The Heart Surgeon's Proposal

by Meredith Webber

  ‘Tripe? When it made such an impression on you?’

  Maggie had stopped the car and she turned to look at him.

  ‘Even a novice in psychoanalysis, knowing how you grew up, would be able to explain all that to you.’

  She reached over and touched his shoulder.

  ‘I think it’s sweet. Like me and the farm and a bedroom of my own! I guess all kids have dreams. But now, Phil Park—what does the word home mean to you now?’

  She hoped she sounded casual enough, asking this question, but this ‘home and hearth’ Phil didn’t square with the playboy who flirted shamelessly and dated women as casually as she changed her clothes. And given her current state, it would be good to know which was the real Phil. So, although she’d brought up the subject of home to divert him from thinking of the situation with the sick baby, now they were talking it had turned into a good idea.

  ‘I suppose it’s wherever I’m living at the time—though none of the places I’ve been lately have felt like home because I’ve always known they were temporary arrangements. First in the US, where I started with Alex at one hospital then moved to another, then Melbourne, now here. I can feel at home just about anywhere, I suppose, but…’

  He turned to look directly at her, and she knew he was about to share another bit of himself with her. This, she knew, was special, because in the nearly eight months she’d worked with Phil, she’d learned little of him, apart from an apparent attraction to blondes.

  ‘A little bit of that corny thatched cottage is embedded deep in my subconscious. If I think at all of marriage—hypothetically, of course—I find myself reverting to a modern-day version of that particular picture. Myself in a chair by the fire—children chattering around the place—pets to pat—a wife in the kitchen. Totally unacceptable view in this enlightened day and age of equal rights and careers for women, I know, but the idea persists. I suppose because my parents’ marriage wasn’t like that—my mother lived her own life based mainly on good works, my father was always away—and it was such a disaster, I have this conviction that only something drastically different would work.’

  He gave a huff of laughter—at himself, Maggie knew—but she also knew this was very real to him, and given his upbringing she could understand why he saw this dream as an ideal.

  Diametrically opposite from her ideal but, then, it would be, she thought gloomily. That was the way life worked!

  ‘I suppose the wife slaving in the kitchen is a blonde?’ she heard herself ask, and hoped she didn’t sound as bitchy as she must be feeling to have said it in the first place.

  Fortunately Phil took it well, laughing as he opened the car door and began unloading the shopping bags.

  ‘At least you stereotyped yourself, offering to do the cooking,’ he reminded her. ‘You can’t blame me for that.’

  ‘I will cook because I enjoy it,’ Maggie told him haughtily, ‘not because I’m a woman.’

  Phil laughed again, then unlocked the back door, freeing a delighted Minnie who leapt about his legs with yaps of excitement before heading for Maggie to welcome her home.

  ‘There’s that damn word again,’ she muttered to herself, half wishing she hadn’t been so persistent in her questioning.

  Phil dumped his load of groceries on the kitchen table, and began to unpack them, stacking things into the pantry or fridge. The woman in his childhood dream kitchen had been a blonde, but watching Maggie bustling about in this real kitchen was far more seductive than any dream.

  ‘I think I’ll go up to the hospital and see if I can see the baby,’ he said, as she stacked things on the bench beneath the window, apparently in readiness for some dish she was about to prepare.

  She spun towards him.

  ‘See Dr Ellis? Ask to see the baby?’

  Phil shook his head.

  ‘I doubt Ellis is still there. My bet is he’s passed it back to the paediatrician. The baby will be in the SBCU—no, that’s English, and PICU is American—special care unit you call it here, don’t you?’

  ‘We all understand PICU to be Paediatric Intensive Care Unit so stick with that. Yes, the baby will be there. So what?’

  ‘So most of the intensivists we have working in our PICU also work in that one, and I know them all, so I’d like to take a peek at the notes and look at the scans. I imagine they did two-dimensional and Doppler echo-cardiography. A lot of these cases are associated with hypoblastic left heart syndrome—meaning the child has virtually no left ventricle. We can operate to help his heart function without one, but there again the mortality rate is high unless it’s done as a carefully staged procedure—three stages to it—when the child is older.’

  He pushed his hair back off his forehead—he had to get a haircut some time soon—and shook his head and sighed.

  ‘I don’t really know why I want to go up there, Maggie, just that I do. I can’t get that baby out of my mind.’

  Maggie shifted some of the things she’d put on the bench into the fridge.

  ‘I’ll come with you.’

  He had to smile.

  ‘To see the baby or be my support person?’ he teased, then realised she wasn’t smiling.

  ‘I’ll come because you’re likely to decide that maybe there is something you can do for him, and if you operate, or opt to assist someone else to operate, then you’ll need the best paediatric anaesthetist available in this hospital, and that’s me.’

  ‘Modest little thing, aren’t you?’ he said, as she ducked past him towards the front door.

  ‘Not falsely so,’ she said, turning to smile. ‘But that’s my goal—to be the best, not only in this hospital but in Australia, and after Australia the world. And I’ll get there, too. I don’t think it’s boasting when we say things like that. We all know our limitations but surely we should also know our abilities as well, and be confident of them?’

  And though he’d been seduced earlier by Maggie’s domesticity in the kitchen, he now remembered other things he knew of her. Maggie was a career-woman through and through. In fact, her determination to learn all she could from working with Alex, and the expertise she had already developed anaesthetising neonates and very small infants, was what had persuaded Alex to bring her to Sydney as a member of the team.

  ‘Would you give up work and be a stay-at-home mum if you had a baby?’ he asked, as they set off to walk the short distance to the hospital.

  She stopped dead, so suddenly he thought at first she must have turned an ankle or injured herself in some other way.

  ‘Are you OK?’

  ‘Of course I am,’ she muttered at him, striding along again. ‘But we’re talking operations, and suddenly you’re asking if I’d stop work to have a baby. Not that it’s any of your business, but the answer’s no. I’ve done as many years of training as you have—well, not quite as many because you’re older. I’m a specialist with skills that go beyond those of general anaesthetics, skills I intend to keep improving and honing. Turn that question around. Would you stop work if you had a baby?’

  ‘Good point,’ he said easily, trying to regain some lost ground, but he knew the companionable ease they’d shared earlier was gone. Her voice could have scythed through bamboo! And he’d guessed that was how Maggie would feel, even though he couldn’t remember motherhood and families coming up in previous discussions, so why had he been stupid enough to ask the question?

  Surely not because of one night in bed with a colleague and a vague memory of a stupid childhood dream!

  ‘If they have decided to go ahead with the operation, will you offer to assist?’

  He glanced her way, wondering if she really wanted to know or if it was just her way of getting the conversation back on medical matters. The full lips that had figured in his dreams of late were set in a tight line, so he guessed it was a deliberate conversational shift.

  He accepted it, thinking through his reply.

  ‘I don’t know,’ he told her honestly. ‘It’s a matter of what’s been dec
ided. And it will depend on the surgeon. He—or she—may not want me there. Scott Douglas is the senior cardiac surgical registrar, and he’s assisted at a lot of our ops. He’s a terrific surgeon, lacking some experience of infants and neonates but getting there.’

  Then something else struck him.

  ‘Will you offer?’

  She turned and smiled at him.

  ‘It’s a baby so, yes, of course I will. I’m lucky in that the decision to operate isn’t mine, but my special skill is in giving the little one the best possible chance during and immediately after the op.’

  She was silent for a moment, then she added, ‘The best possible chance!’ in a voice so soft he barely heard it, and shook her head as if to chase some persistent thought away.

  CHAPTER FOUR

  THE first person they saw in the PICU was Rachel, the theatre sister who was part of their team.

  ‘My guess is they’re going to operate,’ Maggie whispered to Phil, who nodded, his face set in an unreadable mask.

  ‘Glad you guys are here,’ Rachel greeted them. ‘Someone from the hospital phoned Kurt and, thinking it meant Phil had a surgical patient, I tagged along. Now it seems someone else is operating. Kurt went through to Theatre—our theatre—to check his machine, but I don’t know if they’ll need me.’

  She shrugged her shoulders and nodded towards one of the glass-walled rooms where a group of men and women was clustered around a crib.

  ‘You doing the anaesthetic?’ she asked Maggie, who looked from the group to Phil, her mind racing.

  Although he’d said little, she knew he was still fretting over his decision. Would her going into Theatre with the other group seem like a betrayal?

  Worse, how would he feel, definitely on the outside, while all his colleagues on the team were involved?

  Purely for the sake of solidarity, should she refuse to help if asked?

  ‘If they ask me to assist, I will,’ she said, knowing her own ethical standards would dictate that choice, although her heart would have preferred to stand by Phil.

  He nodded as if he understood, but his lips were tight in his grim white face.

  She was asked to assist only minutes later, by Scott Douglas, who looked as haunted by what was going on as she felt.

  ‘Phil,’ he said, but spoke too hesitantly, for Phil had turned away and was walking not towards their rooms but to the lifts. Leaving the hospital—cutting himself off from them.

  From her…

  Routine took over, and she moved to the theatre complex, changing into theatre pyjamas then checking all the equipment and assembling the drugs and fluids she’d need.

  A tall lanky man came in and introduced himself as Evan Knowles.

  ‘I do this stuff over at the Kids, normally, but when one of the surgeons was called over here he asked me to come along.’

  ‘Is he good?’ Maggie asked, stepping back so Evan could familiarise himself with things in the near-new theatre.

  ‘I try not to think about what the surgeons are doing and focus solely on what’s happening with the patient.’

  He smiled at Maggie, and added, ‘To tell the truth, I’m not one hundred per cent certain about how much interference we should run on neonates and infants—how much gross surgical trauma they should have to endure. I’ve read a lot of studies on measuring pain in them and that’s really where I’d like to go—long-term effects of pain in babies and children. Maybe there’s none, but we tend to think about all the other things, like the possibility of brain damage and stroke—yet you and I both know, having managed pain in patients in Intensive Care, just how little we know about it in babies.’

  Maggie warmed to the man who spoke so openly about his doubt, and, watching him check what she had ready, she felt confident he was a good anaesthetist.

  Maybe she could slip away, join Phil at—at Alex’s house.

  ‘You will stay?’ Evan asked, apparently picking up the thought in the air.

  ‘Yes, I’ll stay.’

  It was a long and traumatic afternoon. The baby boy arrested on the operating table, and the shock cart was brought close to shock his heart back to action. Then the small heart was so badly deformed it seemed any kind of surgical intervention would be impossible, yet the surgeon did what he could, Scott and Rachel both helping. Rachel, who for years had worked with Alex, and in the US was known as a physician’s assistant, seemed to know as much as either of the surgeons.

  The first stage was to insert the cannulae, which would run his blood through the bypass machine, but the arteries and veins were so tiny it was a Herculean effort to get the plastic tubes into place.

  The baby arrested again, Rachel reacting first, taking the base of the little heart in her fingers and gently squeezing it, keeping blood flowing to the baby’s brain until he could be hooked up to the machine. Then Kurt had a problem getting the blood flow pressure low enough for the baby’s vessels to handle it and yet sufficiently high to keep the little body perfused.

  ‘This is not going to work,’ Evan whispered to Maggie, who was reading out the temperature figures as the machine cooled the blood.

  ‘I thought you didn’t watch,’ she whispered back.

  ‘I don’t,’ Evan told her, ‘but look at the monitor. Look at the blood acidity reading. If he arrests again—and he will—we won’t be able to do anything.’

  Maggie looked towards the tiny mortal on the table, so little of him in view, and her own pulse rate accelerated as fear clutched at her heart. What if it had been her child?

  What choice would she make?

  Operate on the slim chance he or she might survive?

  ‘We’ll get him through,’ she said fiercely to Evan. ‘We can fix acidity—we can fix anything!’

  She was aware of his eyes, a nice grey colour, studying her, as if trying to make out what had brought on this sudden determination, then he said, ‘Whatever!’ and turned back towards the monitor.

  Maybe she’d have to get out of this field, she thought, once again pressing her hand to her stomach. But even thinking such a thing worried her. She’d always been able to separate her work and personal selves—always been able to focus solely on work when she was working, even to the extent that she barely gave Phil a glance when he was in Theatre with her.

  Well, maybe she did give him the odd glance, but she didn’t, when in Theatre, think the lascivious thoughts about him that were likely to pop into her head outside the hospital world!

  So all she had to do was to divorce the baby-carrying Maggie from the hospital one, and she’d be fine.

  The operation dragged on. The tiny heart was stopped with cardioplegia, so the surgeons could open it up to fix the valves, but because its effect was only temporary, more had to be given after twenty minutes—the timing critical. Everyone was aware of the time, everyone knowing that the longer it stretched, the less chance this baby had of surviving.

  Finally, he was taken off the bypass machine and his heart was stimulated, but the little organ refused to beat. Evan bagged the baby, forcing air into his lungs, while the surgeon’s hands tried to stimulate the heart into beating.

  Collective breaths were held, the air still with a dread anticipation.

  ‘Shock again,’ the surgeon ordered, but once again it was Rachel who saw the action.

  ‘No, it’s beating,’ she said, and Maggie turned to the images on the wall-screens and saw the tiny, stitched heart valiantly pumping.

  She had to blink away a tear, and swallow a lump that had risen in her throat.

  Good thing the more observant team members weren’t around—they’d have caught her out for sure, and her ‘ice-cool Maggie’ image would have been shattered for ever.

  ‘Do you always get emotional?’ Evan asked, and she realised she’d been sprung anyway.

  ‘Hardly ever,’ she told him, bringing the hospital Maggie back into place. ‘Almost never.’

  ‘I think it’s OK to feel something,’ Evan said. ‘After all, these are ba
bies you’re dealing with, and being a woman you must feel some tie.’

  Maggie contemplated kicking him hard on his ankle, but decided against it. He was probably only voicing a thought that ninety-nine per cent of men would voice—or at least think—in similar circumstances.

  ‘Six hours—not too bad,’ the surgeon said, finally stepping back from the table and letting Scott close the wound.

  Maggie heard Kurt mutter something about the time on bypass, and knew he was worried about possible brain or kidney damage to the child. Anyone who had ever worked with Alex knew his feelings about not doing more harm than good, and he was adamant that too long on the bypass machine fell into the ‘harm’ category.

  Rachel was assisting Scott now, explaining to him why Alex was fussy about the way the tubes and drains and wires were taped.

  ‘It makes it more comfortable for the baby,’ she said, ‘and a comfortable baby recovers faster.’

  ‘Does Dr Attwood do that with all his infants?’ Evan asked, as he watched the procedure. ‘Has he ever done any studies on measuring their post-operative comfort—things like pain levels?’

  ‘I don’t know about the post-op studies, but he swears post-operative care is just as important as the surgery.’

  ‘Well, that must include post-op pain relief. I need to talk to this man. Where is he?’

  ‘On his honeymoon,’ Rachel told him, and gave a little laugh that sounded forced.

  Had Rachel had a soft spot for the man with whom she worked so closely? Maggie had never considered it before, assuming, since Rachel and Kurt lived together, that they were a couple.

  But she and Phil were now living together, and they certainly weren’t a couple.

  She shut her mind to these stray thoughts, upset to find her other self intruding yet again at the hospital.

  ‘He’s all yours now,’ Scott said, and Maggie turned to Evan.

  ‘I guess he’s all yours really. You’re the person called in.’

  ‘But you’re the local,’ he said. ‘You’ll be seeing him in hospital. I guess we should share him.’