He was following her lead and referring to her by her surname. Fine. She could cope with that. It felt rude—insulting, almost—but, then again, she’d started it.
‘We’ll have the drains out in the first couple of days and the sutures out in ten days to two weeks,’ Sophie added. ‘But he’ll be on the ward for two or three weeks.’
Then it was the bit she hated: cutting the bone. Even after all her years of experience she still hated the sound of bone being sawn through. But she concentrated on what she was doing, talking Abby through it.
When Charlie took over to deal with the skin flap, she noticed how deft and capable his hands were. Whatever her issues were with him as a person, she respected the way he worked. And she liked the way he treated the scrub nurses— with courtesy, rather than shouting at them or giving curt, dismissive orders.
Maybe, just maybe, she’d got him wrong. Maybe he wasn’t like all the other toffs she’d met at med school.
Or maybe he was. Maybe this was just a smokescreen. All charm, to hide what he was really like underneath. How could she trust him? How could she trust anyone from his class?
Guy had given Abby the time to watch the whole operation. To Sophie’s surprise, Charlie let the young house officer do some of the suturing. ‘Guy says your knots are good. Let’s see how you do with this one.’
Abby was clearly delighted at the chance. Although she worked slowly, her knots were good, and as her confidence grew with Charlie’s praise, the speed of her suturing increased.
‘Well done,’ Charlie said. ‘I think she did well—don’t you, Harrison?’
‘I do, Radley.’
Just as she’d finished changing, Charlie walked over to her. ‘Come and have a coffee while we’re waiting for Tom to wake up.’
‘I’ve got paperwork to do.’
‘Paperwork can wait.’
‘I really don’t need a coffee.’
‘You’ve just spent an hour and a half in Theatre. You need a break. Ten minutes. That’s all I’m asking.’
He was asking? It sounded more like a demand to her.
‘I think,’ he said quietly, ‘we need to talk. My office or the canteen. Your choice. But I could do with a coffee.’
There was nothing to say. Why did he think they needed to talk?
‘Canteen, then,’ she muttered, knowing that she sounded childish. But Charlie Radley rubbed her up the wrong way.
∗ ∗ ∗
She really didn’t want to be there with him. That much was obvious. And he could tell that she was going to insist on buying her own coffee. Well, he wasn’t in the mood for politics of any sort. When they got to the cash till, he glared at her—and the glare worked. She shut up and let him pay.
They walked in silence to a quiet corner table.
‘Right. Cards-on-table time,’ he said. ‘I know everyone expected Guy to get the director of surgery post. I know you were in line to get Guy’s job. I’m sorry that your plans didn’t work out, but that’s the way of the world. Sometimes new blood can be good for a department.’
She snorted. ‘Right.’
‘And your point is?’
‘You’re a nip-and-tuck man. It’s obvious where the money’s going to go.’
‘I’m a plastic surgeon, yes. But I don’t do nips or tucks. I don’t do cosmetic surgery, except in cases of trauma or where there’s a medical reason for it. And the budget for this year was set before I arrived.’
She took a deep breath. ‘Next year’s money, then.’
‘Next year’s budget,’ Charlie said calmly, ‘will be allocated in terms of need. And I’ll be discussing it with Guy and Andy before I make final decisions. Clear?’
‘Clear.’
‘Good. So what’s the rest of your problem?’ ‘What do you mean?’
Nicely parried. She hadn’t denied there was a problem, but she’d shifted the onus on him to say what he thought. OK. He’d play it straight. ‘You don’t like me, Sophie Harrison. Now, I know we’ve never met before, so I can’t have upset you personally. What’s the problem?’
She lifted her chin, and there was a definite spark of challenge in her eyes. ‘OK. You want to know? I think the board appointed you for political reasons.’
He rolled his eyes. ‘Oh, you mean the “lord” bit. Well, if you’d been there when I arrived yesterday, you’d have heard me tell everyone I don’t use it. I answer to Charlie.’
‘If you’d been on time yesterday,’ she pointed out, ‘I wouldn’t have been in Theatre.’
‘Unfortunately, I was delayed.’
‘Your hero rescue work.’
Oh, please. She didn’t think he’d set it up … did she? ‘What would you have done?’ he asked. ‘It’s your first day in a new job—a job where you know most of the staff don’t want you there. A child is stuffing fireworks through a letterbox, but one blows up in his hand. If you stop to help, you’re going to be late and your new team’s going to think you’re too arrogant to care, which means your first day is going to be even worse than you expect. So do you just leave the kid—and whoever’s inside the house, who might also be hurt—or do you call an ambulance and do what you can on the first-aid front? Especially knowing that the general public would pour water or milk on a burn because that’s what all the first-aid stuff says they should do?’
‘Which would be the worst thing they could do to a burn contaminated with phosphorus.’ She sighed. ‘OK. I’d have done what you did.’
‘Thank you.’ Charlie leaned back in his chair. ‘I don’t want to fight with you, Sophie—may I call you Sophie?’
She nodded.
‘As for the “lord” bit—it’s simply an accident of birth.’
Uh-oh. The words were identical to the ones she’d used yesterday morning. Had someone repeated her comment to him?
And why did it make her feel suddenly guilty? She stuck by what she’d said. Why should you be treated differently because you came from a posh background?
‘Don’t hold my background against me,’ Charlie said quietly, almost as if he’d read her mind. ‘It’s not a privilege, it’s a handicap. People think I’ve been promoted because of who I am, not what I can do. I worked hard to get my degree, and I worked hard to get my position. And then I have to work a little bit harder still to prove it to everyone else.’
Pretty much as female surgeons had to—there was still a glass ceiling. To get to the very top as a surgeon, you had to forget about career breaks and children and family. You had to be twice as dedicated as any man.
Prejudice cut two ways. Sophie flushed. And she’d definitely been prejudiced against Charlie. She hadn’t given him a proper chance.
‘I’m a doctor. It’s what I wanted to be—who I am.’
And he meant it. His voice was absolutely sincere.
‘I … I’m sorry.’
‘Apology accepted. Hopefully things will be straight between us now.’
He didn’t sound as if he was gloating. He sounded … relieved.
‘I like the way you work,’ he added. ‘No fuss, no drama, no lording it over junior staff.’
At the word ‘lord’, she met his gaze again. His eyes crinkled at the corners—he was laughing again. But at himself, not at her.
Almost unwillingly, she found herself smiling back. ‘I’m the wrong sex to lord it. Lady it, perhaps?’
The smile in his eyes spread to his mouth, and she wished she hadn’t made him grin like that. Because it made him appeal to her more than any man she’d ever met.
It wasn’t going to happen. Charlie Radley had been photographed with more women than she’d had hot dinners. Women of his kind—the supermodels and debutantes. Sophie knew she wasn’t in the same league; besides, she didn’t want a quick affair. She didn’t want any kind of affair. She just wanted to do her job, and do it well.
‘Given the chance,’ Charlie said, ‘I think I’m going to like you. Working with you, I mean,’ he added.
Given the chance.
The rest of the team seemed to like him. And she’d been impressed by the way he worked in Theatre. Cool, calm, very sure of his skill, but equally concerned that his team should know everything that was going on. Including the nurses. ‘So let’s take each other at face value,’ she suggested.
He nodded, and lifted his coffee-cup. ‘Here’s to a working relationship. Straightforward and honest. Mutual respect for each other’s expertise and judgement.’
She could drink to that. She lifted her own coffee-cup. ‘Cheers.’
‘And maybe,’ Charlie said softly, ‘in the end you won’t dislike me so much after all.’
CHAPTER FOUR
OVER the next few days, Charlie settled in with the rest of the team. Sophie even worked with him a couple of times without her hackles rising, although she still avoided Charlie’s drinks night on the Thursday. Being off duty was a good enough excuse, as far as she was concerned. Although he gave her a quizzical look when they were next on the ward together, at least he didn’t take her to task for it.
Then she got a call from Paul, the registrar in the emergency department. ‘Twelve years old, fell from a horse which then stood on her. Admitted with bruising over her lower ribs and tachychardia. I think she’s ruptured her spleen. Any chance of doing a laparotomy?’
‘I’ll organize Theatre,’ Sophie said. ‘Have you done a CT scan?’
‘Too long a wait. I did a peritoneal lavage,’ Paul said. ‘We had blood staining.’
Blood staining indicated an internal injury to the abdomen, and bruising over the lower ribs was often associated with damage to the spleen, liver or kidney.
‘One other thing,’ Paul added, lowering his voice. ‘The mum’s a Jehovah’s Witness. So is the girl.’
‘Ah.’ That was a possible sticking point. If the girl needed to have her spleen removed, she might need a blood transfusion—which was unacceptable on religious grounds to most Jehovah’s Witnesses, who interpreted blood transfusion as the ‘eating of blood’. Autologous transfusion, where the patient’s own blood was salvaged during an operation and filtered, ready for reuse, was a possible solution, but some patients would find that unacceptable if the blood had left the blood vessels rather than being in continual contact with the patient’s own circulation.
There were alternatives, such as the use of recombinant human erythropoietin, a hormone that helped red blood cells to reproduce. This helped to avoid anaemia around the time of the operation. But it really depended on what happened during the operation.
Sophie bit her lip. She hated cases like this. Ethically, she was bound to defer to the patient’s wishes, but it was a grey area in the case of children. Children under the age of sixteen could consent to blood transfusions but couldn’t refuse one. But if the parents were staunch believers, the surgeon had to either abide by their wishes or apply to the courts. In an emergency Sophie knew she could give a child blood without legal consent—if she let the child bleed to death, apart from being against her personal ethics, it could leave her open to legal prosecution for negligence. But if she did give the transfusion, that would leave an emotional minefield.
It would have to happen on Andy’s day off. Guy was in Theatre. Maybe she could buzz through and get a lead from him. ‘I’m on my way,’ she said grimly, and replaced the receiver.
She pushed through the doors to leave the department, and almost walked straight into Charlie.
‘You OK?’ he asked.
She nodded. ‘ED called. There’s a twelve-year-old girl with a possible ruptured spleen and they want me to take a look.’
‘Complications?’
How had he guessed? Or did he respect her skill enough to think she could do a splenectomy without problems? ‘Mum’s religious beliefs. If I have to do a splenectomy, it’ll have to be without a transfusion.’
‘Ah. Just the mum, or the dad as well?’
‘I don’t know right now,’ she said honestly. ‘I’m guessing it’s both of them.’ If the girl’s father was of a different religion—one that didn’t have the same issues with blood transfusion—she might be able to get his consent. Which would be enough. She only needed the consent of one parent.
‘Want some back-up?’
She was tempted to say no, she could cope on her own; her pride said she shouldn’t accept help from him. Her common sense gave her pride a swift upper-cut. She would have asked Andy or Guy for help. Charlie was here, and he was senior to both Andy and Guy. So what was the difference? ‘Yes. Please,’ she added.
‘What are your plans?’ he asked as they headed towards ED.
‘I’m going to examine the girl and explain the situation to her parents—that I’ll do my best to do the operation without any transfusions, respecting their wishes, but if there’s a complication a transfusion might be unavoidable.’ She sighed. ‘It’s not my place to judge, but I just don’t understand how a parent could stand by and watch her child bleed to death.’
‘Most parents find it acceptable if you say you’ll do your best not to use a transfusion, but you won’t allow the child to die for want of a transfusion,’ Charlie said softly. ‘Besides, all treatment is confidential.’
‘I just hope they see it that way,’ Sophie said feelingly. ‘I’d move mountains for my child.’
For her child? Charlie’s heart missed a beat. Sophie was married? But he’d been so sure she wasn’t. He hadn’t heard anyone talk about her partner or children. He glanced surreptitiously at her left hand. A surgeon never wore rings to work, but maybe Sophie wore a wedding ring on a chain around her neck or something. He couldn’t see any band of pale skin on her ring finger, so maybe she was divorced. Single mum?
‘Boy or girl?’ he asked, trying to sound relatively cool.
‘Pardon?’
‘You said you’d move mountains for your child. I just wondered if you had a boy or a girl.’ Now he was beginning to wish he’d never asked. She’d think he was being nosy. And just why was he asking anyway? It was none of his business.
She shrugged. ‘I don’t have any children. I was speaking figuratively. My parents moved mountains for me—we couldn’t really afford for me to go to med school, despite the student grants and hardship funds, but they both took on extra jobs in the evenings to raise the cash. Mum cleaned and Dad did a few shifts behind the bar at the local pub, and I did bar work in the holidays and at weekends.’
Ouch. No wonder she’d been a bit hostile towards him. A lot of the medical students he remembered had come from rich backgrounds. But he couldn’t think of many whose parents would have made the extra sacrifices that Sophie’s parents had made. His mother certainly wouldn’t have. He, Seb and Vicky had had to fight all the way, too, to get to med school.
Not that he was going to share that with Sophie. He didn’t think she’d believe him somehow.
Her parents’ lack of wealth also explained why Sophie Harrison was so ambitious, so focused on her job. Clearly she wanted to show her parents that their sacrifices had been worth it. Again, he wasn’t going to tell her he’d worked that out. It would sound too patronising, even though he wouldn’t mean it that way. ‘I’d imagine they’re very proud of you,’ he said lightly.
‘I’m proud of them,’ Sophie responded crisply.
Family meant a lot to her. And he envied her for it. He was close to Seb and vicky, though even that was a complicated mixture of sibling rivalry and watching each other’s backs. But his mother … They hadn’t been close for years and years. Since his father’s death. Maybe even before that, if he thought about it.
Not that he was going to. He preferred to keep that shut well away. Where it was safe.
‘Are you an only child?’ he asked.
‘Why?’
‘Just making conversation.’ Trying to find out more about her. Stupid, really. They’d never be anything more than colleagues. Probably not even friends. He’d noticed that she’d avoided his drinks night, when other colleagues who’d been off duty had turned up.
‘Yes. I think my parents wanted more, but they just weren’t lucky. You?’
She actually wanted to know something about him? He suppressed a flare of pleasure. She was probably just being polite. Making conversation. ‘I’m the oldest of three. My brother’s in emergency medicine, and our baby sister’s the clever one. She’s a brain surgeon.’
She looked at him, then, though he couldn’t tell her thoughts from her expression. ‘A brain surgeon.’
‘Yep. We tease her a bit—you know, “our sister, the brain surgeon”—but Seb and I are really proud of her. Vicky’s a brilliant neurologist.’
‘The gossip rags never talk about them.’
Then she looked horrified, as if she’d given too much away.
Charlie’s heartbeat quickened. Had she read them, looking for him?
No, of course not. Don’t be so arrogant, he told himself sharply. Sophie was much too serious to read gossip rags. Anyway, she’d been talking about his siblings. ‘They don’t. Probably because Vicky would break the fingers of any paparazzi who dared to take a picture of her, and Seb’s got the mouth of a lawyer.’ He sighed. ‘And they’re not the ones stuck with—’ He clammed up. Sophie definitely wouldn’t be interested in what it was really like to be a baron. How everyone wanted to be your friend, just so they could say they were friends with the nobility. How the estate was an albatross around his neck—a place he hardly ever went nowadays, although he’d loved it as a child. It hadn’t been his home for well over a decade, but he wasn’t about to throw his mother out or expect her to deal with the upkeep. It was his responsibility. And also the reason why, on a consultant surgeon’s salary, he had less money to spare than a house officer.
‘Stuck with what?’ she asked.
‘Nothing,’ he muttered. ‘Just stuff. And we’ve got a patient to see.’
Well, her patient.
In the ED, Paul introduced them to Katrina, who was white with pain.
‘Katrina, may I examine you?’ Sophie asked.
The girl nodded. Sophie examined her as gently as she could, noting that the girl’s ribs were discoloured, there was localised tenderness and guarding in her abdomen and pain in the upper left quadrant.
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