The Doctor's Engagement

‘I’ve got a fifty-five-year-old man who’s been having blackouts and chest pain,’ he said briskly, coming straight to the point. ‘He’s got a heart rate of thirty-five beats a minute and I suspect he’s got heart block. Are you in a position to do a 12-lead ECG for me?’

She swallowed. ‘Of course. Send him along now.’

She quickly finished with the lady she was dealing with. ‘Drink plenty of fluid, Mrs Page, and contact the surgery again if the symptoms are no better in twenty-four hours or if abdominal pain is persistent or severe.’

Mrs Page stood up, her face pale and drawn. ‘Should I take any medicines?’

‘Better not to,’ Holly advised. ‘Unless you’ve got to go on a long coach journey or something similar, it’s actually best to let your body clear itself of the problem.’

‘Well, thanks for seeing me.’ The woman walked towards the door and Holly gave her a sympathetic smile.

‘I’m sure you’ll soon be better and able to enjoy the rest of your holiday.’

She glanced up, her body tensing as she saw Mark striding towards her, his handsome face expressionless as he met her eyes.

‘This is Mr Fox,’ he introduced the b

alding, slightly overweight man standing next to him. ‘I’ll be in my room when you’ve finished.’

‘Thanks.’ Holly stood to one side to let the man pass, staring after Mark with a growing feeling of despondency. Had it really been worth it? One night of total bliss seemed to have cost her the entire friendship.

‘Just remove your shirt and your socks, Mr Fox.’ She drew the curtain across to ensure his privacy and made a determined effort to bury her personal problems. ‘I’m going to attach some wires to your chest to perform this test, but it’s completely painless.’

‘I hope this is a lot of fuss about nothing,’ the man muttered breathlessly, shifting himself slightly on the trolley. ‘Everyone blacks out occasionally, don’t they?’

‘It’s still worth investigating, Mr Fox.’ Holly smeared the electrodes with contact jelly and attached them to his wrists and ankles with the straps. ‘The ECG gives us a picture of what your heart is doing. I need you to relax.’

Carefully she recorded each of the leads in turn, recording a longer tracing in lead II to act as a rhythm strip for Mark. Then she marked the tracings with a pen to make it easier to read.

‘So what happened?’ Carefully she attached a chest lead to the fourth intercostal space joining the right sternal border. ‘What were you doing at the time?’

‘Helping my daughter move house.’ He watched as she attached the other chest leads. ‘I was lugging furniture and boxes and then I had this crushing pain in my chest. I thought it was indigestion.’

Holly switched the machine to V setting and recorded the six tracings.

‘And you’ve never had that sort of pain before?’

He looked uncomfortable. ‘Well, I have had chest pain before, but I always assumed it was indigestion.’

Holly removed the leads and helped him sit up. ‘You never went to the doctor?’

‘No.’ He slipped on his shirt and looked worried. ‘Should I have done?’

Holly ripped the ECG tracing from the machine and gave him a warm smile. ‘You’re here now, Mr Fox,’ she said quietly, ‘That’s the main thing. I’ll just take this to Dr Logan so that he can look at it while you’re getting dressed.’

She waited outside Mark’s consulting room until his patient left and then she slipped in, her cheeks colouring slightly as her eyes scanned his broad shoulders.

Damn. Would she ever be able to see him as her friend again? After last night the answer was undoubtedly no.

‘I’ve done Mr Fox’s ECG.’

He gave a nod and reached out a hand. ‘And?’

‘My cardiology is a little rusty,’ she admitted, passing him the trace. ‘But it doesn’t look healthy. ‘The p-wave doesn’t seem related to the rest of the complex somehow.’

Mark frowned down at the trace, following it carefully with the blunt end of his pencil. ‘He’s got third-degree heart block,’ he muttered, shaking his head slightly in disbelief.

‘What does that mean?’