The only jewellery she ever wore, apart from that string of matched pearls with one of her little black dresses.
He'd given her nothing. Not even a cheap pendant. As for an engagement ring...he'd known Vicky wouldn't even consider looking for one until after the operation, so he hadn't pushed her. Now he wished he had.
Silently, he put the watch in his wallet.
The anaesthesiologist came in to talk Vicky through the risks of anaesthesia and surgery and check that she hadn't eaten or drunk anything since midnight.
'Nothing since nine o'clock last night,' Vicky reassured him, and signed the consent form.
And then Jake had to leave her. 'I'll see you in Theatre,' he said quietly.
She nodded. 'And I'll see you when I come round.'
He was scrubbing up when Charlie and Seb walked into the scrub room, dressed in theatre greens.
'Jake.' Charlie smiled at him, but Jake could see the strain in his face. 'Is your offer of observing still open?'
'Of course it is.'
'It isn't that we don't trust you,' Seb added.
'You've already looked up my CV on the hospital intranet,' Jake said, straight-faced.
Seb flushed. "Well, yes.'
Jake smiled. 'I would've done the same in your shoes. And it's better that you're here, seeing what's happening, instead of waiting outside and counting how many seconds it is since you last looked at the clock.'
Seb looked sombre. 'Yeah. It's bad for you, too.'
Jake nodded. 'But at least it keeps me too busy to worry. And you're right. If someone else had done it, I'd be fretting that I could have done it better.'
'We're not going to make a single comment,' Charlie said. 'Just forget we're there.'
Jake pursed his lips. 'You're plastics and emergency, right? So you've got a working knowledge rather than a specialist knowledge of what happens in neuro.'
Charlie nodded. 'We both mugged up on it over the weekend.'
Jake grinned. 'Good. I can get technical with you, then.'
'How do you mean?' Seb asked.
'I'll talk you through the op. We'll pretend I'm doing a teaching op.' His voice cracked. 'And that the patient's someone else.'
'Hey. She thinks you're the best. We trust her judgement,' Charlie said. 'But thanks. It'd be great if you could talk us through it.'
Vicky was already under a general anaesthetic when they walked into Theatre, and her head was held in position by a three-pin device. Jake introduced Seb and Charlie to his assistant and the theatre team. This was going to be the hardest operation of his career, but there was no other choice.
'Anyone mind if I have Corelli on while we work?' he asked. The soothing, regular rhythm would help to keep him calm.
When everyone murmured agreement, he arranged for the music to play softly, prepped the incision area and inserted a lumbar drain into Vicky's lower back. "This takes out some of the cerebrospinal fluid and lets her brain relax during surgery,' he explained. 'I've put a local anaesthetic into her skin to decrease bleeding—the scalp always bleeds profusely and the bleeding interferes with surgery.' Of course, Charlie and Seb knew that...but he was treating this as a teaching operation, so he may as well go through the whole thing. Plus, oddly enough, it was helping to calm him. Helping him to stay detached. Just as long as he didn't look at Vicky's face.
He made the pterional incision into her skin, exposed the skull, lifted the skin and muscles off the bones and folded it back. 'Now I can see what I'm doing, I'm making burr-holes into her scalp so I can cut a window of bone.' He did so and lifted the flap. 'We'll store this safely until the end of the operation. OK. I'm opening the dura mater, now.' This was the membrane between her brain and her skull. 'I'll fold it back to expose her brain, then I'll use retractors to open up a corridor between her brain and her skull.'
As he started to work with the microscope, he began to relax. He'd done this before. He knew what he was doing. And everything was going to be fine.
'I'm opening the corridor up now and tracing the artery through to the aneurysm. I'm going to control the blood flow to it now—that's so if it does rupture when we handle it, we can stop the bleeding instantly.' He checked Vicky's vital signs with the anaesthetist. 'OK. The flow's under control. The aneurysm's held tight by connective tissue, so I need to free it. I want to isolate it from the other structures in the brain, and I need to make sure we don't include any perforators.' Perforators were small arteries.
He held the clip open with a clip applier. 'This is made of MRI-friendly metal. I'm going to place the clip across the neck of the aneurysm and release the jaws; when they close, the aneurysm will be blocked from the parent artery.' He did so and inspected the position of the clip. 'Good. It's not narrowing the parent artery at all, and there are no other arteries inside the clip.' Now for the crunch-time bit. 'Next, I need to puncture the dome of the aneurysm to make sure blood isn't filling it.'