‘He’s gone home with a bug. Barb’s rearranging his clinic for this afternoon.’
Charlotte knew what that meant. They were short-staffed and she’d need to do Tim’s rounds. ‘OK. I’ve done the admission forms. Mrs Harvey was bradycardic—Dave and I think she might be hypothyroid and it hasn’t been picked up, so we’ve sent off some bloods. She didn’t respond to atropine, so I’ve put in a temporary pacing wire to get her heart back to a normal rhythm.’
‘I’ll keep an eye on her, and come and get you if there’s a problem.’
Charlotte knew that Steffie was experienced enough to spot a problem quickly, and could tell exactly when to deal with it herself and when to call one of the cardiologists. ‘Thanks, Steffie. I’ll come and see her again when my clinic’s finished, and I’ll do Tim’s round then as well. Did Barb manage to find out how Daisy’s doing?’
‘Still in Theatre.’
Charlotte winced. ‘That’s really not good. Do we know what the problem is?’
‘No, but James has a real reputation.’
Charlotte bit her lip. ‘I hope he lives up to it.’ His reputation as an excellent surgeon, she meant—not the one he had as a playboy.
‘I’m sure he will. Stop worrying, and you make sure you take a break before you go into clinic, OK? Here.’ She handed Charlotte a packet of sandwiches.
‘Thanks, you’re an angel. How much do I owe you?’
The call light flashed outside one of the rooms, and Steffie waved a dismissive hand. ‘Settle up with me later. I have to run. And make sure you take a break!’
‘Course I will,’ Charlotte fibbed, and bolted her sandwich as she checked through the list for her afternoon clinic.
Although she paid scrupulous attention to each of her patients, she looked at her pager between every appointment, just in case there was news. Nothing.
Her last patient was twelve-year-old Ellis Martyn, who was accompanied by his mother, Judy. The teachers at high school had picked up on Ellis being very short of breath in PE lessons; the GP had confirmed a heart murmur and referred him to Charlotte.
‘What you have is something called Ebstein’s anomaly,’she explained. ‘It’s quite a rare heart condition, but the important thing is that we can do something to help you.’
‘So I’m going to be really ill?’ Ellis asked.
She smiled. ‘I should jolly well hope not!’ She did a quick sketch on the pad before her. ‘See this bit here? This is the tricuspid valve. It separates the chamber of your heart that receives blood from the body and the chamber of your heart that pumps the blood to your lungs so it can be oxygenated. In your case, Ellis, the valve’s situated too low in your heart and it leaks backwards. That means some of the unoxygenated blood goes into your body instead of to your lungs—so that’s why you’re tired a lot of the time, why you get a bit short of breath and why sometimes your mouth looks a bit blue.’ Gently, she took his hand and turned it palm down. ‘See, your nail beds are a bit blue as well. When I did the test measuring the amount of oxygen in your blood, it told me the oxygen levels were too low; the X-rays told me your heart’s definitely enlarged; and the echo showed me that the valve was leaking. Now, you said your heart started racing every so often?’
The boy nodded.
‘When I hooked you up to the machine so I could see how your heart beats, the rhythm seemed fine, so I’d like you to take a portable recorder home with you and come back and see me in about a week. I’ll show you and your mum how to attach it and do the recording, and then I can see how the rhythm of your heart changes.’
‘What’s going to happen next?’ Judy asked.
‘Right now, I’m going to put Ellis on antibiotics. It’s not going to cure you,’ she warned, ‘but it should prevent you picking up an infection that’ll affect your endocardium—that’s the lining in the chambers of your heart.’
Judy was scribbling away in a notepad, and Charlotte reached over to squeeze her hand. ‘Judy, there’s a lot to take in and I appreciate you have a lot of questions. I can give you a leaflet to take away with you, and I’m also going to write you a proper letter, explaining everything, so you don’t have to worry about taking notes. It’ll be in the post first thing tomorrow morning, and I’ll send a copy to your family doctor as well. But I do think we’re looking at surgery, so I want to talk to James Alexander, our cardiac surgeon. He’ll need to repair the valve so it stops leaking and makes Ellis well again.’
Ellis looked worried. ‘Is it going to hurt?’
‘You’ll be a bit sore afterwards,’ Charlotte said gently, ‘but the important thing is that we do something to help you.’
‘How did he get it? And is he going to…?’ Judy stopped, clearly not wanting to ask the question in front of her son.
Charlotte squeezed her hand again. ‘He was born with it. In Ellis’s case, it’s relatively mild, because it wasn’t picked up before. Your new GP sent you both to see me because of Ellis’s symptoms, so my guess is that the breathlessness and blueness round his lips have got worse over the years.’ She smiled at them. ‘The good news is that if Ebstein’s isn’t diagnosed until you’re a year old, you have a good chance of having a normal life. Ellis is twelve, so he’s got an even better chance of living a completely normal life.’
‘But he’s going to have heart surgery…’
‘Open heart surgery.’ Charlotte nodded. ‘Very likely. What I’d like is for you to come back next week and talk to the surgeon with me.’
James. Gorgeous, hotshot James who hadn’t bothered telling her how her patient was. But it wasn’t the Martyns’ fault, so she wasn’t going to let them see her anger.
‘If the surgeon agrees with me that Ellis needs surgery, now’s a goodish time as Ellis is relatively well and the school holidays start very soon. If we do the op in the first week of the holidays, it’ll give him a few weeks to recover before the new term starts.’
‘What about exercise? Should he stop doing anything?’ Judy asked.
Charlotte shook her head. ‘Do what you’re comfortable with. I’d say steer clear of really intense, competitive sports, but regular, gentle exercise is good for you. Walking, swimming, cycling…’ She smiled at Ellis. ‘Provided you’re not going for the sprint record, that is!’
As soon as the clinic had finished, Charlotte went in search of Steffie. ‘Any news of Daisy?’
‘Not yet.’
Charlotte sighed. ‘Then I’ll check Mrs Harvey and do Tim’s round. I hope we’ve got cover for tomorrow.’
‘Yes—Barb’s sorted it.’
‘And let me settle up with you for that sandwich.’
Steffie rolled her eyes. ‘Charlotte, it was a sandwich, and you’ve done the same for me plenty of times. Stop fussing.’
Charlotte had finished the rounds and was going through the paperwork in her office when James turned up, carrying two paper cups of coffee with lids. She just about resisted the urge to yell at him and ask him what the hell he was playing at, not keeping her in touch with the results of Daisy’s operation; and it annoyed her that her heart gave that funny little skip as soon as her gaze meshed with his. She didn’t react to people like that. Didn’t want to react to him like that.
She took a deep breath and asked quietly, ‘Is Daisy all right?’
‘She’s fine. Here.’ He passed her one of the cups of coffee.
She took a sip. It was just how she liked it, strong with just a dash of milk. ‘Thank you,’ she said. ‘It’s the first chance I’ve had for a hot drink all day. How did you know how I take my coffee?’
‘I asked Steffie—and I owed you a coffee from yesterday, before you protest.’
‘You don’t owe me anything.’ Including, it seemed, the courtesy of letting her know how her patient was getting on.
He sighed. ‘Look, you’re the paediatric cardiologist and I’m the paediatric heart surgeon. We’re going to have to work together, whether we like it or not—and I for one would much rather have smooth wo
rking relationships. It’s better for the patients.’
Charlotte felt herself flush. ‘Rebuke accepted.’
‘It wasn’t meant to be a rebuke.’ He dragged a hand through his hair. ‘I think we’re getting off on the wrong foot.’ He frowned as she laughed. ‘What?’
‘Your hair’s all messy now.’
‘And?’
‘And I’m waiting for you to whip out the comb and the mirror.’
‘I’m not that vain. Well, not quite,’ he amended. ‘Anyway, I wanted to keep you in the loop about Daisy.’
‘Who was supposed to be out of Theatre more than four hours ago,’ she said pointedly.
‘There were complications.’
She could see shadows under his eyes, and panicked. Despite his reassurance earlier, now she wasn’t so sure. ‘What sort of complications?’
‘May I?’ James gestured to the chair by her desk.
‘Help yourself.’
He sprawled in the chair and set his coffee on her desk. ‘The op was a success, but she arrested in the middle of surgery twice—that’s why I’m late. Obviously she’s settled in ITU now and Leslie and Gary are by her bed.’
‘Thanks. I’ll go and see them. My reports can wait.’
‘Leave it a few minutes,’ he said softly. ‘She’s still sedated, and I told them we won’t be waking her up properly until tomorrow morning.’
It was standard procedure after open heart surgery. It meant that the child was on a ventilator that would breathe for her, and that reduced the work her heart had to do so she could rest properly.
‘So how’s your afternoon been?’ he asked.
‘Pretty busy,’ she admitted. ‘The emergency department needed me because Tim—he’s the other cardiac registrar—went home with a bug.’
‘So you do adults as well as children?’
‘Not usually—I do the kids and Tim does the adults. But we can cover each other’s patients, obviously, when we have to. And I do have a patient I want to talk to you about in the next few days—Ellis has Ebstein’s, and I think we’re looking at valve replacement. The ECG didn’t show any sign of tachycardia, so I’ve sent him home with a portable recorder to see what it picks up. But the results from the echo are pretty clear—the valve’s leaking. I’ve made an appointment for them to come back next week, and I think you need to be in on the consultation, as the surgeon.’
‘Sure. We’ll synchronise diaries.’
‘Thanks.’
Clearly Charlotte was very dedicated, James thought. She didn’t seem to bat an eyelid about doing a colleague’s rounds: she just got on with it. She was quiet and hard-working, so different from the women in his life—even his mother was a society sophisticate who spent her time partying and shopping. Whereas Charlotte Walker was an oasis of calm. Funny, he’d always been one for the bright lights and glitz, but right now he found himself yearning for calm. And Charlotte fascinated him because he didn’t have a clue about what made her tick. ‘What made you choose cardiology?’ he asked abruptly.
She looked surprised, but then she shrugged, as if she’d decided it wasn’t really a personal question. ‘Originally, I was going to specialise in paediatrics. While I was training we had a blue baby and lost her; it really got to me, and I ended up reading up lots on the subject. I wanted to make a difference, so I decided to go into cardiology. And I tend to work on the paediatric cases, so I get the best of both worlds.’ She paused. ‘What about you?’
James could have put some spin on it, but he knew that she’d guess straight away that he was being smooth. He didn’t want her to think him a liar, so he decided to be honest. ‘Not quite so noble, I’m afraid. For me, it was a toss-up between cardiac surgery and brain surgery, but cardiac was the more competitive discipline at the time.’
‘And you like to be seen as the best.’
He gave her what he hoped was a disarming smile. ‘Shocking, isn’t it?’
‘You’re shameless.’
‘No,’ he corrected, ‘I’m honest.’
She made a noncommittal noise. ‘Thanks for letting me know what happened. I think I’d better go up and see the Freemans now.’ She waved her hand at the papers on her desk. ‘Tonight’s post has already gone, so it doesn’t matter if I do them later tonight now. They’ll be ready for tomorrow.’
He raised an eyebrow. ‘You’ll be working late, then.’
‘I’m not going to leave my patients—or their parents—waiting for reassurance any longer than I have to. Anyway, Tim would’ve done the same for me if I’d been hit by a virus.’
‘Look, I was three hours longer in Theatre than I expected to be. I had to reschedule some appointments and I have reports to write,’he said. ‘So I’m going to be working late tonight, too. Why don’t we have dinner together?’
‘Thanks, but no.’
He stared at her. That was it? Just ‘no’? No explanation?
‘You’re already having dinner with someone tonight?’ he guessed.
She shook her head.
‘Then why won’t you have dinner with me?’
‘Because,’ she said, ‘I don’t think we’d like the same sort of places.’
‘Try me. Show me where you like to eat in St Piran.’
‘Thanks, but I’d rather not.’ Still calm, quiet, but very firm.
James couldn’t remember the last time he’d been turned down. And it stung. But there was more to it than that: since meeting Charlotte the previous day, he hadn’t been able to stop thinking about her. Right now, she was polite, sweet and super-smiley—and he had the feeling that she’d just stuck an enormous glass wall between them. And he had no idea why.
‘Would it help,’he asked, ‘if I said that I’m new around here and I’m trying very hard to make a new friend, not asking you out on a date?’
The wariness in her eyes was quickly masked. ‘A friend.’
‘Uh-huh. I’m paying, seeing as it’s my idea, but if it makes you feel better, you can pay next time.’
She was silent for so long that he thought he’d blown it. And then she nodded. ‘As friends.’
‘Good.’ He scooped his coffee cup off her desk and stood up. ‘I’ll be in my office. Come and get me when you’ve seen the Freemans.’
‘OK. And, James?’
He paused in the doorway.
This time she gave him a smile that did reach her eyes. A smile that made his heart skip a beat. ‘Thanks for the coffee.’
When Charlotte went through to Intensive Care, the Freemans both looked tired and stressed, but slightly less anxious than they’d done that morning.
She hugged both of them. ‘I’m so sorry that I didn’t come up earlier.’
‘That’s OK, we got your messages. That lovely lady told us you had to hold the fort.’ Leslie shook her head in apparent frustration. ‘Sorry, I don’t remember her name.’
‘Barbara,’ Charlotte said gently.
‘Sorry, I couldn’t think.’
‘I’m not surprised. You’ve had a hell of a day.’
Leslie was trembling. ‘To think, we almost lost her.’
Gary put his arm round his wife’s shoulders and held her close. ‘Hey, she’s a fighter, like her mum. She’s not going to give up easily and we’re definitely not giving up on her.’
They were going through such a rough time, Charlotte thought, and yet they were lucky: they still had each other. They still had a deep love between them to support them through all the worry and the waiting. The kind of love she knew that she’d never experience. Not after Michael.
She pushed the thought away. Ridiculous. She’d made her decision a long time ago and knew it was the right one. This wistfulness just wasn’t her. She was a practical, sensible cardiologist and she needed to remember that.
‘James was really good. He stayed with us for half an hour, even though he’d been concentrating on our Daisy for so long and he hadn’t had a break—he came straight out of Theatre to see us. He must have been worn out,
but he never once made us feel we were taking up his time or being a nuisance. He’s a lovely man,’ Leslie said.
Lovely, maybe. But he was also dangerous. She must’ve been mad to agree to go out with him tonight—even as friends.
‘I’ll let you get back to Daisy,’ she said. ‘I just wanted to come up and see how you were all doing. Remember you can get hold of me any time you’re worried—just tell them to bleep me. I’m taking my pager home tonight.’
‘Thank you.’ Gary hugged her.
Charlotte finished off her paperwork, then headed for James’s office. She watched him from the door for a moment; he was concentrating on his report, oblivious to her presence. Without that smile, he was still gorgeous—a fine bone structure, the longest, darkest, sexiest eyelashes she’d ever seen—and when he looked serious like that, his mouth was utterly kissable.
Having dinner with him tonight was a bad idea. Maybe she should back out, saying that she had a headache. And yet part of her wanted to know: what was James really like, behind that glossy exterior? When he’d said he could use a friend, there had been a hint of vulnerability. Something she couldn’t put her finger on, but something that she found hard to resist.
She rapped on the door, and he looked up.
‘Hi. How were the Freemans?’
‘OK. I’m taking my bleeper with me, by the way.’
‘Make that two of us,’ he said, surprising her. ‘I’m starving. Give me two seconds to save this file.’ Deftly, he tapped the keys to save his file, log off and switch off the computer.
‘So where are we going?’ James asked
‘There’s a pub ten minutes’ walk from here. They do the best lasagne in St Piran.’
‘I adore lasagne. Good. Is your car in the hospital car park?’
‘No, I walked in.’
‘So are we going in the right direction for you?’
She had a nasty feeling that he was going to offer to walk her home—and she wasn’t quite ready for that. She wasn’t really ready to go out with him tonight either. ‘It’s fine,’she said hastily.
Caroline Anderson, Anne Fraser, Kate Hardy, Margaret McDonagh Page 35