Page 42 of Prognosis So Done

Good. That should deal with any cerebral oedema caused by the pressure of the blood clot on the surrounding tissues.

Now, to find it...

Harriet and Helmut positioned the patient on the table as

Gill gowned and gloved. They propped a doughnut headrest

beneath the head and a sandbag beneath his left shoulder to help keep his head averted to the right. Helmut shaved half the patient’s head and Gill noted the boggy swelling above the temple and a slight graze where the assault had occurred.

‘Remind me to never let you cut my hair,’ murmured Harriet,

and Helmut winked at her.

‘Ready, Joan?’ asked Gill.

‘Yep, all good my end.’

Gill prepped the shaved area with Betadine and Harriet, who was circulating nurse this time, hit the play button on the CD player. The sultry tones of Ella Fitzgerald filled the theatre as Gill made his incision.

It was about three centimetres long over the swollen fracture site, no lower than the cheekbone to avoid cutting the facial nerve, and one finger’s breadth in front of the tragus of the ear. He quickly separated the temporalis muscle and incised the periosteum, inserting a self-retaining retractor and cauterising a couple of bleeding blood vessels.

The white of the skull bone glistened at him and he asked Katya for the drill which she passed over. Drill made it sound fancy when, in actuality it was a manual device, which looked almost exactly like a standard hand-operated wood drill.

Nothing fancy and pneumatic out here which was fine because these ones still did the job. Slowly, Gill cranked the handle round and round to make a hole through the bone, careful not to use too much pressure and accidentally plunge through into the brain.

He felt an irregular wobbling and pulled back, knowing that

he had perforated through the temporal bone. The hole was too small to tell if there was any extradural blood.

‘Conical burr, please.’ Gill used it to enlarge the hole to and then yes! ‘There she blows,’ he said, as the haematoma became evident.

Finding the bleed straight away was a relief and he relaxed a little. He hadn’t wanted to drill any more holes but wouldn’t have been able to avoid it had the first one been negative.

‘Ronguer, please.’

Gill used the heavy bone-cutting scissors to nibble away a little extra bone and expose more of the haematoma. Katya passed him a syringe and he gently washed out the rather large blood clot and cauterised the bleeding point.

‘OK, let’s get this kid out of here,’ said Gill as he prepared to close.

––––––––

Harriet who’d beenwatching attentively, blinked as a rush of faintness washed over her and a wave of nausea tried to outdo the continuing niggly cyst pain for her attention.

‘Pupils are equal and reacting,’ said Joan, flashing a

penlight in her patient’s eyes. ‘Well done, Guillaume. Good

save. I’ve started him on a broad-spectrum antibiotic.’

Harriet vaguely heard Gill thank Joan as she excused herself and hurried to the change rooms, shutting herself in a cubicle and pulling the lid down on the toilet. She sunk onto it with wobbly legs, swallowing down the acrid taste of vomit.

A tear slid out from behind her closed lids as she held her side. God...she felt awful, the night stretching ahead of her like a long dark highway when all Harriet wanted to do was take a painkiller and go to bed for a week.

Bloody ovary! Between this one and her non-existent other one, she’d had enough of her female bits and pieces.

With the nausea settling, Harriet took a couple of deep breaths, pulled off some toilet paper, blew her nose and wiped her eyes.

Only eight hours to go.

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