THE operation took longer they any of them had expected, the baby’s left atrium being small and under-developed, so in the end Alex had to splice the four pulmonary veins so he ended up with only two, then use another shunt to join them, attaching it to the tiny heart.
‘It’s a damn shame,’ he said much later when he’d seen the baby’s parents and had returned to where most of the team were gathered, holding a general debriefing. ‘It means she’ll need more operations as she grows, because the shunts won’t grow with her.’
‘I know you can use tissue from the baby to make patches,’ Maggie said, her hands cupped around a mug of coffee. ‘Could you also use a vessel from the baby instead of a shunt?’
‘I’ve used veins taken from another part of the body for a small repair but for a vein as large as the pulmonary vein, I’ve never tried it,’ Luca said, looking enquiringly at Alex.
‘I have,’ Alex said, ‘and found it didn’t work as effectively as the shunt. Because it was small, and possibly because it didn’t like the insult of being transplanted from one site to another, it closed off almost immediately. Until we work out some way of successfully growing spare vessels inside the baby—which might not be that far away considering how science is advancing—then I believe we’re better using shunts. At least the subsequent operations to replace them shouldn’t require putting the patient on bypass.’
It was a fairly normal post-op conversation but there was nothing normal about Rachel’s feelings, sitting as she was next to Luca who’d pulled a chair up close to her desk.
This distraction had to stop. So far she’d been able to keep one hundred per cent focussed in Theatre, all but forgetting Luca was in the room, but if, as he’d suggested, she was one day called upon to assist him, even a tiny distraction could lead to trouble.
She was due time off. She’d take it. Get right away. Maybe even, if she could get a cheap flight, go home to the States.
She was planning this little holiday in her head when she realised Alex was talking again. Something about a trip to Melbourne.
‘I’m sorry, did you say you’re going away? Does that mean we’re all off duty for a few days?’ She couldn’t go home to the States for a few days but she could go north to somewhere warm—perhaps North Queensland.
Alex grinned at her.
‘No, it doesn’t mean you’re all off duty for a few days. I know you’re due time off, Rachel, but if you can just hang in for this week, I’m sure we can work something out after that.’
He paused and Rachel sensed something bad was coming—it was unlike Alex not to come right out with things.
‘Problem is, Phil, Maggie, Kurt and I are flying to Melbourne tomorrow to do this op. We’re taking an early morning flight, and will overnight there to make sure the baby’s stable before we leave, then be back about ten on Wednesday.’
‘Not me?’
She didn’t particularly want to go to Melbourne, but if the core of the team was going, why not her?
Alex smiled again.
‘It’s not that I wouldn’t like to take you—but you know you trained that theatre sister down there well enough to do your job. Besides, I need you to be here.’
Another hesitation, so Rachel prompted him.
‘You need me to be here?’
A nod this time—no smile.
‘I do indeed. We’ve an op scheduled for midday on the day we get back—a first-stage op for a baby born with HLHS—hypoplastic left heart syndrome. The Flying Marvels, that organisation of private plane owners who volunteer their time and planes, are flying the baby and his parents to Sydney early tomorrow morning. I need someone to do the briefing. Luca can explain the operation to them—what we’ll be doing—but I’d like you, Rach…’ his eyes met hers in silent apology ‘…to explain the post-op situation to them. What to expect when the baby comes out of Theatre—the tubes and drains and special equipment that will be protruding from his body.’
The words hit against her skin like sharp stones, but with the entire team looking at her with varying degrees of interest or concern, depending on how long they’d known her, she could hardly throw a tantrum and refuse Alex’s request. Especially as he wouldn’t have asked if there’d been any alternative! She’d be here, she knew his work, she knew exactly what the baby would be attached to when he left Theatre—so who better to explain?
‘No worries,’ she said, using a phrase she’d heard repeatedly during her time in Australia. And if her voice was hoarse and the words sounded less convincing than when an Aussie said them, that was too bad. It was the best she could do under the circumstances.
With duties handed out, the meeting broke up, though Alex signalled for Luca and Rachel to stay.
‘Luca, if you wouldn’t mind having dinner with Annie and me tonight, I’ll give you a run-through of how we do the procedure. Actually, Rachel, you should come too if you can. I’ll give Annie a quick call to let her know she has extra mouths to feed, then, Rachel, can I see you privately for a moment?’
Rachel nodded glumly, and watched him walk behind the partition that provided the only bit of privacy in the big room.
Luca turned to her.
‘Did I imagine something going on there, a tension in the air? Is Alex perhaps aware you don’t like to get involved with patients? If so, why is he asking you to do this?’
Luca’s dark eyes scanned her face and the sympathetic anxiety in them, and in his voice, weakened the small resolve Rachel had built up during a kiss-less day.
‘He’s asked because there’s no one else, and he wants to see me privately to give me a hug and say he’s sorry he had to ask.’
‘You know him so well?’
Rachel smiled at Luca’s incredulity.
‘On Alex’s team we’re a bit like family—a grown-up family that doesn’t live in each other’s pockets—but we’ve shared good times and bad times and we stick together through them all.’
Alex appeared as she finished this explanation and Luca politely left the room, though the scene panned out exactly as Rachel had foretold.
‘I’m sorry to ask you to do this,’ Alex said, giving her a big, warm hug.
‘That’s OK,’ Rachel told him, and though, deep in her heart she wasn’t at all sure it was OK, she was also beginning to think it was time!
‘You’ll be all right with it?’
She stepped back and looked at the man with whom she’d worked for a long time.
‘And if I’m not?’ she teased, then was sorry when she saw him frown.
‘Of course I’ll be all right,’ she hurried to assure him. ‘Quit worrying.’
He hugged her once again, but she doubted he’d obey her last command. Alex worried over the well-being of all his team.
She’d just have to prove herself tomorrow.
Or maybe she shouldn’t, because she certainly didn’t want this patient-contact stuff to become a habit…
Luca was waiting for them outside, and, though she could practically hear the questions he wanted to ask hammering away in his head, he said nothing, simply falling in beside her as they walked to the elevator, and staying close in a protective way that should have aggravated Rachel, but didn’t.
He held her jacket for her before they walked out into the cool spring air, and brushed his fingers against her neck. His touch sent desire spiralling through her, although she knew it was a touch of comfort not seduction.
This was madness. It was unbelievable that physical attraction could be so strong. And as surely as it fired her body, it numbed her mind so she had difficulty thinking clearly—or thinking at all a lot of the time!
So she didn’t. She walked between the two men, and let their conversation wash across her, enjoying the sharp bite of the southerly wind and the smell of smoke from wood fires in the air.
Annie greeted them as if she hadn’t seen them an hour or so earlier, and introduced Luca to her father, Rod, and Henry, her dog.
Henry, Rachel noticed, seem to approve of Luca, bumping his big head against Luca’s knee and looking up for more pats.
There’s no scientific proof that dogs are good judges of character, she told herself, but that didn’t stop her feeling pleased by Henry’s behaviour.
Which brought back thoughts of brain transplants…
Annie ordered them all to the table, already set with cutlery, plates and thick slices of crunchy bread piled high in a wicker basket in the middle. She then brought out a pot only slightly smaller than a cauldron, and set it on the table.
‘Lamb shanks braised with onions and cranberries,’ she announced. ‘Help yourselves, and take plenty of bread to mop up the juice.’
Discussion was forgotten as they tucked into the appetising meal, and it was only when they were all on second helpings that Alex began to explain exactly what the upcoming operation entailed.
‘It is the same procedure I use,’ Luca told him, when Alex had finished speaking. ‘I’m confident I can explain it well to the parents. I’ve seen you in action with explanations, remember, and I know you always tell the families of the problems that can arise during an operation, as well as the hoped-for outcomes.’
Alex nodded.
‘We talk about “informed decisions”,’ he said, ‘but I fail to see how parents can make informed decisions if they aren’t aware their child could die, or suffer brain or liver damage, during open-heart surgery. And it is equally important they know they will still have a very sick child after surgery, and be prepared to care for that child for however long it takes.’
‘In your experience, do most parents accept this?’ Luca asked. ‘Have you had parents who opted not to let you operate?’
Alex hesitated, his gaze flicking towards Rachel.
‘Many of them over the years,’ he admitted. ‘And I have to respect their decision, though in some cases I was sure the outcome would have been good. But family circumstances come into play as well. Not all families can afford a child who will need a series of operations and constant medical attention for the rest of his life, yet this is all we can offer them in some cases.’
‘It is a terrible choice, isn’t it?’ Luca said.
‘It is, but I refuse to end a pleasant evening on such a gloomy note,’ Annie declared. ‘Dad, tell us some murder stories—that’s far more fun.’
Rod, an ex-policeman who now wrote mysteries, obliged with some tales of bizarre and intriguing true-life cases from long ago.
‘Rod’s stories might not have been ideal dinner party conversation,’ Luca said, as Rachel guided him on a short cut home across a well-lit park, ‘but they got us away from that depressing conversation.’
He spoke lightly, but he’d been sitting beside Rachel at the dinner table and had felt her tension—which had begun back when Alex had asked her to speak to the patient’s parents—escalating during the meal. There was a story behind it and much as he wanted to know more, he was reluctant to ask, fearing it might break the fragile bond he believed was developing between them.
He glanced towards her. She was walking swiftly, her hands thrust deep in her jacket pockets, her head bent as if she had to concentrate on the path beneath her feet, but the unhappiness she was carrying was so strong it was like a dark aura around her body.
This was not the Rachel he knew, she of the glorious hair, and the sunny smile, and the smart remark. This was a person in torment, and her pain, unexpectedly, was reaching out and touching him. He could no more ignore it than he could refuse to help a child in trouble.
He put his arm around her and guided her to a seat in the shadow of a spreading tree. Her lack of resistance reassured him, and once they were seated he tucked her body close to his and smoothed his hand across her hair, holding her for a moment in the only way he knew to offer comfort.
‘Will you tell me what it is that hurts you so much? Why Alex had to give you a hug?’
She turned and looked at him, studying his face as if he were a stranger, then she looked away, back down at the ground, her body so tight with tension he was sure he could hear it crackling in the air around them.
Then she nodded, and he held his breath, wondering if she’d tell the truth or make up some story to stop him asking more.
But when it came he knew it was not make-believe, because every word was riven with raw pain.
‘Years ago, I was going out with this man. I found I was pregnant, we got married, the pregnancy was normal, the scans showed nothing, but the baby was early. I was staying with my parents at the time and had the baby in the local town hospital. He was diagnosed with HLHS, which was ironic considering I was working even then with Alex. Yet I hadn’t given having a baby with a congenital heart defect more than a passing thought. I haemorrhaged badly during the birth, and had blood dripping into me, and drugs numbing my mind, so the paediatrician spoke to my husband, explained the situation, told him to talk to me and think about the options, which included transferring the baby to Alex’s hospital. But that didn’t happen. My husband made the decision not to operate.’
Rachel’s voice had grown so faint Luca barely heard the final words, and he was repeating them to himself—and feeling something of the horror and loss Rachel must have experienced—when she spoke again.
‘It didn’t matter, as it turned out,’ she said harshly. ‘The baby died that night, before he could have been transferred.’
Dio! Luca thought, drawing the still-grieving woman closer to his side and pressing kisses of comfort, not desire, on the shining hair.
‘Oh, Rachel, what can I say?’ he said, and knew the emotion he was feeling had caused the gruffness in his voice. ‘You are a very special person. I knew this from your work, but to know your sorrow and see you helping other people’s babies, assisting them to live—that shows more courage than I would have. More than most people in the entire world would have.’
He felt the movement of her shoulders and knew she was shaking off his praise, and perhaps a little of her melancholy. Something she confirmed when she straightened up, moving away from him, and said, ‘It was four years ago. I don’t usually crack up like this. I guess Alex asking me to talk to the parents brought back memories I thought I’d put away for ever.’
‘No matter how deeply you might bury it in your brain, I doubt you could ever put the loss of a child completely away,’ Luca told her, hearing in his voice the echoes of his own buried memories.
She stood up and looked down at him, and even in the shadows he could see the sadness in the slow smile she offered him.
‘Maybe not,’ she said, ‘but you do get past thinking of it every minute of every day, so maybe now it’s time for me to get past seeing other babies who are ill, and thinking of my Reece.’
Luca stood up too, and took her hand, the clasp of a friend.
What happened to your husband? he wanted to ask. Her name was her own, he knew that, and she wore no ring. Had she divorced the man who’d made the decision not to try to save her baby? Because of that decision?
But surely, with his wife so ill as well, it could not be held against him, especially as the baby died anyway!
‘My husband visited me in hospital the next day,’ she said suddenly, making Luca wonder if he’d asked his question out loud. ‘He brought his girlfriend and explained that she, too, was pregnant, and he’d like a quickie divorce so he could marry her.’
She stopped again, and this time, in the light shed by a lamp beside the path, he saw mischief in the sadness of her smile.
‘I threw a bedpan at him. Best of all, I’d just used it. The pan hit him on the nose—I’d always been good at softball—but she didn’t escape the fallout. Petty revenge, I know, but it sure made me feel better.’
Luca put his arms around her and hugged her tight.
‘Remind me never to upset you when you have a scalpel in your hand,’ he teased.
Then they continued on their way, friends, he felt, not would-be lovers.
Not tonight!