It appeared that day was going to be one of those occasions.
‘I will not allow another surgeon to just step in now without a damned good reason. I know this is not at the patient’s request. I spoke to her only an hour ago.’
‘No, it wasn’t the patient who has requested the change, Dr Turner, and I understand you’re taken aback but I’m just passing on the message, not making the decision. However, I’m telling you the decision’s final. You really do need to stop scrubbing. Having sterile hands won’t change the outcome.’
Not hiding her irritation, Juliet turned off the flow of water with the foot control. ‘Well, we’ll just see about that.’
‘On the bright side, your replacement will no doubt meet with your approval. You’ve worked together more than a few times.’
Juliet was doubly confused with the smirk on Angie’s face. None of it made any sense but if she was to believe the nurse, and she had no reason to doubt her, she was being replaced without notice or reason. ‘I don’t care who’s been brought in to take over, it’s still madness,’ Juliet replied as she pulled her surgical cap free and the mass of brown curls dropped around her face. At that moment, the replacement doctor entered the scrub room.
‘Really,’ she announced, shaking her head in disbelief. ‘This is becoming more and more ludicrous by the minute. They call you back here two days after you retire. What is this craziness? I’ve a patient about to be anaesthetised and I’m told I’m not operating. Will someone please explain the absurd rationale behind all of this? And who made the call to replace me as Kelly’s surgeon?’
‘The hospital director…but with good reason,’ he replied.
‘I can’t think of one.’
‘You have to prepare for your trip.’
Juliet paused for a moment with a perplexed stare. ‘For goodness’ sake has everyone gone completely mad? My trip’s not until the middle of next week. I’ve got five days to prepare for the lectures and board the plane, but Kelly’s baby needs this operation now if he’s to ever walk.’
‘That’s where you’re wrong…not about Kelly and her baby—you’re right on that one, I just finished reading the notes and the surgery’s urgent—but your trip’s not next week. It’s tomorrow. You’re leaving on an eight o’clock flight in the morning.’
‘Tomorrow? But why?’ Juliet dropped her head into her hands still damp from the antibacterial wash. ‘The lecture is not until next Thursday.’
‘You’re not delivering the lecture in Auckland…you’re off to the UK—’
‘The lecture’s been cancelled?’ she cut in.
‘No, the lecture is going ahead…’
‘But without me?’ she asked as she pulled free her surgical gown and dropped it unceremoniously in the bin alongside her discarded cap.
‘Yes.’
‘And the surgery’s proceeding too, just without me?’ They were framed as questions but Juliet’s tone made it obvious they were statements that she was none too happy about.
‘That’s right.’
‘And I’m off to the UK?’ she continued with the volume of her voice escalating and increasing in speed with each word. ‘Before I go completely loopy, just tell me why my schedule is changing before my eyes without my approval?’
‘The call came through from Cheltenham just now.’
‘Cheltenham? As in the Cotswolds?’
‘One and the same.’
‘And who over there’s making decisions without consulting with me?’
‘The decision was made by four babies.’
Juliet blinked and shook her head. ‘Four? You’re speaking in riddles and you know that frustrates me.’
‘Apparently the Assistant Head of Obstetrics at Teddy’s, which is the maternity wing of the Royal Cheltenham hospital, spoke with our Head of Obstetrics about the quads. Almost twenty-nine weeks’ gestation, suffering twin-to-twin transfusion syndrome. Two sets of monozygotic twins. While the girls are fine at this stage, the boys have developed the TTTS. Oliver Darrington believes you’re the best chance that the quads have of all surviving should the parents agree to the in-utero laser surgery. And Professor Le Messurier just approved your secondment.’
‘That’s all very flattering but why am I being called in at the eleventh hour? If there was a risk, I should’ve been consulted upon the initial diagnosis. Surely being quads they would have been having weekly scans and intense monitoring and they’d know at Teddy’s that the earlier the intervention, the better the outcome.’
‘Apparently the quads were being closely monitored throughout the pregnancy, but the TTTS diagnosis has only just been made,’ her replacement continued as he began scrubbing in, and over the sound of the running water he continued his explanation. ‘The girls have separate placentas while the boys have one shared placenta so they were being scrutinised for any signs of transfusion. Up until now there was no indication of anything being amiss. It was picked up when the patient presented in what she thought was premature labour.’
‘Caused by the amniotic fluid imbalance affecting the recipient twin.’
‘Again, apparently but you’ll know more details when you get there.’
‘But the lecture in Auckland?’
‘Handled. I’m not sure who’s your proxy but your focus needs to be on the quadruplets. Darrington’s worried it could deteriorate quickly and there’s an increased risk they could lose at least one of them if you don’t get over to Teddy’s immediately, and of course we know the risks if one dies to the remaining foetuses. The parents have been briefed and want to be fully informed so they can consider all options, in particular the in-utero surgery.’
‘Anything else I need to know?’
‘Just one thing…the attending OBGYN, Dr Charlie Warren, is averse to fetoscopic laser surgery. Believes the risks are too great so no doubt he’ll be challenging you.’
Juliet took a deep breath. ‘Looks like I’ll be catching a plane tomorrow morning to meet Dr Warren’s challenge and convince him otherwise.’
‘I hope he knows what he’s up against.’
‘He soon will.’ With her head tilted just slightly, and the remnants of bewilderment still lingering, she looked at her replacement. ‘Okay, Dad, looks like Kelly and her baby are in your hands now.’
‘Don’t worry, honey. I’ll do you proud.’
‘DR TURNER, WE’RE about five minutes away from the Royal Cheltenham hospital.’
The voice of the immaculately suited driver made Juliet lift her tired eyes to meet his in the rear-view mirror. They were warm and smiling back at her but with a curiosity that she had been so very accustomed to over the years. She was well aware that she didn’t look her thirty-three years and many apparently found it difficult to believe she was a doctor let alone a surgeon. Her curly brown hair and spattering of freckles along with her petite frame, she realised, didn’t help her quest to be taken seriously. She had no time for make-up except for a natural lip gloss to prevent her lips from cracking, and that too added to her young appearance. It also helped her go under the radar and not gain the attention of the opposite sex and, although it wasn’t her primary motivation, it was a welcome side effect.