Книга - Heart Surgeon, Prince…Husband!

Heart Surgeon, Prince...Husband!
Kate Hardy


A convenient proposal…An inconvenient attraction!Prince Luciano Bianchi is a top heart surgeon—but as a future king he’s expected to rule, not operate! To convince his family that saving lives is where his heart lies, he proposes a temporary convenient marriage to his new colleague, workaholic cardiologist Kelly Phillips. Of course there’s no risk of either of them falling in love—until their whirlwind ‘romance’ starts to feel tantalisingly real!







A convenient proposal...

An inconvenient attraction!

Prince Luciano Bianchi is a top heart surgeon—but as a future king, he’s expected to rule, not operate! To convince his family saving lives is where his heart lies, he proposes a temporary convenient marriage to his new colleague, workaholic cardiologist Kelly Phillips. Of course, there’s no risk of either of them falling in love—until their whirlwind “romance” starts to feel tantalizingly real!


KATE HARDY has always loved books, and could read before she went to school. She discovered Mills & Boon books when she was twelve, and decided that this was what she wanted to do. When she isn’t writing Kate enjoys reading, cinema, ballroom dancing and the gym. You can contact her via her website: katehardy.com (http://katehardy.com).


Also by Kate Hardy (#ufa1b3e28-ca4a-5a03-b8cf-421dd1cd29e3)

Mummy, Nurse…Duchess?

Christmas Bride for the Boss

Unlocking the Italian Doc’s Heart

Reunited at the Altar

Carrying the Single Dad’s Baby

A Diamond in the Snow

Miracles at Muswell Hill Hospital miniseries

Christmas with Her Daredevil Doc

Their Pregnancy Gift

Discover more at millsandboon.co.uk (http://www.millsandboon.co.uk).


Heart Surgeon, Prince...Husband!

Kate Hardy






www.millsandboon.co.uk (http://www.millsandboon.co.uk)


ISBN: 978-1-474-08977-7

HEART SURGEON, PRINCE...HUSBAND!

© 2019 Pamela Brooks

Published in Great Britain 2019

by Mills & Boon, an imprint of HarperCollinsPublishers 1 London Bridge Street, London, SE1 9GF

All rights reserved including the right of reproduction in whole or in part in any form. This edition is published by arrangement with Harlequin Books S.A.

This is a work of fiction. Names, characters, places, locations and incidents are purely fictional and bear no relationship to any real life individuals, living or dead, or to any actual places, business establishments, locations, events or incidents. Any resemblance is entirely coincidental.

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www.millsandboon.co.uk (http://www.millsandboon.co.uk)


To Sheila Crighton, a wonderful friend,

with love and thanks for the lightbulb.


Contents

Cover (#u8826182a-415d-572c-895f-71704e588fbb)

Back Cover Text (#udc951872-a191-58ff-82ef-43a78358b4d3)

About the Author (#u7d163d78-fcd9-519e-9357-f4a73492f601)

Booklist (#u72a7b690-9689-51f6-9492-59d3222d69bb)

Title Page (#u2efaabd8-199b-5ab0-9745-af69df9ee755)

Copyright (#ud54d3fbd-64a1-554e-85e3-313424e4c239)

Dedication (#ucb5994ce-a3da-5db3-bbfa-b44cba97120e)

CHAPTER ONE (#u539dfcf8-7b33-5290-ac98-d6fbefb8fa25)

CHAPTER TWO (#ue46cbd81-e8d7-5b08-9101-1a12ff6d6d56)

CHAPTER THREE (#u8a074879-2916-5df5-afe5-21fce8d357f5)

CHAPTER FOUR (#litres_trial_promo)

CHAPTER FIVE (#litres_trial_promo)

CHAPTER SIX (#litres_trial_promo)

CHAPTER SEVEN (#litres_trial_promo)

CHAPTER EIGHT (#litres_trial_promo)

CHAPTER NINE (#litres_trial_promo)

CHAPTER TEN (#litres_trial_promo)

CHAPTER ELEVEN (#litres_trial_promo)

EPILOGUE (#litres_trial_promo)

Extract (#litres_trial_promo)

About the Publisher (#litres_trial_promo)




CHAPTER ONE (#ufa1b3e28-ca4a-5a03-b8cf-421dd1cd29e3)


‘LUCIANO BIANCHI, the new heart surgeon, is starting today,’ Sanjay, the head of the cardiac unit, told Kelly. ‘Can I ask you to look after him for me this morning—take him round the department, show him where the canteen is and introduce him to everyone? I’d do it myself, but I’ve got meetings with suits.’ He rolled his eyes. ‘All day.’

‘Oh, the joy of budgets,’ Kelly said, sympathising with her boss. ‘Of course I’ll show him around.’

‘Wonderful. Thank you.’ Sanjay patted her arm.

Rumours had already flown around the hospital. Luciano Bianchi wasn’t just a cardiothoracic surgeon; he was a prince. His father was the King of Bordimiglia, a small Mediterranean country on the border between Italy and France. Apparently he’d trained in London and worked for some years at the Royal Hampstead Free Hospital; now one of the surgeons here was retiring, Luc was moving to Muswell Hill Memorial Hospital.

Everyone had looked him up on the Internet, of course; it was hard to reconcile the idea of an upper-class playboy who didn’t take life too seriously with a man who’d spent years training to be a heart surgeon. So who was Luciano Bianchi—and would he be part of the team or would he be a royal pain in the backside?

From the photographs, he was definitely nice-looking enough to make all the women in the department sigh and speculate why he hadn’t been snapped up years ago. Tall, with dark hair and dark eyes, Luciano looked more like a model for a high-end fragrance ad than a surgeon. But he didn’t seem to date that much—or, at least, there weren’t loads of paparazzi pictures of him with a princess or the daughter of some wealthy industrialist on his arm, on their way to some high society party or movie premiere. It looked as if he put his job before his position in society, which boded well for life at the hospital.

Kelly wasn’t one for gossip, but one rumour that had caught her attention involved his work. He was allegedly going to set up a trial for a new surgical procedure to help patients suffering from hypertrophic cardiomyopathy—a condition where the muscular wall of the heart thickened and made the heart stiff, making it harder to pump blood around the body.

It was too late for a trial to help Simon; but it wasn’t too late to help his younger brother Jake or Jake’s daughter Summer.

Kelly would never forgive herself for the fact that she hadn’t picked up on her late husband’s heart condition. How could a trained cardiologist have missed something that massive? Since then, she knew she’d become a workaholic—but she was determined that nobody’s symptoms would go unrecognised on her watch. She didn’t want other families to have to go through what her family had been through. And getting Jake and Summer onto the trial might help to blunt the edges of her guilt. If she explained the situation to Luciano Bianchi, then maybe she could persuade him to at least consider Jake and Summer as candidates for his trial.

She kept an eye on the reception area from the office where she was catching up with paperwork, and twenty minutes later Luciano Bianchi walked through the doors. She pushed her chair back and went out into the reception area to greet him. ‘Mr Bianchi?’

He turned to look at her. ‘Yes.’

Oh, help. Maybe she should have called him ‘Your Highness’. But he was here in his capacity as a surgeon, not as a prince, so she’d used the convention that surgeons were called ‘Mr’ rather than ‘Dr’. She summoned up her best smile. ‘I’m Kelly Phillips, one of the cardiologists,’ she introduced herself. ‘Sanjay is stuck in meetings all day, so he’s given me a reprieve from paperwork to show you round and introduce you to everyone. And, if you don’t have any other plans, to take you to the canteen for lunch.’

* * *

Luc was used to people judging him first as a prince and secondly as a doctor, but maybe at last his reputation at work was starting to take precedence, because Kelly Phillips was definitely treating him as a surgeon and a colleague. He really liked the fact that she’d called him ‘Mr Bianchi’ rather than ‘Prince Luciano’. And, OK, there was an unobtrusive bodyguard with him, because of who he was, but his security detail was discreet. Luc didn’t want to be treated any differently from the other staff on the team. He was here to save lives, just like they were. A doctor first and a prince second: and he thought he could serve his country far better with his medical skills than by doing the job he’d been born to do but his older sister would do so much better.

‘Thank you. That would be good,’ he said, holding out his hand to shake hers. ‘Nice to meet you, Kelly. I’m Luc.’

‘Nice to meet you, too, Luc. Welcome to the department.’

She shook his hand, and it felt as if he’d been galvanised. He really hadn’t expected to react so strongly to her, with his skin actually tingling at the contact with hers.

Then he shook himself.

Even if she wasn’t already involved with someone, Luc had no intention of letting his relationship with Kelly Phillips become anything other than professional. Until the situation with his father was resolved, it wouldn’t be fair to start dating anyone. He’d already learned the hard way that women who dated the prince didn’t want to date the doctor, and vice versa. The two sides of his life sat uneasily together, and all his relationships seemed to fall through the fault line.

‘Thanks for the warm welcome,’ he said.

‘It’s a Muswell Hill Memorial Hospital tradition. First stop, staff kitchen,’ she said. ‘Though I’m afraid it’s instant coffee and a kettle, here, rather than a posh coffee machine.’

Uh-oh. It sounded as if she was starting to see the prince rather than the surgeon. ‘Which makes it much easier to add cold water so you can drink the lot down in one,’ he said with a smile. ‘Between the operating theatre, seeing my patients and drowning in paperwork, I’ll take my caffeine any way I can get it. Instant’s fine.’

She looked relieved at the reminder that he was just like any other doctor. ‘And there’s a treat shelf. Patients and their families are always bringing in biscuits or cake for us.’

‘And then they wince and apologise for buying something so unhealthy, given that half of our patients have been given dietary advice to cut back on sugar and fat?’ Luc asked with a smile.

‘I suppose it’s like taking a big tin of chocolates to a gym at Christmas,’ she said with a grin. ‘Though we’re just as grateful for the goodies as the personal trainers are.’

Because sometimes, after a rough shift, when you’d tried everything and it still wasn’t enough to save your patient, cake and a team hug were the only things that could help stop you falling into a black hole. However much professional detachment you had, losing a patient was always grim. ‘Yes,’ he said softly.

‘I assume you’ve already been given your computer login?’ she asked. ‘If not, I’ll ask Mandy to chase it up for you. She’s officially Sanjay’s secretary, but she keeps an eye out for the rest of us. She knows everyone and everything, so she’s the fount of all knowledge, and we keep her in flowers because she keeps us all sane.’

‘I’ll remember that,’ he said. ‘Yes, thanks, I’ve got my login, my staff ID and my lanyard.’

‘Pick up your locker key from Mandy, and you’re good to go.’ She smiled at him again. And he was going to have to ignore the way his pulse rate kicked up a notch when she smiled.

The more he heard, the more he liked the sound of his new department. And all his new colleagues turned out to be as warm and friendly as Kelly, instantly accepting him as one of them rather than being slightly suspicious of Prince Luciano’s motives For working in a hospital rather than a palace.

‘I think we’re both due in clinic now,’ Kelly said when she’d finished introducing him to everyone, ‘but I’ll meet you back here in Reception at one for lunch. Patients permitting.’

‘Of course,’ he said. ‘Thank you for showing me round.’

That handshake had thrown her.

Ever since Simon’s death, Kelly had kept all her relationships strictly platonic, and she hadn’t so much as looked at another man; she barely joined in with conversations in the staff kitchen about the latest gorgeous movie star. It was partly because she wasn’t ready to move on; and partly because the whole idea of starting over again with someone, falling deeply in love with them and then risking losing them, was too much for her.

The sensible side of her knew that what had happened with Simon was rare—a life-threatening genetic condition that usually showed symptoms, but in his case it hadn’t. The chances of dating another man with hypertrophic cardiomyopathy were small; the chances of dating another man with HCM who had absolutely no symptoms of chest pain, light-headedness or breathlessness were even smaller. So minuscule as to be absolutely unlikely.

But.

She could still remember the numbness and shock she’d felt when she’d taken that phone call, two years before. The way her life had imploded, as if in slow motion; she could see it happening but could do nothing to stop it. The sheer disbelief that her husband—the man who cycled to work every day, did a five-kilometre run every Sunday morning and loved playing ball with their nephews in the park—had collapsed and just died. They hadn’t even had the chance to say goodbye; and it was her big regret that they’d waited to start trying for a family. Simon was a brilliant uncle and he would’ve been a great dad. He’d just never had the chance.

For the last six months, Kelly had been fending off well-intentioned matchmaking by her family and friends, urging her to go out on a date and have fun, because Simon wouldn’t have wanted her to be on her own for the rest of her life; he would have wanted her to be loved. She knew that; just as, if she’d been the one to die, she would have wanted Simon to find someone to share his life with and love him as much as she had.

But she just wasn’t ready to move on. She couldn’t forgive herself for not picking up on his HCM. She was a cardiologist; she’d treated quite a few people with Simon’s condition and she knew all the symptoms. There must have been something she’d missed. Something she should have spotted. She’d let the love of her life down in the worst possible way. And she wasn’t going to let any of her patients down.

She blew out a breath. And it was ridiculous to let Luciano Bianchi throw her. Absolutely nothing could happen between them. OK, so he seemed to be dedicated to his career; but even though he didn’t have the lifestyle of a ruler-to-be, that was exactly what he was. The heir to the kingdom of Bordimiglia. No way would he be allowed to get involved with anyone who didn’t have a single drop of blue blood in her veins. He’d end up marrying a princess for dynastic reasons. His relationship with her was strictly business. And that little throb of awareness when his skin had touched hers—well, she was just going to ignore it.

She managed to focus on her patients for that morning’s clinic; and Luc’s clinic clearly ran on time as he was waiting for her in the reception area at one o’clock.

‘Hi. How was your first morning?’ she asked brightly.

‘Fine, thanks. We have a good team,’ he said with a smile.

A smile that shouldn’t have made her feel as if her heart had just done a backflip. She pulled herself back under control. Just.

‘How was your morning?’ he asked.

‘Good, thanks,’ she said. ‘It was mainly follow-up appointments today, and it’s always lovely to see your patients gaining in confidence, once they’ve had time to come to terms with their diagnosis and started to make the lifestyle changes that will help them.’

‘I know what you mean.’ He smiled. ‘We held a yearly party for the heart transplant and bypass patients at the Royal Hampstead Free. It was great to see them all dancing and making the most of the time they didn’t think they would get with their families.’

‘That’s such a nice idea,’ she said. ‘Maybe Sanjay will let us set up something like that here.’ She walked with him to the canteen. ‘It’s your first day, so this is my shout—and don’t argue, because it’s a departmental tradition.’

‘As long as I get to take the next new recruit under my wing and pay that forward,’ he said.

‘Deal.’ She grinned. ‘I think you’re going to fit right into the team, Luc.’

He nodded, looking hopeful.

‘The food is all pretty good here, and the coffee is decent,’ she added.

They’d just sat down to eat their sandwiches when Kelly’s phone pinged to signal an incoming text.

‘Sorry to be rude,’ she said, ‘but do you mind if I check my messages? It’s probably my sister Susie—she’s due her twenty-week antenatal scan today.’

‘And you should have been meeting her for lunch instead of babysitting me?’ Luc asked.

She smiled. ‘No, she’s being seen in a different hospital. Even if we’d arranged to meet halfway, I would only have had time to say hello and give her a hug before I had to rush back here for clinic.’

‘Then go ahead and read your message,’ he said. ‘You’re not being rude. If it was one of my sisters in that situation, I’d want to know how the scan went, too.’

‘It’s probably just a round robin telling everyone it’s fine, or she would have phoned instead of messaging me,’ Kelly said. But she checked her phone anyway, then grinned. ‘Yup. All’s well, and she and Nick decided not to find out whether it’s a boy or girl.’

‘Is it her first baby?’

‘Her third—she already has twin boys.’

‘Twins run in your family, then?’ he asked.

She shook her head. ‘On Nick’s side—her husband. Oscar and Jacob have just turned five, and I think she’s hoping for a girl this time so she gets to do ballet as well as football. Do you mind if I just send her a quick reply?’

‘Of course not.’

She tapped in Great news, love you. X—and then her phone pinged to signal another message from Susie. Kelly didn’t bother reading beyond the first line because she knew exactly what her sister had in mind.

‘Answer that as well, if you need to,’ he said.

‘It can wait.’ Kelly grimaced. ‘I love my sister dearly, but I swear since she’s been pregnant...’

‘Older sister bossing you about?’ he guessed.

‘Trying to.’ She sighed. ‘Actually, you might as well hear it from me, than from someone else in the department who means well. My husband died two years ago, at the age of thirty. He was cycling to work when he had a cardiac arrest. The paramedics couldn’t save him, and the coroner’s report said he had HCM. It was a complete shock because he’d had no symptoms whatsoever.’

‘But, as a cardiologist, you think you must’ve missed something?’ Luc guessed.

Kelly swallowed hard. ‘I’ve been over and over it in my head, trying to see what I missed, and he really didn’t have any symptoms. His dad died young from a heart attack, but his dad had a high-stress job, plus he smoked and drank too much; everyone assumed his heart attack was because of all that and they didn’t bother doing a post-mortem. I guess because of what happened to his dad, Simon was more aware of heart health than the average person, even before he met me. He didn’t smoke, he drank in moderation, he ate sensibly, he cycled to work and exercised regularly. He did everything right.’

Yet still he’d died. And how she missed him. Why, why, why hadn’t she joined the dots together and made him go for that all-important check-up that would’ve spotted his unusual heart rhythm? Why hadn’t she made the connection about his father? Why hadn’t she thought there might be more to his father’s heart attack than his lifestyle?

‘My sister, my mum and my friends have all decided that I’ve been on my own for long enough and they’re forever trying to fix me up with a suitable potential partner,’ she continued. ‘That’s why Susie’s asking me to go over to dinner tonight. She says it’s so she can show me the scan pictures, but I know she’ll also have invited someone that she thinks is perfect for me.’

‘And you’re not ready?’

‘I’m not ready,’ she confirmed. ‘I know they all mean well, but it drives me crazy and I can’t seem to get them to back off. I loved Simon and I know he wouldn’t have wanted me to be alone, but...’ She sighed. ‘Sorry. I didn’t mean to dump all that on you. What I was really going to ask was if the rumours are true about you running a trial for HCM patients, and if so whether you were looking for people to join the trial?’

‘Because you have a patient who might be suitable?’

She wrinkled her nose. ‘Not my patient, but I do know two people. Simon’s younger brother Jake, and his daughter Summer—she’s four. After Simon’s PM, I nagged Jake to get tested just in case there was a faulty gene involved, and unfortunately I was right. Which also makes me think they inherited the condition from their dad—except obviously there aren’t any medical records to back that up.’

‘And Summer has inherited the gene too?’ Luc guessed.

‘Yes. With a family history that spans at least two generations—and I’m pretty sure if you went back there would be more—they’ll be good candidates. And you’ll get a spread of age and gender.’

* * *

Even though Kelly was clearly devastated by her husband’s loss, she was still thinking about his family and trying to help them, putting their needs before her own, Luc thought. He could certainly talk to their current medical practitioner and see if they would be suitable candidates for his trial.

But something else Kelly had said struck a chord with him. Maybe, just maybe, they could help each other out. He’d had a crazy scheme percolating in the back of his head for a while now, but he hadn’t found the right person to help him. Maybe Kelly was the one; she was in a similar kind of position, so she might just understand his problem.

He was normally a good judge of character and he liked what he’d seen of Kelly Phillips so far; her colleagues had spoken highly of her, too. So maybe it was time to take a risk—after he’d had the chance to check out her background and got to know her a little more, because he wasn’t reckless or stupid enough to ask her right at this very second. ‘If you can ask their family doctor to contact me, we’ll go through all the prelims and see if they fit the criteria,’ he said.

‘Thank you. I really appreciate that,’ she said.

‘It’s not a promise that it will definitely happen, but it’s a promise that I’ll do my best to help,’ he said.

‘That’s fair.’ She smiled at him. ‘So did you train at the Royal Hampstead Free?’

‘Yes, and I loved working with the team there. But then this opportunity came up, so I applied for the role,’ he said. ‘How about you?’

‘I trained here,’ she said, ‘and cardiology was my favourite rotation. I love the area, too, so I stayed. What made you become a cardiac surgeon?’ she asked, sounding curious. Then she grimaced. ‘Sorry. Ignore me; that was a bit rude and pushy. You really don’t have to answer.’

‘It goes with the territory. Given who my family is, most people expect me to be part of the family business rather than being a medic.’ He shrugged. ‘That’s what probably would have happened—but my best friend, Giacomo, died when we were fifteen.’ He winced slightly as he looked at her.

‘From a heart condition?’ she guessed.

He nodded. ‘I’m sorry if this opens any scars, but yes—the same one as your husband.’

‘HCM.’ Three little letters that had blown her world apart.

‘It wasn’t genetic, in Giacomo’s case. His family doctor thought the chest pains were just teenage anxiety because Giacomo was worrying about his exams.’

She blinked. ‘Chest pains in a teenager and the doctor didn’t send him for tests?’

‘No. Knowing what I do now, I wish he had. His condition would’ve shown up on the ECG, and then medication or an ICD might’ve saved him. But hindsight is a wonderful thing.’ He shrugged. ‘Giacomo was playing football at school with me at lunchtime when he collapsed and died. The teachers tried to give him CPR but they couldn’t get his heart started again.’

She reached across the table and squeezed his hand for a moment, conveying her sympathy. ‘I’m sorry. That must’ve been hard for you.’

‘It was. He was the brother I never had.’ And it had shocked him profoundly to come face to face with his own mortality at the age of fifteen. Giacomo had been the first person he’d ever known to die, and the fact it had happened in front of him had affected him deeply. Not wanting to feel that way again, he’d put up a slight emotional wall between himself and everyone he loved. ‘I’m reasonably close to both my sisters,’ he added, ‘but we don’t talk in quite the same way, with Eleonora being two years older than I am and Giulia being five years younger.’

‘So you wanted to save other families going through what your best friend’s family went through?’

Just what he suspected she was trying to do, too. He nodded. ‘Becoming a doctor pretty much helped me to come to terms with losing him. And I like my job—bringing people back from the brink and giving them a second chance to make the most of life.’

‘Me, too,’ she said.

When they’d finished lunch, they headed back to the cardiac ward together.

‘Thank you for lunch,’ Luc said.

‘Pleasure. I might see you later today—if not, see you tomorrow and have a good afternoon,’ Kelly said.

‘You, too,’ he replied with a smile.

And how bad was it that he was really looking forward to seeing her?




CHAPTER TWO (#ufa1b3e28-ca4a-5a03-b8cf-421dd1cd29e3)


ON TUESDAY MORNING, Kelly was due in to the cath lab. Her first patient, Peter Jefferson, looked incredibly nervous, and his knuckles were white where he was gripping his wife’s hand.

She introduced herself to them both. ‘Come and sit down. I promise this looks much scarier than it is. I’m going to check your pulse and your blood pressure, Mr Jefferson, and then I’ll put a little plastic tube called a cannula into your arm. Then all you have to do is lie on the couch for me, hold your breath and keep still for a few seconds, and the scanner will take 3D pictures of your heart so I can take a look at what’s going on. Then we can talk about it and decide the best way to treat you to stop the chest pain. Is that OK?’

He nodded.

‘I’m going to inject some special dye into your veins to help the scanner take the pictures. It’ll make you feel a bit warm and you might notice a funny taste in your mouth, but that’s completely normal and it’ll only last for about thirty seconds,’ she reassured him.

‘And it’s not going to hurt?’ He was still gripping his wife’s hand.

‘It’s not going to hurt,’ she said. ‘If you’re worried about how you’re feeling at any stage, just tell me. I might need to give you some medicine called a beta-blocker to slow your heart down very slightly, or some GTN spray under your tongue to make the arteries in your heart get a little bit wider—that will help me get better pictures of your heart. But it won’t hurt,’ she promised.

‘It’s just the chest pain has been so bad lately,’ Mrs Jefferson said, ‘and the medicine our family doctor gave him doesn’t help.’

Angina that couldn’t be helped by medication often meant that the arteries were seriously narrowed, and the treatment for that could mean anything from a simple stent through to bypass surgery under general anaesthetic. Hopefully a stent would be enough, but she wasn’t going to worry him until she could review the scan pictures.

She gave them both a reassuring smile. ‘Once we’ve gone through the tests, I should have a better idea how to help you. Can I just check that you’ve stayed off coffee, tea, fizzy drinks and chocolate yesterday and today, Mr Jefferson?’

He nodded.

‘And he’s been eating better lately and stopped smoking,’ Mrs Jefferson added.

‘Two of the best things you can do,’ Kelly said. ‘OK, Mr Jefferson. When you’re ready, I’ll check your blood pressure.’

As she’d expected, the first reading was really high; a lot of patients were so nervous about the tests that it sent their blood pressure sky-high. By the third reading, he was beginning to relax and Kelly was a little happier with the numbers.

Once she’d put the cannula in, she asked Mr Jefferson to lie on the scanner couch with his arms above his head. ‘I’m going to put some wires on your chest now,’ she explained, ‘so I can monitor your heart rate during the scan, but again it’s not going to hurt.’

But she really wasn’t happy with what the scan showed her. His right coronary artery was severely narrowed, as were the two on the left. An angioplasty with a stent wasn’t going to be enough to make any difference.

‘I’m sure your family doctor has already explained why you’re getting chest pain, Mr Jefferson, but I’d like to go through it with you again. Basically your heart pumps blood round your body, but sometimes deposits of fat and cholesterol—what you might hear called plaques—stick to the wall of your arteries and make them narrower. It’s kind of like when you see the inside of a kettle in a hard water area and the pipes are furred up, except in this case the furred-up bits are inside the pipes rather than outside. This means not enough oxygen-rich blood gets through to your heart, and that’s why it hurts.’

‘But you can make my arteries wide again?’ he asked.

‘I was hoping I could do an angioplasty and put a stent in—that’s basically a wire mesh that I can put inside your arteries to keep them open,’ Kelly said. ‘But in your case there’s a lot of narrowing in three of your arteries, and I think your best option is surgery. I need to talk to one of my colleagues—the cardiothoracic surgeon—very quickly, so if you’ll excuse me I’ll be about five minutes. If you’d like to nip out to the waiting area to get a cup of water while I’m gone, please feel free.’

To Kelly’s relief, Luc was in his office, dealing with paperwork.

‘Can I have a quick word about one of my patients?’ she asked.

‘Sure.’

She drew up Peter Jefferson’s scan results on the computer. ‘My patient has angina, and the meds his family doctor prescribed aren’t helping. I hoped that I might be able to do an angioplasty, but I’m really not happy with the scan results. I think he needs a CABG.’

‘I agree. That narrowing is severe. I’d recommend a triple bypass,’ Luc said as he reviewed the screen. ‘Is he still with you?’

‘Yes. He’s in the cath lab with his wife. He knows I’m having a quick word with you.’

‘Let me check my schedule.’ He flicked into the diary system. ‘Operating days for me are Wednesday and Friday.’ He blinked. ‘I’ve got a cancellation tomorrow, by the looks of it, so we can grab that slot now before someone else does. Do you want me to come and have a word?’

‘Meeting you is going to reassure him more than anything I can say to him,’ Kelly admitted. ‘Would you mind?’

‘No problem.’ He smiled at her.

And her heart would have to feel as if it had done an anatomically impossible backflip because of that smile.

Kelly had got herself completely back under control by the time they went into the cath lab.

‘Mr and Mrs Jefferson, this is Luciano Bianchi, one of our surgeons,’ she said. ‘We’ve had a quick discussion, and we both feel that the best way forward is surgery—a coronary artery bypass graft.’

‘It means I’ll take another blood vessel from your leg and attach it to your coronary artery on either side of the bit where it’s blocked—that’s the graft—so the blood supply is diverted down the grafted vessel.’ Luc drew a swift diagram.

‘I guess it’s a bit like roadworks, when you get diverted down a slightly different road round the bit that’s blocked. Your blood will flow through properly to your heart again and you won’t get any pain,’ Kelly said.

‘Exactly,’ Luc said with a smile.

‘But what about the bit in his leg? Doesn’t he need that vein?’ Mrs Jefferson asked, clearly looking worried.

‘It’s one of the extra veins we all have close to the surface of the skin,’ Luc said. ‘The ones that return the blood back to the heart are deep inside your leg. The rest of the veins in your leg will manage perfectly well if I borrow a little bit for a graft, Mr Jefferson. I’ll stitch it up and you’ll have a little scar, but it’s nothing to be worried about.’

‘Heart surgery. Does that mean you have to cut through my chest?’ Mr Jefferson asked.

‘In your case, yes—unfortunately I can’t do keyhole surgery for you because you need three grafts,’ Luc said. ‘It means you’ll have a scar down your chest, but that’ll fade with time. And once I’m happy with the grafts, I can re-join your breastbone with stainless steel wires and stitch up the opening.’ He smiled. ‘And I happen to have a slot free tomorrow morning, so I can fit you in then.’

‘Tomorrow?’ Mr Jefferson looked utterly shocked.

‘Tomorrow,’ Luc confirmed. ‘Which gives you less time to worry about the operation.’

‘Surgery.’ Mr Jefferson blew out a breath. ‘I wasn’t expecting that.’

‘I’ve done quite a few bypasses in my time,’ Luc reassured him. ‘You won’t feel a thing, because you’ll be under a general anaesthetic.’

‘Isn’t that the operation where you’ll stop his heart beating?’ Mrs Jefferson asked. ‘I read up about that on the Internet.’

‘It’s one way of doing a bypass operation, using a heart-lung machine to breathe and pump the blood round your body for you, but actually I prefer to do my surgery off-pump—where the heart’s still beating while I operate,’ Luc said.

Kelly hadn’t expected that, and it intrigued her.

Mr Jefferson’s eyes widened. ‘But isn’t that dangerous?’

‘It’s quicker, so you’ll be under anaesthetic for less time, there’s less chance of you bleeding during surgery, and you’re also less likely to develop complications after the operation,’ Luc said. ‘So in my view it reduces the risks.’

‘And after the surgery you’ll be with us in the ward,’ Kelly said. ‘You’ll be in Intensive Care at first, where we’ll keep an eye on you to make sure everything’s working as it should be. You’ll still be asleep for the first couple of hours, but then we’ll wake you up and your family will be able to see you.’

‘You’ll be well enough to get out of bed and sit in a chair, the next day,’ Luc said. ‘A couple of days later you’ll be back on your feet, and a couple of days after that you’ll be ready to tackle stairs again.’

‘A whole week in hospital.’ Mr Jefferson looked as if he couldn’t take it in. ‘My doctor said I’d be in here for half an hour, maybe a bit longer if you had to do a procedure like a stent. He didn’t say I’d have to stay in for a week.’

‘But if you need the operation, love,’ Mrs Jefferson said, ‘then you’ll have to stay in.’

‘I’m afraid you do need the operation, Mr Jefferson,’ Luc said gently. ‘Right now I know it feels very scary and a bit daunting. But it’s the best way of preventing you having a heart attack.’

‘But our daughter’s having a baby next month,’ Mr Jefferson said.

‘Which is another reason to have the operation now. You’ll be able to cuddle the baby without worrying that you’ll start getting chest pains,’ Kelly said. ‘By the time the baby’s crawling, you’ll have made a full recovery and can really enjoy being a grandad.’

‘And you won’t be left to deal with everything on your own afterwards,’ Luc added. ‘Heart surgery is a big operation, and we’ll help you recover on the ward.’

‘You’ll come back to us a few weeks after the operation to start a rehabilitation programme,’ Kelly said, ‘and that will help you get completely back on your feet. There are support groups, too, so we can put you in touch with other people who’ve already been through the same thing—they’ll understand how you’re feeling and can help you.’

‘And it’s really bad enough that I should have the operation tomorrow?’ Mr Jefferson asked.

‘Your arteries are severely narrowed,’ Luc said. ‘Right now that’s causing the pains in your chest, and the medication isn’t enough to stop the pain. But on top of that there’s a risk that one of the plaques will split and cause a blood clot that will completely block the blood supply to your heart and give you a heart attack. That could do a lot of damage to your heart muscle.’

‘And kill him?’ Mrs Jefferson asked.

‘We always try our best to save our patients but, yes, I have to tell you that’s a possibility,’ Luc said. ‘I know it’s a lot to take in, but we’d really like to keep you in overnight here and do the bypass tomorrow, Mr Jefferson.’

‘So will the operation cure him completely?’ Mrs Jefferson asked.

‘It will stop the pain and lower the risk of having a heart attack,’ Luc said.

‘But because you have coronary heart disease you’ll still need to look after your heart,’ Kelly added. ‘Your family doctor’s probably already told you what you need to do. Stopping smoking and eating better are brilliant, so definitely keep that up, and maybe add in a bit more gentle exercise.’

Mr Jefferson still looked terrified. ‘I hate needles. I can’t even make myself give blood, even though I know I ought to. Coming here today for this was bad enough.’

Kelly held his hand. ‘I know it’s scary now, but in the long run you’ll feel so much better. And your wife and daughter won’t have to worry about you as much as they do now. Luc’s really good at what he does, and so is the rest of our team. It’s natural to feel worried, and you’ll probably feel a bit wobbly at times after the operation—that’s absolutely normal. But the operation is really going to help you. You’re going to feel a lot better, and you’re not going to worry that your chest pain or breathlessness is going to stop you playing with your grandchildren.’

‘Are there risks?’ Mrs Jefferson asked.

Luc and Kelly exchanged a glance.

‘There are risks with all anaesthetic and surgical cases,’ Luc said. ‘But they’re small, and we’re experienced enough to know what to look out for and how to fix things. I know it all sounds really daunting, but there’s a greater risk if we don’t do the surgery.’

Mr Jefferson swallowed hard. ‘All right. I’ll do it.’

‘Good man.’ Luc rested his hand briefly on the older man’s shoulder. ‘We’ll get you settled in to the ward, and I’ll be doing rounds later if you have any questions. Dr Phillips will also be on hand if you need anything.’

‘Or talk to any of the nurses,’ Kelly added. ‘That goes for both of you.’

‘Thank you,’ Mrs Jefferson said.

* * *

Once Mr Jefferson was settled on the ward and had been put on a nitrate drip, Kelly went back to the cath lab. The rest of her clinic was more straightforward, to her relief, and she managed to catch up with Luc afterwards.

‘Thank you for talking to Mr Jefferson with me.’ She’d liked Luc’s warm, easy manner and the way he’d described things without being dramatic and terrifying their patient even more. He’d acknowledged Mr Jefferson’s fears and reassured him.

‘No problem,’ he said.

‘You actually do the surgery off-pump?’

He nodded. ‘I’m assuming that’s unusual for here, then?’

‘Yes, it is. I haven’t actually seen off-pump surgery done before.’ And it was the first time in a long time that Kelly had been interested in seeing something different—that her old passion for her job had resurfaced instead of being buried by the fear that she might have missed something and let a patient down, the way she’d let Simon down.

‘If you can spare the time, you’re welcome to scrub in and observe as much of the operation as you like,’ he offered.

‘I’d love to. I won’t be able to stay for the whole thing, but maybe I could come before or after my clinic tomorrow, if that’s OK?’

‘Whenever fits your schedule best,’ he said.

‘Thanks. I’m definitely taking you up on that.’

‘Actually, you can spread the word that I’m always happy to have observers,’ Luc said. ‘The actual operation is only a part of caring for our patient. I’m a great believer in all areas of the team knowing exactly what happens in the other parts of a care plan, and the more we all understand what each other does, the more we can work together and help our patients.’

‘That’s very much Sanjay’s approach as the head of the department,’ Kelly said. ‘Cross-fertilisation of ideas. And you’re welcome in my cath lab any time, as are any of your students.’

‘Thanks. I’ll take you up on that.’ He smiled. ‘So is Mr Jefferson settled in?’

She nodded. ‘His wife’s just gone home to pick up his things. She had a bit of a chat with me beforehand. She’s worrying about losing him.’

‘Understandable, in the circumstances,’ Luc said. ‘But that must’ve brought back some tough memories for you.’

She shrugged. ‘If anything, what happened to Simon has probably helped me empathise a bit more with my patients and their partners.’ There had to be some good coming out of such a senseless death.

‘You’re still brave,’ Luc said, patting her shoulder.

Again, his touch made her feel all flustered. Which was crazy. She hardly knew him and this wasn’t supposed to happen. ‘You have to get on with things,’ she said.

As if realising that she desperately wanted him to change the subject, Luc said, ‘So Mr Jefferson’s on his own and he’s got time to worry, then. I’ll go and sit with him for a bit. Catch you later.’

Surgeons had a reputation for arrogance, Kelly thought, the next morning, but Luc Bianchi definitely wasn’t one of them. Yesterday he’d deliberately taken time to sit with a nervous patient and reassure him. Today, he was courteous to the rest of the team in the operating theatre, asking them to do things rather than barking instructions at them, and even checking that they were OK with his choice of music to work to; and he’d made it clear that he was happy to explain anything he was doing and why.

She was fascinated by the glimpses she had of the off-pump bypass surgery where just the small area he was working on was kept still and the rest of the heart was visibly pumping. As a student, she’d been fascinated by cutting-edge treatments. Since Simon’s death, she’d focused on keeping things safe and steady. Work hadn’t been a chore, exactly, but she’d become hyper-focused. She managed to be there for the end of the op too, when Luc was closing up; his movements were deft and very sure.

‘Thanks for letting me sit in,’ she said before he went to scrub out. ‘Can I buy you lunch and ask you a ton of questions about the op?’

‘I’d be delighted to have lunch with you and answer anything I can,’ he said, ‘but I’m paying. I might have to rush back here if the team beeps me too.’

In other words, if Peter Jefferson developed any complications before he came round in the intensive care unit. ‘Of course,’ she said. ‘Thank you. I’ll see you when you’ve scrubbed out.’

* * *

The more time Luc spent with Kelly Phillips, the more he liked her. The kind, calm way she treated her patients; her inquisitive mind; the way she treated all her colleagues with respect.

‘Was that really the first OPCABG you’ve seen?’ he asked when he’d scrubbed out and joined her.

‘Your predecessor preferred working on pump,’ she said. ‘So, yes, it was my first off-pump bypass graft. And it was fascinating.’

‘And you have questions?’

‘Absolutely. Let’s get lunch, and I’ll pick your brain,’ she said with a smile.

She asked a lot of questions. All bright, thoughtful questions. Luc answered to the best of his ability, and finally she nodded.

‘Thank you. I understand a lot more, now. But the most important thing is that you’ve made a real difference to Peter Jefferson’s life.’

‘We’re not quite out of the woods yet,’ he said. ‘But I hope so.’

* * *

Over the next couple of days, Peter Jefferson moved from the intensive care area to the ward. But, when Kelly came to see him on Friday morning during her ward round, he started crying. ‘This is so pathetic. I can’t understand why I feel like this. I was a finance director, used to making decisions and dealing with huge sums of money, and now I’m crying all over the place and it’s just not me. And I can barely even get out of bed without help.’ He looked despairing. ‘Now I’m just a shuffling old man.’

She sat on the bed next to him and held his hand. ‘You’ve been through major surgery, Mr Jefferson. Lots and lots of people feel like this afterwards. You’ll have good days and you’ll have wobbly days. But the rehab programme will really help you, because you’ll meet other people who are going through it too or are a couple of weeks further down the line than you are, and that will help you realise that what’s happening to you and how you’re feeling is all perfectly normal. It’s going to take time to get you back on your feet and doing the same things you did before you had surgery, but you will get there. Just be kind to yourself.’

Luc walked onto the ward at that moment. ‘Good morning,’ he said with a smile. ‘I just popped in to say hello to you before I go into the operating theatre today.’

Mr Jefferson wiped his eyes. ‘I’m sorry. I’m being so stupid.’

‘You’ve had major surgery with a general anaesthetic. Of course you feel wobbly,’ Luc said. ‘Tell me, do you play chess?’

‘I do.’

‘Good. I’ll get a board sorted out and I’m challenging you during my lunch break. I might be a bit late,’ he said, ‘depending on how the operation goes this morning, but I’ll definitely be in to have a cup of tea and a chess match with you, OK?’

‘But—you’ll have been so busy this morning.’

‘And a game of chess is the perfect way to relax,’ Luc said. ‘As long as you don’t mind me eating a sandwich at the same time. I’m horrendously grumpy if I don’t eat regularly.’

‘Thank you, Dr Bianchi. That’s—that’s so kind of you.’ Peter Jefferson wiped his eyes again.

‘I’ll see you soon,’ Luc said, patting his hand.

‘I need to see my next patient,’ Kelly said, ‘but I’ll pop back later, too.’ She walked out with Luc. ‘That’s really nice of you.’

‘I just want my patients to be comfortable.’ He shrugged. ‘I don’t suppose there’s a chess board on the ward?’

‘Probably not, but I might be able to borrow one from Paediatrics. I’ll get that organised—and a sandwich for you. What would you like?’

‘I eat anything, so the first thing you grab off the shelf will be fine,’ Luc said. ‘Thanks, and I’ll settle up with you later.’ He paused. ‘Are you at the team thing tonight?’

‘The ten-pin bowling? No, I’m working. Are you?’

‘Yes. I thought it’d be a good way to get to know the team.’

‘It is.’ She smiled. ‘Have a good time.’

‘Thank you.’

To her relief, he didn’t push to see if she was going to any of the other team events. She liked her colleagues very much—but going out was a strain. Too many people trying to push her into being sociable when she was really much happier here at work, making a difference to her patients’ lives.

* * *

Luc spent the morning in Theatre fixing an aortic aneurysm on an elderly woman, his lunchtime with Peter Jefferson, and his afternoon in Theatre sorting out a narrowed aortic valve in a teenage boy suffering from severe breathlessness.

By the time he got to the bowling alley, he was glad of the chance to let off steam. Though he learned from his colleagues that Kelly hardly ever joined team events nowadays. Because she was still mourning her husband? He needed to tread carefully.

He didn’t see her again until Monday morning. ‘How was your chess match?’ Kelly asked.

‘It was fine,’ he said. ‘I think Peter was glad of the company. He was beating himself up a bit because he was shuffling, and just taking those few little steps exhausted him.’

‘Two days before that, he was in Theatre, having major surgery. He’s doing brilliantly,’ she said.

‘That’s what I told him. I said that my patients always worry that it’ll take ages to get fully back on their feet, and at the same time they’re terrified of overdoing things in case it makes them have a relapse. How he’s feeling is how all my patients feel.’

‘I’ll make sure I reassure him about the rehab sessions,’ Kelly said.

‘I assume it’s the same as we did at the Royal Hampstead Free—an exercise programme tailored to the patient and graded so they can see their progress?’

She nodded. ‘Plus there will be plenty of professionals there, he’ll have a monitor attached during the exercises so we can keep an eye on his heart rate, his blood pressure and his pulse. The team will help each patient progress at the right pace for them, and their safety is paramount.’

‘Good,’ he said. ‘Did you see your sister’s scan photo, by the way?’

‘Yes.’ She took a photograph from her wallet and handed it to him. ‘They’re going to call the baby Reuben if he’s a boy, and Emma if she’s a girl.’

‘Lovely.’ His fingers accidentally touched hers, and again he felt that inappropriate zing. To stop himself thinking about it, he asked, ‘So were you right and Susie had someone lined up to partner you at dinner?’

‘Yes, and he was very sweet and very charming. He understood when I explained that it wasn’t him, I just don’t want to date.’ She grimaced. ‘My best friend’s doing exactly the same thing this weekend. She’s arranged pizza and tickets to a stand-up comedy thing for a group of us, and I know I’m going to end up sitting next to the eligible single man in the group. I know they love me and they mean well, but...’ She shook her head. ‘Sometimes I’m so tempted to invent a fake boyfriend, just to get them to back off.’

A fake boyfriend?

That wasn’t so very far from the marriage of convenience he had in mind.

‘Maybe you should,’ Luc said carefully.

She wrinkled her nose. ‘Except then they’d insist on meeting him. And it’s not really fair to ask someone to—well, be my fake boyfriend and lie to everyone for me.’

She could ask me, Luc thought—or maybe I can ask her. He wanted to get to know her a little better first, but he was beginning to think they really could help each other. ‘If you explained the situation to someone suitable, I’m sure he’d be happy to help you out.’

‘Really?’

For a second, he thought she was going to ask him, and his heart actually skipped a beat.

But then she spread her hands. ‘I might think about that a bit more. But thank you for the male insight.’

If he nudged her to think about it a bit more, then hopefully she’d be receptive when he finally asked her a similar question...




CHAPTER THREE (#ufa1b3e28-ca4a-5a03-b8cf-421dd1cd29e3)


OVER THE NEXT couple of weeks, Luc found himself working with Kelly on their patients’ care between the cath lab and the operating theatre, where she needed to do the investigations and liaise with him about potential surgery. The more he got to know her, the more he liked her. The way she put everyone at ease, the way she told terrible jokes, the way she made the day feel brighter just because she was in it.

In other circumstances, he would’ve been so tempted to ask her out on a date. But she’d told him she wasn’t ready to move on after losing her husband, and he had a political tightrope to walk in Bordimiglia. So he’d enjoy her friendship and he’d just have to start mentally naming every blood vessel in the body, from the internal carotid artery down to the dorsal digital artery, to stop himself thinking of anything else.

But on Sunday afternoon his eldest sister called him.

‘Is everything OK, Elle?’ he asked. He and Eleonora usually managed to grab a few words during the week, but there was something slightly antsy about her tone.

‘Ye—es.’

‘But?’

‘Babbo wants to start taking things easier. He told me yesterday that he’s planning to step down at some point in the next year,’ Eleonora said.

Meaning that King Umberto was expecting his wayward son to give up his job as a surgeon, come home and take his rightful place on the throne? So the clock he’d pretty much managed to ignore, thanks to its silence, had just started to tick. ‘Is that Elle-speak for “come home right now”?’ he asked wryly.

‘No, I’m just putting you in the picture so you know what our father’s thinking. He’ll probably summon you home to talk about it at some time in the next month, though,’ Eleonora warned.

Summon him home. Normal people of his age were happy to visit their parents; whereas Luc knew a visit home wouldn’t be time to catch up with each other and enjoy each other’s company. It would be another chance for his father to nag him about his future in the monarchy, and he’d end up having another argument with his father. He sighed. ‘Elle, you and I both know you’d make a better ruler than I would. So does our father. And you’re the oldest. It’s ridiculous. This is the twenty-first century. It makes absolutely no sense that, even though I’m second-born, I should be the heir just because I have a Y chromosome.’

‘It’s how things are.’

He could hear the resignation in her voice. ‘Well, things need to change. It’s time our father modernised the monarchy.’

She sighed. ‘I hate it when you fight.’

‘Elle, I’m a cardiac surgeon. I’ve spent half my life either studying to become a doctor or practising medicine—and I’m good at what I do. I can make a real difference to my patients and their families, give people a second chance at life. That’s such an amazing thing to be able to do. And I want to stay here for a couple more years, get experience in all the cutting-edge surgical developments. Then I can bring it home to Bordimiglia and set up a world-class cardiac centre.’ And he’d name it after his best friend. So Giacomo would never be forgotten.

‘Giacomo would be proud of you,’ Eleonora said softly. ‘His parents think you’re wonderful.’

Whereas his own parents thought he was being stubborn and unreasonable. They’d given him the freedom to do what drove him, so far, but now it seemed the pressure was going to start in earnest: they’d want him to go back to being a prince instead of a surgeon. But that wasn’t who he was. He could serve his country much better as a surgeon. Make a real difference to people’s lives.

‘I really hate all the fussiness of protocols and politics, Elle. If I become king, I’ll make a dozen horrible gaffes in my first week, and we all know it. Whereas you’re a born diplomat.’ Though even Eleonora hadn’t been able to talk their father into changing a certain tradition.

‘Sometimes you have to pick your battles wisely. This isn’t one we’re going to win, Luc.’

Unless he did a little shaking up himself.

He’d talk to Kelly. Hopefully she’d agree with him that they could do each other a favour and his plan would work. ‘Leave it with me,’ he said.

‘No fighting with Babbo,’ Eleonora warned.

‘I know. Mammahates it when we fight, too, and so does Giu. And it’s not that much fun for me, either. I’m not arguing for the sake of it. Don’t worry, Elle.’ He switched the conversation to how his niece and nephew were doing, and his sister sounded a lot less strained by the end of the call than she had at the beginning.

When he’d hung up, he went through the dossier on Kelly that the palace PR team had quietly compiled for him. There was nothing the press could use to pillory her, so she’d be protected. There might be a bit of press intrusion, to start with, but it would soon die down because he knew that he was too quiet and serious and frankly boring to make good headlines.

He’d talk to her on Monday.

* * *

Luc spent Monday morning in clinic. His first patient, Maia Isley, had Marfan Syndrome—a genetic connective tissue disorder which caused abnormal production of the protein fibrillin, so parts of the body stretched more than they should when placed under stress. It was a condition which needed help from a variety of specialists, as the patient could develop scoliosis, have loose and painful joints, and suffer from eye problems. From a cardiac point of view, Marfan Syndrome could also cause problems with the aorta being enlarged, so patients needed regular check-ups and a yearly echocardiogram where the team could look at the structure of the heart and measure the size of the aorta.

Luc had already compared the new scan that Kelly had just performed to last year’s, and he wasn’t happy with the differences.

‘How are you feeling, Mrs Isley?’ he asked.

‘Fine,’ the young woman replied. ‘But, from the look on your face, you’re expecting me to feel worse than usual, right?’

Luc nodded. ‘Obviously you’ve learned a lot about your condition, so you know there’s a risk of your aorta—the biggest artery in your body, the one that starts at the top of the pumping chamber in your heart—getting wider, and that can make blood leak back into your heart so your heartbeat starts pounding and you get breathless.’

Maia shrugged. ‘My heartbeat feels like it normally does.’

‘And also there’s a risk of the aorta tearing.’

‘If it tears, I die, right?’ Maia asked.

‘There’s a high chance, yes. Your aorta’s grown wider since last year. We’re at the point where we need to do surgery to make sure it doesn’t tear,’ Luc said. ‘And we’ve got three options, depending on what you’d like to do. May I ask, were you thinking of having children?’

‘I’d like to,’ Maia said, ‘but my partner’s worried. Not so much the risks of the baby having Marfan’s, because we can have IVF and with preimplantation genetic diagnosis so we can be sure the baby doesn’t have the gene, but he read up that women with Marfan’s were more at risk of aortic rupture, especially during pregnancy.’

‘And he doesn’t want to lose you,’ Luc said softly. ‘I understand that. Surgery now will take that risk away.’ He drew three quick pictures. ‘The first option is where we replace part of the aorta and its root, including the valve. The treatment’s very safe and has a long track record, but you’ll be at risk of developing a blood clot so you’ll need blood-thinning medication for the rest of your life.’

‘Which means I can’t get pregnant, right?’

‘Which means if you do want to try for a baby, your doctor will switch your blood-thinning meds to one that’s injected under the skin and doesn’t cross the placenta,’ Luc said. ‘Or we can do a different sort of surgery where we replace part of the aorta but keep your valve—it’s called a valve sparing root replacement or VSRR for short. Because we’re keeping your valve, you won’t need the blood-thinning medication, but there’s a one in four chance we’ll have to redo the operation within the next twenty years.’

Maia looked thoughtful. ‘What’s the third?’

‘It’s a very new treatment where we make a special sleeve to go round your aorta, called a personalised external aortic root support or PEARS.’

‘So it wraps round and acts like a support, say like when my knee’s playing up and I have to strap it up?’ Maia asked.

‘Yes. The idea is that it’ll keep your aorta at the size it is now, so it won’t get any wider in the future—and that reduces the risk of a tear or the valve leaking. The procedure’s not as invasive as replacing the root or the valve-sparing surgery, though I’ll still need to open your chest under a general anaesthetic. And it means it’ll be more appropriate if you do want to have a baby, because it’ll keep your aorta at this size and reduce the risks during pregnancy. But it’s still a very new procedure,’ Luc warned, ‘so not that many have been done.’

‘So how do you do it? Wrap it round?’

‘We give you a CT scan and we make a 3D computer model of your aorta from the scan, print it, and we use that to make a fabric mesh support tailored exactly to your aorta,’ Luc explained.

‘3D printing? That sounds cool,’ Maia said. ‘I know you said it’s new, but have you done many?’

‘You’ll be my second patient—and the first at this hospital,’ Luc said. ‘Though, if you decide to go for that option, I’ll ask one of my former colleagues to come over and assist, because he’s got more experience than I have. Or it might be that we end up doing the operation at my old hospital.’

‘Can I talk the options over with my husband?’ Maia asked.

‘Of course,’ Luc said. ‘I’ll want to see you again anyway, and maybe he can come with you if he has any questions. Though I’ll give you some leaflets to take away with you—it’s a lot to remember and it’s always good to have things written down so you can refer back.’

‘Thank you,’ Maia said. ‘I know there are risks, but I’m leaning towards that 3D support thing. I like the sound of that much more.’

‘Let’s book you in my clinic for next week,’ Luc said, ‘and you can talk it over with your husband in the meantime and bring all your questions with you to clinic.’

After clinic, he managed to catch Kelly. ‘Are you free for lunch? I could do with your opinion on something.’

‘Sure.’ She smiled at him.

‘Maybe we could grab a sandwich and head over to the park,’ he suggested. Where it would be quieter and more private than the hospital canteen and he could sound her out.

‘That sounds good,’ she said.

‘Thanks for doing that echo on Maia Isley for me,’ he said when they’d found a quiet bench in the park.

‘Her aorta’s quite a bit bigger than last time. Are you planning surgery?’ she asked.

‘She’s talking it over with her husband, but there’s a fairly big chance she’ll opt for PEARS.’

‘Aortal support?’ Her eyes gleamed. ‘If she does, I’d love to sit in on the op. I’ve heard about it but not seen it done.’

‘Given that you’re her cardiologist,’ he said, ‘if she takes that option then you’ll be involved in the CT scans and you can definitely sit in on the op. We might need to print the 3D model of her heart elsewhere, but I’m sure Sanjay will be happy for you to be involved, and maybe do a presentation to the rest of the team. I need to talk to one of my old colleagues as well as Sanjay, so we might end up doing the actual op at the Royal Hampstead Free instead of here, or it might be that my colleague comes here to help out.’

‘I am so up for that,’ she said. ‘I’ve never done anything like that before.’

He smiled. ‘That’s important to you, isn’t it? Being able to make a difference.’

‘Yes. And I’m pretty sure it’s the same for you.’

‘It is.’ Should he ask her now? He’d been thinking about it ever since Elle had called him. He took a deep breath and said carefully, ‘I think you and I could make a difference for each other.’

‘Job enrichment? Absolutely,’ she agreed. ‘We’ve got a new F1 doctor starting next week. I’m responsible for her training, and it’d be great if she could do some observation or even some work in the operating theatre as well as in the cath lab. And your trainee surgeon might enjoy doing some stent work with us.’

‘That’s fine, but actually I was thinking on a more personal level.’ He paused. ‘What you were saying the other week about inventing a boyfriend.’

She frowned. ‘What about it?’

‘I need to get married. So if you married me, it would solve a problem for both of us.’

Her green eyes widened in apparent shock. ‘What? That’s crazy!’

He winced. He’d been thinking about this for a while; for her, this was completely out of the blue. ‘Sorry. I could have put that better. I’m not hitting on you, Kelly. I mean a marriage in name only.’

‘You’re the heir to the kingdom of Bordimiglia,’ she said. ‘Surely you’ve got to marry someone of royal blood? And why do you need to get married? And why me?’

It was a fair list of questions. ‘This is in confidence, yes?’

‘It’s a little late to be asking that now,’ she said. ‘I might be the heart of the hospital gossip machine.’

‘I’m pretty sure you’re not,’ he said, ‘though you have a point.’

‘OK. In confidence.’

‘Trust you, you’re a doctor?’ he asked wryly.

‘You started this,’ she reminded him. ‘And you haven’t given me any answers yet.’

‘From the top—my parents expect me to get married to someone who’d be suitable as a queen. So, yes, you’re probably right about the royal bloodline. The problem is, someone who wants to be queen doesn’t want to be married to a cardiac surgeon.’ He knew that from bitter experience. ‘A cardiac surgeon is who I am and who I want to be.’

She frowned. ‘But you’re a prince. Don’t you have to take over from your dad?’

‘Technically, yes. But he’s the king and he can change the rules of succession if he wants to,’ Luc explained. ‘I told you I have two sisters, Eleonora and Giulia. Elle’s the oldest and she’d make an absolutely brilliant queen. Apart from the fact that she’s good with people and everyone loves her, she’s astute—she’s got a real business mind, and she’d do a lot for our country.’

‘Would she actually want the job, though?’ Kelly asked.

‘We’ve talked about it, and she agrees that she’d make a better ruler than I would. She already does a lot of royal duties and she advises our father on ecology issues. I don’t believe I should get the job just because I’m the son. And I’m a much better doctor than I am a politician. I know I’ve had a really privileged life and I appreciate that. I’m not shirking my duty—I want to serve my country in a different way, to make it a leading research centre for cardiac health. In a couple of years’ time, I want to go back to Bordimiglia with everything I’ve learned here and set up a new cardiac centre. All our father has to do is change the rules of succession, so then his oldest child instead of his son will take over when he decides to step down. Elle deserves her chance to change our bit of the world. All I’m suggesting is pushing a little bit harder to give her that chance.’





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