Mikki,’ he said in a world-weary tone. ‘For work I have to shut off my feelings so they don’t cloud my judgement. It’s hard to switch them back on again in my private life.’
His private life was a sore point and it made her sound a lot more resentful than she would have liked. ‘You didn’t seem to have too much trouble accessing your feelings the other night with Gabby or Tabby or whatever her name was,’ Mikki said.
‘You really are spoiling for a fight, aren’t you, Mikki?’ he asked.
Mikki opened her mouth to send him a scathing retort but he had already swung away to walk out of the office, almost bumping into one of the registrars as he left the ward.
‘Gosh, Mr Beck seemed rather annoyed,’ Kylie Ingram commented as she came into the office. ‘Has one of his operating lists been cancelled or something?’
‘I’m not sure,’ Mikki mumbled by way of reply, before excusing herself to answer her mobile.
* * *
‘We have four patients scheduled to come in tomorrow for Mr Beck’s list,’ Jane Melrose, an ICU nurse, informed Mikki as she came in for her shift a couple of days later.
‘Have we got the beds?’ Mikki asked, frowning as her gaze swept over the already full unit.
‘Not unless someone is transferred, discharged to the ward or dies,’ Jane said flatly.
Mikki pressed her lips together. ‘Then Mr Beck’s list will have to be culled. We’re stretched to capacity as it is and that’s not leaving room for any A and E admissions.’
‘I’ll call the theatre supervisor,’ Jane said and sighed. ‘Remind me why I work here?’
‘You get paid,’ Mikki said.
‘There’s got to be more to it than that,’ Jane said. ‘Aren’t I supposed to feel fulfilled and get a sense I’m making a difference?’
Mikki smiled. ‘We’re all making a difference, Jane. I’ll call the theatre supervisor. You go and have your tea break.’
Jane instantly brightened. ‘I just remembered why I work here. You are such a nice person to work with.’
‘It’s very sweet of you to say so, Jane, but I have a feeling I’m not going to be popular once I’ve made this call,’ she said as she resignedly picked up the phone in the office.
* * *
‘What do you mean, half my list has been cancelled?’ Lewis snapped at the theatre supervisor who had delivered the news.
‘I’m sorry, Mr Beck, but there are no available beds in ICU,’ the nurse said. ‘Dr Landon was most insistent.’
Lewis frowned. ‘So this was Dr Landon’s decision?’
‘Well, sort of, I guess,’ she said. ‘This stuff happens all the time. ICU is always full to the brim and the op lists have to be shuffled around a fair bit. If there’s no ICU bed post-op, you can’t operate. Some of ICU is contracted out to the private hospital next door, but the unit is too small anyway.’
‘I know how a co-located hospital works,’ Lewis said curtly. ‘I just don’t like having decisions made over my head without consultation with me. Which patients were cancelled? I should be the one deciding which patients are put off, not someone who has never seen the patients. I know who is the most urgent, I’ve done the work-ups, organised the preparation. I will be the one making that decision.’
‘You’ll have to take up that with Dr Landon,’ the nurse said, giving a nervous grimace before she left.
Lewis scraped a hand through his hair in frustration. He didn’t like being the ogre with nursing staff but his first week and a half at St Benedict’s hadn’t gone as smoothly as he would have liked. His office and consultation room were still being painted and fitted out, even though he had been promised they would be ready by the time he arrived, and now half his operation list had been cancelled by his ex-fiancée. Was she deliberately putting him in his place or was there a genuine bed crisis?
He went down to the unit but Mikki was nowhere in sight. He asked one of the registrars on duty, who informed him she had gone to the doctors’ room on the fifth floor for a coffee break.
Lewis took the stairs two at a time and shouldered open the doctors’ room door to find Mikki waiting for some fresh coffee to brew in the percolator on the bench next to a microwave and toaster. ‘Just the person I want to see,’ he said, pressing the door with the flat of his hand so it clicked shut.
Her tawny-brown eyes widened a fraction. ‘I take it this is about your list?’ she said.
‘I have four ill patients I need to operate on tomorrow,’ Lewis said. ‘What am I supposed to say to them now you’ve cancelled the surgery on half of them?’
‘We haven’t got the beds,’ she said. ‘The two we’ve given you don’t need ICU beds post-op. Didn’t Theatre Management tell you?’
‘Find the beds,’ he said, locking gazes with her, his mouth set in an intractable line. ‘I want those two operations to go ahead as planned.’
‘I can’t do that. The unit is full. We had two unexpected admissions from private overnight. That’s the two post-op beds gone. I’m sorry, but that’s just the way it is.’
‘Mikki, this is ridiculous,’ he said. ‘Surely there is a better way of managing this? Those two beds should have been earmarked for neurosurgical post-op. The private hospital should have sent their patients elsewhere. Aren’t there any patients you can transfer to another ICU somewhere else? Is there not one patient here you can wean off a ventilator?’
‘I can’t turn people’s ventilators off just because you need the beds,’ she said with a spark in her eyes.
‘I’m not asking you to do any such thing. There should just have been better communication over this, especially with me.’
‘Look, Lewis, the system is overstretched here. They should have told you that before you took on the position,’ she said. ‘It’s like this just about every week with every surgical speciality in need of high-dependency beds. There just aren’t enough ICU beds for every specialty. People have to be postponed, especially, it seems, public patients.’
‘Mikki, you know neurosurgical patients are nearly always high acuity,’ he said. ‘Surely I don’t have to bargain for beds every time I’m scheduled to do a list?’
Her eyes moved away from his as she poured her coffee. ‘Take it up with the hospital management,’ she said. ‘It’s not my problem.’
‘Have you even thought about a way to manage this better?’ Lewis asked.
She turned her defiant brown gaze on him. ‘It’s my job to keep critically ill patients alive. I don’t have the time to brainstorm on how to manage the hospital better. That’s Administration’s job.’
‘How many non-surgical patients do you currently have in ICU?’ Lewis asked.
‘Seven.’
‘How
