Читать книгу: «Wildfire Island Docs», страница 14

The morning flew by as Anahera treated her patients. Whenever she went outside to call the next person in, it was impossible not to look around to see how Luke was passing the time.

She’d been very unwelcoming, telling him his help wasn’t necessary. She could imagine the look that Sam would give her if he found out. Or what he would say.

You had a doctor there and you made him just sit and wait for you? That’s crazy, Ana. We need all the help we can get here. You know that.

She did know that. So the new guilt, added to what was already there, was taking the shine off a day that she normally loved. But she remembered how well they had worked together all those years ago. How they’d felt like the perfect partnership right from the first case they’d shared, and she didn’t want to feel that professional rapport again. Things were hard enough as they were.

And Luke didn’t seem to be feeling bad about being left out. When she went outside with Lani and looked at the long bench under the fig tree, he was no longer sitting there. In fact, half of the waiting patients weren’t there any more either. A burst of laughter and a child’s gleeful shriek revealed what was going on. A game of barefoot football. Village children had gathered and it seemed like the captains of the two teams were Jack and Luke.

For a moment Anahera watched the game, a smile spreading over her face, and, for the first time today, the knot in her stomach eased a little.

Luke looked so happy. He didn’t need to speak an island dialect to connect to these children and they were loving this game. Could they tell that the way he was trying to block their access to the improvised goal was all for show and he was actually making it easier for them? The triumphant shouting when Luke was dramatically waving his fists in the air to indicate frustrated defeat suggested that they didn’t and the joyful laughter meant that it didn’t matter even if they did know.

And then a small boy tripped as he was running and fell hard, raising a cloud of dust from the bare patch of ground. Luke was there before the dust even began to settle, scooping the child up and settling him on one hip as he checked for any injury.

Anahera could see the concern on his face. The gentle way he was examining small limbs. And then he tickled the little boy and they both burst into laughter.

The stone in Anahera’s belly seemed to turn into jelly.

She had forgotten how great Luke had been with children. That instant rapport that paved the way for making it easy for him to care for them. That patience and kindness that always won over even the most frightened children in the end.

It had been one of the first things she had loved about him.

She had thought about what a wonderful father he would make one day and how his children would adore him.

It wasn’t the heat or dust that was making her throat close up.

It felt more like overwhelming sadness.

Luke set the child down on his feet and he ran off to join his friends. Luke was still grinning and he wiped dusty hands on his already smeared white shirt and then he looked around and caught sight of Anahera and the grin faded. He looked wary rather than happy now.

As if his change in mood was contagious, the game broke up. Anahera had to blink back tears. The happiness had been snuffed out and it felt like it was her fault.

‘Alika? Can you come inside now, please? It’s your turn …’

Finally, the clinic was over.

Luke watched as Anahera locked the door of the simple hut. Jack picked up the supply bin, which was almost empty, in one hand. He had the chilli bin that had held the sandwiches and cold drinks they’d had for lunch in the other.

‘I’m going to drop these back to the chopper and then have a swim,’ he said. ‘Luke’s already had a dip but I’m still filthy from that game of footy. Take your time in the village, Ana, but it’d be nice to get back to Wildfire before dark.’

‘I thought you were going to come with us. Didn’t you want to show Luke the shipwreck?’

‘You know where it is.’ Jack began to walk away. ‘Have fun.’

Luke eyed Anahera. She met his gaze but neither of them smiled.

‘Let’s go, then,’ he said. ‘I’ve got all the snap-lock bags I need for samples and a notebook for recording information about the tea brewing.’

‘Okay.’ Anahera’s nod was brisk. ‘It’s not too far to the village but we’d need to take a slightly longer route if you want to see the shipwreck.’

Did he want more time with Anahera?

This was an unexpected opportunity as he’d also thought that Jack would be joining them for the visit to the village. And it could well be the only chance he was going to get to have a private conversation with her.

‘Yes.’ His hesitation had been brief. ‘I would like that. Very much.’

Their path took them uphill along a forest track, and Luke wasn’t bothered by the silence between them because it added to the magic of the rainforest. It had been so long since he’d walked a track like this and he’d forgotten how intricately intertwined the plant life was. Spaces between the tall, smooth trunks of the trees that stretched to form the canopy were crowded with tree ferns and palms and ginger plants. There were dense tangles of vines that were a startling contrast to spectacular bursts of colour from orchids. Overhead branches had epiphytes and aerial moss competing for room. The raucous screech of parrots and a hum of insects were the only sounds other than twigs breaking beneath their feet.

They emerged from the forest into an area that had been cleared enough for grass to grow. There were some goats farther up the hill but Anahera led him towards a rocky patch that looked disconcertingly close to where the ground fell away steeply.

‘Don’t go too close to the edge,’ she said. ‘And test the rocks before you stand or sit on any of them. Sometimes one goes rolling off. The big ones are safe.’ She scrambled carefully over some small rocks to climb onto the biggest one that jutted out towards the sea. Luke followed and found there was plenty of room for two people and the surface was quite flat. It provided a viewing platform with a stunning panorama of the ocean a long way below. The water was an astonishing shade of turquoise and so clear the ghostly outline of the ancient shipwreck was instantly recognisable.

‘Wow …’ Luke shaded his eyes from a sun that was getting lower in the sky and stared down. ‘That’s amazing …’

‘Mmm. I love it here.’ To Luke’s consternation, Anahera walked calmly to the edge of the rock and folded herself gracefully to sit down with her legs dangling in space.

He followed a little more cautiously.

And there they were. Totally alone with the most stunning view imaginable spread out in front of them, with countless islands in every direction and the curve of reefs sheltering some of them and the changes in sea colour from pale turquoise to the almost navy blue of the deepest ocean. The intense heat of the day had faded and a gentle breeze was playing with the long strands of Anahera’s ponytail. As if to make the moment perfect, a gorgeous gold-and-black butterfly came within touching distance as it flew past.

Luke was unlikely to get a better opening to a conversation.

‘How cool is that?’ He smiled. ‘A flutterby.’

A huff of laughter escaped Anahera and it was the first time Luke had seen a genuine smile on her face in his presence. The kind that made the corners of her eyes crinkle and her whole face light up.

‘You’re not three, Luke. I don’t think you get to call them a flutterby.’

‘But why not?’ It was so good to see her smile. It felt like that impenetrable barrier had just become transparent. ‘It’s such a brilliant word. It’s exactly what they do, isn’t it? Look …’

Sure enough, the stunning insect was fluttering, rising and then swooping as if it needed to explore its surroundings thoroughly.

‘It’s a beauty,’ Anahera murmured. ‘Hana would love it. She’s had this thing for butterflies since she was tiny. I had her outside having a kick in the sun when she was only a few weeks old and she saw her first butterfly. That was when she smiled for the first time and it was the biggest grin.’ Remembering it was making Anahera smile again and her expression was so tender it made Luke’s heart ache.

‘She’s a very beautiful little girl. You must be very proud of her.’

‘I am.’

‘And her dad? He must be over the moon to have a daughter like Hana.’

There was a moment’s silence that felt heavy. Awkward.

‘He’s not in the picture,’ Anahera said.

Oh … Luke’s heart missed a beat. ‘Did … you meet him in Australia? At the hospital?’ Had he been another doctor, like himself, perhaps? Or maybe a paramedic when Anahera was doing that part of her postgraduate training?

She seemed to be still watching the path the butterfly had taken, even though it had disappeared. ‘He was a doctor.’ She took a long inward breath that came out as a sigh. ‘I had Hana in Brisbane and … and there was never any chance of a relationship with her father so … so I came home. To my family. My mother raised me by herself. History repeats itself sometimes, doesn’t it?’

It didn’t have to. The flash of bitterness that Anahera had chosen a path that didn’t include him was ugly enough for Luke to squash it instantly, before its poison could tarnish this moment. He cleared his throat and searched for a way to change the conversation’s trajectory.

‘She looks very happy. When she doesn’t have a sore finger.’

‘She is. She loves the islands.’ Anahera’s tone lightened. ‘There are more butterflies here.’

It was a neat, verbal circle that indicated that that topic of conversation was over. The silence was longer this time but it didn’t feel so awkward. If anything, Luke was feeling more hopeful. Knowing that Anahera wasn’t in a committed relationship with Hana’s father made it more acceptable, somehow, to revisit the past.

‘I’d forgotten,’ Luke said quietly, ‘how beautiful so many things are here. Like the ocean and the forest and the wildlife. The only thing I never forgot … was you.’

He could feel the way Anahera froze beside him. Could feel the transparency of that barrier fading so that it was becoming solid again. And then she moved, pulling her legs up over the edge of the rock and getting to her feet in one fluid movement.

Her voice was like ice. ‘Did you tell your wife, Luke? About cheating on her?’

‘No.’ His response was so quiet he didn’t think she’d heard.

‘Maybe you should.’

‘I can’t do that.’ Luke got to his feet slowly. His muscles felt heavy. Stiff. ‘My wife died, Ana. Years ago. A few weeks after I left Wildfire.’

She was shocked. Her face turned back towards him. Her mouth opened and then closed, as if there’d been no words available. The breeze was still playing with the long strands of her ponytail and a few hairs caught on her lips but she didn’t brush them away, she just kept staring at Luke.

‘She was sick.’ The words sounded wooden. The movement of her hand as she finally scraped the hair free of her lips was impatient. ‘I knew that was why you had to rush back.’

‘Not exactly. She woke up.’

The stare was back again, this time accompanied by a grimace of incomprehension. Disbelief, perhaps.

Luke’s mouth felt dry. This wasn’t exactly the scene he’d imagined when he’d hoped for the chance to tell Anahera the truth. Sitting on Sunset Beach, holding hands might have been nearer the mark. Standing on a windswept rock with a dangerous cliff and the skeleton of a long-ago wrecked ship far below made it all far too dramatic.

‘She’d been in a coma for three years,’ he said. ‘It was the first time I’d been away from her and she’d opened her eyes and asked where I was. Yes, I had to rush back.’

Again, Anahera had no words.

‘And, yes,’ Luke continued quietly. ‘I was married when I was with you but it didn’t feel like cheating. My marriage was over the day of the accident that put Jane into that coma, although it took a very long time for me to accept that.’

‘Was … was she still awake when you got back to London?’

‘No. She never opened her eyes again. I sat with her every day and held her hand but she just slipped away, bit by bit. And then it was finally over. After the funeral, I tried to call you. Someone at the hospital told me you’d gone to Brisbane so I kept trying. I wanted you to know … but …’

He didn’t need to finish his sentence. He could see that Anahera remembered that conversation as well as he did. And now she knew she’d accused him and judged him guilty without knowing all the facts. She looked … appalled. Her gaze slid away from his and, after a long silence, she cleared her throat.

‘We should get to the village,’ she said. ‘If we don’t go now, we won’t have enough time before Jack wants to leave.’

They walked in silence again, but Luke was okay with that. Anahera needed time to process what he’d told her. Maybe it would make a difference or maybe it wouldn’t, but that was okay, too. He’d been able to tell her the truth and that was enough to bring a sense of peace.

It was Anahera who broke the silence, when they’d left the forest track and were walking under an avenue of coconut palms near the beach.

‘How did it happen?’ she asked. ‘The accident, I mean?’

‘Jane was a competitive swimmer. She used to train at a local pool early every morning as soon as it opened. Sometimes the only other person there was the guy who ran the aquatic centre. On that morning, he’d been doing something in the office and when he came out he saw her floating face down in the pool. They think she must have slipped on the tiles and hit her head. He got her out and started CPR but … it was too late. She’d been without oxygen for too long.’

‘That must have been devastating. I’m … I’m so sorry, Luke.’

Was she sorry for what he’d been through or did the apology include the way she’d treated him?

The look in her eyes suggested it was both. Maybe she wanted to say something more but their arrival at the village had been spotted and a bunch of children were running towards them.

‘Football, mister! Come with us …’ The small boy who’d taken the tumble in the game they’d had earlier took hold of Luke’s hand and tugged on it. Small, grinning faces surrounded them.

Anahera shook her head and spoke to the children in their own language. The persuasive sounds turned to disappointed ones but the small boy still kept hold of his hand as they walked between the first bures of the village.

‘Marama, the woman we’re coming to see, lives here.’ Anahera pointed out one of the simple dwellings. ‘She’s going to show you how she makes the tea and take us to where the bushes grow.’

Except Marama wasn’t at home. Anahera asked the children but they shrugged and shook their heads so they wandered farther into the village. Luke recognised a young pregnant woman he’d seen attending the clinic today. She had one arm around the older woman who’d been with her, supporting her shuffling gait, and she had a basket in her other hand, filled with what looked like taro roots.

‘Marama’s in Tane’s house,’ she told Anahera in response to her query. ‘He’s her son and he’s very sick.’

Even if they hadn’t been looking for Marama they would have had to go and see what was wrong.

And something was very wrong.

Tane—a young man in his early twenties—was in the grip of a seizure as Anahera and Luke entered the bure. Several people were crouched around him, trying to hold his limbs still. A woman was trying to put a stick between his teeth.

Anahera touched the woman’s wrist and spoke quietly but urgently. The woman took the stick away and one by one the others let go of the man’s body. Someone shifted a cooking pot farther away and another ran outside.

‘I’ve told him to go and get Jack,’ Anahera told Luke. ‘We need the resus kit. And a stretcher.’

‘Can you find out what’s going on? Do you know this man? Is he epileptic?’

‘Not that I know of. He’s running a high temperature. I can feel the heat from here.’ She began asking questions of the people around her and then she translated the answers.

‘His wife, Kura, says that Tane was complaining of a bad headache yesterday and he was shivering. Marama gave him herbal tea but it didn’t help. He was very sleepy this morning, which was why they didn’t bring him up to the clinic. This is the first seizure he’s had.’

‘No history of any recent head injury?’

‘No.’

‘I can’t tell if there’s any rash.’ Luke leaned closer to peer at Tane’s bare chest but the dark skin was gleaming with sweat.

‘The light’s not good enough. Here … I’ve got a penlight torch.’

‘Great. I’d like to check his pupils as soon as I can. Might give us a clue to his intracranial pressures.’

The jerking of the man’s limbs was lessening. His eyelids flickered and he began groaning and then his eyes opened and he started shouting—a look of absolute terror on his face. Luke wasn’t going to get a chance to check pupil sizes and reaction to light any time soon.

Anahera spoke to him, her tone reassuring and her touch intended to calm, but Luke could see that they needed help. Drugs that would take control of whatever abnormal things were going on in Tane’s brain.

He’d seen many patients like this but having to deal with what was clearly very serious in a remote island village was alarming. Anahera was taking it in stride, however. At her direction, the young woman who was probably Tane’s wife had produced a bowl of water and a cloth and was sponging him to try and bring his temperature down. Thankfully, the dreadful shouting and distressed movements stopped as Tane seemed to be overtaken by exhaustion. His head fell back on the woven bedding and his eyes drifted closed. That was when Anahera looked up and caught Luke’s gaze.

‘Are you thinking what I’m thinking?’

‘Encephalitis?’ Luke nodded grimly. ‘Can you find out if he’s had a mosquito bite recently?’

Anahera’s face fell as she listened to the people around her. ‘There’s been a lot more mosquitoes around recently,’ she relayed to Luke. ‘Lots of people have been bitten. We need to get Tane to hospital as soon as possible, don’t we?’

Like the cavalry arriving, Jack came running, the resus kit looped over his shoulder and an oxygen cylinder in his hand. Behind him, two of the villagers were carrying a stretcher.

‘You’d better take over,’ Anahera told Luke. ‘You’re the expert. Tell me what you need me to do.’

‘Let’s get fluids up and get some diazepam on board. We’ll have to wait till we get back to Wildfire to do the necessary tests, like a lumbar puncture. When we see how well he’s maintaining his airway after sedation, we’ll know whether we need to intubate.’

Luke crouched beside Anahera as she opened the kit and pulled out the IV kit and drug roll. He took the gloves she handed him and pulled them on. Her movements were swift and competent. She put a tourniquet on Tane’s upper arm and swabbed his elbow with an alcohol wipe. Luke had only just finished snapping the latex gloves into place when she peeled open a cannula package and held it out for him.

He hadn’t worked in partnership with Anahera like this since he’d left Wildfire Island.

And it felt good.

Better than good.

It felt … right …

As if something that had been broken had been unexpectedly fixed.

CHAPTER FOUR

THE FLIGHT BACK to Wildfire Island was a race against time.

There was so much to do and everything was so urgent that there was no space in Anahera’s head to even recall, let alone think about, the bombshell that Luke had dropped in telling her about his wife.

When they got their desperately ill patient to the hospital the pace picked up even more but at least there were extra hands to help and the facilities available were enough to surprise Luke.

‘You’ve got a bench top scanning electron microscope?’

‘Down in the research centre laboratory.’ Sam nodded. ‘I’m no microbiologist, though. It’s more a hobby for me—a programme of self-tuition. I use all the other gear more—to do all the standard blood tests like a full blood count, glucose and electrolytes and things like toxicology screens.’

‘I’ve done more than enough with an electron microscope to recognise a flavivirus in a CSF sample. Thanks, Ana …’ Luke picked up the syringe of local anaesthetic from the trolley prepared for the next diagnostic procedure needed.

Anahera stayed to help keep Tane in position for the lumbar puncture, lying on his side with his chin tucked down and his knees bent up. She made sure that there was no disruption to his IV fluids or oxygen supply and then listened to the conversation between Sam and Luke.

‘We’ll start him on acyclovir until we can rule out herpes simplex.’

‘And antibiotics? What about meningitis or a brain abscess?’

‘We’ll do a CT next. Can’t believe you’ve got CT capability now. It’s a huge advantage. I wouldn’t want to be waiting for a plane to get here from Australia.’

‘Must still seem limited to what you have on hand in London.’

‘It’s enough. It’s not as if we’ve got anything more than supportive treatment for any forms of encephalitis other than herpes simplex.’ Luke glanced up as he waited for the drops of clear cerebrospinal fluid to drip into the test tube. ‘You happy with ICU protocols for managing a case like this, Ana?’

Her nod was confident. ‘I’ll get the head of the bed elevated thirty degrees and keep the room quiet and not brightly lit. Daily fluids need to be dropped to three quarters of routine maintenance. I’ll keep a close eye on any signs of increasing intracranial pressure with vital sign monitoring and if we need to intubate, I can monitor the ventilation. I’ll stay in tonight—I just need to give my mother a call and let her know I won’t be home.’

Luke turned to Sam. ‘You’ve got other nurses available, haven’t you?’

‘No one has Ana’s ICU experience. And no one has your expertise in managing an encephalitis case.’ Sam pressed on the puncture site as Luke removed the needle from Tane’s back. ‘I hope you’re not planning on leaving any time soon?’

One corner of Luke’s mouth curled up. ‘I think I’ll be here for a bit longer. Unfinished business …’

Anahera focussed on keeping Tane’s oxygen mask in place as they rolled him onto his back but her heart skipped a beat. Was she included in what Luke had meant by that cryptic comment?

But Sam was nodding. ‘Yeah … Jack said you hadn’t even got near one of the hibiscus bushes to collect your bark samples. I guess we’ll have to get you out to French Island again.’ He clicked the side rails of the bed into place. ‘Do you want to take the CSF and blood samples down to the lab? I’ll have the CT scan done by the time you’re back.’

Anahera watched Luke leave. Sam was happy enough with his interpretation of Luke’s ‘unfinished business’ but she was quite sure that the research into M’Langi tea was only part of it.

The bigger part was the unfinished business of a relationship that had gone so very wrong.

And it seemed that the blame for that could be laid squarely at her own feet. Not only was she guilty in having made a judgement without knowing the facts, she had just made things a whole lot worse by lying to Luke.

She hadn’t really lied, had she?

It was the early hours of the morning now and Anahera was sitting beside Tane’s bed, listening to the soft beep of the cardiac monitor and watching the rise and fall of her patient’s chest.

Sam and Luke were in the staffroom, hopefully catching a little sleep on the comfortable reclining chairs. Hettie was here to help with the nursing but there were other patients that needed care, and Tane couldn’t be left alone, so Anahera’s offer to stay on had been appreciated.

She had seen respect in Luke’s expression when she’d offered to take on the intensive nursing. Admiration, even.

He wouldn’t look at her like that if he knew …

Lying by omission was still lying, wasn’t it? It was the trick to lying convincingly, wasn’t it, to make sure that there was an element of truth in the lie. Of course Luke had believed her. It was true that Hana’s father was a doctor. That she’d been born in Brisbane. And that there’d never been any chance of a relationship with her father.

Except there had been, hadn’t there?

She’d been there when Vailea had come in with the shocking message that his wife was asking for him back in London, and her reaction had been instant and damning.

She’d turned her back on Luke and walked away, without giving him any chance to say anything.

And she’d done it again when he’d tracked her down and phoned her in Brisbane. When she’d known she was pregnant and it could have made all the difference in the world if she’d given him the chance to tell her the truth.

Instead, she’d gone through her pregnancy and the birth of her baby alone. All those struggles of coping with a new baby by herself. Of not knowing whether she’d been doing the right thing and the fear that something was really wrong when there hadn’t seemed to be any way to comfort her infant. Those awful moments of misery when she’d simply been too tired to cope and had had to keep going without anyone there to encourage or reassure her.

Surely that had been punishment enough for her mistake?

No. Thanks to her deception today, there would be more punishment to come if she did tell Luke the truth.

He had been honest with her and he deserved the same respect in return, but the implications of reciprocating were so huge she couldn’t begin to get her head around them.

Her life—and those of the people she loved more than life itself—would change for ever.

It would also destroy any trust that Luke had in her.

And that mattered more than she wanted to admit.

As if her patient was aware of the tension building inside Anahera, a grimace appeared on his face and then the muscles of his body seemed to shrink and stiffen. Within the few seconds of registering what was happening, Tane was once again in the throes of a seizure. Anahera hit the alarm button on the wall, which she knew would sound in the staffroom, and then did her best to stop IV lines tangling or pulling free from the forceful jerking of Tane’s arms.

It was Luke who came into the room.

‘How long has he been seizing again?’

‘About a minute.’

‘Have you given another dose of diazepam?’

‘No.’ Was Luke disappointed with her performance already? ‘I’ve been trying to secure the IV lines. I didn’t have enough hands …’

‘Of course you didn’t.’ The flash of Luke’s smile wiped out any impression that he had been criticising her. He reached for a drug ampoule and syringe. ‘We’ll add in some phenobarbitone.’

Anahera turned her head to glance at the monitor as an alarm sounded. ‘His oxygen saturation is dropping.’

Luke nodded, glancing up as he injected the drug. ‘We need to get effective control of his airway and then I can juggle meds to see if we can stop the intracranial pressure rising any further.’

‘Do you want me to set up for an RSI?’

Luke nodded again. ‘Do you think we can manage that on our own? Sam and Hettie are a bit tied up with a baby that’s come in with bronchiolitis and is in quite severe respiratory distress.’

Anahera caught Luke’s gaze again and held it for a moment. Ideally, a rapid sequence intubation procedure needed a team of three people, an assistant to the person in charge of the airway and someone to manage the drugs. A clear memory surfaced of how well she and Luke had worked together in the past. Could they still do that?

It felt like nothing had changed.

‘No problem,’ she said. ‘I’ll set up.’

She worked swiftly, moving a suction unit, having checked that it worked, and then exchanging Tane’s oxygen mask for nasal prongs that would keep oxygen running while they worked on securing his airway. Then she unrolled a pack on the top of a trolley, revealing the range of endotracheal tubes, stylets, airways and the laryngoscope and blades that would be needed.

The new medications had controlled Tane’s seizure so they had a window of time that would make intubation easier. Luke already had the extra drugs lined up.

‘You good to go?’

‘When you are.’

‘Got a cric kit there?’

The need to create a surgical airway by a cricothyrotomy was an emergency backup in case the intubation attempt was unsuccessful and they had a still paralyzed patient who had no way of breathing for himself. Anahera nodded but then caught Luke’s gaze.

‘You won’t need it.’

Luke maintained the eye contact long enough for Anahera to get the message that he had just as much confidence in her own skills and, despite how critical the next few minutes were going to be, she felt herself relax.

It was still there—that professional connection that had made them such an amazing team.

Luke’s focus was completely on the task ahead the instant he looked away. ‘Let’s pre-oxygenate.’

The procedure went like clockwork. During the three minutes of pre-oxygenation the equipment, drug dosages and monitoring were all checked. Sedation and then the paralysing drugs were administered. Luke obtained visualisation of the vocal cords easily and the tube to secure Tane’s airway was slipped into position. Luke’s focus was still a hundred per cent on their patient at this point, as he confirmed the correct positioning of the tube by listening to Tane’s chest. Anahera’s tasks of securing the tube and attaching it to the ventilator were automatic enough for her to find her focus shifting somewhat.

To the doctor rather than the patient.

This wasn’t the first time they’d worked together. It wasn’t the first time they’d been alone, doing something that had the potential to go wrong with disastrous consequences for the patient either, but it felt like the first time.