Chapter 4 #3
‘Follow me.’ Neil reached for her hand, his arm knocking the tray of slides on the bench beside her. It tipped, sending some of the precious samples Kate had collected over many years into a puddle of broken glass.
There were so many people moving now. Lewis was trying to marshal everybody to leave in an orderly fashion but some were desperately trying to finish or pause the tests they were running and others were moving equipment or samples to protect them in case the overhead sprinklers came on.
Many of her students were stuffing notes into satchels and trying to find their other personal items. Lewis was looking in her direction.
He looked pale, Kate noticed, and he was rubbing the top of his left arm as if it hurt.
‘Leave everything,’ Kate ordered. She could smell the smoke herself now. ‘There’s no time.’ She waited by the door to make sure everyone got out of the department, including Lewis.
‘Are you all right?’ she asked her boss as he joined the people filing through the door.
‘I’m fine. Let’s get going. It’s probably only some burnt toast or something but we can’t take the risk.’
They were all hurrying now. Kate heard a crash and the tinkle of more broken glass as something else was knocked over. More of her collection of slides? She could also hear the faint wail of sirens coming from a distance.
With her heart sinking, Kate followed her colleagues to the evacuation point. Her day had just officially turned to custard.
Connor was taking his time, scrubbing in with meticulous attention to detail.
His hands were already red from the pressure of the soap-impregnated bristles and now he was concentrating on the points between his fingers.
He could hear the familiar sounds of the operating theatre being set up – trolleys being wheeled into position, the clink of metal instruments being laid out.
Those sterile instruments would include a bone saw that Connor desperately hoped he wouldn’t have to use to remove the lower part of Estelle’s leg, but the MRI scan had been inconclusive.
He’d been hoping to see a well-defined margin to the tumour that would indicate that it had been slow-growing enough for the bone to respond to its presence.
If it had been there he could have been virtually certain that they were dealing with a benign growth and he could have gone into this surgery with justifiable optimism.
Instead, he had a gnawing anxiety that was uncharacteristic.
‘Hey, Connor.’ A nurse had his sterile towel ready for when he’d rinsed the soap from his hands and forearms. ‘I saw you the other night. You make a great pirate.’
Connor merely grunted, angling his hands under the stream of warm water. He didn’t want to talk about the other night. He was having enough trouble trying to stop thinking about it as it was.
Part of it, anyway.
The way Kate had looked at him. He’d been shocked, that’s what it was. One minute she was in his arms and he’d been encased in an extraordinary sensation of… of…
Connor sighed, reaching for the towel. No.
He still couldn’t define what that feeling had been.
It had held a warmth that had been pure comfort but also a thrill that had been a precursor of ecstasy.
Above all, there’d been a feeling of something being completely…
right. As if the last piece of the world’s most complicated jigsaw puzzle had been slotted into place.
He couldn’t summon up the sensation again so it had become even more elusive. Unattainable.
And ultimately desirable.
Not that there was any point in even thinking about it. It might have been there, but when Kate had pulled away and given him that look of horror, it had been doused as effectively as if someone had dumped a bucket of icy water on his head.
Had she felt it too?
But why would you run away from it?
Connor simply didn’t understand. Just like he couldn’t understand the random bad luck that a thirteen-year-old girl who lived to surf and dance might have to lose a part of her body that made it possible to live her dreams. The knot in his gut tightened a notch or two.
He could only hope for the best. And do his best for Estelle.
The technician from the pathology lab was already standing by, looking nervous in the corner of the theatre.
Well, she’d have to wait for a while to collect the specimen.
If Connor had been meticulous about scrubbing in, it was nothing compared to how he was about to tackle this potentially life-altering surgery.
He’d be sending a message that the most senior pathologist available needed to examine the specimen, too.
He would remove as much of the tumour as he could but the pathologist would have to X-ray and then thinly section the specimen to identify the lesional tissue.
It would be Connor’s turn to stand by then, in case the pathologist needed a bigger sample.
If there was any chance of a diagnosis that this was a benign osteoid osteoma, Connor was more than prepared to wait as long as it took.
It was a damn shame they were still dithering about finding the funding to have a permanent pathology area up and running right here in the theatre suite so that samples could be processed faster.
Mind you, if they did, they would have a pathologist in the department for every case like this and he might find himself working a lot more closely with Kate.
Would he want to see her almost every day?
No.
Yes.
Maybe.
Some time later, Connor decided he would be prepared to deal with having Kate close by for the convenience factor.
Waiting for the result took far too long.
Apparently there’d been a fire alarm in the basement area of St Pat’s because some idiotic kitchen hand had left a stack of tea towels on top of a glowing element on a stove.
Even after taking his time to remove the specimen, it had been a forty-five-minute wait to get the result phoned through.
And it didn’t take nearly long enough because when that result came through, it was the worst possible outcome. Estelle had an aggressive osteosarcoma and it extended beyond the margins of the bone already removed.
With a heart much heavier than the bone saw he requested from his scrub nurse, Connor moved on to the next phase of what was now a heartbreaking operation.
Kate surveyed the chaos that was still reigning in her laboratory.
Not only was there equipment out of place, but they were still cleaning up broken glass and someone was mopping up blood. Coming back for her possessions, Marie had slipped on something wet and had fallen, cutting her hand quite badly on a shattered test tube.
Technicians were coming up to her constantly asking what to do about tests that had been interrupted and whether new samples would have to be obtained.
The X-ray equipment had been malfunctioning when an urgent biopsy sample had come down from Theatre and it took a while to discover that a fuse had been tripped during the alarm with power being cut off to various points.
Kate had sectioned the sample herself and dismissed the students in favour of doing the diagnosis with her own registrar, Mark, because it was no longer a good time to include the young doctors in the process.
There was simply too much other troubleshooting that needed to be done.
It was at that point that Kate noticed Lewis again.
The head of department should have been in the same kind of firefighting mode she was in herself, restoring calm to the chaos in here, but he was standing to one side of the large area, looking preoccupied.
And… grey. He wasn’t rubbing his arm any longer.
Instead, he had a hand pressed to the centre of his chest.
Kate was by his side in seconds. ‘You’ve got chest pain, haven’t you?’
Lewis nodded.
‘Radiation?’
‘Left arm. And jaw.’ It sounded as if it was hard for Lewis to say anything. As if he was in excruciating pain. He was sweating, too. He had all the classic symptoms of someone who was suffering a heart attack.
‘Run,’ she ordered a young technician. ‘Find the nearest wheelchair or trolley. I’ve got to get Dr Blackman up to the emergency department. Try Medical Records.’
Wheelchairs were often abandoned outside the medical-record department after someone had delivered a heavy load of notes.
If she could transport Lewis herself, Kate knew it would be a lot faster than waiting for an orderly.
And time mattered if Lewis was having a heart attack.
With every passing minute more of his heart muscle could be being destroyed.
Her registrar was clearing an area near one of the microscopes she had been using with her students, clearly preparing to finish the bone biopsy examination.
Mark was fairly new to the department and the specialty but he was competent enough.
Nonetheless, Kate should sign the diagnosis off herself but…
But Lewis could be dying here. He was her boss. Her mentor. A dear friend.
And the technician had just rushed back into the lab with a wheelchair.
‘I’ll be back as soon as possible,’ Kate told Mark. ‘Carry on. If there’s any doubt at all about the diagnosis, wait for me.’
It didn’t take very long to deliver Lewis to the emergency department.
He was rushed straight into a resus area. An oxygen mask and electrodes were on him within seconds. A registrar was gaining IV access to administer pain relief and a nurse produced GTN spray and an aspirin tablet for Lewis to chew and swallow.
‘We’re onto it,’ the staff assured Kate as she stood watching.
‘Go,’ Lewis urged. ‘You’re needed downstairs.’
‘I’ll be back as soon as I can,’ Kate promised. ‘Hang in there.’
By the time she got back to the basement of St Pat’s, the results for Theatre Three had just been phoned through.
‘What was it?’
‘Oesteosarcoma,’ Mark told her grimly. ‘Classic. Late stage.’
‘What? But the X-ray…’ Kate cleared her stunned reaction with a single, sharp shake of her head. ‘Show me.’
Sure enough, the microscopic evidence was clearly that of an aggressive, malignant tumour.
That poor kid, Kate thought. Thirteen years old and she was probably going to lose her leg. Or would they wait and give her a course of chemo before operating again?
They?
It would be Connor holding the scalpel up there. He was a specialist in paediatric bone cancer. The best. At least the girl had the chance of having her life saved, if not her leg.
She still couldn’t believe it. She pulled the slide free from its clips, wanting to see another one. To gather more evidence. It was then that she noticed something that made her blood run cold.
A tiny dot on the corner of the slide. A marker. The kind she always used on the slides she kept for her teaching.
Time seemed to stop and yet Kate’s brain – and her hands – were moving at the speed of light. It took only seconds to confirm the worst. Somehow, one of her teaching slides had become mixed up with the new sample from Theatre.
The thirteen-year-old girl didn’t have a highly aggressive cancer at all. The tumour was benign and could be easily treated.
Kate ran to the phone and dialled the Theatre extension. The phone rang. And rang. What was keeping someone from answering? Were they all too busy? Doing an unnecessary amputation?
Kate shoved the phone at the nearest technician. ‘Wait till someone answers,’ she snapped. ‘Tell them to stop. They’ve got the wrong diagnosis.’
She couldn’t just wait. Kate ran for the door, unbuttoning her coat as she went so that she could move faster.
She was fit. Four flights of stairs would only take a minute. She would take them two at a time. Three, if she could.
This couldn’t be happening.
Not on her watch.
Connor had delayed for longer than he should have.
Looking at the MRI scans again. Trying to decide just how high up they needed to go to try and get past the potential spread of the lethal cancer.
He called in a paediatric oncology consultant to discuss whether to deal with the fracture and wait for Estelle to undergo a course of chemotherapy before the irreversible step of amputation.
But the decision had been made.
Connor picked up the bone saw and tested it.
The whine reminded him of a dentist’s drill.
Just before it hit an exposed nerve in a tooth.
For a few seconds the sound had drowned out the faint ring of the telephone in the technician’s booth that nobody seemed to be in a hurry to answer.
Grimly, he put the saw down and picked up a scalpel.
He needed to fully expose the bone he was going to be cutting through.
Scalpel poised, Connor was astonished to see the double doors leading into the theatre burst open.
Someone was standing there, holding a mask to her face with its unfastened strings dangling loose. She wore a white coat.
Unbuttoned, but it was obviously Kate. Her eyes were wide and frightened and she was panting so hard she could barely speak.
‘Stop…’ she managed. ‘You have to stop.’