The Surgeon's Special Delivery

Caught in her understanding gaze, he distractedly bit into a biscuit. It tasted like cardboard, his body unable to experience anything other than shock. He was going to be an uncle.

The uncle of an orphan. The realisation thundered through him as he spun away from her and continued pacing. He suddenly stopped and swung back, taking a really close look at Tess. Her honey smooth skin shone with lustrous good health and her egg-blue singlet curved over voluptuous breasts. Heated blood shot through him, straight to his groin.

Stunned by his reaction, he pulled his gaze to her belly, forcing the doctor in him to appraise the pregnancy, which she carried low.

Primigravidas may experience lightening and engagement at thirty-six weeks. The information he’d absorbed long ago when he’d been a medical student pushed up from the recesses of his mind and forced down the unwanted lust. ‘Exactly when is the baby due?’

She brushed back her fringe. ‘I’m thirty-seven weeks.’

‘So you’re due any day.’ He couldn’t stop the rising inflection of his voice as an edge of panic tightened his chest.

She smiled her quiet, serene smile. ‘Or in three weeks’ time, yes.’

He ran his hand frantically through his hair as if that would help him make sense of it all. Yesterday his world had been familiar. Today it was as if he’d landed on an alien planet.

Unspoken thoughts tumbled from his mouth. ‘But I don’t understand. Why didn’t we know?’

You hadn’t spoken to your brother in three years, since you accused him of throwing away his life. He ignored the voice of reason. ‘James could have at least told our parents. Hell, they live in the same country.’

Sympathy wove across her cheeks. ‘James and Carolyn wanted your parents to meet, hold and love Oscar before—’

He started. ‘Is that the child’s name?’ It triggered a faint memory from his childhood—the imaginary friend he and James had created to solve disputes between them.

‘Yes. Oscar Callum.’

Guilt ripped at Callum and he tried to shrug it off. ‘You were saying they wanted mum and dad to meet him before what?’

She sucked in her cheeks. ‘Before they learned of his unorthodox birth.’ Her gaze dropped away. ‘Before the press got wind of it.’

The money. Dad’s money. It was an inescapable fact that the Halroyd millions often generated intense media interest and it was no secret that James had taken a low profile to avoid media intrusion in his life. He stared at the woman in front of him, struck by a sudden thought. ‘Is there money involved?’

Her chin tilted up sharply. ‘It’s exactly that attitude which made Carolyn and James decide to hold off telling you. Money played no part in this. I did it out of love.’

If gold sparks were daggers, her eyes would have knifed him clean through the heart. Love. He swallowed a groan. He didn’t believe in love. His job didn’t allow for it and Felicity had crushed any remaining thoughts. But now wasn’t the time for a philosophical discussion about whether love existed or not.

A baby was coming into his family in the next few weeks and nothing he could do would change that. Every plan he’d made for the immediate future swirled in his mind like dust in the wind, being carried further and further away from him. He wanted to put his hand out and grab on tight to all his arrangements but there was nothing to hold onto. Everything had changed.

He sucked in a deep breath and slowly all the confusion in his mind cleared. This was no different from triage at Frontline. Decisions had to be made and priorities needed to be set. He knew immediately what he had to do.

Tess could almost see the cogs of Callum’s mind working behind those enigmatic dark grey eyes. As tall as James was short and as dark as James had been fair, Callum was the physical opposite of his fraternal twin. But the differences didn’t stop there.

James had never made her heart pound or her stomach somersault. He’d been her best friend’s husband, a kind man, a great doctor and the brother she’d never had. She thought back to her ill-fated relationship with Curtis. Not even in their halcyon early days had she ever felt quite this weirdly agitated and tingly.

She pushed away these new sensations and focused on what she knew about Callum, which wasn’t much as James had only ever mentioned him in passing. His biological uncle isn’t exactly the ‘kick a footy to the kid’ type of guy.

Callum’s suddenly brisk, businesslike voice broke into her thoughts. ‘So you’re booked into the Women’s Hospital in Melbourne to have my nephew?’

The ‘take-charge’ doctor had replaced the bewildered man and his question surprised her. ‘Ah, no, I planned to have the baby here.’

He raised his black brows. ‘So Narranbool Bush Hospital has acquired a neonatal intensive care unit since I last visited.’

She ignored his sarcasm. ‘Narranbool District Hospital has probably lost beds since you were last in the country. It’s a constant battle to keep country hospitals open, accredited and debt free. With sixty births a year we hardly qualify for an NICU.’

He folded his arms, his eyes darkening. ‘My point exactly. We need to get you down to Melbourne tomorrow as soon as the funeral is over. You can stay in the east wing of my parents’ house in Toorak and then you’re close to the Women’s when you go into labour.’

Her blood pounded in her head as her hands started to shake. She fisted them closed to steady them against the cocktail of emotions that pounded her. Her worst fear of what Carolyn had always jokingly referred to as ‘Halroyd organisation’ was swinging into action faster than she’d thought possible.

She kept her voice steady against all her fears about the Halroyds taking over that had plagued her from the moment she’d learned of her friends’ deaths. She was a surrogate, not family. ‘I don’t want to stay in the east wing.’

He frowned, momentarily nonplussed. ‘I don’t understand. It’s independent of the rest of the house and has everything you could possibly need for your confinement. Besides, my parents wouldn’t hear of you staying in a hotel and you won’t be inconveniencing them at all if that’s your concern.’

His determination and authoritative tone slammed into her like a truck hitting a brick wall. ‘Look, it’s very kind of you to offer but—’

‘It’s not a matter of kindness, it’s the best thing to do.’ His matter-of-fact voice brooked no argument.

‘The best thing?’ She failed to keep the incredulity out of her voice. ‘I can’t just up and leave Narranbool.’

‘Why on earth not?’ The derision in his voice matched the perplexity on his face.

Because I’m the only doctor here. But she knew telling him that wasn’t going to help her cause to stay in town and have Oscar. She’d just have to hope he would respect the wishes of his brother. She cradled her hands under her stomach. ‘James and Carolyn wanted to have the baby here and I’m going to respect their wishes.’

His brow creased in confusion. ‘So there’s another doctor in Narranbool with obstetric qualifications?’

She skirted the question. ‘I’ve got my diploma in obstetrics.’

The creases deepened. ‘No matter how talented a doctor you are, Tess, you cannot deliver the baby.’ He pressed his palms down onto the scoured wooden benchtop and leaned forward, the muscles in his arms taut with tension. ‘Who is going to deliver my nephew?’ His quiet words hung between them.

My nephew. His family. Oscar’s family. She hesitated as if she teetered on the very tip of a steep mountain, knowing that no matter which way she moved, she would tumble and fall. Fall into his plan of going to Melbourne. She met his piercing gaze. ‘The midwives are experts in healthy, straightforward labours and—’

‘But James isn’t here to act as back-up.’ Callum’s softly spoken words exposed the flaw that now made the original plan less workable if complications did arise.

For three days she’d been on the phone, following leads for another doctor with obstetric qualifications, but all conversations had ended in ‘No’. But she hadn’t given up hope; she still had time to find someone. Like all other outback women before her, she wanted to have her baby in her town and Oscar deserved to be born in the place his parents had adored.

She plastered what she hoped was a reassuring smile on her face. ‘But I’m healthy and the baby is healthy so the chances of me needing a doctor are pretty slim. Worst case scenario, we’re a short helicopter ride to Mildura which is a lot better than women in Africa—’

‘But we’re not in Africa, we’re in Australia.’ His previously warm voice had chilled to a stony determination.

‘Yes, we’re in Australia, and as I pointed out I have access to emergency care if it’s needed. There are other pregnant women in this town, Callum, and I’m not suggesting to them that they all decamp to Melbourne.’

A flash of sorrow flared in his eyes before a muscle in his jaw twitched. ‘Your job is to safeguard my nephew and I want you giving birth with the full suite of backup that modern medicine can offer on the other side of the double doors.’

She stared at his implacable stance, his mouth set in a firm line and his arms crossed over his broad chest. Knowing that exhaustion, grief and pain were driving him, she swallowed her biting retort that she would never put his nephew at risk either. Wearily she pushed at her fringe with her fingers and stalled. ‘Let’s talk about this tomorrow, after a night’s sleep, after the funeral.’

‘There’s nothing more to talk about.’

She sighed. ‘There are so many things to talk about.’ Like the fact that if I leave town, Narranbool has no doctor. The unmistakeable ring of her mobile interrupted her. She glanced at the display. ‘Excuse me, I have to take this call.’ She punched the green button. ‘Tess Dalton speaking.’

She listened carefully as Rosie Whitherton, the director of nursing at the hospital, told her that a patient had arrived and needed to see her.

‘I’ll be right there.’ She snapped her phone shut, relief surging through her that work would definitely end this conversation with Callum. ‘I’m sorry, but I have to go.’ She hunted around for her car keys, which always sank into the furthest corner of her voluminous tote bag.

‘Go where?’ His body rippled with alertness as if a ‘go’ button had just been pushed, locking down all his previous emotions.

‘To work.’ Her fingers touched every possible handbag item except the cool metal of keys. ‘There’s an emergency at the hospital.’

‘You’re on call?’ Surprise spun along his cheeks, vanishing almost as quickly as it had arrived.

She held her breath, hoping it was a rhetorical question, wanting to keep her cover until the last possible moment.

He shrugged and picked up his keys. ‘I’ll come with you.’

Astonishment flipped her stomach. She needed a break from this conversation and she didn’t need Callum Halroyd with his intense stare and his questioning and organising demeanour entering her professional domain. He disconcerted her enough in the kitchen, let alone in A and E.

She started lifting newspapers, still searching for her keys. ‘But you’re exhausted. Shouldn’t you get some sleep?’

He exhaled a ragged breath and hooked her gaze. ‘Have you slept since you heard the news?’

She bit her lip and shook her head. ‘Point taken.’ He needed work as much as she did right now and she couldn’t insist that he stay behind.

Abandoning her key hunt completely, she swung her bag over her shoulder and strode purposefully to the door as much as a pregnant woman could stride. As her hand grasped the doorknob she turned back toward Callum, catching his resolute expression, which contrasted starkly with an unexpected glint in his dark eyes.

Excitement? She suddenly saw him in a different light. Instead of grief being front and centre, an overlay of anticipation shimmered around him. Was Callum an adrenaline junkie? A doctor who worked in war zones as much for himself as for patients. Did work excite him? The thought coiled through her, settling in the back of her mind to be re-examined later.

‘Let’s go.’ She stepped into the hot night, half dreading and half looking forward to working with this enigmatic man.

And that scared the hell out of her.

* * *

Callum assessed the small emergency department of Narranbool District Hospital through the glass panel of the door and sighed. How had James stood working in this two-horse town? The equipment looked older than some of the gear he used in Africa.

Rosie, the DON, had greeted him and Tess with open arms and an apologetic grimace, and had immediately disappeared back to the nursing home to check on a patient. Typical country medicine—under-resourced, understaffed and underwhelming. Bush hospitals had become glorified nursing homes as mainstream surgical procedures were removed to the capital cities and larger regional centres, which had all the up-to-date equipment.

The trip to the hospital had been quick and silent, with the exception of Tess’s husky voice giving navigating instructions. To shut out lust, Callum had made lists in his head of the things he had to organise, including pulling in a favour from a mate who was an obstetrician in Melbourne. The sooner Tess was in Melbourne the better.

Then he could relax.

He ignored the faint voice in his head that he was overreacting, that Tess was right about the safety of giving birth in Narranbool and that he was medicalising childbirth. James was dead and nothing he could do would change that. But he could do everything possible to safeguard James’s son.

He rubbed his temples with his thumb and forefinger. And there was still the problem of his parents. He had no idea how to gently tell two shocked sixty-five-year-olds that they were soon to be grandparents.

Tess grabbed a couple of gowns off the linen trolley, the soft fabaric of her shorts tightening on her behind.

His gaze fixed itself on the plump roundness, his mind immediately imagining how his hands would feel curved against the softness. You’re gawking at a pregnant woman. Now, that’s really classy.

Tess turned, the expression in her chocolate eyes quizzical as she tossed him a gown. ‘Here—catch.’

Her words brought him instantly back to the A and E. Abandoning his lustful thoughts, he immediately became the doctor. ‘What do we know about this patient?’

Tess picked up the beige history folder with the distinctive colour-coded spine that was used in most hospitals around the country. ‘Rosie said he’s a relative of a local family, visiting from Perth. He hasn’t been feeling well since dinner and has complained of heartburn.’

‘That’s the emergency?’ He tugged on his gown and sighed. ‘He probably just needs some antacid and a lecture on the evils of overeating.’

‘You were the one who wanted to come to the hospital.’ She gave him an arch look. ‘We could wish him a myocardial infarction if that’s more exciting for you.’

Her barb hit with unerring accuracy. He loved the rush of an emergency, of dealing with the unknown, having to think on his feet and being just one step ahead of disaster. ‘Sorry. GP work just isn’t me.’

‘No? Really? I would never have guessed.’ Her wide mouth curved up into a smile that raced directly to her eyes, giving her a teasing, sassy look. ‘But you’re here now, action man, so follow me and watch and learn how to talk to a patient who is actually awake.’

Action man. A delicious sensation of warmth unexpectedly scudded through him. His staff at Frontline were fabulous but in Theatre he was the boss and no one ever questioned him. No one ever teased him.

As she walked away from him, an involuntary sound erupted from his throat which he recognised as laughter. A flare of something akin to happiness lightened his chest for a moment before shrinking but not completely fading. He followed her through the double doors toward the source of noise.

‘You need to wait in the waiting area and we will call you back when he’s seen the doctor.’ A tired voice sounded over the clamour of many talking at once.

‘But he’s my brother.’ A woman’s voice rose in agitation, while her pudgy hands gesticulated, sending her many bracelets jangling.

Relatives. They were another reason why he’d become a surgeon. By the time he got to speak to relatives, other staff had usually calmed them down, and after he’d spoken to them briefly, his registrar followed up, answering any other questions.

Callum recognised the distinctive white and blue uniform of a nurse who turned toward them at the sound of the door, relief clear on her face.

‘Tess, I’ve done baseline observations on Mr Renaldo and he’s pretty uncomfortable with epigastric pain.’

‘Thanks, Esther. Mr Halroyd and I will sort him out.’

The middle-aged woman nodded slowly as she took a head-to-toe look at Callum, interest and curiosity bold in her eyes. She turned back to the relatives. ‘The doctors are here now and everyone needs to leave.’ She pointed to the door and started herding the crowd back to the waiting area affectionately known as chairs.

Tess winked at him. ‘Within the hour all of Narranbool will know you’re here. Esther is a great nurse and a great communicator.’

His jaw tightened at the accepted small-town culture. ‘Hmm, that sounds like code for gossip. It probably comes from not having enough to do.’

Tess frowned, her mouth opening slightly before closing into a thin line. With a slight roll of her shoulders she walked into the examination room.

‘Mr Renaldo, I’m Tess Dalton and this is Mr Callum Halroyd. He’s visiting Narranbool, just like you are.’ Tess gave a welcoming smile to their patient.

The pale man propped up on white pillows mustered a smile as the ECG monitor he was connected to beeped reassuringly. ‘Call me Vince.’

Callum nodded in acknowledgement of the greeting.

‘So what’s brought you in, Vince?’ Tess rested the chart board on top of her bump.

‘My sister’s cooking!’ He gave a wry smile. ‘To be fair, I haven’t felt that great since I arrived and tonight the heartburn just got to me.’

Tess’s face expressed sympathy as she rubbed her sternum. ‘I know what you mean. I’m looking forward to eating a curry without revisiting it all night.’

Callum’s patience strained to the breaking point. Small talk had never been his thing which was yet another reason why he’d chosen surgery. By now he would have asked for specific symptoms and be moving into the examination. James had been the member of the family who’d enjoyed a chat, not him.

Tess continued. ‘Is the heartburn just after meals?’

Vince shook his head. ‘It’s been pretty constant and I haven’t been eating much lately. Haven’t really felt like it.’

‘What’s different about today that made you come to hospital?’ Tess rubbed her back.

Callum caught the action and wondered again why she was still on the on-call roster. Surely the registrar could have taken this case.

Vince grimaced and spoke between quick breaths. ‘Today’s a lot worse. I feel really crook, like I’m going to hurl, and I’ve got gut-ache too.’ He gripped the bowl Esther had given him, his knuckles white against the metal.

‘Have you vomited today?’

Beads of sweat formed on his forehead. ‘No, but I’ve had some diarrhoea and I dunno what my sister cooked but it was as black as tar!’

Tess immediately glanced over their patient’s head and caught Callum’s gaze, her brown eyes full of concern. Black bowel motions meant blood.

Callum reached for the stethoscope that hung over the top of the BP machine, planning to hand it to Tess.

‘Vince, we need to examine you and I’m going to ask Callum to do that while I insert an intravenous drip into your arm. When the nurse took your temperature it was up, and it’s always good to have some extra fluids on board when you have a fever.’

And when there’s a possibility that you’re bleeding internally. Tess knew her stuff and had swung into a team action approach. He couldn’t fault her decision and the thrill of excitement he got from work kicked in.

‘If you can lie down for me, I’ll palpate your abdomen.’ Callum put the stethoscope around his neck.

Vince’s expression became confused. ‘Do what?’

Tess raised her brows at Callum, a dimple appearing briefly in one cheek. Almost as quickly the muscles in her face schooled themselves into impassivity and she looked directly at Mr Renaldo. ‘He’s going to gently press your stomach to see if it’s tender.’

The patient’s brow immediately cleared. ‘Oh, right.’ He turned to Callum. ‘You should have said so, Doc.’ He gingerly shuffled down the bed and lifted the gown. ‘At least in this heat your hands will be warm.’

Callum silently groaned; sleeping patients didn’t give cheek. He scanned the patient’s abdomen, immediately noticing it was bloated. ‘Let me know if any of this hurts.’ His fingeres pressed firmly but gently, moving over the area, seeking guarding and rigidity, and then he examined the upper midline.

Callum pressed close to the upper midline.

Vince hissed. ‘Hell, Doc, that hurts.’ He pressed his fist to his epigastric area.

‘Sorry.’ Callum helped him sit up to relieve the reflux pain and then wrapped the blood-pressure cuff around the man’s upper arm. ‘Are you on any medications?’

‘Me knees are arthritic so I take some painkillers for that.’

Tess swabbed Vince’s left arm. ‘What sort of painkillers?’

‘Aspirin mostly or that new stuff with the funny name I.-B.-something.’

The story was coming together. ‘Ibuprofen.’ Callum pumped up the BP cuff.

Callum heard the swish and thud of blood in the arteries as he released the air from the cuff and matched the sounds to the fall of the arrow. He decided to leave the cuff in place, wanting to monitor Vince’s blood pressure closely.

‘Your BP is 110 on 75, which is a bit low. Do you know what your usual blood press—’

Vince suddenly heaved, his eyes wide with alarm as bright red blood filled the basin. The ECG machine screamed a high-pitched warning sound.

Esther came running into the room, quickly taking in the emergency. She deftly removed the bowl. ‘I’ll measure this for blood loss.’

‘Tess, is that IV in yet?’ Callum quickly dropped the back of the bed down so their patient was lying flat and strapped a clear oxygen mask onto his face. For the first time since arriving at the hospital Callum relaxed. Emergencies were what he did best.

‘I’ve got Hartmann’s solution going in full bore.’ Tess taped the drip into place, her expression grave. ‘It looks like he just dropped a litre of blood.’

Callum gave a grim nod. ‘It fits in with all the classic signs of a bleeding ulcer probably exacerbated by using non-steroidal anti-inflammatories for his arthritis.’

She placed her hand on their patient’s wrist, checking his pulse. ‘Vince, you’re bleeding somewhere in your gut. We’re replacing the blood with an electrolyte solution but we’ll need to evacuate you to Mildura Base Hospital for a procedure to stop the bleeding.’

The pallid and sweaty man barely nodded his understanding.

Callum’s brain went into overdrive. Vince was in no fit state for evacuation and unless they could keep his circulating volume up, he could go into cardiac arrest. He walked around to Tess, his hand gently closing around her forearm, her skin warm and soft on his palm. Guiding her a few steps aside, he spoke sotto voce. ‘I don’t suppose there’s any chance that Narranbool Bush Hospital runs to an operating theatre and gastroscope?’

Tess bristled. ‘We have visiting specialists come through here on rotation from Mildura and, yes, we do have a ’scope but no one qualified to use…’ Her eyes sparkled as realisation dawned. ‘You can do the scope and clip the ulcer. That’s fantastic—you’re just what we need.’

Her appreciation wound through him, spreading into every cell with a zing of something he didn’t recognise. He grinned like a fool, which was crazy as he was only going to do something he was very qualified to do and did on a regular basis. ‘I can, if you can do the anaesthetic.’