A seemingly endlessly fascinating man to talk to.
If it wasn’t for the puzzle that Anna represented, Luke might have been tempted to admit defeat.
Every day was the same. Enclosed within the walls of an institution that sometimes felt like it was filled with people who had created their own illnesses. Heavy smokers who seemed surprised that they’d had heart attacks because of their damaged blood vessels. Morbidly obese people who still expected lifesaving surgery.
What for? So they could carry on with their meaningless lives? Lie in bed and keep eating junk food?
‘I’m not going to operate on Walter Robson,’ he informed Anna after a ward round late that week. ‘I refuse to spend my time patching someone up just to give them longer to indulge in slow suicide by their appalling lifestyle choices.’
If he’d hoped to get under her skin with such a terse and controversial statement, he was disappointed.
‘I agree he’s a poor candidate for surgery,’ she said calmly. ‘Maybe that will be enough of an incentive for him to stop smoking and lose some weight. If we can reduce his level of heart failure and get his type-two diabetes and cellulitis under control, it will reduce the surgical risk.’
Luke almost exploded. Thumped the wall beside them or walked away from his colleague. Told Anna what he was really thinking.
That she knew nothing about risk. Real risk—the kind that young, healthy people took for the benefit of their brothers-in-arms, if not for the much bigger human-rights issues. That patching them up was the kind of lifesaving surgery that had some meaning.
But that would open floodgates that had to remain shut. It would take Anna into a life that didn’t exist for him any more except in his nightmares, and winning freedom from those nightmares was the hurdle he had to get through to survive.
He had discovered a new way of dealing with both the terrors of the night and the feeling of suffocation he could get ambushed by at work. He could distract himself by thinking about Anna. Just for a few seconds. Like a shot of some calm-inducing drug.
Her voice became a background hum as she talked about dealing with Walter Robson’s anaemia and whether his chronic lung problems would improve if he carried through his vow to quit smoking.
Luke let his gaze stroke the sleek hair on top of Anna’s head and then rest on the tight knot nestled at the nape of her neck. That clip thing would be easy enough to remove. The hair might still be twisted and squashed but he could bury his fingers in it and fluff it out until it bounced onto her shoulders.
His breath came out in a sigh. It was enough … the feeling of desperation was fading again.
‘Luke?’ Anna had caught the sigh. Fortunately, she misinterpreted it. ‘The decision has to be on medical grounds, not moral ones.’
‘Of course.’
This wasn’t the place to discuss the ethics of what represented a significant part of their careers. Much of the workload was genuine and worthwhile. He knew that. He used to get more than enough satisfaction from it.
Why did everything have to be so different now? So difficult?
And why couldn’t he see what he knew was there— hiding behind the person Anna was within these walls?
She wouldn’t let him. That was why. The boundaries had been marked and were being reinforced every time she changed the subject if he tried to talk about something personal, like the puppy he had named for her. Or had she even kept the name?
No wonder James had sounded puzzled back on his first day when they had been scrubbing in together. As though he had no idea of what Anna was like out of work hours.
Maybe Luke was the only person here who’d had a glimpse of that side of Anna. He liked that notion. He liked it a lot.
‘I’M HAPPY to cover Christmas Day.’
‘So am I.’ Luke’s nod was matter-of-fact. ‘Thanks, Anna. That’s the holiday roster issues sorted, then. Let’s get on with the rest of the agenda.’
Anna couldn’t help but notice the look that passed between James and Charlotte Alexander, who were sitting together in this departmental meeting. No mistaking the look of relief. Joy even at the prospect of spending a special day together with no danger of being called in to work.
The movement of Charlotte’s hand was probably unconscious. She seemed to be listening carefully to Luke as he introduced a new grading system for cardiac patients.
‘It’s hoped that this will be brought in nationwide to try and standardise criteria and address the increasing numbers of people that are dying while on waiting lists for surgery. We’ve been asked to implement this at St Piran’s as of the first of January as part of a multi-centre trial, so your feedback is going to be important.’
Anna was listening, too, but she’d already read the proposal and she and Luke had discussed it at length. It was hardly surprising that she caught that movement from Charlotte in her peripheral vision. A hand that gently smoothed the loose fabric of her top, gathering it up as it came to rest cupping her lower belly. There really was no doubt now that she was pregnant. It would be a special Christmas for them, wouldn’t it, with the extra joy and dreams that came with knowing they were about to become a family?
‘As far as degree of valvar dysfunction goes, we’re staying with the New York Heart Association functional classes. As you can see, mild is class one and scores two. Severe is class three and scores fourteen. If there is coronary artery disease present as well, it puts it into class four and we can add ten to the overall score.’
Luke had the score sheets projected onto the wall. He was going to cover all the non-coronary revascularisation type of patients like valve replacements and then he’d run through the more complex scoring system for patients who had arterial disease. He was being clear and methodical and making sure everyone understood. People were nodding approvingly. A system like this could make prioritising people on the waiting lists much more straightforward.
Charlotte was one of those nodding. As though she would be only too happy to be filling in the score sheets on her patients and adding her comments to the feedback that would be required. But how long would she be around to be doing that?
It was all very well having secrets but it was also annoying. When were they planning to share the information and allow arrangements to be made for Charlotte’s absence for maternity leave? For James to be covered at the time of the baby’s arrival? For a new member of staff to be advertised for, if necessary?
No wonder there was such prejudice against women in top positions. Imagine if she was pregnant herself? Even if she worked up to the last possible moment and then took minimal maternity leave, the disruption to the department would still be huge.
Unthinkable. It always had been.
So why was she watching Charlotte surreptitiously right now instead of focusing on the information Luke was presenting? Wondering what her colleague was thinking and how she’d come to the conclusion that having a baby was more important than her career. What it might be like to feel a new life growing and moving within your own body. To face the enormous responsibility of caring for that baby when it was born.
The disturbing niggle was annoyance, not envy. Luke needed to know. He had quite enough on his plate settling back into running such a busy department and working the kind of hours he did with the extra stress of recovering from a major physical injury. Maybe it wasn’t her place but Anna wanted to warn Luke. She could help him put arrangements into place to make sure they could cope with