by Lilian Darcy
'What's the dose?' Pat demanded. 'I—I've never dealt with this before.'
She had a container rattling with vials. An adult male patient like this could need as much as thirty-six of them before the danger was past.
'One mil per kilo, by rapid infusion,' Candace said, not raising her eyes from the surgical field. 'But I've heard it's hard to mix.'
'I'm shaking it. That's what the instructions say. But it's not— OK, it's mixing, I think it's all right.'
'You can give ten per kilo cumulatively. Check that, because that's from memory, and if I'm wrong... Drain, Doreen.'
'Did you say drain?'
'Yes! Peter, your hand's in the way. I need the cautery again, Doreen. Here's the organ. Steve, are you treating the heart problem?'
'Fifteen mils per kilo over ten minutes,' he muttered. 'Yes, and I've reversed the anaesthesia so you're on a clock.'
'IV saline, surface cooling...' she coached. 'Guys, you do it. I'm not talking you through it. I've got my own problems here.'
Like another bleed, and the blood was still looking too dark, showing its lack of oxygen. She needed the cautery again. Should she have picked up on this sooner? In hindsight, that blood had been darker than usual for a while.
While I was thinking about swimming with Steve in the sea pool...
Temp's not coming down.'
'What is it?'
'Forty-one point six. His body is rigid.'
'Urine's discoloured,' Doreen said.
'I'm closing now,' Candace could report. She'd worked fast. Too fast, probably. She would be keeping an extra close eye on this patient's recovery over the next few days.
'Good. He's lightening, but he's not out,' Steve said.
'Good,' she echoed.
'OK, and we need sodium bicarbonate, IV glucose. Look at those levels!'
It took them another hour to bring Eric Kellett safely out of the crisis, and they all felt shaky, lucky and light-headed with relief when his temperature dropped, his heart rhythm stabilised and his other signs had begun to return to normal.
He was out in Recovery now, still hooked up to monitors and under close observation. He was on two different drugs for maintenance of urine output. His electrolytes, blood gases, central venous pressure and arterial pressure all needed to be carefully watched and adjusted as necessary, as did his potassium level.
The surgical team was back in Theatre, preparing for the next—delayed—procedure in an atmosphere that was still frayed and tensed.
'We nearly lost him. We damn near lost him,' Steve repeated.
'Stop saying that!' Candace snapped. But she was more angry at herself than at him. 'Have you ever had this happen in surgery before?'
'No,' he shook his head. 'I learned about it during my anaesthesia training but, you know, you tend to get complacent, lulled by the routine.'
'We throw away several dozen vials of this expensive drug every time it gets to its use-by date,' Pat confirmed. 'We never use it. We have it on hand, but in fifteen years here I've never had to use it. When I couldn't get it to mix, I got really scared there for a moment.' She shook her head, reliving the feeling.
'The trouble with a country hospital like this one is that anyone who's likely to have complications during surgery gets shipped out to Canberra or Sydney. And anyway, there were no indicators with this patient. I— No!' Steve shook his head again. 'Those are excuses. I should have been on top of it.'
'We were on top of it,' Peter Moody argued. 'We got him out of it.'
'I should have been onto it sooner!' Candace retorted. 'I've handled risky patients. People with Duchenne muscular dystrophy or osteogenesis imperfecta. I've done a lot more surgery than you, Steve. Than any of you. And I've seen malignant hyperthermia before. Admittedly, only once, as a resident, but I should have taken that rise in temperature more seriously as soon as you reported it.'
'There were no other symptoms at that stage,' Steve argued.
'There were. His blood was darker than usual. It should have clicked. But we should let it rest now. Let go of it. You're right, Peter, we did get him out of it. Thanks, everyone.' She took a deep breath. 'Who do we have next?'
'Look at the list. Whoever it is, they've had to wait a while!' Pat said.
Candace had to think hard before it came. Was on the point of doing as Pat had suggested and going to look at the list taped to the wall just outside Theatre, then remembered, 'That's right. Gwen Jolimont for a haemorrhoidectomy and vein-stripping. What's her status?'
'She's not down here yet.'
'She was a while ago, but they took her back up,' Doreen offered. 'They were wondering if you'd cancel.'
'I'll phone through to the ward and check for you if they know to bring her down again,' Sister Wallace said, appearing in the open doorway.
'Thanks, Robyn,' Candace said.
Slowly, the atmosphere returned to normal—on the surface at least. But there remained an element of tension which hadn't been there before. No one chatted this time. People jumped to attention every time Candace spoke. She excised the haemorrhoidal tissue and took out the tired veins with such a determination to stay focused that she actually wasn't particularly focused at all.
She'd temporarily lost her easy sense of control and cool-headedness, and realised only once the patient had been wheeled out to Recovery that she'd forgotten to give her a local. How could she have done that? It meant that Mrs Jolimont would be in a lot of pain when she woke up.
Which meant Steve and Robyn had to spend the next hour walking a tightrope with medication and monitors, because Mrs Jolimont's blood pressure was low—just 75/48 at one point—and that meant they couldn't afford to give her an adequate dose of the narcotic pain relief that she needed. Narcotics lowered blood pressure still further.
'The last patient on the list, the vasectomy, Gordon Southwell, has cancelled,' Pat reported. 'He and his wife had second thoughts.'
The news came as a relief.
As she headed for the shower, Candace heard Gwen Jolimont retching into a kidney dish.
'We'll give you something to stop it,' Sister Wallace soothed. 'I'm sorry you're having such a rotten time.'
And eventually the patient's blood pressure began to climb. In the tearoom, Steve was able to report to Candace, 'I'm increasing her pain relief now.'
'I should have given her that local. I should have picked up on that dark blood, Steve!'
Blindly, she gripped his forearm and felt its strength at once, as well as the ticklish, silky texture of the mist of dark hair that grew there.
'Steady on,' he said quietly, his head close to hers. 'Why the self-accusation? Those were my monitors. I should have been interpreting the data better, not just reporting it back to you. I mean, hell, we could all talk about what we should have done. Pat was panicking, Peter just stood back at first. The fact is, the patient didn't have any history to suggest an increased susceptibility to what is, as we've agreed, a very rare condition. He'd been under general anaesthesia before with no problem. We handled it, and he survived.'
'Too close for comfort.'
'Agreed. But let's put it behind us. Let go of it. You were the one who said it, before Gwen's surgery.'
'Yes, and then I forgot to give her a local because I hadn't put it behind me at all!'
'Let it go!'
Watching her face, Steve saw her tight little nod, and felt the way she was still clinging to his arm. Her touch stoked a glowing fire of satisfaction inside him and he twisted his hand to let his fingers trail along the sensitive skin of her inner arm. Her quick indrawn breath told him once more what he had been sure of all along. So did the way she unconsciously leaned closer, the way her limbs seemed to soften.
It wasn't finished. Whatever she had said to him ten days ago about her ex-husband, whatever the effect of his own angry words, it wasn't finished between them. He'd known it all along, and suddenly he wasn't prepared to bide his time any longer. She must know it, too. She did know it, just as h
e'd meant her to. They had both been holding their breath, waiting for the right moment, and it had come.
'I'll come round at about six,' he told her quietly and confidently. 'Let's go out. There's a nice seafood place on the riverfront. We can talk.'
'About what?'
'Whatever you like.'
He hadn't given her a choice, but he knew Candace wasn't the kind of woman to respond to an order if she didn't want to. Would she choose to be waiting for him tonight? Watching the dark dilation of her pupils and feeling the slight flutter and jerk of her breathing, he felt quite sure that she would be.
Candace was waiting.
Well, she wasn't going to absent herself from her own home just because of his threatened arrival! She hadn't changed her clothes, and still wore the loose ecru trousers and matching blouse in a linen-look fabric which she'd changed into after surgery. She was prepared to talk, and that was all. They could talk just as easily here as they could, dressed up to the nines, at an expensive restaurant. More easily, in fact.
Steve, however, was dressed for dinner. She hadn't seen him look this sophisticated before, hadn't known that he would carry the more formal look with such relaxed grace. Her reaction to him at her door disturbed her, and she knew that this was going to be harder than she'd been prepared for.
He wore a simple white T-shirt that closely hugged the contours of his chest and a blue-grey suit whose baggy jacket and pants created an impression of deceptive ease in the way he held his body.
'Come in,' she said. 'Tea, or—?'
'Tea?' he snorted. 'You can do better than that, Candace.'
'Better...in what way?'
'A better job of telling me to get lost. If you want me to get lost, show me the door. Don't make some insipid offer of tea that you hope will put me off. Come on, you're braver than that!'
'Am I?'
'Brave enough to make love to me on an open beach. Brave enough to tell me afterwards exactly what was going on...or what you thought was going on...inside your soul when it happened.'
'We've been through this.'
She closed her eyes, felt him closing in on her and opened them again quickly. She walked towards the kitchen in search of iced water or juice. Glasses in their hands would offer at least some faint form of protection.
'I've told you,' she said with her back to him, 'that was all about—'
'It wasn't all about Todd!' he cut in angrily, following her. 'I told you that at the time. I've been thinking about it since, and it doesn't make sense. Nothing in the way we made love, the way we responded to each other's bodies so strongly, that night and the other nights, was about proving something to your ex-husband, Candace, and after ten days of cooling off, you can admit it, I think!'
'Admit it to you?'
'Admit it to yourself. You wanted us to become lovers. Every cell in your body wanted it. And you got your wish, and then you back-pedalled as fast as you could. Because you were scared. Not because you were using me. Not because you were proving something. Isn't that the truth?'
Candace was silent.
The truth. She'd told Steve what she'd believed to be the truth ten days ago—that she'd been proving a foolish point to Todd, which her ex-husband would never even know about, and that she'd been coolly using Steve to do it.
Having said that, and having heard Steve's response, watched him leave her life—or leave her personal life, anyway—without more than a token protest, she'd expected the whole thing to subside into a feeling of uncomfortable regret. Perhaps even revulsion.
She'd been on the receiving end of confidences from single female friends more than once. She knew the pattern. 'We slept together twice,' they would say in an agony of regret, 'and now I can't understand what I ever saw in him. Why didn't I stop and think before I leapt into bed? There's no spark at all.'
But she didn't feel anything like that about Steve. Instead, she was all too aware of how easy it would be to let him back into her life, and into her bed.
And he knew it.
She was still fiddling at the sink, trying to get ice cubes out of the tray from the freezer, when he came up behind her, slid his arms around her, just beneath her breasts, and touched his lips to her neck.
'I like it when you have your hair pleated up like this,' he said. 'Makes it much easier to kiss you here. And then, later on, it's so nice to pull down...'
This was the moment to say no, to pull away, to show him the door, but she didn't do it. Instead, she gave a ragged sigh, turned around, leaned against him and waited for the onslaught of his mouth.
'You knew this would happen,' she murmured. 'You knew it...'
'Didn't you?' His lips were soft and slow, and his question was more kiss than language.
'No. I thought... I'd planned to... I tried to...' The words trailed off as her head fell back, her mouth drowning beneath his. 'Yes,' she admitted finally, pressing her forehead against his. 'I knew it.'
He kissed her again, then dragged his lips away and laughed. 'I wonder if you know how great it is that you can't resist this. The sight of you melting, of the same fire building in you that's building in me... It's so good to watch, Candace. So good.'
'Stop talking. Don't make me think too much...'
They didn't get to the restaurant until eight o'clock, and didn't leave it until it closed. He stayed all night at her place, and once again they both had to tackle appointment hours on empty stomachs. On the weekend, he took her swimming in the sea pool and for a hike in the bush, and as the days went by they added more activities to the repertoire.
'It all comes under the definition of things we do to fill in time until it's decently permissible to take each other off to bed again,' Steve teased.
She sighed, then smiled. 'Can't argue, can I?'
They talked on the phone about patients a little more than was strictly necessary. Eric Kellett had had no subsequent after-shocks of malignant hyperthermia and was recovering well from his surgery. As planned, Candace was particularly careful to check the site of his operation, but no complications developed. Steve had taken out Andrea Johnson's stitches in his surgery. Gwen Jolimont was pleased with the results of her two concurrent procedures after her difficult few hours in Recovery.
They ate take-out meals and watched movies, walked along the beach at night, watching the waves. Talked about trivial things, and important things. Brought a blanket to the beach at night sometimes, made love in the secret darkness and were careful about where they left their clothes.
They were careful about other things, too.
Firstly, contraception. Only once had this particular caution broken down—the first night they'd found their special hollow in the dunes. Candace received her body's evidence that there were no unintended consequences to that piece of carelessness and electric spontaneity, but she hadn't been particularly worried in any case, as the timing had been wrong.
. They were, if anything, even more careful about keeping their affair a secret from any of the staff at the hospital. Candace's focus and economy with conversation in surgery camouflaged their almost unnatural distance when they met at the hospital. The fact that Steve lived just five doors away made concealment easier, too. And there was a reason why they took most of their walks under the cover of darkness.
No one made any comments which suggested they'd guessed. And there was an element of luck as well. This was a small community. There were times they could have run into someone they knew on a hiking trail or in a restaurant. But they were lucky, and they didn't.
About four weeks after the night when they'd resumed their affair—the day of Eric Keltett's surgery—Candace received the first inkling that their caution in one of those two crucial areas hadn't been enough.
Her period was over a week late. Her breasts were swollen and tender. The smell of tomato ketchup made her nauseous, as did the smells of her bathroom cleaner, her moisturiser, the fuel she put in her car and about a dozen other everyday things.
It was i
mpossible, surely. Steve had been very responsible in that area.
I'm imagining this, she decided. I have to be.
But those dates weren't her imagination, and all at once her memory of how she'd felt for the first few months of carrying Maddy, nearly sixteen years ago, was strikingly vivid.
She spent two more days talking herself out of it, refreshing her memory as to the statistical reliability of Steve's protection and coming up with as many rationalisations as she could. She had sensible theories like the fact that this was a new environment, and that she was still emerging from the emotional upheaval of the past couple of years. She also had ridiculous theories like the difference in the drinking water and the phases of the moon.
That was why her period was late. That was why she was feeling so queasy. It wasn't the obvious reason at all.
Yeah, right...
Finally, one Sunday morning, she drove an hour and a half north on the highway to a town with a pharmacy which had extended hours. She wanted one where there was no danger of being recognised at the counter as she paid for a pregnancy testing kit.
I won't do the test until I get home, she decided.
Ten minutes later, she screeched to a halt beside a small park, locked herself into one of the cubicles in the surprisingly clean and airy public toilet and began to fiddle about with the plastic testing wand. The result only took a minute or two to appear in the little window.
And there was no doubt. It was positive.
'Hey, nice surprise,' Steve said when he found Candace at his door just after lunch. 'I was heading for the beach. Want to come?'
'Um, no.'
'No?'
He stopped in the act of slinging his towel around his neck. The surf was dead flat today, so he wasn't bothering with wetsuit or board. Looked like he might not even be getting a swim.
Studying her face more closely, he noted her high colour, her distracted manner and the firm press of her lips. Felt a little prickle of apprehension. She wasn't going to have another try at ending this, was she? He felt selfish about it.
Don't rock the boat, he wanted to say. Don't keep analysing it and asking questions. You said you wanted an affair. And it's working as it is, isn't it?