| |
Harriet sobbed as everyone talked around her.
‘Let’s go, people.’ Gill’s authoritative tone was calm but urgent. ‘There’s a lot of blood. Joan, let’s get another line and rapidly infuse some O into her. Are you right to do the anaesthetic?’
‘Of course.’ Joan’s voice now. ‘What about you? You shouldn’t be operating on Harry. I can get Ben.’
‘No.’ Gill again. ‘He’s in the middle of his own amputation.’
‘You can swap.’
Joan’s voice was firm. But... ‘We don’t have time.’ Gill was emphatic. ‘I’m it. I’m doing it.’
All that swirled above her as the miserable implications dawned on Harriet. She’d been pregnant and now she wasn’t. And there was no time to ponder the details or grieve over a baby she had never known about because she was bleeding. A lot. And she knew ectopic pregnancy rupture was the highest cause of maternal death in the first trimester of pregnancy.
So, she could die.
And, if she survived? Then she’d probably never be able to conceive naturally again. It just wasn’t fair.
She clutched Gill’s arm to get his attention as he barked orders. ‘Promise me you’ll try and save the tube, Gill. Promise me. Don’t take away any chance I have of having a baby.’
He shut his eyes looking as bad, if not worse as he had earlier after the call about his grandfather. ‘Harry, I love you and I will try but right now I have to be a surgeon first and a husband second.’
Harriet knew that. She did. But. ‘Just try,’ she begged, her face screwing up as she choked on a sob. ‘Please, Gill. Please.’
‘I’ll try,’ he said tersely. ‘I have to go and scrub now.’ And he walked away.
The next few minutes passed in a blur as Helmut placed a mask on her face and connected her up to the monitor. She couldn’t stop crying. Even among the hustle and bustle all around her and amidst some of her dearest friends, she felt
totally alone.
‘I’m going to put you to sleep now, Harry,’ said Joan gently.
Harriet blinked as Joan’s blurry face appeared above her. ‘No, wait, Joan,’ said Harriet, pulling her mask off, desperate to garner more support. ‘Swear to me you’ll remind Gill of his promise.’
‘Harry...’ Joan was obviously torn between her medical training and Harriet’s tearful plea.
‘I will keep him to it,’ said Katya, her head appearing in
view now. The fierceness in her eyes was about the only thing Harriet could see thanks to the mask Katya was wearing.
‘Thank you, Katya,’ whispered Harriet, more hot tears pouring from her eyes.
She wanted to link hands to touch her friend and convey her gratitude, but even in this warm and fuzzy state she knew Katya was standing with her gloved hands clasped together and in close to her body which meant she was already scrubbed and sterile and therefore untouchable.
‘It’s time,’ said Joan gently, replacing the mask Harriet had removed.
Harriet nodded and swallowed another lump of emotion rising in her chest that threatened to overwhelm her. She pulled the
mask off again. She knew that things were touch and go with her and that she might not pull through. She didn’t want to leave without these people knowing how much they meant.
‘I love you guys,’ she said in a voice she had to force to be loud, a single tear squeezing out from the corner of an eye. She didn’t have the energy for grand speeches but at least she’d said what she’d needed to.
Everyone paused for a moment at Harriet’s words. Gill’s step faltered as he entered the theatre. Joan stopped mid-check of the laryngoscope. Helmut looked up from preparing drugs and Siobhan and Katya stopped their count. Every one of them knew what was on the line.
Harriet’s life was hanging in the balance.
––––––––
Gill recovered first. ‘Let’s go, people,’ he barked tersely.
The team resumed their duties. Joan injected the milky anaesthetic agent into Harriet’s IV and Gill watched, relieved, as her eyes drifted shut and the muscle relaxant smoothed the lines of anguish on her face. He looked away while Harriet was intubated. It was a procedure he’d seen a thousand times, a
necessary requirement for surgery, but he just couldn’t bear
to watch.
Siobhan cut Harriet’s scrubs away, preserving as much of
her modesty as possible, and Gill prepped her abdo with Betadine then quickly draped her body. He couldn’t stand to see her lying there so exposed.
Harriet was comfortable with her nudity, sure, but this wasn’t a beach. It was a cold operating theatre in a strange country and these weren’t random strangers, they were her friends and colleagues.
When he looked back at Joan she had completed the intubation and Gill swallowed hard as she taped Harriet’s not quite closed eyes shut. The large plastic tube protruding from Harriet’s mouth and tied to her beautiful face looked so brutal.
She didn’t look like Harriet, his wife, his lover. Harriet, who he had made love to only that morning. Harriet, who had thrust the divorce papers at him. She looked pale and thin and small and... ill. An edge of desperation rose in him, a moment of panic at all the possible adverse outcomes.
He thought back to all the complicated operations he had
performed over the last ten years. This was so simple in comparison, a lot simpler than the amputation he’d just performed, but the stakes had never been higher.
Trying to mentally prepare himself for what he was about to
do, he understood why surgeons weren’t allowed to operate on relatives. The crush of emotions crowding his head and filling his chest made concentration impossible.
And what if he failed?
What if he couldn’t stop the bleeding and she bled out?
What if he couldn’t do what she’d asked him to do? What if he couldn’t save her tube?
Suddenly he wished Benedetto was doing the operation instead. That Harriet’s life and fertility weren’t his sole
responsibility. He wished he could just pace up and down the corridor outside and be free to worry and think the worst.
He couldn’t think the worst now.
He had to do his best, his very best, and that was all he could think about. He was it. It was his responsibility.
‘Go, Gill,’ said Joan.
He didn’t need to be told twice. ‘Scalpel,’ he said, holding out his hand.
He took a deep steadying breath and made a midline vertical incision from below her umbilicus straight down to her pubic bone. He thought about the scar it would make and wondered if that would prevent her from nude sun-baking.
His hand shook slightly as he made a smaller vertical incision in the fascia and then lengthened the fascial incision, using scissors. He could see the rectus muscle and used the scissors to separate it.
Below was the shiny peritoneal lining and he used his gloved fingers to make a small opening in it near the umbilicus and then used the scissors to lengthen the incision. The object was to be able to view the entire uterus but all he could see was blood.
So much blood.
Oh, Jesus. His pulse pounded through his ears and neck and belly. Don’t die, Harry. Please, don’t die.
‘Suction,’ he said, knowing that he sounded panicky but he couldn’t see a goddam thing and he needed to clear it so he could clamp the arteries and stop the bleeding.
He tried to control his panic as the continuous welling of blood slurped down the suction tubing and spat into the bottle, filling one and half filling the next. And he tried not to think the worst as he manually removed the clots and tissue too large to go down the sucker.
Tried to divorce himself from the grisly facts and failed. The fact that her blood loss was frightening and the tissue he was touching was the remains of a tiny, tiny embryo.
His embryo. His baby. And he could do nothing to save this life. Nothing.
Suddenly he had flashes back to Nimuk’s mother. Her abject
misery as she had handed Nimuk over, knowing he was dying and knowing there was nothing she could do about it. He remembered her powerless, felt it acutely right now as he delved inside his wife’s body and tried to save her life.
‘What’s her pressure?’ he demanded.
‘Holding at eighty. She’s had two lots of colloid and just
finishing her second bag of O.’
He had to stop the bleeding. ‘Bladder retractor.’
Katya handed him the instrument and he placed it, anchoring it on the pubic bone. She also handed him a self-retaining abdominal retractor and he placed that, giving him a good view. He inserted moist towels to absorb the remaining blood and pack off the bowel and omentum from the operative field.
He located the Fallopian tube and his heart sank. “Fuck,” he said quietly, behind his mask as he placed two clamps on the destroyed Fallopian tube between the uterus and where the ectopic had erupted, instantly stemming the haemorrhage.
In a theatre where the atmosphere was so tense that no one even dared breathe, the quiet expletive was loud.
‘What?’ asked Katya, crowding him to get a closer look.
She repeated his expletive in her mother tongue and stepped away. Glancing at her, Gill could see that Katya also knew he had no hope of repairing the tube. He doubted whether the most
skilled gynae microsurgeon could have done anything with it.
He had promised Harriet he’d try, but there was no way anything could be done.
The clock ticked loudly in the silent room. Everyone waited
for Gill’s next move. After a minute Joan said gently, ‘We know you’d repair it if you could, Gill. There’s not a surgeon in this world that could save that tube.’
‘It’s her only one,’ he said, raising anguished eyes to Joan. ‘She wants a baby. I promised her.’
‘No,’ said Katya, opening Gill’s hand and slapping a scalpel into it. ‘You promised her you’d try, and I promised her to keep you to it. And if I thought there was any chance, I would. But there’s nothing you can do. Cut it, Gill, and get on with the op.’
He’d never felt more out of depth in his life. It wasn’t
something he was used to feeling in an operating theatre. Here
he was in control. Always. He looked at Joan.
‘Katya is right. She’s lost a lot of blood, Gill. Don’t
prolong the stress to Harriet’s system. There are other ways to get pregnant.’
Gill nodded, knowing they were right but hating himself for what he was about to do. This was why there was a rule about operating on relations. He was the one who was going to have to face the music for what he was about to do.
And she was going to hate him for it.
He hesitated briefly before slicing through the tubal
pedicle between the two clamps he’d applied earlier. And that
was it. There was no going back now.
It was done.
Pushing all thoughts of Harriet’s reaction aside, he got on with the job - there was still more work to do. He ligated the artery and then ligated the end of the pedicle. Before he could remove the tube completely, he had to divide part of the broad ligament that attached along the length of the tube which he did until the tube was finally free.
Katya held out a kidney dish and Gill discarded the twisted
flesh. It looked alien, so removed from its actual function and too damaged to do it anyway.
‘Keep it,’ he said to Katya. Maybe Harriet would need proof, justification as to why he hadn’t tried to salvage it. Maybe for her grief process she’d need to see it with her own eyes.
She looked at him for a long moment. ‘Da.’ She nodded and indicated to Siobhan to get her a specimen container.
‘Pressure rising. One hundred systolic,’ Helmut said.
An enormous weight lifted from Gill’s shoulders, the cramp in his neck and the tension along his jaw, dissipated. They had done it. He had controlled the bleeding and Joan had replaced Harriet’s blood loss and stabilised her blood pressure.
As he sutured Harriet back together, Gill’s mind began to
wander and he forced himself to push the thoughts away and
concentrate. He would have time later to think about how close
he’d come to losing her, about all the blood and how he’d taken from her the one thing she’d asked him not to.
And that Harriet had been pregnant with his child. A child that he hadn’t even known he’d wanted. Until tonight.