The Rebel Surgeon's Proposal (15 page)

Francesca was speechless with shock.
She
was the main reason he’d come back to Strathlochan? He loved her? It was
her
he had talked about in the night, the one woman he wished could love him back? It was all too much to take in at once.

‘It’s always been you, Chessie. And always will be. We were destined to be together,’ he insisted.

‘No one is ever going to control me again.’

He cursed in frustration, giving her a gentle shake. ‘It’s not about domination or control. It’s opening yourself up that sets you free, Chessie. Do you think I’m not vulnerable to you? I am. You have all the power here. I’m totally exposed to you. My heart, my happiness, my life, they are in your hands. I trust you because I love you. We’re equals, Chessie, partners, sharing the gift, so much stronger together as a unit than we could ever be alone.’

‘Luke…’ She couldn’t doubt the passionate sincerity of his words but she was scared. Scared and confused.

‘I need you to need me as much as I need you. It’s a partnership of equals, Chessie. We work because we love each other, desire each other, but you’re still fighting it, still so desperate not to give an inch of control. I don’t want to use it against you but to give it back and so much more. To know you trust me as much as I trust you.’

He released her, pushing open his door and getting out. She watched, her heart thudding, her mind racing, as he walked round the car and held the passenger door open for her. Legs shaking, she climbed out, her hands clutching her bag in a death grip. Taking her by surprise, Luke cupped her face with gentle hands and kissed her, hot, hard and passionate, before
he stepped back. Green eyes, turbulent with emotion, looked at her for a long moment.

‘I may freely give you everything I have in me and of me, Chessie, but I need at least something back from you,’ he told her, voice husky and laced with sadness and a thread of defeat. ‘If and when you can do that, if you want my love and all we can have together, let me know.’

Francesca stared after him as he drove away. She had never wanted to hurt Luke, but the shadows of pain in his eyes had shown her that she had. He’d laid everything open for her. This strong, independent man had made himself vulnerable for her, had given her everything, every part of him, and she had let him walk away.

Could she commit? Did she deserve Luke’s love? Could
she
love him back as he deserved to be loved? She had so much to think about. But, basically, what it came down to was a simple choice. Life with Luke or life without Luke.

What was she going to do?

‘T
HE
first priority is to get this haemorrhaging under control or we are going to lose her.’

A and E consultant Robert Mowbray’s words greeted Luke as he hurried into the resus bay in the early hours of Tuesday morning in response to the urgent page he had received. The medical team was hard at work, caring for the stricken patient, and, he noted, Francesca was already present, taking X-rays.

‘C-spine, please, Francesca,’ Robert requested. ‘But I want to concentrate on pelvic images before we worry about anything else.’

Even in such a tense situation, just seeing Francesca stirred Luke’s blood, made his heart beat faster and brought a welter of thoughts and emotions—

‘Luke, you’re here. Just the man. We need your expertise.’

‘What do we have?’ Luke asked, snapping back into his professional role when Robert had finished issuing instructions to his staff and turned to greet him.

‘This is Diane, aged fifty-two. She’d been out at a party where there had been a fair bit of drinking and merriment. As it was breaking up, she slipped over in the car park and a vehicle reversed over her hips and pelvis—one wheel. The driver
never saw her,’ Robert explained, giving details of Diane’s overall condition since. ‘The initial suggestion is of an open-book fracture of the pelvis but Francesca is doing some detailed X-rays.’

Luke looked at the monitors displaying Diane’s vital signs, concerned at the deterioration evident there. ‘Internal bleeding?’

‘That’s my fear. Diane was conscious on arrival but is fading in and out now. The anaesthetist is on the way down. We’ve sent blood for urgent cross-matching.’

‘Any other fractures?’ Luke asked, looking over the notes and examining the area of injury.

‘None suspected on first review,’ Robert responded. ‘Her rib cage is clear, femurs feel intact, but we’ll do a thorough secondary assessment once we’ve stemmed this pelvic bleed. We’ve used a splint wrap, hoping it would compress the pelvis and halt the blood loss,’ the consultant continued, his concern and frustration evident, ‘but despite that, and the fluid replacement, nothing we are doing is improving things and her BP continues to drop. She needs surgery now.’

‘And all the theatres are in use thanks to the motorway collision earlier tonight.’ Luke delivered the bad news, unsurprised when the consultant cursed in annoyance. He had an idea but he’d need to make arrangements with his boss before proceeding. ‘Maurice is operating but I’ll ask him to spare some help so I can do a temporary fixation here in Resus.’

Robert indicated his understanding and agreement. ‘Not easy, and not ideal conditions in terms of cleanliness outside an operating room, but unless we do something, Diane won’t last much longer, bleeding out as she is. If you can do it, Luke, you’ll buy her time and save her life.’

‘Let’s hope so.’

‘Tell me what you need. We’ll give you all the support we can.’

Grateful for the older man’s faith in him, Luke smiled. ‘Thanks.’

‘While you look at the X-rays and gather together your equipment, I’ll send a nurse to the blood bank to chase up the units we need and ask for some more. And I’ll update Diane’s family. I think the shock has rapidly sobered up her poor husband,’ Robert informed him, shaking his head as he moved away.

Luke waited for Francesca to finish, admiring the way she went about her work with calm efficiency. There had been some awkwardness when they had met up at the hospital after the way they had parted at her flat hours earlier, but they’d both been professional. Whilst he was sorry that anyone had been injured, the fact that the night shift had been so busy had helped them both to focus on the job and had given him less time to brood. And to worry if he’d made the biggest mistake of his life by losing his patience and rushing her.

He’d done everything he could, had laid his heart on the line, had bared his soul, and now all he could do was wait and see whether it was enough, whether his love could ever compensate for the pain and loneliness and loss that had been all Francesca had known for so long. He didn’t blame her for her lack of trust. He
had
left. At eighteen he hadn’t understood how that would hurt her and he had never intended to be away so long. At sixteen, she would never have understood why or have known he was coming back. It had been just one more in a long line of betrayals. Could she get past that? They needed each other. Would she see that, or would she reject all he was offering her?

It was proving harder than he had ever imagined to act normally and to hide his hurt and his fear. He knew she needed time, but she gave no clues about what she was thinking or feeling. He had no one to blame but himself if he’d ruined everything by declaring himself and demanding her surrender before she was ready to contemplate it.

‘The pictures are ready.’ Francesca’s words drew him back from his thoughts.

‘Thanks.’ Stepping closer to examine the screen also allowed him to enjoy her subtle flowery scent, enough that he was blinded for a moment by the memories of their weekend together, the feel and taste of her. On dangerous ground, he snapped himself back into work mode. ‘Let’s see what we have.’

‘It looks like a classic open-book fracture, as Robert suspected.’

Sure enough, the pelvis had snapped and opened out. Like a polo mint, the rigid ring of the pelvis never broke in just one place. Luke flicked to another image, planning what was necessary and seeing the shadows of fluid in the cavity, which indicated the evidence of the pooling of blood Diane was losing internally.

‘What are you going to do?’ Francesca asked, her interest evident.

‘With the theatres unavailable, I’m going to have to do a procedure here in Resus. I’ll put screws in and externally fixate the pelvis in place,’ he explained, drawing her a hasty diagram. ‘The plan is to hold the pelvis in position and stop the bleeding so that we can stabilise Diane. That will buy us some time for a permanent repair and also to investigate any other injuries, including assessment of possible complications…for example, her urinary situation in case of damage to her bladder.’

Word came down from Maurice instructing Luke, as Specialist Registrar, to carry out the procedure. Moments later a couple of the more junior orthopaedic team doctors arrived in Resus to assist, closely followed by matronly A and E nurse Gail, returning somewhat breathlessly from the blood bank with several cross-matched units of blood.

‘Blood pressure still falling,’ one of the medical team called out as Robert returned from talking to Diane’s family.

‘Right,’ Luke said after scrubbing up, hiding any flicker of nervousness. ‘We’re set to go.’

With the anaesthetist happy with Diane’s condition, and the blood transfusion being pushed through at full volume, Luke prepared to begin, well aware of the responsibility resting on his shoulders to get this right. Working in the Resus bay was very different from the sterile, fully equipped operating theatre he was used to. It was also more cramped. Knowing that Francesca was nearby, looking on, he glanced up and met her gaze. Her tiny smile of encouragement, signalling her confidence in him, brought an inner calmness as he bent to his task.

Diane’s skin had been swabbed with antiseptic to disinfect the area and, using the detailed X-ray images Francesca had already taken to guide his positioning, Luke set about making the first of the four small incisions necessary. With each one he cut carefully down through the layers of tissue and muscle to locate the pelvic bones and then prepared to insert the screws. One of the assisting team worked to suction out the blood. When each screw was in place, four rods protruded from Diane’s body to which an external frame was attached, pulling the pelvis back together to keep it rigid and supported.

‘Can we have another X-ray please, Francesca?’ Luke asked, straightening and mentally running over all he had done to ensure there had been no mistakes. ‘I want to check that everything is positioned properly.’

Those not wearing protective lead aprons stepped out of the way as Francesca manoeuvred the imaging machine into place and took the required pictures. Watching the screen, Luke breathed a sigh of relief when it became apparent that the screws
were
correctly positioned and that the external fixator cradle was already doing its job.

‘Her blood pressure is rising and she’s stabilising!’

The announcement brought a collective sigh of relief,
which continued to grow as Diane’s vital signs improved after the emergency operation, the seven units of cross-matched blood and nearly two litres of fluid replacing the blood that had haemorrhaged to fill the pelvic cavity.

‘Thanks, everyone, I appreciate your help,’ Luke praised, grateful for the help both of the A and E team and his own orthopaedic colleagues. ‘We’ve closed the ring, stopped things moving around and controlled the bleeding. Now we need to send Diane for a CT scan so we can assess the extent of her pelvic injuries and ensure there are no chest, abdominal or hip problems.’

A hand landed on his shoulder. ‘An impressive job, Luke. Well done,’ Robert congratulated him.

‘Thank you, sir.’ The older consultant’s opinion meant a lot to him. ‘We still have a long way to go with Diane.’

‘Indeed. Let’s get her through to Radiology so we can take a detailed CT scan. You carry on.’

Robert’s approval and tacit invitation to maintain control of Diane’s care for this stage of the process bolstered Luke’s confidence. Checking that the patient’s condition was stable, Luke gathered the small team together and followed as the trolley bed was wheeled through to the radiology department and into the CT scan room for the next step in Diane’s care.

For the moment, at least, thoughts of Francesca, and her decision on whether she would accept or reject him were going to have to wait.

Luke was in Theatre, completing the repair of an elbow fracture to a motorcyclist, when their shift officially ended on Tuesday morning. Francesca had no idea how long he might be but she felt an overwhelming need to see him. She had experienced a rush of pride at his achievements during the early hours with Diane in Resus. His skill had been obvious, the
procedure an important one, but he’d worked calmly and shown no sign that the tense atmosphere around the patient had affected him.

She had accompanied the small group that had gone with Diane for the CT scan. The three-hundred-and-sixty-degree orientation showed slices through the body and the computer assimilated the information and displayed the pictures as 3-D images. Everyone had been relieved that Diane’s injuries were confined to the pelvis, but she was not out of the woods yet. Luke’s temporary repair had saved Diane’s life, but complications remained—there were concerns about her bladder and it was likely she would need further surgery.

It had been a hectic night shift and Francesca had been glad of work to keep her busy, but it had not stopped her mind from working overtime about Luke. There had been a new awkwardness between them during their working hours, as hard as they had both tried to act normally. And while part of her longed for things to be back the way they had been before, she had not been able to stop thinking about their weekend together—or to regret it.

Even now her body throbbed with need and she was deliciously tender from the extent of their enjoyment of each other. She had never been desired as Luke desired her. It had been a little alarming at first but soon she had felt a sense of power that his need for her made him lose control, lose himself. Sex—the twice she had tried it before—had never been the joyous, all-consuming, wildly amazing adventure that it was with Luke. She’d never realised what she had missed, had been so careful to never lose control, to never give anyone else a hold on her or power over her again, not after her mother, or her coach. She didn’t want to need anyone. Luke understood that. At least, she thought he did. Now he wanted to change the rules, to change the whole basis of their relationship.

He had made it clear what he wanted from her—she just wasn’t at all sure she could give it. Confused and troubled, she changed her clothes and then went through to the staffroom that served the radiology and orthopaedic departments to make herself a cup of coffee while she waited. She wasn’t sure what she was going to say to Luke, she just needed to see him, to reassure herself they were still friends, whatever else happened.

The staffroom was empty when she went in. The coffee-jar was empty, too, so she went into the galley alcove that served as a store to find some more. She was out of sight in there when the staffroom door opened and several people came in, laughing and joking.

‘You won’t believe it but rumour is that Luke Devlin bagged the Ice Maiden this weekend,’ one male voice she recognised as that of one of the junior doctors on the orthopaedic team announced.

Francesca froze, clutching the new full jar of coffee to her chest and staying hidden as the all-male conversation continued.

‘No way!’

‘Yeah.’

‘I have a book running on it,’ another voice chimed in. ‘Want to place a bet?’

‘Sure. Here’s my stake. I say Devlin didn’t get past first base.’

Several people laughed and then she heard the door open again.

‘Here he is now,’ the main instigator said. ‘We can ask him. Hey, Luke, give us the details, man, I have a lot of money riding on you.’

Francesca pressed a hand to her mouth and fought back anger and pain. She felt used, humiliated, unable to believe that Luke would betray her. She had trusted him, had listened to his words that had seemed so sincere. Surely it couldn’t all have been a joke, a bet?

‘What are you talking about?’ she heard Luke say.

‘Is it true you thawed the Ice Maiden for us over the weekend?’

The room went quiet.

‘What did you say?’ Francesca could hear the chilling malice in Luke’s voice.

She heard a grunt of surprise and another man called out, ‘Luke! Easy, man. Come on, she’s not worth it.’

What sounded like a fist meeting flesh echoed in the air.