On a Scalpel`s Edge

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PROLOGUE

The piercing sound of ambulance sirens penetrates the winter morning drizzle as victims of a multi-vehicle pile-up on the South-Eastern Freeway are brought swiftly to casualty at the City Hospital, Melbourne.

Doctors, nurses, orderlies and other medical staff quickly tend the hapless victims that arrive sporadically on this fateful Friday, to be trundled off to be x-rayed for suspected internal injuries, concussion and fractures, then sent on for further tests or emergency treatment.

An ambulance is manoeuvred into position at casualty, the rookie driver jumps out, strides to the rear of the vehicle and helps a colleague lift out the limp body of a male lying on a stretcher. They wheel him to the entrance of the building.

‘Somebody give us a hand with this bloke? He’s turning blue!’

‘Leave him to me,’ says the resident doctor, Richard Fleming, as he breaks away from a small group of interns to examine the patient. ‘His pupils are fixed and dilated,’ he says, announcing one of the first clinical signs of impending death.

‘Five of these,’ he reminds the driver, and demonstrates, pumping the patient’s chest wall not only to help the patient but also to ensure that he and the ambulance officer act in unison. ‘Then stop while I give a breath,’ he explains, miming to ensure he is understood.

They set to work when the patient responds, though only barely, with a faint flutter of the pulse. He takes the front end of the stretcher and the ambulance driver the rear, and together the two men carry the unconscious accident victim into casualty.

‘We have a cardiac arrest,’ Doctor Fleming shouts. ‘Get him a bed and summon the duty doctor. And stand by with ventilation bags or oropharyngeal airway equipment.’

As medical staff transfer the dying victim onto a bed, Doctor Fleming, annoyed at the delay before the duty doctor arrives, yells angrily. ‘For heaven’s sake! Make sure this patient is given isuprel and bicarbonate injections. Do you have any? If not, get some on the double! And the ECG monitor and defibrillator.’

In due course it is noted in the accident and emergency department that this particular patient is Mario Trogolo, a solicitor. As he is attended to by medical staff, other accident victims arrive in quick succession. Those with the more devastating injuries are taken post-haste to the emergency ward or to the appropriate operating theatre.

Here surgical teams are already poised to render help to the best of their ability; aided by the optimum that modern medical technology and drugs can offer.

While traffic police and ambulance attendants are making their respective reports on the horrendous accident which occurred at roughly 5.30 that morning, in which three people were killed and many injured, Professor John Mervyn Taylor, chief surgeon, prepares to operate on the first of several seriously injured patients, who is writhing in pain on the narrow operating table even as the anaesthetist slowly puts him to sleep.

Competently the second surgeon, Shirley Paige, stems the blood flow, and checks over and protects vital organs; the scrubbed nurse, Thelma Marks, adroitly handles the sterilised surgical instruments used by the surgeons and the scout nurse, Jean Curtis, diligently relays anything needed, from information to equipment, within and from outside the theatre.

Supporting their judgement and experience is a bank of machinery. For example, the pulse oxymeter, a finger-clip, is displaying the heart rate on the ECG and will trigger an alert if the oxygen levels enter the danger zone.

Two other surgical teams are performing similar life-saving procedures on patients in theatres 2 and 3. For the doctors and nursing staff the stress is high, but they are geared to cope with that.

Several hours later, after conducting a variety of operations, Professor John Taylor emerges with his equally exhausted team. He showers and changes, then drops into the canteen for a cup of coffee before the long drive home, when his intimate friend and confidant, Grant MacGregor, approaches. Grant has specialised in cardio-thoracic surgery, and received his professorial appointment a few years before John.

‘I need your help, John,’ he says simply.

‘Oh?’

‘It’s Mario, he’s had a heart attack.’

‘Bloody hell’

Grant nods ‘He was admitted about an hour ago. He’s very weak. We must operate as soon as possible.’

John stares at him in astonishment. ‘He was fine when we the three of us dinner about a fortnight ago.’

‘That’s right,’ replied Grant, frowning thoughtfully, ‘We were celebrating the court victory he won for us.’

‘That’s right,’ says Grant, nodding. ‘ But we knew he had a heart problem.’

‘I never realised it was life-threatening.’

‘It wasn’t initially. But he was involved in the pile-up on the South-Eastern Freeway this morning. The tests show that he’s in need of a mitral valve replacement. We have a team on standby, but I would feel much happier if you’d assist me.’

John shrugs. ‘You’re the cardio-thoracic specialist, but I’ll stand by.’

‘You assisted superbly last week with the Lower and Shumway technique.’

‘Thank you, Grant. But the operative word is assist. You are the cardio-thoracic surgeon, not me. Now, have you considered the keyhole bypass?’

‘Yes, but in Mario’s case it’s not feasible.’

‘A pity’ observes John. ‘It’s less complex and reduces the risk of stroke.’

‘Agreed,’ says Grant equably. ‘And we have used it here in Melbourne. It’s a genuine advantage to be able to operate without a heart-lung machine. But...’

‘But,’ says John, stifling a yawn. ‘This time it’s a conventional approach. When do we go in?’

‘Seven-thirty in the morning.’

The patient, Mario Trogolo, is stretched out on his back on the narrow operating table. It is 7.30 Monday morning. The anaesthetist, Doctor Terence James Penfold, prepares to put the patient to sleep. Meanwhile Professors Grant MacGregor and John Mervyn Taylor nod and smile at each other and murmur greetings to the other members of the surgical team.

They all look alert. This early hour of the morning is the usual time on a weekday when cases such as open-heart surgery are scheduled.

Traditionally the work ethic of the senior consultant who supervised young doctors was formed by a brutal training regime that had more to do with staying-power than humanity. It was a system that could create a macho, doctor-as-god mentality. But conditions at the City Hospital had improved dramatically in recent months, mainly through the intervention of such personalities as Grant MacGregor and John Taylor. Both had started their medical degrees at the University of Melbourne. Grant had graduated first, and John a few years later. In due course both were admitted as fellows of the College of Surgeons.

In companionable silence at the waist-level stainless steel trough in the corridor outside the theatre, the two men begin the required scrub. With soft shower caps to cover the hair, the two surgeons rub brown antiseptic on their hands and up their forearms. John follows Grant as he pushes the swinging theatre door with his back, careful not to contaminate his sterile hands. Holding his hands up high, he remains in the same position until the scrubbed nurse, Thelma Marks, has helped Grant and himself into their sterile gowns, and then into prepowdered, sterile rubber gloves.

Mario Trogolo’s x-rays, clipped to the backlit viewing box on the green-tiled theatre wall, spotlight a chubby yet broad chest, wide shoulders, and a bloated, drooping heart, the shape of an elongated egg. The diseased heart is dilated with a backwash of blood.

The patient’s chest has been washed, painted with an antiseptic solution, and dried. His head, legs, belly and sides are covered under green sterile drapes, leaving only his chest exposed. A bare patch of skin in a sea of green.

The surgical team, masked, gowned, gloved, faceless, begin the operation. Each member of the team has a precise role to play.

John scrutinises the monitors’ continuous digital readout of Mario Trogolo’s cardiovascular activity. Venous. Diastolic. Systolic. Green light traces on the oscilloscope screen. Bleep. Bleep. Bleep. Numbers flash by like fruit on a busy slot machine.

Biting his lip as he digests the information, John asks for a scalpel and starts to cut through to the artery, into which he will thread a catheter that will hook to a line connected to the cardiopulmonary bypass pump.

For two to three hours the heart-lung machine will take over the patient’s circulatory and respiratory functions.

Meanwhile Grant MacGregor, as the main cardio-thoracic surgeon on the case, is examining the x-rays before taking his place at the helm, making sure everything works like clockwork. He will oversee every aspect.

John next picks up the Bovie electrocautery, regulates the current with a foot pedal, and uses the metal tip to make an incision running lengthways from the throat down to the xiphoid, the soft cartilage at the breastbone’s end.

‘Jean, head-lamp please,’ Grant murmurs to the scout nurse. She places the headgear with a small headlight on his forehead.

Together, Grant and John insert a stiff metal frame, called a sternal retractor, into the incision. The pericardial sac enveloping the heart is carefully slit, then sutured tautly to the sternal retractor-like material on a loom.

It will be a five hour operation.

ONE

After a lengthy delay a receptionist led an irate gynaecologist, Kerry-Ann Armstrong, along a corridor to the office of the head of the Department of Surgery at the Hazeldene Medical Centre.

‘Professor Taylor has phoned to say he’ll be a little late,’ she said, opening the door and waving the visitor to a seat in front of a large desk.

‘If I were you I’d select a magazine from the pile on the coffee table. It’ll help to pass the time,’ she suggested.

Kerry-Ann paged idly through a magazine for a few minutes, then feeling restless rose to her feet as her attention was attracted to a series of framed photographs, citations and medals that were strategically hung in the surgery.

She moved on to a few vigorous but angular framed pencil sketches of people enjoying pursuits such as gardening, paintings of flowers and plants and workers plucking fruit from trees.

‘They give patients something to talk about, conversation pieces...’

She jumped in alarm.

‘I didn’t mean to alarm you, but let me apologise for being late. I’m John Taylor,’ he said, holding out his hand and grasping hers firmly for a second or so before relinquishing it.

He appeared to be in his early thirties, which she felt was rather young to be the head of the Department of Surgery.

‘I was held up at City Hospital,’ he said.

She noticed his pale, sensitive well-manicured hands together with his impeccably tailored clothes, were in stark contrast to his rugged, unshaven face. What sort of man was this she wondered. Would he be difficult to work with? But she had learned not to trust judgesments made on first impressions. She tried to hide her irritation at his attempt to make her feel relaxed. If he had really been detained in the operating theatre surely he could have made an effort to postpone the interview?

‘I suppose you’re wondering about the sketches you’ve been scrutinising? Well, they give patients something to talk about. Conversation pieces. I often get a shy youngster, a self-conscious young woman or a boy who doesn’t want to talk. Look at my pen sketch here, I’ll say. it’s the work of an amateur, isn’t it?

‘That soon puts them at ease.’ He smiled self-deprecatingly. ‘But a few words about my own background may help you assess whether the situation here will be to your liking.’

She tried to hide her irritation at this clumsy attempt to make her feel relaxed. She thought his presentation very wooden as he listed the teachers and specialists who had influenced him, who he had worked with and where, and even his reasons for devoting himself to Hazeldene. But it might be that he just felt uncomfortable talking about himself

He told her that he had worked with in his early youth as a revenue clerk before realising that a medical career was his true forte. Then, suddenly a change of tack. Enthusiasm! He picked up a file from an In tray. ‘This morning’s patients,’ he explained, tapping the tray. He opened a file and glanced briefly at its contents.

‘’As well as the necessary medical data, we also use computers for Internet, accounts, correspondence, patients’ names and addresses – with the more personal medical details also kept in files like these.’ He closed the file and slipped it back into the tray.

‘This is my particular obsession. Records must be in date order. I can’t think about a patient unless his or her records are straight. A lot of specialists and general practitioners don’t realise what they miss. They might as well have no records at all.

‘So we are indeed grateful for the advent of the computer age. First aid courses, for example, are no longer an excuse for three days out of the office. We are very grateful for the CD-ROM project developed in recent years by the Commonwealth Bank for St John Ambulance.’

Is this some kind of test? She replied aloud. ‘Yes, I believe the Australian First Aid CD-ROM encapsulates ten hours or more of the theory, and replaces two days of training, so all that is needed afterwards is a day devoted to practical applications.’

‘You know about computers?’

‘And programming,’ she said with a mischievour grin. ‘But did I neglect to mention that in my CV?’

He riffled through the pages, again giving the impression of stiff unease. ‘Ah, I see. Good. It’s an increasingly relevant expertise. Though of course our overall system is maintained by the executive secretary. You will doubtless wish to keep your own client files?’

As she murmured agreement, she thought his glance stayed on her a little longer this time, and more approvingly. Of her physical attractions, or of her neatness? But his nose was in the CV again.

‘Doctor Armstrong, you have been practising in Melbourne for the past nine years, first as a general practitioner, and again, since you qualified in that field, as a gynaecologist. Surely emoluments, prestige and everything in your cultural profile seem to favour your remaining near the central city. So what appeals to you about the country?’

Are you the stereotypical unobservant professor, she wondered, sighing inwardly, or the stereotypical sleepy rural GP? But my snap judgements aren’t adequate for you. I’m missing something, perhaps a lot. After all, you spent over a decade in Melbourne as a general surgeon, and worked with the best, ending up heading a top team at the City Hospital... And as for settling in Hazeldene, who could blame you? For consulting rooms with this fantastic view of the beach and sea!

‘Professor Taylor, stress and tension are as endemic to city life as polluted air, polluted food, and impure water supplies - to mention but three primary reasons.’ Then she added, more thoughtfully, ‘Personally, I prefer getting to know my patients as individuals rather than as numbers.’

He cleared his throat. ‘Let me assure you, Doctor, that even if you do live in the country, you are breathing polluted air. Even without the obvious polluter - traffic exhaust fumes - there are chemicals emitted by industry, and to a lesser extent we are still the victims of cigarette smokers...’

‘I can positively reassure you on one point,’ she interjected.

‘Oh?’

‘I don’t smoke.’

She could see when it sank in that she was taking the mickey out of him: He chuckled appreciatively. ‘My apologies. I’m afraid my ranting against the habit can be tedious...'

‘No need to flog it to death?’

He rose to his feet, ‘Yes indeed. No need to flog it to death.’

When she had come in, in tailored linen suit, matching bag and shoes, Professor Taylor had warily admired her clean, crisp style and her long-legged, shapely figure. But that cloud of black hair hinted at less restrained aspects, and she had an edge to her wit, too. If this incisive, strong-minded woman was genuinely interested in joining the Hazeldene Medical Centre, the centre was definitely interested in having her. In signing her on, rather.

‘You do realise that at peak holiday periods, until we have filled the remaining positions at the Centre, you may be called upon to assist in emergency operations?’

‘Of course. That was contingent upon my appointment,’ she said decisively. ‘My experience as a general practitioner should be useful.’

‘Yes indeed,’ he said. ‘But to be honest, specialist medical personnel such as yourself invariably object to that proviso.’

‘I certainly don’t,’ she noted with a shrug. ‘Probably those who object mainly do so because they have little experience as physicians.’

‘Makes sense,’ he said, pausing as he collected his thoughts. ‘Doctor Armstrong, the Hazeldene Medical Centre invites you to join us as its gynaecologist. You’ll be sharing your suite, which adjoins this, with Brian Ridgway, whose speciality is paediatrics.

‘The aim here is to make the Centre self-sufficient, able to provide any specialist treatment. This will encompass all the paramedical branches such as physiotherapy, occupational therapy and radiology.’ He lowered his tone confidentially as he handed her a written contract, which outlined the terms and conditions entailed in her working from the Hazeldene Medical Centre.

‘Oh no, don’t sign,’ said John hastily.

‘Don’t sign?’ she queried, her pen already high over the paper.

He laughed.

‘Sorry, I don’t mean not ever, I mean not yet. Don’t you think you should have your solicitor review it first?’

She caught his eye for a long half second, then smiled and put her pen down. He was right. Considerate and right. She ought to have the contract professionally looked at, and it was kind of him to draw it to her attention.

Before she could utter a word he continued, ‘We are considering opening a section of the Centre for various branches of alternative medicine. It would be an added inducement for patients to remain with us, rather than chopping and changing from one doctor to another.

‘Now I shall ask Diana to take you on a tour of the rooms we have ear-marked for gynaecology, but you can see from here the same ocean view that those rooms command.’

Dr Kerry-Ann Armstrong suspected that her pretence of casualness was betrayed by her body language as she rose from her seat, evidenced by her glowing eyes, and her rising and falling bosom. His hand gently touched the small of her back, guiding her over the carpeting towards the floor-to-ceiling window. She shivered very slightly.

The view was framed by cream-coloured vertical blinds, strategically opened so as to avoid the direct glare of the sun. The waves rolled tirelessly towards the beach, crashed down and broke into frothy foam as they smashed through the rocky outcrops, continuously washing the beach as the high tide neared its peak.

While her eyes seemingly drank in the scenery, she allowed her thoughts to linger on the interviewer. Initially she had concentrated on creating a good impression. But what had just transpired was like a bolt from the blue. Her favourable estimate of him improved dramatically.

He was impressed with her too, she knew, not only with her medical background, but with her as a person, as an individual, as a woman. Now the chemistry between them was exciting, stimulating, thought-provoking.

Her own research had dislosed that he was an extremely capable surgeon and in essence a very moral man. Contributing to her respect was the acknowledged fact that Professor Taylor was the type that conscientiously stayed up-to-date medically through attending seminars and related medical conferences, through systematic reading and group discussions, something many of his established colleagues neglected.

She wondered whether he realised that she had already sensed the attraction which seemed to be mutual. Was her imagination playing tricks on her? But she approved of the way he had insisted that she refer the contract he had drawn up to her solicitor for scrutiny and approval before she finally committed pen to paper.

There was something about him that was eminently likeable. She liked his long, lean body, his strong-boned lantern face and jutting jaw. The thick brown hair would probably be curly if he’d only let it grow. But he had beautiful eyes, an intense deep blue, with an intelligent gleam. ‘Now, before you meet your future colleagues,’ he smiled. ‘I’ll introduce you to our executive secretary, Diana Warwick, who controls the computers and other electronic equipment. She is a gem: she not only runs the office like a military academy, but also ensures that the cleaning staff keep everything spic and span.

‘She is a veritable mine of information - and very loyal as well as being super efficient. Meanwhile, stay here and enjoy the view while I fill her in about our provisional arrangement. As I said, Diana will show you over the complex. We would of course like your decision as soon as possible, but will be happy to hold the rooms open for you a few days if necessary.’

She nodded as he quietly left the office, carefully closing the door behind him, allowing her complete privacy as she happily anticipated her future at Hazeldene Medical Centre.

Professor Taylor strode purposefully towards the reception area, deliberately clearing his mind of this intriguing woman. Thoughts of his late wife Cynthia, who had been killed in a motor car accident ten years earlier still haunted him, and made him feel guilty whenever a woman stirred his interest. What he needed at that very moment, he told himself sternly, was to keep his mind tethered to minutiae, free from the perils of introspection.

Rodney Hunt peered through the gloom before the onset of another dawn, studying Shirley Paige. She lay on her back, her body outlined by the silken sheet. Moving in her sleep, she stretched a naked arm over her head in a gesture Rodney found both erotic and graceful. He rolled onto his back too and thought about her. They’d met three months earlier, when she’d joined the surgical staff at City Hospital.

‘Welcome to the Hazeldene team at City Hospital,’ he had said after she’d introduced herself, ‘I believe you’ve volunteered to join our Friday surgical team?’

Clasping her outstretched hand with both of his, he had smiled at her approvingly. She had been wearing a knee-length navy-blue dress. The contours of her body fought the confines of the dress and won. Full, soft breasts, narrow waist, rich flare of hips tapering to good legs and ankles.

Freeing her hand, she had looked up at him and replied. ‘No, I did not volunteer. It was a stipulated condition. But also remunerative for a newly qualified surgeon. Any other questions?’

‘Not really. You’ll remain in a standby capacity for the next month or so. Hazeldene Medical Centre will continue to provide such a service until you have become fully familiarised.’

‘So it should!’

Since then her features had become etched on his mind. Her long, fine blonde hair. And those mesmerising, piercing eyes. Those deep greyish-brown, penetrating eyes that dominated her face despite the high cheekbones and heightened colour of her cheeks.

Those expressive eyes. They were always alive, possibly judging his value or measuring his worth. And her hair. He preferred it when Shirley’s hair swung loose and free. When she wore it upswept she seemed unbearably regal to him. Distant. Disdainful. Even arrogant. Somehow he couldn’t identify with her when she looked like that.

Whether working at the Centre, or as a member of the surgical team, dancing, and even playing tennis, she moved with grace and precision of the true professional. It was on the tennis court that he had resolved to possess this dainty, slim, high-breasted beauty who stroked the ball so smoothly, but with such devastating power.

He had courted her assiduously. She had strenuously, then gently, rejected his advances, so that until now his persistence had not paid off. It was only a few hours earlier that she had given herself to him unreservedly, and the first time they had spent the night together. They had enjoyed their lovemaking, at first lustily and vociferously, then meaningfully. He now knew he cared for her. She had made no demands on him. Nothing changed the fact that he wanted to make love to her again and again. Quite apart from her looks she had an earthy, tireless responsiveness that made her extremely attractive. What was more, he was sure that she wanted him in the same way too.

‘Your thoughts must be deep and profound,’ she murmured.

‘You’re awake. I am still feeling a little tired and assumed you were too. So I let you sleep.’

‘Yet you were engrossed in thought,’ she replied.

‘I was thinking of us. What made you decide to take up medicine?’

She frowned in concentration. ‘The topic was always on our minds. No joke was adequate as a student. You remember the jokes? That orthopods were as strong as an ox but twice as smart; that gynaecologists were still trying to find out where they came from - and that paediatricians were forever striving to prove that they were better than the women who bore them....’

‘What about surgeons?’

‘As a student nothing infuriated me more than the prima-donna kind typified by Chris Barnard.’

‘Oh?’

‘You know Richard Fleming, resident doctor at City Hospital?’

‘Of course.’

‘Well, his uncle sometimes worked in the operating room at Groote Schuur Hospital. in Cape Town. Professor Barnard was an overbearing sexist, and occasionally hurled instruments to the operating-room floor in a tantrum when matters went amiss.’

‘I’ve heard similar reports. And that he had an affair, among others, with Gina Lollobrigida – the Italian actress – shortly after performing the world’s first heart transplant...’

‘Let’s not digress. Why were you hell-bent on becoming a surgeon?’

She paused briefly: ‘No-one in my medical school ever suggested that surgery was unattainable for a woman, just exceedingly rare. But I was not interested in what men thought appropriate for me. Our emeritus professor of medicine desperately tried to side-track me into something else - psychiatry, paediatrics, dermatology or even clinical medicine.’

‘A pity you didn’t follow his advice.’ He could tell from the abrupt way she withdrew from him that Shirley was sizzling with indignation. Frantically his mind started churning.

‘You bloody sanctimonious hypocrite,’ she said scathingly, rising from the bed as she hastily began dressing. ‘I’ve allowed myself to be screwed by a warped, chauvinistic pig.’

He jumped out of bed, clasping her half-naked body in his arms as he tried to placate her. ‘Hear me out,’ he urged. ‘I wasn’t denigrating women surgeons.’

‘Weren’t you?’

‘I swear I wasn’t,’ he said, his mind still racing. ‘ I was about to point out how medical science has advanced into the realms of high technology. Pills, potions and prevention – with general surgeons, both men and women, being left behind.’

His distress was so pathetic that she gave him the benefit of the doubt and relented. She had possibly misunderstood him.

It dawned on him that his mobile phone was ringing. It was on her side of the bed. ‘Answer it,’ he told her unthinkingly.

She gave him a look. It told him she was not one of his chattels. The balance was slipping rapidly from the aftermath of strenuous but satisfying lovemaking to disbelief and hostility.

With a bound he reached the phone.: ‘Hello!’

By the time the call had terminated, Shirley had finished dressing. She was the very picture of icy superiority. He didn’t know what to say.

She had her arms cross over her bosom, modestly enough, but there was no way that sensuous body could ever be modest. She left without uttering a word.

The sinking sun, breaking through layers of blue-grey cloud, shimmered on the crest of incoming waves as they crashed incessantly onto the beachfront, within a few hundred metres of The Hazeldene Medical Centre.

The architectural structures of the Centre discreetly displayed a series of ultra-modern buildings overlooking the sea and were an impressive sight. They occupied the lower slope of a mountain range. It blended harmoniously with the surrounding vegetation, a coniferous and deciduous forest of trees and shrubs, interspersed with a variety of plantlife from daisies and cosmos to dandelion, cactus and even bramble and gorse.

Two men were strolling along a pathway which meandered haphazardly along the coastline, enjoying the most spectacular views of the ocean before spreading out to become walkways linking the strategically sited buildings casually referred to as the Centre. John Taylor, the head of the Centre, and long-time friend and colleague, fellow surgeon Grant MacGregor of City Hospital, who had spent the day at an interdepartmental meeting, had decided to stretch their legs after spending several hours sitting with others around a long table, discussing mainly routine medical concerns as well as the inevitable ‘cutting costs’.

The two men paused momentarily to admire the view overlooking the sea. All was quiet, save for the sounds of birds and insects, and the rustle of a gentle breeze through the foliage.

‘I need to talk to you off the record, John.’

John Taylor shielded his eyes against the glare of the setting sun as he turned to face his colleague, a big heavyset man whose manner was outgoing and ebullient; at times more like a high-powered salesman than a surgeon.

‘Have you been receiving threatening letters or lecherous phone calls?’

‘I’m not bullshitting, John. This is serious.’

John stared at his friend. This man could be extraordinarily exhausting. His intellectual capacity was almost limitless, and only his close friends knew whether he truly believed the point of view he espoused.

‘Okay, as we are close friends I’m now convinced you’re not trying to merely provoke a spirited debate. So what gives?’

Grant’s eyebrows go up a notch as his eyes locked with John’s. ‘Computer hacking - and I’m deadly serious.’

John’s expression tensed. ‘I’m listening, Grant.’

Grant detailed the alarming penetration of one or more hackers, with not only hospitals such as City Hospital and The Hazeldene Medical Centre, but military installations as well as the corporate world to have been penetrated

‘What action do you suggest I take?’

‘In recent weeks I have been in close contact with the City Hospital and the police.’

John prodded impatiently. ‘Go on.’

‘We have chosen a small group of specialists led by a global expert on cybercrime,’ growled Grant.

‘Re-al-ly?’ The three syllables, bristling with a mixture of astonishment and irritation. ‘Jeremy Wheeler has a reputation for preferring to work on his own ...’

‘To avoid unnecessary costs,’ interrupted Grant placatingly.

‘And what is his claim to fame?’

‘City Hospital is funding half the costs of the exercise,’ grunted Grant.

‘Now that is called exercising your prerogative’ said John, as he cranked up his most dazzling, debonair smile.

‘Jeremy Wheeler is an ex-SAS man who spent time in Afghanistan and Iraq. He is not only computer literate, but has hands-on experience of the latest command and control systems. And, best of all, he understands a thing or two about discipline.’

Glancing at his wristwatch, ‘I’ll take your word for it, ‘ replied John, masking a smile as he shook hands with his unusually serious friend. While conversing with him he had noted Grant’s palpable sigh of relief at his agreeing to share the financial and personal support provided. Grant worked from facts that could be verified and would hold up in court.

Poised to walk off, Grant turned back, saying: ‘Oh, one last thing, John, the peccadilloes of Shirley Paige and Rodney Hunt could ultimately become a cause for concern. Okay?’

As the fiercely loyal and utterly reliable cardiovascular surgeon headed for home John continued his walk. John prided himself in never obsessing over issues. Grant, of course, was clearly bemused as he had been expecting an adverse reaction from his boss over the hacking revelation. John glanced over his shoulder at the retreating figure of Grant as he made his way to the car park, still perplexed, but mightily content that his argument had been sufficiently persuasive to earn John’s support.

All at once John Taylor’s mind fixated on the newly recruited gynaecologist, Kerrie-Anne Armstrong. He was somewhat surprised and distressed at recalling how she had conducted herself during the interview. Surprised at the many snapshot memories he had of her smile, and her endearing mannerisms, such as shrugging her shoulders and tilting her head when discussing aspects of her work. And particularly how she had gazed deep into his eyes solemnly declaring ‘I don’t smoke.’ And how when he had apologised for ranting against the habit she had retaliated smilingly ‘No need to flog it to death?’

He felt downright agitated when remembering her lovely, long legs and particularly her shapely breasts and splendid posture. She also had a good mind and a sound sense of humour. Then he visualised Kerry-Ann’s twinkling eyes and expressive face – only to be replaced by the hauntingly lovely face of his late wife, Cynthia, who seemed ineffably sad and lonely.

John felt overwhelmed by guilt, shame and disloyalty.

John glanced at the theatre clock at City Hospital. He sighed with relief as he realised that the final procedure was laparoscopy: keyhole surgery to investigate an inflamed bowel.

Ably assisted by the usual Friday emergency team, with the occasional new face replacing someone who was on special study leave, ill or on vacation, he made a small incision in the patient’s abdomen. He inserted into the opening a long metal rod with a miniature camera at the end of it. The television screens angled by the surgical trolley came to life.

Engaged in their relevant duties, each team member eyeballed the screen. They saw a burst of pulsing yellow and pink: the psychedelic recesses of the lower stomach, the delicate curlings of the bowel. Richard Fleming’s hand held the camera steady, his eyes focused on the screen.

An hour later John was making his way through the corridors heading for the car park, his head still full of the curiously peaceful hues of the laparoscopy screen, when he heard a hubbub immediately outside. An ambulance was backing up. The ambulance doors hissed open.

‘Get your filthy hands off me!’ A woman’s shout. John came to a standstill. ‘Leave me alone! Oh damn... My bloody head...’ The two ambulance attendants had pinned the struggling woman down. One looked up and recognised John.

‘Norma Morris, Prof. She’s a 22-year-old, had vicious headaches, vomited twice with us. Her mother... ’ He nodded towards the middle-aged woman who had been helped from the vehicle and was now looking on tearfully. ‘She says all this stroppiness only came on in the last couple of hours. Been fighting the flu over the last couple of days.’

Two other members of his surgical team, scrubbed nurse Thelma Marks and scout nurse Jean Curtis, had also been on their way to the carpark. Both assisted John and the two ambulancemen to subdue the hysterical woman, restraining her wrists and ankles.

Examining her briefly, John was forced to raise his voice to be heard above her ravings ‘A brain haemorrhage is possible, but the flu-like symptoms suggest a new contender: meningitis....’

‘What does that do?’ asked the anxious mother.

‘The major symptoms are an inflammation of the membranes enveloping the brain and spinal cord - usually caused by a bacterial infection,’ he said. ‘Did your daughter use any kind of drugs, or drink alcohol?’

‘Not really. Only marijuana now and then. But she’s a sweet, responsible, wonderful kid.’

‘Medications? Even over the counter? Any prescriptions?’

‘No.’

As the patient was wheeled on the trolley into the emergency ward, John ascertained that she had not recently been under extra stress and that she had never taken pills or tried to hurt herself. She could also tolerate penicillin.

Just then, Thelma called out: ‘Rectal temp 101...’

‘Meningitis?’ Jean asked.

‘Yes, although there’s a small chance of a bleed, even with the fever,’ John answered. ‘But what she needs right away is penicillin. Four million units. Instruct the ward sister to repeat in four hours,’ he said as he filled in the appropriate details.

By this time the change-of-shift nursing staff had arrived. John instructed them that after penicillin, the patient would need a computed topography (CT) scan first, then a spinal tap, and she would need to be sedated.

He then handed over the case