The Surgeon's Special Delivery

Ken handed him the instrument and the sound of suction filled the tense air of Theatre. Just as suddenly it stopped. ‘Damn it, the sucker’s blocked by clots. Saline. I need saline to clear it.’

‘Pressure’s falling,’ Tess stated in words what the incessant beeping told them.

He swore softly under his breath. ‘I’m scubadiving here and I can’t see anything except blood.’ He readjusted the sucker, his hand gripping tightly, and pressed his eye hard against the viewfinder of the ’scope. Don’t bleed out on me before I find the cause.

‘The blood’s arrived.’ Esther called out in relief as she accepted the welcome units from the blood-bank technician.

Tess moved fast. ‘Esther! Start squeezing one unit of blood into the left IV, now.’ She quickly snatched the second unit out of the nurse’s hands and attached it to the other large-bore IV she’d inserted.

Four hands worked furiously, pushing life saving blood into their patient, giving his heart the much-needed volume to pump around. A frown line appeared on the bridge of Tess’s nose. ‘Callum, how much of this is going straight into his gut?’

‘More than we want.’ His terse voice carried his apprehension.

‘I should have tubed him.’ Tess’s usually calm voice sounded ragged at the edges.

He couldn’t look up but he wanted to reassure her. ‘You made the right choice at the time. You’re not an anaesthetist and light sedation is usually better.’ Tension strained every muscle as Callum moved the ’scope to find the bleeder. ‘He’s hosing blood, damn it, but from where?’

The sedated Vince suddenly shuddered and blood and clots projected from his mouth, all over the floor and onto Callum’s shoes. He moved his feet. ‘At least now I can see a bit better. No sign of a peptic ulcer.’

‘I should tube him—he could aspirate.’ Tess ran a fine nasal suction tube down into Vince’s trachea.

Vince’s half-empty stomach immediately filled with blood as Callum probed into the duodenum, the sucker working overtime. Suddenly he caught sight of inflammation, the ugly ragged edges of an ulcer with an enormous clot in the centre. Thank you. ‘Found it. It’s an enormous duodenal ulcer. No wonder he’s been bleeding like a stuck pig.’

He injected the saline down the three-millimetre channel in the ’scope and sent up a prayer that it wouldn’t make things worse.

Ken’s eyes were glued to the screen, his voice disbelieving. ‘Is that a spurting artery at the base of the ulcer?’

It had made things worse. ‘Hell, yes.’ The clot had been trying to seal the bleeding. He sent down more saline to clear the area of blood so he could see what needed haemotosis.

Ken immediately passed him adrenaline. ‘Or will you use diathermy?’

‘Adrenaline first.’ His concentration brought conversation down to the bare minimum. He injected the adrenaline, wishing it speed in constricting the blood vessels and bringing the bleeding under control.

Bringing the whole situation under control. He relaxed slightly. ‘Right, I’ll just put the—’

The monitor screamed and Tess picked up her laryngoscope. ‘His O2 sats are dropping, and he’s got a lung full of blood. Callum, you need to pull out now so I can tube him.’

Sweat pooled on his forehead. He was so close. ‘Give me a minute to put on the haemoclip. I’m almost done.’

‘We don’t have a minute.’ Her eyes flashed with fear and steely determination.

‘Yes, we do. I’ve done this before.’ Callum put out his hand. ‘Kenny, the clip.’

The nurse hesitated, glancing between them.

‘Now,’ Cal barked, and the clip hit his hand.

Tess increased the nasal oxygen, her voice stern with dread. ‘We’re risking him arresting.’

‘Trust me, I’m on it.’ Callum blocked out the panic in Tess’s eyes, blocked out the screaming monitors, the stunned gazes of the nursing staff and did what he did best. With the finesse of the finest craftsman he sealed the bleeding ulcer with the clip.

Exhilaration thundered through him at the save, the buzz making him feel alive in a way no other event or situation ever could. ‘I’m done. The bleeder is plugged and he’s all yours.’ He removed the ’scope from Vince’s gut.

‘Thank you.’ Tess smiled at him with open admiration tinged with school marm disapproval. She immediately busied herself, aspirating the blood Vince had inhaled into his lungs. ‘You’ve done a fabulous job despite giving us all heart failure there for a minute.’ Her eyes held slight censure. ‘Just one more thing. You need to explain it all to Vince’s sister.’

His gut dropped. James had been the ‘touchy-feely’ Halroyd, the people person. Cal didn’t want to have to deal with hysterical relatives, especially when he knew Tess would do it so much better. ‘I can wait for you and we can do it together.’

She shook her head. ‘I’m going to be tied up here for a bit longer getting him stable. The family will be stressing and you need to put them out of their misery.’ Her face was hidden behind her mask but her eyes said it all. ‘I’ll be there as soon as I can.’ She turned back to Esther and issued instructions about commencing antibiotics.

Stunned, he stared at the back of her head. It wasn’t supposed to work like this. He did the life-on-the-edge stuff, not the routine hack work. But Callum Halroyd, the feted Frontline surgeon, had clearly just been organised and dismissed by a country GP.

He didn’t like it at all.

* * *

Callum ran his hand through his hair. Clipping the ulcer had been a walk in the park compared with the conversation he’d just endured with Vince’s sister. Tess had eventually rescued him from the emotional woman and ushered him into the tiny lounge off Theatre.

Glancing over the top of his cup of steaming coffee, he noticed black smudges under Tess’s eyes, marring her clear skin. She pressed one hand to the small of her back while she sipped her tea. She really should be tucked up in bed.

An image of her face relaxed in sleep and her lush body sprawled across a bed thudded through him. Despite fatigue, despite his grief, his groin tightened. Hell. He downed his coffee, almost welcoming the quick scald against his mouth and throat.

‘Sorry about your shoes.’ Tess’s apologetic gaze dropped to his bare feet. ‘I’ve never seen anyone bleed like that before, not even during my residency in Sydney.’

He gave a wry grin. ‘Oh, they can bleed all right. So now you know that you always tube anyone with a belly full of blood and save the surgeon’s shoes.’

‘Not to mention the patient’s life.’ Chuckling softly, she lifted her legs up onto a chair and rotated her ankles. ‘You did brilliantly tonight, action man. Thank you very much. We’d have been in strife without you, and on the plus side you got a bit of excitement tonight after all, so it was a win-win situation all round.’ She smiled smugly.

He knew he’d pushed her out of her comfort zone back in Theatre. ‘Sorry it got a bit hairy in there and that I overrode you, but I knew I could get the clip on.’

She shot him a knowing look. ‘See, general practice isn’t as mind-numbing as you seem to think.’

He snorted, unable to help himself. ‘And the last time you had to open Theatre for an emergency was?’

She had the grace to look like a kid caught with her hand in the lolly jar. ‘We do small procedures here and elective surgery cases go to Mildura or Wagga.’

He nodded, happy in the knowledge that he had Narranbool pegged. ‘And really serious cases would go to Melbourne to state-of-the-art equipment and experienced staff. It’s how the system works.’ He stood up, rinsed his cup and placed it on the drainer. ‘It’s midnight. I’ll take you home.’

Her brows pulled together as she swung her feet down onto the floor. ‘I should stay a bit longer.’

‘Vince is stable and in good hands with Esther and Ken. They’ve got my mobile number and if his condition deteriorates they’ll ring. I’ll visit him in the morning before the service, and check the results for Helicobacter pylori. I imagine that’s the culprit causing the ulcer, and if so I’ll start him on combined antibiotics.’

He gently took her empty cup from her hands. ‘So now all you have to do is go home and crash.’

Luminous eyes stared up at him, clear and penetrating. He expected her to object, and decided to pre-empt her and not wait for the words of refusal to pour from her amazing mouth. A mouth that could go from a pout to a wide smile in a heartbeat. ‘Tomorrow is going to be a long day and—’

‘That sounds like a good idea.’

Amazement rocked him. ‘Pardon?’