Authors: Meredith Webber,Alison Roberts
‘Rex is an old-fashioned gentleman. He calls all the women by their proper titles,’ Hamish told her. ‘Tried to call me Dr McGregor for the first few months I was here, but I kept thinking he must be talking to my father and didn’t answer, so he finally gave it up.’
Hamish was checking the equipment bags as he spoke. Once satisfied that each contained what it should, he’d lower it out of the helicopter. Rex set up a belay rope, using one of the helicopter’s skids as the anchor point, and Kate was reassured by the professionalism of both men.
‘You’ve got the radio but once I leave the top of the gorge you won’t be able to contact me until I’m back overhead in the morning. Use the hand-held GPS to find the patient. When it’s light, if you can see a space—maybe near the waterhole—that’s clear enough for me to do a stretcher lift, you can radio me the position.’ Rex was looking anxiously at Hamish, obviously unhappy that he had to abandon the two of them. ‘I’ll fly over to Wetherby Downs for the night, refuel and be in the air again at first light. Back here soon after six.’
‘We’ll be OK,’ Hamish assured him, handing an abseiling harness to Kate, then fastening himself into a similar one. He followed this up with a helmet, complete with headlamp. ‘Kate, you’re sure you’re happy about this? You could stay with Rex.
It wouldn’t be the first time we’ve broken RRS rules in an emergency.’
‘Not on my first day,’ Kate joked, hiding a tremor of trepidation. The gorge wasn’t all that deep, and dropping down the cliff-face would be simple, but the sun had already left the bottom of the cleft and the shadowy gloom beneath them seemed … unwelcoming somehow.
She watched Hamish disappear, and when he gave the signal helped Rex haul the reinforced rope back up. They hooked the two backpacks, one with medical gear and the other with the stretcher and stabilising equipment, onto the rope, then added another which, Rex explained, held emergency rations.
‘There’s a little gas stove so you’ll be able to have a hot cuppa later tonight,’ he said. ‘No fires, though, it’s a national park.’
Kate nodded, though she was certain park rangers would forgive a small fire should it be needed for warmth or survival.
She watched as Rex lowered the rope. Hamish would undo the gear, then send the rope back up, and it would be her turn.
Strong arms caught and steadied her as she found her feet, then Hamish unclipped her harness and signalled to Rex he could haul it back up. But the pilot was obviously anxious for he repeated all his warnings and instructions about contact before Hamish finally signed off.
He reached down and swung one of the backpacks onto his shoulders, then lifted the other one.
‘That’s mine,’ Kate told him. ‘If you want to be gallant, take the smaller bag.’
He grumbled to himself, but held the medical equipment pack up for her so she could slip her arms into the straps.
‘We’ve a way to walk,’ he warned, and Kate grinned at him.
‘My legs may not be as long as yours, but they’ll get me anywhere we need to go, so lead on.’
He muttered something that sounded like ‘damned independent women,’ then turned his attention to the GPS, marking their current position as Landmark One, then keying in the position of the injured man.
‘It’s about eight hundred yards in that direction,’ he said, showing Kate the route map that had come up on the small screen.
They set off, picking their way through the wide-leafed palms that gave the gorge its name, clambering over the rocks littering the banks of the narrow creek that had cut through the sandstone over millions of years to form the deep but narrow valley. The creek was dry now, at the end of winter, but, come the wet season in late October, and it would roar to life, marks on the cliffs showing how high it could rise.
Darkness was falling swiftly, but they’d left the creek-bank and were walking on more stable ground, the light from their torches picking out any traps for their feet.
‘It shouldn’t be far now,’ Hamish told her. ‘I’ll try a “coo-ee.”’
The thought of a Scot using the Australian bush call made Kate smile, but Hamish’s ‘coo-ee’ was loud and strong, echoing back to them off the cliffs. Then they heard it, faint but clear, definitely a reply.
‘Well, at least he’s conscious,’ Hamish said, reaching back to take Kate’s hand to guide her in the right direction—hurrying now they knew they were close to their patient.
The man was lying propped against the base of the cliffs, an overhang above him forming a shallow, open cave. A very young man, haggard with pain, trying hard to hold back tears he no doubt felt were unmanly.
‘Digger said he’d let someone know, but I thought he was just saying it to make himself feel better about leaving me,’ the lad whispered, his voice choking and breaking on the words.
‘Well, he did the job and here we are,’ Hamish told him. ‘One doctor and one nurse, all present and correct. I’m Hamish
and this is Kate, who’d barely set foot in Crocodile Creek when we whisked her off on this adventure.’
‘Crocodile Creek? You’re from Crocodile Creek?’
He sounded panicky and Kate knelt beside him and took his hand, feeling heat beneath his dry skin.
‘We’re the Remote Rescue Service,’ she said gently. ‘And now you know us, who are you and what have you done to yourself?’
She brushed her free hand against his cheek, confirming her first impression of a fever, then rested it on his chest, unobtrusively counting his respiratory rate. Twenty-five. Far too fast. She’d get him onto oxygen while Hamish completed his assessment.
The Scottish doctor was already kneeling on the other side of their patient, taking his pulse with one hand while the other released the clasps on the backpack. Kate swung hers to the ground and moved so her light swept over the patient’s body, picking up a rough, blood-stained bandage around the young man’s right thigh.
‘There’s a bullet in my leg,’ he said, and the phrasing of the answer made Hamish frown, although he didn’t question how or why, simply repeating part of Kate’s question.
‘And your name?’
The lad hesitated for another few seconds then finally said, ‘Jack. My name’s Jack.’
He was radiating tension that Kate guessed was more to do with his circumstances than his condition, although he seemed very weak. But if his tension arose from being abandoned, injured, in the middle of nowhere, surely their arrival should have brought relief.
And the name? Had he opted for Jack as a common enough name or was he really a Jack? Kate didn’t know, but she did know it didn’t matter. Jack he would be while they tended him, and part of tending him would be getting him to relax.
Hamish was doing his best, chatting as he ran his hands over Jack’s head and neck, asking him questions all the time, satisfying himself there were no other wounds and no reason to suspect internal damage. Where was the pain? Could he feel this? This? Had he come off his horse? Off a bike? Hit his head at all?
Jack’s responses were guarded, and occasionally confused, but, no, he hadn’t fallen, he’d stayed right on his bike. It was a four-wheeler.
And where was the bike?
He looked vaguely around, then shook his head, as if uncertain where a four-wheeler bike might have disappeared to.
The smell hit Kate as she fitted a mask and tube to the small oxygen bottle she’d taken from her backpack. She looked up to see Hamish unwinding the bandage from Jack’s leg. Necrotic tissue—no wonder the boy was feverish and looked so haggard.
‘How long since it happened?’
Jack shrugged.
‘Yesterday, I think. Or maybe the day before. I’ve been feeling pretty sick—went to sleep. Didn’t wake up until Digger moved me here this morning.’
‘Where’s Digger now?’ Kate asked, holding the oxygen mask away from his face so he could answer.
‘Dunno.’
Hamish raised his eyebrows at Kate, but didn’t comment, saying instead, ‘His pulse is racing. He needs fluid fast. I don’t want to do a cut-down here, so we’ll run it into both arms. If you open the smaller pack you’ll find a lamp. Set it up first then in your pack there’ll be all we need for fluid resuscitation—16g cannulae and infusers for rapid delivery. You’ll see the crystalloid solutions clearly marked.’
Kate found the battery-operated lamp and turned it on, a bright fluorescent light pushing back the shadowy evening.
Now it was easy to see what they had—sterile packs of cannulas and catheters, bags of fluid, battery-operated fluid warmers, boxes of drugs.
‘Good luck,’ she said to Hamish as she handed him a venipuncture kit. ‘We’re going to get some fluid flowing into you,’ she added to Jack, as she found the fluid Hamish wanted and began to warm the first bag. ‘And that means inserting a hollow needle into one of your veins. But because you’re pretty dehydrated, your veins will have gone flat so it won’t be an easy job. I’m betting Hamish will need at least two goes to get it in.’
‘I’ll have you know, Sister Winship, I’m known as One-Go McGregor,’ Hamish said huffily, taking the tourniquet Kate passed him and winding it around Jack’s upper arm, hoping to raise a vein in the back of his hand or his wrist.
The needle slipped in. ‘See, told you!’ Hamish turned triumphantly to Jack. ‘Aren’t you glad you didn’t bet?’
Kate had tubing and a bag of fluid ready, and she turned her light onto the cliff-face behind their patient in search of small ledges where they could place the bags.
They changed places, Kate starting the fluid flowing into Jack’s vein, then setting the bag so it would continue to gravity feed through the tube. And all the time she talked to him—not about how he’d come to have a bullet in his leg, but about what she was doing, and how it would help.
‘Once Hamish has you hooked up on that side, we can start pain relief and antibiotics. It’s the infection from your wound that’s making you feel so lousy.’
‘Actually,’ Hamish said mildly, ‘getting shot in the first place would make me feel pretty lousy.’
Jack gave a snort of laughter, and relief flowed through Kate. Surely if he could laugh he’d be OK. But he was very weak and the wound, now she could see it, was a mess. A deeply scored indentation running from halfway down his thigh towards his hip, then disappearing into a puckered, blue-rimmed
hole. Dried blood on the bandages suggested it had bled freely—but not freely enough to keep infection at bay.
Hamish set the second bag of fluid on the ledge behind Jack, then probed through the contents of the backpack.
‘I’ll get some antibiotics into you with that fluid, then I want to check your distal pulses and test sensation in your foot and lower leg. Kate, would you watch for renewed bleeding from the wound? We know you’ve been lucky, Jack, in that the bullet didn’t go into your femoral artery. And how do we know that?’
Hamish had found what he wanted—a small bag of fluid Kate recognised as IV antibiotic medication diluted with saline. He spiked it with an IV administration set, connected it to a second port in the IV line he had running, then placed the small bag on the ledge so the drug could be administered simultaneously with the fluid.
‘Because you’d have bled to death by now—that’s how we know the bullet didn’t hit your artery,’ he said cheerfully. ‘But it might have damaged a nerve, which is why I’m going to prick your foot, or the velocity of the bullet might have chipped a bone and sent that as a secondary missile to squeeze against the artery, which is why I’m going to check to see if blood is still flowing in your foot.’
Kate watched Jack’s face and saw that Hamish’s matter-of-fact approach was just what the young man needed. In fact, he was interested enough to ask, ‘Why does Kate have to watch for bleeding?’
‘Good question! Go to the top of the class.’ Hamish smiled at him. ‘Kate has to watch because you’ll have damaged some blood vessels, but smaller veins and capillaries have the ability to close themselves off if that happens. Problem is, once we build up your fluid levels, they might get all excited and open up again—bleeding all over the place.’
‘Ouch!’
Jack jerked his leg, and the bleeding Kate was watching for began right on cue.
‘Well, you’ve feeling in your toes and a weak but palpable pulse in your ankle, so I’d say you’ve been a very lucky young man. Unfortunately, that luck’s about to change. I need to clean up that wound and, although I’ll anaesthetise the area around it with a local, it won’t be comfortable. Kate, how about you shift over to Jack’s other side and talk to him while I work? Can you talk and pass instruments and dressings?’
Kate stared at the man who was taking this situation so calmly, chatting away to Jack as if they were sharing space on a city bus, not a cave at the bottom of a gorge at nightfall, while someone with a gun lurked somewhere in the darkness.
‘Well?’
Hamish smiled at her and she shook her head, then realised he might think she was answering his question.
‘Of course I can talk and pass things,’ she said, immediately regretting the assurance when his smile broadened and he threw a conspiratorial wink at Jack.
‘I thought so,’ he gloated. ‘Most women can talk and do other things, can’t they, mate?’
Jack smiled back while Kate glowered at the pair of them. She’d walked right into that one.
‘Local anaesthesia is in the green box,’ Hamish continued, ‘and sterile swabs in the white one with the red writing. You might pass me the sharps container and a plastic bag out of that pack as well, so I can put the soiled stuff away as I use it.’
Kate handed him what he needed, then checked the contents of the pack again, trying to anticipate what Hamish would want next. A scalpel, no doubt, to cut away some of the infected tissue, and more swabs to mop up blood as he got down to clean flesh.
Sutures? Would he stitch it up or leave it open until they got back to the hospital where further surgery would be necessary?
She set out what she thought he’d need immediately, placed
them on a large flat stone and lifted it across Jack so it was within Hamish’s reach.
‘You’re supposed to be talking to me,’ Jack reminded her, but his voice was weaker than it had been earlier. Seeing them had probably prompted a surge in his adrenaline levels which had now waned. Did Hamish want her talking to the young man to distract him, or to keep him awake and stop him slipping into unconsciousness?