‘I can’t!’ he exclaimed. ‘Tell her, Jess. Tell her I can’t!’
He began striding away, and Jess hopped awkwardly after him.
‘Ezra—’
‘Jess, don’t you think I’d do it if I could?’ he said harshly, his face haggard, pain-filled. ‘I don’t want him to die, but—’
‘Would you…would you at least come into the operating theatre with me? I’m not asking you to operate,’ she continued, as he thrust his fingers through his hair. She saw they were shaking. ‘All I’m asking is if you’ll be there beside me—perhaps give me your advice. Ezra, I can’t do this by myself. I need you.’
Simply the thought of stepping into an operating theatre again was enough to make him feel physically sick, but as he stared down at her, saw the fear in her eyes, he knew he couldn’t leave her to face this alone, not Jess.
‘What sort of surgical equipment do you have?’ he asked.
‘The best money can buy.’ His eyebrows rose, and she managed a smile. ‘Our previous resident surgeon was determined Greensay was going to be prepared for anything.’
Except for not having a surgeon who could actually perform major operations, she thought, and knew Ezra was thinking the same.
‘What about theatre staff?’ he said tersely.
Cath had been a theatre sister for ten years before she’d given it up to work at the health centre, but there was no way she could ask her to help, not in the circumstances.
‘Will, of course,’ she replied. ‘Fiona has theatre experience, as do Jilly Thompson and Madge Greenwood.’
‘Blood supplies?’
‘Luckily Danny’s type O, and we always carry a full supply of it because it’s the universal donor which we can give to anyone.’ He said nothing, and she stared up at him pleadingly. ‘Ezra, I wouldn’t ask you to do this unless I was desperate. You do know that, don’t you?’
His eyes met hers for a long moment, then he swallowed—hard. ‘Where do we scrub up?’
‘Through here,’ she replied, turning as quickly as she could in case he changed his mind.
It will be all right, she told herself when they went into the changing cubicles and put on their theatre scrubs. It will be all right, she kept repeating in the vain hope that if she said it often enough she might make it true.
‘I’ll have to perform a pneumothorax for his collapsed lung, won’t I?’ she said when they began to scrub up.
‘Yes.’
‘I did one once when I was training. I just hope I remember the drill.’
‘Yes.’
‘My major worry is that he might be bleeding internally,’ she continued doggedly, shooting him a quick sidelong glance. ‘When he was crushed between the two boats, he could have ruptured some internal organs.’
‘Yes.’
Oh, God, it wasn’t going to be all right. Ezra looked awful. Drained of all colour, tiny beads of sweat on his forehead. What was she going to do if he fainted? She needed him, and if he fainted…
‘Tracy told me what happened,’ a familiar voice suddenly said. ‘Would one slightly rusty ex-theatre sister be of any use to you?’
Jess turned to see Cath standing in the doorway of the scrub room and let out a sigh of relief. ‘You bet she would.’
‘Cath, you can’t be serious,’ Ezra said in amazement, seeing her reach for a set of theatre scrubs. ‘You underwent surgery yourself only two days ago!’
‘A needle aspiration,’ she said dismissively. ‘And this is an emergency. At times like this we all rally round.’
And they did, Ezra realised, as Cath disappeared into one of the changing cubicles. They were incredible. Jess, Cath, the staff at the Sinclair Memorial, but especially Jess. Her leg was fractured in two places, she could barely stand without crutches and yet she was willing to operate, to do something she’d only done once before. Only he was useless. Only he would be a spectator—and an unwilling one at that.
‘I don’t much like the sound of his heart,’ Will commented when they joined him in the operating theatre. ‘The beats are far too close together.’
They were.
Tachycardia, for sure, Jess thought grimly. Danny had lost so much blood that his heart was needing to beat faster and faster in order to get what little blood he had left to his brain. And it shouldn’t be happening. Not when the blood transfusion bags were up and running.
‘IV’s running wide open,’ Cath declared. ‘BP 60 over 40. No breath sounds on the left side.’
First things first, Jess told herself. Concentrate on his lung first. Danny’s trachea was shifting further and further to the left, which meant that air was seeping into his chest, creating a large bubble of air which was compressing his collapsed lung. His aorta, as well as his heart, was being squashed by the increasing air in his chest, and he’d have a heart attack if she didn’t relieve the pressure.
Quickly she stabbed a needle into his chest, then took the scalpel Cath was already holding out to her.
‘How big should I make the incision, Ezra?’ He didn’t reply, and she glanced across at him. He was holding onto the edge of the operating table as though his very life depended on it. ‘Ezra, the incision—how big should it be?’
He swallowed behind his mask. ‘Make it…make it as small as you can. But remember you’ll have to go right down into the lining of his lung, and when you ease the chest tube in, do it gently.’
Jess nodded. A trickle of sweat ran down her back as she made the incision. The chest tube next, she told herself as Cath held it out to her. Gently, Ezra had said. Ease it in gently. Almost there. She was sure it was almost there.
‘Cath…’
‘Chest tube hooked up, suction on,’ she replied, and under Jess’s thankful gaze Danny’s lung gradually began to reinflate.
‘BP now, Fiona?’
‘Still 60 over 40.’
It should be going up, not remaining static. Why wasn’t it going up? Had she done something wrong?
‘Ezra…’
‘No pulse, Jess!’ Will suddenly yelled. ‘We’ve got no pulse!’
Jess’s eyes flew to Ezra’s. The pericardium—the sac round Danny’s heart—must be filling with fluid.
‘A thoracotomy—you have to do a thoracotomy!’ he exclaimed.
‘I can’t do that!’ she protested. ‘I’m not a surgeon!’
‘Make a ten-inch horizontal incision across his breastbone right down to his ribs,’ he ordered.
‘But—’
‘Do it, Jess!’
With trembling fingers, she did. She sliced down through Danny’s chest. She saw his ribs, and his heart beneath them, but when Cath held out the large metal rib-spreader to her, she shook her head. ‘I can’t—I can’t!’
‘Jess, if you don’t, he’ll die for sure,’ Cath said quickly.
She knew he would, but…Reluctantly, she took the metal rib-spreader and closed her eyes. Oh, God, help me, she prayed. Please, God, please, God, help me.
And He did. The spreader was suddenly whisked out of her hands, and when she opened her eyes Ezra was holding it.
Without a word he inserted the metal instrument between two of Danny’s ribs and spread them wide enough apart to get his hands into the chest cavity.
‘Clamp, Cath!’
Obediently she handed him one, and swiftly he placed it on the lower portion of Danny’s aorta so that what little blood there was in Danny’s body would all be directed towards his brain to keep it alive. Then deftly he placed his hands round Danny’s heart and swung it to the left.
‘BP falling!’ Fiona called out tensely.
It was, and they could all see why. When Danny had been crushed between the two boats, not only had four of his ribs been fractured but something had pierced his chest, ripping a hole in his heart.
‘Finger, Jess—push your finger into the hole!’ Ezra ordered. Obediently she did as he asked, and the flow of blood stopped instantly. ‘Cath, sutures, needle, forceps.’
She passed the
m over to him, and with a speed Jess could only marvel at he inserted three large sutures into Danny’s heart.
‘BP still 60 over 40,’ Fiona announced.
Ezra nodded, and slowly released the clamp he had inserted in Danny’s aorta. Would the stitches hold? They all held their breath and waited.
‘BP now, Fiona?’ Ezra asked.
‘Eighty over 60. Ninety over 70. One hundred over 80.’
The stitches were holding. Danny’s blood pressure wasn’t great, but they’d stabilised him, and a collective sigh of relief went up.
‘I can manage here now, Jess,’ Ezra said, seeing her slump slightly against the operating table. ‘Your leg must be giving you hell.’ It was, but she didn’t want to leave, and he must have seen it in her eyes because he added softly, ‘It’s OK. I don’t need you any more.’
No, he didn’t need her any more, she thought sadly as she made her way into the changing room. She needed him—she loved him—but he didn’t need her. He never had. She’d coaxed—blackmailed—him into medicine again, but now his confidence had returned he could go back to his world. And it was a world where she didn’t belong.
‘That has to be the most amazing piece of surgery I’ve ever seen,’ Bev enthused as she joined Jess in the scrub room. ‘The man’s incredible!’
‘I know,’ Jess replied, managing to smile.
‘And to think Will actually suggested he should apply for the post of surgeon at the Sinclair.’ Bev shook her head in disbelief. ‘No wonder he turned it down. Lord, if I had even half his ability I wouldn’t want to be stuck on Greensay, operating on warts and verrucas.’
‘No,’ Jess murmured.
‘I’d better phone Tracy,’ the radiographer continued. ‘She’s been telephoning every ten minutes to see what’s happening. I know Danny’s not out of the woods yet, but at least Ezra’s put him on the road to recovery. Talk of the devil,’ she added with a beaming smile, as the door to the scrub room opened and Ezra appeared with Cath. ‘Ezra Dunbar, you’re a lifesaver!’
He certainly was, Jess thought as the two women showered him with praise. How could she ever have thought he’d be happy living on Greensay, working as a GP? This was where he belonged. In an operating theatre, performing major surgery, saving lives with his skill.
‘You must be pleased,’ she said when Bev had left to phone Tracy and Cath had hurried back to check on Danny.
‘Pleased? Oh, Jess, you don’t know what it means to me to be able to operate again,’ he gasped, his face alight with relief and pleasure. ‘To pick up a scalpel and not fall apart. It’s the most wonderful feeling in the world!’
Her smile became a little crooked, a little uneven. She would have said that being in love was the most wonderful feeling in the world but, then, she was only Jess Arden, GP, not Ezra Dunbar, surgeon.
‘What do you want to do about the lifeboat?’ she asked. ‘Should we tell them to keep coming, or…?’
‘Danny’s stabilised for the moment,’ he replied, ‘and I really don’t want him moved—at least not for the next twelve hours—unless it’s absolutely necessary. I think he should stay here until the weather is calm enough for a helicopter to land.’
She nodded. ‘You’re the boss.’
He laughed. ‘Lord, but I didn’t think I’d ever hear anyone say that to me again! And you were amazing, Jess,’ he continued, peeling off his surgical gloves and binning them. ‘For someone who was never trained to be a surgeon, you did really well.’
‘Thank you.’
‘Cath was great, too,’ he enthused. ‘Helping out when she’s got all this worry on her mind. She’s some lady.’
‘I know.’
A slight frown pleated his forehead and he gazed at her searchingly. ‘Are you OK?’
‘A bit tired, that’s all,’ she murmured, avoiding his eyes. ‘I’m just glad I’m not a surgeon. I don’t think I could stand that sort of pressure, day after day.’
‘Jess, I have an idea. I was going to wait until later—tell you about it later—but…’ He grinned. ‘Oh, what the hell. I’ll tell you now.’
‘Sounds a bit ominous,’ she replied, forcing an answering smile to her own lips. ‘What do you want to tell me?’
‘Not tell so much as suggest,’ he said. ‘Jess, the Sinclair Memorial needs a qualified surgeon but not all the time. You need a GP but only a part-time one.’ He cleared his throat. ‘Now that I can operate again, what would you say to me applying for the post at the hospital and helping you in the practice as well?’
Twenty-four hours ago it would have been exactly what she’d have wanted him to say, but now…
‘What about your career?’
‘I could have a career here,’ he said. ‘You said once that you thought I’d make a very good GP.’
‘That was before I saw you operate.’
‘Yes, but I could operate here.’
‘On what?’ she asked. ‘OK, perhaps once in a while you might get something really stretching, but for most of the time the operations you’d perform would be ordinary, mundane.’
‘I wouldn’t care,’ he protested.
‘Maybe not at first,’ she murmured. Lord, what am I doing? she wondered as he stared at her silently. I’m talking him out of my life and I don’t want him to leave, but if he stayed, grew embittered at the waste of his talent…Better for him to leave now. Better for him to go before he became as necessary to her as the air she breathed. ‘Ezra, you’re a surgeon at heart. This afternoon must have proved that to you.’
‘But—’
‘Once you’re back on the mainland you’ll thank me for what I’m doing,’ she said, forcing a smile to her lips. ‘Being a part-time surgeon and a part-time GP—it isn’t for you, Ezra. There’s nothing on this island for you.’
He’d hoped there was. He’d very much hoped that Jess might feel the same way about him as he did about her, but she obviously didn’t.
‘You’re saying I should leave,’ he said with a painful attempt at a smile. ‘That you don’t want me to stay.’
‘That’s what I’m saying, Ezra,’ she said, feeling her heart twist and contract within her. ‘I don’t want you to stay.’
CHAPTER TEN
‘EZRA wants to stay on Greensay.’
Jess put the magazines she’d brought for Mairi down on her bedside cabinet. ‘He told you that, did he?’
‘Not in so many words, but I’ve got eyes and ears, and I know he wants to stay.’
‘He might think he does,’ Jess said, ‘but the novelty of living on an island—being a part-time GP and surgeon here—would soon wear off.’
Mairi’s lips set into a thin line of disapproval. ‘He’s a grown man, Jess. Don’t you think he should be allowed to find out for himself if he’s made a mistake, rather than you giving him his marching orders?’
‘I haven’t!’ she protested, and saw Mairi’s eyebrows rise.
‘No? He’s offered to work part-time with you, and you’ve turned him down. You’ve even managed to dissuade him from applying for the post here at the hospital. Sounds to me like you’ve given him his marching orders.’
Jess bit her lip. ‘I just…Mairi, I want him to be happy. I don’t want him to become resentful or bitter, and that’s what I think will happen if he stays here.’
‘Oh, lass, lass, can’t you see you’re the only one who can make him happy? You’re the reason he wants to stay. He wants to be near you.’
A wry smile crossed Jess’s face, and she picked up the glass of water on Mairi’s bedside cabinet and sniffed it. ‘What’s Fiona being putting in this?’
‘Jess, he’s in love with you—’
‘No, he’s not. Look, I think I know him better than you do,’ she continued when Mairi tried to interrupt. ‘So let’s just leave it, OK?’
Mairi opened her mouth, closed it again and shook her head. ‘All right, I’ll leave it, but I hope you know what you’re doing.’
‘I do.’ Jess nodded. And she did, sh
e decided when she finally left Mairi’s room, and made her way along to Reception to meet Ezra.
If Ezra left today there was a chance her heart would eventually heal, but if he stayed on…To watch him grow bored with the island, bored with his work, resentful of everyone and everything on it? It was too high a price to pay, much too high.
‘How’s Mairi?’ Ezra asked when he saw her.
‘A bit brighter, I think,’ she responded. ‘And Danny?’
‘Amazing, considering he had his accident only a few days ago. Are you still having him airlifted to the mainland tomorrow?’ he continued as they walked towards his car.
‘It seems the best thing to do under the circumstances. You won’t be here, and if he had a relapse it would be a nightmare, trying to split myself between him and the practice.’
Not if you’d let me stay on, he longed to shout as they drove down to the health centre. OK, so you don’t love me, and maybe you never will, but I still want to stay here, and it’s not just because I want to be near you. I’m happy here. For the first time in my life I’m happy.
But he didn’t say any of that. Instead, he said, ‘Does everyone know there won’t be any home visits this afternoon?’
‘They should do. I got Tracy to put a notice up outside the surgery and in Nazir’s shop. I also told Wattie Hope.’
Ezra’s lips curved. ‘Then I think we can safely say that everyone on the island knows.’
‘I would say so.’ She chuckled.
‘What about your tuberculin testing clinic tonight?’ he asked.
‘I’ve cancelled it. It seemed a bit much to expect Dr Walton to work on his first night here.’
‘Perhaps.’ Ezra frowned. ‘But won’t that mean all the tests won’t be completed now until the end of next week?’
‘Yes, but at least none of the tests we’ve already taken has proved positive,’ she argued back. ‘Look, I’ve got everything under control, Ezra,’ she continued, seeing his frown deepen. ‘There’s no need for you to worry, or feel you’re leaving me in the lurch. Dr Walton’s arriving this afternoon to take your place, so everything’s fine.’
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