He winked at her again and Bella didn’t doubt for one minute that Charlie could get whatever he wanted both inside the hospital and out. She knew his reputation as a charmer, she’d heard the nurses talk about him during her numerous admissions, and she knew they competed for his affections and attentions. The combination of his wicked sense of humour, his infectious smile, his gentle nature and his hardened muscles had the female staff members regularly flustered, and Bella herself was no exception.
As far as she knew, only Evie seemed immune to Charlie’s charm. Their ten-year friendship had only ever been platonic and for that Bella was grateful. It meant she was free to adore him without feeling as if she was invading her sister’s territory. She knew that from the day Evie had first met Charlie she’d thought of him as the older brother she wished she’d had. But Bella’s thoughts towards Charlie were far from familial—although she’d never be brave enough to flirt with him, she knew she wasn’t experienced enough to handle Charlie Maxwell. So she just nodded dumbly in reply. She’d lost the capacity to speak again, completely tongue-tied at the thought of Charlie doing things for her. Fortunately Sam’s arrival saved her from needing to answer. He was followed by a nurse and a couple of interns and suddenly her room was overflowing with people.
A ninth person came into the room and Bella saw Evie’s double-take. It was their father.
Bella had assumed Evie had gotten in touch with him during the night, or vice versa, but looking at Evie’s expression now it was obvious she’d heard nothing back and hadn’t been expecting him.
He looked tired and drawn. Bella wished she could pretend he’d lost sleep worrying about her, his middle daughter, but she knew it was far more likely to be a result of a late night of a different kind. She waited for her father to push through the crowd gathered at the foot of her bed but of course he didn’t. He remained standing just inside the doorway, separate and apart from his family. She sighed, wishing for the thousandth time that things were different. At least he was here, which was more than Bella could say for her mother. She nodded in greeting and then proceeded to ignore him as her sisters took up positions on the bed on either side of her. She was tired of always being the one who reached out to make a connection with her father.
Evie took her hand and Bella relaxed, knowing her sisters would try to protect her from harm. Bella saw Sam acknowledge Richard’s arrival with a nod of his own before he began his consult. He checked Bella’s vital signs, checked her obs, listened to her chest and generally prodded and poked while she tried to pretend she wasn’t surrounded by people. The procedure was familiar to her but that didn’t make it any less embarrassing. Once he’d finished he spoke to Bella as though they were the only two in the room.
‘You’ve lost weight since I last examined you, that’s not what we were hoping for, your admissions are getting more frequent and your lung function tests are down.’ Sam was ticking things off on his fingers as he recited the list.
‘Is there any good news?’ Bella asked hopefully.
‘One positive note is that you’ve made some improvement overnight. You’ve rehydrated and your temperature has come down but it’s still higher than I’d like. You’re showing some resistance to the antibiotics and I’ve had to increase the dosage to try to get your chest infection under control. Individually all these things are not so concerning but combined it means I need to reassess your management.’ He paused briefly and Bella knew what he would say next. ‘It’s time for the next stage.’
Bella couldn’t speak. This wasn’t unexpected but she didn’t know what to say. Sam was watching her, waiting for her to acknowledge his words, and she thought she nodded in response but she couldn’t be sure.
Sam looked away from her now, turning to the members of her family, stopping briefly at each and every one as he spoke. ‘I know we’ve talked about this before but the time has come. Bella needs a lung transplant now. She is already on the active transplant list but I have revised her status. This will move her up the list and means she will get the next pair of suitable lungs.’
Bella tightened her grip on Evie’s hand. This was really happening. During her last hospital admission Sam had told her she would need a transplant eventually. That was the way things went with cystic fibrosis. But eventually had become now. Her lungs were officially failing.
Out of the corner of her eye she saw Richard collapse into a chair as though his legs would no longer support him. His response surprised her. Her father was a man of action, he always had a solution for everything, a way to deal with everything—except when it came to her and her mother—but he never normally showed any sign of weakness. Was he actually concerned for her? Bella knew there was nothing he could do for her now but she couldn’t ever recall seeing him flummoxed. Was he concerned or was he confused?
‘What do we do while we wait?’ Lexi’s voice was unexpectedly loud in her ear and Bella jumped.
‘In the meantime, we start the pre-op processes. Physical tests, including blood work and organ function tests, as well as psych assessments,’ Sam replied.
‘What does the surgery involve?’ Richard asked, and his question answered Bella’s own. His tone said this was a question from a man who wanted information and clarification, not a question from a concerned father.
‘Obviously it is major surgery. Bella will be several hours in Theatre. It can take up to twelve hours. She will be placed on a heart bypass machine while both lungs are transplanted via an incision across the bottom of the diaphragm, then she will be transferred to ICU for at least twenty-four hours and then back to the cardiothoracic surgical ward.’
‘What are the survival rates?’ As was his style her father was keeping any emotion out of the equation. He preferred to deal with the facts and figures.
‘The figures are good. Currently eighty-five per cent of people undergoing bilateral, sequential lung transplants in Australia survive one year and sixty per cent are still alive after five years.’
Bella heard a sharp intake of breath. For a moment she thought she’d made the sound but then she realised it had come from Lexi.
Bella knew the odds. She’d lived and breathed them since her last admission. She knew the statistics were good, for the short term at least, but she also knew that to those who hadn’t spent countless hours doing the research she’d done, the odds didn’t sound that fantastic.
‘These stats are not just for CF sufferers,’ Sam clarified. ‘They’re for everybody and Bella has age on her side. Although she will still have cystic fibrosis, it won’t be in her lungs.’ Sam looked directly at Bella. ‘If your lungs are functioning properly, you should notice a far improved quality of life. You’ll have more energy, you should gain weight and you’ll be able to be more active.’
‘What do you mean, she’ll still have CF?’ Richard was frowning.
‘Bella’s lungs will be clear but she will still have CF in her pancreas, sweat glands and reproductive tract. She will still need her enzyme-replacement medication and she will start a course of anti-rejection medication. The transplant is not a cure for the disease, it just eliminates the disease from her lungs, and will hopefully extend her life.’ Sam turned to face her. ‘Bella, do you have any questions?’
She still hadn’t uttered a word.
‘How long do I have?’
‘A month, maybe two.’ Sam’s voice was deep and soft but his words were clear and distinct in the absolute silence of the room.
It was already November. Would she see another Christmas?
‘What choice do I have?’
Her question put an immediate and definite end to the silence. Lexi started to cry and Evie started to reason with Bella. They both knew her choices were limited.
Bella held up one hand, asking Evie to wait. ‘It was just a question,’ she said. ‘I didn’t say I won’t have a trans