Part One Hundred And Twenty One
Well, here she was, George thought as she was wheeled into the anaesthetic room, no going back, no ducking out. She was here to in all likelihood have her breast removed, and there wasn't a single, bloody thing she could do about it. "Having any last minute misgivings?" Zubin asked as he flushed the cannula in her right hand with saline. "Wouldn't you be," George demanded bitterly. "If it was one of your testicles?" "Probably," Zubin answered her mildly. "Sorry," George said quietly. "I shouldn't take this out on you." "Oh, feel free," Zubin said with a smile. "It can't be any worse than Connie on a bad day." George momentarily grinned, trying to picture how Zubin would react under Connie's all too predictable onslaught. "You couldn't have a better surgeon than the one you've got, you know," He added kindly. "Yes, so everyone keeps telling me," George said dryly. After a short, thoughtful silence, Zubin said, "This operation, it really is your best option, no matter how much you might not want to think so." "Yes, I know that too," George said dully. "Just make sure that Mr. Griffin doesn't remove my legendary temper at the same time, or the opposition will think I've had a personality bypass the next time I'm in court." "I don't think that would be possible, do you?" Zubin quipped. Then, giving her a conspiratorial smile, he added, "I'd have given anything to be a fly on the wall that day you ripped into Connie." "Yes, I'm sure you would," George said with a slight smile. "But I think you would have enjoyed it just a little too much." When he'd attached her to the cardiac monitor and set it going, so that she could hear the rhythmic beeps of her heartbeat, he began to move away in order to sort out the drugs he would need to keep her asleep for the required amount of time. But before he could, George caught at his hand, keeping him in place. "Zubin, please will you do something for me?" "If it is within my power to achieve it, yes," he said seriously. "If… If I don't wake up…" "You will wake up," Zubin tried to reassure her. "But if, I don't," George interrupted firmly, putting particular emphasis on the if. "Please will you tell John and Jo that I love them?" Realising just how much this obviously meant to her, Zubin promised her that he would. "You'll be able to tell them yourself," He said quietly. "Hopefully some time later this afternoon." As Ric and Tash appeared, dressed in scrubs, facemasks and gloves, Zubin told her to count down from ten, and when she was definitely asleep, he announced to all and sundry that she was ready for them to begin.
"Right then," Ric said as he carefully moved aside the drapes and the cotton of George's gown. "We have an invasive lobular carcinoma in the lower left quadrant. So," He added to Tash who was acting as his registrar. "How do we begin?" "By beginning the incision at the site of the lobular part of the ducts," Tash replied confidently. "And extending it around the tumour, in preparation for removing as much of it as possible, before assessing how much healthy breast tissue may also have to go." "Good," Ric told her with a smile. "It certainly sounds as though I've taught you something over the years. Scalpel, please." As he delicately began making the incision, Zubin was forced to voice an opinion. "It seems such a shame, that such a beautiful body has to end up looking less than perfect." "I'll do my best," Ric assured him, the blade of the scalpel traversing George's skin, curving around the outer surface of the tumour. "I can't believe she left it so long before coming forward," Tash observed, as she held the edges of the wound open for Ric to inspect the interior. "She didn't, at least not without some serious prodding," Ric informed them. "It was Kay Scarpetta who told me about her, and then obviously persuaded George to attend the appointment she'd made for her." "Certainly sounds like something Kay would do," Zubin replied fondly. "She's really very pretty, your colleague from the States," Tash put in with a knowing smile. "And entirely untouchable where I or anyone else is concerned," Zubin informed her. "Kay's one of those self-sufficient people who doesn't need anyone to rely on for her own existence." "Sounds a bit like Diane," Ric commented thoughtfully. Then, on feeling the question hanging in the air, he added, "Oh, she may be married to Owen, but that doesn't mean she's entirely happy with the situation. Besides, Kay might have someone back home that you don't know about." "She's never mentioned one iota of her personal life," Zubin concluded. "So yes, you could be right."
"Tash, come round here," Ric invited. "And see how much of the tumour you can remove with the current incision." As Tash joined him on the left-hand side of the table, and took the scalpel from him, her thoughts strayed back to her own lump that she'd found almost six years ago now, and which had thankfully turned out to be nothing more catastrophic than a benign cyst. But she too had felt the fear, the terror, the total denial that it could be something more serious. She might have ignored it indefinitely, had Kirstie not forced her into seeking help. Forcing her thoughts back to the job in hand, she said, "I'll need the diathermy on standby. The tumour's attached to a couple of large blood vessels, and she can hardly afford a major bleed at this stage." As he handed her the hand held instrument for cauterising blood vessels, Ric reflected that here was the serious potential for a consultant, in the not too distant future.
After removing as much of the tumour that she could see through the neat incision into a kidney dish, Tash moved aside to allow Ric to continue. "There's still plenty of it left in there," She said as she moved aside. "You're going to have to go for a full radical mastectomy." Examining the wound for himself, Ric was forced to agree that she was right. "Okay," He said, picking up a fresh scalpel. "I'm extending the incision to take in the site for the removal of the axillary lymphnodes, which we will send off for a frozen section and immediate histology." The blade moved swiftly but delicately from the original incision, extending it to under George's left arm. After removing the lymphnodes, he handed them to the theatre nurse and said, "Get that off to the lab straight away," And then began removing the rest of the tumour, very carefully, piece by piece.
When he next glanced up at the clock on the theatre wall, he saw that it was one-thirty, and they'd been going at this for an hour and a half. After removing as much as he could see and feel of the original tumour, he took a sample of what looked like healthy breast tissue, and ordered an immediate biopsy to be done without delay. "I don't want to go any further, until we know how much of this is healthy, and how much of it isn't," He explained. "I did promise her that I would try to save as much of her healthy breast tissue as possible. So, we wait until we know the results, and if it takes any longer than half an hour," He added to the theatre sister. "Tell the labs that I will want to know why." "Throwing your weight around for once, Mr. Griffin," Tash lightly teased him as the theatre sister scuttled hurriedly out of the room. "Well, perhaps I'm doing an old friend a favour," Ric admitted with a shrug. "Oh, you mean the woman who accompanied Ms Channing to her appointment," Tash filled in for Zubin's benefit. "An old flame of yours, was she?" "Something like that," Ric admitted a little uncomfortably. "Karen Betts. She nursed on my ward for about six years, nearly fifteen years ago now." "I met her just before Barbara Mills' trial," Zubin said thoughtfully. "She didn't look like one of your old cast offs." "You talk as though there have been hundreds of them," Ric said, sounding aggrieved. "Well, four marriages does count for a fair few," Zubin quipped back. "So, do you plan to pick up where you left off?" "Who knows," Ric said lightly. "I may at the very least try and do some catching up with her at some point." "Well, anything's better than you lusting after Connie," Zubin said, sounding relieved. "Oh, now, come on, Zubin," Tash protested mildly. "You can't blame anyone for lusting after Mrs. Beauchamp." "You're both as bad as each other," Zubin replied disgustedly, Tash's sexual preferences never having bothered him in the slightest.
A good while later when a phone call came from the histology labs downstairs, Zubin took the call. When he laid the receiver back in its cradle, they all waited for the news. "The tissue sampled you sent is malignant," He said regretfully. "So, a full radical mastectomy it is," Ric said just as regretfully, part of him hating the fact that he had to so destroy this beautiful body before him, even though it would mean doing his best to eventually save her life. As Ric worked, removing the rest of the breast tissue, including the nipple and areola, plus a sizeable portion of the pectoral muscle on the chest wall, Tash handed him instruments when he asked for them, and generally tried to be of as much help as possible. "You do know," She said carefully at one point. "That only one of her partners knows where she is and what is happening to her?" "Hang on," Zubin put in before Ric could say a word. "I've seen Jo Mills in passing, so it can't be her. Are you seriously telling me," He said in horrified realisation. "That the judge has absolutely no idea what is happening to one of the most precious things in his life?" "According to Tricia," Tash filled in for him. "Oh, great," Zubin said disgustedly. "Just you wait till he does find out, and then I can promise you, we'll all be in for the roasting of our lives." "You sound as though you're talking from experience," Ric said, not looking up from his task. "Oh, I am," Zubin said with mounting incredulity. "You should have seen him in court. He asked more questions than the defence and prosecution combined. He's going to want to know everything from why she didn't come forward sooner, to why we've taken away so much of her." "And we'll do our best to answer," Ric said calmly. "Besides," He added with a thought. "How did you know she had two lovers anyway?" "I met with George and Jo on a number of occasions whilst preparing for that trial," Zubin explained. "And although it was never obvious, there was something between them that signified a depth of feeling I've certainly never seen between you and any of your wives." "Well, well, Professor Khan, I didn't know you had it in you," Tash responded with a broad smile. Ignoring her jibe, Zubin continued his explanation. "And the tension that existed between George and the judge in court, sexual or otherwise, can only have come from two people who know far too much about each other's psyches. Anyway, Kay told me that they were once married." "And Tricia told me that they're all involved in some sort of three-way relationship. It's certainly innovative," Tash added with a smile.
When Ric was in the process of removing as little of the muscle on the chest wall as possible, Zubin drew his attention to something he really didn't need. "Look at her wave patterns," He said, gesturing to the cardiac monitor. "They're all over the place." George's heartbeat was erratic, irregular, not at all what it should have been. "Find Mrs. Beauchamp and get her in here right now," Zubin ordered the theatre sister. "I'm not taking any risks with this patient." Laying the scalpel down on the tray of already used instruments, Ric minutely examined the interior of the wound he had created, the final incision running in a straight line from breast bone to under George's arm. There was no major bleed, no clot, nothing that could account for the out of time beeps coming from the monitor.
When Connie pushed her way through the heavy swing doors, she said, "You're lucky, I was just grabbing a coffee." Then, as she moved round to stand next to Tash opposite Ric, she asked, "What have we got?" "This is…" Zubin began. "…George Channing, yes, so I see," Connie finished for him as she stared down into George's unconscious face. "So," She mused quietly. "She finally did come forward after all." "Excuse me," Ric said, looking sharply at her. "Are you telling me that you know this patient?" "I should say so," Connie replied with a tight smile. "But that's not important," She added, suddenly regaining her usual professional mask. "Why do you require my assistance?" "Just look at her ECG," Zubin said, directing her attention to the monitor. "She has minor arrhythmias," Connie stated after giving the monitor a glance. "Give her some Adenosine which should stabilise her output. Come on, Zubin, an SHO would know to do that." "I don't want to take any risks with her," Zubin said quietly, feeling more than a little stupid for worrying so much. "No," Connie agreed with him sombrely. "Nor do I."
Once the Adenosine had been given, and George's heartbeat had begun to stabilise, Connie moved round the table to stand next to Ric. "Was a full radical mastectomy absolutely necessary?" She asked as she watched his delicate movements. "Do you think I'd be doing it if it wasn't?" Ric countered back. "No, of course not," Connie replied, knowing that her question had been unnecessary. "I just know how frightened of it she was, that's all. She said that every minute of every day that wasn't spent thinking about something else, was haunted by what may eventually be done to her." "Are you seriously telling me," Zubin began, his voice steadily rising. "That you've known about this for some considerable time?" "Yes," Connie said regretfully. "I found out about it during the trial." "And didn't you tell her what she was risking by not doing something about it?" Zubin railed at her, always happiest when he could inhabit the moral high ground. "Oh, grow up, Zubin, of course I did," Connie replied stonily. "What did you expect me to do, have her sectioned under the Mental Health Act, and force her to have treatment then and there?" "It might have helped her if you had," Zubin replied just as icily, though he knew this hadn't been even a remote possibility. "Connie, Zubin, the pair of you, drop it," Ric ordered them curtly. "And someone try and find Carlos, please, it's time for him to do his stuff." "You'll be lucky," Connie commented as she replaced her mask of indifference. "He's been called back to St. Mary's on an emergency." "Oh, well," Ric said philosophically. "Ms Channing will have to rely on my own skill of needle-work." "I'm sure it will suffice," Connie replied, trying to give him her own particular brand of reassurance.
Connie was almost mesmerised as she watched Ric deftly stitching together the wound he had created, leaving the left side of George's chest as flat as the day she was born. He implanted a chest drain on the way, as it was known that fluid could accumulate under the skin after such a radical procedure. Glancing up at Connie, he took in her slightly sorrowful gaze as she looked down on what George now had left, just a flat expanse of skin with a scar running from the centre of her chest to under her arm. "It really was the only thing we could do," He said to her quietly. "I know," Connie agreed regretfully. "That isn't going to make it any easier for her though, is it."