A Surgeon Worth Waiting For

by MELANIE MILBURNE

‘Colcannon.’

  ‘Jack. It’s me, Becky.’

  Jack’s hand tightened on the phone. ‘Becky, are you—?’ He stopped in mid-sentence, recalling Ben’s insistence she wasn’t to be informed of the danger she was in. ‘I mean, how are you?’

  ‘I’ve been robbed,’ she said. ‘The police are here and—’

  ‘The police!’

  Becky frowned at his tone. ‘Yes, they’re still here taking photos and so on.’

  ‘I’ll be right over,’ he said. ‘Don’t go anywhere until I get there.’

  ‘But I’m on call at the hospital,’ she said. ‘I have to go in right now. I had a call a few minutes ago. I have to assess a patient in A and E.’

  ‘Right…’ Jack forced his brain into gear. Ben had said he thought she would be fairly safe at the hospital so maybe that was the best place for her right now. ‘I’ll meet you there in a few minutes.’

  ‘But you’re not on call tonight, Brendan Fairbrother is.’

  ‘I’m covering for him from nine this evening,’ he lied.

  ‘That’s funny, he didn’t mention it to me and I was just talking to him.’

  ‘It was arranged weeks ago,’ he said, privately amazed at how easy lying was once you got used to it. ‘I’ll ring him and remind him. It’s his anniversary, he’s probably forgotten. See you soon.’

  Becky didn’t get a chance to respond as he cut off the call. She turned to the police officers who were just finishing up their crime scene investigation, wondering how in the world her life had suddenly become so frighteningly complicated.

  ‘Dr Baxter,’ Constable Daniels addressed her solemnly. ‘It might be a good idea if you stayed off the premises for a few days until we catch this guy. This doesn’t look like a prank. Until we know for sure, it might be best to stay somewhere else, preferably with someone with whom you feel safe.’ He handed her a card with his name and contact numbers on it. ‘Call me at any time if you think of anything else that might help us in our investigation.’

  She nodded in agreement, tucking the card away as she picked up a few items of clothing that hadn’t been slashed, wondering who amongst her friends she could ask to use a spare bedroom for a few days.

  If only she could contact Ben! He was the one and only person who made her feel safe.

  Well…maybe not the only person…

  Not long after she’d done an anaesthetic preassessment on a nineteen-year-old girl with acute appendicitis, Becky received a call from A and E informing her that a motorbike accident victim was on his way. As part of the trauma team she was required in A and E to manage IV and airway for trauma cases.

  She ran into Jack on her way through to the resus room, where the ambulance officers were transferring the patient on a spine board from the ambulance trolley to the resus bed.

  She began her assessment as Jack got a rapid history from the ambulance officers.

  ‘We picked him up half an hour ago, Mr Colcannon. He’d been on a high-powered motorbike and impacted with a steel pylon holding a guard rail, obviously at high speed.’

  ‘What was his GCS at the scene?’ Jack asked.

  ‘Unresponsive to anything,’ the ambulance officer informed him. ‘Totally unconscious. We extracted his helmet and stabilised his neck with a hard collar, got in an IV line and bagged and masked him to here.’

  ‘Good work, guys,’ Jack said. ‘We’ll resuscitate him and then I’ll catch up with you before you go for any other details.’

  Becky looked up as Jack approached the patient.

  ‘I’ve intubated him, Jack. He’s deeply unconscious and has a difficult airway to maintain. He didn’t need any drugs. I just put the endotracheal tube down.’

  ‘Primary survey first,’ Jack said. ‘Airway is secured.’ He listened with a stethoscope before percussing the patient’s chest. ‘Resonant on both sides and good air entry. No visible chest injury. Pulse and BP?’

  ‘Pulse 120, BP 80 systolic,’ the nurse on duty informed him.

  ‘Get in IV lines, Dr Baxter, and start colloid and O-negative blood fast, and get some blood off for cross-match, haemoglobin, electrolytes and amylase.’ He examined the patient’s abdomen by inspection first, then palpation and percussion, and after that listened with his stethoscope.

  ‘Abrasions and bruising extensively over the left flank and a large haematoma. His abdo’s distended and tense, dull to percussion and no bowel sounds. He’s clearly got major intra-abdominal bleeding.’ He turned to the nurse. ‘Can you put in a urinary catheter and nasogastric tube? Dr Baxter, how are those drips going?’

  ‘Both in and running full bore,’ Becky said. ‘He’s getting hard to ventilate, his abdomen looks distended and is compressing his diaphragm.’

  ‘Shall I get CT organised so we can see where his bleeding’s coming from?’ Robert asked.

  ‘There’s no way this guy’s going to CT. He’s in hypovolaemic shock, class 3 at least, we’re barely keeping up, and his ventilation’s going off because of intra-abdominal tension. He doesn’t need a CT, he needs surgery, and now. Get the emergency theatre on line right away. Dr Baxter, are you right to get him to Theatre now?’

  ‘The sooner the better, Jack,’ Becky said. ‘We need that abdomen opened and decompressed so I can ventilate him.’

  ‘Good, get the orderlies in now, and you go up with him in the lift. Keep that O-negative blood going in fast while I get up to Theatre and scrub.’

  The orderlies wheeled the trolley into the emergency lift from A and E straight up to the theatre complex, with Becky and Robert continuing resuscitation on the way.

  Jack was already scrubbed with the theatre team by the time the patient was wheeled through the emergency theatre door. The patient was slid onto the operating table and Jack prepped and draped the abdomen rapidly.

  ‘Don’t worry about a steridrape, Sandra,’ he said to the emergency scrub nurse. ‘And I want two sump suckers on board and diathermy up to 50 coag. Robert, get scrubbed and in here and call the intern—we need an extra pair of hands.’

  As Robert gowned and gloved, Jack made a long midline abdominal incision. A huge fountain of dark blood gushed from the wound over the side of the abdomen and onto the floor.

  ‘Suck, Robert, with both suckers. Packs, Sandra.’

  Jack scooped out three litres of blood and clot from the abdomen and identified the source of bleeding.

  ‘Give me a long artery forceps. Pull hard on that retractor, Robert, I’ve got to see the splenic pedicle.’ He applied a nine-inch artery forceps to the splenic artery and vein, then individually clamped the artery and vein and lifted out the spleen.

  ‘Heavy catgut, Sandra,’ he instructed. ‘Full length, don’t cut it, I’ve got to tie down deep.’ He tied off the splenic artery and then tied off and oversewed the splenic vein.

  ‘Looks like we haven’t damaged the pancreatic tail in those ties, and stomach looks OK. One of the short gastrics is still bleeding.’ Jack tied off the remaining bleeders and then carried out a thorough laparotomy to exclude any other intra-abdominal injury. Confident there was none and after sucking out any residual blood he closed the abdomen.

  ‘That was amazing, Mr Colcannon,’ Sandra said. ‘I have never seen so much blood before.’ She looked down at the floor and added, ‘Or so well controlled.’

  Jack grunted something in response and turned away to strip off his gown and gloves, catching Becky’s look on the way past.

  ‘She’s right, Jack,’ Becky said. ‘We were sailing pretty close to the wind but you pulled it off.’

  He gave a little shrug as he shouldered open the door. ‘I’m sure Brendan would have handled it just as well.’

  The door swung shut behind him and Becky looked down at the still unconscious patient. Brendan Fairbrother was a competent enough surgeon, but he wasn’t as skilled at handling trauma as Jack was. In fact, there were few surgeons at St Patrick’s who could match him for a cool head under pressure.

  ‘He’s one hell of a su
rgeon, isn’t he?’ Sandra said as she stripped off her gloves, sidestepping the massive pool of blood on the floor.

  ‘He certainly is,’ Robert agreed. ‘But I thought Brendan Fairbrother was on call this evening. Did they do a last-minute swap?’

  ‘It’s Brendan’s anniversary,’ Becky said as she and the anaesthetic nurse began to transfer the patient to recovery.

  ‘Anniversary?’ Robert looked at Sandra. ‘I didn’t even know Mr Fairbrother was married.’

  Sandra waited until Becky had left Theatre before responding, ‘He’s not married and as far as I know he hasn’t got any anniversaries to celebrate.’

  ‘So what gives?’

  Sandra gave him a speculative little smile. ‘I think our Mr Colcannon is developing rather a soft spot for Becky Baxter.’

  ‘No way!’ Robert said disbelievingly. ‘He hardly even looks her in the eye.’

  ‘You need to be a little more astute, my boy,’ Sandra said, poking a playful finger at his chest. ‘That man is on a mission, you mark my words.’

  ‘What sort of mission?’

  ‘He wants to be with her as often as he can,’ she said. ‘Why else would he offer to be on call two nights in a row?’

  Robert rolled his lips for a moment. ‘Maybe you’re right. Who wants to be on call two nights in a row?’

  Sandra gave him a knowing wink. ‘Who indeed?’

  Becky did her best to settle the young appendicectomy patient who was nervous about having her very first general anaesthetic.

  ‘You won’t remember a thing,’ she assured her. ‘As soon as I inject the drug into your IV line you’ll start to feel sleepy. Next thing you’ll be in Recovery and feeling a bit sore but it will all be over.’

  ‘Will it hurt?’

  ‘You’ll be a bit uncomfortable for a few days after surgery but nothing a couple of painkillers can’t handle. You’ll be back out partying before you know it.’

  ‘I’m missing three parties as it is,’ Emma Stockport said, wincing as Becky found a vein.

  ‘You and me, too,’ Becky said with a smile. ‘The lead-up to Christmas is a bit full on, isn’t it?’

  ‘Tell me about it,’ Emma said, looking at the cannula Becky had inserted into the back of her hand. ‘Eeuuw, that looks totally gross.’

  ‘Start counting, Emma,’ Becky said, feeding the propofol into her line.

  ‘One…two….thr…’

  Jack came in scrubbed and took a sterile towel off the trolley to dry his hands before putting on his gown and gloves.

  ‘This will be a cinch after the last case,’ he said, addressing Robert who had gowned alongside him. ‘Want me to talk you through it?’

  ‘Thanks, yes, that would be good. My logbook’s looking pretty bare at the moment. None of the other consultants seem to have time to take me through cases.’

  ‘Well, now’s the time. Robert, start prepping and drape the patient.’

  Robert prepped the abdomen with Betadine and draped the right iliac fossa with green drapes.

  ‘Make your incision in the skin crease two thirds the way out along a line from the umbilicus to the anterior superior iliac spine. About 5 centimetres long,’ Jack coached as Sandra handed Robert the scalpel in a yellow kidney dish.

  Jack talked Robert gently through each step of the procedure, correcting Robert’s technical uncertainties and guiding him to complete an uncomplicated appendicectomy.

  ‘Good work. Close the skin with a subcuticular vicryl. Make sure she gets a stat dose of cephalosporin as wound infection prophylaxis. You can write up the op notes, and put yourself down as the primary surgeon and me as the assistant.’

  ‘Thanks, Mr Colcannon, that was great,’ Robert said with a grateful smile.

  Becky was just coming out of the change room when Jack stepped forward from where he’d been leaning against the wall of the corridor, seemingly waiting for her to appear.

  ‘I’m just on my way home,’ he said. ‘I was wondering if you wanted to grab a bite to eat somewhere.’

  Becky stared at him blankly for a few seconds without responding. Jack ran a hand through the dark silk of his hair and shifted his gaze a fraction to the left of hers.

  ‘I’ve been thinking about your flat,’ he said. ‘You probably don’t want to stay there right now.’ He glanced up and down the corridor before adding, ‘I have a spare bedroom you could use for as long as you need to.’

  Becky wasn’t sure why he was issuing the invitation. His body language was giving off totally confusing signals. He looked distinctly uncomfortable, as if he was only offering out of a sense of duty.

  ‘I wouldn’t want to inconvenience you in any way,’ she said crisply, making her way past him to the front exit.

  ‘Hey.’ He caught one of her arms on the way past and turned her around to face him. ‘It’s not an inconvenience. Really.’

  She locked eyes with his. ‘What’s all this about, Jack?’

  He let her arm go, his expression instantly guarded. ‘What’s all what about?’

  She gave him one of her you-can’t-fool-me looks. ‘Come on, Jack, back in Theatre it was “Dr Baxter” this and “Dr Baxter” that, now you’re offering me room and board. What’s going on?’

  His eyes fell away from hers. ‘You’ve had back-to-back scares with an intruder and a robbery. I thought you might like some company for a few days until things settle down a bit.’

  ‘Maybe you should define exactly what you mean by “company”,’ she said. ‘You can barely be polite to me at work—how much worse would it be at your house?’

  ‘Look, I know I haven’t been all that friendly towards you, but I have my reasons.’

  She rolled her eyes and swung away to the exit. ‘Please, spare me your stupid reasons. Do you think I give a termite’s toenail if you can’t even get my name past the hard line of your lips?’ She pressed the night button to release the front door and glared back at him over her shoulder. ‘I’ll book into a hotel until I get my place sorted out. Thanks for the offer but, no, thanks. I can look after myself.’

  She was quite proud of her exit line, it suggested confidence and an assurance that she was still in control of her life no matter what red herrings were dished up to her. It was only when she got to her car at the far end of the hospital car park that she realised her confidence was really all a sham. She stared down at the shredded tyres on her car, and the cold long-legged insect of fear returned to tiptoe its way back up her spine.

  Jack came to stand beside her, looking down at the viciously slashed rubber, his expression grim.

  ‘Jack?’ she whispered, blindly reaching for his hand, curling her small fingers around its solid warmth.

  He squeezed her hand.

  Just once. Briefly.

  But it was enough.

  ‘Let’s go home to my place,’ he said, and led her towards his car.

  CHAPTER FIVE

  BECKY sat in the passenger seat of Jack’s car in silence. Fear had leaked into every layer of her skin until she felt as if she could even smell it. Her palms were sticky, her heart tripping erratically, her bent knees in front of her finding it hard to keep from knocking against each other.

  ‘I wish I could talk to Ben.’ She tied and untied her hands in her lap in agitation. ‘He’d know what to do.’

  ‘He’d want you to do what you’re doing right now,’ Jack assured her. ‘To stay with me until the dust settles. I’ll have your car delivered to the mechanic tomorrow. In the meantime, you can travel to work with me.’

  ‘Who is doing this?’ She swivelled in her seat to look at him. ‘Who can possibly be doing this, and why?’

  He stared straight ahead at the traffic lights while he waited for them to change to green. ‘I wouldn’t take any of this too personally. People get robbed all the time.’

  ‘Are you for real?’ Becky stared at him incredulously. ‘I wasn’t just robbed! I had a man in my bedroom, shining a torch in my face, for God’s sake! Now my tyres have be
en slashed…’ She stopped and gave one quick convulsive swallow. ‘The three flat tyres.’ Her eyes were wide with increasing fear.

  ‘People get flat tyres all the time,’ he said.

  ‘That wasn’t what you were saying the other day,’ she pointed out, resentment creeping into her tone. ‘You thought I was making it up.’

  ‘All right, so I was wrong.’ He sent her a quick unreadable glance. ‘Anyway, you’re nearly always late for work. You know how it gets on my nerves when I can’t start my lists on time.’

  ‘Well, bully for you, Mr Punctual,’ she bit back. ‘But, unlike you, other people have a life that occasionally gets in the way of being at work a whole hour before they need to.’

  ‘I do not get to work an hour before I need to.’

  ‘Yes, you do. You’re always there early, champing at the bit, biting everyone’s head off.’

  ‘You make me sound like a complete tyrant,’ he said. ‘I just want to get the job done. I hate wasting time, and sometimes the under-funded public system can be frustrating.’

  ‘Then why stay? Why not move over to the private sector and make a mint instead of the house-staff wage you’re currently on?’

  ‘I have my reasons.’

  ‘Oh, yes.’ Her tone was deliberately scathing. ‘Those little reasons of yours.’

  ‘Look, Rebecca…’ his fingers tightened around the steering-wheel ‘…I have more than enough money. Besides, someone has to do something about the waiting lists. If every specialist bails out of the public hospital, the uninsured public they cut their teeth on in training will be left abandoned. Someone has to stick in there and solve the problems, not walk away.’

  ‘If you call me Rebecca or Dr Baxter once more, I’ll scream.’

  ‘Oh, for God’s sake,’ he muttered as he turned into his street.

  ‘I mean it, Jack.’ She faced him determinedly. ‘Do it one more time and your ears will suffer. Don’t say I didn’t warn you.’

  He stabbed the remote control and drove into his garage, his jaw tight with frustration. So help me, God, I’ll kill you myself, Ben, for getting me into this, he thought as he wrenched on the handbrake.