A Consultant's Special Care. Joanna Neil
‘I hurt everywhere, but my knees are the worst. My chest hurts as well.’
‘OK. Let’s take a look at you.’ She ran the stethoscope over his chest and heard a faint irregularity of the heartbeat. ‘We’ll do an ECG,’ she told the nurse in an undertone. ‘There may be some inflammation around the heart that’s causing his breathlessness.’
The boy’s knee joints were swollen, she discovered. Frowning a little, she tried to work out what it was that was causing Fraser’s symptoms. ‘Let’s do blood tests as well to see if there’s an infection.’
Turning to his mother, she said, ‘We’re going to do tests to find out what could be causing his illness. As soon as we have the results, we’ll be able to consider our treatment options. In the meantime, we’ll need to admit him for observation.’
Jordan appeared at her side just then, and indicated that he wanted to talk to her privately. She wondered how long he had been watching her. Throughout the day, she had been conscious of him in the background, and she was sure he was keeping an eagle eye on her progress. The last thing she wanted to do was to let him know that she was floundering, but she didn’t know quite how she could avoid it.
‘Are you having trouble making a diagnosis?’ he asked softly, when they had retreated outside the cubicle, leaving the boy with his mother.
‘It isn’t anything I’ve come across before,’ she admitted. ‘I think it may be an infection of some kind, especially if it’s affecting his heart in some way, as well as his joints.’
‘May I take a look?’ he enquired, and she agreed readily enough.
Jordan introduced himself to the boy and his mother, and made a careful examination, just as Abby had already done. ‘On holiday, are you?’ he asked Fraser, and the boy nodded.
‘We came here about ten days ago,’ his mother said.
Jordan smiled. ‘It’s beautiful around here, isn’t it?’ He glanced back at the boy, and said lightly, ‘Have you been taking the coastal walks hereabouts, or do you think you might have been overdoing the football?’
‘No football,’ Fraser answered, struggling a little for breath, ‘but we’ve done lots of walking.’
Jordan gently examined the boy’s calves. ‘Did you keep to the paths, or have you sometimes wandered through the fields?’
The boy looked puzzled, and said anxiously, ‘Both. Did I do something wrong?’
‘Nothing at all,’ Jordan answered cheerfully. ‘I like to take the coastal walks myself. There are some lovely views over the bay.’ He turned to Abby and pointed out a slightly reddened area on the boy’s calf. ‘Do you see that?’ he asked.
She had missed it. It was fairly insignificant, and it wasn’t something that she would have paid much heed to under normal circumstances. Now, though, she sent Jordan a questioning look.
‘What is it?’
‘A tick bite, most likely. Sometimes they’re quite pronounced, but if this happened a few days ago the area around the bite might have settled down a bit.’ He showed the child the reddened patch and said quietly, ‘I think you might have been bitten by a tick when you were on one of your walks. They’re usually found on sheep or deer, but walkers can suffer from their bites occasionally. They can pass on an infection called Lyme disease, which may lead to symptoms like yours. We’ll know for certain when the test results come through.’
‘What does it mean?’ Fraser’s mother asked. ‘Can you treat it?’
‘We can. If it is Lyme disease, we’ll start him off on a ten-day course of antibiotics, and he’ll need anti-inflammatory drugs to bring down the swelling and help relieve the pain. We’ll most likely put him on corticosteroids for a while, too.’
He smiled once again at Fraser and moved away from the bedside. ‘We’ll sort you out,’ he said. ‘Don’t worry.’
The mother followed Jordan and said in a low voice, ‘Will he be cured? I mean, will there be any after-effects, any permanent damage to his joints?’
‘There shouldn’t be. It may take a few weeks for him to be fully well, but he should be fine before too long. He’ll need to rest in the meantime.’
Looking a little more reassured, the woman went back to her son.
Away from the cubicle, Abby bit her lip. ‘I’ve never come across that before. Can you be certain that’s what it is?’
He gave a crooked smile, one that added a roguish attractiveness to his features. ‘You’re a city girl,’ he said bluntly. ‘You’re not likely to be familiar with it. In any case, the tests will take away any element of guesswork. Lyme disease is known mostly in the US, but it’s also a problem in Europe and part of our own southern heathlands. You were right to admit him. He’ll need support over the next few days, especially if his heart is involved, but he should make a full recovery.’
‘I’m glad. He looks so ill and wretched just now, poor boy.’
He slanted her a narrowed glance. ‘If you’re not sure about anything, just ask.’ His tone was brisk. ‘You can’t be expected to know everything, and it doesn’t reflect badly on you if you ask for a second opinion.’
‘I’ll remember that.’
‘I hope you will.’
He moved away then, to attend to another patient, and she was left thinking that perhaps he wasn’t as bad as her first impression of him had led her to believe. He could be acerbic at times, but at least he hadn’t had a go at her in front of the patients.
There was no time to dwell on things, though. More patients needed her attention and she made an effort to pull her mind back to her work. Whatever she did, she was going to be watched, but maybe in time he would realise that she was a capable doctor and he would learn to trust her.
The day wore on, and at mid-afternoon, when she was thinking she could do with a break and a cup of coffee, Sarah, the nurse who had been working with her said, ‘There’s a phone call for you, Abby.’ She laid the receiver down on the desk and walked over to where Abby was signing off some charts.
Abby frowned. ‘Who is it?’ She couldn’t think of anyone who would be ringing her up at work. Her mother hardly ever called during working hours, not wanting to interrupt her in case she was busy.
Sarah gave a grimace. ‘I don’t know, he didn’t say. He just said he wanted to talk to Dr Abby Curtis.’ She lowered her voice and confided, ‘I wouldn’t mind getting his number, though. He sounded wonderful. His voice is really deep and sexy.’ Her blue eyes crinkled at the corners. ‘If you don’t want him, just pass him my way, would you? I’m footloose and fancy-free.’
Abby chuckled. ‘Well, I will, if it’s my brother. I can certainly pass him on to you…but I have to warn you, you might have to wait a while to meet up with him. He’s in South America right now, and he’s not due back for several months.’
Sarah pulled a rueful face. ‘Isn’t that just my luck?’ she said, turning away to find Jordan waiting for her.
He must have heard their conversation, but his expression revealed no hint of his thoughts. ‘Would you suture a gashed hand for me in cubicle four?’ he asked.
Sarah nodded. ‘Will do.’
Jordan went to follow up on a patient of his own, and Abby walked over to the phone on the other side of the room.
In fact, she didn’t think Daniel would be ringing her at the hospital. If he wanted to get in touch, he would be far more likely to use a cheaper method of communication, like e-mail or fax, with perhaps a more private call home once a month.
The phone was housed in a Plexiglas booth, which provided a modicum of privacy. Abby picked up the receiver and said, ‘Hello.’
There