Major Surgery

by Lola Keeley

  “You know sometimes,” Peter says, apropos of nothing, “I wonder if this isn’t all some grand plan, to have your people in place so you can take over the world.”

  “Is that what you wonder?” Veronica teases, not giving away how close it is to her long game. “Just get the damn job, Peter.”

  “Yes, sir.” He stands to leave, ready to go about his day again. “If you’ll excuse me, I have a crop of foundation-year doctors to traumatise into being better at medicine.”

  “I’ll see you out there in a while.”

  Checking her watch, Veronica sighs that the face is out of sight again. Tugging on the thin gold strap to pull it back into place, she turns to the emails she can ignore no longer. If they’re going to get back to full service by next week, it’s going to take some wrangling and ingenuity on her part.

  It must be done, and it will be.

  The sudden burst of optimism is so unexpected she considers checking whether Lea spiked her latte.

  “Let’s see what Travers wants,” she says to her now-empty office with a groan. She’s barely five words in before realising her boss wants to offload some work onto her. Typical. That said, picking up another committee place will look good when she’s going for his job in the relatively near future.

  And as she predicted, he appears in the doorway before she can get around to clicking on ‘reply’. He must have been lying in wait somewhere nearby, because she’s never seen him break into a run. The executive block isn’t far, but as with most places on this hospital campus, “not far” can still be quite a hike. That’s not counting their two other sites, the smaller community hospital farther west, and the terribly impressive university that technically owns the whole Trust now.

  If Veronica still struggles to keep up with the organisational structure, she can’t imagine how unfathomable it is to outsiders. Except Major Taylor, who doesn’t even look for rules in the first place, before blithely breaking them.

  How does that woman keep sneaking back into Veronica’s thoughts? She won’t give credence to Edie’s earlier teasing, even if it has been rather a while since she dated anyone for more than a string of rescheduled dinners, mediocre wine, and the odd ill-advised play somewhere that prided itself more on being trendy than on hiring people who could act.

  “Veronica?”

  In her distraction, she realises that she hasn’t heard a word he said. “Yes, Wesley,” she answers blindly, hoping that’s the right choice. Given how he beams at her, it seems to be.

  Swiping at his nose with a plain cotton hanky, he picks up from wherever he left off. “Now, we won’t let the committee cut into—oh, that’s good, cut into—your operating windows. I’ll make sure it’s only the boring admin this interferes with. Scout’s honour and all that. Dib dib.”

  Veronica gives a tight smile, glad her stapler is out of her line of vision, or she might be tempted to staple his gaudy school tie to his forehead.

  “Just let Marjorie know when there are dates—she runs my calendar.”

  “Of course. I hear we had a bit of excitement this morning with one of the admissions from A&E?” He’s fishing, and clearly knows exactly what happened already, judging by his smug expression.

  “All handled, I understand. Though more Jean’s issue than mine, if you need anything for the insurance.”

  “Oh, we’ve spoken. Seems Major Taylor has impressed the panel and the staff today.”

  Veronica snorts. She’s staff, and certainly unimpressed.

  “I think we have steadier pairs of hands in waiting, Wesley. Don’t you?”

  “Ah. Well, in theory.” He swipes at his nose again, grumbling to himself. “Let the chips fall where they may, et cetera.” Travers is the only person Veronica’s ever met who actually sounds it out like two separate Latin words.

  “Yes, let’s.” She turns back to her coffee and the screen. “Now, if you’ll excuse me, I really must crack on.”

  Chapter 4

  By the time her train crawls into the platform at Paddington, Cassie is about three shallow breaths away from seizing the emergency hammer and breaking the window glass to get out. Even as the doors shriek that they’re finally opening, it takes an eternity for the mass of bodies around her to turn, gather their coats and bags, check their phones, and fix their ties, before she finally gets to spill out into the relative fresh air of the station. It’s about ten degrees cooler for a start, and her overheated cheeks are grateful for it.

  Standing out of the flow of commuters, she feigns interest in a timetable board that’s not in anyone’s way. Fumbling a little past the collar of her coat, she finds the familiar circular discs tucked away on their chain. She turns them over and over between her fingers and waits for a lull.

  Before long, the seemingly endless crowd has reduced to a trickle, and Cassie strides out towards the exit. She attempts to pull her ticket from her coat pocket, only to discover it isn’t there. With a sigh she begins the ritual turning out of all pockets and her handbag, unearthing coins, thread, three paperclips, and a receipt for a film she doesn’t remember seeing.

  She doesn’t waste a smile and a flustered expression on the soulless bureaucrats who have heard every excuse under the sun. Whether she’s paid for her ticket and lost it, or is simply scamming the ticket inspectors, they’ll charge her for a full-price single ticket regardless. A punishment for being scatterbrained, and she’s been racking those up since primary school.

  So long as it doesn’t make her late for her bloody first day. Cassie can’t quite believe they still offered her the job. She’d given a good account of herself at the panel, and her references were impeccable. Despite the resistance from that Mallick woman, a spot of patient pinching hadn’t killed Cassie’s chances after all. Part of her was already giddy at the thought of building a formidable trauma centre, one equipped for every eventuality. It would be a blessing after years of making do in the field.

  “Can I get a return from Swindon?” she asks the much younger woman at the gate, taking in her shaved undercut hair style and varied piercings. Cassie feels a pang of envy at that self-expression. Even if she had the courage while in the army, most of her superiors would have personally removed all that metal with a handy fridge magnet given half a chance.

  “You should really get it at the station,” comes the standard reply. “I mean, you could get fined for traveling without a ticket.”

  “Well, I had one, but now I can’t damn well—”

  The girl’s expression changes from bland indifference to wariness. How many irate passengers turn on her every day?

  Cassie’s righteous indignation is halted in its tracks. “No, right, I’ll remember that. But I’m more than happy to pay for the ticket now.”

  Maybe it’s the way she bit her tongue, or maybe it’s the way Cassie maintains eye contact a fraction too long and smiles just right, but there’s that flicker of recognition, followed by a sigh.

  “Just this once,” the girl says with a wink. “I’m here every morning this week, so I’ll know if you chance it again.”

  “Duly noted,” Cassie says in appreciation, shoving her wallet back in her bag and rushing forward onto the concourse proper. She glances back and, sure enough, Miss Ticket is watching her walk away. Not bad for a Monday morning. Cassie’s not ashamed to admit it puts a little spring in her step and definitely brings a dash of colour back to her face.

  What she needs, though, is a large infusion of caffeine, preferably accompanied by its close personal friend, sugar. The nutritionists would have a field day, and while Cassie knows that she should be chasing down a smoothie made up of something green and fruity, her heart just isn’t in that kind of good behaviour today. Less physician-heal-thyself, and more physician-treat-yourself.

  Besides, new resolutions made on a first day never stick. The sheer bureaucracy of it all still intimidates her, but there shou
ld be ample opportunities to keep operating. As far as she could tell from her brief tour of St Sophia’s on interview day, their usual idea of trauma is simply the gnarlier car crashes and the worst cases who’ll end up in the specialist Burns Unit.

  No, that isn’t entirely fair. She remembers watching the coming and going on the news, after the bombings ten years ago. The doctors and nurses, who’d also just been on their way to work like any other day, tending to the wounded in bombed-out train carriages and on the ground, had the bearing of grim competence. What London lacks in roadside IEDs and active war zones, Cassie’s sure it can make up for in stabbings and occasional flurries of shootings. Whatever this city throws at them, she intends to shape a department that can handle it.

  As a Liverpool girl born and bred, she isn’t overly familiar with this part of London. Not that she knows the city that well at all. Apart from six months in Albany Street barracks with the Logistics mob, she’s only ever been passing through for a few days at a time. Luckily, Cassie has an inbuilt sense of geography, an unshakeable inner compass that settles just as quickly in Kabul as it does in Kensington, but London is uniquely overwhelming in its seemingly endless rush hours.

  There’s a surge of people on the concourse again, although the crowd is dense but not particularly unruly as they flood mostly from the overhead to underground trains. She’s able to bypass the worst of that by making a break for the pedestrian exit and spilling out onto Praed Street.

  Through the impressive wrought-iron gates, Cassie sees the hospital’s main entrance. Gothic statues welcome and warn all who might enter here. It’s crazy that this is her life now, but she can’t help feeling it’s already a good fit, despite the fizzling knot of first-day nerves wriggling around in her stomach.

  There’s no nagging temptation to jump on another patient just yet, but knowing her luck, she’ll only go and get a reputation for it.

  Since she’s at least an hour early, Cassie has the luxury of wandering plenty of empty halls. She catches her reflection in some glass doors. No-nonsense grey suit, creamy blouse, low black heels. It’s as femme as she gets, and it won’t look quite so neat in a few hours. A cursory attempt at first-day make-up, her hair pulled back in the low bun that’s served her so well for years, though with every cut, holding it back requires more pins. She’s beyond tempted sometimes to shave it all off, but the window for experimentation like that seems to have passed her by.

  There’s a small coffee shop in the last corridor before A&E, which is where she can branch off to her own department. The other fork leads to the Acute Medical Unit, domain of one disapproving Ms Mallick. Perhaps fences could make good neighbours after all.

  Cassie orders a dirty chai, something she read about in the free newspaper before the train got entirely packed at Reading. It sounds quite appealing, the cinnamon and other spices she likes in tea, with the shot of espresso to sharpen things up a little.

  Secretly she likes the way the barista doesn’t flinch. It makes Cassie feel urban, almost sophisticated, to order something that isn’t on the painted menu above the counter. It’s bloody nice to get a scalding hot drink that doesn’t have a faint trace of sand around the cup’s edge, without coffee that’s been stewing for four hours at a time.

  The junction outside A&E is where she foolishly pauses. Cassie knows this bit of the hospital better than anywhere else, and some silly part of her likes that feeling. It’s been a long time since anywhere felt especially like home, and she wonders if this is going to be it for her.

  “You know, if someone comes out of there with a trolley, you’re going to be right in the way.”

  Great. Just who she wanted to run into before the caffeine had a chance to circulate. Cassie inhales through her nose a little too sharply and turns, extending her free hand.

  “Ms…?” She knows fine well, but the hell is she letting this bossy woman think she made an impression.

  “Mallick, but we’re quite informal in these parts. You can call me Veronica. Everyone else does,” she tacks on, presumably just in case it should come across as friendly.

  “Cassie, then.”

  “Not Captain?”

  “Major, actually. You just demoted me. But the titles don’t matter much when you’re dealing with civilians.”

  “I’m sure.”

  They’ve been shaking hands a little longer than strictly necessary, so Cassie drops her hand with minimum fuss. She takes a chance to really look at the woman opposite her, like something out of a classy boutique display with her fitted dress. The bold patterns in all sorts of reddish colours are mesmerising at first glance. Not afraid of real heels either, though the toes are so pointed that Cassie almost winces in sympathy. The pearls on Veronica’s necklace match perfectly with the single studs in her ears, but no wedding ring is in evidence.

  “I suppose you’re not exactly thrilled to see me,” Cassie blurts out. This is why she tries not to talk too much. She’s really not very good at it. “With your boy and all.”

  “I’m not going to hold a grudge if that’s what you’re suggesting,” Veronica answers, looking appropriately offended. “It’ll just be a shame to have Mr Wickham operating below his full capacity on my ward for a while longer, but things change quickly around here.”

  That feels more like a veiled threat than the truth, and Cassie feels the prickle of warning at the base of her neck. “Well, I’d really better get on.” She steps around Veronica and heads down the fork in the corridor that leads to the Trauma department. “I assume it won’t be long before my first surgery.”

  “Oh, you won’t be on rotation this morning,” Veronica corrects, taking a step or two as though to follow. “All department heads have the surgical planning meeting.”

  “Surely that’s optional?” Cassie can’t believe they’re going to ensnare her that quickly.

  “Not if you want your department to know what the hell’s going on, no. We’ve cancelled all electives for the past few weeks, for example, which affects a lot of your secondary procedures.”

  “That’s…insane.”

  “You’re welcome to make that point to our bosses and the people who hold the purse strings. See you there.”

  With that, Veronica disappears down the opposite fork to her beloved AMU, heels clicking. Clearly she doesn’t care if Cassie knows where this all-important meeting is. Fine. She can play it that way. Cassie turns towards her new domain with a sudden reluctance. She has made the right call on her future, hasn’t she?

  Beyond the swing doors she sees beds, monitors, some partly drawn curtains. Everything she expected, as she draws closer step by step.

  Despite that, she has the unsettling feeling that nothing about this will be how she expected at all.

  Chapter 5

  Peter is taking rounds with the F1s, or foundation-year-one doctors, still a little rowdy and nervous in their little cluster. By the time they progress to foundation year two, garnering the equally uninspired title of F2s, they’ll have splintered off by specialties and formed their cliques around who hasn’t slept with who yet. At least on this part of their rotation, the opportunities for hijinks are tempered by the on-call rooms being perilously close to Veronica’s office. After hours, though, it’s apparently fair game, and she tries very hard not to know anything about it.

  Gathering her tablet and frowning at the little crack in one corner of the screen, Veronica decides she needs a fresh coffee to face her weekly surgical meeting. They’ve been running on fumes, resources wise. Plugging vacancies like the head of Trauma can help, even if Veronica vehemently disagrees with the choice.

  The trouble is having to give a bunch of departments allocated amounts of theatre time, meaning valuable surgery hours are wasted every week when they’re not needed. Then the departments overflowing in surgeries find their patients pushed and pushed. Someone needs to stand up to the bureaucrats who think running
a hospital is more to do with a balance sheet than actual medicine.

  It could be worse, Veronica knows. She did a fellowship in the States, and while the facilities were almost science-fiction quality at times, the reality of refusing patients who couldn’t pay, or bankrupting them in exchange for health care, turned her against that kind of system for good.

  God, when did the biggest excitement in her life become fantasising about being the big boss? There used to be no thrill like the first surgery of the week, and now she rarely gets to cut before Tuesday afternoon. Which is usually palmed off on someone else while she puts out an administrative fire somewhere else.

  Still, it’s the plan. Some people are content to become a senior consultant and use that, coupled with private practice, to see out the rest of their careers. Veronica has plans to shake this place up. She hasn’t put in all the time and effort on conferences and training courses not to want to turn it into the best hospital in London. The kind of place they make splashy TV documentaries about for NHS anniversaries, to be horribly populist about it. Let them mistake her as just another pen pusher, just long enough to get the big job in the first place.

  At the entrance to the conference room, her happy world-domination reverie is disrupted by that goddamn army surgeon again. They’ve already met this morning, proving beyond reasonable doubt that the woman really doesn’t have a clue what she’s getting into. If she thinks the job is all crash carts and daring surgeries, they’ll soon kick that out of her. The volume of paperwork alone should have the major running for the hills soon. Although she has at least found the right meeting room.

  “Ms Mallick,” the woman—Cassie, that’s it—greets her. “Nice to bump into you again.”

  “Veronica, please. Major Taylor, wasn’t it? Nice to see another woman at one of these things. Apart from Jean—you met Jean—we’re rather outnumbered a lot of the time. I’m sure that will give you whiplash after the army. I hear it’s a real feminist paradise.”