So it was a chest injury and there was fluid—probably blood—collecting around the child’s heart. It was obvious that emergency surgery could well be needed.
The lift doors closed in front of them.
‘Have we got a theatre available?’
‘Yes. That was organised as soon as we got the call about the transfer. Apparently there wasn’t anybody available in Glasgow for emergency chest surgery and we were going to page Colin but somebody said they’d seen you here earlier so I checked your office first.’ Elise smiled up at Luke. ‘If it was my kid, I’d want you to be looking after him.’
The compliment regarding his abilities as a paediatric trauma surgeon had a bitter-sweet edge for Luke as he recalled the moment of doubt he’d experienced only minutes ago. He put everything into his work and continued to strive towards being even better at his job—but was it at the expense of so many other things that life could offer?
The doors opened on the ground floor and they both headed past a busy reception and waiting area, through the emergency department and out through the automatic doors that led to the ambulance bay.
Only a minute later, they could hear the siren of an approaching ambulance and then it came into view. The siren was switched off but the beacons were still flashing as it stopped and then swiftly reversed towards the edge of the loading bay.
Luke could feel his adrenaline levels kick up several notches and he felt like he was the front line again—the way he had been, working with Matteo at the paramedic competition. Waiting right behind that impression was a reminder of Kate but it was easy to ignore. There was a potentially critically injured child inside this ambulance and it was real this time. If it was a blunt force injury to the little boy’s heart, it would be a miracle if he was still alive but, if he was, then Luke was going to do everything in his power to save him.
The cabin of the ambulance was crowded. Luke could see the tiny child, wearing only a nappy, lying deathly still on the stretcher, surrounded by equipment like the portable ventilator, a cardiac monitor and a tangle of IV lines. A paramedic was removing oxygen tubing from the main supply to attach it to a portable cylinder. A distraught-looking woman who had to be the child’s mother was holding her head in her hands and a woman dressed in scrubs had a stethoscope against the toddler’s bare chest. She had her hair scraped back into a ponytail. Blonde hair.
Some tiny part of Luke’s brain registered that this hair was the exact shade of Kate’s hair and then the doctor straightened and turned, hooking the stethoscope back around her neck.
Of course the hair was the same shade as Kate’s. It was Kate’s.
The distraction was only the timespan of one heartbeat but Luke could feel it throughout his entire body.
Kate was here.
And it felt astonishingly good...
‘We’ve got a systolic blood pressure of eighty.’ The flash in Kate’s eyes suggested that she was just as pleased to see Luke but she wasn’t about to waste any time on personal greetings. ‘He’s in a sinus tachycardia of one hundred and eighty and the upper torso cyanosis is increasing.’
The ambulance crew wasn’t wasting any time either. The crew member who had been driving had stepped through into the cabin and unhooked the stretcher restraints. Luke had to step to one side as they rolled the stretcher out, the wheels folding down and locking automatically as it emerged from the ambulance. He was intensely focussed now. This child was still alive...
‘We’re clear to bypass Emergency,’ he told the crew. ‘And an elevator’s being held. We’re heading straight for Theatre.’
The child’s mother stumbled as she stepped down from the back of the ambulance in the wake of the stretcher and Luke caught her shoulder to steady her.
‘Oh, my God...’ she whispered, as she looked up to catch his gaze. ‘Theatre?’
‘I’m Luke Anderson,’ he told her. ‘I’m a trauma surgeon here at the Royal and I specialise in chest injuries like this.’
They were moving now—straight through the emergency department towards the doors at the other end that led to the bank of elevators. Staff were moving obstacles like trolleys and wandering patients from their path.
‘He’s not going to die, is he?’ the mother sobbed. ‘This is all my fault... I should have been watching him more carefully...’
Kate turned her head, IV tubing in her hands as she protected a line. ‘Jacob’s in the best place he can be, Jennie. And with the best surgeon.’
The stretcher rattled as it went over the metal rim of the elevator and there was a moment’s pause as the team manoeuvred everything to make room for people.
‘Can I come with him?’ Jennie begged.
‘Of course you can.’ Elise had been trailing the team but she stepped up now and put her hand on Jennie’s arm. ‘There’s a place that you can wait and someone will be with you all the time. Come with me... We’ll take the next lift. My name’s Elise and I’m a nurse in the intensive care unit that Jacob will be going to after his surgery.’
Luke and Kate squeezed in alongside the stretcher. They were both trying to get as much information as possible by scanning readouts on the monitors and by what they could assess visually.
Luke caught Kate’s glance and he could feel his mouth tighten into grim agreement. It might be just the strong lighting in this small space but they were both thinking that the bluish tinge to Jacob’s skin looked worse. The ability of his heart to function was deteriorating rapidly.
The doors opened and it was another straight line, through two sets of double doors to the suite of operating theatres. A theatre team was waiting beside an empty bed covered with a white sheet. The transfer of the tiny child was swift and smooth and the ambulance crew gathered their equipment on top of the stretcher, preparing to leave.
Luke caught Kate’s glance again as the bed was rolled towards the induction room where the anaesthetist was waiting. ‘Are you going to stay?’
‘Can I? You don’t mind if I observe?’
‘You’re more than welcome. Someone will find you some gear. Or there’s an observation deck if you want a better view from the close-up camera. I need to go and scrub in.’ But Luke paused for a brief moment as he turned away. He didn’t actually smile, but he could feel the corners of his mouth soften. ‘It’s good to see you, Katy.’
* * *
Maybe the view wasn’t as good standing at the head of the operating table, out of the way of the surgical team, but Kate was happy. She wanted to be as close as possible to this small patient whose outcome she was already so invested in. And it meant she was also as close as possible to Luke.
She watched as he entered the theatre, gloved hands crossed in front of his body to prevent any accidental touch of something not sterile, a nurse still tying the strings of his gown behind him. With a hat covering his hair, a mask over his nose and face and protective eyewear on, it could have been any surgeon coming in but Kate’s body told her exactly who it was.
The tingle of anticipation—or maybe it was more like attraction—was powerful enough to actually distract Kate from everything else going on around her. It felt like an electrical current touching every cell in her body and it was emanating from a knot of sensation deep in her belly.
Yep. That was attraction. She recognised the point of origin all too well. But had she ever felt it quite this fiercely?
For a nanosecond, Kate actually thought the alarm she could hear was something internal but, in the same instant, she tapped into the acceleration of tension around her.
‘He’s in VF.’
The nurse painting Jacob’s chest with disinfectant stopped swabbing and her forceps froze in mid-air. Kate held her breath. Ventricular fibrillation meant that the small heart had given up trying to pump blood—probably because of the pressure of the fluid trapped around it. And, if that was the case, simply delivering an externa
l shock would not be enough to keep this little boy alive.
It seemed like time had stopped and frozen this tableau but that impression lasted for only the time it took for Kate’s heart to skip a beat. And then she watched as Luke took complete control of everything with a calm confidence that took her breath away all over again.
‘Scalpel, please,’ he requested. ‘And some blunt forceps. I’ll need the saw in a second, too.’
Stepping closer to the table, he made a swift incision down the centre of their tiny patient’s chest. Within a couple of minutes, the heart was visible. Using forceps, he lifted the tissue surrounding the heart in an enclosed bag and then made another incision.
‘Suction, please...’
Luke was scooping clots of blood from around the small heart as his assistant angled the suction tubing.
‘I can see where it’s coming from,’ Luke said a minute later. ‘We’ve got a right atrial rupture here. Clamp, thanks...’
The bleeding from the heart was controlled within seconds but the heart was still not functioning.
Luke’s hands were continuing to move with smooth confidence. Kate was biting her bottom lip so hard it was painful, as she watched him take hold of that tiny heart in his hand and start squeezing it with rapid compressions.
‘Charge the internal defibrillators,’ he ordered. ‘But this may be enough...’ He eased his hand out of the chest and Kate felt herself leaning forward, trying to see what the heart was doing. Was it still quivering ineffectively? Had it stopped completely? Or...?
The beep from the machine right beside her was a very different sound from the previous alarm. A single beep and then another one after a gap. And then the beeps got faster. Steadier...
‘We’re back in sinus rhythm,’ Luke said. ‘Thanks, team. Let’s get this damage repaired, shall we? Suture, thanks...’
Over an hour later, Kate was still watching Luke—this time in the PICU. Jacob had been transferred there for the intensive care he was going to need for some time and Luke was using transoesophageal echocardiography to examine Jacob’s heart.
‘I’m happy.’ His words were directed at Jennie, who was sitting on the edge of her chair, one hand holding that of her son. Jacob’s father was by her side now, too, and he was holding Jennie’s other hand. ‘There’s no sign of any residual injuries and his heart is working perfectly.’
He removed the tubing that contained the transducer at its tip from Jacob’s throat and then he stripped off his gloves.
‘We’ll keep Jacob in here for a day or two to keep a close eye on things but then we’ll wake him up and move him to the cardiac ward.’
‘Is he...will he...?’ Jacob’s father had to stop and clear his throat and then he couldn’t continue.
‘I’m happy,’ Luke said again, and this time he was smiling. ‘I think he’s going to be running around again in no time—probably giving you all the normal worry that toddlers can create—but he’s come through this crisis with flying colours.’
Jacob’s parents were both smiling and crying at the same time and Kate felt the prickle of her own tears.
From the moment this child had arrived in her emergency department—hours ago now—she had had very little hope of an outcome as good as this.
And it was thanks to Luke. The parents didn’t need to know how close to a very different ending they had been up there in Theatre but Kate knew.
So did Luke.
His gaze met hers as Jacob’s parents embraced each other.
He looked exhausted, which was hardly surprising. Kate felt like she’d just run a marathon herself and she’d only been watching, for heaven’s sake.
At least he would get a break now. Jacob was under the care of an expert team who would only call Luke in if he was really needed and, the way things were looking at the moment, that was very unlikely.
They left the PICU together and walked in silence towards the elevator. Luke pushed the button and then tilted his head, one eyebrow raised as he caught Kate’s glance.
‘So this is what it takes to see you again? Full-on emergent cardiac surgery? Don’t you think that’s a bit high maintenance of you?’
Kate grinned. ‘I have to say it was a very impressive performance but, no...it wasn’t something I want to repeat in a hurry.’
‘At least it broke the barrier.’
‘Barrier?’
Luke waited for Kate to step into the lift ahead of him. ‘I was beginning to think that you didn’t really want to see me again.’
‘Oh...’ Kate could feel a flush of warmth in her cheeks, along with the flash of guilt that she had pretty much brushed Luke off in her last text. And then she looked up to see the way he was looking at her and the warmth suddenly went south.
There it was again.
That flash of a totally new kind of attraction.
‘That’s not true,’ she said softly. ‘I’m really happy to see you again.’
She couldn’t look away. Neither, apparently, could Luke. They were locked in that eye contact until the elevator shuddered to a halt on the ground floor.
‘How are you going to get home?’ Luke asked as they walked through the reception area. ‘Or do you need to go back to work?’
‘I can go home. I was off duty a couple of hours ago. And I can call a taxi. My hospital will cover the cost because I came here as a medical escort.’
‘Are you in a hurry?’
It only took a flash of that eye contact to set off that tingle again. No... Kate wasn’t in any hurry to go anywhere away from Luke. Quite the opposite.
‘Only I’m starving,’ he continued. ‘And I know a really nice Italian place not far from here, if you fancy having dinner with me.’
Saving a small life had been more than enough to make this a great day for Kate but, amazingly, it had just got a whole lot better.
Or maybe not.
‘I can’t go to a restaurant. I’m wearing scrubs.’
‘This is a place that is a favourite with the staff. They’re used to people wearing scrubs. Did you bring a coat with you?’
‘No. We left in kind of a rush.’
‘You can use mine. I’ll get changed so I won’t need it.’ His eyebrows were raised enough to make his face a picture of persuasion. ‘Deal?’
Kate didn’t need much persuasion. She was, in fact, grinning.
‘Deal.’
CHAPTER FIVE
THE RESTAURANT COULD have been tucked away on a back alley somewhere in Florence or Rome.
Heavy beams on the ceiling had trailing vines coming from hanging baskets. The tables were rustic and covered with checked red cloth. Slim white candles had dribbled wax for a long time judging by how encrusted the old wine bottle in the centre of their small table was.
Kate had a glass of Prosecco in front of her but Luke was filling his glass from a carafe of water.
‘Just in case I get called back,’ he said. ‘Even if I don’t, I’ll go and check on Jacob on my way home.’
‘He’s going to be fine.’ Kate smiled. ‘You did such an amazing job, Luke. He’s one lucky little boy.’
She knew that her admiration of how Luke had handled such a critical case had to be written all over her face but she didn’t care. He should be very proud of himself. She was proud of him.
‘I only got to do what I did because you got him to the right place at the right time. If it had been anyone less competent receiving him in Emergency and not recognising what was going on, it would have been a very different story.’
Maybe it was the candlelight but Luke’s gaze seemed just as admiring as Kate knew hers was. As if to remove any doubt, he lifted his glass to tap it gently against the edge of hers.
‘Well done, you,’ he said quietly.
‘Well done, us,’ Kate countered.
One sid
e of Luke’s mouth tilted upwards. ‘We always were a great team, weren’t we? Do you remember our first cardiac arrest?’
‘How could I forget? Back in the days when you had to hold the paddles onto the chest to defibrillate and I was so scared my hands were shaking like I was holding a pair of castanets.’
She could smile about being a nervous medical student now but there was a far more lasting memory from that case. The way Luke had caught her frightened gaze as he’d paused his chest compressions to stand clear. That steady gaze had told her that she knew exactly what to do. That she could do this.
‘How great was it when we got him back?’
‘It was the best.’ Kate took a long sip of her wine. ‘And do you remember the kid that bit your finger?’
Luke laughed. ‘I think I still have a scar.’
Kate was laughing, too. ‘The look on your face! It was priceless.’
‘It was a lesson I’ve never forgotten. I protect my fingers at all times now.’
‘Didn’t put you off working with kids, though.’
‘Ah...but I keep them unconscious most of the time. I find it easier not to get bitten that way.’
Memories—and laughter—were easy to find as they shared an antipasti platter of calamari and olives and then deep dishes of the restaurant’s signature lasagne that came with a fresh green salad and slices of crusty bread. It was only when they both sighed with pleasure over the first taste of the tiramisu they had both ordered for dessert that Kate realised something unusual.
‘Do you know, this is the first time I’ve ever been to a restaurant when someone else has ordered exactly the same things I did.’
‘That’s bad, isn’t it? It means you don’t get the chance to taste something different.’
‘No, no...it’s good. I get terrible food envy.’
Luke grinned. ‘You mean when you see what someone else has ordered and it suddenly looks so much better than what you chose?’
‘Exactly.’
He was still smiling. ‘We always did like the same things pretty much, didn’t we? Same music, same movies.’
The Doctor's Wife for Keeps Page 7
