The Heart Surgeon's Proposal

by Meredith Webber

‘You spread an untrue story through the hospital and I’m pig-headed because I want to tell the truth?’

  He smiled, which was his first mistake.

  The second was uttering the words that followed the smile.

  ‘Too pig-headed to marry me. You know we’d be good together. Just because it wasn’t your idea, you’ve got all uppity about it.’

  Maggie stood up, still glaring at him, wishing she was a man so she could punch him and release just a little of the fury bubbling in her body.

  ‘I wouldn’t marry you if you were the last man on earth, Phil Park!’ she yelled. Then she stormed out of the kitchen, across the living room, up the stairs and into her bedroom, where she flung herself on the bed and burst into tears.

  Phil told himself he was having trouble getting through to Maggie because her hormones were out of kilter but, although he believed her hormones could well be causing havoc in her body, he couldn’t help but feel there were other issues at stake here.

  Things happening in Maggie’s head that he had no inkling of.

  He looked around the kitchen, wishing Minnie was there so he could talk things out with her, but she wasn’t, so he checked the fridge instead, grabbed a light beer, then pulled out a piece of steak and the makings for a salad.

  If they had a potato—and they had—he was set for dinner.

  But grilling a steak, sticking a potato in the microwave and tossing salad ingredients with some oil and vinegar wasn’t a difficult enough task to keep his mind from wandering. Salads were so healthy, but how did you get infants to eat lettuce? Or shouldn’t you bother? Go with the tried and true mashed vegetables for a while, and introduce salad things when they could chew.

  Obviously that would be best—you could hardly give a toothless baby a carrot stick.

  So much to learn.

  Was it too early to buy a baby book?

  And what baby book to buy?

  From what he’d seen in his sorties into book stores, bringing-up-baby books accounted for about half the store’s turnover.

  Maybe a quarter.

  He couldn’t ask his mother. He doubted she’d ever read one in her life, any more than his nanny had. Who did he know with offspring? Someone must know the best book to buy!

  As he ate his meal his mind switched from the baby—plenty of time to find out about the best book—to the woman carrying it. Here he was eating the ultimate in healthy dinners and she’d gone to bed with only a cheese sandwich inside her. She’d wake up some time in the night absolutely starving.

  Would she come downstairs if she was hungry, or should he leave a sandwich—there must be something other than cheese in the fridge—beside her bed?

  Maggie was asleep when Phil crept in to her room, lying face down across the bed, still in her hospital clothes, the bedside lamp casting enough light for him to see the tear stains on her cheek.

  His heart squeezed in his chest, but he ignored this physical manifestation of weakness. She was going through so much, he had to be the practical one.

  He set the sandwich he’d made and covered with clingwrap on the table by the bed, but took the glass of milk back downstairs. He’d make her a hot chocolate, and bring it up, wake her and help her into her nightwear—professionally detached no matter if it killed him!—and encourage her to have the food and hot drink before she went back to sleep.

  But by the time he returned, she’d gone, and he could hear the shower running in the bathroom. He left the drink beside the sandwich and departed. He’d made her cry once already this evening, he wasn’t going to risk it again.

  Maggie came out of the bathroom to find a cup of hot chocolate beside the sandwich, which had appeared while she’d been asleep.

  She wasn’t hungry and a skin was forming on the chocolate so that just looking at it made her feel ill, but he’d meant well.

  He probably meant well about the baby, too, but there was no way she was going to mess up both their lives by marrying him.

  She took the chocolate into the bathroom and tipped it down the sink, then eyed the sandwich. Maybe she should eat some of it. She mightn’t want to marry him but there was no need to insult him further by not eating the food he’d so thoughtfully prepared. She forced it down, then slid into bed, turning her mind resolutely to work. What did they have on tomorrow? An ASD closure first up. Phil was doing it. The patient was a little girl who’d only recently been diagnosed, when she’d taken up horse-riding and had become so breathless after cantering gently around a paddock that the riding instructor had suggested her mother take her to a doctor.

  Phil would go into the chest through a median incision—Scott would do that part—then Phil…

  Always Phil, in her mind, in her dreams, in her heart…

  The atmosphere in the theatre was relaxed and Maggie tried to work out why. Usually as the surgeons prepared a patient to go on bypass, the tension rose, not to an uncomfortable level but enough for everyone to feel it.

  Was it because Rachel and Scott were teasing Phil about the end of his freedom? She opened her mouth to say that there was no end to his freedom, that they weren’t engaged, then closed it again. This was not the time to be creating problems for Phil.

  ‘Atrial septal defects—holes between the atria—aren’t uncommon in congenital heart disease,’ he was saying to the same students Maggie had instructed the previous day. ‘The patient can be asymptomatic for years. Though blood is shunting from left to right across the atria, it isn’t until they show signs of pulmonary obstruction, as little Gemma did, that the defect is discovered.’

  ‘They’ll close all by themselves quite often, won’t they?’ one of the students, a really beautiful young woman—blonde, of course—asked.

  Maggie glared at her, but Phil didn’t even turn in her direction, concentrating on attaching Gemma to the bypass machine and letting Scott answer for him.

  ‘Yes, they do,’ he said, then Kurt took over, explaining to the students how the bypass machine worked, acting as both heart and lungs for the patient while the operation was performed.

  Maggie was listening to him and watching her monitors at the same time.

  ‘She’s fibrillating,’ she said, knowing the panicky beat of the heart could lead to a heart attack if it wasn’t stopped.

  ‘The cannula’s not seating properly, so she can’t go on the pump yet,’ Phil said, ordering the drugs Gemma needed to settle her heart back to an acceptable rhythm.

  Maggie added them to the fluid flowing into the little girl, watching the monitor, not the child, willing the frantic beating of the heart to subside but not to stop.

  ‘OK, go to pump, Kurt,’ Phil said, and everyone breathed again.

  ‘So much for a relaxed atmosphere in Theatre,’ Maggie muttered, and Ned, the theatre sister who assisted in most of their operations, gave her a nudge with his elbow.

  ‘You should know not to even think about such things in Theatre,’ he said. ‘It’s tempting fate.’

  Maggie wanted to agree with him but, though she nodded, her mind was back on the child. Had the problem been something she’d done? Had she added something to the cocktail of drugs immediately before the heart had gone haywire?

  Later, when she read through the notes she made as she worked, she’d have to check if there was anything that could have triggered the reaction. She’d seen it happen before, but usually in very sick babies or neonates, not in otherwise healthy five-year-olds.

  ‘That was unexpected,’ Phil said, much later, when Gemma had been returned to the ward and they were gathered in the unit, discussing the operation.

  ‘No change in your usual protocol?’ Alex asked Maggie, who held up the notes she still had in her hand.

  ‘Nothing!’ she said. ‘But it was scary and I’m wondering if there’s something I don’t know about in these cases where we’re operating on an older and healthier child. I’ll stay here tonight and trawl through whatever info I can find on the Web, and there’s an anaesthetist over at Children
’s who’s pretty savvy. He might have some ideas.’

  She noticed Phil’s scowl but thought nothing of it until he announced, late that afternoon when she settled in front of the computer, that he, too, would stay back and do some Web surfing.

  ‘But your work was textbook,’ Maggie reminded him. ‘I’ve seen Alex do ASDs and he couldn’t have done it better. And the fibrillation was so early in the procedure, I don’t see how it could have been caused by anything you did.’

  ‘I’d still like to know if there’s any paper or report of something similar happening,’ he said, sounding so grouchy she decided to leave him alone.

  Maggie was reading through an article on possible reactions between some pre-medications and the use of pain relief during surgery when a cheery voice interrupted her concentration.

  ‘Two of you hard at work,’ Evan Knowles said. ‘And I bet you haven’t eaten, Maggie. I missed lunch and I’m starving, so how about you guide me to this canteen of yours and we’ll eat and talk? Phil can mind the computers.’

  ‘Phil hasn’t eaten either,’ Maggie said, darting a quick glance in Phil’s direction and catching a scowl as a reward.

  She ignored it and continued, ‘Come on, Phil, we’ll all go and eat. We can talk to Evan over dinner—he might have some experience of what happened.’

  Evan looked put out, Phil looked thunderous, and Maggie wondered why women ever put up with men! But eventually he stood up and, still glowering, took Maggie’s arm and all but frogmarched her out of the room.

  Evan walked on her other side, chatting on, either unaware of the vibes around him or choosing speech as a way of ignoring them.

  ‘Oh, Maggie, I was hoping to see you.’

  One of the nurses who cared for their patients on the open ward was waiting by the lift. ‘I saw Phil yesterday and congratulated him, but I didn’t see you. All the best on your engagement.’

  ‘We’re not engaged.’

  The words came out before Maggie had time to consider the company—or the impact they would have on the two men standing next to her.

  ‘You’re engaged?’

  That from Evan, who’d spoken too early to hear her denial.

  ‘What happened to not saying anything?’

  This from Phil, frowning down at her from what suddenly seemed like a great height.

  The nurse looked embarrassed, muttered something about forgetting to check a list and hurried off.

  ‘It was a misunderstanding,’ Maggie said, mainly to Evan although the answer could equally apply to Phil’s protest.

  ‘Oh, yes,’ Evan said, looking from one to the other. ‘Happens all the time, I imagine, one half of a couple thinking they’re engaged while the other half thinks they’re not. Ordinary kind of misunderstanding!’

  Maggie laughed.

  ‘It’s complicated,’ she said, and Evan sighed.

  ‘More so than you realise,’ he said quietly. ‘Anyway, I wanted to see young Pete while I was here, so how about you two eat on your own? Maggie, I’ll check out some likely sites for anything about your problem and email you.’

  He walked off before Maggie had a chance to stop him.

  ‘Now see what you’ve done,’ she said to Phil.

  ‘I’ve done?’ he echoed with totally false astonishment. ‘I had nothing to do with it—it was the nurse who mentioned engagements.’

  ‘And she’d have known if you hadn’t told the world?’ Maggie stormed at him, wanting to yell but knowing this wasn’t the place for a really good argument.

  Then Phil smiled at her, and all her anger melted.

  ‘I know it’s a terrible cliché, but you look beautiful when you’re angry. Your cheeks go pink and your eyes spark fire, and all I want to do is kiss you.’

  He spoke quietly, although they were now alone, the other people waiting with them having taken the lift.

  ‘Phil, this is all wrong,’ Maggie said. ‘There’s so much more to it—things I haven’t told you.’ Her stomach scrunched but she forced herself to add, ‘Things that will probably make the engagement unnecessary.’

  She knew it wasn’t the ideal place to tell Phil about her previous marriage and two miscarriages, but it was time things were said, and she was ready to say them, so—

  ‘Phil, Maggie, I think you should see Pete.’

  Evan’s voice betrayed his urgency and Phil and Maggie responded immediately, turning and striding towards the unit’s PICU.

  ‘He was fine, breathing well on his own with the machine assisting him, but he wasn’t reliant on it, so we decided to try him off it,’ the intensivist on duty explained. ‘We intended keeping him on ventilatory assistance but getting him off the mechanical ventilator, so he’s been fasting today in preparation for it and we cut his fluids right back, but there’s obviously fluid collecting in his abdomen.’

  The little boy, though awake, was far from alert, lying limply on the bed, his usual cheery smile nowhere to be seen.

  ‘So, not feeling too good, soldier?’ Phil said, while Maggie nodded to Mr Barron, on duty by his son’s bedside today. Mr Barron called his youngster ‘soldier’ and most of the staff had adopted it, pleasing Pete enormously.

  But today he didn’t respond at all, just lying there while Phil poked and prodded at his body.

  Let it not be kidney failure, Maggie prayed, then she reminded herself that Pete’s kidneys weren’t being overworked as he still had a drain in his abdomen and he was undergoing peritoneal dialysis.

  Peritoneal dialysis! Her mind raced through what she knew of it. Usually done during the night while the patient slept, it was a way of cleansing the impurities from the blood and adding needed electrolytes, performing the tasks of the kidneys when they were too weak to function properly.

  But one of the dangers of it was peritonitis, an infection getting into the abdomen through the catheters designed to keep the body healthy.

  Phil was explaining some of this to Mr Barron, whose complexion had gone from a healthy, if somewhat ruddy olive to a dull, tired grey—a skin colour seen quite often in the exhausted family members of PICU patients.

  Only, as well as grey skin, there was a blue tinge to Mr Barron’s lips.

  ‘Phil,’ Maggie said, intending to nod towards the man in case Phil hadn’t noticed, but it was too late. Mr Barron pitched forward off his chair, and little Pete’s weak but frantic cry of ‘Dad!’ was one of the saddest things Maggie had ever heard.

  She didn’t hesitate, hitting the crash button in the room. Although the closest crash cart would be geared towards paediatric resuscitations, it would be better than nothing for Mr Barron.

  Maggie moved around the bed, stepping over Phil who, with Evan, was giving CPR to the prone man, and stood so Pete could no longer see what was going on.

  ‘Daddy’s just fainted,’ she lied to the sick little boy. ‘Probably because Dr Phil was talking about such yucky things.’

  But the monitors showed Pete’s agitation and Maggie sent a nurse for a mild sedative. Just a little of the drug, added to what he was already on, would make him sleepy and unaware of what was happening, at least until they could move his father out of the room.

  Better that way than having the already ill little boy deal with the chemicals his body would produce through anxiety.

  He slipped peacefully into sleep, but Maggie stayed by his side. Someone else would contact Mrs Barron, who would then have to make arrangements for a friend or relative to mind the other children before she could get up to the hospital.

  Mr Barron was defibrillated where he lay on the floor, and the collective sigh of relief told Maggie he’d responded. Within minutes of his collapse he was lifted onto a stretcher and wheeled out of the room, Phil and Evan following, the intensivist obviously wanting to go too, though he did turn back towards Maggie to check that Pete was OK.

  ‘I knocked him out,’ she explained. ‘I’ll stay with him because when he comes to again he’ll want to know his dad’s all right, and we still have to
sort out his problem.’

  She sat down and reached for Pete’s hand, stroking it and talking to him as she waited for him to wake. No one really knew how much an anaesthetised person could take in, but Maggie believed some words filtered into the other world the patient temporarily inhabited, so she always talked to them as they came out of anaesthetic.

  She told Pete he was going to get better, that they’d fight the infection, and before long he’d be going home to play with his sisters and brothers. She crossed her fingers again as she added, ‘And your mother and father, too, of course.’

  Phil walked back into the PICU and hesitated outside Pete’s room, looking through the glass at the woman who sat beside the child’s bed, holding his hand and talking away, although Pete appeared to be comatose.

  ‘You could have gone and had your dinner,’ he told her, coming into the room and nodding towards the sleeping child.

  ‘And leave him on his own—when his parents have been knocking themselves out to make sure someone’s with him all the time?’

  She smiled at Phil.

  ‘And why did you come back? To sit with him, I bet!’

  ‘To check on him, that’s all. Though I might have known you’d be here—persistence personified, that’s you.’

  He knew she was still annoyed with him, but reached out to ruffle her hair anyway.

  ‘It might be an irritating trait to your friends and family, but it pays off in your work, Mags. You worry away at things until you find not only a right solution but a perfect solution.’

  As she hadn’t objected to his touch, he dropped his hand onto her shoulder.

  She didn’t bite it off, which cheered him immensely, not because it was his operating hand but because she must be over the argument and they could be friends again.

  Friends! More and more he was realising the importance of this friendship between them—valuing it, treasuring it…

  Wanting it to continue.

  He reined in his wandering thoughts, returning to the problem at hand.

  ‘Though I doubt even you can find a perfect solution to the Barron family’s dilemma. Five children, one still desperately ill after major surgery, and the prospect of more surgery to come, and now the father in the coronary care unit.’