The Surgeon's Love-Child

‘Um. Yes. Lovely.’ Oh, hell! ‘That would be really nice.’ She tried again, and managed a more natural tone. ‘I’ve been pretty timid on my own, but it’d be great to get out beyond the point where every wave dumps a bucket of sand down my front.’

He laughed. ‘OK, let’s go.’

Then he reached for the plastic zipper and peeled the wetsuit down even further.

He was wearing a swimsuit, of course. Board shorts, in fact. Black, with a blue panel on each side. Beneath the wetsuit, they’d ridden down below his hips. He had his back to her now, and she could see the shallow hollow just above the base of his spine. Like the rest of him, it was tanned to a warm bronze, and was dappled with tiny, sun-bleached hairs.

A moment later, he had hauled casually on the waistband and pulled the board shorts back to where they belonged.

They swam together for an hour, then she went home for lunch and he put his wetsuit back on and returned to the outer boundaries of the surf. She didn’t see him when she went back to the beach for a walk late in the afternoon, didn’t see him when she walked past his house on the return trip, although his car was in the driveway and a sprinkler was spinning round on the lawn.

Definitely, he was just being friendly.

And I appreciate that, she realised. Maybe that’s the problem. I appreciate it, and I need it too much at the moment. I’d better get the rest of it under control.

Candace didn’t see Steve again until Tuesday, when she had her first surgical list, consisting of three patients. Steve was scheduled to handle the anaesthesia.

She’d seen each of her patients the day before for a brief chat, and had gone through their reports from the preadmission clinic. No danger signals. Chest X-rays and cardiograms all normal. Blood pressures within the acceptable range.

First was a scheduled gall-bladder removal on a fifty-three-year-old woman, followed by two straightforward hernia repairs, both on older men. Blood had been cross-matched for the gall-bladder patient as there was a higher risk of bleeding during this operation. All three of the patients were here on a day-patient basis. After the surgery, they’d make use of the ‘political beds’—those reclining chairs that Terry had been so cynical about.

Preparing for surgery was like coming home. The OR—Theatre One, which sounded odd to her ears—was a place in which she was used to possessing undisputed control. She loved this environment, and the way everything was geared towards a single focus. One patient, one operation and six people who knew exactly what they were doing.

The scrub sinks were different—old-fashioned porcelain, with long levers on the faucets which you flicked on and off with a quick touch. She was used to stainless steel, and foot pedals. Theatre One had washable vinyl walls and the hard, antistatic floors which she knew only too well. They were murder on backs and legs after you’d been standing there for more than a couple of hours.

Candace was the last to scrub, and everything was ready to go now that she had arrived. She briefly greeted the other staff and the patient. Mrs Allenby looked a little nervous, of course. Years ago, Candace had had to fight the instinct to give her patients a reassuring pat, but now it was second nature to keep her gloved hands back.

There was music playing on a black compact disc player set up on a shelf. Something classical. Beethoven, Candace recognised. Not that it made any difference.

‘Could we have that off, please?’ she said.

The scout nurse, whose name badge was hidden beneath a green surgical gown, immediately went across and pressed a button on the player, bringing silence.

‘Would you like something else, Dr Fletcher?’ she offered. Her name was Pat, Candace found out a little later.

‘No, thanks,’ she answered, calm and polite. ‘I can’t operate with music.’

She registered one or two slightly surprised looks above pale green disposable masks, but didn’t take the time to explain. This was her space now. All surgeons had their quirks, and she wasn’t going to apologise for hers, now or later. She never swore or threw things or yelled at the nurses; she didn’t practise her golf swing to warm up her hands; she was consistent in her preference of cat-gut length and instrument size.

But she liked silence. It helped her sense of focus. No music. A minimum of chatter. No jokes or ribbing. Absolutely no disparaging comments about the patient.

‘OK, we’re looking good at this end,’ Steve said a few minutes later.

‘Thanks, Dr Colton.’

Her gaze tangled with his as he looked briefly away from his monitors, and she could tell he was still thinking about the ‘no music’ thing. Maybe he’d chosen the Beethoven himself. Well, he could listen to Beethoven at home.

‘All right, are we ready for the gas?’ she asked, and began the operation.

She’d done it hundreds of times, probably.

Several litres of carbon dioxide were injected into the abdomen to provide a space to work in between the outer layers of tissue and the internal organs. A tiny incision allowed the passage of a laparoscope with an equally tiny camera on the end of it, manipulated by the assistant surgeon, Peter Moody. What the camera saw was then screened like a video, allowing Candace to guide her instruments. The lumpy, disorientating appearance of the human abdominal cavity on the screen was a familiar sight to her now.

This patient’s symptoms suggested the need for a cholangiogram, which would confirm or rule out the presence of stones in the bile duct. In this case, the X-ray-type scan showed that, yes, there were three small stones present. Candace decided to remove them immediately, rather than bring Mrs Allenby back for a second procedure at a later date.

The monitors indicated that she was handling the anaesthesia well. Candace had no trouble in removing the stones successfully.

‘If I know Mrs Allenby, she’ll want to see those later,’ Steve said.

‘She’s your patient?’ Candace asked.

‘Since I started here four years ago. And she’s got a very enquiring mind, haven’t you Mrs A.?’ Under anaesthesia, Mrs Allenby’s conscious mind was almost certain to be unaware, but there was strong evidence that many patients could retain a memory of what happened during surgery. ‘She wanted to know last week—’ Steve began.

‘Could we save it until later?’ Candace cut in.

‘Sure.’ He gave a brief nod and a shrug.

Again, there was a moment of tension and adjustment amongst the other staff. Candace ignored it and kept going. She used tiny metal clips to close off the bile duct at the base of the gall bladder, as well as the vessel which provided its blood supply. Next, she used a cautery to detach the gall bladder from the liver, once again working through tiny incisions.

She brought the organ to the incision in Mrs Allenby’s navel and emptied its contents through a drain. The gall bladder was limp now, and slid easily through the incision. She checked the area for bleeding and satisfied herself that all was looking good, then the patient’s abdomen was drained of gas, the incisions were covered in small bandages, Steve reversed the anaesthesia and the operation was over.

Easy to describe, but it had still taken over two hours, and there was more work yet to be done. The two nurses chanted in chorus as they counted up instruments, sponges and gauze to make sure nothing was missing. Forceps and retractors clattered into metal bowls. Surgical drapes were bundled into linen bins. Mrs Allenby was wheeled, still unconscious, into the recovery annexe where two more nurses would monitor her breathing, consciousness, behaviour, blood pressure and pain as she emerged from anaesthesia.

The two hernia operations which came next were simpler and shorter. Both were of the type known as a direct inguinal hernia, which resulted from a weakness in the muscles in the groin area. A short incision just above the crease between thigh and abdomen on each patient allowed Candace to slip the bulging sac of internal tissue back into the abdominal cavity.

The first patient’s abdominal wall had quite a large area of weakness, and Candace asked for a sheet of synthetic mesh to strengthen it. The second patient, several years younger, needed only a series of sutures in the abdominal tissue itself. Each incision was closed with sutures, and both patients would rest on the reclining chairs in the day-surgery room after their first hour or two of close monitoring in the recovery annexe.

She would check on them as soon as she had showered, Candace decided. You never came out of surgery feeling clean.

The shower beckoned strongly as she pulled off her gloves and mask just outside the door of Theatre One. Behind her, Steve and the other staff were preparing for a Caesarean, and Candace crossed paths with Linda Gardner. The obstetrician was about to squeeze in a lunch-break while Theatre One was tidied and replenished with equipment, ready for her to take over.

‘Quiet in here today,’ Linda commented.

‘They’ll probably appreciate a request for rock and roll, I expect,’ Candace answered.

‘So you’re the culprit? You like reverent silence?’

‘Reverence isn’t a requirement,’ she returned quickly. ‘Silence is.’

‘No one gave you a hard time?’ Linda asked with a curious smile.

‘In surgery, I don’t give anyone the opportunity.’ She softened the statement with a smile in return, then went and answered the clamouring of her aching back with a long, hot shower.

She emerged in a skirt, blouse and white coat twenty minutes later to find Theatre Two up and running and ready for her.

‘All the symptoms of appendicitis, admitted through Emergency,’ on-call theatre sister Lynn Baxter explained.

‘Give me five minutes,’ Candace said.

‘And turn off the music?’

‘Word travels fast around here. Thanks very much, yes.’

As usual, she didn’t go on at length. Didn’t admit either that the unexpected extension of her list today was almost as unwelcome as the discovery that the last leg of a long flight home would be indefinitely delayed. She considered it her responsibility to each patient and to the rest of the surgical team never to talk about how she felt.

No complaints, no explanations. Her aching back and feet were private—her problem. So were hunger, thirst and an itchy nose or a throbbing head.

And as for the inner turmoil she’d felt during each agonising step between her discovery of Todd’s affair and their outwardly businesslike divorce…She had said nothing about it at all until the final papers had been signed and their marital assets divided. Then she had simply made an announcement in the doctors’ change-room at the end of a Friday list with a three-day weekend coming up. She had asked those present to pass the word around.

Most of her colleagues had been stunned, she knew, but they had three days to get used to the idea and to recognise the signals she was sending out. They knew her professional style by this time. Comments had been sympathetic and heartfelt, but mercifully brief…

Theatre Two was the exact twin of Theatre One, with all equipment and supplies set out in exactly the same way. This patient, a thirty-five-year-old woman with an uncomplicated medical history, had been given a pre-med through her drip and was already drowsy and relaxed, her considerable pain masked by the medication.

The appendix was notorious for sending out mixed signals, so Candace kept her mind open as she prepared to make the incision. You could open someone up and find nothing at all, even when a patient’s white cell count was up and all his or her symptoms slotted into place. Or you could find—

‘Good grief!’ she said.

She’d spotted it before anyone else. There was a tumour wrapped around the appendix, turning this operation from a routine excision into a complex feat of surgical technique.

‘It’s huge,’ muttered on-call assistant surgeon Mark Daley.

‘But still potentially benign,’ Candace said. ‘We’ll take it out straight away to send to Pathology, then explore a bit to see if there’s any obvious spread to other organs.’

She excised both appendix and tumour, then looked at the ovaries, which were the most likely sites for a primary tumour in a woman of this age. Fortunately, they looked healthy and normal. Neither was there any evidence of metastasis to the liver.

‘We’re looking pretty hopeful on this one,’ she concluded, and there was a sense of relief all round.

It was after three by the time Candace emerged from Theatre, and her stomach was aching sharply with hunger. She took another brief shower, grabbed a packet of potato chips from the vending machine in the emergency department, gulped some coffee and went straight in to check on the recovery of her day patients.

Mrs Allenby had eaten a sandwich and drunk some juice and tea, voided her bladder and shown a return of bowel sounds. She could manage a strong cough, her lungs were clear and she’d walked up and down the corridor a couple of times to assist her circulation.

‘But my shoulder is hurting,’ she said.

‘Your right shoulder?’

‘Yes.’

‘Strangely enough, that’s normal. Quite a common symptom. It’s called referred pain, and that’s really all you need to know about it, Mrs Allenby. It should go away on its own by the end of the day. You’ll probably notice some discomfort from gas as well. Your stomach doesn’t like being manhandled, and it may take a couple of days to settle down. But the surgery went very well, and I’m not anticipating any problems. Dr Colton would like to see you in his rooms in about a week to check on how you’re doing.’

‘I’ll make an appointment.’

‘Meanwhile, you can go home as soon as you’re ready. You have someone to pick you up?’

‘My husband’s waiting.’

‘Great! All the best, then. You were special, you know—my first patient in Australia.’

‘Oh, how nice!’

Mrs Allenby went to the patients’ change-room to dress, while Candace checked on her two hernia patients, who were both progressing normally but still too groggy to leave. As she slid her stethoscope around her neck, Candace heard Mrs Allenby say to a nurse, ‘All right, I’m ready. Do I get my stones now?’

She hid a smile as she crossed to the three-bed recovery annexe where Andrea Johnson was just emerging from her anaesthesia. Steve had predicted his patient’s interest in ‘her stones’. In a relatively small community like this one, where a patient’s GP could also be present during surgery, there would be more examples of this kind of knowledge. As Mrs Allenby had said in a different context, it was ‘nice’. A difference for Candace to enjoy while she was here.

Andrea Johnson was still very sleepy and disorientated. She was lying on a wheeled hospital bed a few metres from the other patient in Recovery, the Caesarean delivery from Theatre One.

‘Hurts,’ was all she wanted to say. ‘Feels awful.’

Candace ordered some additional pain relief, and out of the patient’s earshot said to the recovery annexe sister, ‘She’s not ready to hear about what we found and what we did.’

‘Wait until she goes upstairs?’ Robyn Wallace suggested.

‘Definitely. My notes are pretty clear, I think. I’ll follow up in the morning and answer any questions she’s come up with. If she seems too groggy to be told tonight, it can wait. And, of course, there’ll be a wait anyway for the pathology results. Does she have family here?’

‘No, she’s single apparently. Drove herself in.’

‘There must be someone to tell. Could you try and find out?’

‘She was probably in too much pain to think about next of kin before.’

‘That’s usually when people want family or a friend around.’

‘True.’ Sister Wallace nodded.

‘What have we got here? Two for the price of one?’ said a new voice just behind them.

It was Steve. As anaesthetist, he was technically responsible for any complications in patients for the first twenty-four hours following their surgery, and he’d be taking a look at the two hernia patients as well as the Caesarean delivery he’d just been involved with.

Candace didn’t understand his comment about two for the price of one. She assumed it was another Australian joke, but Sister Wallace looked blank as well.

‘They’re both my patients,’ he explained. ‘Sisters. And there’s a whole posse of other Johnson and Calvert relatives upstairs, waiting to see Carina and the baby. Should probably warn you,’ he added quietly to Sister Wallace, ‘sparks will fly if they each realise the other is here. Andrea and Carina don’t get on. Andrea seems to have cut herself off a bit lately.’

‘I’ll keep that in mind, and pull a curtain across,’ Sister Wallace drawled.

‘Speaking of getting on,’ Candace said lightly, ‘I’m heading off. It’s been an interesting first day, but I’m done now.’

She should have known it wouldn’t be that easy. Steve caught up to her as she reached her car.

‘Heading straight home?’

‘Yes, thanks to the existence of the frozen meals we picked up the other day, I don’t need to stop for anything.’

‘Frozen meals! Yum!’ he drawled. ‘How about steak instead?’

‘Too hungry to wait for steak.’

‘I’ll get it on the grill as soon as I get home. Walk down to my place when you’re ready, and we can call it a late lunch.’

‘You don’t have to.’

‘I know. If I had to, I’d be chafing by now. Terry said, “Look after her till Monday.”’

‘Ah, so he did say that?’

She felt the severity in her expression. Couldn’t always relax straight after surgery. He would probably think she was tight and humourless and no fun at all. From experience, however, she knew it would be worse to force a more laid-back mood. Wait until she got out of these cruel pantihose and unwound the stethoscope from her neck. She’d be far more relaxed then.

‘Yes, he did say that,’ Steve echoed steadily. ‘But it’s Tuesday now. This one’s pleasure, not duty. And I’m such a crash-hot GP I can tell just by looking at you that your iron stores are low.’

Unexpectedly, she laughed. ‘They probably are.’

‘You need steak. And a swim.’

‘The swim I won’t argue with.’

‘Neither will I, as long as it’s after the steak.’

‘All right…’

‘Then, when we’re sitting on the beach, I think we’ve got to talk about why you hesitated even for a second before you said yes to this,’ he finished.

Casual tone. Meaningful after-shock.

It was a threat. Candace was in no doubt about that. And it was a threat which sent twin curls of panic and dizzy need spiralling wildly through her blood. She stalled the car three times on the way home.

CHAPTER THREE

THEY lay side by side on their towels in silence, soaking up some late afternoon sun and digesting what couldn’t possibly have been called a late lunch.

Barbecued steak, a microwaved jacket potato and salad, dished up at a quarter to five? Not lunch. Delicious and satisfying, though. Steve Colton cooked steak very well.

He was going to ask me something, but I’ve forgotten what it was, Candace thought hazily.

She was too busy thinking about signals. Yes, those signals! The ones men sent to women, and the ones women, in their different way, sent back to men.

It’s been so long…So long since I had to decide if I was imagining it or not. If I wanted it or not. If a man really meant it or not. I was so sure about all those questions the other day, but now…

Some men had flirted with her, had given off signals, during her marriage to Todd. They had been signals she had casually interpreted as meaning, If you weren’t attached, I’d be interested. The key attitude on her part, of course, was ‘casually’. She had never needed to test out her perceptions, to work out whether she was right or wrong.

Because of Todd, because of her marriage, it just hadn’t mattered. She’d never had the remotest intention of responding to the possible, or probable, signals in any way. She’d never been tempted into an affair.

This time, it was different. A part of her craved the heady therapy of a successful fling. Another part of her was cynical, sceptical and just plain terrified. If I’m wrong…If I’m right, and it doesn’t work…

If I’m sure I’m right, and I throw myself at him, and he laughs, or he’s kind, or he tells me very carefully, Oh, but I’m married. Didn’t you know? My wife is away visiting her parents for a week in Woggabiggabolliga—which seemed to be the name of at least half of the towns people mentioned around here, as far as she could work out.

Candace had to suppress a gulp of hysterical laughter at this point. Am I going crazy? Who knew that betrayal and divorce could do this to a person?

‘You’re different in surgery, aren’t you?’ Steve said suddenly, sitting up cross-legged on his towel and resting his elbows on his knees.

Candace immediately sat up, too. She didn’t bother to argue his perception. ‘Enough to be worthy of comment, apparently.’

‘I didn’t—’

‘No, go ahead. It’s OK.’

‘I guess I thought you’d be more touchy-feely.’

‘And instead I’m…?’

‘You really give the impression that you know what you’re doing and you know what you want.’

‘Of course I do! I was doing this when you were still dissecting frogs, Steve!’

His abrupt launch into probing questions rattled her, especially the way it followed on from her own jittery train of thought.

‘Don’t,’ he said.

‘Don’t what?’

‘Don’t pull rank.’

‘Why not?’ she retorted. ‘I must be at least five years older than you.’

‘Six, I think.’

‘You’ve been checking?’

‘Terry said you were thirty-nine.’

‘Well, Terry is wrong! I’m only thirty-eight, and my birthday’s not until July!’

They looked at each other and both laughed at the absurdity of her objection.

‘Hey, can we start this again?’ he said.

‘Start what again?’

‘Now you’re being deliberately obtuse. This conversation. I hadn’t intended it to get confrontational. I wanted to say that in surgery you were…’ He hesitated.

‘A royal pain about the music?’

‘Yes, and it was great. I really liked the way you handled it. I liked you in surgery, Candace. I liked your focus and your confidence in the fact that it was your right to dictate the mood. But you were quiet about it. Polite.’

‘I’m well brought up.’

‘So well brought up that normally you’re probably like most women and apologise when someone else steps on your toes, right?’

She laughed again, recognising the arrow-like accuracy of his observation. ‘In my private life, yes. In surgery, Dr Colton, you’d better damn well apologise to me!’

He grinned and his blue eyes sparkled like the sun on the sea. ‘Yep. I liked that. It was good,’ he said, then repeated even more lazily, ‘It was good.’

Seconds later, he was on his feet and reaching down to pull her up as well. ‘Want to?’ he said.

‘A swim? Yes, I do.’

The surf was bigger today. ‘Dumpers,’ Steve told her. ‘Be careful. They can flip you over pretty hard.’

He kept a careful eye on her and on the waves as they swam, and told her a couple of times, ‘Not this one.’

After a while, she could feel the difference in the waves for herself. They didn’t curl and pause and fold smoothly over today, but broke abruptly, like hands crashing on piano keys. If you caught them at the wrong moment, they sent you tumbling so that you emerged disorientated, with wrenched muscles.

‘Where are the flags today?’ she asked Steve.

‘They don’t patrol Taylor’s Beach during the week, outside school holidays,’ he said. ‘We can stop, if you like.’

‘No, I’m enjoying it.’ And she felt very safe beside him, sensed that he really knew what he was doing in the water.

‘Jump!’ he interrupted, and they managed to keep their heads above water as a wave boiled around them. ‘They’re breaking all over the place. We’d have to go out a long way to avoid them.’