Alisha nodded. ‘My left leg was sore when I got up this morning.’

  Her leg was swollen and red as well as tender.

  ‘It’s possible that you’ve got a blood clot that’s formed in one of the veins in your leg,’ Mac told her. ‘If bits of it are breaking off, it would explain what’s happening in your lungs.’

  ‘A clot?’ Alisha’s eyes widened in fear. ‘That’s really bad, isn’t it?’

  ‘You’re in exactly the right place to get it sorted,’ Mac said. ‘I’m going to do an ultrasound on your leg, which will tell us if something’s happening. We’ll do an X-ray of your chest, too.’ He turned to Hanna. ‘We’ll need an arterial blood gas measurement soon but I’d like to get an IV in first.’

  It didn’t surprise him that Hanna already had the IV trolley in the cubicle. With deft movements, she opened drawers and gathered everything he would need. A tourniquet, alcohol wipes, a cannula and sticky patch to cover it, a syringe and an ampoule of saline to flush the line. She was moving rapidly enough for Mac to see that she was sharing his sense of urgency, even though her manner was completely calm.

  ‘This is nothing to worry about,’ she told Alisha. ‘We’re going to need some blood samples to help us figure out what’s going on with you and if we have a line in, it means we don’t have to poke you again if we need to give you some medication.’

  Alisha was coughing again as Mac slid the cannula into place. Hanna began taking another set of vital signs as she finally flopped back against her pillows.

  ‘I feel kind of dizzy,’ she told them.

  ‘Systolic blood pressure’s dropped,’ Hanna informed Mac. ‘It’s less than ninety.’

  Alisha had her eyes closed now. They could see from the movements of her chest wall that her respiration rate had increased noticeably since the coughing.

  Mac stepped towards the end of the bed and lowered his voice. ‘We’ve got a PERT available, haven’t we? A Pulmonary Embolus Response Team?’

  ‘Yes. It’s a collaboration between specialities that’s activated from here. It’s your call.’

  Mac gave a single nod. ‘Let’s do it. I’m comfortable that a Wells score puts the priority for a PE as high. I’m going to get an ultrasound of her leg and set up a heparin infusion but I’d like the team here asap.’

  Bleeding risk needed to be assessed and a decision made about using clot-busting thrombolytics to treat the clot, if it was indeed as big as Mac suspected, or whether surgery or catheter-based techniques would be used before Alisha was admitted to the Intensive Care Unit.

  In the end, the young woman was administered catheter-directed drugs to treat the massive clot and then mechanical removal to clear her vein. If any residual areas were narrow enough to potentially cause a recurrence, she might need further treatment with angioplasty and stenting.

  ‘They’ve placed a filter in the inferior vena cava to prevent any further PEs.’

  Hanna seemed fascinated by the images Mac was able to show her that evening when they were discussing the case. And this was another huge bonus of a relationship that went beyond being colleagues. Mac loved a good debrief.

  ‘It’s only temporary. Once things are stable, she should be able to take blood thinners.’

  ‘How did you know that the clot was so massive? I can’t believe it went all the way from her calf to her groin.’

  ‘I didn’t. And I probably should have taken the time to properly rule out all the differential diagnoses, too.’

  ‘Such as?’

  ‘Aortic dissection. Tension pneumothorax. Triple A.’ Mac was counting them off on his fingers. ‘Ectopic pregnancy.’

  ‘You sounded like you knew.’

  ‘I was trusting my instinct. Also, I’ve never forgotten a case I was involved with treating when I was a med student. The guy was being thrombolysed and I was monitoring him when he had a syncopal episode that started just like when Alisha began feeling dizzy.’

  ‘What happened?’

  ‘His heart rate and breathing rates went up and he was going blue with hypoxia. A minute or two later and he was unresponsive and pulseless. You can imagine how panicked I was.’

  ‘Did he survive?’

  Mac shook his head. ‘Which is why I’ve always remembered him. Huge PE on both sides and a massive clot that disabled the right side of his heart. Did you know that seventy per cent of patients who have a fatal PE die within the first hour of the onset of symptoms?’

  ‘I do now.’ Hanna blew out a breath. ‘And I won’t forget it, either.’ She smiled at Mac. ‘There you go...for the rest of my working life, whenever I see someone who might have a DVT, I’ll be thinking of you.’

  Oh... Mac liked that idea. The whole benefit of any debrief was that lessons were learned and perhaps a different case in the future would benefit.

  He liked the way Hanna was looking at him right now, too. It was obvious she’d had enough of talking about work and it was time for the kind of wind down from a busy day that could take them both to a place that had nothing to do with anyone but each other. The expression on her face reminded him of...what was it? Oh, yeah...that time when they were in front of the clock in Prague and he’d told her that she looked like a dog who couldn’t wait to be allowed off leash.

  He also told her, in a somewhat roundabout fashion, that he thought she was beautiful. And he realised that being here, in this space between holiday fantasy and real life, wasn’t, in any way, changing what he thought about this astonishing woman. She was just as enchanting. Just as captivating as the first moment he’d noticed her outside that hotel in Prague.

  ‘Do you know,’ he said softly. ‘I suspect I’ll be thinking of you for the rest of my life whenever I see a clock.’

  ‘That’s way more romantic than a DVT.’ The smile curving the corners of Hanna’s mouth was reaching her eyes and making them distinctly misty. ‘Okay... I’ll think of you whenever I hear someone talking about Barcelona.’ Her gaze dropped to his lips. She was thinking about kissing him, wasn’t she? ‘Or see people dancing, perhaps,’ she added softly.

  ‘It was the best holiday,’ Mac said. ‘The best fling.’ He was looking at her mouth, now, savouring the moment before that imminent kiss. ‘We should do that nose-following thing again.’

  ‘Mmm... When?’

  ‘Next summer?’

  ‘Northern hemisphere summer or southern hemisphere summer?’

  Mac lifted his gaze. ‘Why not both?’

  Hanna laughed as she leaned closer. ‘I like the way you’re thinking.’

  Her lips brushed his, a soft butterfly kiss that was teasing him into making the first move and Mac needed no more encouragement. In the heartbeat before he began what was becoming a familiar but no less delicious prelude to their love making, he was realising something else.

  That Hanna was the perfect woman for him. They shared a passion for the same career in emergency medicine and would always, always have interesting things to discuss. They both loved travel. The sex, that had been the best ever from that first night, wasn’t losing any of its attraction and, perhaps the biggest connection of all, they both felt the same way about marriages and families of their own.

  Like the locum position Mac was currently in being a blurred area between real life and a holiday, the idea of going away with Hanna twice a year was like a soft-edged space between a relationship and a holiday fling.

  It could be safe.

  Perfect, even...?

  CHAPTER NINE

  ‘IS THERE SOMETHING going on that I should know about?’

  Hanna tried a surprised expression on Jo but she should have known that her best friend would see straight through it.

  ‘Oh, my goodness...there is something going on, isn’t there?’ Jo’s smile was growing. ‘You can thank me later for helping choose him for covering my maternity leave.’

  Hanna cast a glance over her shoulder from where she and Jo were sitting on a couch in front of the bay window with the amazing view out to Dunedin’s picturesque harbour, but Mac was still busy in the kitchen of Jo and Cade’s house, opening the bottle of wine they’d stopped to buy on their way here.

  ‘To be honest,’ she said, ‘it started in Prague.’

  ‘No... You didn’t say anything.’

  Hanna bit her lip. ‘Maybe I didn’t want to admit I’d jumped into bed with someone the first day I’d met them.’

  Jo laughed. ‘Hey...no judgement here. It was the first date for me and Cade. There’s no getting away from that kind of chemistry.’ Her glance in Mac’s direction was thoughtful. ‘It’s that good, huh?’

  ‘Gets better every day,’ Hanna murmured.

  Not just in gradual increments, either. After that evening last week, when Mac had suggested they had two summer holidays together every year, there was a new, stronger thread that was binding their connection even more tightly.

  Because it suggested permanence.

  Not in the normal sense of a couple choosing to spend the rest of their lives together but Mac was never going to ask Hanna to marry him, was he? Or suggest that they lived together. So this...the idea that they would meet up, to have a wonderful adventure somewhere, was probably the closest he was ever going to come to committing himself to a significant relationship.

  And it was enough for Hanna.

  Enough to fill her heart with the kind of joy that could only come from being in love. From knowing, deep down, that Mac was feeling the same way. Even if he wasn’t admitting it, even to himself. She could feel it in the way he touched her when they made love and now, because he was thinking of ways they could be together in the future.

  Perhaps Mac could sense that he was under observation. He looked up from where he was pouring red wine into two glasses.

  ‘What can I find for you, Jo?’

  ‘There’s some orange juice in the fridge. I’d like that diluted with some soda water, please. Half in half.’

  ‘No worries.’

  Jo grinned at Hanna. ‘He’s starting to sound like a Kiwi.’ She lifted an eyebrow. ‘He might decide to stay?’

  Hanna shook her head. ‘I don’t think so.’

  But the idea of Mac leaving as soon as his locum finished wasn’t scaring her. After all, it was only a short time ago that she thought all she would ever have with Mac were the memories they had already made. His idea of all those holidays to come was giving her a whole future of opportunities to keep making memories and, when they weren’t together, they could be staying in touch and planning for the next time and that would be enough to keep this joy alive.

  Wouldn’t it?

  Jo was distracted by the vibration of her phone on the coffee table. ‘I hope that’s Cade,’ she exclaimed. ‘He should have been home half an hour ago. He’s the one who’s supposed to be doing the barbecue.’

  She read the message and groaned.

  ‘What’s up?’ Hanna asked.

  ‘He’s been stuck. The patient he was called out to see was deceased by the time he got there and he had to wait for the police to arrive. He’s only just heading back to the station.’

  ‘Oh, no...’ Mac had heard Jo as he came in with the drinks. ‘That sounds like it could take a while?’

  ‘We won’t wait for him. I’m sure you’ll be able to drive the barbecue, Mac.’ Jo put her glass down on the table. ‘I can get it going to warm it up.’ She started to get up from the sofa but fell back with an even louder groan than reading the message had elicited.

  Mac frowned. ‘Are you okay?’

  Jo nodded, but her eyes were closed. ‘It’s getting harder every time,’ she said. ‘I’ve had trouble staying on my feet today because it makes my back ache and then, when I sit down, it’s too hard to get up.’

  ‘Don’t move,’ Mac instructed. ‘I’ll sort the barbecue.’

  ‘And I can do the food,’ Hanna said.

  ‘There’s not much to do.’ Jo still hadn’t opened her eyes. ‘There are some salads in the fridge, fresh bread that just needs slicing and a potato bake that’s already in the oven. The sausages will take longest so they need to go on the grill first. There’s steak and bacon as well.’

  ‘Sounds delicious,’ Hanna said. ‘But let’s wait a bit before we start cooking in case Cade gets away soon. Or are you starving?’

  ‘I’m not even hungry,’ Jo confessed. ‘I don’t think there’s any room in my belly for food now.’ Her smile was wry. ‘Remind me why I thought it was a good idea to get pregnant at my advanced age?’

  ‘Advanced age?’ Mac raised his eyebrows. ‘What... I thought mid-thirties was the usual age these days.’

  ‘Mid-thirties?’ Jo laughed as she threw Hanna a meaningful glance. ‘I can see why you fell for this guy.’

  There was a beat of something in the air that Hanna had not expected. It felt like Mac was startled—as if it hadn’t occurred to him that Hanna might have fallen in love with him? She didn’t dare meet his gaze but, from the corner of her eye, she could see that he hadn’t moved a muscle. He was still focused on Jo.

  Jo shook her head at Mac. ‘I’m forty-six,’ she told him. ‘So this is my one and only shot at motherhood. You’re not likely to see a primigravida more elderly than me.’

  Mac blinked and that odd frisson that Hanna had been aware of evaporated.

  ‘Okay... I’m impressed,’ he said. ‘Even more so that you travelled all the way to Europe when you were how many months pregnant?’

  ‘Close enough to six. But I wouldn’t have gone if there’d been any complications. The trip home was the hardest. I got such a backache on the plane that Cade was scared I was going into labour.’

  ‘When’s your due date?’ Mac asked.

  ‘Not soon enough,’ Jo sighed. ‘I’ve probably got at least another four weeks of this.’ She used the arm of the couch to haul herself properly upright as her phone began to ring, leaning forward to grab it from the coffee table.

  ‘Cade?’ She listened for a moment. ‘Okay... No speeding.’ She was smiling as she ended the call. ‘He’s on his way,’ she told her guests. ‘And he loves a run on the peninsula road on that bike of his. He won’t be...’

  Jo’s smile was being overridden by a grimace that suggested severe pain. Mac did look up to catch Hanna’s gaze this time, but he wasn’t thinking about anything Jo had said. This was the kind of glance that was becoming familiar. The one that signalled a level of alertness when an internal alarm had sounded. The sort they’d exchanged within minutes of meeting before their tour guide had collapsed. Just like the more recent occasion when Mac had realised that their patient with the pulmonary embolus might be critically unwell.

  But this was about Hanna’s best friend and there was no reason to think that she was in trouble, was there?

  ‘Do you need something for that back pain?’ she asked. ‘Have you got a heat pack or a hottie somewhere?’

  ‘I’m fine.’ Jo was getting to her feet. ‘I just really need to go to the loo. An empty bladder will help.’

  She had a hand pressed to her back as she tried to straighten up but she didn’t lift her head and Hanna was aware of another strange beat—as if the universe was holding its breath. The feeling intensified as Jo spoke slowly.

  ‘Uh-oh...’

  She was still looking down and Hanna shifted her gaze to see what Jo must have felt happening. There was fluid soaking her leggings.

  ‘Did I just wet myself or is it what I think it might be?’ Jo was sounding perfectly calm as she lowered herself back onto the couch. ‘Han...would you mind getting a towel or two out of the linen cupboard? It’s in the hall, beside the bathroom.’

  Hanna could hear Mac sounding just as calm as Jo as she rushed out of the room.

  ‘Tell me about this back pain of yours, Jo. When did it start? Give it a score out of ten...’

  The soft, clean towels Hanna grabbed were a pale, oatmeal colour. In the time it took to put them between Jo and the couch, the faint bloodstains were obvious.

  ‘I think we should call an ambulance,’ Mac said.

  ‘No...’ Jo shook her head. ‘Cade will be home any minute. It’s quite normal for there to be a bit of blood in amniotic fluid and it’s also normal for contractions to not even start for twenty-four hours after waters break. There’s no need to panic.’

  Except that in the silence that followed her words, there was an odd expression appearing on Jo’s face.

  ‘I can feel something weird,’ she said quietly.

  Hanna felt her heart sink. ‘What sort of weird?’

  ‘Pulsatile weird,’ Jo whispered.

  ‘Okay...’ Mac was rolling up the sleeves of his shirt. ‘Let’s get you lying down, Jo, and find out what’s going on.’

  It was Hanna who helped remove Jo’s lower clothing so she was the first to see the loop of umbilical cord. They all knew the implications of a cord prolapse. The oxygen supply to the baby was in danger of being cut off by pressure from the baby’s head and it could be catastrophic. Severe oxygen deprivation could lead to brain damage or death. They all knew the recommended management, which was to keep the pressure off the cord until the mother could be rushed into Theatre for an emergency Caesarean section. And they all knew that being this far away from hospital was a significant addition to the risk factors. It was Hanna who helped Jo turn onto her knees, putting her head down to let gravity help with easing the pressure on the cord. As she moved away to call for an ambulance without alarming Jo, she was grateful to hear the reassurance in Mac’s voice.

  ‘I’d say you’re very close to being fully dilated. I can feel baby’s head.’ He still sounded calm as Hanna returned within a few moments. ‘Okay...you’re going to feel me pushing a bit now that the head’s far enough down to elevate. It’s a good thing you’ve got a full bladder. That’s going to help take pressure off as well.’ He looked up at Hanna. ‘What’s the ETA for the ambulance?’