He ran his hand over the child’s head, mourning the fact that all this silky dark hair would be gone in a matter of minutes now, as he was prepared for the life-changing surgery. He refused to let himself remember cradling another little head, little knowing just how short that precious life would be.
Abir had settled under his touch, his big dark eyes gazing up at the two of them with that strange solemnity that he sometimes saw in these little ones.
‘If you would like to clean your hands, you could make an examination of Abir,’ he invited, and stepped aside slightly to gesture towards the child, inviting Dr Emily Livingston to make her own assessment of Abir’s condition.
‘I used antibacterial gel on my hands just before I stepped inside the room,’ she said, then startled him by blushing softly. ‘And apart from trying to shake hands with you, I haven’t touched anything since then.’
‘So…’ He repeated his gesture towards the infant, who seemed almost as captivated by the woman’s blonde hair as he was.
‘Hello, Abir. Haven’t you got beautiful big brown eyes?’ she crooned as she bent down to bring her head almost to the same level as the child’s. She reached out a slender hand to stroke a gentle finger over the back of a chubby little fist and smiled when the little one immediately grabbed it and held on tightly.
‘That’s a clever boy,’ she praised as she began to stroke her other hand over the silky dark hair covering the unusually shaped skull, her voice taking on an almost sing-song quality that clearly mesmerised the child.
The tone of her voice stayed the same as she continued speaking softly to the little one so that it was a couple of seconds before Zayed realised that she was now speaking to him.
‘Without seeing any X-rays, I’m assuming that this is craniosynostosis, with some of the cranial sutures fusing before birth,’ she said with an air of steady confidence in her diagnosis that impressed him no end. Her fingertips were gently tracing the lines where the joins between the plates of the skull were already showing pronounced abnormal ridges. ‘Is there a genetic component here— any history of Crouzon or Apert in the family, for example?’
‘An uncle and a cousin,’ he confirmed. ‘But we only found that out when we started questioning the rest of the family. As neither of the affected members has survived, their disfigurement meant that they are rarely mentioned any more, and especially not in front of a pregnant woman.’
‘For fear her baby will “catch”the problem?’ she asked with a smile in the baby’s direction that had him gracing her with an answering open-mouthed, gummy grin.
‘That sort of superstition still lingers in some of the more remote villages in Cornwall, too,’ she continued, this time smiling directly up at him as though sharing a particularly delicious secret as she added, ‘At one time, it even included redheads being banned from visiting.’
‘And what would be your preferred treatment modality?’ He wouldn’t allow himself to be beguiled by a pair of sparkling green eyes. There was no point.
‘Surgery, of course, to excise the affected bone,’ she answered, so promptly that he wasn’t sure whether it was her own decision or one based on the fact she’d already been told about the impending surgery.
‘Because?’ he probed with unexpected intensity, suddenly needing her to be able to justify her assertion, although he had no idea why.
‘Because otherwise the fact that the bones had already fused before he was born will mean that there’s no room for expansion and his brain will end up terribly damaged. If I remember correctly, a linear craniotomy and excision of the affected sutures is most effective when performed in the first three months of life,’ she added.
She was looking down into those big brown eyes, and he suddenly knew that she had recognised the gleam of intelligence already lighting them, too, and understood just what a tragedy it would be if that spark were crushed out of existence.
‘What are the potential hazards of the operation?’ He forced himself to ignore the sudden feeling of connection with her by concentrating on the specifics of the procedure. This was the sort of detail that he would hope she knew backwards, forwards and inside out, having taken her latest exams so recently.
There was a sudden flash of concern in her eyes, as though she was genuinely concerned that he might not be sufficiently satisfied with her answers to give her the placement on his team. But surely he’d been mistaken. She would only have been informed of Mr Breyley’s departure when she’d arrived at the hospital that morning. It wasn’t as if this position was one that she desperately wanted or that she’d had time to become nervous about a make-or-break interview…or was it?
There was something about the tension in her feminine frame that told him there was a burning need in her to gain his approval for the placement, that there was something inside her that meant she would work every bit as hard in his department as she had in his colleague’s.
So, was there another reason why she wanted the job, a personal reason, completely separate from her career aspirations?
Perhaps she particularly wanted to stay in this part of the country, between the wild desolation of the moors and the rugged majesty of the coast. Perhaps she had family here, or a boyfriend she wanted to be close to.
He was almost grateful for the fact that she began speaking, able to ignore the sudden unexpected clutch of disappointment in his gut at the thought that some undeserving man had the right to wrap that beautiful body in his arms. He had absolutely no right to feel anything for this woman other than the need for her to be the best junior she could be.
‘During surgery, there’s the possibility of hypovolaemic shock, especially in such a young patient,’ she announced with a slight quiver in her voice that belied her apparent confidence. ‘There’s also the chance that there might be dural tears unrecognised during the procedure that can cause cerebrospinal fluid leaks. They could leave a pathway open for infection. There could also be epidural or subdural haematoma due to surgical trauma. Post-operatively,’ she continued swiftly, almost as fluently as though she were reading word for word from the relevant specialist text, ‘there will be facial swelling, of course, especially around the eyes. That usually resolves in the first few weeks, but the improvement in the head shape is almost immediate.’
‘And have you observed such surgery?’ He was careful not to reveal just how impressed he was. Not only had she made a correct diagnosis of a relatively rare condition, but had obviously recalled, verbatim, everything she had read about it.
‘Only in my teaching hospital’s video library,’ she admitted. ‘I’ve always been interested in paediatric orthopaedics.’
‘In that case, we just have enough time to introduce you to Abir’s parents before it’s time to scrub,’ he announced, suddenly eager to see how well this young woman would acquit herself in an operating theatre.
As if they were obeying some invisible signal, that was the precise moment that the Hananis chose to emerge from the interview room.
Zayed led the way towards them, touched by the matched pairs of reddened eyes that were clear evidence that both parents had obviously given in to a bout of tears in his absence.
‘Dr Emily Livingston, these are Abir’s parents, Meera and…’
Further introductions seemed unnecessary as the newest member of his team stepped forward to take the young mother’s hands in hers.
‘You have a beautiful baby,’ Emily said simply, as though she’d guessed that neither of the child’s parents had a detailed command of English. ‘I will do everything I can to help make him well.’
Athar Hanani