in?’
Juliet Turner spun around with confusion dressing her brow and a surgical gown covering her petite frame. ‘My patient’s on the operating table, prepped for an open foetal repair of a neural tube defect. I have to scrub in. This can’t be postponed.’
‘It hasn’t been postponed, Dr Turner,’ the theatre nurse told her. ‘The surgery’s going ahead today. It’s just that you’re not the surgeon operating.’
Juliet’s nostrils flared behind the operating mask. ‘That’s even more ridiculous. There has to be a mistake.’
‘No mistake, Dr Turner. Another in-utero specialist has been brought in to take over,’ the nurse replied firmly. ‘He’s already arrived, and in gowning now. Orders came from further up the food chain than me, so don’t go shooting the messenger.’
‘He’s in gowning! I’m sorry, Angie, but this is absolute nonsense,’ Juliet said as she returned her focus to lathering her hands and forearms as a visible protest. She wasn’t backing down and had no intention of relinquishing her role. Kelly Lester would have her surgery and her baby would have the best chance of a normal life. And she was operating as scheduled.
Being a female in a male-dominated profession had taught her to stand up for herself very early on. She had known entering the profession that women were at least twice as likely to drop out of surgical training programmes as men, making her well aware that it would not be an easy path and a shrinking violet would not succeed. During her studies her father, also a surgeon in the same field, often told her that, while half of the medical students in Australia and New Zealand were female, women made up less than ten per cent of fully qualified surgeons. It was a harsh reminder that she would have to be strong, focused and have a voice to survive. And she was going to use her voice whenever needed. Loud and clear.
It appeared that day was going to be one of those occasions.
‘I will not allow another surgeon to just step in now without a damned good reason. I know this is not at the patient’s request. I spoke to her only an hour ago.’
‘No, it wasn’t the patient who has requested the change, Dr Turner, and I understand you’re taken aback but I’m just passing on the message, not making the decision. However, I’m telling you the decision’s final. You really do need to stop scrubbing. Having sterile hands won’t change the outcome.’
Not hiding her irritation, Juliet turned off the flow of water with the foot control. ‘Well, we’ll just see about that.’
‘On the bright side, your replacement will no doubt meet with your approval. You’ve worked together more than a few times.’
Juliet was doubly confused with the smirk on Angie’s face. None of it made any sense but if she was to believe the nurse, and she had no reason to doubt her, she was being replaced without notice or reason. ‘I don’t care who’s been brought in to take over, it’s still madness,’ Juliet replied as she pulled her surgical cap free and the mass of brown curls dropped around her face. At that moment, the replacement doctor entered the scrub room.
‘Really,’ she announced, shaking her head in disbelief. ‘This is becoming more and more ludicrous by the minute. They call you back here two days after you retire. What is this craziness? I’ve a patient about to be anaesthetised and I’m told I’m not operating. Will someone please explain the absurd rationale behind all of this? And who made the call to replace me as Kelly’s surgeon?’
‘The hospital director...but with good reason,’ he replied.
‘I can’t think of one.’
‘You have to prepare for your trip.’
Juliet paused for a moment with a perplexed stare. ‘For goodness’ sake has everyone gone completely mad? My trip’s not until the middle of next week. I’ve got five days to prepare for the lectures and board the plane, but Kelly’s baby needs this operation now if he’s to ever walk.’
‘That’s where you’re wrong...not about Kelly and her baby—you’re right on that one, I just finished reading the notes and the surgery’s urgent—but your trip’s not next week. It’s tomorrow. You’re leaving on an eight o’clock flight in the morning.’
‘Tomorrow? But why?’ Juliet dropped her head into her hands still damp from the antibacterial wash. ‘The lecture is not until next Thursday.’
‘You’re not delivering the lecture in Auckland...you’re off to the UK—’
‘The lecture’s been cancelled?’ she cut in.
‘No, the lecture is going ahead...’
‘But without me?’ she asked as she pulled free her surgical gown and dropped it unceremoniously in the bin alongside her discarded cap.
‘Yes.’
‘And the surgery’s proceeding too, just without me?’ They were framed as questions but Juliet’s tone made it obvious they were statements that she was none too happy about.
‘That’s right.’
‘And I’m off to the UK?’ she continued with the volume of her voice escalating and increasing in speed with each word. ‘Before I go completely loopy, just tell me why my schedule is changing before my eyes without my approval?’
‘The call came through from Cheltenham just now.’
‘Cheltenham? As in the Cotswolds?’
‘One and the same.’
‘And who over there’s making decisions without consulting with me?’
‘The decision was made by four babies.’
Juliet blinked and shook her head. ‘Four? You’re speaking in riddles and you know that frustrates me.’
‘Apparently the Assistant Head of Obstetrics at Teddy’s, which is the maternity wing of the Royal Cheltenham hospital, spoke with our Head of Obstetrics about the quads. Almost twenty-nine weeks’ gestation, suffering twin-to-twin transfusion syndrome. Two sets of monozygotic twins. While the girls are fine at this stage, the boys have developed the TTTS. Oliver Darrington believes you’re the best chance that the quads have of all surviving should the parents agree to the in-utero laser surgery. And Professor Le Messurier just approved your secondment.’
‘That’s all very flattering but why am I being called in at the eleventh hour? If there was a risk, I should’ve been consulted upon the initial diagnosis. Surely being quads they would have been having weekly scans and intense monitoring and they’d know at Teddy’s that the earlier the intervention, the better the outcome.’
‘Apparently the quads were being closely monitored throughout the pregnancy, but the TTTS diagnosis has only just been made,’ her replacement continued as he began scrubbing in, and over the sound of the running water he continued his explanation. ‘The girls have separate placentas while the boys have one shared placenta so they were being scrutinised for any signs of transfusion. Up until now there was no indication of anything being amiss. It was picked up when the patient presented in what she thought was premature labour.’
‘Caused by the amniotic fluid imbalance affecting the recipient twin.’
‘Again, apparently but you’ll know more details when you get there.’
‘But the lecture in Auckland?’
‘Handled. I’m not sure who’s your proxy but your focus needs to be on the quadruplets. Darrington’s worried it could deteriorate quickly and there’s an increased risk they could lose at least one of them if you don’t get over to Teddy’s immediately, and of course we know the risks if one dies to the remaining foetuses. The parents have been briefed and want to be fully informed so they can consider all options, in particular the in-utero surgery.’
‘Anything else I need to know?’
‘Just one thing...the attending