St Matthew's Passion - By Sam Archer Page 0,24

in the locker room. Whatever the nurse’s opinion of her, and despite Melissa’s growing suspicion that Fin and Deborah were a secret item, Melissa had to admit that Deborah never let any of that stuff get in the way of their working relationship. She was cool towards Melissa, but she wasn’t spiteful.

Perhaps she’s more emotionally stable than me... Melissa shook the thought away. This wasn’t the time or the place to get maudlin. She was too tired, her defences were too weakened, for her to dare to let such poisonous considerations to creep in. They’d take hold, and would disrupt the sleep she desperately needed later.

But already Melissa knew she wouldn’t fall asleep easily. She’d slept poorly for days, ever since she’d seen Fin buying the necklace. When she did finally drop off, her dreams were tormented by his presence. He wasn’t even necessarily with his mystery woman in the dreams; just his image was enough to drive her to despair when she awoke again and remembered that he was out of reach. Had always, perhaps, been out of reach.

Melissa consulted the medication chart Deborah had handed her and scribbled the drugs and their dosages on the prescription pad. Like many patients who came through the Trauma Department, this woman was on a number of preexisting drugs, and it was important to include them on the discharge prescription along with the antibiotics, painkillers and other meds for the post-operative period.

She handed the prescription and chart back to Deborah who murmured her thanks. Melissa moved through her list patient by patient until she’d finished her reviews, then made her way to the nurses’ station to check if there were any last outstanding things to deal with before she signed off and went home.

Deborah appeared at her side. ‘A word?’

What now, thought Melissa wearily, the fatigue starting to make her irritable. She followed Deborah into the nurse’s office.

Without a word, Deborah handed her a prescription. Melissa took it. It was the one she’d filled out earlier.

‘What’s the problem?’

‘Take a closer look,’ said Deborah quietly.

Melissa ran her eye down the list of drugs, their names lettered in her tidy hand. Metronidazole and flucloxacillin to fight off bacterial infection. Dihydrocodeine for pain. Furosemide and digoxin for chronic heart failure.

Her glance caught on the last one. Digoxin.

She stared at the dose she’d written beside it. 125 mg. One hundred and twenty-five milligrammes.

The correct dose was 125 microgrammes. She’d prescribed one thousand times the safe dose.

Melissa put her hand to her mouth, stared at Deborah. The nurse gave a small smile and took the prescription from her.

‘I noticed it when I was about to give it to the patient at the door.’

‘I don’t know what to say,’ breathed Melissa.

‘It’s my fault. I shouldn’t have asked you to write it out when you were tired and distracted.’ Deborah shrugged. ‘A learning experience for both of us. Anyway, no harm done. And the pharmacy would have noticed it immediately, before dispensing it.’

Her mind reeling, Melissa rewrote the prescription with the correct dose, checking through it three times to make sure she’d got it right. After Deborah had gone, Melissa stood in the office gazing at nothing in particular.

Prescribing errors happened. They couldn’t be prevented altogether, given the sheer numbers of drugs that were prescribed daily in the health service. But they’d never happened to her before. It was something she prided herself on.

Yes, Deborah was probably right in saying that the pharmacy would have spotted the error in time. But what if they hadn’t? What if a junior pharmacist overlooked it, and issued the medication as written? Digoxin was a powerfully effective heart drug, but it was also deadly if misused. A dose one thousand times higher than intended would prove lethal in every case. Melissa would have killed the patient.

Fatigue was well known to impair a doctor’s performance, or anybody else’s, come to that. Yet Melissa knew it wasn’t tiredness that was responsible for her mistake. She’d been just as exhausted as this before, but had never made a potentially fatal error like this. No, her failure to pay adequate attention had been due to something else entirely.

Namely, the turmoil in her head over Fin, what he meant to Melissa, and how his purchasing gifts for someone else had devastated her.

This was serious. If her ability to perform effectively, even safely, as a doctor was being compromised, she needed to address the problem urgently. And she knew she wouldn’t be able to do that unless and until