by Fiona Lowe
And she’d just gone and said it. ‘Look, Hayley, I tried to make it clear the other day that—’
‘This is nothing to do with the other day.’ The cutting tone in her voice could have sliced through rope. ‘Just listen to me. There’s a young woman in ER with a brain tumour and an associated bleed. There isn’t a neurosurgeon available between here and Wollongong and I have to operate. Now. I need you in Theatre with me, Tom. I need you to talk me through it. Be my guide.’
He heard the fear in her voice and it matched his own. There was a huge difference between being able to see the operating field whilst guiding a registrar through the procedure and depending on Hayley telling him what she was seeing so he could tell her what to do next. ‘Can dexamethasone reduce the swelling enough to hold her until the guy from Wollongong arrives?’
‘No.’ Her tone softened slightly. ‘Believe me, Tom, if I had any other choice I would have taken it but there isn’t one. We are this girl’s only chance.’
He swung his legs over the side of the bed. ‘Hell, she’s having a really bad day, then.’
‘She is.’ Hayley’s strained laugh—the one all medical personnel used when things were at their darkest—vibrated down the line, bringing with it a camaraderie that called out to him.
‘I’ve sent a taxi, which is probably arriving any minute. I’ll see you at the scrub sinks, Tom.’
The line went dead.
The scrub sinks.
She’d rung off, leaving him with no option.
He was going back to Operating Room One. Going home. Only home was supposed to be a place of sanctuary and safety and this felt like walking off a cliff.
‘You didn’t shave off all her hair, did you?’
Tom sat on a stool behind Hayley, noticing the varied array of smells in the operating room that he’d never noticed when he’d been sighted. Disinfectant mixed in with anaesthetic gases and blood, plus a couple of other aromas he couldn’t quite identify and wasn’t certain he wanted to. But no matter how pungent the odours, Hayley’s perfume floated on top of them all in a combination of freshness, sunshine and summer flowers. He wanted to breathe in more deeply.
‘No, we only shaved off half her ponytail.’
‘Good. Neurosurgery is a huge invasion and I always make it a point to shave the bare minimum out of respect for the patient.’
Made it a point. You’re not operating any more.
Being back here felt surreal—he was in his theatre that wasn’t his any more, part of a team rather than leading it. He wasn’t scrubbed. Hell, he couldn’t remember the last time he’d been in the OR and not scrubbed. Probably when he’d been a med student. He interlocked his fingers, keeping his hands tightly clasped together in his lap.
He heard Hayley murmuring to the anaesthetist and then she said, ‘Tom, I have Theo scrubbed in, David’s the anaesthetist, Jenny is scouting and Suzy—’ she seemed to hit the name with an edge ‘—is assisting David.’
He and Suzy had shared a fun night three years ago after one of the OR dinners, but he’d never called her. He’d never called any woman because work and patients had always come first and he would never allow anyone to derail him from his goal of staying on top and keeping the demons of his childhood at bay.
He could feel the gaze of many on him and then came the chorus of ‘Hello, Tom’, just as it had when he’d owned this space and had been called in for a night-time emergency. He knew everyone and he also knew, despite all their idiosyncrasies, they worked together as a team. Given the circumstances, Hayley had the best support she could have.
‘Tom, the pinion’s in place, holding Gretel’s head in position, so let’s start.’
To someone who’d not met her before, Hayley’s voice would have sounded confident, but Tom detected her massive stress levels in the tiny alto quavers. She’d explained the scan to him earlier and he could picture it all very clearly in his mind. ‘Due to the position of the mass, you’re making a lateral incision and then performing a suboccipital craniotomy.’
‘Removing a bone flap to relieve the pressure,’ Hayley muttered as if it was a mantra. ‘That’s the easy part.’
It is. ‘One step at a time and we’ll get through this.’ But he too was talking out loud to reassure himself as much as everyone else. So much could go wrong in so many unpredictable ways and he couldn’t see a damn thing.
He’d always operated with music playing, but not soothing classical. His OR would vibrate with hard rock and, during extremely tense moments, heavy metal. Hayley was operating in silence so he sat listening to the whoosh of the respirator and the hiss of the suction, which only ramped up his agitation. He started to hum.
‘Tom, I’ve turned the skin flap and I can see bone.’
‘Now you use the high-speed drill and make three small burr holes into the skull.’
The shrill shriek of the drill against bone always made medical and nursing students jump the first time they heard it. Tom had always teased and laughed at their reaction, but he didn’t laugh today. Instead, his fingers clenched against nothing, wishing they were holding the drill, wishing he was able to do the job, not just for himself but for the patient. For Hayley.
The shriek died away. ‘Done.’ Hayley swallowed. ‘What’s next?’
He visualised the silver instruments all laid out in neat rows on the green sterile sheet. ‘Use the Midas Rex drill to create the bone flap.’
‘Oh, my, it’s like a can opener.’ Hayley gave a tight laugh and a few moments later said, ‘The bone flap’s removed and I can see the dura.’
Like an illustrated textbook, Tom’s mind beamed the image Hayley was looking at. ‘Excellent. Now you need the grooved director. It’s your atraumtic guide. Using the scalpel, cut the dura over the groove and this protects the brain tissue underneath.’
‘Too easy.’
But the everyday slang expression was laden with her anxieties. He moved to reassure her. ‘You’re doing fine, Hayley. David, how’s our patient?’
‘She’s holding her own at the moment, but I’ll be happier when Hayley’s stopped the bleeding.’
‘You’re not alone there.’ Tom counted to ten because he didn’t want to rush Hayley, but he also needed to keep her within a particular time frame. ‘Can you see brain tissue, Hayley?’
‘I’ve found the clot.’ Her relief filled the theatre.
‘Theo, position the microscope.’
The rustle of plastic-covered equipment being wheeled into place was the only sound and Tom hated not being able to see what was going on. ‘Hurry up, Theo.’
‘It’s in position now, Tom,’ Theo said.
‘Good. Hayley, have you found the bleeding?’
‘Give me a minute, I’m still looking.’
Her normally mellow voice rose as her semblance of calm shredded at the edges. Tom wished he could take over, relieve her of this unwanted task that was stretching her and forcing her to go places she’d never been before. But he was powerless to help so he did the next best thing. ‘Theo, suction the clot and keep the field clear. She needs to be able to see.’
‘On it, Tom,’ the nurse replied.
For a moment all he could hear was the gurgle of suction and he couldn’t stop his foot from tapping on the floor.
‘Okay.’ Hayley’s breath came out in a rush. ‘I see it.’
Thank you. ‘Stop the bleeding with the bipolar forceps.’
‘What if that doesn’t work?’
Don’t panic on me now, Hayley. He infused his voice with a calm he didn’t feel. This surgery was something he’d perfected over years of training. Hayley was being thrown in feet first. ‘We’ve got the option of clipping, but try the electrical coagulation first because it will probably work.’
Please let it work. The sooner she stopped the bleeding, the better it was for their patient.
He held his breath while Hayley worked, but he could only guess at what was going on because, apart from a few muttered words, she was sil
ent. He’d always grunted, yelled, talked and even sung his way through surgery. Her silence was unnerving.
‘Suction, Theo,’ Hayley snapped.
‘Her intracranial pressure’s still rising.’ David sounded seriously worried.
‘Has it worked?’ Tom hoped like hell it had.
‘Pray that it has,’ Hayley said. ‘This is the moment of truth, team.’
No one said a word. Only the buzz and whirr of the machines dared to make a sound as time slowed down, stretching out interminably and reaching into infinity.
‘Yes!’ Hayley’s woot of relief bounced around him. ‘Field is clear. Bleeding’s stopped. Clot’s evacuated. We did it. Thank goodness I’m sitting down or my legs would collapse.’
‘Great job. You’ve done well.’ Tom grinned, wanting to high-five her. She’d held her nerve in a tight corner and now step one was complete. He immediately focused. ‘Don’t get too excited. You’ve stopped the bleeding, but we’ve still got the problem of the pressure. With a mass that size you’re going to have to excise a part of it so the brain can get some relief and relax. This takes the risk of her brain herniating down to zero. We also need a biopsy for pathology so we can hand over to Lewis Renwick, who’ll operate to remove the rest of the tumour in a day or so.’
‘You make it all sound so simple.’
‘It’s just brain surgery.’
Like a pressure valve being released, everyone laughed. Despite the life-threatening emergency, the fraught conditions and the fact he couldn’t operate, something inside Tom relaxed. Something that hadn’t relaxed in a very, very long time.
Hayley felt utterly shattered as she walked toward ICU. Even though it had only been three and a half hours since she’d operated on Gretel, it felt like years ago. Having used up every ounce of her concentration whilst operating on her neurological patient, she’d expected to be able to fall in a quivering heap the moment the surgery was over. Instead, just as Tom and David had left the OR to escort Gretel to ICU, she’d been called back down to Emergency for another consultation. Half an hour later she’d been scrubbed again and busy resecting an ischaemic bowel. It hadn’t been an easy operation either.
Now pink streaks of dawn clung to the clouds and all she wanted was her bed, but she couldn’t go home without calling in to see Gretel. She pushed open the doors, checked the patient board, and walked directly to cubicle four. She stood at the end of the ICU bed and blinked. Twice. Shooting out her hand, she gripped the edge of the bed as her legs threatened to collapse in shock. She didn’t know what stunned her more, the fact that Gretel—whose head she’d had her hands inside a few short hours ago—was sitting up, awake and talking to two doctors, or that Tom was one of those doctors.
He was sitting by the bed, holding Gretel’s hand. His face had lost its taut expression—the one she’d become convinced was a permanent part of him—and he looked almost happy.
Tom turned slowly and his nostrils flared. ‘Hayley?’
A buzz of hope streaked along her veins. He knows it’s you.
It’s not personal. He’s got ninja olfactory skills.
She nodded automatically and then realised her mistake. ‘Yes, Tom, it’s me.’
‘Lewis …’ Tom threw his arm out toward her ‘… meet Hayley Grey, the registrar who operated on Gretel.’
A man in a crumpled suit extended his hand in greeting along with a tired smile. ‘Lewis Renwick. Last neurosurgeon in Sydney, it seems. Sorry I was tied up at RPH, but Tom’s been telling me that you coped admirably. Looking at the most recent scan, I agree. You’ve done a wonderful job.’
Hayley grinned with relief. ‘Thank you, but I’m pretty good at following instructions.’
Lewis laughed. ‘Which is fortunate as Tom’s pretty good at giving them.’
Tom’s dark brows rose but a grin clung to his lips. ‘Only because most people need them.’
Gretel smiled and touched her hair. ‘Thanks, Dr Grey, not just for saving my life but for saving most of my hair.’
‘You’re very welcome, but it was very much a team event, with Mr Jordan guiding me through it.’
‘I know, he told me all about it.’ Gretel glanced between the three of them, but spoke directly to Hayley. ‘I can’t believe all this has happened to me, but at least the tumour isn’t cancerous. I’m so lucky that you and Mr Jordan were here tonight and now to have Mr Renwick looking after me.’
Tom patted Gretel’s hand and gave her a big wink. ‘He’s almost as good a neurosurgeon as me except for his lousy taste in music.’
‘So now you’re taking on Mozart?’ Lewis folded his arms in mock effrontery.
‘I always let my patients choose their playlist for the awake part of their surgery.’
The joking faded from Tom’s voice and Hayley saw how much he missed hospital life. It wasn’t just the surgery but his patients as well. Perhaps the patients even more than the surgery? The thought hovered for a moment before she discarded it.
‘I tell you what, Gretel …’ Lewis made a note on her chart ‘… ask your family to bring in your MP3 player and as long as there’s no hip-hop on it, you can listen to your music while I’m removing the tumour and the anaesthetist is asking you questions.’
‘That’s awesome, Mr Renwick. Thank you.’ Gretel touched the bandage on her head. ‘It’s going to be weird being awake while you’re operating on my brain.’
Hayley gave Gretel’s foot a pat. ‘I’ll leave you to talk to Mr Renwick about the surgery as I’m heading home now, but I’ll call by later tonight when I’m back on duty.’
‘I’ll come with you.’ Tom rose and flicked out his cane.
Hayley’s feet stayed still in surprise. He’d been brilliant in Theatre, but she could still vividly remember what he’d said when he’d first answered the phone. Now he wanted to leave with her? It didn’t make sense.
He’s in ICU with machines everywhere. He’ll need some guidance to get to the safety of the corridor.
Yep, that would be it.
Logic didn’t stop the sneaking fizz of disappointment.
‘You’re in good hands, Gretel.’ Tom’s voice suddenly took on a parental tone with an underlying warning. ‘Take care of her, Lewis.’
Hayley stepped up to Tom and said quietly, ‘Would you like to put your hand on my shoulder or tap your way out?’
His entire body stiffened. ‘I’ll take your elbow.’
She lifted his hand and guided it to her left elbow. ‘Are you ready?’
‘As I’ll ever be.’
The prickly man was back and she didn’t try to make polite conversation. She walked normally, but she did slow just before the nurses’ station. ‘Do you want to speak to any staff before you leave?’
He frowned and his mouth flattened. ‘Is there any point? Gretel isn’t my patient.’
She didn’t even try to stop the snarky tone in her voice. ‘Oh, right. How could I have possibly forgotten that you don’t do social niceties?’
The corner of his mouth twitched, but he didn’t say a word.
She kept walking and was about to say ‘The door is just ahead’ when Tom got in first.
‘Five steps to the door,’ he said. ‘If you open it, I’ll walk through the doorway and meet you on the other side.’
‘Okay.’ She did as he asked and then rejoined him in the corridor. She wondered if he might insist on walking on his own but he took her arm again.
As the music played around them in the lift, he said, ‘You did a great job today.’
‘Thank you.’ The ping sounded and the doors opened.
He gave a brisk nod. ‘I’m going to use the exit into the lane.’
She thought about where she’d run the other day. ‘The one where Pete’s got the rubbish dumpster?’
‘That’s it.’
It was on the other side of the hospital from the exit she usually used, and she wondered if it was Tom code for I’ll walk on my own now? But he hadn’t let go of her arm so she kept w
alking with him toward the door. Just as Hayley pushed open the heavy external door, a ward clerk, hurrying in for the morning shift, stopped to let them through.
‘Mr Jordan?’ The woman’s face lit up with a huge smile. ‘It’s Penny. It’s so great to see you. You’ve been missed.’
Tom extended his hand, which the clerk pressed warmly. ‘Penny, it’s great to hear your voice. How’s Ben doing?’
‘He’s thriving, thanks to you. Can you believe that he’s even playing football in the under nines?’
Tom moved his head toward her voice. ‘I can believe it. He was a determined kid and I’m pleased to know he’s doing so well.’ He gave her a warm smile. ‘You take care, Penny.’
Hayley stared at him, hardly able to recognise the man standing next to her.
Be fair. He was like this with Gretel.
Just not with me. Her silent sigh dragged her shoulders down a touch.
‘You take care too, Mr Jordan.’ Penny squeezed Tom’s hand again. ‘Goodbye.’ She hurried inside to work and the door slammed shut behind her.
Tom’s grip on Hayley’s arm increased ever so slightly and he leaned in towards her, his deep voice caressing her ear and sparking such a swirl of longing that she wanted to move her head so her lips would brush his.
‘And you thought I didn’t do social chitchat.’ He tapped his cane and grinned. ‘Time to pick your jaw up off the ground, Hayley Grey.’
Just when she thought she’d got Tom Jordan figured out, he went and did something totally unpredictable like this. She tried to close her gaping mouth, but before she could, a giggle escaped, and then another and another, until she couldn’t stop. It was like her veins were full of laughter bubbles and they just kept rising to the surface, being carried up on a wave of fatigue and sheer relief that the night was finally over. Everything seemed uproariously funny and she gave in to it, loving the reckless feeling and the joy that came with it.
Tom’s bass laugh joined hers, making her laugh even harder until tears streamed down her face, her sides ached and she could hardly hold her head up. She let it fall onto his shoulder as she gasped for breath. ‘I don’t even know why I’m laughing.’
‘The non-technical term is slap happy.’ He pressed his free hand gently against her hair. ‘It’s a release for the pressure of the last few hours.’