Heart Surgeon in Portugal (20 page)

‘Are we ready, Dr da Silva?’

The little man's eyes were wary again. He hitched his stool closer to Vivienne's head, as if her defenceless figure might afford some protection, and pulled his machinery right up to the end of the table. Ellie wondered why Lilian, Rafe’s favourite, wasn’t working with him today …

A scalpel stroked swiftly across the small square of exposed skin under which lay Vivienne's unsuspecting heart. The thin red line began to bleed gently, and for all her intended self-control Ellie feared she was going to faint. Cold perspiration broke out on her forehead and she looked away, focusing her eyes on the bag on the anaesthetic machine as it puffed gently in and out, in and out. The rhythm helped to calm her and she regained her self-control. Much safer to forget it was Vivienne who lay there. Concentrate instead on that consummate skill which was about to heal her friend before her very eyes.

Rafe had not asked for any music and there was no sign of a CD player or radio. It would have been Ellie’s job to see to the music if the surgeons had wanted it, but she knew – one of her brother’s anecdotes of hospital life – that Cardiac ORs are solemn places of intense concentration where everyone is aware that complications come at you very fast; where even simple mistakes can kill. No music, no hospital gossip, no jokes. ‘Sucker!’ muttered Rafe. Dr Flora’s gloved hands moved in with the sucker and drew blood away from the open wound, allowing a clear field in which to work. So far the atmosphere was serenely efficient, the two surgeons communicating in a shorthand of phrases and clipped sentences. So far - Ellie heaved a long breath - so good.

One of the observing surgeons moved in to assist, using retractors to hold back the friable edges of the wound, gently so that the vulnerable flesh would not be damaged. Rafe was talking to them quietly, changing now to a scalpel with an adjustable blade and demonstrating its advantages. ‘Virtually cuts round corners. See? This joint here can be set at any angle and locked into position.’

Sister Cecilia, heading the nursing team, spoke up with a quiet firmness and for the first time Ellie noticed a trace of Scots accent. ‘That swab can still be used, Mr Harland. They're too expensive to waste.’

Ellie froze in anticipation of explosion. She dared not glance in Rafe's direction. The anaesthetist looked ready to dive behind his machine for cover.

‘Quite right, Sister!’ came the calm reply and Rafe continued to use the offending swab until it was well and truly soaked with blood. ‘Diathermy, please.’

‘Nurse!’ he barked, raising his head and looking in Ellie’s direction, though it was difficult to tell with all that gear covering his eyes. Under the hot surgical lights Rafe's forehead was in danger of dripping sweat into the gaping wound so Ellie moved in close to mop his brow with a paper towel, making very sure she touched no other part of him or in any way contaminated the field of surgery. How Viv would smile to see them!

‘This might interest you, Ellie.’ he murmured, his hands probing inside Vivienne’s chest cavity. ‘Mitral valvotomy was the first operation ever done on the human heart – by Lord Brock of Guy's, where I did my training. Most of his early patients died, but he was sure enough of the logic of the operation to continue until he achieved success… we've got a little bleeder here - can I have more suction … Of course, now that rheumatic fever has become such a rare disease, mitral stenosis is far less common.’

They had been standing beneath the merciless theatre lights for nearly two hours and Ellie was feeling the strain – a blend of unaccustomed tension and constricted movement. Not the four surgeons, though: their concentration was close and intense, quiet murmurings which lapsed into silence during during those dangerous moments when Rafe, with infinite delicacy, dealt with the dread adhesions. Ellie wondered how his back muscles could stand it. Now she understood why he worked hard to keep his body at the peak of fitness and pushed his system to the physical limits.

The lives of others depended upon him.

‘Shall I finish for you, Rafe?’ offered Dr Flora.

‘No thanks, Flora, I want to see this one off the table.’

In went the last few sutures and Sister Cecilia moved in to swab the incision with chlorhexidine. A neat dressing to finish—and all was safely over.

As she drove back to the Casa in the late afternoon, alone, Ellie reflected on an amazing, exhausting, day. On aching feet she made her way up the aisle of rosemary bushes and inhaled the sweet scent of the Madonna lilies. The thought came into her mind that this could be their last evening alone together at the Casa. Rafe’s woman friend might well arrive tomorrow and the fact that neither Ellie nor Giovana had been told just wouldn’t cross Rafe’s mind.
Because you’ve only got yourself to think of!
grumbled Ellie to herself.
If you were a married man, if you’d got a wife and children, things would be very different! Oh yes, Mr Harland, very different! And just when can I expect you back tonight? A bit of information would be helpful, you know …

He was still at the Centre, waiting for his surgical patients to come round from the anaesthetic.

Giovana had placed a letter from England on the hall table, addressed to Ellie in her mother's neat, cursive hand.
A proper letter – good old Mum
! Ellie slit open the envelope with the bread knife, poured herself an ice-cold
citron pressé
, and perched on the poolside, toes dabbling in the sparkly blue depths while she caught up with all the news from home...

Rafe ought to have been exhausted after a long operating schedule in which the mitral valvotomy was first on the day’s list. Instead, like an actor after a demanding performance, the adrenalin still surged, and he was out of the car and into the swimming pool before Ellie could tackle him. After twenty fast and furious lengths out he came and there was Ellie, handing him a big fluffy towel and full of anxious questions. ‘She’s fine, but groggy. Very sleepy - you know the score. No point going to see her just yet.’

‘I’m so happy I was there in theatre! You were wonderful! Just wonderful!’ exulted Ellie, aching to help dry the rippling muscles of his wide shoulders. How could you possibly thank a surgeon adequately for saving a life? How could you find words that didn’t sound like a cliché?

‘Yes, well, it’s all part of a day’s work. Right, I’m going to shower and you need to get your glad rags on, Nurse Robey.’

Ellie’s face was startled. 'My glad rags?’

‘I've booked a table at the Castelo Laranja.’

‘The
Castelo
!’ Ellie stared up at him in wide-eyed wonder. Why, the Castelo was for the sort of people you saw in
Hello
magazine — fearfully grand and expensive. Her pulses started to race with excitement, all traces of weariness forgotten. ‘What ever shall I wear?’ All those lovely new clothes hanging in the wardrobe. Here was the perfect chance to show Rafe Harland how well ‘little Ellie’ could scrub up …

‘That black thing with the roses. The one you wore that night you took me to the airport ...’ But even as he spoke, in a flash it came to him! He'd wondered at the time why Ellie was looking such a dream, but he’d been in too great a hurry to follow up the train of thought. Now, suddenly, all was crystal clear. She must have left him at Faro and gone on to some club with Rico Schiapa. Then, with the cat safely out of the way, that rat must have had the run of the Casa de la Paz! ‘Wear whatever you like,’ he said sharply, ‘just be quick about it.’

Ellie stared up at him, perplexed and shaken. This man was
dangerously
unpredictable — one moment smiling at her with warm and genuine affection. The very next, glaring as if he couldn’t stand the sight of her! ‘Be ready in an hour,’ he commanded curtly and turned on a dismissive heel.

After the stresses of the day - the trauma of watching Vivienne's operation, the undeniable thrill of watching this man, this top-flight heart surgeon in action - Ellie began to tremble and her legs turned to cotton wool. What was it with Rafe? Didn't he have any conception of what it did to someone if one moment you raised them to the heights of happiness and then, with deliberate cruelty and the most heart-stopping volte-face, plunged from approval to rejection?

How could it be that she’d managed to offend him in the space of seconds? This was going to be a terrible evening; she felt utterly weary even if Rafe did not.

She showered quickly and shampooed her hair which was sticky from being confined in a theatre cap. Trying to make herself look a bit taller, she scooped the heavy mass on top of her head in an Edwardian onion, wispy trails framing a freckled anxious face. What were they supposed to be celebrating anyway when Viv wasn’t yet out of the woods? Was this the warning that Charlotte was about to arrive from London and that come midnight Ellie should morph into Cinderella mode?

Tonight was going to test all the confidence she could pull together.

Anyway, the black flowered cotton wasn’t swanky enough. This was the perfect outing for the ankle-length, pale gold, one-shouldered gold silk. Ellie looked at the label: silk plus 24% metallic fibre and 10 per cent lycra – perfect combo for a snazzy clinging fit. She did a careful smokey-eyed look and stained her mouth with a black-cherry gloss. Her one good piece of jewellery was the seed pearl necklet and earrings her grandmother had given her for her eighteenth birthday. Against the fine skin of her shoulders the tiny delicate pearls gleamed with a milky iridescence. But it didn’t work with the one-shoulder so she discarded the necklet and kept the pearl ear-rings for a less-is-more effect. Yes, she looked glamorously slinky, which made her feel better about coping with what might not be the best of evenings. Come what may, the two would be alone together and Ellie Robey intended that Rafe Harland, her darling Mr Big, wasn’t going to be able to forget her in a hurry.

The front door was open and she found Rafe outside in his cream dinner jacket, going round the house and closing and fastening all the shutters. ‘Wind’s getting up,’ he warned, ‘we could be in for a change in the weather.’

Ellie hovered in the doorway. Rafe stopped what he was doing and stared, a blatant head-to-toe appraisal that had Ellie secretly punching the air. ‘Can I help?’ she offered.

‘You’re much too gorgeous to come out in this wind.’ There, he’d said it – exactly what she wanted most to hear. He grinned at her and disappeared round the back of the Casa while Ellie retreated back indoors.

The restaurant was ultra-swish with an old-fashioned formality.

Rafe seemed to have got over his earlier bad mood, and it was exciting being with a man who visibly turned heads. Impassive-faced waiters hovered behind their gilded tapestry chairs, whisking dishes away and topping up her wine glasses, it seemed to Ellie, every time she took the smallest sip. They must be listening to every word. Not that their presence seemed to bother Rafe who simply behaved as if the waiters were invisible. He must be used to this sort of thing. Probably often dined at The Ivy where Charlotte was bound to be a regular.

‘How much can you see in theatre when you’re wearing those head pieces?’ she quizzed him.

‘I could see you all right. Noticed you looking a bit green when I made the first incision. Thought you might be going to crash out on us.’

‘Really?’ countered Ellie with brave sarcasm as she struggled with a lobster claw. ‘Are you sure you weren't confused by my emerald eye-shadow? There wasn't much else of me on display.‘

‘Made up for that now, though, haven't you.’ A significant eye explored Ellie's body. She imagined the waiters smirking. Felt her cheeks turn warm. ‘That's hardly polite,’ she pointed out primly.

‘Am I ever polite?’ grinned Rafe in that heartrending fashion that turned her bones to water. He cracked open a claw and with his fingers dripping rich juices held a succulent bit of lobster up to her mouth. Deliberately he allowed his fingers to brush with butterfly delicacy against her lips; so deliberately that Ellie almost choked with the effort to breathe normally and chew at one and the same time. She snatched up her wine glass and hid behind it, her fingers playing with the crystal stem.

‘Thanks - lovely,’ she mumbled, as those amused black eyes travelled thoughtfully over her vivid mouth and glittering eyes. She gulped some more wine and her glass was immediately topped up. ‘Do they breathalyse people out here?’

Rafe’s response was forthright. ‘I certainly hope so! Having done my whack of patching people up in casualty departments, if I had my way they'd hang, draw and quarter drunken drivers.’

Ellie blanched. Trust Rafe to have decided and colourful opinions on any topic you threw at him. Her eyes swivelled to the other diners, exploring the opulence of the gilded candlelit dining-room, the glittering scene reflected in the great baroque mirrors dominating every wall.

‘I hoped we might dine out on the balcony beneath the stars — hadn't bargained on a rising gale. Good thing I latched all the shutters before we left. They’d be banging all night, keeping us awake.’

The wind had now increased to a surprising strength, but its howl was drowned by the string orchestra playing music to smooch by, tugging at the heartstrings and making Ellie’s feet itch to dance. Several couples were already swaying on the raised arena of the intimate dance floor. It was all very luxurious, very discreet, very sensual. And doubtless extremely expensive.

‘Come.’ Rafe, the mind-reader, stood up and held out his hand to her. A waiter held her chair while Ellie rose breathlessly to her feet, her heart racing at the wildest of dreams coming true. Rafe took her into his arms, his right hand cradling hers, his other hand firm against her lower back, tantalising her through the thin golden silk. Just then the music changed from smooch to foxtrot and Rafe moved expertly into the moves, his arms turning her and the pressure of his thighs guiding hers so that the tricky steps happened as easily as if she had been dancing foxtrots all her life.

Was there nothing this man did not do with supreme and confident ease?

When the music finished they returned to their table and their steaks were set before them. ‘What a lovely dance,’ said Ellie happily. ‘Like being in an old Hollywood movie. Where did you learn to dance like that?’