‘He’s been taking anti-inflammatories,’ Nate said, ‘but he says they don’t even touch the pain any more.’
‘So you’re looking at major surgery and weeks of rehabilitation?’ she asked. ‘If so, Mr Bishop could be a candidate for the sensory garden.’
‘No, no and no,’ Nate said. ‘He won’t be here for long. I’m planning to use an interspinous spacer device this afternoon rather than doing a laminectomy.’
‘I’ve read about that,’ she said. ‘Isn’t there a larger risk of the patient needing to have surgery again in the future if you use a spacer rather than taking a slice of bone off the area putting pressure on his spinal cord?’
‘Yes, but there’s also a much lower risk of complications than you’d get from taking off the bit of bone that rubs and causes the pain, plus it’s just a small incision and he’ll be out again in a couple of days. I’d normally use the procedure for older patients or those with higher risks of surgery,’ Nate said. ‘Kevin Bishop is still young but, given that he’s overweight and has high blood pressure, I think he’s higher risk.’
‘Fair enough. So how exactly does the spacer work?’
Nate could see that she was asking from a professional viewpoint rather than questioning his competence; he knew that Erin was a neurologist rather than a surgeon. ‘We’ll put a spacer into his lower vertebrae. It’ll act as a supportive spring and relieve the pressure on the nerve. It gives much better pain relief than epidural steroid injections, plus the spinal nerves aren’t exposed so there’s a much lower risk of scarring.’ He paused. Maybe this would be a way of easing the tension between them after that meeting. ‘Provided Mr Bishop gives his consent, you can come and watch the op, if you like.’
‘Seriously?’ She looked surprised that he’d even offered.
‘Seriously.’ Was she going to throw it back in his face, or accept it as the offer of a truce?
‘I’d really like that. Thank you.’ She smiled at him.
Again Nate felt that weird pull of attraction and reminded himself that this really wasn’t appropriate. For all he knew, Erin could be in a serious relationship. Not that he was going to ask, because he didn’t want her to think that he was interested in her. He didn’t have the headspace or the mental energy right now to be interested in anyone. His focus needed to be on his daughter and learning how to be a good full-time dad to her. ‘Uh-huh,’ he said, feeling slightly awkward, and went with Erin to see his patient.
He introduced her swiftly to Kevin Bishop.
‘I’ve reviewed the scans of your spine, Mr Bishop, and your blood tests are all fine, too, so I’m happy to go ahead with surgery today,’ he said. ‘Would you mind if Dr Leyton here sits in on the operation?’
‘No, that’s fine,’ Mr Bishop said, looking relieved. ‘I’m just glad you’re going to do it today. I’m really looking forward to being able to tie my own shoelaces again, and to stand up without my legs tingling all the time.’
‘It’s been that bad?’ Erin asked sympathetically.
Mr Bishop nodded. ‘The pain’s been terrible. Rest doesn’t help and the tablets don’t seem to work any more. My doctor said I’d have to have surgery—I was dreading the idea of being stuck in hospital for weeks, but Mr Townsend said that I’d only be in for a few days.’ He gave her a weary smile. ‘I just want to be able to play football with my kids again and get back to my job.’
‘The surgery will make things much better,’ Nate promised. ‘I know we talked about it before, but I’d like to run through the situation again to make sure you’re happy about what’s happening.’
Mr Bishop nodded.
‘Basically what happens is that the nerves in your spine run down a tunnel called the spinal canal. You’ve had a lot of wear and tear on your spine, and that makes the spinal canal narrower; that means it squeezes the nerves when you stand or walk, which is why you’re getting pain. What I want to do is put a spacer between two of the bones in your spine, and that will relieve the pressure and stop the pain. Now, you haven’t eaten anything since last night?’
‘No, though I’m dying for a cup of tea,’ Mr Bishop admitted.
Nate smiled. ‘Don’t worry, you’ll get your cup of tea this afternoon. I’ll get the pre-op checks organised now and I’m going to operate on you at two. The operation’s going to be under a local anaesthetic, but you’ll also be sedated so you won’t remember anything about it afterwards. You’ll be lying face down during the operation on a special curved mattress; that will reduce the pressure on your chest and pelvis, and also give me better access to your spine.’
‘How long will the operation take?’ Mr Bishop asked.
‘It should be about an hour or so, depending on what I find—but from your scan it looks pretty straightforward.’
‘That’s great.’ Mr Bishop smiled. ‘I still can’t believe I’ll be able to go home again in a couple of days. I thought I’d be stuck in here for weeks.’
‘You’re not going to be able to go straight back to work or to drive for the first few weeks after the operation,’ Nate warned, ‘and you’ll need to do physiotherapy and exercises. They’ll start about four weeks after the op—and in the meantime it’ll be better for you to sit on a high, hard chair than a soft one with a low back.’
‘And no bending or lifting?’
‘Absolutely. Listen to whatever the physiotherapist tells you,’ Nate said. ‘This is a newish procedure, Mr Bishop. I do need to tell you that, because it’s so new, there’s a very small possibility the spacer might move in the future or need replacing.’
‘If it takes the pain away, I can cope with that.’
Nate talked Mr Bishop through the likely complications and all the possible consequences of the operation, then asked him to sign the consent form. ‘I’ll see you later this afternoon,’ he said with a smile.
* * *
Later that afternoon, watching Nate perform in Theatre, Erin was spellbound. His instructions to Theatre staff were clear, he was polite as well as precise and he talked her through every single step of the operation, explaining the methodology and what it would do for the patient.
With their patient and in Theatre, he was a completely different man, she thought. Not the cool, critical and judgemental stranger he’d been in the meeting. This man had deft, clever hands and really knew his stuff—and he treated everyone around him as his equal. She noticed that he made the time to thank every member of the team at the end of the operation, too.
This Nate Townsend, she thought, was a man she’d like to get to know.
And she understood now why so many of her colleagues had dubbed him the sexiest surgeon in the hospital. The only bit of his face she could see clearly was his eyes—a gorgeous, sensual dark blue. And the combination of intelligence and clever hands made a shiver of pure desire run down her spine.
Which was totally inappropriate.
She was here to observe, not to go off in some ridiculous, lust-filled daydream.
‘Thank you for letting me observe, today,’ she said when they’d both scrubbed out. ‘That was really useful. I can talk to patients with spinal stenosis about their options with a lot more authority now.’
‘No problem. And if you have any questions about the procedure later, come and find me.’
He actually smiled at her, then, and she caught her breath. When he smiled like that—a smile that came from inside, more than just politeness—he was utterly gorgeous.
And