The Italian Surgeon

by Meredith Webber

  CHAPTER NINE

  ‘I WILL not have men with guns in my theatre!’

  ‘We are the baby’s bodyguards—we go everywhere with him.’

  ‘Not into my theatre!’ Alex sounded adamant—and not a little angry.

  It was two hours later. Rachel had eaten. Well, she remembered putting food into her mouth, though for a million dollars couldn’t have said what it was.

  Mostly, she’d tried to think. Looking at Luca and trying to think and then, when that didn’t help clear the confusion in her head, not looking at Luca and trying to think.

  ‘Do not fret about it,’ he had said at one stage. ‘I would not have spoken if I’d known you’d be so surprised. I thought you must have known, but now you’re worrying and that won’t do. I do not ask that you love me back, only that you accept how I feel. So, relax and let your mind focus now on the operation.’

  They’d parted in the lounge, she to change and check the theatre, he to go into conference with Phil and Alex. So now she was waiting in the theatre for the patient to be wheeled in, listening to a conversation nearly as bizarre as the one she’d had with Luca earlier.

  She’d turned at the sound of Alex’s voice and now realised the baby was here, though whether he’d come further than the door depended on whether Alex won the argument he was currently having with two burly men.

  Through the open doorway she could hear a woman crying softly, and men’s voices conversing in a language she didn’t understand. Annie’s voice as well, explaining, placating, trying desperately to sort out the situation.

  Then Alex’s voice again.

  ‘I don’t care if they wait on Mars, but they’re not coming into my theatre.’

  Luca came in from the changing rooms, crossing the theatre towards Rachel, the anxiety and concern in his eyes warming her.

  ‘You are all right?’

  As ever, when he was stressed, his English became more formal.

  ‘I’m fine,’ she assured him. Utter lie! ‘Don’t worry about me, worry about that baby.’

  She nodded towards the double doors that led from the passage to the theatre.

  ‘There’s more trouble?’ Luca’s voice expressed his disbelief.

  ‘Only men with guns,’ Kurt told him. ‘Strange as it might sound, Alex doesn’t want them in Theatre.’

  ‘I should think not,’ Luca said, moving closer to Rachel. ‘This is a ridiculous situation, particularly with women involved.’

  ‘Hey, Luca, enough of this protectiveness where Rachel and I are concerned,’ Maggie, who’d followed him into theatre, told him. ‘Women fought long and hard for equal rights—and now we’ve got them, we have to take equal responsibility.’

  ‘I still don’t like it,’ Luca said stubbornly, and Rachel smiled at his insistence. It was old-fashioned but nice, that kind of chivalry.

  And he loved her?

  Now movement at the door suggested Alex had prevailed, as he and Phil walked beside the trolley bearing the baby boy.

  Rachel studied the face of the man with whom she’d worked for so long. It was set and hard, his eyes grim, and she wondered if he was having second thoughts about operating.

  ‘Luca, would you and Scott open while Phil and I scrub? Maggie, you set to go? Kurt, Rachel, you two ready?’

  He barely stayed for their nods before crossing to the scrub room, where a nurse waited with gowns and gloves for both surgeons. Maggie hooked the baby to her monitors, Ned set up a metal frame over the baby’s head so it was protected during the operation, and Rachel spread drapes across his little body.

  ‘I wonder why the incidence of congenital heart defects is higher in boys than girls—with nearly all the different defects, we seem to see more boys than girls,’ Kurt said, making conversation while checking that the plastic tubes that would run from the baby to his machine and back again to the infant were all out of the way of the operating staff.

  Rachel knew one kinked tube could mean death for an infant and, though nobody was saying anything, she was pretty sure they all felt the threat of the men with guns outside the theatre doors.

  ‘The men with guns, who apparently are the baby’s personal bodyguards, have been replaced by hospital security men—also with guns,’ Alex explained when he returned, ready to take over the lead role from Luca. ‘They will wait in the corridor outside Theatre while the other bodyguards—and there are four in all, two for the father as well—will wait with the family somewhere up on the admin floor.’

  ‘Does that mean that if the baby happens to not live through this operation, we won’t be gunned down in Theatre?’ Kurt’s plaintive question made everyone smile and released some of the tension the men-with-guns scenario had built up.

  ‘No, they’ll wait and gun us down in the street,’ Ned said, but Rachel had spent more than enough emotion for one day and didn’t find it a joking matter.

  ‘This baby will not die,’ she said fiercely. ‘Not if you all concentrate on your jobs, instead of thinking about what’s happening outside.’

  ‘Hear, hear,’ Alex said, carefully cutting a small patch from the baby’s pericardium and setting it in a liquid solution in case he needed it later. ‘This baby is no different to all the others we have operated on. We will do our best for him—no one can ask more than that.’

  But it seemed fate could, for the baby fibrillated badly when he went onto the bypass machine, and had to be resuscitated on the table.

  Alex gave sharp orders and Maggie fed different drugs into the drip line—drugs to prevent fibrillation and to restore the balance of chemicals in the baby’s blood. Anxious moments passed, Rachel’s gaze going from the baby to the monitors and back again.

  ‘Should we shock?’ This from Phil, while behind him Ned stood by with the generator and paddles ready should they be needed.

  ‘No, he’s stable again,’ Maggie said, but the tension in the room had tightened considerably, so it seemed to Rachel the air had become solid and now vibrated with the slightest move.

  Alex worked swiftly and, though his fingers seemed too big and clumsy to fit within the baby’s small chest cavity, he cut and stitched with delicate efficiency.

  ‘His blood’s thickening,’ Kurt warned, and Alex ordered more drugs from Maggie to thin the blood so it would pass more easily through the machine. Too thick and it could clot, too thin and the slightest mistake could lead to a bad haemorrhage—it was a razor-sharp line they walked as the surgeons worked, realigning blood vessels and opening valves in an attempt to give the little one a chance of life.

  ‘OK, three minutes and we’ll be off bypass,’ Alex announced. ‘I’ll give the word, Kurt.’

  But no one breathed easy until the pump stopped and they saw the little ill-formed heart beat valiantly.

  Alex stayed and closed, as if this baby were more important than others, but Rachel guessed he couldn’t walk away from his team and chose to close rather than make it obvious he was hanging around in case of trouble.

  He closed each layer with fastidious care, first the pericardium, then the chest, looping one curved needle into the bone on one side, then the needle on the other end of the thin wire into the other side, positioning four wires before he and Phil, using plier-like needle-holders, crossed them over and knotted them tight, then clipped off the ends and pressed them flat so they wouldn’t cause problems to the baby later.

  Finally the skin was closed, and the wound dressed. They were done!

  ‘Maggie’s right,’ Alex said, when he finally stepped back from the table and unplugged his headlight, rubbing wearily at the indentations it had left on his forehead. ‘We can’t transfer him immediately. We’ve all we need to keep him stable right here in Theatre. What say we keep him here until morning, see how he’s doing, then make a decision?’

  That way, Rachel realised, the men with guns wouldn’t scare the living daylights out of all the parents sitting by their children in the PICU, and they were not endangering anyone else’s life.


  ‘I am happy to stay,’ Luca said, ‘but surely most of the staff should leave.’

  ‘He’s my responsibility post-op so I’d be staying anyway,’ Maggie said. ‘I might as well watch over him here in Theatre as anywhere else.’

  ‘Well, if you lot are in, so am I,’ Rachel told them, ‘though I might do a bit of my waiting in the lounge. Shall we take turns to have a break in there?’

  ‘Good idea,’ Phil replied. ‘Alex, you and I will go first. We’ll take a break, grab some coffee and a bite to eat and be back in about an hour.’

  Alex didn’t argue, and Rachel, who knew how fiercely he concentrated during an operation, thought tiredness had probably prompted him to accompany Phil so meekly out of the door. But Maggie had a different idea.

  ‘They’re plotting something, those two,’ she said, looking questioningly at Luca. ‘Are you in on it?’

  Luca spread his hands wide.

  ‘Me? We’ve all been here, gathered around the table, concentrating on the baby—what chance has anyone had to plot?’

  ‘Well, I know Phil, and he’s plotting,’ Maggie announced.

  ‘Alex will want to see the family,’ Scott suggested. ‘He always does straight after an op.’

  ‘Maybe he’ll call Annie from the lounge and have her do it,’ Ned suggested, and Rachel realised they were all feeling residual tension, for the whys and wherefores of the two men’s departure to be so closely analysed.

  The theatre phone rang an hour later, and Ned answered it, spoke for a while, then hung up.

  ‘That was Alex, apologising for keeping us in the dark, but apparently Phil had a brilliant idea and they had to run it past the parents—using Annie as a go-between.’

  ‘So tell us!’ Maggie demanded, but at that moment the inner door opened and Alex ushered in two people, a man and a woman, both so obviously distressed Rachel knew they were the parents.

  Phil, like Alex, still in theatre scrubs, followed behind them.

  ‘Let them be with the little boy for a few moments,’ Alex said, and the team members, with the exception of Maggie at the monitor, all fell back. The pair spoke quietly, their eyes feasting on their child, then the man put his arm around the woman’s shoulders and she lifted a handkerchief to her eyes. Alex joined them and all three walked out into the corridor. Phil waited until the doors closed behind them, before explaining.

  ‘They had to agree to our idea, and then to see the baby, but we are giving out that he died during the operation. I thought of it when he fibrillated—thought it might be an answer to how to keep him safe post-op. As far as the world—and that includes everyone in the hospital who is not in this room—is concerned, what you saw was the parents’ last farewell to their son. The baby died in Theatre. Annie is organising all the things that have to be done, including a memory box, and while some of you might feel this is tempting fate, it’s the only way we could see of keeping the baby here, yet removing any risk to the hospital and staff.’

  He paused, then looked at each of them in turn.

  ‘To ask you to swear you won’t betray this child would be melodramatic, but you must all know in your hearts how important it is to maintain the charade. We’ve had a devil of a job convincing the baby’s bodyguards that they must also leave with the coffin that will be arranged, or the plan won’t work, but having got them out of the way, then it would be really bad if someone on the team gave the game away.’

  Luca watched the team members all nod, and wondered at the unity Alex had achieved among his staff—though some of them had not been with him for long. Would he be able to bring such a team together when his clinic opened?

  And would that team include Rachel?

  Dared he ask her?

  What of her loyalty to Alex?

  Luca found that he, who usually planned his life so carefully, finding answers to all his problems through thought and application, had no idea of the answers to these questions. Things had seemed to be going well until his fear for her earlier today had prompted him to mention his love.

  Since then it was as if she’d departed to some other place, where words alone were not enough to reach her. Tonight, or tomorrow—whenever they could be alone—he would show her as well as tell her of his love.

  He would also tell her of his plan for them to be a team in every way, building up the clinic together, sharing the future.

  ‘Well, I for one am desperate for coffee,’ Kurt announced. ‘Seeing a dead baby breathe does it to me all the time.’

  And that was something else, Luca thought, watching Kurt hook his arm around Rachel and guide her out of the room. Would his team joke and fool around to relieve tension in the theatre? This was something he hadn’t come across before. Leaving the circulating nurse, Ned, Maggie and Phil in Theatre with the baby, Luca followed Kurt and Rachel to the lounge where Kurt was already pouring coffee.

  ‘One for you, Luca?’ Kurt asked, waving the coffee-pot in the air.

  ‘Please,’ Luca said, then he sat down beside Rachel and took her hand.

  ‘You’re all right?’

  She turned towards him with a tired smile and he noticed the lines of weariness on her face and the dark shadows beneath her eyes. Guilt that he might be responsible for some of her tiredness struck him, but he didn’t think an apology would work. Not here and now, anyway.

  ‘It shouldn’t be long before the baby can be moved somewhere else,’ he said, hoping to contribute to the lightening of tension, ‘and we can all go home.’

  ‘It’s not the staying here that bothers me,’ Rachel told him, accepting the cup of coffee from Kurt with such a sweet smile Luca wished it had been for him. ‘It’s the state of our world when a tiny baby needs two bodyguards.’

  ‘But kids all over the world, from wealthy, or famous or in some way important families, have bodyguards, Rach,’ Kurt reminded her. ‘Having fame or money isn’t all it’s cracked up to be—it makes people very vulnerable.’

  ‘Well, I wouldn’t like my kids—if I had them—to have to spend their lives shadowed by men with guns, so maybe it’s a good thing I’m not wealthy or famous or even a little bit important.’

  Rachel turned to Luca.

  ‘You grew up with money. Did it bother you?’

  She saw his face close as she asked the question and immediately regretted it, but it was too late to take it back.

  ‘How can you be so innocent, so trusting?’ he demanded. ‘Lots of terrible things happen all over the world, they always have done and will continue to do so, yet you still believe the world is a safe and wonderful place.’

  ‘But it is, by and large,’ Rachel argued. ‘I know bad things happen to good people but on the whole there’s a lot more positives than negatives happening. Look at the development in cancer cures, particularly the results for childhood cancer.’

  ‘And take our own field,’ Kurt put in. ‘Not so long ago, babies with HLHS were cared for until they died, but now we can fix them to the extent they can lead near-normal lives.’

  Luca smiled at him.

  ‘Yes, here is plenty to be optimistic about. Maybe the pessimism I sometimes feel is to do with my own personal experience.’

  ‘Well, I brought up the gloomy subject,’ Rachel admitted, ‘talking about bodyguards, and guns. Maybe we can agree to disagree.’

  But although she spoke lightly, she was aware that she’d lost the closeness she’d felt with Luca earlier. Her personal question had struck some kind of nerve, and erected a barrier between them.

  Perhaps that was just as well. In spite of the wondrous nature of the time they’d spent together, and the joy they’d shared in their love-making, she was still uncertain about their affair and afraid, for all Luca’s words of love, that it was doomed to be just that—an affair.

  Rachel stayed on in the lounge, but Luca had departed soon after the strained conversation with her and Kurt about the state of the world.

  Kurt, too, had wandered off, so she was on her own. And although s
he was physically tired, her mind buzzed with speculation about what lay ahead—for the baby, and his parents, for herself and Luca…

  No, better not to think about herself and Luca! He’d talked of love, but had he meant it?

  And even if he had, what did it mean?

  Her tired mind couldn’t decide, but neither could she stop it going around in circles, getting nowhere.

  Remembering she’d shoved her theatre nurses’ newsletter into her handbag some days ago but still hadn’t read it, she went to her locker and found her bag, pulling the magazine from its depths.

  Back in the lounge, she flicked through it, wondering if there were any articles to hold her interest in her current state of near-exhaustion.

  Nothing caught her eye, though on her second pass through it she saw the ad.

  Or the photo of the man in the centre of the ad.

  Luca!

  Exhaustion forgotten, she spread the flimsy newsletter out and stared at the double-page spread. A photo of a sparkling new building took up a quarter of the page opposite the photo, and below it were lists of staff positions that needed to be filled. The ad had been placed by an agency in the US that Rachel knew by name, mainly because it was so big it recruited staff to work in jobs all over the world.

  Some positions had been filled, but the largest and seemingly most urgent advertisement sprang out of the page at her.

  Physician’s assistant—twelve-month renegotiable contracts—the pay range enough to make her eyes widen in disbelief. Luca was offering serious money for someone to assist him in Theatre.

  Language would be no barrier, the ad assured would-be candidates. Lessons in Italian would be provided for all foreign staff.

  Reading through the qualifications and experience required, Rachel knew the job description could have been structured just for her, but with this knowledge came suspicion.

  She tried to banish it with common sense. The magazine was a month old or even older, and the position had probably been filled.