A Change Of Heart

‘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.

The atmosphere in Theatre relaxed progressively as David wired the sternum back together and closed the chest. Gerry Greene’s plans for a dinner party had been finalised and other staff members were talking excitedly about an upcoming cardiovascular conference in the South Island tourist mecca of Queenstown.

‘Will you be going, David?’

‘I doubt I’ll be eligible for conference leave for a while.’

Alan laughed. ‘I forgot to tell you—we’ve got you down as one of the speakers. I don’t think leave will be a problem and it’s only for a weekend.’

David grinned. Speaking at a national conference on short notice shouldn’t be any problem and could only speed up his acceptance. It sounded great. Unconsciously, he found his gaze searching for the cardiology registrar, wondering whether she would be attending the conference. But Lisa had vanished and David merely shrugged mentally. It was of no great importance after all.

‘No! You musn’t do that, Donald.’

Both David and Jane Maddon turned at the sound of the alarmed protest. The familiar pink candlewick, wedged between the bars of the walking frame, was quivering ominously.

David’s eyes widened. ‘Don’t tell me that’s Mr Judd.’ He eyed the pencil-thin, late-middle-aged man with some awe.

‘Sure is,’ Jane whispered. ‘He absolutely adores her. He comes in every day to look after her and do her washing.’

‘So I see.’ David was just as awed by the size of the pair of knickers Mrs Judd was pulling from her husband’s hands. Her voice had quietened due to the exertion of her protest but was still quite audible.

‘If you put them in the drier they’ll shrink, and then what’ll I do, Donald?’

David grimaced at Jane. The alternatives didn’t bear thinking about.

Jane smiled. ‘We have a laundry where patients and relatives can take care of their nightwear and smalls. Donald Judd uses it more than anyone.’

‘Smalls?’

Jane glanced at the item of clothing Mrs Judd had now draped over the bar of her walking frame. She elbowed David as she cleared her throat. ‘What can we do for you, Mr James? Are you on the hunt for new patients? I hear Mr Knight is doing very well.’

‘He is, indeed. I like the set-up in the post-surgery intensive care unit. Very impressive.’

Jane was watching Donald Judd hovering anxiously near his wife as she rolled slowly back to her room. ‘Mrs Judd is in need of some attention to her coronary arteries, I believe.’ She eyed David with amusement. ‘We just need to get her diabetes under better control and see if we can get on top of the asthma. Lisa has her scheduled for a cardiac catheter next week.’

David was backing off. ‘I really only came to find Mike. Is he around at the moment?’

Jane grinned. ‘I guess Mrs Judd will have to wait, then. Mike was helping Lisa with an admission a while back. Try the staffroom.’

Half expecting to find Lisa with her consultant, David was relieved to find Mike sitting alone. The feeling changed to one of concern as he saw how morosely Mike was hunched over half a cup of coffee.

‘What’s up?’

‘Upsetting admission.’ Mike shook his head sadly. ‘Fourteen-year-old boy with cardiomyopathy, Stephen Taylor. He’s been on the waiting list for a cardiac transplant for over six months. Went up to Auckland a couple of months ago but it all fell through. He’s not looking good right now.’ Mike sighed heavily. ‘Stephen’s a great favourite around here. He’s got a brilliant attitude to life. He’s particularly attached to Lisa Kennedy. She’ll probably be here all night, watching him like a hawk.’

‘Are you planning to hang around as well?’

‘No.’ Mike stood up and emptied his cold coffee down the sink. ‘Lisa’s more than capable of handling things and knows when to call me if she isn’t.’

‘Are you otherwise free?’

‘Of course. Permanent state of affairs these days.’

‘Good.’ David was determined to cheer his friend up. ‘Gerry Greene’s invited us both for dinner. Probably wants to rehash unsavoury memories. Could be just what you need.’

‘Could be.’ Mike was looking more cheerful already. ‘Sounds great. Gerry’s over the other side of town. Do you want me to give you a lift?’

‘No, thanks anyway. I’ve bought a car and this will give me the opportunity to give it a test run. I’ll meet you there at seven.’

The car was a heap but it had been all David could afford without putting himself into serious hock. Maybe it hadn’t been such a great idea, buying his parents that town house as a present to celebrate his father’s retirement. Property in central Auckland didn’t come cheap. Hell, it didn’t even come reasonable. Then he grinned as the engine on the aging Toyota finally caught and held. Of course it had been worth it. His parents had struggled financially all their lives and it had been their sacrifice that got him through medical school. The look on their faces when he’d presented them with the keys!

He had flown home for the occasion, having had his younger sister, Melanie, and a real-estate agent make all the arrangements. The project had had the useful spin-off of keeping Melanie out of trouble for longer than usual. His parents had been pleased enough about that—they couldn’t believe it when the reason for their daughter’s preoccupation had been revealed. The Jameses had only ever lived in rented houses and retirement had simply been yet another financial challenge. Now they could look forward to having the time of their lives. They were both fit and healthy.

Maybe when he got back on his feet again he’d shout them a trip through Europe. His own two-month jaunt, before returning to New Zealand, had been a wonderful experience but had also been responsible for clearing the last of his savings.

David joined the still heavy stream of traffic circling Hagley Park. At the first set of traffic lights the engine on his car died suddenly. David swore softly but got it started again just as the car behind gave him a blast on its horn. He began to feel concerned about his purchase but it seemed to be running fine until he had to slow for the roundabout at the next corner. The engine cut out without so much as a cough.

David tried to restart repeatedly as the traffic banked up around him. Cars tried to edge into the other lane to pass the obstacle he had created but other motorists were having none of it. Angry shouts and blaring horns contributed to the build-up of road rage. David opened his door, having released his handbrake. He ignored the insults thrown from a car of youths beside him and began to push, one hand on the steering-wheel, the other on the roof above the door opening. Nobody offered to help.

Once rolling, the car gathered speed and David fought to control the steering while he aimed for the side of the road. A front wheel mounted the kerb and David dived for the handbrake as he saw the cyclist on the footpath. Now he was stationary but only the front half of the car was off the road. He was still causing a traffic hazard. With an apologetic grin at the alarmed cyclist David released the catch and opened the bonnet. Surely someone would be able to offer a hand with his distress so clearly advertised.

Sure enough, a car pulled up, neatly mounting the kerb to park on the footpath, well out of the way of the traffic. A shiny, low-slung, convertible MGB. Bright red. A car buff! Just what the doctor ordered.

The driver climbed out. High-heeled shoes, long, slim legs, a neatly fitting skirt with a slit up the side.

‘No…’ David groaned. ‘It couldn’t be!’

It was. Lisa Kennedy had swapped her white coat for a tailored jacket in the same fabric as her skirt. She looked as though she would have a briefcase and several cellphones on her passenger seat.

‘Having problems?’

‘You haven’t got a cellphone on you, have you?’

‘Of course.’

‘Could you ring someone for me? A breakdown service?’

‘Let’s have a quick look first. What happened?’

David was feeling very tense. His popularity with the general public of Christchurch was rapidly plummeting. He’d heard some pretty colourful abuse in the last ten minutes and the traffic wasn’t showing any signs of abating.

‘The car stopped,’ he said sarcastically. ‘I’d think it was fairly obvious.’ He glared at the elegant figure in front of him. ‘I also think it would be a good idea to clear the obstruction I’m causing.’ He shut his eyes briefly. ‘Now.’

‘Sure.’ Lisa was looking amused. ‘But it would probably take half an hour for a tow truck to get here. Do you really want to wait and listen to that?’

‘Get a horse!’ someone yelled. Lisa’s mouth twitched but she controlled her expression admirably.

David gritted his teeth. ‘I don’t know anything about cars.’

‘Hop in,’ Lisa ordered. ‘Turn the key and push gently on the accelerator.’

David didn’t move. ‘I do know how to start a car,’ he said coldly. ‘If that had worked, I wouldn’t be standing here now. And, yes, it does have some petrol in it.’

Lisa silently stepped around him and got into his car. The engine started first try and David swore profusely under his breath. He already felt embarrassed enough by his situation. Now he was going to look a complete idiot. The engine ran for thirty seconds and then died. Lisa turned it over but it failed to start. David was perversely relieved.

Lisa moved swiftly. Opening the tiny boot of her car, she pulled out a toolbox. Removing a torch, she marched back towards him. ‘Get in, turn it on and press suddenly on the accelerator,’ she commanded. Her attention was on his engine as she shone the torch into its depths.

With a frustrated grunt David did as he was told. At least he was partially hidden, sitting in his car. The insults had become appreciative whistles and hoots as Lisa leaned over the bonnet. David slumped a little further down in his seat.

‘Looks like it could be a problem with your fuel line.’ Lisa’s voice floated through the window. ‘Stay there.’ She collected some items from her toolbox, including a glass jar.

‘Turn the key—briefly,’ she called a minute later. David complied. ‘And again. OK, stop!’

David stuck his head out of the window. He watched as Lisa reconnected some tubing and then emptied the jar of petrol into the gutter.

‘Blocked fuel line, I think. Try her again.’

The engine caught, held, but then died. ‘For God’s sake,’ David muttered. ‘I did ask you to call a tow truck.’

‘This will only take a minute,’ Lisa snapped. ‘I’m going to check the spark plugs.’

David sat, drumming his fingers on the steering-wheel. The minute passed. And another. He jumped out. ‘I thought you were staying in the hospital overnight.’ He refused to be impressed by the confident manner with which she selected the socket and wrenches.

‘I am. I’m just going home to grab a change of clothes. Stevie’s asleep.’ Lisa shook her head. ‘Look at that. Black! It hasn’t even been firing. And this one’s oily, see?’ She held the spark plug under his nose. ‘Probably a shot PCV valve. When did you have this car in for a service last?’

‘I only bought it yesterday.’

Lisa’s look suggested that there was one born every day. She replaced the spark plugs and David watched as she continued working rapidly. ‘You need new spark plugs, your wiring’s just about had it and the battery’s corroded to hell. Did you even look under this bonnet when you bought this car?’

David grinned. The funny side of the situation finally struck him. A feminist plot to destroy a manhood. A role reversal to die for. ‘How come you know so much about engines?’ he countered.

‘I like old cars.’ Lisa nodded at the gleaming machine parked nearby, wiping her hands on a rag. ‘I could never have afforded to keep one on the road if I hadn’t learned to look after it myself. I’ve had this since I was a student.’ She looked back at David’s car. ‘How much did you pay for this?’

‘Two thousand dollars.’

‘Take it back,’ she suggested. ‘It’s worth about five hundred.’ She glanced at her watch. ‘I’ve got to go. Have another try.’

The engine started instantly and chugged happily. Lisa listened for a minute. ‘Your timing’s way off.’ She shrugged. ‘Sounds like it might get you home, though.’ She slammed the bonnet shut. ‘I’ll follow you for a block or two, just in case.’

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