17

“So what do you expect to find when you open him up?” Mel tentatively directed her question to Silas. The query was posed more as a display of acquiescence for the benefit of the listening guards in order to allay suspicion that discussion had been taking place on their determination to escape.

Silas recognised her ploy and submitted to her change of tactic. “In all probability, it’ll be a leaking spleen, but there could be damage to other tissue, liver or gut, maybe.” He turned suddenly and confronted Mel, crossing his arms. “Tell me, nurse, what do you know about the spleen? Describe it to me,” he fired.

“Er, well,” began Mel, taken completely off guard. Suddenly she felt her credibility was at stake. She swallowed hard. “Well, it’s purplish in colour; about 12 cms long by, roughly, 6 or 7 cms. Weighs nearly half a pound.”

“More. Where is it? What does it do? No good expecting to assist with an operation you know nothing about!”

Mel couldn’t tell from his aggressive counterblast whether he was attempting to impose his superiority over her or prove to the spectators the foolhardiness of the project. She stood her ground. Meekly, she replied, “It’s positioned between the pancreas and the left kidney, superiorly and posteriorly to the diaphragm.”

“And...”

“It’s encased in a capsule under the peritoneum. It’s a reservoir for blood mostly. It’s where antibodies and antitoxins are made.” Mel was fast running out of anything else to say about it, although she thought it might have other functions as well.

“Not bad,” Silas conceded. “All we’ve got to do is get the bloody thing out in the sterility of a theatre built to be a pig sty!” He threw a glance at the two guards, who instantly averted their gaze.

Maddie and Hood returned to the room. This time Hood brought with him a pile of blue theatre scrubs, which he almost threw down onto the first chair he came to.

“You first.” Maddie directed her words to Mel. “Take a set of these and come with me.”

Almost relieved to be excused from Silas’s examination, Mel obediently selected a pair of medium sized scrubs from the pile and followed Maddie from the room, skirting round the big guard whom, she observed, now displayed a healthy growth of grey stubble. He had clearly not shaved since abducting her two days earlier. There was a little satisfaction to note that their facilities in the old priory had not offered greater creature comforts than they themselves had experienced.

It was warm in the flat. Hood’s menacing face now exhibited glistening droplets of perspiration on his deep forehead. Mel was more frightened of him than any of the others. The huge man, the boss, with his cold reptilian eyes and aggressive manner, was fearsome enough when surrounded by his henchmen, but she felt would be physically incapable of moving quickly. That man at least, she thought to herself, would be unable to pursue them if they did manage to make a run for it.

Along the hallway, Mel was ushered into a large family bathroom with blue painted walls and white tiles and included a shower cubicle amongst its sanitary-ware. She heard the door locked with a key from the outside and was left alone to shower and change. Immediately she crossed the room to examine the sash window, but as expected, this was also locked. Electric shavers had been provided for the men and a pile of clean white towels stood like a tower on a painted wooden chair next to the washbasin.

Refreshed from the shower and wearing the new attire, she knocked on the door, which was immediately opened by her charge. Without speaking, her bundle of clothes was roughly taken from her and she was returned to the lounge. In turn, all three enjoyed the refreshing hot water and soap, each lingering in its indulgence as it washed away the filth and grime of the previous days torment.

The coffee, shower and shave transformed Silas. Gone was the dark unshaven stubble. His short, dark hair was again shiny and neat. Comfortable in theatre scrubs, he again walked with head held high, his self-esteem restored. Clive, the last to take advantage of the amenities, still looked anxious. The blue and yellow ochre of bruising now spread down one side of his face, a physical reminder, if one were needed, that their change in surroundings did not necessarily herald a change in their precarious situation.

Escorted back down to the ground floor, they were shown into an enclosed section in the rear extension of the building. Clinical disinfectant filled the air, pleasing the senses with its atmosphere of cleanliness. The area housed a series of clinical rooms, each exposed by an open white painted door. All rooms were light but Mel noticed sadly that the long rectangular windows were well above head height and two further large supplementary roof windows to the building’s flat extension were sealed units with no means of opening. There would not be much chance to break out of there, then.

They first passed a treatment room, equipped for minor dressings, dentistry and nail clippings of small animals. Next, was a large walk-in store-cupboard containing floor to ceiling shelves, brimming with boxes and packets of dressings, sterile instruments and medicines. The window to this room, Mel noticed, was level with the upper-most shelf, a stash of boxes shielding most of the natural light.

In contrast to the well-stocked storeroom, the room labelled ‘Intensive Care’ was barren and showed no testament to the recent habitation of patients. Lined along both sides of a square room, gleaming metal animal cages, varying in size, lay empty and clean. Clipboards to chart individual treatments and feeding regimes hung in preparation for the unwitting casualties of the small animal kingdom. The floor was tiled and spotless.

The question of the complete or temporary abandonment of the premises by its owners crossed Mel’s mind. Such an establishment would warrant a number of staff and an on-going clientele, unless the practice was up for sale or the business closed down. There was, however, just as she had experienced upstairs in the flat, an atmosphere in the building, a presence even, which suggested that occupancy was very recent. Had this been a fortuitous find by the gang, or had its acquisition a more sinister background? The silent cages and absence of animal smells or overlooked hairs were an example of meticulous cleaning that even a hospital would have been proud. Lastly, and distinguished by a red line painted across the passageway, were two small operating theatres, separated from each other by a flimsy Perspex partition, and each measuring approximately two meters by three. Glossy cream painted walls and polished grey flagstone tiles gave a creditable hygienic environment for the surgical treatment of its small patients. An orthodox kitchen sink sufficed for hand washing. Stainless steel troughs, with long-handled taps were seemingly unnecessary in this setting. It was like a miniaturised hospital department, perfect for its intended purpose, but too small and inadequate for an operation on a human.

Clive was instinctively drawn to one of the anaesthetic machines, positioned beside an operating table. Lifting off one of the green linen dust covers, which were draped over each machine, he stood back to appraise the equipment. Supplied with oxygen from two E-size cylinders, it had no means of positive pressure ventilation to sustain the respirations of their unconscious patients. Animals, seldom requiring the use of muscle relaxants, except during chest surgery, were provided with a small continuous supply of oxygen mixed with an anaesthetic agent and were thus able to spontaneously breathe throughout their procedure. This would not be the case for Charlie. Clive examined the equipment grimly. Whatever equipment he had hoped would be provided, this was not it. On the central shelf of the machine, a row of rubber endotracheal tubes for the management of animal airways, ranging in sizes suitable for large dogs to small mammals, were neatly covered over with a paper towel in preparation for use. The Bain circuit elephant tubing, for the delivery of the gases, was at least the normal size. However, the re-breathe reservoir bag attached to it was again a miniature version of that needed for an adult male. Clive looked despairingly towards Silas but his attention was absorbed with the inspection of the operating tables.

Each table, only two feet in width and approximately five feet in length, was a simplified version of that used in hospital operating theatres. A thin firm mattress, encased in a vinyl cover, lay on the metal surface of the table, the height of which could be moderately adjusted by a foot pedal at the base of the central stand.

“This has to be some kind of joke!” exploded Silas, no longer able to contain his decorum. “You can’t seriously expect me to operate on a human being on this!” He slammed both fists down onto the table, his knuckles white with the tension. Quiet and unnaturally subdued for so long, the old fire was back in his belly and Mel was surprised to realise she almost felt relieved. He wasn’t going to take this insult to his professional pride without a fight, but at the same time she feared his resistance might come at a cost. Clive still bore the marks from just such a confrontation. She held her breath as she watched the surgeon walk round the table, extending his arms to their full extent to demonstrate the confinement of the small room.

Maddie looked unperturbed by his behaviour. Standing in the doorway, arms folded, she scowled at Silas and spoke slowly and deliberately. “The partition between the theatres is removable. You have one hour to set up and get ready. Charlie is in a room down the corridor. When you are ready, we will bring him in to you. The bags with all your equipment have been placed in the storeroom next door. Anything else you find useful, you may use. I’m sure the owner won’t mind,” she sneered and with a toss of her head turned to leave.

“Wait a minute!” Silas yelled after her. “He’ll die if we do it here,” he protested angrily. “For God’s sake woman, think about the man you’re trying to save. This place is for animals, not humans. I mean it; he’ll die here if we operate in this place.”

“Then he won’t be the only one, will he?” she called over her shoulder and, leaving Hood to stand guard inside the door to the department, closed it with a bang and they heard the unmistakable rattle of the key as it turned in the lock.

The trio looked from one to the other in dismay.

“We should never have let it get to this,” Silas continued to complained, ignoring the presence of their guard. If we do it, we’ll break every rule in the book. Probably get done for murder. If we don’t we’ll likely get shot anyway. Wyatt Earp over there,” he indicated to Hood with a nod of his head, “looks like he can’t wait to use us as targets in a firing range.”

“For goodness sake,” pleaded Mel, “we don’t have a choice. Let’s just get on with it and do the best we can.”

“Like living dangerously, do you?” Silas barked. “You’re probably down for two murders already; I suppose one more won’t make much difference to you.”

“That’s enough!” bawled Clive. “If we fight amongst ourselves, we stand no chance. We’ve got to work as a team. I think Mel’s right; we don’t have a choice. So let’s calm down and try and make the best of what we’ve got.”

“Well you would say that, wouldn’t you,” Silas spat between clenched teeth. He glared vehemently at his colleague before diverting his eyes to Mel, who instantly recognised the implications of his last statement.

Mel stepped away from the two men and turned to face them. “Look,” she began tentatively, “whether either or both of you were taken from your hospitals because they knew you, I don’t know, but I was taken at random. They hadn’t got a clue about me except that I was some sort of theatre nurse when they snatched me. Frankly I don’t much care about unsupported accusations between you two. I’ve got parents at home who will be worried sick by now; I’ve lost my holiday and if I’m held responsible for the shooting of that man last night, then I’ve probably lost my job and registration as a nurse as well. I just want to get out of here alive. If that means I have to go through with this pantomime, then that’s what I want to do. I can’t take much more.” Her voice trailed away. She did not want to cry, but she felt the tightness in her throat as she fought back tears. For several moments an awkward silence reigned.

“Best get on with it then,” Silas said softly. “Can’t have you blubbing all over the place.” He walked across to the partition wall to examine how it could be removed in order to extend the size of the room.

“We’ll be fine, don’t worry.” Clive crossed over to Mel and placing both arms around her, held her tightly against his chest. Mel swallowed hard, and took a deep breath, controlling the urge to openly weep.

“This will slide out,” interrupted Silas, who was already gripping the lower part of the partition and pulling it towards him. “If you grab a hold of the other end, I think we can lift it out of its runner. It’s only held along the top and fixed into a groove down the wall, but it’s heavy. We’ll have to try and stand it along the wall in the corridor by the storeroom.”

Clive released his embrace and they both went to the aid of their colleague. Once removed, the long rectangular space would at least allow them to move around in the theatre without fear of touching the walls. Mel released the brake on one of the tables and pushed them together.

“If we position one across the top end of the other, into a ‘T’ shape,” she suggested, “we should be able to get the length we need and extend his arms. We’ll need something to tie the two tables together though.”

Without further reference to or indication of the tensions before, the three quietly set about preparing the area for the operation. Hot water and cleaning solutions at one of the sinks enabled Mel to wash down the two tables, standing the mattresses on their sides to dry. After scrubbing out the second sink, she found a small trolley on which she placed the sterile gowns and glove packs in readiness for herself and Silas to use. Four smaller instrument trolleys were located in the storeroom and these were also claimed and washed ready for use.

Clive applied himself to the adaptation and improvement of one of the anaesthetic machines. Using a makeshift connector, he was able to incorporate the cylinder of nitrous oxide to the tubing that supplied oxygen from the two cylinders attached to the machine. Discovering an adult sized Bain circuit and re-breathe bag in one of the yellow sacks, he exchanged the items and switched on the gases for an elementary test. From the storeroom he lined up more new cylinders as back-up for those in use. Clearing the row of rubber tubes from the shelf of the anaesthetic machine, he laid out the drugs and more familiar adult endotracheal tubes from their stolen goods.

Silas, using one of the trolleys cleaned by Mel, laid the large metal instrument pack on its upper surface. Frustrated that he could not open the tray until the operation was imminent, he searched in the storeroom until he found some twine with which to fasten the two operating tables together. This achieved, he brought into the theatre a bag containing a sterile metal bowl and a large yellow clinical waste sack, identical to the ones in which the stolen goods had been carried.

Leaning back against a wall with arms crossed, he surveyed the surroundings with a modicum of satisfaction. Staring down towards his dirty shoes, he remained transfixed in thought for several minutes. “How are you doing, Clive?” he asked eventually. “Will it do the job?”

The strain between the two doctors appeared, at least temporarily, to have dissipated.

“Depends how long you take,” Clive responded without looking up. “Without a ventilator, I’ll have to manually bag oxygen into the patient throughout the operation.”

“Bugger. That means you won’t be able to leave the head-end at all once he’s asleep. We’re going to need another pair of hands. With Mel scrubbed with me, someone will have to act as circulator.”

“We could ask if Danny can help us, then,” interjected Mel as she set out the hand wash solutions by one of the sinks.

“Not a good idea to have one of them helping, is it? No, I’m not happy about that.”

“Well, we need someone to fetch things and open packs for us. Better it’s him than any of the others,” replied Mel, glancing at Hood who had remained motionless throughout by the outer door, his arms crossed and feet splayed apart. His grisly face showed no emotion and she was uncertain how much attention he had been paying to their conversation. There was something about Hood’s demeanour that his very presence unnerved Mel even more than the other members of the gang. It wasn’t just his size and solid muscular physique, which she had already painfully experienced, but more his silent menacing composure, like a tiger poised awaiting the moment to attack. He seldom spoke and then only brief commands.

Mel emptied the contents of the yellow bags onto an empty trolley, piling onto its lower shelf the litre bags of intravenous fluids. Handling the yellow bags again, she was unable to suppress the memory of the shooting and their escape from the hospital with the stolen goods. Kurt had shot the man in cold blood and his own demise had been no less brutal. She tried to force it from her mind; she had to.

Silas took the opportunity to describe to Mel every action and detail of the planned operation. He paced the floor distractedly as he spoke, pausing occasionally to clarify a point or ask whether she had understood. His demeanour transformed from agitated resentment to dedicated enthusiasm as he became engrossed in the concentrated coaching in a piece-by-piece tutorial, even appearing to be unconsciously relishing in such a challenge.

There seemed so much to remember. Mel was familiar with the basics of theatre etiquette, but whether she could remember the names of all the fifty or so instruments and the order in which they were to be used, would test both her memory and Silas’s patience. He had nodded with satisfaction at the assortment of sterile dressings, sutures and additional packs of gauze swabs, which had been acquired to supplement the main set, but it was too late now for any items that had been overlooked.

“I think I’m about as ready as I can be,” Clive solemnly surveyed the rows of syringes, drug ampoules and bags of intravenous fluids which he had laid out on one of the trolleys next to the anaesthetic machine. He had obtained a monitor for pulse oximetry from the veterinary storeroom which, attached to Charlie’s ear, would detect his heart rate and measure the level of oxygen in his circulation. Regrettably, the lack of electronic means to measure blood pressure would add to the difficulty of the anaesthetic by necessitating regular manual measurement using a stethoscope and an old traditional mercury blood pressure monitor which he had found in one of the storerooms. He stood, grinding one fist into the other, silently calculating the needs and process of what looked to be a challenging and very hazardous anaesthetic. With so much time lost already, there was every possibility that Charlie’s health had already deteriorated too far to enable him to survive such an anaesthetic, let alone the surgery.

Silas approached Hood and stood facing the guard in a confrontational pose. “I want to speak with whoever is in charge of this monkey farm,” he declared provocatively.

“Get back away from this door, then.” He knocked the door behind him with the butt of his revolver, more as a demonstration of his power than the necessity to make a loud noise. The door was opened almost immediately and Maddie reappeared.

Silas glowered at the woman, his jaw set tight. “I don’t wish to communicate with you, woman. I want to speak with whoever is in charge.”

For a moment Maddie held his stare, incensed by his disparaging demand. She looked about to say something, paused and instead retreated from the room, cursing under her breath. A few minutes later they heard the shuffling gait of the big fat man as he responded to the request.

“Are you ready?” he puffed, perspiration shining on his forehead. “Let’s get on with this.”

“The anaesthetic is going to be difficult without the more sophisticated equipment that we’re used to. So we can’t proceed without more assistance. Therefore, we want to use Danny to pass things to us once we get started. Without another pair of hands, it will be impossible for us to carry on.” Silas glared coldly at the mountainous man, prepared to assert his demands. “He will have to shower and change into theatre scrubs. As soon as we’ve told him what we need him to do, we can start.”

“If this is just another time-wasting exercise, you’ll regret it. My patience is fast running out.”

“We’re doing everything you’ve asked. All we want is someone to help us. It’s up to you. How much do you want Charlie to survive this operation?”

The big man turned and shambled out of the room. Fifteen minutes passed before an anxious looking Danny presented himself to the team, accompanied by Maddie. Looking uncomfortable in the unfamiliar attire, he fidgeted awkwardly as he looked from one to the other before fixing his gaze upon the empty operating table, as though he were in the presence of empty gallows awaiting a condemned man. They were waiting for his father. His commitment to the care of his father and the long hours spent anxiously at his bedside had drained him and now the expectation that he should participate at his father’s operation put fear on the face of the young man. How much could he trust these strangers who had been subjected to such violence and imprisonment? They wouldn’t care if he lived or died. He looked as if he were about to be sick.

Observing his distress, Mel was the first to step forward, smiling. “Thank you for coming to help.” She knew he had been given no choice in the matter, but felt his co-operation had to be encouraged. “When we start,” she continued, “none of us will be able to leave what we are doing. I am going to scrub with the surgeon. That means neither of us will be able to touch anything that is not sterile until the end of the operation. Clive here will be looking after Charlie throughout the operation, keeping him anaesthetised and managing his breathing. That means that you will have to open some of our packs and help me count all the swabs and needles to make sure we finish with everything we started with.”

Danny looked even paler and apprehensive. A fleeting thought struck Mel that he might just faint when the opening incision was made into his father’s abdomen, but brushed it quickly aside, preferring not to consider yet more possible complications. He was part of a tough gang, she assured herself, and so such a sign of weakness would hardly be tolerated by the other members of the gang.

Clive and Silas waited patiently while Mel spent several minutes demonstrating to the young man the correct way to strip open a package and tip it forwards onto her trolley without touching the contents with his fingers. They used a couple of dressing packs from the storeroom for practise and when satisfied that he was competent to assist, Mel nodded to Silas that they were ready.

Silas approached Hood, this time ignoring Maddie’s presence completely. “Right, then,” he commanded, almost appearing to enjoy his temporary superiority, “you’d better send for our patient.”