‘No pulse. He’s arrested!’
‘It looks as though his heart must have been damaged, then,’ Liam exclaimed. ‘If enough blood has collected in the pericardium, it will have stopped his heart beating. We need to get him on the floor so we can start CPR.’
Sophie grabbed the man’s legs while Charlie gave him a hand to lift the seaman off the bunk. Liam turned to Sophie. ‘I’ll need you to give me a hand opening him up.’
‘You mean you’re going to do a thoracotomy?’ she exclaimed incredulously. ‘Here?’
‘I don’t have a choice. External cardiac massage won’t work if the pericardium is full of blood so I’m going to have to open his chest to do it. We don’t have the time to get him up to Theatre because his brain will stop functioning in three minutes without any oxygen reaching it.’
He didn’t waste any more time on explanations. Slipping the scalpel into the hole he’d made already under the man’s armpit, he sliced horizontally across the patient’s chest. Sophie was searching through his bag—finding scissors and dressings—and he breathed a sigh of relief. It was reassuring to know that he had someone with her experience to help him and didn’t have to explain every little detail to her. It left him free to get on with his job.
‘Oh, my Gawd!’ Charlie muttered as Liam took the pair of scissors from her and began to cut through the tough layer of muscle beneath the patient’s skin.
‘I know it looks brutal but it’s his only chance.’ He reached the breastbone and felt beads of sweat gather on his forehead as he struggled to saw through the bone. Every second that passed meant that the chances of the patient surviving were decreasing. He grunted in relief when he felt the last bit of the bone give way so that he was able to complete the incision.
‘What I wouldn’t give for some retractors,’ he muttered, struggling to see inside the chest cavity.
‘What’s them, Doc?’ Charlie asked curiously.
‘Great big metal clamps that you use to open up the chest,’ he explained. ‘Where’s that torch? Thanks.’
He peered into the chest cavity while Charlie held the torch for him, and immediately spotted the cause of the problem. As he’d suspected, the pericardium—the sac surrounding the heart—was bulging with blood and preventing the heart from beating.
‘Definite signs of tamponade.’ He grasped the sac with a pair of narrow forceps and managed to cut through it. However, when it came to removing the blood clot, it proved impossible. His fingers were just too large to fit through the limited amount of space he’d been able to make.
He turned to Sophie. ‘See if you can get those clots out of there, will you? Your hands are smaller than mine.’
She quickly changed places with him and he saw the tip of her tongue poke between her teeth as she inserted her fingers through the opening in the chest wall. Liam felt a wave of heat rush through him and looked away because it shocked him that he should be so responsive to her at a time like this.
Why hadn’t he allowed for this when he’d taken the job? he wondered incredulously. He’d been attracted to Sophie from the first moment they’d met, when she’d been a student nurse and he’d been a brand new houseman, yet it had never crossed his mind that he might still feel the same about her. Why should it have done when he was committed to Julia?
His heart began to thud because that question had naturally led to a second, one it was even more difficult to answer.
If it was Julia he loved then why did he feel this desire for Sophie?
Sophie held her breath as she inched her fingers through the narrow gap. If anyone had told her she’d be helping to perform major surgery on the floor of a cabin, then she would have laughed out loud. But if Liam thought they could save the man’s life, she would give it her best shot.
Relief swept through her as she finally managed to reach the blood clot. She scooped it out of the way and dropped the bloody mass on the floor beside the bunk.
‘Got it!’ she declared triumphantly, glancing up. She frowned when she saw how abstracted Liam looked. He looked as though he was miles away, a worrying thought in view of the seriousness of what was happening.
‘Liam?’ she prompted anxiously, and saw him jump.
‘You’ve got it out? Good work!’ He made an obvious effort to collect himself. ‘Now, see if you can encourage the heart to start beating again. There’s not enough room to massage it so try flicking it with the tip of your finger.’
Sophie followed his instructions and felt her excitement mount when the man’s heart suddenly fluttered. She tried it again and laughed when she felt it start to beat. ‘It’s working!’
‘Right, we need to get him up to Theatre, stat.’ Liam was all business once more as he got up. ‘We need something to use as a stretcher. Can you sort it out, Charlie?’
‘No problem, Doc.’
The steward hurried away as Sophie sank back on her heels. ‘Do you think he’ll make it?’
‘With a bit of luck, but we’re going to have to stop that bleeding.’ He frowned in concern as he watched a few drops of blood ooze out of the man’s chest. ‘That wound needs stitching as soon as possible—can you get everything ready in Theatre? I don’t want to have to waste precious time setting up once we get him there. It’s going to be touch and go as it is.’
‘Of course.’ She scrambled to her feet and stripped off her blood-soaked gloves and dropped them on the floor then grimaced when she saw the mess they’d made. ‘This place is going to need a thorough cleaning before the crew can use it again.’
They both looked round when the door opened and Charlie appeared with Mike Soames in tow. Sophie saw Mike turn a delicate shade of green when he saw all the blood, and sympathised with him. The cabin must look like a scene from a horror film to the uninitiated.
‘Did you find us something to use as a stretcher?’ Liam demanded, oblivious to the petty officer’s distress.
‘I’ve commandeered one of the kitchen trolleys,’ Charlie explained. ‘It’s too big to get it in here so we’re going to have to carry Alexei outside.’
‘That shouldn’t be a problem with the three of us,’ Liam declared.
Sophie hoped he was right and that poor Mike wouldn’t pass out before they managed to get the injured seaman onto the trolley. It was amazing how many grown men she’d seen keel over at the sight of blood.
There was no time to worry about it, however, because she had more important things to do. She ran back upstairs to the hospital bay and quickly scrubbed up then slid on a gown and a fresh pair of gloves. She’d been a theatre nurse for a number of years and it was reassuring to slip back into the familiar routine. She laid out the instrument trolley then unpacked sterile drapes to cover the patient during the operation. By that time Liam had arrived.
‘I need to scrub up,’ he told her tersely, shooting an anxious look at the man lying on the stainless-steel kitchen trolley. ‘We’re going to have to be quick, though, because he’s losing a lot of blood.’
‘I’ll take him through while you get ready,’ Sophie assured him. ‘Who’s going to do the anaesthetic, though?’
‘Me.’ Liam’s tone was grim. ‘It’s times like this when you could do with an extra pair of hands, isn’t it?’
‘We’ll manage.’ She smiled at him and saw his grey eyes darken before he abruptly turned away.
‘I’ll be as quick as I can,’ he said gruffly.
Sophie wheeled the patient into Theatre, trying to decide exactly what she’d glimpsed in Liam’s eyes just now. She sighed when it struck her how pointless it was to worry about it. Once her replacement arrived she would be leaving the ship and she doubted if she and Liam would ever meet again. The thought gave her very little pleasure, oddly enough.
Liam must have got ready in record time because barely a minute had elapsed before he elbowed the door open. He had Charlie Henshaw with him and Sophie raised her brows when she saw that the steward was gowned and gloved as well.
‘Charlie has offered to help,’ Liam
explained, going straight to the trolley. He nodded to Charlie. ‘Let’s get him on the table.’
Sophie didn’t question his decision as she hurriedly draped the patient. If Liam thought that Charlie would be of use then that was fine by her. He was preparing the anaesthetic now—checking the settings on the machines then attaching the tubes which would provide sufficient drugs to keep the patient unconscious during the operation. It was obvious that he knew what he was doing, too.
‘Looks as though you’ve done that a time or two,’ she observed lightly, swabbing the man’s chest. Blood was oozing out each time his heart beat so she checked the bag of fluid to see if it needed replacing.
‘More times than I care to count. I had to be anaesthetist, surgeon, physician and general dogsbody in my last job. There certainly wasn’t any point standing on your professional dignity when there was just Julia and me to deal with every patient who turned up at the clinic.’
‘It must have been tough,’ Sophie said quietly, because hearing him speak about the difficulties he and Julia had encountered made her heart ache. Once upon a time she would have been the one to share such experiences with him.
She shrugged off the thought as Liam instructed Charlie to keep an eye on the monitor that registered the patient’s blood pressure and heart rate, and to tell him immediately if there was any change. She and Liam had had their chance at happiness and it hadn’t worked. What had she told him earlier, that it was a case of once bitten and twice shy? Well, that applied doubly in this instance. She would never make the mistake of falling for her ex-husband again!
The operation progressed remarkably smoothly, given all the problems they faced. Sophie had to admit that she was impressed by Liam’s expertise. He handled the delicate operation of stitching up the hole in the patient’s right ventricle with a skill and panache that she’d rarely witnessed during her time in Theatre. By the time it came round to closing the patient’s chest, she was confident about the outcome.
‘You did a great job,’ she said sincerely as Liam administered the drugs which would reverse the anaesthetic. The patient was now ensconced on a proper hospital trolley and would shortly be moved to the sick-bay.
‘Thanks, but I couldn’t have managed without your help, or Charlie’s for that matter.’ Liam smiled as he stripped off his mask. ‘You two make a great team!’
‘All part of the service, Doc,’ Charlie observed cheerfully then chuckled. ‘Wait till I tell my missus that I assisted at an operation. She’s mad keen on all those hospital dramas on the telly and she’ll be really impressed!’
‘And so she should be.’ Liam clapped the steward on the shoulder. ‘Remind me to buy you a drink as a thank you.’
‘I’ll hold you to that, Doc.’ Charlie suddenly grimaced. ‘And now I’d better get that trolley back to the kitchen. The chef is going to be less than impressed when he finds out what it’s been used for.’
‘If you have any problems, just give me a call and I’ll sort it out,’ Liam told him. He turned to Sophie after the steward left. ‘Rather a baptism of fire, wouldn’t you say?’
‘I would. A bit more exciting than handing out tablets for sea-sickness.’
‘Just a bit!’ Liam chuckled, a throaty sound which made the tiny hairs on her arms stand to attention. ‘I’d forgotten about your dry sense of humour, Sophie. You always did make me laugh.’
‘Not always,’ she said, bending to pick up the bag of rubbish because she didn’t want him to see how much that comment had stung. In the weeks leading up to their divorce they’d had very little to laugh about and the memory still had the power to hurt.
‘No. We had bad times, too, didn’t we? Far too many of them at the end. But it wasn’t like that in the beginning, was it? We seemed to spend most of our time when we were together having fun.’
‘Did we? I really don’t remember.’
She quickly sealed the sack and elbowed her way out of the door. She wasn’t sure what the procedure was for disposing of surgical waste so she turned round to ask Liam and felt her heart ache when she saw the sadness on his face. Was he thinking about how much joy they’d found in one another’s company? She might have claimed not to remember how wonderful it had been, but it had been a lie.
She was filled with a sudden and overwhelming sense of loss. Liam had been her whole world at one time and she’d been his. How had they allowed themselves to lose all that they’d had?
CHAPTER FOUR
LIAM took a deep breath but the pain in his heart wouldn’t budge. His mind seemed to be awash with memories of all the wonderful times he and Sophie had enjoyed together. He had honestly believed that he’d found his soul mate when he’d met her, and that they would be together for ever, but it had all gone so terribly wrong.
Why hadn’t he tried harder to make her understand that nothing had happened between him and Amanda that night? he wondered sickly. If he hadn’t allowed his pride to get in the way, they might never have got divorced. Granted, they would still have had to work through their grief over Zoë’s death, but it had been Sophie’s belief that he’d had an affair which had brought things to a head. He’d made a terrible mistake by not making her listen to him, but maybe it wasn’t too late to rectify matters.
He’d actually opened his mouth when it struck him what he was doing. He was trying to patch things up with Sophie not because he wanted to draw a line under the past but because he hoped they could recapture the magic they’d once known. Fine, but where did that leave him and Julia?
Liam’s head swam so that it was a second before he realised that Sophie had spoken to him. ‘I’m sorry. What did you say?’ he said huskily, praying that she couldn’t tell how shocked he felt. Julia was a wonderful woman and he both admired and respected her. It made him feel like the lowest form of pond life to even consider letting her down.
‘I asked what I should do with this waste.’
‘Just leave it there for now. I’ll check with Mike Soames and find out what the procedure is for disposing of it.’
Liam saw her frown when she heard the tremor in his voice, and hastily cleared his throat. It had been a temporary lapse, he assured himself, a small blip on the route to everlasting happiness which he would achieve once he and Julia were married. It was natural that he should feel rather…nostalgic about the past, but it certainly didn’t mean that he didn’t love Julia. How could he not love a woman who was as self-sacrificing and dedicated—not to mention beautiful—as Julia was?
He took swift advantage of the return of common sense. ‘Everything else can be left for the cleaners. Once we’ve moved the patient into the ward, that’s basically it for tonight.’
‘Surely he’s going to need monitoring?’
‘Of course, but it won’t need both of us to do it. You get yourself off to bed once we’ve got him settled. I’ll sit with him.’
‘You can’t stay with him for the whole night,’ she protested. ‘What’s going to happen tomorrow when we hold our first surgery? You’ll be worn out.’
‘I doubt we’ll have many people turning up so early in the trip,’ he replied dismissively. ‘Anyway, I’m used to functioning on very little sleep so it isn’t a problem.’
‘We could take it in turns. If you do the first shift, I can take over from you in a couple of hours’ time.’
Liam shook his head, although he knew it would make more sense if they shared the task. It was just that he preferred to do it himself rather than sit there, wondering how long it would be before Sophie appeared to relieve him. Maybe she’d be wearing those sexy little pyjamas that she’d had on earlier…
He shut off that thought before it could get him into any more trouble. He’d allowed his libido quite enough leeway for one night. ‘There’s no need for that. I can manage. Now, if you’d just help me get him to the ward, we can both get some rest.’
He saw her mouth draw down at the corners when she heard the authoritative note in his voice but he refused to feel bad about p
ulling rank. It was for her good as well as his, even though she obviously didn’t believe that.
They took the patient to the ward and made him comfortable. Sophie didn’t wait for Liam’s instructions as she did the man’s obs and noted them on a chart which she hung on the end of the bed.
‘His BP, pulse and respiration are all within acceptable limits,’ she informed him in her most professional manner. ‘Temperature is normal.’
‘Good.’ Liam played his part, refusing to let her see that it stung to have her treat him as a work colleague. He could hardly complain when he’d been the one to instigate this. ‘That’s it, then. You may as well get off to bed now.’
‘Fine. Goodnight.’
She didn’t say anything more before she left the room. Liam sighed as he drew up a chair. Sophie wouldn’t readily forgive him for playing the heavy-handed boss but there was little he could do about it now. At least he had the comfort of knowing that one of them would get a good night’s sleep, which was something.
He decided to write up the patient’s case notes while he had the chance. Once they reached port the following morning, the injured seaman would need to be transferred to hospital and he wanted to be sure the doctors there had a full account of everything he’d done.
It took some time to write it all down and he yawned as he put the cap back on his pen. It was two a.m. and time he got some rest. He checked the patient’s obs once more then settled down in the chair. Normally he had no problem sleeping but the moment his eyes shut he started getting flashbacks to what had gone on that night.
He made himself breathe slowly and deeply but it was hopeless. Images flashed through his mind like stills from a film: the shock on Sophie’s face when she’d discovered they would be working together; the way that damned purser had leered at her over dinner—here Liam ground his teeth; the way her face had lit up when their patient’s heart had started beating…
He sighed as he opened his eyes and got up. Sitting there, mulling over everything that had happened, was only making matters worse. Maybe it would help to settle him down if he read for a while?
A Very Special Marriage Page 4