didn’t appear amused. ‘It’s a temporary relationship. You know that a normal life will be entirely possible when you get a kidney transplant.’
‘Yeah.’ Impossible to keep her tone light now.
‘That’s it, isn’t it?’ Ryan looked as though he wanted to slap his forehead for being obtuse. ‘That’s what’s changed. I thought you brushed off that disappointment last month rather too easily.’
Holly couldn’t deny it. ‘It’s caught up with me now. To get that far…’ The disappointment cut more deeply than ever right now. ‘I kept telling myself it was better to have the plug pulled then than to go through the surgery and then have to wait to see if the transplant would work and then battling rejection and dealing with failure and the knowledge that another transplant would be that much more difficult, but I was kidding myself. To actually get prepped for surgery and then sent home was awful.’
‘The donor kidney was found to have kidney disease that hadn’t been diagnosed, hadn’t it?’
‘Yeah. Polycystic. Same as me. Ironic, eh?’
‘No.’ Ryan reached out to cover Holly’s hand with his own. He gave it a brief, gentle squeeze. ‘Incredibly disappointing. You’d waited so long.’
The empathetic touch would have been enough to generate tears in someone other than Holly, but Holly Williams had never cried about her illness. She had simply got on with the most important things in her life and refused to even consider letting it slow her down. Until now, anyway.
She touched the second pager she wore clipped to her pocket. The one that had only sounded once in all that waiting time. ‘It’s been more than two years,’ she said quietly. ‘I went on the waiting list as soon as I had to start regular dialysis.’
‘You haven’t fallen off the list,’ Ryan reminded her. ‘You’ll still be at the top. A compatible organ could come up any time.’
‘With my blood group? I’m O, Ryan—but in my case that’s not really O for ordinary.’
He smiled. ‘I could have told you that.’
Holly’s smile in return was wry. ‘I’m a universal donor but I can only receive from another O. And that’s just the blood group. There’s tissue and cross-matching factors to complicate things as well. Which reminds me, I’m due to send in the monthly sample today. Could you draw some blood for me later?’
‘Sure.’ Ryan had finished his coffee but he made no move to get up. In fact, he had a rather determined look on his face. ‘I’m glad the subject’s come up, actually, Holly.’
‘Oh?’ He was going to agree with her, wasn’t he? Had Ryan just been waiting for an opportunity to ease her out of her senior registrar position?
‘Yes. I’ve been giving your situation quite a lot of thought recently. Ever since that hiccup with the transplant last month.’
Holly waited, her heart sinking. He did want her to give up trying to work full time. He’d supported her so much for so long and the ace up her sleeve had always been that it was worthwhile because when she got her transplant she would make up for any inconveniences she had caused. They would never have such a committed and hard-working registrar on their team. Now Ryan could see, as she did, that holding out for the miracle a transplant could provide might be just a dream. The odds of it happening before she deteriorated further or even died suddenly seemed much smaller.
Almost non-existent.
The door to the staffroom opening at that point to admit one of the ICU nurses was a reprieve that Holly grasped with alacrity.
‘Sue, hi! How’s Callum doing, do you know?’
‘He’s good.’ The nurse sat down and opened a packet of sandwiches. ‘What are you two doing in here? I heard there was a blue baby on its way in.’
Holly’s gaze swerved to Ryan. ‘That baby must have arrived ages ago. Why haven’t we heard anything?’
‘I popped down to see her before while you were…getting the coffee. Sorry, I should have told you.’
Holly could feel the muscles in her jaw tighten. No. She should have been there as well. ‘So what’s the story?’
Ryan stood up, taking Holly’s coffee-mug to the sink along with his own. ‘Full-term baby girl. Nothing abnormal noted on foetal ultrasound. No murmurs but a loud second heart sound and she was still cyanosed on a hundred per cent oxygen.’
‘Transposition of the great arteries?’
‘That’s our pick for the moment. They’ve probably done the echocardiogram by now. Shall we go and see what they’ve found?’
‘Cool.’
Back to business as usual was fine by Holly. She was regretting having let the conversation become so personal. Her warm smile at Sue as they left the staffroom was, in some part, thanks for interrupting before Ryan had been able to ease into the subject of firing her, and Holly made sure their communication was purely professional as they threaded their way through the busy corridors of the large children’s hospital.
‘We don’t get a transposition very often, do we?’
‘Fortunately, no.’
‘Surgery won‘t need to be immediate, will it?’ The physical demands of the rest of Holly’s day were suddenly looking rather more manageable.
‘No, but it’s usually done within the first week or two of life, before the left ventricle becomes unable to handle systemic pressure. If it’s severe enough, they’ll need an interim measure to improve the cyanosis.’
‘A Rashkind procedure?’ Holly had no difficulty in sounding more than interested.
‘Ever seen one?’
‘No.’ Any residual despair at having her own physical weakness demonstrated so recently was chased away by excitement. ‘I’d love to, though.’
‘How much do you know about it?’
‘It’s designed to allow the systemic and pulmonary circulations to mix, isn’t it? They thread a double lumen catheter into the left atrium via the umbilical vein. A balloon gets inflated with contrast medium and then pulled back through the atrial septum to create a tear.’
‘Mmm. Strange business, this, isn’t it? We spend half our morning repairing a septal defect and our cardiologist colleagues might well spend half their afternoon creating one.’ Ryan was smiling at Holly. ‘I take it you’d like to go and watch if it goes ahead?’
‘Oh, could I?’
‘Absolutely. Good learning experience for you. To be honest, I’d quite like to go and watch myself.’
‘What about rounds?’
‘We’ll fit them in. We’ve got a consult to do in the ward as well. Another VSD who’s developing pulmonary hypertension.’
‘How old?’
