“He needs to be fed.” He tried to keep his voice steady, light even, to pretend somehow that he hadn’t heard her words. “And I really ought to get to the hospital.”

“Daniel, please, there’s something you really need to know.”

Please, don’t do this!

It was the one thing he couldn’t take—to have Louise try to appease him with a story that he knew could never be true.

“I’m trying to tell you something, Daniel!”

“Maybe I don’t want to hear it.” His voice came out way too sharp and he struggled to control it.

“I’m talking about your son!”

The Surgeon’s Miracle Baby
Carol Marinelli

www.millsandboon.co.uk

COVER

TITLE PAGE

PROLOGUE

CHAPTER ONE

CHAPTER TWO

CHAPTER THREE

CHAPTER FOUR

CHAPTER FIVE

CHAPTER SIX

CHAPTER SEVEN

CHAPTER EIGHT

CHAPTER NINE

CHAPTER TEN

CHAPTER ELEVEN

CHAPTER TWELVE

CHAPTER THIRTEEN

CHAPTER FOURTEEN

EPILOGUE

PROLOGUE

‘HE’LL be OK at the crèche, won’t he?’ Louise stared into the carry seat at her sleeping son, watching as a gummy smile flickered over Declan’s face, his eyelids flickering as he dreamed milky dreams, utterly oblivious to the hellish guilt that was racking his overwrought mother.

‘He’ll be fine,’ Maggie groaned, snuggling into her dressing-gown and nursing a large mug of tea as she stood in the hallway of the tiny third-floor flat they were sharing. ‘It’s his mother I’m more worried about. You’ll end up in my ward with me taking care of you if you don’t lose some of the guilt!’

Which was surely a joke, but given that Maggie was a psychiatric nurse, it wasn’t in the best of taste!

‘It’s normal to be anxious on the first day in a new job,’ Louise said defensively. ‘And it’s my first day back at work since I had him—I’m still breast-feeding, remember.’

‘As if I could forget! I heard that blessed breast pump going all night—you’ve got enough milk in that cool bag to feed the whole crèche.’ Maggie’s joking façade faded as she saw the anguish on her friend’s face.

‘He’ll be fine,’ she said gently, putting down her mug on the hall table and pulling Louise into a hug. ‘He’s going to be ten minutes down the corridor from you, being loved and fussed over in the hospital crèche while his mummy’s earning lots of lovely money.’

‘I know.’ Louise sniffed. ‘To tell the truth, it’s not just Declan I’m worried about—I feel as if I’ve forgotten everything I know.’

‘It’ll all come back the second you set foot on the ward.’

‘Do you really think so?’ Louise asked dubiously.

‘I promise,’ Maggie said assuredly. ‘And at the end of the day you’re a casual nurse—they’re hardly going to be expecting you to run the show and you can just ease yourself in gently. Remember, a little more than a year ago you were a senior RN on a high-dependency unit in one of London’s busiest hospitals. Childbirth can’t have scrambled your brains that much!’

‘Were you nervous?’ Louise asked. ‘I mean, when you came here to Melbourne and had to start all over again?’

‘No,’ Maggie answered, then laughed. ‘But I’m a psychiatric nurse, remember! People are the same whatever side of the globe you’re on. Go!’ she said, picking up the car seat and handing it over to Louise. ‘Do you want a hand to get down the stairs?’

‘No, thanks.’ Louise shook her head but after bypassing the out-of-order lift and struggling down the stairwell with car seat, nappy bag, handbag and baby, she wished she hadn’t been quite so proud! Strapping Declan into the back of the car, Louise climbed into the driver’s seat, flicked on her lights and glanced at the clock on the dashboard, guilt layered on guilt as she saw that it was only six-thirty in the morning and that she’d dragged her sleeping babe up. She was so grateful to Maggie for being there.

Mad Maggie! They’d met a couple of years back on the other side of the world. Louise had been starting out on the adventure of a lifetime—a working holiday in the UK. She had been working a night shift in a busy London teaching hospital and Maggie had been on the surgical ward, specialling a psychiatric patient who had attempted suicide. Chatting, as night nurses invariably did, they’d hit it off immediately.

Both adored shoes but hated pedicures.

Both had credit limits on their cards that would make most mortals faint with shock.

And both were holding out for Mr Perfect.

‘Mr Really Perfect,’ Louise had elaborated, peeling open a box of chicken snacks at some ungodly hour and hoping that the carbohydrate rush would see her through to the morning. ‘Someone who will still make my knees knock when I’m fifty.’

‘Someone rich,’ Maggie had sighed, ‘someone who can afford my liposuction and Botox when I’m fifty!’

It had turned out that Maggie had been looking for a new flatmate and Louise had fitted the bill.

How times had changed.

Nearly two years later, it was Maggie now on a working holiday.

Maggie who had landed in Melbourne and had borrowed Louise’s spare room in her small rented flat for a few nights, which had turned into a few weeks!

And it was Maggie waving her off as she stepped out into the world on her first day as a working, single mother.

CHAPTER ONE

‘SORRY, what was your surname again?’

‘Andrews,’ Louise repeated, her bag over her shoulder, standing awkwardly as everyone else sat and trying not to blush as a very pretty but clearly irritated nurse relayed her details down the telephone to the nursing co-ordinator in front of the entire handover room. She was already feeling self-conscious enough in her new navy uniform, with new navy shoes and newly trimmed long dark wavy hair tied back with a new navy hair tie and now, and to make her feel even more self-conscious, the charge nurse seemed far from pleased to see her.

‘Hi, Kelly, it’s Elaine here on ASU. I’ve got a Louise Andrews here from the hospital bank—she says that she’s booked to work here for the next four weeks to cover Del’s sick leave, but Del was rostered for a late shift today.’ The longest pause ensued, the night staff yawning loudly, no doubt keen to get handover out of the way so they could head for home, while, in contrast, the day staff chatted happily, sipping their coffee and catching up on news—clearly in no particular rush to get out on the ward and start working.

‘How can she possibly be down for four weeks of early shifts?’ Elaine’s surprised voice snapped everyone to attention. ‘Since when did Del only work early shifts? If the bank nurse is supposed to be covering for Del, surely she should just take over her roster.’

Another horribly long pause ensued, only this time it wasn’t filled with idle chatter—and Louise could feel every eye on her as Elaine’s far from dulcet tones filled the room.

‘Oh, we’d all love to pick and choose when we work, Kelly, but for most of us it isn’t possible! Now it would seem that I’m going to have to spend the best part of the morning changing my regular staff’s shifts to accommodate a casual. It’s simply not on. Either Sister Adams—I mean Andrews—is to come back at one p.m. for the late shift or another nurse will need to be arranged to cover Del’s roster.’

A year ago she’d have been tempted to turn tail and run—correction, Louise thought, a year ago she would have crumbled on the uncomfortable spot and offered to work each and every one of the mysterious Del’s shifts and anything else in between just to get this difficult moment over with—but a lot of things had changed since a year ago, so instead Louise stood if not firm then feebly resolute, pointedly not saying anything until, with a very pained sigh, Elaine handed her the telephone.

‘The nursing co-ordinator wants to talk to you. Could you take it outside, please, so that we can get on with handover?’

Which meant one of two things. Either she was about to spend the entire morning barely knowing what was going on with the patients, thanks to missing out on handover, or—Louise gulped at the least palatable option—she was going home.

Without a word and with an incredibly steady hand, given the circumstances, Louise took the phone and headed out into the corridor, making sure the door was closed behind her before speaking to the nursing co-ordinator. She was determined to keep calm, determined not to let the knot of anxiety that was in her stomach creep into her voice, but her eyes were screwed closed as Kelly introduced herself. Leaning against the wall, Louise waited to find out if the weeks of careful planning and major upheaval had all been worth it, waited to find out if she actually had a job.

‘Is Elaine giving you a hard time?’ A tinkle of laughter from the nursing co-ordinator had Louise peeling her eyes open. ‘I’m Kelly, by the way.’

‘Hi, Kelly,’ Louise said, relieved to hear a friendly voice and warming to the other woman’s tone. ‘It would seem that Elaine wants me to take over Del’s shifts; but I’m sorry—I’m just not able to. I did say at my interview that I could only work early shifts and only on weekdays—’

‘Don’t apologise,’ Kelly cut in. ‘The whole point of being a bank nurse is being able to choose your shifts. Elaine should be counting herself lucky that we’ve been able to send the ward an experienced surgical nurse. Did you tell her just how qualified you are?’

‘We didn’t actually get that far with introductions,’ Louise admitted.

‘Well, it was either you and four weeks of early shifts or a grad nurse straight out of uni—and if I were the one in charge of the acute surgical unit this morning, I know who I’d choose!’

‘So it’s OK for me to stay?’

‘Absolutely. Look, you’re going to have to grow a thick skin pretty fast, I’m afraid, Louise. The hospital bank is still fairly new—till a few months ago we used an agency. Some of our ward staff can’t quite get used to the idea that a casual staff member should get to choose their shifts, get a better hourly rate of pay and use the facilities like the gym and crèche. Feel free to point out to them that your work isn’t guaranteed, and there’s no such thing as sick pay or annual leave…’ Kelly was no doubt trying to help, but as she pointed out the pitfalls of being a bank nurse, Louise felt that familiar knot of anxiety tighten a fraction, the precariousness of her situation not something she wanted to dwell on right now. ‘The fact of the matter is,’ Kelly continued, ‘it’s far better for the hospital to have our own team of casual nurses—you get to know the wards, and we get to know you, so everyone wins.’

‘Thanks for that,’ Louise said, though she was sure that Elaine would take rather a lot more convincing, ‘I’d better get back to handover.’

‘Sure. Oh, and, Louise…’ Just as she was about to ring off Kelly called her back. ‘There’s an eight-week stretch coming up in Outpatients, just after you finish on the surgical ward. The hours are eight till four, except on Wednesdays when you’d have to stay till five. The work might not be quite as varied or interesting as you’re used to, but the hours are great and at least you’d know where you’d be for a while.’

‘It sounds great,’ Louise enthused. ‘How do I apply?’

‘You just have to say yes.’ Kelly laughed. ‘Can I put you down?’

‘Sure.’ Louise blinked. ‘I mean, yes, please.’

‘Done! I’ll pop the details in your pigeonhole. Now, if you have any more problems with Elaine, just give me a call, but I’ll be up on the ward doing my rounds around eleven. I’ll come and say hello to you then. Welcome to Melbourne General!’

Even Elaine’s sour expression as she walked back into the meeting room and took her seat at the table couldn’t dampen her spirits.

Eight more weeks of guaranteed work!

OK, outpatients wasn’t exactly cutting-edge nursing, but Louise truly didn’t care. She’d have directed the traffic in the staff car park if it guaranteed her a wage! Eight weeks on top of these four meant that she had work for the next three months. It would see her right up through Christmas, and also meant she could start looking around for a rather more suitable home!

‘We’re up to bed nine.’ The nurse next to her pushed a handover sheet towards her as the lethargic night nurse—who’d been yawning before—now zipped through the patients with renewed energy, clearly buoyed by the prospect of home and bed. ‘I’ll fill you in on the rest after handover. I’m Shona by the way.’

‘Thanks, Shona.’ Louise smiled, snapping on her pen and running her eyes down the handover sheet, which thankfully contained the names and details of all the patients on the ward with a space left for her to add her own notes. Despite the rocky start to the morning, despite the rather frozen look on Elaine’s face as she’d returned and sat down, Louise was utterly determined to enjoy the rest of the day—back in the workforce, doing the job she loved. Nothing could spoil that except…

Room 3 Age 35 Danny Ashwood APFI

For a second Louise froze, reading again the small amount of information about the patient in Room 3 and trying desperately at the same time to concentrate on the details that were being given about the patient in Room 10.

It couldn’t be him, Louise scolded herself, writing down a complicated antibiotic and IV regime, listening carefully to the handover. But at the same time a small part of her brain was having its own conversation and every now and then, between patients or when the handover was interrupted by a phone call or a nurse popping her head around the door for the drug key, Louise couldn’t help but listen to the argument that was raging somewhere in her mind.

It couldn’t be him because for one thing he lived in England! As if Daniel would be here in Melbourne.

As if!

Anyway, this patient was called Danny—Daniel never shortened his name! And it wasn’t exactly a rare one—there must be loads of thirty-five-year-old Daniel Ashwoods around the world and no doubt a fair share of them were in hospital at this very moment with abdo pain for investigation.

It could even be a woman, Louise reasoned. Whoever had typed up the handover sheet might have spelt the name wrong! She was getting worked up over nothing—no doubt the patient in Room 3 would turn out to be a thirty-five-year-old named Danielle with endometriosis.

Silencing the voices in her head, Louise’s lips moved into a pale smile—she was just being paranoid.

‘Right!’ Handover completed, Elaine looked down at her notes then at the team of nurses as she worked out the complicated task of allocating patients. ‘Have you had any experience on an acute surgical ward, Louise?’

‘Quite a bit.’ Louise nodded. ‘I worked on a high-dependency—’

‘OK,’ Elaine cut in, clearly not remotely interested in where Louise had worked before. ‘I’ll give you some easy ones this morning and then you can help out anywhere else you’re needed. Beds 4 through 8 are all due to be discharged after morning rounds, so can you take them, please? Make sure that their discharge letters and drugs are all in order and check that the district nurse has been booked for Mrs Hadlow in bed 5. I’ll take beds 1 to 3, though I might need a hand with Jordan in bed 1. He’s just out of ICU with a tracheostomy—are you comfortable with tracheostomies? If not,’ she said, despite Louise’s nod, ‘call me or Shona if you’re at all concerned.’ Louise waited for further patients to be added to her rather paltry workload, but Elaine had already moved on, leaving Louise feeling curiously deflated. For the last couple of weeks she’d dreaded this day, had been reading each and every one of her nursing books and cramming in information, determined not to turn to jelly on her first day back to nursing. And though she knew she should be pleased to be eased in gently, she still felt just a touch disappointed, as if she’d been training for a marathon only to find out it had turned into a rather gentle jog around the park.

‘I’ll show you around,’ Shona offered, and Louise gratefully accepted.

‘Don’t worry,’ Shona said in a dry voice as she took Louise on a quick tour of the ward. ‘Elaine’s just as lovely to everyone on their first day—I think she just likes to make it clear who’s the boss.’

‘Well, she’s made it very clear,’ Louise said in an equally dry voice, but with a smile on her face, deciding that she liked Shona.

The other nurse grinned back. ‘Right, to business. The whole ward is basically shaped like the letter H—you’ve got the patients’ rooms running along either side. A few single-bedded rooms and some double-rooms with the all the sickest patients are in the middle, near the nurses’ station. That’s beds 1 to 3 and beds 25 to 28.’

‘Is bed 3 very unwell, then?’ Louise blushed as she fished for a little more information on the mysterious Danny Ashwood, but Shona just laughed.

‘Very embarrassed, I think, would be more apt,’ she said cryptically, then carried on with her introduction to the ward. Louise desperately tried to pay attention, but over and over her eyes were drawn to the closed door of Room 3. ‘Each corridor is a mirror image of the other and in the middle is the nurses’ station, doctors’ room and the NUM’s office—but Elaine takes it over whenever Candy’s off duty. This is the pan room—I’m sure you’ve seen plenty in your time. The clean room’s the one opposite—dressings, IV trolleys, that type of thing. Next door we’ve got the equipment room, which is kept locked or the other wards nick our IV poles…’ They were chatting as they were walking, Shona pointing things out as they went.

‘You’ll soon get used to it.’ They were back to the middle now and both stopped while Louise got her bearings. ‘This screen lights up when a patient buzzes—red means it hasn’t been answered, green means there’s a nurse in attendance. And here’s the crash cart. Do you want to go through it? I’m supposed to check it today so it’s no trouble to do it now.’

‘Please.’ Louse nodded. The crash cart would be needed in an emergency, not just when a patient went into cardiac arrest but during any sudden deterioration in their condition, and as an emergency wasn’t the ideal time to familiarise herself with the contents, she was glad of the chance to go through it now.

‘It’s all pretty standard.’ Shona pulled out the list and called out the contents as Louise located them and checked for expiry dates and working order. It was a check that was done daily on any ward to ensure the cart was always up to date, and also each time the trolley was checked or used it was signed off by two staff members.

‘How long have you worked here?’ Louise asked.

‘Six months and no time off for good behavior either.’ Shona smiled. ‘It can be so busy here. Mind you, it’s all good experience. Right, if you’re happy that you know where everything is, I’d better get on.’

‘Sure. Sing out if you need a hand,’ Louise offered. ‘I’m not exactly going to be rushed off my feet with the patients I’ve been allocated—they’re all about to be discharged!’

‘Don’t count on it.’ Shona rolled her eyes as the patient call-board lit up like a Christmas tree. ‘That’s two of mine buzzing already.’

‘Do you want me to get one?’

‘You’d better do your own work first. I’ll soon call if I need a hand.’

There was nothing worse than having little to do when everyone else seemed flat out. Elaine was preparing for the doctors’ round with the ward clerk as the other nurses were dashing past, looking flustered and busy, but despite Louise’s offers to help, everyone seemed to prefer to be busy by themselves than share the load.

Her own patients were all self-caring, the night staff had done all their observations and, checking their files, Louise felt even more at a loose end when she saw that all the meds and discharge orders had been completed.

‘Do you want me to give Jordan his wash and meds?’ Louise offered as Elaine raced over to grab some X-rays the doctors would need for the ward round, but she shook her head.

‘Just leave him. He’s had a rough night and only settled off to sleep around four a.m. I’ll do him once the ward round’s finished.’

Suddenly she smiled and Louise remembered that her first impression of Elaine had been how pretty she was, because when she forgot to frown she looked lovely.

Not that Elaine was smiling at her! Louise didn’t even have to look over her shoulder to where Elaine was looking to guess who had just walked through the door.

Holding in a weary sigh Louise made herself scarce as a group of dark suits approached—clearly the Monday morning consultants’ round was way above her station.

It hadn’t been, though.

Checking her patients’ notes for the umpteenth time and trying to look busy, for the first time in the longest time a wave of nostalgia practically knocked her off her feet. Sitting down at the nurses’ station, watching the theatre of a busy ward unfolding before her eyes, tears were suddenly appallingly close as she remembered how it had once been.

When she, Louise, had been in charge and taking the consultants’ around—when she’d known not just what she was doing, but where she was going in her career. Having spent more than a year in a famous London teaching hospital, she could have walked into any job she had wanted once she had returned to Australia. The surgical nursing world had supposedly been her oyster—but she had met Daniel Ashwood.

If that brief flirting during the ward round hadn’t led to a drink, followed by dinner, followed by…

Louise coloured up just at memory, still stunned, all this time later, that she’d tumbled, literally tumbled into bed with him that very night. At the time it had felt so right—the attraction so intense, so completely overwhelming that their first date couldn’t have ended any other way. It had been like opening the door to paradise, Louise recalled, but, watching as Elaine giggled girlishly at something one of the consultants had said, a rather nasty smile twisted on her lips. Elaine should be very careful what she wished for—even paradise had its drawbacks!

Danny Ashwood.

Staring down at her handover notes—even though she knew it couldn’t possibly be him, there was some strange comfort to be had just seeing the name in print—and till she opened the door and confirmed that it was a different person entirely, it was nice to dream for a moment, nice to hold onto that tiny sliver of fantasy that Daniel was close.

For goodness’ sake, Louise chided herself for even daring to go there. Daniel Ashwood was the last person she wanted to see right now—the very last person she needed complicating her life! Deciding to put herself out of her misery, Louise took action and stood up, heading for the shelf of nursing notes, only to find bed 3’s wasn’t there. Perhaps they were being used for the ward round, but no. Louise frowned, because only bed 3’s slot was empty. All the other nursing files were neatly in place.

Well, she’d just go right ahead and look, Louise decided, just pop her head around the door and ask if everything was OK. Then she could put this stupid fantasy to bed, put Daniel Ashwood firmly out of her mind—where he belonged.

‘Did Danny buzz?’

Her hand on the door, jumping as if she’d been caught stealing, Louise froze as Elaine bustled over.

‘Sorry.’ Louise forced an apologetic smile. ‘I got the rooms mixed up. I thought this was Room 4. I was just going to strip the bed now that the patient’s gone home.’

‘Then it’s just as well I stopped you. Danny needs his rest. You’re to let me know if he buzzes and I’ll attend to him. I’ve just called the orderly to come and prepare Room 4—there’s going to be a new admission direct from Theatre, a twenty-two-year-old male with a stab wound to the loin. That’s all the information I have. I’ll let you know more when I find out.’

‘Thanks.’ Louise answered easily but her mind was working overtime as she bade farewell to ‘Danielle’ and tried to fathom Elaine’s rather proprietorial response—consoling herself that Elaine had been exactly the same about Jordan. However, for the rest of the morning it was as if the room taunted her. Her obsession with the patient behind the firmly closed door grew, because even if her Daniel was safely setting the world on fire in London, this one was clearly something special, too, because it took a trip to the loo, a squirt or perfume and a fresh coat of lipstick for Elaine to even go and take his temperature.

Still, at least Louise had something to do now. Once Room 4 had been cleaned by the orderly, she set about preparing it for the new admission, bringing in the observation trolley and making the bed.

‘Getting a new one?’ Shona asked, coming in and taking over one side of the bed, both nurses chatting as they tucked in the sheets and blankets in unison.

‘Stab wound to the loin,’ Louise said. ‘He’s in Theatre now.’ They worked in silence till Louise could take it no more—if she didn’t find out, then quite simply she’d burst! ‘What’s wrong with the patient next door?’ Louise asked as casually as she could, hiding her blush as she stuffed a pillow into its case and took great interest in plumping it up. ‘I nearly went in by mistake and Elaine said that if the patient even buzzed then she was to be told—is he being barrier-nursed?’

‘Oh, no.’ Shona laughed. ‘Nothing like that. Elaine probably thinks it fitting that only the most senior staff look after him—he’s one of our consultants.’

‘The patient in Room 3?’ Louise croaked.

‘Yep.’ Shona nodded. ‘I think Elaine’s trying to dazzle him with a bit of TLC, but she can spray as much perfume and put on as much lipstick as she likes, that’s one nut she’s not going to crack…’ She let out a peel of laughter. ‘Pardon the pun.’

‘You’ve lost me.’

‘Oh, that’s right, you missed handover, didn’t you?’ Shona checked there was no one around and then leant over the bed and spoke in a low, delighted whisper. ‘Well, just in case you do end up going in there, you’d better know that he isn’t really abdo pain for investigation—he had a rather painful injury playing cricket yesterday! The Ashwood family jewels are as black as coal, but thankfully saved and in full working order!’

‘Sorry?’

‘He had a torsion of the testes, the poor guy!’ Shona winced and grinned at the same time, crossing her legs as just the thought of it! ‘Very nasty. He was operated on yesterday afternoon, then had to return for drainage of a haematoma—he only got back from his second op at six this morning. All the poor guy wants, no doubt, is to go home, not spend the morning flirting. More’s the pity, mind you—he’s gorgeous!’

‘I used to work with a consultant by that name—well, he was called Daniel…’ Louise’s heart was hammering in her chest as she spoke, torn between hope and dread. ‘Mind you, that was in London. There must be loads of doctors…’

‘Danny’s from London,’ Shona shrugged. ‘He’s on a year’s rotation here—maybe it is him!’ Oblivious to Louise’s expression, she glanced around the room. ‘I’ll go and get a gown for the new admission and a kidney dish, then you might as well go for your coffee-break before the new admission comes up.’

As surely as if a cricket ball had hit her at high speed, Louise felt as if the wind had literally been knocked out of her, could feel her scarlet cheeks paling as the blood literally drained from her face. Shaking, she lowered herself onto the newly made bed and buried her face in her hands, still, at the eleventh hour, trying to reassure herself that it was a simple mistake, that the man in the next room wasn’t really Daniel.

And wondering how on earth she’d cope if indeed it was!

‘Jordan needs suctioning urgently.’ One of the student nurses came racing down the corridor, looking more than a little alarmed. ‘His chest sounds terrible.’

Instantly Louise snapped to attention, her personal dilemma completely pushed aside as she heard the note of urgency in the student’s voice. ‘What happened?’ Louise asked, as she made her way swiftly down the ward, because even though it was Elaine’s patient, a tracheostomy patient with breathing difficulties couldn’t wait for anyone. ‘Who’s in with him?’

‘Just me,’ the student started, her voice trailing off as she realised the folly of her ways as she said the words out loud. Louise would need to talk to her about it later. Now wasn’t the time or place to tell her never to leave a patient who had difficulty breathing distressed and unattended. Bracing herself for what she might find, hearing his distress from halfway down the corridor, Louise flew the last few steps.

‘It’s OK, Jordan.’ Louise’s voice was reassuring as she entered the room, straight away pushing the call bell for further assistance. Pulling on a pair of gloves, she carefully checked his tracheostomy, relieved to see that it was securely in place. From her handover sheet, Louise knew that Jordan had been in a high-impact motor-vehicle accident two months previously—a mixture of booze, dope and high jinks had almost ended his life. Along with abdominal injuries, he had suffered head and facial injuries. The facial injuries had compromised his airway, necessitating a tracheostomy, which he was being weaned off. But the tracheostomy tube could sometimes fall out or, as was the case in this instance, as Louise immediately decided after a brief assessment, a patient’s airway could become blocked with a mucous plug. Jordan still had air entry, his chest was moving on inspiration, but the air entry was poor and he was clearly distressed.

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