24/7
The cutting edge of Harlequin® Medical Romance™
The emotion is deep
The drama is real
The intensity is fierce
24/7
Feel the heat—every hour…every minute…every heartbeat
Dear Reader,
I’m often blown away by stories of everyday heroism many people display in facing enormous obstacles in life. Coping with a condition like renal failure requiring dialysis is huge and I know there are many people who struggle and succeed, just like the heroine of my story, Holly.
If you are one of them, you have my heartfelt admiration. And I wish, that just like Holly, a heroic person will appear in your life with the courage and the heart to give you the precious gift of health.
In Holly and Ryan’s case the donor-recipient bond provided a rocky testing ground for a much deeper relationship. I got so involved with these characters that giving them the ending they both deserved was particularly satisfying.
Happy reading,
Alison Roberts
The Surgeon’s Perfect Match
Alison Roberts
CONTENTS
CHAPTER ONE
CHAPTER TWO
CHAPTER THREE
CHAPTER FOUR
CHAPTER FIVE
CHAPTER SIX
CHAPTER SEVEN
CHAPTER EIGHT
CHAPTER NINE
CHAPTER TEN
CHAPTER ONE
THE tremor was tiny.
So slight it could only be felt, not seen, but it was enough to threaten her confidence.
Could she manage this?
The smallest slip could be catastrophic. A tiny heart lay carefully exposed beneath her fingertips. The defect causing a three-year-old boy’s heart failure was visible and ready to be covered by the small teardrop-shaped patch of Dacron caught between the teeth of the forceps that surgical registrar Holly Williams was holding.
The tremor could be the result of first-time nerves, in which case Holly knew she could conquer it and succeed—as she had done countless times already on the totally focussed journey that had brought her to precisely this point in time.
But it could also be the result of fatigue and, no matter how much practice Holly had had in battling the physical effects of exhaustion, she knew there were times when she simply couldn’t win. And the notion of a three-year-old child sharing the repercussions of losing that battle was absolutely unacceptable.
Pushing herself this far might have been a huge mistake. What if…?
‘You can do this, Holly.’
The quiet, deep voice was so close that Holly could feel the vibration of air as clearly as she’d felt that embryonic tremor. And the confidence that had cloaked the words didn’t stop at her ears. It seeped instantaneously into her brain and then swept further. The ache in Holly’s calves subsided, the knot in her stomach unravelled just enough and her fingers felt rock steady.
She gave a single, decisive nod.
Of course she could do it. She had worked far too hard for far too long to pass up the opportunity of actually touching her dream.
Being more than an assistant, however vital that assistance might be.
So what if this procedure was an almost routine repair of one of the most common types of a ‘hole in the heart’—a ventricular septal defect? Or that all the skilled preparation had already been done by one of the country’s foremost paediatric cardiac surgeons? It was still Holly holding the suture needle and patch. Doing an actual repair herself and not just the final closure for the open heart surgery. There weren’t many consultants in any field that would trust their registrars enough to provide such an opportunity so soon.
She owed it to her mentor to justify that trust. As she had done on more than one occasion when Ryan Murphy’s confidence had deepened, if not actually engendered, an equal trust in herself.
‘Begin on the right side of the inferior rim.’ Ryan’s instruction was calm. ‘And carry it in a counter-clockwise direction to penetrate the septal leaflet.’
Tiny stitches. Through the cardiac tissue and then through the edge of the patch. Again. And again.
‘Perfect.’
The final suture was tied and cut. The rush of oxygen as Holly took a deep breath gave her momentary dizziness. How long had she been holding her breath?
‘Want to carry on?’
Holly glanced up to catch a pair of hazel eyes regarding her over the edge of a surgical mask. Ryan’s tone was as calm as ever but Holly could see a gleam of pride that was bright enough to more than replace an emotion she couldn’t afford to indulge in just yet.
‘Yes—thanks.’
‘Don’t thank me. I’m getting a holiday here.’
As if. Ryan was aware of every factor involved in this operation. Coaching and monitoring Holly’s work would require far more effort than doing it himself, and Ryan was also keeping tabs on all the parameters being measured on their small patient as the procedure was completed and preparation made to come off bypass.
‘Clamp coming off. Happy that you’ve removed all the air in the aorta, Holly?’
‘Yes.’ Holly moved to insert the needle into the largest chamber of the heart, the left ventricle.
‘Good.’ Ryan nodded. ‘You’ve got it right on the apex.’
The pause as the team watched for the heart to resume pumping stretched on longer than seemed normal and Holly felt a chill race up her spine. It was rare these days for defibrillation to be needed to restart the heart. Had something gone wrong?
Her gaze was riveted on the child’s heart, still lying motionless, but Holly was aware of a very subtle movement beside her. The tall figure that had already been standing close beside her seemed to sway an infinitesimal degree. Not enough for anyone to notice but Holly was aware of Ryan’s shoulder almost touching her own. The solid wave of reassurance the almost-touch provided coincided with the first movement of the tiny heart in her line of vision.
Just an uncoordinated wiggle to start with but it was enough for a collective, if inaudible, sigh of relief as the heart settled into a steady beat with reassuring swiftness. Then the whole chest moved as ventilation of the child’s lungs began again. Step by step, Holly continued the procedure, repairing the connection sites for the heart-lung machine, positioning drains and closing the small chest with fine wire to hold the edges of the breastbone together. She had used virtually all these skills previously but never continuously, and the strain was telling as the final layer of closure was reached.
The tremor was clearly visible now.
Not that Ryan offered to take over. Not even when it took two attempts to knot and tie the final suture. His clipping of the excess length was perfunctory as his attention turned to the anaesthetist.
‘How’re we looking?’
‘All good. Blood pressure’s fine. Oxygen saturation is ninety-eight per cent.’
‘Probably the best it’s ever been for this wee chap. Happy to move, Holly?’
Holly finished covering the sutures with a clear plastic dressing and scanned the chest drains. There was no sign of any untoward blood loss from the field of surgery.
‘I’m happy if you are, Ryan.’
‘Oh, I’m more than happy.’ They could all hear the smile in Ryan’s words. ‘Well done, Holly.’
‘Yes, well done!’ The sentiment echoed amongst theatre staff who were quite aware of what a large step Holly had just taken towards her ultimate goal of being a paediatric cardiac surgeon. The congratulatory sounds stayed with her as they transferred their small patient to the intensive care unit where he would stay on a ventilator for the next twenty-four to forty-eight hours.
She h
ad done well but her clumsiness at the end of the procedure couldn’t have gone unnoticed. How many of the staff were thinking, as Holly was, that it was just as well it hadn’t occurred earlier? Or that maybe Ryan was a little too trusting. Worse—that maybe Holly Williams wasn’t quite up to doing the job she had set her heart on.
Having directed them towards bed position one in the ICU, the charge nurse gave Holly a look that confirmed her fears.
‘You look dreadful, Holly! You’re as white as a sheet. Are you all right?’
‘I’m fine.’
‘Hmm.’ But the nurse’s attention was now on her new admission as they positioned the monitoring equipment and checked all the information made available. ‘Callum’s parents are in the relatives’ room,’ she told Ryan finally. ‘You can send them in to sit with him when you’ve had a talk.’ She raised her eyebrows. ‘I’m assuming everything went well?’
‘You’d better ask the surgeon.’
Holly smiled at the new level of respect she could detect in more than one face turning in her direction.
‘It went very well,’ she said modestly.
‘Textbook perfect, actually,’ Ryan added. ‘Let’s go and give Callum’s parents the good news, shall we, Holly? We might even have time for coffee before we do our rounds after that.’
‘Don’t bank on it,’ the nurse warned. ‘I’ve heard that the neonatal retrieval team have been sent out to collect a blue baby from one of the maternity hospitals.’
‘What’s the ETA?’
‘Thirty minutes or so, I’d guess.’
‘Cardiology up to speed?’
‘They’re standing by.’
Holly listened to the exchange with dismay. An afternoon of patient rounds evaluating their current case load had seemed manageable, but if she was already drained enough to have people commenting on her appearance, how could she hope to find the stamina to assist with what could be a very difficult procedure on a critical newborn baby?
‘In that case…’ Ryan’s tone belied any similar misgivings he might be having. ‘Coffee is imperative. Holly, would you go and put the jug on, please? I’ll talk to Callum’s parents.’
‘But—’
‘No “buts”,’ Ryan said sternly. ‘I need coffee stat!’
He could have been the one to go ahead to the staffroom while Holly spoke to the child’s family but they both knew why that wasn’t happening and it was with a heartfelt sigh, a few minutes later, that Holly sank into an armchair and closed her eyes.
Sometimes, this was just so hard.
His registrar was sound asleep.
Ryan Murphy shut the staffroom door quietly behind him when he arrived nearly an hour later. He’d spoken at length to Callum’s parents and then accompanied them to their son’s bedside, taking the opportunity for another check on his patient. He’d caught up with the cardiology team as their new admission had arrived via ambulance. The neonate was in trouble all right, with a level of cyanosis obvious enough to require urgent management. An X-ray and echocardiogram would be needed to make a definitive diagnosis, however, and that gave Ryan some breathing space.
It was time for coffee.
Maybe it was also time to have that talk with Holly.
She hadn’t stirred as Ryan had entered the small staff-room. Before long, the area would start being used by staff snatching a lunch-break, but for the moment it was peaceful and Ryan was reluctant to disturb Holly. Exhaustion was etched onto that pale face in the form of an uncharacteristic frown line between her eyes and bruised-looking skin beneath the fan of dark lashes.
He’d never seen her asleep like this before and for a long moment Ryan felt mesmerised. That aura of strength had deserted her and the sheer vulnerability of the woman in front of him caught and squeezed Ryan’s heart painfully. She was way too thin now. In another life, with Holly’s height and stunningly good looks, she could easily have been a model. But that was not what Holly had set her heart on being, was it?
Ryan sighed inaudibly and moved towards the bench. He shouldn’t have pushed her to go solo on that VSD repair. He’d seen that moment of hesitation—the self-doubt. He’d also felt the gathering of whatever internal resources had been needed to succeed, and he hadn’t realised how tense he’d been himself until Holly had moved to take that first stitch and he’d been able to breathe again.
Not that he’d doubted for a moment that she could do it. If sheer courage and determination were all it took to succeed, there would be no stopping Holly Williams. Sadly, that wasn’t all it took, though, was it? And Holly was getting just a shade too close to the wall now. Maybe others hadn’t noticed yet but Ryan had become so closely attuned to his registrar that he knew as well as she must how much more of a struggle it was all becoming.
Yes. Ryan quietly set two mugs onto the bench and reached for the jar of instant coffee.
It was definitely time for the talk.
‘Holly!’
Her eyes flew open at the sound of her name. Blinking, Holly focussed on the source of the sound. Shaggy, gold-streaked brown hair. A face too craggy to be conventionally good-looking but a pair of the kindest hazel eyes in existence. A wide mouth, more inclined to curve into a slow smile than a grin. The kind of smile she could see right now, in fact.
‘Feeling better?’
Holly nodded, sitting more upright as she noticed the steaming mug of coffee Ryan was holding out for her.
‘Thanks.’ Embarrassed at being found asleep, Holly avoided more than the briefest eye contact. Her gaze slid past Ryan’s face, catching the wall clock visible just behind his shoulder. Her exclamation was horrified.
‘Oh, my God! I’ve been asleep for an hour!’
‘You needed a rest.’
‘I thought you’d only be five minutes. I only sat down to wait for the jug to boil.’ Holly shook her head in disbelief, pushing a long, single braid of dark hair over her shoulder. ‘I’m so sorry, Ryan. This is awful!’
‘It’s no big deal. Don’t beat yourself up over it.’
‘Falling asleep on the job is a pretty big deal in my book.’ Holly tried to stamp on a fear that had been gnawing at her for days. The fear that things were getting worse far too rapidly to control now. That she was reaching a point when she would have to admit defeat. She could only hope that fear wasn’t showing in her eyes as she looked up at Ryan again. ‘Why on earth do you put up with me, Ryan?’
The gentle smile broadened into the closest he ever came to grinning as he sat down beside Holly.
‘What is it they say on the wrinkle-cream ads? “Because you’re worth it”?’
‘Ha!’ But Holly couldn’t help smiling back at Ryan. He’d always made her feel like that. Mind you, he made everybody feel like that. His small patients, their parents—even their siblings. Ryan was just one of those amazing people that made anyone they spoke to feel special. Holly had never known him to complain of any personal cost he suffered and she had to be running up a fair account by now. ‘You have to juggle on-call rosters because half the nights I’m unavailable. I have more time off work than any normal registrar would be allowed and now I’m falling asleep on the job, for heaven’s sake!’
‘You had a big morning.’ Ryan raised his coffee-mug in a salute. ‘Well done again, by the way. When I think back to what my first patch was like on a VSD, I’m impressed all over again. In fact, I think I was only allowed to do half of it before my consultant muttered darkly about having to call in a plumber to fix the leaks and then took over.’
‘I don’t believe that for a minute.’ Holly’s glance at Ryan was very direct. ‘Why did you let me do it?’
‘Because you could.’
‘You didn’t know that. I didn’t know that. I’ve never done it before.’
‘You have more than enough ability. You’ve got to stretch your wings some time.’
‘But something might have gone horribly wrong.’
‘Of course it could. Something could have gone horribly wrong for
me as well. That fear is always there.’ Ryan’s expression was quizzical. ‘You’ve had your heart set on a surgical consultancy for as long as I’ve known you, Holly. And that’s, what…two years now?’
She nodded. ‘Off and on.’
‘And as a consultant, you take that risk and responsibility on board and do the best you can. Your best is more than good enough.’
‘I’m not talking about the risk of complications or error.’ Holly stared into the depths of her coffee-mug. ‘I’m talking about the lack of physical ability. What if I’d blacked out or got the shakes badly enough to create a disaster?’
‘You didn’t.’
‘You took a hell of a risk, though, Ryan.’ Holly swallowed hard. ‘And while I’m enormously grateful, I don’t think you should do it again.’
‘That’s my call.’
Holly shook her head sadly. ‘I’m not so sure about that. Not any more.’
‘What do you mean?’
‘Maybe it’s time I faced reality here. The odds are stacked pretty high against me getting where I want to go.’ Holly took a deep breath. This was hard to say. To admit that her fiercely defended independence wasn’t as great as she’d believed. ‘Maybe it’s just not fair that people like you have to keep propping me up.’
Ryan was giving her an oddly wary look. ‘You’ve been battling those odds for as long as I’ve known you and I’ve never heard you come even within spitting distance of admitting defeat. What’s changed?’ He frowned. ‘Did I put too much pressure on you this morning? If I did, I’m sorry, Holly. I never meant to—’
Holly shook her head again, interrupting any apology. ‘It’s not that. You’ve never put too much pressure on, Ryan.’ She smiled. ‘You seem to know how to put on just enough to push people into discovering what they’re capable of without destroying their confidence. You’re a brilliant teacher, you know.’
Ryan shrugged off the compliment. ‘So what is it? Are you just tired?’
‘I’m always tired.’
‘What’s changed, then?’ Ryan persisted. Hazel eyes seemed to darken with concern. ‘Are you needing dialysis more often?’
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