The Doctor's Gift

by Fiona McArthur

  Andrew looked up and then adjusted another gauge on his machine as he coughed to hide his amusement. ‘So are you people going to be long?’

  Fergus had tied off the last of the rogue vessels. ‘Closing now.’

  * * *

  Over the next ten minutes Emma’s blood pressure crept up and the abdominal layers were closed without further setbacks. Ailee stepped back as the final closure began and stripped off her gloves.

  ‘Thank you, Dr Green.’ Fergus didn’t take his eyes off the patient but his voice raised the awareness between them.

  ‘My pleasure, Mr McVicker.’

  She smiled at the registrar. ‘Well done, Tom. It’s all good experience afterwards, isn’t it?’ The registrar looked like he was going to faint. ‘Go get a drink of water.’

  Ailee stripped off her outer gown to leave the bloodstained clothing in the theatre. She waved at Andrew and smiled at each person in the room except Fergus before she pushed open the door. ‘Bye, everybody.’

  Ailee didn’t go back to the ward. She sat in her office and pretended to do paperwork as her mind kept going over the crisis in theatre.

  To lose Emma would have been a horrible, disastrous tragedy, and it had been close. Fergus had been exceptional, very talented. The bleeder had been no one’s fault and the spotting of it before closure would have made the difference to trying to retrieve an irretrievable situation if they’d missed it.

  When William’s transplant was over she would be able to go back to what she loved doing. Be a part of the magic of restoring function to the human body, something she was skilled at and felt passionate about, and there would always be hospitals to take her. Dr Harry had already offered her tenure, working with an eye to a consultancy in the not-too-distant future.

  The problem was now that she’d worked with Fergus, it would seem flat. From only that brief window she’d seen skills that she hoped to emulate one day. And that was a whole new kettle of Asian jumping worms.

  She picked up the phone. There was work to do before the rounds started.

  Chapter 12

  Fergus

  * * *

  Fergus knew the moment Ailee arrived on the ward. He tried not to glance her way but it was hard, especially after yesterday.

  He’d heard about her skill as a surgeon, he had asked, and that had been backed up by her quiet confidence and skill in the OT. He attributed a portion of the retrieval of Emma’s haemorrhage to Ailee’s help. It seemed his Ailee was a good woman to have by his side in a crisis. Except she wasn’t his Ailee.

  Before coming to theatre she’d already had a tough morning, being there to support Eva’s grieving parents again and he had no doubt she’d give everything in her work.

  Which reminded him, considering her undoubted skill in surgery, it was even more ludicrous she was temping as a co-ordinator.

  He had to ask Rita, the unit manager, when he had a chance. But for now there was work. There was always work.

  Peter was back from his operation, still groggy from the anaesthetic and pain relief. He opened his eyes and squinted up at Fergus. ‘How’s Emma, Doc?’

  ‘Emma’s doing well. She lost more blood than we anticipated but she’s fine now. She’ll stay in Intensive Care tonight and High Dependency tomorrow, but it all looks good so far. How are you feeling?’

  Peter almost smiled. ‘Sore. Glad it’s over.’ His eyelids drooped and his voice faded. Then he forced his eyes open again. ‘You’re sure Emma’s okay?’

  ‘She’s fine. The best thing you can do for your partner is to rest and recover. She’ll be just as anxious about you when she comes back to the ward.’ He watched Peter’s eyes close and the young man’s concerned face soften. Thank goodness.

  Fergus rubbed his eyes. They felt scratchy with lack of sleep after twelve hours of concentrated surgery. He’d head home for the rest of the morning and catch a couple of hours’ shut-eye before the afternoon surgery.

  When Fergus opened his eyes, Ailee had come up to the group and her concerned look tore at the fabric of his control. He’d love to rest his head on her. But he couldn’t.

  ‘Yes, Ailee?’ His voice came out much sharper than he’d intended in a knee-jerk reaction to his own weakness.

  He saw her recoil from the harshness in his tone and he winced. Held his hand up. ‘Sorry.’ Now he just sounded gruff. ‘Tired.’ Lord, what this woman was doing to his emotions. ‘Did you want something?’

  ‘There’s a call for you. Rita asked me to pass the message on.’

  An excuse to leave! Fergus grabbed at the chance. ‘I’ll come now. After the round, if you have to contact me, I’ll be at home. Ring me there.’

  Ailee nodded and turned away to answer a question from Maurice about a new patient who’d just arrived.

  * * *

  Fergus was losing his battle to remain aloof with Ailee. Since the time in theatre she’d never been far from his thoughts.

  He woke in the morning dreaming of her back in his arms and at work he felt every smile she gave so freely to all except him. This was crazy. He’d have to do something soon or he’d crack.

  ‘Dr Green? Ailee?’ Fergus caught up just as Ailee came to the entrance of the renal ward. She jumped and put her hand to her chest as if he’d leapt out in front of her.

  Fergus frowned. ‘Sorry. Didn’t mean to startle you.’

  He watched her take a deep, calming breath and unconsciously his hand lifted to lie on her arm in reassurance.

  When she looked down at his fingers on her skin, he felt his own gaze drawn as well. It was as if they were both back in Singapore and finally, lightbulb-moment wise, he had an inkling she was just as affected by his proximity as he was by hers. How had he missed that?

  ‘We need to talk.’ His words came out with more overtones than he’d intended, but it was a measure of his relief that he had no control over his voice.

  Why hadn’t he noticed this before? He wanted to back her into a corner of the ward, put his arms on either side of her head — trap her so she couldn’t escape — and find out then and there why she had really run away that morning.

  Slowly her head came up and she met his look with a fierce one of her own. ‘Is it about a patient?’

  No use lying. ‘No!’

  ‘Then I’m busy.’ She glared at him but he didn’t believe her this time.

  Under her bravado Fergus could feel Ailee’s indecision and he stepped closer. ‘Give me a time and we’ll talk then.’

  Fergus suspected if he didn’t pin her down now he would have trouble cornering her again. She hesitated and he pounced. ‘No is not an option,’ he said quietly.

  ‘How unenlightened. I believe no is always an answer for a woman. Or a man for that matter.’

  Fergus winced and understood what he’d said was completely inappropriate. Time for appeal. ‘You are entirely correct. Let me try again... Ailee, we need to talk. Would this afternoon, when you finish, suit? Please.’

  Ailee shook her head. ‘I have a family dinner at seven.’

  ‘Could still work. I can pick you up at five from here and we’ll find somewhere private, then I’ll drop you back.’

  Her eyes narrowed. ‘Not too private.’ Though her voice remained calm and she looked composed, he had the feeling she wasn’t as cool as she seemed.

  ‘As you wish,’ he said, and watched her nod and turn to walk away from him.

  He just hoped he hadn’t been mistaken about his instinct or he was going to look even more of a fool.

  Chapter 13

  Ailee

  * * *

  Ailee sensed Fergus behind her shoulder, not as staggered an arrival as she would have liked, and even though he wasn’t touching her, they entered the ward together.

  Rita raised her eyebrows and Ailee assumed that everyone else could see the tension between them, too. Thankfully the unit manager didn’t make one of her usual teasing comments.

  The ward had a new patient today and soon all attention centred
on Lawrence Roper.

  Lawrence had needed a kidney transplant after going into renal failure a year ago and, because he was an orphan and a single man, and the average waiting time in Australia for a donated kidney was four years, sometimes longer, he’d decided not to wait.

  With commercial transplantation prohibited in Australia, the United Kingdom and the United States, he’d sold his house and used the money to go overseas and purchase a black-market kidney from a country with a commercial programme giving donors a needed organ for monetary compensation. This alternative to waiting had proved to be a sometimes dangerous option for those who chose it, and it certainly seemed so for Lawrence.

  Fergus shook the patient’s hand. ‘Good morning, Lawrence.’

  The man was in his late twenties, dark-haired and unwell-looking. ‘Hello again, Doc. Bet you didn’t expect to see me again.’

  ‘No. I’m sorry you’re not well, old son.’ Fergus turned to the team with a wry smile. ‘Lawrence was over at Sydney East and decided to not wait for the donor programme. He went for broke — literally.’

  He smiled at the young man and Ailee agreed with Fergus’s non-judgemental attitude of Lawrence’s choices.

  Fergus turned to the staff. ‘When Lawrence returned to Australia post-transplant he was well. Unfortunately, that didn’t last. He’s become concerned that his condition has deteriorated.’

  He glanced down at the report in his hand. ‘We’ve brought him in to fine-tune his medication regime, stabilise any damage if we can, and follow up a few of his concerns.’

  He lowered his voice to speak directly to Lawrence. ‘I’ve got your blood tests back and I’m afraid it is what you suspected. You contracted a blood-borne disease from your donor or the equipment during the procedure.’

  Lawrence closed his eyes and sank back in the bed. ‘You warned me.’

  Fergus murmured to Ailee. ‘Lawrence’s condition has been complicated by contracting hepatitis B, despite his surgeon’s assurance his donor had been screened. He’ll need help with information and support so he can come to terms with that.’

  Lawrence managed to smile wryly at Ailee. ‘I suppose I can be glad it’s not AIDS, but hepatitis B can be pretty rotten, too, can’t it?’

  Ailee felt her respect for the beleaguered young man rise at his attempt to be philosophical. ‘Can be... or might not be.’ She leaned towards him and touched his shoulder ‘I’ll have the communicable disease sister come and see you, Lawrence. Trudy can answer any questions and concerns that you have, as well as connect you to some support so you don’t feel as isolated as you do now.’

  Fergus nodded. ‘When we sort out your medications, you’ll feel better as well. Give yourself a few days to get over the shock and we’ll have you as well as you can be before you leave.’

  ‘Thanks, Doc.’ Lawrence held out his hand. Fergus shook it and then rested his hand on the young man’s shoulder for a moment before moving on.

  Ailee saw the tension in the surgeon’s shoulders, the slight bow of the usually lifted chin, and could tell that Fergus wasn’t unaffected by Lawrence’s plight.

  Personal issues forgotten for the moment, she caught up to him and spoke quietly. ‘It’s a sad twist for him.’

  Fergus turned his head to meet Ailee’s eyes. ‘It may be worse than a twist. Five of the last sixteen patients that I know of who have gone overseas have died within twelve months.’

  Ailee said, ‘If we could lift our donor rates, people like Lawrence wouldn’t have to take this risk.’

  They both knew contracting a blood-borne disease because of inadequate screening was one of the major causes of complications following commercial transplants.

  His mouth compressed. ‘The tragedy is that if we could lift our state donor rate to where it is in progressive places like,’ he waved his hand, ‘South Australia, even, Lawrence wouldn’t have been driven to take the risks he had.’

  Ailee nodded because she couldn’t agree more. They desperately needed to raise public awareness for participation in the donor programme. Fergus felt as strongly as she did, that was not surprising but good, because donor promotion was dear to her heart.

  Maurice came up to them and waited until Ailee looked at him in question. ‘I wondered if you had time to explain haemodialysis again to Agnes, please, Ailee. I came to talk about her medications but she doesn’t seem to understand dialysis and I know how good you are at explanations.’

  Ailee was glad of the distraction because she was becoming more anxious about her reactions to Fergus. Her awareness. Her respect for him as a man. In fact, she’d skip the rest of the round because there was no further need for her here today.

  And she needed to think. There was more here because her feelings were progressing to far more dangerous ground, seeing the way he dealt with his patients. His empathy. Hearing his passion for the donor program. This wasn’t just about their Singapore stopover anymore. This was much, much more.

  Ailee bit her lip and closed her eyes briefly. This was not the place to think about this.

  She drew a deep breath and brushed her face as if to brush away non-work-related thoughts. There were a hundred things to do and she’d better get started.

  The patient Maurice wanted her to see was an elderly lady who was almost – but not quite – at the dialysis stage and they’d met before.

  When Ailee searched out Agnes, the white-haired woman’s lined face still looked mapped with years of laughter. Just the sort of person Ailee needed. ‘Hello again, Agnes. Maurice says you have some more questions about haemodialysis.’

  ‘Haemo-whatever.’ The old lady snorted. ‘I suppose it would help if I could remember what to call the darned thing, but what I really want to know is how my blood can go into some machine dirty and come out clean without killing me.’

  Ailee grinned. ‘If it was my blood, I’d want to know, too.’ She sat down beside Agnes. ‘If you remember me saying, Agnes, with your increasing renal failure, the amount of water you are passing is getting less and less.’

  ‘Hmmph,’ said Agnes. ‘And that’s a good thing as I don’t have to get up at night to pee, finally.’

  Ailee shook her head. ‘It will keep getting less until you might only pass an eggcup full of urine in twenty-four hours. That’s not good.’

  ‘Why not?’ The older lady narrowed her eyes.

  Ailee could tell Agnes was determined to understand this time. ‘Because any extra fluids you swallow can’t leave your body until the next three-times-a-week dialysis can remove it.’

  ‘Oh.’

  Oh, indeed. Ailee went on. ‘Too much extra fluid in your bloodstream causes oedema, or water in your tissues – like swollen ankles – which puts a load on your heart. Your heart will blow up like a balloon to cope with the extra fluid and then deflate when dialysis takes the fluid off. All that stretching and deflating weakens your heart as well.’

  Agnes nodded slowly. ‘So, it’s the fluid that’s the problem?’

  Ailee smiled. Agnes was catching on. ‘Not just the fluid. Your kidneys are like a filter in a coffee-machine. They collect the impurities from your blood and send the wastes out in the urine. If your kidneys don’t work, they won’t filter and your body fills up with toxins.’

  Agnes nodded and Ailee went on. ‘The haemodialysis is your artificial kidney. You weigh yourself before being connected to the machine and your weight determines how much extra fluid needs to be removed while your blood is being cleaned.’

  Agnes frowned. ‘And if I don’t have this haemo-whatever, I just die from the poisons and fluid that builds up in my body that I can’t get rid of on my own?’

  ‘Dialysis saves people’s lives,’ Ailee agreed, ‘but still at best only provides fifteen per cent of what is called “normal” kidney function.’

  ‘So I have to stay on the piddly amount of fluid I’m allowed to drink? Four cups, is it?’

  ‘I’m afraid so. It can cause cramps if you drink too much and the machine has to take the
extra out of your blood.’

  ‘So how does the blood go in and out? Do they put a tap in or something?’

  ‘Something like that,’ Ailee said. ‘Before you start treatment, one of our doctors will put a shunt in your arm—’ Ailee pointed to a spot halfway between Agnes’s hand and her elbow ‘—where they will connect you to the machine with a needle each time.’

  Agnes rubbed her wrist and shuddered at the thought. ‘So how does this coffee-machine clean my blood, or have you told me that bit and I didn’t get it?’

  ‘No, I’m slow but I’ll get there.’ The two women smiled at each other and Ailee went on. ‘Dialysis is a lot to take in at one time and we’ll go over it again at each stage.’

  ‘Give me the good news,’ Agnes snorted.

  ‘Your blood is pumped through a plastic cylinder that contains thousands of very fine tubes. Each tube has tiny holes that let the waste and extra fluid pass through but not the blood cells or protein. A special fluid washes around the outside of the tubes so that your blood can be returned to you with the toxins removed.’

  ‘So how long do I have to stay tied to the machine with a needle in my arm?’

  ‘It takes about four hours for all your blood to pass through the machine about six times.’

  ‘Blimey. And to think I never appreciated my kidneys.’

  Ailee grinned. ‘That’s what I learnt when I came to work here.’

  Agnes scratched her chin and the hair poking out under her lip wobbled. ‘Okay, dearie. I’d say my old brain’s done as well as it can.’

  ‘Your brain is better than a lot of much younger people. It’s a pretty heavy topic,’ Ailee agreed, ‘but each time you come in, ask more questions. Everyone is happy to help you understand what’s happening. Good luck.’

  Agnes had restored Ailee’s sense of humour and she headed back to her office happier and without so much as glancing at Fergus as he completed the round. Unfortunately, she could still feel his gaze on the back of her neck all the way up the corridor.