He suddenly stood up and offered her his hand, the signal that their conversation was over, then leaned towards her and added conspiratorially, ‘Unofficially, Dr Langley, if I were you, I’d make sure you get as much sleep as you can, while you can. I’ve a feeling that your life is about to get very busy, very soon.’
Lily couldn’t wait to see Razak the next morning, desperate to find out if the decision had been formally announced.
She’d been almost too excited to sleep, in spite of their busy day, but when she’d contemplated calling the hospital switchboard to ask to be put in contact with him, she knew she was going too far.
Imagine what the hospital grapevine would make of that if it became common knowledge. It didn’t bear thinking about, especially as it would have looked as if she was chasing after him a couple of days after meeting him.
So, here she was, at least an hour early for her shift and waiting for him to appear so she could find out whether he’d been given the news. Deep inside she felt a quiver of excitement that she would be in at the start of something momentous, but until he said something to let her know that the decision had been made public, she was just going to have to bite her tongue.
The sound of hurried footsteps coming along the corridor towards the staffroom had her looking up eagerly, but then the door slammed back against the rack of pigeonholes behind it, narrowly missing her on the way, and she saw Reg Smythe framed in the doorway with a face like thunder.
For several seconds he stood and glared at her, looking as if he was about to explode, then, rather than speaking, he brushed angrily past her and snatched the bundle of post waiting in his slot.
One letter in particular took his attention and he ripped the envelope open with hands that were almost trembling with suppressed emotion.
‘It’s bloody nonsense, that’s what it is,’ he snarled, clearly unconcerned who heard him as he scanned the contents. ‘Wasting money, wasting resources…’
‘Lily! Have you heard?’ demanded Razak, suddenly appearing in front of her with a face wreathed in smiles. She’d been so focused on Reg’s display of bad temper that she hadn’t even realised that her immediate superior had entered the room.
‘Heard what?’ she asked automatically, as her heart gave a stupid leap in response to the man’s sheer vitality. His dark eyes were almost glittering with suppressed emotion.
‘As if you didn’t know,’ Reg sneered, as he crumpled the sheet of paper in one hand and flung it towards the bin. He didn’t even react to the fact that it didn’t make the distance, neither did he make any attempt to retrieve it. ‘No wonder you were in such a hurry to avoid a conversation with me last night. An appointment to sort out your paperwork? Ha! Scurrying off to toady up to your new boss is more like it. Well, you might live to regret that decision, my girl. You’ll find you’ve made the wrong choice when it gets to the end of his contract and no one wants you in their firm.’ And with that warning still bouncing off the walls around her, he stomped out of the room.
‘What on earth was that about?’ Razak demanded of the room at large.
‘Reg clearly isn’t a happy bunny,’ Colin offered wryly as he unfolded himself from a chair in the corner of the room. ‘So that must mean that the decision’s been made about your trial and you’ve got your way, but what it’s all got to do with your new colleague I have no idea. She hasn’t been here long enough to have any influence on the bean-counters.
‘Anyway,’ he continued, as he ambled across to retrieve his own post, ‘congratulations, if you have got the go-ahead, and the best of luck to you. I can’t say I’d ever want to work that way—too long in the tooth now to want to change my ways and hopefully too close to retirement for even the most eager bean-counter to try to force me to—but I’ll be interested to see how it goes.’
‘You’ve heard?’ Lily asked, needing to hear the decision in words of one syllable, although the question was totally redundant if Razak’s delighted expression was anything to go by. ‘Your trial has finally been approved?’
‘The committee chairman was waiting for me as I came in this morning,’ he said, surrounding her in an almost electric field of energy. ‘Apparently, it had been pointed out to him that the theatre suite was almost finished and we would need some lead-in time to get everything organised for the first surgeries. So…’ He took her arm in a gentle hold that belied the strength she knew he could use when needed, and led her to the opposite side of the room where there was some semblance of privacy.
Lily worried for a moment that he’d somehow found out that she had been the first one to have received the heavy hint that the decision had been made in his favour, afraid that he was about to demand why she hadn’t found some way to let him know.
‘I need to know if you’re likely to change your mind,’ he demanded bluntly, his gaze direct and uncompromising. ‘You must have given it some thought since I explained what was going on. You already know that it’ll mean long hours in a high-pressure experimental situation, but after that…’ He gestured towards the door that had closed in Reg’s wake. ‘If you decide that it might be too much of a threat to your career to be associated with something so unpopular with the head of department…that it isn’t right for you…’
‘What on earth gave you the idea that I would be so indecisive?’she challenged, quite shocked that he would think it of her. ‘I’ve had to fight every step of the way to get this far and unless you think I’m not up to the job, wild horses wouldn’t drag me away. This is the sort of experiment that could actually do wonders for my career, to say nothing of the numbers of patients it could benefit.’
‘There is also the sheer volume of experience you would amass in a relatively short period of time,’ he pointed out, and she suddenly realised that this might be one of the reasons why he was so keen for the new regime to succeed. If he was leaving in a matter of months, it could be that he already had a more senior post lined up. In that case, the prospect of heading up such an innovative speciality within a specialty would stand him in equally good stead.
‘So, have we got a firm date so we can get everything organised?’ she demanded eagerly. ‘How much longer are we going to have to wait before the suite will be signed off as fully equipped and ready?’
‘I have a meeting at—’ He got no further as his pager shrilled sharply. ‘A and E,’ he muttered, after retrieving it from his waist. He reached for the phone and Lily found herself holding her breath as she tried to hear what the voice on the other end of the line was saying.
Whatever it was, it must have been something horrific if the expression on Razak’s face was anything to go by.
‘Get on to the theatre manager and find out how soon there will be a table free,’ he demanded, as soon as he put the phone down. She had to stride out to keep up with him as he set off at his usual cracking pace, his brain obviously working at the speed of light if the list of orders was anything to go by. She just hoped that she would be able to read her writing when the time came to decipher her hurried notes.
She had no idea yet how the incoming patient had amassed his injuries but already the paramedics had warned them that he had impacted fractures of both ankles, possible damage to his knees, hips and spine and severe trauma to his neck.
‘We’ll need ultrasound to check the circulation into his extremities. I’ll let you know as soon as I can whether we’ll need microsurgery for tendons and blood vessels. Can you check how long it will be if we need a CT scan and/or an MRI? I’ve no idea whether Plastics will need to be involved. I’ll let you know when I see him.’ The last words emerged just as the door swung shut behind him as he set off at full tilt down the stairs, obviously not wanting to risk a wait for a lift.
The next half an hour would have been a nightmare if the hospital hadn’t recently seen sense and lifted its out-of-date ban on mobile phones. As it was, when the patient, Simon Bullen, left A and E, it was to go straight to the head of the queue for a CT scan, and by the time he w
as wheeled into Theatre the results of that and the full array of X-rays were on display.
Also ready and waiting was a full team of theatre personnel, half of whom had only just finished a busy night on call, and the fact that every one of them had seemed only too eager to work with Razak spoke volumes about the respect they had for him. In fact, the more she thought about it, the more she realised that, in spite of the relatively short time he’d been working there, he’d obviously impressed even some of those who’d been employed in the hospital for years.
The gleam in the women’s eyes when they watched him stride into the room, his gloved hands held up and away from any chance of contamination, could be taken for another sort of eagerness. But that certainly wasn’t the case with the anaesthetist, who’d willingly stayed on in spite of having only just finished a shift. Tim, it seemed, was one of Razak’s more ardent supporters in his attempts to reorganise their operating methods.
‘Ready when you are,’ Tim called from his station. ‘He’s stable for the moment, but I’d be grateful if you could get in there and stop some of that blood loss pretty soon or, as fast as I’m pushing the fluids in, he’ll go into hypovolaemic shock.’
‘What on earth did he do to himself?’ Lily demanded in shock when she got her first good look at the pictures lined up along the view boxes. ‘Tib and fib in both ankles, both femurs, three lumbar vertebrae with compression fractures, two cervical vertebrae with avulsion fractures and his right humerus shattered just above the elbow joint.’
‘The paramedics said it’s a failed attempt at hanging himself,’ Tim said over the sounds of the various items of monitoring equipment that surrounded him, obviously following everything going on in the theatre even though his eyes were focussed on his dials. ‘Apparently, he climbed up into his roof and tied a rope to the rafters then climbed down and jumped off the top of the stairs.’
‘And?’ prompted one of the nurses in tones of horrified fascination.
‘And the rope broke,’ Tim finished almost ghoulishly, prompting a round of groans and half-hidden winces.
‘That explains everything except the broken humerus,’ said the scrub nurse from the other side of the table.
‘Hit the banister on the way down?’ Lily suggested, the picture only too clear in her mind. With the man landing feet first from such a height, it was small wonder that his ankles, femurs and lumbar vertebrae had been fractured. It was a common set of injuries when parachutes failed to open. The gruesome part, to her way of thinking, were the avulsion fractures caused before the rope had broken. The man had literally broken his neck and survived—so far.
‘Where are we going to start?’ she asked Razak, as she compiled a tentative list in her own head.
‘Well, his neck’s going to need Colin’s skills to stabilise it, and he’ll be in Theatre with his own patient for at least another hour. Luckily, that’s relatively stable with the collar on. The CT scan of his head is good and there were no apparent visceral injuries on the ultrasound. So, at the moment, the most pressing thing is the blood loss into that thigh, so let’s get moving, please.’
They all knew, without Razak having to say any more, that the blood loss into the surrounding tissues after such a break could be life-threatening.
‘Peripheral pulses have gone,’ warned Tim, as Razak began his initial incision, letting them know that their patient must have already lost approximately thirty per cent of his total blood volume. There was very little blood loss evident on the outside of his body so that left the scenario of profuse bleeding somewhere inside and Lily was glad that she’d ordered plenty of replacement fluids.
They definitely couldn’t wait for the arrival of the specifically cross-matched supplies—as it was, it looked as if they were going to use all of the O negative before it came. In the meantime, she was hard-pressed to keep up with Razak’s lightning-fast decisions once the shattered femur was exposed, more impressed than ever by the way he could seem so cool and calm in such a high-risk situation.
CHAPTER FOUR
RAZAK had long ago learned what was meant when someone was said to ‘raise their game’ but he’d never seen such a prime example until today.
If he hadn’t seen a copy of Lily’s CV detailing her relative inexperience as a surgeon, he would never have guessed it. At every stage of their complicated task, from finding and isolating a shredded vein in the man’s thigh and clamping it, ready for the vascular surgeon to repair, to taking over the management of one of the ankle fractures entirely, she was very impressive.
Both legs had suffered fractures of the tibia and fibula and would require screwing and pinning of the medial malleolus and plating of the tibia to restore mobility and reduce the severity of traumatic arthritis, but with the patient already stressed by the length of time he’d been on the table, Razak been wondering just how he was going to manage to effect the repairs in a reasonable length of time.
‘Do you want me to begin on his other ankle?’ Lily had suggested quietly, as soon as the surgical site on the thigh had been satisfactorily closed. Colin had been and gone, leaving the patient’s head and neck enclosed in the cage of metal that would prevent any movement in his spine while his fractured vertebrae healed, and the vascular surgeon had gone to join one of the Plastics team who had the unenviable job of trying to piece together an arm that had gone through a plate-glass window.
Razak looked up from the complicated jigsaw of broken bones that he was trying to piece together and was almost taken aback by the calm confidence in those cool grey-blue eyes.
He dragged his eyes away for another analytical look at the X-rays of the other limb before meeting her gaze again.
‘Have you done a Steinmann pin unassisted before?’ he challenged, and saw one slender eyebrow lift briefly.
‘Once,’ she admitted honestly. ‘Closely supervised.’
‘Well, they do joke that learning surgery is a matter of see one, do one, teach one, don’t they?’ he said wryly. Then he gave a nod of permission. ‘But tell me if you start to have any problems.’
‘Of course,’ she said quietly, but he’d heard the edge of excitement in her voice that told him she was eager for the new challenge.
In the event, she had no problems at all, her handiwork meticulous as she positioned the broken segment of the fibula and held it with just the right number of screws through the slim plate she’d angled to fit precisely. The screw and Steinmann pin needed to relocate the segment that had been broken off the tibia were a little more complicated, but only because both of them were trying to work in the same limited space.
Even so, her concentration on the job in hand seemed to be much better than his own, his thoughts jolted by every inadvertent brush of her willowy body against his, her slender arm or the curve of her hip. It was both a relief and a disappointment when he finished his work on the man’s ankle and moved away from her to work on the damaged elbow. Then, with all the procedures completed, she straightened up and met his gaze and he realised that the distraction might not have been one-sided.
She tried to hide it, tearing her eyes away from his and quickly hurrying into speech, but when he saw the soft bloom of colour spreading up her throat from the loose V of the faded green scrub top and into her cheeks and registered the tell-tale urgency of her pulse in the side of her slender throat, he knew.
‘Good work,’ Tim pronounced in satisfied tones, and snapped Razak out of his crazy preoccupation.
What on earth was he thinking? No matter how beautiful or how alluring she was, the woman was a junior colleague. He would be leaving himself open to all sorts of accusations if he were to make any advances. He certainly didn’t want to go back to his own country with a suit for sexual harassment hanging over him.
‘How are his vital signs?’ he demanded, hoping no one else could hear the revealing roughness in his voice. Gossip was something else he could do without.
‘He’s a hell of a lot more stable than he was when he got here,’ Tim
said wryly. ‘In fact, now that you’ve got all the hardware installed, he’s almost perfect…until he tries it again.’
That was enough to sober them all up from the heady feeling at the end of successful surgery.
‘Do you really think he’ll try to hang himself again?’ Lily gasped, clearly horrified by the idea.
Tim gave a slightly hollow laugh. ‘I doubt he’d try the same method again—at least, not with the same rope.’
‘Tim! That’s enough!’ warned one of the more senior theatre nurses. ‘You really are a gruesome man.’
‘Unfortunately, he may be right,’ Razak said, resigned to the foibles of his fellow man. ‘It doesn’t matter how long we take to put him back together, if he’s determined to end his life, sooner or later he will succeed.’
For a moment it looked as if Lily was going to add something to the conversation but, unaware that he was watching her, she shook her head and briefly rested one gloved hand on the man’s shoulder in a gesture that almost looked like a benediction.
Even as he watched her strip her gloves off and lob the neat package into the bin he could see that she was preoccupied and somehow knew that, at some stage, she would make a point of going up to the ward to visit the man. It was unlikely that her effort would make any difference to the eventual outcome, but…but it was exactly what he’d intended doing, too.
He felt a strange shiver travel the length of his spine at the thought that they might have more than their love of surgery in common. So many of his colleagues seemed quite content to do an operation to the best of their ability while keeping a clinical distance between themselves and the person on the table. Did he and Lily share the same very different attitude?
Then he realised just how far his thoughts had strayed from the job in hand and he deliberately wiped away all such extraneous thoughts. He had a critically ill patient to check up on, and wasting his time on frivolous thoughts of his far-too-beautiful colleague definitely wasn’t on his agenda.
Sheikh Surgeon, Surprise Bride Page 5
