Prognosis So Done

by Andrews, Amy

  MedSurg had set up in an old whitewashed convent that harked back a couple of hundred years to colonial times. Kelly used this building for the medical side of the mission and across the dirt a long, rickety concrete path connected it to the old orphanage building, which was where the surgical side

  was housed.

  The area had once been a thriving community — now it was just a few buildings in the middle of nowhere on the periphery of a war zone. The buildings had been used until the recent civil unrest as a medical facility. The nearest towns were at least one hundred kilometres in any direction, the nearest hospital at least two hundred and fifty kilometres away.

  The old orphanage now used as the surgical block, was a double-storey building with wide, open verandahs that wrapped around the entire building to take advantage of any breeze that might be wafting by. Two downstairs rooms had been converted to operating theatres with basic tables, anaesthetic machines, monitors and overhead lights, and smaller side rooms each housed ancient instrument sterilisers and served as excess storage.

  Another of the bigger rooms was set up as the HDU/recovery area and there were various smaller rooms used for their triage meetings and as a communal kitchen and lounge area.

  Upstairs were the living quarters. The bedrooms were all small but they had French-style doors that opened onto the verandahs. Not that it was actually that safe to be sitting out there a lot of the time, but the tantalising luxury was there if anyone had the nerve.

  It wasn’t much but in a country that had so very little, nobody complained. They were here to make a difference – that was all that mattered.

  By the time Gill got to the theatre the team was there and everything was under control. Siobhan was scrubbing up when he asked a masked Harriet, ‘Everything good to go?’

  ‘Just about. Go scrub.’

  She was busying herself with opening sterile packs. Harriet was the circulating nurse today which was a rather grand term for gopher. She set up and opened all the outer packaging of the different surgical packs and instruments and anything required during the operation by any of the sterile people, she fetched. The three nurses took it in turns, rotating from scrubbing to circulating, and the system worked well.

  Gill took a quick brain picture. Harriet in her hat and mask, her features completely hidden from his gaze, was mystically beautiful. The deep brown depths of her eyes were emphasised tenfold, and he felt like he always did – like he was falling into a warmed vat of deep rich chocolate and drowning.

  Siobhan entered then, her arms held slightly aloft and bent at the elbow, water dripping from them and Gill departed to do his scrub returning a few minutes later exactly as Siobhan had. Picking up the sterile towel that sat folded on top of the sterile gown that Harriet had opened, he dried his hands and arms thoroughly then picked up the gown.

  Thrusting his arms into it with an efficient technique, he turned so Harriet could tie it at the neck. Her quick movements brushed at his nape and Gill’s eye shut but it was over too soon and next he was shoving first one hand then the other into the size-nine gloves an already gowned up Siobahn held open for him.

  Grasping the tab at the front of the gown he pulled on it to release the waist tie and, with a non-touch technique, he passed off the end to Harriet who tied it at the back.

  Siobhan was now sorting out the tray of instruments on her sterile draped table and Gill watched as she and Harriet conducted a count of the swabs, towels and instruments most likely to be used during the procedure. Harriet scribbled the numbers on the count sheet so they could all be accounted for at the end of the procedure.

  The patient came in then, accompanied by Katya and Joan, and it was all hands on deck. Joan and Helmut anaesthetised him and Katya left to scrub in as well.

  Finally everything was ready. The suction was working, the diathermy was in order and an earthing plate had been stuck to the patient’s thigh. The patient was draped and the surgical area prepped with Betadine. Joan signalled she was happy with their patient’s condition and for Gill to commence.

  As Gill removed the staples he had placed less than twelve hours ago, Harriet placed an Ella Fitzgerald CD in the portable player and switched it to background. It was his favourite thanks to his grandfather’s influence and he loved to listen

  Ella’s dulcet tones as he operated. They were soothing and focused his brain.

  Gill quickly reopened the abdo wound. ‘Retractor,’ he said.

  Siobhan placed it in his hand and he inserted the heavy metal contraption into the wound and turned the cogs, watching as it slowly cranked open, taking the skin and layers of adipose tissue with it, pushing them back to either side to give a clear view of the abdominal cavity.

  ‘OK, folks,’ he said, ‘let’s find us a hole.’

  Gill knew this could take five minutes or two hours. Finding a little tear was sometimes like trying to find a needle in a haystack. Lucky they had a short cut.

  ‘Saline.’

  Gill tipped the sterile bowl full of warmed sterile saline gently into the abdominal cavity, submerging the bowel, and waited. After a beat or two a small bubble floated to the surface and popped. Yes! Now he just had to find it!

  It was probably on a posterior side somewhere. He’d have to start from the top and work his way down. Siobhan used a sucker to remove the fluid and Gill began the painstaking process of checking every centimetre of the intestine. It was warm in his gloved hands and squishy, like a bowl of jelly, but looked and felt like a string of sausages.

  He heard Harriet humming to ‘Cry me a River’ and glanced up. She always did that. Even scrubbed, she would hum along to Ella, completely unaware she was doing it. He’d missed that this last year, watching Harriet move around a theatre, humming quietly to herself. Or standing next to him, rubbing shoulders, passing him instruments as she hummed away.

  He’d had it back for a blissful two months and she was going to snatch it all away again.

  His eyes flicked back to what he was doing. He really needed to concentrate, damn it! He was too aware of her. Too aware of her every move around the theatre. Opening things, writing things, murmuring something to Helmut and humming along to Ella.

  ‘Could you adjust the light, Harry?’ he asked.

  Why, he didn’t know. The light position was just fine. But then she moved closer and reached up for the light and he could smell her perfume, and he was so very glad he had.

  She’d moved it a millimetre when he said, ‘That’s fine.’

  She glanced at him, a puzzled look in her eyes as to why he needed such a miniscule adjustment and their gazes locked for a second. Then she was stepping away and Gill pulled his head back in the game.

  After another twenty minutes of looking, he finally located a small nick on the posterior wall of the ascending colon not far from the appendix.

  ‘Bingo,’ he murmured. ‘Suture.’

  Gill over sewed the minor tear, and then gave the entire area a good lavage with warmed saline to wash out any debris that might have found its way into the abdominal cavity through the small hole. Fortunately the patient already had triple antibiotics on board to cover infection. Siobhan suctioned the saline out again as Gill reinserted a new drain through the old tract.

  Once Harriet and Siobhan had finished their final count and were satisfied they had everything back that they’d started with, Gill went ahead and closed the abdomen. The phone rang just as he was finishing up.

  Harriet reached for the phone. ‘Theatre. Harriet speaking.’

  ‘Good morning. This is Genevieve from MedSurg communications

  centre. We have an urgent message for Dr Remy. Is he around?’

  Harriet clutched the phone, a sixth sense making her

  uneasy. What had happened? It had to be bad for comms to be passing on a message.

  ‘He’s closing an abdomen at the moment. I’m his wife. You can leave it with me.’

  She could feel herself blush and Harriet was grateful for the mask
as Gill looked up abruptly from his work. She knew it was a bit rich, making a claim on a marriage that she had in effect just ended and the slight mocking expression in his eyes told her the irony wasn’t lost on him, either.

  ‘Who is it?’ he asked.

  ‘Comms. Urgent message for you.’

  ‘Tell them to give it to my wife.’

  Harriet didn’t miss the derision in his emphasis, although she was sure the others hadn’t noticed. ‘Did you hear that?’ Harriet asked Genevieve.

  ‘Yes. OK. We have a phone call from his father. Henri Remy has had a massive heart attack and is in a critical condition in Coronary Care.’

  Harriet closed her eyes briefly and swallowed hard. No. Not

  Henri. Gill was exceptionally close to his grandfather. Hell, so was she. It was hard to believe that a man who had a heart the size of Henri’s would ever succumb to human frailties.

  This news would hit him hard.

  ‘What?’ Gill asked, his brow furrowed as Harriet slowly replaced the receiver.

  She looked at him hoping the anguish she felt in her heart wasn’t reflected in her eyes. ‘It’s Henri,’ she said, pronouncing it with the correct French inflection as Gill did. On-ree.

  ‘Is he dead?’ he asked bluntly.

  Harriet flinched at Gill’s directness but noticed his vice-like grip on the instrument in his hand and wanted to go to him. Scrubbed or not. Sterile or not. ‘No.’ She shook her head and tried to expel the tremor from her voice. ‘MI. He’s critical.’

  She saw the disbelief and shock and they shared a brief moment of solidarity. He blinked rapidly a few times, said, ‘Okay,’ then turned back to his patient and closed the wound.

  CHAPTER SIX - 1200 HOURS

  Harriet sat opposite Gill in the lounge area. He had pulled his hat off and was running a hand back and forth through his rumpled hair as he had an animated discussion in French with his father. He was sitting on the edge of the chair cushion, bent forward at the waist, his elbows on his knees, his head bowed. She was sitting in a similar fashion, their knees almost touching.

  He looked awful.

  She’d never seen him look his age before, but right at this moment he looked every one of his forty years. His forehead was creased with concern and he looked pale and haggard, like he’d been operating for twenty-four hours straight.

  She fought a battle over touching him and lost. The sensible side of her, which had been trying to step back, resisted, but the emotional side caved in. He was still her husband and even if he wasn’t - which was soon to be the case - he was a significant part of her life and had just received bad news.

  The urge to comfort him was strong.

  Harriet placed her hand on his knee and he glanced at her as he continued his conversation, giving her a grim smile. He stopped worrying his hair and covered her hand with his, stroking her fingers, curling his into hers, linking them together, his thumb brushing back and forth across her knuckles.

  He replaced the phone a minute later and sat there quietly for a beat or two before saying, ‘They’re very worried about him.’

  ‘Oh, Gill, I’m so sorry,’ she whispered.

  ‘He’s eighty-eight. I guess we keep forgetting that. He’s always been so larger than life.’

  She nodded because suddenly she felt too emotional to speak. Tears pricked at Harriet’s eyes as she imagined Henri - big, strong Henri - lying helpless in a hospital bed. She wanted to say, he’ll be OK but she couldn’t when she wasn’t sure if Henri would pull through this at all.

  Things didn’t look good.

  ‘Harry,’ he whispered, his probing gaze easily clocking the shine of tears in her eyes.

  His voice conveyed the same kind of devastation she felt and she wanted to put her arms around him so badly. They may be breaking up but she hadn’t stopped loving or caring about him.

  Giving in to her gut feeling, Harriet’s knees hit the floor and she pushed herself between his legs as her arms slid around his waist and she hugged him for all she was worth.

  And he hugged her back.

  It felt so good, being like this. Everything seemed right with the world from this perspective. It didn’t matter that outside these walls a stupid civil war raged or that his grandfather was probably going to die or that he didn’t want babies.

  Wrapped up in his embrace, everything was OK for now.

  But, it couldn’t last forever and eventually Harriet eased away, leaning back onto her haunches. ‘At least it happened today,’ she said, searching for something positive.

  She knew that, despite his deep affection and loyalty towards his grandfather, Gill would have been very uncomfortable leaving them mid-mission. It was part of that humanitarian streak and work ethic his grandfather had instilled in him.

  ‘Everything is already arranged for your departure tomorrow. Or are you leaving immediately?’

  ‘No. There’s only today to get through. I may as well see the mission out. It probably couldn’t be arranged much before tomorrow anyway.’

  Harriet swallowed before she said what she was about to say. It was a possibility she didn’t want to think about but it had to be said. ‘What if he...?’

  ‘Dies before I get home?’

  She nodded. ‘Yeah.’

  ‘By the sound of it, that’s a distinct possibility. But, given how far from home we are, there’s not much I can do about it.’

  It was a gloomy statement. Of course, Henri was going to die eventually. He was an old man but the vitality of the Remy patriarch had lulled them all into a false sense of security.

  Harriet absently ran her hands along Gill’s thighs. She’d barely seen him for a year but two months back in his life and his bed and she’d slipped easily into old intimacies. What was the expression — old habits died hard?

  ‘Do you remember the first time I met Henri?’ she asked.

  He smiled at the memory. ‘Of course. You were an instant hit.’

  Henri had announced it was Harriet’s lucky day because he was cooking escargots and she had clapped her hands and declared she’d always wanted to try the delicacy.

  ‘You were the only woman I’d introduced him to that didn’t screw up her nose at the thought of snails.’

  ‘I was just relived he hadn’t said frog’s legs.’

  He laughed. ‘Do you know what he said to me that afternoon, before we left?’

  ‘No. What?’

  ‘He said, Guillaume, if you don’t marry that girl, I

  will.’

  They laughed together and Harriet saw the tension ease a little from Gill’s shoulders. She was grateful she’d been able to take his mind off things a little.

  His hands slipped over top of hers, his thumb finding her wedding ring and he rubbed it back and forth as he stared at it on her slim finger. It had been his grandmother’s.

  ‘You’re still wearing it.’

  Harriet shrugged. ‘We’re still married.’

  One year ago she’d separated from him but physical separation was much easier than mental separation. Things like wedding rings and giving up Remy as her name and missing his toiletries next to hers in the bathroom cabinet were much harder to come to terms with.

  ‘You still wear yours,’ she murmured, fondling the wide gold band she had given to him on their wedding day.

  Harriet remembered how she used to make him take his ring off and she would take off hers so she could slip it inside the circumference of his. It had been like a confirmation that she would always be snug and safe and supported in his love.

  ‘Of course.’

  She glanced back at the narrow band of her ring. ‘I guess I’ll have to give it back,’ she said wistfully.

  The ring and all it represented — not just Gill’s love but

  it’s heritage and family value — were so integral to her that parting with it would be gut-wrenching. She may have only had it for six years but the ring that Henri had worn on his little finger for thirty years after his dear
Renée’s death, had tremendous sentimental value.

  Henri had taken her aside after their engagement and told her it would honour him if she were to take Renée’s ring as her wedding band, and she had been touched and worn it with love and pride. That it had history and meaning, not just for Gill and her but for past lovers, had always made it extra-special.

  ‘No,’ he said quietly, still fingering the thin metal. ‘Henri would want you to keep it.’

  ‘I couldn’t.’ She shook her head as she slipped her hands out from under his and sat back on her heels. ‘It’s a family heirloom.’

  ‘Henri gave it to you because he loves you and thinks you’re worthy of my grandmother’s ring. Whether you’re married to me or not, that won’t change.’

  It seemed strange to be talking about Henri as an active, vital person when on the other side of the world he was fighting for his very life. The mood changed to sombre again, the talk of parting ways not helping.

  ‘Is your father going to keep you up to date?’

  ‘Yes. He’s going to call again in a few hours.’

  ‘Make sure you send them my love. Tell them I’m thinking of them and to kiss Henri for me.’

  ‘Why don’t you do it yourself? Come back with me tomorrow.

  Don’t go to London first. Henri would love to see you again.’

  MedSurg, being an English charitable organisation, was based in the UK and had its headquarters in London. It was usual to fly teams out of wherever they might be at the end of a mission into London for a few days’ R and R and then fly them back to their homes.

  It made up for the lousy pay.

  ‘Gill...’ A pain, like the slide of a knife between her ribs took up residence in her chest. She couldn’t. It was just too hard. The strings had to be cut and the longer she kept them tied, no matter the reason, the harder it would be. ‘I can’t.’

  He nodded. ‘Yeah. I know.’

  But did he? ‘I can’t come back to Australia with you. We’ve made the break - we need to stand by it. I will go and see Henri when I get back next week.’ God, please let him be alright.