Hot Single Docs: London's Calling. Lynne Marshall
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the way he had when he’d voiced that ‘all or nothing’ ultimatum about their marriage? When he looked at the big picture, he saw it in terms of benefit versus suffering for the individual involved from a clinical perspective.
Abbie was the opposite. She saw the same big picture, but her scales weighed the emotions of everybody involved and not just the patient at the centre of the decision to be made. And the results she came up with were very different sometimes.
But not wrong.
Rafael knew that. He also knew that he’d made things much worse while Abbie and Ella had been away in New York. He’d buried himself in his work and when he had thought about his family, the fear that he would never see his daughter again had been easily shrouded in anger and then resentment towards Abbie. He’d been cool and clipped in any communication. No wonder it had trailed away into impersonal emails and text messages.
But how did you go about changing something that was a part of your personality? How could you learn to feel the things that someone like Abbie could feel?
By finding someone to teach you?
The lift doors slid open in front of him but, instead of stepping in, Rafael turned swiftly and headed for the stairs.
* * *
Abbie knew it was Rafael coming into the theatre without even having to turn her head.
What she didn’t know was why he had come in. The surgery for the grade-three microtia on seven-year-old Annabelle was well under way. Rib cartilage had been harvested and Abbie was sculpting the new ear. She had to look up for a second as Rafael stepped closer, however. Had something happened to Ella?
The eye contact was reassuring. ‘Don’t let me interrupt,’ Rafael said. ‘I just had the urge to come and watch an artist at work.’
Abbie blinked. ‘Really? What brought this on?’
‘I was checking Lucy. Admiring your needlework. And then I remembered you were doing this today and it’s been a long time since I’ve watched the procedure. Do you mind?’
‘No, of course not.’ Hardly. He had been admiring her work? Wanted to watch ‘an artist’? How could anyone object to such a professional accolade?
It put the pressure on a little more, though. Not that Abbie hadn’t been doing her best before but now she was determined to make this perfect.
‘This is Annabelle,’ she told Rafael. ‘She’s been waiting a long time for this surgery but I needed her to be old enough to have sufficient rib cartilage to harvest.’
‘She could have had the surgery much younger with a Medpor reconstruction, couldn’t she?’
Was Rafael criticising her choice? Abbie couldn’t help sounding a little defensive.
‘Using an artificial framework means that the ear can’t match the other one perfectly. It also doesn’t grow with the child. This creates an ear that’s alive. One that’s going to last a lifetime.’
‘But not many surgeons are gifted enough to do it well. Annabelle is lucky to have found you.’
There was a murmur of agreement from the rest of the team. Abbie shook off the praise. ‘I think she chose me because I said I’d put an earring in to match her other ear so it’ll be there when the bandage comes off for the first time next week.’
Happy with the shape of the outer ear she had carved from the cartilage, Abbie turned her attention to the peanut-shaped deformity that had been Annabelle’s right ear until now. She could use the lower part for the ear lobe. The tiny gold stud earring was bathed in disinfectant and waiting in a kidney dish nearby.
Rafael was watching her examination of the deformed ear tissue.
‘She must have been teased a lot at school.’
‘Yes. She’s kept it covered pretty well with her hair but she was very self-conscious about it. Her mother said they had all sorts of problems when she was expected to do swimming at school.’
‘Has it affected her badly, do you think?’
‘Well, she’s very shy. Hard to say whether she would have been more outgoing without the deformity but I’m sure it’s contributed. It would have become progressively more of an issue as she got older, of course.’
‘Si... It would be torture for a teenage girl to look so different.’
‘Mmm. That’s why I favour the rib graft method. She’ll need a bit more surgery to refine things down the track but by the time Annabelle’s interested in boys, her ear will look and feel as if it’s always been there.’
This was weird. She might have expected a keen interest from Rafael but Abbie would never have picked that it would focus on the emotional side of the surgery and its aftermath. Why wasn’t he asking about the dimensions of the suture material she was using? Or the technique for elevating a skin flap to preserve all the hair follicles so that Annabelle wouldn’t be left with a bald patch?
‘She has conduction deafness, I assume?’
‘Yes. There’s no ear canal or eardrum on this side.’ That was more like it. A clinical query.
‘Is that causing problems for her? Or her family?’
‘Doesn’t seem to be.’ He was doing it again. Looking past the clinical picture and considering the bigger, emotional picture. Something was going on in his head, Abbie realised. He was making a deliberate effort. To connect with her way of thinking about patients, perhaps?
Whatever it was, she liked it.
‘They’re under the care of an audiologist to make sure they look after the good side.’ Abbie was peering through the magnifying lenses she wore to make tiny stitches that attached the ear lobe to the new part she had crafted. ‘I think they’re all more concerned about the cosmetic side of it all at the moment, though.’
She checked again that the lobe was at exactly the same level as Annabelle’s other ear.
‘Looking good.’ Her registrar nodded. ‘You ready for the earring?’
Abbie grinned. ‘Let’s do it.’
Even when the surgery was completed, the pressure dressing in place and protected with the plastic cup that was taped on, Rafael didn’t seem inclined to talk about anything clinical.
‘Were you happy with Lucy’s progress?’
‘She’s doing well, isn’t she?’ Abbie stripped off her mask and gloves. ‘I’ll be happier when she can eat again, though. She’s lost quite a lot of weight.’
‘I’ve arranged for a physiotherapist who specialises in maxillofacial injuries to start working with her. Her grandmother’s keen to help, too.’
‘It’s great that she’s got the family support there.’ But Abbie sighed as she pulled off her gown. ‘Her mother’s still in ICU. It’s not looking hopeful.’
‘And the father?’
‘Not in the picture.’ Abbie balled up the gown and threw it in the bin. ‘Hasn’t been since she was a baby.’
A broken family. The kind that Abbie didn’t want for Ella. Or for herself or Rafael, for that matter. She forced a smile to her lips.
‘On a more positive note, I found a gorgeous dress and shoes for the wedding tomorrow. Did you get your suit cleaned?’
‘I have to pick it up at the dry-cleaner’s after work.’
‘But you’ll come and see Ella later?’
‘Of course.’
The smile was genuine this time. ‘We’ll look forward to that.’
‘Me also. And tomorrow...the wedding? It will be another date for us, perhaps?’
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