her spleen removed, she might need a blood transfusion—which was unacceptable on religious grounds to most Jehovah’s Witnesses, who interpreted blood transfusion as the ‘eating of blood’. Autologous transfusion, where the patient’s own blood was salvaged during an operation and filtered, ready for reuse, was a possible solution, but some patients would find that unacceptable if the blood had left the blood vessels rather than being in continual contact with the patient’s own circulation.
There were alternatives, such as the use of recombinant human erythropoietin, a hormone that helped red blood cells to reproduce. This helped to avoid anaemia around the time of the operation. But it really depended on what happened during the operation.
Sophie bit her lip. She hated cases like this. Ethically, she was bound to defer to the patient’s wishes, but it was a grey area in the case of children. Children under the age of sixteen could consent to blood transfusions but couldn’t refuse one. But if the parents were staunch believers, the surgeon had to either abide by their wishes or apply to the courts. In an emergency Sophie knew she could give a child blood without legal consent—if she let the child bleed to death, apart from being against her personal ethics, it could leave her open to legal prosecution for negligence. But if she did give the transfusion, that would leave an emotional minefield.
It would have to happen on Andy’s day off. Guy was in Theatre. Maybe she could buzz through and get a lead from him. ‘I’m on my way,’ she said grimly, and replaced the receiver.
She pushed through the doors to leave the department, and almost walked straight into Charlie.
‘You OK?’ he asked.
She nodded. ‘ED called. There’s a twelve-year-old girl with a possible ruptured spleen and they want me to take a look.’
‘Complications?’
How had he guessed? Or did he respect her skill enough to think she could do a splenectomy without problems? ‘Mum’s religious beliefs. If I have to do a splenectomy, it’ll have to be without a transfusion.’
‘Ah. Just the mum, or the dad as well?’
‘I don’t know right now,’ she said honestly. ‘I’m guessing it’s both of them.’ If the girl’s father was of a different religion—one that didn’t have the same issues with blood transfusion—she might be able to get his consent. Which would be enough. She only needed the consent of one parent.
‘Want some back-up?’
She was tempted to say no, she could cope on her own; her pride said she shouldn’t accept help from him. Her common sense gave her pride a swift upper-cut. She would have asked Andy or Guy for help. Charlie was here, and he was senior to both Andy and Guy. So what was the difference? ‘Yes. Please,’ she added.
‘What are your plans?’ he asked as they headed towards ED.
‘I’m going to examine the girl and explain the situation to her parents—that I’ll do my best to do the operation without any transfusions, respecting their wishes, but if there’s a complication a transfusion might be unavoidable.’ She sighed. ‘It’s not my place to judge, but I just don’t understand how a parent could stand by and watch her child bleed to death.’
‘Most parents find it acceptable if you say you’ll do your best not to use a transfusion, but you won’t allow the child to die for want of a transfusion,’ Charlie said softly. ‘Besides, all treatment is confidential.’
‘I just hope they see it that way,’ Sophie said feelingly. ‘I’d move mountains for my child.’
For her child? Charlie’s heart missed a beat. Sophie was married? But he’d been so sure she wasn’t. He hadn’t heard anyone talk about her partner or children. He glanced surreptitiously at her left hand. A surgeon never wore rings to work, but maybe Sophie wore a wedding ring on a chain around her neck or something. He couldn’t see any band of pale skin on her ring finger, so maybe she was divorced. Single mum?
‘Boy or girl?’ he asked, trying to sound relatively cool.
‘Pardon?’
‘You said you’d move mountains for your child. I just wondered if you had a boy or a girl.’ Now he was beginning to wish he’d never asked. She’d think he was being nosy. And just why was he asking anyway? It was none of his business.
She shrugged. ‘I don’t have any children. I was speaking figuratively. My parents moved mountains for me—we couldn’t really afford for me to go to med school, despite the student grants and hardship funds, but they both took on extra jobs in the evenings to raise the cash. Mum cleaned and Dad did a few shifts behind the bar at the local pub, and I did bar work in the holidays and at weekends.’
Ouch. No wonder she’d been a bit hostile towards him. A lot of the medical students he remembered had come from rich backgrounds. But he couldn’t think of many whose parents would have made the extra sacrifices that Sophie’s parents had made. His mother certainly wouldn’t have. He, Seb and Vicky had had to fight all the way, too, to get to med school.
Not that he was going to share that with Sophie. He didn’t think she’d believe him somehow.
Her parents’ lack of wealth also explained why Sophie Harrison was so ambitious, so focused on her job. Clearly she wanted to show her parents that their sacrifices had been worth it. Again, he wasn’t going to tell her he’d worked that out. It would sound too patronising, even though he wouldn’t mean it that way. ‘I’d imagine they’re very proud of you,’ he said lightly.
‘I’m proud of them,’ Sophie responded crisply.
Family meant a lot to her. And he envied her for it. He was close to Seb and Vicky, though even that was a complicated mixture of sibling rivalry and watching each other’s backs. But his mother…They hadn’t been close for years and years. Since his father’s death. Maybe even before that, if he thought about it.
Not that he was going to. He preferred to keep that shut well away. Where it was safe.
‘Are you an only child?’ he asked.
‘Why?’
‘Just making conversation.’ Trying to find out more about her. Stupid, really. They’d never be anything more than colleagues. Probably not even friends. He’d noticed that she’d avoided his drinks night, when other colleagues who’d been off duty had turned up.
‘Yes. I think my parents wanted more, but they just weren’t lucky. You?’
She actually wanted to know something about him? He suppressed a flare of pleasure. She was probably just being polite. Making conversation. ‘I’m the oldest of three. My brother’s in emergency medicine, and our baby sister’s the clever one. She’s a brain surgeon.’
She looked at him, then, though he couldn’t tell her thoughts from her expression. ‘A brain surgeon.’
‘Yep. We tease her a bit—you know, “our sister, the brain surgeon”—but Seb and I are really proud of her. Vicky’s a brilliant neurologist.’
‘The gossip rags never talk about them.’
Then she looked horrified, as if she’d given too much away.
Charlie’s
