Gill nodded. He had two patients they hadn’t been able to evacuate last night and neither would take priority over the liver. One had been lucky and had taken minor shrapnel damage to his gut and the other had a penetrating eye injury that, while serious, was not life-threatening.
These were the decisions they made every day. Who couldn’t wait, who had to. Patients triaged in the field as requiring medical or surgical intervention were choppered to the MSAA facility. The objective of the surgical teams was to operate so the immediate threat to the patient’s life was alleviated and then evacuate as soon as possible to the most appropriate major centre.
Usually there were a couple of cases that, due to stretched resources, had to stay behind post-op. In this situation the least critical stayed and were nursed in their limited high-dependency unit. This had five beds and two nurses, with back-up from the surgeons and anaesthetists.
‘Comms from HQ this morning has confirmed they can evac everyone,’ said Ben.
‘Good.’ Gill nodded. ‘We’ll do your liver first then the three abdo traumas then the eye.’
Harriet watched as everyone nodded in agreement. No one batted an eyelid that the patients were recognised by their body parts rather than their names. This had been the hardest thing for her to come to terms with in this field of medicine. Maybe it was the nurse in her but it just didn’t seem right to not know a patient’s name.
To be fair, a lot of this had to do with the language barrier and the fact that the majority of their patients were in no condition to divulge their names. Seventy-five per cent of their workload were unconscious, and with no IDs their names were impossible to know. But surgeons did have a nasty habit of referring to their patients as a bunch of body parts and it was so dehumanising Harriet knew it was one part of this job she wouldn’t miss. But, then, nothing was more dehumanising than war.
‘I have an update on yesterday’s casualties,’ said Theire, the translator, in her soft, heavily accented voice. Now, that was something she would miss. The accents. Every working day she was surrounded by the music of other languages. From the people she worked with to the locals who were unfortunate enough to end up on their operating tables, it was like living in an opera composed by the UN.
She hadn’t realised just how deeply it had become a part of her subconscious. Her ears didn’t hear it any more but the thought of no longer hearing a mish-mash of foreign tongues was depressing.
Just in this room they had Italian Ben, Russian Katya, German Helmut, Irish Siobhan, Theire, who spoke several of the local dialects, and various English, American and Australian contributions as well. And then there was Gill. He spoke with the careless drawl of a fair dinkum Aussie, but when he spoke French it was like he’d been born there.
She would really miss that. Miss how he would speak French with his parents and grandfather in her presence from time to time, or jokingly ask for an instrument in the language while he was working to crack everyone up, or casually slip into it at home because he knew how much it turned her on. He made love in French, too.
‘I have been in contact with the various facilities that our patients were transferred to.’ MedSurg always employed a local interpreter for each mission. Their services were invaluable.
‘The man with the bullet in his brain did not make it. Nor did the little boy with the traumatic amputation of his leg. The three chest traumas are still in critical conditions but holding their own. The woman with the gut full of shrapnel had to go back for more surgery. They removed an extensive amount of ischaemic large bowel and she now has a colostomy.’
There was silence in the room as they all thought about the people from the day before. Gill had operated on the little boy. The child had lost so much blood, and even as he had been operating to tie off the bleeders and stabilise his condition, he had known deep inside that the child wouldn’t make it.
The wound had been incredibly dirty, dragged through filth and mud as the boy had crawled to safety. It was always going to be a matter of whether his profoundly hypovolaemic state or a massive bacterial infection would kill him first. Gill wanted to punch the table at the unfairness of it all. What had a child of eight done to deserve that?
He looked at Harriet and could see she was affected by the news as well. He suddenly envied her turning her back on all of this. To never have to look into the eyes of another man, woman or child injured through the stupidity of war. For the first time he wondered how long he could do it for. There was always going to be another war. Could he do this for ever? He’d always thought he would but…
She gave him a sympathetic smile and he shook himself out of his reverie. Their divorce conversation had obviously got to him. He just needed a break. Two months of this kind of stuff was tough mentally. But this was what he did. This was who he was.
CHAPTER FIVE
1100 HOURS
‘GILL, can you review your abdo trauma from last night? He’s febrile and tachycardic. His drain losses are increasing as well.’
Damn it! He must have missed something. He’d spent two hours picking shrapnel out of the rebel soldier’s intestines and was confident that they’d removed it all. But as thorough as he’d been, Gill knew that the chances of missing a little hole somewhere, caused by the trajectory of the shrapnel, was always a possibility.
‘I’ll be right there,’ he said, smiling at the HDU nurse.
Harriet rolled her eyes as Megan turned a pretty shade of pink and beamed back at the sexy surgeon. Her husband. For another few weeks anyway. Man, he should be banned from smiling. She couldn’t blame Megan for feeling a little flushed, it made her go positively weak at the knees.
She watched them as they walked side by side and then disappeared into the room that housed the HDU. How was it possible to make a set of plain blue baggy scrubs sexy? She remembered how she had thought him breathtakingly gorgeous that night in London dressed to impress and later how magnificent he was undressed, but equally impressive was how he filled out a set of scrubs.
It was like the minute he donned them he became Dr Guillaume Remy, surgeon. The sense of authority that exuded from him was powerful, virile—almost sexual. The blue theatre cap tied and anchored at the back of his neck just below his hairline made him look even sexier.
If anyone were to ask her in years to come what her fondest memory was of their time together, there would be no hesitation. Seeing Gill in his scrubs and cap, laughing his deep, sexy laugh, oblivious to his innate sex appeal. Harriet felt a moment of panic as she stored away the memory. One more day of memories and that was it.
Gill took one look at his patient and knew he was going to have to reopen him. The man was burning up and muttered unintelligibly, the words both foreign and muffled by the face mask. Megan gave Gill the hand-held ultrasound and he could feel the rigidity of the man’s abdomen as the transducer glided through the gel. There was a significant amount of free fluid visible.
‘I’ll mobilise the team,’ he said to Megan.
Gill strode down the corridors, figuring everyone would have adjourned back to the dining area for another cup of artificial stimulant.
Only Harriet and Siobhan were there. ‘Let’s go,’ he said. ‘We have to reopen the soldier.’
The soldier. Harriet shook her head as she stood. He’d looked no more than sixteen and had refused to give Theire his name. What was wrong with the world? Babies fighting wars?
But that’s what they did. This was the organisation’s mission. It didn’t matter how young or old, male or female, civilian or military, goodie or baddie. If you were injured and needed surgery, the doors were always open. There were no moral or ethical judgments—it was just patch ’em up and ship ’em out.
‘I’ll alert the others,’ said Harriet.
‘Where’s Theire?’ he asked.
‘Making some more calls,’ replied Siobhan as they moved past him to go and set up the theatre.
‘I’ll get her to talk to the patient. I’ll also see Ben about evac-ing him out with the liver. See you there in five,’ Gill said.
Harriet and Siobhan located the team in all their scattered locations, which wasn’t difficult, given their close confines. There wasn’t the infrastructure for a paging system so word of mouth was how it usually worked, except when there were mass casualties arriving. Then a hand-operated siren was used by Dr Kelly Prentice, the on-site medical director, who took the call from comms. It wailed mournfully between the two buildings occupied by MedSurg, spreading its bad news like an involuntary shudder to the furthest reaches of the complex.
MedSurg had set up in an old whitewashed convent that harked back a couple of hundred years to colonial times. Kelly used this building for the medical side of the mission and across the dirt a long, rickety concrete path connected it to the old orphanage building, which was where the surgical side was housed. Gill’s territory.
The area had once been a thriving community—now it was just a few buildings in the middle of nowhere on the periphery of a war zone. The buildings had been used until the recent civil unrest as a medical facility. The nearest towns were at least one hundred kilometres in any direction, the nearest hospital at least two hundred and fifty kilometres away.
The old orphanage now used as the surgical block was a double-storey building with wide, open verandahs that wrapped around the entire building to take advantage of any breeze that might be wafting by. Two downstairs rooms had been converted to operating theatres with basic tables, anaesthetic machines, monitors and overhead lights, and smaller side rooms each housed ancient instrument sterilisers and served as storage rooms.
Another of the bigger rooms was set up as the HDU/recovery area and there were various smaller rooms used for their triage meetings and as a communal kitchen and lounge area.
Upstairs were the living quarters, which, although were small, had French-style doors that opened onto the verandahs. Not that it was actually that safe to be sitting out there a lot of the time, but the tantalising luxury was there if anyone had the nerve.
By the time the rest of the team arrived, Harriet and Siobhan had everything under control. Siobhan was scrubbing up when Gill strode into the theatre. ‘Everything good to go?’ he asked a masked Harriet.
Gill forgot the urgency for a fleeting moment. Harriet in her mask, her features completely hidden from his gaze, was mystically beautiful. The deep brown depths of her eyes were emphasised tenfold, and he felt like he was falling into a warmed vat of deep rich chocolate and drowning.
Her luxurious hair was also hidden within the confines of the most unglamorous headwear on the planet, but he still couldn’t disguise his fascination with it. He knew that beneath the almost see-through blue fabric it was up in a ponytail and, despite her complaints about hat hair when she removed it between cases, it always made him forget to breathe.
‘Yup.’ Harriet nodded briskly and busied herself with opening the sterile packs, ignoring the brooding presence of her husband. She daren’t look at him. She could feel the intensity of his gaze like he had X-ray vision. What was he thinking? Was he reconsidering his position? Or just trying to visualise her naked? Suddenly the mask felt claustrophobic and she was grateful when he left.
Siobhan entered a few moments later, her arms held slightly aloft and bent at the elbow, water dripping from them occasionally. She picked up the sterile towel that sat folded on top of the sterile gown that Harriet had opened for her and placed on a stainless-steel trolley.
Siobhan dried her hands and arms thoroughly on the cloth and then picked up the gown, climbing into it with an efficient sterile technique and turning so Harriet could tie it at the neck. Next she moved to the size-six gloves Harriet had also opened and in a couple of smooth movements had gloved up. Siobhan set about sorting out the tray of instruments on her sterile draped table and she and Harriet conducted a count of the swabs, towels and instruments most likely to be used during the procedure. Harriet scribbled the numbers on the count sheet so they knew how many extra bits and pieces had to be kept track of.
Then Gill entered the room in the same fashion as Siobhan and after he’d dried his hands he gowned, and Harriet had to get up close to tie his gown for him. She lingered for a moment too long and could tell by the stiffness of his shoulders that he was more than aware of it. He smelt so good and it was hard to believe she would never see him operate again after today.
The patient came in then, accompanied by Katya and Joan, and it was all hands on deck. Joan and Helmut anaesthetised him and Katya left to scrub in as well. Harriet was the circulating nurse—euphemism for gopher. Anything any of the sterile people needed, she fetched. The three nurses took it in turns, rotating from scrubbing to circulating, and the system worked well.