The Doctor's Gift

by Fiona McArthur

  Tell me about it, Ailee thought, but knew they were necessary. ‘I know, Teuila. It’s to make sure you’ll be well after donating your kidney. We’d look pretty silly if you only had one kidney, or only one working well, and we let you give it away.’ Ailee held up the renal imaging studies and pointed. ‘There are your two kidneys and this one shows the blood supply and structures in and around your kidneys, which are all normal.’

  Teuila looked vaguely at the dark pictures and shrugged. ‘If you say so.’ She frowned. ‘Because my son and I match blood groups, it’s a good sign, isn’t it?’

  Ailee agreed. ‘To be the same type is the best, but even a blood type your antibodies won’t fight can be fine. People with O-type blood are still compatible to give but not receive from all the others, and AB-type blood, like yours and Fetu’s, can receive from A, B, or O.’

  ‘So how do they tell if Fetu’s blood antibodies are going to fight with mine?’

  ‘To cross-match, we take blood from you and Fetu, separate it down, and the laboratory incubates your lymphocytes with Fetu’s serum. They look to see if Fetu has antibodies form to fight against your cells.’ Ailee paused to allow Teuila time to understand that concept. ‘Like unexpected milk lumps in your tea.

  ‘Antibodies that are already formed, called preformed antibodies, can cause acute rejection after transplant. If antibodies already exist, the transplant can’t go ahead. That’s why some people are on waiting lists for years and others seem to have managed to jump the queue.’

  Teuila nodded. ‘I wondered about that.’

  Ailee went on. ‘It depends on the antibodies in the match as much, if not more, than how long you’ve been waiting.’

  Teuila squinted at the results Ailee had facing her. ‘So Fetu hasn’t any preformed antibodies against my blood?’

  Ailee smiled. ‘None were found, so that is the best news.’

  ‘Good then. When do we start talking about operation dates?’ Teuila sat back and folded her plump arms across her ample breasts.

  ‘It takes quite a while for all the tests to come back, and because transplanted kidneys don’t always last for a long time, we make as much use of the failing kidneys as we can. It’s usual to wait until just before someone like Fetu needs dialysis. Then we do the operation.’

  Teuila drew her dark brows together. ‘He might need another transplant in the future? How long will my kidney last?’

  ‘It can vary, and we hope each kidney lasts a very long time. The majority of donor kidneys last between fifteen and thirty or more years if they are not rejected. Live donor kidneys, like yours, seem to last longer than those from someone unrelated who has died.’

  Teuila nodded and Ailee went on. ‘You must remember that the fifteen or thirty years we talk about means that someone like Fetu can have a normal life in that time. Even a shorter time than that makes a huge difference to a chronically ill person’s quality of life.’

  ‘You mention rejection. That seems to be the big worry.’

  These were the more worrying aspects. ‘And infection. Most renal experts believe the amount of acute rejection episodes Fetu has is a factor. That’s why we keep a watchful eye on him for a long time.’

  Teuila sighed. ‘We seem to have been getting ready to do this for months and months. I just want it all to end.’

  Ailee leant across and squeezed Teuila’s hand. ‘I know. I’ve been waiting to do the same for my brother for more than a year. It is a nerve-racking time. I even travelled overseas for a few months because my brother didn’t need the operation at the time, but he’s ready now.’

  Ailee gritted her teeth as she said it. He’d better be. Teuila’s eyes widened. ‘When do you go in?’

  Ailee thought of her last conversation with Fergus about William and stamped down her reservations. ‘We’re waiting for the final go-ahead from the surgeon, but it should be next week.’

  * * *

  When Ailee went back to see William that afternoon, she was dreading another confrontation.

  But a different brother waited for her.

  William smiled, somewhat sheepishly, but smiled nonetheless. ‘I’m sorry, sis.’

  Ailee felt the tears rush to her eyes and she stepped closer until William hugged her. She sank against him and hugged him back fiercely. ‘I’m so sorry I didn’t see how you were feeling.’

  William brushed his own damp eyes. ‘I’m sorry I was such a jerk.’

  Ailee smiled and sniffed. ‘You aren’t a jerk but you scared me.’ She tilted her head. ‘What changed your mind?’

  William half laughed. ‘Who.’

  It took Ailee a moment to get his meaning. ‘Okay, then who changed your mind?’

  ‘Lawrence.’ William’s face reddened. ‘He practically kicked my butt he was so amazed at my stupidity.’

  Ailee rocked back. Amazed. ‘When did you meet Lawrence?’

  ‘Mr McVicker introduced us.’ William shook his head. ‘And I thought I had it bad. Hell. Poor Lawrence, but don’t tell him I said that.’

  Ailee felt like hugging the absent patient. Bless Lawrence. ‘I won’t, but what did he say?’

  ‘It was what he knew.’ Judging by her brother’s awed expression Lawrence obviously had made a big impression. ‘He knew what I was thinking. How I felt. It was weird to hear it come from someone else’s mouth. He said Mr McVicker wanted a commitment from me today or he would cancel the op.’

  Ailee felt sick. She licked suddenly dry lips and put her hand over where her heart pounded faster. ‘What did you do?’

  William shook his head at the enormity of what could have happened. ‘I got it. How stupid I’d been. How much I wanted to get on with my life. I asked to see Mr McVicker and said I would look after your kidney more carefully than anyone else in the world. He said I’d better or he’d be gunning for me.’

  He grinned. ‘It looks like we’re going to Theatre next week, sis.’

  * * *

  On Wednesday, between ward rounds and transplant co-ordinator duties, Ailee was retested with another serum cross-match and tissue type to check that nothing had changed.

  The new transplant co-ordinator would start on Monday and Ailee needed to ensure all her records and tasks were up to date. At least her workload meant she had little time to dwell on the disaster of her love life.

  Any interaction with Fergus had dwindled to the barest minimum, and although he continued to treat everyone else with his usual warmth and care, Ailee was excluded from the circle with polite distance. It didn’t escape her notice that this was exactly what she’d requested from Fergus.

  * * *

  On the Friday before the surgery, both she and William underwent the final psychological testing to ensure they were mentally ready for the operation. This time the results came back resoundingly affirmative.

  * * *

  After a subdued weekend spent lazing around at home with her family – and not one phone call from Fergus – Ailee was admitted on Monday afternoon as soon as William had his final dialysis. This admission there’d been no fluid overload on William’s part, even though both he and Ailee had been on a clear fluid diet for the last twenty-four hours.

  Ailee unpacked her hospital bag in the single room allocated to her. It was so weird to be the patient doing this stuff. She set up the bedside table for easy reach of things she imagined she might need when her movements would be severely restricted by the surgery.

  As a quirk of her job, Ailee had quizzed Emma’s husband, Peter, on any tips he might have for her in the post-operative period and he’d laughed quietly and said, ‘Take the pain relief.’

  * * *

  The morning of the operation finally arrived and Ailee woke up on the ward. In a ward bed.

  Dr Harry was back and would perform Ailee’s surgery.

  Fergus, on his last day at the hospital, would assist with William’s transplant.

  Ailee couldn’t be happier with this surgical team. She could hear William’s voice in the roo
m next door as she slid her arms into her white hospital gown that threatened to expose everything to the world.

  Her tummy rumbled more from nerves than the fact that she’d been fasting since midnight, and she imagined William felt the same. She slid a dressing gown over her theatre robe and poked her head into her brother’s room.

  ‘Morning, bro.’ Ailee’s nonchalance didn’t quite come off but the new closeness with William excused that and they smiled at each other.

  ‘Hungry?’ Wiliam teased to hide his own nervousness, and they both looked up as the night sister came around with their charts to finalise the theatre requirements.

  ‘I thought I’d find you in here, Ailee.’ Greta had settled them to bed the previous night and had bullied Ailee into a sleeping tablet.

  ‘I did sleep, Greta.’ Ailee smiled at the nurse and she grinned back.

  ‘Good. That’s much better than you harassing me all night.’ They both knew what she meant. ‘A good sleep helps down the track.’

  Greta smiled at William and then Ailee. ‘I need some observations from both of you so pop back to bed because Dr Harry will be in soon and I have to do my duty before I go off.’

  Ailee obediently went back to her room and climbed up into the bed. Her bedside table had been moved.

  In her absence a basket of glorious Singapore orchids had arrived. The fragile blooms perfectly matched her fragile mood and the memories rushed back. Tears clouded her vision.

  Chapter 21

  Fergus

  * * *

  Fergus watched Ailee’s hand stretch out to touch the velvet of a purple orchid, and the tightness in his chest prevented him from speaking. He cleared his throat and moved from the wall opposite the bed.

  ‘Hello, Ailee.’ It was all he could manage at that moment as the full impact of how close she was to going to theatre hit him in the heart — just like the day he’d first seen her – but even more now that he knew and loved her.

  ‘The flowers are beautiful.’ He could barely hear her voice for the rushing sound in his ears. He wanted to sweep her up into his arms and carry her away to safety, even though he knew the idea was ridiculous, because she was a strong and brave woman and didn’t need saving. Just loving.

  He cleared his throat again. ‘I hope you don’t mind but I needed to wish you well before you go in.’

  ‘Thank you.’ Ailee turned away and tried to brush the tears away without him seeing, but he came up in front of her and rested his hands on her shoulders.

  Unable to help himself, he bent and kissed her lips and tasted the salt of her tears. ‘Staying away has been the hardest thing, Ailee.’

  Greta bustled into the room with her charts and Fergus stepped back as she spoke to the folders in her hand. ‘So, all we need is...’ She looked up and blinked when she saw Fergus was in the room. ‘Mr McVicker?’

  ‘I’m just leaving.’ He looked at Ailee. ‘I’ll be in William’s theatre. Good luck.’

  Chapter 22

  Ailee

  * * *

  Their eyes met for a final lingering look and for a moment Ailee thought he was going to lean in and kiss her again, but he left, almost in a rush – this wasn’t easy for him she thought as she watched him go – knowing he carried her heart with him.

  She wondered what they would have said to each other if there had been more time. But they were out of time. The orderly and trolley would be here soon to take her to theatre.

  She lifted her chin. ‘So what do you need, Greta?’ Greta ticked the boxes on the pre-admission sheet. ‘Just need to take your blood pressure and check your armband.’

  Ailee nodded and lifted her arm.

  * * *

  An hour later Ailee lay on her back, slightly fuzzy from the pre-anaesthetic medication, on her way to the operating theatre. She’d always wondered what it would feel like to see the ceiling go past, like in the movies, so many times.

  The air-conditioning vents streamed by, faceless voices came and went from her peripheral vision, and it seemed to take forever to arrive at the swinging plastic doors of the operating theatres.

  A figure clad in a scrub suit took her hand and checked her armband. ‘Hello. Can you tell me your name and what operation you are having today?’ Ailee had heard it all so many times and now it was her turn.

  After the first check they passed through into the anaesthetic room and Andrew was all bouncy good humour.

  ‘So, Ailee—’ he said as he patted her wrist and squared up to impale her vein with an incredibly large cannula ‘—bet you never thought you’d see me from this angle.’

  ‘If you didn’t have a mask on, I’d be able to see up your nose,’ she bantered back, but the nerves were starting to squirm inside at what lay ahead and some of it must have shown in her eyes.

  Andrew dropped his humour and patted her shoulder. ‘You’ll be fine, my friend. We need your sort around here. I’ll take good care of you.’

  ‘I know you will. Just make sure your colleague next door takes good care of William, too.’

  ‘Done. Now, off you go to sleep.’

  And that was the last Ailee heard.

  Chapter 23

  Fergus

  * * *

  Fergus couldn’t stay away as he waited for his own operation to start. He hovered around the theatre doors, not able to cope with the viewing-room window, and went over in his mind what would be happening inside.

  Ailee’s kidney would be removed first and the operation would take about an hour. His love lay in the theatre next door and William would come into this theatre when Ailee’s kidney was ready. The scrub room lay between the two theatres.

  Fergus had checked and Dr Harry had chosen to use the open-excision method he’d used for thirty years. Fergus admitted to less chance of injury to the donor organ than the keyhole method of excision if the surgeon wasn’t as used to laparoscopic nephrectomy. He just wished Ailee hadn’t had to suffer the extra recovery time, pain, and movement restriction from the large excision.

  Although William’s operation would take twice as long as Ailee’s, Ailee would be the one with the extended recovery time and greater shock to the system because she’d previously been well. William would start to feel better almost immediately.

  But Fergus had no say, either in her choice of surgeon or anything to do with her life. She’d told him that.

  An hour passed. ‘What are you doing out here?’ Dr Harry said as he slipped out of his sterile gown to have a small break before he had to re-scrub to assist Fergus with William’s operation.

  ‘Waiting for a friend. Is she out yet?’

  The older surgeon smiled. ‘I thought you might be. She’s fine. And the young fellow will come along well, too.’ He looked at Fergus from under his brows. ‘She’s just going through to Recovery now and isn’t really awake. Go on through and see her.’

  Fergus had been debating, but Dr Harry was on a mission now. ‘We can afford a few minutes before we start on young William. There has to be some bonus for all the extra hours we work.’ Dr Harry’s bushy eyebrows bounced up and down. ‘So that’s why you didn’t want to do this one, eh?’

  ‘As you say.’ Fergus didn’t enlarge on the subject and the older man didn’t pursue it.

  They entered the recovery area and Fergus picked out Ailee at twenty paces. She was asleep. Her face pale and the intravenous line running a blood transfusion so she must have lost a bit. Or a lot.

  She was so pale. He sucked in his breath in shock.

  Dr Harry heard the noise. ‘She had a little bleeder, but we got it in the end.’ He looked at Fergus and almost chuckled. ‘She probably didn’t need the blood but it saved her feeling tired for the next month, so don’t look at me like that.’

  This was a common enough complication for patients, but not for Fergus, and not for Ailee. There was no escaping his need for this woman, and while he’d loved and mourned his first wife this was for now and the future, and his future revolved around this woman.


  There were obstacles before them, but as he looked down at her, unconscious and moaning gently in her sleep, he vowed to himself he would have and hold his Ailee.

  It might take time but Simone would get used to the idea.

  He moved across and lifted Ailee’s hand to his cheek. She felt cold and he warmed her fingers between his hands before tucking them back under the covers.

  He lifted his head. He had a job to do.

  As Fergus cleaned his nails with the brush in the scrub room, he averted his eyes from the container where Ailee’s kidney waited to be transplanted.

  * * *

  Fergus entered the theatre and strode to the table. William lay anaesthetised, his abdomen exposed. The scrub sister handed Fergus the bowl and sponge forceps so he could prep.

  He drew a deep breath. Renowned for his perfectionism, this would be his most meticulous transplant yet.

  ‘Now, that’s a beautiful kidney,’ Dr Harry said nonchalantly.

  ‘It’s the most beautiful kidney in the world,’ Fergus stated, and then he cleared his mind of the external distractions and set about placing Ailee’s kidney in William’s pelvis.

  The donor kidney was seated near William’s bladder so that the ureter could be easily connected through an incision in the lower part of his body. William’s old kidneys would not be removed. It took hours.

  Chapter 24

  Ailee

  * * *

  When Ailee surfaced slowly through the anaesthetic mist, she realised she had returned to her bed on the ward. Gingerly she turned her head and it seemed there were bright splotches around every wall. That was funny — she hadn’t noticed those that morning.