St Matthew's Passion: A Medical Romance (5 page)

Melissa broke off, partly because her voice was rising and in a moment somebody was going to come and investigate, and partly because she’d been struck by a sudden thought, an insight about Deborah that almost floored her. She took a step back, lowered her hand, began to bring her breathing under control. Across from her, the other woman’s emotions were being held in check, though her eyes still burned.

‘I shouldn’t have come to you,’ Melissa muttered. ‘I won’t do it again.’

She managed not to slam the door on the way out. On shaking legs she stalked the corridors, unable to sit or stand still. She didn’t quite snap at the porter who called hello to her, but she was brusque, leaving his eyes boring into her back.

Even if the woman was right about Melissa’s feelings for Fin – and she wasn’t, she was just speculating – what right did that give her to interfere? How dare she judge how two people ought to behave towards one another if one of them wasn’t her? She’d said they would all suffer if Melissa carried on with her supposed pursuit of Fin, but that was absurd. Office romances were controversial, they raised all kinds of ethical questions – but they didn’t damage a service as finely honed and smooth-running as the Trauma Department.

The only reason Deborah Lennox might have to get so worked up about an imaginary relationship between Melissa and Fin – and it was the insight that had arrived out of the blue while Melissa had been responding to Deborah’s accusations – was that Deborah was herself after Fin. Basic, primal jealousy had driven her to say what she’d said. She’d worked with Fin for years, was close to him professionally, and it was natural that she’d develop feelings for him. She might content herself that these feelings would be reciprocated one day, given enough time. But now this interloper, this younger potential rival in the form of Melissa, had arrived, and Deborah felt threatened.

Melissa slowed, then stopped at leaned against the wall of the corridor, her anger subsiding. She felt a twinge of sympathy for Deborah. Melissa had known jealousy herself, like most people, and she knew what a powerfully irrational and painful force it could be. But – and the thought stopped her from feeling entirely well disposed towards the other woman – Deborah still had no right to turn Melissa’s perfectly reasonable request for feedback on her work performance into an extended diatribe about Melissa’s dark designs on her boss, which were entirely products of Deborah’s unbalanced imagination.

As she walked back to the wards, Melissa reflected that two good things had come out of the otherwise highly unpleasant encounter. One was that she had a better idea now of Deborah and her agenda, and forewarned was, as they always said, forearmed. The other positive thing was that amid all the allegations Deborah had actually given Melissa one useful piece of advice.

In order to find out what Fin truly thought and felt about her performance in the job, she needed to confront him directly.

***

In retrospect, Melissa realised one of the turning points in her life came the day Frank Copper was brought to hospital.

The week had been a frenetically busy one, so much so that despite Melissa’s resolution to confront Fin she hadn’t managed to find the time, had barely seen him other than when they were in theatre together when the bringing up of such a delicate subject wouldn’t have been appropriate.

It was a Saturday afternoon and Melissa was on standby for Accident & Emergency. There was a big football match on in north London, and the possibility of traumatic injury inflicted by or on fans of either team was high. So nobody was surprised when the call came crackling through the department’s two-way radio, announcing that the air ambulance had been scrambled.

What nobody was expecting was that the patient who arrived a few minutes later through the doors would be Frank Copper, one of the star players. Or that he’d been injured even before the match started.

The name was being whispered around the department even as the paramedics from the helicopter pushed the trolley into ‘majors’ and began giving a rundown to Melissa. Copper had been heading for the stadium in his sports car when the vehicle had collided with a lorry pulling out from the side. He’d sustained blunt chest trauma and was having difficulty breathing.

The young man was semi-conscious. There was no external evidence of head injury. His chest was a different matter. An enormous purple bruise spread across the centre, courtesy probably of the steering wheel or even the dashboard.

‘Cardiac monitor,’ Melissa said sharply, and one of the nurses bared the footballer’s chest and began to attach the sticky pads to which the leads would be fixed. Melissa had just called for the portable X-ray machine when Copper went into cardiac arrest.

It meant, Melissa knew, that the injury to his chest was extreme. Copper was a supremely physically fit 21-year-old man, with no medical history as far as was known. One moment he was shifting and moaning from under his oxygen mask. The next, he stopped making any sound. Melissa glanced up, saw that his head had stopped rolling from side to side.

She moved to the man’s head and tilted it back. No evidence of airway obstruction. She pulled away the oxygen mask and put her ear to his open mouth, but could feel no breath. Her fingers probed his carotid artery. No pulse.

On the cardiac monitor Melissa saw the steep, jagged-toothed pattern of ventricular fibrillation. Copper’s heart muscle was firing chaotically, unable to do its job of pumping blood yet generating some electrical activity still.

The procedure for dealing with a cardiac arrest was as engrained in Melissa as a reflex. She commenced the rescue breaths and chest compressions even as the nurses hurried across with the defibrillator and the syringes of adrenaline. Unable to stimulate a pulse after two cycles of chest compressions, Melissa attached the adhesive defibrillator paddles to the man’s chest and, establishing that nobody was touching him, administered the first shock to his heart.

The pattern on the monitor remained unchanged.

Melissa injected the first shot of adrenaline through the cannula in Copper’s wrist and cued up the defibrillator a second time, sending the shock. Still no response.

The cycle repeated, with the nurses taking turns to administer cardiopulmonary resuscitation in between doses of adrenaline and electric shocks. The fibrillation pattern stubbornly refused to change.

Melissa fought down rising panic. She was going to lose him.

It was time to call it. She met the eyes of the nurses working with her and nodded.

Glancing at the clock, her heart like a boulder in her chest, she said: ‘Time of death –’

The plastic curtain flipped open and Fin strode into the cubicle.

‘What have we got?’ His eyes roved over the prone man.

‘Blunt trauma to the sternum in a 21-year-old man,’ said Melissa. ‘Cardiac activity initially, then arrest. Consistent V-fib pattern despite multiple attempts at defibrillation.’

‘How long?’ Fin was in a shirt and tie but no white coat. He yanked his tie off and began rolling up his sleeves.

‘Ten minutes. I’m just calling it –’

‘No,’ said Fin. ‘He’s too young. We’re not letting him go.’ He nodded at one of the nurses. ‘Thoracotomy tray. Gown up, everyone.’

Melissa felt her pulse quicken. She’d never yet witnessed this, still less participated. It was one of the most heroic procedures in all of medicine. As did the others, she slipped on a protective gown, a face mask and plastic goggles to protect her eyes. There was going to be blood.

‘I’ll intubate,’ she said, and Fin gave a nod. While the thoracotomy tray was uncovered and Fin prepared himself, Melissa stood at the head of the bed and used a laryngoscope to expose the unconscious man’s vocal chords, then passed an endotracheal tube deep into his airways.

She moved to his side and watched in awe as Fin made the incision in the footballer’s chest, cutting through layers of taut, tough muscle, then used a rib spreader to prise the chest open. With a saw he rasped though the breastbone, extending the incision further. There, amazingly, was the young man’s heart, enclosed in its thin sac. Fin slipped both hands into the cavity, grasped the heart, and began to massage it rhythmically.

An age passed, although it must have been only a minute or so. A nurse, her fingers on the patient’s neck, said, ‘A pulse.’

Melissa moved over and felt the other side of his throat, disbelieving. Yes, there it was. A weak but regular throb in the carotid.

The young man, Copper, was alive again.

She stared at Fin over the top of her mask. His eyes met hers, the only part of his face that was visible.

There was an enormous grin there, in his eyes.

He said, ‘Time to tidy up.’

The occupants of the cubicle, three nurses and Melissa herself, broke into applause, muted though it was by the latex gloves they were wearing.

Despite the enormous amount of work still to be done, despite all the precautions that would have to be taken to minimise the risk of infection in the footballer’s chest wound, Melissa felt in the pit of her stomach that he was going to be all right. She couldn’t take her eyes off Fin’s face. All her annoyance with him, all her doubts about his opinion of her, had disappeared, at least for now. All she saw was strength, and kindness, and warmth.

And something else, in the way he gazed back at her. Something that once again triggered a deep, dark heat within her lower body and made her genuinely fear that her legs would give way beneath her.

She realised that Deborah, whatever her own agenda, had been right. Melissa couldn’t delude herself any longer.

She was in love with Fin.

***

Weighted down by a tiredness so profound it felt as if it had seeped into his bones, Fin let himself into his flat and flicked on the lights. The rest of the Chelsea street was in darkness, as was to be expected even on a Saturday night. It was after all four thirty in the morning, a time when the last late-night revellers had finally collapsed and before the early birds had risen.

He stumbled into the kitchen, vaguely aware that he needed to eat something before he crashed out. Would it be a late – a very late – supper, or an early breakfast? Could you technically have breakfast just before going to bed? Such philosophical questions were beyond Fin, especially at that hour. Groping for whatever he could find in the refrigerator, he heated a pan and concocted something involving eggs, mushrooms, ham and chives that couldn’t make up its mind if it was an omelette or an elaborate version of scrambled eggs.

Fin had promised to read over a colleague’s draft research paper on the benefits of a new management protocol for head injury, and sitting at the breakfast bar in his kitchen he turned the pages of the document with his left hand while forking food into his mouth with his right. When he realised he’d just read the same paragraph three times, he tossed the paper aside with a sigh, finished his meal and put the plate in the dishwasher, an appliance that took half a week to fill up with crockery and cutlery. He cast an eye about the kitchen, a gleaming, futuristic landscape of chrome and glass that would be a professional chef’s dream and which he barely used.

Before heading for bed he wandered into the open-plan living-cum-dining room and sat for a few moments on one of the high-backed chairs at the table, knowing it would be fatal to sink into an armchair as he’d fall asleep instantly and wake with aches and cramps he didn’t need. Impeccably tasteful, friends and former ladies in his life had called his flat, and he wasn’t ashamed to agree: furniture carefully sourced from Harrods and from Sotheby’s auctions; the rugs and wall hangings he’d selected himself during conferences in Morocco and Tokyo; the original Chagall and Pollock paintings he’d paid a small fortune for.

Perfect taste... and yet Fin was rarely ever at home to appreciate the luxuries he’d chosen over the years, the beauty he’d cultivated for a living space. He left the flat by seven each morning, at the latest, and returned no earlier than midnight, spending the evenings playing squash when he wasn’t at work. On his rare days away from the hospital he gave lectures, attended conferences, frequented the library of the university to which St Matthew’s was affiliated in order to track down that obscure reference, that overlooked research finding, which would add to his own studies.

He hadn’t had a holiday since... well, since his honeymoon, seven years earlier. He’d been a young, up-and-coming registrar and even then had felt guilty about taking any time off at all, but had to agree with Catherine that two weeks away from work immediately after one’s wedding wasn’t exactly unreasonable. A fortnight in the Maldives, basking in the luminous Indian Ocean sun, and towards the end of the first week Fin had actually started to unwind, to stop thinking about work, and started to enjoy the experience of simply
being
.

There’d been no more holidays after that. Catherine, not a doctor herself, understood at first, or said she did. And since she’d left him, he hadn’t felt the slightest inclination to go away on his own.

Fin knew there was no point in brooding; knew also that by doing so he was deliberately avoiding the subject that had been occupying his mind ever since the early afternoon, more than twelve hours ago. To distract himself further he got ready for bed, hoping sleep would overwhelm him immediately.