Having caught the cancer when it was only in the one kidney had been his saving grace, Sarah Davis, Surgical Registrar to Mr Ishram at St Oliver’s Hospital, had told Patrick Devlin that morning. Fuming after Mr Ishram’s polite request, at short notice, that she operate on his patients that afternoon, Sarah had skim-read her consultant’s notes on the ward before marking the entry point on Patrick’s abdomen with gentian violet ink, adding her initials with her usual flourish. A reminder of the gratitude her patients owed her. Patrick’s pregnant wife said she had been worried he wouldn’t get the chance to meet his unborn son and Sarah laughed and said not to worry, Patrick would be home for Christmas. By late afternoon, Patrick’s kidney was out and he was in the Recovery Unit under the care of the fastidious Dr Mike Crone. Sarah was just about to drink her first coffee in the theatre restroom when her bleep went, calling her back to Patrick’s bedside.
‘Something’s not right,’ Mike said, examining the swelling in Patrick’s arms and legs and looking up at Sarah anxiously.
Patrick should have been sitting up asking for drinks and greeting his wife and daughter, who were waiting in the relatives room down the corridor. Instead he was retching into a metal bowl, his moonlike face more yellow-tinged than earlier on the theatre slab.
‘Probably just a reaction to the drugs,’ Sarah shrugged.
She untied Patrick’s theatre gown to reveal the purple colouration, pockmarked with staples on the right side of his swollen stomach, with the initials ‘SD’ untouched below.
‘Everything as it should be.’
She always thought of the childhood story, ‘The Tortoise and the Hare’ when she worked with Mike. He was conscientious but dull, whereas surgery was about breaking new ground and taking quick decisions to save those worth saving. She’d always wanted to be a surgeon, ever since she’d watched the re-runs of ‘Doctor in the House’ with her granny after school. She wanted to be a mother also but that had proven more elusive, even with surgery. Probably for the best, David had said, more time to party.
‘Blood pressure falling, zero urine, heart beat slowing, his body’s starting to close down,’ Mike’s voice rose as he pushed his bifocals up his nose to review the vital signs on the patient notes. ‘Are you sure it was the right kidney that had the tumour?’
Sarah watched Patrick’s eyes turn to her, she saw the confusion in them before his breathing suddenly became more laboured and he dropped back against his pillows, unconscious. She wrinkled her nose in distaste as the sick bowl clattered to the ground and its contents splashed across the grey tiles, the yellow bile and traces of blood like a smashed chick’s egg. A nurse came running.
‘Bleep Mr Ishram. Tell him his Registrar needs his help. Then prepare Mr Devlin for further surgery,’ Mike instructed.
Sarah stomped out of the recovery unit and back into the theatre, with Mike in pursuit. Patrick’s scan was still mounted on the back-lit wall and she noted, with satisfaction, the X highlighting the tumour on the right kidney. Mike Crone had never liked her. He thought she wasn’t serious about being a surgeon, just because she didn’t want to spend all her waking hours in theatre. Mike lifted the scan down for a closer look. A couple of other surgeons had heard the commotion and they stood at the back in a sea of blue gowns. Sarah watched Mike fiddle with his glasses and then turn the x-ray upside-down before replacing it under the light.
”The diseased kidney is on the left,’ he said quietly.
In the silence that followed, punctured only by the bleeping from the anaesthetic machine, their eyes were drawn to the sealed box on the theatre table where the removed organ sat in its own watery fluids, like a marinating chicken breast, waiting for disposal. She heard the heavy tread of Mr Ishram on the tiled corridor outside.
‘I need to operate,’ Sarah said. She looked around but no one caught her eye.
‘I’ll take over now, Sarah.’ She felt Mr Ishram’s firm hand on her shoulder as he steered her off to the side. A few minutes later, an unconscious Patrick was wheeled in and Mr Ishram cut into the skin on the left. Mike paused beside Sarah.
‘You know you haven’t been yourself,’ he said.
‘I don’t know what you mean.’
Mike leaned towards her and sniffed. ‘I think you do know,’ he said.
Sarah looked away first, biting her lip. ‘What’s his chances?’
‘I’d say 50:50. The nurse is speaking to Patrick’s wife now. You should go home.’
She heard the cries from the relatives room and the nurse’s gentle voice in response. Mrs Devlin stumbled out, clutching the hand of a pale little girl in a red coat and recognised Sarah through her tears. ‘You told me Patrick would be home for Christmas,’ she said. Sarah took in the frightened eyes and the child’s pale face as she hurried past. Behind her, she could hear the girl’s voice. ‘Will Santa still get me the puppy Daddy promised?’
The party was well underway by the time she arrived home and she slipped upstairs. She pulled out the bottles from the back of her wardrobe, piled them into bags and dumped them in her car, the clinking drowned out by David’s rock music. Her phone rang just after 3am, when their guests were dancing in the hall. It was Mike. He sounded tired.
‘Patrick’s still alive. He’ll need a transplant but Ishram thinks he’ll make it.’
The white face of Patrick’s daughter washed before her. She reached for the proffered glass of champagne and gulped it down.
‘Please, Sarah, take this as a final warning. You’ll not be so fortunate the next time.’
She held her glass out for a refill. Slow and steady never won the day.