St Piran's: The Brooding Heart Surgeon

by Alison Roberts

  ‘It’s a great name,’ she said softly. ‘Crash?’

  The big pup wriggled in her arms and looked up at her. He tried to prick up his ears but they were too heavy and stuck out sideways. Liquid brown eyes were full of trust and a long tail gave a thump of approval.

  ‘Crash it is,’ Anna announced. She smiled up at Luke. ‘Hey, thanks.’

  ‘No problem.’ But the smile had well and truly vanished from Luke’s face and he stood up.

  He was leaving. Something oddly like panic made Anna’s heart skip a beat.

  ‘Would … um … would you like a coffee or something?’

  ‘No. You’re busy and I’m on my way to Penhally. I’ll leave the journal.’ He dropped it onto a chest of drawers by the door. ‘There’s a good review of restrictive pericarditis in there. I thought you’d be interested.’

  The reminder of work was timely. She had to work with Luke. Work and home couldn’t mix. Professional and personal couldn’t mix. What had she been thinking, blathering on about her rescue puppy? She scrambled to her feet.

  ‘Thank you.’ There wasn’t a thing Anna could do about what she was wearing or what her home looked like, but she could summon as much as she could of Dr Bartlett. Lifting her chin, she could feel the shell of professionalism beginning to enclose her. Protect her.

  ‘That was thoughtful of you. I did do as much research as possible when Colin was admitted but it might well be something I didn’t come across.’ She looked pointedly at the door. ‘I’ll see you out, shall I?’

  ‘No need.’ Luke turned to leave but then paused. ‘Actually, there was something else.’

  ‘What?’

  The hesitation was almost imperceptible. ‘You don’t seem to have reported that incident from Colin Herbert’s surgery. Or not that I’ve heard about.’

  ‘No. I decided not to.’

  ‘Why not?’

  ‘Because you said it wouldn’t happen again.’ And I believe you, Anna added silently, looking away so that he wouldn’t see any crack in her newly formed shell. I trust you.

  Luke didn’t say anything. After a long moment he broke the eye contact and gave a single nod. ‘Thank you,’ he said, the words somewhat curt. And with that he was gone.

  Anna stood very still. She listened to the sound of her front door closing. And then the sound of a car engine starting up and a vehicle moving away.

  Even then she didn’t move. Standing like this, she could feel that shell cracking and falling away, exposing something tender. She could almost feel Luke’s presence still in the room. She could still see that amazing smile.

  And, heaven help her, but she wanted to hang onto it for just a little longer.

  The sound pierced his eardrums, his body rocking from the force of the impact. Through the painful buzzing that came in the wake of the explosion he could hear the cursing of his companions. The screaming.

  ‘Get out!’

  ‘Get down!’

  The ping of bullets ricocheting off the metal of their armoured vehicle came faster. An unearthly shriek from someone who had been struck ripped through the sounds of chaos.

  Of panic.

  He could feel the heat now. Not just the normal strength-sapping attack of the desert sun but the kind of heat that could sear flesh. A lick of flames that could bring death with far more suffering than a bullet.

  The dust was thick. Getting thicker. The chop-chop-chop of a nearby helicopter was stirring the ground. Bringing assistance, but it was going to be too late. It was getting hard to breathe. He could smell the dust. Taste it. Dust mixed with blood to become a suffocating soup.

  His companions needed help. The driver was slumped over the wheel, others bleeding. The young paramedic was crying. Facing death and terrified.

  He could feel that terror reach out and invade his own mind. He was frozen. Becoming aware of the pain in his own leg. Terrible, unimaginable pain. He couldn’t breathe. Couldn’t move …

  They were his brothers, these men. All of them. And he was going to watch them die.

  He was about to die himself. He could see the enemy emerging from the clouds of dust, their bodies shrouded with the clothing of the desert, their faces disguised by heavy, dark beards. He could see the cruel muzzles of the weapons they were pointing at him but he couldn’t move.

  Couldn’t even breathe …

  The sound of his own scream was as choked as the air around him.

  Arghhh!

  The desperate, strangled sound that finally escaped his throat was, mercifully, enough to wake him. Even as his eyes snapped open, Luke was throwing back the covers on his bed, swinging his legs over the edge so that it was a continuous, flowing movement that had him sitting, hunched on the side of his bed, his head in his hands as he struggled to drag in a breath.

  The feeling of suffocation—of imminent death—was still there.

  He couldn’t afford to stay still. He knew what he had to do.

  The warm, fleecy trackpants were draped over the end of his bed. His shoes were right there to shove his feet into. Running shoes.

  It wasn’t real, he reminded himself as he pulled the laces tight. It hadn’t even happened that way. He had never seen the enemy. He had been able to move. To drag his companions to shelter behind the vehicle as the helicopter hovered overhead. He had staunched the flow of blood and kept airways patent. None of them had died.

  But the nightmare was always the same.

  He was watching his own brother die. Feeling the fear. Unable to help.

  Matthew. Mattie. The clumsy kid with the happy grin who’d had to tag along with his older brothers and do everything they did. Crash.

  Oh … God! What on earth had possessed him to suggest that Anna Bartlett use that precious nickname for that skinny, ridiculous-looking dog?

  What was she doing with a dog in the first place? How could she keep a pet that needed so much time and love with the kind of hours he already knew she put into her career? She did love it. He had seen that in the way she held it and soothed it. The way her face had brightened with joy at finding a name she really liked.

  He had now pulled on the coat hanging by the door. Within seconds he was lurching down the rough track that led to the beach. It didn’t matter that it was the middle of the night. His night vision was better than most people’s and he was getting very familiar with this route.

  Maybe it didn’t matter that he’d given his brother’s name away to a dog. It wasn’t as though he was planning to visit that unlikely little cottage again and they were hardly likely to be chatting about it at work because they never talked about anything remotely personal.

  In fact, he was having enormous difficulty reconciling the woman who was his assistant head of department with the person he’d found on the floor of that room cuddling … Crash.

  Sea air so fresh that it bit into his lungs and numbed his face barely penetrated his awareness. He could feel the shifting of sand beneath his feet and hear the sound of the surf crashing in right beside him but his mind had fastened onto that picture of Anna on the floor.

  With her hair in a soft tumble of curls. Her arms holding a vulnerable creature. Comforting it. Protecting it. He had felt the love. That was what had hit him in such a poignant place. What had reminded him of the kid brother who had never come home.

  He’d reached the end of the beach now. Turned to go home again. He might even manage another couple of hours’ sleep before daylight came. Usually, by the time he had done this punishing circuit, the nightmare had faded.

  And it was only then that Luke realised he hadn’t had to fight the remnants of that terrible dream the way he always did. From even before he’d left his house, all he’d been thinking about was Anna.

  Or rather the two Annas.

  Now that he’d seen her at home, he’d be able to recognise what he’d missed at work so far, surely? Some signs that hidden beneath that power-dressing, uberprofessional, calm, cool and collected surgeon was … the most compelling w
oman he’d ever met in his life.

  He was watching her. And he was puzzled.

  Anna could feel the unasked questions hanging in the air between them.

  Had it been real? Had he really found her wearing scruffy clothes, with her hair in an untidy mop, living in a shambolic house with a rather large and definitely unhygienic animal? Did she really have a sense of humour?

  It was easy to emanate denial because that wasn’t who she was at work. She’d also had years of practice in deflecting any line of communication that threatened to become personal. Patients could be so useful.

  Like first thing on Monday morning when the anticipation of seeing Luke for the first time since he’d been in her house was making Anna feel more nervous than she had since her junior years as a doctor when she’d had to perform in front of some eminent consultant.

  Luke hadn’t looked any different.

  ‘Good morning, Anna. How are you?’

  ‘Very good.’ She wasn’t going to return the query. Luke wasn’t one of her patients.

  ‘How’s—?’

  Crash? She knew that was coming next and she had to stamp on that topic of conversation before it could start. The temptation to talk about her puppy was too strong. She wanted to tell Luke that Crash had learned to sit. That he had stepped on an overturned lid of a paint tin and made a giant pawprint on her wooden floor and it had been such a perfect signature she’d been reluctant to clean it off. Would that make him smile again? She couldn’t afford to find out.

  ‘Mrs Melton?’ She interrupted smoothly. ‘Finally getting to Theatre, thank goodness. I know it’s your slot this morning but I’m more than happy to do the surgery. Or assist.’

  ‘It’s a long time since I did a CABG.’ He knew exactly what she’d done in changing the subject. She could see him taking it on board that her private life was not up for discussion. Could see the focus as he let it go. ‘Might be a good idea if you assisted.’

  Was this a challenge? To see if she did trust him to operate safely on his own? A sideways glance as Luke fell into step beside her made her notice that his hair was damp. Just out of the shower? That image was disturbing. Anna dragged in a breath, only to catch a whiff of something fresh and clean. Like a sea breeze. Good heavens, she could almost imagine Luke had just been for a dip in the ocean. In the middle of winter? Who would be that crazy?

  Her senses were threatening to override her train of thought. What had he asked? Oh, yes … Was he offering her the opportunity to observe and judge his capabilities in Theatre or might he want her company for an entirely different reason?

  ‘I can’t imagine that you’ll have any problems,’ she said calmly. ‘But I am a little concerned about the quality of her saphenous veins. I’m wondering about harvesting the lesser saphenous or possibly upper extremity veins, in which case I could probably be more helpful than a registrar.’

  Your choice, she threw at him silently. I’m available.

  He simply nodded. ‘Excellent. Have we got time to review her films? I’d like to have a word with her as well and introduce myself.’

  ‘Sure. I’m heading to the ward right now.’

  Mrs Melton was thrilled to hear that the head of department would be doing her surgery. She beamed at Luke.

  And he smiled back. Anna was watching and she could see that it was a purely professional sort of smile. It still softened his face and reminded her of when he’d smiled at her but it wasn’t anything like the same. It didn’t make his face come alive. It didn’t come anywhere near his eyes.

  She found herself watching him just as intently as she suspected he was watching her. She saw him smile in greeting colleagues. She saw him smile in satisfaction when he was informed of how well a patient was doing. He even smiled directly at her on one occasion. All mechanical gestures. Done because it was expected and it would be impolite not to.

  Anna wanted to know what those shadows in his eyes were from and why they were dense enough to smother real smiles. She wanted to know who the real ‘Crash’ had been and why talking about him had cracked open the armour Luke wore.

  For that was what it was. Anna could recognise it because she had her own. By the end of their second week of working together, she had the weirdest sensation that they were like actors. Playing their part on stage but with each of them knowing perfectly well that the role the other was playing was not the real person.

  Even more disturbing, Anna was becoming obsessed with wondering about the real Luke. The man that had really smiled at her. Why did he come to work each day with his hair damp and smelling of the sea? The temptation to ask was becoming unbearable. Or maybe it was the desire to touch his hair … to press her face against it and see if that was where the impression of the outdoors and punishing exercise came from.

  She wanted to know why he refused to admit that his leg hurt even when it was obvious it did. When there were lines of pain in his face at the end of a long day that she could feel herself. She could smooth those lines away. With her fingers. Or her lips. If he let her.

  If she let herself …

  The intrigue refused to go away. The pull became stronger but Anna was fighting it. Anyone seeing Mr Davenport and Dr Bartlett together would see nothing more than a purely professional association. Reserved but respectful. Discussions might be animated but they were only about their patients. Their work. Current research. New technologies. Endless topics to talk about.

  A seemingly endlessly fascinating man to talk to.

  If it wasn’t for the puzzle that Anna represented, Luke might have been tempted to admit defeat.

  Every day was the same. Enclosed within the walls of an institution that sometimes felt like it was filled with people who had created their own illnesses. Heavy smokers who seemed surprised that they’d had heart attacks because of their damaged blood vessels. Morbidly obese people who still expected lifesaving surgery.

  What for? So they could carry on with their meaningless lives? Lie in bed and keep eating junk food?

  ‘I’m not going to operate on Walter Robson,’ he informed Anna after a ward round late that week. ‘I refuse to spend my time patching someone up just to give them longer to indulge in slow suicide by their appalling lifestyle choices.’

  If he’d hoped to get under her skin with such a terse and controversial statement, he was disappointed.

  ‘I agree he’s a poor candidate for surgery,’ she said calmly. ‘Maybe that will be enough of an incentive for him to stop smoking and lose some weight. If we can reduce his level of heart failure and get his type-two diabetes and cellulitis under control, it will reduce the surgical risk.’

  Luke almost exploded. Thumped the wall beside them or walked away from his colleague. Told Anna what he was really thinking.

  That she knew nothing about risk. Real risk—the kind that young, healthy people took for the benefit of their brothers-in-arms, if not for the much bigger human-rights issues. That patching them up was the kind of lifesaving surgery that had some meaning.

  But that would open floodgates that had to remain shut. It would take Anna into a life that didn’t exist for him any more except in his nightmares, and winning freedom from those nightmares was the hurdle he had to get through to survive.

  He had discovered a new way of dealing with both the terrors of the night and the feeling of suffocation he could get ambushed by at work. He could distract himself by thinking about Anna. Just for a few seconds. Like a shot of some calm-inducing drug.

  Her voice became a background hum as she talked about dealing with Walter Robson’s anaemia and whether his chronic lung problems would improve if he carried through his vow to quit smoking.

  Luke let his gaze stroke the sleek hair on top of Anna’s head and then rest on the tight knot nestled at the nape of her neck. That clip thing would be easy enough to remove. The hair might still be twisted and squashed but he could bury his fingers in it and fluff it out until it bounced onto her shoulders.

  His breath came
out in a sigh. It was enough … the feeling of desperation was fading again.

  ‘Luke?’ Anna had caught the sigh. Fortunately, she misinterpreted it. ‘The decision has to be on medical grounds, not moral ones.’

  ‘Of course.’

  This wasn’t the place to discuss the ethics of what represented a significant part of their careers. Much of the workload was genuine and worthwhile. He knew that. He used to get more than enough satisfaction from it.

  Why did everything have to be so different now? So difficult?

  And why couldn’t he see what he knew was there— hiding behind the person Anna was within these walls?

  She wouldn’t let him. That was why. The boundaries had been marked and were being reinforced every time she changed the subject if he tried to talk about something personal, like the puppy he had named for her. Or had she even kept the name?

  No wonder James had sounded puzzled back on his first day when they had been scrubbing in together. As though he had no idea of what Anna was like out of work hours.

  Maybe Luke was the only person here who’d had a glimpse of that side of Anna. He liked that notion. He liked it a lot.

  CHAPTER FIVE

  ‘I’M HAPPY to cover Christmas Day.’

  ‘So am I.’ Luke’s nod was matter-of-fact. ‘Thanks, Anna. That’s the holiday roster issues sorted, then. Let’s get on with the rest of the agenda.’

  Anna couldn’t help but notice the look that passed between James and Charlotte Alexander, who were sitting together in this departmental meeting. No mistaking the look of relief. Joy even at the prospect of spending a special day together with no danger of being called in to work.

  The movement of Charlotte’s hand was probably unconscious. She seemed to be listening carefully to Luke as he introduced a new grading system for cardiac patients.

  ‘It’s hoped that this will be brought in nationwide to try and standardise criteria and address the increasing numbers of people that are dying while on waiting lists for surgery. We’ve been asked to implement this at St Piran’s as of the first of January as part of a multi-centre trial, so your feedback is going to be important.’