Deftly, she started applying elastic bandages over the dressing. ‘Tell Vittoria it’s not meant to hurt—if she feels any pain, I need to know right now because it means the compression’s too tight and it will affect her circulation.’
‘She says it’s fine,’ Orlando translated.
‘Good.’ She pursed her lips in frustration. ‘I hate having to ask you to speak for me. It’s wrong. I should be able to talk to my patient myself. Reassure her, listen to her, answer any questions she might have and second-guess what she’s not asking me.’
Orlando smiled at her. ‘You’re a good doctor, Eleanor.’
‘Not right now, I’m not. Can you tell Vittoria that she’ll feel more pressure at the ankle and less towards the knee? And explain that this is to help counteract the raised pressure in the leg veins.’ The pressure that had caused the problem in the first place.
When she’d put the third layer of bandages on, she checked that Vittoria could still move her ankle around. ‘Più dolore, um, pede?’ she said to Vittoria, pointing to her foot, and mimed telephoning before pointing to herself.
‘Piede,’ Vittoria corrected with a smile, patting her hand. ‘Bene.’
‘Febbre? Eleanor said, remembering what Orlando had said about Jed’s sunstroke, and mimed the phone again.
Vittoria laughed, and said something to Orlando.
‘She says you’re stubborn. And she likes the fact you’re trying to speak Italian,’ he informed Eleanor.
‘Just confirm that if it starts to hurt more, or her foot feels hotter or colder or changes colour, she needs to call me straight away. I mean, call you,’ she amended.
‘Us,’ Orlando said, ‘and we will check her foot.’ He quickly gave Vittoria Eleanor’s instructions.
‘And in the meantime, there’s an exercise she can do sitting down.’ She sat next to Vittoria and moved her foot in a circle, then up and down, then pointed to Vittoria. ‘E lei?’
Once she’d checked that Vittoria could do the exercise, she smiled. ‘Una volta, due, ora?’
Vittoria nodded, held up one finger and then a second, then mimed the minute hand going round her watch once.
Do it once or twice an hour. Exactly. ‘Bene,’ Eleanor said, smiling.
Vittoria said something to Orlando, who nodded. ‘She says you’ll do,’ he told Eleanor. ‘You’ll do just fine.’ And something in his eyes told her that he agreed.
CHAPTER SEVEN
ELEANOR rang her boss in England the next morning to see if she could arrange a sabbatical. When she’d explained the situation with Bartolomeo, Ian said immediately, ‘Take as much time as you need. We can get locum cover for you here.’ ‘I feel as if I’m letting you down.’
‘No, you’re not. The last year’s been pretty rough for you, and you’re a marvel to have got through it as well as you have. Now you’ve got a chance to meet the family you never even knew existed, I think you should go for it. Spend some time with them.’
‘There’s a bit more to it than that,’ she admitted. ‘I’ve, um, had the offer of working over here. Temporarily.’ ‘And you want to do it?’
‘Yes. So I’d better give you my resignation, hadn’t I?’ ‘Not necessarily. You’re a good registrar and we don’t want to lose you,’ Ian said. ‘Anyway, working abroad would be good experience for you. Call it job enrichment, if you like. I’ll sort out the admin side this end. If you need a reference, just let me know.’
Tears pricked her eyelids. ‘I really appreciate this, Ian.’ Especially the feeling that she belonged somewhere. That they’d keep her place open for her. Maybe her thoughts about leaving emergency medicine were just a knee-jerk reaction to the fact she missed her family. And maybe working in family medicine for a while would make her realise how much she loved her real job.
She heard the faint sound of a bleep on the other end of the phone. ‘Ah, I’m needed in Resus. Gotta go. You take care, Ellie. Ring me if you need anything,’ Ian said. ‘And stay in touch. Let us know how you’re getting on and when you’re ready to come home.’
‘Thanks, Ian.’
So now she could stay in Italy as long as she liked. Instead of the three weeks she’d planned, it could be the whole summer. Getting to know her father. Getting to know Orlando.
Even at her lowest point, she’d believed there would eventually be light at the end of the tunnel. Right now, it was blazing away like the Mediterranean sun itself.
For the next week, Eleanor spent her afternoons getting to know her father and her mornings shadowing Orlando in the surgery. The rest of the practice seemed to accept her as part of the team immediately: Serafina roped her in to help with the minor injuries clinic; Alessandro and Giacomo quizzed her about the way things were run in England and asked her opinion about setting up specialist clinics for their diabetic patients; Orlando talked about the possibility of setting up an expat clinic; and Chiara took Eleanor under her wing, making coffee exactly how Eleanor liked it without having to ask.
It was strange how she felt so at home in Naples—and so quickly.
And the more time she spent with Orlando, the more she liked him. He was funny, he was clever, and he cared.
But since that kiss in the surgery he’d kept an emotional distance between them. As if he was running scared.
She met Bartolomeo on the Friday for lunch in the city after the morning surgery ended, then spent the afternoon with him poring over his old family photographs, Bartolomeo explained who everyone was and told her little anecdotes that made her laugh. He also had some old ciné film that he’d had transferred to DVD format, and she had to swallow hard as she saw her mother at the age of twenty-one. Constance looked so beautiful, so vibrant.
‘If only,’ Eleanor said wistfully, ‘the film had sound—so I could have heard Mum’s voice just once more.’
‘I know. It makes me feel that way, too,’ Bartolomeo said, squeezing her hand. ‘It reminds me of all the opportunities I missed. But I’m glad she had a happy life. I would have hated my Costanza to be sad.’
‘Would you …? Could I, please, have a copy of the disc?’ she asked. ‘I’m more than happy to pay for it.’
‘It will be my pleasure. And there’s no need to pay. I can do it for you myself.’ He smiled at her. ‘In fact, I can do it today. And this evening I will scan in the photographs for you and make you a CD of the stills.’ He forestalled her protest with a lifted finger. ‘It will amuse me to do it. And what’s the point of having good computer equipment if you don’t use it?’
Later that afternoon, when they were sitting on his terrace with coffee and pastries, Eleanor decided to tackle him about his health. Find out the truth. She’d hoped to be able to piece it together from the little bits she’d managed to get him to admit, but so far the diagnosis eluded her. Bartolomeo had avoided her gentle probing, so now she had to change tactics and ask him straight.
‘So are you going to tell me what the problem is?’ she asked. ‘With your health, I mean?’
Bartolomeo waved a dismissive hand. ‘Nothing is wrong, Eleanor.’
Obviously they were going to have to do this the hard way. ‘I’m thirty, so that would make you … what … fifty-three?’ He nodded.
‘And you’re tired all the time.’ He shrugged. ‘It’s my age.’
No, it wasn’t. ‘And I suppose it’s because of your age that you became breathless when we walking along the bay the other day?’
He smiled. ‘Exactly so. I had a job where I sat down all day, every day. And even though I’ve sold the company now and I have time on my hands, I still don’t exercise enough. I really should go to the gym.’
Eleanor scoffed. ‘I’m a doctor, Bartolomeo. I add things together. Like the way you bruise easily—you’re wearing short sleeves today so I can see the bruises.’ Bruises in certain places that made her wonder if they’d been caused by a needle. ‘And your gums were bleeding over lunch today.’
He made another dismissive gesture. ‘Because the bread was a
little too crusty.’
‘It still shouldn’t have made your gums bleed,’ she said. ‘And you’re too young to be tired and breathless like this. I think your platelet count might be low. Are you going to tell me the truth about this, or do I have to nag you?’
He sighed. ‘Your mother was sharp, like you. She noticed things. All right. The doctors say I have anaemia.’
Simple iron deficiency wouldn’t have caused Bartolomeo’s symptoms. There had to be more to it than that. ‘What sort?’
‘Aplastic.’
That explained a huge amount. The anaemia accounted for Bartolomeo’s pallor—but aplastic anaemia was serious and couldn’t be treated just by a course of iron tablets and changing his diet. The way he got tired so quickly and became short of breath was caused by low numbers of red cells in his blood. The way he bruised easily and his gums bled were due to low platelet levels, and she’d just bet, because his white cells weren’t high enough either, that he picked up every cold and infection going. And it confirmed her suspicion that those bruises on his arms—bruises that seemed to appear between one day and the next—were due to transfusions into his arm. ‘How long have you had it?’
He leaned back in his chair. ‘Four months or so. Maybe a little longer before we found out what it was.’
In severe cases of aplastic anaemia, she knew that the chance of survival after six months of having the condition was less than fifty per cent. So her guess was right. Bartolomeo was dying. He clearly knew he was on borrowed time, and that was why he’d tried to find Constance Firth. To make his peace with her before he died.
No. This wasn’t fair. After thinking she was all alone in the world, Eleanor had found after all that she did have someone. Her biological father. In the few days they’d spent together she’d found that she liked him—liked him a lot—and she wanted to get to know him better.
But now she might not get the chance. Because the aplastic anaemia might take him from her. Way, way too quickly.
Well, she wasn’t going to stand by and let it happen. There had to be something she could do.
‘Do you know the cause?’ she asked carefully.
‘The consultant said there was no cause—it just happened.’
From what she could remember about the condition, it was an auto-immune reaction, caused when the body’s immune system became confused and started to attack the body’s own tissues; it damaged the bone marrow, and around two-thirds of cases had no known underlying cause. ‘What treatment are you having?’ she asked.
‘Blood transfusions, antibiotics.’
They were standard treatments for the symptom of a low blood count, but they clearly weren’t working well enough. ‘What about a bone-marrow transplant?’
Bartolomeo closed his eyes. ‘My sisters had the test to see if their tissues were compatible with mine. It seems that tissues aren’t the same as blood type.’
She nodded. ‘We inherit three antigens from each parent.’ She drew a swift diagram on the back of a napkin, with a stick woman and a stick man; she added two blocks of three numbers underneath the woman and two blocks of three letters underneath the man. ‘If you inherited 1, 2 and 3 from your mother and A, B and C from your father, that leaves 4, 5 and 6 and C, D and E that don’t match your tissue type.’ She drew a circle round each block of three antigens, then drew lines from each to show potential matches. ‘You see? That gives you a one in four chance of the tissues matching.’
He smiled. ‘Like a probability tree. You inherited my talent for maths, then.’
‘Yes.’ She smiled back, but her heart was heavy. A one in four chance. Twenty-five per cent. The odds were too low. ‘I take it they didn’t match?’
‘They match each other because they’re twins—but, no, they don’t match me. My consultant has put me on the waiting list for a donor, but …’
He didn’t have to say any more. ‘It’s the same in my country. There aren’t enough donors.’ But when Bartolomeo had been put on the waiting list, the situation had been different. Then, he’d thought there was nobody in the family with his tissue type. Now he knew he had a child. One who would have inherited three of his antigens. Which meant a tissue match. ‘We need to talk to Orlando.’
‘Orlando?’ Bartolomeo looked puzzled. ‘I told you about him—the family doctor I’m working with right now.’
Bartolomeo’s eyes narrowed. ‘You haven’t said that much about him. Or that you were working here, come to that. I thought you were here on holiday?’
‘I met him on the plane on the way over,’ Eleanor explained. ‘We worked together to help a fellow passenger who’d had a heart attack. We became friends.’
‘Friends?’ Bartolomeo sounded suspicious.
She sighed. ‘He gave me a lift from the airport. And he took me to Pompeii.’
‘On a date?’
‘As friends.’ Lord. Anyone would think she was thirteen, not thirty!
Though they had ended up walking hand in hand at Pompeii. And had they not rescued the American tourist, Orlando might well have kissed her in the shadow of Vesuvius. Exactly the same way he’d kissed her in the surgery. And then …
Oh, she had to get a grip. ‘I’ve been thinking about maybe retraining and doing family medicine. Orlando’s a medico di famiglia, so he offered me a chance to work with him while I’m over here to see if family medicine suits me. And my boss said I can have a sabbatical. Which means I get the chance to spend the whole summer over here.’
‘The whole summer?’ Bartolomeo smiled. ‘We would have more time together.’
‘I’d like that,’ she said.
‘And this man, Orlando—he knows something about aplastic anaemia?’
‘Probably as much as most family doctors,’ Eleanor admitted. ‘But the thing is, he worked in England for a couple of years. His English is perfect, so he’ll know the medical terms in your language and mine—and he can help me talk to the consultant and find out what I need to know. But we’ll need your permission to discuss your condition with your doctor.’
‘Hmm,’ Bartolomeo said, looking faintly suspicious. ‘I don’t know the man.’
‘I do. And he’s a good man. A good doctor.’ Eleanor paused. ‘Maybe we could have a drink together—a coffee, perhaps. And then you could decide, once you’ve met him.’ She glanced at her watch. ‘He might still be at his surgery, if he’s not on a house call. I’ll ring him now.’
Bartolomeo laughed. ‘Something else you inherited from me. You’re bossy.’
She smiled back. ‘No, I’m efficient.’
His smile faded and he took her hand. ‘Eleanor, I know I’m on borrowed time. I have you now, and I just want to enjoy you in the time I have left. It might be weeks, it might be months—and we might be very lucky and it will be longer.’
‘And on the other hand we might not be lucky. I’ve just found you—and I’m not giving you up without a fight. I want time to get to know you.’ She lifted her chin fiercely. ‘I have my mother’s genes, too. So that makes me stubborn.’
‘I can see that.’ His eyes glittered with amusement.
‘This isn’t a condition I deal with in the emergency department. But I know where to start looking for the answers. I want to do some research on this and see what we can do. You’re not in this on your own any more.’ She squeezed his hand gently. ‘You’re with me. And together we’re going to fight this.’
The glitter in his eyes was no longer amusement: she could see the tears forming.
‘So will you meet Orlando? Talk to him?’
Bartolomeo dragged in a breath. ‘All right.’
Still holding his hand with one of hers, she fumbled for her mobile phone, and flicked through the directory until she found the surgery number.
Chiara answered.
‘Buona sera, Chiara. It’s Eleanor. May I speak with Orlando?’
‘ Un minuto, Eleanor.’ There was a pause. ‘No, he has left for house calls. He has surgery later, at—ah, yes, four.’
‘Can you ask him to call me, please? Tell him it’s about … about Bartolomeo.’ Good as Chiara’s English was, Eleanor doubted that she’d be able to translate the English condition to Italian either—and she didn’t want to involve Alessandro or Giacomo.
‘Of course. A presto.’
‘A presto,’ Eleanor echoed. ‘Grazie, Chiara.’ She cut the connection and flicked through to Orlando’s mobile number. The chances were his phone would be switched to divert or voicemail—but if it was the latter she could at least leave him a message.
To her relief, it was voicemail. ‘Orlando, it’s Eleanor. Please can you ring me?’ She left him her number.
Bartolomeo finished his coffee. ‘Eleanor, cara, I hate to say it but …’
‘You’re tired,’ she said gently. She could see that. ‘You need some rest. I’ll leave you in peace.’
He smiled ruefully. ‘Once I could walk through Naples all day and dance all night.’
She squeezed his hand. ‘I don’t think I could do that, and I’m younger than you!’
‘What will you do with yourself this afternoon?’
‘Be a tourist,’ she said. ‘Visit churches and museums and eat cake.’ Actually, she had other plans, ones which involved finding an internet café so she could do some research. ‘And maybe tomorrow you can eat gelati with me. Show me where they sell the best gelati in Naples and introduce me to your favourite flavours.’
Eleanor took the metro back to her hotel and asked for directions to the nearest internet café. Armed with coffee—which she ordered molto caldo, not caring that it marked her as a tourist because she really didn’t like her coffee the lukewarm Italian way—a pen and paper and two hours’ credit, she started her research, moving from journal to journal and paper to paper until she found what she was looking for.
She was halfway through when her mobile phone rang. ‘Eleanor Forrest,’ she answered crisply. ‘It’s Orlando. Chiara gave me your message. What’s up?’ ‘I’ve found out what’s wrong with Bartolomeo.’ ‘And it’s serious?’ His voice radiated concern. ‘Aplastic anaemia.’
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