скачать книгу бесплатно
And the door closed behind him, leaving her alone with her chaotic emotions.
They reappeared two hours later, deep in conversation and clearly troubled. Helen, back with her paperwork again, looked up, smiled and carried on.
‘So what do you think we should tell him?’ Ross asked, reaching for the coffee-pot.
‘Hmm.’ Tom propped himself against Helen’s desk and shrugged. ‘I don’t know. What do you think the prognosis is?’
‘I should say he doesn’t have one,’ Ross said candidly, passing Tom a cup of coffee. ‘Helen?’
‘No, thanks. Who are you talking about?’
‘Ron Church—we’ve just done a sigmoidoscopy and he’s got very widespread CA colon and rectum—God knows how he’s been so symptom-free for so long.’
‘Perhaps he hasn’t,’ Tom said quietly. ‘Perhaps he just didn’t realise it was anything to worry about till he started passing blood.’
‘Yes, it’s the fresh blood that frightens people. A higher bleed will usually go unnoticed. Oh, hell. So, what would you tell him?’
Tom frowned thoughtfully. ‘That we found something that needs further investigation and removal? That he will have a colostomy, and that depending on what else we find he will need further surgery and possibly other treatment to alleviate symptoms. That it’s possible that relieving pain and preventing further distress is all we will be able to do.’
Ross regarded him steadily. ‘What if he says no?’
‘Then he’ll suffer unnecessarily, possibly intolerably. I’d do my best to talk him into it, even if I know that we can’t save him.’
‘Would you mention the word cancer at this stage?’
‘Maybe. I’d let him lead me on that.’
Ross nodded. ‘Fine. Would you like to go and talk to him now?’
Tom looked resigned. ‘If you think so, but I don’t know him—wouldn’t it be better if you gave him the news?’
Ross’s mouth lifted in a wry smile. ‘Now how did I know you’d say that?’ he murmured, and, putting his cup down, he left the room.
‘Poor chap.’
Tom looked at Helen quizzically. ‘Who, Ross?’
Helen laughed. ‘No, Mr Church. He seemed a nice man—he’s only in his forties, isn’t he?’
‘Yes—forty-six. God, Helen, it was unbelievable considering his lack of symptoms. He’s within a few days of perforating, I should say—if that.’
‘His wife’ll be shocked—she said this morning as she was leaving, “Oh, well, at least once they’ve done this you’ll know there’s nothing wrong and you’ll be able to stop being such a worrywart.” She’ll feel dreadful, I should think.’
‘I wonder,’ Tom said slowly, ‘if that’s why he hasn’t done anything until now? Although the bowel is notorious for not giving signals.’
‘Yes.’ Helen sighed. ‘How about the others?’
‘The endoscopies? Two duodenal ulcers and one narrow bile duct, probably due to scarring following an infection. No sign of any stones now, but Ross is going to operate and enlarge the duct if he can, and have a closer look. He might even link the gall bladder to the duodenum and bypass the bile duct—it looked pretty tight. We’ll have another look at the plates before we operate, I guess, but I doubt we’ll see anything new.’
‘Are they staying?’
‘Ron Church will be, I imagine, but the others will go out and come back in a few days or weeks—Mrs Tranter and her bile duct sooner, I suspect.’
Helen smiled teasingly at Tom. ‘Funny how it’s usually the men who get ulcers. It’s because you all bury your emotions and won’t talk to each other—everything piles up and becomes intolerable.’
A fleeting shadow crossed Tom’s face, and he straightened up and set the cup down on her desk.
‘Yes, very likely. Mind if I have a look at the post-ops?’
The sudden change in atmosphere was puzzling. What had she said? Had he taken her remarks as criticism? She hoped he wasn’t going to be all tetchy and theatrical—it would drive her mad.
‘Feel free,’ she offered.
Then his bleep squawked and with a muttered, ‘May I?’ he reached for the phone.
She listened as he talked to the A and E department, and then he cradled the receiver and straightened up. ‘Acute abdo in A and E—probably surgical.’
‘Who did you speak to?’
‘Chap called Jack Lawrence?’
‘The consultant—if he says it’s surgical, it’s surgical. I’ll get a bed ready. Once you’ve seen him, can you let me know if it’s an ITU job?’
He grinned. ‘Sure—and it’s a she. Will you tell the boss?’
She nodded. ‘You go on down—can you find the way?’
The grin widened slightly. ‘Just about, I expect. I’ll be in touch.’
She followed him out and with one of the junior nurses she prepared a bed for post-op in the side-ward nearest the nursing station where the patient could be observed continuously. Depending on the nature of the emergency, the patient would be specialled for the first few hours anyway if necessary, but a little extra supervision wouldn’t go amiss.
She watched for Ross and saw him coming out of the little side-ward reserved for the day cases, his face grave. She followed him into her office and watched as he poured another cup of coffee. ‘How is Mr Church?’ she asked him.
‘Unsurprised. He wants to tell his wife himself, and then I’ll talk to her after he’s seen her. Where’s Tom?’
‘He’s gone down to A and E—acute abdo. I’ve alerted Theatre and prepared a bed. I’m just waiting to hear more.’
Just then the phone rang and she scooped it up. ‘Surgical—oh, hello, Tom.’
‘Hi—look, it’s a woman, early twenties, looks like a burst appendix. Is Ross around?’
She handed the phone over, waited while Ross talked to Tom and then looked at him expectantly. ‘Well?’
‘I’ll go in with him but I think Tom can handle it—he’s very good, if his performance this morning is anything to go by.’
‘So why go in?’
Ross shrugged. ‘If it’s a real mess it might take two of us to clean her up—and anyway, I’d like to see him in action.’
They were in Theatre for nearly two hours with her, and when they came back to the ward Helen heard all about it.
‘Ghastly mess,’ Ross told her, reaching for the coffee. ‘Must have been festering for months. Abcesses all over the place, all sorts of gynae implications—she’s obviously had roaring pelvic inflammation for ages, poor kid.’
‘What did you do?’
Tom pulled a face. ‘What could we do? We cleaned her up as well as we could, repaired the damage and sewed her up again, but goodness knows how well she’ll recover. She’ll probably get an infective ileus, so don’t assume that just because she’s got bowel sounds she’s ready for food, OK? It would just be the healthy bowel above the paralysed section trying to overcome the obstruction in the paralysed loops.’
Helen smiled slightly. ‘Don’t worry, Dr Russell—I’m well trained. I’ll do nothing and give her nothing without instruction.’
Tom evidently picked up a slight reprimand because his face relaxed and he gave a rueful grin. ‘Sorry—just making sure I didn’t leave anything to chance. Oh, and one of the gynae chaps is coming down to look at her later. We took a vaginal swab and a smear test in Theatre just to be on the safe side before we started her on the IV antibiotics.’
‘OK, I’ll look out for him. Is she still in Recovery?’
Ross nodded. ‘Yes, she’ll be there for some time, I think.’ He yawned hugely, and laughingly apologised. ‘Sorry, Sarah was up in the night and Lizzi’s feeling a bit rough at the moment so I ended up changing nappies and singing nursery rhymes at three o’clock.’
Helen chuckled. ‘Do you good.’
He gave a non-commital grunt and helped himself to more coffee, waving the pot at Helen and Tom, who both declined.
‘You’ll OD on that stuff if you aren’t careful,’ Helen remarked casually, and got a snort for her pains.
‘Et tu, Brute?’
Helen grinned. ‘Lizzi been nagging you?’
‘Constantly. And I don’t care if she is right.’
Tom looked at him thoughtfully. ‘You look tired.’
‘I am tired. I think I’m too old to be a father.’
Helen patted his prematurely grey hair teasingly. ‘Poor old man—what a shame.’
He glared at her. ‘Less of the old!’
‘You started it!’
‘Humph. Right, what’s next?’
‘Lunch?’ she suggested.
He glanced at his watch and blinked. ‘Lord, I suppose so—oh, well, we might as well grab something while we can. Coming, Tom?’
They left, and Helen went back out into the ward. Ruth Warnes, the staff nurse on duty, was standing at the nursing station staring after them.
‘Wow,’ she said, clearly awestruck. ‘There aren’t many like that around.’
Helen gave a non-commital shrug. ‘Seems quite ordinary to me,’ she lied.
Ruth eyed her suspiciously. ‘Do you need your bumps felt? He’s a dish!’
‘Like tripe and onions,’ Helen muttered.
Ruth chuckled. ‘Philistine! I was thinking more of some exotic Eastern number full of fascinating spices and unusual combinations of flavours—
‘Now who needs their bumps felt?’ Helen asked drily, and Ruth laughed.
‘Never mind—no doubt he’s on the menu for some totally undeserving ingrate who doesn’t appreciate the full subtlety of those wonderful blue eyes…’ She sighed, and Helen felt an irrational urge to hit her. Instead she unlocked the drugs trolley from the wall and snapped her fingers under Ruth’s nose.
‘If I could drag you away from your reverie, Staff, perhaps you could spare the time to help me with the drugs?’
Helen went into the staff cloakroom, unpinned her frilly cap and tucked a wisp of hair back into her bun. She was feeling harrowed—harrowed and emotionally drained.
Ross had spoken to Mrs Church and explained the full implications of her husband’s condition, and then left Helen to pick up the mess he left behind when he was called urgently to Theatre.
Tom stayed and talked to the Churches together once Mrs Church had settled down a little, and then Helen had given them a cup of tea and gone to see Judy Fulcher, the girl with the burst appendix who was down from Recovery.
She was doing reasonably well, nicely stable and not too nauseated, and Helen was happy that she was being nursed to her satisfaction. She had put Ruth on to special her as she had plenty of experience and was well aware of the implications of any possible change in her vital signs, but even so she had checked the chart herself, discussed her progress with Ruth and checked the flow of the drip and the suction drains from the stomach and the abdomen before she was happy to go off duty.
She was just coming out of the cloakroom when Tom walked through the double doors from the ward, his suit jacket slung over one shoulder, his car keys dangling from his hand.
‘Hi—off now?’ she asked him, and he nodded.
‘Ross implied that I should get some sleep while the going’s good—I think once I know where everything is and how it all works he’ll chuck all the notes at me and run!’
Helen laughed softly., ‘I doubt it, he’s very conscientious. How are the Churches?’
Tom’s face sobered. ‘Pretty grim. Mrs is certainly taking it hard. I think actually he’s known for ages that there was something pretty damn drastic wrong with him, so he isn’t really surprised, but she is.’
‘Yes, she seemed to be quite stunned. Is he going to have the op?’
Tom nodded. ‘Yes, I think so. He’s gone home for the night as planned, but I think he’ll be back tomorrow for surgery.’
‘Difficult start for you—I’m sorry.’
He threw her a quick grin. ‘Doesn’t matter when you start, Helen. It’s always difficult for someone. I suppose that’s why I’m here—to make it easier if I can’t take it away. That’s all any of us can do.’ He glanced at his watch, then back at her. ‘Got time for a cup of tea?’
‘In the canteen?’
He wrinkled his nose. ‘I was thinking of my room here—hospital tea is usually strong enough to stand a spoon up in, and I could do with something a little more subtle after all that coffee.’
She knew it was only a casual invitation and her reaction was probably foolish, but why not? She was tired and uptight, and anyway, she might find out something a little more personal about him.
Tea would be lovely,’ She said rashly.
They walked together through the sprawl of the hospital to the residents’ wing, and he opened his door and ushered her in with a flourish.
‘Welcome to Cell Block H.’
