Her Very Special Boss. Anne Fraser
child rehydrated as soon as possible.
‘I can’t find any in her arms. They all seem to have collapsed,’ Kirsty told Greg, fear catching her voice. They had no time. The child could die if they didn’t treat her right away.
Greg looked up at her. ‘Slow down. We’ll find one. Look here just above the foot. We’ll need to do a cut down. It’s not ideal, but it’s all we have. Have you done one before?’
‘I have, but I’d rather watch you first, if that’s OK,’ Kirsty said. This child was so small, so desperately ill. What if she was too slow?
‘You’ll have to do it, I’m afraid. You may have noticed my right hand only has restricted movement. It’s fine except for the most delicate stuff.’ Kirsty could only guess what it cost Greg to admit his limitations. At the same time she admired him for it. She had once seen a doctor attempt to perform procedures above his capabilities and the results had almost been disastrous.
Greg noticed Kirsty’s hesitation. ‘You’ll be fine. I’ll talk you through it.’
Somehow his belief in her gave her confidence and with very little assistance from Greg she performed the procedure perfectly and without any wasted time.
‘Excellent job.’ Greg’s praise was fulsome and genuine and Kirsty felt elated. She thought that she might grow to like her job here.
‘OK, let’s get her started on the usual regime.’ He directed a few rapid words towards the mother.
‘She’s three years old,’ he translated for Kirsty.
Once again Kirsty was horrified. Three! It wasn’t possible. The child looked no older than nine months, a year at the most. She was so tiny.
‘Obviously we can’t use her age to work out how much we need to give her. By my guess she weighs just over eight kilograms. Could you pop her on the scales?’ he asked the nurse.
The nurse scooped the child up and laid her gently on the scales.
‘Just right—eight kilos,’ she told Greg.
‘Any thoughts on the dosage we should be administering?’ Greg asked Kirsty.
Kirsty thought frantically. She had completed six months in paediatrics as part of her houseman jobs. But the children there had been so much bigger, stronger than this child in front of her. She had never seen anyone in such an advanced stage of starvation before. How could she have? But she remembered a child, physically handicapped, who had been brought in following a severe episode of diarrhoea. The child’s condition had been similar to if not quite as drastic as that of this child in front of her.
She was about to hazard a guess, but Greg hadn’t waited for her response. He adjusted the drip and straightened up. She could sense the fatigue and something else—could it be anger?—behind his professional exterior.
‘We’ve done everything we can for the time being. It’s in the lap of the gods now.’ He tossed his gloves into the bin. ‘The main problem is caused by formula. The government spends substantial sums of money promoting breast-feeding, but the problem is with the women who are HIV positive. The danger of them transmitting the disease to their infants through breast milk is just too large, so they are encouraged to give their babies formula. Unfortunately formula is too expensive for most of them, so they start diluting it to make it go further. Then the children simply don’t get enough calories or nutrition. And as if that isn’t bad enough, a large number of the outlying villages still don’t have access to clean water. So the women mix the powder with water from the river. And what you see before you is the result.’
‘Can’t we do anything about it?’ Kirsty asked. ‘Surely it’s just a matter of education?’
Greg smiled, but there was no humour in his eyes. ‘Education and clean water. That’s what is needed. In the meantime…’ He let the words hang in the air for a moment. ‘In the meantime we do the best we can. Come on, Kirsty, as you’re about to see, there is plenty more for us to do.’
‘But doing the best we can isn’t enough. Is it? Not if children are still dying?’ Surely he wasn’t going to tell her there was nothing they could do to prevent this? He didn’t strike Kirsty as a man who let anything stop him from doing what was right.
‘We’ll talk about it later,’ Greg said quietly but firmly. ‘Right now we have work to do. You take the consulting room next door. I’m just across the hall. If you need me, give me a shout, but try the nurses first. I think you’ll find that there is precious little they can’t help you with.’ And without waiting for a reply, he turned on his heel and left the room.
CHAPTER THREE
THE rest of the morning passed quickly. Kirsty saw many children with the swollen bellies and stick-like limbs of kwashiorkor, a condition the nurses told her was caused by poor nutrition and lack of vitamins. The nursing staff were fantastic. They worked unstintingly throughout the day, pausing to answer Kirsty’s questions with unfailing good humour and patience. Kirsty felt humbled to be part of their team and full of admiration for their level of expertise. The patients too were remarkably stoic and, despite long waits in the overcrowded department, were universally grateful for everything Kirsty did, however small. Occasionally, to her surprise, she could hear laughter filtering through the walls of the consulting room.
Eventually the clinic quietened down, until all that was left was dressings and vaccinations that the nursing staff on the back shift would finish off.
As Kirsty leaned back in her chair, a wave of exhaustion washed over her. But it felt good. She closed her eyes.
‘Lunch?’ Greg popped his head around the door and as if in answer Kirsty’s stomach growled. Now that he mentioned it, she was starving. The cup of coffee and the watery porridge she had eaten at breakfast-time had made her appreciate why the others ate at home. As soon as she had the opportunity she was going to stock up on provisions, but in the meantime…
‘Lead me to it,’ she said, jumping out of her chair. I hope he doesn’t think I’ve spent the morning snoozing, she thought.
‘Come on, then. I gather you did pretty well this morning. The nurse told me you worked throughout without a break. Well done.’
Kirsty felt herself glow with pleasure. Maybe he wasn’t going to be so difficult to work for after all.
‘I am going out to one of the villages tomorrow to do a clinic, if you’d like to come with me,’ Greg said as they made their way to the staff dining room. Kirsty almost had to run to keep up with his long strides. ‘You’ve seen the bad, now I’d like you to see the good.’
‘I’d love to,’ Kirsty said, ‘but I’d like to check up on the child we saw this morning before lunch, if that’s OK. I don’t mind missing lunch if we’re pushed for time.’
Greg’s eyes swept over her figure. He shook his head. ‘You look as if you could do with a good feeding up yourself, so missing lunch isn’t a good idea. You’ve been working hard and a sick or weakened doctor is no good to anyone. Of course we can take the time to pop into Paediatrics before we eat, but if you are going to survive out here, you’ll need to become less emotionally involved. I find too much emotion can cloud a doctor’s judgement.’
So much for thinking he was going to be easy to work for! It hadn’t taken long for his habitual curtness to resurface. And who was he to tell her when she had to eat? And as for telling her not to become too involved, she had heard those words before. She thought it would be different out here. She thought, if anything, doctors came here to work because they wanted to be involved. But clearly not Dr Greg du Toit. The man had no feelings. He was simply a working machine.
‘I think I’m old enough to look after myself,’ Kirsty said frostily. ‘I don’t mind you commenting on my work, but what I eat and what I feel is up to me, don’t you think?’
Her words stopped Greg in his tracks. He turned to look