Hearts of Gold: The Children's Heart Surgeon

A sound outside, beyond the glass, made her look up. How appropriate—here was fate himself.

The door opened, and Alex walked in.

‘He’s doing well—better than I’d expected,’ he said, and Annie nodded.

‘I know. I’m not here because I’m worried, but because Madeleine—Mrs Ross—needed to sleep and she wasn’t happy about leaving him on his own.’

Alex smiled.

‘Then you’ll be pleased to know the cavalry’s arrived. I’ve just been talking to Ben, Madeleine’s husband. He’s come down from the country with a tribe of relatives—a brace of grandparents, several aunts and the odd cousin, if I got the introductions right.’

‘I’m glad they’re here,’ Annie told him, ignoring the squelchy feeling of regret she’d felt as Alex had spoken of family. She, too, had a brace of grandparents, several aunts and various cousins—relatives she no longer saw, who no longer knew where she was, or even who she was. ‘Madeleine’s been strong, but she’s still only, what, three days post-partum, and she needs to look after herself as well. With family support she should be able to do that.’

The door opened again and Madeleine Ross returned, with a tall, suntanned man she introduced as Ben. As she moved to the bed to introduce her husband to their son, Annie slipped away.

She assumed Alex had stayed to answer any questions Ben might have, so was startled when he joined her in the lift.

‘Are you heading home?’ he asked, no doubt finding the conclusion easy as she had her handbag slung across her shoulder.

She nodded confirmation and edged slightly away, al-though there wasn’t much room for manoeuvring in a lift crammed with end-of-visiting-hours commuters.

‘I’ll walk you there,’ he announced, leaving no room for manoeuvre at all.

She could hardly say there was no need when he lived only four doors up the road, and they could hardly make the walk—if he was going to his place—ignoring each other.

So they left the building and walked through the soft autumn night, cutting down the side street away from the hospital traffic and along the tree-lined avenue where they both lived.

‘I flew up a month ago to look for a place to rent then I saw these old houses and knew I wanted one,’ Alex remarked. ‘They’re like something out of a fairytale.’

They were. It was exactly what Annie had loved about them, but walking with Alex in the lamplit darkness had filled her with too much emotion for speech so she made do with a nod of agreement.

Until they passed his house.

‘You’ve missed your gate,’ she told him, stopping on the pavement outside his place. He smiled at her.

‘I’m walking you home, remember?’

‘It’s only four doors. I hardly need an escort.’

‘No, but I’ll escort you anyway,’ he said, and waited patiently until she began walking again. ‘See you safely home to Henry and your father.’

Already confused—by the walk, his presence, her own reactions to it—she was even more fazed by his mention of the dog. Suddenly letting him believe Henry was a person seemed unfair and yet…

Surely it was OK if she was doing it for protection?

Protecting herself against herself?

They reached her gate and he leaned over to open it. A low, gruff bark woke the night’s stillness, and as Alex straightened he smiled.

‘Henry?’

Then, without acknowledging her reluctant nod of agreement, he put his hand behind her back and guided her down the path, up onto the little porch with its gingerbread decorations and into the shadows cast by the huge camellia bush that grew beside the fence.

And Annie went, propelled by something beyond the pressure of his hand on her back. Guided by the acceptance of fate.

He turned her, slid his hands behind her back and drew her close, then he bent his head and kissed her.

Annie stood there, held not by the light clasp of his hands on her back but by memories, then, as the gentle, questing exploration continued, she kissed him back, losing herself in sensations she’d forgotten existed because five years ago she’d been too frightened to enjoy them.

The kiss went on for ever—nothing hasty or half-hearted in Alex Attwood’s kisses—but just when Annie knew her knees were going to give way beneath the emotional onslaught, he raised his head and looked into her eyes. Another long moment, then he said, ‘I had to know!’ And walked away.

Annie slumped against the wall and watched him. Up the path, out of the gate, along the street, in through his gate—then he disappeared behind the shrubbery in his front yard.

Thoughts and feelings battered at her, so strongly felt she rubbed her arms as if to stop them bruising. Clearest of all was the knowledge that Alex knew exactly who she was—maybe not her old name, but certainly that she was the woman on the terrace.

Annie was certain of this because, although she’d have scoffed if someone had suggested to her that all kisses were different, she’d certainly have recognised Alex by that kiss.

So, he’d left the ball in her court. It was up to her to admit they’d met before, or to carry on the charade. Thank heaven it was Friday and she had two whole days before she had to see him again.

Before she had to sort out the muddle in her mind…

‘I know I don’t have to go to work, Henry, and I know going up there carries a risk of running into Alex, but it’s early—barely six-thirty—and not many people will be out of bed, and I want to see for myself how Baby Ross is doing. Maybe they’ve even decided on a name for him. I’ll just slip up there, then come back and take you for a walk.’

Lacking a waggable tail, Henry made do with wiggling his hindquarters on the floor at the sound of his favourite word, but he obviously hadn’t taken much notice of the first part of the conversation because the moment Annie stood up, he fetched his lead and stood hopefully beside her.

‘Put it down before it goes all mushy,’ she told him, then added, ‘Later,’ knowing it was one word he did understand. Food, walk, later, fetch—he had quite a vocabulary.

She walked to the hospital, adding words to her list of Henry’s vocabulary, deliberately not peering towards the front of the house where Phil and Alex resided.

Fancy buying a house when you were only here for twelve months! Although houses in this area were a good investment…

Thinking about the house was better than thinking about the man, or thinking about the situation the two of them were now in, so she mused on why someone might buy a house for a short-term stay all the way to the hospital and up to the fourth floor.

‘I’m sure he’s more alert than he was,’ Madeleine Ross greeted her when she walked into the room.

The sister on duty had reported a quiet night, and assured Annie all the monitor results were positive.

‘It was weird, working in here on my own and with only one baby,’ she’d added. ‘Though staff from the special care unit next door, your old stamping ground, kept popping in to see me.’

‘Make the most of the quiet time,’ Annie warned her. ‘You know how hectic it can get, and I have a feeling that will happen sooner rather than later.’

‘Once word gets out Dr Attwood is operating here, you mean?’

Annie nodded. She’d had her doubts but referrals were coming thick and fast, from as far afield as Indonesia and the Middle East.

She sat with Madeleine until Ben returned with coffee and a doughnut for their breakfast, and was about to leave when Ben asked her to stay.

‘We want to ask you something,’ he said. ‘About the baby, but not about his health. About his name.’

Annie waited.

‘It’s like this,’ he said, so slowly she wondered if he was having trouble finding even simple words. ‘We had names picked out, but now they don’t seem right…’ There was a long pause, then Ben looked at his wife as if he didn’t know how to continue.

Annie came to his rescue.

‘They were names for a healthy baby—a different baby you’d pictured in your mind.’

She smiled at both of them, and touched her hand to Madeleine’s shoulder.

‘It’s OK to feel that way. In fact, it’s healthy to grieve for that baby you didn’t have. It’s natural for you to have a sense of loss.’

‘It’s not that I don’t love him,’ Madeleine hastened to assure her, touching the still arm of the little mortal on the bed.

‘I know that,’ Annie said. ‘Of course you do. You probably love him more because he needs so much help. But you can change your mind about his name—call him something different.’

‘We’d like to call him Alexander, after Dr Attwood,’ Madeleine said shyly, and Annie smiled, wondering how many little tots with congenital heart disease were trotting around America, proudly bearing the same name.

‘I’m sure he’d be honoured,’ she said, and heard a voice say, ‘Who’d be honoured, and by what?’

He was there again—as if she was able to conjure him up just thinking or talking of him. Like a genie in a bottle. Not a good thing when most of the genie-in-a-bottle stories she’d heard had terrible endings!

‘I’ll let Madeleine tell you,’ Annie said, and she slipped away.

It had been stupid to come up here. She’d needed two whole days—two months? Two years?—to work out how to tackle the recognition thing. And the kiss! Now here he was, back within touching distance again. Or he had been until she’d fled the room.

Determined to head straight home and thus avoid any chance of having to walk with him, she was leaving the ward when the sister called to her. A different sister, seven o’clock change of shifts having taken place while she was in Baby Ross’s room.

‘We’ve a new admission coming in. Sixteen-month-old baby, Amy Carter, shunt put in to deliver blood to her lungs at birth, but now something’s gone wrong. Dr Attwood’s called in all the theatre staff. He’s briefing them in half an hour.’

The information upset Annie. She should have been the first one called so she could contact the necessary staff. She’d been at home until half an hour ago. She had her pager.

She touched her hand to her hip and realised she didn’t have it! How could she have been so careless?

She didn’t like to think about the answer to that, because she knew it involved distraction, and the reason for the distraction was so close.

But she was here now—she could be involved.

Alex came out of Baby Ross’s room—Alexander’s room?—at that moment and she turned to him, ready to confess her mistake, but he did little more than nod at her before entering the next room where, Annie guessed, Amy Carter would be nursed.

Annie followed him, and saw him peering at the X-rays in the light cabinet on the wall.

‘You’ve heard we’ve an urgent referral on the way?’

He didn’t wait for an answer, but pointed to a small tube clearly visible in the cloudy murk of the X-ray.

‘The cardiologist sent these on ahead. I believe in shunts—I use them myself in a lot of cases. You can insert them through a thoracotomy, rather than cracking open the chest, which is far less traumatic for the infant, and by putting in a shunt you give the baby time to grow, and give the heart muscle time to firm up so it’s not like sewing mousse.’

He had his finger on the shunt, as if he could feel the small plastic tube itself rather than the image of it.

‘The other school of thought, of course, is to do all the repairs as early as possible—do a switch like we did on Baby Ross within days of discovering the problem. That saves the baby another operation later, and is possibly easier on the parents in the long run, but to me it’s still a huge insult to a newborn infant and the softness of the tissues can lead to complications. Stitches not holding, that kind of thing.’

He was frowning as he spoke, voicing a debate that must often rage in his head, but when he’d switched off the light he turned and smiled at Annie.

‘I’m operating in an hour. As you’re here, do you want to watch? I didn’t call or page you because I felt you deserved a day off, and you’ve seen one switch. This will be similar.’

‘I’d like to watch.’ Mental apology to Henry—did he understand ‘later’ was a very indefinite concept?

‘Good.’

Alex walked away, leaving Annie wondering just where things stood between them. This was not the post-second-kiss conversation she’d expected to have. Had he forgotten what he’d said last night?

Or did he have no wish to pursue it—now he knew she’d lied to him?

Or—duh!—maybe he was just better than she was at separating work from personal matters.

Whatever, it didn’t matter. Alex was working and she was here to see it all went smoothly. Theatre first.

Rachel was supervising the scrub nurse setting out what the surgeons would need, telling the nurse, a lanky six-footer called Ned, what would be happening.

‘I saw him at work in an adult cardiac operation the other day,’ Rachel said, following Annie out of the theatre. ‘I think he’s good and I’d like to think we can keep him.’

‘If you want him, he’s yours,’ Annie promised her. If he was equally popular with the adult cardiac surgeons she might have a battle, but she was willing to fight for what-ever they needed to make the unit work. She was good friends with the director of nursing and would speak to her first thing Monday.

‘Saturday morning—I was going sailing on the harbour with some mates from the UK, and what happens? The slavedriver drags us all into work.’

When Annie went in, Phil was sitting in the office, drinking a cup of coffee from the machine she’d had installed to feed Alex’s habit. She smiled at Phil’s grumble, made a note about phoning the DON, then asked who else was coming.

‘Not Maggie. She had the good sense to get out of town for the weekend. Alex has got some hospital anaesthetist—with paediatric experience—so we should be OK.’

‘And Kurt?’

‘Yes, he’ll be here. As a matter of fact, I think Kurt sleeps with his machine, and as it’s now fitted in Theatre here, he was probably asleep beside it when the call came.’

Phil was still grumbling when they moved to the little lecture room, where Alex had already drawn a diagram of Amy Carter’s heart on the whiteboard. With simple words, and an economy of description, he outlined what he intended doing, pointed to the spots where trouble could be expected then asked for questions.

‘I saw the X-rays,’ Phil said, surprising Annie, who thought he’d been mooching in her office since his arrival. ‘There seemed to be a lot of scarring on the heart—far more than there should be if the duct was inserted through a thoracotomy.’

Alex sighed.

‘You’re right. I looked at it with Annie, and hoped I was wrong, but I’ve just received another file—fortunately, her parents had kept a comprehensive one as they moved from hospital to hospital. She’s had two operations already. The first tube became compromised and they opened up her chest. We’re going to be going through a lot of scar tissue, both outside and inside.’

‘So we don’t really know what we’ll find in there,’ the registrar suggested, and Alex agreed.

‘Expect the worst in these situations,’ he said, ‘then if things aren’t as bad, you’re pleasantly surprised.’

‘And if it is the worst?’ Ned asked.

‘You have to remember that this little girl will die without the operation,’ Alex said carefully. ‘She may still die with it. I’ve just told her parents that. She could die on the table and we might not be able to save her. But we go into every operation confident of a positive outcome. If I didn’t feel that way, I wouldn’t do it.’

This operation was different. Annie felt it in the tension that vibrated around the room, and heard it in the quiet swear words Alex and Phil were both muttering into their masks.

She could see for herself the difference between Alexander Ross’s heart and the scarred, gristly organ little Amy was carrying inside her chest.

Alex, no doubt conscious of the registrar and his need to learn and understand, explained things as he went—explained what should be happening, and how little Amy’s tiny heart should be configured, cursing only when he found too many anomalies.

‘The problem is the heart has compensated for its weakness. The coronary arteries, feeding blood to the heart muscle, were compromised when the shunt was put in, so the body has grown new vessels and now we’ve this bizarre network and can’t be sure what we can safely touch.’

He bent his head to his work again, then added, ‘Touch none of them is the rule in these cases. If you don’t know what it is, don’t touch it.’

Four hours later Alex thanked them all and left the theatre. Ned helped Annie down from her stool, and she followed Alex out, passing him as he packed away his loupe and light just outside the door.

‘Annie!’

She stopped and turned towards him. The equipment he’d been wearing had left parts of his face reddened and his cheeks were drawn. He looked exhausted.

‘Are you doing anything now?’

‘Right now? Going to my office.’

‘After that—are you busy?’

He paused and rubbed at the red marks on his face as if they bothered him.

‘I know you have a life, and you have no obligations to me, but…’ Another hesitation, then he said, ‘I don’t know the area. I have to shop or Phil and I will starve to death over the weekend. I need a guide to help me get my bearings.’

Annie’s turn to hesitate.

It wasn’t much to ask, but it would put her in his company for the rest of the day.

‘I’ve promised Henry a walk,’ she said, and saw Alex smile.

‘But that’s great. Minnie needs a walk as well, and though I’ve seen the park down the road, I don’t know where dogs can or can’t go. We’ll walk them both and then we’ll shop, grab some lunch somewhere along the way. I’ll change, see Amy’s parents, then collect you from the office and we can go home together.’

Go home together! The three words rang in Annie’s ears, prompting a surge of loneliness.

But she wasn’t going to be seduced by words or loneliness. This was a business proposition. They’d walk their dogs—presuming Minnie was a dog—then shop, and that was it.

‘I’m worried about that baby.’

Alex’s opening remark as they left the office reassured Annie. The business side of things had been confirmed.

‘She’s been through so much,’ he continued, putting his hand behind Annie’s back to steer her into the lift. ‘And she was really down when she came in. Can a child in such a debilitated state survive another major operation?’

‘But you must have seen so many children like Amy. There must be plenty of cases where you’ve been called in after a previous operation hasn’t worked.’

He nodded, and escorted her out of the lift.

‘Of course, but I still worry every time. It’s one of the reasons I’d like to see more trained paediatric cardiac surgeries, and units set up specifically to handle congenital heart disease. CHD is the most common of all congenital conditions and the long-term survival rate of children who have surgery is excellent. It’s not a question of allocating blame in an operation that’s gone wrong. I understand the difficulties a cardiac surgeon who operates on adults ninety-nine per cent of the time must face when he sees a neonatal heart. But it needn’t happen—he wouldn’t be forced to operate—if there was a paediatric cardiac surgeon within reach.’

‘But would that have made a difference to Amy? Having someone more skilled to do the op?’

They were outside the hospital now, walking towards the crossing, and Alex paused and looked down at Annie.

‘Are you really interested or just making conversation?’ His voice made a demand of the question and she frowned at him.

‘Of course I’m interested. What are you thinking? That I’m asking questions so I’ll sound interested in your job? That it’s a way of showing interest in you? As if!’ Scorn poured like hot oil over the words. ‘I’d like to remind you that it’s my unit, too, but I can’t run it effectively if I don’t know as much as I possibly can about it.’

Alex saw her anger reflected in her eyes, and wondered how an intelligent man like himself could always find the wrong thing to say to a woman.

But walking with Annie—talking about work—had made him feel great—comfortable, relaxed and at ease with the world. Then his pessimism had surfaced, and with it memories of women who’d shown interest in his work early on in a relationship, then had blamed his job for the breakdown of the same relationship.

Not that this was a relationship. Other than purely work-related…

Not yet, hope suggested.

Maybe not ever, pessimism reminded him, giving an extra nudge with a reminder that she’d lied about not having met him before.

Unless she really didn’t remember…

Damn his pessimism! Right now he had to make amends to his colleague.

‘I’m sorry. I don’t know why I said that. Of course you’re interested.’

They resumed their walk, but he’d lost the conversation. It was being with Annie that was the problem—being with his ghost. The kiss, if it had done nothing else, had confirmed that.

But it had done something else. It had stirred his blood and not a little lust, so he’d walked home determined to get to know her better. Actually, he’d walked home with phrases like ‘woo her and win her’ running through his mind, but in the sober light of day he had modified these aims.

In the sober light of day he’d also found his tattered list of the delegates at the congress, and had gone through it once again, searching among delegates and partners for an Anne, or Annie, even Joanna and Annabel—any name that might conceivably be shortened to Annie.

He hadn’t found one, and couldn’t help but wonder just who she was.

Get to know her first, he’d decided, yet now here he was, treating a simple question with suspicion.

‘So, are you going to answer me, or shall we continue this walk in silence?’

‘What was the question?’

‘I asked about Amy. Would it have made a difference if she’d had a paediatric cardiac surgeon do the first two ops?’

Alex set aside thoughts of stirred blood and lust and concentrated on his reply.

‘I couldn’t say that. So much can go wrong. There are risks involved in all operations. But I firmly believe we can cut down on the percentage of risks with more specialists and specialist units.’

They’d reached his gate and Annie stopped.

‘I want a shower, and need time to write a shopping list if we’re shopping straight after we drop off the dogs. Say half an hour? You’ll be going past my gate to get to the park so I’ll wait for you there.’

‘You’ll wait for me?’ he teased, eager to rebuild the relaxed atmosphere they’d shared early in the walk.

‘Yes, I’ll wait for you. I don’t subscribe to the “women are always late” theory. I find, in fact, that women are more likely to be on time than men.’

She walked away from him, leaving him wondering just where things stood between them.

Not relaxed and easy, that was for sure! Her pert retort had underscored that point.

CHAPTER FIVE

ANNIE managed to stay angry with Alex until she saw him emerge from his front gate twenty-five minutes later. Though it wasn’t Alex emerging from the gate that made her laugh, but the little black bundle of curls trailing along behind him on the end of a lead.

Alex Attwood had a spoodle! A designer-bred spaniel-poodle cross, clearly still a puppy as it was the size of a large guineapig. The little thing cavorted along behind him like a curly black wig caught up on a rat on speed.

‘I hope you’re not laughing at my dog,’ Alex said, though the corners of his mouth were twitching as if he understood her mirth. ‘And you know the old joke about a little dog killing a big dog. Tell your Henry he’ll choke to death if he tries to swallow Minnie.’

But Annie didn’t have to tell Henry anything. He was sitting at her feet, forty kilograms of Rottweiler muscle and bone, gazing at the little spoodle with love-struck eyes, while she yipped and yapped about his feet, and explored him as if he were a new kind of doggie toy.