Читать книгу The Doctor's Tender Secret - Kate Hardy - Страница 6

BRAD HUTTON was beginning to regret his decision to oversee the paediatric assessment unit this morning. They’d had a non-stop string of cases, from suspected poisoning to asthma attacks to viruses where the GP didn’t want to risk missing meningitis. The parents had all been so worried that they’d hardly heard a word he’d said and he’d had to repeat everything three times. He’d barely had time to draw breath.

The only bright spot in PAU was his registrar, Zoe Kennedy. He’d seen her around the ward over the last few days, but this was the first time he’d actually worked with her. She made him want to start humming ‘Poetry in motion’—because that really was what it was like, watching her. The way she reassured the parents, scanned the notes, assessed the child and decided on the best treatment—fast, fluent, yet very thorough. And every decision he’d seen so far today had been spot on. She really knew her stuff.

Don’t get too interested, a voice in his head warned him. You’re in no fit state to get involved with anyone.

I’m not planning to get involved, he defended himself. I don’t know anyone in London. A friend won’t go amiss.

Just make sure that ‘friends’ is all it is.

It will be. Anyway, she’s not my type.

She couldn’t be much more than five feet three inches, whereas the girls he’d dated had always been nearer five-ten. Her hair was mouse brown and cut into a short bob, not blonde and falling almost to her waist. Her eyes were warm and brown, not cool and blue. And beneath the baggy long-sleeved sweater and loose jersey trousers she wore, he had a feeling that Zoe Kennedy was all lush curves rather than the rail-thin type he usually went for. A pocket Venus.

Yeah, definitely Venus. She had a heart-shaped face. Cupid’s-bow lips.

And she’s not Lara, the voice in his head reminded him. If you rush straight in to find Lara’s opposite, you’re not the only one who’s going to get hurt.

‘Mr Hutton?’

Then he realised that the object of his thoughts was talking to him. ‘Sorry, Dr Kennedy—Zoe, isn’t it?’

She nodded.

He held out his hand. ‘Brad. I prefer working on first-name terms.’

She shook his hand and he almost flinched as a large dose of static electricity discharged. At least, he assumed it was static electricity. The alternative was something he didn’t want to consider right now.

‘What can I do for you?’

‘I’d like a second opinion on a case.’

‘Sure. Though from what I’ve seen of you this morning, you don’t need it.’

‘Um. Thanks for the compliment. But…’

Those pink spots in her cheeks were cute. She looked young for a registrar, which meant she was clever. But the blush at his compliment proved she’d kept at least a trace of humility, so she’d treat her patients as human beings, not just academic cases. ‘OK. What have you got?’

‘Michael Phillips, aged twelve months. According to the notes, he was a floppy baby. He’s had problems feeding right from the start, with poor sucking and chronic constipation; he smiled late and didn’t roll over until he was eight months old. He’s just starting to crawl now, but it’s commando-crawling—’ in other words, he lay on his stomach and propelled himself along with his arms, like a commando under a net ‘—and if you hold him up to stand, his reflexes aren’t what you’d expect.’

‘And you’re thinking?’ Brad prompted.

‘Cerebral palsy. Probably a mixture of spastic and athetoid.’

That would account for the late development. ‘What do the parents think?’

‘The mum’s worried sick because he’s not hitting the milestones in her parenting books. The dad’s in denial and saying everyone’s making a fuss over nothing, his son is perfectly all right and will catch up by the time he goes to school.’

‘OK. I’ll come over.’

Zoe introduced him to Jenny and Dave Phillips. Brad examined little Michael. ‘Tell me, does he have any problems eating?’ he asked.

‘Of course he does. He’s a baby,’ Dave said. ‘They all dribble their food, don’t they?’

‘Michael doesn’t like finger food,’ Jenny said. ‘He likes yoghurt and he’ll eat purées, but he’s not keen on lumps.’

‘He’ll grow out of it,’ Dave insisted. ‘You’re making a fuss, Jen. He’s perfectly all right.’

She shook her head. ‘There’s something wrong, Dave. I know it.’

‘Tell her, Doc,’ Dave pleaded. ‘Tell her she’s fussing over nothing.’

‘Actually,’ Brad said, ‘I think she’s right.’

Panic flowed in Dave Phillips’s eyes. ‘What’s wrong with him, then?’

‘We’re pretty sure it’s cerebral palsy,’ Brad said.

‘But—Are you telling me my son’s…?’ Dave trailed off, as if not voicing his fears would mean that it wasn’t true. That it was only a bad dream. That everything was going to be all right.

Zoe squeezed his hand. ‘You’re both right, actually. Michael will be fine—but he’ll need some help as he grows older.’

‘But…cerebral palsy? He doesn’t even look like a retard! He’s bright, he points to things,’ Dave burst out. ‘It can’t be that!’

‘Cerebral palsy’s a motor disorder,’ Brad explained. ‘It’s Michael’s movements that are affected, not his intellect.’

‘A lot of children with cerebral palsy have normal or above average intelligence. There’s every chance Michael will be able to go to a mainstream school rather than a special school,’ Zoe added. ‘The condition really varies—it can be very severe, but it can also be so mild that you hardly notice.’

Dave didn’t look convinced. ‘So what is cerebral palsy, then?’

‘There are three types,’ Brad said, ‘and they all jumble the messages from the brain to the muscles. The most common form is called spastic cerebral palsy, and it’s caused by an impairment in the cerebral cortex—that’s the outer layer—of the brain.’

‘Spastic?’ Dave squeezed his eyes tightly shut. ‘Oh, no. At school, we used to say…’ He stopped, his face bright red with what Brad guessed was a mixture of shame and embarrassment.

Zoe must have guessed it, too, because she stepped in fast. ‘The word “spastic” just means “stiff”. It’s referring to his muscles—they get stiff and shorten, so the child finds it hard to control his movements. It means he has to work harder than the average kid to walk or move.’

‘The second sort’s called athetoid cerebral palsy, and it’s caused by an impairment in the basal ganglia area of the brain,’ Brad said. ‘It affects the child’s posture and, because the muscles change from being floppy to being stiff, it causes these jerky movements and the child doesn’t have any control over them. A child with athetoid CP often has speech problems because it’s hard for him to control his tongue, vocal cords and breathing. He might also have problems eating and may drool. And he’ll seem restless, as if he’s constantly moving—as if he’s only really relaxed when he’s asleep.

‘The third type,’ he continued, ‘is really rare and affects less than ten per cent of children with CP—it’s called ataxic cerebral palsy, and it’s caused by an impairment in the cerebellum part of the brain. This affects the child’s co-ordination and balance. He often has shaky hand movements and his speech is irregular, and he’ll find it hard to judge the position of things round him.’

‘Which type has Michael got?’ Jenny asked.

‘It’s very hard for us to say,’ Brad admitted. ‘The condition affects each child individually and he might have more than one type, in varying degrees.’

‘So he’s going to drool and he won’t be able to walk?’ Dave asked.

Zoe shook her head. ‘We really can’t tell at the moment. The main problem is difficulty in controlling his movements and facial expressions. He might have some learning problems—it all depends on which part of his brain has been affected. His speech might be a bit unclear, and he might find it hard to communicate—or he might have what we call a specific learning disability, say, a problem with maths or reading or drawing, if a specific part of his brain has been affected.’

Dave took a deep, shuddering breath. ‘And that’s it? Or can it get worse?’

‘Worst-case scenario,’ Brad said, ‘is that he might also have a squint or hearing loss. And around a quarter to a third of children with CP have epilepsy.’

‘But there’s a lot we can do to help, and we can put you in touch with the local support group,’ Zoe added, ‘so you can talk to other parents who’ve been through what you’re feeling right now, and they can help you.’

‘Is it curable?’ Jenny asked.

‘There’s no cure,’ Brad said gently, ‘but the good news is that it won’t get any worse. Treatment can help to improve Michael’s condition, and his disability really doesn’t mean that he can’t lead a full and independent life when he gets older.’

‘Doesn’t it?’ Dave rubbed a hand across his face.

‘The earlier we start treatment, the more we can help him,’ Zoe said.

‘So what causes it? Is it anything I did while I was pregnant?’ Jenny asked.

‘No, it wasn’t your fault at all. The risk factors include if either of you were under twenty, he was your fifth or later child, he was a twin and the other twin died, he was very light when he was born—that’s under one and a quarter kilos—or he was born more than three weeks early. Around one in four hundred babies are affected,’ Brad reassured her. ‘What happens is that part of the brain—the bit that controls muscles and body movements—fails to develop either before birth or in early childhood. It can be caused by a blocked blood vessel or a bleed in the brain, or a difficult labour, if he was very premature or ill after the birth, or he had an infection during early childhood, such as meningitis.’

‘I can’t take this in,’ Jenny said. ‘I knew there was something wrong. I knew it. But nobody would listen to me.’

‘Your health visitor did,’ Zoe said softly. ‘She referred you to us. And sometimes it’s hard to pick up—it might not show until the baby’s twelve to eighteen months old. She said that he was hypotonic when he was born—that his muscles were floppy.’

‘And sometimes you might find his muscles are spastic, or tight.’ Brad looked at Dave. ‘You might prefer the word “hypertonic”. It’s the same thing.’

Dave shook his head. ‘I thought he was all right, that Jen was blowing everything up out of proportion and Michael was just a bit of a fussy eater. You know, not liking lumps and…well, having constipation so much.’

‘They’re common in children with Michael’s condition,’ Zoe explained. ‘It might be that he’s having problems chewing and swallowing. How’s his sleeping?’

‘Average,’ Dave said.

‘He only wakes up three or four times a night,’ Jenny said.

Brad exchanged a glance with Zoe. By twelve months, Michael should have been sleeping through the night.

‘What kind of treatment will he need?’ Jenny asked.

‘A physiotherapist can help you with his coordination—teach you exercises he can do at home,’ Brad explained. ‘As he gets older, a speech therapist will be able to help with speech and using language. And he’ll need regular eye checks. He might not have a physical problem with his eyes, but he might find it hard to distinguish shapes.’

‘That’s something an occupational therapist can help with,’ Zoe said. ‘The important thing is that you don’t have to cope on your own—there are a lot of people who can help Michael reach his full potential.’

By the time they’d finished answering questions, made a referral to the physiotherapist and orthoptist and left the Phillipses, Zoe looked drained.

‘Come on. I think we’re both overdue a break. I’ll shout you a coffee,’ Brad said.

Zoe could feel herself blushing and was furious with herself. She really, really didn’t want Brad Hutton to think she was bowled over by him. He might be tall, blond and utterly gorgeous—with those white teeth and his tan, he’d immediately been nicknamed ‘surf-boy’ by some of the more jealous males in the department, particularly when they found out he hailed from California—but he wasn’t for her. She didn’t have room in her life for a relationship. Not now, not ever. For ten years she’d kept to her decision of offering friendship, and nothing more, when it came to the opposite sex.

But this hadn’t sounded like a trying-for-a-date sort of offer. It was more like a boss-rewarding-good-work sort of offer. Which meant it was perfectly safe to smile at him and say yes. ‘Cheers. I think I need some caffeine,’ she admitted.

Though she was still thoughtful when they were sitting in the canteen, nursing a large coffee and a muffin each.

‘Penny for them?’ Brad asked.

‘I just hope the Phillipses will work things out,’ she said. ‘You know, there’s a high divorce rate for parents of children with cerebral palsy, and I think Dave Phillips is going to have a lot of trouble adjusting to the idea that his son is less than perfect.’

‘But they’re not on their own. There are good support groups—and you handled the situation very well. You gave him the facts, you weren’t judgmental, and you gave him some hope, too.’

Pleased by the praise, Zoe met his eyes. And wished she hadn’t. They were the blue of an ocean on a summer’s day. The kind of eyes you could drown in.

He smiled at her. ‘PAU isn’t the easiest of areas. I’m glad I’ve got someone like you on my team—someone I can work with.’

‘Thanks for the compliment, but I think you’ll find the rest of the ward’s the same.’

‘No dragon matron?’

‘No. The senior sister—Val—is more like a mother hen.’ She smiled back at him. ‘It’s so frantic on the ward these days that you don’t get time to meet people properly. Are you doing anything tonight?’

He blinked. ‘Are you asking me out?’

‘Um, no. Yes. Well, not me personally.’

‘Thanks for the offer,’ he said drily, ‘but I don’t need a date.’

‘You’re married?’ She glanced automatically at his left hand. No wedding ring, no pale band of flesh hinting at the recent removal of a wedding ring either. ‘But I thought you were in London on your own?’

‘I am on my own,’ he said quietly.

But there was a slight prickliness to his voice that hadn’t been there before. She backtracked fast. ‘I’m sorry. I wasn’t trying to pick you up or anything. It’s just that you’re on secondment and you don’t know many people around here, so I thought you might be a bit lonely.’

Lonely? She could say that again. He’d been bone-deep lonely since losing Lara. ‘I’m OK.’

‘Well, I’m going out with Jude and Holls tonight—they’re my best friends—and I wondered if you’d like to join us. Nothing fancy, just pasta and the house red at our local Italian.’

‘Thanks, but I’m fine.’

‘If you change your mind, we’ll be at Giovanni’s from about seven tonight until they chuck us out.’

She was planning to drink until closing time? ‘I hope you’re on a late tomorrow.’

She didn’t seem at all offended by his rudeness. Her eyes were lit with amusement and she grinned at him. ‘No, I’m on an early. So after the second glass of wine I’ll be on mineral water. Until we start on the ice-cream—and then it’s coffee all the way. Giovanni’s does the best latte in London.’

He should have guessed that, from what he’d already seen of her. Zoe was a professional. She wouldn’t come on duty with a hangover. ‘Right.’

‘So are you busy next Wednesday night?’

She was persistent, he’d give her that. ‘Why?’

‘If you’re not, how would you like to make some money?’

He frowned. ‘You’re going to a casino? Or…’ Hadn’t he heard someone on the ward talk about greyhound racing? ‘The dogs?’

She shook her head. ‘Nothing like that. It’s a fund-raiser for medical equipment. Jude, Holls and I do it once a month, and split the proceeds between our wards—Jude’s in maternity and Holls is in Emergency. So we all benefit.’

‘What’s involved?’

‘You can buy a ticket, for a start. Or go and flash your smile around, flutter your eyelashes and talk people into buying tickets. Unless…’ She looked thoughtful. ‘You’re not musical, by any chance, are you?’

‘I play the piano a bit,’ he admitted.

Big mistake.

‘Yes!’ She punched the air. ‘I think I’ve just found our guest star.’

‘Hang on.’ This was all going way too fast. ‘I’m out of practise. I’m rusty.’

‘You’ve got a week. You can practise on Jude’s piano.’

‘But…’ His protest died as he realised that he had no chance of winning. Zoe would come up with an answer for any excuse he made.

She gave him that grin again. The one that put amber glints into her brown eyes. ‘That’s settled, then. Thanks. We’ll add your name to the posters. Guest star, Brad Hutton—is that vocals as well as piano?’

‘Has anyone ever told you you’re a…?’ He shook his head. Words failed him.

Zoe chuckled. ‘My nickname on the ward’s Hurricane Zoe.’

‘It suits you,’ he said feelingly.

‘So, is it piano only, or vocals?’

He sighed. ‘Both. I don’t have any choice, do I?’

‘You can say no.’

But that would mean letting her down. With shock, Brad realised that he didn’t want to do that. He didn’t want to see disappointment spill over her face. Which meant that Zoe Kennedy was the first person he’d actually responded to in nearly a year. He wasn’t sure if that made him feel relieved—that he hadn’t become a complete automaton, that he could still feel something—or scared. ‘How many people are there?’

‘It’s not a huge thing, it’s in the hospital social club. We sell quite a few tickets—Holly can be very, um, persuasive—but only about thirty people tend to turn up. I do the food, Holls does the tickets and Jude wows everyone with her singing.’ She gave him a sidelong look. ‘Perhaps you should change your mind about coming to Giovanni’s tonight. You need to talk set lists with Jude and posters with Holls. Unless you want to leave the decisions with me?’

With Hurricane Zoe? He’d never heard a nickname that fitted someone so well. Heaven only knew what she’d agree to on his behalf! ‘I’ll be there tonight,’ he said.

‘Good.’ She sketched a map hurriedly on the back of a paper napkin. ‘This is London City General,’ she said, marking a big block on the paper. ‘You go out of the main entrance, turn right down this little street here, take a left, then the second right, and Giovanni’s is on the corner.’ She circled a smaller block. ‘It’s pretty easy to find. Look for the green, red and white stripy shutters.’

‘Won’t your boyfriends mind me joining you?’

She shook her head. ‘It’s just the three of us tonight. Besides, Holls and Jude are happily married to their careers.’

What about Zoe? She hadn’t said she was single. She hadn’t said she was attached either. Though why was he even wondering about it? He wasn’t in the market for a relationship. Not now, probably not ever—it had been nearly a year now and he still felt as lost. It was one of the reasons why he’d leapt at the London secondment, to go somewhere where there were no memories to haunt him.

Zoe Kennedy wasn’t for him. And the chances were she was already attached anyway.

‘Good. Seven o’clock at Giovanni’s, then.’ She smiled at him. ‘We’d better get back, or there’ll be a list of patients as long as my arm!’