The first time it happens Serena doesn’t really notice. She’s in the middle of surgery - a standard routine surgery, something she could have done in her sleep. She’s done the same procedure countless times before - If not more times than she’s had glasses of Shiraz then it must at least be a close run thing. The ED had sent the patient up due to his ischemic left leg. They maintained that he needed Serena’s vascular skill. Serena maintained (to herself at least) that it looked much more like the ED needed the bed. Regardless it was clear that the patient, Mr Burgess, did indeed need an emergency embolectomy. Emergency for him, bread and butter for a vascular surgeon of Serena’s calibre.
At first everything went exactly to plan. Identifying the site of the blood clot causing the obstruction had been text book. The balloon catheter had gone in at the perfect angle and made its way straight to where it was needed. The balloon inflated smoothly and, to start with, the slow and gradual removal of the captured clot and balloon went like clockwork - until it didn’t.
It was Serena’s years of experience that meant she realised almost as soon as it happened. The artery had ruptured.
“Oh! Come on!” Serena exclaimed. It was entirely possible for an artery to rupture during a balloon embolectomy, especially if the obstruction was the result of a trauma. It wasn’t a question of the skill of the Surgeon - some arteries were just weaker than others, some were already damaged. There were a whole host of reasons why it could happen. It just didn’t happen to Serena though. Not to her, a Vascular Surgeon at the peak of her career. Certainly it didn’t happen without Serena taking it as a personal affront. For Serena, usually calm, cool and collected in theatre, totally in control, to lose that facade even for a second (especially during what should have been a routine, if urgent, procedure) was unusual enough to reduce the Operating Theatre to a hushed silence. Then it was broken by Bernie’s voice.
“Convert to a graft.” she says. “Bypass the rupture.”
“Not enough time. We’ll lose the leg if we leave it without blood long enough to do a graft. The leg will last thirty minutes without a blood supply at most. I can’t do a graft in that time.”
“Believe.” Bernie replies. Serena can feel the certainty and confidence Bernie exudes in that one word wash over her. The feeling is like a warm and cosy blanket gently covering her. It takes her back to the way she had always felt when she and Bernie had operated together before; how they worked together seamlessly, bringing out the best in each other, pushing each other to excel, pre-empting each others every thought and moving like a finely choreographed ballet.
“Prep for a graft.” Serena calls across the theatre in a voice now full of authority and confidence. She looks up from the patient on the table to check that the surgical team are following her instructions. Like the well trained team they are hands were already in action, reaching for clamps, scalpels and swabs. Just for a moment though, as she looked round, she saw a glance fly between Donna and Fletch. It was subtle, too subtle for her to be able to identify exactly what it was attempting to convey. Some kind of concern or worry she thought. It’s not the time to try and work out what’s going on between them though, her patient needs her.
“Scalpel.” she calls as she turns her attention back to Mr Burgess and his leg laid out on the operating table. Within seconds her focus is back on the surgical challenge ahead of her, and her world has shrunk to the blood, flesh and tangle of veins and arteries in front of her.
Almost wo hours later Serena, clad in her scrubs, is sat at her desk up in AAU. She’s just finished writing up Mr Burgess’ surgical notes and is sitting back in her chair stretching out the kinks in her spine. She’s decided that she has more than earnt ten minutes to herself. Ten minutes of peace and quiet before she changes out of her scrubs and into her work ‘uniform’ of black trousers and a bright loose blouse. Ten minutes before she has to plaster back on her professional personna and head out onto the ward.
Her eyes have just flickered closed when there is a knock at the purposely shut door of the office. Beneath their lids her eyes roll. Trying to keep any hint of annoyance at the interruption and regret at the loss of her precious quiet time out of her voice she calls
“Come in.” Fletch’s head appears from the other side of the now opening door.
“What can I do for you?” Serena asks.
“Other way round.” Fletch replies as the rest of his body follows his head round the door. He’s clutching two steaming paper cups in Pulses’ instantly recognisable vivid shade of red. “I thought that you might be in need of a coffee after that masterclass in Theatre. You take it hot and strong, right?” Serena smiles.
“Coffee would be very welcome. Thank you.” Fletch steps fully into the room, kicks the door firmly shut behind him and hands one of the cups to Serena. Without waiting for an invitation of any kind he sits himself down on the sofa along the wall of the office. Leaning back he makes himself comfortable and takes a gulp of his hot coffee. Not just a social visit then, thinks Serena. It’s just too engineered.
“Anything on your mind, Nurse Fletcher?” with the sound of a raised eyebrow in her voice, even if not visible on her face.
“Just thought you might need some coffee. And anyway, I’ve not seen you since you came back from your break. I wanted to find out how you were doing. You know, just generally catch up,”
“Right.” says Serena, still not convinced that this is all the visit is about. Fletch’s nonchalance is far too casual for it to be totally genuine. “Well, my break was very peaceful thank you. Very restful. But, as you can see, I’m back now. Refreshed and ready to get on with it.”
“That’s great Boss. Still, that surgery was quite the dramatic way to come back.”
“Arteries do rupture Fletch, you should know that.”
“Well, yes.” Fletch admits, “But I don’t think I’ve ever any one pull off a graft quite that quickly. “
“Years of practice Fletch.” Serena watches his face. He’s obviously searching for another way to get the the point he’s trying to make
“Got a bit hairy there for a minute though.” He tries.
“A little. Nothing we couldn’t handle. We have a good team.
“We do. There was a moment there though when you seemed to be talking to someone."
“I spoke to lots of people, everyone on the team probably. Talking to the people you are working with is quite a vital part of surgery. It does tend to help things run more smoothly.” Serena notes, still not quite sure she knows this is going.
“It wasn’t any of the team you were talking to though.” Fletch says cautiously. “Or it didn’t seem like you were.” He adds in attempted mitigation.
“Really?” queries Serena, not able to recall anything which might match what Fletch is describing. Whatever it is Serena is confident that it’s the reason Fletch has engineered this chat.
“Um. You were saying something about not having enough time to do the graft before the leg would be too starved of blood to be viable.” It takes Serena a few seconds to piece together what Fletch is referring to, to piece together what had happened in Theatre. For a moment her face registers shock and disbelief before she wrestles it back into a mask of disinterested calm.
“Thinking aloud Fletch. Nothing more.” she offers as a rather unconvincing explanation. Before Fletch can push her any further on the topic she adds “As nice as this cosy chat is, I’m sure that you have things to be getting on with - and if you don’t I certainly do!”
“Right ho Boss.” Fletch capitulates gracefully recognising Serena closing down a conversation when he sees it.
“Thank you for the coffee. Maybe we can catch up properly soon over a drink in Albie’s.” Serena offers as Fletch stands up and heads for the door.
“Absolutely.” Fletch replies as his hand reaches the door handle and he flashes Serena his trademark cheeky chappie smile. Serena waits until she hears the door click shut behind him before she buries her face in her hands and lets herself get lost in the flood of emotions threatening to overwhelm her.
She hadn’t been thinking aloud, or even been talking to anyone else in the room. She’d been talking to Bernie; brave, talented Bernie who had never been afraid to take a risk in surgery; Bernie who had pulled off more minor miracles in Theatre than Serena could count. Bernie who’d survived being blown up in Afghanistan but hadn’t survived the bomb blast in Somalia. Beautiful, wonderful Bernie who was dead. She’d heard Bernie’s voice though, as loud and clear as if she’d been standing right next to her, as she had been so many times in the past. She’d felt the same certainty and calm decisiveness that Bernie had always brought to an Operating Theatre with her almost as if it had been a physical presence. It had been the most natural thing in the world for Serena to reply to her. Except it wasn’t because Bernie hadn’t been there, couldn’t have been there, because Bernie was dead.
Of course, Serena knew Bernie was dead. She’d been to the funeral. Put on a brave face at the memorial in the hospital Peace Garden. For those few moments in Theatre though, Bernie had - for her at least - been as alive and present as she had ever been. Serena thought that she ought to have felt a fresh surge of grief at the realisation that Bernie had never been there earlier and could never be there again. Of course she felt did feel grief - absolutely and deeply. There was another feeling though. Another feeling that was insisting on being heard. Fear.
Serena was caught tightly in the grip of fear. She’d have a conversation with Bernie in the middle of surgery, in front of her friends and colleagues. That in itself would have been bad enough, but she hadn’t even realised what she’d done until Fletch had called her out on it. She’d had a conversation with a dead woman and hadn’t even realised it. What was wrong with her? What on earth had happened to her. Serena took a deep breath and tried to put her thoughts into a semblance of order.
She thought she’d come to terms with Bernies’ death; She’d taken time off to grieve for her. She’d learned from the way she handled Elinors’ death that there was no way you could work your way around grief. No matter how busy you kept yourself, how many interesting cases you took on, grief would always find a way in. Grief was an opportunist. It would slip into those quiet moments between one task and the next, in the suspension of reality in the moments before sleep claimed you, and every other chance it got. There was no blocking it out, and once it had found itself a foothold it spread. It brought itself into every aspect of your life, touched them all and made everything its business.
She’d learned this when her Father had died, the lesson had been brutally reinforced when she’d watched her Mother’s health fail before she’s finally passed away. When Elinor had been torn away from her the grief had very nearly claimed everything. Towards the end of the lengthy sabbatical she’d taken after Elinor’s death she’d promised herself that she’d never let grief overwhelm her that way again, warp and change her so much that she could no longer recognise who she was, didn’t believe that her actions had actually been hers. She’d promised herself that next time she’d handle it differently, better. At the time it had seemed an easy enough promise to make herself. Nothing, she had believed, could hit her as hard and as painfully as her daughter’s death had done. She’d been wrong. She’d never considered she’d lose Bernie too - not so soon and not like that. It had been just as hard and as painful losing Bernie as it had been losing Elinor. Not in the same way. Watching your only daughter die was its own particular form of torture. Knowing the woman you loved, even though you couldn’t be together, was no longer in the world was a highly specific form of misery. Mourning the loss of the woman who had been your rock whilst you had been consumed by grief for your daughter was torment of the kind only ancient Greek Gods were capable of thinking up.
Serena’s hands unconsciously make their way to the pendant around her neck, her fingers twisting and twirling it round whilst her whirling thoughts started to still. She’d thought that taking some time, taking a break, was the right thing to do. She was still sure that it was the right decision. She considered if she might have come back too early. She didn’t think so. No matter how good her reasons there was a limit to how long she could stay home and brood; when the need for time and space stopped being healing and started to become self indulgence. She had certainly reached that point. There were, after all, people who needed her at Holby, people who relied on her. No, she thought, it had been the right thing to do, to come back.
What on earth had happened in Theatre then? If she hadn’t been talking to Bernie - and she obviously hadn’t been - then who had she been talking to? She quickly rules out having been talking to herself - the voice had been Bernie’s: the choice of words, the feeling of calm reassurance that had come with them - they were all unmistakably Bernie. If it wasn’t herself she had been talking to she could rule out anyone else in the Theatre for the same reasons. The whole of the exchange had been too ‘Bernie’ to be anyone but her. Maybe that was it, she wondered? Maybe her desire for Bernie, her longing for Bernie to be by her side had played tricks on her? Brought a version of Bernie to life in her mind so vividly that she’d believed, for those brief moments, that Bernie had actually been there. Serena tossed the idea around, looked at it from all the analytical angles that her mind could think up. There were certainly enough memories and echos of Bernie in AAU for her active imagination to latch onto. Bernie’s presence in every corner and corridor had been both curse and blessing to Serena. The memories of the good times - the successes, the teasing, the laughter, the joy of operating seamlessly together, the all too brief window of happiness they had experienced together, the glances, the simmering sexual tension, the feeling of having built the Trauma Bay together, and of course the kisses. Dear God, the kisses! Etched on her mind and lips for eternity.
The flip side of those joyous memories were, of course, the ones she’d like to forget: The reminders of her return to Holby alone; facing the nurses station without Bernie leaning on it, the second chair in what had been their joint office without Bernie sitting in it. Then there had been the growing realisation that whilst her heart had been with Bernie in Nairobi her home was in Holby; and the heart rending pain the realisation brought when she had finally stopped hiding it from herself. The feeling when she had walked away from Bernie to go where she was needed, to Greta, Jason and her Grand Niece rather than where she wanted to be. The aching loneliness of long shifts wondering what Bernie was doing, what Bernie would say or do if she was with her. The struggling with the reality of the love of her life being in a different continent and not at her side. More painful yet were the memories of the way she had behaved over Leah. AAU was full of memories of waiting for, longing for Bernie; both because Bernie wasn’t hers, then because she was and wasn’t there, and finally because she no longer was either there or hers. The memories of what she had lost, what she could have had, were the worst, she decided, except she hadn’t ‘lost’ Bernie she had let her go, set her free. Painful as all these memories were Serena knew that she would not only accept their bitterness but embrace it in order to have the sweetness of the other, happier, memories.
Maybe the memories weren’t as strong for the others - and why would they be she asked herself? She’d walked back into the hospital after her break and had been immediately struck by how unchanged it was. How for all her colleagues, well almost all of her colleagues, life was continuing just the same as it ever had done. Nothing had changed for them - yet, for her, everything had changed and nothing would ever be the same again. Bernie was never coming back. Not a chance. Up until Alex had brought the news that Bernie was dead, up until a few weeks ago, there had been the slenderest of threads of hope hidden in the depths of Serean’s heart; well protected and shielded. That slender thread of hope had refused to accept that she would likely never see Bernie, refused to accept that they would never, after all, make ‘them’ work, that there would never, at some point in the future, be a time and place that was right for them, when they could finally be together and happy, could be enough for each other. Now, though, the logical and analytical part of her brain had forced her to confront and accept the horrible truth that Bernie was gone and wasn’t coming back. That the bomb in Somalia hadn’t just blown Bernie up, it had blown up Serena’s hopes and dreams.
With a considerable effort Serena lifts her head up off her hands, sit back in her chair and attempts to steer her thoughts away from the overly emotive track they were on into a more pragmatic direction - answering the question at hand: What exactly had happened in Theatre. Bernie couldn’t have been there, she was dead. It just wasn’t possible. Neither did Serena believe in ghosts, so any kind of paranormal explanation just wasn’t going to fly. She’s certain that she hadn’t been talking to herself, way, maybe in a way she had. The most logical way of explaining what had happened, Serena thought, was some kind of ‘wishful thinking’. At that moment, in the highly charged atmosphere of the Operating Theatre when things stopped going to plan Serena had needed a rock, something to cling to, something to bring her clarity and confidence in her assessment of the situation and her plan of action. Of all the people she had operated with, and there had been many, Bernie was the one who brought out the best in her, whose confidence in her own surgical skills was so rightly high that it flowed out into Serena. Not that she didn’t have confidence in her own abilities, she did, she knew that she was an excellent surgeon. Yet she’d spent years of feeling less than: less than good enough daughter to her mother, less than good enough mother to her daughter, less than good enough wife to her husband, a less than good enough partner to Bernie. She’d been less than good enough for the CEO position, but, she had to admit, it seemed, good enough to step up to fill the breach when there was no better option- dispensable when there was. Although on a cognitive level she knew her surgical skill were nothing short of top notch her history of feeling less than good enough had left a part of her, on a deep and more emotional level, which refused to let her believe that her surgical skills could be enough. Was there, she wondered, any surprise that in a moment when self doubt threatened to raise its’ ugly head she should search out reassurance? Reassurance from the person who had always believed in her skills and brought out the best in her.
Serena didn’t really do deep introspection. She was more of a practical person, especially where work was concerned, but she was willing to give it a go now. She very much felt that summoning some kind of mental recreation of Bernie in a moment when she was in need of the things only Bernie gave her was very much the most likely explanation. The fact that it was the least concerning explanation as well as the one that showed Serena in the best light was neither here nor there. Still, she thought, not really ought to happen again. She really did have to pull herself together. It really wouldn’t do if word got out that the Director of Medicine was talking to dead people - no matter how innocent it was.
Having found, and settled, on a logical explanation for what had happened Serena’s mind began to calm. It was, after all an innocent one off thing. She was on top of things now, it wasn’t as if it was going to happen again. Safe to put it to one side and say no more about it.
Her focus started to shift back to work. She took a sip of the coffee Fletch had brought her, and recoiled when she realised that it was barely lukewarm anymore. She wonders how long she has been sitting pondering in her office. Obviously far too long she decides without needing to consult a watch. She considers what needs doing before the end of her shift - which is rapidly approaching. For once there is no urgent paperwork she needs to complete - well nothing that won’t wait until tomorrow anyway. Hansen isn’t currently pushing her to produce one report or another for the Board. No, it seems that all she needs to do before she goes off duty (and can get herself on the outside of at least one glass of Shiraz) is a ward round and handover notes. Not in her scrubs though. Most certainly not her favourite look. Time to change back into her own clothes and face her colleagues and the ward. She has nothing to be embarrassed about, she reassures herself as stands up, pushes her chair back and fixes her professional demeanour firmly in place. It would be business as usual she tells herself as she steps out of the office door and heads towards the locker room.
The second time it happens is only a couple of days later. Serena is stood in the middle of AAU surveying a scene of what looks like utter chaos in front of her. The ward is full to bursting point; stuffed with more patients than it can comfortably manage, and cluttered with more concerned relatives than Serena can count. Despite Fletch having come back to his former stomping ground to lend a hand, bringing Essie and Dom with him, it was clear to see that even with these reinforcements her regular team of Ric, Donna and Doctor Duval were struggling to cope.
Of course Serena could have pitched in to help, but she knew that what her enlarged team needed most now wasn’t another pair of medical hands, it was leadership and that was very much her job. Watching closely what was going on around her she takes it all in. She realised that whilst everyone was working hard, darting from one bed to another, one task to another, they weren’t working smart. They were wasting too much time bustling around. What they needed, Serena thought, was a better system, better organisation. AAU wasn’t really set up for this level of admissions. Usually they might deal with a handful of truly urgent or life threatening cases a month. Their usual bread and butter work was rapid diagnosis and treatment - often serious or potentially life changing, but as a rule the ED dealt with the emergencies. AAU just wasn’t set up to deal with such a number of emergency admissions, and certainly not all at once. Today, however, wasn’t a normal day. A driver had suffered a stroke at the wheel and had crashed his bus. Unfortunately the stroke and resulting lack of consciousness had occurred just before he had been supposed to turn right to avoid the low bridge ahead of him. Not being conscious meant he hadn’t made the turn and the bus had ploughed straight into the bridge. The top of the bus had been ripped off as easily as you might rip the wrapping paper of a present. Mercifully the bus had ground to a halt after only a few feet of the roof had been torn off. Less mercifully the van behind the bus hadn’t been able to stop in time. The impact of colliding with the stonework of the bridge caused the bus to come to an abrupt halt and the van had slammed into the back it. The van’s cargo of chemicals - mainly industrial bleach - had fallen out of the back doors as they burst open under the jolt of the crash. As they hit the ground at force they had smashed open and their noxious contents had flowed along the slight slope of the road, under the van and on under the bus.
Initially the victims had been sent to the ED but they had soon become swamped and had started sending patients up to AAU. They had sent so many that AAU was itself on the verge of being overwhelmed. In addition to the various cuts, bruises, broken bones and head injuries from the crash there were also serious crush injuries and foreign objects in bodies needing removal. Then there were the patients who had come into contact with or been splashed by the bleach - and the large number of people who had inhaled the caustic fumes.
Just for a moment Serena felt at a loss for a solution.
“Kandahar style.”says Bernie from behind Serena’s shoulder.
“What?” asks Serena, not understanding.
“You need to create a flow, like I did in the field. Group the patients together according to the treatment they need.”
“That would work!” Serena says, enthused. “I could…” and her voice trailed off. “You’re dead, you’re not here.”
“Of course I’m here. I’m always here with you.” Bernie says as her voice fades away. Serena turns to where the beautifully familiar voice had come from and, as she had expected, there is nobody there - least of all Bernie. Still, she thought, the idea was an inspired one and now certainly wasn’t the time for worrying about where it had come from. Now was the time for action, and she switches her focus back to the ward and her patients.
“Can I have everyone's’ attention please.” she calls out in a calm, controlled voice. “I want to see all staff at the nurses’ station now.” The request was made very politely but in tones of such expectation of compliance that it’s only a minute or two before all the staff are gathered around Serena.
“You’re all doing sterling work, and I’m very grateful, but we need to work smart as well as hard. We’re going to do things Kandahar styIe, create some flow.” Serena again sees a look fly between Fletch and Donna at these words. Once again though there isn’t time for worrying about what is going on there. She has work to do.
“Dr Copeland, please call Sasha and ask if he can spare Lofty for a couple of hours? I want all the relatives moved into the meeting room and all the patients under observation for chemical inhalation without any other injuries to go into the relatives room. Lofty can keep an eye on them for us. Fletch, can you use your charm to get everyone moving?”
“Leave it to me.” Fletch says.
“Dom and Essie, I want you over on the far side of the ward looking after all the burns patients. Dr Duval, I want you by the ward door with Donna and all the patients needing any kind of imaging. Monitor, assess their situation, and, when imaging comes back, treat or refer as appropriate.” Dr Duval, who had looked rather put out at first, soon started to cheer up when he realised the scale of the autonomy he had been handed.
“Dr Griffin and I will be in the centre of the ward, with all other available staff, dealing with those with foreign bodies, crush injuries and multiple issues. We’ll be available for consults and support if any of you need us. Well? What are you all waiting for?” The staff rapidly disperse to their new stations and soon the ward is a hive of focused activity with beds, people and equipment being moved into the correct areas.
“Novel approach.” Ric Griffin says quietly to Serena.
“Novel situation.” Serena replies with a miniscule shrug. Ric gives her a wry smile before he heads of to see what awaits him in the centre of the ward. Fletch walks past Serena and she reaches out to touch his arm.
“It might be useful to have someone from Darwin down here Fletch. I think we’re going to have a lot of cardio thoracic issues to deal with. Do you think that you can persuade Jac to send us Miss Goddard down?”
“Now you’re asking! I’ll do my best but no promises. You know Jac.”
“I do. Thanks Fletch.” Serena says slightly absent mindedly, her attention swiftly turning to the patients who needed her.
Several hours after her shift had officially finished Serena was sat in Pulses, her hand wrapped around a hot coffee. Ric was sat opposite her in companionable silence as they both gathered their thoughts. AAU was finally back in some kind of semblance of order. Serena couldn’t have been prouder of how hard her team had worked to treat the injured. None of them had stopped from the moment they’d arrived until Serena had gratefully either sent them back to their wards or for a well earned break. Those suffering from fume inhalation had served their time under observation, and, fortunately, none of them had suffered any ill effects. All of them had been sent home. Dom and Essie had irrigated and dressed burns with efficiency. All their patients had been kept topped up with pain relief whilst they had been treated. Some got sent to the Burns Unit, luckier ones got sent home, and Dom and Essie took Lofty with them back up to Keller, Serena’s thanks ringing in their ears. Dr Duval had surpassed himself. He and Donna had worked together like a well oiled machine. Xav had kept a cool head under pressure and had dealt with his patients calmly, quickly and efficiently. It seemed that the greater autonomy suited him. His clinical judgement had been spot on in almost every case. Much to Serena’s surprise he’d been perfectly happy to call her on her and Ric to assist when they’d been needed. He’s maturing as a Doctor, Serena thought to herself. I must remember to let him know just how well I thought he handled things.
She and Ric, assisted by Fletch, had been knee deep in treating the worst injured: rapidly diagnosing and treating .They had been able to pass the complex chest injuries over to Chloe and the team up on Darwin. Several of their patients had needed urgent surgical removal of shrapnel and debris from the crash that had lodged in various parts of their bodies. Serena, and more particularly her vascular surgery skills, had been required for several of the crush victims. Whilst Serena had been saving limbs, Ric had been removing spleens and repairing ruptured organs. It had taken more hours than either of them had cared to count, but they had eventually cleared the urgent operations. There were many more surgeries that would be required in the next few days, but none of them were urgent any more. As soon as the last of their surgical patients had been brought back to the ward Ric and Serena had sent Xav, Donna and Fletch on a break, well had sent Fletch home to his family, and insisted that they would keep an eye on the ward while the others rested. The ward was, momentarily, blissfully still and full of welcome quiet. Ric and Serena had little to do in this lull but to complete the patient notes and the various other bits of paperwork that the day had had generated. By the time all their team had either finished their shift and gone home or had a break and a chance to grab some food and drink Ric and Serena were starting to work out which further surgeries needed to be done before they went home that night, and which could be safely left until the following day. Serena wanted to get through as much as possible tonight. Ric was leaning towards leaving as much as possible to the following day when they would be well rested. They weren’t exactly arguing, but the tension of the day and the tiredness were causing the atmosphere in the office to be a little more than strained.
The animated discussion was in full swing when they were disturbed by a knock on the door. Before Ric or Serena could call out ‘come in’ the door had opened and Hansen stepped into the office.
“Still here I see.” He commented rather needlessly. “I have two things I need to discuss with you, if I may have a minute of your time?” Although framed with the utmost courtesy it was clearly not a request or a question. It was more akin to an order. Knowing that there really was no point in trying to argue, Serena and Ric bowed to the inevitable and nodded to Hansen to continue.
“Thank you” he acknowledged. “Firstly I wanted to pass on congratulations from myself and the Board for the way in which you handled today’s testing events. I trust you will pass this onto your team. I understand that you implemented some rather radical ideas today. By all accounts they were particularly successful and enabled you to process all your incoming patients much faster than we would have expected. I’d be very interested in hearing more about them Ms Campbell. In due course, that is, certainly not now.” Serena lets out an inward sigh of relief. She’s in no place to start explaining what she had done and where the idea had come from at the moment. She was grateful that under the efficient and reserved facade Henrik was more empathetic than you might imagine.
“Of course Henrik.” Serena concurs.
“The other matter I wanted to raise. I’ve finished for the day and I understand that neither of you have yet had a break today, and that you are both likely to be here for some time yet. Nurse Fletcher tells me that all is, though, now calm and in order on the ward. I’m therefore offering my services for the next hour to hold the fort, as it were, to allow the two of you to take a break and come back to the fray refreshed. I’ve spoken to Dr Duval and I’m sure that, with his assistance, I’ll be able to do an adequate job of keeping things on a steady course.”
Serena and Ric look at Hansen and then at each other. It’s not the kind of offer that happens often and certainly not one either of them is going to turn down. Before he can change his mind Serena jumps up, grabs her purse and says,
“Thank you Henrik. Much appreciated. We’ll be in Pulses if you need us.” Ric, having jumped up almost as rapidly as Serena, is already opening the office door.
“Thank you Henrik.” he says as he slips through it and holds it open for Serena to follow him. A wry smile teases the muscles around Henrik’s mouth as his two colleagues make a hasty exit from the office.
“Where did that come from?” Ric asks as they head out of AAU towards the lifts.
“Right now I really don’t care. All I want is a strong coffee and some food.”
“Lead on.” says Ric, knowing better than to raise any objections when Serena was this determined. Besides, coffee and food was exactly what the doctor had ordered.
The first thirty minutes of their break had been focused on acquiring and eating the food there were so desperately in need of, but now, hunger sated energy levels beginning to recover their minds turn to the events of the day. Having worked together for years they had a level of understanding of each other that meant they were fairly rapidly able to reach a compromise on the issue of what surgeries should be scheduled for that night, and which for the next few days. Serena conceded that they couldn’t work on indefinitely and Ric conceded that there were two cases in which operating overnight rather than waiting until the following day would likely significantly improve the outcome for the patient. Fortunately neither of the surgeries was especially long or complex and they’d both be free to head home afterwards to as much Shiraz or as many hot baths full of aromatic oils as they wanted. Decisions made the conversation halted momentarily, Ric fiddles with his coffee cup, clearly working out how to broach whatever topic he was about to bring up. Obviously he’d decided on casual indifference Serena noticed, as with an overly disinterested tone Ric said
“Interesting way of handling things up on the ward today.” Serena fixed her eyes on her coffee cup, not wanting to risk looking at Ric, wondering what he’d realised or worked out, or let him see what her face might be giving away,
“Do you think so?” Serena replies as blandly as she can manage.
“Hmm.” said Ric “For a minute there it was like Bernie was back with us.” and he left the comment hanging in the air between them. For Serena, of course, it had felt exactly like that; painfully and wonderfully like that. She wasn’t going to tell Ric though. Good friends though they were, she wasn’t going to go there with anyone, not even him. She needed to give him some sort of reply, and for what seemed like an age, she debated what she could say. She decided to stick as closely to the truth as she could.
“I suppose, in a way, she was. The way we organised the ward, it was the way Bernie used to organised her field hospitals. She always said it was the most effective way of dealing with multiple casualties.” She risks a look up from her coffee into Ric’s face and sees him weighing up whether to believe her or not. Time for the clincher, Serena thinks
“You know, we did talk. There was once a time, an all too brief time, when we were together, on the same continent and we actually talked to each other - about all sorts of things.” It works, to a degree.
“Of course.” Ric replies. Ever the gentleman he back pedals slightly, not wishing to cause Serena any further pain by pushing what is obviously a sensitive topic. The woman has been through enough in Ric’s opinion. Still he feels, in spite of this, he needs to ask one more regrettable question.
“It did sound rather like you were having a conversation with someone though. You were using the same voice you used to speak to Bernie with. She could have been right there.
“If only!” Serena replies, aiming for light hearted levity and just pulls it off. “Obviously I’ve spent too much time alone recently if I’ve taken up talking to myself. Still it’s about the only way to guarantee a good, intelligent conversation around here.
“I’m wounded!” says Ric in tones of mock hurt.
“As are several of our patients upstairs. We should head back to them and see if Hansen has spent so much time in his office and with the Board that’s he’s forgotten how to run a ward.”
Without a word, Ric picks up his coffee cup and heads towards the lift. Serena rapidly follows suit. As they wait for the lift the companionable silence descends on them again. Serena’s brain, however, was whirring. It had happened again. She’d been talking to Bernie, a dead woman, in the middle of the ward. Thank heavens that at least, this time, she’d realised what was going on herself, and it hadn’t been pointed out to her by one of her colleagues. There was no chance this time that it had been anyone else on the ward. It absolutely had to be in her head. It felt so real though; the timbre of the voice, the inflections, the phraseology. It was all so very Bernie. Was there a chance it was Bernie she thought? Almost immediately (as quickly as she had when the possibility had occurred to her after the first time she’d spoken to Bernie since her death) she again dismissed the notion. She was a woman of science she reminded herself. She didn’t believe in ghosts of paranormal phenomena. It was a fanciful thought and out of the question. She was, therefore, once again left with the concerning possibility that she was subconsciously conjuring up some kind of version of Bernie in her own head. That she was channelling her love and longing for the woman she had lost in more ways than one, until it was so vivid and so powerful it became real and almost corporeal - to her at least. It didn’t seem the epitome of sanity and rationality to Serena, but still she wondered, was it really such a bad thing? The wealth of emotions she was dealing with when it came to Bernie, the loss and regret, certainly, but also the love, joy, freedom and closeness. They just couldn’t disappear, could they? They had to go somewhere, be dealt with somehow. Was hearing Bernie so clearly in her head that it felt like she was standing right next to her such a bad thing. Certainly the advice she’d heard Bernie give hadn’t been a bad thing for the patients who’d benefited from it. No one had been damaged, or even inconvenienced by it. Was there really any harm in it, she wondered. Before she could answer her own question, the lift stopped moving, the doors opened and Serena’s thoughts were back on her patients and whatever awaited her on AAU.
It turned out what was awaiting Serena on AAU was Henrik - and a Henrik who was rather pleased with himself at that. At least Serena thought he was. The tall Swede wasn’t exactly known for his overt shows of emotion. Serena was fairly certain she could detect a slight upwards curve in the edges of his mouth and a hint, a mere suggestion, of a sparkle - if not dancing in his eyes certainly tapping its feet along to the beat. She decided that these clues did indeed indicate Henrik had managed to hold AAU together in their absence.
“Ah! Ms Campbell, Mr Griffin. Back with us suitably refreshed and rested I trust?”
“I wouldn’t go that far.” Ric said dryly.
“We appreciated the break. Thank you. How is the ward?” Serena asks.
“A very model of calm and efficiency.” Henrik claims happily. Serena casts her eye over her ward. She trusts Henrik but she still needs to see it for herself. It certainly looks calm, peaceful and under control. There were barely any relatives left on the ward and quite right too, thought Serena. Visiting was long since over and her patients needed rest. It seemed that they were getting it. She saw that many of the beds had been relocated back to their original positions, giving the patients who were remaining on AAU space and a modicum more privacy in which they could sleep. Serena could see that many of them were taking full advantage of it to catch up on some desperately needed shut eye. It was a good job that they’d been able to transfer so many patients to other wards and departments. AAU was, even now, running on the very edge of its’ capacity. Serena knew that this was also true of many other parts of the hospital this evening, particularly the ED. They’d been very lucky indeed that the incident hadn’t been any more serious and stretched them beyond their capacity. She could also see that, whilst the ward was, overall, a picture of peace, there were nurses moving from bed to bed, taking obs, administering medication and ensuring, their patients comfort with quiet efficiency.
“I’m impressed Henrik. Thank you for lending us your obviously very safe pair of hands. Everything seems to be under control.”
Her words, however, are almost immediately contradicted as Donna comes hustling straight towards the small group of Consultants. She’s clearly a woman on a mission and the look on her face suggests that she isn’t the bearer of good news.
“Knew it would be too good to last.” Ric says under his breath. Serena responds with a distracted ‘hmm’. She’s mentally bracing herself for whatever Donna is about to throw at her. Donna pulls up just short of the group and starts to speak.
“That was Connie from the ED on the phone. The rescue team at the crash site have found a car. Looks like it swerved to avoid the crash and ended up going over the embankment. It flipped as it went over and landed on its roof. There are four passengers inside and they’re being cut out now. It sounds like they’re in a bad way. The ED can’t take them and they want to know if you can.”
“Can’t they take them to St James’?” Serena asks, only too aware how full their ward is, and knowing that all her staff have given more than they should have been asked to.
“St James’ have closed to new admissions. They’ve had a cyber attack and their systems are down. They’d be transferring patients here if they could get away with it.”
“If we don’t take them where will the casualties go?” Ric asks.
“The Royal Wyvern,” says Donna.
“Over 50 miles away.” Hansen notes blandly “Ms Campbell, it’s your ward, your call.” Everyone’s attentions turns to Serena. She’s well and truly been put on the spot. Obviously bringing the casualties to Holby as the closest hospital is the logical thing to do and certainly best for the patients. In normal circumstances Serena wouldn’t have batted an eyelid and would have taken them straight away. Today isn’t a normal day though and Serena has to weigh up whether her stretched ward and her amazing but over worked staff can offer the care these unfortunate victims need or if - on balance - they would get better care at the Royal Wyvern, even taking into account the risks of the extra distance. Hansen, Donna and Ric are looking expectantly at Serena as her mind runs rapid cost and benefit analysis and weigh up the risks and benefit of each option. It’s such a fine call and one that needs to be made rapidly.
“Of course we’ll take them.” Bernie says.
“It’s not that straight forward.” Serena counters.
“Isn’t it?” asks Hansen, assuming that Serena is replying to his previous statement. “Either AAU has the capacity to take four more patients or it doesn’t. Having been working with your team for the last hour I think they would rise to the challenge admirably and I will do all I can to ensure that you have whatever support and facilities you need.” Serena barely hears what he is saying because it’s Bernie’s voice, almost right in her ear, which is holding her attention as she says
“Serena, you can do this. You have to take them. You know you do.”
“It’s not your decision.” Serena says and it comes out more tersely that she had expected it to. The day had obviously taken more out of her than she had expected it to. Hanson takes a step back and adjusts his tie needlessly.
“Indeed it is Ms Campbell.” he confirms, slightly taken aback by the vigour of Serena’s reply. Serena isn’t talking to Hansen though, she’d barely even heard what he’s saying. Her attention has been completely focused on Bernie and the dispute they are having.
“We can do this Serena.” Bernie insists. “They might not survive if they have to go all the way to the Royal. You have to do what’s right for the patients.”
There are a lot of things that Serena will put up with, but no one, not even Bernie, is allowed to get away with questioning her commitment to her patients.
“Are you suggesting that I don’t want to do what’s best for my patients?” Serena asks with a calm voice, veiling the danger beneath the words. Hansen looks bemused, Donna looks awkward and Ric looks concerned, He reaches out to touch her arm and says gently,
“Serena, no one is suggesting that you don’t care about the patients, far from it.”
“But...” Serena starts, then realises that the only person who has been questioning her is Bernie – and none of the others know what she has said because she’s not there. “Yes, yes, I know, I’m sorry. Long day. It’s left me a little edgy and short on patience.” She fills in quickly in an attempt to hide her slightly strange behaviour.
“Understandable.” says Hansen as he visibly relaxes (as much as Hansen ever does). Ric is still looking at her with an air of concern. It’s Donna who breaks what is fast becoming a rather embarrassing silence. Her face is scrunched up in a picture of awkward nervousness.
“Sorry to push you Ms Campbell, but I really do need to give the rescue team an answer as soon as possible.”
“Of course,” Serena acknowledges as she slips back into professional mode and turns her attention back to the matter in hand. “Please tell them that we’re sorry but we’re at full capacity and can’t take any more casualties.”
“Thank you.” Donna says before making a rapid escape back to the nurses station and the phone call waiting for her. Ric is still looking at Serena rather strangely, but this time it’s Hansen who speaks and breaks the atmosphere.
“Whilst it’s been a pleasure offering my services I shall hand AAU back to the experts and take my leave. I’m sure that you are keen to complete your final surgeries and get home.”
“Yes, thank you Henrik.” Serena calls after Hansen as he leaves the ward.
As soon as he is gone from earshot Ric turns to Serena and says,
“Are you sure you’re Ok?” with genuine concern.
“Never better.” Serena snaps slightly, knowing that Ric has not been fooled by the explanation that she has just given Hansen. They’ve been friends far too long for him not to see right through her. Ric too though is a consummate professional and Serena take a calculated risk that he can be distracted by the patients.
“So who do we want to take to theatre first?” She asks. It pays off and they are soon deep in discussion about which of the surgeries should be tackled first. Although she would never admit it, even to herself, it serves as as distraction for Serena too.
It’s gone 10pm before Serena is home, settled comfortably on her sofa, a half drunk glass of Shiraz in her hand and the rest of the bottle open on the coffee table in front of her. She’s exhausted and her body is screaming at her to go to bed. Her brain, however is refusing to allow sleep until it’s had a chance to go over the events of the day to it’s own satisfaction. Serena knows herself well enough by now to realise that she’ll get no sleep until she’s at least made an effort to process what’s happened, She’s decided though that she’s not going to do it without wine. She knows exactly where her brain will take her first – to Bernie – and she’s not going there without Shiraz on board. The deep red liquid has just finished sloshing into her glass when a voice says
“I was only trying to help.” The voice is unmistakeably Bernie’s. “I wasn’t trying to say you didn’t want what was best for your patients, that you didn’t care about them. I know you do. But you’re better than you think you are, more skilled, more talented, more capable. I still think that you could have taken those last patients and made it work. I never doubted that you could. Not for a second.”
“I know you don’t think that, although I do think you give me more credit than I deserve.” Serena finds that she’s replied before she’s had time to thing about what she’s doing. She’s talking to Bernie - again – and this time there’s no way it could be anybody else because she’s the only one in her leafy semi-detached. Since she and Bernie broken up the house had been quiet. Too quiet. Elinor was gone. Jason and Greta had their own lives and their own place. They much preferred Serena to visit them in their cosy new build flat as it was far less of a disruption to their routine. Serena was happy to oblige, but it did mean her house rarely saw any visitors. Since her return from her sabbatical the only visitor the house had welcomed was Bernie on her all too infrequent returns to Holby. Serena had got used to the peace and solitude of home. Had no choice but to adapt to it. To her surprise though, having Bernie’s voice once again fill the air in the living room was strangely comforting. There was something in the familiarity of hearing it in the space where they’d, for far too brief a time, created a happy and contented home. There was something calming and reassuring about it once you got past the fact that you were talking to a dead woman. It’s less worrying, talking to Bernie at home. It’s less embarrassing as there’s no chance of being caught by a colleague and having them worry about your sanity. In fact, Serena thinks she quite likes talking to Bernie at home. It seems that she likes it enough to forgo the tongue lashing anyone else who questioned her commitment to her patients would have received. Serena never could hold a grudge when it came to Bernie. Instead of full of anger her tone is soft, warm and inviting.
“I could have used you and your skills in theatre today. There were some very tricky trauma cases you could have got your teeth into.” Serena say, as if idly making conversation with your dead Ex is an everyday, run of the mill event.
“But I was there. I was right there with you. I always am.” Bernie’s voice replied..
“Oh, I know you were. I always take a bit of you into theatre with me – even if it’s only the memory of how much you believed in me and what you believed we could achieve. Still, there were one or two cases I’d have loved to have handed over to you, that could have done with your trauma expertise.
You weren’t exactly there in a “hands on” capacity though.”
“I wish I could have been. I would happily have taken them off your hands. You know how much I love a challenge in theatre.”
“I miss operating with you. I miss you.” Serena confides. She says it in a very matter a fact way but she can’t disguise the sadness that creeps in around the edges of the words.
“I miss you too, but I’ll always be a part of your story and you’ll always be a part of mine” Bernie tells her and they allow a silence to enter the room. It hangs heavily between them. Not a big enough part of my story, Serena thinks. Not a long enough part of hers. A story that hadn’t been finished. A story that should have had a happy ever after. The silence extends, but Serena doesn’t need the lack of words to know that Bernie has gone. She can feel the lack of her presence. She sips on the glass of wine she’s poured and tries to wrap her mind around what’s going on.
She had to admit, after a deal of thought and a deal of wine, that she really doesn’t know what’s going on. She doesn’t understand it and she doesn’t know what it means. Other than making her feel a little awkward in front of her colleagues as she tries to hide it, it seems harmless enough. Her patients were benefiting from the conversations she was having with Bernie certainly. She’s pretty sure she’s benefiting too – professionally and personally. Would it be so wrong of her to indulge herself it it brings her comfort? Serena honestly doesn’t know, and she’d not really in the best place to try and work that one out. It’s late. It’s been a long day. A very long and trying day filled with complex surgeries and a constant stream of problems to solve. She needs to sleep more than she needs answers right now. Although she really wants to figure this out, is desperate for answers, somehow her brain seems calm and content, as if she’s able to hold both these conflicting states in parallel. Even though she’s no closer to an answer she’s somehow comfortable with that. She wonders idly if it might be something to do with how reassuring she had found Bernie’s presence when she was alive, and also it seemed, now she was dead. Deciding not to look a gift horse in the mouth and to make the most of having a calm enough mind to make sleep a distinct possibility, Serena gets ready to head to bed. It doesn’t take her long to finish the last of the wine in her glass. She opts not to have another glass and puts the cork back in the bottle. A brief look at her watch tells her that it’s not quite 11pm. She should just about have time to fit in a steaming hot shower before collapsing onto her bed.
As luck would have it, or not depending on your perspective, Serena has an early start the next day. She wakes at 6.30 am (or, more accurately is ripped from her sleep by the Dr Who theme tune Jason had programmed as her alarm clock’s signature tune and she’d not got round to figuring out how to change) and finds, to her surprise, that she’s slept a lot better than she thought she would. A lot better than she has for quite a while. She wouldn’t go as far as to say she was raring to go (that really would be pushing things), but she certainly felt up to facing the day. It’s been quite a while since she’s got out of bed if not quite with a spring in her step, at least without dragging her heels. It’s not long before a fully caffeinated and smartly dressed Serena is striding onto AAU and taking stock of her ward. It seems that the night shift has done a pretty good job of keeping things going. All the patient notes are up to date. All the obs have been done. Two more patients have been moved to Keller and a further two are earmarked for discharge that morning. Serena, it seemed, was free to focus on the surgery remaining from the previous day.
It didn’t take Ric and Serena long to divide up the procedures. Serena had a crushed leg to attend to – replacing yesterday’s temporary fix with a more permanent solution now the swelling had started to subside. Ric had a tricky damaged liver to try and patch, which might or might not be doable. That was both their mornings booked out. They agreed that they could tackle the repair of the crushed fingers and laparoscopic investigation of the free fluid in Mrs Lloyd’s abdomen together that afternoon. Serena had called dibs on the earlier free theatre slot. Ric had put up a token show of resistance but in reality he had been happy enough to let Serena have her way. In truth it had been a while since she’d seemed so relaxed and happy. She put on a good show – always every inch the professional, always on top of her game, but Ric knew Serena well. Knew her too well to be fooled by the veneer she’d been presenting recently. Today had been the first time in a while that he’d seen genuine enthusiasm in her face, and when he’d feigned annoyance at her claiming the earlier theatre slot he’d seen mischief light up in her eyes in a way that her hadn’t seen for longer than he cared to think about.
Serena was aware that there was more of a bounce in her step than there should have been, given the events of the day before and the still mountainous amount of work ahead of her. Whilst she was obviously not unaffected by the disaster that had left so many injured yesterday she couldn’t help feeling eager to get into theatre and work her magic. Her surgical skills had never been in doubt. She’d never been anything less than professional in theatre, her skills never anything less than top notch. Somehow, though, ever since she’d ended things with Bernie, her heart just hadn’t been in it in the same way. The joy of a successful procedure had become dulled around the edges, the gut punch of a surgery that doesn’t get the desired result lands with less impact than it had before Bernie’s death. Today though, today, feels different. Serena is absolutely looking forward to giving her surgical muscles a good stretch. Her good mood is absolutely nothing whatsoever to do with the possibility that Bernie might show up in theatre.