‘No.’ Her tone softened slightly. ‘Believe me, Tom, if I had any other choice I would have taken it but there isn’t one. We are this girl’s only chance.’
He swung his legs over the side of the bed. ‘Hell, she’s having a really bad day, then.’
‘She is.’ Hayley’s strained laugh—the one all medical personnel used when things were at their darkest—vibrated down the line, bringing with it a camaraderie that called out to him.
‘I’ve sent a taxi, which is probably arriving any minute. I’ll see you at the scrub sinks, Tom.’
The line went dead.
The scrub sinks.
She’d rung off, leaving him with no option.
He was going back to Operating Room One. Going home. Only home was supposed to be a place of sanctuary and safety and this felt like walking off a cliff.
‘You didn’t shave off all her hair, did you?’
Tom sat on a stool behind Hayley, noticing the varied array of smells in the operating room that he’d never noticed when he’d been sighted. Disinfectant mixed in with anaesthetic gases and blood, plus a couple of other aromas he couldn’t quite identify and wasn’t certain he wanted to. But no matter how pungent the odours, Hayley’s perfume floated on top of them all in a combination of freshness, sunshine and summer flowers. He wanted to breathe in more deeply.
‘No, we only shaved off half her ponytail.’
‘Good. Neurosurgery is a huge invasion and I always make it a point to shave the bare minimum out of respect for the patient.’
Made it a point. You’re not operating any more.
Being back here felt surreal—he was in his theatre that wasn’t his any more, part of a team rather than leading it. He wasn’t scrubbed. Hell, he couldn’t remember the last time he’d been in the OR and not scrubbed. Probably when he’d been a med student. He interlocked his fingers, keeping his hands tightly clasped together in his lap.
He heard Hayley murmuring to the anaesthetist and then she said, ‘Tom, I have Theo scrubbed in, David’s the anaesthetist, Jenny is scouting and Suzy—’ she seemed to hit the name with an edge ‘—is assisting David.’
He and Suzy had shared a fun night three years ago after one of the OR dinners, but he’d never called her. He’d never called any woman because work and patients had always come first and he would never allow anyone to derail him from his goal of staying on top and keeping the demons of his childhood at bay.
He could feel the gaze of many on him and then came the chorus of ‘Hello, Tom’, just as it had when he’d owned this space and had been called in for a night-time emergency. He knew everyone and he also knew, despite all their idiosyncrasies, they worked together as a team. Given the circumstances, Hayley had the best support she could have.
‘Tom, the pinion’s in place, holding Gretel’s head in position, so let’s start.’
To someone who’d not met her before, Hayley’s voice would have sounded confident, but Tom detected her massive stress levels in the tiny alto quavers. She’d explained the scan to him earlier and he could picture it all very clearly in his mind. ‘Due to the position of the mass, you’re making a lateral incision and then performing a suboccipital craniotomy.’
‘Removing a bone flap to relieve the pressure,’ Hayley muttered as if it was a mantra. ‘That’s the easy part.’
It is. ‘One step at a time and we’ll get through this.’ But he too was talking out loud to reassure himself as much as everyone else. So much could go wrong in so many unpredictable ways and he couldn’t see a damn thing.
He’d always operated with music playing, but not soothing classical. His OR would vibrate with hard rock and, during extremely tense moments, heavy metal. Hayley was operating in silence so he sat listening to the whoosh of the respirator and the hiss of the suction, which only ramped up his agitation. He started to hum.
‘Tom, I’ve turned the skin flap and I can see bone.’
‘Now you use the high-speed drill and make three small burr holes into the skull.’
The shrill shriek of the drill against bone always made medical and nursing students jump the first time they heard it. Tom had always teased and laughed at their reaction, but he didn’t laugh today. Instead, his fingers clenched against nothing, wishing they were holding the drill, wishing he was able to do the job, not just for himself but for the patient. For Hayley.
The shriek died away. ‘Done.’ Hayley swallowed. ‘What’s next?’
He visualised the silver instruments all laid out in neat rows on the green sterile sheet. ‘Use the Midas Rex drill to create the bone flap.’
‘Oh, my, it’s like a can opener.’ Hayley gave a tight laugh and a few moments later said, ‘The bone flap’s removed and I can see the dura.’
Like an illustrated textbook, Tom’s mind beamed the image Hayley was looking at. ‘Excellent. Now you need the grooved director. It’s your atraumtic guide. Using the scalpel, cut the dura over the groove and this protects the brain tissue underneath.’
‘Too easy.’
But the everyday slang expression was laden with her anxieties. He moved to reassure her. ‘You’re doing fine, Hayley. David, how’s our patient?’
‘She’s holding her own at the moment, but I’ll be happier when Hayley’s stopped the bleeding.’
‘You’re not alone there.’ Tom counted to ten because he didn’t want to rush Hayley, but he also needed to keep her within a particular time frame. ‘Can you see brain tissue, Hayley?’
‘I’ve found the clot.’ Her relief filled the theatre.
‘Theo, position the microscope.’
The rustle of plastic-covered equipment being wheeled into place was the only sound and Tom hated not being able to see what was going on. ‘Hurry up, Theo.’
‘It’s in position now, Tom,’ Theo said.
‘Good. Hayley, have you found the bleeding?’
‘Give me a minute, I’m still looking.’
Her normally mellow voice rose as her semblance of calm shredded at the edges. Tom wished he could take over, relieve her of this unwanted task that was stretching her and forcing her to go places she’d never been before. But he was powerless to help so he did the next best thing. ‘Theo, suction the clot and keep the field clear. She needs to be able to see.’
‘On it, Tom,’ the nurse replied.
For a moment all he could hear was the gurgle of suction and he couldn’t stop his foot from tapping on the floor.
‘Okay.’ Hayley’s breath came out in a rush. ‘I see it.’
Thank you. ‘Stop the bleeding with the bipolar forceps.’
‘What if that doesn’t work?’
Don’t panic on me now, Hayley. He infused his voice with a calm he didn’t feel. This surgery was something he’d perfected over years of training. Hayley was being thrown in feet first. ‘We’ve got the option of clipping, but try the electrical coagulation first because it will probably work.’
Please let it work. The sooner she stopped the bleeding, the better it was for their patient.