Читать книгу Her Celebrity Surgeon - Kate Hardy - Страница 9

‘I CAN’T believe Tom didn’t even notice his foot was gangrenous!’ Abby said.

‘Type-one diabetic, male, early thirties, single, lives on his own—no, I can buy it,’ Sophie said.

Abby shook her head. ‘I can’t, even though I know people with diabetes are more at risk of foot infections and ulcers—their circulation doesn’t work properly and it affects the motor, sensory and autonomic nerves.’

‘Which means?’ Sophie asked.

‘The motor nerves supplying the small muscles of the foot and the calf don’t work properly so the weight-bearing bit of the foot is distorted,’ Abby recited. ‘The effect on the autonomic nerves means the foot doesn’t sweat, and the sensory nerves don’t work so the patient doesn’t feel any pain.’

‘Exactly.’ Sophie thought Abby was shaping up to be an excellent doctor—she knew the textbook stuff. Now she just needed to understand her patients a bit more and empathise with them. ‘You don’t feel it, so you don’t do anything about it. Nearly half the time diabetic patients spend in hospital is because of foot problems.’

‘But surely he must have seen it?’ Abby asked.

‘He probably hoped it would just go away on its own. A lot of people do—they’re scared of doctors and hope if they ignore the problem it’ll go away.’

Abby shook her head in disgust. ‘So why didn’t his diabetic nurse pick it up?’

‘Because,’ Sophie said, ‘he didn’t turn up for any of his appointments. He got divorced last year and his mum told me yesterday he cut himself off from the rest of the world. The only reason we know about his foot is because he had a hypoglycaemic attack at work and the foreman insisted on him coming to hospital. Lucky ED was clued up enough to guess if he wasn’t keeping his glucose levels under proper control, he probably wasn’t looking after himself and might have a bit of ulceration on his feet as well.’

‘A bit of ulceration? Soph, the entire dorsum of his foot is necrotic!’ Abby said, aghast.

‘Yup.’ The top of Tom’s foot was red, swollen and puffy, and the tissue beneath was dead. ‘The sad thing is, it could all have been avoided if he’d come for treatment earlier.’ Sophie sighed. ‘The gangrene’s too bad for me to save his foot. I just wish I could have done reconstructive surgery on it—which I would have been able to do if he’d seen us weeks ago. He might have lost a toe or two, but it would still have been workable. Whereas this…It’s going to take him months of physiotherapy to get used to a false leg.’

‘What does Charlie say?’

‘Same as me. It has to come off.’ Sophie had checked with him the previous afternoon, and together they’d explained the options to Tom. She’d been impressed by the way Charlie had handled it and had tried to give Tom some dignity. ‘He’s doing the op with me this afternoon. We’ve been giving Tom an epidural for the last twenty-four hours.’

‘Why?’

‘Studies show he’s less likely to suffer from phantom limb pain after the amputation,’ Sophie explained. ‘We’re going to do a below-knee amputation—I need to go high enough to make sure the tissue I cut through is healthy. Why?’

‘Because otherwise there’s a risk the wound will break down and become ulcerated, so you have to do another amputation. You’re going below the knee—mid-tibia—because it’ll improve his mobility with a prosthesis,’ Abby added.

‘Perfect textbook answer,’ a voice said beside them.

Sophie did her best to ignore the tingling at the back of her neck. Charlie was just another one of the team, and she was going to treat him accordingly. He was just another doctor. So what if he had the sexiest mouth she’d ever seen? So what if his neck just invited you to caress it? The two of them were worlds apart, and it would stay that way.

‘Want to come and watch, if Guy can spare you?’ Charlie asked. ‘The full op takes about an hour and a half, but if he can only spare you for part of it, that’s fine.’

‘Could I?’ Abby beamed at him. ‘I’ll go and ask Guy!’

When she’d gone, that left Charlie and Sophie together. Alone.

Well, they had to work together. Just because she didn’t like what he stood for, it didn’t mean she’d be deliberately obstructive—not where work was concerned. Patients took priority in Sophie’s eyes.

‘How’s Tom?’ Charlie asked.

‘Pretty miserable. And wishing he’d seen a doctor earlier,’ Sophie said wryly.

‘Poor bloke. But there was too much necrosis for us to be able to save the foot.’ He looked at Sophie. ‘You didn’t mind me asking Abby if she wanted to watch, did you?’

‘No. It’s good experience for her.’ And he had at least said it was on condition Guy could spare his house officer. He wasn’t just expecting everyone to drop everything because the director of surgery said so.

‘I noticed you coaching her just then,’ Charlie added.

Sophie shrugged. ‘Just doing my job.’

‘Some surgeons hate dealing with junior doctors.’

‘Abby’s keen, bright and fits in well with the team. I’m more than happy to help,’ she said stiffly.

There had definitely been an undercurrent to her words. What? Was she saying she didn’t think he fitted in with the team? Charlie sighed inwardly. He hadn’t been there long enough to know if he’d fit in or not. But Sophie wasn’t even giving him a chance. He’d been drawn to her when he’d overheard her coaching Abby—the encouragement in her voice, the smile on her face, those beautiful brown eyes lively as she’d talked about the operation. He hadn’t been able to stop himself joining in.

And she’d frozen on him completely.

Until that moment he’d had no idea how cold brown eyes could be.

But he’d never met her before yesterday. He was sure of that: Sophie Harrison was definitely a woman he’d remember. So it couldn’t be anything he’d done personally to upset her.

It had to be the baron thing.

OK. He’d deal with it. After the operation he’d pull rank, take her for a coffee and straighten things out between them.

For professional reasons, of course. He wasn’t stupid enough to get involved with somebody he worked with. Unlike his younger brother, he didn’t mix work and play. Even though Sophie Harrison pressed all his buttons. Long blonde hair she kept caught back from her face with a clip in a way that made him want to remove it and run his fingers through it. Deep brown eyes he could drown in. And a perfect Cupid’s-bow mouth that made him want to cup her face in his hands and kiss her.

And if he did it, he had the feeling she’d break both his legs.

Professionally, they might be able to work together. Socially, no chance. So he wasn’t even going to go there.

‘I’ll see you in Theatre, then,’ he said.

‘Sure.’

Was it his imagination, or was there relief on her face—relief that he hadn’t suggested having lunch together? Suppressing the sting of hurt, he walked away. It wasn’t personal. He needed to find some middle ground, some way for them to work together. It’d take time. He just had to accept that and live with her suppressed hostility in the meantime.

Sophie’s spine tingled as she walked into the changing rooms. It was the adrenalin rush she always had before an operation, the one that kept her on the top of her game. When she’d worked with Guy, he’d always said that the day she stopped being nervous before an operation was the day she should hang up her scrubs—because you should never, ever take anything for granted in surgery. Even apparently routine jobs could suddenly change, develop an unexpected complication.

She changed quickly, tucked her hair into a cap, put her mask on and went to scrub up. Charlie was already there—clearly he’d already done his nails and the initial wash because he was scrubbing his hands and forearms. Nice forearms, she thought absently. Strong. Nice hands, too, strong and capable. For one shocking moment she actually wondered what they’d feel like on her skin.

Then she shook herself. It wasn’t going to happen. She’d sworn that his type would never touch her again.

Once they’d finished scrubbing up and were gowned, gloved and masked, they went into the operating theatre. Tom had had the choice of a spinal block or general anaesthetic—he’d opted for a general. It carried more risks than a spinal, but she could understand that he didn’t want to know what was going on. How could you just lie there as a surgeon removed your foot and half your lower leg? Even though you wouldn’t be able to feel it and the anaesthetic meant you wouldn’t be able to move anyway, you’d know exactly what was happening. You’d hear everything.

And it would be unbearable.

‘Poor man. He’s got a tough time ahead of him,’ she said.

‘What’s going to happen after the operation?’ Abby asked.

‘We’ll check his bandages aren’t too tight after about eight hours, then remove the drains a bit later without disturbing the dressings. In a couple of days he’ll start gentle physiotherapy to make sure there are no contractures at the hip or knee joints. And we need to get in touch with the limb-fitting and rehab departments as soon as possible,’ Sophie explained.

‘Over to you, Dr Harrison,’ Charlie said quietly.

Sophie checked that the anaesthetists were happy to proceed. ‘OK, Abby, I’ll talk you through what we’re going to do. In the old days they used to just slice off the limb and leave it to heal—it reduced the risk of gas gangrene or tetanus, but it was hopeless trying to fit a prosthesis to the limb.’

Charlie would be the best one to explain about the skin flap. But what did she call him? Mr Radley? She wasn’t up on Debrett’s, so she didn’t know what you were supposed to call a baron, but she was pretty sure it wouldn’t be ‘Mr’. Did she copy his formality or strike a blow for the common people and call him ‘Charlie’?

In the end, she went for a cop-out. ‘Our director of surgery will explain about the skin flaps.’

Then she made the mistake of glancing up. All she could see were his eyes above his surgical mask. Gorgeous slate-blue eyes. Sexy slate-blue eyes. But there was also a glint of amusement there. Was he laughing at her?

Just like his type had laughed at her before. She lifted her chin. ‘Problem, Radley?’

‘No, Harrison.’

He was definitely laughing at her, and Sophie scowled as she made the first incision.

‘Abby, the blood supply to the tissues of the lower leg is better at the front than at the back, so what I’m going to do is something called a “skew flap”. It’s a long posterior flap of muscle, with equal skin flaps. Harrison’s going to cut about twelve centimetres below the tibial tuberosity, so it preserves the patient’s knee joint and makes rehabilitation easier.’

He was following her lead and referring to her by her surname. Fine. She could cope with that. It felt rude—insulting, almost—but, then again, she’d started it.

‘We’ll have the drains out in the first couple of days and the sutures out in ten days to two weeks,’ Sophie added. ‘But he’ll be on the ward for two or three weeks.’

Then it was the bit she hated: cutting the bone. Even after all her years of experience she still hated the sound of bone being sawn through. But she concentrated on what she was doing, talking Abby through it.

When Charlie took over to deal with the skin flap, she noticed how deft and capable his hands were. Whatever her issues were with him as a person, she respected the way he worked. And she liked the way he treated the scrub nurses—with courtesy, rather than shouting at them or giving curt, dismissive orders.

Maybe, just maybe, she’d got him wrong. Maybe he wasn’t like all the other toffs she’d met at med school.

Or maybe he was. Maybe this was just a smokescreen. All charm, to hide what he was really like underneath. How could she trust him? How could she trust anyone from his class?

Guy had given Abby the time to watch the whole operation. To Sophie’s surprise, Charlie let the young house officer do some of the suturing. ‘Guy says your knots are good. Let’s see how you do with this one.’

Abby was clearly delighted at the chance. Although she worked slowly, her knots were good, and as her confidence grew with Charlie’s praise, the speed of her suturing increased.

‘Well done,’ Charlie said. ‘I think she did well—don’t you, Harrison?’

‘I do, Radley.’

Just as she’d finished changing, Charlie walked over to her. ‘Come and have a coffee while we’re waiting for Tom to wake up.’

‘I’ve got paperwork to do.’

‘Paperwork can wait.’

‘I really don’t need a coffee.’

‘You’ve just spent an hour and a half in Theatre. You need a break. Ten minutes. That’s all I’m asking.’

He was asking? It sounded more like a demand to her.

‘I think,’ he said quietly, ‘we need to talk. My office or the canteen. Your choice. But I could do with a coffee.’

There was nothing to say. Why did he think they needed to talk?

‘Canteen, then,’ she muttered, knowing that she sounded childish. But Charlie Radley rubbed her up the wrong way.

She really didn’t want to be there with him. That much was obvious. And he could tell that she was going to insist on buying her own coffee. Well, he wasn’t in the mood for politics of any sort. When they got to the cash till, he glared at her—and the glare worked. She shut up and let him pay.

They walked in silence to a quiet corner table.

‘Right. Cards-on-table time,’ he said. ‘I know everyone expected Guy to get the director of surgery post. I know you were in line to get Guy’s job. I’m sorry that your plans didn’t work out, but that’s the way of the world. Sometimes new blood can be good for a department.’

She snorted. ‘Right.’

‘And your point is?’

‘You’re a nip-and-tuck man. It’s obvious where the money’s going to go.’

‘I’m a plastic surgeon, yes. But I don’t do nips or tucks. I don’t do cosmetic surgery, except in cases of trauma or where there’s a medical reason for it. And the budget for this year was set before I arrived.’

She took a deep breath. ‘Next year’s money, then.’

‘Next year’s budget,’ Charlie said calmly, ‘will be allocated in terms of need. And I’ll be discussing it with Guy and Andy before I make final decisions. Clear?’

‘Clear.’

‘Good. So what’s the rest of your problem?’

‘What do you mean?’

Nicely parried. She hadn’t denied there was a problem, but she’d shifted the onus on him to say what he thought. OK. He’d play it straight. ‘You don’t like me, Sophie Harrison. Now, I know we’ve never met before, so I can’t have upset you personally. What’s the problem?’

She lifted her chin, and there was a definite spark of challenge in her eyes. ‘OK. You want to know? I think the board appointed you for political reasons.’

He rolled his eyes. ‘Oh, you mean the “lord” bit. Well, if you’d been there when I arrived yesterday, you’d have heard me tell everyone I don’t use it. I answer to Charlie.’

‘If you’d been on time yesterday,’ she pointed out, ‘I wouldn’t have been in Theatre.’

‘Unfortunately, I was delayed.’

‘Your hero rescue work.’

Oh, please. She didn’t think he’d set it up…did she? ‘What would you have done?’ he asked. ‘It’s your first day in a new job—a job where you know most of the staff don’t want you there. A child is stuffing fireworks through a letterbox, but one blows up in his hand. If you stop to help, you’re going to be late and your new team’s going to think you’re too arrogant to care, which means your first day is going to be even worse than you expect. So do you just leave the kid—and whoever’s inside the house, who might also be hurt—or do you call an ambulance and do what you can on the first-aid front? Especially knowing that the general public would pour water or milk on a burn because that’s what all the first-aid stuff says they should do?’

‘Which would be the worst thing they could do to a burn contaminated with phosphorus.’ She sighed. ‘OK. I’d have done what you did.’

‘Thank you.’ Charlie leaned back in his chair. ‘I don’t want to fight with you, Sophie—may I call you Sophie?’

She nodded.

‘As for the “lord” bit—it’s simply an accident of birth.’

Uh-oh. The words were identical to the ones she’d used yesterday morning. Had someone repeated her comment to him?

And why did it make her feel suddenly guilty? She stuck by what she’d said. Why should you be treated differently because you came from a posh background?

‘Don’t hold my background against me,’ Charlie said quietly, almost as if he’d read her mind. ‘It’s not a privilege, it’s a handicap. People think I’ve been promoted because of who I am, not what I can do. I worked hard to get my degree, and I worked hard to get my position. And then I have to work a little bit harder still to prove it to everyone else.’

Pretty much as female surgeons had to—there was still a glass ceiling. To get to the very top as a surgeon, you had to forget about career breaks and children and family. You had to be twice as dedicated as any man.

Prejudice cut two ways. Sophie flushed. And she’d definitely been prejudiced against Charlie. She hadn’t given him a proper chance.

‘I’m a doctor. It’s what I wanted to be—who I am.’

And he meant it. His voice was absolutely sincere.

‘I…I’m sorry.’

‘Apology accepted. Hopefully things will be straight between us now.’

He didn’t sound as if he was gloating. He sounded…relieved.

‘I like the way you work,’ he added. ‘No fuss, no drama, no lording it over junior staff.’

At the word ‘lord’, she met his gaze again. His eyes crinkled at the corners—he was laughing again. But at himself, not at her.

Almost unwillingly, she found herself smiling back. ‘I’m the wrong sex to lord it. Lady it, perhaps?’

The smile in his eyes spread to his mouth, and she wished she hadn’t made him grin like that. Because it made him appeal to her more than any man she’d ever met.

It wasn’t going to happen. Charlie Radley had been photographed with more women than she’d had hot dinners. Women of his kind—the supermodels and debutantes. Sophie knew she wasn’t in the same league; besides, she didn’t want a quick affair. She didn’t want any kind of affair. She just wanted to do her job, and do it well.

‘Given the chance,’ Charlie said, ‘I think I’m going to like you. Working with you, I mean,’ he added.

Given the chance. The rest of the team seemed to like him. And she’d been impressed by the way he worked in Theatre. Cool, calm, very sure of his skill, but equally concerned that his team should know everything that was going on. Including the nurses. ‘So let’s take each other at face value,’ she suggested.

He nodded, and lifted his coffee-cup. ‘Here’s to a working relationship. Straightforward and honest. Mutual respect for each other’s expertise and judgement.’

She could drink to that. She lifted her own coffee-cup. ‘Cheers.’

‘And maybe,’ Charlie said softly, ‘in the end you won’t dislike me so much after all.’