The Surgeon’s Gift

by Carol Marinelli

  ‘I don’t like hospitals,’ Sheila said, sinking back on her pillows.

  ‘A lot of people don’t. Is the pain easing now?’

  Sheila nodded. ‘A bit.’ Her anxious eyes met Rachael’s. ‘Can you stay for a little while?’

  ‘Of course. We’ll give it a couple more moments and if it hasn’t eased off some more we’ll give you another spray and see about calling the doctor.’ The chiming from her pager was unfamiliar and it took a couple of seconds to turn it off and read the message. Pulling back the curtains, Rachael saw that indeed there was a light above Hailey’s bed. ‘Is everything all right, Hailey?’

  ‘I asked for some water. I thought you might have forgotten.’

  Mustering as much tact as she could, Rachael smiled. ‘I haven’t forgotten, I’m just with someone right now. I’ll get it just as soon as I can.’

  ‘And you won’t forget?’

  How could I? Rachael was tempted to ask, but thought better of it. Her irritation was soon replaced by concern as she heard Sheila starting to retch. Reaching for a kidney dish, Rachael soothed the elderly lady, her concern growing as she felt the clammy skin beneath her touch. Pressing on the call bell three times, she connected the oxygen.

  ‘Sheila, I’m just going to pop on some nasal prongs to give you some oxygen.’

  ‘Everything all right?’ Helen’s face peered around the curtain.

  ‘Chest pain,’ Rachael said fiddling with the flow-meter. ‘Could you page her doctor for me? I’m just going to run off an ECG.’

  ‘Here …’ Helen handed her a portable phone. ‘We’re high-tech now! You stay with her and page the doctor and I’ll fetch the ECG machine.’

  Thankfully the doctor came just as Rachael had finished the heart tracing. Though it showed no acute changes, Sheila’s symptoms, coupled with her cardiac history, meant that she merited a full cardiac work-up and a dose of aspirin in case she was indeed having a heart attack. Through it all she clung to Rachael’s hand as the doctor listened to her chest and took bloods for urgent levels, and by the time Rachael finally surfaced from her patient’s bedside to check on her other patients a good forty-five minutes had passed. It was a rather martyred Hailey that greeted her first.

  ‘Sorry, Hailey, I’ll get your water now.’

  ‘No need.’ Rachael wasn’t sure but she thought she detected a slight edge to Hugh’s voice as he placed a water jug on Hailey’s locker. He’d even iced it!

  ‘I was just about to do that,’ Rachael said quickly. ‘I got caught up with—’

  ‘It’s no big deal. Hailey wanted some water, I fetched it for her.’ Turning to his patient, he gave Hailey the benefit of a very nice smile. ‘How are you feeling this afternoon?’

  ‘I’m in a lot of pain actually.’

  With a small frown Hugh checked her drug chart. ‘You haven’t had any analgesia for ages. Why on earth didn’t you let the nursing staff know?’

  ‘Well, they seemed so busy, I didn’t like to make a fuss.’

  ‘You’re not making a fuss. If you have pain you need to let the staff know. Sister here will get you something for it straight away. Have you been doing your deep-breathing exercises?’

  ‘It hurts,’ Hailey moaned.

  ‘But it’s essential. I explained the importance of them before you had your operation. That’s why you’ve got a chest infection now, because you’re not doing your post-op exercises.’ His eyes scanned the chart again. ‘Her IV antibiotics were due at one, they haven’t been signed for.’

  ‘They haven’t been given yet. I was just—’

  ‘About to do it’ Hugh finished for her. ‘Well, could you see she gets them immediately, please?’

  ‘Certainly.’ Which unfortunately was far easier said than done. The new ward design meant that the drug cupboard no longer existed. It had been replaced by a drug room, which you could only enter by swiping your ID badge. The theory was that fewer mistakes were likely to be made with fewer distractions, the only trouble with that theory being that it meant two staff leaving the ward floor at any one time, and at precisely eight minutes past one there wasn’t another free registered nurse available.

  Hugh took the news well, at least sort of, even offering to check the drugs with her if it meant his patient didn’t have to wait any longer. But his rather prolonged sigh and obvious irritation made it quite clear he considered Rachael disorganised, and unfairly so, when in truth she was an efficient and meticulous nurse.

  As the door closed behind them the distractions of the ward might have disappeared momentarily but the designers had obviously never factored into their calculations the far bigger distraction of a blond giant in a bad mood, whose aftershave was practically asphyxiating her, his unmasked irritation making it hard to concentrate on the endless vials of drugs that greeted her.

  ‘Sorry,’ she muttered. ‘I’m not sure of the layout.’

  Luckily all the antibiotics were stored alphabetically and for the most part none of the drug names had changed in her absence, but the drumming of his very neat, very well manicured fingers on the bench only exacerbated her nervousness.

  She showed him the vial of antibiotic and Hugh checked the name and expiry date with a brief nod. Rachael did the same with the vials of saline. Opening the controlled-drug drawer, she located the drug book before opening the box of pethidine.

  ‘Seven,’ she stated, showing Hugh the box.

  ‘Fine. Where do I sign?’

  ‘You’re supposed to look before you sign,’ Rachael said through gritted teeth. ‘You’re supposed to check that there are actually seven ampoules of pethidine remaining. The law requires it.’

  ‘I did,’ he said tartly. ‘I’m not some two-year-old who has to use my fingers to count. Now, where do I sign?’

  To add insult to injury, when it was Rachael’s turn to add her signature, she realised she had left her pen at Sheila’s bedside and no amount of rummaging through her pocket was going to produce one.

  ‘Here,’ he said with annoying calmness. ‘You can use mine.’

  ‘Thank you.’

  ‘Do you have a problem with cosmetic patients Rachael?’ Hugh’s question wasn’t exactly unexpected, given the chain of events, but it still hurt none the less.

  ‘No, of course I don’t,’ she answered briskly, filling out the columns in the drug book.

  ‘Well, you wouldn’t be the first nurse on this ward if you did.’

  ‘Then it’s good that I don’t.’

  ‘You can see why I’m asking, can’t you? Hailey had to ask three times for a simple jug of water, her antibiotics are late and she’s also in considerable pain.’

  ‘My other patient had chest pain. Surely you don’t expect to leave a potentially life-threatening incident to replenish your patient’s water jug? And as for her pain, Hailey never gave me any indication she was in distress—in fact, the only thing on her mind seemed to be the fact that she didn’t have any water.’ She was on a roll now and added her signature with a flurry as she continued. ‘And if you’d give me a moment, I can draw up her antibiotics and they’ll only be …’ glancing at her watch, Rachael met his eyes with a defiant look ‘… fifteen minutes late, hardly a reportable incident by anyone’s standards.’ Despite her fiery response, tears were appallingly close now, and the very last thing Rachael wanted to do was break down—not here, not now and certainly not in front of Hugh.

  ‘Look …’ His voice was softer now and Rachael stared pointedly at the blur of her signature in the drug book as he spoke. ‘Maybe I came on a bit strong. Of course, a patient with chest pain has to take precedence. I tend to jump in without looking sometimes, particularly in the last few weeks. Suffice it to say there’s been a few teething problems with my patients on the general wards. Some of the nurses have the attitude that cosmetic patients are somehow less deserving of pain control, as if the fact they elected for the procedure should mean they’re prepared to suffer the consequences. I know they can be demanding and difficul
t, but the simple truth is that most of them have saved hard or have waited a long time for these procedures. It isn’t something they’ve taken lightly and they’re scared of it all going wrong.

  ‘Hailey doesn’t ask for pain control because she thinks she’ll get out of here more quickly without it. Unfortunately, in this instance it’s worked the other way. She was in too much pain to mobilise and do her deep-breathing exercises and now she’s going to be here for at least a week on IV antibiotics.’

  He had a point, Rachael was honest enough to admit that. After all, more than a few eyes had rolled during handover when they’d discussed the cosmetic patients, but his unjust assumption had riled her and she certainly wasn’t going to take the blame because a couple of her colleagues’ haloes might need a polish. ‘Well, that isn’t my attitude,’ Rachael said firmly. ‘I’ve nothing against cosmetic patients and I resent the implication.’ She could feel his eyes on her but still she didn’t look around.

  ‘In that case, I apologise.’

  Rachael would have answered, would have accepted his apology, but the tightness in her throat and the tremor in her bottom lip as she battled not to cry made it safer to ignore him, the silence growing louder as he awaited her response.

  ‘Fine,’ he snapped eventually, and from the rather curt turn on his heel Rachael’s inadvertent snub hadn’t gone unnoticed. Following him out onto the ward, trying to keep up with his long angry strides, Rachael rued the day she’d decided to come back to nursing. One hour into her shift and already she’d made an enemy.

  Well, Hugh Connell could go and jump!

  What right did he have to judge her? What right did he have to make such assumptions and then expect her to meekly accept his apology? If his patient’s drugs being ten minutes late was all he had to worry about, then Hugh Connell was a lucky man indeed!

  He should try walking a mile in her shoes.

  CHAPTER TWO

  ‘SORRY it took so long, Hailey, it’s just been a bit busy.’ Despite her internal anger, Rachael managed an easy smile and chatted away to her patient. ‘If I could just have your wrist, I can check your ID band.’

  Everyone knew the patient was Hailey but policy decreed that two staff members check the ID band against the drug chart. Happy that everything was in order, Rachael expected Hugh to leave them to it, and was somewhat taken back when he hovered.

  ‘I still have to check her wound,’ he said by way of explanation as Rachael removed the cap on the IV bung.

  ‘These have to be given over five minutes,’ Rachael said, expecting Hugh, like most doctors, to take the opportunity to make a quick phone call or grab a coffee. But Hugh, Rachael was quickly learning, was absolutely unlike anyone she’d ever come across.

  ‘I’m happy to wait,’ he said easily. Which was pretty amazing in itself, but when he sat on the bed and started to idly flick through the newspaper and make small talk with Hailey, Rachael thought she had seen everything. Most consultants would have positively baulked at the idea of having to make five minutes of small talk with a patient. Hugh, though, seemed delighted at the opportunity and it was a credit to them both that Hailey couldn’t even have imagined the rather curt exchange that had taken place only moments before.

  ‘I was telling Rachael earlier that I remember her from the last time I was in here.’

  ‘Was that when you had your appendix out?’

  ‘Yep, Rachael here was just about to go off on maternity leave.’

  She felt Hugh’s eyes turn to her and she fiddled with the IV bung, trying to ignore the conversation that was unfolding.

  ‘So what did you call her?’ Hailey asked.

  ‘That’s the first.’ Rachael didn’t look up as she swapped over syringes. ‘I’m just going to give you your second antibiotic now.’

  ‘Your daughter,’ Hailey insisted, pursuing the conversation despite Rachael’s obvious reluctance. ‘What did you call her?’

  Glancing up briefly, Rachael saw them both look at her expectantly and knew there was no getting out of it. ‘Amy,’ Rachael said simply, turning her attention back to the IV, painfully aware that both Hugh and Hailey were waiting for her to elaborate.

  ‘What a gorgeous name.’ Hailey rested back on the pillows as the pethidine started to take effect. ‘And I’ll bet she’s beautiful.’

  ‘Very,’ Rachael said softly.

  ‘How long have you been back?’

  She must have counted every tiny hair on the back of Hailey’s hand but still Rachael’s eyes didn’t move. ‘It’s my first day.’

  Hailey let out a small laugh. ‘And here’s us running you ragged. Your mind must be a million miles away, worrying about crèches and babysitters and the like. We’ll have to treat you gently. So how old is Amy now? Must be coming up for a year.’

  Slipping the cap back on the IV, Rachael patted her patient’s hand. ‘All finished now. The painkillers should start to kick in soon. If you need anything, just press the buzzer.’

  Walking smartly to the treatment room, she tipped the empty ampoules and syringes into the sharps box. The footsteps she heard behind her were heavy and already familiar, and she could feel the animosity from Hugh as he banged about, laying up a dressing trolley.

  ‘I can do her dressing for you.’

  ‘It’s fine. I just want to reinforce it.’ He stared at her thoughtfully for a moment. ‘You should add a postscript to your little platitude about pressing the buzzer, Sister.’

  ‘Meaning?’ Although Rachael knew where the conversation was leading, she was stalling for time, trying to avoid the inevitable.

  ‘Meaning you should add ‘‘unless I’m tied up with one of my real patients’’ or ‘‘so long as you don’t want a bit of friendly conversation’’.’

  ‘I don’t like talking about my personal life.’

  ‘She was just being nice, for goodness’ sake.’

  ‘Look, Doctor, you might be happy to sit on the beds and tell the patients what you had for breakfast this morning. I don’t work like that. I prefer to keep a professional distance.’

  ‘So I’ve noticed.’ He raked a hand through his hair and turned to go, but just as Rachael thought the lecture was over, Hugh had second thoughts.

  ‘You’re like a breath of fresh air, Rachael, you know that? You’re a real charmer to work with.’

  ‘I don’t have to wear my heart on my sleeve to be a good nurse.’ Rachael retorted.

  ‘Maybe not,’ Hugh said crisply, turning on his heel. ‘But observing a few social pleasantries wouldn’t go amiss either.’

  As first days back went, it wasn’t a exactly a howling success, but neither was it a total disaster, Rachael reflected as she sat at the nurses’ station towards the end of her shift, writing up her patients’ notes. It actually was good to be back. OK, the United Nations might need to draw up a peace treaty to keep her and Hugh from killing each other, but for the most part, the day had been all right.

  Sheila had been reviewed by Cardiology and though her bloods and ECG had been reported unchanged, the event meant her operation had been set back further. Hailey, once the pethidine had kicked in, had slept for most of the afternoon, happily receiving visitors during the evening. And her other two patients had pretty much taken care of themselves, apart from needing some drugs and dressing changes. Everything Rachael had done during her shift had to be diligently recorded and as she sat there, chewing the end of her pen, she realised it was nice to be actually using her brain again, to be dwelling on other people’s problems for once. OK, so there had been a few hiccoughs, but Rachael was determined not to dwell on them.

  She had survived her first day back.

  ‘They’re ready for you.’ Helen gave an encouraging smile as she came out of the office. Stepping in, Rachael felt a million miles away from the nervous wreck that had started the shift only hours earlier.

  ‘Be gentle with me, guys.’ She smiled before she started her handover. ‘I haven’t done it in ages.’

  A
few cat-calls showed that one thing that definitely hadn’t changed was the below-the-belt humour of nurses, and with the help of an encouraging wink or two from a couple of old colleagues Rachael handed over her patients to the care of the night staff.

  ‘They didn’t eat you alive, then?’ Helen asked as Rachael pulled out her hair tie and slipped on her jacket.

  ‘They were fine. Everyone’s been great.’

  ‘So we’ll see you back here tomorrow?’

  Rachael nodded. ‘Thanks, Helen.’ As she went to go, her colleague called her back.

  ‘Drop these into the doctors’ office on the way past, would you? Hugh just buzzed for them.’

  There was no getting out of it. Rachael hesitated before knocking. Hugh’s blond head was turned from her as he tapped away on the computer. Opening the door, she slipped the papers on the desk. ‘Helen said you needed these.’

  Not waiting for an answer, she started to leave.

  ‘Rachael, about this afternoon …’

  ‘Let’s not go there, huh?’ She really didn’t want to end the day on a confrontational note. All she wanted to do now was go home, peel off her uniform and slip into a warm bath. Rowing with Hugh again was way down on her list of priorities, but realising, in the name of patient of care, that something needed to be said if they were going to work effectively together, after only the slightest pause Rachael swallowed her pride. ‘I’m sorry for earlier. I think we got off to a bad start. Maybe we can start afresh tomorrow?’

  The bitter pill of apologising was made sweeter by his quick response. ‘I’d like that.’ He had swung his chair around to face her now. ‘I’m sorry as well. Some of my comments were uncalled-for. I’m sure I just got it all wrong. Helen’s been singing your praises, and she’s a pretty good judge of character.’