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When he went to the scrub sinks, Sophie was still there, soaping her hands and arms. With her face mask and plastic goggles on, he couldn't see the expression on her face as she swiftly noted his entry and then turned away again. There was something about her body language, her physical stance, that made him certain she was less than pleased at having to scrub for his first case.

'I'll give you five minutes' head start, Ms Dunhill,' he said, as he casually tied on a face mask and put on his plastic goggles. 'Do you think that will be enough time for you to get your set-up ready? I don't want to hassle you by snapping at your heels, so to speak.'

'Now, that would come into the canine category, Dr Sotheby,' she said coolly, not
looking at him.
'I thought we'd established that you were in the feline category. At least, Rhona has been trying to convince me that you're just a pussycat.'

Clay laughed. 'Rhona should know,' he said.

'Make it seven minutes, Dr Sotheby,' Sophie said, 'although I can do with no minutes if I have to.' She turned up the water pressure full blast by manipulating the long handles of the taps with her elbows. 'And I seldom feel hassled in the OR.'

'I see,' he said, smiling as he helped himself to a sterile scrub brush. 'Then why do I detect an atmosphere, Sophie? May I call you Sophie?'

'You know you can,' she said. 'Everybody else does. And if there's an atmosphere, as you say, it's because of the dissonance between your perception and mine.'

'Ah, yes... the tiger.'

'Precisely.'

Such badinage helped to diffuse tension in the OR, even though he sensed her antipathy which in itself could produce a tension of sorts if they weren't careful. Anyway, he considered, this was better than blind adoration, not uncommon, which could produce its own problems.

Rick Sommers burst into the scrub area breathlessly, dissolving by his presence any atmosphere. 'Sony I'm late, sir,' he said to Clay, who didn't like to be called 'sir' because it made him feel old. 'Got called down to Emergency for a quick consult.'

'Anything for us down there?' It wasn't uncommon for the elective cases in the OR to get bumped to make way for emergencies that came in via the emergency department.

'No, the chest guys are going to deal with it,' Rick panted, putting on a face mask and goggles in short order. 'Hi, Sophie.' He turned on the taps at the sink next to her, preparatory to getting scrubbed.

'Hi, Rick,' she responded warmly. 'How are you these days?'

It was as though she hadn't seen him for a couple of years, Clay thought.

'Tired,' Rick said. 'I was on call for the weekend. All I want to do is sleep. I can't understand how people get addicted to drugs when there's sleep.'

'You're off tonight, though?' she asked commiseratingly, so that Clay wondered anew whether they were sleeping together. They always seemed pretty close in the OR.

'I sure am,' he said feelingly.

'Well, you can go out to eat,' she suggested. 'In this great weather you can go to a street cafe, have a beer and a meal, get away from hospital food.'

'Nope,' Rick said, scrubbing his hands and arms vigorously with hexabetadine, 'I'm just gonna go home, stay in and sort through my unmatched socks. Then I'm going to sleep, sleep, sleep.'

Sophie's soft laugh added to the lightness of the mood which had pervaded the place from the moment Rick had breezed in. Somewhere along the line Clay had lost the knack for that sort of lightness, he realized that as he, too, began to scrub.

Sophie gave her hands and arms a final rinse, before backing into room four with her hands held up so that she wouldn't inadvertently touch anything. Clay was left wondering why he couldn't get to her with the same kind of insouciance Rick displayed. It must be something to do with the fact that Rick was ten years younger than he was.

Why would he want to impress Sophie, anyway? he argued with himself. He didn't, of course. He simply felt guilty at breaking his own rules of conduct. That was it. Otherwise why would he worry about her, when there was Dawn, who clearly wanted to be with him as often as possible, as well as plenty of other nubile women on whom he had but to turn an eye? He knew that much from experience. Maybe it was because she seemed to wear a label that said 'Not available to Clay Sotheby'.

'Well, I hope we can get away with only a temporary ileostomy here,' Rick said. 'I really feel for the guy.'

'Everything points towards that,' Clay said. 'We'll do our best, that's for sure. I appreciate that you're assisting me today, Rick, even though I know you're functioning on adrenaline.'

Rick chuckled ruefully. 'Dr Claibourne wanted some help, but I told him I'd already done a work-up on your patient, so I wanted to follow through with that.'

'Good,' Clay said.

'Talking of Dr Claibourne, sir, are you going to be taking over his position when he steps down? I'm asking because it would be great if we could have two really good guys one after the other. There are rumours.'

'Well,' Clay said carefully, 'I have expressed an interest. That's all I can really say at the moment. And I don't want that spread around, Rick. I'm not about to set myself up to look like a loser if someone beats me to it, or if I decide not to go for it.'

'Yeah, I understand,' Rick said. 'There're all sorts of dirty tricks abounding in these days of tight money. The latest sick joke going the rounds is that the definition of a friend in a hospital these days is someone who stabs you in the chest rather than in the back.'

Smiling commiseratingly, they both entered operating room four. Sophie paused in what she was doing to pass them sterile towels on which to dry their hands and arms, then she opened a sterile gown, holding it by the shoulders so that Clay could put his arms into the sleeves. The second circulating RN in the room, Cathy Stravinsky, tied the gown up at the back. Rhona May was running between two rooms. Sophie held
open each rubber glove in turn so that Clay could insert his hands.

'Thank you, Ms Dunhill,' he murmured, noting that she didn't meet his eyes before she turned away to open a sterile gown for Rick. Vowing to maintain his equanimity at all costs today, he turned towards their patient on the operating table.

Mike Dolby was already anaesthetized, the end of a plastic endotracheal tube protruding from his mouth and attached by tubing to the anaesthetic machine that was delivering oxygen and the anaesthetic gases that would keep him unconscious. The two intravenous lines were running fluid into veins in the backs of his hands. Dr Alex White was standing at the head of the table, between the patient and the anaesthetic machine.

'May I start, Alex?' Clay asked.

'Yes, I'm all set,' Dr White said, making some adjustments to the gas gauges on his equipment.

'Are you all set, Ms Dunhill?'

'Yes. Go ahead.'

Cathy Stravinsky folded back the green cotton sheet that covered their patient to expose his abdomen. Clay took a breath and blew it out slowly. He picked up the sponge-holding forceps, with a gauze sponge already in place, which Sophie had prepared for him on a separate prep tray, and with his other hand he picked up the small metal pot of Betadine iodine solution. As he approached his patient he was able, from long experience and training, to clear his mind of everything but the case in hand. With sure, sweeping motions he spread the cleansing solution over the pale skin.

Sophie handed him four small sterile green towels, folded in half, which he positioned on the patient's abdomen, leaving exposed a relatively small rectan
gular area of skin which had been cleaned with the iodine antiseptic solution. Then she handed him four towel clips with sharp, fine, pincer-like tips which anchored the towels to the skin. This was their operation site.

Next, she passed him a large disposable, waterproof sheet which had a small area cut out of its centre, that covered the entire patient, leaving the slit over the operation site. Over this went a similar large green cotton sheet. Using more towel clips, Clay carefully secured the sheets around the operation site.

He could have done all this preparation with his eyes closed, of course, if he had to, yet Clay never let his concentration waver for one moment. In addition to Rick, he was assisted by two surgical interns who would hold retractors if necessary and might be allowed to cut some catgut or silk ties or sutures. Mainly, they were there to observe and to learn.

The two circulating nurses, Rhona May and Cathy Stravinsky, pushed Sophie's instrument tray-on-wheels over the patient's recumbent body, then pushed a large wheeled table holding more instruments and a double bowl-stand with more equipment and gauze sponges into position at right angles to the patient's legs. These were for Sophie to organize, from which she would pass instruments to the surgeon as he needed them.

Clay waited until Sophie was in position. He felt perfectly calm, his mind focused. The room was quiet, everything orderly, all in place as it should be.

'Ready, Ms Dunhill?' Clay said.

'Yes.'

'OK, Alex?'

'Sure.'

'Knife.' Clay held out his right hand.

With the razor-sharp scalpel blade, held in a steady hand, he made a long incision with a single, careful stroke in the rectangle of exposed skin. The cut went through the skin and a little of the underlying tissue. The long incision, pink against the brown of the iodine, quickly became dotted with little beads of blood. Rick Sommers blotted them carefully with a pristine white gauze sponge.

Sophie took away the scalpel that had been used for the skin and handed Clay a fresh one. He didn't need to ask her, she knew exactly what to do. He would deepen the incision with the knife, then use curved scissors to make the final cut into the abdominal cavity.

Every person in the room had a specific job to do, an area of responsibility. An atmosphere of concentration and calm descended as each individual geared up mentally to see the job through to the best of his or her ability.

Clay cleared his mind of everything other than what he could see and feel in front of him. Although he had a very good idea of what he would find, it wasn't until he could actually see the state of Mike Dolby's gut that he could plan his final strategy.

 

CHAPTER THREE

The
surgical team arrived in the coffee-room of the OR at more or less the same time to have a late coffee-break, all except Alex White who was still with Mike Dolby in the recovery room to make sure he was recovering well from the anaesthetic, before handing over to the very competent nurses there.

'That went as well as we could have expected,' Rick commented as they joined other staff who were taking a much-needed break. 'He's sure going to be happy that the ileostomy won't be permanent. Do you want me to explain to him, sir, that it's just a temporary one?' Rick helped himself to a mug of coffee and a doughnut from the large box that someone had provided. Not the hospital—they didn't supply anything free these days.

'If you would like to,' Clay said. 'Whichever one of us gets to him first after he's capable of comprehending what we say to him.'

Sophie was part of the crowd. She was sitting with a small group of her nursing colleagues, who were all drinking coffee. They tended to gather at one end of the fairly spacious room, away from the doctors. It wasn't easy to relax with people you worked with in what was a relatively formal setting, where certain rules of professional conduct applied. Clay noted her presence without appearing to do so, wondering why he was so aware of her.

Most of them would have a fifteen-minute coffee-
break, before having to rush back to keep the momentum of the operating lists going. There were twenty-two operating, rooms on this floor of the hospital, including the neurology service but not the cardiac service which was on another floor.

'Ah, it's great to get a shot of caffeine,' Rick commented, taking a swallow of liquid from his mug, 'and a bit of glucose to keep the blood sugar up.'

'Mmm,' Clay agreed. 'Not too much longer now, Rick, before you can crash out.'

Jerry Claibourne came into the room and immediately came over to Clay, who stood up to greet him.

'Hi, Clay. How are you?' Jerry Claibourne was of medium height and solidly built, one of those muscular men who made Clay think of a bricklayer. A handsome man, charismatic and even-tempered, he seemed unaware of his charm which affected male and female alike. A very fair man in all he did, he'd been tremendously successful as head of department.

'I'm fine, Jerry. How are you?'

'Great. Are you intending to be at the medical advisory committee meeting tomorrow morning, seven-thirty sharp?'

'I plan to be there,' Clay said.

'Good,' Jerry said quietly. 'I want to talk to you about this job. The hospital plans to advertise it in the journals in two weeks' time. We have to do that, even though we hope to get someone who's already here. You know that I favour you, Clay, so I hope you're giving it some serious thought.'

'I am, Jerry.'

'I'll see you tomorrow, then.' The two men split up after the brief exchange. Clay saw that Sophie was
leaving the room so, on impulse, he took a last swallow of his coffee and followed her.

'Sophie,' he said, catching up with her as she passed through the double doors back into the OR suite proper, 'I just want to say that you were great with that last case.'

When she stopped to look at him with serious eyes he wondered whether she would think he was patronizing her. After all, she had just been doing her job to the best of her ability. Taking her arm, Clay steered her through the doors. 'I don't want to sound patronizing,' he said. 'I just hope we're friends again.'

For a moment she smiled up at him as they walked briskly side by side down. the main OR corridor. 'Thank you,' she said. 'Were we ever friends, Dr Sotheby?'

'I think so,' he said lightly. 'And if you think not, maybe we could rectify that here and now.' He stopped and held out his hand. 'Friends?'

Sophie took his hand, while a few passers-by stared at them curiously in the bustle of the comings and goings. Clay felt curiously light-hearted when she smiled again. 'All right, Dr Sotheby,' she said, 'if that's what you want. Friends.'

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