‘Oh, hell, Annie. Look at this. It’s a complete mess.’
It was. All morning she’d been hoping that Louise Harper’s PID might be confined to a small, localised area. Right up until the second when Gideon had made the incision into the girl’s stomach she’d still been hoping, but the evidence of the video camera was irrefutable. It was bad. Very bad indeed.
‘The damage to her Fallopian tubes, and that large abscess on the right side of her uterus—it’s got to have been caused by gonorrhoea or chlamydia, hasn’t it?’ she said.
He nodded. ‘Considering the pain she was experiencing when she was brought in, I’d say it was definitely caused by gonorrhoea. With a chlamydial infection there’s generally no symptoms at all. I’ll take samples to confirm it, of course, and I’d better take some to test for HIV as well.’
‘HIV?’
‘Annie, you only need to make love with one infected person to catch the disease.’
She knew that, but it would be tough enough telling Louise she had pelvic inflammatory disease. Please God, she didn’t have to tell her she was HIV positive as well.
‘Look, if she does turn out to be HIV positive, I’ll tell her,’ Gideon continued as though he’d read her mind, but she shook her head.
‘I’ll do it. I was the one who talked her into having the laparoscopy, remember?’ she said quickly as he opened his mouth to protest. ‘And I don’t want her thinking I was too chicken to give her the bad news.’
‘Chicken’ was the last word he’d use to describe Annie Hart, Gideon thought as he drained the abscess in Louise’s uterus, then began taking samples from the girl’s damaged Fallopian tubes. She was gutsy, and pretty, and a total idiot where men were concerned if Jamie’s father was anything to go by.
Lord, but he’d felt such an idiot when he’d stood in her sitting room, clutching those damn flowers, which he’d known had been a mistake. Then he’d been pleased. Of course he had. OK—all right—so maybe initially his heart had contracted in a most puzzling way, but he’d been pleased to discover that she wasn’t all alone in the world, that she had somebody to take care of her.
But the more he’d thought about it, the angrier he’d become.
What sort of man allowed the woman he loved—not to mention his own son—to live in a dark, depressing flat where she was constantly harassed by her landlady? What sort of man never offered to help her with her shopping but expected her to drag it home by herself?
It was obvious the man was a jerk. And not just a jerk, but a married jerk, too, he thought grimly, or why else had Annie reacted so furiously when she’d thought he was married?
It’s none of your business, his mind whispered. Women are fools all the time where men are concerned, so it’s none of your business. All you can do is be her friend. Be there if she ever needs help, but otherwise keep out of her life.
Which was what he fully intended doing, so why was he having such trouble forgetting the tantalising glimpse he’d had of a pair of lush, creamy breasts encased in a plain white bra? Why did he suddenly have such an overwhelming desire to go out and punch something, or someone?
‘Louise won’t ever be able to get pregnant without undergoing IVF treatment, will she?’
Annie’s blue eyes were fixed on him above her mask, clearly hoping he would deny it, but he couldn’t.
‘It’s highly unlikely,’ he admitted. ‘And even with IVF, a woman with a history of PID is ten times more likely to have an ectopic pregnancy.’
‘Because her Fallopian tubes are so badly damaged?’
He nodded. ‘The fertilised egg can’t pass into the uterus to grow. Instead, it attaches itself to the Fallopian tube, and because it can’t grow there the pregnancy can be life-threatening to the mother as well as almost always fatal to the foetus.’
She sighed. ‘Poor Louise.’
‘In a sense she’s one of the lucky ones,’ he commented, sliding the samples he’d taken into sterile dishes and sealing them. ‘At least we’ve discovered she’s got it, and can start treating her.’
Annie doubted very much whether Louise would consider herself lucky as she watched Gideon remove the laparoscopy tube, then insert a few stitches into the incision he’d made. In fact, Louise was undoubtedly going to be devastated.
‘I’ll finish up here,’ Gideon said suddenly. ‘It’s well past one o’clock. Get yourself down to the canteen and have something to eat.’
‘I don’t mind waiting.’
He shook his head. ‘I’ll manage fine, and you look worn out.’
He looked worse, she thought, but the last thing he needed was her arguing with him, so reluctantly she left the theatre, changed out of her scrubs and made her way downstairs. Not to the canteen—she had no appetite for food—but into the staffroom instead.
‘You’re back late from Theatre,’ Rachel Dunwoody said, glancing up at her entrance.
She made it sound like an accusation. Actually, everything that Woody said to her sounded like an accusation. Helen had said it was just the specialist registrar’s manner, but it still set Annie’s teeth on edge.
‘There was a slight hold-up,’ she replied as evenly as she could. ‘Tom had to shoot off because of an emergency, and it took time for Gideon to scrub up.’
‘I heard about the woman he was operating on—the driver involved in the M8 pile-up,’ Woody said. ‘It was unfortunate.’
‘Unfortunate’ wasn’t the word Annie would have used but she let it pass. ‘Do you know anything about the emergency Tom had to go to?’ she said instead.
‘A major placenta praevia with vaginal bleeding.’
‘Is the patient all right—and the baby?’ Annie asked, concerned.
‘She was thirty-eight weeks pregnant so Tom delivered by Caesarean section. Mother and baby are fine, as far as I know.’
The information didn’t appear to give Rachel much pleasure. In fact, she looked depressed. Thinner too, if that was possible, with dark shadows under her eyes. If it had been Helen or Liz, Annie would immediately have asked what was wrong, but the specialist registrar wasn’t the kind of woman who invited confidences. She wasn’t the kind of woman who invited conversation, full stop, and it was a guilty relief to Annie when she finally left.
Her relief, however, was short-lived. Just when she was trying to make up her mind whether to make herself a piece of toast or not, Liz appeared, looking worried.
‘Annie, sorry to interrupt your break, but Kay Wilson hasn’t eaten any of her lunch, and she says she’s not hungry.’
Annie’s eyebrows shot up. ‘Not hungry?’
‘That’s what I thought,’ Liz said with an uncertain laugh. ‘I mean, normally Kay considers anything less than half a haunch of lamb for lunch a mere snack, but today…’
‘Did she eat any breakfast?’ Annie asked, putting down her mug.
The sister shook her head. ‘She said she felt a bit queasy, but that could be because of the chicken curry her husband smuggled in to her last night.’
‘He smuggled a chicken curry into the ward?’ Annie said in disbelief as she followed Liz out of the staffroom.
‘I know.’ Liz chuckled. ‘You’d think the idiot would have realised the smell would carry, wouldn’t you?’
A bubble of laughter sprang to Annie’s lips. At the Manchester Infirmary it had been quite common for husbands and partners to smuggle in fish and chips in for their loved ones, but a chicken curry?
‘What’s this I hear about you refusing our superb hospital food?’ she asked as Liz closed the curtains round Kay’s bed.
The young woman managed a weak smile. ‘I don’t seem to feel very hungry today, Doctor.’
‘Nothing to do with the chicken curry you had last night, I suppose?’ Annie observed, her eyes dancing.
‘No—at least I don’t think so. I just, well, I just don’t feel very great somehow.’
That was unusual, too. Kay had been the life and soul of the ward since she’d had her baby. In fact, it had
been virtually impossible to get her to rest when it had finally been confirmed that the high levels of sugar present in her urine during her pregnancy had been caused by her fluctuating hormone levels and not because she’d developed diabetes.
‘I’d like to take a quick look at you, Kay,’ she said.
‘Must you?’ the girl protested. ‘I’m fine. Just a bit itchy down below.’
‘Itchy?’ Annie repeated. ‘What sort of itchy?’
‘How many kinds of itchy are there?’ Kay said irritably. ‘I’m just itchy, and my legs—my legs feel like lead weights.’
Annie nodded to Liz but when the sister swiftly pulled down the bedclothes and rolled up Kay’s nightdress it was all Annie could do not to gasp out loud. Kay’s breasts were red and inflamed, and so was her vagina.
Puerperal fever. It was rare—very rare in Western countries—but it did happen. A mother who had experienced a long labour and lost a lot of blood, as Kay had done during her son’s birth, had a greatly reduced defence mechanism. Any raw surfaces provided easy access to micro-organisms, and especially to the bacterium streptococcus haemolyticus.
‘I’m afraid I need to take some more blood samples and swabs from you, Kay,’ she declared with a calmness she was very far from feeling.
‘Doctor, I already feel like a pin cushion after all those samples you took when my baby was born,’ Kay exclaimed.
‘Hopefully, these will be the last,’ Annie said soothingly, ‘and I’ll be as fast as I can, I promise.’
She just prayed the lab would be as quick to test them. If Kay did have puerperal fever they had to get on top of it immediately. Left unchecked it could spread to the surrounding lymph ducts and veins, causing abscesses, peritonitis, deep-vein thrombosis and even septicaemia.
‘Well spotted,’ Gideon commented, when Kay’s blood results came back from the lab confirming Annie’s diagnosis. ‘Puerperal fever’s not the kind of thing most doctors expect to come across nowadays in Britain.’
‘I can’t take any credit,’ Annie replied, embarrassed by his praise. ‘It was Liz who noticed she wasn’t eating.’
‘Yes, but you had the foresight to immediately send off blood samples, thereby saving valuable time. We’ve got a blood transfusion started, and an IV line of penicillin, so with luck we should be able to knock it on the head before it has a chance to spread. And speaking of samples,’ he continued as they walked down the ward together, ‘Louise’s results are back from the lab.’
‘And?’ she asked, not really wanting to know.
‘The good news is she tested negative for HIV. The bad news is the damage to her Fallopian tubes was definitely caused by gonorrhoea. We need to get her started immediately on intravenous antibiotics—at least two different kinds to really give this thing a double whammy.’
‘What about her boyfriend?’ she said, her heart sinking. ‘He’s going to need treatment, too, isn’t he?’
‘As will her previous boyfriend. Look, I’ll speak to her, Annie,’ he continued, clearly sensing her dismay. ‘It’s too much to expect—’
‘I said I’d tell her, and I will,’ she interrupted, but her talk with Louise turned out to be one of the worst forty-five minutes of Annie’s medical career.
‘Nothing I said made it any better—nothing I said helped,’ she sadly told Gideon in his room later.
‘I don’t believe that for a minute,’ he protested. ‘I’ve seen you with patients, and you’re good.’
‘But she’s still got PID,’ she murmured, and he sighed.
‘Annie, we’re not magicians, or gods. We can’t wave a magic wand and make everybody better, or eradicate the need to break unwelcome news. At least we can treat Louise—cure her infection. OK, so her Fallopian tubes are badly damaged, but she’s still alive, she has a future, and it was your powers of persuasion which gave her that.’
‘I…I guess so,’ she said, clearly unconvinced, and he smiled.
‘You’re just like my wife. She wanted to cure the whole world, too.’
What could she say? ‘I’m sorry she died’ sounded so inadequate, but to say nothing…
‘She sounds like she was a very nice lady,’ she said hesitantly.
‘Yes. Yes, she was.’ He picked up a file from his desk, then put it down again. ‘Susan didn’t get the chance you’ve given Louise. I didn’t know she had ovarian cancer until it was too late, you see. It was ironic, really. I got promoted to consultant just after we were married, and yet I didn’t know.’
‘Nobody could have,’ she exclaimed, seeing the pain and heartache in his face. ‘Ovarian cancer—it’s such a horrible, insidious disease, with so few symptoms…’
‘I know.’ His face tightened. ‘I know, but…it doesn’t help.’
‘Gideon—’
‘Good heavens, is it four o’clock already?’ he exclaimed with a forced brightness that tugged at her heart. ‘You’d better get your skates on or Jamie will think you’re lost.’
He was right—Jamie would—but she didn’t want to leave him like this, looking so lost, suddenly so very lonely.
‘I’m not in any great rush,’ she lied. ‘Especially when Mrs Patterson will undoubtedly be waiting for me with her latest list of complaints.’
‘Would you like me to talk to her again—more tactfully this time?’ he offered. ‘Or how about if I ask around the hospital—see if anybody on the staff has a flat to rent?’
She shook her head. ‘I’m afraid Jamie would be noisy wherever we lived. What he really needs is to get out more, to run off some of his high spirits.’
‘Why don’t you take him to the Botanic Gardens?’ he suggested. ‘There’s long walks, short walks…’
‘I know. I used to take him there a lot in his pram when I lived in Hyndland, but it’s too far to walk from Thornton Street, and the buses are a nightmare.’
‘Couldn’t David…?’ Gideon gritted his teeth. Lord, simply saying the man’s name was enough to make him angry, but he was going to be calm if it killed him. ‘Couldn’t he drive you to the park?’
‘He takes us out as often as he can, but he’s really busy right now, and I don’t like to impose on him when he’s got his own life to lead,’ she said without thinking.
Heaven give me strength, Gideon thought furiously. So David has his own life to lead, has he? Was Annie terminally stupid, or just so much in love that she couldn’t see the jerk was using her?
‘What sort of work keeps him so busy?’ he demanded.
‘He’s a specialist registrar in obs and gynae at the Merkland Memorial.’
An obs and gynae specialist registrar who had clearly never heard of condoms or responsibility, Gideon thought savagely.
Well, he was not going to lose his temper. He was not going to tell her she was a fool, but he was going to say something whether she liked it or not.
‘I’d have thought even a busy specialist registrar could have spared the odd afternoon to take his son to the park.’
A slow flush of uncomfortable colour spread across Annie’s cheeks. For a second she’d forgotten that Gideon thought David was Jamie’s father. Well, she had two choices. She could tell him the truth or she could allow him to go on believing the lie.
It’s better if he believes the lie, a part of her insisted. It’s safer, remember?
Yes, but it wasn’t better. One lie would become another, then another, and this was a nice man, a genuine man. To lie to him would be unforgivable.
‘David…’ She cleared her throat. ‘David isn’t Jamie’s father. He’s my brother.’
‘Your brother?’ he echoed faintly.
‘Didn’t I introduce him when you came round?’ she said brightly, praying she wouldn’t be struck down for the lie. ‘I thought I did.’
‘No—no, you didn’t.’
He looked slightly dazed, but at least he didn’t look quite so depressed any more, and she reached for her handbag. ‘I’d better be going.’
‘I could take Jamie to the Bot
anic Gardens. No, listen,’ Gideon continued, when she stared at him, open-mouthed. ‘We’re both off duty tomorrow so why couldn’t we all go then?’
He couldn’t be serious—he couldn’t possibly be serious—but it seemed he was.
‘No—really,’ she floundered. ‘I couldn’t ask you to do that.’
‘You didn’t. I’m volunteering.’
‘But…but what if you’re needed at the hospital?’ she said, clutching at straws.
‘Annie, even consultants are allowed days off, but if it will set your mind at rest I’ll take my bleeper with me so if there’s a sudden mass outbreak of obstetric or gynaecological emergencies the hospital can contact me.’
‘It could rain—or snow,’ she offered as a last-ditch stand.
‘Then we’ll take him to the Burrell Collection and he can run up and down until we’re thrown out for creating a disturbance. Annie, quit with the “what ifs”, and just give me a simple yes or no, OK?’
Jamie would love it—she knew he would. The trouble was, she would like it as well, which gave her a very good reason to say no.
But why should she say no? All right, so she’d vowed never to get involved with a man again, but going to the park with Gideon wasn’t getting involved.
It depends on what it leads to, her mind whispered, and a disconcerting shiver ran down her spine.
‘Annie, if you’re worried about upsetting me or hurting my feelings by saying no, there’s no need.’
She glanced up at him. He was expecting her to refuse. He looked tired, and resigned, and just a little sad, and suddenly she knew she didn’t want to refuse.
‘We’d love to come.’
‘Y-you would?’
An involuntary chuckle broke from her at his stunned expression. ‘You can take back your invitation if you want to.’
‘Of course I don’t want to. I just—I mean, I didn’t…’ A broad smile lit up his face. ‘That’s great. Really great. I’ll pick you up at ten-thirty tomorrow, then, shall I? We don’t want to get to the gardens too late—not with there being so little daylight at this time of year. And why don’t we have lunch in one of the cafés near the park afterwards? I’m sure Jamie would love it, and then after lunch…’
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