Sheikh Surgeon

by Meredith Webber

  Kal shook his head, and smiled ruefully at Nell.

  ‘I knew it was a specialist field, but that’s common sense. I should have thought of it.’

  ‘You can’t think of everything, but now you know, I think you can start with this woman. She’s fit enough in herself to stand an anaesthetic and while you’ve got her under, you can take off all the burnt tissue, do a small graft from her arm to this area here above the knee. Because the knee needs flexibility, you’re better going with a full-thickness graft which has more elasticity. We use epinephrine and thrombin to control the bleeding from the donor site, and xeroform gauze and heat-lamp treatments to help heal the site.’

  Kal nodded and spoke to the woman again, then smiled at Nell.

  A smile shouldn’t make me feel as if the sun’s come out, she thought, especially here and now, but before she could pursue this reaction, he was questioning her again.

  ‘Now, if we’re taking all the burnt tissue off and only grafting that small area, what’s best to use on the rest of the wound?’

  ‘An allograft—false skin—or one of the new preparations that promote wound healing, or maybe, if it’s suitable, some of my spray-on skin.’

  She smiled at him.

  ‘You didn’t think I’d let you go into Theatre without me, did you? I’ll be with you and whatever other surgeons you can muster through this first op, though there are other things more important than surgery for me to do after that.’

  ‘Other things more important than surgery!’ he grumbled, and this time Nell’s reaction was one of remembered pleasure. She and Kal had worked well together all those years ago. It had been their shared dedication to the job that had brought them together—that and an attraction that Nell had never felt before.

  Or since, she admitted honestly to herself as Kal spoke again to their patient.

  A nurse was sent to get an anaesthetist and a young resident told to prepare the patient for surgery, while Nell moved on, seeing the rest of the patients in the special unit.

  ‘I know it was set up for this reason,’ she said to Yasmeen, ‘but you could hardly have expected to have to ever deal with this many burn-injured people at once.’

  Yasmeen told her about the oil fire and Nell understood that it was for a large-scale emergency Kal had started the unit.

  Just in time, as it had turned out…

  The patient she thought of as ‘her’ man was the last she saw. Tucked into a corner of the ward, with mobile equipment monitoring him, Nell almost cheered to see him still alive. But she forgot about cheering when she saw his respiratory function was still poor.

  ‘I’d like to do a fibre-optic bronchoscopy to check his upper respiratory tract, then a proper lung scan. There might be pockets of air trapped in his lungs by obstructions of some kind.’

  ‘I’ll arrange it,’ Yasmeen told her, giving orders in her own language, though Nell had realised by now that most of the staff spoke some English. ‘They must be ready for you in Theatre.’

  Nell glanced at her watch but, though she’d set it to local time on the flight, the time didn’t seem to mean anything to her. She’d work and then she’d sleep and eventually the days and nights would sort themselves out and her body clock would adjust itself.

  But as she was shown into the theatre area by a young nurse, and she saw Kal scrubbing up on the other side of the room, she wondered about his night and day—his body clock.

  ‘You haven’t slept—are you up to this?’ she demanded, and heard a gasp of what sounded like shock from the theatre sister who was holding out Kal’s gown.

  Kal turned and grinned at her, the smile lighting up his exhausted face.

  ‘You’ve shocked Sister Aboud,’ he chided. ‘Sister Aboud thinks very highly of me and would never speak to me like that.’

  Nell smiled at the sister, who was now looking extremely embarrassed.

  ‘When I knew him, he was a fellow student—a post-grad surgical nobody just like me,’ she explained, having known from the gasp the woman could understand English.

  But the woman didn’t seem appeased, and throughout the operation, which was watched by half a dozen other surgeons, she cast doubtful glances Nell’s way, as if wondering what the intruder was doing in her theatre.

  ‘Thanks,’ Kal said quietly, when they’d done all they could at the moment for the woman. ‘You’ve set me on the right track for future ops.’

  ‘Once the Spanish team gets here, you’ll have specialist burns surgeons,’ Nell reminded him. ‘But in the meantime, that’s enough for one day. If you don’t get some sleep, you’ll collapse on top of a patient and then he or she will sue for injuries sustained in hospital and—’

  Kal had pulled off his cap and mask and looked down at her, and the flow of light banter stopped, the words dried up by the expression in his eyes. They burned into hers, seeming to see past all her defences, deep, deep down into her soul.

  ‘I will go and sleep,’ he said quietly, ‘when I am satisfied all is well in my hospital.’

  Uh-oh! Nell thought as he swept away. Was I just put in my place?

  But ‘mind your own business’ hadn’t been the message in his eyes. That message had been personal.

  Scorchingly personal!

  At least he was gone and she could relax and do her job. She stripped off her theatre gear and headed back to the ward, ready to take up where she’d left off, but when she entered the procedures room, ready to insert a naso-gastric tube into a patient, Kal was there.

  ‘You need to sleep,’ she told him yet again, cross because, at a time when she needed to be fully focussed on her work, Kal’s presence was proving a distraction. Physically, because her skin burned—bad analogy—when he was near, and mentally because parts of her mind kept thinking of why she was there—the why that had nothing to do with the burns unit.

  ‘I’m a surgeon and I’m needed here,’ he snapped back. ‘Now, let’s get to work.’

  ‘Kal, there’s nothing the doctors here can’t handle at the moment. None of the other severely burned patients are well enough for major surgery. The rest of today’s jobs are medical, getting patients stabilised, working out their nutritional needs and starting tube feeding. Even those well enough to take food by mouth probably won’t be able to eat enough to take in the calories they need—we’re talking 3000 to 4000 calories a day. I need a dietician up here to work out their caloric intake and the individual formulas for each patient.’

  ‘Working on the weight of the patient and the severity of their burns?’ Kal said. ‘Do you use the total body surface area affected in the figuring of their requirements?’

  ‘Yes, it’s one of the most important factors, because the extent of the injury determines what the body is losing, particularly in protein.’

  ‘And the problems associated with tube feeding?’

  Was he testing her? He would know this stuff. She studied him for a moment before answering, but looking directly at him made her heart feel fluttery so she turned back to the patient on the table.

  ‘Aspiration’s the most dangerous—the head of the bed needs to be elevated at thirty degrees and gastric residuals measured frequently—then, too, the tube placement needs to be checked.’

  She managed a smile.

  ‘It will drive your head of nursing mad but I think these patients are going to need one-on-one nursing for some time to come.’

  Why was he testing her? Kal wished she hadn’t smiled. And how the blazes was he going to get the staff to provide one-on-one nursing for any length of time?

  He couldn’t think straight. He must be tired, but he wasn’t going to have Nell erupting back into his life and telling him what to do. Though he knew he’d be better off getting some sleep now, and working when she was sleeping. That way he didn’t have to go through an experience like the one he’d had in Theatre, where working next to her had been so distracting he’d wanted to swear long and hard.

  Which really would have shocked Sister Abou
d!

  ‘I’ll make sure we have the nurses,’ he said, dragging his mind back to the issue at hand. ‘There are two small private hospitals, mainly used by expats, and both have offered to lend us staff.’

  Nell smiled again, but he knew it was with the pleasure of knowing that the staff would be provided. Then the smile warmed as she ordered gently, ‘Go, Khalil. Go and sleep. By tomorrow we’ll have more patients well enough to begin excision and grafting, and once that starts it’s an ongoing process as we can only do small areas of burn every two to three days.’

  No one had ever said his name as Nell said it. Perhaps she was going through a mid-life crisis and was revisiting a lost love.

  Reviving a lost love?

  Renewing a lost love?

  Excitement soared as the falcon had soared, then dropped like a stone as he told himself not to be fanciful. Even if Nell was no longer married, she’d always known of his commitment to family and she’d certainly assume he was. Hadn’t he told her that’s how things worked in his country? One married for life. Sometimes more than once, that was allowable, but marriage was for ever.

  Most of the time!

  Nell worked through the day and into the night, with Yasmeen and with doctors she didn’t know, trying to keep patients alive being the first priority, stabilising them so they’d be well enough for surgery the second. At some stage Kal came back and ordered her to leave the ward, but when she returned the following morning and saw him there, dishevelled and unshaven, she knew he’d stayed on in her place.

  ‘Get some sleep,’ she said to him, realising from the way other staff treated him that no one else would dare tell him what to do, although she seemed to be making a habit of it. ‘You won’t be any use in the state you’re in, and there are other surgeons willing to work on any patient well enough for surgery. Skin grafting takes a clear head and a steady hand, Kal, and you’ve got neither at the moment.’

  For a moment she thought he was going to argue, but then he turned and walked away.

  ‘You know him from before?’ Yasmeen asked, having watched this small interchange with wonderment.

  ‘We met while he was studying in Australia. Out there he was just a fellow student, not the Grand Poo Bah or whatever he is here.’

  ‘He’s not a Poo Bah, or whatever you said, but a sheik,’ Yasmeen protested, and Nell regretted her attempted levity. Yasmeen had already demonstrated that she held Kal in some kind of awe. ‘His family, they’ve been our rulers for generations. It is unusual he became a doctor, but he’s a good doctor and he’s made the hospital what it is, insisting on the best of everything.’

  ‘He’s certainly got that,’ Nell agreed, but uneasiness stirred within her. She’d always known Kal’s family had some kind of standing in this country, although he’d never boasted about them in any way. It was something she’d guessed from his bearing and sometimes from his attitude.

  But the ruling family?

  Oh, hell! Would that complicate things?

  She didn’t need, or even particularly want, them to acknowledge Patrick, but she might one day want some of their bone marrow…

  Damn!

  ‘Dr Warren, could you come?’

  A young nurse drew her towards a patient with twenty per cent burns to his body.

  ‘Here!’ The nurse pointed, showing her a small area of redness near the patient’s thigh, the first sign of an infection.

  Thanking the woman, Nell turned her attention to the task of fighting this invader before it took over the man’s body. All thoughts of Kal and his family were forgotten…

  Chapter 3

  It was late afternoon, and she was unlocking her apartment when Kal emerged from his, refreshed from the sleep but more confused than ever about Nell.

  ‘Do you keep an apartment here because the hospital demands so much of your time?’ she asked. ‘Wouldn’t you have been better going home and having a proper break?’

  ‘This is my home,’ he said, looking into the eyes of the woman he’d thought he’d never see again, seeing the dark rims around the irises of her clear grey eyes and tiredness in the bloodshot whites. But the question wouldn’t wait any longer.

  ‘Why are you here, Nell?’

  She hesitated, just long enough for him to suspect she was going to fob him off.

  ‘I don’t want some tale about spray-on skin!’ he growled. ‘I want the truth.’

  The pale eyes pleaded with him.

  ‘I want to tell you, Kal,’ she whispered, what little colour there was in her face draining from it. ‘But now?’

  ‘Now!’ he said, listening to the voice in his head suggesting again that this woman was up to something, and ignoring common sense which reminded him that the hospital desperately needed her expertise.

  But she was antagonising him just by being here—making him want to touch her, to take her in his arms and hold her, remembering her body, kiss her, remembering her lips…

  ‘I need a coffee,’ she said, walking into her apartment but not shutting the door in his face.

  He followed her, and saw the bags and parcels strewn across the couch. He should at least let her unpack. And when was she going to eat?

  After she’s told me what’s going on—that’s when!

  ‘Coffee?’

  No smile accompanied the offer but that was just as well.

  ‘Please.’

  He didn’t smile either, but he watched her move as she filled the kettle, her litheness and economy of movement unchanged by the years they’d spent apart. He noticed her hands as she spooned instant coffee into mugs. No rings, but she’d just come from the ward and few staff wore rings at work as they could tear the fragile rubber gloves.

  She concentrated on the simple task, not looking at him, not even glancing up to ask him how he liked it.

  She pushed a cup towards him, then put sugar on the table.

  ‘There doesn’t appear to be any milk anywhere, but I don’t mind drinking it black.’

  He heard her speak but the anguish in her eyes suggested they weren’t the words she wanted to say, so he waited, sipping at his coffee. The old Nell would weigh things up, practise what she wanted to say, but usually, in the end, it would all come out in a rush, as if she was afraid if she stopped to sort the words into the practised order, she’d lose them.

  Her parting speech to him had been testimony to that. ‘I’ll love you for ever—that’s all I can say.’

  The words had burst from a throat constricted with tears, but the letter she’d pressed into his hands—a letter he’d read and reread on the trip home until it had fallen to pieces in his hands—had contained the rehearsed speech, with words like ‘always knew it couldn’t be for ever between us’ and ‘totally understand’ and ‘admire your loyalty and devotion to your family and your commitment to your promise’.

  He watched her struggle for a moment, then it came, a statement so abrupt he had trouble processing it.

  ‘We have a son.’

  There was a deafening silence before he could answer.

  ‘We have a son?’

  He knew the loudly spoken echo had been his—it was his voice—but the sentence still made no sense.

  ‘A boy. I was pregnant when you left. I didn’t know at the time and when I did find out I couldn’t tell you because you were going home to get married—you were probably already married by then. It was part of the bargain with your parents, and I couldn’t ruin that for you or have you torn between two loyalties or spoil your marriage with that kind of news, and I thought you’d never need to know—’

  Kal halted the flow of words the only way he could, by grabbing her shoulders and giving her a little shake.

  ‘Stop right there!’ he ordered. ‘Right now!’

  His voice was rising with his anger. No, his anger was rising much faster, hot and dangerous as the flow of new lava spewing from a volcano.

  ‘I have a son? You were pregnant and you didn’t tell me? By what right did you make that
decision? You, who knew my feelings about family! About blood ties! My son, and you kept him from me? How could you? How dared you?’

  Nell felt the heat of his rage burning through her T-shirt, as fierce as the flames she’d watched on her arrival. She stared into the furious face of the father of her son and imagined she could see a thousand generations of Bedouin warriors ranging behind him in defence of the family honour.

  ‘Kal—’ she began, anxious to explain—aware she’d made a hash of it. But he thrust her away, so roughly she had to catch the bench to stop from falling.

  ‘Kal!’ His name was a plaintive plea on her trembling lips, but he’d moved away, striding towards the door, though when he’d flung it open he turned back to glare at her, anger still reverberating in his deep voice as he spoke.

  ‘And where is he now, my son? If he’s stuck in some boarding school…’

  An unspoken threat hovered in the air, but Nell ignored it, desperate to calm things down so she could get to the really important part of this revelation.

  ‘He’s with my parents. We’ve always lived with them so they could be there for him while I worked.’

  ‘Which was, of course, important for your fulfillment, no doubt, and your self-esteem and all the other palaver you so-called liberated women go on about.’

  That was too much altogether for Nell. Forget calming him down.

  ‘I’d say at least half of the doctors I’ve met in your hospital are women, so don’t make this a women’s lib issue, Kal! I’ve worked to support my son, and to provide him with a good life.’

  ‘And I couldn’t have done that?’ Smooth as silk, his voice now—smooth and somehow scary. ‘Couldn’t have given him far more than your puny salary would ever have provided for him? And what’s his name, this son of mine? Warren, after some man you married to gratify your own desires?’