A Man of Honour

A Man of Honour

Caroline Anderson

www.millsandboon.co.uk

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Table of Contents

Cover

Title Page

Chapter One

Chapter Two

Chapter Three

Chapter Four

Chapter Five

Chapter Six

Chapter Seven

Chapter Eight

Chapter Nine

Chapter Ten

Copyright

CHAPTER ONE

SHE didn’t know what it was about him—in a department filled with attractive men, his regular features and easy, natural bearing were not particularly remarkable—but there was something compelling, some elusive, indefinable je ne sais quoi that drew her.

Perhaps it was his smile, the hesitant, slightly quirky twist to his lips, gone as swiftly as it had come; or perhaps the eyes, that strange combination of ice-blue and the dark, practically navy line around the iris that gave them a penetrating, almost haunting quality.

Whatever it was, Helen Cooper found his presence at the meeting distracting in the extreme.

His name, she learned, was Tom Russell, and he had just been offered the post of senior registrar to Ross Hamilton, one of the consultant general surgeons at the Audley Memorial.

Which meant of course, that she would be seeing very much more of him that was going to be good for her concentration, if today was anything to go by.

The meeting was an informal get-together, an opportunity for Tom to meet some of the team before he joined them at the beginning of May, and as they chatted over coffee Helen found her eyes straying to him again and again.

He was quieter than the rest—still, she imagined, on his best behaviour for the occasion—but his eyes followed the conversation and his mouth lifted now and again in response to a joke.

Oliver Henderson was there, propping up her desk and asking Tom if he had any ambition to be a cartoonist, which brought howls of laughter from the other members of the team and a puzzled frown from Tom.

Ross’s smile was wry but good-natured. ‘Ignore Oliver,’ he told his new SR in his soft Scots burr. ‘He’s just trying to provoke me.’

A bleep squawked, and Ross’s SHO, Gavin Jones, excused himself and lifted the phone. After a murmured conversation he turned to Ross.

‘Sounds a bit tricky. They’ve got an RTA victim in the trauma unit—suspected leaky aorta.’

Ross set down his cup and stood up. ‘Sorry, Tom, think this needs my attention. Sister Cooper will ply you with coffee and point you in the right direction, I have no doubt. I’ll see you in a month—don’t hesitate to ring if you’ve got any queries.’

They shook hands and Ross left with Gavin, followed by Oliver and then Linda Tucker, the staff nurse on duty, and Helen found herself alone with Tom in a silence that seemed to stretch on forever. Just when she thought she would have to find something to say to fill the void, he met her eyes.

‘Do you mind if I ask you something?’

‘No, of course not, ask away.’

‘What was all that about cartoons?’

She laughed softly, caught off her guard. ‘Oh—well, one of the surgical team was a bit of a joker. He’s moved on now, but he’s supplementing his hospital salary quite nicely by freelancing as a cartoonist for medical journals, I gather.’

Tom nodded, and the silence closed softly round them again, suffocating her. He seemed so close, so big, somehow, his hips propped against the windowill and his suit jacket drawn back by hands thrust casually into his trouser pockets in an unconsciously masculine gesture.

Awareness tingled through her, quickening her pulse and making her breathing unsteady. She looked away, taken aback by her reaction, and the silence yawned on. After a moment her natural good manners overcame her distraction.

‘Would you like another cup of coffee?’ she offered him, and was struck again by the haunting eyes.

‘Thank you, but I’d better not. I’ve had about five cups already this morning—I’m in danger of drowning in it!’

His lips, firm but with a hint of fullness, quirked into an appealing smile and Helen felt her heart kick against her ribs.

‘Another look round the ward?’ she suggested, her composure really rattled now. They suddenly seemed very alone together in the little ward office.

‘Have you got time?’

She laughed wryly. ‘No, but the paperwork can wait.’

He laughed with her, a quiet, restrained laugh, and shrugged away from the window. ‘If you’re sure, then, I would appreciate it.’

He held the door for her, and as she passed through it she caught the faint trace of cologne, a subtle lemon fragrance tinged with something peculiarly masculine and very personal, something inextricably linked with her confusion and the strange, haunting feeling of being poised above an abyss.

And then he smiled, that strange, quicksilver smile, and she felt the edge of the precipice shift and start to crumble beneath her feet.

The first day back after the spring bank holiday was destined to be hectic from the start. Ross Hamilton’s team were on take for emergencies, and Oliver Henderson had a list that morning. There were three day cases in for endoscopy and a fourth for sigmoidoscopy, and, if that wasn’t enough, one of her staff nurses was off sick with a summer cold that had been doing the rounds.

Even so, and most untypically, Helen found time after she had taken the report and programmed her nurses to dive into the staff cloakroom and give herself a critical once-over.

Not, of course, that it had anything to do with a certain dark-haired, enigmatic young registrar who was starting work today—heavens, no!

But there was a becoming touch of colour in her pale cheeks, and deep in her soft grey eyes the light of hope glimmered. She didn’t see that, of course. Instead she saw the mousy brown hair escaping from the bun, and the little smudge of mascara under her lashes—lack of practice, or a shaking hand? Could have been either, she thought, licking a tissue and dabbing at it. Better. She stood back and examined herself critically, tugging her uniform dress straight over her slight figure and staring, unsmiling, at her reflection.

What she saw dismayed her, and the ray of hope in her eyes flickered and died. With a sigh of resignation she turned away and went back to her duties with customary efficiency, putting aside her foolish fancies.

What would Tom Russell see in her, anyway? And besides, he was probably married, or at least engaged or living with someone. His type always were. It was only the perennial bachelors with the morals of alley-cats that were still free—and Helen wouldn’t touch them with a barge pole.

Not that she was a prude exactly, but there was a line over which she wouldn’t step, and casual sex with overgrown schoolboys fell far beyond that line.

So she was lonely, and a little out of practice at dating men, although she worked with them as patients and colleagues every day of her life without any problems.

No, he wouldn’t be interested, and she was crazy to imagine he would be, she told herself firmly, and set about putting him out of her mind.

She was bent over a set of notes, transferring information on to the computer, when his voice sent a shock-wave through her.

‘Any chance of that coffee you offered me a month ago?’

Schooling her expression, she straightened and turned.

‘Dr Russell—welcome aboard.’ Her words were stilted, but her smile was natural, open and generous, and her voice was filled with a warmth she was unable to disguise.

‘Thank you,’ he replied, his eyes searching hers, and his lips twitched briefly into that smile. ‘Are you on my side?’ he asked conspiratorially.

‘Your side?’ Helen was momentarily nonplussed.

‘Yes—my side. Can I hide behind your skirts when I commit some bureaucratic misdemeanour and get yelled at by the powers that be?’

She chuckled. ‘Is that likely?’

He shrugged. ‘I hope not, but I must confess to a rotten case of nerves.’

Oh, no we can’t allow that!’ she said with a smile. ‘Come on.’ She led him into her office. ‘Here—coffee.’

There was a jug always on the go, at the insistence of the consultants who disdained the ‘sewage produced by the canteen’ and supplied their own coffee grounds. Helen poured Tom a cup and passed it to him, and then as he perched on the edge of the desk and downed it gratefully she watched him, unable to look away.

He was even more attractive than she had remembered, the smooth line of his jaw faintly shadowed even this early in the day. There was a tiny nick in the skin of his throat where he had cut himself shaving, and she wondered absently if anyone had kissed it better.

She looked away. Thoughts like that would get her nowhere. The cup rattled gently in the saucer, and she turned back.

‘Gorgeous,’ he said, his grin crooked. ‘God, I needed that! Thank you.’ He took a deep breath, then shrugged himself off the desk and smiled at her.

Her heart faltered for a second, then speeded up, much to her confusion. This was ridiculous! She couldn’t react like this to him every time he smiled at her! She had to get things back on an even keel, and fast.

‘How are you really feeling about starting here?’ she asked him, determined to hold a normal conversation without blushing and stammering.

His grin was fleeting and hesitant. ‘Really? I’m terrified,’ he confessed.

‘I don’t believe you,’ she told him bluntly. ‘You don’t look that easily intimidated.’

His eyes, those haunting ice and midnight-blue eyes, met hers and held, and they were backlit by a lurking glimmer of humour. ‘I’m not usually. It must be first-night nerves—either that or a hang-over from last week’s exams. I had the written papers for my FRCS Part Two, and I thought I was going to die of fright.’

‘Unlikely,’ she assured him drily. ‘Still, I remember starting on this ward as sister. I was absolutely terrified, too, but everyone was so friendly. One of the older SENs came and perched on my desk and started to chat. I was so grateful to her, and it was fine after that—a lot of fun, in fact.’

His smile was wry. ‘I doubt if it’ll be fun.’

‘Oh, I don’t know. Ross Hamilton has a terrific sense of humour.’

‘Hmm—I’ll reserve judgement on that. I gather he’s a hard task-master.’

She grinned. ‘Only if you’re totally incompetent—or if your name’s Mitch Baker!’

His mouth quirked. ‘Not guilty.’

Helen chuckled. ‘Mitch was. He’s the cartoonist I was telling you about. He drew an anonymous series of cartoons about Ross and Lizzi when they first started going out together, and some of them were a bit close to the knuckle. He probably would have got away with it if he’d been good at his job, but at that point he still had an awful lot to learn, and so, yes, Ross was hard on him, but he certainly deserved it, from what I can gather.’

‘So,’ he said, his eyes smiling, ‘provided I’m whiter than white and toe the line, I’ll be all right?’

‘I don’t think Ross would have taken you on if he hadn’t thought highly of you,’ she told him seriously. ‘He doesn’t suffer fools gladly.’

Tom sobered. ‘That suits me,’ he murmured, ‘because neither do I. Right, what has he got for me this morning?’

‘Four day cases, and you’re on take for emergencies.’

‘Fine. What are the day cases?’

‘Two endoscopies for investigation of query gastric or duodenal ulcers, and an ERCP for query cholecystitis.’

He chuckled. ‘The miracles of modern technology. Thank God for abbreviations—endoscopic retrograde cholangiopancreatography is a hell of a mouthful!’

‘But probably quicker than saying sticking a tube with a camera on down someone’s throat and into the duodenum and injecting radio-opaque medium into the bile duct to see what happens! Oh, and there’s a sigmoidoscopy—middle-aged man with fresh blood in his stools—Ross is querying colitis or carcinoma; his wife reckons he’s got piles.’

Tom looked thoughtful. ‘Well, I hope to God she’s the one that’s right.’ He glanced at his watch. ‘Is it OK if I wait here? Hamilton said he’d meet me here at eight-thirty.’

Just then the door opened and Ross came in.

‘Tom—good to see you again,’ he said, extending his hand, and after a brief exchange of pleasantries he turned to Helen.

‘Got the day cases in yet?’

‘Yes—Gavin’s clerked them and they’ve been prepped—they’re all ready for you.’

‘Good girl. Right, Tom, let’s go and see you in action.’

‘I can hardly wait,’ he said drily under his breath, and winked at Helen, drawing his finger across his throat.

‘Coward,’ she muttered at his departing back, and he chuckled.

‘Too damn right. Save me some coffee—I’ll need it.’

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.