The Bush Doctor's Challenge Read online

  ‘Bill doesn’t have a choice Abby. You do.’

  She opened her mouth to speak but Kell beat her to it. ‘I’m not asking you to live here for ever, Abby. Hell, I understand about the drug clinic, about your career, but surely we’re worth a few more months. Surely what we’ve had together merits you spending a little bit longer here.’

  Oh, it did.

  Tenfold, a hundredfold.

  But how could she possibly tell him her fears, that another six months beside him, waking with him each morning, falling asleep with him at night, could only make it harder? Make leaving impossible.

  ‘I just can’t,’ Abby said hopelessly, a paltry return to such a heartfelt statement, and she heard Kell’s low sigh of disbelief as he shook his head. ‘It’s better this way, Kell.’

  Thankfully they were professional enough and, perhaps more pointedly, busy enough to put their personal feelings to one side as the clinic got under way. Even though she had only been here a handful of times, already Abby felt accepted, recognising a few familiar faces amongst the patients, working methodically as Kell ran the post- and antenatal clinics alongside her.

  ‘That’s looking a lot better.’ Smiling as he removed the bandage on Jim’s leg, Abby checked the wound thoroughly but there were no signs of infection or inflammation. In fact, the wound had healed way beyond Abby’s expectations. ‘Maybe Jim can spare me the recipe before I head back to the city because whatever he put on your leg certainly worked.’

  As Kell saw his last patient, Abby started to pack up and pulled out the esky, but even the sight of lunch did nothing to whet her appetite, remembering so poignantly their first lunch together, right here in this very spot. Opening up to each other, telling Kell the real reason she was here.

  It was hard to believe it was over so soon.

  ‘Abby.’ Kell’s voice had a ring to it Abby had never heard before, and even before she had looked up her adrenaline was starting to kick in. Between them they had seen some sights over the past months but never had Kell sounded anything other than his usual laid-back self.

  It took only a second to realise the cause of his concern. Kell was standing beside a woman and in her arms lay an infant, or at least that was what Abby first thought, but on closer inspection the child lying limp and exhausted in the woman’s arms would have been around two, his large dark eyes were sunk in his head, his mouth drooling as he struggled with each breath. As Abby recognized Vella, Kell’s arms reached out to take the child from its mother’s arms and Abby found her voice.

  ‘Leave him with Vella.’ Her words were firm, decisive, and Kell instantly put his arms by his side, a questioning look on his face as he turned to Abby. But there wasn’t time to explain. Guiding the woman to the Jeep, Abby felt rivers of sweat running down her back and between her breasts as the direness of the situation hit home.

  ‘Is this your little boy?’

  Vella nodded, clutching her child closer, her eyes watching Abby’s every movement. ‘His name’s Billy. He can’t breathe.’

  ‘Do you want me to put in an IV?’ Kell was pulling emergency trays out, snapping into action, but Abby shook her head.

  ‘No. I want you to get on the radio and get the flying doctors here, a.s.a.p. Kell, tell them we’ve got a suspected case of epiglottitis.’

  She watched as the word registered with Kell, and for a second she was sure he paled beneath his tan, but even before she nodded a confirmation, Kell was onto it, back to the calm efficient bush nurse he was.

  ‘Help him?’ Vella’s eyes looked pleadingly at Abby and she sensed her impatience.

  ‘Vella, I think your son…’ Abby started, but her voice trailed off. There was no place for long words here, their different languages, barely allowing for the briefest of exchanges let alone medical terminology. Vella simply wouldn’t understand that one false move, one fright and her child’s throat would spasm, blocking off his airway so tightly that even with medical intervention the chance of intubating him would be remote at best. ‘Billy is sick,’ Abby said slowly. ‘We mustn’t move him or upset him.’

  ‘They’re mobilising.’ Kell approached softly, placing one heavy yet reassuring hand on Abby’s shoulder. ‘Dr Hiller’s on the line.’

  ‘Thanks.’ Though desperate for advice, Abby stood slowly so as not to upset the child.

  ‘Try not to disturb him,’ Abby warned—needlessly, she realised. Now Kell knew the diagnosis he was standing back, letting Vella do all the reassuring. ‘Explain to Vella that he needs to be kept calm, that there’s a reason why we’re not doing anything for him.’

  ‘Sure.’

  Their eyes locked for the tiniest of instances and as Kell flashed a reassuring smile Abby was eternally grateful, grateful not just that Kell was here with her but for the blessed fact that today was the day of the mobile clinic, that medical help was actually on hand.

  That this little boy stood a chance.

  ‘Have you done any anaesthetics?’

  Dr Hiller was straight to the point and Abby was relieved at the absence of small talk instantly, warming to the wise, reassuring voice on the radio.

  ‘I have,’ Abby started, ‘but not on a child with epiglottitis. The couple of cases I’ve seen have been with an anaesthetist in the room.’

  She was telling the truth. Epiglottitis struck the same fear into doctors as meningitis did into mothers everywhere. Rarely seen now with immunisation, it still popped up every now and then, and Abby, not for the first time, realised the enormity of the work here in the outback, that the massive net they tried to cast was shot with gaping, awful holes, how the very immunisations Vella had reluctantly accepted for her newborn had been missed by this child.

  ‘Don’t move him.’ Dr Hiller’s voice was crisp over the radio. ‘Don’t distress him with the portable oxygen or by putting needles into him. Just sit tight and let the mother do all the comforting. It’s her you’ll need to keep calm, but Kell will be onto that.’

  ‘What if…?’ Abby’s voice trailed off, knowing the awful answer to her question before Dr Hiller even responded.

  ‘If he stops breathing, his airway will be so swollen it will make intubation almost impossible. Give it one go and if there’s no luck move straight to a needle cricothyrotomy or tracheostomy.’

  Abby winced into the receiver she held in her hand. A cricothyrotomy or tracheostomy involved making an incision into the patient’s throat and establishing an artificial airway, but in a child as sick as this a happy result was definitely not guaranteed. And though, as an emergency registrar, Abby had performed her share of this lifesaving procedure, they had all been done in a well-stocked resuscitation room with relatives safely tucked away and an anaesthetist hot-footing it down the corridor, a world away from this dusty desert and their limited equipment with the child’s mother watching her every move…witnessing the last-ditch attempt to save her child’s life.

  ‘How long till help arrives?’

  The crackling of the radio didn’t diminish the direness of the answer.

  ‘An hour.’ There was a slight pause as Abby felt the abyss of solitude. ‘Give or take, we hold clinics there, so there’s no trouble getting in and they’re already on their way. Just set everything up as best you can, and if he stops breathing you’ll be ready.’

  Kell had been busy while Abby had been away. He hadn’t put an oxygen mask on the child, but he had placed the tubing over Vella’s shoulder, unnoticed by the babe in her arms, and Vella was holding it near her child, hopefully raising the concentration of oxygen he was breathing.

  Mike, the mujee, had appeared as if from nowhere, and sat with Vella, patiently talking to her, and Abby was grateful for his presence, knowing that right now he was what Vella needed.

  They worked on, only sharing the occasional murmur between them as they opened packs and checked their equipment, but the glance they shared as Abby check the tracheostomy pack was one of pure dread, the outlook, if it came to that, too dire to contemplate.
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br />   But for all their internal fears, Vella was only ever the recipient of gentle words of reassurance as they took it in turns to fan her and her child. Billy was leaning forward, his body sagging with each noisy breath, and never had Abby felt more useless, her years of study and practice counting for nothing against this harsh, unforgiving land, waiting with ears on elastic for the low hum of the plane, the only chance Billy really had.

  It was the longest hour of her life, the wait interminable, Abby could only liken it to watching some awful documentary, watching a child dying in some remote foreign land and knowing there was nothing you could do. But this wasn’t on the screen, this was real life, this was Australia in the twenty-first century, for heaven’s sake!

  For once even the flies didn’t bother her. She barely bothered to flick them away as she took her turn to fan Vella and Billy.

  ‘It’s coming.’ Mike gave her a reassuring nod as Abby cocked her head.

  ‘I can’t hear anything.’

  ‘You won’t yet.’ He pointed to some birds flying overhead and Abby frowned. ‘They know before us.’

  Another seemingly tiny snippet, yet again it floored her, all the knowledge, the generations of learning, secrets passed down, ever down. Abby heard the distant hum of the plane, her mouth opening in admiration as she offered up a silent prayer of thanks.

  Maybe it was the movement, the sudden lift in tension, but just as they all relaxed, as an end to this torturous time seemed in sight, Abby saw the child lie back a fraction in his mother’s arms. Vella simultaneously let out a low moan of terror. Billy’s colour, never particularly good, seemed to be grey now, the life force draining out of his tiny body. Abby rued the second she had relaxed and Kell, in one movement, took the limp body from Vella, laying the toddler on the rug at the back of the Jeep as Mike took the weeping woman to one side, his dark, knowing eyes catching Abby’s. She felt the weight of modern medicine fall to her shoulders as she felt the tiny lifeless form beneath her hands.

  Kell deftly slapped the back of Billy’s hands to bring up the veins, finally getting IV access into the child, pushing in the antibiotics they had already pulled up and connecting a flask of fluids as Abby placed an ambu-bag over Billy’s slack mouth and tried to push oxygen into his lungs.

  They had both set up for this moment, formed a plan of attack should the worst happen, but the resistance in the bag told her she wasn’t getting anywhere, and with a frantic shake of her head she looked over at Kell who passed her the laryngoscope—the curved torch that would act as a guide to the tube Billy so desperately needed to help him breathe.

  ‘I can’t see anything.’ Abby’s voice trembled as she peered into the child’s throat, trying to visualise the vocal cords, but Billy’s throat was too swollen, making any hope of passing the tube impossible.

  The seconds that had ticked by so slowly for the past hour were suddenly whizzing past at an alarming rate, every second moving them unwillingly closer to the three-minute mark that would mean this little boy would suffer irreversible brain damage.

  ‘They’re coming.’ Mike’s voice was jubilant, hopeful, but both Abby and Kell knew his hope was false, that even if they ran like Olympic sprinters from the plane they would be too late.

  Resuming the bagging Abby shook her head as she saw his rapidly decreasing oxygen saturations on the portable monitor. ‘I’m going to do a cricothyrotomy. Pass me the twelve-gauge needle.’ Abby’s firm voice belied the appalling sense of dread in every fibre of her being, her one last shot at getting vital oxygen into the little boy.

  Vella’s screams multiplied as she watched Abby prepare the neck with a swift swab of Betadine, the pitiful wails causing a flurry of activity in the trees around them, startled birds flitting away, but it all went unnoticed by Abby, every cell in her being focussing on the little boy before her as she felt for the correct area in his neck, felt her way with trembling fingers and then held her breath as she pushed the needle in, dissecting the swollen tissue, the tiny space the needle created allowing a hiss to escape as Abby let out the hot air she had been holding in her own lungs.

  ‘Come on, Kell,’ she snapped, as he pushed together the connections, the harshness in her voice not even meriting a glance. No criticism intended and none taken, just a desperate attempt to save a life. He connected the tiny airway she had created, no wider than an intravenous needle, to the oxygen tubing, and this time, when Abby squeezed the ambu-bag gently, she watched with sheer relief as Billy’s chest moved, colour slowly returning with each gentle push of the bag.

  ‘His oxygen saturation is coming up,’ Abby said, glancing at the tiny portable monitor. ‘This will at least hold him until…’ She didn’t finish the sentence, the sight of the flying doctor team descending upon them the sweetest she had ever seen.

  ‘We meet again’ was the only greeting Dr Hall gave as he set to work, checking his patient, listening to Abby’s handover as his nurse worked alongside him, passing him the equipment he needed as they secured Abby’s handiwork, stabilizing the little boy before moving him to the plane.

  ‘Dr Abby?’ Mike came over, his face almost obliterated by a huge bushy beard, but there was no mistaking the gratitude in his eyes as he shook her hand. ‘This is your last clinic?’

  ‘Yes,’ Abby said simply, not quite ready for the first round of goodbyes yet knowing they had to be faced.

  ‘Thank you.’ His hand reached into his pocket and, pulling out a glass jar, he handed it to Abby, his dark hands closing around Abby’s for a moment, the significance of his gesture bringing tears to Abby’s eyes as she looked at the muddy lotion in the bottle.

  ‘Billygoat weed.’ Abby smiled through her brimming eyes. ‘I’ll use it wisely. And thank you, too, Mike. I’ve learnt a lot from you.’

  And then he was gone, back to where ever he’d come from, and Abby stood there, holding the treasured glass jar in her hand. She was barely able to answer as Kell broke into her thoughts with a slightly gruff voice, the inevitable farewells undoubtedly painful for him, too. ‘Dr Hall’s ready to move Billy.

  ‘We’ve taken bloods and given him his first dose of antibiotic,’ Kell said to Dr Hall, his voice resuming its more usual nonchalant tones as the team gently moved Billy onto a stretcher. Abby carried the IV flask as they headed for the plane, with Kell relaying all the drugs that had been given as if he were reading off a shopping list, the emotion gone from his voice now, back to the unflappable bush nurse Abby knew.

  Loved.

  Now order was restored, now a life wasn’t balancing on a knife edge, that word popped into her consciousness again, knocking her sideways with its impact, taunting her with the impossibility of the match.

  ‘You did pretty damn good there, Dr Hampton.’ They were both shielding their eyes, watching the white plane winging its way through the blue sky, carrying its precious load. ‘And without a radiographer or path lab in sight. You saved his life,’ Kell said more insistently when Abby didn’t respond, wrapping an arm around her and pulling her towards him.

  ‘We did,’ Abby corrected, but Kell wasn’t having a bar of it.

  ‘No, Abby, you did. The second you saw him, you knew what was happening. It was you who told me to leave him with his mum, not to touch him, not to upset him.’

  His words hit home and it was then Abby realised how far she had come, how right Reece had been to send her, that Tennengarrah had been a learning curve she had needed to explore.

  ‘Let’s get you home, huh?’

  Home.

  Climbing into the Jeep, Abby rested her head against the passenger window, and this time as she gazed out of the window it wasn’t aimlessly. This time she tried to capture each image, to relish it, to save it, to hold it in her heart for ever and wondered why she had to feel this way.

  Why the word ‘home’ couldn’t conjure up for her endless red earth dotted with white weatherboard houses, why it didn’t signify tired, lonely windmills working woefully empty dams. A career was there for the taking
, one where she could make a real difference.

  And for the hundredth time in as many minutes she wondered what was wrong with her. Why the sterile anonymity of a concrete hospital and the pressures of dealing with drug addicts held more charm than the medicine she was practising here. Why the creamy sails of the Opera House seemingly billowing across the harbour filled her mind when she thought about home. Why walking unnoticed along a crowded street with shops and cafés held more charm than the life she could lead here…

  If only she would stay.

  Kell sensed her pensive mood and drove along in silence, idly humming along to his favourite CD. Even when they pulled up at the clinic, laboriously restocked the boxes and refuelled the Jeep, filled in Ross on the day’s events and headed for home, there was no idle chit-chat, just a loaded sadness as she pushed open her front door.

  ‘I’ll say goodnight, then.’ She heard the uncertainty in Kell’s deep voice as her eyes shot up, startled.

  ‘Where are you going?’

  Soft lips met hers briefly, the scratch of his cheeks brushing against hers as he pulled away. ‘I know this is hard for you, Abby, it’s hard for me, too. I can understand if you need some space. Anyway, I’ve got to be up early.’

  ‘You’re not on duty tomorrow.’

  Kell shrugged. ‘I’m hitching a ride with Bruce. I’ve got a few things to do in town.’

  ‘Oh, Kell.’ Her eyes sparkled with tears and she squeezed them closed. The thought of one night apart from him sent her into a spin of uncertainty, yet here she was checking out for good, signing up for a life without him. ‘I don’t want you to go, that’s not what this quiet mood’s about.’

  ‘You don’t?’ Hope sparked in his eyes, that lazy, familiar smile spilling onto his face and Abby didn’t even try to resist the urge to reach out and touch him, to somehow capture his smile in the palm of her hand.

  ‘I don’t,’ she said, her word muffled by the weight of his kiss.