The Doctor's Destiny by Meredith Webber

Author:Meredith Webber
Language: eng
Format: epub
Publisher: Harlequin
Published: 2013-09-09T04:00:00+00:00

CHAPTER SEVEN

AWARE that the situation was urgent, Rory drove to the hospital. He set his mind firmly on the problem ahead of him, refusing to consider what the big blond man had been doing at Alana’s flat all this time.

Though his subconscious refused the ban on conjectures and kept right on working.

Not that it was hard to guess, the way she’d been dressed.

Not that it was any of his business.

Hypovolaemic shock! That’s what he had to think about.

It was a sign of poor tissue perfusion—not enough fluids in the tissues, including brain tissue. The patient presented with low blood pressure, clammy skin, feeble pulse, accelerated heartbeats and rapid breathing. Usually it went along with massive blood loss, but there was no evidence of that in the patient, while scans showed no internal bleeding.

At the level the resident had mentioned, it was lethal, and while staff were already pumping fluids into the man, if they didn’t find a cause for his sudden collapse, they wouldn’t know what to add to the fluids to rebalance the patient’s system.

His blood test showed hypoglycaemia, a low level of glucose in the blood, and this was being addressed by the addition of five per cent dextrose in the saline. According to his wife, he’d been tested recently for diabetes, after complaining of tiredness to his GP.

‘I’m glad you’re here. He’s stabilised slightly but there’s obviously something very wrong.’

Doug Weaver was the junior resident on duty and, though Rory had only met him briefly, he’d heard good reports of the younger man.

‘Let’s take a look,’ he said, and saw Doug relax. He remembered the feeling from his early days in hospitals, where calling in a specialist could result in appreciation or a tirade of abuse for not being able to handle things himself.

The patient, Albert Cross, still looked extremely ill, but as Rory examined him, small red marks like tiny burst blood vessels on the man’s skin suggested a possible cause.

‘See these,’ he said to Doug, pointing to them.

‘Petechial haemorrhages. I associate them with drowning or suffocation—hanging and the like.’

‘They can also occur as the result of fever and for a variety of other reasons, but look at his hands.’

The skin, particularly in the knuckle wrinkles, seemed dark for a man who was ginger-haired.

‘Some kind of adrenal insufficiency?’ Doug guessed. ‘Addison’s disease?’

‘Not necessarily Addison’s disease, but you’re right about adrenal insufficiency. We’ll ask the lab to check levels of cortisol in his blood and if it’s low we’ll add cortisol, hydrocortisone phosphate, to the drip, six-hourly doses until the acute symptoms subside.’

Doug turned to the nurse to explain what they wanted, while Rory flipped through the patient’s chart, seeking the results of the preliminary blood tests. They were good as far as they went, but failed to show the more complex values of either an increase or decrease in ACTH, the adrenocorticotrophic hormone produced by the pituitary gland to stimulate the adrenal gland into producing corticosteroids.

He ordered further blood tests, asking specifically for what he needed,

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