in the doctors’ change-room at the end of a Friday list with a three-day weekend coming up. She had asked those present to pass the word around.
Most of her colleagues had been stunned, she knew, but they had three days to get used to the idea and to recognise the signals she was sending out. They knew her professional style by this time. Comments had been sympathetic and heartfelt, but mercifully brief…
Theatre Two was the exact twin of Theatre One, with all equipment and supplies set out in exactly the same way. This patient, a thirty-five-year-old woman with an uncomplicated medical history, had been given a pre-med through her drip and was already drowsy and relaxed, her considerable pain masked by the medication.
The appendix was notorious for sending out mixed signals, so Candace kept her mind open as she prepared to make the incision. You could open someone up and find nothing at all, even when a patient’s white cell count was up and all his or her symptoms slotted into place. Or you could find—
‘Good grief!’ she said.
She’d spotted it before anyone else. There was a tumour wrapped around the appendix, turning this operation from a routine excision into a complex feat of surgical technique.
‘It’s huge,’ muttered on-call assistant surgeon Mark Daley.
‘But still potentially benign,’ Candace said. ‘We’ll take it out straight away to send to Pathology, then explore a bit to see if there’s any obvious spread to other organs.’
She excised both appendix and tumour, then looked at the ovaries, which were the most likely sites for a primary tumour in a woman of this age. Fortunately, they looked healthy and normal. Neither was there any evidence of metastasis to the liver.
‘We’re looking pretty hopeful on this one,’ she concluded, and there was a sense of relief all round.
It was after three by the time Candace emerged from Theatre, and her stomach was aching sharply with hunger. She took another brief shower, grabbed a packet of potato chips from the vending machine in the emergency department, gulped some coffee and went straight in to check on the recovery of her day patients.
Mrs Allenby had eaten a sandwich and drunk some juice and tea, voided her bladder and shown a return of bowel sounds. She could manage a strong cough, her lungs were clear and she’d walked up and down the corridor a couple of times to assist her circulation.
‘But my shoulder is hurting,’ she said.
‘Your right shoulder?’
‘Yes.’
‘Strangely enough, that’s normal. Quite a common symptom. It’s called referred pain, and that’s really all you need to know about it, Mrs Allenby. It should go away on its own by the end of the day. You’ll probably notice some discomfort from gas as well. Your stomach doesn’t like being manhandled, and it may take a couple of days to settle down. But the surgery went very well, and I’m not anticipating any problems. Dr Colton would like to see you in his rooms in about a week to check on how you’re doing.’
‘I’ll make an appointment.’
‘Meanwhile, you can go home as soon as you’re ready. You have someone to pick you up?’
‘My husband’s waiting.’
‘Great! All the best, then. You were special, you know—my first patient in Australia.’
‘Oh, how nice!’
Mrs Allenby went to the patients’ change-room to dress, while Candace checked on her two hernia patients, who were both progressing normally but still too groggy to leave. As she slid her stethoscope around her neck, Candace heard Mrs Allenby say to a nurse, ‘All right, I’m ready. Do I get my stones now?’
She hid a smile as she crossed to the three-bed recovery annexe where Andrea Johnson was just emerging from her anaesthesia. Steve had predicted his patient’s interest in ‘her stones’. In a relatively small community like this one, where a patient’s GP could also be present during surgery, there would be more examples of this kind of knowledge. As Mrs Allenby had said in a different context, it was ‘nice’. A difference for Candace to enjoy while she was here.
Andrea Johnson was still very sleepy and disorientated. She was lying on a wheeled hospital bed a few metres from the other patient in Recovery, the Caesarean delivery from Theatre One.
‘Hurts,’ was all she wanted to say. ‘Feels awful.’
Candace ordered some additional pain relief, and out of the patient’s earshot said to the recovery annexe sister, ‘She’s not ready to hear about what we found and what we did.’
‘Wait until she goes upstairs?’ Robyn Wallace suggested.
‘Definitely. My notes are pretty clear, I think. I’ll follow up in the morning and answer any questions she’s come up with. If she seems too groggy to be told tonight, it can wait. And, of course, there’ll be a wait anyway for the pathology results. Does she have family here?’
‘No, she’s single apparently. Drove herself in.’
‘There must be someone to tell. Could you try and find out?’
‘She was probably in too much pain to think about next of kin before.’
‘That’s usually when people want family or a friend around.’
‘True.’ Sister Wallace nodded.
‘What have we got here? Two for the price of one?’ said a new voice just behind them.
It was Steve. As anaesthetist, he was technically responsible for any complications in patients for the first twenty-four hours following their surgery, and he’d be taking a look at the two hernia patients as well as the Caesarean delivery he’d just been involved with.
Candace didn’t understand his comment about two for the price of one. She assumed it was another Australian joke, but Sister Wallace looked blank as well.
‘They’re both my patients,’ he explained. ‘Sisters. And there’s a whole posse of other Johnson and Calvert relatives upstairs, waiting to see Carina and the baby. Should probably warn you,’ he added quietly to Sister Wallace, ‘sparks will fly if they each realise the other is here. Andrea and Carina don’t get on. Andrea seems to have cut herself off a bit lately.’
‘I’ll keep that in mind, and pull a curtain across,’ Sister Wallace drawled.
‘Speaking of getting on,’ Candace said lightly, ‘I’m heading off. It’s been an interesting first day, but I’m done now.’
She should have known it wouldn’t be that easy. Steve caught up to her as she reached her car.
‘Heading straight home?’
‘Yes, thanks to the existence of the frozen meals we picked up the other day, I don’t need to stop for anything.’
‘Frozen meals! Yum!’ he drawled. ‘How about steak instead?’
‘Too hungry to wait for steak.’
‘I’ll
