huge bottles filled with the fluid needed for the machine. A chest of drawers beside that held saline and tubing lines. A trolley with slide-out trays housed alcohol wipes, needles, tapes, dressings and all the other paraphernalia that went along with home dialysis.
The routine of setting up was automatic. Inserting the two needles into the surgically enlarged vein on her forearm was virtually painless. Now all Holly needed to do was wait. In a matter of four to six hours, the entire volume of blood in her body would have passed through the dialysis machine at least six times, having waste products and excess fluid drawn out.
Holly often used most of this time to sit, propped up by pillows, in her bed, studying or catching up on journals. She had brought home a textbook she wanted to read, detailing the latest techniques in arterial-switch procedures such as baby Grace would need to undergo shortly, but she simply couldn’t find the energy or enthusiasm to open it.
On top of a physically challenging day, Ryan’s offer had left her utterly drained and Holly would have to sleep while the machine did its life-prolonging magic tonight. It also seemed the only way she could turn off the endless treadmill of the thoughts that interview with Ryan had sparked. Tomorrow she would feel so much better she’d be able to carry on as normal. And, with a bit of luck, Ryan’s offer wouldn’t change anything other than her appreciation of what a kind person he was.
The call to the intensive care unit came as Holly stepped through the front doors of St Margaret’s at 8 a.m. the following day. Rather than waste time by finding a phone to contact the unit staff, Holly just kept going. It was so good to be able to move along the still quiet corridors and feel as if she was walking normally and not pushing her body through air that felt as thick as treacle. At this rate she would be actually in the unit by the time she would have completed a phone call.
The speed of Holly’s response had far more to do with her renewed level of energy than the early morning absence of obstacles caused by people or equipment, and she took full advantage of the physical strength, bypassing any wait for a lift and heading for the stairs.
It had to be Callum that was causing concern in the unit and the page had been urgent. Hearing footsteps far more rapid than her own behind her on the stairs was frustrating. Dialysis might be magic but it couldn’t work a miracle, like giving her the sudden ability to race up stairs two at a time as someone else was obviously doing.
‘Holly!’ The steps slowed to match hers and Ryan’s smile was delighted. ‘You must be feeling a lot better to be using the stairs. That’s great!’
Holly just nodded, not wanting Ryan to know that climbing stairs half as quickly as him had left her somewhat breathless. He held the door open as they reached the second floor.
‘You’ve been paged by ICU?’
She nodded again.
‘Any idea what’s going on?’
‘We’ll soon find out.’ Holly’s words were clipped but not just by lack of breath. She was fighting a dread that her first VSD repair might be going pear-shaped. Had her stitches not been quite deep enough or sufficiently close together? Was Callum bleeding around his heart and suffering a life-threatening tamponade? Respiratory failure or a hypertensive crisis? Had he spiked a fever or developed renal failure?
Ryan touched her arm as they reached the unit. ‘Don’t worry so much,’ he said. ‘Whatever it is, we’ll sort it out. Together.’
Ryan’s reassurance, even his presence, was kind of like dialysis for her soul, Holly thought wryly. Fears and insecurities got filtered out and confidence renewed. She could focus and perform and not be intimidated when pushed to voice her own opinions.
Such as what she thought about the concern raised by Callum’s heart rate and rhythm. Disturbances were frequent following open heart surgery and fortunately the abnormal pattern being recorded on Callum’s ECG was not immediately life-threatening.
‘It’s supraventricular,’ Holly said in response to Ryan’s raised eyebrows. ‘The drop in blood pressure is most probably rate-related.’
‘How do you want to manage it?’
‘I’ll consult with Cardiology,’ Holly decided. ‘It’s A-fib so adenosine is probably the drug of choice. If it continues, a digoxin infusion should give us sinus rhythm again or drop the ventricular rate, but that‘s much slower. If neither works, we’d need to look at other anti-arrhythmic agents or a DC conversion.’
A telephone call to one of the cardiology consultants led to a rapid instigation of treatment, but by the time Callum was showing a good response and his anxious parents had been soothed, Ryan and Holly were running late for their 9 a.m. theatre start time.
‘Slow down,’ Ryan complained as they made their way to the changing rooms adjacent to the operating theatre suite. ‘I’m not as young as I used to be.’
‘Neither am I.’ Holly threw a quick grin over her shoulder. ‘I turned thirty last week, you know.’
‘No, I didn’t know.’ Ryan quickened his pace to walk alongside her. ‘Hey, happy birthday—belatedly.’
‘Thanks.’
‘Was it a good party?’
‘I didn’t have a party,’ Holly said quickly. She certainly didn’t want to add to any unfortunate impression she might have given yesterday that she didn’t like Ryan enough to consider him a friend and therefore he hadn’t been invited to any party she had held. ‘I didn’t really feel like celebrating my slide into middle age.’
Ryan snorted. ‘I’m thirty-six,’he said indignantly, ‘and I don’t consider myself anywhere near middle-aged, thank you.’ He pushed open the door leading to the male side of the changing-room complex then paused. ‘Don’t you like parties?’ he asked curiously.
‘I like other people’s parties,’ Holly told him lightly. ‘Not mine.’ She grinned again. ‘That way, I don’t have to clean up the mess.’
Inside the changing room, Holly’s face stilled as she sighed. Why had she started that conversation in the first place? Reaching her fourth decade should have been worth celebrating. The trouble was, in her case she wasn’t just marking a significant milestone in the passage of time. It would have been more a celebration that her time hadn’t run out.
Yet.
Why hadn’t Holly wanted a party to celebrate such an important birthday?
She should have had candles and a cake and people around to let her know how special the day was. How special she was. Ryan wished he had known. He could have given her a hug even, without stepping over the boundaries he observed so carefully. He should have known, dammit. He must have seen or signed papers that had to have had the date on them often enough. Perhaps he was closer to being middle-aged than he suspected and was developing a selective memory.
Pulling on white rubber theatre boots, Ryan moved to the dispensing box on the wall of the changing room to pull out the disposable bootees to cover the boots’ soles. Then he plucked a hat and mask from adjoining boxes.
He was feeling older today. Older and wiser.
He’d gone about it all the wrong way and he’d tried so hard to do things just right, too. To keep it all on a kind of professional basis so that Holly would not be influenced by
