Judy Campbell - Return of Dr Maguire

Christa drew in a sharp breath. ‘I know that boy—it’s Carl Burton. He’s a patient! What’s he doing in the barn?’

‘I’m not waiting to find out,’ growled Lachlan. ‘Is there a torch anywhere?’

He ran quickly across the yard and Christa flew to the surgery, scrabbling round in a drawer to find a torch, and instinct telling her to grab the emergency medical bag she kept locked in a cupboard by her desk. She was back in the barn inside two minutes.

The light in the outbuilding was dim, but in the torch’s beam they saw a boy lying on the floor, ominously still, his legs splayed at an awkward angle. His face was so pale that the large gash over his forehead looked as if it had been painted on. A piece of wood had fallen from the roof and was wedged above him at an angle. Carl Burton crouched by the victim’s side and he looked up at Christa and Lachlan with a mixture of fear and bravado on his face.

‘Bloody hell,’ muttered Lachlan, darting forward and pushing Carl out of the way. ‘Let me see what the damage is.’

Carl backed away from the victim. ‘Is he dead?’ he said, his voice cracking. ‘Has he been killed?’

Lachlan put his fingers on the boy’s neck to feel his carotid artery. He raised his eyes to Christa’s questioning look and nodded. ‘He’s still with us...better get some help, PDQ.’

‘It wasn’t my fault,’ Carl blurted out. ‘Greg saw that ladder. I told him not to climb on the roof, but he did. He was being stupid, standing on one foot and waving his arms about. Then he...he...dropped, like a stone...’ He stopped, putting his hands over his face.

‘That’s why he’s got to be treated as quickly as possible.’ Lachlan’s voice was brusque. ‘It’s lucky we were here.’

Christa pulled her mobile out of her pocket and flicked it open, punching out numbers. She walked over to the doorway as she spoke, glancing back at Lachlan bent over the victim’s body. Christa felt an almighty surge of thankfulness that she wasn’t alone in having to cope with things.

‘Ambulance and the police services, please—Dr Lennox here from the Ardenleigh Practice in Errin Bridge. I need the air ambulance for a serious leg, head and possible spinal injury to a youth who’s fallen from a roof just by the practice. My colleague and I will try and stabilise him, but he needs hospitalisation without delay. If you could inform St Luke’s to have an orthopaedic surgeon and anaesthetist on standby, please.’

‘We’ll have to do our best until they get here,’ observed Lachlan. He pulled back the upper lids of the boy’s eyes. ‘Pupils dilated,’ he murmured to himself, then examined the victim’s body, checking his head and other visible injuries. ‘He’s not bleeding too much from this head wound...’

‘That’s good, isn’t it?’ Carl looked up at Lachlan hopefully.

‘I’m afraid it’s not the same as just banging your head on a cupboard. Hitting your head at speed can give rise to arterial bleeding, and he’s had a tremendous crack to his forehead, besides his possible back and neck injuries and a broken leg.’

Christa bit her lip. Had the boy’s spine survived the impact of falling from the roof? Could they keep him alive until the paramedics arrived with their specialist equipment? She looked closely at the young boy’s face, where a bruise was developing around the gash on his forehead.

She drew in her breath. ‘Oh, God, I know this guy too...he’s Gregory Marsh, aged about sixteen.’ Her eyes met Lachlan’s. ‘Are you thinking acute subdural haematoma?’

He nodded and bent low over the boy, saying clearly, ‘Do you know where you are, Gregory?’

After a few seconds the boy whispered, ‘I’m in the barn, aren’t I?’

‘That’s right, Gregory, well done. Now, where does it hurt? Can you tell us?’

The boy’s eyes fluttered open, his breath rasping, his face contorted with pain. ‘My leg...bloody hell, it’s my leg,’ he muttered.

‘You can feel your leg, then?’ A measure of relief in Christa’s voice.

‘Of course I can feel my effing leg...’ he croaked. ‘It’s agony...’

‘Let’s look at this leg,’ said Lachlan briskly. ‘Can you cut his jeans?’

Christa used a pair of scissors from the bag to cut the leg of the jeans very gently from the distorted leg. They both looked down at the limb, which was gashed and swollen. Protruding through the gash was a white piece of bone.

Christa grimaced. ‘A compound fracture, not very nice...’

‘Poor blighter—it needs splinting.’

‘That’s OK. We’ve got some we use for the mountain rescue work. I’ll get them.’

‘Give me your bag of tricks and I’ll put some sterile dressings on these open wounds, and give him a ten-mil shot of morphine for the pain.’ Lachlan looked down reassuringly at Gregory and laid a comforting hand on the boy’s shoulder. It was a gesture not lost on Christa. Physical touch was an incredibly important and soothing thing, and reassurance could reduce the severity of shock—it was as important a medical tool as any conventional treatment.

‘Don’t worry, Gregory, you’re in good hands and we’ll soon have you in hospital.’

Christa went to get the collapsible splints and returned swiftly, snapping the splint joints into place and laying them out. The two doctors worked as gently as possible to immobilise the leg by strapping the limb to the splint, but Lachlan kept flicking a wary look at the beam above them, jammed across most of Gregory’s body. Christa heard him suck in his breath.

‘Bloody hell—can you hear that beam creaking?’ he muttered. ‘The whole damn thing could fall on top of us. It has to be moved.’

‘I don’t know how...’ began Christa.

He turned to Carl, watching them mutely, his face as white as a ghost’s. ‘I tell you what, Carl—you can help me try and push it out of the way.’

‘Don’t even think of doing that!’ Christa’s voice was sharp. ‘The helicopter will be here soon—’

‘And that could be too late. If I could get underneath it, I could lift it out of that gap in the wall and with Carl’s support we could push it to one side.’

She stared crossly at Lachlan. ‘Suppose you get crushed?’

‘If we wait for that damned air ambulance to come, the boy will need more than a spinal brace and a leg splint.’

Christa got up from Greg’s side and pulled at Lachlan’s arm. ‘Do you want there to be two casualties, for heaven’s sake?’

He shook her arm away irritably. ‘I’ll be OK. We haven’t got a choice—look, it’s swaying again...’

For a second they looked at each other stubbornly then Christa shrugged, acknowledging that Lachlan was right. They couldn’t just ignore the situation—something had to be attempted. She looked around the barn desperately. There were some old packing cases and dust sheets by the wall near Carl. She began dragging them across to Gregory and shouted to Carl.

‘Come on! Help me get these over Gregory to protect him before you start tampering with the damn beam—put the sheets over him and then the packing cases like a cage. It might just take the shock if the beam falls.’

‘Why can’t we just pull him away from it?’ asked Carl.

‘Because,’ said Christa in a low voice, ‘we don’t know what damage Gregory’s done to his spine. If he’s damaged it in the fall, we could sever it.’

They worked feverishly to construct some sort of barrier between Gregory and the chunk of wood wedged over him, then Lachlan slid his body underneath it to the side of the injured boy, so that he could try and shift the beam from where it was so precariously perched. There was a tense silence: Gregory’s eyes fluttered open again and he focussed them on Christa.

‘What’s happening?’ he whispered.

Christa’s voice was calm. ‘Nothing to worry about, Gregory, just making sure the beam’s secure. Everything’s under control.’

She hoped devoutly that that was the case, and indeed something told her that if anyone could handle an emergency like this, Lachlan Maguire could. She watched him tensely as he manoeuvred the beam, calm but concentrated, no sign of panic. Perhaps she shouldn’t have been surprised by his competence—someone who worked with the Flying Doctor service had to be able to think on his feet, quite an asset for someone she was going to work with.

Lachlan pulled the rag from his pocket and wound it round his hand to try and get more purchase. ‘Come on, Carl—I know you’re in shock, but you’ve got to help me, for your mate’s sake.’ His voice was tough, uncompromising. ‘Give me a hand to try and shift this. While I push it up, get your arms round it to pull.’

Both men grunted with the effort of trying to shift the wood away from over Gregory’s body, and eventually, with a final push and a shout of warning from Lachlan, it fell harmlessly to one side.

‘Thank God,’ whispered Christa, blowing out her cheeks and closing her eyes in relief. Lachlan climbed stiffly to his feet with a relieved grin and dusted his hands together.

‘There you are—nothing to it!’ He went across to Carl. ‘Thank you for helping there,’ he said quietly. ‘I couldn’t have done it without you. Now, tell me how all this started.’

Carl hung his head and muttered, ‘We...we were trying to get at the guttering—we saw the ladder and Greg thought it would be easy. I told him not to, but he started pretending he was a high-wire act and just fell from the beam up there.’

‘Were you trying to nick the lead?’

‘We didn’t think nobody would miss it. We didn’t mean any harm, we just needed a bit of cash...’ The boy started to shake at the memory of the accident, wrapping his arms round his thin body, rocking slightly on his heels.

Lachlan looked at Carl’s white face. ‘You feel all right?’

The boy shook his head helplessly as if unable to express just how he felt. ‘I...I just can’t believe it... Seeing it happen...’

His voice petered out, not equal to describing what he’d just seen, and Lachlan nodded, recognising all the signs of violent emotional shock in the boy. What Carl had witnessed had happened with appalling swiftness, with no time for him to prepare or adjust to the situation. His senses were stunned by the events and Lachlan recognised all the signs of ‘onlooker reaction’. He put his arm round Carl’s shoulder and drew him to the wall.

‘I want you to sit down here. Your body’s got a touch of shock, just as much as if you’d had a physical injury. After a nice hot cup of sweet tea you’ll feel much better.’

The boy’s face relaxed slightly. He hadn’t been expecting any kind words, but they helped to calm him, bring back something of normality to his fractured emotional state. There’d be plenty of condemnation later, thought Lachlan wryly.

Christa attached an oximeter peg to Gregory’s finger to get a readout of his vital signs.

‘What’s it like?’ said Lachlan.

Christa grimaced and murmured, ‘BP’s low, eighty over fifty. Not surprising, and his pulse is thready. How’s the pain, Greg?’

The boy stirred slightly but didn’t speak, and Lachlan looked at his watch.

‘How long are they going to be?’ he growled.

Then through the beating of the rain on the roof there was the sudden clatter of a helicopter’s rotors overhead, the sound increasing in volume as it descended somewhere near the surgery. Christa sent up a silent prayer—they’d arrived just in the nick of time.

‘Where will they land?’ asked Lachlan, as he and Christa exchanged relieved glances.