“A gripping contemporary tale told with a rare elegance. Captivating.”
C.F. Dunn, author of Fearful Symmetry
“Perfect blend of gritty life and romance. Engrossing!”
Carol A. Brown, author of Highly Sensitive
Text copyright © 2020 S.L. Russell
This edition copyright © 2020 Lion Hudson IP Limited
The right of S. L. Russell to be identified as the author of this work has been asserted by her in accordance with the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without permission in writing from the publisher.
Published by
Lion Hudson Limited
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ISBN 978 1 78264 303 6
e-ISBN 978 1 78264 304 3
First edition 2020
Acknowledgments
Scriptures quotations are from the Good News Bible © 1994 published by the Bible Societies/HarperCollins Publishers Ltd UK, Good News Bible© American Bible Society 1966, 1971, 1976, 1992. Used with permission.
A catalogue record for this book is available from the British Library
Cover images: both iStockphoto.com
(surgeon © andrei_r; knife © kunertus)
ACKNOWLEDGEMENTS
It’s been said before, but bears repetition: no book is the product of one mind alone. I am most grateful to my perceptive beta readers and my supportive family and friends, and for the skill, enthusiasm, and patience of the Lion team.
CONTENTS
Acknowledgements
Part One: Porton West
Part Two: Brant Lyon
Part Three: Roqueville
Part Four: Home
January 2016
PART ONE
PORTON WEST
Death is everywhere, and it makes me angry.
Those months when I couldn’t afford to live in the city, looking out of the bus window in the early morning, close-packed with other half-awake commuters – shoppers – whoever they were, with just the occasional cough or muttered word breaking the silence, I’d see slumped by the roadside a fox, or a rabbit, maybe even a badger. Something that had once had a purpose, however mysterious it might be to human understanding; something that had sight and hearing, could feel the wind in its pelt and food between its teeth, now pathetic in death, nothing but a broken body of no significance. I should be used to it by now – death – and I am, but I give my fury rein, because after all it’s that hatred of death that drives me.
I’d never admit to it – of course I wouldn’t – especially not to any of my colleagues. They’d raise their eyebrows and laugh. Do they feel it? Is it what drives them too, but they hide it for fear of ridicule, just as I do? Or is it just a job to them? Did they have it once, but now are fixated on their careers to the exclusion of all else? I don’t know. I hardly know them, and I don’t care to.
Of course I can’t win – not ultimately; I know that. I’m not so deranged or arrogant to think that I can make much of a difference at all, not when I look at the vast numbers of living creatures dying every day. Everything that breathes comes to an end, and so will I. That miraculous pumping organ on which we all depend will wear out eventually, even if there is no disaster. But I can work, one day at a time, cut by cut, stitch by stitch, and give someone a bit longer to live and breathe and love and laugh – or not, depending on their circumstances.
I know I can’t win the war. Death, with his scythe and grinning skull, always has the last word. But I can win a few of the battles. I can send a person out with the chance of a few more years of life. I can give the old tyrant something to think about. That’s what keeps me going.
I was never much of a speculative thinker. More of a practical person, which is as well in my work. If I were to give in to “what if?” thinking I’d be paralysed. These last months, though, I’ve found myself taking a long, hard look at things. Life. Myself. My motives. My choices.
I didn’t think in those terms that day, of course. I didn’t know then – how could I? – that my ordered world was about to crack open like a melon under a hatchet. But since then I’ve wondered what would have happened if I’d ignored the phone, which I often do on my day off. Would Malcolm have called on someone else? He said there wasn’t anyone, but that’s not true. Someone could have done the job. If they had, would everything have come out differently? Useless to wonder now. The fact is, I did pick up the phone. I expected it to be something to do with the hospital, but I wasn’t prepared for what came.
“Rachel? It’s Malcolm. I’m in A and E.”
“What? What’s up?”
I heard a sheepish laugh. “I fell off my bike. Just coming into the car park. A lorry was reversing, I swerved out of the way, must have hit an icy puddle. The bike’s a mess.”
I could feel myself frown. “What about you?”
“That’s just it. I’ve broken my arm – quite a nasty complex fracture. Must’ve fallen awkwardly.”
“Oh, Malcolm! What were you thinking of, riding your bike to work in January? Have they patched you up?”
“Yes, I’m in plaster.” He hesitated. “Rachel, you know I wouldn’t ask if there was any other way. I was due to do the Rawlins op on Monday, first on the list. The other things can be given to someone else, or postponed. But not this one.”
My frown was rapidly turning into a scowl. “Malcolm, I’m not a paediatric surgeon.”
“I know. But you’re the best choice, Rachel. Wesley’s in the Caribbean somewhere. Sefton’s got something infectious, and – this is off the record, by the way – Chan has put himself in rehab.”
“About time too,” I muttered.
“And,” Malcolm pursued, “Craig Rawlins is hardly a baby. He’s nearly thirteen.”
“And undersized.”
“Well, of course he’s undersized! So would you be, if you’d had his problems. Look, Rachel, he has to have this operation now. It can’t wait any longer. You know what a mission it’s been getting his mother to agree to it. And it’s his best hope of anything like a normal life. Or life at all, come to that.”
I exhaled loudly, making sure he’d hear. “All right, all right, I’ll do it. But you’ll need to brief me.”
“They’re bringing me home by ambulance, so there’ll be a wait. I should have time to get up to my office for the file. If you drive over to my place now you’ll be there before me. Bridget will find you something to eat, I’m sure.”
“Malcolm, did you fall on your head?”
“What? No, just my arm. They gave me all the scans – everything else is OK. Bruised to hell, but nothing worse. Why?”
“You’re not thinking straight. If I have to get my car out, I can take you home. You don’t have to wait for an ambulance.”
“You’re right.” He sounded slightly bewildered. “Perhaps it’s the shock.”
“Have you rung Bridget?”
“Not yet. She wasn’t expecting me home for hours, so she won’t be worried. I’ve spent ages ringing round for cover. Scuppered today’s clinics, obviously.”
“Don’t you have a secretary for all that?”
“Well, yes. She’s been ringing people too. Had to cancel some routine appointments, and there’ll be a few people having to wait a bit longer for their operations. But Craig Rawlins can’t wait.”
“All right, Malcolm – you win. Give me half an hour; I need a shower. Then I’ll drive over and you can bring me up to speed.”
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“Yes,” he said, sounding brighter. “We can go up to my office, and I’ll show you the latest angiograms. They’ll convince you if nothing else does.”
“Half an hour, then. And for goodness’ sake ring Bridget.”
“I will. Thanks, Rachel. You’re a good friend.”
Standing under pounding hot water ten minutes later I reflected that Malcolm and Bridget Harries were the nearest thing I had to friends at the hospital – despite their being quite a bit older than me – even after two years, four if you counted the time I was doing locum work to finance my PhD. He wasn’t exactly my boss; it didn’t work that way. I had my own patients, my own clinics, my own preferred teams. But as a professor at a respected teaching hospital he was certainly a senior colleague. He was where I planned to be in a few years’ time, if all went well. Unlike some, he treated me with professional courtesy and trusted my ability. The fact that I was a woman in a specialism dominated by men, many of them boorish sexist jerks, didn’t seem to make a jot of difference to him. I didn’t want to do the Rawlins surgery, but in a way it was flattering he’d asked me. As for Bridget, she did her best to mother me, for reasons I couldn’t fathom. She’d eye me up and down and complain I was too thin. I ate whatever she put in front of me, even though it didn’t seem to make me any fatter. I can cook – more camping cookery than haute cuisine, if I’m truthful – but I’d much rather not. So as I reversed my car out of its parking space that afternoon I was anticipating something hot and tasty when I got Malcolm home.
It was at least another two hours before we were on our way to the Harries’ place, because I wanted to have a handle on everything to do with Craig Rawlins’ case. Malcolm had talked about him, of course, and I had some idea of his background, but none of the details. If I was to operate on this boy in a few days’ time I needed every last morsel of information that was relevant. Malcolm copied sheets from the paper file and we studied the latest angiograms, taken only the week before.
“There’s an aneurysm forming here, I think.” He pointed to the image on his computer screen. “As well as the enormous one that practically hits you in the eye here.” He looked at me, the late afternoon sun glinting on his steel-framed glasses as he turned his head. “You can see why I’m concerned.”
“So these developments are relatively recent?”
He sighed and shook his head. “We’ve been keeping an eye on Craig for years,” he said. “You know he suffered considerable damage to his coronary arteries following that attack of Kawasaki’s he contracted at age four. Undiagnosed till too late.”
I nodded. This much I knew.
“Well, it was very much a watching brief until quite recently. Perhaps it’s something to do with his age, with the onset of puberty, because believe it or not he’s grown a bit over the past year. Perhaps he’s been exercising a bit of adolescent rebellion, doing what he wants instead of giving in meekly to his mother’s over-protectiveness. I don’t know. Whatever it is, his condition has worsened. If I’d been able to convince his mother of the urgency I’d have done the operation six months ago.”
“Why wouldn’t she agree? Couldn’t she see it was in his best interests?”
Malcolm shook his head. “You need to meet Eve Rawlins. She’s no ordinary mother. But to be fair, if she has a dim view of the medical profession you can hardly blame her. If that dull-witted GP had made the right diagnosis Craig wouldn’t be in this state now, teetering on a razor-edge, needing coronary artery bypass before he’s even a teenager, poor lad.”
“Kawasaki’s not something you see every day, though, is it?”
Malcolm shrugged. “It’s all academic now. Whether Craig gets his life back is down to you.”
I frowned. “And the rest of the team. It’s not just the cutter.”
“I know that, you know that. The public, generally speaking, tend to think the surgeon’s the hero – or the villain.”
We were silent for a few moments, thinking our own thoughts. Then I said, “You only ever mention Craig’s mother. Doesn’t he have a father?”
“Presumably so,” Malcolm said. “But it’s not a question I’m brave enough to ask. On that subject Eve Rawlins is fiercely private. Whatever the case, Dad’s not in the picture.” He glanced up at the window. “It’s getting dark. Let me print these bits and pieces off for you, and then we can go home.”
“Did you ring Bridget?”
“Yes. She says you must stay for dinner, if you’re free.”
“I was rather hoping she might say that.”
I laid down my fork. My hostess was sitting across the table from me, her own meal finished. Malcolm had gone to soak in the bath, trying to ease his aching joints and purpling bruises.
“Keep that plaster out of the water!” I told him.
“Yes, yes,” he muttered. “Don’t nag.”
I turned to Bridget. “You are a wonderful cook,” I said. “That was delicious.”
“Well, I think you need looking after,” Bridget said. ‘You work far too hard; I know you do. I don’t think you get enough sleep. And I always say you’re too thin.”
“I’m perfectly healthy,” I said, smiling at her. “I work long hours – we all do. But I love my work. I run most days. And I do eat, but it just gets used up. That’s how I am.”
She shook her head. “I worry you might – what’s the word? – burn out. People do, you know.”
“No need to worry. I thrive on pressure. And I don’t need mothering!”
“That’s a matter of opinion,” Bridget muttered. “From all I’ve heard, your mother’s not a lot of use.”
I laughed. “Not as a mother, that’s true. She wasn’t really cut out for it. She agreed to one child, grudgingly, just to please my dad. But even with Martin she wasn’t exactly hands-on. And I was an accident, as she never tired of reminding me.”
“Honestly! What a thing to say to your child! It’s amazing you had any confidence at all.”
“My father was as good as two parents, if not better,” I said quietly.
“I guess you must miss him.”
I shook my head. “Not any more. He’s been gone twenty-two years. But he’s the reason I’m where I am, doing what I do.”
She leaned forward, about to ask me more, but then we heard a faint yell from upstairs. “Hold on,” she said. She pushed her chair back and left the room. I took the opportunity of clearing the plates and stacking them in the dishwasher. A few moments later Bridget came back. “You needn’t have done that, Rachel!” she said. She seemed a little breathless.
“Is he OK?” I asked.
She laughed. “Yes, just couldn’t reach the towel. Helpless Harries.” She sat down again, sobering. “He’ll be out of commission for weeks, won’t he? What a good job he’s got you to do the Rawlins operation. I know he’s concerned about it.”
“It’s just a straightforward CABG, isn’t it?” I said, puzzled. “I do them all the time – admittedly on older patients.”
“As far as I can gather, it’s not so much the surgery as the circumstances,” Bridget said softly.
Malcolm poured himself a large brandy – medicinal, he called it, for shock. I declined. In his lamplit study, swathed in a huge velour dressing-gown in a startling shade of green, he sat at his desk, and I lounged in the one easy chair.
“Will I need to see Ms Rawlins and Craig before Monday, do you suppose?” I asked.
“It might be as well,” he said after a moment’s thought. “I’ll ring her this evening and tell her you’re doing it. Then I’ll let you know. But if you do meet her, Rachel, tread softly.”
“What do you mean?”
He took a deep breath, then exhaled loudly. “Well, she’s not the easiest. As I say, it took me some time and effort to get her to agree to the op. Now she seems to think I’m some kind of surgical angel, so she might balk at someone else carving up her son.”
I was beginning to feel slightly irritated by the whole scenario. I still wasn’t b
est pleased at being dropped in it. Perhaps I might have felt differently if it had been some kind of groundbreaking procedure, something needing imagination and ingenuity as well as concentration and manual dexterity. But replacing someone’s coronary arteries is bread and butter these days.
“Look, why don’t I ring her now?” Malcolm said. “While you’re here? Do you have your diary with you?”
I leaned down to where I had dumped my handbag on the floor. “Yes, I think so.”
“We can set up a meeting if she wants one.” He picked up the desk phone, dialled, and waited for what seemed a long time.
“Ms Rawlins? Malcolm Harries.”
I heard him explain what had happened. He made himself sound like an idiot for having an accident; it seemed to me that he bent over backwards to persuade her to accept me as her son’s surgeon. Surely it was me or no one, wasn’t it? Wasn’t her son’s life worth more than her ignorant prejudice? It was nice to hear Malcolm telling her how very competent and experienced I was, but I felt my pride raise its head and snarl. I wouldn’t have said so, but I was, even then, easily as good a surgeon as Malcolm, though I certainly didn’t have his bedside manner – or his benevolent teddy-bear appearance.
Eventually he said goodbye and hung up. He blew out his cheeks. “See what I mean? Anyway, she’d like to meet you, and it wouldn’t hurt for you to have a word with young Craig. He’ll be scared, poor little chap. She’ll be bringing him in on Saturday so they can keep an eye on him over the weekend. How are you fixed?”
I flicked the pages in my diary. “I’ve got clinics on Saturday. I could call in on the ward at lunchtime.” A thought struck me. “No, it’ll have to be later. I’ve got my monthly duty visit to my mother: ‘Two thirty and don’t be late, Rachel!’”
Malcolm chuckled. “A weekend of problematic mothers for you, I see. Later will be fine. I have no doubt Eve will be there right up to the point where they ask her, I hope politely, to leave.” He looked over at me, no doubt noting my raised eyebrows. “You don’t have children, Rachel,” he said gently. “I can put myself in Eve Rawlins’ shoes. I remember a few worrying times when our lads were young. And Craig, I suspect, is all she’s got.”
The Healing Knife Page 1
