a gloved finger into the pleural cavity, checking the position of the incision. ‘I’ll want a 36F tube. Have it ready.’
‘Roberts forceps.’ Without being asked, Liv handed him the instrument she knew he’d need next and watched as he slid the drain into position through the track he’d made. Then he attached the tube to an underwater seal drainage system.
‘That’s a large tube he’s used,’ Phil muttered and Liv glanced at him briefly.
‘It has to be of sufficient calibre to drain the haemothorax without clotting. And if the haemothorax doesn’t drain, there’s a risk of infection.’ Her attention back on Stefano, she reached for the suture. ‘Zero gauge suture.’ She held it out to him and he took it immediately, their movements smooth and synchronised even though they’d never worked together in Resus before.
He inserted a purse-string suture to secure the drain and then glanced at the monitors again.
‘I want another chest X-ray so that I can check the position of the drain.’
The radiographer hurried over and as they shifted the patient and took the X-ray, Phil glanced at the drain.
‘He’s losing a lot of blood. Should we clamp the tube?’
Stefano shook his head. ‘Clamping the tube has no effect on the amount of haemorrhage—the blood just collects in the chest and further compromises respiratory function.’
‘Mr Lucarelli? The X-ray is up on the screen,’ the radiographer said and Liv glanced up as the door suddenly opened and Anna walked into the room.
‘His wife’s arrived. I’ve put her in the relatives’ room,’ she said. ‘Can someone find a moment to talk to her?’
Liv glanced towards Stefano Lucarelli but the consultant was staring at the X-ray, his handsome face unsmiling and his concentration absolute. He’s young, she thought, looking at his masculine profile and dark glossy hair. Young to be in such a responsible position. His strong legs were planted firmly apart, the thin cotton of the scrub suit skimming wide, muscular shoulders, his dark head tilted slightly as he studied the screen. He was staggeringly good-looking, confident and very much in control.
Realising that she was staring, Liv looked away quickly and caught Anna’s speculative glance.
Her friend gave her a wide smile. ‘I can see everything is going well in here.’
Liv glared at her. ‘We’ll talk to his wife in a minute, Anna.’
Stefano turned. ‘We’re waiting for the trauma surgeon. When the patient is stable and they’ve decided on the next step, I’ll talk to his wife.’
Phil studied the drain again. ‘He’s drained 1000 mils.’
‘The initial volume of blood drained is not as important as ongoing bleeding.’ Stefano looked up as the trauma surgeon strode into the room.
The two men conferred although Liv could see that the entire conversation was driven by Stefano Lucarelli.
Clearly his reputation was as formidable as his clinical skills because the senior trauma surgeon seemed only too happy to listen to his advice.
‘I don’t want to perform a thoracotomy unnecessarily.’
‘I’ve used a large enough tube and it’s positioned well.’ Stefano glanced at the drain as if daring it to misbehave. ‘It will drain the haemothorax. Admit him for observation, monitor the drainage output over the next four to five hours. If he loses more than 200 to 250 mils of blood per hour, take him to Theatre. I’m going to talk to his wife. Liv, come with me.’
Liv blinked. ‘I— Yes, of course.’
She was about to make a mild comment about his dictatorial style when he looked at her, his gaze frank and direct. ‘You’re an excellent nurse. When I’m in Resus, I want you with me.’
‘Oh…’ The compliment was so unexpected that hot colour flooded her cheeks but she was saved the bother of replying because they’d reached the door of the relatives’ room.
Without pausing, Stefano opened the door and strode into the room, leaving Liv to follow. She closed the door behind her, braced for him to open his mouth, put his foot in it and then walk out leaving the patient’s relative distraught, a scenario she’d witnessed on all too many occasions with other doctors.
But instead of fumbling for words and making the quickest possible exit, he walked across to the patient’s wife and sat down next to her. ‘I am Stefano Lucarelli, the consultant. I’ve been looking after your husband.’ He held out his hand and the woman shook it and gave a wobbly smile.
‘I’m Helen Myers.’
‘This has been a shock for you, I know.’ He spoke in a deep, velvety voice that held equal amounts of confidence and sympathy. ‘I am sorry I couldn’t speak to you earlier, but your husband was my priority.’
‘Of course—I understand.’ The woman was white with shock, her eyes pink from crying. ‘Is he—is he going to be all right?’
‘He was kicked in the ribs and that kick has damaged his lung.’ In simple, easy-to-understand terms, Stefano gave her the facts, explaining what had happened and the treatment he’d given so far. He kept it short and non-technical. ‘Tim has been transferred to Intensive Care. They are going to monitor him and, if necessary, they will take him to Theatre and drain the blood clot.’
Tim? Liv blinked. She hadn’t realised that he even knew the patient’s name.
‘Oh God, I can’t believe this is happening. I saw him at lunchtime and we were making plans for Christmas. We were going to take our two girls to Lapland to see Santa Claus.’ The woman sat still for a moment and then her face crumpled and she started to cry. ‘I’m sorry, I’m really sorry, it’s just that it’s such a shock.’
Reaching for a box of tissues, Liv sat down on the other side of the woman and waited for Stefano to leave so that she could offer whatever comfort she could. But instead of leaving the room as fast as possible as most of his colleagues would have done, Stefano leaned across and took a tissue from the box.
‘Don’t apologise. It is hard for you, I know. Here.’ He handed the woman the tissue. ‘You mentioned that you have daughters? So who is looking after them now?’
‘My mother.’ Helen blew her nose hard. ‘I called her as soon as I got the news. I didn’t want to bring the children here. I’m sorry. You don’t want to listen to this. I know how busy you must be. You have much more important things to do than talk to me.’
‘At the moment, talking to you is the most important thing,’ Stefano said calmly, his gaze not shifting from her face. ‘Is there anything else you want to ask me?’
Helen gave a choked laugh. ‘I want to ask you if he’s going to be all right, but you can’t tell me that, can you?’
‘Not at this stage,’ Stefano said honestly. ‘The consultant in Intensive Care will be able to give you a better idea in a few hours.’
He was good, Liv thought to herself. Really, really good. He was honest, didn’t give false hope and didn’t try and escape from the emotions in front of him. And despite the workload pressing down on him, he seemed to really care.
‘Liv will stay with you for a few minutes,’ Stefano said, ‘and then she will ring ICU.’
Liv gave an inward smile. He was also controlling. ‘Once they have him settled, I’ll take you up there,’ she assured Helen and the woman blew her nose again.
‘Thanks. You’ve been incredibly kind, both of you.’ Tucking her handkerchief up her sleeve, she tried to smile. ‘Men. Why must they play these dangerous sports?’
Stefano rose to his feet, a sardonic smile touching his mouth. ‘We are incomprehensible, no? Blame it on testosterone.’