‘Not until tomorrow but if we put in the catheter this afternoon, he should be able to start first thing in the morning. He’s staying overnight.’ She smiled as they entered the wash room where they scrubbed up. ‘Of course Dr Price asked that you review him before we start. I was going to ask you to look at his notes this afternoon after the round and get Jack to supervise—’
‘But he’s in Theatre, for a long haul.’
‘Probably all afternoon. And Pharmacy needs the okay today to make up his drug regime.’
‘No problem. Let’s go and say hello to Danny, then.’
Richard was pleased to find out the thirteen-year-old patient and his father, who looked more nervous than the boy, had been well prepared. Anita had explained exactly what would be done and Danny had been given a mild sedative by one of the nurses as soon as it was confirmed the procedure was to go ahead.
Richard introduced himself.
‘I’m Dr Richard Howell, the specialist who will be looking after you from now on. Anita is going to put a tiny plastic tube into one of the large veins in your chest so you can have the amount and type of drugs you need without having to have a new line each time you come in.’
‘Will it hurt?’ Danny said drowsily.
‘A little,’ Anita answered with a smile. ‘You’ll feel the needle with the local anaesthetic like a pinprick, but that will make the skin go numb.’
Richard turned when he heard the curtains of the cubicle part.
‘Hi, champ,’ Joanna said cheerfully, as if she had known Danny for years. Richard’s worries about any difficulties she might have coping were immediately allayed. ‘And I checked up about…ahem.’ Joanna made a theatrical show of clearing her throat. ‘That very special person is coming to the ward on the day you have your second treatment, but you mustn’t tell a soul I told you. It’s supposed to be a big surprise,’ she added with a wink, and Danny managed a grin.
‘Our secret,’ he said.
She nodded in the direction of Danny’s father. ‘Jenny’s with the kids today, is she, Pete?’
He nodded and then paled, looking as if he was about to faint.
‘It’s getting a bit crowded in here. Why don’t you go and make yourself a cuppa in the parents’ room?’ she said tactfully, glancing in Richard’s direction for his approval to give Pete an excuse to leave. He nodded, aware that their young patient’s anxiety level had definitely ebbed after Joanna had appeared. ‘Okay, Danny?’
The teenager’s eyes had drifted closed and he opened them briefly, managing the slightest smile. ‘Yeah, you go, Dad, but you’ll stay, won’t you, Sister?’
She patted his leg. ‘Of course. Someone has to keep an eye on these doctors. Is that okay with you guys?’ she asked.
She was in total control, treating Richard like a consultant she was working with, behaving exactly as she should be. Maybe he’d blown out of proportion her almost hostile reaction to him on Friday night. She was certainly better at filing away the past than he was.
‘Fine by me,’ Richard said, trying to adopt the same attitude, which hovered somewhere between professional and friendly-casual.
‘Good.’
Joanna peeled open another set of sterile surgical gloves and then tilted the bed head down to help fill Danny’s chest and neck veins. She went off to wash her hands while Anita carefully swabbed the skin of the right side of the boy’s torso.
‘Feeling all right?’ Anita asked, but Danny seemed to be drifting in and out of a light sleep, a sign of effective sedation. There was a good chance he wouldn’t even remember the catheter insertion.
Joanna returned and slipped her hands into her gloves.
‘I’ll just watch and let me know if you want any help or advice,’ Richard said as he moved back from the bed and stood where he had a good view of the two women at work.
Anita anaesthetised the skin just below the clavicle then made a small cut to locate the subclavian vein, which sits beneath the bone but in front of the artery. Joanna dabbed at the small wound and placed a finger in the notch at the top of the breastbone so that Anita could line up the needle at the correct angle. Insertion of the plastic tube into the vein and its tunnelling under the skin went smoothly, a good back flow of blood indicating it was likely to be in the correct position. A small cuff on the tube was inflated to help keep it in place under the skin and an X-ray would confirm it was in the right place and that no damage had been done to the underlying lung.
‘Well done.’ Richard checked the time. ‘Can I leave you to suture, check Danny’s chest and organise radiology? I’ll speak to Danny’s father before he leaves.’
‘Yes. And thanks, Dr Howell.’
‘I’ll see you on the ward round when you’ve finished.’
Richard was only five minutes late to the round and Anita joined him and his group not long after, but he noticed Joanna’s absence.
‘Isn’t Sister Raven joining us this afternoon?’ he asked Lynne quietly when they were walking between patients.
‘No, she’s working in the chemo suite until the day cases finish. It’s better she stays there. Is there a problem?’ He chose to ignore the curious look in the charge sister’s eyes.
‘No, of course not. It’s just that…’
‘She brightens your day?’
Yes, that’s exactly right, he thought. She’s like a ray of sunshine generously shedding light and warmth wherever she goes.
‘She brightens everyone’s day,’ he conceded to say with a pleasant but what he hoped was detached smile as they reached a grizzling toddler in a cot.
‘Hello, Mrs Bryant.’ The child’s mother looked overwrought and overtired. Now was not the time to enquire how she was coping and he made a mental note to call back and see her at the end of the round.
‘Would you mind if Travis…’ he indicated one of the medical students ‘…gently examines Taylor’s tummy?’
The child had a Wilm’s tumour, a cancer arising from the kidney, and often presented as an abdominal mass. She was undernourished and being fed by a nasogastric tube in order to try and improve her general condition prior to surgery the following week.
‘All right,’ Liz Bryant said with a sigh, but she moved protectively towards her daughter and began to stroke her head.
Travis completed the examination awkwardly, one of his hands big enough to span the child’s abdomen from side to side.
‘I’d like to come back and see you later on my own,’ Richard said quietly.
She picked up her crying child and rocked Taylor in her arms. She nodded then turned her back on the group and walked to the window. Richard wished Joanna was available to comfort her and realised, after one short week back in Matilda Ward he had begun to take her bubbly, happy, caring presence for granted. He was coming to depend on her being there for her tireless ability to comfort and offer hope in the grimmest situations.
He missed her…
He wanted part of the joy she spread for himself.
‘Come on,’ he said with enthusiasm. ‘Let’s head for the tutorial room. Don’t think you can get out of it. Alan told me he’d asked one of you to prepare a case presentation.’
There was a general chuckle from the group as they followed him down the corridor and out of the ward.
* * *
Richard wasn’t like some of the other hospital consultants who would rather starve than go to the canteen, but sometimes, like this afternoon, he wanted solitude during his breaks. The couple of times he’d had lunch in the busy dining hall, hoping to see Joanna, he’d found himself bullied into sitting with a group of chattering nurses, at least one of whom would decide to flirt with him.
Not that there was anything wrong with nurses, or chattering, or flirting, but if it continued unremittingly he knew it would wear him down. If he’d been ten years younger he would have been flattered but he had matured and was past all that now.
So after the tutorial he’d headed for the public coffee shop, which he knew was
rarely frequented by staff. He needed a few minutes time-out before he went back to Matilda to tidy up loose ends and leave his work in the ward in order for the evening staff. That had always been his way of coping with the stress of never seeming to have enough time in the day—pacing himself; not succumbing to time pressure or being hurried; not leaving a job half-done, hoping others would pick up the pieces.
It was close to closing time so he wasn’t surprised to see he was the sole customer and ordered a flat white—it was the only place you could get a decent coffee in the hospital—and chose a quiet table hidden from the entrance but with a view of the passing parade going in and out of the main hospital block.
When he’d seen Joanna coming out of the nurses’ amenities building and heading his way he’d assumed she was on her way home but Marnie—the woman had introduced herself the first time he’d visited the shop—must have seen him looking at her.
She’d set his drink down and said, ‘She’s one of the few who are brave enough to go all the way.’
He hadn’t quite understood what she meant.
‘Sorry?’
‘The full shave.’
‘Oh, I see what you mean.’
‘She’ll have a cappuccino. I’ll put money on it.’
‘If she comes in and asks for one, let me buy. I work with her and I wouldn’t mind some company.’
The woman’s eyes widened fractionally and then she smiled as if they were plotting a secret revolution together.
‘Okay.’ She sashayed back to the counter.
A few seconds later Joanna did come into the shop and although Richard couldn’t see her he could hear the conversation. The muscles of his jaw tightened just a little and he unconsciously began tapping his saucer with his spoon. He seriously wanted to share a drink with Joanna, enjoy her smile and her honey-smooth voice. And if it was only work they talked about, that would be okay. He realised he’d be more than disappointed if she refused. So when Marnie started rambling on about secret admirers he felt he had to show himself. He’d set up the situation, and there was no room for second thoughts.
* * *
There were only a few kids Joanna came back to visit after-hours and she was careful not to give the impression she had any favourites. She knew how attached many of the sick and frightened children could become to a staff member who gave that little bit extra. She was lucky she had plenty to give but made sure she rationed her off-duty time and energy with care.
She couldn’t help what she felt for young Danny Sims, though. It would take a miracle to cure him; she knew from firsthand experience the odds were stacked miserably against him.
When Sam had been diagnosed with Ewing’s, Richard’s knowledge of paediatrics hadn’t been enough for her. She’d read everything she could get her hands on about the disease that had been threatening the life of her son, from scientific, evidence-based research to personal anecdotes on the internet. Even testimonials about farfetched miracle cures. She remembered one of the few times Richard had become frustrated with her emotional attempts to cling to increasingly fading hopes. He’d accused her of clutching at straws and it had probably been the first tiny step at the fork in the road—where she’d begun to reject him.
If she could turn back the clock…If she knew what she did now…
Richard had been trying to cope in his own way.
She’d seen only one case of Ewing’s since she’d been working on Matilda and the boy, a couple of years older than Sam, who had just turned six when he passed away, had miraculously survived and was in remission.
But Danny Sims’s case was different.
For a start, his chances of getting the disease in the first place were roughly the same as winning Lotto. And if you ticked the boxes of the features of the teenager’s cancer that were associated with a poor prognosis, he would probably score a six or seven out of ten.
But Joanna’s philosophy was that there was always hope, exceptions to those horribly inhuman statistics. Miracles did happen, and if they didn’t, Joanna always tried her best to make the road less bumpy for the unfortunate few in her surrogate brood.
If she couldn’t have children of her own, she’d decided, she’d devote that instinctive maternal part of herself to her job—caring for kids with cancer.
She had completed her nursing degree during her pregnancy and graduated a month before the baby was due. Then she’d put her career on hold while she’d been a full-time mum. She’d planned to go back nursing when Sam started school, but it hadn’t happened. Her son’s illness had been diagnosed when Sam had been in pre-school and he’d survived only eleven heart-breaking months.
Making the decision to go back to work had been a turning point for her once she’d managed to control her grief and had been sure Richard wasn’t coming back. It had been an easy decision to extend her nursing qualifications to include oncology. The last two years had been immensely satisfying.
And now Richard was back…well…there was no reason anything should change other than formalising their separation with a divorce.
I am a good nurse, I love the children I care for and that’s all that matters.
‘That’s all that matters,’ she repeated in a whisper to reinforce the words she’d found herself repeating several times over the weekend when troubling thoughts of her husband had kept steam-rolling into the peaceful solitude of her days off.
Thank goodness it was Monday afternoon and she’d finished her shift. She planned to call back and see Danny and Taylor as well as Raymond, a new admission who’d looked scared to death when he’d come in but she hadn’t had a chance to have a proper talk to him. Then she’d buy some take-away for dinner, head home and spend a quiet evening watching a DVD. Relaxing. Unwinding from her hectic day.
She changed into jeans and a T-shirt, slipped out of her sensible black lace-ups and into low-heeled sandals, deciding to head for the hospital shop. She might even treat herself to the luxury of a cappuccino in a real china cup before she hit the wards again. At least once a week she enjoyed checking out the magazines as well, so she knew what was stocked in-house if one of her patients who needed cheering up had a passion for soccer or horseriding or fashion. Small, personal things could make a big difference.
She breezed into the shop.
‘Hi, Jo. Love the five-o’clock-shadow look,’ Marnie, the woman in charge of the coffee shop cum newsagent cum florist said with a smile. Joanna was finally becoming used to her bald look but the comments still came in abundance, especially about the bump that at least now was reducing in size. She ran her palm across the stubble on the top of her head.
‘Like it? Maybe I’ll keep it this short. It’s certainly easy to care for.’
‘Don’t you dare. You’ve got beautiful hair. Finished for the day?’ she added.
‘Yes, thank goodness. It’s been a long one.’ She wasn’t about to tell Marnie that it was partly due to the trouble she’d had sleeping the last couple of nights.
‘We all have those but in your job you probably get more than your fair share.’
‘Mmm…’
Joanna began flipping through a magazine on home renovation. It had caught her eye because on the cover was a photo of a house that looked uncannily like the house she’d lived in with Richard and Sam; the house she’d loved and had had every intention of spending the rest of her days in.
The best-laid plans, she thought with more than a hint of world-weary cynicism.
‘There’s a special on cappuccino today.’ Joanna could tell her friend was about to come out with a friendly jibe. If the shop was empty Marnie would sometimes give her a second cup free of charge. That was usually when she couldn’t hide her tiredness or the fact she’d had a particularly difficult day. Perhaps the prison hairstyle made her look gaunt and contributed to the poor me, I need some comfort look. She hoped that she wasn’t so transparent that even Marnie could see right through her.
‘Oh, yeah?’ she said with a grin as she placed th
e glossy on the counter. ‘I’m going to treat myself. What was that about the coffee?’
‘On the house, sort of. I’ve got instructions from a secret admirer.’ The middle-aged woman giggled like a schoolgirl and Joanna wasn’t sure she’d heard correctly.
‘Pardon, what did you say?’
Marnie’s gaze fixed on something behind her and Joanna turned to see, of all people, Richard emerge from behind a large display of dried flowers. If she hadn’t been so surprised, she would have laughed. He and Marnie were looking at each other conspiratorially.
‘What’s all this about?’ Joanna asked, with a sudden urge to turn around and head out the way she’d come in.
‘I’ll leave it to the doctor to explain. Coffee for two, I presume.’
‘Thanks,’ Richard said as he led Joanne to a table by a large window at the back of the shop.
She wondered if it was more than coincidence that she kept bumping into him at every turn.
* * *
‘Richard…er…what a surprise,’ Joanna said with a twinkle of what Richard assumed was amusement in her eyes. She was definitely more relaxed than the last time he’d seen her outside the workplace.
‘Just needed a break and some real coffee for a change. I thought you’d finished for the day.’
She certainly looked different in her civvies. The clingy, watermelon-pink T-shirt, scooped low at the neckline, highlighted the delicious fact that she had generous curves but in all the right places. And she had gorgeous legs, snugly denim-clad and stretching right up to…She was as beautiful as the day he’d met her.
‘Please sit down and join me.’
‘Thanks.’
‘I thought as soon as you downed tools you’d be heading off to relax.’
A wayward hand went up in the direction of her hair. Nervous? It was the only indication she gave. He smiled.
‘Phantom hair?’ He couldn’t resist the jibe. The conversation was flowing smoothly and he didn’t want the tone to change, not just yet.
‘Pardon?’ she said, obviously not understanding his light-hearted remark.
‘You know, like a phantom leg. A person who’s had an amputation can still experience sensations like itching or pain where the limb used to be.’ He paused, waiting for a response, but her face was expressionless. ‘You have phantom hair,’ he repeated.
How To Save a Marriage in a Million Page 6