Where There's Hope…

And this was, after all, just another day. Elliot Hope frowned as he tried to focus on the iPad that had been thrust under his nose. He didn't much care for technology; why couldn't people just read the books? Books were clearer to him and he missed the feel of the paper between his fingers as he turned the page. Elliot looked up at the F2 holding the iPad and forced his lips into a faint smile.

"What was it you wanted to show me Jenkins?" Elliot asked. Jenkins took a deep breath and swallowed awkwardly. He didn't want Professor Hope to see that he was shaking on the inside just to be in the presence of the eminent surgeon. He knew Elliot was staring at him but he couldn't find the right words to say. "Is there something I can help you with?" Jenkins screwed up his eyes and opened his mouth but still there were no words. He could only muster a tiny squeak and immediately kicked himself for allowing such a ridiculous noise to be made in Elliot's presence.

"I just wanted you to have a look at Mr. Carpenter's x-ray," Jenkins said at last. He watched as Elliot's gaze drifted back down to the iPad and a look of concentration appeared, etched across his face.

"Hmm," said Elliot.

"What do you think I should do?" Jenkins asked, holding the iPad down beside his thigh. Elliot rubbed his eyes and blinked.

"I'm going to organise an ECG," Elliot informed him. "And we'll take it from there." Jenkins nodded and turned to leave. "But I'm not liking the look of Mr. Carpenter's coronary arteries. He's at genuine risk of an MI. I'll be along in a minute." Jenkins nodded again and quickly left Elliot's office, leaving the Consultant alone with his thoughts.

Elliot sat back in his chair and looked over at Jac Naylor's desk; everything was neat, tidy and ordered but Jac was still on leave and the pressure of covering her theatre lists was beginning to get to him. He didn't mind of course and before Jac had left, they'd both assumed that the Board would hire a locum in the meantime. That would have been the sensible option but then Elliot remembered the Board meeting and the casual manner in which the phrase 'cost-cutting' had been thrown around the room. Elliot often found himself wondering whether any of those management suits had any idea of how a hospital actually ran. There were no cost-cutting measures when it came to saving a person's life or the life of one of their friends or relatives. Elliot looked at the time on his phone and stood up quickly. A spasm of pain struck his chest and for a moment the surgeon felt winded. Yet the pain quickly passed and after it did not seem to show any sign of coming back, Elliot left his office.

"The ECG shows a rather erratic heartbeat," Elliot informed Mr. Carpenter. Mr. Carpenter coughed, his face was white with fear and his lips grew thin. "I want to run a blood test before I-"

"Before you what?" Mr. Carpenter interrupted. "Am I having a heart attack?"

"I want to see what the blood test shows up before I make my diagnosis," said Elliot and he smiled, hoping to reassure the patient that everything would be okay without actually having to say it. "In the meantime, I'm sure that Dr. Jenkins here will be more than happy to keep an eye on you." Elliot had already started to walk away from Mr. Carpenter's bed when the short man called out to him again.

"What about you?"

"I'll be along to check on you later," Elliot told him.

"But this one's barely out of bloody nappies," Mr. Carpenter protested. "I mean no offence," he said in an aside to Jenkins.

"Dr. Jenkins is more than capable," Elliot explained.

"I'm sorry Professor Hope but I was assured that you'd be my surgeon today not some junior wannabe," Mr. Carpenter was pleading with Elliot to stay but Elliot had a mountain of other patients to see and, in any case, until the blood test results came back, there wasn't a great deal else he could do. Elliot attempted to explain this to Mr. Carpenter but nothing seemed to convince him and extreme exhaustion was wearing Elliot's patience thin.

"Look Mr. Carpenter, I have a lot on my plate today without patients making demands left right and centre. I will be back when I've got your blood test results. Now do you think you could just sit quietly and not give Dr. Jenkins here any trouble unless it relates to your condition?" Mr. Carpenter scratched his head, evidently trying to compose a suitable reply in his mind.

"Sorry Professor Hope, I know you're busy and all that but I err, I shouldn't have said anything. Thank you."

"That's not a problem," Elliot smiled again and it turned to one of quiet relief as he finally made his way to the next patient on his list.

Elliot caught his breath as he reached the top of the stairs. He knew he wasn't the fittest man in the hospital but it surprised him how out of breath he had felt climbing back up to Darwin. The pain in his chest had returned and he had what seemed like the beginnings of a throbbing headache bubbling away inside his head. Elliot supposed it was a result of covering for Jac but deep down he knew there was something wrong. The uncomfortable tightness in his chest intensified as he forced himself to open the door and step back onto the ward. Screwing up his eyes to bare the pain, Elliot decided it would be best to ignore it and get on with his duties. He stared across the ward and his eyes fell upon Mr. Carpenter, hollering at him.

"Professor Hope!" Mr. Carpenter was paler than before and there were telltale signs of fresh vomit around the corners of his mouth. "Have you got my results?" He asked, lowering his voice to a whisper as Elliot stood over him. Elliot nodded gravely.

"I'm afraid it's not good news," The energy seemed to leave Mr. Carpenter's eyes as he stared up at Elliot. It was this moment that always got to Elliot; the moment where he held a patient's future in his hands and wielded the power to decide the next course of their life. Mr. Carpenter clenched his fist and then unclenched it as he tried to keep his expressions as stoic as he could.

"What's the verdict then eh Professor Hope?" Mr. Carpenter asked but even his stoicism could do nothing to keep the shakiness out of his voice. "Do I need to sort out my will?"

"You have what we would term severe cardiovascular disease," Elliot began slowly.

"And what the heck's that when it's at home?"

"In laymen terms, heart disease," explained Elliot and studied Mr. Carpenter's reaction carefully. "I take it you're not surprised?"

"My whole family's got a history of heart disease and that. It seemed the logical explanation for them pains I've been feeling." Elliot arched his eyebrows.

"What sort of diet do you have?" Mr. Carpenter looked down at his bulging stomach and for the first time a slight smile seemed to appear on his face.

"It's not great Professor Hope," Mr. Carpenter began. "I mean it's tasty but that's about it if you know what I'm saying."

"Mr. Carpenter, you really ought to take better care of yourself, you're at major risk of a -" Elliot stopped suddenly mid-sentence as another pain shot across his chest, more severe than before and he felt a wave of nausea.

"I know, I know but I can't help it. I tried having a diet once y'know, to get the old bodyweight down a bit but nothing worked and after about a year I just figured, sod it. Everyone in my family's overweight, I think it must be our genes or something." Elliot understood where he was coming from and he wanted to do everything he could to help him but there was no point if he refused to help himself.

"You need to make some serious changes to your lifestyle," Elliot said forcibly but Mr. Carpenter was too gripped by fear to listen to him.

"I know what I need to do and I'm telling you it's not that easy. You're not exactly a perfect role model yourself," replied Mr. Carpenter irritably as he pointed at Elliot's own large stomach.

"We all have our vices," Elliot told him. "And I'm not the patient here." He held his breath as another spasm of pain ran through his chest.

"Maybe not today but tomorrow-"

"Then I shall worry about tomorrow."

"Look am I going to have have surgery or…what's the matter?" The colour had drained from Elliot's face and he was clutching at his chest. Tiny droplets of what seemed to be blood appeared in the corner of his mouth.

"I'm fine, I'm just a bit-" But before Elliot could explain what he was the renowned surgeon had collapsed to the floor and he vomited a great deal of blood. Mr. Carpenter watched in horror as Elliot convulsed and the only thing he could think to do was scream.

TO BE CONTINUED