Doctor's Orders

Out of the frying pain, into the fire of desire…

Isabel McKenna couldn't imagine anything worse than the misery that chased her away from Edinburgh. Now she wishes she hadn't allowed a broken heart to make her impulsively take the first job that presented itself.

Pediatrics was easy compared to dealing with the prima-donna attitudes of the doctors in County General's operating theatre. The cold gray eyes of anesthetist Dr. Michael Blakeney make her blush hotly—and nervous a single mistake will bring him down on her like a ton of bricks.

Digging deep into her personal well of Scottish grit, Isabel is determined no man—especially no arrogant doctor—will ever again shake her composure. But when she glimpses a hint of lonely vulnerability beneath his steely eyed exterior, she finds herself all too ready to respond as a friend…and a woman.

This Retro Romance reprint was originally published in 1986 by Mills & Boon.

Doctor's Orders

Ann Jennings

Chapter One

A white wellington boot kicked open the swing doors that led from the operating theatre into the anaesthetic room. Startled, Isabel McKenna looked up from the anaesthetic machine where she had been checking over the items the anaesthetist would need. The elderly surgeon, whose name she knew to be Mr Goldsmith, glowered at her over the top of his half-moon glasses, all the time keeping the door propped open with his white-booted foot. He held his scrubbed rubber gloved hands rigidly up in the air, annoyance and impatience coming out of his ears like visible steam. He had very bushy eyebrows that were fiery red in colour and they flared out angrily from beneath his theatre cap, adding power to the image of an enraged man!

“Tell the damned anaesthetist to get started immediately,” he barked.

Isabel hesitated. It was her first day in the hospital as a theatre nurse; in fact it was her first day at the County General, and she didn't want to be rude. “We are waiting for the patient, sir,” she began, “there seems to be some delay with the…”

“Don't give me excuses and don't just stand there, go and get the damned anaesthetist!” With that he withdrew his foot from the doorway and the door swung shut violently, leaving the anaesthetic room in peace once more.

Isabel still hesitated. She knew the anaesthetist was in the room shared by the operating suite doctors, known as the surgeons' room, she had seen him go in. A tall, good looking man with a rather forbidding, stern expression. He was writing while he waited for the patient to arrive, and he didn't look the type who would take kindly to being interrupted. Anyway, what was the point of asking him to come into the anaesthetic room when the patient hadn't arrived! Surely even Mr Goldsmith must see
that,
she thought irritably.

Her first day she reflected miserably, and already she was wishing she hadn't taken the job as a theatre nurse, but had waited for the job she had really wanted, staff nurse on one of the paediatric wards. A bad tempered surgeon and a cold, forbidding looking anaesthetist did nothing to improve her mood and merely strengthened the feeling that, in her haste, she had jumped out of the frying pan into the fire, as the saying went.

A broken engagement had made her flee her native Edinburgh down to the south coast of England. An instinct to put as many miles as possible between herself and her ex-fiancé had clouded her judgment, and she had accepted the first job she had been offered at the County General.

Restlessly she moved one of the laryngoscopes to a better position on the anaesthetic trolley. She should never have taken the job. She had known when she had finished her theatre training that the world of prima donna surgeons and pedantic anaesthetists, all of whom thrived on drama, was not the world for her. Now, after only half an hour in the theatre suite, she had already been treated to a display of temperament by the surgeon! Not that she hadn't been forewarned. Sister Clarke, the theatre sister, had told her that morning, before she started, that Mr Goldsmith, the surgeon, was “demanding” as she had so delicately put it!

Isabel wondered what the anaesthetist, Dr Blakeney, was like. First impressions hadn't been very good, and if he was as bad as Mr Goldsmith she could see it was going to be a jolly day! An all day list of operations ahead, and already the surgeon was jumping up and down!

The door burst open again, propelled by the same white-booted foot. The same eyes glowered at her over the half-moon glasses beneath the tufted, fiery eyebrows. “Well?” Mr Goldsmith demanded.

“The patient still hasn't arrived yet, sir,” said Isabel, trying, with difficulty, to keep her soft, lilting, Scottish voice as sweet as possible.

“Where is the anaesthetist?”

“Outside, sir, in the surgeons' room.”

“Drinking all the coffee I've no doubt,” snarled Mr Goldsmith, “Why didn't he come in?”

“Because I didn't ask him, sir,” replied Isabel. “I thought that there seemed little point as the patient hadn't arrived.” For a moment Isabel thought steam really was going to come out of Mr Goldsmith's ears. What she could see of his face above his mask and beneath his green paper cap turned a dark puce colour.

“When I want you to start thinking, Nurse, I'll tell you. In the meantime, just do as you are told and get the anaesthetist.”

Without another word Isabel turned on her heel and walked quickly out of the anaesthetic room, leaving Mr Goldsmith, still standing wedging the door open, watching her departure. She was trembling with fury. She had met some rude and arrogant surgeons in her time, but this one, she thought resentfully, takes the biscuit!

The door of the surgeons' room was open, and she could see the broad shoulders of the anaesthetist. He was sitting with his back to the door, his head bent over some papers he was studying. Isabel couldn't help noticing his broad, powerful shoulders, the muscles showing through the crisp green cotton of his theatre shirt. Probably a good rugby player in his day, she thought idly. She knocked on the open door.

“Excuse me, Dr Blakeney, but Mr Goldsmith has asked if you would come into the anaesthetic room.”

“Tell the old buffoon to get stuffed,” came an ice cold and distinctly irritable voice. “He knows damned well we can't start without a patient.” He didn't turn round but obviously sensed that Isabel was still standing there. “Well, go on, tell him that I'll come as soon as the patient arrives.”

This is going to be one of those days, thought Isabel, drawing her breath in sharply as she felt her anger begin to seeth. She was obviously going to have to work with two impossibly rude and arrogant men, and she was going to be the unfortunate pig in the middle!

When she re-entered the anaesthetic room, Mr Goldsmith was still standing wedging the door open with his boot. Hovering in the background she could see the anxious face of the scrub nurse, and the terrified face of the Chinese house surgeon.

“Well?” demanded Mr Goldsmith in the same manner as before.

She swallowed hard. “Dr Blakeney says he will be available the moment the patient arrives,” said Isabel, marvelling at her display of tact in the circumstances.

“That's not good enough,” boomed Mr Goldsmith, “tell me exactly what he said. I want to know, word for word what his reply was.”

Isabel's Scottish temper, always impulsive even at the best of times, finally erupted. “What he actually said,” she said loudly and clearly, “was ‘Tell the old buffoon to get stuffed. He knows damned well we can't start without a patient.'”

After she had delivered her speech, she leant back against the drug cupboard and waited for the storm to break. To her utter amazement, Mr Goldsmith's face creased with laughter.

“Huh,” he snorted, “trust Mike to be damned rude!” With that he walked happily back into theatre, leaving Isabel standing dumbfounded at his sudden mercurial change of mood. Whether or not the mood would have lasted if he had had to wait any longer, she never found out, because at that moment the theatre porters wheeled the first patient due for surgery that day into the anaesthetic room.

Dr Michael Blakeney, the consultant anaesthetist, strode into the anaesthetic room close on the heels of the theatre porters. He was already capped and gowned and wearing his mask. An exceptionally tall man, he towered over everyone else around him. Yes, thought Isabel, definitely a rugby player, there was an air of athletic strength about him which couldn't be hidden even by baggy theatre clothes. As for the man himself, he didn't exactly exude friendliness. His dark grey eyes swept over her briefly and dismissively, and, apart from giving Isabel a curt nod, he then proceeded to ignore her completely.

All he needs is an automatic robot to assist him, thought Isabel rebelliously, as she handed him the ampoule of a drug he had asked for. Although she did notice that he gently reassured the patient, talking calmly in quiet, measured tones to the woman until at last she was asleep and ventilated. Then he nodded to the porters through the glass window of the anaesthetic room door, and they re-entered to wheel the patient through into the operating theatre.

Mr Goldsmith was still standing with his hands held up in the air, and Isabel wondered briefly how long he had been in that uncomfortable position. The unconscious patient was lifted gently from the trolley to the operating table, and after Mike Blakeney had satisfied himself that the patient was settled, he looked up at Mr Goldsmith. “You can start now, Bill,” he said quietly.

“About time too,” spluttered the surgeon, but that was the only comment he made as he swabbed the skin with antiseptic, ready for the incision for the cholecystectomy.

To Isabel's surprise, the atmosphere in the operating theatre was relaxed and cordial. After Mr Goldsmith's apoplectic explosion first thing in the morning, he seemed to have calmed down, and proceeded to operate swiftly and expertly.

He was assisted by a registrar whose name Isabel didn't know, but she had immediately warmed to him when she had walked through with the patient into theatre, because he had given her a wicked wink, as if to say, don't take any notice of the senior surgeon's histrionics! She noticed he seemed pretty experienced as well, and Mr Goldsmith often let him tackle difficult parts of the various operations, although he was always there keeping a watchful eye over him.

As for the anaesthetist, Mike Blakeney—at least, Mr Goldsmith and the surgical registrar called him Mike, although everyone respectfully called him Dr Blakeney—he seemed cool and efficient. Almost to the point of coldness thought Isabel. Once or twice she was aware of his cool grey eyes studying her and she found it unnerved her, for some inexplicable reason. She was not normally a nervous girl, but at his piercing glance she was afraid she would make a mistake, and carefully double-checked every ampoule before she handed him the drug he had requested.

Not a flicker of expression lit his eyes, and Isabel gradually found herself getting slightly annoyed. She felt that perhaps he could acknowledge her work with a nod of his head occasionally, especially as she had done everything he had wanted. Even Mr Goldsmith said “thank you” to the sister who handed him the instruments, absentmindedly it was true, as he was concentrating on the surgery, but at least it
was
a thank you. But Mike Blakeney, it seemed, reserved the friendly side of his nature for the patients only, everyone else in theatre was just a pair of hands to be used as the need arose.

The last case before the lunch break was wheeled into the anaesthetic room and Isabel smiled reassuringly at the patient as she took the notes from the nurse who had accompanied him from the ward. As she flicked quickly through the notes she couldn't help being glad that it
was
the last case, Dr Blakeney was beginning to get on her nerves with his aloof silence.

The patient was a very thin old man for a laparotomy for a pelvic mass. Quickly Isabel looked at his scraggy arms. He had hardly any veins to speak of and she knew it would be difficult for the anaesthetist to give the injection. She also knew from the procedure with the last four patients that Dr Blakeney always preferred to inject into the right hand, but after another glance she saw that the veins, although not good, were better in the left hand. Without waiting for the anaesthetist to return—he was still in recovery with the previous patient—she started preparing the sphygmomanometer cuff on the left arm.

“Wrong side, Nurse,” said a cold voice.

Isabel looked up. Mike Blakeney had re-entered the anaesthetic room quietly and she hadn't heard him, so intent had she been on her task. “I think you will find, sir, that the patient's veins are better on this arm,” she said quietly.

He flashed an enigmatic look from over the top of his mask and Isabel couldn't make up her mind whether she saw a light of irritation, annoyance or surprise! Anyway, the fleeting expression was quickly replaced by the usual, cold, bland look she had grown accustomed to. He bent his head down, examining the old man's arms, all the while talking to him gently and reassuring him concerning the operation he was about to have.

Isabel didn't remove the cuff, just waited silently for her instructions. If she had to change it over to the other arm, then of course she would, but she knew she was right.

“Inflate the cuff, Nurse,” said Mike Blakeney abruptly as he finished his examination.

I suppose it was too much to hope that he might have acknowledged that I made the correct decision, thought Isabel, as she carefully inflated the cuff to the diastolic blood pressure. The mere fact that he hasn't asked me to change it to the other arm indicates that he thinks I made the right decision. Even so, she couldn't help thinking again that she would be glad when the operation was finished, at least then she would be able to get out of theatre for an hour. A whole hour to get away from the human robot she was working with! I'll go to the canteen and mix with some real flesh and blood people, she thought.

Mike Blakeney slid the needle into the vein with the expertise born of many years' practice, and soon the old man was asleep and on the operating table. Isabel was glad when the pelvic mass turned out to be nothing more than a benign tumour. At least, Mr Goldsmith was ninety-nine per cent certain it was benign because of its appearance, although he sent the tumour for histology to be on the safe side.

He was pleased too. “I feared the worst for this chap,” he confessed to his registrar as they made ready to close the incision. He nodded to the house surgeon, a small Chinese young man, very eager and willing, and very anxious to please. “You may cut the stitches,” he said magnanimously, “you haven't done it before have you?”

“No, sir,” said the young doctor nervously.

“It's quite simple,” said Mr Goldsmith, “I put the stitch in place, you cut the thread. Not too short and not too long. Do you understand?”

“Oh yes, sir!” the house surgeon nodded enthusiastically.