St Piran's: Italian Surgeon, Forbidden Bride

‘Y
OU
need Jessica Carmichael.’

He didn’t
need
anyone… not any more.

Giovanni Corezzi bit back his instant denial of the suggestion made by paediatric registrar Dr Megan Phillips. It was his first day as consultant neurosurgeon at St Piran’s Hospital in Cornwall and although his primary focus was always on doing his best for his patients, he also hoped to make a good impression and to form a friendly working relationship with his new colleagues.

‘Jessica Carmichael?’

He frowned, disturbed at the way the unknown woman’s name flowed from his tongue. As if it were a caress. And somehow important. What nonsense was he thinking? With an impatient shake of his head, he refocused on Megan.

‘Jess is a hospital counsellor. She’s very knowledgeable and good with patients and their relatives,’ the paediatric registrar explained with obvious admiration. ‘Unfortunately we don’t have extra time for everyone. Jess fills that gap.’

‘I’ll bear it in mind,’ Gio replied, knowing the involvement
of a counsellor was often helpful to his patients but reluctant to bring one in now.

‘It’s your decision.’ Megan’s disappointment and disagreement were apparent. ‘I think you’d find Jess useful in Cody Rowland’s case.’

Gio bit back irritation as the young registrar questioned his judgement. Instead of an instant retort, however, he considered whether he had missed anything regarding the young boy admitted to his care. Three-year-old Cody had fallen from a climbing frame two weeks previously, but had not shown any symptoms at the time. Recently he had become increasingly listless, complaining of a headache, going off his food and feeling nauseous. His frightened parents had brought him to the hospital that morning.

A and E consultant Josh O’Hara had examined Cody and called the neurology team. Busy in Theatre, Gio had sent his registrar to do an assessment. The subsequent tests, including a CT scan, had revealed the presence of a chronic subdural haematoma. As the bleed had continued and the clot had increased in size, it had caused a rise in pressure and the swelling brain to press on the skull, causing bruising and a restriction in blood flow.

Cody was now on the children’s ward and awaiting surgery. Unless he carried out the operation soon, Gio feared the boy’s condition would deteriorate and, if the clot and pressure continued to grow, there was a possibility of irreversible brain damage.

It was after noon and his first day was proving to be a hectic one. That morning he had undertaken three minor and routine operations—as minor and routine as any brain surgery procedures could be—and his first neurological clinic was scheduled later that afternoon.
Before that, he needed to return to the operating theatre with Cody.

‘I’m sure this woman is good at her job,’ he commented, ‘but Cody—’

‘Cody might need Jess at some point. Right now I’m thinking of his parents.’

Gio hated to admit it, but she was right. He
did
have concerns about the Rowlands and that Megan had picked up on the same signs was something he should find pleasing, not irritating.

‘They aren’t coping well,’ he conceded with frustration. ‘And their anxiety is distressing Cody. I need him to be settled for surgery?and for his parents to be calm and understand why we need to operate. I wish to press on them the urgency without further panicking them. They are listening but not hearing, you know?’

‘I know,’ Megan agreed. ‘They’re in denial… Mrs Rowland particularly.’

‘Exactly so. Which is understandable. I’m not unsympathetic but I don’t know how much time we have to play with.’

Megan hesitated, as if unsure of her ground. ‘That’s why I suggested Jess. I’m sorry to keep on about her, and I’m not questioning your skills,’ she added hastily as his eyebrows snapped together. ‘But I know how helpful she is in these situations. Everyone in the hospital likes Jess. She’s a wonderful listener… and it isn’t just the patients and their relatives who benefit. The staff frequently offload their problems on her, too. She’s definitely your woman.’

Gio’s frown returned in earnest, both at Megan’s phraseology and the implication of her words. ‘I don’t know…’

Was he being too hasty? It was uncharacteristic of him not to listen to the suggestions of others, even if they were his juniors. He considered his reluctance to follow Megan’s advice. Was it because he didn’t want his new colleagues to think he couldn’t do his job? Here he was, halfway through his first day and already needing to call in someone else to help with a case! He shook his head. What mattered was the well-being of his patients, not his own status.

Checking his watch, aware that
he
was now the one wasting precious time, he wondered how long it would take for Ms Carmichael to arrive. Once she was there, he would need to bring her up to date on the case and, as yet, he had no idea how much she understood of medical issues.

‘Won’t she be tied up with existing appointments?’ he asked Megan. ‘Cody can’t afford to wait much longer.’

‘Jess doesn’t work like that, Mr Corezzi. She’s on call and responds to whichever department or ward has need of her. It’s just a matter of paging her—she usually comes right away,’ the paediatric registrar explained, jotting a note on the front of Cody’s file.

‘Call me Gio.’ He made the invitation with a distracted smile as he considered his options. He needed Cody in Theatre without further delay. If this counsellor could help facilitate that, then so be it. ‘All right, Megan, please call her,’ he invited, decision made, adding a word of caution. ‘However, if she’s not here soon, we may have to move without her.’

Megan’s smile was swift. ‘You won’t be sorry, Gio,’ she assured him, and he could only hope she was right.

‘I’ll ensure the operating theatre and my team are
ready. And I’ll arrange for the anaesthetist to assess Cody,’ he informed her. ‘Everything will be in place and we can move quickly?
when
we have the Rowlands’ consent.’

As Megan went to the ward office to organise the page, an inexplicable shiver of apprehension and anticipation rippled down Gio’s spine. He had done the right thing for Cody. So why did he feel unsettled? And why did he have the disturbing notion that in bringing Jessica Carmichael on board he would be taking on much more than he had bargained for?

‘Consultants don’t spend time taking histories or chatting to patients and their relatives. That’s why they have registrars and juniors,’ Jess protested with a mix of wry cynicism and surprise.