The Doctor's Gift

by Fiona McArthur

  The tragedy felt heartrending and her voice was quiet as she addressed the nurse. ‘I’m Ailee Green, the transplant co-ordinator.’

  The nurse was very young but remarkably composed. ‘It’s Dr Green, isn’t it? I’m Sam. The family are waiting to speak to you. I told them you’d be here soon. I’ll introduce you.’

  Sam took Ailee across to the grieving parents. ‘Excuse me, Mr and Mrs Ellis. This is Dr Green. She’s the transplant co-ordinator we spoke about who can answer your questions.’

  A grief-ravaged woman in her early fifties held out her hand and her fingers trembled in Ailee’s grip with the force of her will not to cry. ‘I’m Marion. This is my husband, John.’

  Ailee squeezed the woman’s hand. ‘I’m Ailee. I’m so sorry to meet you in these circumstances and to intrude on your grief at this time. The fact that your daughter has signed and carried a donor card tells us a little about how special a person she was.’

  She let that hang in the air.

  The words were important. Respectful. Admiring. ‘I know this is very hard to discuss but I will try to keep it as simple as possible.’

  Marion blinked tears away and Ailee went on. ‘I understand you and your husband didn’t know that Eva had signed a donor card?’

  Both parents shook their head.

  ‘So you were shocked?’

  Marion nodded. ‘It wasn’t something we’d ever talked about. Now, seeing Eva like this...’ Her voice broke before she composed herself with a deep shuddering breath. ‘It would be like killing our own daughter to give away her organs. We don’t know what to do.’

  ‘It’s understandable for you think that way.’ Ailee’s voice was very soft, very gentle. She reached out and took Marion’s hand. ‘You both know that the person you knew as Eva, your daughter, has gone. She can’t ever come back except in your memories. Her brain has suffered such a loss of oxygen that it cannot even tell her body to breathe for her.’

  Ailee looked at the machine, and Eva’s parents followed her gaze. ‘If the machine wasn’t inflating her lungs, she would have died hours ago.’

  Ailee stopped to let her words sink in. She couldn’t imagine the pain these parents must be going through at this moment, and for a second she doubted she could control her own emotions.

  Then she thought of Jody — a young woman with her whole life ahead of her, except she’d needed a new kidney and pancreas — and how the incredible gift bestowed by her donor and their family had changed her life.

  Ailee lifted her chin. Blinked away the stinging in her eyes and drew a breath. Surely it was unnecessary to waste Eva’s perfectly functioning organs when Eva herself had seen the value in the concept.

  ‘If I could share something with you. To give you a different perspective?’

  Eva’s parents both inclined their heads.

  ‘We had a young woman on our transplant ward who went home this week. She is a wonderfully genuine and intelligent young woman, much like I imagine your daughter was, and has a lovely sense of humour. Only a month ago she was dying—’ Ailee slowed for them to take this in ‘—because her kidneys had both stopped working and dialysis was making her sicker. She’s had severe diabetes since she was ten.’

  Marion said, ‘Eva had a school friend with diabetes. With the needles.’

  ‘Then you know what this means.’

  Eva’s mother waved for her to go on.

  ‘On Monday this young woman went home with not only a new kidney but a new pancreas as well. Amazingly, she isn’t even a diabetic now. This young woman’s life is possible because of wonderful people like you and your daughter who have made the decision to donate their organs after they have died.’

  ‘Does the donor—’ Marion stumbled over the word ‘—does her family get to meet the person who has their relative’s organs?’

  Ailee shook her head. ‘Not usually. But this woman I mentioned is writing a letter that I will pass on to the family. Of all the people who know what a huge thing this is for the donor family to agree to, the recipients are the most aware. They actually find it very hard to get over how fortunate they are.’

  ‘We’ve been trying to reconcile this and that helps. Thank you.’ Marion turned to her husband who nodded back. ‘Eva was a very caring person. She would hate to think we wasted her organs when she didn’t need them any more.’

  John spoke for the first time. ‘We can’t let our little girl down on this, Marion.’ The balding man’s eyes were brimming with tears. ‘It’s what she wanted and it’s the last thing we can do for our baby.’

  Ailee’s eyes stung again. For these amazing people. ‘If you both agree, Eva’s donation will help a lot of people — not just one or two. In a week or so I will let you know just how much your daughter’s donation is going to change the lives of so many people.’

  Marion blew her nose and sniffed. ‘How does it happen?’ And then, ‘Will you be there?’

  ‘I won’t be in the actual operating room, but I will be co-ordinating from the outside. I can arrange for you to speak to someone who will be at the operation, though.’

  Marion looked at her husband and their eyes met and held. ‘Yes. Please. I think we need that.’

  ‘I’ll arrange that. We also need to know if there are any organs or tissue restrictions you would like me to pass on to the transplant team. Some people do have restrictions and we respect that.’

  Marion looked across at John and he shook his head slowly. ‘They can take whatever will help someone else. The real essence of our daughter is free. She doesn’t need her body now.’

  ‘I’ll come back this evening after I’ve organised the teams and set up the paperwork. We need to have blood taken for tissue-typing and other checks.’ Eva’s parents dipped their heads. ‘And we need you to fill out a questionnaire to ask about her general health. Nurse will help you with that.’

  * * *

  Ailee contacted the transplant data office and the patient’s details were entered. The computer assimilated the information and allocated the organs to those most in need and who were compatible.

  There was one phone call she was dreading. She’d run through who on the transplant or harvest team she would contact to meet Eva’s parents, and the most obvious choice was the man in charge. Ailee had no doubt that despite Fergus’s behaviour towards her at the moment, he would be a very caring advocate to introduce to the grieving parents.

  ‘Mr McVicker? It’s Ailee Green. I’m sorry to bother you at your surgery but I have a favour to ask.’

  ‘Yes, Ailee?’ There was an expectant note in his voice but she was too anxious to try and figure it out.

  ‘The family of the young woman donor who was admitted today would like to speak to someone who will be present during the operation. Would you speak to them for me, please, before you scrub?’

  ‘Of course. I’ll meet them in ICU at seven. Is that all?’

  Ailee sighed with relief. ‘Yes, thanks,’ she said, and as she tried to put the phone down she realised she’d have to consciously release her fingers because she’d been gripping the receiver far too fiercely.

  Seven. She’d be home late tonight then.

  * * *

  The afternoon passed swiftly and it had been dark for an hour when Ailee returned with Fergus to meet the parents.

  ‘This is Mr McVicker. He’s the renal surgeon and in charge of the transplants in this hospital.’

  Fergus shook hands with Marion and John. ‘Please, accept my sincere commiseration for the tragic loss of your daughter and the difficult and awful situation you are both in.’

  Marion swallowed visibly and Fergus went on, ‘I want you to know that the operation is performed with every respect and dignity by each of the very experienced transplant teams who will come to our hospital.’

  Eva’s parents nodded.

  ‘The operations are carried out as sterile operations, of course. Afterwards we do repair any incisions we make as neatly as in all operations.’
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  Fergus answered a few more questions and then it was time for him to go to theatre.

  Marion and John went once more into Intensive Care, heads bowed, weighed down by the magnitude of saying their final goodbye to Eva. ‘Will we be able to see Eva’s body after the operation?’

  Ailee nodded. ‘Tomorrow morning I’ll come and take you to our chapel in the mortuary, where you can spend as much time as you wish.’

  ‘Thank you, Ailee.’

  Ailee swallowed the lump in her throat, her face schooled to show nothing but compassion and control. ‘Thank you. You have made the right decision. We all appreciate your kindness during your immense grief. Your daughter’s legacy will live on through those she helps.’

  ‘We know. It’s just hard to think of it at the moment.’ Marion squeezed her husband’s hand and Ailee bit her lip.

  ‘Of course. This isn’t the time to worry about that. Please, try and get some rest. I’ll see you in the morning. Just remember that this is what Eva wanted, but it takes courage from everyone to make this decision.’

  Marion looked sadly at Ailee. ‘We don’t feel brave, just heartbroken.’

  Ailee watched them walk away arm in arm, leaning on each other, and she allowed the tears to well in her eyes. Just for a second before she brushed her hand across her face to stem the flow, at least until she reached the safety of her office. But as she pushed open the door the heartbreak overwhelmed her and she sobbed against the closed door.

  ‘I knew you’d be upset,’ Fergus said softly from within.

  Fergus leant against the wall and had pushed himself off when she entered. He held open his arms and her brain said no as her heart steered her into the comfort of his embrace. His scent, spicy and masculine and familiar, surrounded her with comfort. Just comfort.

  She sobbed quietly for a minute to ease the strain of staying strong for the last few hours, and he just held her gently until the storm passed. She had no idea Marion and John’s grief had affected her so much. Perhaps there’d been more emotional impact because she was now so personally invested, with William’s and her upcoming ops. And her mother’s difficult last few months.

  ‘I’m sorry if you think I’m unprofessional. This isn’t the first time I’ve dealt with loved ones, though not as the coordinator of consents and consistent close family contact. Something about Eva’s mother affected me.’

  ‘Shhh,’ Fergus said quietly. ‘Being upset is human and you were totally professional until you closed your door. There is no shame in that.’

  Despite her tears, and the embarrassment of letting go, she did feel better and Ailee lifted her ravaged face to thank him, but that thought caught and died as they stared at each other. There was nothing either of them could do as a force greater than their wills drew them together for a single, healing kiss.

  His mouth felt undemanding, gentle and healing, but still hot and heavenly, and her body softened into him for a few wonderful moments before reality forced her back.

  She could not do this here, now, with him. It was so inappropriate, so unprofessional.

  ‘No.’ Ailee stepped back out of his arms and her hand came up to cover her mouth. ‘You said this wouldn’t happen.’

  ‘I did, didn’t I?’ Fergus looked at her and again she couldn’t read the expression on his face. ‘I’m sorry,’ he said, and walked out of the office.

  She felt like crying again, for a different reason.

  * * *

  The next morning, Thursday, when Ailee went to meet Marion and John to take them to the mortuary, Fergus was with them. He had his arm around Marion, whose face looked ravaged by tears.

  Fergus looked so put-together, instead of having operated all night, and only the lines around his eyes betrayed his tiredness.

  As Ailee drew closer she could hear no weariness in his voice.

  ‘You can ring my surgery if you have any other questions and I’ll phone you back as soon as I can.’

  He looked up. His eyes darkened with concern when he saw Ailee, as if he knew how hard this was for her, and she was transported back to their kiss yesterday and how he’d caught her at her most vulnerable.

  Then he looked away and she felt cold.

  How did he do that?

  Fergus spoke to the bereaved parents. ‘Here’s Dr Green. I have to go but I will leave you in her capable hands.’ He shook hands with John and to Ailee’s surprise hugged Marion. ‘It’s been a privilege meeting you both.’

  They all watched Fergus move away and John reached over and took his wife’s hand. He looked at Ailee and then the sign that pointed the way to the chapel. ‘Let’s say goodbye to our daughter, love.’

  By the time Ailee made it back to the ward she felt emotionally shattered by sharing Marion and John’s grief again.

  After the last twenty-four hours she admired the injured Maureen, the woman she was replacing at the moment, more than ever. Dealing constantly with such emotive issues, day in and day out, as a transplant co-ordinator was proving more difficult than she could have imagined. So much easier to be the surgeon.

  As soon as she walked into the ward her pager went off, just as Rita appeared breathlessly beside her.

  ‘Ailee.’ Rita gulped air. ‘Mr McVicker is looking for you. The page is from the operating theatres. Emma is bleeding and they need more help. The extra team had to leave and are tied up in a critical trauma case down in Emergency. Fergus wants to know if you can assist in Theatre Six.’

  Ailee felt her stomach drop at the thought of Emma, mother of the baby twins, with a major haemorrhage. ‘Answer the page. I’m on my way.’

  Ailee turned and ran out the door. She didn’t bother waiting for the lifts. It was only two flights and the stairwell came out beside the operating suite. She’d surgically assisted Dr Harry there for twelve months before going off to Scotland and she knew the way.

  Ailee pushed through the plastic doors. Ominously, there was no one in the reception area. It seemed everyone was caught up with the emergency.

  She slipped into the change room and swapped into her theatre scrubs faster than she’d ever done in her life.

  When she entered the scrub room to wash up, a spare gown and two pairs of gloves were waiting for her, and before she’d finished drying her hands the scout nurse came in to tie her gown.

  ‘What’s happening?’ Ailee struggled with her gloves while the nurse finished tying her gown.

  ‘Don’t know. The transplanted kidney was seated and blood supply established and everything was routine. The other surgeon left for the emergency downstairs, but then Mr McVicker suspected a hidden bleeder and the new registrar hasn’t enough experience to be the help he needs.

  ‘Mr McVicker asked for help and the anaesthetist — you know how Andrew likes to bend the rules — said there was no one else except you. The kidney is at risk, let alone the patient.’

  ‘Nice to be the last hope.’ Ailee was finished and spun around to enter the theatre.

  ‘You had our vote.’ The nurse glanced through the window into the theatre to make sure the way was clear for the sterile-gowned Ailee to enter.

  ‘You’re finally here.’ Fergus looked up and his expression appeared grim.

  ‘What can I do?’ Ailee answered calmly as she stood beside the shaking registrar and peered into the wound that was awash with bright blood.

  ‘I need some vision through this blood and with only two of us we don’t have enough hands.’

  ‘I’ll take the sucker.’ Ailee spoke to the registrar who thankfully handed over the plastic nozzle. ‘You take the retractor and pull from that angle with two hands. It will be easier now.’ The young man straightened his shoulders and nodded.

  ‘More swabs.’ Fergus stared with narrowed eyes into the wound and Ailee took swabs from the scrub sister, who looked pale under her eye shield as she hurried to do what she was told.

  ‘And can I have a swab on a stick as well, please, when you’re ready?’ Ailee’s gentle voice seemed to d
issipate the tension in the room as the scrub sister looked at her with relief.

  Ailee swabbed the area she’d just suctioned and for a brief instant a welling of blood could be isolated from the rest before it disappeared under a tide of red that filled the cavity again. ‘There.’

  ‘Good work, Ailee.’ Fergus had seen it, too, and now that he knew where the problem lay, he set to isolating the vessel as fast as he could.

  ‘Blood pressure’s going through the floor.’ Andrew’s voice drifted laconically to the surgeons as he set about increasing the amount of fluid he was infusing. ‘I’m on the last packed cells now.’

  ‘I can see the bleeder.’ Fergus acknowledged he’d heard the warning. ‘I won’t be long and we’ll stop wasting the stuff.’

  The alarms sounded from the anaesthetic equipment and Ailee spared a brief thought for Peter and Emma’s baby girls if Emma’s lack of blood caused her to go into cardiac arrest on the table. It was a horrific scenario to contemplate.

  She forced away the thought. The situation was grim but she didn’t doubt that Fergus would gain control. He had almost finished repairing the vessel, and Ailee had never seen one ligated so well under such circumstances. ‘That was quick, but there’s still too much blood.’

  ‘Then find where it’s coming from, fast.’ Fergus finished his knot and held his hand out for another suture.

  Ailee spoke to the registrar. ‘Can you pull from a more lateral angle? I want to see under the bladder.’ For the briefest moment, after suctioning and a quick swipe with the swab at the end of the long forceps, Ailee spotted another mini-fountain of blood. ‘There.’

  That explained it and she knew they’d win the battle now.

  ‘Saw it. Got it.’ Fergus pressed his finger on the spot and collected another swab from the scrub sister. ‘You little bastard,’ he said softly.

  Ailee raised her eyebrows. ‘Language.’

  The registrar looked doubtfully at Ailee taking on the boss, especially after the morning he’d had. Fergus glanced up in time to see her censure and his eyes crinkled as he relaxed. ‘Smack me later.’