other benefit of being on night duty was that I could spend a bit more time with patients without the hustle and bustle of ward rounds and relatives visiting. ICU was quiet all but for the hiss and groan of ventilators or beeping of heart monitors and heart-lung machines.
I sat by Jason Ryder’s bed in the end room and watched as his chest rose and fell with the action of the ventilator. It was coming up to two weeks since his surgery and he was still in a deep coma, and every time we had tried to bring him out of it his brain pressures had skyrocketed. It wasn’t looking good but I refused to give up hope. I couldn’t get his wife, Megan, out of my mind. I could imagine how devastating it was for her to be expecting a baby at a time like this. The stress she was under wasn’t good for her or the baby. Studies indicated that high cortisol levels in expectant mothers could cause epigenetic changes in the foetus, leaving them at higher risk of heart disease or some types of cancers in later life.
And then there were Jason’s parents. I could imagine how my parents would feel if either Jem or I were in a coma. They would be frantic with worry, desperate for some thread of hope. No parent wanted to outlive his or her child. It wasn’t the natural order of things. Every time I looked at Jason’s parents I felt a pressing ache inside my chest, like a stack of bricks pressing down on my heart. I so wanted a good outcome for them and for Jason, who’d had such a bright future ahead of him.
I picked up the children’s book Jason’s parents had left earlier. It was one of my own favourites, The Indian in the Cupboard by Lynne Reid Banks. Apparently Jason had loved it when he’d been about nine or ten years old. I, too, remembered being captivated by the idea of a toy coming to life. I picked up where Jason’s mother had left off before they’d left for the night and read a few pages.
I looked up after a few minutes to see Matt Bishop standing in the doorway, watching me. I had no idea how long he’d been there. I hadn’t seen his name on the night-shift roster but, then, he might have been called in for a patient. I knew he worked ridiculously long hours. It had taken me quite an effort to avoid running into him. I even darted into the broom cupboard next to the doctors’ room a couple of evenings ago when I heard him speaking with a colleague around the corner.
I can tell you I got a bit worried when he stopped right outside it and talked to Brian Kenton from Radiology. I had a sneaking suspicion he might have known I was in there. He took an inordinately long time to discuss a patient before moving on. I felt a fool, sneaking out of there a few minutes later, but what else could I have done?
I put the book down on the bedside table and rose to my feet. ‘Did you want me—I mean something?’ I asked, mentally cursing the fact I was blushing.
‘How’s he doing?’
‘Much the same,’ I said. ‘His IC pressures spike every time I try to wean him off the ventilator. Stuart wants to keep them low to maximise perfusion of what might be marginally viable brain around the tumour bed. But before we ramp up sedation each time, there’s no sign of consciousness. He’s having another CT tomorrow to look at perfusion. And an EEG is planned after that.’
I handed him the notes, which he read through with a frown of concentration pulling at his brow. He drew in a deep breath, closed the notes and put them back on the end of the bed. He picked up the children’s book and turned over a few pages. ‘I remember reading this when I was about eight or nine.’
‘I read it too,’ I said. ‘I can tell you I never looked at a toy the same way again.’
His mouth curved upwards in a half-smile as he tapped the book against his hand. ‘So, this is part of your childhood awakening therapy?’
I searched his features for any sign of mockery but he was either keeping it under wraps or was genuinely giving me a fair and unbiased hearing. Or maybe he’d looked up some of the fledgling research online and was prepared to keep an open mind. ‘Reading familiar stories, playing favourite music, relating family memories of holidays or whatever to the patient can sometimes trigger an emotional response,’ I said. ‘There’ve been a few cases reported now where patients have woken from comas when exposed to something particularly emotive from their childhood.’
‘One assumes it would be beneficial to have a happy childhood in order to expect that sort of response.’
I frowned. ‘You didn’t have a happy childhood?’ I asked it as a question, but it could easily have been a statement of observation, given the way his features were set.
‘Not particularly.’ He put the book back on the bedside table before he gave me a little quirk of a smile. ‘What about you?’
‘Mostly.’ I gave him a rueful look and then added, ‘My parents are a little out there, if you know what I mean.’
‘I would never have guessed.’
I couldn’t help a short laugh escaping. ‘I’m ultraconservative compared to them. At least I turn up at work fully clothed.’
His eyes darkened as they meshed with mine. ‘What time’s your break?’
I glanced at my watch. ‘Ten minutes ago.’
He took my elbow with a firm but surprisingly gentle hand. ‘Come on. Boss’s orders. Caffeine and sugar.’
We took our coffee and a packet of chocolate biscuits to his office. I got the feeling this was his way of calling a truce. He pulled out his office chair for me to sit on. ‘Here, you play the boss for a while. Tell me how you would do things around here if you were me.’
I sat on his chair but I’m so short my feet didn’t reach the floor. I tucked my ankles beneath its centre stand and hoped he wouldn’t notice. I took a sip of coffee and looked at him over the rim of my cup. He was sitting in the chair I’d used the last time, his features showing the signs of the stresses of his job.
It looked like he hadn’t shaved in over eighteen hours, his eyes had damson-coloured shadows beneath them, his hair was ruffled, as if he’d recently combed it with his fingers, and there were two lines down each side of his mouth I hadn’t noticed before. I knew for a fact he wasn’t on that evening because I’d checked. After the broom cupboard hideout I wasn’t taking any chances. He had worked day shifts for the last week, presumably so he could keep in closer touch with the hospital management staff while he ironed out the problems he’d inherited.
It made me wonder if he had anything outside work to distract him. A hobby or interest that gave him some respite from the human tragedy he dealt with day in, day out.
He was a dedicated workaholic. The type A personality who found it hard to be anything but task-oriented. Emotions were not to be trusted. It was facts and data and completing the job that motivated him. I knew from my study how important it was to search for balance. I’m not sure I had found it, given the way things had turned out between Andy and me, but at least I understood the dynamic.
I was starting to realise why Matt had taken such a stand with me on that first day. For a man who valued facts over feelings I must have come across as a complete nut job. He wanted the unit to be one of the best in the country, if not the world.
No wonder he had taken the line he had with me. I was like a loaded cannon to him. Someone who was unpredictable, perhaps even—in his opinion—unstable. I had some ground to make up to make him see me as the dedicated professional I was. Sure, I wore wacky clothes and did interesting things with my hair, but that didn’t mean I wasn’t a competent and committed anaesthetist. I took my responsibility with patients seriously. I literally had their lives in my hands.
