going to operate?’ she exclaimed.
‘Of course.’ He frowned. ‘Although I’m not sure where would be the best place to use. One of the bedrooms would be easiest but the lighting is too poor for this kind of intricate surgery.’
‘You mean that you’re going to operate here?’
‘Yes. It’s far too risky to take him to the hospital. Matthias warned me that we mustn’t drive around at night so we’ll have to make do with whatever facilities we have here and simply hope for the best.’
‘I see,’ she murmured, trying to get her head round what was going on. Obviously Adam was less concerned about the injured man being a terrorist than he was about saving his life, so she made herself focus on the problem of finding a suitable place to use as a makeshift operating theatre. It would need to be somewhere with decent lighting, as he’d pointed out, and it would also help if they had access to water for washing.
‘How about the dining room?’ she suggested. ‘The lighting isn’t too bad in there and we have direct access to the kitchen. We can use one of the tables as a temporary operating table, too.’
‘Good choice. Can you get everything set up while I bring him inside? I just need to stop this bleeding before I move him.’
‘Here.’ She quickly unbuttoned her blouse and handed it to him, thankful that she’d decided to wear a T-shirt underneath and was still decently covered up.
Adam chuckled as he took it from her and bound it tightly over the wound in the man’s shoulder. ‘It should have been a petticoat, by rights, of course.’
‘Like in all those old western movies? Every time someone got shot, the heroine would start ripping up her petticoat for bandages. Unfortunately, it’s not quite what the modern woman wears,’ she told him pithily, and he laughed out loud.
‘Sadly not. Jeans and a T-shirt seem to fit the bill nowadays for most occasions.’ He smiled up at her, his green eyes sparkling with laughter, and her breath caught because the change it brought to his expression was enough to make her heart race. ‘Still, some women manage to look good no matter what they wear.’
Kasey wasn’t sure if the compliment had been aimed specifically at her or if it had been a general observation, and didn’t allow herself to speculate. There really wasn’t time to think about it right then, despite how tempting it was. She made her way back inside the hostel where she was greeted with relief by the rest of the team, who’d heard the commotion and had gathered in the hall.
She quickly explained what had happened, carefully omitting any mention of how Adam had tried to protect her after that first gunshot. However, she saw the speculation on several people’s faces when they realised that she and Adam had both been outside when the shooting had started and knew they were putting their own interpretation on the facts.
Kasey didn’t attempt to correct them—she knew it would probably make matters worse if she tried to explain that they hadn’t arranged to meet in the grounds of the hostel—but it was unsettling to know that she and Adam were being linked together like this. It was an added pressure she could have done without but, fortunately, there was too much to do to worry about it. As soon as she’d sorted out some volunteers to help, she headed for the kitchen to get everything ready.
‘We’ll use one of the tables,’ she instructed, pointing to the largest of the refectory tables. ‘If you can move it directly under the central light fitting, that would be best.’
Daniel and Alan Jones, their radiographer, immediately set to and moved the heavy table into position while she and June went to find some theatre drapes and dressings. Their equipment had been piled into one of the empty storerooms off the kitchen and it didn’t take them long to sort out what they needed. Kasey also collected a set of sterile surgical instruments, although she didn’t break open the pack but just placed it on a nearby table. Adam could open it once he was ready to operate.
‘Everything sorted?’
Adam came into the room with the injured man draped over his shoulders. Daniel and Alan helped him lie the man on the table then he looked round. ‘Right. I don’t need all of you here so I’ll just take a couple of volunteers. June will you do the honours? And, Daniel if you could cover the anaesthetic?’
‘Excuse me?’ Kasey stepped forward, barely able to contain her annoyance at the way he had deliberately cut her out of the proceedings. ‘There’s no need to involve Daniel. I’m perfectly capable of handling this.’
‘You had a shock tonight,’ he replied curtly, walking into the kitchen and turning on the old-fashioned, hot-water geyser. ‘I suggest you get a good night’s sleep and give yourself time to get over it.’
‘Was that a suggestion or an order?’ she demanded, following him into the room.
‘It’s simple common sense.’ He pumped a handful of antiseptic solution out of the dispenser she’d placed there for them to use and lathered his forearms.
‘In that case, wouldn’t it be sensible if you excused yourself as well?’ She stared back at him, experiencing a pang of regret when she saw the flicker of annoyance that had lit his green eyes. There was no sign of amusement in them now. ‘You were shot at, too, Adam, don’t forget, so you had just as big a shock as me. If I’m not up to handling this job, neither are you.’
‘I shall decide whether or not I’m fit to operate.’
‘And I shall decide whether or not I’m fit to act as your anaesthetist.’
She stared back at him, knowing that if she lost this battle it wouldn’t be worth her staying on in Mwuranda. If he didn’t trust her to do her job then she would have to go home. Maybe she could put up with his hostility on a personal level but she refused to compromise when it came to her work.
‘Fair enough.’
He inclined his head in brief acknowledgement then spun round on his heel. Kasey let out her breath in a small sigh of relief, only then acknowledging how important it was to her that she should be allowed to stay. She quickly scrubbed up and put on a gown then went back to the kitchen. June had set up a drip and was now cleaning the injured man’s shoulder with antiseptic solution. The rest of the team had gone back to bed, so all she could hope was that Adam’s apparent lack of faith in her hadn’t caused any long-term damage. It would be difficult to work with the other members of the team if they had doubts about her ability.
It was a sobering thought and it put her on her mettle as she began anaesthetising the patient. Without the aid of artificial ventilation equipment, she couldn’t administer a muscle relaxant otherwise the patient wouldn’t be able to breathe, so she opted for an anaesthetic agent and pain relief, administering the drugs via a cannula in the back of the man’s hand because it would be easy to top up the drugs throughout the operation.
The lack of modern equipment also meant that she would have to rely more heavily on physical signs to ensure the patient was maintained at a suitable level of unconsciousness. Increased sweating and salivation, irregular breathing, changes in muscle tone and eye movement were all indications that a patient was receiving an inadequate level of anaesthesia. She would also need to monitor his general status through his heart rate and blood pressure, so she would be kept busy, but she had no doubts about her ability to do the job. She was a first-rate anaesthetist and she intended to prove that to Adam and everyone else on the team.
‘I’ll
