David gave the slightest shake of his head. She turned the oxygen on full and slipped the mask over his face. ‘I’m just going to try and make your breathing a little easier. Rest back in the chair.’
The truth was she really needed a chest X-ray to get a clear picture of what was happening. But that would involve transporting David over to the hospital—and, to be honest, he didn’t look fit for that.
Then again, maybe he would be better over at the hospital?
Panic was starting to fill her. Her inexperience in general practice was starting to feel like a weight around her chest. She was used to paediatric emergencies. They were part and parcel of her previous life. But this was entirely different.
All her paediatric emergencies had been dealt with in a hospital environment, with a whole host of equipment, drugs and other staff to help. As an experienced paediatrician, even when chaos was erupting around her, she was confident in her abilities to deal with the situation. Right now she had no idea what was wrong with this young man. But he was looking sicker by the second.
Maybe she should go and see if Logan or one of the other partners was around?
Logan. She really, really wanted to talk to him. She was starting to feel a bit sick herself right now. But she pasted a composed smile on her face.
‘Mrs Robertson, can you tell me more about your holiday? Did you take part in any unusual activities? Eat anything different? Get bitten by an insects?’
Her questions were starting to sound desperate. Just like the way she was feeling.
Mrs Robertson looked a bit confused for a second. ‘Well, we went on a camel ride one day. And we ate out in the desert one night at a special restaurant.’
‘Any unusual foods you haven’t eaten before?’
She shook her head. ‘I don’t think so, and call me Pam. I can’t get used to Mrs Robertson.’ She lifted her eyes, clearly racking her brain for the rest of their activities, as her other hand anxiously twisted the new wedding ring on her finger. ‘We did a tour inside the pyramids, oh, and I bought David some diving lessons. He did them too.’
Diving. Her brain started to go mad. She’d been reading all about this just the other day. ‘When was the last time he dived? Was it a few days before you came home?’
Pam shook her head again. ‘Oh, no. It was just a few hours before we got on the plane. He had three lessons to fit in, and we’d been so busy that it was the only time he could fit the last one in.’
No. It couldn’t be. The thing she’d researched just the other day because she didn’t know a single thing about it. But all these little symptoms were starting to look horribly familiar.
‘Let me just check with you. Nausea and vomiting. Joint pains. Dizziness. Itching. Anything else you can think of?’
Her head was adding in the clinical symptoms she was seeing. Hypotension. Low oxygen saturation. The strange-sounding lungs.
She was trying to remember the recommendations for flying after diving. Was it wait twelve hours after a single dive and eighteen hours after multiple dives? There had been so much information she couldn’t recall all the details.
But there had been a checklist of symptoms and a neurological assessment.
She crossed over to the computer and checked her browsing history, pulling up the pages she needed.
Her heart was starting to race. One thing was clear. She needed to act quickly or this young man could die. The diving lessons his new wife had bought him could be the death of him.
Logan. She needed to speak to Logan.
‘Can you excuse me both a second?’
Hoping her face wasn’t betraying her and her demeanour was remaining calm, she crossed over to the door. The waiting room and surrounding area was empty. The door to Logan’s door was open with no one around.
Julie was in the staffroom, her sandwich just heading to her lips. ‘Where’s Logan?’
Her eyes widened. ‘What’s wrong?’
‘Is he here? Are any of the other partners here?’
Julie shook her head. ‘Logan’s on his way to Shortbank Farm, Mr Gallacher’s got some kind of injury—and that’s out of range for the mobile. I can’t even phone him for you.’
‘Is anyone else around?’
Julie shook her head. ‘Dr King is away to the mainland. He had a hospital appointment in Glasgow this afternoon.’
Gemma couldn’t help the words that streamed out of her mouth.
Julie put down her sandwich and stood up. ‘What can I do to help? Is it David Robertson?’
Gemma took a deep breath. Julie hadn’t exactly been over-friendly before, but she could obviously be counted on in a moment of crisis. She’d worked in the surgery for a few years, so must have a good handle on how things were dealt with in an emergency.
‘I think David Robertson is showing signs of decompression sickness. He was diving just before getting on the plane. But I haven’t done the neurological assessment yet, so I’m not entirely sure.’
Julie shook her head. ‘Time is what matters here. I’ll page the consultant at Aberdeen and you can speak to him while you do the assessment on the patient. He’ll arrange the emergency transport and getting the hyperbaric chamber at Millport ready.’ She waved her hand at Gemma. ‘I’ll put the call through as soon as I get him, and I’ll keep trying Logan on the other line.’
‘Has Logan treated a patient with decompression sickness before?’
Julie’s nose wrinkled. ‘I’m not sure. But he did some specialist training over at the hyperbaric chamber last year. So he’ll be able to tell you everything you need to know.’
Gemma felt a tiny glimmer of relief. She went back through to the consulting room. It was obvious that there had been no improvement.
She sat down beside Pam and reached over and touched David’s hand. ‘Okay, the signs and symptoms that you’re showing, David, are causing me some concern. I’m wondering if there’s a connection between you diving and then flying quite so soon afterwards. It can cause something called decompression sickness and I’m just going to run through a checklist. There i
s a specialist who deals with this condition and I’m waiting for him to call me back, so I might have to talk to him as we are doing this.’
Tears started to fall down Pam’s face. ‘Decompression sickness? Isn’t that what the people who do diving for a living get? The nitrogen bubbles floating around their body?’
Gemma nodded as she started to quickly fill in the form that appeared on her screen, Name. Age. Date. Gas used...
‘Do you know any details of the dive?’
David shook his head. Pam’s eyes widened. ‘What do you mean?’
‘The type of gas used? How deep it went? How long the dive was?’
Pam was starting to sob now. ‘I don’t know any of that. David just did the same as everyone else that was there. It was a dive school in Egypt. I’d bought the package online.’
Gemma nodded. ‘Can you remember the name of the company? I might be able to contact them later and get some details.’
Pam pulled a bent card from her purse. ‘I picked this up in the office when we went to book the lessons.’
At least it was something. She could deal with that later.
‘Can you remember how long the dive lasted?’
Pam took a deep breath. ‘Over an hour? Maybe an hour and a half?’
Gemma kept quickly typing. David wasn’t talking right now. She was going to have to keep getting all information from his wife. ‘Do you know if David stopped on the way up?’
Pam shook her head.
‘And how many dives did he do? Was it three?’
She nodded her head.
Gemma checked the last question. ‘This is really important. Can you remember when the last dive finished?’
Pam checked her watch and screwed up her face. ‘Our time or theirs?’
Gemma reached over and gave her hand a squeeze. ‘I’ll work out the time difference. How long ago was it?’
‘About ten hours?’
Gemma noted it on the record and turned back to face David just as the phone rang. It only took a few moments to introduce herself and the background of her patient to the hyperbaric consultant. She gave the signs and symptoms she’d already noted, the dive details and his blood pressure, oxygen saturation and current treatment.