the driver of the car had sustained a head injury. It didn't look too bad, but blood had poured down his face from his forehead.