The Surgeon's Gift
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Carol Marinelli
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CHAPTER ONE
AFTER today, it would only get easier.
Reminding herself for the umpteenth time, Rachael painted on a smile and took a deep breath before entering the office.
‘Don’t tell me you’re the R. Holroyd rostered on for this afternoon?’ The beaming face of Helen Wells was as familiar as it was welcome.
‘The very same.’ Rachael cleared her throat as she dropped her bag to the floor and rummaged on the desk for a handover sheet. ‘Didn’t Admin tell you I was starting back this afternoon?’
‘When did Admin ever tell us anything? It just never clicked, what with the name change and everything. Had they said an R. Carlton was coming back we’d have splashed out on a cheesecake!’ Jumping down off her desk, Helen crossed the room and embraced Rachael in a huge bear hug. ‘It’s so good to see you, Rachael.’
‘It’s good to see you, too,’ Rachael answered truthfully. Helen Wells wasn’t only an efficient charge nurse who ran the ward like clockwork, she was a kind woman who looked after her staff and was also a close friend.
Or would have been a close friend if only Rachael had let her.
‘Are you on a late shift?’
Helen nodded. ‘I’m doing a double shift, so I’ve been here all morning as well. We’re as short staffed as ever, so it’s great to see you. But not just for that,’ she added quickly. ‘We’ve all missed you. How are you doing?’
Rachael glanced around the office, smiling at the unsure faces that greeted her. A couple of her colleagues smiled back briefly before pretending to examine their notes, others just downright stared. ‘Fine,’ she replied in a voice that was just a touch too loud and a touch too bright. ‘Although I might revise my opinion once I’ve heard the night shift’s handover. It looks as busy as ever out there.’
‘It certainly is, and if Hugh here would stop tapping away on the computer and let me at the desk, we might be able to get started with handover.’
It was the first time Rachael had even noticed the doctor sitting at the desk, but she had been too busy concentrating on getting this first awkward greeting out of the way. Still, as he stood up, Rachael soon realised he wasn’t the type of man that would usually go unnoticed, unless you lived in Sweden, of course. There, no doubt, six-foot-five blonds with green eyes and clear complexions were falling from the rafters, or yodelling their way down the mountains in droves, or whatever it was gorgeous Swedes did, but here in an inner-city Melbourne hospital they cut quite a dash.
Not, of course, that Rachael was remotely interested, it was a mere statement of fact.
Nothing else.
‘Are you ladies waiting for me? I didn’t realise.’
‘No doubt you’re only too used to keeping the ladies waiting,’ Helen said in a teasing voice.
‘I happen to treat the ladies very well,’ he said with a slow smile in a deep, rich voice with not a trace of a Swedish accent, which discounted that theory. ‘At least, I’ve never had any complaints.’
‘Well, you wouldn’t, would you?’ Helen said matter-of-factly. ‘One flash of that smile and you’d be forgiven anything. Hugh Connell here is our consultant plastic surgeon and resident heartthrob.’
Definitely nothing else, Rachael decided as she blushed slightly under his scrutiny. The tiny mole on her cheek took on gigantic proportions in her mind, and she automatically assumed that this dashing plastic surgeon was measuring her up for a new nose as he offered his hand.
‘And this is Rachael Holroyd, formerly Carlton, one of our nursing sisters. Rachael’s back with us after a year away.’
‘Pleased to meet you,’ Rachael smiled accepting his hand.
‘Newly married?’ His eyes were smiling, his question utterly merited, given the snippet of information Helen had so readily parted with, but the gentle pre-handover murmur that had filled the office stilled, the silence broken only by a couple of nervous coughs as Rachael stood there, wishing the ground would open up and swallow her whole.
‘Newly divorced, actually.’ In an attempt to sound casual her voice came out too loud, too joky, and as she took her hand away she noticed a flicker of embarrassment flash over Hugh’s face as Rachael’s own colour deepened. ‘And loving every minute,’ she added, but her attempt to inject some humour into the embarrassing exchange only served to increase the awkwardness.
It was Hugh that gave a slightly embarrassed cough this time. ‘Glad to hear it,’ he said, flashing a quick on-off smile which went nowhere near his eyes. With a brief nod he picked up his stethoscope and pager as Rachael sat down, her cheeks burning, trying and failing to focus on the handover sheet in front of her, aware she had made a total fool of herself.
Again.
It was an all too common occurrence these days, almost as if she didn’t know how to react to people any more. Even the most basic of polite exchanges seemed to end in awkward blushes and not for the first time Rachael questioned the wisdom of coming back to work. If she couldn’t deal with her colleagues, what chance would she have with the patients?
But sitting moping at home hadn’t been getting her anywhere, and it certainly wasn’t going to get the bills paid—there really hadn’t been any other choice but to come back to work. Anyway, Rachael consoled herself, at least she wouldn’t have to see that Hugh Connell much—after all, the surgical unit rarely had cosmetic patients. She was reading far too much into it. He’d probably forgotten the whole embarrassing exchange by now.
So what if she had made an idiot of herself?
At least she hadn’t cried.
‘The bad news is that all the beds are full,’ Helen started. ‘But the good news is that at least we can’t accept any more patients. Oh, and, Rachael, I don’t know if you’re aware of it but we’re no longer just a general surgical ward. We’ve got twelve cosmetic beds now or, as Hugh keeps reminding me, twelve ‘plastics’ beds, which doesn’t quite have the same ring to it if you ask me.’
‘Oh, no.’ Rachael let out a groan as she ran her eye down her patient list. So much for avoiding Hugh!
‘Oh, yes!’ Helen said, but without any enthusiasm, completely misinterpreting Rachael’s misgivings. ‘I felt exactly the same.’
‘So when did this happen?’
‘Last month. The refurbishment of the private wing of the hospital is taking longer than expected so, rather than lose the admissions, they’re being ‘blended’ into the public wards—and that’s Admin’s expression, not mine! The surgical wards were all supposed to take eight each, but because our ward’s new and has the best facilities we’ve been lumbered with more than our share.’
‘So they’re private patients?’
Helen rolled her eyes. ‘Private patients on a public ward—not the greatest mix at the best of times, and they’re all constantly pushing their bells, asking for their water jugs to be moved two inches to the right. But what can you expect when they’ve got a doctor like Hugh?’
‘What do you mean?’
‘He treats them like china. Nothing, and I mean nothing, is too much trouble for him.’
‘Well, he’s being paid to be nice,’ Rachael grumbled, but Helen shook her head.
‘He’s just nice, full stop, as well as a good doctor, which makes it hard to point out just how difficult it can be. He’d move the jug, so to speak, and move it again and again if it would keep his beloved patients happy. So a word of warning for you when you’re in charge—it doesn’t matter if it’s midnight on New Year’s eve, if one of Hugh’s patients is unwell he wants to be informed. So whereas with most doctors you might sit on things for a while, don’t even think about it with Hugh—he likes to keep his finger on the pulse.’
‘He can keep it on mine.’ Bev, one of the other nurses, laughed.
‘And mine,’ Trevor chimed in, which had everyone in stitches until Helen let out a yelp as she glanced at the clock. ‘Come on, guys, let’s get hand-over out of the way.’
Rachael knew that once the report was over she wasn’t going to get away that lightly from Helen, and was already half expecting it when Helen called her back as she made her way out onto the ward.
‘Here’s your pager,’ she said, handing Rachael the small fluorescent orange bleeper.
‘What on earth is this for?’
‘You’ve got Orange Bay.’ She laughed at Rachael’s bemused face. ‘The new system is finally under way. Now, when a patient presses the call button, their allocated nurse is alerted directly by their pager.’
‘You’re serious, aren’t you?’ Rachael asked, slowly turning the small pager over.
‘Oh, I’m serious all right. You can’t escape for a moment, not even when you go the bathroom. And look at this.’ She tapped the computer in front of her. ‘This records how long it takes for you to answer the call bell—a bit “Big Brother” if you ask me, but you soon get used to it.’
‘And here was me thinking I’d take up where I left off. A year’s a long time in nursing these days.’
‘It’s a long time, full stop,’ Helen said gently. ‘We really have missed you, you know.’
‘I know.’
‘You’re looking great.’
Rachael gave a thin laugh. ‘You mean I’ve lost weight.’
‘Not just that, you look fabulous.’
‘Amazing what a year of stress will do,’ Rachael said dryly. ‘I’m sure Richard would still be able to find fault.’ She tapped the edge of her cheekbone. ‘I mean, look, horror of horrors, I’ve still got a mole.’
Helen rolled her eyes. ‘So have a couple of super-models I can think of but, then, no doubt, that ex-husband of yours would find fault even with one of them.’
‘Look, Helen, I’m sorry I didn’t return your calls and letters…’
‘You had enough on your mind.’ Helen waved her hand dismissively. ‘I’m just glad that you got them, glad that you knew I was thinking of you. So how are coping?’
‘Getting there.’ Rachael gave a small shrug. ‘Helen, I know you mean well, and I don’t want to come across rude, it’s just that…’
‘It’s none of my business?’
‘No,’ Rachael answered quickly, somewhat taken aback at Helen’s take on things. ‘I just can’t talk about it. I know talking is exactly what I’m supposed to be doing, but I just can’t, especially not today. It’s hard enough as it is, coming back to work, without bringing it all up.’
‘Fair enough.’ Helen looked at her shrewdly. ‘But if you ever change your mind, you know that I’m here.’
Rachael nodded and turned to go, but Helen hadn’t quite finished. ‘I suppose a girls’ night in with a bottle of wine and a pile of slushy films is out of the question, then?’
‘With no secret agenda?’ Rachael questioned. ‘No waiting for me to open up and reveal all?’
Helen nodded. ‘Scout’s honour. I’ve missed you, Rachael, and our chats.’
There was twenty years’ difference in age between the two women. Helen, happily overweight, blissfully married and successfully juggling four boys with her career, was a world away from a rather brittle Rachael who, as well as being far too thin, was newly single and having enough trouble juggling just getting up in the morning.
‘I’ll bring the videos, you can supply the wine. You did manage to get a couple of decent bottles from the divorce settlement, I hope?’
Rachael grinned. ‘A couple Richard didn’t know about.’
‘I’ll look forward to it, then.’ Helen’s tone changed, adopting a slightly more businesslike attitude she peered at her work sheet. Friends they might be, but at work Helen was definitely the boss.
‘I’ve just given you beds one to four this afternoon. They’re all pretty straightforward—two surgical, two cosmetic, all a couple of days post-op except for Sheila Cosgrove, who’s awaiting her surgery, so hopefully you’ll have a gentle start back.’ As Rachael’s pager sprang into life, Helen started to laugh. ‘Famous last words. Hailey Watkins will run you ragged.’
However, it wasn’t Hailey buzzing but Sheila Cosgrove, eighty years old and awaiting the removal of a large abdominal tumour. The delay in her operation for once had nothing to do with waiting times and bed shortages. Instead, her condition was complicated by a long history of heart problems and other medical ailments which were all causing problems at the moment. Her operation, though necessary, was just too much of a risk while her medical condition was so unstable, and a lot of specialists were playing their parts in getting Sheila relatively well before she underwent surgery.
‘Good afternoon, Mrs Cosgrove. I’m Rachael Holroyd, I’ll be looking after you this afternoon. What seems to be the problem?’
‘I’ve got some pain.’
Pulling the curtains around to give Sheila some privacy from the other three patients in the bay, Rachael made her way over to the bed. ‘In your stomach?’ she asked, making to pull back the sheets.
‘No—here.’ Sheila’s hand reached up to her chest as Rachael checked her handover sheet.
‘You suffer with angina—is it the same type of pain?’ Sheila nodded as Rachael checked her drug chart. ‘I’ll go and get you some spray, Sheila, and then I’ll do a set of obs.’
As Rachael made her way swiftly across the small ward, the patient in bed three called her back. ‘Sister?’
‘Yes, Mrs Watkins?’
‘Hailey, please. It’s Rachael, isn’t it? I remember you from last year when it was the old ward—I was in, having my appendix out.’
‘That’s right,’ Rachael said, a smile breaking on her face as she remembered her patient from the previous year. ‘I thought your name sounded familiar.’
‘I said then I’d be back for a breast enlargement before my fortieth birthday, do you remember?’
Rachael didn’t, but she smiled warmly as Hailey chatted on in her slightly dizzy voice. ‘Dr Connell told me I need to drink more. Would you mind filling up my water jug?’
She couldn’t at the moment, Sheila’s chest pain had to take precedence, but Rachael gave an easy smile. ‘Sure, I’m just caught up right now, but I’ll be back in a moment and then I’ll come and make sure you’re comfortable.’
‘Thanks.’ Turning her attention back to her magazine, Hailey suddenly looked up. ‘By the way, what did you have?’
The simple sentence stopped Rachael in her tracks. Half turning to go, she literally froze for a moment, hesitating at Hailey’s question.
‘You were just about to go off on maternity leave when I was in here.’
‘That’s right.’ For something to do, Rachael busied herself pulling out the bedspread and tucking it again, a futile task, and totally needless, but it beat talking about her personal life.
‘So what did you have?’
‘A girl,’ Rachael said with a brisk smile, wheeling Hailey’s table into perfect alignment with her bed and shuffling a pile of magazines into shape. ‘Look, I have to go,’ she said apologetically. ‘I’ll be back to you soon.’
Sheila’s respirations were raised and her hands were shaking so much she wasn’t able to work the little pump spray. Though Rachael had no doubt at all that while Sheila did indeed have chest pain and was having an angina attack, anxiety was playing a large part in her symptoms, exacerbating her pain and generally making things worse. Helping her with the spray, Rachael spoke in gentle tones. Although she had only just met her patient, Rachael noted with satisfaction how her comforting words seemed to be working as gradually Sheila’s respiration rate and pulse settled to a more normal state.
‘I don’t like hospitals,’ Sheila said, sinking back on her pillows.
‘A lot of people don’t. Is the pain easing now?’
Sheila nodded. ‘A bit.’ Her anxious eyes met Rachael’s. ‘Can you stay for a little while?’
‘Of course. We’ll give it a couple more moments and if it hasn’t eased off some more we’ll give you another spray and see about calling the doctor.’ The chiming from her pager was unfamiliar and it took a couple of seconds to turn it off and read the message. Pulling back the curtains, Rachael saw that indeed there was a light above Hailey’s bed. ‘Is everything all right, Hailey?’
‘I asked for some water. I thought you might have forgotten.’
Mustering as much tact as she could, Rachael smiled. ‘I haven’t forgotten, I’m just with someone right now. I’ll get it just as soon as I can.’
‘And you won’t forget?’
How could I? Rachael was tempted to ask, but thought better of it. Her irritation was soon replaced by concern as she heard Sheila starting to retch. Reaching for a kidney dish, Rachael soothed the elderly lady, her concern growing as she felt the clammy skin beneath her touch. Pressing on the call bell three times, she connected the oxygen.
‘Sheila, I’m just going to pop on some nasal prongs to give you some oxygen.’
‘Everything all right?’ Helen’s face peered around the curtain.
‘Chest pain,’ Rachael said fiddling with the flow-meter. ‘Could you page her doctor for me? I’m just going to run off an ECG.’
‘Here…’ Helen handed her a portable phone. ‘We’re high-tech now! You stay with her and page the doctor and I’ll fetch the ECG machine.’
Thankfully the doctor came just as Rachael had finished the heart tracing. Though it showed no acute changes, Sheila’s symptoms, coupled with her cardiac history, meant that she merited a full cardiac work-up and a dose of aspirin in case she was indeed having a heart attack. Through it all she clung to Rachael’s hand as the doctor listened to her chest and took bloods for urgent levels, and by the time Rachael finally surfaced from her patient’s bedside to check on her other patients a good forty-five minutes had passed. It was a rather martyred Hailey that greeted her first.
‘Sorry, Hailey, I’ll get your water now.’
‘No need.’ Rachael wasn’t sure but she thought she detected a slight edge to Hugh’s voice as he placed a water jug on Hailey’s locker. He’d even iced it!
‘I was just about to do that,’ Rachael said quickly. ‘I got caught up with—’
‘It’s no big deal. Hailey wanted some water, I fetched it for her.’ Turning to his patient, he gave Hailey the benefit of a very nice smile. ‘How are you feeling this afternoon?’
‘I’m in a lot of pain actually.’
With a small frown Hugh checked her drug chart. ‘You haven’t had any analgesia for ages. Why on earth didn’t you let the nursing staff know?’
‘Well, they seemed so busy, I didn’t like to make a fuss.’
‘You’re not making a fuss. If you have pain you need to let the staff know. Sister here will get you something for it straight away. Have you been doing your deep-breathing exercises?’
‘It hurts,’ Hailey moaned.
‘But it’s essential. I explained the importance of them before you had your operation. That’s why you’ve got a chest infection now, because you’re not doing your post-op exercises.’ His eyes scanned the chart again. ‘Her IV antibiotics were due at one, they haven’t been signed for.’
‘They haven’t been given yet. I was just—’
‘About to do it’ Hugh finished for her. ‘Well, could you see she gets them immediately, please?’
‘Certainly.’ Which unfortunately was far easier said than done. The new ward design meant that the drug cupboard no longer existed. It had been replaced by a drug room, which you could only enter by swiping your ID badge. The theory was that fewer mistakes were likely to be made with fewer distractions, the only trouble with that theory being that it meant two staff leaving the ward floor at any one time, and at precisely eight minutes past one there wasn’t another free registered nurse available.
Hugh took the news well, at least sort of, even offering to check the drugs with her if it meant his patient didn’t have to wait any longer. But his rather prolonged sigh and obvious irritation made it quite clear he considered Rachael disorganised, and unfairly so, when in truth she was an efficient and meticulous nurse.
As the door closed behind them the distractions of the ward might have disappeared momentarily but the designers had obviously never factored into their calculations the far bigger distraction of a blond giant in a bad mood, whose aftershave was practically asphyxiating her, his unmasked irritation making it hard to concentrate on the endless vials of drugs that greeted her.
‘Sorry,’ she muttered. ‘I’m not sure of the layout.’
Luckily all the antibiotics were stored alphabetically and for the most part none of the drug names had changed in her absence, but the drumming of his very neat, very well manicured fingers on the bench only exacerbated her nervousness.
She showed him the vial of antibiotic and Hugh checked the name and expiry date with a brief nod. Rachael did the same with the vials of saline. Opening the controlled-drug drawer, she located the drug book before opening the box of pethidine.
‘Seven,’ she stated, showing Hugh the box.
‘Fine. Where do I sign?’
‘You’re supposed to look before you sign,’ Rachael said through gritted teeth. ‘You’re supposed to check that there are actually seven ampoules of pethidine remaining. The law requires it.’
‘I did,’ he said tartly. ‘I’m not some two-year-old who has to use my fingers to count. Now, where do I sign?’
To add insult to injury, when it was Rachael’s turn to add her signature, she realised she had left her pen at Sheila’s bedside and no amount of rummaging through her pocket was going to produce one.
‘Here,’ he said with annoying calmness. ‘You can use mine.’
‘Thank you.’
‘Do you have a problem with cosmetic patients Rachael?’ Hugh’s question wasn’t exactly unexpected, given the chain of events, but it still hurt none the less.
‘No, of course I don’t,’ she answered briskly, filling out the columns in the drug book.
‘Well, you wouldn’t be the first nurse on this ward if you did.’
‘Then it’s good that I don’t.’
‘You can see why I’m asking, can’t you? Hailey had to ask three times for a simple jug of water, her antibiotics are late and she’s also in considerable pain.’
‘My other patient had chest pain. Surely you don’t expect to leave a potentially life-threatening incident to replenish your patient’s water jug? And as for her pain, Hailey never gave me any indication she was in distress—in fact, the only thing on her mind seemed to be the fact that she didn’t have any water.’ She was on a roll now and added her signature with a flurry as she continued. ‘And if you’d give me a moment, I can draw up her antibiotics and they’ll only be…’ glancing at her watch, Rachael met his eyes with a defiant look ‘…fifteen minutes late, hardly a reportable incident by anyone’s standards.’ Despite her fiery response, tears were appallingly close now, and the very last thing Rachael wanted to do was break down—not here, not now and certainly not in front of Hugh.
‘Look…’ His voice was softer now and Rachael stared pointedly at the blur of her signature in the drug book as he spoke. ‘Maybe I came on a bit strong. Of course, a patient with chest pain has to take precedence. I tend to jump in without looking sometimes, particularly in the last few weeks. Suffice it to say there’s been a few teething problems with my patients on the general wards. Some of the nurses have the attitude that cosmetic patients are somehow less deserving of pain control, as if the fact they elected for the procedure should mean they’re prepared to suffer the consequences. I know they can be demanding and difficult, but the simple truth is that most of them have saved hard or have waited a long time for these procedures. It isn’t something they’ve taken lightly and they’re scared of it all going wrong.
‘Hailey doesn’t ask for pain control because she thinks she’ll get out of here more quickly without it. Unfortunately, in this instance it’s worked the other way. She was in too much pain to mobilise and do her deep-breathing exercises and now she’s going to be here for at least a week on IV antibiotics.’
He had a point, Rachael was honest enough to admit that. After all, more than a few eyes had rolled during handover when they’d discussed the cosmetic patients, but his unjust assumption had riled her and she certainly wasn’t going to take the blame because a couple of her colleagues’ haloes might need a polish. ‘Well, that isn’t my attitude,’ Rachael said firmly. ‘I’ve nothing against cosmetic patients and I resent the implication.’ She could feel his eyes on her but still she didn’t look around.
‘In that case, I apologise.’
Rachael would have answered, would have accepted his apology, but the tightness in her throat and the tremor in her bottom lip as she battled not to cry made it safer to ignore him, the silence growing louder as he awaited her response.
‘Fine,’ he snapped eventually, and from the rather curt turn on his heel Rachael’s inadvertent snub hadn’t gone unnoticed. Following him out onto the ward, trying to keep up with his long angry strides, Rachael rued the day she’d decided to come back to nursing. One hour into her shift and already she’d made an enemy.
Well, Hugh Connell could go and jump!
What right did he have to judge her? What right did he have to make such assumptions and then expect her to meekly accept his apology? If his patient’s drugs being ten minutes late was all he had to worry about, then Hugh Connell was a lucky man indeed!
He should try walking a mile in her shoes.
