Chapter One
SOME WOULD SAY that Rachel Walker had a superpower.
She was an emergency nurse, slight of build, and looked younger than her thirty-two years, which wasn’t much of an advantage.
With her fiery red hair and porcelain skin it might be expected that she would blush easily.
But Rachel’s pale skin rarely flushed. As well as that, her huge green eyes revealed little of her thoughts even as she held someone’s gaze.
And while that might not sound like much of a superpower, when a patient was critically ill and terrified, or revealing his innermost troubles, it rather helped that the emergency nurse remained outwardly calm and seemingly unfazed.
Rachel had long ago learnt to hide her deepest feelings.
Growing up in Sheffield, in a loud, happy family, with gregarious parents and four older brothers, she had found it necessary, from an early age, to retain a neutral expression and not let anyone reap the effects of their persistent, albeit good-natured, teasing.
But then, aged six, Rachel had come home from school to a house full of aunts and uncles, neighbours and family friends and found out that her mother had suddenly died.
The teasing had stopped and the laughter had faded from the Walker home, and the little girl had quickly discovered that her dad and her brothers could not deal with her grief and tears.
‘Take her to the park,’ Dad would say when she cried for her mum.
Rachel had duly been taken to the park and pushed on a swing, or spun on a roundabout, or bumped up and down on a seesaw until her brothers had been satisfied that she’d return home smiling, at least for a little while.
The tears would soon start again, of course.
Especially at night, when she’d missed her mum tucking her up in bed and reading her bedtime stories, or when she would wake from a dream calling out for her.
‘Come on now, Rachel,’ her dad would tell her. ‘You’re upsetting our Phil with your carry-on.’
When she’d cried one day at school, and they’d had to call her dad to come from work to pick her up again, she’d known her tears were causing real problems. Her dad owned his own removal company and, as he’d explained that afternoon, people relied on him to get the job done.
‘It’s their moving day, Rachel,’ he said as she sat in the front of his lorry.
‘If I have to be called away, who’s going to move them into their new house?
And what about the family that are waiting to move in to theirs?
You’ve got them thinking they’ll have nowhere to sleep tonight.
Now, stop with them tears and be a good girl. ’
Then one day it had been ‘our Phil’ himself who had warned her. ‘Enough now, Rachel! Dad doesn’t need to hear it. He’s upset enough and missing Mum too. You’re just making things worse.’
Finally Rachel had stopped with the tears and the questions about her mum. Her emotions hadn’t stopped, of course—she’d just learnt to hide them.
This superpower she now possessed hadn’t done much for her relationships, but on this cold February morning, in the Emergency Department of London’s Primary Hospital, even though Rachel had only worked there for a week, her particular skill had been recognised.
She had been assigned to the minor injuries unit and was helping a young man with crutches when the intercom buzzed and she heard her name being called by May, the unit manager.
‘Excuse me a moment,’ Rachel said. But, reluctant to leave the man wobbling, she just went and stood by the curtains, so she could keep an eye on him as she answered the call.
‘Yes?’
‘Can I ask you to come down to Resus?’
‘Sure,’ Rachel said. ‘I’ll just—’
‘Immediately.’
As May summoned her, the chimes went off and the request for an anaesthetist to go to the ED went out.
Rachel called over her shoulder to a colleague to come and take over with the young man.
Then she made her way through the department, via Reception and the central waiting room, which was particularly full, and through to the main section of the unit, where she could see May standing outside the resuscitation area looking in.
Rachel liked her new unit manager. She was caring in the way of a mother hen, but also wise and sharp.
May gestured for Rachel to stand with her and observe as she told her about the patient. ‘Thomas Jennings, eighteen-month-old with query epiglottitis, just arrived in the department. Mother drove him here...thought he had croup.’
Even from this distance Rachel could see that Thomas was a very sick little boy indeed. He sat on his mother’s knee, leaning forward and drooling, his breathing noisy and laboured. She could hear the stridor—a high-pitched wheezing—from outside the room.
‘Where is everyone?’ Rachel asked, because she could only see Tara, a fellow RN, in there.
‘Jordan the paediatrician is here,’ May explained. ‘He’s on the phone, out of earshot of Mum, trying to get hold of an anaesthetist. But the on-call team are up on ITU and the second team is in Theatre.’
Sure enough, as soon as May said that the chimes went off again, summoning an anaesthetist to the resuscitation area of the ED.
Epiglottitis could quickly turn life-threatening.
It was an inflammation of the flap of cartilage and mucous membrane at the back of the throat that guarded the windpipe.
Thanks to immunisation, it was now rarely seen.
Still, at any moment little Thomas’s airway could become obstructed—hence the need for an anaesthetist to be present.
‘Mum’s getting upset that we’re not doing anything and Tara’s getting a bit flustered,’ May explained, and then glanced at Rachel, who stood there unruffled, taking it all in.
She must have looked so calm that May felt she had to double-check that she understood the precariousness of the situation.
‘You do know how quickly a patient with epiglottitis can deteriorate?’
‘Yes, May,’ Rachel answered calmly. ‘Has everything been set up for a tracheostomy?’
‘That’s why I called for you to come down,’ May admitted. ‘I’ll leave you to it. I’m staying back, so as not to distress the little man with too many people around him, but I’ll be hovering should you need me.’
‘Thanks,’ Rachel said, glad to know that May was near as she walked into the room.
‘Morning.’ Rachel smiled at both Tara and the mother, but she didn’t fuss over the little boy.
His blond hair was dark with sweat and plastered to his head, and he buried his face in his mum’s chest at the sight of a new arrival.
The monitors were all turned up and bleeping loudly. Rachel turned the volume down—given all the staff who were close by—doing what she could to make the surroundings less scary.
‘He’s never been in hospital before,’ Mrs Jennings said.
‘It’s very overwhelming.’ Rachel nodded. ‘But you’re doing great. I know it looks as if we’re not doing much, but the most important thing right now is to keep Thomas from getting upset.’
‘Where’s the anaesthetist?’ Mrs Jennings asked, her voice rising in panic.
‘On the way,’ Rachel said, privately hoping that was the case.
Tara spoke then. ‘I was just explaining to Mum that if we can get a couple of local anaesthetic patches onto Thomas it would be a great help when we cannulate him.’
‘Good idea—but perhaps Mum could do it,’ Rachel suggested, and then looked over to Mrs Jennings. ‘I’ll show you how.’
There probably wouldn’t be time for the cream to take effect before he was cannulated, but hopefully it would save him a little pain and distress, which was the main goal here.
Thomas didn’t flinch as his mother copied Rachel’s instructions and the patches were applied, which concerned Rachel greatly.
She glanced over to Tara. ‘Has everything been set up for the transfer?’
‘I was just about to do that,’ Tara said.
Thomas had only been in the department for ten minutes, but things had to be moved along speedily, as the situation could change at any minute.
And it was starting to. He was becoming increasingly exhausted, and Rachel knew she had to get everything they might possibly need on a trolley as quickly as possible.
‘I’m going to get things ready for Thomas’s transfer,’ Rachel said to the mum, ‘but I’ll be right here.’
All seemed calm.
All was not.
Outside the room there was a flurry of activity taking place.
The paediatrician was alerting the operating theatre, and the anaesthetist, who had just arrived in the hospital and collected his pager, was sprinting down the long corridor towards the ED.
Rachel was preparing the trolley, and outside May was calling Security to clear the corridor and hold the lifts while the transfer was made.
It was imperative that the little boy did not become distressed, so the staff were hands-off, leaving it to his mother to comfort him as they hovered discreetly and prepared for the worst.
Rachel started to collect the equipment they would need for the transfer while keeping an eye on Thomas.
She glanced out and saw Jordan on the phone, running a worried hand through his hair, but he plastered on a smile when he returned from his call and gave Rachel a nod, then made small talk with Mrs Jennings about his own three children while keeping a very close eye on Thomas.
‘There’s Nicholas, who is Thomas’s age,’ Jordan said, ‘and the twins are three—’
His words halted as the doors slid open.
‘Ah, the anaesthetist is here, Mrs Jennings. This is Dr Hadley.’
Hadley?
Rachel glanced over towards the doors at the sound of the familiar name. And the world as she knew it changed as Dominic Hadley stepped in.
Rachel quickly turned back to the trolley she was preparing, drawing in a deep breath when she suddenly felt giddy.
Dominic Hadley worked at The Primary?
Dominic was a doctor?
An anaesthetist?
How?
When?