There were things that didn’t make sense. Surely the asthma hadn’t hit so suddenly that Bill hadn’t time to locate his salbutamol and mask. Experienced asthmatics knew when an attack was starting. And why was he coughing blood?

She placed her hand on his forehead and winced. His temperature was sky-high.

A return of the pneumonia?

‘We need to get you to hospital, Bill,’ she said briefly. Her uncle had his car outside. ‘We’ll take you now.’

‘You don’t reckon we ought to get Doc Gallagher with his ambulance?’ Al asked uneasily.

Fern shook her head. ‘Ring and let him know we’re coming,’ she ordered. ‘But the sooner I get Bill into a hospital bed the happier I’ll be. OK, Bill?’

Bill’s hand came up to clutch her arm and the expression on his face was one of wholehearted agreement.

Quinn was waiting for them.

Al’s phone call had elucidated three short, sharp questions and then a command.

‘Get him in fast.’

Al had done as ordered, driving like a maniac with his hand on the horn and, Fern suspected, rather enjoying the drama.

Fern hadn’t. She’d sat in the back seat with her young neighbour, holding the mask and attempting reassurance, and all the while asking herself what could be wrong.

Bill was three years younger than Fern but she knew him well. He’d always had asthma but it hadn’t seemed to slow him down. He played football and cricket and put in a hard day’s labour with the best of them. Now, though…

Now Bill’s big frame seemed to have shrunk. Fern’s arm was around his chest, supporting him, and it seemed that he must have shed almost half his weight.

Pneumonia…This weight loss didn’t fit with one bout of pneumonia and then a relapse. It was more typical of terminal cancer.

Quinn would have eluded cancer-surely. So what was going on?

Legionella? AIDS? Psittacosis?

He didn’t seem a candidate for any of those things-but who knew?

Possible diagnoses were still running through her head as the car screeched to a halt and Quinn hauled open the back door.

He had oxygen ready. Quinn’s mask replaced Fern’s in seconds and Fern moved swiftly to assist in lifting the absurdly light farmer to a stretcher.

She’d have to stay. A quick glance at Quinn had found his face grim and drawn and maybe she had something to do with that but the situation Quinn was facing with Bill was enough to make any doctor look grim.

This was no ordinary asthma attack.

For the first time, Fern found herself feeling what it must be like to be a lone doctor in a place like this. There was no fall-back position at all-except for a plane to take patients to the mainland in dire emergencies. The plane couldn’t get here for hours and even then patients could choose not to go. Many of the islanders chose just that.

Like Aunt Maud…

‘I’ll live and die on the island, thank you very much. I don’t want mainlanders muddling my insides with heaven knows what.’

How many times had Fern heard words like that from elderly islanders, even when there was no doctor on the island at all.

Quinn Gallagher was therefore a heaven-sent blessing for the islanders. Even if he was a toad, at least he was a medically competent toad.

‘What’s happening here?’ Fern asked softly as together they pushed the trolley down the corridor. ‘Do you have any idea what’s going on?’

Quinn glanced down at Bill and his face set, if possible growing even grimmer. ‘God knows,’ he said frankly. ‘Bill’s been ill for months-though never so critically as this. I’d appreciate a bit of your time here, Dr Rycroft.’

She couldn’t refuse. Given the same scenario, Fern would be terrified.

A critically ill man with no clear diagnosis…

In Sydney she’d call in the big guns. The top physicians.

Here there was Quinn and Fern.

‘I’ll wait for you outside, Fern,’ Al said unsteadily. Fern’s uncle had been steering at the foot of the stretcher while Fern walked beside Quinn at the head. At the door to the ward he stopped dead.

‘No need. I’ll run Fern home-or one of the nurses will,’ Quinn said shortly, and Al cast Quinn a look of real gratitude.

He’d done his duty. Now he wanted out.

Fern couldn’t protest She couldn’t be concerned that she was forced to spend yet more time with Quinn Gallagher.

The tension between Fern and Quinn had to be put aside. Bill’s needs took precedence. He was losing ground. Even after five minutes of oxygen the young farmer appeared cyanosed and limp.

‘Adrenaline, I think,’ Quinn muttered, his hands already adjusting tubing.

‘I’ll do it.’

Thankfully, emergency trays were set up the same everywhere. Whoever had set the standards knew what they were doing. It meant that a doctor strange to a hospital could work at almost maximum efficiency straight away.

She reached for the syringe and her uncle blenched.

‘See you at home, Fern,’ Al muttered and bolted.

Fern’s escape route was cut.

Fern had to fight an almost overwhelming urge to bolt right after her uncle.

She had to stay. She and Quinn were Bill’s lifeline.

She had no choice.

It was a good two hours before Bill decided to live-for the moment-and at the end of that time Fern was exhausted. Her skills had been stretched to the limit and the fact that Bill was a childhood friend didn’t help one bit.

Finally, Bill drifted into a near-normal sleep, his breath still rasping and laboured but at least it was steady.

‘For now,’ Quinn said bitterly as they left the ward. The night sister was sitting by the bed and would stay there until morning. ‘The pneumonia’s obviously taken hold again-but why? Why?’

They were walking slowly down the corridor together, the tension between them put aside as both concentrated on Bill’s plight.

‘Malignancy?’ Fern suggested and Quinn shook his head.

‘There’s no sign. When Bill started losing weight I persuaded him to spend a couple of days in Sydney. I gave the radiologists carte blanche to find anything-and there was nothing. The antibiotic stops the pneumonia but this is the third bout he’s had. There has to be an underlying cause.’

He paused and dug his hands deep in his pockets. The lights in the corridor were dimmed but the strain around Quinn’s eyes was still obvious. He looked exhausted, Fern thought, her image of the indefatigable Dr Gallagher who never needed sleep fading fast. Now he leaned back against the corridor wall and ran his hand through his hair in a gesture of absolute exhaustion.

‘When Bill was in Sydney I had a physician look at him,’ Quinn continued. ‘He suggested Bill’s only problem was mycoplasma pneumonia and I hadn’t left him on antibiotics long enough the last time he’d had it. He’s been on antibiotics almost continually since then, though, and here he is crook again. I guess…I guess I should send him back to Sydney. Trouble is, I reckon the next we’ll hear of Bill will be of his death. The Sydney physicians don’t seem to have any more of a clue than I have.’

And his death would hurt, Fern knew, looking up at Quinn’s defeated face. This man might be a cheat to the women in his life but there was no doubting that he was a caring doctor.

He was worried sick now.

‘What’s causing the haemoptysis?’ she asked slowly. The plugs of bloody phlegm Bill was coughing were not normal for straight pneumonia.

‘The coughing might be causing it-or the continued infection.’ Quinn shrugged. ‘His cough’s so dry and consistent that he could be breaking small blood vessels. There hasn’t been much haemoptysis till now.’

‘There was a fair bit tonight.’ Fern frowned. ‘You’ve excluded things like AIDS?’

‘Of course.’ Quinn wasn’t offended. He seemed almost grateful to go through the options with another doctor and Fern knew how he was feeling. There was nothing worse than not knowing what was wrong when you were the only one qualified to do anything about it.

Quinn lifted a hand and wearily counted on his fingers. ‘It’s not HIV, or Q fever, or legionella or psittacosis. A CT scan of the thorax and abdomen were normal. Mycoplasma and Brucella serology were normal. He’s been on Aminophylline twice a day and bronchodilator and steroid inhalers for his asthma, and until six months ago his asthma was well controlled. It certainly isn’t now. He’s lost over four stone and is still losing. His sputum grows only a light growth of beta haemolytic Strep Group D and at last count his white cells were 7.38.’

Fern stared. For a country GP without specialist internal medicine training, Quinn’s search for a diagnosis was impressive.

But not conclusive.

There had to be something else.

‘Have you excluded TB?’ asked Fern thoughtfully. TB was rare in this country now-but not unheard-of. Mostly it occurred in migrants coming from more heavily infested areas, in AIDS sufferers or in elderly derelicts whose general poor health made then susceptible. Bill was certainly none of these.

‘His Mantoux test showed a positive response,’ Quinn told her. ‘But we’ve sent off pleural aspirate for cytology with negative results. Pleural biopsy, bronchoscopy and bronchial washings have all shown nothing. If I send him to Sydney now, the hospital’s going to waste time repeating all those tests and meanwhile…’

‘Meanwhile he’ll be dead,’ Fern said brutally. ‘We’ve run out of time for tests.’

‘Bill’s run out of time for living, then.’

‘Maybe.’

Fern scuffed her toe on the polished wood of the corridor, a habit she’d started as a child when she was thinking hard.

Silence.

‘He’s running a fair temperature,’ she said at last.

‘He has all along. Even when we cleared the pneumonia he’s been spiking nocturnal temperatures of thirty nine plus,’ Quinn told her. ‘I saw him the day after your…after your attempt at a wedding…because I was concerned he might have eaten some of those damned oysters.