Surgeon Of The Heart

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‘Correct. The full name being?’

Melissa cleared her throat. ‘The central venous pressure line.’

‘Good. And do you know what that shows?’

‘Not really, Staff.’

‘Well, it gives us a clear indication of the state of the volume of fluids within the body. It would tell us, for example, if the heart was overloaded—by being raised. It is, as you can imagine, of vital importance, particularly as we’re operating on the heart itself. It will be removed when the patient is ready to leave the intensive care unit.’ She smiled at the student’s rapt expression. ‘And what other lines might we expect to find?’

‘A venous line?’

‘At least one,’ answered Cat. ‘Dr Crone prefers to use four, although he isn’t typical—as you might have already heard, Dr Crone is a law unto himself!’

‘Yes, Staff,’ smiled Melissa.

Further discussion was halted by the appearance of two surgeons—Phil Bennett and Morgan Crossland—Cat knew them well. These were the surgeons who would prepare for the arrival of the professor himself. The operation being performed was a coronary artery bypass graft—an inspirational procedure to any member of the profession. The coronary arteries—vital for supplying the heart with its own blood supply—having become furred and clogged up with arteroma, would be removed, then replaced with veins taken from the lower leg. Thus one surgeon would open up the leg to remove the leg veins, while the other opened up the chest wall, ready for the professor to carry out the swop itself.

Both men grinned when they saw Cat, Morgan, an out-and-out ladies’ man, frowning very slightly.

‘Been on a diet, Cat?’

‘No.’ She knew that her uniform was hanging in voluminous folds around her waist. The plain green theatre dress hid a multiple of sins, but even it couldn’t disguise the fact that ten pounds had fallen off her since her return from Italy.

‘You’re too thin,’ said Morgan critically. ‘It doesn’t suit you.’

Cat could see Melissa Lloyd listening to the interchange with interest, and decided to nip any speculation in the bud. ‘Nice of you to be so concerned, Morgan,’ she said sweetly. ‘But, speaking of diets—couldn’t you do with losing a little yourself?’

Morgan laughed easily, finding something other than total female capitulation quite refreshing. He knew perfectly well that Cat was the last person to fall for his well-worn chat-up lines, but that didn’t stop him trying!

Both men began to scrub as the patient was wheeled in, a man in his late fifties. Dr Crone and his scrub nurse accompanied him, the nurse compressing the ambi-bag, which was feeding oxygen into the patient’s lungs, until he could be connected to the ventilator in Theatre.

Also in the room was the theatre technician, who was responsible for working the bypass machine. The patient’s body needed to be cooled right down, and this was done by putting a cannula in the heart itself, running the patient’s blood through the bypass machine, which cooled it, to have it returned to the patient by an artery in the groin.

Phil started opening the leg, while Morgan began opening the chest, both chatting away, quizzing Cat about her time in Rome. The atmosphere seemed relaxed, but they all worked like clockwork, and the moment that any one of the team in the whole theatre expressed any degree of concern about the proceedings then a tight tension would grip the air.

In reality, Cat would be working for all three surgeons, so she would need to be right on the ball. It was a prospect that daunted a lot of theatre nurses.

‘So how was Rome?’ asked Morgan.

‘The conference was great,’ she said, her voice only slightly unsteady. ‘I learnt a lot. There were two people from the States who——’

‘Wouldn’t you just know it?’ exclaimed Morgan as she slapped a forcep into his gloved hand. ‘Only Cat could go to a country like Italy in the height of summer and come away talking about cardiology! What else did you do apart from the conference? Didn’t some dashing Italian sweep you off your feet?’ he teased, not noticing that she had blanched. ‘And, speaking of dashing Italians,’ he continued cheerfully, ‘I don’t suppose you’ve met our newest maestro?’

‘Morgan’s had his nose put out of joint,’ interjected Phil mischievously. ‘His position as number-one hospital heart-throb has gone. He’s finally been usurped.’

Cat didn’t trust herself to answer, just carried on, slapping instruments between the two, handing over swabs, and making sure that Melissa Lloyd kept a swab tally on the board at the back of the theatre.

She was aware when the professor came in, even though she had her back to him. A good scrub nurse was aware of every single thing that went on in her theatre, and there was always an imperceptible change in the atmosphere when the top man arrived. Jokes stopped. No words were exchanged. They took their lead from him. If the chief surgeon liked to operate while having Sibelius piped over the loudspeakers then that was fine. If his tastes ran to the Rolling Stones then that was fine too! Cat had often thought that it must be a bit like being minor royalty—the top surgeon was in such an awesomely responsible position. Scarce wonder that so many chiefs of surgery had phenomenally huge egos!

She could hear him washing his hands in the corner, and Melissa Lloyd went scurrying over to tie his gown for him. He moved towards the operating table. Out of the corner of her eye she noted that he was exceptionally tall.

‘Good morning, everyone,’ he said in a faintly accented Italian that sounded just a little unusual.

Unusual? Cat started. Now she was going crazy! It was because she had Nico on the mind.

The surgeon moved round the table to face her. ‘Ah, a new nurse?’ he queried softly.

Cat lifted her face, the smile frozen there into a ghastly grimace. Please no, she thought. Dear God, no.

Dark brown long-lashed eyes looked into gold-flecked green. She saw incredulous recognition become a tight anger, and with a resounding clatter she dropped the forcep she was holding on to the floor.

CHAPTER THREE (#ulink_555f93b2-5ae6-5e42-a95f-74da9362ef57)

THERE was confusion for approximately three seconds. Morgan stared at her in stupefaction. ‘Are you OK, Cat?’ he queried.

She could understand his surprise. After all, why should someone who was famous for her sleight of hand and her unflappability suddenly behave like the most nervous and inadequate junior?

‘Cat?’ repeated Morgan anxiously.

At the repeated sounding of her name she heard Nico’s sharp intake of breath, and she met his eyes steadily. There was denial there, a question, and then they looked just exactly like cold chips of ice.

Morgan was speaking again. ‘Professor Rossi—this is Catriona—absolutely our best scrub nurse.’

The dark brows were raised imperiously, the voice was chilly. ‘Indeed? I’m afraid that I must beg to differ—or perhaps standards are different over here. In my experience good scrub nurses are not those who drop the instruments, and then stand there shaking, obviously not in control of themselves.’

With a sinking feeling of regret she knew that his words had a deeper, more insidious meaning. She had not been in control then, either. In Rome.

‘Perhaps you’d like someone to relieve you, as you’re obviously not up to it?’ he suggested.

She drew her shoulders up. ‘I’m fine,’ she said with a surprising firmness in her voice that she was eternally grateful for. ‘Are you ready to commence the operation—sir?’

‘Indeed.’

Things went on automatic pilot then. She forced herself to put every thought of him out of her mind—she had to. He was just a surgeon. Any surgeon. And she was assisting him. She watched as the long fingers gradually exposed the heart. Watched as he performed the breath-takingly dramatic act of stopping the heart with ice-cold water.

She did her best, but it was not her best. She was adequate, and that was about all that could be said. The qualities that separated her from the run-of-the-mill theatre nurses were sadly missing today. Oh, she didn’t commit another sin so grave as dropping an instrument, or anything so inept as forgetting to register a newly opened packet of swabs. She handed him every instrument that he needed, but that extra dimension was missing. Even though it was the first time she had worked for him, she normally would have anticipated his needs, rather than having to wait to be asked. Watching the motion between a good surgeon—and she could see that he was a very good surgeon, there was no doubt about that—and a good scrub nurse was like watching a perfectly choreographed ballet—the whole painstakingly intricate operation looking absolutely effortless. Today she felt worse than useless, and she was miserably aware that his barely concealed impatience with her performance had affected everyone around them. Even Morgan looked slightly miffed.

At the end he defibrillated the heart to get it started, and contemptuously peeled off his gloves to throw them in the bin by her feet. As a gesture of utter disdain, it could hardly have been bettered.

He marched out of the theatre without another word, leaving the rest of the team to finish up, Morgan and Phil both looking disgruntled.

‘What the hell’s eating him?’ demanded Phil. ‘He was fairly reasonable yesterday. Well,’ gloomily, ‘as reasonable as any of these flaming experts are.’

‘There, but for the grace of God, go you!’ said Morgan.

Dr Crone regarded Cat speculatively. ‘Something tells me that our Cat might just responsible for his temper,’ he mused.

Every pair of eyes was turned in her direction, but she set her face in its most glacial Ice-Queen expression, and no one dared speak to her, save when necessary, for the rest of the operation.

She was longing to just escape, to be alone with her thoughts, to try to make sense of this nightmare situation. Why the hell was he here? But there was to be no escape. As soon as she walked through the swing doors she saw Sister Henderson, a serious expression on her face, and knew exactly what had happend.

‘Sister——’ she began, but the older woman uncharacteristically interrupted her.

‘Would you please come into my office?’

Miserably Cat followed her, and once there the older woman turned to her, an anxious look on her face. ‘Catriona—if you’re not fit to come back to work then you simply shouldn’t be here.’

‘But I am fit, Sister, honestly I am.’

Sister Henderson shook her head. ‘I have just had Professor Rossi in my office. To say he was angry would be a mild understatement. He was absolutely furious. He said that you were incompetent and substandard. He said that your performance today was not what he expected at all—he called it an insult to provide him with a nurse who was simply not up to scratch. Do you deny that what he said is true?’

Cat bit her bottom lip. ‘No, Sister.’

‘I explained to him that you’d been ill recently, but he soon gave me short shrift. I told him that you were the best nurse I had, but he didn’t seem to be listening.’ The older woman’s eyes were creased with anxiety. ‘Don’t you see, my dear, that if we subject visiting and very eminent professors to situations like that it makes us all look very foolish. It whittles away at our reputation. We are the finest cardio-thoracic centre in the country. Surgeons come here, knowing that. They expect—and they have a right to expect—the very best, and today Professor Rossi did not get it. I’d like to know whether you can offer me a satisfactory explanation for what happened in Theatre today.’

Cat hung her head, shame staining her cheeks. She had never received such a blunt dressing-down in all the time she’d been nursing. It was justified, she knew that, but it didn’t make it any easier to bear.

‘He wants to see you in his office, Catriona. I shouldn’t dawdle, if I were you.’

Cat felt as though she were going to the gallows, and not just because she was about to get a professional scorching—she would have withstood a million of those, anything rather than have to face him, to have to stand alone in the same room with him.

She tapped on the door of his room. The visiting professor was awarded a room that reflected his status, and consequently was very large, well-appointed, and right to the back of theatres. Cat had only been in there once before, when a very amiable American professor had invited them all for drinks on the eve of his departure. An enjoyable occasion, and anything less like the encounter she now anticipated she couldn’t imagine.