She’d been held in the arms of a countless number of people in her lifetime. Not so much these days, of course, but it did happen occasionally—like when Alex, the orthopaedic registrar, had helped her negotiate the tricky access to the operating theatre gallery. Noah had only been offering the same kind of assistance and, while it had actually been happening, Abby had been too stressed about seeing her sister to acknowledge how different it had been.
It was only much, much later, when all the drama of that night had settled down and her flat tyre had been taken care of by a car rescue service and she had been back home and safe in her own bed that she’d realised just how strong that memory was. If she thought about it, she could still feel the strength that had been in his arms, despite the workout he’d just given them on the basketball court. She could feel his muscles working beneath where she’d been hanging onto his neck and she could smell his warmth and that masculine undertone that could have been the lingering scent of an aftershave but which she suspected was purely his own. She had also felt the tension when he’d carried her into Lisa’s room and she’d known why when she’d seen the expression on his face just before he’d escaped.
Okay...make that three memories because she wasn’t about to forget that haunted look on Noah’s face as he’d left Lisa’s room in the maternity ward. How hard had it been for him to carry her into that room when it had to have triggered memories of a very different birth of a baby? No wonder he’d been avoiding her for the last couple of days and pulling the mantle of his professional life around him like a protective cloak. Interrupting a therapy session wasn’t the most professional thing to do, mind you, and Noah wasn’t looking at all haunted now. He was, in fact, looking almost as happy as he had when he’d come off the basketball court the other night.
‘He said yes.’
Abby grinned back. ‘The last time someone told me that and was looking this happy was when a friend came into my room at my uni hostel in the middle of the night to tell me about proposing to her boyfriend.’
Noah blinked and Abby had to give herself a mental shake. What a stupid thing to say. Noah probably wanted to avoid memories of proposals and marriages about as much as being close to newborn babies.
But he was still smiling. ‘Steve,’ he added. He was holding a clipboard in his hand that had papers attached to it. ‘He’s signed all the consent forms. I thought you might like to come to the team meeting later this afternoon when we start planning the surgery.’
‘Oh...that’s wonderful news. I’ll start making my own treatment plans for after the surgery. If I’m still going to be his therapist?’
‘As a matter of fact, he said that was part of the deal.’ There were crinkles at the corners of Noah’s eyes, even though his smile was fading. ‘He said that was what had changed his mind was the conversation he’d had with you and Pauline this morning. About...babies?’
Abby’s smile was a bit misty. ‘I was telling him about the excitement of the other night. About how amazing it was to be holding a brand-new baby. And Pauline was helping Steve to hold his baby and we reminded him of all the things he’d be able to do with her more easily if he had a new thumb. Like giving her a bath or holding her hand to walk her to school or...’ Abby’s voice trailed away. Was she rubbing salt into a wound that Noah was always going to have, by reminding him of his own loss? He didn’t seem upset, though, even though that smile had vanished.
‘Five o’clock, then? In the conference room?’
‘I’ll be there.’ She still hadn’t had the chance to thank Noah for his help the other night but this wasn’t the time either. He was already disappearing through the door and, behind her, Audrey was sounding frustrated.
‘I can’t do it. I can’t make my thumb touch my ring finger and it’s miles away from my pinkie.’
Abby turned back to her patient. ‘It’ll come, don’t worry. Just think about how far you’ve come since the cast came off your wrist. This is something you can practise at home and every time you do it, you’ll be getting a little closer to making it happen. Now...let’s try something else...’
* * *
Places at the long, oval table in the conference room were full by the time Noah had hooked his laptop up to the data projector ready for his presentation. He turned to the group and their conversations faded instantly. For many of the people here—the same mix of surgeons and senior ancillary staff that had been involved in Steve’s earlier surgeries—the procedure he was about to discuss would be a first and there was a distinct air of professional interest in the room. A hum of excitement, even, and he could feel the intensity of their focus on him. Especially Abby’s...
‘So...big toe transplantation has proven itself to be the ideal form of thumb reconstruction in the case of traumatic thumb loss,’ he began. ‘It has a single interphalangeal joint just like the thumb and, for most people, the length and appearance of the big toe is not dissimilar to their other thumb.’
The photograph he put up was the one that he and Abby had shown Steve when they’d been telling him about the option of this surgery and that felt a lot longer ago than a couple of days. It wasn’t so much that so many things had happened but that they’d dragged him back to such a traumatic episode of his personal history. Why was it that the time period to deal with difficult things seemed to stretch out but the most enjoyable things went past in a flash—like that first attempt he’d made at playing wheelchair basketball?
‘As you all know,’ he continued, ‘Steve is a father to three children, the youngest of whom is just a baby. He’s fortunate enough to have a strong and supportive marriage, he has many years ahead of him to provide for his family and he’s extremely motivated to work hard towards a successful outcome and, preferably, to return to a job he loves that requires a good level of hand function.’
He could feel a reflection in the room of his own investment in the upcoming surgery for Steve. This was going to be a very long and technically demanding procedure but it was an intriguing solution to a major issue and everybody here knew what a huge difference it could make, not only to a young father but for his whole family.
As Noah clicked through and discussed slides that labelled the tendons, nerves and blood vessels that would need to be dissected free of the foot and left attached to the isolated toe for the implant surgery, he could feel a faint echo of what he’d said about Steve sitting there in the back of his mind. It was quite astonishing, in fact, that he could be giving a seamless presentation like this and that part of his brain could be aware of something that had nothing to do with anatomy or surgical procedures or anything to do with his patient at all, really. Except it did, didn’t it? It was the core of the reason they were all here and why they were so passionate about their work.
It was that notion of family, that’s what it was.
Noah wasn’t consciously thinking about it, of course, but he could feel it—like a vast space behind an open door. And that door was only open as far as it was because he’d had to confront his own loss of family all over again the other night, and he hadn’t been prepared for that at all. He hadn’t been prepared for that close physical contact when he’d been carrying Abby either—or the disturbing dreams it seemed to have triggered for the last couple of nights—but it had been the unexpected proximity to Lisa’s baby in the first few minutes of its life that had really done his head in.
He pressed the arrow button on his keyboard to bring up a new diagram. A photograph this time of a foot with lines drawn on it with a marker pen. It took only a split second to push that button but it was long enough for one of those momentary flashbacks that he’d never been able to get away from, especially if he saw the tiny face of a newborn or heard that distinctive warbling cry. He’d got very good at pushing the flashbacks away, however, and, without missing a beat, Noah dealt with that image in his mind by flicking it away as if it were no more than an annoying fly near his face.
How weird was it, though, that just a glimpse could still carry the weight of unbearable emotions that were associated with that image of Ellen, lying there on a bed in the emergency department.
The consultant in charge of her attempted resuscitation was looking up at the clock to record the time of death. The looks that were exchanged amongst the crowd of people in the room were acknowledging that they’d failed but also that there were two patients involved here. The decision to do something that was too horrific to even contemplate—a post-mortem Caesarean—was being made in that instant and Noah could only grapple with the way his heart was being so completely torn between grief and hope as he saw that tiny baby coming into the world and struggling to take her first breaths.
And then...as they always did—the unwanted images and echoes of associated feelings vanished and it had all happened so fast that nobody would ever guess they’d been there. Except... Noah looked up as he took a breath to talk about this new photograph. His gaze happened to catch Abby’s and he had the oddest sensation—like the softest touch on the back of his neck—that made him wonder if she might see more than he realised.
‘These lines are the markers for the initial incision,’ he said, turning back to point to the screen. ‘As you can see, it extends well in to the first web space. We need to leave sufficient flap length to let us close up with minimal shortening of the first metatarsal. These next photos will demonstrate the dissection that needs to happen to identify the arterial branches, the extensor tendon and a dorsal vein...’
There would be two teams working in Theatre, one to harvest the toe and then repair the foot and the other to prepare the site on the hand and then do the implantation.
‘When the implantation team is ready, that’s when we ligate and transect the dominant artery and vein on the toe. The sequence for implantation is, as you’d expect—bone, extensor tendon, flexor tendon, nerves, artery, vein and finally the skin.’
Noah flipped through slide after slide that covered the rest of this surgery and answered any queries that the team came up with. One of the last was from an ICU consultant.
‘How long do you expect he’ll need to be in the unit?’
‘Three to five days. We’ll need to keep a close eye on limb baselines with the help of a Doppler signal and continuous pulse oximetry. It’s going to take a few days at least to get all our ducks in a row for a major surgery like this so we’ve got plenty of time to meet and put a more extensive plan in place. I’ll try and get to everyone involved so that we can discuss any details that this overview might have missed.’
There were nods around the table and people began gathering any personal items like notepads and phones. This meeting was almost over.
‘Just to finish up,’ Noah continued, ‘I’d like to—belatedly—welcome Abby Phillips to this meeting. Rehabilitation in a case like this is of huge importance if we’re going to get a successful outcome. Do you have any comments you’d like to make, Abby? Or questions to ask?’
‘I understand that gentle mobilisation can start as early as three to four days after the procedure if the bone fixation is stable and that starting active exercises will depend on the strength of the tendon repairs. The real work of strengthening and vocational therapy will start at about the two-month mark, yes?’
Noah nodded. ‘Let’s sort out a time for us to meet before you head away. Same goes for everybody else—I’ve got my diary here. Thank you for taking the time to come to this meeting and I look forward to working with you all again.’
Abby seemed perfectly happy to wait while he made arrangements to talk through the case in more detail with the various specialists involved and, for his part, Noah felt curiously happy that she was here and waiting for him. He was getting to know his new colleagues now and they were great people to be working with but Abby definitely stood out from the rest of them. She stood out from everyone he’d ever met in his life, to be honest.
He’d never met anyone who used humour the way she automatically did to diffuse any potential tense moment. She’d done that within minutes of meeting him, joking that she might never walk again after that accident, and she’d done it again today, when she’d told him he was repeating the words of someone who’d just proposed to their boyfriend. And she’d done that because she recognised that there was tension between them. Because he’d been avoiding her—avoiding anything other than purely work—after what had happened the other night.
Noah knew perfectly well that hospital grapevines worked between cities as much as departments. That everybody at St John’s had probably heard about his tragic backstory within a very short time of him walking through the doors, and he was quite used to the occasional glance coming his way that varied from curious to being full of pity. It was rare to get one that made him feel that someone actually understood how hard it had been, however, especially when it could acknowledge a struggle with no hint of pity or OTT admiration, and he’d received a glance exactly like that in the last moment before he’d escaped Lisa’s room in the maternity ward.
Abby had already got past his usual barrier that kept him from engaging in social events with the people he worked with by persuading him to go to that basketball training session but that hadn’t been exactly social, had it? It had been exercise and stress relief and he’d been attracted to the idea because it was just so different from anything he’d ever done before. New ground—and new ground was the best because it was guaranteed not to trigger flashbacks of any kind.
Finally, they were the only two people left in the conference room and Noah found himself deliberately relaxing. There was a huge amount of preparation for the gruelling stint in Theatre that Steve’s surgery would entail and, from experience, he knew that he needed to make the most of any downtime before that.
‘How’s your diary looking for meeting times?’
‘A lot emptier than yours, I expect.’ She was smiling at him. ‘It’s a big challenge, isn’t it?’
‘I love a challenge.’ Noah was smiling back. ‘I suspect you do as well.’
‘Story of my life. I’d probably get bored in no time without one.’ Abby’s tone was light but there was something serious in her gaze. ‘Having said that, though, there are the occasional challenges that can make me feel kind of vulnerable and I had one of those the other night—with that flat tyre and then the power cuts. I’ve been waiting for a chance to thank you for helping me.’
Noah tried to shrug off the thanks. Already, he was waiting for a flashback and preparing himself to find a distraction.
‘And, what’s more, you managed to do it without reminding me that I have limitations,’ Abby added. ‘There’s not many people who can step in like that and let someone like me keep their dignity.’
Noah had found a new smile. ‘I think you’d keep your dignity in any situation. From what I’ve seen, you own whatever you choose to tackle.’
It was Abby’s turn to shrug something off. Maybe she didn’t like compliments?
‘Anyway... I was trying to think of a way to say thank you but, I dunno, I didn’t think flowers or chocolates would cut the mustard.’
That made Noah’s breath come out in a huff of laughter. ‘Touché,’ he murmured. ‘We do have that in common, I guess.’
‘So I came up with the idea of offering to cook you dinner,’ Abby continued. ‘It’s not common knowledge but one of my splinter skills is that I’m a fabulous cook. I’ve thought about entering one of the television chef competitions, in fact.’
‘Oh?’ Noah was impressed. Was there anything Abby wasn’t good at? ‘I can’t cook to save myself. I usually end up getting those ready-made meals from the supermarket. Some of them are surprisingly good, mind you.’
Abby waved a hand dismissively. ‘Can’t compete with made from scratch. So, that’s a yes, then? We could kill two birds with one stone and talk about Steve’s rehab and that way you’ll have more
time in your schedule for any extra meetings you might need.’
‘You mean tonight?’
Her glance held a glint of amusement this time. ‘No time like the present. I often find if you give yourself too much time to think about something, you’ll just come up with a whole bunch of reasons why it isn’t a good idea. Unless you’ve got other plans?’
How did she know that he was already formulating a polite reason why he couldn’t have dinner with her tonight? The same way she knew he didn’t have anything on his agenda for the evening, other than to spend hours going over his plans for Steve’s surgery? She probably knew why he would back away at the speed of light from a dinner invitation from a single woman, too, but that clearly wasn’t going to be a barrier in a friendship that suddenly felt remarkably safe. Different.
New ground.
‘No other plans,’ he heard himself saying aloud. ‘And a home-cooked meal does sound like a treat. Give me your address and a time and I’ll be there.’
* * *
Abby hurriedly threw the packaging from the ready-made meals into her rubbish bin before speeding to her front door when the bell rang.
‘I didn’t realise you lived so close to the staff quarters,’ Noah said. ‘Walking distance.’
‘It’s a great location.’ Abby nodded. ‘But I just loved the building for its character. High ceilings like this give it such a feeling of spaciousness.’
So did having minimal furniture, of course, polished wooden or tile floors throughout with no rugs to break the smooth surface, and wider than normal doors to accommodate her wheelchair.
‘I love it.’ Noah belatedly remembered that he had a bottle of wine tucked under his arm. ‘Hope you like red?’
‘It’ll be perfect with our dinner but I have to say I’m a bubbles girl. Can I interest you in a glass of Prosecco to start with?’
Saved by Their Miracle Baby Page 6