Prognosis Incompatible

desk said five. ‘Why don’t you go home? I’m going to do a bit of catching up, I’ll lock up when I leave.’
‘Okay, okay. I get it, I get it. Mind my own business,’ Veronica grumbled good-naturedly as she gathered her stuff then dropped a quick peck on Madeline’s cheek on her way out.
Alone, Madeline walked around the surgery, absently re-familiarising herself with the tastefully decorated waiting area. She checked the appointment book and whistled out loud, recognising quite a few of her regulars. It was going to be a busy Tuesday!
Her colleagues had insisted she didn’t start work again until then, to fully recover from her jet lag.
The odd restlessness returned again and she yawned as she wandered into her office. Man... she was tired. But she refused to succumb. It was still too early for bed so she might as well hang here for a while.
Sitting in her chair she picked up the various drug company toys she kept on her desk to amuse children and opened her drawers, checking she had plenty of prescription pads and stationery. Her gaze fell on the framed photo of Simon. Something else she wasn’t ready to ditch just yet.
She remembered Veronica’s pursed disapproving lips at her lack of action in London. But that just wasn’t Madeline’s style. Veronica had spent her teens and early twenties having a good time, experimenting with men and life, secure in the arms of a loving family.
Madeline had spent hers reeling from one tragedy to another while trying to study hard and be there for Abby, too. Simon had stuck by her side through all of it.
She traced her fingers over his face. So he wasn’t skater guy but he had a nice smile and, despite everything, she still loved him. They’d been together forever — since they’d been twenty. You couldn’t just wipe that love out overnight.
And she’d be damned if she’d let some explicable attraction to a bit of rough derail her conviction that the split with Simon was just temporary.
The bell dinged over the door and Madeline was pleased at the distraction. She thought it would probably be George back from his house call so she was surprised to see young Brett Sanders looking as white as a ghost, supporting his very grey, very sweaty mother.
Madeline hurried over. ‘Mrs Sanders, what’s wrong?’ she demanded, quickly assessing the woman’s cool, clammy skin, breathlessness and racing pulse.
‘It’s her indigestion,’ said Brett. ‘I wanted to take her to the hospital but she said she was fine and that you were closer. But she got worse in the car...’ He trailed off, his voice cracking with fear and unshed tears.
‘It’s OK,’ Madeline soothed, sitting Mrs. Sanders down next to the emergency trolley near the front desk. It was only basic, holding just oxygen, an ambubag, some adrenaline mini-jets and a portable defib unit.
She quickly assembled a face mask and placed it on her patient’s face, cranking up the oxygen. She hoped it wasn’t too little too late. Mrs Sanders was in a lot of pain and it was extending down her left arm.
‘Brett, go and ring the ambulance on the phone at the desk. Triple zero.’
Even at seventeen, people in a panic could forget the number that had been drummed into them since they could talk. And Brett Sanders was about as panicked as she’d ever seen.
‘Tell them that your mum is having a heart attack. OK, Brett? Do you understand?’
He looked at Madeline, alarmed, and she thought he was about to cry. ‘Brett.’ Madeline shook him. ‘I can’t leave your mother. You’ll be okay, you’re doing well. But I need you to do this.’
Her voice was calm but firm and Brett responded crossing to the desk and making the call, while Madeline took Mrs. Sanders’s blood pressure. Suddenly, the woman let out a pained moan, clutched at her chest and lost consciousness.
Madeline knew immediately without having to feel for a carotid pulse that the woman was in cardiac arrest. With Brett’s help she dragged Mrs. Sanders onto the floor, rolled her on her side and cleared her airway.
‘Brett, run next door. There is a doctor there called Dr Hunt — tell him I need him. Go now, Brett. Now.’
The youth took one look at his mother and fled.
CPR was much easier with two people and whilst she didn’t approve of what Marcus had chosen to practice he was, apparently a bona fide medical doctor and Mrs Sanders needed all the help she could get right now. She just hoped Marcus would be able to see past their earlier confrontation.
Madeline dragged the semi-automatic external defibrillator off the trolley, switched it on and followed the electronic voice prompts. She ripped open Mrs. Sanders’s blouse, cut open her bra with scissors from the trolley and slapped the two defib pads in the right positions on her chest.
While the machine analysed her patient’s heart rhythm, Madeline assembled the mask-bag apparatus and hooked it up to the oxygen to deliver mechanical breaths to Mrs. Sanders as soon as the machine had done its thing.
‘Shock not recommended,’ the electronic voice announced. ‘Commence CPR.’
Madeline was in the middle of chest compressions when Marcus and Brett came through the door.
‘What happened?’ he demanded, shirt flapping wide.
‘Fourteen, fifteen,’ Madeline counted out loud with each downward compression of the sternum. She passed him the bag-mask and was grateful that he expertly took over the respirations, holding the mask and the patient’s jaw with the practised ease of an anaesthetist.
‘Myocardial infarction. She’s arrested. The ambulance is on its way.’
They worked together as a team. Marcus gave one breath to Madeline’s five compressions, stopping every two minutes for the defib to analyse the rhythm again.
‘Shock recommended,’ the voice said after six minutes.
Madeline almost cheered. They’d gone from an unshockable rhythm to one the defib deemed it could help. Had she moved from asystole into VF? Were they making real headway with their CPR?
‘Brett,’ she said, ‘why don’t you go and wait for the ambulance outside? They’ll be here