even consider him to be a friend.
But how could she not be aware of a bond that went so far past the normal interaction of a registrar and consultant? Had he been so good at hiding the gradual development of his feelings that Holly, and any onlookers, assumed they simply shared a passion for their work that made them inseparable during working hours?
It was entirely possible, Ryan realised as their case for the morning got under way. Their twelve-year-old male patient had had a congenital lesion of aortic stenosis treated by a balloon valvuloplasty in infancy but residual stenosis and incompetence had led to an increasingly severe degree of symptoms which meant it was no longer advisable to wait until growth had completely stopped before replacing the valve. Besides, young Daniel was also very keen to play rugby and strenuous activity had so far been denied him because of the risk of sudden death. If all went well with the new valve he was going to receive today, his life would change considerably for the better.
It was a technically challenging procedure due to the congenital malformation of the valve but Ryan was more than happy to keep up a running commentary and answer Holly’s eager queries.
‘We make the transverse aortotomy about fifteen millimetres above the level of the right coronary artery. We don’t want to be any lower because that can jeopardise the artery and create problems in seating the valve.’
‘What happens if you go higher?’
‘Not much. It’s easy to angle down and any lip can be retracted.’
That was typical of Holly. She had always demonstrated the ability to determine all possible alternatives to any course of action and weigh up the potential consequences. She was sharp enough to do it almost instantly and it was a skill that would stand her in very good stead when she got to be a consultant surgeon herself.
If she got to be a consultant surgeon.
Given a technical problem, Ryan was confident that Holly could make a correct choice of an appropriate course of action. He spared a very fleeting moment of concentration to wonder why she couldn’t apply the same skill to a personal arena.
Maybe she would. Maybe Holly just needed some time to get used to the idea and if he didn’t push her she would be able to view it as an independent choice and find a way to get past what she saw as unacceptable potential consequences.
All he could do was wait. And hope. And help her to do what she wanted to do with her life as far as he was able or allowed to help.
‘You did such a good job on that patch yesterday, Holly,’ he said, when the more technical aspects of preparation had been completed. ‘How about tackling part of this prosthetic valve insertion?’
She was feeling a lot better today. The sparkle Ryan detected in the dark eyes that flashed up to meet his held no hint of any doubt in her own ability. Or any desire not to be given that level of responsibility. Holly was eager to spread her wings again and Ryan only too happy to support her.
As he always would be, given the chance.
Never mind anything too personal. As Ryan guided Holly through what was a new procedure for her, he was very aware of how much less satisfying his job would be without Holly to share his fascination in operating on what was, for them both, at the top of the list of the vital organs humans possessed.
There had to be a way to secure a future for Holly because Ryan didn’t want to even consider the alternative.
And he wouldn’t. Not yet.
‘MICHAELA! Hello, sweetheart!’
Holly’s intended destination, to visit Daniel who was back in the ward only three days after his aortic valve replacement, simply had to be postponed. Michaela Brown had never been one of Holly’s patients but the tiny thirteen-year-old was a favourite and sadly one of the most frequent inpatients in the cardiology ward.
There was an empty chair beside the one Michaela was using in the central corridor. Holly sat down on it.
‘What are you doing here?’
‘I had…to come back in.’ The blue tinge to the girl’s lips was obvious despite the nasal cannula leading to the portable oxygen cylinder on the floor beside her chair. ‘My kidneys aren’t…working so well.’
‘Oh.’ Holly’s face scrunched into lines of sympathy. Michaela’s heart failure had been getting less and less responsive to the raft of medication she was on. Renal failure could be a sign that they were getting near the end of the road but Holly had to squash her dismay before that could show on her face so she smiled instead. ‘That’s no good, hon. But what I meant was, why are you sitting all by yourself in the corridor?’
Michaela was never alone. At least one of her parents was always close by and her twin five-year-old sisters were devoted little shadows whenever possible. It had been the bond between the small, identical versions of Michaela and their big sister that had first attracted Holly’s attention a year ago but it hadn’t taken long to understand why this girl was the sun that the whole family orbited.
Huge blue eyes beneath a mop of golden curls gleamed with sheer joy in response to Holly’s query. It didn’t seem to matter that every breath was a struggle to provide oxygen to the inadequate level of circulation her failing heart could provide.
‘The twins are…making a surprise. I’m not…allowed to see.’ Michaela took several quick breaths and then lowered her voice. ‘I think it’s…a picnic…on my bed.’
Holly stood up and peeped through the small square window in the door to the nearest single room. Sure enough, two small girls were arranging paper plates holding bite-sized treats like fairy bread and grapes. Their mother, Robyn, was pouring soft drink into plastic cups.
‘Is it…a picnic?’
‘Not telling.’ Holly grinned and sat down again. ‘How’s school going?’
‘Good. I miss heaps, though.’
‘You’re more than smart enough to catch up. How’s Toby?’
‘He’s good, too. But I’m not riding…just now.’
Of course she wasn’t. Michaela had been a star junior rider in the pony club until a year ago. The rare complication of an ordinary viral illness had given her congestive cardiomyopathy—a dilated, floppy left ventricle incapable of pumping blood effectively.
Michaela had not come under Ryan’s surgical firm’s care because the only surgery that could help was a heart transplant. The cardiology team was doing its best to keep her alive in the hope of that happening, but the chance that Michaela could ever ride her beloved pony, Toby, again was slim at best.
Her pets had always been a favourite topic of conversation, however.
‘Does Toby still like eating jelly snakes?’
‘Yeah…I’ve got a…new kitten now.’
‘Oh, cute! What colour?’
‘Black.’
