The Surgeon's Perfect Match

But she wasn’t in a position to be looking, was she? And while Ryan’s concern and support for her had been so much more than she could have wished for, it had never crossed any professional boundaries. They might think highly of each other but they were colleagues on very different rungs of a professional ladder. Not friends, because they knew nothing of each other’s lives outside work.

Holly wouldn’t have a clue what Ryan might be eating for dinner that night. She put the frozen supermarket dinner into her microwave with a grimace. This meal was a cop-out. Only acceptable because the level of protein and probably anything else in the nutrition stakes was low enough for the occasional use not to tip her carefully balanced diet into disarray. Whatever Ryan chose or possibly cooked for himself, it was bound to be more appealing than the plastic-looking pumpkin and spinach lasagne she was heating.

He certainly wouldn’t be counting out pills to have with his food either. Working her way methodically along the row of canisters adorning her window-sill, Holly shook out the phosphate binders, vitamin and mineral supplements, the iron tablets and her doses of diuretics and anti-hypertensive medication.

Maybe Ryan had exotic spice jars on his kitchen win-dowsill. Or herbs growing in pots. Holly wondered what his kitchen looked like. And his house. She had never thought about Ryan in such personal terms before and some of the anger she had felt earlier returned when she couldn’t shake her current train of thought.

Too tired to be hungry, she forced herself to eat and wondered, in some dismay, whether just voicing that extraordinary offer had been enough to seriously undermine her professional relationship with the man who headed her chosen department.

Holly didn’t want to have to leave St Margaret’s Children’s Hospital. She’d have to go offshore to find anything similar and with the support team she had in the renal department of the nearby general hospital, she couldn’t afford to look elsewhere. Neither did she want to leave her home town of Auckland, New Zealand. This was her home. Where she wanted to live. And work.

This apartment would never be her ultimate goal, of course, but it was close to both hospitals. It was tiny and low maintenance, and while it might be without soul it was valued nonetheless for its contribution to Holly’s independence. Did Ryan have a house rather than an apartment? A cat? A garden, maybe, instead of a sad set of pot-plants on a minuscule balcony? The plants weren’t going to receive the attention they urgently needed this evening either. Not when she seemed unable to shake the imaginary comparisons between her life and Ryan’s.

That kind of thinking had the potential to destroy things between them. Holly couldn’t afford to be envious of anybody and particularly her boss. What if she became resentful that he had a life at all outside work when she didn’t? A home and garden to go to? That he had the prospect of that life continuing and including something as wonderful as a family? Something Holly could dream about only if she became healthy again.

Health that could potentially be restored by an offer she couldn’t possibly accept.

Why had Ryan made the offer?

Because he felt sorry for her?

Maybe he’d been influenced by recent media coverage of one of New Zealand’s foremost sportspeople, Steve Mersey, whose career and Olympic hopes were about to be ended due to the sudden onset of debilitating kidney disease. Complete strangers had started putting up their hands, offering to donate an organ. Had that given Ryan the idea? Did he feel obliged to emulate such altruism because of the type of person he was? Or had he realised how much further it was possible to go in helping someone like her and, having done so much already, felt obliged to go that extra mile?

Either explanation was pretty cringe-making. Holly had done the right thing in refusing to consider acceptance. The only thing she could have done. Now all she needed to do was to stop thinking about it, despite Ryan’s exhortation.

What she needed, above all, was rest.

And treatment, of course.

With all her essential chores completed, Holly moved to her bedroom, a small room in which the bed was actually the least significant piece of furniture. Tonight it seemed far more depressing than usual to retire to a room that would not have looked out of place attached to some hospital ward.

Her dialysis machine was the size of an average refrigerator. It would have been enough to make the room look clinical all by itself, but it was far from alone. The large water purifier was flanked by a tall cabinet that held ranks of huge bottles filled with the fluid needed for the machine. A chest of drawers beside that held saline and tubing lines. A trolley with slide-out trays housed alcohol wipes, needles, tapes, dressings and all the other paraphernalia that went along with home dialysis.

The routine of setting up was automatic. Inserting the two needles into the surgically enlarged vein on her forearm was virtually painless. Now all Holly needed to do was wait. In a matter of four to six hours, the entire volume of blood in her body would have passed through the dialysis machine at least six times, having waste products and excess fluid drawn out.

Holly often used most of this time to sit, propped up by pillows, in her bed, studying or catching up on journals. She had brought home a textbook she wanted to read, detailing the latest techniques in arterial-switch procedures such as baby Grace would need to undergo shortly, but she simply couldn’t find the energy or enthusiasm to open it.

On top of a physically challenging day, Ryan’s offer had left her utterly drained and Holly would have to sleep while the machine did its life-prolonging magic tonight. It also seemed the only way she could turn off the endless treadmill of the thoughts that interview with Ryan had sparked. Tomorrow she would feel so much better she’d be able to carry on as normal. And, with a bit of luck, Ryan’s offer wouldn’t change anything other than her appreciation of what a kind person he was.

The call to the intensive care unit came as Holly stepped through the front doors of St Margaret’s at 8 a.m. the following day. Rather than waste time by finding a phone to contact the unit staff, Holly just kept going. It was so good to be able to move along the still quiet corridors and feel as if she was walking normally and not pushing her body through air that felt as thick as treacle. At this rate she would be actually in the unit by the time she would have completed a phone call.

The speed of Holly’s response had far more to do with her renewed level of energy than the early morning absence of obstacles caused by people or equipment, and she took full advantage of the physical strength, bypassing any wait for a lift and heading for the stairs.

It had to be Callum that was causing concern in the unit and the page had been urgent. Hearing footsteps far more rapid than her own behind her on the stairs was frustrating. Dialysis might be magic but it couldn’t work a miracle, like giving her the sudden ability to race up stairs two at a time as someone else was obviously doing.

‘Holly!’ The steps slowed to match hers and Ryan’s smile was delighted. ‘You must be feeling a lot better to be using the stairs. That’s great!’

Holly just nodded, not wanting Ryan to know that climbing stairs half as quickly as him had left her somewhat breathless. He held the door open as they reached the second floor.

‘You’ve been paged by ICU?’

She nodded again.

‘Any idea what’s going on?’

‘We’ll soon find out.’ Holly’s words were clipped but not just by lack of breath. She was fighting a dread that her first VSD repair might be going pear-shaped. Had her stitches not been quite deep enough or sufficiently close together? Was Callum bleeding around his heart and suffering a life-threatening tamponade? Respiratory failure or a hypertensive crisis? Had he spiked a fever or developed renal failure?

Ryan touched her arm as they reached the unit. ‘Don’t worry so much,’ he said. ‘Whatever it is, we’ll sort it out. Together.’

Ryan’s reassurance, even his presence, was kind of like dialysis for her soul, Holly thought wryly. Fears and insecurities got filtered out and confidence renewed. She could focus and perform and not be intimidated when pushed to voice her own opinions.

Such as what she thought about the concern raised by Callum’s heart rate and rhythm. Disturbances were frequent following open heart surgery and fortunately the abnormal pattern being recorded on Callum’s ECG was not immediately life-threatening.

‘It’s supraventricular,’ Holly said in response to Ryan’s raised eyebrows. ‘The drop in blood pressure is most probably rate-related.’

‘How do you want to manage it?’

‘I’ll consult with Cardiology,’ Holly decided. ‘It’s A-fib so adenosine is probably the drug of choice. If it continues, a digoxin infusion should give us sinus rhythm again or drop the ventricular rate, but that‘s much slower. If neither works, we’d need to look at other anti-arrhythmic agents or a DC conversion.’

A telephone call to one of the cardiology consultants led to a rapid instigation of treatment, but by the time Callum was showing a good response and his anxious parents had been soothed, Ryan and Holly were running late for their 9 a.m. theatre start time.

‘Slow down,’ Ryan complained as they made their way to the changing rooms adjacent to the operating theatre suite. ‘I’m not as young as I used to be.’

‘Neither am I.’ Holly threw a quick grin over her shoulder. ‘I turned thirty last week, you know.’

‘No, I didn’t know.’ Ryan quickened his pace to walk alongside her. ‘Hey, happy birthday—belatedly.’

‘Thanks.’

‘Was it a good party?’

‘I didn’t have a party,’ Holly said quickly. She certainly didn’t want to add to any unfortunate impression she might have given yesterday that she didn’t like Ryan enough to consider him a friend and therefore he hadn’t been invited to any party she had held. ‘I didn’t really feel like celebrating my slide into middle age.’

Ryan snorted. ‘I’m thirty-six,’he said indignantly, ‘and I don’t consider myself anywhere near middle-aged, thank you.’ He pushed open the door leading to the male side of the changing-room complex then paused. ‘Don’t you like parties?’ he asked curiously.

‘I like other people’s parties,’ Holly told him lightly. ‘Not mine.’ She grinned again. ‘That way, I don’t have to clean up the mess.’

Inside the changing room, Holly’s face stilled as she sighed. Why had she started that conversation in the first place? Reaching her fourth decade should have been worth celebrating. The trouble was, in her case she wasn’t just marking a significant milestone in the passage of time. It would have been more a celebration that her time hadn’t run out.

Yet.

Why hadn’t Holly wanted a party to celebrate such an important birthday?

She should have had candles and a cake and people around to let her know how special the day was. How special she was. Ryan wished he had known. He could have given her a hug even, without stepping over the boundaries he observed so carefully. He should have known, dammit. He must have seen or signed papers that had to have had the date on them often enough. Perhaps he was closer to being middle-aged than he suspected and was developing a selective memory.

Pulling on white rubber theatre boots, Ryan moved to the dispensing box on the wall of the changing room to pull out the disposable bootees to cover the boots’ soles. Then he plucked a hat and mask from adjoining boxes.

He was feeling older today. Older and wiser.

He’d gone about it all the wrong way and he’d tried so hard to do things just right, too. To keep it all on a kind of professional basis so that Holly would not be influenced by how strongly he felt about it all. Maybe he had tried too hard. He’d done such a good job of not taking advantage of his position of power and acting on any personal interest in Holly that she didn’t even consider him to be a friend.

That had hurt.

A lot.

Ryan’s attention to scrubbing his hands in preparation for surgery was always thorough but it was more vigorous than usual this morning after his registrar joined him at the basins. He welcomed the sting of the bristles on the tender flesh between the base of his fingers.

It was just as well Holly had no idea of the real reason for him making the offer of donating a kidney.

That he was in love with her. That part of his soul was sharing her physical deterioration and would, if she died, be lost for ever.

Boy, would that scare her off in a hurry! She didn’t want to be burdened by gratitude or guilt on a purely professional level. Imagine if she knew how he felt and took it the wrong way—thinking he might be trying to pull her into a closer relationship by offering such a valuable gift?

She would be appalled. Hell, she didn’t even consider him to be a friend.

But how could she not be aware of a bond that went so far past the normal interaction of a registrar and consultant? Had he been so good at hiding the gradual development of his feelings that Holly, and any onlookers, assumed they simply shared a passion for their work that made them inseparable during working hours?

It was entirely possible, Ryan realised as their case for the morning got under way. Their twelve-year-old male patient had had a congenital lesion of aortic stenosis treated by a balloon valvuloplasty in infancy but residual stenosis and incompetence had led to an increasingly severe degree of symptoms which meant it was no longer advisable to wait until growth had completely stopped before replacing the valve. Besides, young Daniel was also very keen to play rugby and strenuous activity had so far been denied him because of the risk of sudden death. If all went well with the new valve he was going to receive today, his life would change considerably for the better.

It was a technically challenging procedure due to the congenital malformation of the valve but Ryan was more than happy to keep up a running commentary and answer Holly’s eager queries.

‘We make the transverse aortotomy about fifteen millimetres above the level of the right coronary artery. We don’t want to be any lower because that can jeopardise the artery and create problems in seating the valve.’

‘What happens if you go higher?’

‘Not much. It’s easy to angle down and any lip can be retracted.’

That was typical of Holly. She had always demonstrated the ability to determine all possible alternatives to any course of action and weigh up the potential consequences. She was sharp enough to do it almost instantly and it was a skill that would stand her in very good stead when she got to be a consultant surgeon herself.

If she got to be a consultant surgeon.

Given a technical problem, Ryan was confident that Holly could make a correct choice of an appropriate course of action. He spared a very fleeting moment of concentration to wonder why she couldn’t apply the same skill to a personal arena.

Maybe she would. Maybe Holly just needed some time to get used to the idea and if he didn’t push her she would be able to view it as an independent choice and find a way to get past what she saw as unacceptable potential consequences.

All he could do was wait. And hope. And help her to do what she wanted to do with her life as far as he was able or allowed to help.

‘You did such a good job on that patch yesterday, Holly,’ he said, when the more technical aspects of preparation had been completed. ‘How about tackling part of this prosthetic valve insertion?’

She was feeling a lot better today. The sparkle Ryan detected in the dark eyes that flashed up to meet his held no hint of any doubt in her own ability. Or any desire not to be given that level of responsibility. Holly was eager to spread her wings again and Ryan only too happy to support her.

As he always would be, given the chance.

Never mind anything too personal. As Ryan guided Holly through what was a new procedure for her, he was very aware of how much less satisfying his job would be without Holly to share his fascination in operating on what was, for them both, at the top of the list of the vital organs humans possessed.

There had to be a way to secure a future for Holly because Ryan didn’t want to even consider the alternative.

And he wouldn’t. Not yet.

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