Seven Nights with Her Ex (6 page)

He stretched out his legs. ‘I worry about lots of things. I just choose not to show it.'

Leo came over and rested against the rocks next to them. ‘You're a surgeon, though, aren't you? You can't show your patients that you're worried. They'd have no confidence in your abilities if you did.'

Gray nodded. ‘That's right. It's a strength not to wear your heart on your sleeve. Patients need to see that you're confident and sure.'

But Beau was thinking about their past. ‘And what if you're
not
sure about something?' she asked, her face curious. ‘Do you talk to them about your concerns? Do you ever share your doubts so they know the full picture?'

It was obvious he knew she wasn't just referring to his work. ‘I always let my patients know the full picture. They always understand the risks. Letting them know about dangers and possibilities doesn't stop you from being confident.'

‘But what if you're
not
confident in an outcome? What then?'

He stared at her, long and hard. ‘Then I don't proceed.'

She nodded, her face stony. ‘You don't move forward?'

‘No.'

Leo looked between the two of them, clearly puzzled at the tone of the conversation and at the way they were looking at each other. He took a bite from his trail bar. ‘Looks like Mack's about to start the next lesson.'

He was right.

Mack gathered them all round. ‘Okay, I'm sure that as we made the climb up here we all noticed we were getting a little out of breath. Now, imagine being like that all the time...not being able to breathe, feeling like there isn't enough air, struggling to take in enough oxygen. How do you think that's going to affect you on a day-to-day basis?'

Rick put up his hand. ‘You'd struggle.'

Mack nodded. ‘Too long in too high an altitude, without a period of adjustment, can affect thinking skills and judgement calls, and it leads to hikers and climbers taking risks. Luckily here in Yellowstone we don't have the extreme elevations that provoke serious cases of altitude sickness, but we do have heights over eight thousand feet, and as soon as you go beyond this number, you'll start to see symptoms. Now, can anyone tell me what those symptoms are?'

Beau was itching to answer, but she thrust her hands in her pockets and bit her lip to stop herself from speaking.

Conrad suggested an answer. ‘Dizziness?'

‘That's one. Can you give me another?'

‘Nausea?'

Mack nodded. ‘Most people complain of a headache first. They get nauseous, feel exhausted. Then they might be short of breath, might get nosebleeds, muscle weakness. So what do we do to alleviate the condition?'

Beau gritted her teeth, let Mack continue.

‘We descend. Height creates the problem, so going back down to where it's easier to breathe solves it. People
can
adjust, though. This is why on mountain climbs—and specifically when tackling Everest and those sorts of places—climbers ascend and then come down for a bit. Then they go up again—then down. It's a back and forth dance. Two steps forward, one step back. It acclimatises them to the new altitude. It allows their bodies to get used to the thinner air.'

Everyone nodded.

‘The air itself still has oxygen at about twenty-one per cent. That doesn't change as you go higher. What
does
change is the air pressure, and that's what causes altitude sickness. Unfortunately we can't tell who will succumb. Some of you may even be feeling it now.'

He looked around at them and Claire raised her hand and mentioned that she had a headache.

He nodded once. ‘So we start to head down. Let's go!'

They all got to their feet and slung on their backpacks wearily. The air did seem thinner. Everything seemed so much sharper up high. But the trail Mack led them down quickly led them into a beautiful green valley where they had to wait for a herd of moose to pass by.

Beau got out her camera. They were magnificent animals! As tall as she was, heavyset, with brown-black coats and long, horse-like faces. There was one with huge cupped antlers, and he stood there proudly as his herd passed the hikers, heading for a crop of willow trees, where they stopped to graze.

She took shot after shot, excited by getting her first close-up with an animal she hadn't a chance of seeing in the wild in the UK, and when she finally put her camera away, Gray smiled at her.

‘What?'

He laughed. ‘You're still the same.'

She shook her head, disagreeing with him. ‘I'm older. Wiser, I hope.'

‘I grant you that...but you still have that joy in you that I saw all those years ago. You always saw the joy and goodness in everything.'

‘That's my problem. I
thought
I saw it in you once, but...I was wrong.'

He stopped walking and sighed. ‘You weren't wrong.'

‘Then why did you hurt me so badly?' She stopped to look at him directly. The others were ahead. They couldn't hear.

Gray looked down at the ground. ‘That wasn't my intention. I was trying to stop you from being hurt further down the line.'

He passed her and began to walk to catch up with the rest of the group.

Beau watched his retreating form and felt the old hurt and anger begin to rise. She pushed it down, refusing to show him that he could still press her buttons.

She hurried to catch up, too, and as she passed him, she muttered, ‘Just for your information...it didn't work.'

Gray stopped and stared after her.

* * *

They walked for a few more hours. They passed through rocky canyons, small copses and grassy open plains. They followed the Gallatin River, passing a few men who stood in it in waders, fly-fishing, and giving them a wave.

Gray could feel the weariness in his legs—particularly his left leg—and ached to stop and stretch out, but he said nothing, preferring to soldier on.

They were all alert and on the lookout for bears, knowing that these mammals were keen on fishing themselves, but they saw none, and Mack soon led them off the popular trail and deeper into wilder country.

Just as Gray was feeling the familiar pinching pain in his left calf that told him a cramp was about to set in, he heard crying and groaning. His ears pricked up at the sound and his doctor radar kicked in. Someone was afraid and in pain. And then suddenly, there before them, in a clearing, were three people lying on the ground with blood everywhere.

Adrenaline shot through his system. The cramp was forgotten as he raced past the others in his group with Beau to attend the casualties before them.

There were two men and a woman. First he needed to assess them all, find out who was in the most medical danger, and he knelt by the first patient—the woman—who lay on her back, clutching at a bleed in her thigh, hopefully not her femoral artery. Out here, a bleed like that could be fatal.

‘Lie back! Can you tell me what happened?'

He went to check the leg, already pulling off his belt so that he could create a tourniquet, and then he noticed that there was no wound. No tear in the fabric. And the blood was fake. He looked up at the others, to see Beau looking confused, too.

Mack knelt down beside him, grinning. ‘Pretend patients! The wounds aren't real, but you might come across people on your travels with serious injuries. I want you to work in groups of four. Each group take a patient. Assess the injury, ascertain what happened, and then I want you to tend to that patient. We'll feed back to the group what we did and why. Gray, you work with Beau, Conrad and Barb. Jack and Leo—you're with Dean and Rick. The rest of you, tend the third patient.'

Gray had already got fake blood all over his hands and he let out a huge breath.
Thank goodness it's not real!
It had really got his own blood pumping, though.

Beau knelt beside him and Conrad and Barb gathered round.

‘Barb and I will let you two take the lead, Doc,' said Conrad. ‘We're sure you know more than us.'

‘Maybe, but you need to learn. Let's see what our “patient” can tell us.' He looked down at the woman on the ground. ‘Can you tell me what happened to you today?'

‘We were camping when we were attacked.'

‘By animals?'

‘No, some lads came into our camp. They were drunk and waving knives around.'

Gray nodded. He'd actually been in a similar situation once before, hiking in the Peak District. A group of rowdy teenagers had wandered into his campsite, drunk and disorderly, and had become very threatening. Luckily he'd managed to talk them down and send them on their way—but not before one of them had tripped over his guy rope and broken his nose.

‘Was your leg injured with a knife or something else?'

‘I'm not sure.'

He nodded, then looked up at Conrad and Barb. ‘What do you think we should be thinking about doing here?'

‘Stopping the bleeding?' Barb suggested.

‘Good. How?'

‘We could apply some pressure? Raise the injured limb?'

He nodded.
Good. They knew some basics.
‘What else? What if it was an arterial bleed?'

‘Pressure and a tourniquet?'

‘Good—but you'd have to be quick. Arterial bleeds spurt, and with force. The area around the wound will get messy quickly and the patient can lose a large amount of blood in a short time. What else do we need to do?'

Conrad and Barb looked blankly at each other. ‘We're not sure, Doc.'

Beau smiled at them. ‘Once you've dealt with an arterial bleed, and it appears to be under control, you need to do two things. Find a way of getting more help, but also look for further injuries. Too many people assume that if a patient has one major injury that's all they have to look for. But patients can quite often have more possibly fatal injuries, so you need to assess your patient properly once the bleeding is stemmed and under control.'

‘What if the bleeding doesn't get under control?'

‘Then your patient could go into hypovolaemic shock. If they don't get help, they'll die.'

Barb paled slightly and Conrad put a comforting arm around his wife's shoulders. ‘That's terrible.'

Gray showed the couple how to check for further injury, and how they could assess their patient's level of consciousness, then Mack gathered them all together.

The three ‘patients' stood and had a bit of a stretch, grinning.

‘Okay, so what did we all learn?'

Gray gave a brief rundown on what they'd covered with Conrad and Barb. One group had dealt with a venous bleed to an arm; the other had dealt with what had looked like a simple contusion—or bruising—to the abdomen.

Mack focused on this last one. ‘Who else thinks that this was just a simple case of bruising?'

Beau put up her hand.

‘Yes, Beau?'

‘There could be internal bleeding. A bruise is the definition of an internal bleed, in fact.'

‘So what could happen to our patient if this is ignored as a minor injury?'

‘He could die. There are multiple major organs in the abdomen, all at risk—the liver, the spleen, the pancreas...'

‘Dangers of internal bleeding, please?'

‘Exsanguination—possibly a tamponade on the heart.'

‘Which is...?'

‘A closure or blockage. Fluid collects around the heart, between the organ and the pericardial sac, and surrounds it, applying pressure and preventing it from beating.'

Mack looked at the group. ‘Do we all see how different injuries—even ones that
seem
minor—can have devastating effects on a patient?'

The group nodded and agreed.

‘And can we all agree that when you've been hiking for a long time—when you're exhausted, maybe sleep-deprived, hungry or starved of air, perhaps in a dangerous situation—how easy it might be to miss something important when assessing a patient or to make a mistake?'

Again there were murmurs of assent from them all.

‘Out in the wilds you need to be on your game. You need to see the present danger, but you also need to be looking three steps ahead. Keeping your wits about you. Not making avoidable mistakes. Now...the likelihood of getting help immediately can be small. You might find yourself on your own, needing to get help and having to overcome obstacles to find it. Everyone get ready—I'm about to show you how to cross a river safely. Without a bridge.'

Gray raised his eyebrows. Surely everyone was exhausted? They'd hiked miles today and barely eaten. Though he guessed this was all part of the package. Trying to replicate the environment people might find themselves in and show them how easy it was to make a mistake.

He knew all about mistakes.

He'd made plenty.

He fell into step beside Beau and found himself drawing into himself. As always, when he focused on medicine he could exclude every other worry or emotion in his head—but when he wasn't, and real life had an opportunity to take residence, there was nothing to distract him.

Beau's presence had shaken him. With her here, he couldn't ignore what he'd done any more. Every time he looked at her it was a reminder of the pain he'd caused, even though at the time he'd told himself he was doing it to save her greater pain in the long run.

Beau had had aspirations for their future. It wasn't just going to be marriage for them—it was going to be a whole life together. Children. Grandchildren.
Great
-grandchildren. That was what she'd seen for them when she'd said yes to his spur-of-the-moment proposal.

She hadn't just said yes to him, but yes to all that, too. She'd seen years ahead of them, spent happily in each other's company as they went on holidays or had romantic weekends away, had picnics in the park, ice creams on the beach. She'd seen cosy chats, the pair of them snuggled under a quilt, holding hands, kissing, enjoying being with each other. Snatched kisses in the hospital as they passed each other on their way to work.