Sacrifice

'But given the state of the corpse out there, maybe someone around here dabbles in the black arts.'

She sat up, lost her bored look.

'What do you mean?'

'You should wait for the post-mortem. I could be wrong. The pelvic region is my specialty, not the chest. Oh, and could you ask your colleagues to be careful? I was fond of that horse.'

'I think they have more on their minds than your horse right now, Dr Guthrie.'

'It's Miss Hamilton. And they can show some respect.'

'What do you mean?

'Respect for my property, my land and my animals. Even the dead ones.'

'No, what do you mean, "It's Miss Hamilton"?'

I sighed. 'I'm a consultant surgeon. We are addressed as Mr or Miss. Not Dr. And Guthrie is my husband's name. I'm registered under my own.'

'I'll try to remember that. In the meantime, we need to do some- thing about that horse.'

She stood up. My heart quickened.

'We'll need to get rid of the carcass,' she went on. As quickly as possible.'

I stared at her.

'Today,' she emphasized, when I hadn't responded.

'I'll bury him myself just as soon as you're done,' I said, as firmly as I knew how.

She shook her head. 'I'm afraid that won't be possible. The Scientific Support Unit from the mainland will be arriving soon. They'll need to sweep the entire area. We may be here for weeks. We can't work around a rotting horse.'

I think it was her choice of words, accurate but insensitive, that caused the tight ball to materialize in my chest, the one that tells me I'm mad as hell and I really, really need to take care what I say for the next few minutes.

And, as I'm sure you're aware, burying your own horse has been illegal for several years,' she continued. I glared back at her. Of course I was bloody aware: my mother had been running a riding school for the last thirty years. But I was not about to argue with Sergeant Tulloch about the prohibitive cost of having a horse taken away on Shetland. Nor was I going to tell her about my (admittedly very sentimental) need to keep Jamie close.

Tulloch stood up and looked round. She spotted the wall- mounted telephone above the fridge and walked over to it.

'Would you like to make the arrangements,' she said, 'or should I?'

I honestly think I might have hit her at that point; I even started to stride towards her and, out of the corner of my eye, I saw the WPC step forward too. Fortunately for us both, before Tulloch could lift the receiver, the phone rang. To my increasing annoyance, she answered it, then held it out. 'For you,' she said.

'You don't say!' I made no move to take it from her.

She withdrew her hand. 'Do you want to take the call or not? Sounds important.'

Giving her my best glare, I grabbed the phone and turned my back on her. A voice I'd never heard before started talking.

'Miss Hamilton, Kenn Gifford here. We have a twenty-eight- year-old patient. Thirty-six weeks pregnant. She arrived about fifteen minutes ago, haemorrhaging badly. Foetus showing signs of mild distress.'

I willed myself to focus. Who the hell was Kenn Gifford? Couldn't place him at all; one of the house officers, maybe, or a locum?

'Who is she?' I said.

Gifford paused. I could hear paper being shuffled. 'Janet Kennedy'

I swore under my breath. I'd been keeping a close eye on Janet. She was about three stone overweight, had a placenta praevia and, to cap it all, was a rhesus negative blood group. She was booked in for a Caesarean six days from now but had gone into labour early. I looked at the clock. It was five-fifteen. I thought for a second.

Placenta praevia means that the placenta has implanted in the lower, rather than the upper, part of the uterus. It blocks the baby's exit, meaning the little tyke is either stuck where it is – not a good situation – or is forced to dislodge the placenta and interrupt its own blood supply – an even worse situation. Placenta praevia is a major cause of bleeding in the second and third trimesters and of haemorrhage in the final two months.

I took a deep breath. 'Get her into theatre. We need to anticipate intra-operative bleeding so let the blood bank know. I'll be twenty minutes.'

The line went dead, just as I remembered that Kenn Gifford was the Chief Consultant Surgeon and Medical Director at the Franklin Stone Hospital, Lerwick. In other words, my boss. He'd been on sabbatical for the past six months, his departure pretty much coinciding with my arrival on Shetland. Although he'd approved my appointment, we'd never met. Now he was about to watch me perform a difficult procedure with a serious possibility the patient might die.

And there I'd been, thinking the day couldn't possibly get any worse.

2

TWENTY-FIVE MINUTES LATER I WAS GOWNED UP, SCRUBBED and heading for Theatre 2 when a house officer stopped me.

'What?'

'We don't have any blood,' the young Scotsman replied. 'The bank's out of AB negative.'

I stared at him. What the hell else was going to go wrong? 'You're kidding me,' I managed.

He wasn't kidding. 'It's a rare group. We had an RTA two days ago. We have one unit, that's all.'

'Well, get some more, for God's sake!' On top of everything I'd been through already that day, I was sick with nerves about the coming procedure. I'm afraid I don't do polite in those circumstances.

'I'm not an idiot, you know. We've ordered it. But the helicopter can't take off at the moment. The wind's too strong.'

I glared at him and then pushed my way into theatre just as a huge man in airforce-blue cotton scrubs made the final incision into Janet's uterus.

'Suction,' he said. He took a tube from the attendant scrub nurse and inserted it to drain off the amniotic fluid.

In spite of the mask and theatre hat he wore, I could see at once that Kenn Gifford was exceptional-looking; not handsome, quite the opposite in fact, but striking all the same. The skin I could see above the mask was fair, the type that reveals the blood vessels beneath it and looks permanently pink after a certain age. He hadn't reached that age yet, but the theatre was hot and his colour was high. His eyes were small and deep set, hardly visible from a distance and of an indeterminate colour, even close up. They weren't blue or brown or green or hazel. Dark rather than light; grey perhaps came the closest, and yet I didn't look at him and think, grey eyes. Large, half-moon shadows lay beneath them.

He saw me and stepped back, holding his hands at shoulder height and, with his head, gestured me forward. A screen had been set up to shield Janet and her husband from the gorier aspects of the operation. I looked down, determined to think about nothing but the job in hand; certainly not of Gifford, who was standing, uncomfortably close, just behind my left shoulder.

'I'll need some fundal pressure,' I said, and Gifford moved round to face me.

I went through the usual checklist in my head, noting the position of the baby, location of the umbilical cord. I put my hand under the baby's shoulder and eased gently. Gifford began to push on Janet's abdomen as my other hand slipped in around the baby's bottom. My left hand moved upwards to cup the head and neck and then gently, forcing myself to go slowly, I lifted the mucus-covered, blood-smeared little body out of his mother and into his life. I felt that second of sheer emotion – of triumph, elation and misery all at once – that makes my face sting, my eyes water and my voice tremble. It passes quickly. Maybe one day it won't happen at all; maybe I'll get so used to bringing new life into the world that it will cease to affect me. I hope not.

The baby began to scream and I allowed myself to smile, to relax for a second, before I handed him to Gifford – who had been watching me very closely – and turned back to Janet to clamp and cut the cord.