The Surgeon’s Gift

by Carol Marinelli

  And if Rachael hadn’t fainted through her whole theatre rotation as a student, there was no doubt at all in her mind that this was where she would have specialised.

  Another patient was being wheeled out now, and Rachael felt her heart rate quicken as Hugh followed the gurney. It was the only time in the short time they’d known each other that she had seen him out of a suit, and there was nothing disappointing about it. Blond chest hairs displayed above the baggy theatre blues, but even the extra-large, creased blues couldn’t diminish the taut, refined lines of his body, the solid muscular thighs, the broad back. Peeling off his paper hat, he tossed it into the metal bucket. His blond hair was dark now, plastered to his head, his face lined with concern as he carefully observed his patient, his deep voice dictating his orders to the staff as he wrote up his op notes. Perhaps he felt his eyes on her, but suddenly their eyes met across the busy recovery room. Rachael managed a tentative, nervous smile, as he stared at her for a moment.

  He did smile back.

  Briefly.

  His eyes did meet hers.

  Guardedly.

  ‘She’s all yours.’ Helga’s voice seemed to be coming from a long way off. ‘Her blood pressure’s stable now. Are you happy to take her back to the ward?’

  Checking the obs chart and her patient, Rachael hesitated. ‘I thought Dr Khan was going to review her.’

  ‘Her blood pressure’s fine now. He can come and see her on the ward.’

  But Rachael shook her head. She liked Helga and, perhaps more to the point, she hated confrontation, at least when it didn’t involve Hugh, but Helen’s warning was ringing in her ears and Sheila’s welfare had to come first. ‘I’d rather he reviewed her before I take her back.’

  ‘Fair enough.’ Helga’s pretty face broke into a smile. ‘It was worth a try. Do you mind sitting with her while I go and find him? I think he’s grabbing a coffee between cases.’

  ‘Sure.’

  Rachael was positive that the only reason Hugh came over and spoke to her at that point was because he had to. She was convinced, in fact, that had there been another door to take him into Theatre without needing to pass her, Hugh would have used it. And the strained words that came out of his mouth when he briefly stopped at the end of the gurney only confirmed her doubts. The man talking in stilted fashion, addressing the top of her head, was nothing like the Hugh she had seen last night. Nothing at all.

  ‘Having a busy morning?’

  Rachael nodded. ‘Not yet.’ She gestured to Sheila. ‘I’m sure all that’s about to change, though. How about you?’

  ‘Pretty full on.’ He gave a brief nod. ‘Better get back to it, then.’

  Rachael mumbled a reply, managed a quick smile then turned back to her patient with cheeks burning, her mind whirring as she tried to fathom a reason for the change in him.

  What had she done wrong?

  Why was he acting so differently all of a sudden?

  And though she listened closely to Dr Khan’s instructions when he finally came and reviewed Sheila, though she chatted light-heartedly with the porters while carefully observing her patient every careful step of the way back to the ward, it was Hugh that saturated her mind. She knew then that she wasn’t imagining things. Hugh had definitely been guarded, and not just this morning.

  In the restaurant last night, just when she had relaxed, when she had finally opened up, when the conversation had flowed and her barriers had come down somewhat, she had felt him slipping away from her. When she had criticised his work, questioned his motives, been an appalling companion, she had held him in the palm of her hand. So why, then, when things had been going well, had Hugh backed off?

  She would have kissed him.

  If only he had tried.

  ‘Is something wrong?’ Helen stood at the head of her bed as Rachael checked Sheila’s obs.

  ‘No.’ Rachael frowned slightly. ‘At least, there doesn’t seem to be.’

  ‘So why are you doing her obs every ten minutes instead of half-hourly?’ It wasn’t a criticism and Rachael didn’t take it as one.

  ‘I’m not sure,’ Rachael said thoughtfully. ‘The operation went well, and apart from a small blood-pressure drop in Recovery her observations have been fine, it’s just …’

  ‘You’re not happy?’

  Rachael nodded.

  ‘Why not page Dr Khan?’

  ‘And tell him what? That I’ve got a bad feeling about this one? Hardly enough to make him stop mid-op and rush to the ward to review Sheila. He’s been really good. He already reviewed her when I wasn’t happy about bringing her back.’ Rachael ran a worried hand across her forehead. ‘Maybe I’m just overreacting. It’s just that …’ She stopped talking, her voice trailing off in mid-sentence.

  ‘Just what?’ Helen questioned gently.

  ‘The last time I got a bad feeling …’ Picking up a pen, she started to write on the chart but the slight tremor in her hand didn’t go unnoticed by either woman.

  ‘Amy?’

  Rachael shook her head firmly and forced a smile. ‘I’m being silly, comparing the two. I’ll give the surgeons a page and ask them to come and review her as soon as they’ve finished in theatre. Till then I’ll just keep a close eye on her.’

  ‘They just rang—your next patient’s ready to come back. Do you want me to send Trevor?’

  Rachael nodded gratefully. ‘I’d rather not leave Sheila.’

  It was a tiny decision, but one that Rachael was very grateful for, grateful for the time to fuss over Sheila and make sure that the elderly woman was every bit as comfortable as possible. As Trevor arrived with her newest patient, so too did Dr Khan.

  ‘I was just about to page you,’ Rachael said as he made his way over.

  ‘Why, what’s the problem?’

  ‘I just wanted you to review Mrs Cosgrove after your theatre list. I didn’t realise you’d already finished.’

  ‘I haven’t,’ Dr Khan said without elaborating. ‘How are her obs?’

  ‘Fine.’

  He nodded briefly checking the chart and then gently pulling the blankets back and assessing the wound. ‘Why did you want me to review her?’

  Rachael gave a tiny shrug, wondering how to best voice her worries. ‘I’m just concerned. I honestly can’t give a solid reason. How come you came up between theatre cases?’

  Dark eyes flicked up to hers and Dr Khan gave the same brief shrug. ‘You will page me if you are concerned again.’ His strong accent didn’t mask the sentiment behind his words. He went to go and then turned. ‘There doesn’t always have to be a solid reason.’

  Sheila surfaced momentarily, licking her pale lips. ‘So thirsty,’ she whispered, pulling at the oxygen mask.

  ‘I know, darling.’ Rachael spoke gently, her endearment genuine and comforting. ‘But it’s too early to have a drink. You’ve got a drip giving you lots of fluids, all I can do for now is moisten your mouth.’ Dipping some swabs into water, she gently wiped the elderly lady’s lips. ‘Does that feel a bit better?’

  Sheila nodded, resting her head back onto the pillow. ‘How did it go?’

  Rachael hesitated. Dr Khan had only written up the briefest operation notes. No doubt he would elaborate on his findings later, but for now there wasn’t much Rachael could tell Sheila. ‘It went well,’ she said gently. ‘Dr Khan’s just been up to review you and he’ll be back later.’

  The pale hand again peeped out from under the blanket and Rachael held it. ‘I’m glad you’re here, dear, glad that it’s you on this morning.’

  ‘I’m here all day, Sheila. You just rest now, try and get some sleep.’

  ‘Sorry to interrupt.’ Hugh’s voice caught her unawares and Rachael turned quickly, her hand still holding Sheila’s. ‘I spoke to Trevor, but he said that you were looking after Kathleen. She’s had a skin graft on her left cheek, the donor site is on her left thigh—that’s probably going to cause her more pain than the graft itself. I want the pressure bandages to stay in plac
e for twenty-four hours. I’ll take them off myself when I do the round tomorrow. If there’s any ooze, just reinforce them. I don’t want the graft disturbed.’

  His words were formal, his eyes looking everywhere but at her.

  ‘Fine,’ Rachael said crisply, taking her cue from Hugh. If professional was how he wanted to be, then professional was what he’d get. ‘I’ll come and do her baseline obs.’ Which she would have done, but almost imperceptibly she felt the grip of the hand she was holding slacken, just a fraction, again nothing solid.

  ‘Hugh, pass me the sats machine.’ He did so quickly, watching as Rachael clipped the probe onto Sheila’s finger.

  ‘Ninety per cent,’ he relayed the findings.

  Ninety per cent on its own wasn’t a terrible reading but given the fact that Sheila was on one hundred per cent oxygen and only moments before her saturation had been much higher, it was a marked and somewhat ominous drop.

  Rachael never missed a beat. In one movement she pushed the ‘alert’ bell above the bed and Helen appeared almost instantly. ‘Page Dr Khan, tell him Sheila’s saturations have dropped,’ Rachael said quickly, blowing up the blood-pressure cuff around Sheila’s arm and putting her stethoscope in her ears.

  ‘What’s her blood pressure?’ Hugh asked, opening the intravenous cannula and pushing the flask of fluids through by squeezing his hands as Rachael lowered the head of the bed.

  ‘I can’t get it.’ Her voice was clear but there was a definite tremor to it. Pulling her stethoscope from her ears, her fingers flew to Sheila’s neck. ‘Hugh, I’ve lost her pulse.’

  But even as she laid Sheila flat, called her name and felt again for a pulse, Rachael knew it was over, that this was the beginning of the end for this lovely old lady. By the time Dr Khan arrived, breathless and worried, at the bedside, the cardiac arrest team was being paged.

  Hugh stayed, expertly intubating Sheila with the equipment on the cardiac arrest trolley before the anaesthetist had even made it the bedside. Rachael knew from what he had told her last night that he must have been nervous, but not a single water jug went flying. He dealt with the emergency in a calm, authoritative manner, only stepping back when the resuscitation team arrived. Helen stayed to help, relaying the details efficiently to each and every doctor who pulled up breathless. Trevor pulled up the drugs as Rachael massaged the chest, only breathlessly stepping aside when the medics took over. They all played their part, all did their best.

  Only it wasn’t enough.

  Amazing herself, Rachael somehow remained calm throughout. Her biggest fear in coming back to nursing was that she’d somehow let herself down, let the patients down, if she let her emotions get in the way of patient care. Even when the team had dispersed, when she was left alone with her patient to gently remove the equipment and offer a final prayer, still Rachael held it all together. It was almost as if she was on autopilot, as if she couldn’t quite bear to look at the bigger picture. But seeing the relatives, watching them say goodbye to their loved one, was almost more than she could bear. As the sharp sting of tears bit at Rachael’s eyelids, the reality of the morning finally sank in, and it took every ounce of Rachael’s professionalism to do her last act for Sheila.

  Help her family to say goodbye.

  Orange Bay was subdued. Kathleen slept on, blissfully unaware of the tragedy behind the drawn curtains, but the other two patients lay back on their pillows in respectful silence, nodding briefly when the porters arrived and Rachael pulled the curtains around their beds.

  ‘I’ve paged Housekeeping,’ Helen said in a matter-of-fact voice. ‘They’ll come to wash and make up the bed when they can—they’re a bit snowed under.’

  ‘I’ll do it,’ Rachael said in a slightly weary voice. ‘It will be better for the patients in the bay. They’ve had enough to deal with this morning, without staring at her stripped bed.’

  ‘No,’ Helen said firmly. ‘You’ll go and have your lunch. It’s already long overdue. How’s your post-op patient?’

  ‘Fine.’

  ‘And how are you?’

  ‘Fine,’ Rachael said again, a touch too firmly. ‘But you’re right, I could certainly use a break. If Housekeeping don’t come …’

  ‘Then I’ll make the bed up myself.’ Helen shooed her off. ‘Go and have something to eat.’

  Hugh was in the staffroom, munching on a mountain of sandwiches, but for once Rachael couldn’t have cared less, her mind too full of the morning’s events to worry about last night. She nodded a polite greeting then sat down, peeling the foil off a carton of yoghurt, her mind a million miles away from the dashing blond surgeon only a couple of feet away.

  ‘I’ve just spoken to Dr Khan,’ he started, as Rachael stirred her yoghurt. ‘Apparently there was secondary cancer everywhere—on her liver, her lungs. They only removed the tumour for palliative reasons, to give her some comfort. It was probably for the best.’

  ‘Probably.’

  ‘I heard you talking to her. She wasn’t in any distress. If anything, she was just relieved the operation was over.’

  Rachael nodded dismissively.

  ‘Rachael?’ Hugh’s voice was questioning, probing. ‘This must be really hard for you.’

  ‘Why?’ For the first time she looked at him.

  ‘It’s your first death since Amy.’

  The directness of his observation took her aback. She was used to people swallowing nervously, going anywhere rather than there. ‘You can hardly compare the two. Sheila was old, she’d had a life, she was ill …’ All the platitudes that had stamped angrily through her mind were recited one by one, but even said out loud they offered not one shred of comfort. Yes, Sheila had been old, yes, she had been ill, but a beautiful life had ended, and the horrible inevitability of death had invaded once again.

  ‘I didn’t think it would hurt so much,’ Rachael stated honestly. ‘After what I’ve been through, I didn’t think seeing it happen to a virtual stranger could affect me.’

  ‘But it did?’

  She nodded, but still the tears stayed well away.

  ‘Is there someone you can talk to? Someone who can come over tonight, go over things with you? You shouldn’t be alone.’

  She waited, for what she wasn’t quite sure—an offer, a suggestion of dinner?

  ‘Perhaps your sister, Helen even …’

  Staring down at her yoghurt, she could hear the concern in his voice, the genuine tinge of worry, but that didn’t count for much, not in the scheme of things, anyway.

  ‘I’m sure I can rustle someone up.’

  ‘Good,’ he said, standing up and picking up his empty coffee-mug. ‘Someone ought to be there for you.’

  Just not me.

  He didn’t say it exactly, but his omission didn’t go unnoticed and Rachael knew there and then that she hadn’t been imagining things. The distancing she had felt last night as he’d driven her home had been real.

  Hugh didn’t want to get involved, which she could understand.

  Hugh wanted to stay out of it all, which would have been fine.

  If only she hadn’t already let him in.

  CHAPTER SEVEN

  IT WAS nice to be home, Rachael realised as she stepped out of the shower. OK, it wasn’t the plush townhouse she had lived in for the last eight years and the furniture wasn’t exactly showroom standard, but it was definitely a home. Nice, too, not to have Richard grumbling about how late she was, revving up the car in the drive, moaning she’d kept his clients waiting for dinner in some ludicrously expensive restaurant.

  Nice not to have Richard, full stop.

  Pulling on one of his ancient shirts that had long ago seen better years, she dragged a comb through her hair. Catching sight of herself in the mirror, she eyed her image for a moment, sucking in her cheeks, imagining the pout she was pulling with a quick burst of collagen. Then, craning her neck, Rachael parted her hair, quietly pleased to find that there wasn’t a single strand of grey. After the year she’d had, Rachae
l had half expected to be a bottle brunette by now! OK, she wasn’t perfect, far from it, but she was passable, pleasantly passable even.

  Peering closer, she took a more critical look. Except for that mole, Rachael thought darkly. Richard might have been way out of line in the timing of things when he had suggested that Rachael have it removed, but she’d always hated it. Yes, supermodels had them, yes, gorgeous actresses painted them on, but they all had figures to die for, perfect, pert noses and huge eyes. Maybe it was time to do something about it. Her time with the plastics patients had been enlightening, to say the least, and a mole removal was the tiniest of operations. It would hardly even leave a scar. But it wasn’t the thought of a scar that had put her off having it removed. Hugh had been right with his observations on the first day, though she’d never in a million years admit it to him, to anyone come to that. She had been a bit prejudiced, and not just against the doctors. Hailey’s decision to go under the knife had just seemed so extreme, so … Making her way down the stairs, Rachael tried to find a word that eloquently described how she felt.

  Superficial. That was the one.

  But not now. Slowly Rachael was coming round to the fact that there wasn’t anything wrong with trying to make the best of yourself, within reason, of course! The problems arose when you were so busy pleasing other people that somewhere along the way you forgot to please yourself.

  Curling her lip around the beginning of a smile, Rachael pulled ice cream out of the freezer and collected a spoon on the way through to the lounge, reading the label on the tub as she did so.

  ‘Five hundred kilojoules per fifty grammes,’ she muttered, flicking on the television and settling back to watch exactly what took her fancy.

  Richard would have had a fit.

  It wasn’t the most glamorous pose to be found in: a shabby old shirt barely skimming the top of her thighs and one hand clutching a bucket of double chocolate ice cream (with real chocolate chips). But when the doorbell rang Rachael immediately thought it was one of her neighbours come to tell her that they’d brought in the garbage bin for her or signed for a parcel on her behalf—certainly nothing earth-shattering.