Then she remembered the size of the hearts Alex operated on, and the skill he required from his anaesthetist.
Would an exhausted anaesthetist exhibit the same skill?
How could she not offer?
‘We’ve plenty of room at our place and it’s just down the road—you can walk to and from work. You don’t have to stay for the whole year, but at least it would be handy while you looked around. You can pop down and check the place out during your break between ops and meet my father, and if you like it, I can drive you to your sister’s after work and bring you and your gear back home.’
Maggie stared at her.
‘You don’t know me,’ she pointed out, and Annie grinned at her.
‘I know you’re an excellent anaesthetist and this unit needs one of those, so anything I can do to make your job easier, it’s yours.’
Maggie got up from where she’d been slumped behind a desk and came across to give Annie a big hug.
‘It needn’t be for the whole year,’ she assured Annie. ‘Just until I get my bearings in Sydney and find somewhere for myself.’
‘Whatever suits you,’ Annie said, though a sinking feeling in the pit of her stomach told her she’d have a boarder for a year. Where else would Maggie find so ideal a situation?
Maggie was chattering on, so obviously delighted by this change in fortune Annie had to feel happy for her.
‘You don’t need to drive me. I’ve got my own car. I’ll check out your place at lunchtime then go back to my sister’s for tonight to say goodbye to them all, pack my stuff into the car and bring it all over tomorrow.’
‘Bring what all over where tomorrow?’
Annie turned at the sound of Alex’s voice. Inside, her stomach turned as well, a happy little flip-type somersault.
She smiled at him—a unit co-ordinator greeting the main man smile—and saw a bit more warmth in the smile he gave her back. Although the warmth faded, and the smile grew forced as Maggie happily explained the situation.
‘Maggie’s coming to live with you?’ Alex asked, when Maggie had left the suite to check her new patient.
He sounded hurt, and puzzled, and Annie understood both reactions.
‘It might only be temporary,’ she said, then remembered why she’d offered.
‘Personally, it might not be ideal,’ she said, standing up so she could look Alex in the eye, ‘but professionally—do you really want a sleep-deprived, twitchy anaesthetist working with you on a child? What else could I do but offer?’
His smile improved, though it was still a wry effort.
‘I wish I’d been here. I could have offered to have her at my place. With Phil there already, it wouldn’t have mattered and we’d still have had some privacy from work colleagues at your place.’
He brightened considerably.
‘We could still do that! I’ll offer to have her at my place. She’ll be with Jamie. I’ll go now.’
He touched Annie on the shoulder and breezed away, obviously delighted with his own brilliance.
But his face was glum again when Annie saw him at the briefing, and he looked far from happy as he explained Jamie’s problem, where a hole in the wall between the heart’s two upper chambers, the atria, hadn’t closed, so blood shunted between the two chambers.
‘It causes increased pressure in the right atrium and ventricle, and too much blood flowing into the lungs. Usually the patient suffers few symptoms—a bit of breathlessness and fatigue from time to time. In Jamie’s case these didn’t become obvious until she started at Little Athletics. Echocardiography has confirmed the hole is there, and her cardiologist has done a cardiac catheterisation as well to determine just where the hole is.’
Alex pointed to his diagram on the whiteboard.
‘New technology is being tried for holes in the centre of the atrial wall, and holes are being successfully closed using transcatheter management—inserting wires through a catheter. But Jamie’s hole is higher up and the new technique doesn’t work, hence the need for an operation.’
‘If she’s been OK up until now, and is only breathless after running or jumping at Little Athletics, is it worth the risk involved in any operation—particularly open heart where she’ll be on a bypass machine for some of it?’
One of the sisters from the special care unit asked the question, and Annie was pleased. For one thing, she’d wondered about it herself, and for another, it meant all the unit staff were becoming increasingly involved in all stages of their patients’ operations.
‘There’s a twenty-five per cent risk of early mortality through pulmonary vascular obstructive disease if it’s not repaired and a less than five per cent—in fact, I feel less than one per cent—risk with the operation itself.’
Alex turned back to the board and sketched a small chest.
‘We make a much smaller incision than we do for a PDA, only…’ He paused, then smiled at them all. ‘I have to convert inches to centimetres…say eighty to a hundred centimetres. Then the defect is fixed with either a patch or stitches, depending on what we find. As you said, the child has to go on the heart-lung machine as soon as we open the pericardium, then once the aorta is clamped, we stop the heart beating with cardioplegia, open it up, fix the hole and Jamie’s back in business again. Within weeks she should be back at Little Athletics.’
‘The results are really good,’ Phil added, turning to smile at the sister who’d asked the question. ‘You probably won’t have her more than a few hours in the PICU, then she’ll be moved to the ward.’
‘Which reminds me,’ Alex said, directing his question to the two nurses present who had been specially selected to work with his patients once they reached the children’s post-surgical ward. ‘How do you think you’ll go, working with our patients exclusively when they’re back in the ward with the others?’
‘I love the idea of it,’ one of them said, while the other nodded agreement. ‘It means you can really get to know the children and their families, and there’s something special about being chosen as part of the team that’s working to make them well again.’
Whatever gloom Alex had shown earlier disappeared, and he beamed at the pair, one male and one female.
‘That’s great to hear, and don’t forget, if you run into administrative trouble at any stage, see Annie and she’ll sort it out.’
Annie’s turn to smile. Alex could so easily have said to see him, but he had enough faith in her to know she’d handle it.
She just hoped his faith would never prove to be misplaced.
The briefing over, the operating crew headed off for the theatre, the nursing staff back to their places and Annie returned to the office. Alex’s prediction that there’d be hospital infighting was already coming true. She had a meeting with the CEO and other surgical co-ordinators at nine-thirty, and guessed pressure would be applied for other surgical services to have equal access to the new theatre.
Not this week they wouldn’t, as Alex was booked to operate twice and sometimes three times a day right through until Friday.
‘Adult cardiac surgery brings in more dollars than CHD,’ the administrator of the adult cardiac programme yelled at her less than an hour later, confirming Annie’s prediction.
‘But it requires more outlays as well,’ Annie shot back, determined to remain calm. ‘And takes more hospital resources as patients are hospitalised for longer. Plus, you have to realise that if we operate on infants and