Kate Hardy - His Honourable Surgeon

She went to see Violet Carter. ‘How are you doing?’ she asked.

‘Fine. Can I go home now?’ Violet asked.

‘No. I’ve found out what caused your funny turn this morning. Your carotid arteries are narrowed.’ Gently, she ran her finger along one side of Violet’s neck. ‘They run both sides of your neck and they supply the blood to your brain. If they become narrow, not enough blood or oxygen reaches your brain.’

‘So what does that mean?’

‘They’re narrowed because some fatty material in your blood sticks to the lining of your arteries—it’s called atherosclerosis. You have a choice. We can do an operation called an endarterectomy—what that does is remove the lining of the arteries and the stuff that’s starting to block them, and the lining will grow back within a couple of weeks of surgery.’

As she’d expected, Violet caught on quickly. ‘And if I don’t have the operation?’

‘They could block completely. Which means you’ll have a full-blown stroke. If you want the figures, about half of people who have a TIA have a stroke within a year, and twenty per cent of those have a stroke within a month.’

‘And if I have a stroke, I’ll have to go into a home instead of being in my own place.’

Vicky nodded. ‘You won’t be able to look after yourself. You’ll need care.’

‘If I have the operation, I’ll be all right.’

‘There are no guarantees—but the odds are loaded in your favour.’

Violet seemed to be thinking about it. ‘Would I be awake during the operation?’

‘No, you’d have a general anaesthetic.’

Violet sighed. ‘So I’m going to have to stay in.’

‘For a few days,’ Vicky explained.

‘Which means I have to tell my daughter.’

‘If you were my mum, I’d want to know,’ Vicky said.

‘Your mum’s lucky,’ Violet grumbled. ‘She’s got a sensible one who doesn’t panic and run around like a headless chicken.’

Vicky’s common sense was nothing to do with Mara. Besides, there wasn’t room for two headless chickens in a family.

She pushed the thought away.

‘I hope she appreciates you,’ Violet said.

Vicky made a noncommittal sound. Mara didn’t understand her and always said Vicky should have been born a boy. Especially after Vicky, as a five-year-old, had taken scissors to her tutu and ballet shoes and threatened to chop off her hair if anyone made her go back to ballet lessons. Mara also hadn’t appreciated Vicky getting herself expelled from finishing school in the first week. Or finding out that she could get herself made a ward of court so she could do her A-levels if Mara tried to make her go to another finishing school.

‘I’ll ring your daughter and explain the situation,’ Vicky said. ‘I can get you on this afternoon’s list, if you’d like to sign the consent form.’

‘And you’ll be doing the operation?’

‘With our consultant, Jake Lewis. I’ll introduce you to him before the operation,’ Vicky said. ‘Oh, and in the meantime…’ She pulled a magazine out of her pocket. ‘Just to stop you getting bored.’

Violet took the puzzle book and flicked through it. ‘Oh, yes! It’s got those logic problems in it. I like them.’ She smiled at Violet. ‘Thank you, love. That’s really kind of you.’

‘Pleasure. I had a feeling you’d enjoy it.’ Because Vicky could see herself like Violet, in forty years’ time. Except she wouldn’t have a daughter fussing over her, or teenage grandchildren. She just hoped a stranger would show her that same kindness.

Vicky introduced Jake to Violet, and noted approvingly that Jake treated the elderly woman with respect, rather than talking down to her. He explained exactly what they were going to do and how long she’d need to be in afterwards, and that they were going to do the operation by keyhole surgery.

Though when they were scrubbing up, she noticed the brooding expression in his eyes.

‘Are you all right?’ she asked.

‘Fine,’ he said curtly.

Hmm. Maybe it was surgeon’s nerves. Every surgeon she knew was keyed up before an operation—which was a good thing, as it meant they weren’t taking their skills for granted and there was less chance of them being sloppy. Some people talked too much when they were nervous. Jake clearly went the other way and barely spoke at all.

Jake had chosen to operate to Corelli, surprising her. She’d expected him to work to pop music rather than classical. Then she was cross with herself for reacting in the same snobbish way Mara would have done. Sure, Jake had an East-End accent rather than a posh one, but since when did the way you spoke dictate your tastes in music?

He talked her through the two-hour operation, clearing one artery himself and then giving her a chance to work on the other carotid artery. She liked the way he worked: deft, neat, precise. But as soon as the operation was over he seemed to switch back to the brooding, uncommunicative man he’d been while scrubbing up.

Something was wrong. Not the operation—it had been a complete success. She didn’t think it had been anything she’d done either. So had this op brought back bad memories? A patient he hadn’t been able to save?

When Violet was out of the recovery room and had settled back on the ward—with her daughter fussing round her bedside—Vicky quietly slipped out to the canteen on her break. She bought a slice of carrot cake and two coffees—he took his black and sweet, she remembered—then headed for Jake’s office and rapped on the door.

‘Come in.’

He was doing paperwork at his desk, and there was strain in the lines of his face.

‘What’s this?’ he asked when she closed the door behind her and put the coffee and cake on his desk.

‘Carrot cake.’

Cake. The Hon. Victoria Radley had brought him cake. ‘Why?’

She shrugged. ‘The men in my life are cake addicts.’

Jake tried to squash the pinpricks of jealousy. He had no right to be jealous. She was a colleague—a distant colleague at that, barely even an acquaintance. The men in my life… He didn’t think she meant that she had a string of men, but clearly she’d been good at keeping her relationships secret from the hospital grapevine. ‘Oh.’

‘Our cook made the best cake in the world,’ she said, almost as if explaining. ‘Which is why both my brothers are putty in the hands of any woman who gives them cake.’

Jake frowned. Was this her way of saying she wanted him to be putty in her hands? Or was she just explaining about the men in her life—her brothers?

As if in answer to his unspoken question, she said quietly, ‘You looked upset earlier. I wanted to make you feel a bit better. It’s also an apology for running out on you over breakfast this morning.’

He shrugged. ‘No problem. You were paged.’

‘Want to talk about it?’ she asked.

Then he realised what was going on. Vicky had made a fuss over little Declan, who’d been bullied. She’d fussed over Violet, too, but on the old lady’s terms—practical things, like bringing her a puzzle magazine. And now she was quietly adding him to her collection of lame ducks, bringing him cake and offering him a sympathetic ear.

‘I’m fine,’ he said stiffly.

‘No, you’re not. It’s something to do with Violet.’

How did she know?

She must have been able to read his mind, because she said quietly, ‘She got to me, too. I never really knew my grandparents because they died when I was very young. Violet’s the kind I would’ve liked as a gran.’ Her smile was suddenly bleak.

Jake knew exactly where she was coming from. The same place as him. Loss and loneliness. ‘She reminds me of my nan,’ he admitted.

‘You were close to her?’