‘Crikey!’ Riley swung himself up into the tray the instant the truck stopped. ‘You believe in making life exciting. This is like a nose bone, only different.’
‘Funny, ha-ha,’ Gerry muttered, and Riley knelt and put his hand on his shoulder.
‘We’ll get you out of pain in no time,’ he told him. Joyce was already handing up his bag. ‘Let’s get some pain killers on board before we shift you inside.’
‘Will I have to go to Sydney?’
And the way he said it… No matter how much pain he was in, Pippa realised, the thought of the city was worse.
‘No promises, mate,’ Riley said. ‘We need to figure what the damage is. We’ll get you out of pain and then we’ll talk about it.’
It was amazing how such a diverse group of professionals could instantly make an elite surgical team.
Even Harry took part. By the time the morphine took effect, Harry had organised an electric buzz saw, with an extension cord running from the veranda. ‘Electric’s better,’ he said briefly. ‘Less pressure and this fitting’s got fine teeth. It’ll take seconds rather than minutes by hand.’
The picket had pierced one side of Gerry’s calf and come out the other. Pippa helped Joyce cover Gerry with canvas to stop splinters flying. Riley and Pippa supported Gerry’s leg while Harry neatly sliced the picket above and below.
‘Closest I can get without doing more damage,’ Harry muttered, and put the saw down and disappeared fast.
‘Turns green, our Harry,’ Riley said, grinning at his departing friend. ‘Still, if you asked me to pilot a chopper in weather Harry’s faced, I’d turn green too.’ He was slicing away the remains of Gerry’s pants, assessing the wound underneath. It looked less appalling now there was less wood, but it still looked dreadful. ‘Pippa, what’s your experience in getting bits of wood out of legs?’
‘I’ve done shifts in City Emergency. We coped with a chair leg once.’ She made her voice neutral and businesslike, guessing what Gerry needed was reassurance that this was almost normal. Riley’s question had been matter-of-fact, like bits of wood in legs were so common they were nothing to worry about.
‘You got it out?’
‘We did. When he came out of the anaesthetic the publican was there, demanding he pay for the chair.’
‘So this little picket…’
‘Piece of cake,’ she said, smiling down at Gerry. Thinking it wasn’t. The wood had splintered. The wound looked messy and how did they know what had been hit and not hit?
‘Then let’s organise X-rays,’ Riley said. ‘And an ultrasound.’
‘You can do an ultrasound here?’
‘Portable kit,’ Riley said, sounding smug. ‘Eat your heart out, Sydney. Okay, Gerry, let’s get you inside. Boys, slide that stretcher in beside him. Pippa, shoulders, Joyce hips, I’ve got the legs. And picket. Count of three. One, two, three…’
They moved him almost seamlessly and in less than a minute Gerry was in what looked to Pippa to be a perfect miniature theatre.
‘I thought this place wasn’t a real hospital?’ she said, astounded.
‘It’s not.’ Riley was manoeuvring the X-ray equipment into place. ‘Dry Gum’s too small for much government funding. Joyce is funded for a remote medical clinic, nothing more, but we have lots more. This place is run on the smell of an oily rag. Joyce and I do a lot of begging.’
‘And blackmail,’ Joyce said. ‘Any company who wants to mine out here, who makes money off these people’s land, can expect a call from me.’
‘Joyce even buys shares,’ Riley said in admiration. ‘She’s been known to get up in shareholder meetings and yell.’
‘She’s a ripper,’ Gerry said faintly. ‘Hell, if she had some money… imagine what our Joyce could do.’
‘She’s doing a fantastic job anyway,’ Riley said. ‘Okay, Gerry, that leg’s positioned, everyone else behind the screen. Let’s take some pictures.’
The leg wasn’t broken. There was a communal sigh of relief.
The wood had splintered. Surgery would be messy.
The ultrasound came next and Pippa watched in awe. Reading an X-ray was one thing, but operating an ultrasound…
She could pick out a baby. Babies were big. Even then, when the radiographer said look at a close-up she was never sure she was looking at the right appendage.
But that Riley was competent was unquestionable. He was checking for damage that’d mean Gerry had to go to Sydney regardless. He was looking at flow in the main blood vessels-evidence that the artery was obstructed; blockage to blood supply that might turn to disaster when splinters were dislodged.
Despite the trauma Gerry seemed relaxed. As long as he didn’t need to go to Sydney, whatever Doc Riley did was fine by him.
‘I reckon we can do this,’ Riley said at last. He cast a thoughtful look at Pippa. ‘How tired are you?’
She was tired but she wasn’t missing this for the world. ‘Not tired at all,’ she lied, and he grinned.
‘Right. We have one doctor, two nurses and an orderly. That’s Harry. Green or not, he gets to keep the rest of the place running while we work. Pippa, you’ll assist me. Joyce, are you happy to anaesthetise?’
‘Sure,’ Joyce said.
‘You can anaesthetise?’ Here was something else to astound. A nurse acting as anaesthetist…
‘Joyce is a RAN, a remote area nurse,’ Riley said. ‘RANs are like gold. Sometimes she’s forced to do things a doctor would blanch at, because there’s no choice. We both do. Like now. I’m not a surgeon and Joyce isn’t an anaesthetist but we save lives. If you end up working with us…’
‘You’ll get to do everything as well,’ Joyce said briskly. ‘Out here we do what comes next. Okay, Riley, let’s not mess around. I have work to do after this, even if you don’t.’
She had to ask. This was tricky surgery and to attempt it here… ‘I know he’s scared,’ she ventured. ‘But surely it’d be safer to take him to the city.’
‘I can do it.’ She and Riley were scrubbing fast, while Joyce was booming orders outside.
‘Without a trained anaesthetist? To risk…?’
Riley paused then turned to her.
‘Think about it,’ he said harshly. ‘Gerry’s seventy years old and he’s lived here all his life. No, that’s not true. He’s lived near here. For him Dry Gum is a big settlement. Even here is a bit scary. If I send him to Sydney I’ll be throwing him into an environment that terrifies him. I’ll do it if I have to, but it’s a risk all by itself. I’ve had one of my old guys go into cardiac arrest in the plane and I’d swear it was from terror. With three of us… I’ve weighed the risks and they’re far less if he stays here. Accept it or not,’ he said grimly. ‘We’re doing it.’
By the time it was over Pippa had an even greater breadth of understanding of this man’s skill. Quite simply, it took her breath away.
He took her breath away.
Joyce was competent but she wasn’t trained in anaesthesia. That meant that Riley needed to keep an eye on what she was doing, checking monitors, assessing dosages, at the same time as he was performing a complex piece of surgery that frankly she thought should have been done in Sydney. By surgeons who’d had experience in such trauma, who had skilled back-up…
She was the back-up. She worked with an intensity she’d seldom felt. She was Riley’s spare pair of hands and he needed her, clamping, clearing blood, holding flesh back while he eased, eased, eased wood out of the wound. The splinters first of all and then the main shaft…
He had all the patience in the world.
It was a skill that awed her-this ability to block out the world and see only what was important right now.
Few people had it. A psychologist once told her it usually came from backgrounds where the skill was necessary to survive.
What was Riley’s background? She didn’t have a clue. All she knew was that there was no one she’d rather have in this room, right now, doing what he had to do in order to save Gerry’s leg.
They worked on, mostly in silence except for Riley’s clipped instructions. That fierce intensity left no room for theatre gossip, and she wouldn’t have it any other way.
And finally, finally, Riley was stitching both entry and exit wounds closed. The stockman had been incredibly lucky. To have not severed an artery and bled to death in minutes… To have not even have fractured his leg…
‘He’ll stay with you for a week, though, Joyce,’ Riley said in a seeming follow-on from Pippa’s thoughts. ‘There’s a huge chance of infection. I’ll put a brace on and tell him if it comes off in less than a week he’ll have permanent nerve damage. It’s a lie but it’s justified. If he heads off back to camp, we’ll have him dead of infection in days.’
‘Won’t antibiotics…?’ Pippa started.
‘He won’t take them,’ Riley said wearily. ‘None of the older men will, unless we force-feed them. They see medicine as a sign of weakness. The women accept them now; they see how the kids respond and they believe. We’re educating the kids, but Gerry missed out. So he’ll wear an immobilising cast for a week. And I’m sorry, Pippa, but we need to stay here tonight until Gerry’s fully recovered from the anaesthetic.’
She’d already figured that out. She’d been horrified that he’d attempt such surgery here, but having done it… he couldn’t walk away with Gerry recovering from anaesthesia and no doctor on call.
‘I can manage,’ Joyce said, but Riley shook his head.
‘I’ll be the one who tells Gerry the rules in the morning. Can you put Pippa up here?’
‘It’s a full house,’ Joyce said.
‘Your sitting room?’
‘Glenda Anorrjirri’s in it,’ Joyce said, apologetically. ‘Her Luke’s asthma’s bad and she’s frightened. They’re staying with me until it’s settled.’
‘I told you-’
‘To keep myself professional? I do,’ Joyce said, flaring. ‘I keep my bedroom to myself.’
‘Which is a miracle all by itself,’ Riley growled. ‘Joyce has a one-bedroom apartment attached to the hospital,’ he explained. ‘She has a sitting room and a bedroom, which she’s supposed to keep private.’
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