‘It’s not a publicly owned chopper.’ Harold Keen, the showground caretaker, drove her to the hospital in grim-faced anger. ‘It seems it belongs to the chap that had the heart attack-Hubert Witherspoon. His man’s the pilot. He’s under instructions to take your young man to Sydney and there’s no way he’s turning back.’
‘But Michael’s on board. Surely he can overrule.’
‘I don’t think he has any say in the matter.’
Rachel stared straight ahead. She was wearing one of Doris Keen’s Crimplene dresses. She’d hauled a comb through her hair, but her curls were still dripping. She was wearing a pair of Doris’s sandals. She was heading to a tiny country hospital where they were facing surgery that was a nightmare.
Help!
‘I suppose someone’s looking after Penelope,’ she said in a small voice, and Harold looked her over with evident approval.
‘Your dog’s fine,’ he told her. ‘There’s any amount of folk looking after her. You look after Kim and we’ll look after you.’
‘Thank you.’ She felt like she was about to cry. Damn Michael. Damn him. He had the skills she didn’t. He had the helicopter she needed.
He was gone.
‘It’s no use being angry. We just have to get on with it.’
Hugo was already kitted out for surgery in green theatre gown, cap and slippers. The nurse had ushered Rachel straight through to the theatre. She glanced around and her heart sank. This was a tiny surgery, set up for minor procedures. Not the major trauma that was facing them now.
She swallowed and looked up, and some of her panic must have shown in her face.
‘What’s your background?’ he asked, his voice gentling a little.
‘I’m a registrar at Sydney Central. Emergency medicine. I don’t… I don’t have the surgical skills to cope with this.’
‘But you’re the reason we were able to clamp the arteries so fast,’ he told her. ‘So you saved Kim’s life in the first place. It’s just a matter of finishing what we started.’
Yeah, right. ‘You’re planning on rejoining the femoral artery?’
‘If we can-yes.’ He shook his head. ‘It may be unlikely we’ll succeed but we have to try. I’ve been on the phone to specialists in Sydney and we don’t have a choice. By the time we get her evacuated to Sydney the leg will be dead. If we don’t try then she loses the leg. It’s as simple as that. I’m assuming you can give an anaesthetic?’
He wasn’t expecting her to operate. That was such a relief her knees almost buckled right then.
‘Yes.’ If he was prepared to be heroic then so was she. This was heroic surgery, she thought. Damn fool surgery. The outcome seemed almost inevitable but he was right. They had to try.
‘It’s not as bad as it seems,’ he told her. ‘We have a video link to Sydney. Joe Cartier, one of the country’s leading vascular surgeons, has agreed to help us every step of the way. I’ve hauled in Jane Cross, a local who plays at being a film-maker. She’s setting up computer equipment and she’ll video while we operate. She can do really intricate close-up stuff so everything I do goes straight down the line to Sydney and I get immediate feedback.’
He’d organised all this while she’d been in the shower?
‘I… You’re not a surgeon?’
‘I’m a family doctor,’ he told her. ‘I’m two hours away from back-up. I’m everything. If you weren’t here-if I didn’t have an anaesthetist-then I’d count this impossible. But we have enough going for us now to hope. So what are we waiting for? Let’s go.’
Afterwards, when Rachel was asked to describe what had been done, she’d simply shake her head. How they did it…It was impossible. All she could describe were the technicalities, and they were impressive enough.
They had a speaker-phone mounted just beside the table. Every sound they made went straight down the wire to Sydney.
Jane Cross, a woman in her forties, looking crazily incongruous with theatre garb covering a purple caftan and a mass of jangling earrings dangling beneath her theatre cap, directed a video camera straight at the wound.
‘You promise you won’t faint?’ Hugo had asked the middle-aged woman as she’d set up the equipment, and Jane had regarded Hugo and Rachel with incredulity. Even with a hint of laughter.
‘What, faint? Me? When I’ve got a captive audience? I intend to faint at least three times and I’ll probably throw up too, but later. Not until I’ve done my job.’
She was wonderful, Rachel decided. She was right there behind Hugo’s hands, but somehow she had the skill and the sensitivity to stay clear enough for his fingers to do their work.
The pictures she took were via a digital video camera linked to video conferencing equipment. In Sydney Joe Cartier had a clear view-and Hugo was asking questions every step of the way.
Rachel couldn’t help him at all. She had her own battles. She wasn’t a trained anaesthetist-she’d done basic 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.