The Sheikh Surgeon's Baby

by Meredith Webber

  ‘I have told them the two options,’ he said to Mel as she entered the room.

  Mel felt relief, then wondered how much time the young parents would need to discuss these unhappy options.

  ‘We want to go ahead with the operation,’ Tia said, looking directly at Mel. ‘That was what I had already decided, and when my husband was asked, he said the same. The baby deserves to have the chance of life and without the operation that is taken from him.’

  ‘You understand he still might not live,’ Mel pressed, because she had to hear for herself that they had considered that.

  Both heads nodded, and the young man reached out to clasp his wife’s hands.

  ‘OK, we go ahead,’ Mel told them. ‘I’m going to take him now to Radiology for some scans while Arun collects the team of people we’ll need for the operation and Kam organises the theatre and makes sure we have everything we need on hand.’

  She looked at the two young people, so patently lost in their concern and grief, and stretched out her hands to them.

  ‘It’s going to be a long, hard wait for you two. Why don’t you go somewhere private—maybe out to the compound—so you can comfort each other and perhaps even think of other things while the operation is going on?’

  Tia looked at Mel and managed a weak smile.

  ‘Private at the compound? I don’t think so. No, we’ll stay here in my room. We’ll sit and talk and pray and know you’re doing the best you can for our baby.’

  She took her husband’s hand and led him away. Arun turned to watch them go, a small, sad smile on his face.

  ‘So my baby sister has grown up,’ he said quietly, and Mel felt the weight of what she was about to undertake press down on her. So many people wanting this baby to live—so many people’s happiness dependent on this operation…

  She straightened up and took a deep breath. She could do this!

  She went back to the baby’s room

  ‘Come on, kid,’ she said to the little mite in the crib. ‘Let’s get you sorted.’

  To Arun the most amazing thing was the noise in the room. He’d imagined operating theatres as places of deep quietness, but here, as he stood beside Kam, second assistant and general dogsbody, it was the noise that struck him.

  He tried to think back to his student days when he’d done stints in Theatre, but although he remembered music playing in the background, and surgeons telling stupid jokes as they worked, he didn’t remember the buzz of the Bovie as small blood vessels were sealed off or the blip of the heart monitor and the puffing noise of the ventilator.

  He looked at the tiny baby on the table, his eyes taped closed, a ventilation tube in his trachea, a tube feeding into the radial artery at his wrist, a central line in the jugular vein in his neck and a fourth line, just in case, in his foot. The anaesthetist was organising the necessary mix of gases into the stressed lungs and the drugs that were needed in the blood. Heparin, Arun knew, to thin the blood so it wouldn’t clog up the heart-lung machine when the little one went on bypass. The anaesthetist had everything on hand, blood, saline, drugs, ready for any emergency. The perfusionist was taking blood all the time, checking the balance, while the monitor showed everyone in the room the baby’s blood pressure, heart rate, oxygen saturation and temperature.

  Melissa had used shears to cut the small chest open, and while he held it open with retractors Kam had fitted brackets to the sides of the sternum and turned a handle—more noise—to give Melissa a good opening to work in.

  The heart-lung machine was ready, the baby’s temperature was being reduced and they were approaching the moment when he would be connected to the machine.

  ‘I’m cutting these small pieces of pericardium to use as a patch for the ventricular septum,’ Melissa explained, using a stitch to secure two small squares of the pericardial tissue to an intercostal muscle. ‘By stitching it there I’m not frantically looking for it when I need it. Now I use a stitch to keep the pericardium out of the way so we can get to the heart cleanly.’

  Arun knew she was explaining this for the benefit of Sarah, who was in Theatre with them, but he couldn’t help feeling proud that she was making the effort to explain while ninety-nine per cent of her mind must be concentrated on the difficult task.

  ‘Now we put a cannula into the aorta, and it will send blood from the machine around the body while this cannula goes into the right atrium and we’ll be sucking blood through it into the machine. Heart rate?’

  ‘One-thirty,’ someone answered.

  ‘Temp?’

  ‘Thirty.’

  Arun shivered, thinking how cold the deep hypothermia must be, but it slowed the heart rate and made it easier to transfer the baby to the machine.

  ‘Now we need to check the pulmonary artery. We come back from where it divides to right and left arteries to where it merges with the aorta—that’s where we cut and put in the grafted artery. We’ll fix that to the right ventricle…’

  He was following it all, mainly because Melissa had called them all together earlier and drawn diagrams on a whiteboard, taking everyone who’d be involved through every stage of the operation. But how could she be so calm, operating on a baby—stitching together blood vessels so small one misplaced stitch could close them completely?

  Yet she worked with a concentration that excluded all outside thoughts, quietly telling Kam what needed to be done, giving orders to the theatre staff to tie this, Bovie that, suction here, check the screen. And as he watched, and helped, he felt a sense of pride. This was his woman, doing this—his woman producing the miracle the baby needed.

  Or was she?

  She’d said she wouldn’t marry him.

  Why now?

  What had happened to make her change her mind?

  And why was it so hard to accept?

  Painfully hard.

  ‘OK, now we go. Pavulon to paralyse the heart muscle then we’re going onto the machine—you all know what you need to do.’

  Arun forgot everything but the baby on the table, and even the theatre noises seemed to abate as Melissa cut and stitched, fixing up the malformation that something as simple as a virus in Tia’s early pregnancy might have caused.

  He stood beside Kam, suctioning, passing instruments, tossing debris away, totally concentrated on the baby now, barely breathing, although he didn’t realise that until Melissa said, ‘OK, coming off bypass now,’ and he had to take a gulp of air.

  ‘This is the moment,’ Kam whispered to him as Melissa reconnected the baby’s vein and artery then massaged the heart to get it beating. Drugs were flowing into him to stimulate the heart, and those gathered in the room held their collective breaths and waited for the heart muscles to contract and lift the floppy, patched and stitched heart back to a working organ.

  ‘There,’ someone said, and they were right. The little heart was beating valiantly. Arun looked across at Melissa and behind the goggles she was wearing he saw the brightness of tears in her eyes. She must have sensed his regard for she looked at him and shook her head.

  ‘That’s the easy part,’ she said lightly, although he could hear exhaustion in her voice and knew how much it had taken out of her. ‘Now we have to put him back together again, then get him through the after-effects of the terrible trauma we’ve caused him. First off, Kam, could you check for bleeding on any of the joins we’ve made? And I want oxygen stats, BP and heart rate. No point sewing him up if there’s still a problem somewhere.’

  The results must have pleased her for within minutes she bent her head again, working swiftly and surely, putting, as she’d said, the little baby back together again.

  ‘I’ll stay with the anaesthetist and the baby,’ Kam said to Arun when Melissa finally stepped back from the operating table. ‘You take Melissa back to the apartment. She’ll be exhausted—it’s mental strain as much as the physical effort of concentration. Tell her I’ll call if there’s any change.’

  Arun moved away—the theatre was noisy again, instrume
nts clanging together, people talking, most in awed tones, as they cleared away the debris of a long operation. Melissa was at the far side of the room, stripping off her gloves, the fourth set she’d worn during the operation.

  ‘Come, there’s a room here where you can change in privacy, then I’ll take you home and get some food and drink into you—you must be totally depleted.’

  She had slid the goggles she’d been wearing to the top of her head, and now pulled them off.

  ‘Home?’ she echoed, a tired smile on her face.

  ‘The apartment, you know I meant that—no talk, hidden agenda, not after what you’ve just done for us.’

  She shook her head.

  ‘Not for you, but for the baby. Not even for Tia and her husband, just for the baby.’

  She pressed her hand against her stomach, and he wondered how often she worried whether the child she carried was OK. Working with babies with congenital conditions, she couldn’t help but wonder…

  ‘So, where’s this private space?’

  Her apron and outer gown had joined her mask, gloves and goggles in the bin and she stood there in the pale green scrub suit, looking so spent he wanted to lift her into his arms and carry her back to the apartment.

  ‘This way. Your clothes are there, but if you don’t want to change, you can come up to the apartment as you are and shower there.’

  ‘I’ll do that—just get out of the boots and into my sandals. Thanks.’

  But as she was about to leave the theatre complex she turned back.

  ‘The baby?’

  ‘Kam will stay with him. He’ll contact you immediately if there’s any change or any cause for concern.’

  She nodded and Arun realised just how tired she must be to not argue that he too should stay, or even she herself.

  Mel let him take charge, leading her out of the warren of rooms around the theatre then up to the apartment, where with gentle hands he stripped off her clothes and helped her step into the shower, already running at a beautiful temperature, the water jets spraying from the wall just what she needed for her aching back.

  Eventually, certain her skin had shrivelled to crêpe, she left the shower, to find Arun waiting once again, wrapping her in a big warm towel, then leading her to the bedroom where he sat her on the bed while he towel-dried her hair.

  ‘Now, you’re to eat—doctor’s orders,’ he said, and Mel looked around, saw daylight at the window and frowned.

  ‘It’s morning?’

  Arun nodded.

  ‘We went down to the baby’s room at six last night and you’ve been working ever since,’ he said. ‘You were in Theatre five hours.’

  ‘It didn’t seem that long,’ Mel managed, but as she spoke she felt a wave of tiredness bear down on her, all but engulfing her.

  She sipped some tea and ate two pancakes, then shook her head.

  ‘No more. I really, really need to sleep.’

  But as she set her cup down she thought of the baby and looked up at Arun.

  ‘You will wake me up if I’m needed?’ she demanded. ‘No nonsense about letting the poor little woman sleep?’

  He smiled and in spite of her tiredness and her determination to stop loving him, her heart beat faster.

  ‘Poor little woman indeed,’ he teased. ‘Woe betide any man who dared to use that description for you.’

  Then he bent and kissed her on the lips.

  ‘I will wake you up,’ he promised. ‘You can be sure of that, so sleep at peace, my beautiful one.’

  She lay back on the pillows and he drew the sheet over her naked body, then touched her gently on the cheek and left the room.

  ‘My beautiful one?’ Mel murmured to herself, savouring the words, then she remembered back before the operation.

  Remembered telling him they wouldn’t marry…

  Remembered he hadn’t asked why…

  She turned on her side, tucked her hands beneath her head and sighed, though for what she wasn’t quite sure, and she was too darned tired to think about it now.

  ‘His name is Shiar.’

  Tia rose from beside the crib in the ICU room to greet Mel with this news as Mel, refreshed, fed and anxious to see her patient, entered at about midday.

  ‘Oh, I’m so glad you’ve named him,’ Mel told her, giving the young woman a quick hug.

  ‘And you didn’t meet Sharif, my husband—not properly,’ Tia added, introducing Mel formally to the young man who bowed over her hand and rushed into a welter of thanks for all she had done for the baby.

  ‘It is nothing,’ she said, resting her hand on the sleeve of the white gown he now wore. ‘And the little one, Shiar, is still far from well. We must wait and see.’

  Both parents nodded, but Mel could read the hope in their shining eyes and prayed it would not be misplaced.

  She checked Shiar, who was to be kept sedated for at least twenty-four hours, then said goodbye to the pair, but once outside the baby’s room she leaned against the wall, uncertain what to do next.

  It was to be her wedding day so the women who were still trickling into the A and E department with sick children had been told she wouldn’t be available, although, having assured Arun she intended to keep working, she did have appointments lined up for the following day.

  But today?

  Perhaps she could ride. She’d go out to the compound—

  ‘I was looking for you.’

  Arun had pushed through the doors into the ICU without her noticing.

  ‘Come!’ he said, and took her hand. ‘I want to take you somewhere.’

  She tried to tug her hand away but his grip was too strong.

  ‘I’m not going with you to get married,’ she told him, and he smiled the kind of knowing smile that always made her heart flutter. Only today it made her angry as well and she tugged again at her trapped hand.

  ‘Did I mention marriage?’ he teased, releasing her hand but slipping his arm through hers so she would have to make a scene to escape his touch.

  They reached the bank of lifts and to Mel’s surprise he pushed the ‘up’button rather than the ‘down’ one.

  ‘We’re going up? Are your rooms up? No, they’re on the same floor as the ICU, aren’t they? Why are we going up?’

  ‘You’ll see,’ he said.

  And Mel did, for the doors of the lift opened onto a flat roof and there, not forty feet in front of them, was a small green helicopter.

  ‘I thought I’d show you my kingdom,’ he said, leading her towards it. ‘So you can see what you’re missing out on by not marrying me.’

  Mel frowned at him. Surely he couldn’t think she would have been marrying him for riches or property or to be the sheikhess—no, that was wrong, Jenny was a sheikha. But her annoyance was more than outweighed by excitement that she would be seeing more of this beautiful desert country. With Arun…

  He helped her into the helicopter then walked around and climbed in on the other side, taking the controls himself.

  ‘There are parts of the land where you can’t fly helicopters—out near the mountains where Jenny was, for instance—but most of the country is accessible this way and flying takes many hours off a journey.’

  His long slender fingers worked easily at the controls and the little machine lifted into the air and took off, circling the city first, Arun pointing out the port where ships from all over the world docked to take on oil, and the swathes of green contrasting with the red-brown desert sands—golf courses and resorts—playgrounds of the wealthy. Then the city disappeared and beneath them lay the desert, dotted here and there with encampments of black tents or clusters of palms that indicated oases.

  ‘This is the long wadi—there are oases all along it,’ Arun explained as they banked over a small village, stone and earth brick houses clustered by the green patch of vegetation. ‘And here we are—see below—the winter palace.’

  The winter palace?

  Where Hussa was buried?

  Mel felt her chest
grow tight and her breathing become shallow and irregular. Why was he bringing her here?

  She turned towards him, wanting to ask, not about Hussa but about the reason for the visit, but he was concentrating on putting the little aircraft down on the ground, onto a white circle painted on a concrete pad just outside the walls of the rambling, red stone building he’d called the winter palace.

  CHAPTER TEN

  HE TURNED the engine off and climbed out, ducking beneath the slowing rotor blades to come around and open the door on her side.

  ‘Come,’ he said once more, the word peremptory but not an order. He took her hand to help her alight then led her towards the long shallow steps that rose towards the entrance of the huge, many-turreted building.

  ‘In the old days, when this was first built, it was a fort as well as a home, so instead of many buildings, as we have in the city compound, all the functions are in one main palace, broken up into many…I suppose you would say apartments—for different families and different uses.’

  Mel looked around. The red stone, much of it ornately carved, was old enough to be crumbling in places, but she could see the design of an ancient fort in it, for the windows were narrow slits, many of them inset with carved stonework. Huge wooden doors were folded back and they walked beneath an arch and into a courtyard, not landscaped, as the city courtyard was, but cobbled.

  Around the courtyard was a cloister, and Mel glimpsed, here and there, robed figures flitting through the shadows.

  ‘It was here the men prepared their mounts and armed themselves for raids,’ Arun said. ‘It was built for practicality, not beauty, but walk carefully—the cobbles are old and very rough in parts.’

  He took her arm, drawing her across and to the left where they passed into the shadow of the cloister and shed their sandals before entering the building. Once inside she had to gasp for instead of the red stone all was cool white marble—the floor, the pillars, the walls, all the same white-grey, streaked here and there with black, and inlaid in the arches and above the windows with what looked like precious gems.

  ‘You cannot show your wealth to the enemy,’ Arun explained, leading from room to room, pointing out the tapestries and telling her the history of his family that was depicted in them, showing her the great hall where he and Kam would still hold audiences for their people, listening to grievances, trying to right wrongs.