‘X-rays are up,’ the radiographer called and he went to take a look, frowning when he discovered that the patient’s sternum was fractured in two places, at the manubrium—the top triangle-shaped portion—where it joined the body of the sternum, and close to the xiphoid process—the small leaf-shaped bit at the very bottom.
‘No wonder he’s having problems breathing,’ he said, calling Claire over and pointing to the screen. ‘The joint between the manubrium and the body of the sternum—it’s called a symphysis joint,’ he added for her benefit, ‘has been damaged. That means there’s reduced flexibility during breathing.’
‘The heart may have been damaged if the sternum is broken,’ Claire suggested tentatively.
‘It could indeed. Well done for remembering that,’ Ben praised her, pleased to see that she was getting into her stride. He pointed to the screen again. ‘Fortunately that doesn’t appear to have happened in this instance, although undoubtedly there’s been severe bruising caused to the heart. In this type of accident the heart gets squashed between the sternum and the spine. It often ruptures, which is immediately fatal, of course. This chap’s been lucky, but the severity of the bruising could be a major factor that determines his recovery. We’ll finish stabilising him and leave it to the cardiac team to decide how to proceed.’
Claire went back to her post while Ben made a thorough check on their patient. There were no other major injuries apart from the ones he had noted so once the cardiac reg arrived, he handed over the driver.
Zoë was still working with Sam and he went across to see if they needed a hand, trying to still the noisy beat of his heart when Zoë looked at him with worried grey eyes.
‘Are you OK?’ she said, and he nodded.
‘Yep. I got caught up in an accident on the Motorway—the guy we’ve just sent to the cardio unit was driving the lorry that tried to demolish my car,’ he explained, trying to make light of it. It didn’t work because she blanched and he cursed himself for telling her too much.
‘I’m fine,’ he assured her. ‘Take no notice of the state of my clothes—I must have bumped my nose and that accounts for the blood. It’s certainly tender.’
He gingerly felt his nose, hoping to allay her fears. Zoë gave him a quick smile. ‘You were lucky.’
‘I was.’ Ben felt his heart race when he saw the relief in her eyes. It was obvious that she had been worried about him and the thought made him want to punch the air for joy before it struck him that it didn’t mean anything. She would probably have been equally concerned about any of their colleagues.
It was a depressing thought for some reason. Fortunately, Sam Kearney chipped in just then and Ben didn’t have time to dwell on it.
‘I wouldn’t mind another opinion, Ben. Have a listen to this little one’s chest, will you?’ Sam glanced at the little girl. ‘She was in a house fire—chip pan caught fire but Dad managed to put it out while Mum got the kids out of the house. The other two children are fine but this little lady is having problems with her oxygen levels. Her sats are way too low and we can’t seem to get them up.’
Ben took the stethoscope Sam offered him and smiled at the little girl. ‘Hi. I’m just going to listen to your chest, sweetheart. Is that OK?’
She nodded her head then lay perfectly still while he listened to her chest, back and front, and examined her throat. ‘There’s no sign of swelling to the tissues in the throat,’ he observed, looking up.
‘According to the mother, the children were in the front room and there was very little smoke in there,’ Zoë explained.
Ben nodded, determined to stick to what was important at the moment, the child’s well-being. He would worry about why he had felt so depressed at the thought of Zoë treating him the same as any other colleague later. ‘So it’s doubtful if the amount of smoke she inhaled has caused a problem with her breathing. Any history of asthma?’
‘No. That was one of the first things we checked with the parents when she was admitted,’ Zoë replied.
‘In that case, I’d say it needs further investigation,’ Ben concluded. ‘Sorry I can’t be more help.’
‘Not to worry. We’ll just have to try a different line of enquiry, won’t we, Zoë?’ Sam turned to Zoë, who shrugged.
‘Looks like it. Hopefully, we’ll learn more when the results of the bloods come back, although I’m pretty sure there’s something else going on.’
‘It sounds as though you’ve got everything covered,’ Ben said lightly, handing back the stethoscope. ‘In which case, I’ll leave you to it. I’ll see you later,’ he added, glancing at Zoë, and was surprised when he saw her colour.
‘Yes.’ She didn’t say anything else and Ben was left with the distinct impression that he’d said something wrong, although he had no idea what…
He groaned as he left Resus. Zoë probably hadn’t wanted anyone to know that she was staying with him and now he’d let the cat out of the bag, although how she’d hoped to keep it a secret, he had no idea. Although personal data was supposed to be confidential, someone would have found out that they were living at the same address. Then there was the fact that they’d been seen together in the oncology unit that morning—people would soon know about that too.
He frowned. This was something they hadn’t considered: what were they going to tell everyone about Zoë’s illness and the baby? It all depended how much she wanted people to know. One thing was certain, though, they needed to present a united front if they hoped to avoid a lot of unsavoury gossip. People would think it was very strange when they discovered that he and Zoë were having a baby, yet weren’t really a couple, so they would have to gloss over the facts.
His heart sank. He hated to think that he might have to lie to the people he worked with, yet it could come down to that. He was merely acting as a back-up in case things went wrong, but in no way did Zoë want to be with him on a permanent basis.
Pain speared through him and he grimaced. It still hurt to know how she felt and it was pointless denying it. He had loved her so much but she hadn’t wanted him or his love. It was only in fairy-tales that the couple rode off into the sunset and lived happily ever after. Real life was far more complicated. Now all he wanted was to be allowed to help her and their baby. Maybe it wasn’t much compared to what he had dreamed about once, but it was enough. He didn’t intend to risk his heart all over again.
CHAPTER NINE
THE results of the blood tests arrived shortly before Zoë was due to leave work. Sam called her over and they went into the office to read them. Zoë’s heart sank because, according to the data they’d received, little Bethany Morris had a worryingly high white-cell count. There were also blast cells—immature blood cells—present in her blood.
Sam shook his head. ‘I don’t like the look of this. If I had to lay odds on it, I’d bet that Bethany has leukaemia.’
‘It certainly looks that way from these figures. It would also account for her low oxygen levels and fatigue, wouldn’t it?’ Zoë sighed. ‘The white cells are invading her body and there’s not enough red blood cells to carry oxygen from her lungs.’
‘I wonder if the parents have noticed anything unusual. There are usually other symptoms—headaches, joint pains, tenderness, etcetera.’
‘We’d better ask them. We’ll also check if there’s any sign of swelling in the lymph nodes. That would be a good indication that we’re on the right track.’
‘It would.’ Sam grimaced. ‘We were so sure that Bethany’s symptoms were the result of smoke inhalation, we didn’t explore any other options.’ He glanced at his watch. ‘You’re due to finish soon, aren’t you? I can deal with this if you want to get off.’
He didn’t say it but Zoë knew he was remembering that comment Ben had made about seeing her later. Although she didn’t want to advertise what was going on, she liked Sam and knew it would easier if he had some idea of the situation.
‘Ben knows where I am.’ She shrugged. ‘I’m staying with him at the
moment.’
‘Easier than having to find a place of your own when you’ve just got back from France,’ Sam replied evenly and she decided to leave it at that. She would tell him the rest if and when she needed to.
She sighed as they left the office. It wasn’t a case of if but when surely? There was no way that she could hide her pregnancy and no way that she wouldn’t start to show the effects of the chemotherapy either. At some point everyone would need to know and she had to decide what she was going to tell them.
It was worrying to wonder what people would think when they found out that she and Ben were having a baby, but she put it aside while they went to speak to Bethany’s parents. Mr and Mrs Morris were sitting with their daughter in one of the cubicles and they both looked up when she and Sam went in.
‘Sorry about the delay but we wanted to see the results of the blood tests,’ Sam explained.
‘She seems a bit better now, Doctor,’ Alison Morris said hopefully.
‘That’s good.’ Zoë smiled at the couple, wishing they didn’t have to turn their world inside out. If she and Sam were correct in their suspicions, this would be just the start for the family and there would be far worse times to come.
The memory of her own shock at being told she had cancer helped her understand how distraught the parents were going to be. Zoë chose her words with care. ‘Bethany’s blood test results aren’t quite what we expected. Can you tell us how she’s been lately? Has she been her usual self or have you noticed any changes in her?’
‘I’m not sure,’ Alison said uncertainly. ‘She’s seemed a little more tired than normal, but I put that down to the fact that she had that tummy bug at Christmas. We all had it, in fact. It was awful!’
‘There’s been a lot of it around,’ Sam said evenly. ‘Apart from that, have you noticed anything else? Has Bethany complained that her legs ache, for instance, or does she seem to be getting a lot more bruises?’
‘Why, yes!’ Alison Morris exclaimed. ‘Only this morning she started crying as we were walking to school, said that her legs hurt and she couldn’t walk any further. It ended up with me carrying her.’
‘And she did have a couple of nasty bruises on her shins last week,’ Steve Morris put in. ‘I noticed them when I was giving her a bath and asked her how she’d got them but she didn’t know.’ He glanced at his wife. ‘She’s also complained of having a headache a few times too.’
‘That’s right, she has.’ Alison was looking really upset now. ‘What’s this all about, Doctor? Are you saying there’s something seriously wrong with our Beth?’
‘We think there’s a possibility,’ Zoë said quietly. ‘However, Bethany will need to undergo some more tests before we can be sure.’
‘Tests? What sort of tests?’ Alison demanded, clutching Bethany’s hand tightly.
‘More blood tests and possibly a bone-marrow biopsy as well,’ Sam explained gently.
‘Bone marrow!’ Steve blanched. ‘They do that with those poor little kiddies who have leukaemia. Is that what you think is wrong with Beth?’
Both parents were becoming increasingly agitated and it was upsetting Bethany. Zoë glanced pointedly towards the cubicle entrance and Sam nodded.
‘Why don’t we go to the relatives’ room while we discuss this?’ he suggested. ‘You’ll stay here with Bethany, won’t you, Dr Frost?’
‘Of course.’ Zoë sat down beside the bed after the parents reluctantly allowed themselves to be ushered away. Picking up a book that one of the nurses had left on the trolley, she smiled at the little girl. ‘Shall I read you a story until your mummy and daddy come back?’
She had just finished when Sam returned with the child’s parents, who looked grey with worry. It was a relief when Sam quietly told her he could manage and that she was to go home. Zoë fetched her coat, deciding that she would take a taxi rather than wait for a bus. She hadn’t realised how exhausting it would be to deal with such a highly emotive case and she felt completely drained. Ben was listening to some music when she let herself in and he turned down the sound when he heard her footsteps crossing the hall.
‘Hi! You’re late. Did you get held up?’
‘Yes.’ Zoë didn’t bother to remove her coat as she sank down on the nearest seat. Tipping back her head, she closed her eyes as exhaustion washed over her. She heard Ben get up but couldn’t muster enough energy to wonder what he was doing.
‘Here you go. I made you some supper.’ There was the rattle of cutlery as he placed a tray on a table and moved it closer to the chair. Zoë managed to prise one eyelid open a fraction and saw him smile at her. ‘It’s nothing much, just soup and a sandwich.’
‘It’s lovely. Thank you.’
Zoë felt her eyes well with tears as she looked at the tray. There was a steaming bowl of vegetable soup and a roast beef sandwich to go with it. There was even a napkin, only paper, but that didn’t matter. It was the fact that Ben had taken the trouble to prepare it for her that counted.
‘I know my cookery skills aren’t exactly cordon bleu level but I don’t usually reduce people to tears,’ he teased her and she found herself smiling and sniffing at the same time. Picking up the spoon, he placed it in her hand. ‘Go on, be brave and risk a mouthful.’ His voice dropped to the level of a stage whisper. ‘I didn’t actually make it. I just opened the can.’
Zoë dipped the spoon into the bowl and scooped up a mouthful. ‘It’s delicious.’
‘Phew!’ He pretended to wipe sweat from his brow. ‘Worth slaving over a hot can opener.’
He went back to his seat, leaving her to eat her supper in peace. Zoë felt a lump come to her throat and forced it down as she bit into the sandwich. She didn’t deserve to be spoilt like this when she had done nothing to deserve it. She had caused him so much pain yet he treated her with such kindness. Would he have behaved this way if she hadn’t been pregnant with his child? she wondered suddenly. She knew how Ben felt about children, that he adored them, and it could explain why he was so eager to lavish attention on her.
The thought took away some of her pleasure but she made herself finish every scrap of her supper for the baby’s sake. ‘That was lovely,’ she said finally, pushing the tray aside. ‘Thank you.’
‘You’re welcome. Do you want a coffee? Or tea, perhaps?’ Ben half rose but she waved him back to his seat.
‘No, I’ve had more than enough. It was really good of you to make it for me, but I don’t expect you to wait on me, Ben.’
‘I just thought you might need a bit of an energy boost. It’s been an eventful day, one way and another.’
‘It has.’ Zoë bit her lip as she recalled the shock she’d had when she’d seen him in Resus, looking all bloodied and battered. ‘You gave me a real scare when I saw you in Resus tonight,’ she blurted out.
‘Sorry. I hadn’t realised what a state I was in, although I got off pretty lightly all things considered.’
‘You did.’ Zoë shivered as she thought about what could have happened. She had no idea what she would do if she lost Ben. She drew herself up short, knowing how dangerous it was to think like that. She’d sworn she would get through the next few months by relying on herself and that’s what she must do.
‘It wasn’t only that which upset you, was it, Zoë?’
Ben’s tone was level enough, but her heart jerked painfully. He had always been very astute so had he realised that she’d been upset by the thought that his desire to take care of her stemmed from concern for their baby? Maybe it was silly to let it bother her, but she couldn’t help wishing that he would put her first.
‘You’re right, it wasn’t,’ she said hurriedly, wanting to dispel the idea as fast as she could. There was no future for her and Ben other than that of parents. ‘It was that case we discussed with you, little Bethany Morris.’
‘You got the results of the blood tests?’ he said, apparently accepting her explanation.
‘We did.’ Zoë breathed easier, relieved that she’d got aw
ay with it. She didn’t want Ben to think that she cared how he felt about her—that wouldn’t be fair. She should just be glad that he felt so strongly about their child that he was prepared to do everything it took to protect it. ‘They showed an excessive amount of white blood cells, roughly thirty times the normal level. There was also a significant number of blast cells present.’
‘You’re thinking it could be acute lymphoblastic leukaemia?’
‘It points that way, doesn’t it?’
‘Sadly, yes, it does. It tends to occur in kids of Bethany’s age, too. It’s far more common in the fives and under than in any other age group.’ He sighed. ‘I expect the parents were gutted when you told them.’
‘They were.’ She could feel all the emotions welling up inside her again as she recalled the parents’ distress, and stood up. ‘Anyway, enough about work. I’ll take these through to the kitchen and wash them before I go to bed.’
‘Put them in the dishwasher,’ Ben told her, standing up to open the door. He followed her into the kitchen, leaning against the doorjamb as he watched her stack the crockery in the machine. ‘Are you OK, Zoë? A case like that is bound to have hit you hard.’
‘I’m fine.’ She straightened up and shrugged. ‘I can’t allow myself to go to pieces over every patient I treat.’
‘No-o-o…’
The scepticism in his voice made her bristle. She didn’t want his pity—it was the last thing she needed. ‘I said I’m fine, Ben.’
‘Of course.’
He stepped aside to let her pass and if she hadn’t known him so well she’d have thought he believed her. However, one glance at his face was enough to tell her differently. Zoë chose to ignore it rather than get into an argument that neither of them could win. ‘I’ll get off to bed, then.’
‘Before you go we need to decide what we’re going to tell everyone.’
‘About what?’ she asked, pausing.
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