Page 49 of Prognosis So Done

amputation. Most surgeons incised about fifteen centimetres above the knee joint but each case was individual and traumatic amputation often required a higher amputation level to allow for viable skin and muscle coverage of the bone.

Gill made his incision about twenty centimetres, estimating there would be enough healthy skin to cover the stump. The tourniquet provided a perfectly bloodless field, enabling Gill to do his job without having to diathermy any bleeding points.

He was aware only of the leg and Harriet beside him. She wasn’t humming as she usually did, but Gill couldn’t think of a better person to be in the zone with. She passed the instruments smoothly, the pain obviously not affecting her ability to assist him and he drew comfort from that.

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Harriet made a supremeeffort to concentrate on the operation. Gill was proceeding through the muscle layers, dividing the nerves as he went so the cut ends would retract below the end of the remaining bone. This was important to

help with the phantom limb pains suffered by most amputees.

She did a quick mental check that everything Gill would need or ask for after this stage was on the tray and within easy reach. Orthopaedic sets were just a big boy’s tool set, the instruments not dissimilar to a standard toolbox — saws, chisels, hammers, screws, drills and nails.

Sure, they had more sophisticated names but looked almost exactly the same. Harriet found the bone crunching and sheer force required in a lot of orthopaedic ops unsettling. It was kind of brutal and she guessed you just had to have the Y chromosome to get it.

The pain had become hot and stabbing now and Harriet shut her eyes briefly. She opened them again, forcing herself to tune it out and concentrate on what Gill was doing. There was a long way to go yet, and she would not let him down.

The clock ticked by as he worked, to relative silence in the theatre, apart from Ella’s singing and Joan and Helmut’s occasional condition updates. Harriet reflected how the in-theatre dynamics were different to their out-of-theatre dynamics.

Their team chatted and joked a lot outside the operating theatre. They were close and revelled in banter. But on the job it very much depended on the type of surgery and the pressure Gill was feeling. If he was relaxed and chatty then everyone followed suit. If he was quiet then they all knew and respected his skill enough to let him work in peace without distraction.

The clock was just about to tick over to the next hour when Gill said, ‘Release the tourniquet please, Helmut.’

The tourniquet deflated slowly and Harriet watched the operative site pink up as blood flowed back to the tissues. A couple of little vessels oozed and Gill achieved hemostasis with quickly, not bothering with the tourniquet.

Harriet picked up the Gigli saw for the next stage of the

operation — cutting the femur. An intense, stabbing pain kicked

her hard in the side with breathtaking ferocity and, startled, the saw slid from Harriet’s fingers, dropping with a loud metallic clatter to the floor.

An instrument dropping in theatre pealed as loudly as a church bell. Everyone started and stopped what they were doing.

‘Harry!’ Gill frowned. ‘Are you OK?’

‘Of...course,’ she said weakly, swallowing a wave of nausea as she clutched the operating table for support. ‘Sorry, it slipped.’

His eyes searched hers. ‘You’ve never dropped an instrument in my theatre - ever.’

‘Surely I’m allowed one slip-up in seven years, aren’t I?’ She forced a jovial tone into her voice as she fought to get her breath back from the suddenness of the fierce pain.

‘Siobhan, I’m sorry, can you sterilise the saw again?’ Harriet asked.

Siobhan picked it off the floor at her feet and took it

outside to run it through the three-minute sterilisation process.

‘Are you sure you’re OK?’ asked Gill. ‘Do you want Katya to scrub in?’

‘I’m fine,’ Harriet dismissed as the pain settled again to more of a throb.

She’d never not seen an op through to the end, and she wasn’t about to start on her last day!

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