How Did We Get Here?

When Jac Naylor approached the trial and practically demanded the surgery, Hannah had no choice but to support her. She had spent so long convincing herself that none of it was her fault, that she was in no way responsible for Jac's injury; but seeing her like that and knowing that her whole life was in jeopardy no matter what, she had to try and help her. She did everything she could to convince John to take Jac on as a patient, Roxanna was an easy sell, but John seemed so averse to the idea and Hannah really had no idea why.
Of course, Jac got her way and she was put on the theatre list for the following week. John asked Hannah to lead the surgery with the hope that it would help ease her nerves, but he could tell that she was feeling uneasy about performing surgery on her consultant.
On the day of the surgery, Hannah went to visit Jac who seemed less than impressed to see her.
'How are you feeling?' Hannah asked quietly and Jac sighed.
'Peachy, come on we both know that being a patient is the worst for a doctor.'
Hannah attempted a small smile in response but her hands wrung together, betraying her nerves.
'Are you scared, Hanssen?' Jac asked softly and Hannah took a deep breath.
'Not scared, no, I'm nervous though. There's a lot riding on this operation, not just for the trial but for you. If I screwed up then...' she trailed off and Jac grinned.
'Then it would be your brother that shot me but you that killed me.' she joked but it stuck on Hannah and she was suddenly horrified. Jac noticed that she had hindered rather than helped Hannah and her face fell a little. 'I'm sorry, I didn't mean anything by it, it was a joke. Look, I have taught you almost everything you know, and John is one of the best surgeons in the world, between you I'm not sure anything can really go wrong.'
Hannah knew that Jac was attempting to comfort her, which was a little strange and out of place for Jac, but even so Hannah appreciated the effort.
'I won't screw up.' Hannah promised and Jac smiled again.
At that moment Meena entered to conduct some pre-op tests and Hannah said her goodbyes before hastening off to meet John and go over the operation one more time. Frieda had been the one to initially operate on Jac so Hannah felt like it really should be her performing this operation too, but she had somehow wound being an official part of Gaskell's trial and she couldn't get out of it. She knew that this operation, and being part of the trial itself, would be a huge thing to put on her CV and she could be a part of medical history; but all that responsibility and pressure was just a little bit daunting.
Once she had gone over the operation many times she had a little time to herself before the actual procedure and she found herself in the stairwell. She sat on the bottom step of the stairs and stared out into the car park. It was a sunny day and the hospital was hot, almost too hot. She did her best to count the cars and stop her hands from shaking but she knew that today was not going to be easy. The time seemed to crawl by but then, eventually, she headed towards the theatre.
John was outside as Jac was being wheeled in and he was speaking to Meena, something felt wrong. Hannah approached Jac and gave her a reassuring smile.
'Remember, the best possible hands.' Jac said to her as Meena called John away again. Hannah tried to keep her attention focused on Jac but her eyes strayed to John and Meena who seemed to be having a heated discussion just outside of the door, Jac had noticed it too. The sensation of something being wrong heightened for Hannah but she put it down to nerves as John returned through the doors and Meena was left outside. Hannah made eye contact with her for a second before John called her into theatre and she rushed off to scrub in.
Hannah did her best to ignore the sneaking suspicion that something was wrong as they prepared to begin the operation and once it was underway she found herself being able to separate herself from the suspicions much easier. She watched as John began the operation and waited for her turn, she knew exactly what she was doing, she was confident.
She took over from John and began her work, completely focused until even the theatre around her seemed to disappear. Everything was going perfectly smoothly, then, suddenly, there was blood, and a lot of it.
'Swabs please.' Hannah said calmly and did her best to stem the bleed but nothing seemed to be helping. 'TXA.' she instructed as she clamped the swabs to the site of the bleed but they were still soaking red.
'I don't understand...' she muttered, her brain racing as panic started to cloud her focused thinking. She continued to search for the source of the bleed but couldn't find it exactly, a machine started to ping.
'Cross match four units.' Hannah instructed, her voice tinging with panic now.
'What's happening?' John asked from the other side of the table and Hannah tried hard to control her breathing, her eyes searching all the while.
'I can't find the source of the bleeding and it is not stopping.' she explained, her voice laced with panic.
'Let me see.' he requested but Hannah couldn't move the swabs.
'If I move them then she will bleed out in seconds.' she countered.
'And if you don't then we won't find the bleed and she will bleed out anyway.' John snapped and Hannah looked up at him in shock and fear, she'd never heard him speak like that to anyone.
'She's lost so much blood...' she whispered and John gently took the swabs from her.
'We'll fix it.' he promised and she took a step back and a deep breath before moving in again to assist him in any way she could, she had to save Jac's life.
John searched for the bleed but seemed to have the similar luck to Hannah, Jac was pumped with more blood but she was losing it faster than they could replace it and Hannah began to panic, this was her fault.
'John what do we do?' she asked, her voice barely above a whisper.
'TXA?' he said but Hannah shook her head.
'She's already had it.' Hannah replied and John groaned before sighing slightly.
'Alright let's go for aminomethylbenzoic acid.' he instructed and held the bleed firmly, replacing the swabs, as the drug was injected.
They waited with bated breath for a few moments before Hannah peered into the wound.
'The bleed's letting up a little.' she observed and John gently removed the swabs. The wound was still bleeding heavily but it was no longer so bad that she couldn't locate the source.
'Got it, clamps please.' she requested, her confidence returning. She was passed the clamps and she managed the clip the bleed shut and the area was clear once again, she was able to continue.
'It shouldn't affect her, right?' she asked, more for her own peace of mind than anything else.
'No... She had the infusion, everything should be fine...' John replied but he sounded a little uncertain. Hannah looked up at him.
'John?' he took a deep breath before replying.
'I mean, there's always the risk of an infection but it's extremely unlikely.' he explained and Hannah did her best to put her worries to the back of her mind.
'Extremely unlikely...' she repeated under her breath as she finished her part of he surgery and handed back to John so he could do the main part of the operation, the neo-conduit. Hannah watched Jac’s face, she couldn’t bring herself to watch what John was doing, and thought about how Jac was a fighter, how she would fight off any kind of infection, she was strong.
The rest of the surgery went smoothly but it took so long, it was over after nearly three hours and, as soon as she had scrubbed out, Hannah sought her spot in the stairwell and collapsed onto the bottom step, burying her head in her hands. It wasn't long before she felt someone sitting beside her, she didn't have to look up to know who it was.
'What if I screwed it up?' she asked quietly and John put a hesitating hand on her back.
'You've done nothing wrong, everything went well, Jac's on the road to recovery.'
‘I know, I know, but that bleed was so extensive. It could lead to irreparable damage and you know that as well as I do, I can’t afford for this to be messed up she’s already suffered enough.’ Hannah said quietly and John gently took her shoulder and drew her closer so she rested her head on his chest.
‘Hannah, everything will be fine. You’re a great surgeon, what happened today could have happened to anyone. Everything will be fine, I promise.’ he did his best to comfort her but Hannah was still nervous. Her only consolation was the fact of being so close to John, it made her heart flutter a little like she was a schoolgirl with her crush.
'I just can't help but feel like something's going to go wrong.' she mumbled into his chest, she was very aware of his face just above her head. She hadn't felt the reckless, urging impulse to kiss him in a long time but it came back now. Even if it was just something that would make her feel like she had a little comfort, it would be something. She fought her impulses but they grew stronger and stronger and before she knew it her head was tilting up to look at him. He was speaking to her but she couldn't hear a word; they were almost nose to nose and Hannah knew it was now or never, time to make a fool of herself.
A cough from behind them made them both suddenly pull away from each other and turn to see Roxanna stood above them on the stairs, looking down with a glint of disapproval in her eye. Hannah's instinct to run away from her newfound mother kicked in and she jumped to her feet.
'Is everything okay with Jac?' she asked quickly and Roxanna nodded.
'Everything's stable, she should be waking up within the hour.' she replied and Hannah nodded quickly before turning and hurrying down the opposite set of stairs, not saying another word.
Roxanna was left alone with John, who could barely meet her eye.
'It's not my place to say anything...' Roxanna said quietly and John shrugged.
'If it's about the trial or Ms Naylor's operation then you're well within your rights.' he replied, leaning back against the railing and Roxanna raised an eyebrow.
'You know as well as I do that it's not about work.' she said and he took a sharp breath.
'Hannah...' he looked down at the floor, unable to meet her eye.
'She's just... been through a lot.'
'Yes, I heard. Were you and Henrik ever going to tell me? Or even her, from what I heard she had to work it out?' there was an accusatory edge to his tone which made Roxanna steel herself.
'The situation wasn't ideal, but we've all moved past that. I just don't want to see Hannah get hurt.'
'You think I'm trying to hurt her?'
'What I see, as an outsider, is a young doctor, on the brink of her career, who has a crush on her boss and he is encouraging it. If there is something here then let that be as it may, but if I see or hear about anything that I think will hurt her, I will not hesitate to go to Henrik.' Roxanna finished confidently and John felt momentarily proud of his friend as he saw the protective mother in her emerge, Hannah was lucky to have her. There was a pause between them as John tried hard to think about the best response to her concerns.
'I promise...' he began slowly, 'that I will not let her career suffer in any way.'
Roxanna paused for a moment, trying to determine whether it was a satisfactory answer. She apparently deemed it so as she turned and walked back up the stairs without addressing the issue further.
'I'll let you know when Jac's awake.' she called over her shoulder and John slumped against the railing. He knew that he either needed to confront his feelings about Hannah or try to leave them behind completely, Roxanna was right, he couldn't allow himself to keep playing with Hannah and her feelings in this way. He wanted to trust in her completely, to reveal the problems with the trial to her and seek her advice; but she was connected to it now, if the trial went south then so did her professional reputation. He had to fix things before they got to that point.
When Roxanna found Hannah again she was sitting in the office on Darwin, staring at Jac's chair and tapping her fingernails together.
'Everything alright?' Roxanna asked from the doorway and Hannah nodded vaguely, not acknowledging her in any way. Roxanna sighed before shutting the door behind her and sitting down on the chair.
'I don't want you to think that I'm interfering, not after what you told me...' she began and Hannah's head whipped around.
'Then stop talking.' she said curtly and Roxanna stopped short, Hannah sighed. 'There's something wrong, Rox, I can feel it. I don't know what, but somewhere, somehow, something's going to go wrong.' she stopped and there was a pause between them as Roxanna tried to work out how to respond, Hannah continued before she had the chance. 'I feel like I need to run, from John and you and dad and Danny and everything here. I feel like if I stay then something terrible will happen and all I can ask myself is, what would Jac do?'
'Hannah, you don't need to rely on what Jac would do. You're a smart girl and can make your own decisions. If you feel like acting on your feelings for John would bring something to you, whether it be closure or even a reciprocation, then you should do it.' Roxanna said slowly and Hannah looked at her with a quizzical expression.
'I thought you were going to tell me that it was all a bad idea.' she replied and Roxanna smiled.
'I think you're old enough and ugly enough to make your own choices, and like I said, you're smart.' Hannah looked at her for a moment before she allowed herself to smile and there was a moment of clarity between them. For the first-time Hannah felt like she was able to accept Roxanna as her mother, she forgot the animosity.
The spell was broken as a nurse hurried into the office, barely knocking.
'Ms Hanssen, it's Ms Naylor.' the nurse said quickly, she looked concerned.
'What's wrong?' Hannah asked, jumping to her feet, Roxanna quickly followed suit.
'There's been a complication.' the nurse explained and Hannah didn't wait to hear more, she pushed past the nurse and hurried to Jac. She was awake but clearly in agony. Hannah was whipping her stethoscope from around her neck as she hurried to Jac's side and Roxanna placed a hand on her arm to keep her still whilst Hannah listened to her back.
'There's something wrong.' Jac managed to splutter and Hannah gently but quickly rolled her onto her back and pressed her stethoscope to her ribs.
'Hannah?' Roxanna asked, the registrar had grown pale.
'The bleed...' she whispered and Jac looked at her with wide eyes.
'What bleed?' she demanded but Hannah shook her head.
'It can't be we fixed it...' Roxanna could tell that she was shocked. 'Go and find John.' Hannah demanded as she checked Jac's fluids and began to unhook her from her IV. 'We need to get her back into theatre as soon as possible.'
'Don't you dare let me die, Hanssen.' Jac growled, grabbing Hannah's wrist and gripping it tightly. Hannah couldn't respond as Jac was rushed from the room and her anaesthetist was called.
Hannah didn't waste any time in waiting for John or Roxanna, she scrubbed in herself and began work on Jac immediately. She had already re-opened the wound and was surveying the damage, but couldn’t find the problem, when John and Roxanna burst into the theatre.
'What's happened?' John asked.
'Severe internal bleeding, there's something else wrong here, it can't be due to what happened in theatre earlier it just can't be.' Hannah explained hurriedly, she was starting to panic.
Roxanna and John scrubbed in as quickly as they could but Jac was already going into cardiac arrest. Hannah spared no time, she was pumping her fist on Jac's chest, she would not let her die. She kept going and going and going but nothing ever changed, Jac was dying. Roxanna and John didn't have a chance to get close, they had to call it.
'Hannah...' John said softly but Hannah shook her head, tears pouring down her cheeks.
'No!' she cried, continuing to do her best to revive her friend and mentor.
'Hannah.' John said again, more sternly as he came over to her, putting his hand out to guide her away, but she batted at him impatiently.
'Shock her again.' Hannah instructed but Roxanna held up a hand to halt it and was obeyed. Hannah took a step back, her shoulder heaving as she sobbed.
'No... I can't have... she can't...' her legs suddenly gave out and John caught her neatly and held her to his chest as she sobbed. Roxanna gave the time of death and the theatre was silent.

.....

The news of Jac's death spread throughout the hospital like wildfire and the press were waiting outside the main entrance for a statement.
As soon as she could get herself out of theatre, Hannah locked herself in the office on Darwin and wouldn't let anyone see her or speak to her; Fletch and Sacha were the first to fail, then Dom and Lofty tried but didn't fare much better, even John and Roxanna were met with stony silence, eventually it fell to Henrik Hanssen to try and get through to her.
He stood outside the door and tapped lightly, he had heard everything that had happened and he knew how guilty Hannah must have felt. He shared in a little of that guilt, this had all been Fredrik's fault in the first place.
'Hannah?' he called softly and he heard a sniff from the other side of the door so took that as a good sign. 'I need you to let me in, please. It's just me.' he tried to make his voice sound confident but there was a tremor he knew that she would detect. He lowered his voice further: 'I think we need to talk about this.'
There was a lengthy pause and he wondered if she would comply when he finally heard the gentle click of the lock and the door opened a crack. He slipped through and shut the door behind him before looking at her.
Hannah was a mess; the tears hadn't properly stopped since the surgery and her hair was wild. His eyes instinctively sought her wrists, frightened of what they might find, but they were clear. Hannah leaned against the desk, Jac's desk, and he could tell she was trying hard to keep it together.
'I've been trying to work out what I'm going to say, to the press.' when she spoke her voice sounded like it was being restrained by something.
'You don't have to say anything.' he said but she shook her head.
'Of course I do, it's my fault she...' Hannah pressed her lips together and inhaled sharply like she was in pain. 'They all want to hear about the implant but it had nothing to do with it, what went wrong is I wasn't able to stop a bleed. It's basic stuff, dad, what the hell kind of a surgeon am I if I can't cope with the pressure of finding and stopping a bleed?' Hannah picked up a small envelope and looked down at it.
'That better not be...' Hanssen began but Hannah cut him off.
'My resignation, I'm going to announce it during the press conference and then give it to Abigail. It saves her the trouble of firing me.'
'That's not a good idea, you can still come back from this Hannah, surgeons make mistakes all the time, we've all lost someone.' he tried to reason with her.
'Jac wasn't just "someone", dad, and I can't take the way people look at me. Everyone knows it was me...'
'Hannah, please...' Hanssen tried to interject and took a step forward with pleading eyes and his arms slightly outstretched.
'I killed her.' Hannah finally admitted and she couldn't stop the tears then, she dropped her letter of resignation, forgotten, as sobs overtook her again and Hanssen suddenly rushed forward and placed his arms around her. He held her tightly, it had been a while since he had comforted her like this but he had never seen her like this before either. She clung to him like a small child and cried as he comforted her.
Neither of them were sure how long they stayed there but they didn't break apart until there was a knock at the door and John interrupted them.
'I'm sorry, Hannah, I'm going down to give the statement to the press, I didn't know if you would like to be there.' he said and Hannah nodded, brushing away her tears and stooping to pick up her letter, Hanssen tried to take it from her but she pulled it back.
'I have to do this. I have to accept responsibility.' she said quietly and pushed past John, leaving the two men alone.
'She's going to resign?' John asked and Hanssen nodded, he hadn't noticed the tears in his own eyes.
'I would never say it to her face, but this is the end of her career. No doctor let alone patient will ever trust her again. She recognises that, but there's little we can do.' he replied sadly before leaving via the other door.
When John arrived in the lobby Hannah was waiting for him, looking out at the mob of reporters with her hands stuffed deep into her pockets, her letter hidden from sight.
'I want to say something, before you say anything.' she requested without looking at him.
'I don't think that's a good idea.' he replied as Roxanna joined them.
'You wanted me to be a part of this trial, you wanted me to lead this operation, I have to say something or else how bad is it going to look?' she justified and headed for the door before either of the others could object. They shared a glance as Hannah faced the reporters head on. As the doors slid open the sound of cameras and shouted questions hit them and John found his brain spinning as he questioned himself, was he really going to let Hannah's career end when he knew that this wasn't her fault. What neither Roxanna nor Hannah knew was that there had been a second, much smaller, bleed caused by the implantation but John hadn't given it any thought, it had been the neo-conduit which had killed Jac.
'Ladies and gentlemen, today we operated on one of our own, Jac Naylor, head of cardiothoracics here at Holby City hospital. I, Ms Hannah Hanssen, led the operation assisted and supervised by Professor John Gaskell and Ms Roxanna MacMillan.'
John was faced with a dilemma, if he owned up to the truth now then the whole trial would be over, completely; there would be no way he could ever save it. But if he didn't own up to the problems with the implant then Hannah would take the blame for a death that wasn't her fault. His professional emotions battled his personal ones for Hannah and he was acutely aware that he was running out of time to make a decision.
'In theatre, there was a bleed and at first we... I had trouble locating and stopping it. I thought I had done but it became apparent upon Jac's waking up, that the bleed had not been stopped and there was nothing further we could do to save her. Jac's injury itself was a result of the hospital shooting which happened here last December, as many of you are probably aware that shooter was my brother, Fredrik Johanssen.' Hannah took a deep breath and John wanted to lunge forward and comfort her but a look from Roxanna stopped him, not here, not in front of all these people. He was finding it harder and harder to hide his feelings for her.
'The blunt way to put it I suppose it that my brother shot Jac Naylor, but I killed her.' Hannah said, her voice cracking as she recalled Jac's joke.
'No.' John said loudly, before any of the press had a chance to even respond and Hannah turned to him with a questioning look. He hadn't been able to see before but she was crying again, he hated to see her cry.
'What Ms Hanssen is saying is untrue.' John said calmly, it was time to face the truth, he couldn't let Hannah suffer for his mistakes. He might have been willing to sacrifice someone, anyone else for the good of his trial, but not her.
'John what are you...?' Roxanna tried to grab his arm but he shook her off and joined Hannah, she was staring at him, dumbfounded, but he didn't look at her.
'The real problem lies with the implant. The neo-conduit caused a tear which went undetected and that was what killed Jac Naylor, it was my fault and not Ms Hanssen's. Furthermore, there has been an alarming correlation with the implantations and the developments of deadly infections within the trial patients. I would therefore like to take this opportunity to state that the neo-conduit is currently unsafe for human testing, and the medical trial needs to be halted immediately. It is likely that we will have to step back to a more theoretical approach.' he kept his voice even and calm throughout his entire speech, ignoring the shocked looks his colleagues were giving him.
The mob of press erupted immediately into a mess of questions but John simply turned on his heel and walked back into the hospital. Hannah and Roxanna looked at one another, rooted to the spot, unable to form any kind of comment or answer to the questions which were being hurled at them. Roxanna was the first to snap back into action.
'As you might be able to tell, Ms Hanssen and I were completely unaware of these findings but I will do my best to answer any of your questions.' she spoke loudly and clearly but took Hannah by the arm and turned her away from the crowd, dropping her voice so nobody else could hear.
'Go and find John, find out what the hell just happened.' she whispered and Hannah didn't wait to reply she simply took off at a run, she knew where she would find him.
She took the stairs down to the basement and found John in the corridor with his bag, he was getting ready to leave, anger surged up in Hannah and she couldn't quell it.
'So that's it, is it? You throw everything under the bus and leave Roxanna and I to pick up the pieces?' she blocked the door, a trick she had learnt from trying to deal with her father.
'I never meant for things to go this badly.' he replied calmly and Hannah felt her face go hot with anger.
'People have died and you knew why! Jac died and you knew that this could have killed her! You let me believe that it was me, Jesus John you begged me to be a part of this trial, is this why? You needed someone to throw under the bus when things got a bit tricky?' she was yelling and even he seemed to be struggling to keep his cool.
'Of course not, I never expected any of this to happen.'
'Why did you let me believe it was me? Better question: why didn't you just let me take the fall?' she yelled and he tried to speak but she couldn't hear his counter-arguments as she continued to make demands of him.
'Why did you even bother to come clean when you could have just let my career end and then everything would have continued right as rain with the trial? Why didn't you just tell me the truth? Why did you even want me to be a part of this trial in the first place?'
John's frustration finally boiled over and he couldn't contain it any more, he had no filter, no way of stopping himself and he finally snapped.
'Because of the way I feel about you!'
The silence between them was terrible. Of course, they had both known it was the case but the confirmation of it, merely hearing the words come out of his mouth, shocked them both. John wasn't sure if he instantly regretted it, but he did know that the anger in her eyes had only intensified and that frightened him.
'How dare you.' she said quietly, her voice was barely above a whisper, constrained by the lump in her throat which threatened tears, but it was dangerous and John knew immediately that he had made the wrong call.
'I didn't mean...' he began but she cut him off.
'Are you mocking me?' she asked and he was shocked for a moment, it hadn't occurred to him that she wouldn't believe him.
'What? No! Hannah, the timing might be poor but I am telling you the truth.' he took a step forward and took her arms, holding her tightly but wishing he could hold her tighter. 'I have had feelings for you for a long time now and I haven't known how to deal with them but that doesn't diminish them in any way. I don't care about myself, my professional reputation could be torn to shreds but as long as your is intact I would be happy because you are the most important person in the world to me.' he explained delicately and she didn't reply, she just looked at him with a confused mix of anger and shock, tears in her eyes; he could almost see her own battle with herself as to whether she could accept it and admit her own feelings or fight against him.
'Well that complicates things a bit, doesn't it.' Abigail said from the other end of the hallway, John didn't let Hannah go and that was what convinced her that he was being genuine, these weren't just words. However, she gently stepped away from him and sniffed back tears, wiping her nose on her sleeve, as they both turned and Abigail approached them.
'None of this was Ms Hanssen's fault.' John said but Abigail silenced him with a glare.
'From where I'm standing, Hannah has messed up and it has resulted in the death of a patient and because of these feelings you have for her you are willing to throw away everything you've worked for. That's how it's going to look to a lot of people too, regardless of the truth. I have to acknowledge Hannah's statement that she is responsible for the death of Jac Naylor and hold her accountable for it.' Abigail spoke slowly and at every pause Hannah wanted to interject and defend herself but she couldn't find the words so she stayed silent, staring between them. It was too much information to process at once, her head felt like it was going into overload.
'But she didn't do anything wrong!' John retorted.
'We will have to wait until the coroner's report to confirm that, until then Hannah...' she turned to Hannah who was white as a sheet, she wasn't aware just how unwilling she was to give up her job, especially now that she believed John when he said it hadn't been her fault.
'I'm suspended? Fired?' Hannah whispered, unable to raise her voice any higher.
'No,' Abigail said with a slightly sympathetic smile, 'but you'll have to be on very light duties, and I think it's safe to say that Ms Petrenko will be offered the job of senior Registrar for Darwin.'
Hannah nodded slightly and sniffed back more tears, looking down at the floor and trying to hide her weaknesses, her head was starting to pound.
'I suggest that you two keep whatever's going on here between yourselves though.' Abigail suggested and Hannah's head snapped back up as she looked to John and the anger at his betrayal seared up again.
'Don't worry, that won't be a problem, there's nothing here.' she said quickly, making her decision in a snap, and then turned back towards the stairs and stormed away.