His Honourable Surgeon

Mrs Foster nodded. ‘If I can.’

‘Has he had any previous head injuries?’

‘Not that I know of.’

Good. ‘Is there any family history of easy bruising, or bleeding that doesn’t stop?’

‘No.’

Even better. ‘Has Declan ever had a cerebral shunt?’

‘What’s one of those?’ Mrs Foster asked.

‘If he’d had hydrocephalus as a child, we would have operated to put a special valve in his head to drain off excess fluid—and it would have been replaced several times before now as he grew bigger,’ Vicky explained. And Mrs Foster would definitely have known what a cerebral shunt was—the fact she’d asked meant it was highly unlikely Declan had had one.

Mrs Foster shook her head. ‘No, nothing like that.’

‘Does he have any allergies—penicillin or anything like that?’

‘No. He’s always been so healthy.’

Even so, Vicky needed to ask the last question. ‘Is he taking any medication?’

‘No. What’s wrong with him?’

‘I’ll know more when I see the results of his scan, but I think he’s got a subdural haematoma. That’s a blood clot between the tissue of his brain and the membrane called the dura mater, which goes between his brain and his skull. It sometimes happens after someone bangs their head hard—the bridging veins between the brain and the membrane stretch and tear, a bit of blood leaks out and forms a clot.’

Mrs Foster’s face turned a shade paler. ‘Does that mean you’ll have to operate?’

‘I won’t know until I see the scan,’ Vicky answered honestly. ‘Sometimes we can treat it without operating—just by careful monitoring—because smaller ones tend to go away on their own, but sometimes we need to operate before it puts too much pressure on the brain.’

‘Oh, my baby,’ Mrs Foster whispered.

‘Is there anyone we can call for you?’

‘M-my husband’s on his way.’

‘Good. If you want me to run through anything with you again, or you’ve got any questions, just let me know. That’s what I’m here for.’

Mr Foster had arrived by the time Declan had had his scan. Vicky reviewed the files and pointed out one area to Hugh. ‘I’m really not happy about this. I’m going to have to take him to Theatre.’ She went back in to see Declan and his parents.

‘Was the scan all right?’ Mr Foster asked.

‘I’m afraid not,’ Vicky said gently. ‘It showed me there’s a clot forming between Declan’s brain and the membrane covering it. It’s pressing down on the brain and causing pressure, which makes the brain swell and not enough oxygen gets to it—that’s why Declan’s finding it a bit difficult to see and why he’s sounding a bit confused. The good news is that I can operate—he’ll have a general anaesthetic, and I’ll cut a tiny lid into his skull so I can get the clot out. He’ll need to be in here for about a week so we can keep an eye on him, but he should be fine.’

‘Is he going to die?’ Mrs Foster mouthed, turning her face away so Declan wouldn’t see the question.

‘There are risks, yes, but it’s much safer to do the operation than to leave it,’ Vicky said quietly. ‘He’ll have a headache afterwards, but he won’t be in any real pain.’

‘I’ll kill them,’ Mr Foster said between gritted teeth. ‘I’ll kill them for what they’ve done to our Declan. Just leave me on my own with them with a cricket bat.’

‘Neil, no,’ Mrs Foster said. ‘You can’t do that. That makes you as bad as they are.’

‘Well, they’re not going to get away with it,’ Mr Foster declared.

‘There are things you can do,’ Vicky said quietly. ‘But, right now, let’s concentrate on getting Declan sorted.’

While Declan was being prepped for Theatre, Vicky rang up to the ward. ‘I’m going to be in Theatre Five.’ And this was the bit she’d been dreading and looking forward to at the same time. ‘Could you page Mr Lewis?’ It didn’t really matter whether she led or assisted: this was where she’d see what he was made of, and whether he was better with patients than he was with the staff. Or, at least, than he was with her.

She’d just scrubbed up when he came into the room. ‘What have we got?’

‘Craniotomy, to remove a subdural haematoma. The files are there, if you want to take a look.’

Jake reviewed the files swiftly. ‘Good call. Have you done a craniotomy before?’

She nodded. ‘I’d use a linear incision rather than the standard reverse question-mark incision in this case. We’ve pinpointed exactly where the haematoma is—and a linear incision will mean we spend less time controlling bleeding and it reduces surgery time.’

Jake’s dark, dark eyes appraised her—and she thought she saw the glimmering of respect. But luckily she was prepared for his next comment. ‘Good call. I’ll lead, you assist.’

She’d told herself it didn’t matter: but it did. ‘How about I lead,’ she said, ‘and if you don’t like the way I do it, you can take over?’

He finished scrubbing up before he answered her. ‘All right. But you talk me through exactly what you’re doing and why.’

Her mouth tightened behind her mask. ‘Like a junior?’

‘Like any other senior registrar on their first operation with a new consultant. It’s a quick way of getting to know how we both work.’

Fair enough. He was still a bit abrupt for her liking, but maybe he’d discovered that she was the daughter of a baron and thought she was just playing at being a doctor. This was her chance to prove to him that she was serious—and she wasn’t going to blow that chance.

As part of the preparation, Declan’s head had been completely shaved. Instead of making him look like a thug, the haircut made him look like a defenceless little boy. Which was exactly what he was.

But there was no room for sentiment or emotion here in Theatre. Vicky had a job to do. And she was going to do it well.

‘This is where I’m going to cut,’ she said, indicating the area on Declan’s head.

‘OK,’ Jake said.

Deftly, she cut through the layers of skin, muscle and membrane at the site. ‘Burr-holes next,’ she said, drilling a series of tiny holes. ‘The bone’s not too thick at this point, so I don’t need to drill them very, very close together.’

She talked him through the rest of the operation—using a Gigli’s saw, passed between the burr-holes using a malleable saw guide, then lifting the lid of bone back on a hinge of muscle so she could open the dura mater to reveal the inner membranes. ‘Here’s the clot. Suction and irrigation,’ she said, working carefully to remove the clot. ‘Here’s the ruptured blood vessel. I’m going to clip it here.’

When she’d finished and was sure the blood vessel had stopped leaking, she gently replaced the bone, ready to sew the membranes, muscles and skin back into position.

‘Want me to close?’ Jake asked.

It wasn’t really a question. He’d assessed her; now it was time for her to see how he worked. She nodded and stood back.

He was good. Fast, thorough and very deft. She’d never seen such neat stitching—and said so.

‘Thank you.’ He inclined his head slightly at the compliment, but didn’t allow anything to detract from his focus.

That, Vicky thought, was impressive. She had a feeling she was going to enjoy working with Jake Lewis. A like mind, focused on his job. He really didn’t care what people thought about him—the patient came first. Refreshing.

When they’d finished, he walked back to the ward with her. ‘Do you want me to talk to his parents?’

She shook her head. ‘I’ll do it. They know me from the emergency department, and it’s better that they have continuity of care as far as possible.’

‘I agree. You know where I am if you need me.’

Meaning that he trusted her. Quite why that should make her feel enveloped in a warm glow, she had no idea. She already knew she did her job properly, so it shouldn’t matter what he thought.

She went into the relatives’ room, where the Fosters were waiting anxiously. ‘I’m pleased to say the operation was a success. Declan should be coming round in a few minutes and you’ll be able to see him straight away. We’ll need to keep him flat for the next day or two so his brain can settle down again, and gradually we’ll raise the head of the bed. We’ll be assessing him very, very frequently and he’ll have more CT scans over the next few days, so we can keep an eye on how he is and pick up on any little niggles before they turn into problems.’ She decided not to mention the fact that the CT scan would pick up extra fluid; it was perfectly routine, but would sound scary to the Fosters and they were already upset enough.

‘So he’s going to be all right?’ Mrs Foster asked.

‘He should be,’ Vicky said with a smile.

‘Oh, thank God. Thank you.’

‘And my consultant. If you have any questions, please, ask for me or Mr Lewis and we’ll do our best to reassure you.’

‘So that’s everyone—oh, except Vicky, but you were with her in Theatre,’ Gemma said.

‘Dr Radley.’

Gemma grinned. ‘Don’t stand on ceremony. She doesn’t even use her title around here.’

‘Title?’ That was news to Jake. What title?

‘She’s an Hon.—the Honourable Victoria Radley,’ Gemma explained. ‘Though she’s always made it very clear she’s a doctor first.’ She smiled. ‘You’ve probably heard of her brother, Charlie. Baron Radley.’

The name rang a bell, though Jake wasn’t sure why. He never bothered with celebrity magazines or gossip pages in the paper.

‘But don’t go thinking she’s a snob or anything like that. I mean, she doesn’t tend to go on ward nights out, but it’s not because she thinks she’s too good for us. It’s because she’s writing a paper or she’s got the chance to shadow someone on a particularly interesting case.’ Gemma sighed. ‘She works too hard.’

‘Nothing wrong with being dedicated,’ Jake said. He’d had that accusation thrown at him a few times, too. And if Vicky was dedicated, that explained why she’d been so confident during the craniotomy.

But an Hon….

It was only then that Jake realised he had been thinking about acting on his attraction to Vicky. Asking her out for a drink, perhaps. He already knew she wasn’t married so he didn’t think he’d be treading on anyone’s toes. But being an Honourable put her miles out of his league socially. Someone who was used to mixing with the likes of royalty wouldn’t want to go out with a boy who’d grown up on a council estate.

Better to know now before he made a fool of himself. And that would teach him for thinking about breaking his personal rules. Vicky was a colleague, so she was off limits. For good.

CHAPTER THREE

AFTER a fortnight at the Albert Memorial Hospital in Chelsea, Jake felt as if he’d been there for years. He’d been accepted as part of the team and he’d been included in invites to drinks to celebrate a staff nurse’s twenty-fifth birthday, as well as the team night out at the local Indian restaurant. He’d gone to both and had had a great time—though he’d noted that Vicky hadn’t been to either event. Technically, she’d been on duty, covering for other staff—but after a couple of glasses of wine Gemma had let it slip that Vicky always covered staff nights out. Vicky worked on bank holidays, Christmas and Easter, too, so staff with children could spend time with their families. And when she did take time off, she was booked onto a course or had arranged to shadow someone and get more experience.

And he still hadn’t apologised to her, he remembered, feeling guilty. Not that he’d had the chance. She’d kept all conversation to a minimum, and what she’d said had focused entirely on their patients. But he didn’t think she was a snob: her manner with patients was too good for that. So was she just avoiding him? And was that because he’d been rude to her the very first time they’d met—despite the fact he’d given her a genuine compliment on her surgical skills since?

He’d do something about it today, he decided, and did the last five reps on the lateral raise machine before leaving the weights room for the pool. Twenty lengths, and he’d hit the shower. Then a bacon sandwich and a strong, sweet cup of coffee in the staff canteen, and he’d be ready to start the day on the ward.

And he’d talk to Vicky. Today.

There were already three or four people in the pool. But only one of them arrested his attention. She was doing lengths—but the front crawl she used was a precise and neat stroke, rather than flashy. She looked as if she’d been trained professionally, to get the maximum speed from the minimum stroke, and her whole attention appeared to be focused on her swim. Up and down, up and down, face in the water, turned to the side for a breath between strokes, then straight again. Jake couldn’t quite put his finger on it, but something about her drew him.

He dived cleanly into the pool when she was part way through a length. Surfaced beside her. And nearly forgot to swim when she turned her face towards him for a breath and he recognised her.

Victoria Radley.

Well, he shouldn’t have been so surprised. Clearly she was as focused when doing exercise as she was at work. But one thought wouldn’t go out of his head: was she that focused when she made love?

Oh, for goodness’ sake. They were both professionals. She was his colleague. He wasn’t supposed to be thinking about her in those terms. He didn’t have room in his life for a relationship right now.

But the thought wouldn’t go.

And when she climbed out of the pool—how on earth could she manage to look so elegant, scrambling out of the pool?—Jake found himself swimming straight for the side, ignoring the fact that he hadn’t done the twenty lengths he’d promised himself, and also climbed out of the pool.

He fell into step with Vicky just before she reached the entrance to the changing rooms, and tried his best to sound casual. ‘Hi.’

‘Oh. Hello.’ Cool, no flicker of friendliness.

‘I didn’t know you were a member here.’

She shrugged. ‘It’s the nearest gym to the hospital.’

Mmm, he’d worked that one out, too. And it meant no wasted time travelling to the gym—so he wouldn’t have to get up at an unearthly hour or rush to the ward after a training session.

Her words were perfectly polite, but there was no hint of invitation in her voice. She was just the cool, calm professional he knew from the hospital.

And he wanted to know what lay beneath the smooth, unruffled mask. What made Victoria Radley tick? What made her smile? What made her eyes light up? What made her angry, and what made her laugh?

‘Will you have breakfast with me?’

Those beautiful blue eyes widened. Clearly she hadn’t expected that. He hadn’t expected it either. His mouth had worked before his brain had gone into gear.

‘I really ought to get to the ward,’ she said.

‘You’re on the same shift as I am. Which doesn’t start for…’ he glanced at the clock ‘…forty minutes. We’ve got time for a shower and breakfast.’

There was the slightest, slightest flush against her cheekbones. And it vanished before he was really sure that she’d blushed. But he hadn’t said anything out of place…had he?

Unless she’d interpreted ‘shower’ and ‘breakfast’ rather more intimately than he’d intended.

And that thought alone set his whole body tingling, as if champagne instead of blood was whooshing through his veins. He pulled himself back together with an effort. ‘I hear the staff canteen does an excellent bacon sandwich,’ he said.

And it’d be just his luck that she was vegetarian.

She said nothing.

Still sore at him? ‘My shout,’ he said, ‘because I need to talk to you about something.’

That got a reaction. ‘What?’ She sounded suspicious and her eyes were slightly narrowed.

‘Work.’

It was almost as if he’d waved a magic wand, because she seemed to relax again. ‘OK. Meet you in the lobby in ten minutes?’

Most women he knew would take at least half an hour to get ready after a workout. But he was beginning to realise that the Hon. Victoria Radley wasn’t like any other woman he’d met. ‘Ten minutes,’ he agreed.

And then she did something that threw him completely. She smiled. A proper smile. And his heart rate practically doubled.

He’d only just got his pulse back to normal when he reached the lobby, still slightly damp, nine minutes later. Precisely sixty seconds after that, Vicky joined him.

‘I had a call from the hospital CEO yesterday,’ he said as they walked down to the hospital.

‘Oh?’

‘About Declan Foster. His parents wrote in and said how good you’d been.’

Vicky shrugged. ‘Just doing my job.’

‘And a bit more besides. I’ve noticed your paperwork is meticulous and you always make sure that the patients, as well as their relatives, know exactly what’s going on. And I think teaching a small boy to play chess might not be in your job description.’

‘It was as good a way as any to spend a lunch-break,’ Vicky said lightly.

‘Several lunch-breaks,’ he corrected. He’d noticed.

She frowned. ‘Do you have a problem with that?’

‘No, as long as you’re not overdoing things. We all need time to recharge our batteries, Victoria.’ At her sharp look, he added, ‘May I call you Victoria? I prefer working on first-name terms.’

For a moment, he thought she was going to say no.

Then she nodded. ‘It’s Vicky.’

‘Vicky.’ He could actually taste her name. Crisp, slightly astringent. And it made his mouth water.

Oh, he needed coffee. Before he said something stupid. ‘You’re supposed to take breaks.’

‘I’m fine.’

There was a slight edge to her voice, and he sighed inwardly. ‘I’m making a mess of this. What I’m trying to say is, I’m sorry. When we first met…I didn’t mean to imply you were a slacker. You caught me on the hop, doing a recce. I was embarrassed, and I said the first thing that came into my head.’

‘I see.’

Clearly she wanted him to eat humble pie. OK. As long as it meant she kept talking to him, he’d do it. ‘You’re dedicated. Very dedicated. I’ve never met anyone who works this hard before.’

‘It’s the only way to break through the glass ceiling,’ she said as they walked into the canteen.

The glass ceiling? That was something he hadn’t even considered. ‘This is the twenty-first century. It’s supposed to mean equal opportunities.’

She raised an eyebrow. ‘How many female heads of department do you know? How many women professors?’

He thought about it. ‘Not many.’

‘Exactly. If they have a family, they’re expected to take a career break, which holds them back because they’ve spent five years raising children and need to brush up their skills again—not to mention the years of experience they’ve lost and the fact their male colleagues are now five years ahead of them. If they don’t take a career break, they get a reputation as hard women who don’t care enough about their families, and it’s held against them.’

He frowned. ‘Discrimination is illegal.’

‘But it happens.’

He had no answer to that. ‘So I take it you don’t have children?’

‘No.’

He just about managed to stop himself asking the next question. And what does your partner do? Because it was none of his business whether she was involved with someone or not. And he’d already told himself he wasn’t going to act on his attraction to her. He needed to talk about something neutral. Fast. ‘What would you like for breakfast?’ he asked as they reached the canteen.

‘Coffee, fruit and yoghurt, please.’

Polite and distant again. Which was what the professional in him had wanted—but what the man in him hadn’t wanted. ‘Do you mind if I have a bacon sandwich?’

She gave him a wry look. ‘They’re your arteries.’

When they sat down, he added tomato ketchup to his sandwich. ‘Lycopene,’ he said with a grin.

‘Which doesn’t negate all the cholesterol,’ she shot back.

‘Don’t care.’ He bit into the sandwich. ‘Oh, yes. This is seriously good.’ He nodded towards the half-sandwich on his plate. ‘Sure you don’t want to share?’

Vicky adored bacon sandwiches. Had it been Seb or Charlie opposite her, she wouldn’t even have waited to be asked. But sharing a sandwich was intimate. She barely knew Jake—and it was going to stay that way. She couldn’t afford a relationship. Not when she was so close to getting a consultant’s post. If she let herself get distracted, her career would go straight down the plughole. She’d worked too hard, too long, to let that happen now. ‘Quite sure, thank you.’ She poured yoghurt over her fruit. ‘So what did you want to talk to me about besides Declan?’

‘I did the getting-to-know-you bit with the rest of the staff on team nights out.’

And because she’d been covering the ward, he hadn’t had the chance to have that kind of chat with her. She sighed. ‘I’m sure my personnel file will tell you all you need to know about me.’

‘That you’re a senior registrar, that your exam results were superb, that your appraisals have always been excellent, and you’re tipped for the next consultant’s post.’

If he’d already reviewed her files, what else did he want to know?

The question must have shown on her face, because he said softly, ‘I don’t know you. I’ve seen how you are with patients and staff, and I’m impressed.’

Please, don’t let him be trying to come on to her. She knew her willpower was strong, but she didn’t need the extra temptation. Jake Lewis, with his dark eyes and the floppy hair that made him look like a disreputable cherub, could be a temptation. Like rich, dark chocolate. Addictive. ‘You’ve reviewed my files and you’ve seen me work. That’s all you need to know,’ she said primly.

‘Wrong. If I’m to develop the staff on my team—so they’re happy in their jobs and work well for me—I need to know what they want out of their job. Where they want to be in five years’ time, and what they think they need to get there. Where they think they’re weak and need more experience or more training. Things that aren’t written in files.’

Was he serious?

She risked a glance. He looked serious enough.

Though he also looked good enough to eat, with his hair still slightly damp from the shower. She thought of rich, dark chocolate again and suppressed a groan. Jake Lewis was dangerous. Someone she needed to avoid.

‘So what do you want, Vicky?’ he asked. ‘To be head of department? Professor?’

‘Both.’

He nodded. ‘From what I’ve seen, you’ve got the skill and the dedication to make it.’

Was he trying to curry favour? No, he looked completely sincere. ‘Thank you.’

‘So your plan is?’

‘Consultant next year. Then a part-teaching, part-practising post—I want to do the academic side and work on some research, but I like working with patients too much to give it up. Plus, theory’s worth nothing if it’s unworkable in a real-life situation.’

‘And what experience do you think you need now?’

‘More surgery.’

‘Noted,’ Jake said. ‘When you’re in Theatre with me, I’ll try to give you the chance to lead as much as possible.’

‘Thank you.’

‘And let me have a list of the training courses you want to go on.’

‘There’s a small thing known as the departmental budget,’ Vicky said.

‘Which is why I’m not promising to send you on every course you want to go on. But when I know what everyone’s skills are, and where there are training needs, I might be able to arrange interdepartmental training. Shadowing, mentoring, that sort of thing.’

‘Provided our head of department agrees.’

‘He’ll agree,’ Jake said softly. ‘I can be very persuasive.’

Vicky looked at his mouth and thought, I just bet you can. Then she stifled the idea. She was not going to start thinking about Jake Lewis in that way.

‘And I find a cost-benefit analysis usually does the trick,’ he added.

He understood admin as well as medicine? Interesting. In Vicky’s experience, most doctors were either people-oriented or paper-oriented. They couldn’t do both. That made Jake a rarity.

‘Why did you become a doctor?’ he asked conversationally, as he added sugar to his coffee.