The speed of Holly’s response had far more to do with her renewed level of energy than the early morning absence of obstacles caused by people or equipment, and she took full advantage of the physical strength, bypassing any wait for a lift and heading for the stairs.
It had to be Callum that was causing concern in the unit and the page had been urgent. Hearing footsteps far more rapid than her own behind her on the stairs was frustrating. Dialysis might be magic but it couldn’t work a miracle, like giving her the sudden ability to race up stairs two at a time as someone else was obviously doing.
‘Holly!’ The steps slowed to match hers and Ryan’s smile was delighted. ‘You must be feeling a lot better to be using the stairs. That’s great!’
Holly just nodded, not wanting Ryan to know that climbing stairs half as quickly as him had left her somewhat breathless. He held the door open as they reached the second floor.
‘You’ve been paged by ICU?’
She nodded again.
‘Any idea what’s going on?’
‘We’ll soon find out.’ Holly’s words were clipped but not just by lack of breath. She was fighting a dread that her first VSD repair might be going pear-shaped. Had her stitches not been quite deep enough or sufficiently close together? Was Callum bleeding around his heart and suffering a life-threatening tamponade? Respiratory failure or a hypertensive crisis? Had he spiked a fever or developed renal failure?
Ryan touched her arm as they reached the unit. ‘Don’t worry so much,’ he said. ‘Whatever it is, we’ll sort it out. Together.’
Ryan’s reassurance, even his presence, was kind of like dialysis for her soul, Holly thought wryly. Fears and insecurities got filtered out and confidence renewed. She could focus and perform and not be intimidated when pushed to voice her own opinions.
Such as what she thought about the concern raised by Callum’s heart rate and rhythm. Disturbances were frequent following open heart surgery and fortunately the abnormal pattern being recorded on Callum’s ECG was not immediately life-threatening.
‘It’s supraventricular,’ Holly said in response to Ryan’s raised eyebrows. ‘The drop in blood pressure is most probably rate-related.’
‘How do you want to manage it?’
‘I’ll consult with Cardiology,’ Holly decided. ‘It’s A-fib so adenosine is probably the drug of choice. If it continues, a digoxin infusion should give us sinus rhythm again or drop the ventricular rate, but that‘s much slower. If neither works, we’d need to look at other anti-arrhythmic agents or a DC conversion.’
A telephone call to one of the cardiology consultants led to a rapid instigation of treatment, but by the time Callum was showing a good response and his anxious parents had been soothed, Ryan and Holly were running late for their 9 a.m. theatre start time.
‘Slow down,’ Ryan complained as they made their way to the changing rooms adjacent to the operating theatre suite. ‘I’m not as young as I used to be.’
‘Neither am I.’ Holly threw a quick grin over her shoulder. ‘I turned thirty last week, you know.’
‘No, I didn’t know.’ Ryan quickened his pace to walk alongside her. ‘Hey, happy birthday—belatedly.’
‘Thanks.’
‘Was it a good party?’
‘I didn’t have a party,’ Holly said quickly. She certainly didn’t want to add to any unfortunate impression she might have given yesterday that she didn’t like Ryan enough to consider him a friend and therefore he hadn’t been invited to any party she had held. ‘I didn’t really feel like celebrating my slide into middle age.’
Ryan snorted. ‘I’m thirty-six,’he said indignantly, ‘and I don’t consider myself anywhere near middle-aged, thank you.’ He pushed open the door leading to the male side of the changing-room complex then paused. ‘Don’t you like parties?’ he asked curiously.
‘I like other people’s parties,’ Holly told him lightly. ‘Not mine.’ She grinned again. ‘That way, I don’t have to clean up the mess.’
Inside the changing room, Holly’s face stilled as she sighed. Why had she started that conversation in the first place? Reaching her fourth decade should have been worth celebrating. The trouble was, in her case she wasn’t just marking a significant milestone in the passage of time. It would have been more a celebration that her time hadn’t run out.
Yet.
Why hadn’t Holly wanted a party to celebrate such an important birthday?
She should have had candles and a cake and people around to let her know how special the day was. How special she was. Ryan wished he had known. He could have given her a hug even, without stepping over the boundaries he observed so carefully. He should have known, dammit. He must have seen or signed papers that had to have had the date on them often enough. Perhaps he was closer to being middle-aged than he suspected and was developing a selective memory.
Pulling on white rubber theatre boots, Ryan moved to the dispensing box on the wall of the changing room to pull out the disposable bootees to cover the boots’ soles. Then he plucked a hat and mask from adjoining boxes.
He was feeling older today. Older and wiser.
He’d gone about it all the wrong way and he’d tried so hard to do things just right, too. To keep it all on a kind of professional basis so that Holly would not be influenced by how strongly he felt about it all. Maybe he had tried too hard. He’d done such a good job of not taking advantage of his position of power and acting on any personal interest in Holly that she didn’t even consider him to be a friend.
That had hurt.
A lot.
Ryan’s attention to scrubbing his hands in preparation for surgery was always thorough but it was more vigorous than usual this morning after his registrar joined him at the basins. He welcomed the sting of the bristles on the tender flesh between the base of his fingers.
It was just as well Holly had no idea of the real reason for him making the offer of donating a kidney.
That he was in love with her. That part of his soul was sharing her physical deterioration and would, if she died, be lost for ever.
Boy, would that scare her off in a hurry! She didn’t want to be burdened by gratitude or guilt on a purely professional level. Imagine if she knew how he felt and took it the wrong way—thinking he might be trying to pull her into a closer relationship by offering such a valuable gift?
She would be appalled. Hell, she didn’t even consider him to be a friend.
But how could she not be aware of a bond that went so far past the normal interaction of a registrar and consultant? Had he been so good at hiding the gradual development of his feelings that Holly, and any onlookers, assumed they simply shared a passion for their work that made them inseparable during working hours?
It was entirely possible, Ryan realised as their case for the morning got under way. Their twelve-year-old male patient had had a congenital lesion of aortic stenosis treated by a balloon valvuloplasty in infancy but residual stenosis and incompetence had led to an increasingly severe degree of symptoms which meant it was no longer advisable to wait until growth had completely stopped before replacing the valve. Besides, young Daniel was also very keen to play rugby and strenuous activity had so far been denied him because of the risk of sudden death. If all went well with the new valve he was going to receive today, his life would change considerably for the better.
It was a technically challenging procedure due to the congenital malformation of the valve but Ryan was more than happy to keep up a running commentary and answer Holly’s eager queries.
‘We make the transverse aortotomy about fifteen millimetres above the level of the right coronary artery. We don’t want to be any lower because that can jeopardise the artery and create problems in seating the valve.’
‘What happens if you go higher?’
‘Not much. It’s easy to angle down and any lip can be retracted.’
That was typical of Holly. She had always demonstrated the ability to determine all possible alter
natives to any course of action and weigh up the potential consequences. She was sharp enough to do it almost instantly and it was a skill that would stand her in very good stead when she got to be a consultant surgeon herself.
If she got to be a consultant surgeon.
Given a technical problem, Ryan was confident that Holly could make a correct choice of an appropriate course of action. He spared a very fleeting moment of concentration to wonder why she couldn’t apply the same skill to a personal arena.
Maybe she would. Maybe Holly just needed some time to get used to the idea and if he didn’t push her she would be able to view it as an independent choice and find a way to get past what she saw as unacceptable potential consequences.
All he could do was wait. And hope. And help her to do what she wanted to do with her life as far as he was able or allowed to help.
‘You did such a good job on that patch yesterday, Holly,’ he said, when the more technical aspects of preparation had been completed. ‘How about tackling part of this prosthetic valve insertion?’
She was feeling a lot better today. The sparkle Ryan detected in the dark eyes that flashed up to meet his held no hint of any doubt in her own ability. Or any desire not to be given that level of responsibility. Holly was eager to spread her wings again and Ryan only too happy to support her.
As he always would be, given the chance.
Never mind anything too personal. As Ryan guided Holly through what was a new procedure for her, he was very aware of how much less satisfying his job would be without Holly to share his fascination in operating on what was, for them both, at the top of the list of the vital organs humans possessed.
There had to be a way to secure a future for Holly because Ryan didn’t want to even consider the alternative.
And he wouldn’t. Not yet.
CHAPTER THREE
‘MICHAELA! Hello, sweetheart!’
Holly’s intended destination, to visit Daniel who was back in the ward only three days after his aortic valve replacement, simply had to be postponed. Michaela Brown had never been one of Holly’s patients but the tiny thirteen-year-old was a favourite and sadly one of the most frequent inpatients in the cardiology ward.
There was an empty chair beside the one Michaela was using in the central corridor. Holly sat down on it.
‘What are you doing here?’
‘I had…to come back in.’ The blue tinge to the girl’s lips was obvious despite the nasal cannula leading to the portable oxygen cylinder on the floor beside her chair. ‘My kidneys aren’t…working so well.’
‘Oh.’ Holly’s face scrunched into lines of sympathy. Michaela’s heart failure had been getting less and less responsive to the raft of medication she was on. Renal failure could be a sign that they were getting near the end of the road but Holly had to squash her dismay before that could show on her face so she smiled instead. ‘That’s no good, hon. But what I meant was, why are you sitting all by yourself in the corridor?’
Michaela was never alone. At least one of her parents was always close by and her twin five-year-old sisters were devoted little shadows whenever possible. It had been the bond between the small, identical versions of Michaela and their big sister that had first attracted Holly’s attention a year ago but it hadn’t taken long to understand why this girl was the sun that the whole family orbited.
Huge blue eyes beneath a mop of golden curls gleamed with sheer joy in response to Holly’s query. It didn’t seem to matter that every breath was a struggle to provide oxygen to the inadequate level of circulation her failing heart could provide.
‘The twins are…making a surprise. I’m not…allowed to see.’ Michaela took several quick breaths and then lowered her voice. ‘I think it’s…a picnic…on my bed.’
Holly stood up and peeped through the small square window in the door to the nearest single room. Sure enough, two small girls were arranging paper plates holding bite-sized treats like fairy bread and grapes. Their mother, Robyn, was pouring soft drink into plastic cups.
‘Is it…a picnic?’
‘Not telling.’ Holly grinned and sat down again. ‘How’s school going?’
‘Good. I miss heaps, though.’
‘You’re more than smart enough to catch up. How’s Toby?’
‘He’s good, too. But I’m not riding…just now.’
Of course she wasn’t. Michaela had been a star junior rider in the pony club until a year ago. The rare complication of an ordinary viral illness had given her congestive cardiomyopathy—a dilated, floppy left ventricle incapable of pumping blood effectively.
Michaela had not come under Ryan’s surgical firm’s care because the only surgery that could help was a heart transplant. The cardiology team was doing its best to keep her alive in the hope of that happening, but the chance that Michaela could ever ride her beloved pony, Toby, again was slim at best.
Her pets had always been a favourite topic of conversation, however.
‘Does Toby still like eating jelly snakes?’
‘Yeah…I’ve got a…new kitten now.’
‘Oh, cute! What colour?’
‘Black.’
‘Girl or boy?’
‘Girl.’
‘What’s her name?’
‘Sooty.’ Michaela looked disgusted. ‘The twins…named it before they…gave her to me.’ Her face lit up again as a man approached. ‘Hi, Daddy!’
‘Hey, gorgeous.’ Michaela’s father was carrying a wicker basket with flaps, and Holly was as curious as the girl beside her. Wasn’t the picnic food already in Michaela’s room?
‘What’s…in the basket?’
‘Not telling.’ Don Brown looked stern. ‘It’s supposed to be a surprise.’
The faint mewing sound that followed his words led to a startled silence.
Michaela giggled. ‘You’re…busted, Dad.’
Don cast an anxious glance at Holly. ‘I’m breaking the rules, aren’t I?’
Holly stood up. ‘I didn’t hear a thing,’ she claimed. She winked at Michaela. ‘See you later. I hope you enjoy your lunch.’
Daniel’s lunchtime food and entertainment was a lot less inventive but the atmosphere around him was happy without the poignancy of Michaela’s case. His mother was pinning up pictures of Daniel’s heroes, the members of his favourite Auckland rugby team who were also part of the national All Blacks squad.
Sitting on the end of his bed, discussing the finer moments of the last match they had played, was Ryan.
‘And did you see that drop kick? Scott Grigg’s the man, isn’t he?’
‘He’s called Sox.’
‘Why?’ Holly hadn’t heard the popular rugby player’s nickname. ‘Because he has stinky feet?’
‘Please!’ Ryan’s look was as pitying as Daniel‘s. ‘We’re discussing the man of the match here.’
‘D’you know he’s only eighteen?’ Daniel twisted in bed to look up at the poster in prime position. ‘And he didn’t even start playing rugby until he was thirteen.’ He looked back at Ryan. ‘I’ll be able to start playing soon, won’t I?’
‘At the rate you’re recovering, it won’t be too long before you can get active, but we need to keep a good eye on you for a while yet.’
‘Will I get out of hospital in time to go to the next game? It’s in Auckland. I was too sick to go last time they played here.’
‘We’ll see what we can do,’ Ryan promised, before excusing himself. Outside Daniel’s room, he raised an eyebrow in Holly’s direction. ‘How are things in the unit?’
‘Grace is still running a bit of a temperature. Her white count is normal but there’s the possibility it’s some kind of infection. The medical team isn’t happy to clear her for surgery until they have more idea of what might be going on. Leo’s clear for surgery if you want to swap their slots tomorrow.’
Ryan nodded. ‘Let’s go and have a chat to his parents.’
They passed Michaela’s door and Ryan’s casual sideways glance made hi
m come to an abrupt halt. Holly stifled a giggle but the sound earned her a suspicious glance.
‘You know what’s going on in there, don’t you?’
She tried to look convincingly innocent. ‘Michaela’s back in. Sounds like things are deteriorating, unfortunately. She said something about her kidneys not functioning too well and…’
But Ryan didn’t appear to be listening. He grabbed Holly’s elbow and tugged it to pull her closer. It wasn’t until Holly co-operated, turned and spotted who was at the end of the corridor that she realised what Ryan was doing. The hospital’s CEO‘s personal assistant, a woman not noted for her sense of humour, was making visit to the ward. If she saw the additional visitor in Michaela’s room, the family picnic was unlikely to end on a very good note.
Both Ryan and Holly were quite tall enough to block any inadvertent view through the window in the closed door behind them.
‘What’s the creatinine level?’ Ryan then queried with uncharacteristic brusqueness.
Holly blinked. ‘Um…’
‘You’d better get on top of this, Holly.’ Ryan was frowning. ‘Deterioration in renal function is going to mean having to juggle anti-failure medication. Really, I’m surprised at you for not having the lab results available already.’
The tone, suggestive of a professional rebuke, earned Holly a similar frown from the passing administrator, but the woman clearly wasn’t going to interrupt such an exchange. Ryan waited until she was turning into the nurse manager’s office and then he smiled apologetically, turning to wave through the window.
‘Maybe you should suggest that the four-footed friend goes back in its box before the white witch returns.’ The remnants of his smile faded as he turned back to Holly. ‘The clock’s ticking a bit loudly in there, isn’t it?’ His face was sombre now. ‘I’ve got a quick phone call I really have to make, Holly. Meet you in Leo’s room in ten minutes?’
‘Sure.’
Ryan had turned away quickly enough for Holly not to have picked up anything personal in his glance, but it surfaced anyway as she let herself into Michaela’s room to join the picnic for a minute or two.
The Surgeon's Perfect Match Page 4
