“WILL I BE in here over Christmas?” Lord Twinsbury demanded. “I can’t be in here over the holidays.”
“I’m afraid so,” Thomas said as he finished his examination. “You’re not healing as quickly as I’d like and you’re still not ready to go home. You’ve had two open heart surgeries in the course of a couple of weeks. You need to stay in the hospital. So I’m afraid you’ll be here for Christmas.”
“Blast, I didn’t want to miss the carols from King’s College at Cambridge. It’s important I attend.”
“Understandable, but you’re staying put.”
Lord Twinsbury groaned. “You, of course, wouldn’t understand. You’re an Oxford man.”
“Oxford or Cambridge makes no difference. You’re recovering from surgery.” Thomas leaned over. “Oxford is the far superior university anyway. You should know that.”
“Young pup, if I weren’t laid up...”
Thomas cocked an eyebrow. “You’d do what? Tan my hide? I think I can outrun you.”
Lord Twinsbury huffed grumpily.
There was a knock at the door and Thomas turned to see Geraldine standing there. It had only been a couple of days, but his heart skipped a beat seeing her standing there in her business clothes and her pristine white lab coat.
“Am I interrupting?” she asked.
“Ah, now there’s a sight for sore eyes!” Lord Twinsbury exclaimed with delight.
“Lionel, you flatter me,” she said sweetly.
“Nonsense, you’re a damn sight better than the duke here,” Lord Twinsbury grumbled.
“That’s Mr. Ashwood, my lord,” Thomas corrected him.
“Can I speak with you, Mr. Ashwood, about a case?” Geraldine asked.
“Of course.” He was glad to get away from Lord Twinsbury’s complaining.
“Please come and see me afterward, my lady. Your visits make my day.”
Thomas rolled his eyes.
“I will try, Lionel.” Geraldine shut the door when Thomas was in the hall. “I’m sorry for pulling you away from your rounds, but I had a referral from a general practitioner in Aylesbury of a pregnant woman who has suffered a myocardial infarction.”
“Your mother is dead, Thomas. So is the baby. They’re gone and crying won’t bring them back.”
His father’s harsh words haunted him. It had been at that moment his father had turned his back on him. Resented him for being like her. All Thomas had wanted was the comfort of his father when his mother had died, but he’d been denied it. Instead he’d been sent to boarding school. The day his mother had died had been the day he’d really lost both of his parents.
There had never been a chance for him or his father to make things right between them. The day Zoe had been born with the atrial septal defect and had almost died, his father had tossed him out of the room.
“Haven’t you haunted me enough?”
It was almost as if his father had been blaming him for Zoe almost dying at birth. It’s why Zoe’s mother had walked away from his father and instead had became the surrogate of the parent he’d never had. His father had resented him for that too.
And they’d never had a chance to resolve anything. His father had hated him until the day he’d died, when Zoe had been ten.
At least his father had loved Zoe. That was at least something. Her life wasn’t as devoid of love as his had been.
“I’m sorry?” Thomas said. His father’s voice had drowned out Geraldine’s words. The moment she’d mentioned a pregnant patient who had suffered a myocardial infarction he’d been taken back to that terrible day long ago when his father had told him his mother wasn’t coming home.
“How is she?”
“I don’t know, other than stable. She’s in an ambulance on the way here. She’s too far along in her pregnancy to be flown in. She’s thirty-one weeks and could be on the verge of pre-eclampsia as well. They’re trying to keep the baby in there as long as possible, but I have Obstetrics on standby as well.”
“What is their plan?”
“Save the baby and then assess the mother.”
Thomas nodded. “I can have my fellow finish rounds on my surgical patients and I’ll go down to Accident and Emergency and wait for her arrival.”
“Thank you. Hopefully she won’t need extensive surgery on her heart.”
“She’ll need a heart catheterization, that much I know. I need to see the extent of the damage, but I want to be in that operating theater to watch her vitals.”
“Yes, that’s what the obstetric team is hoping for. As she’s my patient now, I insisted on you taking care of her. I hope you don’t mind.”
“Mind? No, that’s why we’re in practice together.”
“Yes.” She glanced down at her pager. “They’ll be arriving shortly. Shall we?”
“Let’s go.”
Thomas led the way down to A and E. The obstetrics team was standing by. They were going to deliver that baby so that Thomas could take over.
Focus.
This situation wasn’t as dire as his mother’s had been. His mother’s heart attack had been fatal and his brother had been too young to survive outside the womb at twenty-one weeks. Even now, with all the technological advances, babies still rarely survived if they were born that early.
At least this patient’s baby was thirty weeks. Still premature, still a fight ahead, but the percentages on surviving were far greater than they’d been thirty-odd years ago.
The ambulance pulled up and they went to work. Geraldine met the paramedics and the general practitioner, who had ridden with his patient from Aylesbury. He was explaining the situation to Geraldine, which was good. Then he could focus on taking care of the patient’s heart as the obstetrics team dealt with the baby.
“She had another heart attack, minor, but another nonetheless on the way here. Her blood pressure is far too high to have flown her in.” Thomas heard the general practitioner say.
“We need to get this baby out of her so I can address her heart,” Thomas said above the din.
“Get her to a theater now,” Mr Jones, the obstetrician, shouted to a resident. “Have the team prepare for a crash C-section.”
Thomas took her blood pressure and it was dangerously high, the heart sounding like it was fighting to pump blood through her body. Even if they had stabilized her, the baby wouldn’t survive with the mother’s heart struggling so much.
From what he was seeing, she needed open heart surgery and she needed it now. Her heart was failing. It sounded like an enlarged heart. Cardiomyopathy.
Damn.
They rushed her to the operating theater and he set up all his monitors, the crash cart ready and standing by. It wouldn’t take long to get the baby out and that was a blessing, especially if he needed to get in there and massage the heart or shock the mother’s heart back into rhythm.
This operating theater didn’t have a gallery, because no one needed to witness this. This was a possible tragedy in the making, but he wished that Geraldine was beside him. Right now he was a horrible mess of emotions.
Live. Just live.
Instead of his patient on the table, he saw his mother.
“Thomas, I love you.” His mother’s voice was in his head as he watched his patient. He hadn’t heard his mother’s voice in so long. He’d thought he’d forgotten it, but it came to him now and he closed his eyes, listening to the heart monitor. Willing his patient to live.
Live.
The jostling from the C-section played merry havoc with the heart monitors, but so far she was not having another heart attack. Which was good. In less than five minutes he heard the tiny wail of a premature boy as he was lifted up and placed into the hands of the waiting pediatric team.
Thomas smiled behind his mask and then whispered to his patient, who was under anesthesia, “It’s a boy. You have a boy, you need to pull through.”
“How is her heart, Mr. Ashwood?” Mr. Jones asked.
“Stable for now, Mr. Jones.”
Mr. Jones nodded and continued his work on their patient. At least the baby was out and had a good fighting chance to survive. Thomas’s job was making sure that the mother also had a fighting chance.
He was going to save that baby boy’s mother, because he’d been unable to save his own.
* * *
Geraldine saw that Thomas was still sitting in the room of Mrs. Rimes, their patient who had been pregnant and who’d suffered two heart attacks.
“How is she doing?”
Thomas looked up. “Stable. She had massive damage to her heart and has severe cardiomyopathy. At least with the delivery of the baby she won’t succumb to eclampsia.”
“What do you think it was?”
“Arrhythmogenic right ventricular dysplasia.”
“You’re certain?”
He nodded. “She’s at a risk for the rest of her life. When she recovers from her surgery I’ll speak to her about her options, in particular implanting a device that will shock her heart should it happen again. And it will happen again.”
“Poor woman.”
Thomas got up and walked out of her room, shutting the door. “How is the baby?”
“Doing well,” Geraldine said.
“Good.” He scrubbed a hand over his face.
“Are you okay?”
“No, it hits a little too close to home for me. All I could hear was my father’s voice in my head, telling me my mother was dead, when you came to tell me about our patient.”
Geraldine reached out and touched his arm. She could see his pain again. Like the pain he’d had when Zoe had been in the heart catheterization lab. She couldn’t even begin to comprehend what he was going through.
“I need to get a coffee. Would you care to join me?” Thomas asked.
“Of course.” They walked toward the small coffee shop that was located in the hospital. Thomas ordered them a couple of cups of coffee and they sat down at a table. It wasn’t busy in the coffee shop and that was fine by her.
“I’m so sorry this situation reminded you of your mother,” she said.
“It’s why I became a heart surgeon. I think we all have a reason why we become what we become. Why did you become a cardiologist? Was it because of your father?”
“No,” Geri said quickly. “No, not at all.” She was uncomfortable discussing this. It was hard to step back and not be in the operating theater where she belonged. She felt useless and helpless. Almost worthless.
Thomas cocked his head to one side. “You said that with such conviction.”
“Well, I didn’t know about him and he didn’t know about me until last year. No, my decision to be a cardiologist was because I wanted to save lives. But I’m not cut out for the operating theater.”
“I disagree,” he said.
“Why?”
“You’re stronger than you give yourself credit for.”
Geri wished she could believe that. “Well, it wasn’t in the cards.”
And she hoped that would stop the conversation.
“I’m surprised that you didn’t become a surgeon.”
I wanted to.
“I wasn’t made for surgery.”
Liar.
“What makes you think that? You didn’t shy away in the operating theater when Lord Twinsbury was having his surgery. You thought quickly with that suggestion about the umbilical vein. I think, given your drive, that you belong in the operating theater, as I’ve said before. I think you’re made for it.”
Geri sighed. “Well, it’s a little too late for that. I’m a cardiologist and I’m taking over my father’s practice.”
“It’s never too late.”
“I’m happy as a cardiologist.” She took a sip of her coffee. Then she changed the subject. “How is Zoe doing? Is she enjoying her Christmas tree?”
“She’s doing well and, yes, she’s enjoying her tree. I’m not, for the record.”
Geri chuckled. “Why am I not surprised? How can anyone not enjoy a Christmas tree?”
“It sheds. It’s worse than my grandmother’s Pomeranian, which shed everywhere.”
“How can a tree be worse than a dog?”
“It can.” As he winked at her, his pager went off. “Our patient is awake and her husband has been waiting very patiently in the waiting room. I’ll counsel them on the next steps.”
“I look forward to reading your report so I can continue guidance on the matter as well.”
Thomas nodded.
She should head back to the office. There was nothing more she could do here. She wasn’t a surgeon. There were times she regretted running away, taking the easy way out, like now, and like what had happened with Zoe. But that was her burden to bear.
No one else’s. It was all hers.
Despite what Thomas had said, it was too late for her to continue with her specialization. She would never be a surgeon. It’s just the way it was and she was okay with that.
Though she had the feeling that Thomas didn’t believe her.
And she didn’t know why. It shouldn’t matter to him. Why did he want her to become a surgeon anyway? There wasn’t room in the practice for two surgeons. Did he want her to be competition?
Geri shook her head and threw her empty coffee cup in the garbage. She’d head back to Harley Street and wait for Thomas’s report on their new patient, because when she no longer needed the surgeon that’s when Geri had a chance to help save a life.