The Heart Consultant's Lover. Kate Hardy

Чтение книги онлайн.

СКАЧАТЬ you must know, the Prof was tearing me off a strip. Apparently he’d booked the demonstration ages ago. Ours wasn’t the only slot he’d moved.’

      Jack shrugged. ‘Might be better to check before you act next time.’

      Her eyes narrowed. ‘So you think I’ve been unreasonable?’

      ‘Yes and no. You were right to challenge our slot being moved—but you should have made sure of your facts.’ Maybe he should have warned her about Jordan’s slapdash tendencies—though he’d tried to be fair and let her make up her own mind about their theatre manager instead of prejudicing her against him.

      ‘Great. So you think I’m incompetent, too.’

      Jack frowned. ‘No, of course not.’ And her father couldn’t think it either, otherwise he wouldn’t have let the others on the selection panel offer her the job. ‘Just…you’re playing a dangerous game.’

      ‘So what am I supposed to do? Curry favour with the Prof?’

      Was that what she thought he was doing, just because he’d agreed to go down to Paeds? It wasn’t that at all. He was interested in paediatric cardiology—besides, he owed it to his family to get on as well as he could at the hospital. He wasn’t going to turn down opportunities just because Miranda was having a private war with the Prof. Just in time, he stopped himself telling her that. It was none of her business. ‘If you’re going to argue with your father, that’s up to you—but leave the ward out of it.’

      Her eyes darkened. ‘I’m not playing games.’

      Yeah, right. And neither had Jessica, he thought bitterly. Except on a day with a Y in it. ‘You asked my opinion. I gave it to you.’

      ‘OK. I’m sorry. What did you want to see me about?’

      He couldn’t remember now. Not now she’d made him think of Jessica. ‘Doesn’t matter,’ he said. ‘Some other time.’ He left, closing her office door and resisting the temptation to bang it. He was not going to let her get under his skin. In any way.

      Thursday was less fraught, until Miranda promised to help their new student with setting up an ECG and reading the results.

      ‘Dr Sawyer, can I borrow you for a second?’ Miranda asked.

      ‘Sure,’ Jack said, with a smile that turned her knees temporarily to jelly. ‘What’s up?’

      ‘I need a model. I’m walking Hannah through a 12-lead ECG, and she doesn’t want to do it on a patient.’

      ‘So you’re just after my body?’

      She wished he hadn’t said that. The images his words brought to mind were way too disturbing—particularly after the way he’d smiled at her. But she wasn’t going to let him know that he’d rattled her. ‘That’s right. Any old body’d do, but I thought Hannah might find a supposedly young and fit male easier for her first ECG,’ she said, adopting the same light, teasing tone he’d used. ‘Come into my office and strip to the waist.’

      Definitely disturbing, she thought as Jack took off the white coat, shirt and tie to reveal a perfectly toned torso and a light sprinkling of dark hair on his chest. Just pretend he’s middle-aged with a paunch, she told herself. He may be gorgeous, but he’s off limits. ‘OK, Hannah. The V1 lead goes on the edge of the sternum, on the patient’s right-hand side. Count down between the ribs until you get to the fourth intercostal space.’

      ‘Here?’ Hannah asked.

      ‘Perfect. The V2 lead goes in the same place on the left-hand side.’

      Hannah did as she was asked.

      ‘Now we’ll do the V4 lead. Why do you think I want to do that one next?’

      ‘No idea,’ Hannah admitted.

      ‘V3 goes halfway between V2 and V4, so it’s easier if you put V4 in place first,’ Jack explained.

      Miranda was forced to meet his eyes. She stopped herself blushing—just. She only hoped he wasn’t a mindreader—she definitely didn’t want him knowing what she was thinking, right then. ‘Exactly. V4 picks up the patient’s apex beat. That’s the point furthest from the manubrium—that’s the hexagonal part at the top of the breastbone—where we can still feel the heart beating. It’s in the fifth intercostal space, in a line roughly halfway across the collar-bone.’ She found the spot and her fingertips brushed lightly against Jack’s skin. Just as well he was the one having the ECG, she thought. Her own heartbeat had just become extremely erratic, simply from touching him. This was crazy. He was her colleague. Her junior. She couldn’t think like this about him. Particularly when she’d agreed to go on a date with someone else. This really, really wasn’t good.

      ‘Can you show me where you’d put V3?’ she asked Hannah, avoiding looking at Jack.

      Hannah nodded. ‘Here.’

      ‘Well done.’ Miranda smiled at her. ‘The rest of the leads go in a horizontal line with V4. V5 is here, in the anterior axillary line, and V7 is on the posterior axillary line. So V6 goes…?’

      ‘Halfway between them?’ Hannah guessed.

      ‘Spot on,’ Miranda said, then talked the junior doctor through placing the rest of the leads. ‘Great. You’re done.’ She switched the monitor on. ‘The trace shows the electrical activity of the heart so we can see what’s going on. We can tell if someone has had a heart attack, and roughly when it was—in the last few hours, days, weeks or months.’ She let the machine run until she had a strip of a dozen heartbeats, and turned it off. ‘This is a good example of normal sinus rhythm. There’s a small rise here at P just before the upper heart chambers contract.’ She marked it with a cross and labelled it ‘P’. ‘Then there’s the QRS spike…’ again, she labelled the points on the trace ‘…which happens just before the lower heart chambers contract. And finally there’s the rise at point T at the end of the beat.’

      ‘To find the number of heartbeats per minute,’ Jack added, ‘you measure how many big squares there are between the R points—what we call the “R-R interval”. The ECG machine usually runs at twenty-five millimetres per second so you just divide three hundred by the number of big squares.’

      ‘Some machines run at fifty millimetres per second, so always check if you’re not sure,’ Miranda added.

      Hannah looked at the trace and did a quick calculation. ‘Three hundred divided by four—that’s seventy-five.’

      ‘Well within the normal resting range,’ Miranda pronounced.

      She couldn’t help looking at Jack. And there was a distinct question in his eyes which she dared not answer. She forced herself to think of work. ‘Do we have a book of sample traces, Jack?’

      ‘For teaching? Yes—I’ll go and get it.’ He removed the leads. ‘You’ll be surprised how quickly you learn to spot the differences in the waves and what they mean,’ he told Hannah. ‘When you first start, you think you’ll never remember them all, but you’ll soon get the hang of it. And you can always ask one of us if you’re not sure. We won’t mind or think you’re stupid. We’ve all been in the same position.’

      Miranda СКАЧАТЬ