Surgeon Of The Heart
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‘Have you worked in Anaesthetics yet, Melissa?’
‘Not yet, Staff.’
‘Then I’ll tell you a little about it before the patient arrives, as we’re ready. At this moment the patient is being anaesthetised, and the anaesthetist is inserting lots of different lines into him, which will enable him to monitor his progress during the operation. What lines do you think he might use?’
‘A CVP line.’
‘Correct. The full name being?’
Melissa cleared her throat. ‘The central venous pressure line.’
‘Good. And do you know what that shows?’
‘Not really, Staff.’
‘Well, it gives us a clear indication of the state of the volume of fluids within the body. It would tell us, for example, if the heart was overloaded—by being raised. It is, as you can imagine, of vital importance, particularly as we’re operating on the heart itself. It will be removed when the patient is ready to leave the intensive care unit.’ She smiled at the student’s rapt expression. ‘And what other lines might we expect to find?’
‘A venous line?’
‘At least one,’ answered Cat. ‘Dr Crone prefers to use four, although he isn’t typical—as you might have already heard, Dr Crone is a law unto himself!’
‘Yes, Staff,’ smiled Melissa.
Further discussion was halted by the appearance of two surgeons—Phil Bennett and Morgan Crossland—Cat knew them well. These were the surgeons who would prepare for the arrival of the professor himself. The operation being performed was a coronary artery bypass graft—an inspirational procedure to any member of the profession. The coronary arteries—vital for supplying the heart with its own blood supply—having become furred and clogged up with arteroma, would be removed, then replaced with veins taken from the lower leg. Thus one surgeon would open up the leg to remove the leg veins, while the other opened up the chest wall, ready for the professor to carry out the swop itself.
Both men grinned when they saw Cat, Morgan, an out-and-out ladies’ man, frowning very slightly.
‘Been on a diet, Cat?’
‘No.’ She knew that her uniform was hanging in voluminous folds around her waist. The plain green theatre dress hid a multiple of sins, but even it couldn’t disguise the fact that ten pounds had fallen off her since her return from Italy.
‘You’re too thin,’ said Morgan critically. ‘It doesn’t suit you.’
Cat could see Melissa Lloyd listening to the interchange with interest, and decided to nip any speculation in the bud. ‘Nice of you to be so concerned, Morgan,’ she said sweetly. ‘But, speaking of diets—couldn’t you do with losing a little yourself?’
Morgan laughed easily, finding something other than total female capitulation quite refreshing. He knew perfectly well that Cat was the last person to fall for his well-worn chat-up lines, but that didn’t stop him trying!
Both men began to scrub as the patient was wheeled in, a man in his late fifties. Dr Crone and his scrub nurse accompanied him, the nurse compressing the ambi-bag, which was feeding oxygen into the patient’s lungs, until he could be connected to the ventilator in Theatre.
Also in the room was the theatre technician, who was responsible for working the bypass machine. The patient’s body needed to be cooled right down, and this was done by putting a cannula in the heart itself, running the patient’s blood through the bypass machine, which cooled it, to have it returned to the patient by an artery in the groin.
Phil started opening the leg, while Morgan began opening the chest, both chatting away, quizzing Cat about her time in Rome. The atmosphere seemed relaxed, but they all worked like clockwork, and the moment that any one of the team in the whole theatre expressed any degree of concern about the proceedings then a tight tension would grip the air.
In reality, Cat would be working for all three surgeons, so she would need to be right on the ball. It was a prospect that daunted a lot of theatre nurses.
‘So how was Rome?’ asked Morgan.
‘The conference was great,’ she said, her voice only slightly unsteady. ‘I learnt a lot. There were two people from the States who——’
‘Wouldn’t you just know it?’ exclaimed Morgan as she slapped a forcep into his gloved hand. ‘Only Cat could go to a country like Italy in the height of summer and come away talking about cardiology! What else did you do apart from the conference? Didn’t some dashing Italian sweep you off your feet?’ he teased, not noticing that she had blanched. ‘And, speaking of dashing Italians,’ he continued cheerfully, ‘I don’t suppose you’ve met our newest maestro?’
‘Morgan’s had his nose put out of joint,’ interjected Phil mischievously. ‘His position as number-one hospital heart-throb has gone. He’s finally been usurped.’
Cat didn’t trust herself to answer, just carried on, slapping instruments between the two, handing over swabs, and making sure that Melissa Lloyd kept a swab tally on the board at the back of the theatre.
She was aware when the professor came in, even though she had her back to him. A good scrub nurse was aware of every single thing that went on in her theatre, and there was always an imperceptible change in the atmosphere when the top man arrived. Jokes stopped. No words were exchanged. They took their lead from him. If the chief surgeon liked to operate while having Sibelius piped over the loudspeakers then that was fine. If his tastes ran to the Rolling Stones then that was fine too! Cat had often thought that it must be a bit like being minor royalty—the top surgeon was in such an awesomely responsible position. Scarce wonder that so many chiefs of surgery had phenomenally huge egos!
She could hear him washing his hands in the corner, and Melissa Lloyd went scurrying over to tie his gown for him. He moved towards the operating table. Out of the corner of her eye she noted that he was exceptionally tall.
‘Good morning, everyone,’ he said in a faintly accented Italian that sounded just a little unusual.
Unusual? Cat started. Now she was going crazy! It was because she had Nico on the mind.
The surgeon moved round the table to face her. ‘Ah, a new nurse?’ he queried softly.
Cat lifted her face, the smile frozen there into a ghastly grimace. Please no, she thought. Dear God, no.
Dark brown long-lashed eyes looked into gold-flecked green. She saw incredulous recognition become a tight anger, and with a resounding clatter she dropped the forcep she was holding on to the floor.
THERE was confusion for approximately three seconds. Morgan stared at her in stupefaction. ‘Are you OK, Cat?’ he queried.