Читать книгу Sheikh Surgeon, Surprise Bride - Josie Metcalfe - Страница 8

BY THE time she staggered back to her bedsit that evening Lily was totally exhausted and wondering if she was ever going to be able to keep up with Razak’s seemingly inexhaustible supply of energy.

Things had started off calmly enough as the two of them had first examined an apparently endless series of patients referred by their GPs, many of them needing orthopaedic surgery sooner rather than later for their painful joints. Later that afternoon they had moved on to the review of the two patients who had been admitted that day for surgery the following morning, but before they had been able to take any sort of a break for her to ask any of the questions already buzzing around in her head, Razak had been contacted for an urgent consultation on a patient in the emergency department and she had found herself running in his wake when he had suggested she come, too.

‘Sir, listen to this,’ exulted a very young doctor as he reached out towards the blood-spattered body on the trolley in front of him. ‘You can actually hear the bones grating when you spring the man’s hips.’

‘Don’t!’ snapped Razak, before he could make contact, the word like the crack of a lash. ‘How many times have you already done that?’

‘A couple,’ he admitted, then smiled almost innocently. ‘It’s the first time I’ve actually heard a break when I’ve done it and I—’

‘And you could be responsible for killing the man,’ Razak interrupted fiercely. ‘What’s his blood pressure doing? If the sharp edges of the broken bones damages one of the pelvic arteries he could bleed out in a matter of minutes. Your job here is to stabilise his condition so we can get him up to Theatre, yes?’

‘Yes, sir,’ he agreed, clearly crestfallen. ‘Do you want to use an external fixator before he’s transferred?’

‘Have X-rays been taken yet to show the position of the fracture?’ Razak demanded briskly. ‘If there’s more than one break we may have to. Otherwise, if you can guarantee not to make him any worse while he’s transported to Theatre, we’ll do it upstairs while we do an open reduction and internal fixation.’

Even as he was speaking, the radiographer was positioning the equipment above the moaning patient and there were so many members of staff noisily occupied in taking care of him that Lily wondered for a moment whether they would even hear the radiographer’s warning countdown to the first exposure.

At the last second the last nurse whipped her hands off the body and stepped back smartly, only to step forward just as swiftly as soon as that view had been taken.

The whole process had to be repeated several times to build up an accurate picture of what was going on inside, and all the while the members of the resus team were going about their tasks. Machines were monitoring the patient’s blood pressure and airway but one of the nurses was specifically detailed to document each dose of painkilling drug and every procedure as it was done while another was keeping up a soothing running commentary in the hope that it would make everything just a little less frightening.

At least the hospital had the latest digital X-ray technology, so there was no long wait while old-fashioned plates were hurried away to be developed. With this state-of-the-art equipment, as soon as the shot was taken it was available for viewing on the monitor with the touch of a button.

Razak muttered something vehement under his breath when he saw the first view, and even without knowing his language Lily could tell that he’d sworn. She certainly felt like it when she saw the damage the man had sustained.

‘Definitely an external fixator,’ she murmured as she stepped aside to reach for the wall phone. ‘Who should I ask for to bring the kit down?’

‘Can you see if Colin Wetherall’s free at the moment?’ Razak asked. ‘Tell him what we’ve got here and that I’d like him to do a demonstration for you.’

‘A demonstration?’she murmured under her breath, while someone up in the orthopaedic department checked to see if Colin was still in Theatre. He’d had two operations scheduled that afternoon, a knee and a shoulder. If everything had gone well, he should be nearly finished. But why should she need Colin to demonstrate the fixator kit? It wasn’t as if she hadn’t used it before, although, admittedly, not very often.

Was calling him down Razak’s way of saying that he wasn’t impressed with her level of skill? She didn’t think she’d made any mistakes today, their only disagreements having been over matters of personal preference for various prosthetics.

‘I hope he is free,’ Razak said suddenly, his voice right behind her telling her that he’d come far closer than she’d realised. ‘He spent some time in Russia at the institute where this particular fixator system was developed and he’s nothing short of brilliant with it. The best in the department, I think.’

Lily hadn’t known the man long, but she had a feeling that Razak didn’t give praise easily, so it was with an unexpected feeling of anticipation that she waited to see what would happen. For the moment, her role was more of a passive observer, but that could change at any moment.

To the uninitiated, the external fixator kit that arrived just before Colin might have been confused with a rather sophisticated construction toy with its various shiny rods and connectors, but in the hands of someone who had obviously been taught by masters how to use it best, it was a revelation.

Using the X-rays as a guide, Colin swiftly tightened the special screws into position in the bones then fitted the rods between them, tightening them only when the pelvis had been restored to the correct shape.

‘How’s his blood pressure?’ Colin demanded, without even lifting his head from the last titanium rod, his movements swift and accurate, while Razak automatically braced the unstable pelvis for him.

‘No sign of hypovolaemia so far, but blood is being cross-matched and sent up to Theatre.’

They sounded so calm, but those few words were a measure of the potentially deadly nature of this particular injury. There were so many veins and arteries in this area and this sort of bony injury was often accompanied by massive soft-tissue injury and a more than fifty per cent chance of dying of massive blood loss.

So far, their patient had been lucky. His blood pressure was holding fairly steady, indicating that there was no great dip in his blood volume. He also seemed to have avoided any apparent injuries to his kidneys, bladder or urethra as there was no sign of blood in his urine or on the ultrasound scan that had largely replaced the need for peritoneal lavage.

Now, with Colin straightening up from his completed task and the pelvis stable enough for the patient to make the journey up to Theatre safely, it was just a case of opening him up on the table and performing an internal fixation of each of the fractures. Only then would the bones have a chance of healing normally so that the patient could walk again.

‘Do you want me to finish the job off?’ Colin offered. He tried to sound diffident but Lily had the feeling that this was the sort of case he thrived on. She’d known other surgeons who found the never-ending stream of joint replacements stultifying, only really enjoying the adrenaline rush of repairing life-threatening traumatic injuries.

‘Do you have enough theatre time left?’ Razak asked. ‘You’ve already been operating this afternoon.’

Lily knew what he was asking. Their standard sessions were three and a half hours and this wasn’t going to be an easy job or a quick one. If Colin had already operated on two patients that afternoon…

‘One of mine didn’t make it into Theatre this afternoon, unfortunately. She had a CVI on the ward just after she took her pre-med. She’s up in ICU now.’

‘In which case, be my guest,’ Razak said with a smile, standing aside as the trolley set off towards the bank of lifts. ‘Call me if you need another hand on the screwdriver.’

Lily felt a tremendous sense of anticlimax as everyone dispersed, leaving just the nurses to gather up the debris and get the room cleaned and restocked for the next emergency. She’d honestly believed that Razak would be operating on the patient and had been gearing herself up for the probability that she would be in the theatre with him.

‘Don’t be impatient!’ he teased, and she wondered with a jolt whether he was also a mind-reader. ‘I promise you’ll have your chance tomorrow morning. I’ll be putting you through your paces then.’

The anticipation was different this time, a mixture of excitement that she would be doing what she loved and dread lest he find her skills lacking.

But even as she followed him out of A and E and shared a lift with him up to the orthopaedic department to retrieve her purse and keys, there were questions circling inside her head.

It was nothing that anyone had said…more what they hadn’t said or, even worse, things that had been hinted at. If she was going to be able to give of her best when the two of them were working together tomorrow, she needed to clear the air, and the only way of doing that was to ask for an explanation.

Even then she hesitated and it wasn’t until he had his hand out towards the door of his office that she spoke.

‘I need to speak to you,’she blurted. ‘I…I need to ask you some questions.’

‘Now?’ he asked, turning back to her with a weary smile, and she remembered suddenly that he’d had a late night repairing the damage after a fight outside a pub last night. ‘Of course,’ he said politely, but as he turned to lead the way into his office his stomach growled and her feelings of guilt were doubled.

‘Have you eaten?’ he asked, then shook his head. ‘Stupid question! Of course you haven’t because you’ve spent the whole day in my shadow. So, will you join me for a meal?’

‘Oh, but…’ She was already shaking her head, unaccustomed to such invitations, especially at short notice. And to be invited by her boss… ‘We don’t need to…We…we can talk tomorrow,’she suggested hurriedly, cursing her pale complexion when she felt the searing heat of a blush.

To her surprise, he seemed completely oblivious to her discomfort.

‘We won’t have time to talk tomorrow,’ he said flatly, ‘certainly not without Colin and Reg and who knows who else listening in to every word. And if you have questions, we need to get them answered to clear your mind for the morning. You’ll need all your concentration in my theatre. Anyway,’ he added, not giving her time to come up with a solid objection as he pulled his door shut again and the keypad lock clicked shut, ‘we both need to eat, Dr Langley, and we could talk at the same time. Very efficient.’

What could she do but agree, in spite of her automatic reluctance to share a meal with him? Partly it had been the formal way he’d spoken to her as Dr Langley that had made her give in, but that didn’t explain the strange emotions churning inside her.

She was attracted to the man, that’s what it was, she realised as he ushered her into her seat in the little French restaurant in one of the side streets near the hospital. And it had taken her this long to recognise the feeling because it the first time it had happened to her like this.

But, then, Razak Khan was a rather exceptional man…charismatic, powerful, good-looking, courteous…there wasn’t much she couldn’t admire about him. But somehow she understood that this went deeper than a surface appreciation for a handsome successful man…This was…

Nothing, she told herself fiercely as she buried her nose in her menu. This was her boss and if she was ever going to make it up that final rung of the ladder, she was going to have to keep her concentration where it mattered—on the job.

‘So, explain this big scheme to me,’ she invited brightly, and had to hide a wince when she heard how air-headed she sounded.

‘How much do you know?’ he countered, then had to pause when the waiter arrived to take their order, clearly delighted when Razak switched into fluent French.

If she concentrated hard, Lily found she could actually follow what the two of them were saying, and it was evidence of yet another fascinating facet of the man that she’d love to explore. When had he learned French and why? Was it his native language or…

That is not why you’re sitting here, she reminded herself sternly. He asked you a question and now he’s waiting for a reply.

‘How much do I know?’she said. ‘Apart from the fact that Reg hates it, nothing at all.’

‘Wasn’t it explained at your interview?’ he demanded, clearly surprised by her reply.

‘No. Not that I can…’ She paused, suddenly remembering the moment when one of the bean-counters had started to ask her something, only to be talked down by Reg. Had that been the point when she should have found out what Razak was proposing to do? Had that been the moment when Reg had decided that appointing one of the women he so blatantly despised might be the straw that broke the camel’s back as far as Razak’s scheme went?

The more she thought about it, the more likely it seemed.

Without a strong, committed junior on his team…one with the stamina to keep up the pace for long hours at a stretch…the scheme would never get approval, never mind be a success.

A sudden sickening idea burst into her brain. Was that why she’d got the job in the first place? Not because she was the best candidate for the job but because Reg thought she would be a weak and feeble woman?

‘What?’ Razak demanded, breaking into her unpalatable thoughts.

‘What, what?’ she countered, wondering if he was waiting for an answer to another question. She honestly couldn’t remember.

‘I wanted to know if you’d reached a conclusion?’ he asked patiently.

‘A conclusion about what?’ she temporised, hoping he would tell her which part of their conversation she’d missed.

‘Well, you obviously had some sort of an internal debate going on just then, and from the expressions on your face I would guess that there was something said at your interview, but that someone—either Colin or Reg, but most likely Reg—prevented anyone telling you the whole story. So…’ He frowned in concentration, far too close to the truth for her comfort. He really did seem to be able to read her thoughts. ‘You were wondering why he didn’t want you to know. After all, it would strengthen his case to have good surgeons withdrawing their candidacy for the job because they didn’t like what they were being asked to do…No! That’s not it!’ he contradicted himself with a closer look at her face, as though the words were actually written there. ‘You were wondering whether the reason you were offered the job was because the appointment of a woman as my junior would make it less likely that the scheme would be given the go-ahead. You were wondering whether you got the job because you were the weakest candidate rather than the strongest. Am I right?’

‘Spot on,’she agreed through gritted teeth, steam practically coming out of her ears. ‘Just wait till I tell that pompous—’

‘Hey, don’t get mad, get even!’ he suggested, with a wicked grin that made his teeth seem even whiter in the darkened intimacy of their corner of the room.

‘How?’ she demanded, the thought definitely appealing.

‘Prove him wrong,’ he said simply. ‘Be everything you can be so that he has to eat his words not just about women as orthopaedic surgeons but also about the scheme I’m trying to get going.’

‘And about which I still have no idea,’ she pointed out, and it was like letting loose a tidal wave of enthusiasm.

‘It’s a whole new way of managing lists for orthopaedic surgery,’ he said with all the fervour of an evangelist, barely pausing to sample his meal when it arrived. ‘Not new in America, where some surgeons have been doing it for years, or in France, where they also use a similar system, but as far as Britain is concerned…’

‘Mr Khan?’ she interrupted with a touch of impatience.

‘Yes?’ his own impatience was even greater for having been halted in mid-flow.

‘What system are you talking about?’

‘Oh! Yes!’ He threw her a brilliant smile. ‘I forgot to start at the beginning, didn’t I?’

‘Yes, you did, Mr Khan,’ she agreed, for the first time feeling like smiling back.

‘In that case, I apologise, Dr Langley, but I—’

‘Lily,’ she offered, before he could go any further. ‘My name is Lily.’

‘Lily,’ he echoed thoughtfully, tilting his head on one side before shaking it. ‘No, that’s not the flower I was thinking of. I would have said jasmine.’

He’d actually been thinking about her name or…

‘I’m wearing jasmine,’she blurted, wishing she’d kept her mouth shut when she realised she would have to explain. ‘My mother’s called Rose and she named us girls after flowers, too…Lily, Iris, Violet and Marguerite…and for years she’s given us flower-scented toiletries for Christmas and birthday presents. This year mine was—’

‘Jasmine,’ he finished for her, then shocked her to the core by taking her hand in his and bringing her wrist up to his nose. ‘No, nothing there,’ he pronounced, almost seeming disappointed.

‘Too much hand-washing,’ she suggested, to cover the shiver of response that travelled the length of her spine when his dark eyes almost seemed to take inventory of the other places he might search out to find the elusive scent.

‘Ah…you were saying?’ she fumbled as she tugged to retrieve her hand, horrified by how swiftly things had strayed away from the purely businesslike. ‘About the new system?’ she prompted, as she knotted both hands together on her lap, trying to quell the strange tingle that lingered where his fingers had held hers.

‘Ah…yes.’ She saw him blink as though it took an effort to gather his concentration. ‘It’s production-line surgery, to put it at its crudest. Have you heard anything about it?’

‘Where the surgeon has a whole string of operating theatres on the go at one time, with juniors starting and closing the operations while the consultant does the complicated bit in the middle? Yes, I’ve heard of it,’ she agreed with a buzz of excitement. ‘Is it true that some can keep twelve theatres busy at once?’

‘I believe so, although I didn’t witness it when I was over in the States, or when I was in France, where orthopaedic surgeons use a version of the same system.’

‘So what are the advantages over what happens here? Doesn’t it tie up an enormous number of other staff—anaesthetists, nurses and so on? And then there’s the number of specialist staff for post-operative care, too…and physiotherapists for mobilisation…and the number of beds needed all at once and…’

‘I know! I know! These are all the objections that Reg has been pointing out ad nauseam to anyone who will listen, even though I have told him that I only want to use two theatres and to operate for five hours instead of three and a half.’

‘So tell me about the benefits,’ she challenged.

‘For the hospital accountants, the first one is obvious,’ he said with a shrug. ‘The most expensive member of an operating team is the surgeon, and at the moment the hospital is paying for him…or her…to spend unnecessary time sitting drinking tea or coffee while they wait for the theatre to be cleared and restocked and their next patient to be prepped. It just doesn’t make economic sense to pay them to be idle.’

‘And secondly?’ she prompted, already seeing that he’d thought deeply about this, having seen the system working in other countries.

‘The benefit to the patients is when the waiting lists are cut to nothing,’ he said decisively. ‘Other countries are horrified by the idea that someone already in pain and needing replacement surgery for a hip, maybe, should then be put on a list and have to wait for up to nine months before their pain can be relieved. For some, the only bearable option is to pay to go privately, but for many, even that option is not possible because of the high costs involved. This just doesn’t happen in France, for example, because the production-line system means that the theatres and surgeons are utilised properly…to full capacity.’

‘And the disadvantages?’

‘Once again, financial, with the cost of building and equipping extra theatres, and then there’s the specialist theatre and ancillary staff. There’s also the fact that if the waiting lists disappear, far fewer people will be interested in paying for their operations privately, so the surgeons who are boosting their incomes with private work will feel the pinch, apart from having to work longer shifts and work harder during the hours they’re on shift.’

‘So it’s no wonder that Reg and his coterie are less than enthusiastic about your plans,’ Lily said with dawning comprehension. ‘If they agree with you, it’s tantamount to upping their workload by nearly fifty per cent while dropping their income by a similar amount.’

‘Don’t forget the fact that their tea-breaks will virtually disappear!’ he added, then gave a sigh. ‘It all just so frustrating when the theatre suite is all but completed and I’ve already got the anaesthetists and theatre staff on board.’

‘So,’ Lily mused thoughtfully, ‘the last thing you needed was to have a female surgeon foisted on you. I suppose you see me as the last nail in the coffin of your plans.’

‘To be honest, I won’t know that until I see you work,’ he said bluntly, those dark eyes fixing her steadily, unequivocally. ‘If you’re a good surgeon, you could actually be the card that wins the game.’

‘So, before you start pushing them for the go-ahead, you need to know that Reg appointed the right person in spite of himself. I take it that when we’re in Theatre together tomorrow morning, you’ll be watching me like a hawk?’

‘Will that worry you?’ One dark brow lifted quizzically but there was a watchful stillness about the man that sent an atavistic shiver through her.

That was enough to put some steel into her spine. She’d never allowed any man to intimidate her and wasn’t about to now.

‘Not in the least,’ she said firmly, confident of her abilities. ‘I might not have had the experience you have, but I’m good at what I do. Very good, because I’ve worked hard at it.’

There was an unexpected warmth and…was it respect?…in his eyes. ‘I’m looking forward to it,’ he said softly.

If ever there was a challenge to put her on her mettle, Razak Khan was that challenge, she thought as they finished their meal, tacitly agreeing to stick to more general topics as they got the measure of each other.

It was only when he’d walked her back to the hospital and she was making her solitary way towards her cramped bedsit that she remembered her idea of having a word with the chairman of the committee, just in case Reg had read the bean-counters right.

Initiating this new scheme was going to use up finite resources, with a full staff on duty in both theatres simultaneously, but if Razak had the support of everyone on those teams, even his untried junior…If everyone knew that she was fully behind Razak’s initiative, would that remove any of their reservations?

Of course, much of that would largely depend on how well she performed the next day, whether she and her new boss could find that elusive synchronicity that made for a good operating team, and if she was too tired, it definitely wouldn’t happen.

Razak flung the bedcovers to the floor in a fit of impatience and swore softly into the darkness.

‘What on earth is wrong with me?’ he demanded aloud. ‘So what if she’s a woman? She’s an orthopaedic surgeon, and that’s what matters.’

Except she wasn’t like any other orthopaedic surgeon he’d ever met. He’d never met anyone who presented such a calm, serene exterior while underneath…Did she even know the depth of passion that was hidden under the surface? He doubted it. There was such an untouched air about her that it aroused the hunter in him the way no woman ever had.

She didn’t even look like any of the other women in his life. His upbringing had conditioned him to appreciate the lush voluptuous woman who knew how to pleasure a man, while Lily…

She was so much like her name…tall, slender, elegant, cool, with her pale gold hair and even paler skin the colour of rich cream sprinkled with just a handful of cinnamon freckles. For a crazy moment he found himself speculating whether those sun-kissed spots were confined to her face and arms or whether they extended to the rest of her body. He was seized with the urge to explore beneath the camouflage of her neat professional clothes to find…

‘No!’ he growled, and winced when he heard the throaty tones of arousal in his voice. Was she some kind of witch that she’d tied his thoughts up in her, his body already in thrall?

It couldn’t be allowed, not if he was going to achieve his goal. He must be allowed to set up this programme if he was going to strengthen his claim in time for his return to his homeland. There were so many willing to point the finger and to whisper of nepotism. This was important to him. This was one thing that he needed to achieve on merit alone. He was so close to achieving his dream that he could almost touch it, and he couldn’t allow anything—or anyone—to stand in his way.

‘So, tomorrow you will watch Lily as she operates and you will do it with eyes as sharp as the scalpel in her hand,’ he told himself sternly. ‘You will assess her skills and her weaknesses and you will decide whether she is going to be an asset or…’

He shook his head. There could be no or. Failure was not an option. Lily Langley was his junior, for better or worse, and if he needed to retrain her himself in time for the start of the project, he would do it.

‘I just hope you’re up to it, pretty Lily,’ he growled. ‘If not, the next few months could be misery for both of us.’