Secrets In Sydney: Sydney Harbour Hospital: Tom's Redemption

CHAPTER FIVE

‘HAYLEY, come talk to us.’ Theo winked and patted the space on the couch next to him. ‘Been having any more dinners with dark-haired doctors?’

All the other night-duty nurses’ heads turned toward her so fast she could hear cervical vertebrae cracking. Damn it, why had she asked Theo about Tom?

‘ I know it won’t be Finn Kennedy.’ Jenny looked up from her cross-stitch, sympathy in her eyes. ‘I see you’re back on the night-duty roster again. That’s his way of saying, “Behave and don’t usurp your superiors.”’

Thank you, Jenny, for moving the conversation away from Tom and thank you, Mr Kennedy, for a week of nights and seven days of sleep. ‘I promise I’ll be well-behaved from now on.’

‘Good.’ Theo pulled a green badge from his pocket and handed it to her.

She stared at the picture of a light bulb with a red line through it. ‘What’s this?

‘It’s to remind you to turn out the lights. You’re my worst offender. Do you realise everywhere you go you leave a trail of light behind you and that’s adding to global warming? Meanwhile, ICU is whipping us and I want to win the sustainability grant. Everyone …’ he paused and glared at all the staff ‘… has to get on board. If you’re not in a room, turn out the lights.’

‘I didn’t realise you had a scary side, Theo.’ Hayley forced a smile and stuck the badge on her scrubs, knowing that was the easy part. Turning lights off went against years of ingrained behaviour, years of using light as a refuge from fear.

‘And now back to who you’re dating.’ Suzy Carpenter’s mouth was a hard, tight line.

‘Don’t stress, Suzy,’ Theo teased. ‘There’s no new doctor on the block so she’s not stealing anyone from you.’

Thankfully, Hayley’s pager started beeping because, short of torture, she refused to tell anyone how she’d made a fool of herself with Tom. As she read the page she quickly rose to her feet. ‘This can’t be good. Evie wants me downstairs stat for a consult. Gear up, gang, we could be operating soon.’

Hayley took the fire-escape stairs two at a time rather than waiting for a lift, and a couple of minutes later she was in the frantic emergency department. Nurses were speed-walking, doctors looked harried and she glimpsed three ambulances standing in the bay. It all pointed to a line-up of serious cases.

‘Hayley!’ Evie gave her an urgent wave while she instructed a nurse to get more dexamethasone. ‘We’ve got a problem.’ She tugged her over to a light box where a CT scan was firmly clipped. She tapped the centre of the film. ‘Gretel Darlington, a nineteen-year-old woman presenting with a two-month history of vague headaches, but tonight she’s had a sudden onset of severe, migraine-type headache. She’s in a lot of pain, slightly disorientated, and on examination has shocking nystagmus. She’s not got control over her eye movements at all.’

Hayley frowned as she stared at the black and white image of the patient’s brain, wondering exactly why Evie was showing it to her. ‘She hasn’t got a migraine. That tumour’s the size of an orange.’

Evie moved her pen around the perimeter of the tumour. ‘And she’s bleeding. She needs surgery now to relieve the pressure.’

‘Absolutely.’ Hayley had no argument with the diagnosis or the treatment plan, but she was totally confused as to why Evie had paged her. ‘Exactly what’s this case got to do with me?’

The usually unflappable Evie had two deep lines carved into her forehead and her hazel eyes radiated deep concern. ‘You have to do the surgery.’

Tingling shock whooshed through Hayley so fast she gaped. ‘I’m a general surgical registrar, Evie, and this girl needs a neurosurgeon!’

‘You think I don’t know that?’ Evie shoved her hair behind her ears with an air of desperation. ‘Rupert Davidson is at a conference with his registrar and Lewis Renwick, the on-call neurosurgeon, is already in surgery over at RPH. By the time he finishes there and drives over the bridge to here, it could be three hours or more. She doesn’t have that much time.’

Hayley bit her lip. ‘There has to be a neurosurgeon in private practice we can call.’

‘Tried that. The problem is that most of Sydney’s neurosurgeons are at the Neurosurgical Society of Australasia’s conference.’ She shrugged, the action full of resignation. ‘It’s in Fiji this year and because it’s winter more than the usual number went, leaving all the hospitals stretched.’

‘What about Finn Kennedy? He’s got all that trauma experience from his time in the army.’

Evie flinched. ‘He’s not answering his pages. It’s you, Hayley.’

Brain surgery. A million thoughts tore around her mind driven by fear and ranging from whether she could actually do the surgery without damaging the patient to possible law suits against her. She was in Sydney, NSW, not Africa. This lack of appropriate surgeons shouldn’t have happened here and yet circumstances had contrived to put her in this position. To put her patient in this position.

She stared at the scan again, but it didn’t change the picture. The brain fitted snugly inside the bony protection of the skull and the design didn’t allow for anything else. No extra fluid, no blood, no extra growths. Nothing.

She was between a rock and a hard place. If she didn’t operate, the woman would die. If she did operate, she risked the life of her patient and her career. She could just see and hear the headlines of the tabloid papers and the sensational television current affairs programmes if something went wrong.

‘Evie, it’s so damn risky, and not just for the patient.’

The ER doctor’s hand gripped her shoulder. ‘Believe me, if there was another option, I would have taken it. Pretend we’re in Darwin, Hayley. All emergency neurosurgery up there is done by general surgeons.’

She shook her head. ‘That doesn’t reassure me.’

The scream of sirens outside muted as Hayley forced herself to block out everything except the task at hand. Slowly the chaos that Evie’s request had generated started to fade and her thoughts lined up in neat rows—problem, options for best outcome, solution.

Tom.

The thought steadied her. There was a neurosurgeon close by. Now wasn’t the time to think about what had happened the last time they’d met. About his completely unambiguous rejection of her. This was a medical emergency and the stakes were life and death. All personal feelings got set aside. Must be set aside no matter how hard.

‘Evie, go grab a taxi and send it to the Bridgeview Building.’ She grabbed the phone on the wall and punched 9 for the switchboard. ‘It’s Hayley Grey. Connect me to Mr Tom Jordan, now. It’s an emergency.’

The shrill ring of the phone on Tom’s bedside table woke him with a jerk. Once he’d always slept lightly, used to being woken at all hours by the hospital, but two years on from the last time he’d worked as a surgeon and his body clock had changed. Now the only thing that woke him at three a.m. was his own thoughts.

Completely out of practice, he shot out his hand and immediately knocked into the lamp. He heard the crash and swore before reaching the phone. Hell, this had better not be a wrong number or he’d just sacrificed a lamp for nothing. Not that he technically needed it. Hating not being able to read caller ID, and not recognising the ringtone, he grunted down the phone. ‘Tom Jordan.’

‘Tom, it’s Hayley.’

This time he instantly recognised her sultry voice and his gut rolled on a shot of desire so pure that it couldn’t be mistaken for anything else. He immediately chased it away with steely determination. The sort of single-mindedness that had driven him to become the youngest head of neurosurgery, and now drove him to master braille and attempt echolocation so he could be as independent as possible. He wouldn’t allow himself to want Hayley. It would only make him weak.

She wanted you. He sighed at the memory and now it was the middle of the night and a week since he’d been beyond rude to her to keep her away from him. Was this a drunken booty call or a drunken ‘how dare you reject me?’ call? Either way, he didn’t need it. He ran his free hand through his hair. ‘Hayley, don’t say anything you’re going to regret in the light of day.’

‘I need you, Tom.’

And she’d just gone and said it. ‘Look, Hayley, I tried to make it clear the other day that—’

‘This is nothing to do with the other day.’ The cutting tone in her voice could have sliced through rope. ‘Just listen to me. There’s a young woman in ER with a brain tumour and an associated bleed. There isn’t a neurosurgeon available between here and Wollongong and I have to operate. Now. I need you in Theatre with me, Tom. I need you to talk me through it. Be my guide.’

He heard the fear in her voice and it matched his own. There was a huge difference between being able to see the operating field whilst guiding a registrar through the procedure and depending on Hayley telling him what she was seeing so he could tell her what to do next. ‘Can dexamethasone reduce the swelling enough to hold her until the guy from Wollongong arrives?’

‘No.’ Her tone softened slightly. ‘Believe me, Tom, if I had any other choice I would have taken it but there isn’t one. We are this girl’s only chance.’

He swung his legs over the side of the bed. ‘Hell, she’s having a really bad day, then.’

‘She is.’ Hayley’s strained laugh—the one all medical personnel used when things were at their darkest—vibrated down the line, bringing with it a camaraderie that called out to him.

‘I’ve sent a taxi, which is probably arriving any minute. I’ll see you at the scrub sinks, Tom.’

The line went dead.

The scrub sinks.

She’d rung off, leaving him with no option.

He was going back to Operating Room One. Going home. Only home was supposed to be a place of sanctuary and safety and this felt like walking off a cliff.

‘You didn’t shave off all her hair, did you?’

Tom sat on a stool behind Hayley, noticing the varied array of smells in the operating room that he’d never noticed when he’d been sighted. Disinfectant mixed in with anaesthetic gases and blood, plus a couple of other aromas he couldn’t quite identify and wasn’t certain he wanted to. But no matter how pungent the odours, Hayley’s perfume floated on top of them all in a combination of freshness, sunshine and summer flowers. He wanted to breathe in more deeply.

‘No, we only shaved off half her ponytail.’

‘Good. Neurosurgery is a huge invasion and I always make it a point to shave the bare minimum out of respect for the patient.’

Made it a point. You’re not operating any more.

Being back here felt surreal—he was in his theatre that wasn’t his any more, part of a team rather than leading it. He wasn’t scrubbed. Hell, he couldn’t remember the last time he’d been in the OR and not scrubbed. Probably when he’d been a med student. He interlocked his fingers, keeping his hands tightly clasped together in his lap.

He heard Hayley murmuring to the anaesthetist and then she said, ‘Tom, I have Theo scrubbed in, David’s the anaesthetist, Jenny is scouting and Suzy—’ she seemed to hit the name with an edge ‘—is assisting David.’

He and Suzy had shared a fun night three years ago after one of the OR dinners, but he’d never called her. He’d never called any woman because work and patients had always come first and he would never allow anyone to derail him from his goal of staying on top and keeping the demons of his childhood at bay.

He could feel the gaze of many on him and then came the chorus of ‘Hello, Tom’, just as it had when he’d owned this space and had been called in for a night-time emergency. He knew everyone and he also knew, despite all their idiosyncrasies, they worked together as a team. Given the circumstances, Hayley had the best support she could have.

‘Tom, the pinion’s in place, holding Gretel’s head in position, so let’s start.’

To someone who’d not met her before, Hayley’s voice would have sounded confident, but Tom detected her massive stress levels in the tiny alto quavers. She’d explained the scan to him earlier and he could picture it all very clearly in his mind. ‘Due to the position of the mass, you’re making a lateral incision and then performing a suboccipital craniotomy.’

‘Removing a bone flap to relieve the pressure,’ Hayley muttered as if it was a mantra. ‘That’s the easy part.’

It is. ‘One step at a time and we’ll get through this.’ But he too was talking out loud to reassure himself as much as everyone else. So much could go wrong in so many unpredictable ways and he couldn’t see a damn thing.

He’d always operated with music playing, but not soothing classical. His OR would vibrate with hard rock and, during extremely tense moments, heavy metal. Hayley was operating in silence so he sat listening to the whoosh of the respirator and the hiss of the suction, which only ramped up his agitation. He started to hum.

‘Tom, I’ve turned the skin flap and I can see bone.’

‘Now you use the high-speed drill and make three small burr holes into the skull.’

The shrill shriek of the drill against bone always made medical and nursing students jump the first time they heard it. Tom had always teased and laughed at their reaction, but he didn’t laugh today. Instead, his fingers clenched against nothing, wishing they were holding the drill, wishing he was able to do the job, not just for himself but for the patient. For Hayley.

The shriek died away. ‘Done.’ Hayley swallowed. ‘What’s next?’

He visualised the silver instruments all laid out in neat rows on the green sterile sheet. ‘Use the Midas Rex drill to create the bone flap.’

‘Oh, my, it’s like a can opener.’ Hayley gave a tight laugh and a few moments later said, ‘The bone flap’s removed and I can see the dura.’

Like an illustrated textbook, Tom’s mind beamed the image Hayley was looking at. ‘Excellent. Now you need the grooved director. It’s your atraumtic guide. Using the scalpel, cut the dura over the groove and this protects the brain tissue underneath.’

‘Too easy.’

But the everyday slang expression was laden with her anxieties. He moved to reassure her. ‘You’re doing fine, Hayley. David, how’s our patient?’

‘She’s holding her own at the moment, but I’ll be happier when Hayley’s stopped the bleeding.’

‘You’re not alone there.’ Tom counted to ten because he didn’t want to rush Hayley, but he also needed to keep her within a particular time frame. ‘Can you see brain tissue, Hayley?’

‘I’ve found the clot.’ Her relief filled the theatre.

‘Theo, position the microscope.’

The rustle of plastic-covered equipment being wheeled into place was the only sound and Tom hated not being able to see what was going on. ‘Hurry up, Theo.’

‘It’s in position now, Tom,’ Theo said.

‘Good. Hayley, have you found the bleeding?’

‘Give me a minute, I’m still looking.’

Her normally mellow voice rose as her semblance of calm shredded at the edges. Tom wished he could take over, relieve her of this unwanted task that was stretching her and forcing her to go places she’d never been before. But he was powerless to help so he did the next best thing. ‘Theo, suction the clot and keep the field clear. She needs to be able to see.’

‘On it, Tom,’ the nurse replied.

For a moment all he could hear was the gurgle of suction and he couldn’t stop his foot from tapping on the floor.

‘Okay.’ Hayley’s breath came out in a rush. ‘I see it.’

Thank you. ‘Stop the bleeding with the bipolar forceps.’

‘What if that doesn’t work?’

Don’t panic on me now, Hayley. He infused his voice with a calm he didn’t feel. This surgery was something he’d perfected over years of training. Hayley was being thrown in feet first. ‘We’ve got the option of clipping, but try the electrical coagulation first because it will probably work.’

Please let it work. The sooner she stopped the bleeding, the better it was for their patient.

He held his breath while Hayley worked, but he could only guess at what was going on because, apart from a few muttered words, she was silent. He’d always grunted, yelled, talked and even sung his way through surgery. Her silence was unnerving.

‘Suction, Theo,’ Hayley snapped.

‘Her intracranial pressure’s still rising.’ David sounded seriously worried.

‘Has it worked?’ Tom hoped like hell it had.

‘Pray that it has,’ Hayley said. ‘This is the moment of truth, team.’

No one said a word. Only the buzz and whirr of the machines dared to make a sound as time slowed down, stretching out interminably and reaching into infinity.

‘Yes!’ Hayley’s woot of relief bounced around him. ‘Field is clear. Bleeding’s stopped. Clot’s evacuated. We did it. Thank goodness I’m sitting down or my legs would collapse.’

‘Great job. You’ve done well.’ Tom grinned, wanting to high-five her. She’d held her nerve in a tight corner and now step one was complete. He immediately focused. ‘Don’t get too excited. You’ve stopped the bleeding, but we’ve still got the problem of the pressure. With a mass that size you’re going to have to excise a part of it so the brain can get some relief and relax. This takes the risk of her brain herniating down to zero. We also need a biopsy for pathology so we can hand over to Lewis Renwick, who’ll operate to remove the rest of the tumour in a day or so.’

‘You make it all sound so simple.’

‘It’s just brain surgery.’

Like a pressure valve being released, everyone laughed. Despite the life-threatening emergency, the fraught conditions and the fact he couldn’t operate, something inside Tom relaxed. Something that hadn’t relaxed in a very, very long time.

Hayley felt utterly shattered as she walked toward ICU. Even though it had only been three and a half hours since she’d operated on Gretel, it felt like years ago. Having used up every ounce of her concentration whilst operating on her neurological patient, she’d expected to be able to fall in a quivering heap the moment the surgery was over. Instead, just as Tom and David had left the OR to escort Gretel to ICU, she’d been called back down to Emergency for another consultation. Half an hour later she’d been scrubbed again and busy resecting an ischaemic bowel. It hadn’t been an easy operation either.

Now pink streaks of dawn clung to the clouds and all she wanted was her bed, but she couldn’t go home without calling in to see Gretel. She pushed open the doors, checked the patient board, and walked directly to cubicle four. She stood at the end of the ICU bed and blinked. Twice. Shooting out her hand, she gripped the edge of the bed as her legs threatened to collapse in shock. She didn’t know what stunned her more, the fact that Gretel—whose head she’d had her hands inside a few short hours ago—was sitting up, awake and talking to two doctors, or that Tom was one of those doctors.

He was sitting by the bed, holding Gretel’s hand. His face had lost its taut expression—the one she’d become convinced was a permanent part of him—and he looked almost happy.

Tom turned slowly and his nostrils flared. ‘Hayley?’

A buzz of hope streaked along her veins. He knows it’s you.

It’s not personal. He’s got ninja olfactory skills.

She nodded automatically and then realised her mistake. ‘Yes, Tom, it’s me.’

‘Lewis …’ Tom threw his arm out toward her ‘… meet Hayley Grey, the registrar who operated on Gretel.’

A man in a crumpled suit extended his hand in greeting along with a tired smile. ‘Lewis Renwick. Last neurosurgeon in Sydney, it seems. Sorry I was tied up at RPH, but Tom’s been telling me that you coped admirably. Looking at the most recent scan, I agree. You’ve done a wonderful job.’

Hayley grinned with relief. ‘Thank you, but I’m pretty good at following instructions.’

Lewis laughed. ‘Which is fortunate as Tom’s pretty good at giving them.’

Tom’s dark brows rose but a grin clung to his lips. ‘Only because most people need them.’

Gretel smiled and touched her hair. ‘Thanks, Dr Grey, not just for saving my life but for saving most of my hair.’

‘You’re very welcome, but it was very much a team event, with Mr Jordan guiding me through it.’

‘I know, he told me all about it.’ Gretel glanced between the three of them, but spoke directly to Hayley. ‘I can’t believe all this has happened to me, but at least the tumour isn’t cancerous. I’m so lucky that you and Mr Jordan were here tonight and now to have Mr Renwick looking after me.’

Tom patted Gretel’s hand and gave her a big wink. ‘He’s almost as good a neurosurgeon as me except for his lousy taste in music.’

‘So now you’re taking on Mozart?’ Lewis folded his arms in mock effrontery.

‘I always let my patients choose their playlist for the awake part of their surgery.’

The joking faded from Tom’s voice and Hayley saw how much he missed hospital life. It wasn’t just the surgery but his patients as well. Perhaps the patients even more than the surgery? The thought hovered for a moment before she discarded it.

‘I tell you what, Gretel …’ Lewis made a note on her chart ‘… ask your family to bring in your MP3 player and as long as there’s no hip-hop on it, you can listen to your music while I’m removing the tumour and the anaesthetist is asking you questions.’

‘That’s awesome, Mr Renwick. Thank you.’ Gretel touched the bandage on her head. ‘It’s going to be weird being awake while you’re operating on my brain.’

Hayley gave Gretel’s foot a pat. ‘I’ll leave you to talk to Mr Renwick about the surgery as I’m heading home now, but I’ll call by later tonight when I’m back on duty.’

‘I’ll come with you.’ Tom rose and flicked out his cane.

Hayley’s feet stayed still in surprise. He’d been brilliant in Theatre, but she could still vividly remember what he’d said when he’d first answered the phone. Now he wanted to leave with her? It didn’t make sense.

He’s in ICU with machines everywhere. He’ll need some guidance to get to the safety of the corridor.

Yep, that would be it.

Logic didn’t stop the sneaking fizz of disappointment.