He looked down into the cot. Megan was lying on her side, one thumb pressed hard into her mouth. She wasn’t asleep. But …
She was quiet. She was oddly still. First rule for care of children. Worry about the quiet ones.
And she looked so small. Malnourished? Probably. The cigarette burn on her hand looked stark and raw, and once again his gut clenched in anger.
No. Put emotion away. He was there for a reason.
‘How’s her mother?’ he asked, still watching the little girl. They’d called him for something and he needed to figure out what. He was switching into professional mode, checking visually with care. Yesterday Megan had seemed lethargic. This morning he’d have expected her to be brighter. But she seemed apathetic. When he put his hand down in front of her eyes she blinked but didn’t otherwise respond.
Hell.
‘Lizzie’s good,’ Georgie said softly into the stillness. She was watching Megan’s reactions as well. ‘She’s even managed a little breakfast. We’ve put Davy and Dottie into the ward beside her so they can see her as she sleeps, and she’s a hundred per cent better than yesterday. Certainly she’s out of danger. And so is Thomas.’
This was the benefit of a country hospital, Alistair thought. To combine medicine with family … It’d be great to be able to do these things.
‘But you’re worried about this little one,’ he said.
‘We are.’
‘Tell me all you know.’
‘It’s not a lot but it’s more than yesterday. Damn, we should have picked this up on admission.’ Charles’ words were almost a growl as he wheeled away from the cot to bring an X-ray back from the desk. He handed it to Alistair without a word.
Silence.
The X-ray showed the little girl’s skull. With damage. The fracture was only hairline—no worse than the fracture of Georgie’s cheek. But under Georgie’s fracture lay muscle which could bear damage. Under Megan’s skull fracture lay her fragile brain. Internal bleeding would be a catastrophe.
Internal bleeding may well be causing the symptoms they were worried about.
‘Can I check?’ he asked at last, and got three sharp nods for assent.
He crossed to the sinks and washed, carefully. Megan had survived the squalid circumstances of the hut. There was no way Alistair was risking infection now.
What infections did chicken bones carry? He washed twice as diligently as he normally did, and then he washed again.
Then he examined her. Cal left them, obviously needing to be elsewhere, but Georgie and Charles stayed. He ignored them. Instead, he talked to Megan, explaining gently that he was looking at her head, trying to find what was hurting her, trying to find a way to make her feel better. He wasn’t sure that she was taking in anything.
He could see no retinal haemorrhage. That had to be a good sign. There was no obvious swelling.
‘No fever?’ he asked.
‘No,’ Georgie whispered. ‘But … Charles didn’t like the look of her. It was more on a hunch than anything that we did the X-ray.’
‘Good hunch.’
‘Which is when we bailed out and called you,’ Charles said.
‘Do we have the facility to do a CT scan?’
‘Our radiotherapist is on his way in,’ Charles told him. ‘He’s boarding up his mother’s windows or he’d be here now.’
‘Send someone else to board windows. I want him here now,’ Alistair snapped. He closed his eyes, thinking things through. But his decision was inevitable. ‘This little one was talking and responding normally last night. The provisional diagnosis is that she’s bleeding internally, but slowly. If I’m right then we get in there now to try to stop lasting damage. There’s no choice.’
We? Him.
He was under no illusion as to why Georgie had called him. He was a neurosurgeon.
But here …
He wanted a major city hospital. He wanted MRI scans. He wanted …
‘We can’t fly her out,’ Charles said, sounding apologetic. ‘Even by road we’re starting to get worried. We’ve had a couple of big trees come down already, and the road’s getting dangerous. They’re saying it’s worse down south—not better. With this level of wind it might be a few days before we can evacuate.’
‘But we can’t wait,’ Georgie said. She looked terrified, he thought. She looked a far cry from the cocky, gum-chewing, bike-riding Georgie who’d greeted him at the airport yesterday. This morning she was wearing a professional white coat over jeans, T-shirt and sandals. Her sandals were crimson, matching her toenails. There were little gold crescent moons on each toenail. Despite her bruising, she’d gone to some trouble with her make-up—her lips matched her toenails.
There were traces of yesterday’s Georgie left, but she looked young, vulnerable and afraid.
How could he ever have thought she was a tart?
‘I don’t want her brain damaged,’ she said fiercely. ‘I’ll operate myself if I have to.’
She knew what the score was. Internal bleeding could cause—would cause—irreparable damage. The only option was to operate to relieve pressure, a tricky operation at the best of times, but here …
‘You’re not doing anything while we have Alistair. Gina says you’re good,’ Charles said grimly.
‘Let’s run a CAT scan first,’ he said. ‘I’m not doing anything on the basis of one X-ray. I don’t have a clue where the bleeding is. We need to get a definitive diagnosis and I’m not moving without it. And then I need the equipment.’
‘I suspect we have most of what you need,’ Charles told him. ‘Many of our indigenous people refuse to go elsewhere for treatment so if someone’s available, we fly in specialists and they operate here. We’ve had a couple of neurosurgeons who’ve done locum work here, and they’ve set up a store of surgical equipment. If you weren’t here, I’d have to ask Cal to do it. But he’s a general surgeon. He doesn’t have your level of expertise.’
‘He’d still do it,’ Georgie said bluntly. ‘Will you?’
And the thing was decided. ‘Of course,’ he said. ‘OK, get this radiologist here now. I’ll check the scans, the equipment and the personnel available, and then we go. Let’s move.’
If anything could take Georgie’s mind off Max, this was it. Urgent, lifesaving surgery.
It had to be done. The CT—computerised tomography—scan showed very clearly a build-up of fluid, and when they shaved Megan’s hair they could see swelling. Not huge swelling, but it was there.
Then there was a swift family conference. Lizzie was exhausted, but fully conscious and aware. She was appalled at what was happening to her daughter—but at first she couldn’t believe Smiley would have done such a thing.
But the evidence was irrefutable. The white-faced woman held Davy’s hand and trembled while Davy answered Georgie’s questions.
‘It was when Megan was hungry and Mummy was asleep,’ Davy said, faltering. ‘Megan started crying. Dad burned her with his cigarette and then when she wouldn’t stop he hit her hard against the wall.’
For a moment Lizzie looked like she was about to pass out, but then anger took over and by the time Georgie explained exactly what the problem was, it was just as well Smiley was safely locked up.
‘Just save her for me,’ Lizzie said, close to tears. ‘I swear he’ll never lay a finger on her again but, please, Georgie, make her well.’
‘We have Alistair,’ Georgie said, and felt an almost overwhelming relief that this skilled surgeon was right here, right now.
She returned to Theatre to find everything was in place. Alistair examined Megan once more and then he nodded.
‘We have no choice. We go in now or brain damage’s inevitable. As it is …’
‘I should have picked it up yesterday,’ Georgie repeated, immeasurably distressed.
‘There were no signs yesterday. All her symptoms could be explained by dehydration. They probably were caused by dehydration. I’m thinking this bleeding’s gradual and slow, so we mig
ht be in time. There’s no need to punish yourself over it.’
‘So stop blaming yourself,’ Charles told her. ‘That’s Georgie’s specialty,’ he told Alistair. ‘She takes on the problems of the world and makes them her own.’
‘Well, you’re not on your own here,’ Alistair said. ‘Lizzie’s OK’d the operation? If she approves, we go in.’
‘We shouldn’t ask you. You’re not covered by insurance or medical indemnity,’ Charles reminded him.
‘But you are asking, right?’
‘I guess we are,’ Charles said, and managed a smile.
‘But Lizzie wouldn’t sue,’ Georgie said, horrified.
‘Smiley might,’ Charles said.
‘Alistair won’t care,’ Georgie said roundly, and Alistair met her look and held it.
‘God knows, I have no taste for heroic surgery,’ he said bluntly. ‘I’d like a skilled paediatric surgical team on this one, but we make do with what we’ve got.’
‘Maybe you’d better put your suit on first,’ Georgie said faintly.
‘Suit?’
‘It makes you look clever,’ she told him. ‘Shorts and sandals don’t cut it in the clever stakes and I want you to be clever.’
‘So no stilettos, Dr Turner?’
She managed a shaky smile. ‘No stilettos. Megan is too important.’
And after that there was no time to think of anything. There was certainly no time for Alistair to don his suit—he put on operating gear over his shorts and left it at that. Emily was called away from her hair appointment to perform the anaesthetic. Yes, this afternoon she planned to be a bride but ‘I’ve got hours and hours and how long does it take to put on a dress?’ Cal assisted Alistair and Georgie assisted Cal. Four doctors, three nurses and they were all needed.
That they all knew what to do was a testament to Alistair’s skill. ‘He does a lot of teaching,’ Gina had told Georgie, and she believed her. For not only did Alistair’s fingers move with skill and precision, knowing exactly what he was doing, improvising for any equipment he couldn’t find with a dexterity that left her awed, he also seemed to know exactly what everyone else in Theatre was doing—where every person needed to be moments before they needed to be there.
His soft orders filled the room, and under his commands they worked as a team that a major teaching hospital could be proud of.
The procedure sounded straightforward enough, but what looked straightforward in textbooks was technical surgery of the most challenging kind. First he needed to lift a piece of Megan’s small skull, working with infinite precision, aware that any false movement would aggravate the bleed. Then he worked carefully through the dura mater—the tough membrane around the brain—carefully separating the dura to locate the subdural clot causing the swelling.
After that he had to evacuate the haematoma and make sure there was no further bleeding from ruptured blood vessels. The skill lay in causing no more damage. This tiny brain was still developing. Any fractional miscalculation could have consequences for life.
Alistair worked as if this were a normal, everyday procedure. His demeanour was calm and methodical, as if this was nothing more serious than an inflamed appendix. But so much hung on his skill. OK, Cal would have tried to do this alone if Alistair hadn’t been there, but as a general surgeon Georgie knew his chances at succeeding would have been much less. If all the bleeding vessels weren’t located, the damage would continue.
Georgie knew instinctively that neither of these things would happen after Alistair had operated. This man was just too competent.
Too competent for his own good? Ego driven? Maybe, she thought, but now wasn’t the time to quibble about egos. He could be as egocentric as he liked, as long as he saved Megan.
And gradually it seemed that the combined skill of Alistair and Cal might do it. Hopefully they’d caught it in time. Hopefully there’d be no damage and Megan would grow up to be a normal, healthy kid like her brothers and sister.
Thanks mostly to Alistair. Georgie worked on with quiet competence, but inside she felt like weeping. They were so lucky this man was there. And to think she’d nearly abandoned him in the heat.
‘Yeah, you still owe me for that,’ Alistair said, as Cal carefully suctioned the wound, and she jerked her head up to meet his eyes.
The toad was smiling.
‘You didn’t want—’
‘And you figured that was exactly what I’d do.’
‘What are you guys talking about?’ Emily queried, and to her fury Georgie felt herself blushing. She turned back to her tray of equipment, thinking, Dammit, did the man have a mind-reader on board?
He scared her witless.
But he was saving Megan.
Maybe he’d already saved her. The worst of the damage had been cleared. Now he waited patiently, taking his time, watching carefully for any ongoing haemorrhage. Then, satisfied that the area was dry, he began the laborious task of suturing the dura and reattaching the bone.
He left nothing to chance. His fingers were so skilful Georgie could only watch in awe. Hand him equipment as it was needed. Try to anticipate his needs. Marvel at the skill of the procedure she was watching.
Finally he moved on to the superficial sutures. Even that wasn’t straightforward. For such surgery a specialist unit would have ready-made staples, but here Alistair could only suture, and the results of his suturing now would mean the difference between major scarring or whether Megan could wear her hair any way she liked as she grew up. Maybe such scarring didn’t matter so much in the greater scheme of things—he was well within his rights to hand over to Cal for this last step—but Georgie could tell by Alistair’s fierce concentration that he knew what scars could mean to a young woman. He was thinking forward to Megan’s life after this surgery.
He cared.
There would be minimal scarring from this man’s work today, she thought as he worked on. For a surgeon already weary from such an intense procedure, his sutures were flawless.
And then, finally, he could relax. They could all relax. Finally Georgie could hand over dressings, he could fit them over the child’s neat wound and he and Cal could step back from the table.
‘We’ll need a further CT scan in a few days but it’s looking good,’ he breathed.
Only then did Georgie notice a trickle of sweat running down his face. The release of pressure … He’d held himself contained, until now.
There were advantages to being a control freak, she thought, but suddenly she was far from being in control herself. She was suddenly shaking. She stepped back from the table and leaned hard against the wall.
‘Cal,’ Alistair said urgently, and Cal was by her side, pressing her onto a nearby stool, pushing her head between her knees.
‘I’m not fainting,’ she protested weakly, for that was exactly what her body felt like doing. ‘I never faint. Go back.’
‘You’ve excuse enough to faint if you feel like it,’ Alistair growled. ‘Take her out, Cal. We’re done here.’
‘But we’ve succeeded,’ Georgie whispered, and Alistair allowed himself the luxury of a smile.
‘Yeah. We’ve succeeded. With a little luck—but not much, because this is as fine a job as any I’ve seen in major US teaching hospitals, and you picked it up so early that it’s my guess she’ll end up with nothing to show for this morning’s dramas but a tiny scar.’
Georgie didn’t answer. She couldn’t. Why was she shaking now?
It was the bruised cheek and the drama of yesterday, she told herself, though she knew it was no such thing. It was a mixture of all sorts of stuff, not the least the way she was feeling about the man at the operating table.
He was way out of her league, but he was so …
‘Go,’ he said gruffly, and she looked up and her eyes met his. A silent message passed between them. Unmistakable. Go on. You’ve done well here. Look after yourself.
It wasn’t said out loud but it may as well have been.
Why it mad
e her eyes well with tears …
She didn’t cry. She never cried. She wiped her eyes with an angry swipe and stood up. Once more she had to grab for the wall for support.
‘Take her, Cal.’
Alistair sounded as if he wanted to take her himself, she thought, but maybe that was just wishful thinking on her part.
She glanced at him again. Once more that look …
She had to get out of there.
She went.
He found her twenty minutes later. Transferring a small child from the operating table to a bed in Intensive Care sounded on the surface an easy thing to do, but the attached tubing, monitors and assorted medical paraphernalia were complex. At this stage nothing was to be left to chance. Alistair had supervised it all. Finally free, with Cal doing the first shift of ICU watch, he went to do what every surgeon must. He went to tell the family.
Lizzie.
This woman had been living a nightmare. Hopefully now the nightmare would lift.
He pushed open the door to her ward and Georgie was there. Of course. And Davy. The six-year-old was sitting on the bed with his mother while Georgie was talking to them both.
‘I thought I told you to go to bed,’ he growled, and Georgie smiled at him.
‘No. You just told me to go away.’
‘I meant you to go to bed.’
‘You’re not my doctor—sir.’ She was still smiling.
‘My Megan is going to be all right?’ Lizzie whispered. ‘Georgie says she should …’
‘She’s not completely out of danger yet,’ Alistair said, knowing there was no point in being less than honest. ‘But the outlook is good.’
‘Georgie’s explained it to me,’ Lizzie said. ‘So I know.’
‘It’s great,’ he said softly, smiling at Georgie, and she smiled back. The shaking had stopped. She’d regained a bit of colour. Basically back to normal?
Except for one smashed cheek and one missing kid brother.
‘And I know what happened to Georgie’s face,’ Lizzie continued. Lizzie’s strength was returning as the antibiotics took hold. Antibiotics had been flowing for twenty-four hours now, knocking the infection, and the difference was amazing. ‘I hardly noticed her face this morning but now I have, and the police have been in to get my statement. But they said Smiley’s going to jail, no matter what I say, so I may as well be truthful. It didn’t make sense but then I saw Georgie’s face. I really saw …’
The Australian's Desire (Mills & Boon By Request) Page 7
