A Life-Saving Reunion Page 3

  Everybody in the team who had—or would be—directly involved in Penelope Craig’s case had been invited to this meeting, including Rosie as one of the nurses that had provided so much of her care over the many admissions the little girl had had. One of the only people missing as the clock clicked onto the start time of eleven a.m. was her surgeon.

  Rebecca Scott.

  He hadn’t seen her all week, come to think of it. Not that he’d wanted their paths to cross. The shock of their last interaction hadn’t been only due to her lack of professionalism. Or that she had so unexpectedly crossed the boundaries of what their new relationship allowed.

  No. Thomas had not been able to shake the echo of that vehement parting shot. That he chose to shut his eyes. To run away. And that he had always made that choice.

  Did she really think he was such a coward?

  He wasn’t a coward. Had Rebecca had no understanding of how much strength it had taken to deal with what they had gone through? How hard it had been to keep putting one foot in front of the other and keep going?

  Obviously not.

  No wonder their marriage had fallen apart so easily.

  No wonder he had been left feeling such a failure. As a husband and as a father.

  But to drag it out again and hurl it in his face like that...

  It had been uncalled for. Unhelpful. Insulting, even.

  And so, yes, he was angry.

  ‘Sorry we’re late...’ The door opened as Rebecca rushed in to take a seat at the oval table, followed by her senior registrar.

  Thomas could feel himself glaring at the late arrivals.

  Rebecca was glaring right back at him. ‘We got held up in Recovery after our last case. I couldn’t leave until I was sure my patient was stable.’

  ‘Of course you couldn’t,’ someone said. ‘We wouldn’t expect you to.’

  Thomas looked away first. Just in time to notice the raised eyebrows and shared glances that went round the table like a Mexican wave.

  ‘No problem,’ he said evenly. ‘But let’s get started, shall we? We’re all busy people.’

  The tension in the room behind him felt like an additional solid presence as he faced the screen and clicked the pointer to bring up his first slide.

  ‘As you know, we’re here to discuss a case we’re all involved with—that of Penelope Craig, who’s currently an inpatient in our cardiology ward. For those of you who haven’t been so directly involved in the last few years, though, here’s a quick case history.’

  The slide was a list of bullet points. A summary of a clinical case reduced to succinct groups of words that made one crisis after another no more than markers on a timeline.

  ‘The diagnosis of hypoplastic left heart syndrome was made prenatally so Penelope was delivered by C-section and admitted directly to the cardiac intensive care unit. She underwent her first surgery—a Norwood procedure—at thirteen days old.’

  He had been in the gallery to watch that surgery. Rebecca had been a cardiothoracic surgical registrar at the time and it had been the most challenging case she’d assisted with. She’d sat up half the previous night as she’d gone over and over the steps of the surgery and Thomas had stayed up with her, trying to make up for any lack of confidence she was feeling. Even as he paused only long enough to take a breath, the flash of another memory came up like a crystal-clear video clip.

  He had been in the front row of the gallery, leaning forward as he looked down at the tiny figure on the operating table and the group of gowned and masked people towering over it. Over the loudspeaker, he had heard the consultant surgeon hand over the responsibility of closing the tiny chest to Rebecca. As they changed positions, she had glanced up for a split second and caught Thomas’s gaze through the glass window—as if to reassure herself that he was still there. That he was still with her with every step she took. And he had smiled and nodded, giving her the silent message that he believed in her. That she could do this and do it well.

  That he was proud of her...

  His voice sounded oddly tight as he continued. ‘A hemi-Fontan procedure was done at six months to create a direct connection between the pulmonary artery and the superior vena cava.’

  Rebecca had been allowed to do most of that procedure and she’d been so quietly proud of herself. They’d found a babysitter for Gwen and they’d gone out to celebrate the achievement with dinner and champagne and a long, delicious twirl around the dance floor of their favourite restaurant.

  Those ‘date’ nights had always had a particular kind of magic. It didn’t matter how frantic the hours and days before them had been or how tired they were when they set out. Somehow they could always tap back into the connection that had been there from their very first date—that feeling that their love for each other was invincible. That there could never be anyone else that they would want to be with.

  The idea that the night after that surgery would be the last ‘date’ night they would ever have would have been unthinkable at the time. As impossible as losing their precious child.

  Thomas didn’t actually know if it had been Rebecca who had done the final major surgery to try and improve the function of Penelope’s heart. He’d walked out by then, taking a new job in adult cardiology at a major hospital up north in the wake of that personal tragedy that had torn their lives apart.

  He’d run away...like he always did...

  Thomas cleared his throat as he rapidly ran through the list of the more recent admissions.

  ‘April of this year saw a marked deterioration in Penelope’s condition following a series of viral infections. She’s been an inpatient for the last ten weeks and was placed on the waiting list for a heart transplant about two months ago. This last week has seen a further deterioration in her condition and there’s an urgent need for intervention.’

  The next slide was a set of statistics about the availability of transplant organs and how many young patients were unlikely to make it as far as receiving a new heart.

  The slide after that sombre reminder was a picture of a device that looked like a tiny rubber plunger with a single tube attached to the top and two coming out from the base.

  ‘For those of you not familiar with these, this is a ventricular assist device—an implantable form of mechanical circulatory support. Parental consent has been given and it’s our plan for Penelope to receive a VAD as soon as theatre time can be arranged.’ Thomas sucked in a longer breath. ‘Dr Scott? Perhaps you’d like to speak about what the surgery involves?’

  Using her formal title caused another round of those raised eyebrows and significant glances. Was it his imagination or did this meeting feel really awkward for everybody here?

  ‘Of course.’ Rebecca’s gaze quickly scanned everybody at the table. It just didn’t shift to include himself. ‘To put it simply, it’s a straightforward bit of plumbing, really. The device is a pump that uses the apex of the left ventricle as the inflow and provides an outflow to the aorta, bypassing the ventricle that’s not functioning well enough.’

  Thomas could feel himself frowning. It was fine to describe something in layman’s terms for the members of the team with no medical background, like the dietician and the psychologist, but to his own ears it was simple enough to be almost dismissive. Like describing a donor organ as a spare part?

  His anger had settled into his stomach like a heavy stone. No wonder he hadn’t been that interested in eating in the last few days. Was it going to get even worse when he had to work so closely with Rebecca on Penelope’s case? Perhaps the unwanted memories that had ambushed him during his brief presentation had been a warning that it was going to become increasingly difficult to work with his ex-wife. The prospect was more than daunting, especially given that everybody else here seemed to be aware of the tension between them.

  David, the cardiac intensive care consultant, was giving him a speculative glance as if he was also having concerns about how this particular combination of the lead carers in this team was going to work. With an effort, Thomas erased the unimpressed lines from his face.

  ‘Of course it’s not quite that simple in reality,’ Rebecca continued. ‘It’s a big and potentially difficult surgery and there are complications that we have to hope we’ll avoid.’

  ‘Like what?’ The query came from one of the physiotherapists.

  ‘Bleeding. Stroke. Infections. Arrhythmias.’ Rebecca was counting off the possible disasters on her fingers. ‘Some might not become apparent immediately, like renal failure and liver dysfunction. And some intraoperative ones, like an air embolism, are things we will certainly do our best to control. I guess what I’m trying to say is that there are risks but everybody agrees that the potential benefits outweigh these risks in Penny’s case.’

  Rebecca’s smile was poignant. ‘As most of you know, Penny Craig is one of those patients you just can’t help falling in love with and we’ve known her all her life.

  ‘I’m sure we’re all going to give this case everything we’ve got.’ Her smile wobbled a fraction. ‘I know I am...’

  The murmur of agreement around the table held a note of involvement that was very unusual for a clinical team meeting like this. Heads were nodding solemnly. Rosie was blinking as if she was trying to fight back tears.

  For heaven’s sake... Did nobody else understand how destructive it could be to get too involved? Was the staff psychologist taking this atmosphere on board and making a mental note that a lot of people might need some counselling in the not-too-distant future if things didn’t work out the way they all had their hearts set on?

  Tho
mas raised his voice. ‘It’s certainly all about teamwork and it’s to be hoped that we will see a dramatic improvement in this patient’s condition within a very short period of time.’ He glanced down at the laser pointer in his hand, looking for the ‘off’ button. ‘Thank you all for coming. I look forward to working with everybody.’

  A buzz of conversation broke out and more than one pager sounded. David came around to his end of the table. ‘I’m being paged to get back upstairs but come and see me when you have a moment? I’d like to go over the postoperative care for Penny in some more detail so I can brief my staff.’

  ‘Sure. I’ll be heading up there shortly. There’s a four-year-old who was admitted to ICU with severe asthma last night but now they’re querying cardiomyopathy. We might need to transfer her to your patch.’

  ‘I heard about that. Page me if you need me in on that consult.’

  ‘Will do.’

  The rest of the room was emptying during the brief conversation with David. Everybody had urgent tasks waiting for them elsewhere, including himself. Thomas shut down the programme on his laptop and picked it up, his thoughts already on the case he was about to go and assess. Severe breathlessness and wheezing in children could often be misdiagnosed as asthma or pneumonia until more specific tests such as echocardiography were used to reveal underlying heart disease.

  It was a complete surprise to turn and find he was not alone in the room.

  Rebecca was standing at the other end of the table.

  ‘We need to talk,’ she said.

  Thomas said nothing. Given how disturbing their last private conversation had been, he wasn’t at all sure he wanted an opportunity that could, in fact, make things worse.

  ‘I’m sure you agree that we can’t work together with this kind of tension between us. Especially not on a case like this. Everybody’s aware of it and it’s destructive to the whole team.’

  He couldn’t argue with that. And, to his shame, he knew he had to take part of the blame. He had no reason to feel angry with Rebecca for anything to do with her involvement in Penelope’s case. He was letting personal baggage affect his relationship with a colleague to such an extent, it was actually difficult to make eye contact with her right now.

  He looked down at the laptop in his hands.

  ‘So what do you suggest? That we call in a different cardiologist? In case you hadn’t noticed, they’ve been short-staffed around here ever since the threat of the merger got real. That’s why I agreed to take on a permanent position again.’

  A brief upwards glance showed that Rebecca’s gaze was on him. Steady and unrelenting. He held her gaze for a heartbeat. And then another as those dark eyes across the length of the table merged with that flash of memory he’d had during his presentation—when they’d been looking up at him for reassurance that she had his support when she’d been facing one of her biggest challenges.

  A different lifetime.

  One in which giving and receiving that kind of reassurance and support had been as automatic as breathing. When success for either of them had created a shared pride so huge it could make it hard to catch a breath and when failure was turned into a learning experience that could only make you a better person. A lifetime that had been iced with so much laughter.

  So much love...

  It had been a long time since that loss had kicked him quite this hard. A wave of sadness blurred the edges of any anger he still had.

  ‘That’s not what I’m suggesting,’ Rebecca said quietly. ‘Penny deserves the best care available and, on either side of the actual surgery, you are the person who can provide that.’

  ‘And you are the person who can provide the best surgical care,’ he responded. ‘She deserves that, too.’ He closed his eyes in a slow blink and then met her gaze again. ‘So what is it that you are suggesting?’

  ‘That we talk. Not here,’ she added quickly. ‘Somewhere more...’ She cleared her throat. ‘Somewhere else.’

  Had she been going to suggest somewhere more private? Like the house they’d lived in with Gwen that Rebecca had refused to sell?

  He couldn’t do that. What if she still had all those pictures on the walls? That old basket with the toys in it, even?

  ‘I’m going for a walk after work,’ Rebecca said quietly. ‘Through Regent’s Park and over to Primrose Hill. It’s a gorgeous day. Why don’t you come with me?’

  A walk. In a public place. Enough space that nobody would be able to overhear anything that might be said and the ability to walk away if it proved impossible to find common ground without this horrible tension.

  Except they had to find that common ground, didn’t they, if they were going to work together?

  If they couldn’t, Thomas would have to add a failure to remain professional to the list of his other shortcomings and this one wouldn’t be private—it would be fodder for gossip and damaging for both their careers.

  And his career was all he had left now.

  ‘Fine.’ He nodded. ‘Page me when you’re done for the day. I’ll be here.’

  * * *

  Out of one meeting and straight into another.

  Rebecca only had time to duck into her office and grab a folder from her desk before heading down to the coffee shop on the ground floor where the committee members in charge of organising the Teddy Bears’ Picnic would be waiting for her.

  The countdown was on for the annual event that Rebecca had been instrumental in setting up four years ago and this one promised to be the biggest and best yet.

  The committee president, a mother of a child with cystic fibrosis who had received a double lung transplant six years ago, waved excitedly at Rebecca and she weaved her way through the busy café opposite the pharmacy on the ground floor.

  ‘We had to start without you, I’m afraid.’

  ‘No problem, Janice. I’m so sorry I’m late.’ It seemed to be becoming the theme of her day today, but at least she didn’t have anyone glaring at her. Janice was beaming, in fact.

  ‘I’ve got such good news. Your suggestion to contact the president of the World Transplant Games Federation really paid off. We’re going to have trouble choosing which inspirational speakers we want the most.’

  ‘Oh? That’s fantastic.’ Rebecca smiled up at the young waitress taking orders. ‘I’ll have a flat white, please. And one of your gorgeous savoury muffins.’ The way her day was shaping up, it was highly likely to be the only lunch she would get.

  ‘We’ve got an offer from a man called Jeremy Gibson. He got a liver transplant when he was in his early thirties and had three young children. He’s competed in the games for four years now and, last year, he led a sponsored hike in the Himalayas to raise awareness for organ donation and advertise how successful it can be.’

  Rebecca nodded but she wasn’t quite focused on this new meeting yet. The way Thomas had looked at her—after he’d asked if she wanted to call in a new cardiologist for Penny’s case...

  The tension had still been there. That undercurrent of anger that she knew had been caused by her telling him that he always ran away was still there. But there’d been something else, as well. A sadness that had made her want to walk around the edge of that table and simply put her arms around him.

  To tell him how sorry she was.

  For everything.

  That was a bit of a shock, all by itself. She was over the breakup of her marriage.

  She was over Thomas.

  Who, in their right mind, would choose to be with someone who simply wasn’t there when the going got too rough?

  ‘And then there’s Helena Adams,’ Janice continued. ‘A double lung recipient who’s a champion skier and...’ She consulted a notepad on the table in front of her. ‘And Connor O’Brien—a young heart transplant recipient who ran in the London Marathon last year.’

  ‘They all sound amazing,’ Rebecca said.

  ‘Maybe they could all come,’ their treasurer suggested. ‘They don’t all have to speak. They could just mingle and join in some of the fun and chat to parents and kids. And the press, of course. We’re going to get way more coverage this year, what with the threat to Paddington’s already getting so much publicity.’