we operate. She can do really intricate close-up stuff so everything I do goes straight down the line to Sydney and I get immediate feedback.’
He’d organised all this while she’d been in the shower?
‘I … You’re not a surgeon?’
‘I’m a family doctor,’ he told her. ‘I’m two hours away from back-up. I’m everything. If you weren’t here—if I didn’t have an anaesthetist—then I’d count this impossible. But we have enough going for us now to hope. So what are we waiting for? Let’s go.’
Afterwards, when Rachel was asked to describe what had been done, she’d simply shake her head. How they did it … It was impossible. All she could describe were the technicalities, and they were impressive enough.
They had a speaker-phone mounted just beside the table. Every sound they made went straight down the wire to Sydney.
Jane Cross, a woman in her forties, looking crazily incongruous with theatre garb covering a purple caftan and a mass of jangling earrings dangling beneath her theatre cap, directed a video camera straight at the wound.
‘You promise you won’t faint?’ Hugo had asked the middle-aged woman as she’d set up the equipment, and Jane had regarded Hugo and Rachel with incredulity. Even with a hint of laughter.
‘What, faint? Me? When I’ve got a captive audience? I intend to faint at least three times and I’ll probably throw up too, but later. Not until I’ve done my job.’
She was wonderful, Rachel decided. She was right there behind Hugo’s hands, but somehow she had the skill and the sensitivity to stay clear enough for his fingers to do their work.
The pictures she took were via a digital video camera linked to video conferencing equipment. In Sydney Joe Cartier had a clear view—and Hugo was asking questions every step of the way.
Rachel couldn’t help him at all. She had her own battles. She wasn’t a trained anaesthetist—she’d done basic training but that was all—and Kim was so severely shocked that just keeping her alive was a major battle.
She worked with a phone link, too. They’d run out of phone lines but Jane’s partner, a dumpy little woman in jeans and sweatshirt, sat in a corner of the theatre where she didn’t have to see—her stomach was evidently not as strong as Jane’s—and relayed Rachel’s questions down the line to an anaesthetist in Sydney.
‘Minimal anaesthesia for such a shocked patient,’ the specialist told her, working her through a careful, haemody-namically neutral induction method. He worked through her needs with her and Rachel wondered that such a small hospital could meet the requirements he snapped down the phone.
It could. For a tiny hospital Hugo had brilliant equipment. It was stunning that they had sufficient blood supplies on hand, but there was so much more. Rachel had blood on request, she had plasma, she had saline and a team outside the theatre was warming all the fluids before she even saw them.
The fluids weren’t the only thing being heated.
‘Keep the patient warm at all costs,’ the anaesthetist barked down the phone, and warmed blankets appeared like magic to cover every part of Kim’s body that Hugo didn’t need to work on. After that one instruction Rachel didn’t need to worry about warming—the blankets were replaced every few minutes by freshly warmed ones handed through the door. There must be a hive of industry out there.
It was an amazing scene. As well as the unseen industry outside, they had two nurses working with them in the theatre.
Elly was a competent middle-aged woman, white-faced and shocked because she was best friends with Kim’s mum, but that fact wasn’t allowed to get in the way of her professionalism. Then there was David, a ginger-headed kid who looked like he was hardly old enough to be qualified—but was magnificent under pressure.
They were all magnificent under pressure, Rachel thought. The whole town.
And Hugo …
What was being asked of him was unthinkable. His concentration was fierce—he didn’t lift his head. He concentrated as she guessed he’d never concentrated in his life.
Where was the laughing man at the dog show? Gone. He’d been replaced by a pure professional—a professional being asked to work well past his level of training.
This was nightmare stuff. The specialist at the end of the phone could only guide—there was no way anyone could help Hugo manoeuvre the fine particles of tissue back into being a viable blood supply.
Rachel, concentrating fiercely on an anaesthetic that was taking her to the limits of her ability, could only wonder. If Hugo hadn’t been there, could she have done such a thing?
No, she thought honestly. Hugo had obviously done far more extensive reading and studying in this area than she had. The questions he asked the specialist showed keen intelligence and an incisive knowledge of what he was trying to achieve.
The man was seriously good.
And he was succeeding.
Even when the femoral artery was somehow—amazingly—reconnected and the first surge of pink started to appear in the lower leg, he didn’t relax. His questions to the unknown Joe in Sydney seemed, if anything, to increase. He worked on and on, tying off vessels that were damaged beyond repair.
He completed the vascular surgery, took a deep breath, and a plastic surgeon came on the line, guiding him through the complex steps in closing such a wound to give a decent cosmetic outcome.
They were worrying about appearances, Rachel thought jubilantly, watching the colour seep back into Kim’s toes and making sure the heart line on her monitor stayed steady as blood pressure stabilised. They were worrying how she’d look in the future.
They were winning!
And finally—finally, after hours without lifting their heads—the team in Sydney let out a cheer down the phone lines.
‘Well done, Cowral,’ they told them. ‘Unless you have any more big dogs menacing the populace, we’ll leave you to it.’
And to the thanks of the entire theatre team, the telephone lines went dead.
The theatre fell silent. Rachel was still concentrating. Hugo was placing dressings around the wound and she had to concentrate on reversing the anaesthetic, having Kim reestablish her own breathing. But the satisfaction …
She glanced up and the joy she felt was reflected in every face in the room.
Except Hugo’s. He looked sick. The strain Rachel had been under had been immense—the strain Hugo had felt must have been well nigh unbearable. He’d won, but at a cost.
She’d worked as a team member for long enough to know that it was time for someone else to take charge. And she was the only possible option.
‘David, take over the dressing,’ she ordered. ‘Hugo, leave the rest to us. We don’t need you here any more.’ He’d been under more pressure than any doctor should face and now, job done, reaction was setting in with a vengeance.
‘I’m OK.’ But the hands holding the pad were suddenly shaking. His fingers had seemed nerveless for hours, skilled and precise past understanding. It was more than understandable that reaction should set in now.
‘Go and tell the Sandersons their kid will keep her leg,’ she told him. ‘Kim’s parents will still be worried sick. Go.’ Kim was taking her first ragged breaths. One of the nurses had given them the news some time ago that their daughter would be fine, but they wouldn’t believe it until they’d heard it from Hugo.
And Hugo needed to tell them. Hugo had achieved the impossible. This was his gift.
The theatre team agreed. David lifted the tape from Hugo’s nerveless fingers and started applying it. Job done.
‘You’re being kicked out of Theatre, Dr McInnes,’ the young nurse