Hawaiian Sunset, Dream Proposal

‘The romance of the island is finding its way into your heart. It happens to everyone after a while. It casts a spell on you, and you never want to leave.’

Ethan came to stand in front of her, laying a hand on the bole of the palm tree just above her head, and then he leaned towards her, dropping a kiss lightly on her mouth.

‘I hadn’t expected it to happen,’ he said softly, ‘but you’ve made a huge impact on my life. You caught me unawares, and now I can’t stop thinking about you—day or night.’

He made a half-smile, his gaze running over her. ‘Especially in the night.’

He kissed her again, teasing the softness of her lips with the brush of his mouth, enticing a flurry of expectation within her nervous system, stoking the flame that burned inside her.

When Joanna Neil discovered Mills & Boon®, her lifelong addiction to reading crystallised into an exciting new career writing Medical™ Romance. Her characters are probably the outcome of her varied lifestyle, which includes working as a clerk, typist, nurse and infant teacher. She enjoys dressmaking and cooking at her Leicestershire home. Her family includes a husband, son and daughter, an exuberant yellow Labrador and two slightly crazed cockatiels. She currently works with a team of tutors at her local education centre, to provide creative writing workshops for people interested in exploring their own writing ambitions.

Recent titles by the same author:

NEW SURGEON AT ASHVALE A&E

POSH DOC, SOCIETY WEDDING

HOT-SHOT DOC, CHRISTMAS BRIDE

THE REBEL AND THE BABY DOCTOR

Hawaiian Sunset, Dream Proposal

by

Joanna Neil

www.millsandboon.co.uk

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CHAPTER ONE

‘HE’S not doing very well at all, is he?’ The young woman’s voice was choked with emotion, and her eyes filled with tears as she looked at Amber. ‘Isn’t there something more that you can do for him? Nothing seems to be happening.’

Amber removed the printed trace from her patient’s heart monitor and taped the paper strip into his file. The readings were erratic, showing a dangerous, uncoordinated rhythm. ‘I know this must be a very difficult time for you,’ she said in a quiet voice, turning towards the girl, ‘but I want you to know that we’re doing everything we can for your father. I’ve given him an injection to take away the pain, and he’s receiving medication through a drip in his arm to try to prevent things from getting any worse.’ There was a defibrillator on standby in case his condition deteriorated, but she wasn’t going to point that out to her patient’s anxious daughter.

The girl pulled in a shaky breath. ‘He looks so dreadfully ill. I know he hasn’t been well these last few months, but this has come as such a shock. As soon as I saw him, I knew it was bad. His secretary called me at the university to say that he was unwell and that they’d called for an ambulance…I was in the middle of a lecture, and I rushed over there as quickly as I could.’

She gulped, sending a worried glance towards her father. ‘She said he had been in his office, trying to get through a backlog of work, when he suddenly felt nauseous and short of breath. At first he thought he was suffering from a bad attack of indigestion, but then things got worse and he felt this awful pain in his chest…a crushing, vice-like pain.’

She broke off and dabbed at her eyes with a tissue. ‘By the time I arrived at the office, he had collapsed and the paramedics were there. It all seemed to have happened so quickly.’

‘The paramedics gave him emergency treatment before they brought him here,’ Amber told her. ‘They did everything that was possible to make sure he arrived here safely.’

Martyn Wyndham Brookes had been conscious when he’d arrived at A and E but, despite his pain and discomfort, his one thought had been for his daughter. ‘She’s very young,’ he had managed to say, ‘and she’s a long way from home…studying at university. She always wanted to come to London.’ His face had been haggard with pain, but his concern for his daughter had been obvious as he’d looked anxiously at Amber, and she had hurried to reassure him.

‘We’ll look after her, I promise,’ she’d told him gently. ‘I’ll have a nurse take care of her…but right now we need to concentrate on making you feel better.’ She had taken to him straight away…such a strong, warm-hearted man.

Now, after he had lapsed into a drowsy, semi-conscious state, she felt it was time to explain to his daughter what had happened. ‘I suspect he’s had a heart attack,’ she said, ‘and that there’s a blood clot blocking an artery somewhere and causing problems with his circulation.’

Tears trickled down Caitlin Wyndham Brookes’s cheeks. ‘That’s what the paramedic said…but that’s bad, isn’t it?’

‘It’s something we’re used to dealing with,’ Amber said. She studied the girl’s pale features. ‘Is there anyone we can call for you…someone who might come and be with you?’

Caitlin shook her head. ‘My mother died some years ago, and there’s no one over here…just my friends at university.’ She gazed at Amber in an agitated fashion. ‘Isn’t there something more you can do for him? What if you have to go off and deal with other patients? I know you have others to see, and it’s so busy here. There are so many patients being brought in…I want somebody to be with him all the time, someone in a senior position.’

The flow of words stopped suddenly, as though she was taking stock of what she had said. ‘It’s not that I’m doubting your ability,’ Caitlin tried to explain, ‘but he’s just lying there, looking so frail…It isn’t like him at all…he’s always been so tough, so busy, on the move all the time.’ Distress caused her voice to waver, and Amber hurried to soothe her once more.

‘We’ll know much more about what’s happened to him when we’ve done all the necessary tests. It will take a little while for all the results to come back, though. In the meantime, we’re taking good care of him. He’s receiving oxygen through a face-mask, and his condition is being observed the whole time with the aid of the heart monitor and various other machines. If I’m called away to attend to another patient, I’ll still know what’s going on, because the nurses will alert me to any change as soon as it happens.’

She frowned as she ran the stethoscope over her patient’s chest. Initially, his heart rate had been alarmingly fast, while his pulse had been barely discernible, but now the heart rhythm was becoming chaotic and everything about the man told her that he was gravely ill.

‘Unfortunately, we don’t have any records for him, over here in the U.K.,’ Amber said, turning to look at the girl once more. Caitlin Wyndham Brookes was twenty or so years old, a slender young woman with black hair expertly cut into a smooth, jaw-length bob. Her eyes were grey, sombre at the moment, much like an overcast, rain-drenched sky. ‘You mentioned that he lives overseas for most of the year,’ Amber added. ‘Do you know who looks after his medical care back home?’

‘He has his own doctor in Oahu…in Hawaii.’ Caitlin glanced at Amber. ‘I suppose I could try to get in touch with my step-cousin over there. He’ll be very concerned about my father—they’re so much like father and son. My father took Ethan under his wing after his parents died, and there’s a real bond between them.’

She hesitated for a moment, thinking things through. ‘Ethan would probably be able to have a word with the doctor back home, if that would help, and I know he’ll want to be kept informed about what’s happening over here.’

Amber nodded. ‘That would be great. As he’s so far away, it might be quicker and easier if he could fax the information we need, or perhaps send the bare essentials by e-mail. If you were to go and have a word with our nurse, I’m sure she could help sort things out.’

Sarah, the nurse on duty, was happy to oblige, and Amber sent her a grateful glance as she led the young woman away. Sarah gave her a discreet smile in return, her fair hair making a silky swathe across her shoulders as she nodded with gentle perception. ‘I’ll take a few details and see if we can find out any more information.’

She could see that Amber had enough on her hands, dealing with a difficult situation that could take a turn for the worse at any moment. Much as she wanted to help in any way she could, Amber was finding it distracting, trying to keep the young woman calm throughout everything.

Amber turned her attention back to her patient. Martyn Wyndham Brookes was in his mid-fifties, a tall, personable man, she guessed from talking to the paramedics, with black hair streaked with threads of silver. She gathered that he was a wealthy man, a man of some standing in the international business community. According to the paramedics who had brought him into hospital, his U.K. office was situated in Docklands, occupying a prestigious block that overlooked the grand vista of the river Thames.

It seemed, though, that illness was no respecter of wealth or position. Martyn’s condition had gone downhill rapidly, and Amber knew that it was going to take all her skill to help him to recover. His features were ashen, his skin had taken on a clammy appearance, and he was no longer attempting to talk.

‘How’s it going?’

She glanced up to see that James, her boyfriend, a senior house officer like herself, had come to join her. She looked at him with affection, feeling as though a faint glow of sunshine had come into her life. ‘Things could be better,’ she said in a low tone. ‘It’s always good to see you, though. How are things with you?’

He shrugged, draping an arm around her shoulders, so that she immediately felt warm and cherished. ‘Soso. It’s been pretty stressful around here, lately, with one thing and another. We’re still waiting on the results of job applications, aren’t we, and our contracts here come to an end within a couple of weeks? Have you heard anything yet?’

She shook her head. ‘Nothing, so far, though I haven’t had time to check my hospital mail box yet today. We’ve been so rushed in here.’

He gave a brief, half-hearted smile. ‘I expect you’ll come through it all right. You’re very good at everything you do. Look at the way you sailed through your exams. No one is going to turn you down. You applied for a topnotch job in emergency medicine and you’re bound to get it.’ Even as he was singing her praises, there was a flat note in James’s voice that made Amber glance up at him, a frown indenting her brow.

He let his arm fall to his side, leaving her feeling suddenly bereft. Something was clearly wrong with him, but she had no idea what it might be. James had not been his usual self for some weeks now. At first she had thought it was the pressure of exams weighing him down, along with the aftermath of results, but now she was beginning to wonder if it was something more than that.

‘I don’t think it’s as cut and dried as it seems. I’m waiting to hear the news just the same as everyone else. From what I’ve heard, it’s all down to the computer system matching up job applications with employers. There were some terrible glitches, apparently.’ She frowned. ‘It’s all a bit worrying, isn’t it? Sarah said that there have been quite a few mix-ups, and a lot of people have missed out on getting any kind of job. Some junior doctors have been talking about leaving medicine altogether.’ She shook her head in sad reflection, causing her burnished chestnut curls to quiver in response. ‘It’s such a waste, after all those years of training.’

She looked back at her patient. He seemed to be oblivious to everything that was going on around him, but perhaps that was just as well, given how desperately ill he was.

‘I doubt you’ll have any problems,’ James said. ‘All the senior staff speak very highly of you, and you could pretty much do anything you want. I guess it puts me in the shade.’ His mouth made a rueful shape, and Amber sent him another quick look, wondering what had got into him to make him appear so downbeat.

‘You sound as though things are becoming too much for you,’ she murmured, sending him a sympathetic smile before checking the pulse oximeter reading to see how her patient was doing. The machine kept bleeping, warning her that the level of oxygen in his blood was falling as his circulation became more impaired. She decided to check with the consultant about starting him on thrombolytic drugs to try to dissolve, or reduce, the size of any clot that might have formed.

‘I’m really hoping that we’ll be able to work together at the London University Hospital. We’ve worked well with one another here in A and E, haven’t we?’ Amber studied James closely, seeing the troubled look in his eyes. ‘Perhaps we could have lunch together later today and talk things through? I’m fairly sure that you won’t have any trouble getting the research job you were after.’

‘Maybe. There aren’t that many people lining up to study my particular area of enquiry into asthma. It all depends whether the powers that be can come up with the funding.’

He straightened up, looking more at ease with himself, and moved away from her, towards the door. ‘I’ll go and check in the office again to see if any more news has come in.’ He looked at the man lying motionless in the bed. ‘Poor chap. It looks as though he’s having a rough time.’

Amber nodded, brushing a hand over her temples to tease back tendrils of hair that threatened to obscure her vision. Her chestnut-coloured hair was a shoulderlength mass of wild curls, a genetic gift from her mother that needed to be ruthlessly tamed with clips or scrunches. They shared the same eye colour, too, a soft, jewelled green.

‘I want to start him on thrombolytics,’ she said, ‘but until I have the results from the lab, I’m working in the dark a bit. My boss is operating on a badly injured patient right now, and I don’t want to disturb him unnecessarily, but I don’t think I can afford to wait.’

‘I know what you mean. It’s a balancing act, knowing when to prescribe and when to bide your time. I’d be inclined to interrupt your boss if I were you.’ James walked towards the door. ‘I’ll be back down here in a few minutes to see how you’re doing—I only came to see if you had heard anything about the job you applied for. Someone said letters were being given out this morning but for now I need to go and check up on a patient. Do you want me to check your box for any letters while I’m there?’

‘Yes, thanks.’ Amber nodded and turned her attention back to the businessman, writing up his medication notes on the chart as Sarah came into the room. Sarah shot a glance towards James as they passed each other in the corridor, and a small frown started up on her brow. Martyn’s daughter was by her side, but Caitlin was preoccupied just then, speaking to someone on her mobile phone. She stayed in the doorway, and Amber guessed Sarah had asked her not to bring the phone into the room.

Amber put the chart to one side and looked once more at the chest X-ray in the light box. Martyn’s heart was enlarged, and that was not a good sign.

Sarah inspected the settings on the infusion meter and made sure that their patient was receiving the right amount of medication through a drip in his arm.

‘Is everything okay with you and James?’ she asked in a quiet voice, throwing a brief glance in Amber’s direction. ‘He doesn’t seem to be his usual self these days, does he? It’s hard to pinpoint, but there’s definitely something…’

‘I was just thinking the same thing,’ Amber answered cautiously. ‘I think the world of him, as you know. We’ve been together for over a year now, and I thought everything was fine, but just lately I’m not so sure. He doesn’t smile as often as he did, and he has a sort of hangdog air about him, doesn’t he?’

Sarah nodded. ‘It’s probably the aftermath of exams, and waiting around for results and job offers,’ she remarked. ‘It seems to have affected everyone. My boyfriend’s gone into a bit of a decline, too. We’ve just not been having any fun lately.’

‘I dare say things will get better.’ Amber looked across the room at Caitlin, and saw that there was an awkward air about her, a reticence, as though she was in some way holding back. ‘Was there something you wanted to ask?’ Amber murmured.

Caitlin indicated the phone. ‘It’s my step-cousin, Ethan,’ she said, in a hesitant fashion. ‘He asked me to put him on speaker-phone. He wants to be involved in everything that’s going on.’

‘That’s fine with me.’ Amber nodded. ‘Just don’t bring the phone any closer to the medical equipment, or it might cause interference.’

She checked Martyn’s pulse. It was thready, his features were drained of colour, and she was worried in general about his condition. ‘It must be frustrating for your cousin to be so far away and not know what’s happening.’

‘But not for much longer, I hope.’ A male voice cracked in a whip-like fashion across the room. His tone was concise and authoritative, and Amber braced herself in startled recognition of the fact that he must be able to hear every word that was being spoken. ‘I’d like to talk to the doctor in charge of my uncle’s case,’ he said.

‘That would be me,’ she answered. ‘I’m Dr Amber Shaw. I’m the senior house officer in A and E. I was on duty when your uncle was brought in. I take it you are Ethan Wyndham Brookes?’

‘I’m Ethan Brookes without the Wyndham. Yes, my cousin explained the situation to me. I understand you’ve been taking care of my uncle, and I’m grateful to you for that. I heard that you have him on anticoagulant therapy to prevent any more blood clots from forming, but his condition seems to be deteriorating.’

‘Things are going very much as we might have expected,’ Amber told him. ‘As I explained to your cousin, we’re still waiting on the results of tests, but they should be here very soon.’

‘Hmm. But in these situations time is of the essence, isn’t it? So, I’d like to speak to the consultant in charge, if I may?’

He posed it as a polite question, but Amber was in no doubt that it was a request. She guessed from his deep, well-modulated and assured tones that he was used to having things his own way. He would be somewhere in his mid-thirties, she imagined.

‘Of course, I’ll put you in touch with him as soon as possible, but he’s in Theatre at the moment. Perhaps I could assist you in the meantime? I’d like to reassure you that we’re doing all that we can to make your uncle comfortable.’

‘I’m glad to hear it. My cousin and I are very worried about her father.’

Amber had the feeling he didn’t want to be dealing with an underling at all, but she made an effort to remain calm and not take it personally.

‘I’m very well aware that this is a difficult time for both of you,’ Amber murmured, ‘but I can assure you that everything that can be done is being done. Your uncle has received the recommended treatment so far…oxygen, aspirin, glyceryl trinitrate and painkilling medication, as well as blood-thinning drugs. I’ve already cleared the way for him to be taken up to the angiography suite. As soon as my boss has finished in surgery, he’ll come down and assess your uncle’s state of health.’

‘So you’re thinking about operating on him?’

‘It’s a possibility, if his condition will allow us to do so. We may be able to find the clot that’s causing the damage and remove it by means of a catheter. That might do away with the need for more intrusive, major surgery, but I have to say that Mr Wyndham Brookes’s condition is very precarious. From the looks of his X-ray there could be an underlying disease that might cause more problems. That’s why it would be extremely helpful for us to have access to his medical records.’

‘I’m already onto it, and I’ll send them to you as soon as possible. In the meantime, I’d like to set up a video link with his hospital room. I know you have conferencing capabilities, so it shouldn’t be too difficult to arrange.’

His suggestion took Amber’s breath away. This man clearly knew what he wanted, and didn’t see why he shouldn’t sweep every obstacle to one side in order to get things done.

‘Is that going to be a problem for you? Perhaps I should speak with your chief administrator?’ Perhaps he had heard her swift intake of breath. Ethan Brookes sounded as though he had no time for shilly-shallying. If she couldn’t deal with it, he would go to someone who could.

‘That won’t be necessary,’ she murmured. ‘Your uncle is in a private room, so I’m sure we can accommodate your request, as long as his daughter has no objection.’ She glanced at Caitlin, raising her brow in a faint query.

‘I’d like that,’ Caitlin said. ‘It will make me feel better to know that Ethan’s looking on.’

Amber wasn’t at all sure how she felt about it. Having her every move watched by a stranger wasn’t something she welcomed, but technological advances meant that it could be done, and if it was something that helped unite families in their hour of need, who was she to object?

‘My boss should be here within a few minutes,’ Amber said. ‘I’ll speak to him about it, and if he agrees, we’ll call on one of our technicians to set it up. Now, if you don’t mind, I need to give my full attention to your uncle…unless there was something else that you urgently wanted to discuss?’

‘No…it will keep. Thanks for your co-operation,’ Ethan said. The speaker-phone link was cut, and Caitlin went out into the corridor to finish her conversation with him in private.

Amber drew in a deep breath. It was one thing to deal with worried relatives close at hand, but having difficult, long-distance discussions with someone she had never met was a first for her.

A few minutes later, she left Martyn in Sarah’s care, while another nurse took Caitlin away to show her to a waiting room. There she would be able to sit in comfort and talk about her concerns to the nurse with the aid of a reviving cup of tea. Having Caitlin looked after took a great deal of the strain off Amber’s shoulders and left her free to go and check on her other patients.

When her boss came down from Theatre, Amber grabbed the opportunity to update him on Martyn’s condition.

‘We’ll take him up to the catheter suite as soon as the team is assembled,’ the consultant agreed. ‘As to the video link, I see no reason to object.’ He gave a brief, wry smile. ‘Besides, I’ve heard of the Brookes’s international fruit-shipping company. I read about their goings-on in the newspaper from time to time. These people are high-powered, influential individuals. Let’s not get on the wrong side of any of them, if we can help it. Call the technician and ask him to sort out the video link. Anything to keep them happy.’

Amber lifted a faintly arched brow. Her boss wasn’t someone who usually worried too much about following protocol and treading carefully around people, so if he thought it expedient to appease Ethan Brookes, who was she to argue?

‘Professor Halloran,’ Sarah interrupted, ‘you’re needed in the resuscitation room. One of your pacemaker patients is in difficulty.’

The consultant nodded. ‘Okay, I’ll be along right away.’ He sent a brief glance towards Amber. ‘Prepare Mr Wyndham Brookes for surgery, and I’ll be along as soon as possible.’

Amber did as he asked, leaving a nurse to call in the technician to set up the video link. Martyn was barely conscious, but she spoke to him gently, explaining what they were going to do.

‘Professor Halloran is the best cardiac surgeon we have,’ she told him. ‘He’ll use X-ray images to look at your blood vessels through our cardiac monitor, and that should help him to find exactly where the blockage is. He’ll most likely insert a very thin catheter into a blood vessel of the top of your leg, and then he’ll use specialised instruments to remove the clot that’s causing the problem.’ She looked into his grey eyes. ‘Do you understand what I’m saying?’

He nodded almost imperceptibly. ‘I do.’

‘Is there anything that you’d like to ask me about it?’

‘Nothing. Thank you. I’m very tired.’ He tried to lift his hand and made a frail attempt to pat hers as it rested gently on the bedclothes beside him. His breath came in quick gasps. ‘I know you’ll do your best for me. You mustn’t worry if it all goes wrong.’

Amber felt the quick sting of tears behind her eyelids. Somehow, this man had managed to reach her inner core, the place where she tried to keep her feelings hidden. In the short time she had known him, she had found an affinity with him, and she realised that she cared deeply about what happened to him.

‘Nothing will go wrong,’ she said softly. ‘I’m going to take good care of you, I promise, and you have to know that Professor Halloran is the very best.’

He didn’t speak any more after that, but lapsed into what seemed like an exhausted sleep. The heart monitor began to bleep, the trace showing a chaotic descent into a dangerous rhythm, and Amber called for help. ‘I need a crash team here—now. Call for Professor Halloran.’ Her patient was going into shock, and cardiac arrest was imminent. ‘He’s in V-fib.’ Ventricular fibrillation meant the heart was unable to pump blood around Martyn’s body and without swift intervention he would die.

James and Sarah rushed to the bedside. Sarah started chest compressions, while James set the defibrillator to analyse the patient’s rhythm and prepared to deliver a shock to Martyn’s heart. Amber was aware of Caitlin standing in the room, watching everything that was going on, tears rolling down her cheeks, but she couldn’t let that distract her. She worked quickly to secure Martyn’s airway with an endotracheal tube and ensure that he was receiving adequate oxygen through a mechanical ventilator.

‘Stand clear, everyone,’ James said. As soon as the shock had been delivered, Sarah continued compressions. Amber checked for a pulse and looked to see if the rhythm of the heart had changed.

‘He’s still in V-fib,’ she said. ‘Let’s go again with a second shock.’ By now, Caitlin was making small sobbing sounds, and Amber was aware of another strange background noise, an odd swishing sound that she couldn’t quite make out.

James set the machine to deliver the second jolt of electricity, but Amber could see it hadn’t had the desired effect. ‘Keep up the compressions,’ she said. ‘I’m going to give him a shot of adrenaline.’

They continued to work on their patient, but after a while, when Martyn’s response was still insufficient, Amber added amiodarone to his intravenous line. She wasn’t going to give up on this man, no matter how resistant his condition seemed to her efforts.

‘You can do this, Martyn,’ she said, under her breath. ‘Come on, now, work with me. You’re going to the catheter suite and you’re going to come through this. Don’t let me down.’

James glanced towards Caitlin, clearly disturbed by the girl’s distress, but he could see that Sarah was tiring and moved to take over the chest compressions. Sarah watched the monitors and recorded the readings on a chart, while Amber worriedly assessed the nature of the heart rhythm and debated whether to add atropine to the medications she had already given him.

Professor Halloran came into the room, taking everything in with one sweeping glance. ‘How’s he doing?’ he asked. ‘Do you have a normal rhythm now?’

Amber checked the monitor and turned towards him. ‘We do,’ she said, relief sounding in her voice, and Professor Halloran nodded in satisfaction.

‘Well done, everyone.’ He turned his attention to the flat screen of the computer monitor that had been set up on a table across the room. He held up his hands in a thumbs-up sign. ‘He’s back with us,’ he addressed the screen, and now, at last, Amber realised where the swishing sound had been coming from.

The screen was filled with the image of a man standing on what appeared to be a wooden veranda, surrounded on all sides by a balustrade. He was looking towards them, long limbed, lean and fit, with broad shoulders that tapered to a slim, flat-stomached midriff. He was wearing casual clothes made of fine-textured cotton that would be cool and comfortable in the heat of the Hawaiian summer. In the background she made out a palm tree and the clear blue of ocean waves lapping on a golden, sandy beach.

‘I see that,’ the man said. ‘I saw it all, as clearly as if I had been there.’ He moved closer to the webcam, and Amber realised that the computer must be situated on a ledge in front of him. The screen showed him now in clear view, blotting out most of the background, and she was aware of the strong, angular lines of his face, of thick, black hair cut in a way that perfectly framed his features. Most of all, she was stunned by his clear, blue eyes, the exact colour of the sea, that appeared to be looking right at her.

‘We’ll take your uncle up to the catheter suite right away,’ Professor Halloran said. ‘It’s important that we get to work as soon as possible.’ He glanced at Amber. ‘I’ll leave you to bring him up in the lift, Amber, while I go and prepare.’

Amber nodded, dragging her gaze away from the image on the screen. She was glad to have something to distract her. There was something about the way Ethan Brookes looked at her that was infinitely disturbing. It was as though he could see into her very soul, and that was an unnerving thought.