The Surgeon She's Been Waiting For

‘IT WAS definitely a heart attack. Look at the lab results…they show that her cardiac enzymes are elevated.’ Megan scanned the report on screen and then switched to the results of the echocardiograph. ‘See this area here?’ She glanced at the senior house officer by her side and pointed out the region that was giving her concern. ‘The heart function is definitely impaired.’

‘I see it. It’s not good, is it?’ Sarah winced. Her face was pale against the gold of her hair, and Megan guessed the long hours on duty were beginning to take their toll on her. She hoped she could send her to the doctors’ lounge to take a well-earned rest soon, as things had been hectic in A and E.

‘Not good at all.’ Megan turned her attention to the monitor that was recording her patient’s vital signs. ‘Her heart rate is way too high and her condition’s deteriorating fast.’

‘What are you going to do?’ Sarah was worried, her gaze troubled as she studied the laboratory results. ‘You’ve already given her glyceryl trinitrate and diamorphine, along with an infusion of tirofiban and heparin, but the chest pain is coming back, and she’s struggling to get her breath.’

Megan pressed her lips together. ‘We’ll leave her on the infusion for a while longer to see if things settle down.’ She frowned, pushing back a silky lock of chestnut hair that tumbled across her cheek. ‘Is there any news of Mr Carlson yet? We’re running out of time. If we don’t get her to surgery soon, she could go into cardiogenic shock and that would be grim.’

‘I’ll go and check, but last I heard he was tied up in Theatre at a hospital across the county.’

Megan winced. ‘We really need more people that we can call on. We’ve been understaffed for months now, and the situation doesn’t show any sign of changing for the better, does it?’

Sarah shook her head. She went to make her phone call, while Megan spoke quietly to the nurse who was assisting, before checking the infusion meter and keying in the appropriate settings.

‘Let me know if there’s any change,’ she murmured, and the nurse nodded.

‘I will.’

Megan drew in a quick breath and went in search of her next patient. It had been non-stop from the minute she had come on duty. A traffic accident at a notorious road junction had kept her and her colleagues busy for most of the morning, tending to the injured, and then she’d had to deal with a patient who couldn’t breathe properly and a child with a broken arm. Then had come the woman who had suffered a heart attack.

Just another day in the emergency department, and problems were piling up on one another, thick and fast. Wasn’t that the nature of the job?

An hour or so later she headed towards the central area to see who was next on her list.

‘Ouch.’ A small voice caught her attention and she glanced into one of the treatment rooms off the central area in time to see a small boy clambering up onto a trolley bed. He was attempting to unhook an oxygen mask and tubing from the outlet on the wall at the back of the bed, and it looked as though he had banged his leg in the attempt. He stopped to rub his injury momentarily and then went on with his examination of the oxygen equipment.

What on earth was he doing in there on his own? Megan went to investigate.

‘Is someone looking after you?’ she asked. He couldn’t be much more than five years old, she guessed.

The boy glanced at her and then nodded without saying anything.

‘Are you sick?’

He shook his head.

‘That’s good. But I saw that you banged your leg on the bed. Do you want me to take a look at it?’

Again there was a perfunctory shake of the head, an action that sent his dark hair into a quiver. Losing interest in her, he tugged at the tubing and started to play around with the mask.

‘You really shouldn’t be playing with that,’ she told him. ‘If you pull on it like that it might get damaged, and then it won’t be of any use if we need it when someone needs help to breathe.’

‘Oh.’ He put the mask down on the pillow and looked around him in a disgruntled fashion. ‘I don’t want to stay here,’ he said, giving her an accusatory glance. ‘I want my mum.’

‘OK.’ Megan studied him, wondering what had brought about the downward slant to his lip. ‘I’ll see if we can do something about that.’ She held out her hand to him. ‘Do you want to come with me and we’ll see if we can sort this out?’

His glare was truculent. ‘I don’t know you. You’re a stranger.’

‘Ah…’ For a second or two his simple logic knocked her for six. ‘Well, yes, you’re quite right about that,’ she murmured, recovering. ‘And it’s very sensible of you to stay put, under the circumstances.’ Her mouth twisted as she thought things through. ‘Who is supposed to be looking after you?’ she asked, trying another tack. ‘You really shouldn’t be here on your own, you know.’

A boy of few words, he pointed to the central area beyond, and then shrugged his shoulders upwards, clamping his bent legs with his arms and burying his chin on his knees. Watching him, Megan didn’t think she was going to get much more out of him.

She looked to where he had pointed and saw that Sarah was talking to someone who had his back to her. She stared for a moment at that tall, grey-suited figure, and all at once she stiffened. There was something instantly recognisable about those broad masculine shoulders and the long sweep of taut legs.

What was Theo Benyon doing here? And did he make a habit of leaving children to their own devices?

‘Stay here,’ Megan said to the child. ‘What’s your name, by the way? What should I call you?’

‘Harry.’ His blue eyes held a belligerent spark, but she sensed that underneath all the muted aggression there was a troubled, vulnerable little boy.

‘I’ll be back in a little while, Harry.’

Sarah was clearly captivated by the artist’s easygoing manner. There was a flush of warmth in her once pale cheeks, and her green eyes were lit with a kind of awed expectation.

Megan clamped her lips together. Theo was a disruptive influence. Why was he taking up space in their A and E unit if he wasn’t sick?

‘Well, hello, there,’ she said on a brisk note as she approached him. ‘I wasn’t expecting to see you again quite so soon. Is there something we can do for you, Mr Benyon?’

‘Theo, please.’ A faint smile hovered on his lips, but it disappeared almost as soon as he met her gaze. ‘Uh-oh,’ he said, narrowing his eyes. ‘Am I in trouble again? I seem to recognise that expression on your face. It’s the look that says, You had better watch your step, because I’m not best pleased.’

‘I can’t imagine why you should think that way,’ she murmured. Turning to Sarah, she said softly, ‘Why don’t you go and take a break for a while, Sarah? Things seem to be calm around here for the moment.’

Sarah smiled. ‘You know that’s the cue for all hell to break loose, don’t you?’

Megan’s mouth curved briefly. ‘I do, but we’ll manage somehow if it does.’

‘Good. I could do with a coffee. I’ll just check on my patients, though, before I go.’ Sarah glanced at Theo. ‘It was interesting talking to you. I’m sorry I couldn’t be of any help.’

She walked away, leaving Megan to direct her attention towards Theo. ‘I hardly like to bring the subject up,’ Megan said in an even tone, ‘but young Harry over there says he belongs with you and he doesn’t look to be a very happy bunny right now. I’m afraid he might get into mischief if he’s left to his own devices for much longer.’

Theo frowned, as though he had no idea what she was talking about. ‘I’ve just rescued the oxygen equipment from his inquisitive fingers,’ she explained, ‘and…’ her glance went to the treatment room, a line indenting her brow ‘…it looks as though he’s moved on from there. It would be my guess that the trolley bed is about to go walkabout any moment now.’

Theo’s blue eyes narrowed. ‘He was supposed to be looking at picture books.’

Her mouth flattened. ‘Was he? I can’t imagine why he’s not looking at them when there’s a whole ward full of gadgets to explore.’ Her tone held a hint of sarcasm. ‘Clever boy. It can’t have taken him above two seconds to figure out the wheel-release mechanism.’ Her brows met in a fine, dark line. ‘I just hope he’s worked out how the brake operates.’

‘I don’t know about clever,’ Theo said under his breath. ‘What Harry has in abundance is determination. Excuse me.’ He was already striding purposefully towards the treatment room.

A moment later he was back again, with a scowling Harry in tow. ‘I want to see my mum,’ the boy said.

‘You will.’ Theo lightly tousled the boy’s hair. ‘Just let me apologise to the doctor for leaving you to fend for yourself. She thinks I don’t know how to look after young children, and you’ve more or less proved her point.’ He turned his gaze on Megan once more, treating her to the full blaze of eyes that were the colour of a summer sky.

‘I was entirely in the wrong,’ he said, bowing his head in a way that might have signified contrition, if she hadn’t caught the faint glimmer of a smile in that devilish glance. ‘I thought I could rely on him to stay out of trouble for a minute or two while I left a message for Mr Edwards, but obviously my faith was misplaced.’

‘I dare say these things happen,’ she returned evenly, ‘though I don’t know of any child who can resist exploring. But I guess things turned out all right in the end. It would probably be better if you were to keep him by your side from now on.’

‘I’ll do that.’ His mouth pulled wrily. ‘I’ll take him away and we’ll leave you in peace.’

Megan nodded. She might have said more, but he was already starting to turn away from her, and the nurse who had been assisting with the cardiac patient came hurrying forward, saying in an anxious tone, ‘Mrs Claremont is going downhill fast. I think she’s going into cardiogenic shock—all the signs you said to look out for are there, and her circulation appears to be shutting down. Will you come?’

‘Of course. Phone through to the catheter suite and tell them I need to operate, will you, and ask the senior house officer on duty to assist me? I’ll need two nurses to come along as well.’ She started to swivel around in order to hurry back to the observation ward, but added, ‘I don’t suppose there has been any news from Mr Carlson?’

‘He phoned to say it’ll be several hours before he can get away. He said to put her on thrombolytics.’

Megan winced. ‘We’ve done that, but it isn’t working. I’ve no choice but to do an emergency angiography and try to open up the blood vessel with a balloon implant. I just hope we can buy her some time.’

She glanced back towards Theo, something in her drawn to seek him out. He, too, had stopped in his tracks, she discovered, and he was watching her, an odd expression on his face, one that she could not read, no matter how she tried. Then Harry tugged on his arm and he gathered himself together and reluctantly began to turn in the direction of the exit.

Megan continued on her way. Perhaps it was just as well that he had gone. Somehow he was managing to cloud her vision and cause a blip in her usually clear thinking. ‘You had better let Mr Edwards know what we’re doing,’ she said to the nurse. ‘He wanted to be kept informed.’

‘OK. I’ll page him. He was working with a patient in Resus a while ago.’

Megan hurried to check on her patient. The woman’s renal system was failing despite the intravenous diuretics and medications she had received.

‘Let’s get her up to the catheter suite,’ she said, when the nurse returned. ‘I’m guessing that she has a critically narrowed artery, and I need to restore her circulation as soon as possible.’

The hour that followed was nerve-racking. Megan introduced a catheter into an artery in her patient’s groin and guided it into the descending aorta, the heart’s main blood vessel, monitoring her progress all the time with the aid of the computer. ‘OK, I see the blockage and I have the balloon in place. We need to set up the pump so that it will inflate and deflate the balloon at the right intervals.’

They worked as a team, and then watched the pump in action to ensure that it was working properly. When the patient’s heart was in the resting phase, the balloon inflated, increasing the supply of oxygen-rich blood to the coronary arteries. When the heart was ready to work, the balloon deflated, decreasing the workload on the heart.

‘Well done, everybody,’ Megan said, moving away from the bedside some time later. ‘We’ve done all we can for now, and we’ve managed to restore her circulation for the time being. The balloon can stay in place until Mr Carlson is ready to operate.’

Her boss, Mr Edwards, met up with her as she was leaving the catheter suite. ‘How did it go?’ he asked.

‘She’s stable for the time being.’ Megan’s expression was troubled. ‘I just hope Mr Carlson will be able to do a coronary bypass before too long. She’s in desperate need of the surgery. She’s still relatively young, and she has a family waiting for her.’

‘It’s always a worrying time for all concerned.’ Mr Edwards walked with her to the lift. He was a tall man, distinguished-looking, with steel-grey hair that was cut close to frame his head. ‘By the way, the nurse on Reception told me Theo Benyon was in here looking for me. She said she saw you talking to him, but then he left… Was there a problem? Do you happen to know where he went?’

Did her boss know the man? Megan shook her head. ‘I’ve no idea. I was just relieved that he gathered up the child that was with him and kept him from getting into any more mischief. I was worried that the equipment would be damaged if he didn’t rein him in.’

Mr Edwards frowned. ‘You didn’t say anything to annoy him, did you?’

‘No. At least, I don’t think so. I may have been a trifle curt with him, I suppose.’ She sent him an enquiring look. ‘Why…is there a problem? Is it to do with the artwork you were thinking of commissioning?’ It suddenly occurred to her that Theo was an artist, and Mr Edwards had been talking about having the children’s wing of A and E spruced up—was Theo famous for his murals, or something? ‘Is that why he was here, to see you about artwork for the children’s unit?’

‘Artwork? No, not at all. Nothing like that.’ Mr Edwards was unusually distracted as he pressed the button for the lift. ‘I operated on the boy’s mother—I expect he wanted to talk to me about that. I hope you didn’t say or do anything to upset him?’

Megan sent him a confused glance. It wasn’t like her boss to be so edgy and preoccupied. Had something gone wrong during the operation? That would be a tragedy in itself, but it was unlikely to have been Mr Edwards’s fault. He was an excellent surgeon with an impressive track record.

It was all very puzzling. What was wrong with the boy’s mother? And if his wife was seriously ill, what had Theo been thinking of when he’d lightly flirted with her? Or had she misjudged his actions? It was possible, of course, or perhaps he was one of those men who saw every woman as a challenge. Either way, the man had a lot to answer for.

‘As I was saying,’ she said as they stepped into the lift, ‘I spoke to Mr Benyon, but I simply suggested that the boy needed to be taken in hand. Of course, I didn’t realise that the child’s mother was ill. No wonder Harry was acting up. He must be very worried about her.’

‘Yes, I expect he is. Anyway, if you run into Theo again, go carefully. I don’t want to alienate him in any way.’

And what was that supposed to mean? She opened her mouth to ask him, but her boss was frowning heavily, deep in thought and locked away in some world of his own. It wasn’t at all like him to be this way, and Megan had no idea what to make of it. Perhaps, though, this was not the best time to start quizzing him.

Anyway, with any luck she wouldn’t run into Theo again any time soon.

The lift came to a halt and they stepped out into the corridor. Mr Edwards headed straight towards his office, and Megan decided to go in search of a late lunch.

Sarah was just preparing to leave her table at the cafeteria when Megan set down her lunch-tray.

‘I heard you had to operate,’ Sarah said. ‘Do you think Mrs Claremont will pull through OK?’

‘I hope so. It all depends on whether Mr Carlson will be able to operate successfully. She’s very weak.’

‘That’s hardly surprising, but you’ve done everything that you could for her.’ Sarah glanced at Megan before pushing her chair back from the table and getting to her feet. Her green eyes were sympathetic. ‘No one could have done anything more, and they’ll take good care of her in the intensive care unit. It’s just a question of waiting to see what happens.’

‘I know.’ Megan sighed and gazed back at her friend. ‘Dealing with a heart attack is difficult enough at any time, but when it happens to a relatively young mother it’s heartbreaking.’

Sarah nodded and glanced down at her watch. ‘I have to get back to work,’ she said, tucking a strand of golden hair back into place. ‘I’ll see you later, Megan. Try to eat something. It will make you feel better and help to keep your strength up.’

‘I will.’ Megan toyed with the salad on her plate, twirling her fork idly in the mound of grated cheese, as she watched her friend walk away.

The food tasted good, and she ate carefully, savouring the variety of flavours—honey-baked ham, crisp red and green peppers and a crusty bread roll.

For just a few moments it was good to relax and enjoy the freedom from responsibility. This job meant everything to her, but she had to acknowledge that she was in real need of a break.

As difficult as it was, heart-rending though it might be at times, her career in medicine was her life. She had worked hard to come this far, and as a specialist registrar inA and E she had a good deal of responsibility resting on her shoulders…shoulders that ached right now with a growing knot of tension.

She put down her fork and sipped at her hot cup of coffee, moving her limbs to ease the tightness in her muscles. It was a relief to be able to unwind for a few precious minutes. Stretching her legs out in front of her, she let her mind drift over the variety of cases she’d had to deal with so far today.

It was as though every minute was taken up with life-and-death decisions, and she faced a struggle each day to keep one step ahead. Why did she put herself through all this?

She stared out of the window as though she might find the answer in the tubs of brightly coloured pansies that were dotted about the paved quadrangle.

‘Hello, there… Meeting up like this is getting to be something of a habit.’

Megan gave a start and looked up as the sound of that familiar male voice intruded on her reverie.

‘You’re right. So it is.’ She stared at Theo Benyon. What on earth was he doing there?

‘Sorry, I didn’t mean to startle you.’ He was holding a tray, laden with a coffee cup and pastries, and now he asked, ‘Would it be all right if I join you?’

‘Help yourself.’ She waved a hand towards the chair opposite.

He sat down, his gaze shooting over her as he stirred his coffee with a spoon. ‘You look wiped out,’ he murmured. ‘Have things not been going too well for you?’

She sent him a wry smile. ‘What was the give-away—the dark shadows under my eyes or my general drawn appearance?’ He, of course, looked absolutely great. His grey suit was beautifully tailored, cut from dark fabric that looked fabulously expensive. His jacket was open, so that she could see the fine linen of his shirt, and his tie was subtly patterned to blend in with the whole.

His mouth made an odd quirk. ‘Nothing like that. You just look generally weary.’

Her mouth flattened. ‘It’s been a difficult day, one way and another.’

He lifted a brow in query. ‘Last I saw of you, you were headed up to the catheter suite. Did things not go too well?’

‘They went well enough. My patient suffered a myocardial infarction—a heart attack—and unfortunately it took a long while for her to be brought into hospital in the first place. She lives out in a remote rural area. It never helps if the patient goes for a long time without receiving specialised attention. She was only in her early forties and eventually she went into cardiogenic shock. It was all we could do to bring her back from the brink.’

She pressed her lips together, and then glanced at his plate and the pastries. ‘It looks as though you have a sweet tooth,’ she murmured, changing the subject. ‘Are you planning on eating all of those by yourself?’

‘Not necessarily.’ He sent her an amused look. ‘You’re welcome to choose one if you like. I recommend the fruit tart. Just save the jam doughnut for Harry. That’s his favourite, and he’ll be coming along to demolish it just as soon as he’s finished with the vending machine. I think he’s trying to nab himself a small rubber ball…not one of his best ideas, because you can bet it will bounce all over the place and be lost in no time at all.’

‘Ah, I wondered what had happened to him.’ She glanced across the room to the machine where the boy was gazing thoughtfully at a collection of coloured balls. ‘Thanks all the same, but I’m content with my salad.’

She looked at him more closely. ‘So is this where I’ve seen you before? Are you visiting a patient here?’

‘I am. As you say, that’s probably it. I’ve been here several times over the last couple of weeks.’

‘It must be difficult for you, fitting in visits around work and taking time to look after Harry as well. Or perhaps you’re able to work from home? I imagine that painting must be the ideal job.’

His mouth curved, lending a roguish slant to his features. ‘I’m flattered you think I could make a decent living from it, but I haven’t actually put it to the test. Anyway, I have Harry to look after just now, and that’s a full-time job in itself.’

‘Oh, I see. I mean… Yes, I can imagine that it is.’

Harry came over to the table, hefting a small rubber ball in his palm. ‘I got it,’ he said. ‘I wanted the red one with the white swirls, and I got it. See?’ He opened out his palm to show it to Theo.

‘That’s obviously a very special one,’ Theo remarked. ‘Just see that it doesn’t roll about the floor and get in everybody’s way.’

It was already too late as he spoke. Harry gleefully tried out the ball for bounce-ability, and what followed was an excited chase to retrieve it from under the nearby tables.

Theo’s mouth set in a resigned expression. ‘Hold onto it, or I’ll look after it for you,’ he warned.

Turning back to Megan, he said thoughtfully, ‘I meant to ask how the man from the pub fared after his collapse. Did you manage to follow up on what happened to him?’

Megan nodded. ‘I did. The doctor who looked after him on admission to hospital has ordered tests, including a CT scan. We’ll know more in a day or so, but for the moment he’s comfortable.’

‘That’s something, anyway.’

The rubber ball was on the loose once more, and as quick as a flash Theo caught it, enclosing it in his palm.

‘I want to play with it,’ Harry said. ‘Can I have it back, please?’

Theo shook his head. ‘Not until we get home. People in here are sick, or upset because they’re visiting relatives who aren’t well. They don’t want to be having to duck out of the way of your ball every few seconds.’

Harry’s lip jutted in a belligerent fashion. ‘I’ll keep hold of it, I promise.’

‘No, you won’t. I’ll look after it until we get home.’

Harry opened his mouth to protest but thought better of it at the last moment. He turned his attention to Megan. ‘Do you work here?’ he asked.

She nodded. ‘I do, and actually I should be getting back to work right now. I have patients to see.’ She swallowed the last dregs of her coffee, and glanced across the table at Theo. ‘I expect you have things you need to be doing, as well.’

‘He said he would take me fishing,’ Harry said, nodding vigorously. ‘And we’re going to plant things in the garden so it’s nice for Mummy when she comes home, and then we’re going shopping to get me some new clothes.’