Major Surgery

by Lola Keeley

  From there it’s easy to untie the rest. Veronica hasn’t tied her own since she was an SHO, back when Senior House Officers were still called that. She pulls until the material is balled up in her hands and dunks it straight in the bin.

  Death is supposed to be routine, and Veronica would have thought only more so for someone who learned her craft in a war zone. They’ve had their clashes over technique and procedure, but there’s no denying the neatness of the work Cassie has been doing since she arrived. There’s not an unnecessary centimetre of incision, not a wasted strip of gauze. Whatever killed that young man in the end, it won’t be bad surgical procedure.

  “Cassie?” she ventures. It’s been too long without talking. Not that it’s the same as treating shock, exactly, but the symptoms are the same. “Cassie, I know that you know this, but this wasn’t your fault.”

  The only response is a snort, though seemingly not of laughter.

  “I won’t patronise you with mortality rates or the unpredictable surgical variables, but his death is not a result of your care for him. He would have died anyway, and sooner, without your intervention.” Said just like every bland pamphlet on the subject, ever.

  The sound that breaks out of Cassie makes Veronica stumble back in alarm. Not quite a scream, nor a sob, but something raw and jagged. If not for the tears that hurl themselves down pale cheeks, Veronica might still be in the dark. Instead, she does what she’s always done when presented with someone else crying: she reaches out with both arms and pulls Cassie close. Even if it provides nothing more than an absorbent surface, it’s something.

  Cassie doesn’t wriggle away or attempt to bolt. She clings to Veronica as if she’s the pool wall after twenty lengths of butterfly, every bit as breathless as the sobs continue to rise in her throat. It wouldn’t do to offer words of comfort, even something as banal as promising that this wretched feeling will pass with time. Which, admittedly, is about the extent of Veronica’s repertoire when it comes to these matters. She opts instead for stoic, solid, and silent. That’s the same courtesy as she’d hope to be extended in return.

  Pauline returns with Adrian as requested, and they enter on the opposite side of the room. Veronica nods in acknowledgment, angling her body a little more to block Cassie from view. They all understand the privacy of grief.

  “I’m sorry,” Cassie is muttering, over and over again. “I’m sorry, so sorry.”

  Veronica is about to gently correct her, but there’s no gap in the torrent of sorry sorry sorry until a new word pops out with them. “I’m sorry, Jan.”

  Okay, even allowing for the fact that she only operated on him once, Veronica is sure the poor man’s name is Steven. Clearly, something else is in play, and she has no idea how to ask.

  “Maybe this is one to shower off, hmm?” Showers are safe, hard to talk during, and private. Veronica very much likes the sound of that, if only because it gives her a decent excuse to retreat and gather herself.

  “No,” Cassie says, pushing away from Veronica and heading into the locker room. “Not yet.”

  “Oh God, you’re one of those, aren’t you?”

  “One of what?” Cassie’s reply is snappish.

  Veronica holds her hands up in surrender. “The exercise ones. Go hit a tiny ball hard against a wall, punch a few bags of sand… You run, don’t you?”

  “It’s still light out,” Cassie says, which is true despite the time orthopaedics took over their lunchtime surgery and the recovery time before Steven threw his unexpected clot. “Once around the park will do it. Thanks for… I should go.” She already has some gear out of her locker, retreating into the bathroom.

  Well. Another time that would read as lack of gratitude, but grief comes out in strange ways. Determined to do right by Cassie, Veronica decides to wait it out. She could get back to her own patients, but honestly the ward is running as smoothly as it ever does, the new staff bedded in, and the patient load only middling.

  Instead, she steps back into the scrub room, flipping the light off as she goes. Watching in silence, it’s a form of last rites to see the padding removed, heavy with blood as it’s tossed into waiting kidney basins. Instruments are gathered onto waiting trays, ready for their re-sterilisation. The huge pale blue sheets crumple to nothing in strong hands, filling the plastic bag that handles all non-sharp waste. Veronica didn’t notice the anaesthetist on her first pass through, but he’s duly going through his own part of the ritual.

  Veronica lingers long enough that she walks back in to find Cassie’s discarded scrubs on one of the benches. Tutting under her breath, Veronica picks them up and folds them out of habit, ready for the dry-cleaning sack in the corner. She happens to check the labels and sees that Cassie doesn’t have her name penned in. Most of the senior staff have their own sets of scrubs embroidered over the chest pocket, but no doubt the impatient Major hasn’t seen the need to do anything other than pull from the central store of waiting clean scrubs.

  Fishing around in her own locker, Veronica finds a laundry marker and writes C. Taylor on the labels of both. This way they’ll be returned directly to this room, and they did seem a good fit. Next time they speak, maybe the personalisation order form will be a good distraction.

  There’s no reason to do anything now beyond returning to her day. But in the spirit of doing something she herself would appreciate, Veronica collects two clean travel cups and her purse and heads for the park via her usual coffee stop. It would help if she knew Cassie’s regular route, but everyone entering from this side of Hyde Park on foot makes a beeline from the tree-lined path towards the Serpentine. It seems to mark a reasonable way around, but Veronica doesn’t make a point of looking for a flash of blonde in the distance.

  Instead, she waits on a bench by the Diana Memorial. Not her taste, with how it just seems to flow into the ground, but a popular spot nonetheless. The flowers are gathered every other day it seems, but the blooms laid in memory are still fresh. Twenty or so years on and the former princess is still remembered.

  Back in theatre lies a pleasant and brave young man with no one to mark his passing but the doctors and nurses who treated him. It’s an imbalance that she’s gotten good at ignoring. Except for days like these.

  She sips at her coffee, still scalding, putting the other cup beside her to deter the occasional weirdo who thinks talking to strangers is somehow welcome or acceptable while out in London. Beside it is a bottled water grabbed on a whim, in the vain hope that something will make Cassie feel better at this point.

  It’s nice to be outside; that’s enough to focus on for now. Sip the coffee, watch the occasional jogger or speeding cyclist. A gaggle of toddlers led by harassed au pairs. Veronica can be patient.

  Before too long, the heavy footfalls on her stretch of packed gravel start to slow. Where everyone else has passed, this runner is coming to a halt. Cassie, presumably. As a kindness, Veronica doesn’t look round. She simply holds out the bottle of water and waits.

  Then the bottle is gone, fingers brushing her own. A moment later, Cassie slumps onto the seat beside her, and Veronica does her best to keep looking straight ahead.

  Chapter 12

  “So,” Cassie says, although it isn’t really meant as the beginning of her thoughts. More like, it’s all she has words for at the moment. Veronica is handling this perfectly, and it’s maddening that Cassie doesn’t know how. It’s easier to form words now, because Veronica isn’t staring at her, looking for clues as to what pieces have come loose this time. “This is the thingy, isn’t it? The memorial for, uh…”

  She can picture the woman, blonde and glamorous, but the name won’t come.

  “Princess Diana,” Veronica replies, finally turning just enough to make eye contact. “It wasn’t intentional, just a nice place to wait.”

  “I really am okay, you know.”

  “It’s really okay not to be, you know. We do a
llow the occasional human emotion here. Not that I’d know, obviously.”

  “Obviously.” Cassie offers the weakest attempt at a smile, sees in an instant that she’s fooling no one.

  She should have known Veronica wouldn’t be the gloss-over-and-move-on type. Some scenes can be ignored: a patient whose gown flaps too much in the back, a crying relative at a suddenly empty bedside, a Cabinet minister showing up with false promises and a camera crew. A surgeon freezing in theatre will never make that list.

  Cassie doesn’t owe this woman anything but a brief and meaningful thank you, but this is a collision course. She recognises those when she sees them now. It’s the gut instinct that told her to get in the second car of a convoy and not the first. To check one last time for a forgotten lap pad before closing. She has to explain herself, and for once she actually wants to. “I’ve seen a lot worse than that. Lost men from my own unit, people I worked beside for years in close quarters.”

  “I can only imagine. Still, we develop that callous, don’t we? My ex-wife used to tell me, when things had rather deteriorated, that I had scar tissue where my feelings ought to be. They never really understand in the end.”

  Cassie reaches for her necklace, counting the tiny stainless-steel beads like a rosary of sorts, until her fingers close around the discs. It’s about time she told someone. If nothing else, it might buy her some future privacy.

  But why not wait to talk about it with Pauline, with her brisk good humour and kind eyes? Except nurses are notoriously tougher than doctors; it’s a cliché for a reason.

  Instead, Cassie finds herself baring her well-guarded soul to someone who seems to disapprove of her, whose sudden patience for how Cassie’s conducts herself feels too good to be true.

  “So I suppose you’ve worked out that it’s not just about the sergeant.”

  “I had. That doesn’t mean you have to tell me anything more than that.” Veronica reaches out, her hand firm when it grips Cassie’s forearm. Her hands are soft, but there’s that slightly chalky quality that comes from spending too much time in latex gloves, the powdered residue becoming part of the skin after a while. “But if you wanted to, well, I would listen.”

  “There’s a reason they don’t let us treat our family members,” Cassie begins, before amending. “Loved ones.”

  “Doesn’t stop most of us,” Veronica reminds her. “We write prescriptions, we call in favours from friends. Danny always says I’d send him to school if his leg fell off. I told him only if we staunched the bleeding first.”

  Cassie stands, grabbing the coffee now that her water is drained. She tosses the empty bottle in the recycling side of the bin.

  “Do you mind if we walk?”

  Veronica nods, getting up and setting out on a determined course. Cassie falls in step, trying to get her bearings. They cross the road through the park and head towards Hyde Park Corner, with its daily rabble of speechmakers, some saner than others. Not that they’ll make it that far, probably. Grownups don’t get to just walk out on their jobs.

  “Don’t get me wrong, it’s not one big happy family on active duty.” Cassie almost wishes Veronica would take her arm like she’d seen her do with Dr Hyatt-Wickham. Something about the slower pace makes falling seem like more of a possibility.

  “People you could quite cheerfully slap are in your face for weeks on end. But even the worst of them, when shit goes down…they end up feeling like the only people in the world who give a damn. You have to trust them with your life. No choice on that part. Seeing someone from that world, even a stranger, it brings a lot of things back all at once.”

  As they walk, Veronica doesn’t interrupt or question, simply nods in acknowledgment at each pause. As though she’s saying I’m still here. It gives Cassie the wherewithal to go on.

  “I couldn’t save her.” Cassie has to say it now, or she’ll lose her courage. “Jan, she was a translator. We so rarely used women, but she was good, could make anyone talk to her.”

  “Was she…?” Veronica waves her hand to fill in the blank. “Is that too personal?”

  “I’m not used to being ‘out’. I know it’s no big deal now, in a big city like this. The army isn’t bad about it, all things considered, but fraternising is still an issue. We had to be discreet. And when the enemy nearby is the Taliban, you don’t want to paint any more targets on your backs. You know, I might have brought this up sooner, but I wrongly assumed you were straight.”

  “You thought I was straight?” Veronica’s mouth quirks up at one side, fighting a smile. “I don’t know when I’ve ever been so offended, Major.”

  “The kid threw me, that’s all.”

  “Hmm.” Veronica considers her next question, and Cassie wants to blurt something out just to divert it. It’s always too revealing, when Veronica asks her something. “So when you say you couldn’t save her…”

  “I’m sure you saw the sort of thing on the news. Moving from one base to another, they didn’t let us bed in for too long, and we were needed in so many places. We had scouts, there were all kinds of detectors, but in the end it was the luck of the draw.”

  “One of those IEDs?” Veronica presses. “Bloody nasty business. I’m sorry.”

  “It was the crash. The car in front took the worst. I got out unharmed, but the impact in the front seat was too much. She, uh, I mean, I tried with the mobile kit but it was too much damage. Triple A, the autopsy confirmed in the end.”

  “And you blame yourself for not being able to treat an aortic aneurysm? In the middle of the desert with no real surgical kit? While still reeling from the accident itself?”

  “I just—”

  “Listen here.” Veronica stops right in front of Cassie, grabbing her by the bare upper arms. Her fingers are warm, making Cassie realise how cool she is in comparison. Strong, too, though that’s not unusual with all the hours of surgery Veronica must have under her belt. There’s something grounding, though, in being touched. Cassie feels the floating feeling start to recede.

  “I’m listening,” she says, for lack of anything wittier. The thump in her chest, the dull ache of missing Jan and finally sharing some kind of memories of her, it feels like something she can handle head on, now that Veronica has quietly slipped into her corner. Those dark brown eyes and the serious set of her jaw brook no argument: Cassie is being supported here, and she can deal with this.

  “You might be a damn fine trauma surgeon, Cassie Taylor. For all I know, you might be the best this country has to offer. But you are not—hear me on this—not a miracle worker. We save who we can and we mourn the rest, but you don’t get to take the blame just because you cared about them.”

  Cassie’s throat is tight. The tears are threatening again, just like the dark grey clouds overhead. It’s a struggle, but she forces the words out. “Rationally, I know you’re right.”

  “Actually, I’m always right.” Veronica hasn’t let go yet. “It’s usually quicker to just accept that going forward.”

  “Duly noted.”

  “How was Peter in there? Need me to have a word?”

  Cassie shakes her head. “I fight my own battles, thanks. And he was just doing his job. More professionally than I was.” Her phone beeps, and then the surgical pager that the NHS insists on clinging to follows suit. The boxy little thing is a real throwback, but like everyone else, Cassie has learned to use it simply as a ‘bleeper’ that grabs the attention and using her actual phone to find out what the hell is going on. “Incoming,” she adds, though they both know it.

  “Listen, you don’t have to go back in there.” Veronica is sincere about that much, but Cassie turns away, forcing Veronica to almost stumble in coming after her. “Will you at least call for me if you need another pair of hands?”

  “Best thing for it is to get right back on the horse.” Cassie wipes the last of her tears from her face. The call of the opera
ting theatre is rising inside her again, despite it all. “Thank you, Veronica. Truly.”

  “Just helping out a friend,” Veronica assures her, before catching what she’s just said. The woman looks a little stunned to even have thought it, never mind said it aloud. Still, this is the unflappable Veronica Mallick, and she styles it out with a stiff smile and a wave of her hands. “I won’t try and keep up with you. Go on.”

  Cassie gives a stilted little wave of her own, before turning back towards the hospital, kicking up her heels on the first few strides. It’s probably her imagination, and she hates how it sounds like something out of a self-help book grabbed on impulse at the airport, but she does feel just a little lighter for saying it all out loud.

  And the rest? Well, that’s what work is for. She’ll be elbow-deep in a surgery within the hour, and that’s the best place for her.

  Chapter 13

  Veronica dives headfirst into the rest of her week, and in typical St Sophia’s fashion, it’s too busy for her to spend much time wondering how Cassie is recovering from her momentary freeze.

  The nurses’ network does its bit when it comes to gossip, so Veronica can stay safely in her own domain—or at least in meeting after meeting, punctuated by the odd surgery—while keeping tabs on what’s happening across the way in Trauma. It sounds very much like business as usual. A rash of car accidents, a few motorcyclists who picked a battle with physics and came off worse, and the usual weekend spate of stabbings and drug-fuelled fights.

  AMU has done its bit, admitting and treating and filtering to more long-term wards as needed. It might not be the same high stakes and energy, but it’s been bloody frantic all the same. What it always comes down to is that there are a finite number of beds and other resources, but a seemingly infinite flow of bodies.

  And of course, there’s always those initially minor issues that get much worse out of nowhere. The sudden bleeds or organs failing that nobody can predict. It puts all the staff in crisis mode, just when they thought they could catch a nap or sit down for five consecutive minutes. They’re all beyond knackered at the end of the day, surviving on caffeine and determination alone, but they get the few hours in a proper bed to recharge, and then do it all again.