training but that was all-and Kim was so severely shocked that just keeping her alive was a major battle.
She worked with a phone link, too. They’d run out of phone lines but Jane’s partner, a dumpy little woman in jeans and sweatshirt, sat in a corner of the theatre where she didn’t have to see-her stomach was evidently not as strong as Jane’s-and relayed Rachel’s questions down the line to an anaesthetist in Sydney.
‘Minimal anaesthesia for such a shocked patient,’ the specialist told her, working her through a careful, haemodynamically neutral induction method. He worked through her needs with her and Rachel wondered that such a small hospital could meet the requirements he snapped down the phone.
It could. For a tiny hospital Hugo had brilliant equipment. It was stunning that they had sufficient blood supplies on hand, but there was so much more. Rachel had blood on request, she had plasma, she had saline and a team outside the theatre was warming all the fluids before she even saw them.
The fluids weren’t the only thing being heated.
‘Keep the patient warm at all costs,’ the anaesthetist barked down the phone, and warmed blankets appeared like magic to cover every part of Kim’s body that Hugo didn’t need to work on. After that one instruction Rachel didn’t need to worry about warming-the blankets were replaced every few minutes by freshly warmed ones handed through the door. There must be a hive of industry out there.
It was an amazing scene. As well as the unseen industry outside, they had two nurses working with them in the theatre.
Elly was a competent middle-aged woman, white-faced and shocked because she was best friends with Kim’s mum, but that fact wasn’t allowed to get in the way of her professionalism. Then there was David, a ginger-headed kid who looked like he was hardly old enough to be qualified-but was magnificent under pressure.
They were all magnificent under pressure, Rachel thought. The whole town.
And Hugo…
What was being asked of him was unthinkable. His concentration was fierce-he didn’t lift his head. He concentrated as she guessed he’d never concentrated in his life.
Where was the laughing man at the dog show? Gone. He’d been replaced by a pure professional-a professional being asked to work well past his level of training.
This was nightmare stuff. The specialist at the end of the phone could only guide-there was no way anyone could help Hugo manoeuvre the fine particles of tissue back into being a viable blood supply.
Rachel, concentrating fiercely on an anaesthetic that was taking her to the limits of her ability, could only wonder. If Hugo hadn’t been there, could she have done such a thing?
No, she thought honestly. Hugo had obviously done far more extensive reading and studying in this area than she had. The questions he asked the specialist showed keen intelligence and an incisive knowledge of what he was trying to achieve.
The man was seriously good.
And he was succeeding.
Even when the femoral artery was somehow-amazingly-reconnected and the first surge of pink started to appear in the lower leg, he didn’t relax. His questions to the unknown Joe in Sydney seemed, if anything, to increase. He worked on and on, tying off vessels that were damaged beyond repair.
He completed the vascular surgery, took a deep breath, and a plastic surgeon came on the line, guiding him through the complex steps in closing such a wound to give a decent cosmetic outcome.
They were worrying about appearances, Rachel thought jubilantly, watching the colour seep back into Kim’s toes and making sure the heart line on her monitor stayed steady as blood pressure stabilised. They were worrying how she’d look in the future.
They were winning!
And finally-finally, after hours without lifting their heads-the team in Sydney let out a cheer down the phone lines.
‘Well done, Cowral,’ they told them. ‘Unless you have any more big dogs menacing the populace, we’ll leave you to it.’
And to the thanks of the entire theatre team, the telephone lines went dead.
The theatre fell silent. Rachel was still concentrating. Hugo was placing dressings around the wound and she had to concentrate on reversing the anaesthetic, having Kim reestablish her own breathing. But the satisfaction…
She glanced up and the joy she felt was reflected in every face in the room.
Except Hugo’s. He looked sick. The strain Rachel had been under had been immense-the strain Hugo had felt must have been well nigh unbearable. He’d won, but at a cost.
She’d worked as a team member for long enough to know that it was time for someone else to take charge. And she was the only possible option.
‘David, take over the dressing,’ she ordered. ‘Hugo, leave the rest to us. We don’t need you here any more.’ He’d been under more pressure than any doctor should face and now, job done, reaction was setting in with a vengeance.
‘I’m OK.’ But the hands holding the pad were suddenly shaking. His fingers had seemed nerveless for hours, skilled and precise past understanding. It was more than understandable that reaction should set in now.
‘Go and tell the Sandersons their kid will keep her leg,’ she told him. ‘Kim’s parents will still be worried sick. Go.’ Kim was taking her first ragged breaths. One of the nurses had given them the news some time ago that their daughter would be fine, but they wouldn’t believe it until they’d heard it from Hugo.
And Hugo needed to tell them. Hugo had achieved the impossible. This was his gift.
The theatre team agreed. David lifted the tape from Hugo’s nerveless fingers and started applying it. Job done.
‘You’re being kicked out of Theatre, Dr McInnes,’ the young nurse told him, giving his senior a cheeky grin that was still flushed with triumph. They were all high on success. It was a fabulous feeling. ‘The lady’s told you to leave and what the lady wants the lady should get. Don’t you agree?’
Hugo stepped back from the table. He gave Rachel a long, assessing look and then his face broke into the beginnings of a crooked smile.
‘I guess. We owe the lady big time.’
‘There you go, then,’ Rachel said with a lot more placidity than she was feeling. ‘Pay your debt to us all by getting out of here.’
‘If you’re sure.’
‘I’m sure.’ And then for some reason she couldn’t fathom she put her hand on his arm. It was a fleeting gesture-of congratulation?-of comfort? She wasn’t sure but she knew that she was compelled to do it.
Her hand stayed. He looked down at her fingers resting on the sleeve of his theatre gown and his face twisted into an expression she didn’t recognise. For one fleeting moment his hand came up to cover hers. Warmth flooded between them-and something else. Something she couldn’t begin to recognise.
‘You’re right, Dr Harper,’ he said softly, so softly she could hardly catch the words. ‘I need to get out of here.’
He left. The two nurses wheeled Kim through to Recovery and Rachel was left with Jane, the lady with the video, and Pat, the lady on the floor holding the mobile phone.
They’d never met until three hours ago and they were grinning at each other like fools.
‘That was fantastic,’ Rachel said, and if she couldn’t keep her voice steady, who could blame her? ‘Jane, I have no idea how you filmed that without fainting.’
‘Fainting isn’t what I felt like,’ Jane admitted. ‘What I felt like was far more messy. But I figured I could do the messy stuff afterwards when no one needed me and, hey, guess what? Now I don’t feel like it at all any more.’
‘You realise you guys saved Kim’s leg.’ The video recording and computer link had meant the specialists on the end of the line had been able to watch them every step of the way and Pat’s relayed instructions had given Rachel every skill she’d needed.
‘We all saved Kim’s leg,’ Pat decreed. She rose and came across to give her friend a hug and then the two of them hugged Rachel. This wasn’t something that’d happen in a big city hospital but it was an entirely appropriate action here. A great action. ‘We make a fantastic team,’ Pat said roundly. ‘We’re so glad you’re here now, Dr Harper. Something tells me Dr McInnes is going to need the best team he can get.’
The words somehow broke through her exhaustion. They didn’t make sense. What was Pat saying? Something
