Could Ryan perform this surgery? Yes. Did Alex want to pass it on? He could use his position as head of department and say that Ryan needed the experience of this case.
Layla had remained silent while Alex studied the CT scan images. She stood back when he went to meet Dayna and Matthew. Small for his age, Matthew had a very pale face, big brown eyes and spiky black hair. He was in pain and terrified.
‘Hey, buddy …’ Alex could feel something squeeze hard in his chest when he smiled gently at the little boy. ‘I hear you’re going to be a fighter pilot when you grow up?’
Huge brown eyes were locked on his face. He heard the suppressed sob that came from Matthew’s mother, who was sitting beside the bed, holding her son’s hand. And he could feel Layla’s watchful gaze from somewhere behind him. Could feel the hope.
‘I’ve heard that there’s a special airplane bed somewhere around here,’ he told Matthew. ‘What say I arrange for you to fly upstairs to come and have the operation to fix that nasty headache you’ve got?’
He had to brush close to Layla as he went ahead to set things up. He hadn’t expected her to follow him. He didn’t want to see the gratitude in her eyes when she touched his arm and forced him to stop just as he got to the internal double doors of the emergency room.
‘Thanks,’ she whispered.
‘Don’t thank me.’ Alex knew he sounded curt but he couldn’t let this go on. ‘This isn’t anything personal, Layla.’ He held her gaze and had the odd sensation that he was trying to use his own to push her as far away as possible. ‘I’ve thought about it,’ he added, ‘and the answer’s no. We’re colleagues now. And that’s all we can be. Anything else is a recipe for disaster.’
He saw the shock of his words but he had to hand it to Layla. If she was disappointed she hid it completely.
‘You’re probably right,’ was all she said. ‘I’d better get back to Matthew. Maybe I can catch you later to follow up.’ She turned away. ‘On the surgery, I mean.’
Alex pushed the doors open with a little more force than necessary. Probably right? What did that mean? And had she really needed to underline that talking to him later would be purely professional?
Hell … maybe she wasn’t disappointed at all.
Scrubbing in for Matthew’s surgery a commendably short time later should have been the end of any personal undercurrents in Alex’s thoughts. This was always a private time when he could centre himself and focus completely on what was going to happen when he had finished this intensive preparation.
Except it was taking a lot longer than usual to get to that focussed space. The suds being formed by the small soap-impregnated scrubbing brush foamed all over his hands but he wasn’t ready to rinse them off.
He kept scrubbing. Under each fingernail. In the webbing between each finger. In a world of his own during this automatic preparation for surgery.
When you looked back on your life, he found himself musing, sometimes it’s easy to see a particular day that marked a turning point in your life.
He’d had quite a few of them.
Like that dreadful day when he’d been only ten years old, and his beloved mother had died of breast cancer.
The day he’d finally walked out on his abusive stepfather, when he’d been sixteen, having made the heart-breaking decision that it would be better for Cade if he removed himself from the picture.
The day he’d first set eyes on Layla Woods and had realised that, against all the odds, he was still capable of trusting someone else.
Of loving them.
The flow of warm water was like balm after all that scrubbing. Alex rinsed the foam off his hands and then changed the angle of his arms so that he could rinse from his wrists to his elbows without letting the foam touch the well-cleaned skin of his hands. He picked up the sterile towel to dry himself, still lost in his thoughts.
In a few seconds he knew he would be able to turn them off as decisively as the tap he’d just been using and focus with the same intensity on the job ahead of him, but he also knew that, to get to that point of focus, he needed to let this train of thought reach its conclusion.
None of those earlier, turning-point days had been clearly marked in advance so that you got the chance to think about it and weigh up the potential benefits and downsides. Like he had been able to do ever since he’d parted company from Layla after their time in Central Park. Ever since he’d seen that willingness in Layla’s eyes to start something between them again.
The history he had with both Callie and Cade would colour whatever advice they might give him. The history he had with Layla made it impossible to think rationally when he was close to her, let alone talk to her and hear that sweet Texan drawl that had been one of the first things that had attracted him to her.
By late Sunday night Alex had decided that getting back into any kind of a relationship with Layla would be a bad idea. He’d been quite confident that, with the calming distraction of a heavy day at work, that decision would seat itself so firmly he would be more than ready to talk to Layla later and find another way to deal with having to work together.
He was still confident that the decision was right. He just hadn’t bargained on this turning out to be such a stressful day.
OK, he’d known that making a decision about Tommy Jenner would be a tough call and his heart had sunk as he’d watched the MRI images coming up on screen this morning. The call was too close to make one way or the other right now. A professional and emotional tightrope. The hardest thing had been to face Mike and Gina in his office and tell them he needed more time. That, despite their desperate pleas, he couldn’t tell them his decision until he’d given it a lot more thought.
And it had been at the end of that interview that he’d received the summons to join Layla in the emergency department.
Well … he’d told her his decision now. And she’d accepted it.
The worst was over.
Now he could focus properly and move on. Do what he did best and go into Theatre to try and save a young life.
Layla slipped into the observation area above the operating theatre.
She saw the busy team preparing the theatre around the tiny, still form that was Matthew lying there under the bright lights. The television screen up here showed a close-up of Matthew’s head. A large patch of his adorable, spiky hair had been shaved off and a nurse was painting the skin with iodine.
She saw the moment the star of the show arrived, hands held carefully crossed in front of his body, using his shoulder blade to bump open the swing doors that separated the theatre from the scrubbing-in area.
Alex …
He could do this. He could save Mattie. Layla’s teeth sank into her bottom lip so hard it hurt. It didn’t matter about the decision Alex had come to regarding what they did about the attraction they had for each other. All that mattered in this moment was the life of the child on the table.
Please …
As if he felt the force of her plea, Alex looked up as he took his position at the head of the operating table. Layla was by no means alone in the observation area but his gaze went unswervingly to where she was sitting.
Could he actually see her face behind the wall of glass when the lights down there were so much brighter?
Possibly not. But he was aware of her, that was for sure.
Layla’s heart gave a painful thump. Maybe she shouldn’t be here. Could her presence, reminding him of the tension between them, distract him in any way? The way she’d always believed it had in Jamie Kirkpatrick’s case?
She’d put pressure on him back then, ending their affair.
She’d put pressure on him again now, suggesting that they revisit that affair as a way of dealing with their unfinished business.
If anything bad happened to Matthew today, that would be the end. Alex would never want anything to do with her again.
Had she realised how much she was putting on the line by insisting that Alex get involved with this case? H
ad she even thought that he might take the opportunity to get what he wanted to say over with?
Of course she hadn’t. She had followed her heart.
The disappointment of hearing his decision had been a body blow that she was still reeling from but Layla was fighting back. She shouldn’t be this disappointed. She’d never expected to have Alex Rodriguez back in her professional environment, let alone her personal life.
Why couldn’t she learn not to be so impulsive? To take the time to really weigh up the repercussions of making emotionally based decisions? She’d done this too many times in her life already.
Like when she’d fallen into Alex’s arms in the first place, all those years ago.
When she’d ended things between them because she hadn’t been able to stand the guilt and the way he had been making her feel.
When she’d practically thrown herself at Alex and suggested they kept seeing each other. Intimately.
The emotional overload was unbearable but, thankfully, it coalesced into only an imperceptible moment in time.
The subtle nod that came from Alex was probably just as imperceptible to anyone other than Layla. He seemed to be acknowledging her presence.
And reassuring her that it wouldn’t distract him.
The whole team was poised as Alex turned his attention to the exposed patch of Matthew’s head. He held out his hand.
‘Scalpel.’
The critical point of this surgery came when the blood supply to the brain had to be compromised to allow a permanent repair to the damaged vessel, which was a major artery. There was only a small window of time—four minutes—before the blood flow had to be fully restored to avoid the certainty of brain damage. If the repair hadn’t been done well enough by then, there would be no second chances.
‘Start the clock.’
The order was delivered with crisp precision.
Alex was ready.
A small boy’s life depended on what he was about to do. The child’s desperate mother was sitting in a waiting room not far away. Layla was sitting in the observation area of this operating theatre.
Part of Alex’s brain was aware of all these things and their implications but none of them could even begin to intrude on his intense focus on the job in hand. The intricate and challenging clipping of this defective blood vessel without allowing it to burst or cause any collateral damage through the technique.
The clock kept ticking.
‘Two minutes,’ the anaesthetist warned.
Beads of perspiration formed on Alex’s forehead. A nurse patted them dry with a gauze swab. He had to blink and refocus his vision through the magnifying lenses of his eyewear.
The clip was so tiny. Slippery. So hard to slip into exactly the right position and keep it there long enough to secure it.
‘Fifty-eight seconds,’ the anaesthetist said quietly. ‘Forty-five … thirty …’
It was there. In place. Alex squeezed it shut.
‘Stop the clock.’
Another minute of complete silence as Alex inspected his handiwork in minute detail and finally he could give the verdict that created a collective release of breaths being held.
‘Looking good. We can close up now.’
It was done and he knew it had been done well.
Only now could Alex allow himself a split second of satisfaction before focussing on the automatic protocols of closing. A moment to take a deeper breath and know that he had made a difference. Saved a life?
Quite possibly, although there was still plenty to be anxious about until he could measure the steps to recovery that Matthew would need to take.
Still, he could look forward to telling Dayna that the surgery had gone as well as they could have hoped for.
He could imagine what he would see in Layla’s eyes when they next came face to face.
Gratitude, for sure. Far more than he’d seen when he’d agreed to take on this surgery in the first place.
Admiration as well?
The bone flap was back in place in Matthew’s skull a short time later and the probe to measure intracranial pressure was secured and tested. The final stitches and bandaging were the only tasks to be completed. Alex could relax.
And it was then that the realisation hit him.
He had been aware of the undercurrent of emotional pressure of this surgery, not only for his patient and the family but from Layla’s investment in this case. From having her right there, watching his every move.
And it hadn’t made any difference. He had put it aside and done exactly what he’d needed to do, to the very best of his ability.
Maybe he could handle more than he’d thought he was capable of when it came to Layla.
If he was aware of the danger of real emotional involvement, he could overcome it. Just like he’d just demonstrated when he’d been concentrating on Matthew’s operation.
If he heeded Callie’s warning, he could make sure he didn’t start trusting Layla too much. So that when the end came, as it would, he would be prepared for it and it wouldn’t destroy him because he would have been in control all along.
Maybe Layla had been right all along.
If they threw fuel on the smouldering ashes of what had once burned so brightly between them, it could burn itself out for once and for all.
It had worked with Callie Richards, hadn’t it?
And if it could burn itself out, he wouldn’t be left for the rest of his life wondering what if …?
No wonder last night’s decision had been so hard won.
It had been the wrong choice.
But he’d already told Layla so it was too late to change his mind.
Or was it?
As the final stitch was cut, Alex dropped the curved needle and its holder onto the instrument trolley and looked up to where Layla had been sitting at the end of the row of seats. As soon as he saw her again, he might know the answer to that burning little question.
The seat was empty now. Layla wasn’t there.
Layla had slipped out of the observation area with much the same stealth as she’d entered it, only this time she was having to swallow past a painful constriction in her throat.
She was just so darned proud of Alex.
Not that she could tell him that. She needed to clear her head and get back into a space where she could tell him how well he’d done on a strictly professional level without revealing such a personal response. He wouldn’t want to see that. It would spell the end of being able to work together without the kind of tension that would inevitably become too poisonous to be tolerable.
Keeping herself busy, Layla waited a couple of hours before going to the PICU herself, where she found Matthew resting comfortably, still well sedated, and Dayna exhausted but with her eyes still bright with tears of relief.
‘Dr Rodriguez is brilliant, isn’t he?’
‘He sure is.’
‘He said we won’t know if there’s been any lasting damage until Mattie’s properly awake again. That he might have some hurdles with his speech for a while, or a weakness on one side. But that he’s young enough to recover completely from anything like that and that it was so lucky we found the problem in time.’
‘I’m so happy we did.’ Layla shared a hug with Dayna. ‘I’ll come by and see how you’re both doing again tomorrow morning.’ She stood back to cast a practised eye over the monitors surrounding Matthew’s bed and Dayna followed the direction of her searching gaze.
‘Dr Rodriguez said it’s all looking real good. You just missed him. He said he had to go and check on another patient on the ward. That it seemed to be his day for special little boys who needed big operations.’
Layla caught her breath.
Tommy.
Alex must have gone to give his decision to Mike and Gina about whether or not he would operate. She knew how big a decision that would have been to make because she’d seen those MRI results.
The tumour had shrunk thanks to the chemotherapy but it was stil
l a nasty one and it was in a very difficult spot. Uncannily like the one Jamie Kirkpatrick had had.
She could understand if that was enough to make Alex shy away from the challenge but would it have made any difference, having had the success with Matthew today?
Layla had to find out. This wasn’t personal so she had no trouble justifying the need to see him. She didn’t even give herself the time to question the wisdom of doing so.
She went straight from the PICU to the neurology ward. To Alex’s office.
The door was very slightly ajar and she could see the screen on the wall with an image from an MRI being displayed. Tommy’s MRI.
Did he still have Mike and Gina in the office? She couldn’t hear the sound of any voices but could they be sitting in stunned silence trying to absorb some very bad news?
No. Alex would have closed his door before having a conversation like that.
Indecisiveness was not an option here. Layla tapped lightly on the door and went in, pushing the door shut quietly behind her.
Alex was alone in his office. Standing by the window, clearly lost in thought, tapping the end of the ballpoint pen he was holding against his bottom lip. Papers were strewn across his desk and some of them had rough-looking sketches. The kind you might make if you were talking someone through what was going to happen in a complex operation.
Alex turned slowly to watch Layla as she looked up from noting the sketches.
‘You’re going to do it?’ she asked softly. ‘Tommy’s operation?’
The response was a curt nod. ‘Everybody understands the risks.’
‘But it’s worth a shot?’
Another nod. More considered this time. Alex was holding her gaze and Layla could see something that had nothing to do with any patient in his eyes. She had to take in a slow, steadying breath. What she was seeing now was very, very different from the way he’d looked at her when he’d told her his decision.
NYC Angels: An Explosive Reunion Page 8
