A Change Of Heart. Alison Roberts

Desmond Knight chuckled. ‘The bad news is that he’s only got a week to live.’

      ‘And the good news?’

      ‘Well, the surgeon points to a nurse who’s really…’

      ‘Stunningly gorgeous?’

      Desmond nodded enthusiastically. ‘And he said, ‘‘You see that great-looking nurse over there?’’ The patient looks and then he nods eagerly and looks back at the surgeon kind of hopefully and the surgeon says, ‘‘Well, the good news it that I’m taking her out on Saturday night.’’’

      David laughed with genuine amusement. He even looked in the direction Desmond had been pointing, but there was no nurse, stunningly gorgeous or otherwise. There was, however, an impressive expanse of pink candlewick—a back view of Mrs Judd, her walking frame parked in the doorway as she stopped to catch her breath. David caught Desmond Knight’s eye.

      ‘Rather you than me,’ Desmond murmured.

      The pink tidal wave receded, replaced almost instantly by the slim figure of Lisa. The contrast was astonishing and Desmond’s face brightened considerably.

      ‘Hi, Doc.’

      ‘Hi, Des. I see you’ve met our new surgeon.’

      ‘He tells me I’ll never play the violin again.’

      ‘You couldn’t play it before.’ Lisa’s smile was only for her patient but David could sense its warmth and felt oddly excluded.

      ‘I’ve just been explaining the surgery to Desmond here. We’re scheduled for 8 a.m. tomorrow.’

      Lisa nodded. ‘I wondered if you had the time now to review everything. I’ve got all the notes and I’ve set up the cardiac catheter film in the viewing room if you want to see it.’

      ‘Of course. I was about to call you.’ David turned back to Desmond. ‘Try and have a good rest and I’ll see you in the morning.’ He leaned forward conspiratorially. ‘I’d better check out the home movie you had done in the cath lab. I wouldn’t want to miss a bit of plumbing that needs attention.’

      ‘Make sure you do the bolts up nice and tight. That’s what bothers me.’

      David could see the fear beneath the levity. He reached out and gripped Desmond’s hand briefly. ‘No worries, mate. I’ll get you running on full bore and leakproof.’

      The faint pink flush he could see on the back of Lisa’s neck indicated that she had not appreciated the interchange as much as Desmond Knight, but David hadn’t been able to resist rubbing her nose in it just a little. He would never admit to the extent that her attack had nettled him yesterday, but between that and the paroxysms of mirth from the neighbouring bedroom last night David had been sorely tempted to pack his bags and return to a more congenial hemisphere.

      ‘What time did Desmond come in yesterday?’

      Lisa was flicking a series of switches, dimming the lights in the angiography viewing room. ‘About two o’clock.’ She moved swiftly towards the projector. ‘Why?’

      ‘Just curious.’ David took a seat, leaning back and resting his chin on one hand. The admission must have been just before he’d turned up in her office with her remaining belongings and that stupid rose. So that was what she’d been taking out on him—her frustration at being unable to provide the treatment her patient needed so desperately. Understandable. Commendable, even. But it didn’t excuse her earlier rudeness or that cutting remark about library books. Lewis Tanner may well have soured her opinion of newcomers but it was still inexcusable to act on it so blatantly.

      ‘You’ve got his hypertension under good control,’ he commented, picking up the case notes. ‘And coronary perfusion’s not looking too bad.’

      ‘Surprisingly,’ Lisa agreed. She started the projector. ‘We got these shots this morning.’

      They both watched the screen—the shadowy background of the heart pumping, the outline of the main arteries and their filigree of branches darkening clearly as each dose of dye was injected.

      David grunted. ‘Not pretty.’

      ‘No,’ Lisa agreed quietly. ‘It’s not.’

      They went through the film twice. David held the catheterisation report in his hand the second time, checking the diagram that documented which arteries were damaged and to what extent. ‘We’re looking at a quadruple graft here,’ he murmured. ‘Should keep me out of mischief for the morning.’

      ‘Would you mind if I stood in for a while? If I get the chance, that is.’

      ‘Not at all.’ David deliberately gave his tone a professional detachment. Scrutiny was only to be expected as a newcomer, and David had never suffered from nerves due to an audience. This time yesterday his pulse rate would have jumped at the thought of being observed by Lisa but he was delighted to find himself unmoved today. Sure, the woman was physically attractive but his initial reaction had been ridiculous. She was a colleague. One who had advertised her ability to be antagonistic and would therefore need to be treated cautiously. The idea that she might be anything other than a colleague had fortunately vanished completely. He was no longer remotely interested despite Mike Foster’s advocacy of her virtues and suitability. That teenage-like surge of testosterone had been nothing more than part of the excitement of starting a new job and the pleasure of renewing old friendships. The novelty had worn off amazingly fast.

      The theatre team was fantastic. David was delighted to find that the anaesthetist was Gerry Greene, a contemporary and one of the old party crowd. Now married with three children, he was still keen to arrange a get-together. The nursing staff were welcoming and the selection of CDs for some relaxing background music was surprisingly good. David’s choice of Dan Fogelberg was met with general approval. By the time Alan Bennett slipped in to observe, David had opened the chest, separated the sternum, retracted the ribcage and was carefully opening the membranous sac of the pericardium which enclosed Desmond Knight’s heart. His registrar was doing a very competent job of harvesting the leg veins required for the grafts.

      ‘I’m about to cannulate for bypass with aortic arterial and venous RAIVC lines,’ David informed Alan.

      The transfer to bypass on the heart-lung machine was smooth, and by the time David applied the cross-clamp and stopped the heart by injecting the cardioplegic solution he was thoroughly enjoying himself. David loved surgery. Politics were non-existent. The goal was defined, everybody was working on the same side and he had the skills to lead them and deal with any complications. It was a dramatic occupation. David had often thought ‘theatre’ was a very appropriate name for the room. It was also often highly stressful, especially when unforseen difficulties presented themselves, but David thrived on the pressure.

      ‘7.0 Prolene, thanks.’ David handled the floppy section of empty vein gently as he sutured one end of it carefully into place. ‘OK. Let’s check the run-off.’ The adjustment of the clamp allowed blood volume to move through the graft and David nodded with satisfaction, before turning his attention to attaching the other end of the graft to the wall of the aorta.

      He stood back and stretched some time later but the break in the long procedure was brief. ‘Let’s move on to the anterior descending, folks. We’re doing well.’

      Lisa did not appear in Theatre until the last graft was being attached to the aorta. It would have been easy to miss her arrival, due to the number and activity of the theatre staff, but something made David glance up. The brown eyes were magnified by being the only exposed part of her face. Even by themselves they were remarkably expressive. David dismissed the faint jolt the recognition gave him but acknowledged Lisa’s presence with a slight nod.

      ‘Let’s get this cross-clamp off and check out the plumbing,’ he suggested, his smile hidden by his mask. David knew quite well that he’d done an excellent job. Even Lisa should be impressed. Alan and the theatre staff certainly were. Desmond Knight was weaned from bypass uneventfully and his heart restarted spontaneously.