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‘Mr Khan?’ she interrupted with a touch of impatience.
‘Yes?’ his own impatience was even greater for having been halted in mid-flow.
‘What system are you talking about?’
‘Oh! Yes!’ He threw her a brilliant smile. ‘I forgot to start at the beginning, didn’t I?’
‘Yes, you did, Mr Khan,’ she agreed, for the first time feeling like smiling back.
‘In that case, I apologise, Dr Langley, but I—’
‘Lily,’ she offered, before he could go any further. ‘My name is Lily.’
‘Lily,’ he echoed thoughtfully, tilting his head on one side before shaking it. ‘No, that’s not the flower I was thinking of. I would have said jasmine.’
He’d actually been thinking about her name or…
‘I’m wearing jasmine,’she blurted, wishing she’d kept her mouth shut when she realised she would have to explain. ‘My mother’s called Rose and she named us girls after flowers, too…Lily, Iris, Violet and Marguerite…and for years she’s given us flower-scented toiletries for Christmas and birthday presents. This year mine was—’
‘Jasmine,’ he finished for her, then shocked her to the core by taking her hand in his and bringing her wrist up to his nose. ‘No, nothing there,’ he pronounced, almost seeming disappointed.
‘Too much hand-washing,’ she suggested, to cover the shiver of response that travelled the length of her spine when his dark eyes almost seemed to take inventory of the other places he might search out to find the elusive scent.
‘Ah…you were saying?’ she fumbled as she tugged to retrieve her hand, horrified by how swiftly things had strayed away from the purely businesslike. ‘About the new system?’ she prompted, as she knotted both hands together on her lap, trying to quell the strange tingle that lingered where his fingers had held hers.
‘Ah…yes.’ She saw him blink as though it took an effort to gather his concentration. ‘It’s production-line surgery, to put it at its crudest. Have you heard anything about it?’
‘Where the surgeon has a whole string of operating theatres on the go at one time, with juniors starting and closing the operations while the consultant does the complicated bit in the middle? Yes, I’ve heard of it,’ she agreed with a buzz of excitement. ‘Is it true that some can keep twelve theatres busy at once?’
‘I believe so, although I didn’t witness it when I was over in the States, or when I was in France, where orthopaedic surgeons use a version of the same system.’
‘So what are the advantages over what happens here? Doesn’t it tie up an enormous number of other staff—anaesthetists, nurses and so on? And then there’s the number of specialist staff for post-operative care, too…and physiotherapists for mobilisation…and the number of beds needed all at once and…’
‘I know! I know! These are all the objections that Reg has been pointing out ad nauseam to anyone who will listen, even though I have told him that I only want to use two theatres and to operate for five hours instead of three and a half.’
‘So tell me about the benefits,’ she challenged.
‘For the hospital accountants, the first one is obvious,’ he said with a shrug. ‘The most expensive member of an operating team is the surgeon, and at the moment the hospital is paying for him…or her…to spend unnecessary time sitting drinking tea or coffee while they wait for the theatre to be cleared and restocked and their next patient to be prepped. It just doesn’t make economic sense to pay them to be idle.’
‘And secondly?’ she prompted, already seeing that he’d thought deeply about this, having seen the system working in other countries.
‘The benefit to the patients is when the waiting lists are cut to nothing,’ he said decisively. ‘Other countries are horrified by the idea that someone already in pain and needing replacement surgery for a hip, maybe, should then be put on a list and have to wait for up to nine months before their pain can be relieved. For some, the only bearable option is to pay to go privately, but for many, even that option is not possible because of the high costs involved. This just doesn’t happen in France, for example, because the production-line system means that the theatres and surgeons are utilised properly…to full capacity.’
‘And the disadvantages?’
‘Once again, financial, with the cost of building and equipping extra theatres, and then there’s the specialist theatre and ancillary staff. There’s also the fact that if the waiting lists disappear, far fewer people will be interested in paying for their operations privately, so the surgeons who are boosting their incomes with private work will feel the pinch, apart from having to work longer shifts and work harder during the hours they’re on shift.’
‘So it’s no wonder that Reg and his coterie are less than enthusiastic about your plans,’ Lily said with dawning comprehension. ‘If they agree with you, it’s tantamount to upping their workload by nearly fifty per cent while dropping their income by a similar amount.’
‘Don’t forget the fact that their tea-breaks will virtually disappear!’ he added, then gave a sigh. ‘It all just so frustrating when the theatre suite is all but completed and I’ve already got the anaesthetists and theatre staff on board.’
‘So,’ Lily mused thoughtfully, ‘the last thing you needed was to have a female surgeon foisted on you. I suppose you see me as the last nail in the coffin of your plans.’
‘To be honest, I won’t know that until I see you work,’ he said bluntly, those dark eyes fixing her steadily, unequivocally. ‘If you’re a good surgeon, you could actually be the card that wins the game.’
‘So, before you start pushing them for the go-ahead, you need to know that Reg appointed the right person in spite of himself. I take it that when we’re in Theatre together tomorrow morning, you’ll be watching me like a hawk?’
‘Will that worry you?’ One dark brow lifted quizzically but there was a watchful stillness about the man that sent an atavistic shiver through her.
That was enough to put some steel into her spine. She’d never allowed any man to intimidate her and wasn’t about to now.
‘Not in the least,’ she said firmly, confident of her abilities. ‘I might not have had the experience you have, but I’m good at what I do. Very good, because I’ve worked hard at it.’
There was an unexpected warmth and…was it respect?…in his eyes. ‘I’m looking forward to it,’ he said softly.
If ever there was a challenge to put her on her mettle, Razak Khan was that challenge, she thought as they finished their meal, tacitly agreeing to stick to more general topics as they got the measure of each other.
It was only when he’d walked her back to the hospital and she was making her solitary way towards her cramped bedsit that she remembered her idea of having a word with the chairman of the committee, just in case Reg had read the bean-counters right.
Initiating this new scheme was going to use up finite resources, with a full staff on duty in both theatres simultaneously, but if Razak had the support of everyone on those teams, even his untried junior…If everyone knew that she was fully behind Razak’s initiative, would that remove any of their reservations?
Of course, much of that would largely depend on how well she performed the next day, whether she and her new boss could find that elusive synchronicity that made for a good operating team, and if she was too tired, it definitely wouldn’t happen.
Razak flung the bedcovers to the floor in a fit of impatience and swore softly into the darkness.
‘What on earth is wrong with me?’ he demanded aloud. ‘So what if she’s a woman? She’s an orthopaedic surgeon, and that’s what matters.’
Except she wasn’t like any other orthopaedic surgeon he’d ever met. He’d never met anyone who presented such a calm, serene exterior while underneath…Did she even know the depth of passion that was hidden under the surface? He doubted it. There was such an untouched air about her that it aroused the hunter in him the way no woman ever had.
She didn’t even look like any of the other women in his life. His upbringing had conditioned him to appreciate the lush voluptuous woman who knew how to pleasure a man, while Lily…
She was so much like her name…tall, slender, elegant, cool, with her pale gold hair and even paler skin the colour of rich cream sprinkled with just a handful of cinnamon freckles. For a crazy moment he found himself speculating whether those sun-kissed spots were confined to her face and arms or whether they extended to the rest of her body. He was seized with the urge to explore beneath the camouflage of her neat professional clothes to find…
‘No!’ he growled, and winced when he heard the throaty tones of arousal in his voice. Was she some kind of witch that she’d tied his thoughts up in her, his body already in thrall?
It couldn’t be allowed, not if he was going to achieve his goal. He must be allowed to set up this programme if he was going to strengthen his claim in time for his return to his homeland. There were so many willing to point the finger and to whisper of nepotism. This was important to him. This was one thing that he needed to achieve on merit alone. He was so close to achieving his dream that he could almost touch it, and he couldn’t allow anything—or anyone—to stand in his way.
‘So, tomorrow you will watch Lily as she operates and you will do it with eyes as sharp as the scalpel in her hand,’ he told himself sternly. ‘You will assess her skills and her weaknesses and you will decide whether she is going to be an asset or…’
He shook his head. There could be no or. Failure was not an option. Lily Langley was his junior, for better or worse, and if he needed to retrain her himself in time for the start of the project, he would do it.
‘I just hope you’re up to it, pretty Lily,’ he growled. ‘If not, the next few months could be misery for both of us.’
CHAPTER THREE
LILY deliberately arrived early the next morning, nearly an hour before her shift was due to start, with a squadron of butterflies in her stomach.
She was determined to have one last check through the equipment she was going to be using for the first operation and wanted to do it before Razak arrived and began monitoring her every action, but she was too late. He was already there, as alert as if he always enjoyed a full eight hours’sleep a night, while she was so nervous that she felt as if she might fly apart at any second.
‘Keen and eager?’ he asked her, as he strode along beside her towards the theatre they’d been allocated that morning, but she was certain that somehow he knew that it was nerves that had brought her in this early.
‘Looking forward to getting on with the job,’ she agreed, wishing she dared cross her fingers for luck. Although she had a feeling that luck wouldn’t be enough to take her through this first operation. She was going to need to demonstrate every bit of the skills she’d learned so far, while learning everything she could from the man who had so much expertise to impart.
And the first thing she learned was a lesson in simple humanity.
Their patient had stuck in her mind from their meeting yesterday, soon after her admission to the orthopaedic ward.
Cicely Turner wasn’t a very tall woman, and she weighed hardly more than a sparrow, which was probably the only reason why she’d managed to keep going as long as she had on hips that were so damaged it was a wonder she was still able to stand, let alone lead a full and active life with dozens of grandchildren and children around her.
‘My mother’s hip replacement was a success but my father’s was a disaster,’she’d told them bluntly when the two of them had invited her into Razak’s office to review her case notes, the X-rays prominently displayed on a view box. The whole procedure had then been discussed with her in detail before she had been asked whether she had any questions.
‘Not really, no, thank you very much,’she’d said politely. ‘I’m certainly not expecting to be able to run a marathon when you’ve done it. I just want you to promise me that you’ll take the pain away so I can help my children out by doing a bit of babysitting now and again. I do love getting my hands on the babies,’ she confided in an aside to Lily. ‘Luckily, by the time I couldn’t have any more of my own, my children had started producing their own, so I’ve always had plenty to cuddle.’
Razak had pointed out, quite properly, that he couldn’t guarantee the success of any operation. ‘All I can guarantee is that we’ll both do our very best,’ he’d said seriously.
And that morning, before the anaesthetist had put her under, he’d made a point of going through to hold her hand and tell her that he hadn’t forgotten his promise.
The smile of relief on the woman’s face wasn’t something that Lily would forget in a hurry, neither was the fact that Razak had understood just how frightened Cicely would be in such an alien situation. It was proof of something special in the man that, despite the time constraints on their limited theatre hours, he had sacrificed a couple of those precious minutes to put her at ease.
The operation itself was textbook perfect, as was the meshing of their skills as the procedure unfolded.
The joint was badly worn, their first view of it once it had been disarticulated confirming Razak’s diagnosis that this patient would be requiring a complete prosthetic replacement for both components of the ball-and-socket joint.
‘I still think the Exeter will be the best choice for her,’ Razak murmured, with another long look from the open joint in front of them to the most recent X-rays displayed on the wall.
‘One of the earliest designs and still the best?’ Lily suggested, wondering if he could tell that she was smiling behind her mask. ‘I believe it got its name because the man who designed it worked at Exeter University in the engineering department.’
‘That’s probably why it has stood the test of time with so few modifications, then—because it was designed to stand up to the stresses to which it would be subjected, rather than to look pretty,’ he commented, even as she saw him checking his measurements to ensure the finished leg length would match its opposite number.
It was strange how, as soon as she’d touched the scalpel to the woman’s prepared flesh, all hint of nerves disappeared. She was still overwhelmingly aware of Razak standing just inches away from her as she dissected her way through the layers of skin and muscle but when his hands came into the operating field it wasn’t as an intrusion into what she was doing but rather as if she’d somehow grown another pair of hands to help her to complete the task.
‘Ready to close?’ he asked, when the cement that had been specially developed to hold the prosthesis to the bone had set properly and the smooth new ball of the joint had been relocated in the relined socket. Lily had been concentrating so hard that it seemed that just moments had passed since the initial incision. A quick glance up at the clock hung prominently on the theatre wall showed that, in fact, the patient had been under anaesthetic for nearly three hours. ‘Are you happy with everything?’ Razak added, almost as an afterthought.
For just a second she wondered if the question was some sort of test and she began to doubt herself, but a quick inspection of the operating site told her that all was exactly how it should be.
‘I’m happy,’ she confirmed, and held out her hand for the first of the absorbable sutures that would be buried deep inside the muscles of the thigh.
Her technique was flawless, Razak mused as he stood aside to watch Lily closing the final layers of the wound with the neatest row of stitches he’d seen in a long time.
Her requests and comments to the other staff had been calm, clear and concise and her concentration…probably better than his own, he admitted with a wry smile behind his mask. Particularly today when his focus had continually been interrupted by an awareness of the soft floral scent that had drifted around him from her skin.
This strange sensitivity towards a work colleague had never happened to him before, even though he’d been surrounded by women in every operating theatre he’d worked in.
Was it just her perfume? That was unlikely. The human sensory system was designed to be able to switch off such input after a relatively short time.
So, was it Lily herself? It certainly seemed that way, although he had no idea what it was about the woman that was affecting him this way. There was something about her that was different to every other woman he’d known but…was she that different that she could interfere with his usual level of concentration?
He suddenly realised with a frown of concern that he might be in a different sort of trouble if his scheme didn’t get the go-ahead.
At least with Lily working in the other theatre, prepping and closing each patient in turn, he wouldn’t be working beside her. It might be the only way he’d be able to demonstrate that the scheme worked, and that was so important to him when he had much less than a year left before he returned to his own country at the end of his contract. After all, it was exactly this sort of system that he was hoping to instigate when he returned home and he needed a success here to silence any doubts.
And still he couldn’t help watching her as she straightened up from applying the final wound dressing, taking in the way she ran a smoothing hand over the supportive anti-embolic stockings that Cicely had been helped into before the operation. They would be removed and replaced twice a day for skin inspection and hygiene purposes.
Then he saw her checking that the notes specified the correct doses of post-operative pain relief and that the antibiotic prophylaxis that had commenced preoperatively would continue until healing had taken place. The last thing any of them needed was for their patient to suffer a deep vein thrombosis or develop a post-operative infection that could destroy their work.
‘Good,’ he said quietly, when she finally stepped back and the trolley was wheeled through to the post-operative ward where Cicely’s recovery from the anaesthetic would be closely monitored. ‘That went very smoothly. I am pleased.’
He could see from the way her eyes lit up that she was smiling, even though her expression was still largely hidden behind her mask. He’d had years of discovering how much a man could learn about a woman when he could see little more than a pair of expressive eyes, but for the first time was discovering just how much physical effect they could have on him.
Out of the corner of his eye he saw her strip her bloodstained gloves off, the way she automatically tucked one inside the other without having to watch her hands performing the manoeuvre a testament to just how many times she’d done it. Her aim into the bin was equally accurate.
Only then did she pull her mask down around her throat to show him that her smile was every bit as wide and just as delighted as he’d imagined.
‘Really? You’re pleased with the way I…it…?’ She stumbled to a halt, an endearing hint of pink darkening that creamy skin. He took pity on her.
‘Yes, I was pleased with the way the operation went and, yes, I was most definitely pleased with your technique,’ he said firmly. ‘Now, let’s get out of here so the staff can get everything ready so we can do it all over again.’
He gestured for her to precede him out of the room, ironically looking forward for the first time to wasting some of their precious theatre time drinking tea with her and rehashing the recently completed procedure.
It was only as she strode ahead of him and his eyes slid down the long slender length of her legs that he noticed that where other theatre staff had written their names or initials on the clogs they wore in Theatre, Lily had drawn a simple stylised picture of the flower she had been named after. The unexpected touch of whimsy suddenly made him realise that there could be far more to this woman than the fact that she was a talented junior surgeon.
The second procedure, a debridement and removal of osteophytes from an osteoarthritic knee, went every bit as smoothly as the first and his heart lifted with the realisation that, whether he had intended it or not, Reg had certainly chosen a perfectionist to be his junior.
His only lingering concern as they reached the end of their shift was whether someone so slender would have the stamina to keep up that standard over the longer operating sessions he wanted to instigate, and neither of them would know the answer unless or until they were given a chance to find out.
‘Dr Langley. A word, please,’ Reg Smythe said pompously as she was just about to leave the orthopaedic department at the end of her shift.
Lily glanced swiftly at her watch, delighted to see that she really didn’t have time to find out what he wanted to say. She had a strong feeling that he wouldn’t have used the same unpleasantly autocratic tone if she’d been a man and her respect for the head of department took a further dip.
‘I’m sorry, Mr Smythe, but I’m going to be late for an appointment.’
‘An appointment?’ he echoed superciliously, as though nothing could be more important than his request.
Lily didn’t want to give the man any more excuses to dislike her. ‘With someone in the administration department,’ she added helpfully.
‘The administration department?’ he repeated impatiently.
‘That’s where they sort out contracts and tax codes and things, isn’t it?’ Lily elaborated blandly. She certainly didn’t want to give him a hint that it was the senior administrator’s office that was her destination. It would be better if he didn’t know what she hoped to accomplish that evening.
‘Ah, yes. Probably,’ he said dismissively. ‘I suppose you’d better run along, then. I’ll have a word with you later.’
Not if I see you first, she said to herself as she hurried away from him, hoping she didn’t look half as guilty as she felt, but until she knew what the chairman of the committee wanted to talk about, she wasn’t going to risk any conversation with Razak’s nemesis. For all she knew, the man who was one of the hospital’s most senior administrators did want to talk to her about her tax code or her pay scale, unlikely though that might be for a man of his status. His message had given her no reason to think that it could be anything to do with the proposed change in operating methods.
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