LITMIR.BIZ

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Alex was working and she was here to see it all went smoothly. Theatre first.

      Rachel was supervising the scrub nurse setting out what the surgeons would need, telling the nurse, a lanky six-footer called Ned, what would be happening.

      ‘I saw him at work in an adult cardiac operation the other day,’ Rachel said, following Annie out of the theatre. ‘I think he’s good and I’d like to think we can keep him.’

      ‘If you want him, he’s yours,’ Annie promised her. If he was equally popular with the adult cardiac surgeons she might have a battle, but she was willing to fight for what-ever they needed to make the unit work. She was good friends with the director of nursing and would speak to her first thing Monday.

      ‘Saturday morning—I was going sailing on the harbour with some mates from the UK, and what happens? The slavedriver drags us all into work.’

      When Annie went in, Phil was sitting in the office, drinking a cup of coffee from the machine she’d had installed to feed Alex’s habit. She smiled at Phil’s grumble, made a note about phoning the DON, then asked who else was coming.

      ‘Not Maggie. She had the good sense to get out of town for the weekend. Alex has got some hospital anaesthetist—with paediatric experience—so we should be OK.’

      ‘And Kurt?’

      ‘Yes, he’ll be here. As a matter of fact, I think Kurt sleeps with his machine, and as it’s now fitted in Theatre here, he was probably asleep beside it when the call came.’

      Phil was still grumbling when they moved to the little lecture room, where Alex had already drawn a diagram of Amy Carter’s heart on the whiteboard. With simple words, and an economy of description, he outlined what he intended doing, pointed to the spots where trouble could be expected then asked for questions.

      ‘I saw the X-rays,’ Phil said, surprising Annie, who thought he’d been mooching in her office since his arrival. ‘There seemed to be a lot of scarring on the heart—far more than there should be if the duct was inserted through a thoracotomy.’

      Alex sighed.

      ‘You’re right. I looked at it with Annie, and hoped I was wrong, but I’ve just received another file—fortunately, her parents had kept a comprehensive one as they moved from hospital to hospital. She’s had two operations already. The first tube became compromised and they opened up her chest. We’re going to be going through a lot of scar tissue, both outside and inside.’

      ‘So we don’t really know what we’ll find in there,’ the registrar suggested, and Alex agreed.

      ‘Expect the worst in these situations,’ he said, ‘then if things aren’t as bad, you’re pleasantly surprised.’

      ‘And if it is the worst?’ Ned asked.

      ‘You have to remember that this little girl will die without the operation,’ Alex said carefully. ‘She may still die with it. I’ve just told her parents that. She could die on the table and we might not be able to save her. But we go into every operation confident of a positive outcome. If I didn’t feel that way, I wouldn’t do it.’

      This operation was different. Annie felt it in the tension that vibrated around the room, and heard it in the quiet swear words Alex and Phil were both muttering into their masks.

      She could see for herself the difference between Alexander Ross’s heart and the scarred, gristly organ little Amy was carrying inside her chest.

      Alex, no doubt conscious of the registrar and his need to learn and understand, explained things as he went—explained what should be happening, and how little Amy’s tiny heart should be configured, cursing only when he found too many anomalies.

      ‘The problem is the heart has compensated for its weakness. The coronary arteries, feeding blood to the heart muscle, were compromised when the shunt was put in, so the body has grown new vessels and now we’ve this bizarre network and can’t be sure what we can safely touch.’

      He bent his head to his work again, then added, ‘Touch none of them is the rule in these cases. If you don’t know what it is, don’t touch it.’

      Four hours later Alex thanked them all and left the theatre. Ned helped Annie down from her stool, and she followed Alex out, passing him as he packed away his loupe and light just outside the door.

      ‘Annie!’

      She stopped and turned towards him. The equipment he’d been wearing had left parts of his face reddened and his cheeks were drawn. He looked exhausted.

      ‘Are you doing anything now?’

      ‘Right now? Going to my office.’

      ‘After that—are you busy?’

      He paused and rubbed at the red marks on his face as if they bothered him.

      ‘I know you have a life, and you have no obligations to me, but…’ Another hesitation, then he said, ‘I don’t know the area. I have to shop or Phil and I will starve to death over the weekend. I need a guide to help me get my bearings.’

      Annie’s turn to hesitate.

      It wasn’t much to ask, but it would put her in his company for the rest of the day.

      ‘I’ve promised Henry a walk,’ she said, and saw Alex smile.

      ‘But that’s great. Minnie needs a walk as well, and though I’ve seen the park down the road, I don’t know where dogs can or can’t go. We’ll walk them both and then we’ll shop, grab some lunch somewhere along the way. I’ll change, see Amy’s parents, then collect you from the office and we can go home together.’

      Go home together! The three words rang in Annie’s ears, prompting a surge of loneliness.

      But she wasn’t going to be seduced by words or loneliness. This was a business proposition. They’d walk their dogs—presuming Minnie was a dog—then shop, and that was it.

      ‘I’m worried about that baby.’

      Alex’s opening remark as they left the office reassured Annie. The business side of things had been confirmed.

      ‘She’s been through so much,’ he continued, putting his hand behind Annie’s back to steer her into the lift. ‘And she was really down when she came in. Can a child in such a debilitated state survive another major operation?’

      ‘But you must have seen so many children like Amy. There must be plenty of cases where you’ve been called in after a previous operation hasn’t worked.’

      He nodded, and escorted her out of the lift.

      ‘Of course, but I still worry every time. It’s one of the reasons I’d like to see more trained paediatric cardiac surgeries, and units set up specifically to handle congenital heart disease. CHD is the most common of all congenital conditions and the long-term survival rate of children who have surgery is excellent. It’s not a question of allocating blame in an operation that’s gone wrong. I understand the difficulties a cardiac surgeon who operates on adults ninety-nine per cent of the time must face when he sees a neonatal heart. But it needn’t happen—he wouldn’t be forced to operate—if there was a paediatric cardiac surgeon within reach.’

      ‘But would that have made a difference to Amy? Having someone more skilled to do the op?’

      They were outside the hospital now, walking towards the crossing, and Alex paused and looked down at Annie.

      ‘Are you really interested or just making conversation?’ His voice made a demand of the question and she frowned at him.

      ‘Of course I’m interested. What are you thinking? That I’m asking questions so I’ll sound interested in your job? That it’s a way of showing interest in you? As if!’ Scorn poured like hot oil over the words. ‘I’d like to remind you that it’s my unit, too, but I can’t run it effectively if I don’t know as much

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