St Piran's: The Brooding Heart Surgeon

She saw a rugged, unsmiling face, with deep furrows from his nose to the corners of a mouth wide enough to balance the size of his nose. He wasn’t what you’d call classically good-looking but it was hard to look away. The raw, unpolished masculinity was compelling. Those frown lines were still there at the top of his nose so maybe they were a permanent feature. When Luke started tugging off his bloodstained gown as he neared the swing doors of the theatre, Anna saw the lean muscles of deeply tanned arms. She could have sworn that those doors opened of their own accord, which was impossible but there was something about the commanding height and the way this man moved that made the notion perfectly feasible.

Luke Davenport was a soldier as much as—or possibly more than—he was a surgeon.

Every female in the room was watching as he made his exit, no doubt equally impressed, but Anna knew she would be the only one who found the image conflicting. Downright confusing, really.

Yes, Luke had lived up to his reputation as a gifted surgeon and he was apparently prepared to let her close enough to absorb valuable new skills but … what the heck had happened back when that bleeding had occurred?

Was Luke even aware of the way he had zoned out like that? He certainly hadn’t acknowledged her contribution to the situation. He’d been injured during his time on the front line. An injury that was serious enough to prevent his return to his army position. Maybe he’d received wounds to more than his leg? A head injury perhaps that had left him with a form of epilepsy? Absence seizures where the sufferer was unaware of their surroundings and could freeze for up to a minute or so would explain it, but if that was the case, there was no way he should be still holding a scalpel.

That explanation didn’t seem plausible, however. A seizure would have someone looking blank and Luke hadn’t looked blank at all. He’d looked … Haunted was the word that sprang to mind. As though he’d been sucked into a flashback that he hadn’t been able to escape from. This seemed far more likely but no less excusable.

What if he’d been close to the pulmonary artery? Or, worse, the aorta? Even a few seconds of delayed response in trying to control the kind of bleeding those vessels were capable of producing could have been disastrous. What really bothered Anna was knowing that she was probably the only person who had noticed the incident, which meant that saying anything might be seen as a form of professional sour grapes. Revenge, even, for the reprimand she’d received because of her late arrival for the case. Everyone knew that she’d missed out on the job as departmental head when she’d first applied. Now they’d be watching to see how she was handling her new role. To make an accusation that could have major repercussions on Luke’s career within the first few hours of them working together was unthinkable.

There was only one person who might accept and understand her concerns. The same person who could provide an explanation that could possibly negate the need to take it any further. If nothing else, Luke deserved the courtesy of direct communication but it was also a conversation that needed to happen in private.

Right now her focus had to remain with their patient as he went into Recovery and was then settled into the intensive care unit for monitoring and post-surgical care. She had surgery she was due to perform with a registrar to remove sternal wires from a patient who’d had heart surgery a long time ago but was continuing to suffer pain that was probably a reaction to the foreign material in her body. The procedure wouldn’t take too long and she’d planned to use her lunch break after that to talk to Luke and suggest a detailed ward round to bring him up to speed with all the cardiac inpatients.

Maybe she’d better use that time for something rather more personal. To make a judgment call on the integrity of the man she had to be able to trust if she was going to work with him at all. For some reason, the prospect of getting that close to Luke Davenport was more intimidating than anything Anna could remember facing.

She needed to think of it as nothing more than a new professional challenge. Backing away or trying to make it easier was not an acceptable option. She’d take it face on. Anna gave a decisive nod as she followed Colin’s bed out of Theatre. She actually found herself almost smiling, having made the decision to confront Luke. If the situation had been reversed she had no doubts at all that Luke would be addressing the issue. He would probably have done so on the spot, with no thought of sparing her the humiliation of an audience.

Maybe this was a subtle opportunity to demonstrate not only her ability to do the job he had reclaimed but that her way of doing it might be better.

The prospect of the private interview with Mr Davenport was no longer simply intimidating.

It was … exhilarating.

CHAPTER TWO

THE need to escape was overwhelming. And impossible.

Having ripped off the theatre scrubs, Luke had gone straight to the showers in the changing room but he couldn’t wash away the aftermath of those few seconds in the middle of Colin Herbert’s surgery. Turning the water to lukewarm hadn’t brought its recent comfort of familiarity. Even the icy cold blast he finished with couldn’t shock it out of his head the way it could chase nightmares away.

His clothes felt wrong, too. His trousers and an open-necked shirt felt too smooth against skin used to the thick fabric of camouflage overalls. At least he didn’t have to knot a tie around his neck, like tying a bow on a pretty parcel. How ridiculous would that seem when he would far rather be fastening the Velcro straps of a Kevlar bulletproof vest over his shoulders. Feeling the weight of the armour plating and the bulkiness of pockets stuffed with whatever he might need at a moment’s notice.

He felt too light as he strode out of the theatre suite without a backward glance. Almost as though he was floating.

Lost.

The corridors were full of people going about their business, but it was all so slow. There was no sense of urgency as beds and wheelchairs were propelled to new destinations or staff moved from one task to another. They had time to stop and chat to each other. He saw people smiling and even heard laughter at one point. Someone said hello to him and Luke managed to smile back, but the facial contortion felt grim.

He didn’t belong here any more. This was a joke that wasn’t the least bit funny. Like the whole of civilian life. It was a game. A pretence. Meaningless.

Going outside was better. A brisk walk around the sprawling, modern structure that was busy St Piran’s hospital. A helicopter was coming in to land, no doubt bringing a trauma patient to the emergency department. Luke’s eyes narrowed as he watched it intently and soaked in the sound of its rotors. If anything was likely to give him a flashback, surely that was?

It wasn’t going to happen. He knew that because he was aware of the potential and he was focused. In control. The way he should have been for every second of that surgery. He kept watching anyway. Testing himself, until the helicopter took off again and disappeared into the distance.

A tempting distance. He could start walking again and just keep going. Stride down the cobbled streets of this picturesque market town until he got to the harbour. Or, better yet, a stretch of beach where he could push himself with the added difficulty of walking in sand. Or hurl himself into the surf with its magic, albeit temporary, ability to numb his body and brain and wash everything away. An effect a thousand times better than a cold shower.

But this was early December. It was freezing and his wetsuit was hanging to dry on his back porch after his early swim that morning. His leg hurt, too, thanks to standing so still for so long in Theatre. And he was here because he had a job to do. A job he had been lucky to be able to come back to. An anchor. Something to build on and the only thing he had, really. Given time, this might start making sense again, giving him the bonus of feeling like he was doing something worthwhile even, though after this morning that goal seemed further away than ever.

At least the patient who had been unfortunate enough to be his first case back here was doing well.

It was nearly an hour later that Luke arrived in the intensive care unit and Colin was awake, though very drowsy. A nurse was by his side and she smiled warmly at the surgeon.

‘I’ve been hearing all about the surgery,’ she said to him. ‘I wish I could have seen it. I hear you did an amazing job.’

Luke made a noncommittal sound without looking away from the monitor screen giving detailed recordings of what was happening inside Colin’s heart thanks to the catheter that had been positioned at the very end of the surgery.

Surgery that could have been a total disaster.

An amazing job? He didn’t think so.

The nurse was still hovering. He heard the intake of her breath. She was about to say something else. Possibly another admiring comment. Luke shifted his gaze to give her what he hoped would be a quelling glance. Sure enough, her mouth snapped shut, a flush of colour stained her cheeks and she turned to fiddle with an IV port on her patient’s arm.

Colin’s eyes flickered open. He saw the surgeon standing beside his bed and smiled weakly.

‘I’m still here,’ he said, his voice slightly raspy. ‘Thanks, Doc.’

Luke returned the smile. ‘You’re doing fine. We’ll keep an eye on you in here for a bit and there’s a few tests we need to run later today, but we’ll get you onto the ward as soon as possible. Do you have anything you want to ask me about?’

Colin’s head moved in a slow shake. ‘I think my wife’s asked everything already. Dr Bartlett seems to know what she’s talking about. I’m still a bit groggy to take it in but I’m alive and that’s what matters.’ He smiled again, his relief obvious.

‘I’ll be back later. I can talk to you and your wife then.’

‘Dr Bartlett said how well things had gone. What a great job you did.’

‘Oh?’ That surprised him. Or did Anna not worry about embellishing the truth when it came to reassuring her post-operative patients?

‘The wife’s just gone to find my mum downstairs and look after the kids so Mum can come in for a visit. Hey, did I say thanks?’

‘You did.’

Luke knew he sounded brusque. He didn’t need the nurse to give a look vaguely reminiscent of the glare he’d seen more than once in Theatre from Anna. Did she know? Had word spread that his new colleague had had to leap in and prevent the error he’d made during surgery becoming a potential catastrophe?

‘Where is Dr Bartlett?’ he asked the nurse as he signed off a new addition to the drug chart and prepared to leave the intensive care unit. ‘I need to have a word with her.’

‘Back in Theatre, I expect.’

Of course she was. He’d seen the case listed on the whiteboard in the theatre suite. A sternal wire removal. In the same theatre Colin had been in. With the same theatre staff, presumably. Would Anna be checking whether anyone else had noticed the incident and could back up her report on the concerns she now had about the abilities of the returning head of department?

She hadn’t said anything at the time. Hadn’t even sent a significant glance in his direction, but that said something in itself, didn’t it? She hadn’t bothered to hide what she thought of him returning to take her job in those early glares. It suggested that she was weighing the implications. Making sure she used the ammunition he had handed her to best effect by choosing the best time and place.

Dammit! How the hell had it happened? He was well used to the nightmares, but to have a flashback like that happen during the day? In the middle of surgery? It was appalling. He wasn’t quite sure of how long he had lost his focus but he had no doubts about what could have happened if there hadn’t been someone as quick as Anna on the other side of that table.

It wouldn’t happen again. He’d lost focus because that had been his first slot back in a civilian theatre. His concentration had been too much on a procedure that couldn’t have been more different to the kind of work in an Iraqi field hospital or, more particularly, as a member of the medical emergency response team on a mission on the front line. It had been slow and fiddly compared to the aggressive, lifesaving measures of treating major trauma under circumstances as tough as they got. It had been a mental ambush, triggered by the unexpected amount of blood he’d seen, or the way it had pooled, maybe.

Whatever. It wouldn’t happen again because he’d be ready for it and wasn’t going to allow a loss of control. Luke was perfectly confident of his ability to do just that.

But would Anna believe it?

A pair of green eyes came to mind. Framed by dark lashes that were unadorned by any mascara. Angry eyes. Accusing and assessing at the same time. What would they be like, softened by trust?

Even more compelling, no doubt, but Luke had to wonder if he would ever witness such a change.

Winning Anna’s trust was not even the priority it probably should be because this underlying tension … this waiting for something potentially unpleasant to happen, was oddly welcome. It made him feel a little more alive than he had ever felt since he’d been shipped home.

He was there, in the hospital canteen. Sitting alone near a window.

Brooding was the word that sprang to Anna’s mind. Hunched over a plate of food he appeared to be toying with rather than eating. The big room was well populated and noisy. Was that why the table with its single occupant seemed to stand out like a beacon? Or was her glance drawn there like a magnet because so many other people were eyeing the newcomer and probably talking about him?

She could understand not wanting to be in there and either listening to or being the object of the kind of speculation and gossip rife in any group of people as large as the St Piran’s staff was, but why on earth hadn’t he done what she almost always did—buy a sandwich and some fruit to take back to the privacy of an office?

Was he hoping for company? There must be so many people there who knew him but there was a hierarchy involved and maybe there weren’t any of his peers around. Anna found herself hoping that by the time she got to the end of this long queue someone would have joined Luke. That way, she wouldn’t need to feel guilty about not doing so.

Not that she didn’t want the chance to talk to him, but this was hardly the place to have the kind of conversation she had in mind, and the idea of making small talk with this man was not appealing. It would be dishonest, in a way, when they both knew what needed to be discussed—the kind of game-playing Anna had never had the slightest inclination to indulge in. Besides, Luke was making himself look so very unapproachable. Self-contained and cool. If he knew and agreed with all the praise going on behind his back, his self-image would have to be more than a little inflated. Maybe his own company was enough?

Like Anna, Luke had changed out of his scrubs and was dressed neatly. Professionally. Anna slid her tray along the metal bars in front of the food cabinets and found herself running her hand down the side of her close-fitting skirt to make sure it wasn’t creased. And then touching her hair to ensure that no tendrils had escaped the sleek knot at the back of her neck. She could do professional, too. Better than anybody, which was no surprise given the amount of practice she’d had.

‘Anna. Hi!’

A new burst of hungry staff members was milling behind her, settling into the queue. The greeting had come from Charlotte Alexander, one of St Piran’s cardiology staff members, who was behind a couple of nurses who’d stopped to stare into a chilled cabinet containing rolls of sushi.

If Anna made personal friendships among her colleagues, which she didn’t, Charlotte would have been at the top of her list. While their relationship was friendly, it was still as professional as Anna could keep it. Even now, when the loose top Charlotte was wearing reminded her that she’d noticed the obvious increase in weight a week or two ago and it had occurred to her that Charlotte could well be pregnant, she wasn’t about to ask such a personal question.

Girl stuff, like heart-to-hearts or sharing secrets and especially wedding or baby talk, was never going to happen. They were in the same category as frilly clothes or loose hair or make-up. Badges of femininity. Barriers to acceptance as an equal in a male-dominated profession. How did women like Charlotte manage it? Looking and dressing in a way that accentuated their best features but still having the respect of both colleagues and patients?

It made Anna feel like she had some kind of split personality, but it was so engrained now it was getting hard to know whether it was the Anna at home or the Dr Anna Bartlett at work that was the real her. The only thing she could be sure of was that never the twain could meet.

But sometimes … like right now … it struck Anna that her work persona was simply armour. Concealing anything feminine and vulnerable. Giving her focus and strength. Her gaze strayed of its own accord back to the solitary figure of Luke Davenport. What was it about him that made her even more aware that she didn’t look as feminine or, God help her, attractive as she could? Just as well her work persona was so firmly engrained. If armour was what it was, she might need its protection more than ever.

Charlotte had been held up too long. She moved around the nurses who couldn’t decide between the teriyaki chicken or smoked salmon.

‘Hi.’ She smiled at Anna. ‘How’s it going?’

‘Very good. Theatre’s over for today and both patients are doing well. I just took the sternal wires out of your Violet Perry. I’m sure the irritation will be gone and she’ll be pain-free in no time.’

‘That’s great.’ Charlotte was peering into the sandwich cabinet. ‘Hmm. Chicken and Camembert sounds nice. Or turkey and cranberry. No … we’ll be sick of that soon. Have you seen how many Christmas decorations are up already?’

‘Mmm. Way too soon, in my opinion.’ Anna found the seasonal celebrations at work disquieting. Too much of a bridge to personal lives.

‘Ham salad,’ Charlotte decided, reaching for one of the triangular plastic boxes. ‘Oh … weren’t you in Theatre with Davenport this morning? Doing Colin Herbert’s pericardectomy?’

‘Yes.’ Again, Anna’s gaze strayed towards Luke.

‘How did it go?’

For a split second Anna considered confiding in Charlotte. Telling her all about how Luke had frozen and she’d had to take over the surgery. If she did, she’d be taking a step she could never undo. Charlotte would tell her husband, James, and the snowball effect might sweep them all into places they would rather not go. This man was going to be her professional partner from now on. They would be working closely together. Closer than she was with Charlotte or James or any of the other cardiology or cardiac surgery staff. She and Luke would share duties in Theatre, on ward rounds, during outpatient clinics.

As though he sensed her stare, Luke raised his head to look up. Straight at Anna. Just for a heartbeat she held his gaze and tried to analyse what she could feel in that connection.

Maybe he wasn’t bad tempered and brooding, she decided as she looked swiftly away. Strangely, for that moment in time, it had looked more like something deeper. Possibly even unhappiness? What reason could he have?

He had been forced to leave the army early due to his injury, hadn’t he? Perhaps Luke didn’t want to be here just as much as Anna didn’t want him to be.

She looked away but not before she felt an odd squeeze beneath her ribs. She knew what it was like to feel unhappy.

Lonely.

Did she really have to kick someone who might already be down? Maybe she was overreacting. She had stepped in so fast, after all. If he’d been about to move at the same time it wouldn’t have been such a big deal at all. Not that she’d had the impression he would have moved that fast, but it wouldn’t hurt to think about things a little longer.

‘It was amazing,’ she heard herself telling Charlotte, absently picking up a pack of chicken sandwiches. ‘I’ve never seen a technique quite that precise. I got to do a patch behind the left ventricle and it wasn’t easy.’

‘Wish I could have seen it,’ Charlotte sighed. ‘Did you know he’d ordered the observation deck closed?’

Her disappointment was clear. It was an opportunity to express caution about the man’s personality or even say something negative. Curiously, Anna felt the need to defend Luke.

‘I guess you wouldn’t want too many people watching when you’re doing your first case after a long time away.’

‘I guess. How’s Colin doing now?’

‘Really good. We might be able to move him to the ward later today. Tomorrow, anyway, if he stays this stable. We should be well past the danger period for complications from acute dilation of cardiac chambers but his heart’s still got to get used to dealing with much more of a blood flow.’

‘I’ll get up to see him this afternoon. Here’s hoping the surgery report won’t be far away. I’ll be very interested to read it.’

So would Anna, but her agreement was silent. If she’d voiced it, her tone might have suggested that there would be more to read about than Charlotte might expect. They were getting near the cashiers’ part of the counter now and she turned her attention to the baskets of fruit. An apple, she decided. The nice-looking green one on the top of the second basket.

The crash that came from somewhere in the kitchens behind the food counters was astonishingly loud. Metallic. Jarring enough for every head in the cafeteria to swivel sharply in that direction and for conversation to cease abruptly.

And in that second or two of startled silence a scream rang out. And then a cry for help.

Jaws dropped as staff members looked at each other as though trying to confirm the reality of what was happening. Anna heard Charlotte’s gasp behind her but she was watching something else. Weirdly, her instinct had been to look away from the source of the sound so she had seen the first movement in the crowd. A reaction time so fast it was hard to process.

Luke Davenport was on his feet. His chair tipped backwards and he pushed at the table in front of him rather than stepping around it. The table also tipped, the tray sliding off to send china and cutlery crashing to the floor but Luke didn’t even spare it a glance. He was heading straight for the kitchen.

Access was blocked by the tall, glass-fronted cabinets apart from the space where Anna was, beside the tills and the fruit baskets. There was a flap in the counter beside the last till where kitchen staff could go in and out with the trolleys of used dishes but Luke didn’t bother to stop and lift it. Or maybe he didn’t see it. He swept the baskets clear to send apples and oranges bouncing around the feet of those still standing motionless and then he vaulted the space, making the action seem effortless.

Kitchen staff were backing away hurriedly, but not quickly enough for Luke.

‘Move!’ he barked. ‘Clear the way. What’s happened?’

‘Over here,’ someone shouted. ‘Oh, my God … I think he’s dead.’

Luke took several steps forward. Between the tills, Anna could see the blue uniforms of kitchen staff moving. Clearing a space near the stoves in front of which a large man in a white jacket lay very still.

Luke took in the scene. He turned his head with a single, rapid motion.

‘Anna!’ he shouted. ‘Get in here. I need you.’

Someone had raised the flap now but, if they hadn’t, it occurred to Anna that she might have tried to leap over it, too. Luke needed her?

The man was obviously one of the chefs. His white hat had come off when he’d collapsed and was lying amongst the pots and pans of an overturned rack.

Luke kicked one of them aside as Anna raced into the kitchen. ‘Get rid of those,’ he ordered. ‘Someone help me turn him. Did anyone see what happened?’