Challenging Dr. Blake Page 11

  Immediately she wanted to ask him if he was inviting her so that he could watch her, but bit back the retort, telling herself not to be paranoid.

  ‘Yes,’ she agreed, ‘I would like to do that.’ Since theatre work was her specialty, she knew that he would have no reason to find fault with her. Don’t get paranoid, she admonished herself again. That was the last thing she needed, on top of the guilt of being alive while Dominic was dead, as well as having the dreams to contend with.

  Even so, as she followed him out to the reception area, she found herself agreeing with Terri that he did arrange things so that she was spending an inordinate amount of time with him, and again the sense was growing that she couldn’t put a flattering connotation on that.

  ‘We’ll go up to the labour room first while I take another look at my patient. Come up to the OR with us, Terri,’ Dan was saying. ‘It looks as though we have a C-section to do, and you may as well help the circulating nurse and see how things are done in a very small community hospital, especially as I know you come from a high-powered teaching hospital.’

  ‘Thanks,’ Terri said. ‘I’d like to. The clinic nurse just came back, so I’m ready.’

  ‘I’ll tell her where we’re going. My other patients will have to wait,’ Dan said. ‘Tomorrow you two should spend time in the emergency department, to see what types of accidents we get here, coming in from the backwoods and from the sea.’

  In the operating rooms Signy and Terri changed into blue scrub suits, then walked down a short corridor to the designated room where the operation would take place, Dan having decided that they needed to operate right away. Just as Dan came out of the room to meet them at the scrub sinks, Max came out of a room opposite.

  ‘Ah!’ Max exclaimed with exaggerated delight, coming over to Signy and Terri and putting his arms round their shoulders. In his green scrub suit he looked every bit the part of the dashing surgeon. ‘I do love having you girls here. You bring a breath of fresh air to this backwater.’

  Terri grinned, lapping it up, though evidently taking Max with a pinch of salt, while Signy found his company relaxing after the odd tension of being with Dan, the apparent complexity of his character. Max was more of a type, or so she thought, and therefore more manageable.

  Dan viewed this little scene with a wryness that was almost comic, and Signy suppressed a grin. Getting along well with all and sundry was part of the job, a skill that one had to learn, sometimes painfully, sometimes only understanding in retrospect what one had learnt.

  ‘Go to it, girls!’ Max said, waving them goodbye as he strode, in all his masculine splendour, down the corridor.

  ‘Saving lives and fighting disease,’ Terri commented as they watched him go, not caring that Dan was there. ‘Wow! He’s cute, but if there’s one thing nurses hate it’s being referred to as girls.’

  ‘Here, girls,’ Dan said, grinning at them, ‘come in here to the scrub sinks and get suited up.’

  In a small anteroom they all donned caps and masks. ‘Get yourself in there, Terri,’ he went on, ‘and help the circulating nurse, her name’s Patty. The patient’s already on the operating table. Her name’s Mrs Weaver—she prefers that to being addressed by her first name. The anaesthetist’s there, ready to go. We’re going to give her a general anaesthetic. We’ll prep the operating site before he puts her under. Signy, you get scrubbed here with me.’

  When they were alone, Signy began the scrub process.

  ‘There’s something you said to me this morning, Signy,’ Dan said quietly, standing next to her as he tore open a pack containing a sterile scrub brush, ‘that I’ve been thinking about. You said that the system failed Dominic Fraser. I made some enquiries by phone today to the headquarters in Vancouver. The system didn’t fail him, Signy. He failed himself. It may seem unkind, and perhaps irrelevant, to say that now, but sadly it’s the truth.’

  ‘I…don’t think this is the time to talk about it, Dr Blake,’ she said, while she felt as though her heart were contracting, as once again the image of Dominic as she had seen him in her dream, and so many times in real life, with the bush hat on, squinting into the African sun, came vividly to her. He had always been so full of life and a sense of adventure, revelling in the fact that he was on the continent where he had always dreamed of being. That energy and promise were gone for ever. It was unbearable. Signy found her agitation growing.

  ‘Maybe,’ Dan said quietly, soaping his arms. ‘I’ve been wanting to say it, and I couldn’t hold off any longer. Just think about the fact that he put you in danger as well. Not that you were a passive victim. We’ll talk about it some other time.’

  ‘He didn’t know I was going to hang around there,’ she said hotly, ‘at the medical station, waiting for him.’ By saying that, she had condemned herself out of her own mouth. ‘He had no way of knowing.’

  Dan merely looked at her sideways as he washed his arms, the expression telling her that he understood what had happened and why, that he had expected as much. ‘We’ll put it aside for now,’ he said.

  The thought came to her strongly that he’d said those things just before they were to do an operation, with her as the surgical assistant, in order to put her off her stride, to test her, to see how she shaped up under stress. Then she dismissed the idea immediately as being paranoid. Instead of the ready angry retort that was on the tip of her tongue, she bit her lip hard and bent her head to the task of scrubbing her hands and arms under the warm running water. The presence of Dan at the sink next to her, his arm a few inches away from hers, made her feel on edge, compounding the agitation she already felt.

  Their patient, thirty-nine years old and having her first baby, had been somewhat distressed when they’d seen her in the labour unit. She had been told that the labour wasn’t progressing and that she had a large baby that was in the breech position. As Signy went into the operating room to put on a sterile gown and gloves, she saw that Mrs Weaver was calmer now that things were in progress, so she went over to her to give a few words of encouragement.

  Electronic monitors recorded the vital signs of blood pressure, pulse rate, respiration, temperature and circulating oxygen. Signy took all this in at a glance as she shrugged into her gown, seeing also a foetal monitor in place which told them the vital signs of the baby inside the uterus.

  ‘We’re going to clean your skin and put some sterile drapes on you first, Mrs Weaver,’ Dan explained to her, as a nurse tied up his sterile gown at the back. ‘Then, when we’re absolutely ready to start, we’ll give you the anaesthetic.’

  Their patient, who had an oxygen mask over her nose and mouth as she lay flat on the operating table, could only nod slightly in understanding. Still in active labour, she groaned about every two minutes as a strong contraction hit her. Although the staff needed to hurry to make a start and to get the baby delivered as soon as possible, they went about their task very calmly and methodically.

  ‘This will be a little cold on the skin,’ Dan said, as the scrub nurse handed him a small container of iodine prep solution and a gauze sponge on a long metal holder. With long, even strokes, he swiftly cleaned the woman’s protuberant abdomen, then he and Signy draped her with large blue sterile drapes so that only a small portion of her abdomen was visible, the part where they would make the incision. All the while, the doctor who was to give the anaesthetic talked quietly to the woman, bending down close to her, letting her know what was happening.

  When the instrument tables were in place and the staff in their positions to start the operation—with Signy, as the assistant surgeon, on the opposite side of the table from Dan—he nodded at the anaesthetist. ‘Ready,’ he said quietly.

  From now, things would move quickly. While feeling a little nervous, as if she was somehow on trial, Signy had to admire Dan’s way of doing things so far. She did it grudgingly. His calm professionalism, his empathy with the patient, couldn’t be faulted. She took a deep breath and let it out slowly, willing herself to be calm.

/>   As the anaesthetist injected the drugs into the patient’s IV line that would put her to sleep, then intubated her and connected up the tubing to the anaesthetic machine, Signy armed herself with a large gauze sponge with which to soak up blood. The scrub nurse silently handed Dan a scalpel. Then the anaesthetist looked up from his expertly executed task and nodded.

  Dan quickly and smoothly used the scalpel to make a long horizontal incision through the skin at the lower end of the abdomen. Signy, letting out a pent-up breath on a quiet sigh, pressed her gauze sponge against the multiple small beads of blood that appeared instantly along the line of the incision.

  The baby, a large boy weighing just over eleven pounds, was alive and apparently well.

  ‘Wow!’ the scrub nurse and the circulating nurse said in unison as Dan eased the oversized baby by the feet through the incision he had made. As he did so, Signy quickly suctioned up amniotic fluid and blood that flowed out of the uterus at the same time.

  Holding the baby firmly by his ankles, with the other hand supporting his back, Dan put him down quickly and carefully into the baby resuscitation cart nearby so that the paediatrician, who was ready and waiting, could attend to him by sucking mucus from his throat and stimulating him to breathe.

  ‘Wow!’ Signy echoed softly, glancing briefly at the baby before she and Dan attended to the task at hand, which was to deliver the placenta from the uterus, prevent any unnecessary bleeding and to stop existing bleeding as much as possible. Then they had to sew up the incision in the uterus. Signy concentrated on suctioning and sponging.

  Just then the baby gave a tentative, gurgling cry, followed by two or three seconds of silence and a stronger cry. A collective wave of relief seemed to pass over the room, a lessening of tension. Thank God, Signy said to herself, the baby’s all right.

  ‘Well done, Signy,’ Dan murmured to her. ‘That’s great, keep it up. I could recommend you as an assistant surgeon.’ He had his hand inside the uterus, loosening the placenta, then easing it out. At the same time the anaesthetist injected an IV drug to make the uterus contract and to keep bleeding to a minimum. The scrub nurse passed up a stainless-steel bowl for the large placenta.

  Warmed by Dan’s appreciation in spite of herself, she concentrated on what she had to do.

  Later, he said to her, his head bent down close to hers as they were suturing the incision, ‘Are you enjoying this?’

  ‘Yes,’ she said, her eyes meeting his briefly, ‘this is my element.’

  As though to complement her reply, the baby continued to fill the room with his lusty cries. When Signy allowed herself a quick glance at the resuscitation cart she could see his limbs waving about as he yelled, and that his skin had a healthy pink glow to it. She wanted to strip off her gown and gloves, to pick him up and cuddle him against her. He had, after all, endured much.

  Later on, she walked back to Dan’s cottage, grateful for the cool, fresh air on her face and arms. Wearing the comfortable trousers and blouse in which she’d travelled to Brookes Landing, she carried a light rain jacket with her.

  It had been a satisfying day, finished off with an early supper in the hospital dining room with the other nurses in her group. Dan still had work to do and had told her to go on alone to the cottage. After the Caesarean section she had gone to see Clark Jakes, the man who had been attacked by the cougar, and had found that he was in a small acute-care unit off the men’s surgical unit. He had been asleep, the sutured wounds on his face and neck uncovered to the air.

  ‘How is he?’ she’d said to a nurse in the unit.

  ‘He’s doing pretty well, except that he’s traumatized, as you can imagine, having been attacked and nearly killed by a wild animal in an area where he’s walked safely before,’ the nurse had said. ‘From now on, I guess he’ll be much more aware and careful. There are places where he won’t go without a shotgun.’

  ‘I can imagine,’ Signy had murmured, looking at the man’s face, which was swollen around the eyes and in the areas of the wounds where the skin was purple and red from bruising. The black silk sutures looked like so many miniature train tracks here and there on his face and neck.

  ‘We’re doing what we can to prevent infection,’ the nurse had said, indicating the intravenous line, ‘and he’s having anti-rabies shots just in case the animal was rabid. You never know. The other guy who was with him is a little worse off, he’s in the intensive care unit. They’ll both be all right, I’m sure.’

  Signy nodded and went, the feeling very strong in her that here they were very close to raw nature, where man didn’t always come off best in any confrontation. It was a sobering thought and it certainly cut one down to size…like Africa in many ways, yet different. Here, if you respected nature, understood it, took common-sense precautions, you could survive.

  On the way to the lobby she met Sal, the nurse from the operating room.

  ‘Hey, Signy!’ Sal called to her.

  ‘Hello,’ she said, feeling how nice it was that people recognized her and called her by her name after such a short while in Brookes Landing, even though she had mixed feelings about talking to the chatty Sal.

  ‘What happened?’ Sal had said breathlessly, coming up to Signy with an avid expression on her face.

  ‘Happened?’ Signy said, mystified.

  ‘With you and Dan Blake?’ Sal said, glancing round her as though they had a conspiracy going. ‘You did spend the night with him, didn’t you?’

  Signy laughed. ‘Not in the way I think you mean,’ she said. ‘He let me sleep at his house.’ She could imagine what Sal could do with the information if she told her that she had spent a good part of the night sleeping on a sofa, with Dan holding her hand. It would be all around the hospital, embellished, no doubt.

  They parted without any significant exchange of information.

  Now she enjoyed the walk, looked at the small, cosy houses nestled among conifers on quiet streets, separated and private from each other by the vegetation that surrounded them. The air was pure and scented with odours of moist soil and plants. There was moisture in the air, the promise of a gentle rain that kept the forests burgeoning with life.

  At the cottage she changed into her nightclothes and robe so that she could put her clothes into Dan’s washing machine, as he’d told her she could use it. Then she lit the log fire in the grate, which had been replenished by the woman who came in daily to clean Dan’s house. It was fun, poking around the little cottage by herself, looking into cupboards, finding the things she needed to make herself a hot drink. She intended to have a long, luxurious bath, then sleep on the sofa by the fire before Dan came back.

  Sitting with her hot drink, staring into the flames of the crackling fire which gave off an aromatic scent from an unknown wood, Signy acknowledged that for the first time in a long time she felt the glimmerings of something she could only call peace. The voices in her head, which had seemed to nag at her constantly, were silent, the images muted, toned down by the immediate scenes of mountains, wild woodland and dark, brooding trees nurtured on rain and by changing seasons. They seemed to have the power to blot out the arid plains of Africa, the memories of dry, hot winds.

  The fire was still crackling when she woke up, and Signy had a sense that someone had put more logs on it. Immediately alert, she watched the firelight dance on the vaulted roof of the sitting room, where the massive rough-hewn beams were exposed. Someone was moving about in the kitchen.

  She had intended to get up and dress before Dan came home, but it was obvious that she had slept on. It was dusk, and a light shone into the room from the kitchen. She swung her feet down onto the wooden floor, on which colourful woven rag rugs were scattered here and there.

  ‘Hi.’ Dan stood in the doorway of the kitchen. ‘I was just contemplating whether I should wake you to find out if you want supper.’ He looked tired, serious, wearing utilitarian cotton trousers and an open-neck shirt.

  There was something about his lean yet muscular frame that m
ade him look as though he was ready to spring into action at any moment, Signy thought, whether it was to reach for a shotgun to fight off a wild animal or to jump into a vehicle to drive to the hospital at a moment’s notice.

  Looking at him, Signy doubted whether anything very much took him by surprise. She could also imagine that he could have his life planned down to the last detail almost and that, while he liked women and, no doubt, needed them to a certain extent, he would be very much in control of himself. That insight came to her swiftly, out of the blue, in those unguarded moments that often came to one after a refreshing sleep. Perhaps it was small wonder that he and the beautiful Marianne Crowley hadn’t seen eye to eye. Signy also felt the irony of sharing a cottage with this man who had a strange link with her past.

  Dan’s eyes ran over her, from her mussed-up hair down over the robe to her bare feet. Involuntarily, his regard sent a rush of heat over her, and she instinctively pulled the robe closer around her body, castigating herself for not having woken sooner. She tried, by an act of will, not to let that flush reach her cheeks.

  ‘I…um…I had supper at the hospital, thank you,’ she said formally, pushing untidy stands of hair out of her eyes.

  ‘A mug of hot chocolate, then?’ he offered, lounging against the doorframe, still looking at her intently, ‘since it’s a little cool now that the sun’s gone.’

  ‘That would be very nice.’ She felt she had to force the words out. She was experiencing the odd feeling of trying to hate him for his part in what had happened in Africa yet admiring him for the work he did in this place. These ambivalent feelings were aroused in her because he was an attractive man, in spite of the twisted nose and the slightly gangsterish demeanour, as though he ought to have a gun in a holster slung low on his hip.