Italian Doctor, Dream Proposal / Wanted: A Father for her Twins

by Margaret McDonagh / Emily Forbes

  ‘Not in America.’ He paused a moment, thanking the waitress who came to clear away their cups and saucers. ‘I was there for a few weeks giving lectures and training sessions, as well as consulting on a couple of cases, but my home and my clinic are in Italy.’

  ‘Oh! I didn’t realise. When you said you were flying in from New York, I assumed that was where you were based.’

  Before he could explain, a German colleague wanted to exchange a few words about the workshop Rico was leading that afternoon. Instead of the enjoyment he normally felt in being able to meet up and talk shop with fellow doctors, now it was impatience that gripped him. He wanted everyone to go away so that he could have time alone with Ruth. But he was destined to be thwarted. For now.

  The temptation to escape and miss the rest of the programme was great, but he couldn’t yet succumb to the urgent desire to forget everything else and carry Ruth off to bed. Not only did he have his own commitments but it was important for Ruth to learn and absorb as much as she could, both in terms of increasing her knowledge and being able to make a decision on whether or not to consider a change of direction in her career. However difficult, it was work first and pleasure second—when he had worked out a plan to win her trust and her heart.

  ‘There is much we don’t yet know about each other,’ he said when they were left alone again. ‘I am looking forward to learning all about you, but unfortunately I will have to wait a little longer.’ He smiled, noting the mix of anxiety and anticipation that warred in her expression. ‘We will have time when conference business has finished for the day—I’m sure we can slip away a bit early. But there is much for us to discuss on a professional level.’

  ‘Pippa Warren,’ Ruth ventured, mentioning the eight-year-old girl whose illness had been the catalyst, causing Ruth to email him in the first place.

  ‘Indeed, yes. Sadly her situation is far from rare. I learn about cases of delayed or incorrect diagnoses all too often, both in adults and children. And, with the latter, there are parents who are often at the end of their tether, with no idea which way to turn,’ he explained, momentarily distracted by the shimmering colours as Ruth nodded her head and her pale gold hair glinted in the sunlight.

  ‘That was certainly how Pippa’s mother Judith appeared when I first met her,’ Ruth agreed, a tiny frown knotting her brow. ‘She had been passed from pillar to post for several years, with various doctors insisting that Pippa was fine and telling Judith that she was fussing unnecessarily and an overanxious mother.’

  Rico heard similar stories far too frequently. ‘A mother’s instinct should never be dismissed out of hand. Judith and Pippa struck gold the day they walked into your surgery,’ he praised, seeing the hint of a blush colour her cheeks.

  ‘I don’t know about that.’

  ‘I do,’ he insisted, refusing to let her play down her achievements. ‘Many doctors, including those with far more experience than you, would not have recognised what you did, never mind follow it through with such tenacity.’

  Looking embarrassed, she shrugged. ‘I was just lucky.’

  ‘Luck had nothing to do with it,’ Rico chastised, determined that she acknowledge what she had done for Pippa and her mother. ‘You are a special doctor, Ruth. And equally as important as your academic excellence is that you really care about your patients. You listen to them and you give them your time—not easy given the pressures doctors are under and the limited period alloted to each consultation. But you go the extra mile, just as you demonstrated with Judith and Pippa. Whereas many others had taken the easy way out—treating only what they saw on the surface, or simply not understanding the relevance of the history and range of symptoms because of lack of training and knowledge—you trusted your instincts and you didn’t give up until you had solved the puzzle. And, with immunology, making a diagnosis is often a case of detective work, of sticking in there and not giving up. You did that, Ruth. On your own. I think—in fact, I know—that you are amazing.’

  ‘Thank you.’

  Two little words and yet they revealed so much, especially an inner aloneness that tightened a knot in his stomach and made him want to pull her into his arms and hug her tight. Her smile was tremulous, while the emotion in her voice, and the expression in eyes glimmering with a suspicion of unshed tears, brought the instinctive knowledge that support of her and belief in her had been in short supply in the past. He didn’t yet know why, but he intended to find out. And then he would ensure that she knew her own worth in the future.

  ‘Where do things stand with Pippa now?’ he asked, forcing himself to keep things professional.

  ‘We are waiting for the hospital appointment to come through. I saw Judith last week and she has lots of questions about what will happen when Pippa goes for assessment, and what is involved if the consultant confirms that it is CVID.’ It was through Rico’s help that Ruth had been able to determine that common variable immunodeficiency or CVID, was the most likely diagnosis. She paused, tucking a strand of hair back behind her ear, an endearing knot of consideration creasing her brow. ‘I’ve tried to reassure her as best I can, but I can’t answer everything for her.’

  ‘Have Pippa’s symptoms improved at all?’ he asked, happy to help Ruth set Judith and Pippa’s minds at rest about what might lie ahead for them.

  ‘There has been a small lessening in the severity of some of the symptoms now she has started the broad-spectrum antibiotics you recommended,’ Ruth told him, gratitude evident in her smile. ‘After her years of recurring infections and other problems, I’m hoping that there hasn’t been any permanent damage and that she hasn’t developed bronchiectasis.’

  Rico nodded as Ruth expressed her worries about the chronic condition that caused widening and scarring of the structures of the bronchi, or breathing tubes. It was one of his concerns for Pippa, too. ‘You said that the blood tests showed low levels of serum immunoglobins.’

  ‘That’s right. Very low.’ She glanced at him, then away again, but not before he had noted the flash of indecision in her eyes. A small sigh escaped and she seemed to be wrestling with something, but before he could question her, she grimaced and began speaking again. ‘I had a few problems getting the blood tests done.’

  ‘How do you mean?’ Rico frowned.

  ‘They are not tests that would usually be requested from a general practice surgery.’

  Rico’s frown deepened. ‘You had trouble from the hospital when you asked for the tests? Or from your own practice?’

  ‘Questions were asked. But the tests got done, that’s what matters. And it told us what we needed to know to help Pippa,’ Ruth said, but Rico was certain she was glossing over much of the struggle she had faced. He wanted to know who had put obstacles in her way. And why. But he let it go…for now.

  ‘The consultant immunologist will test Pippa’s antibody levels. The vaccine tests can take up to six weeks, which I know is frustrating, but it is important to define the degree of immunodeficiency,’ he explained, seeing the sharp intelligence in Ruth’s eyes and knowing she was absorbing all the information. ‘If the final diagnosis is CVID—as we believe it will be—Pippa will have immunoglobin replacement therapy, which should help end the cycle of recurring infections.’

  ‘I read that the immunoglobin infusions can be delivered either intravenously or subcutaneously?’ Ruth commented, a query in her voice.

  Rico nodded, unsurprised by her thoroughness. ‘That is so. At first Pippa will have regular treatment at the hospital, but once she is stabilised, and if both mother and daughter can cope, they can be taught how to administer the subcut treatment at home.’

  ‘The subcut sounds scary,’ Ruth pointed out. ‘Especially for an eight-year-old.’

  ‘Patients generally find it easier than they first think and it is well tolerated. It is better than prolonged IV access, which can increase the risk of infection and also becomes difficult if the veins are hard to find. And, because the home infusions are given once a week, they
help to keep the levels more constant than with the IV infusion in hospital,’ he reassured her, although her desire to keep her patient informed was typical of the caring doctor he was coming to know.

  Aware that time was running out, he ran through some advice and suggestions that Ruth could pass on and which might help the Warrens as they faced the next stage of the journey in gaining a diagnosis and an ongoing treatment programme for Pippa.

  A high-voltage smile hit him full on, testing his restraint. ‘I’m very grateful, Rico. You’ve given so much of your time and I know how Judith and Pippa really appreciate your advice. As do I,’ she added shyly, touching his heart. And he loved the way she said his name, how her refined English voice, melodious but throaty, made it sound.

  ‘It has been my pleasure to help, carissima. And I shall be interested to hear how things progress in the weeks and months ahead. You must keep me up to date.’

  ‘Yes, of course. I’ll do that,’ she promised.

  Rico knew that whatever happened between Ruth and himself in the next couple of days, the Warrens’ case would keep their link intact and the avenue of communication open. He obviously didn’t like the fact that Pippa was ill, but without Ruth being concerned and searching the internet for information, he would never have met her. And even after a very short time in her company, he could not now imagine his life without Ruth in it. He just hoped he didn’t mess things up.

  Rico wished the moment of intense closeness could go on forever but, much to his regret, the call came to announce the start of the conference’s second session that would take them up to lunch.

  ‘As I have told you in our email exchanges, I am genuinely impressed by your skills. You have an innate gift for learning, Ruth, and for caring, for healing.’ Aware of people moving around them and returning to their places in the main room, Rico leaned closer and focused on Ruth. ‘We have no more time now, and this afternoon I have the workshop.’

  ‘I’m looking forward to it,’ she admitted, making him smile.

  Private time with Ruth would be scarce, at least until the evening, but he was determined to be alone with her so he could learn all about her and do everything possible to persuade her to come and work with him. And be with him. Once more the line between professional and personal blurred.

  ‘We can continue our discussion later.’ He drew in a deep breath, realising how nervous he was, how desperate to get things right and not scare her away. ‘Will you have dinner with me tonight, Ruth?’

  Time seemed suspended as he waited for her answer. He felt each beat of his heart beneath his ribs, was sure she must hear its anxious pounding. He watched her changing expressions, wondering what more he could do to convince her, nearly groaning aloud as she nibbled at her bottom lip, making him yearn to taste her, kiss her.

  ‘Yes…I will.’

  The whispered words brought untold relief and gratitude that this first hurdle had been crossed. But he knew more lay ahead. They could sort out the details of the evening later. Now he had a few short hours in which to plan his campaign to get Ruth to say yes to a whole lot more than dinner.

  CHAPTER THREE

  FOR the tenth time in as many minutes, Ruth checked her watch. Any moment now, Rico would arrive to escort her to dinner and her anxiety was growing. As was her excitement. Her whole body felt alive with anticipation, her breathing was too fast and too shallow, and her blood was pulsing wildly though her veins. Unable to settle, she paced across the room and paused at the window, scarcely noticing the view out over the shimmering expanse of Morecambe Bay to the western horizon where the sun would soon be setting.

  No matter how many times she told herself that the only reason she had accepted the invitation to have dinner with Rico was because of the work-related discussions they were going to have, she knew it was a lie. Just as she could not deceive herself about the extra effort she had made when getting dressed for the evening. She rarely wore dresses, but as well as insisting on swimwear, in the unlikely event she had time to try out the hotel’s indoor pool, Gina and Holly had persuaded her to bring her black dress—standard issue in most women’s wardrobes—in case of a smart dinner.

  As promised, she had sent her two friends text messages to confirm she had arrived OK, but she had not divulged any information about Rico. Both were nurses. Gina McNaught at Strathlochan’s multi-purpose drop-in centre and Holly Tait on the children’s ward at Strathlochan Hospital. Both had expressed concern about her intention to accept the last-minute invitation to this conference, although Gina had been the most vociferous.

  ‘Being stuck with two hundred stuffy old doctors for a couple of days doesn’t sound like fun to me,’ Gina had complained in her soft Scottish burr. ‘Besides, you probably know more about the immune system and allergies than most of the delegates, even though you’ve only been learning about the subjects for the last month.’

  Ruth hadn’t taken umbrage at the implication that she was a swot because she’d known no judgement had been intended. Not from Gina. Aside from the fact that her friend never said a bad word about anyone, there had been obvious affection and admiration in her voice. Far removed from the criticism, resentment and snideness Ruth had become accustomed to all her life…first at home, then at school, following on during her medical training, and now in her first job as a GP.

  ‘You’ll be too busy overseeing final preparations for your wedding on Saturday to even notice I’m away,’ Ruth had teased in an effort to reassure her friend.

  ‘I’ll notice. And I can’t get married without you and Holly beside me as my bridesmaids. So make sure you don’t let the mysterious specialist you’ve been emailing persuade you to disappear off to America to work for him.’ Genuine worry had laced Gina’s tone. ‘Remember how much we all love you here.’

  Recalling the words now brought a lump to Ruth’s throat, just as they had at the time. She wasn’t good at emotion and personal involvement. And she had no idea how to deal with affection, especially when directed at her, as she had never experienced it in her life before. Not until she had arrived in Strathlochan a couple of years ago when, much to her surprise and bemusement, she had immediately been taken under the protective wings of Gina and Holly. Likewise, the warm and generous welcome she had received from many within the local medical community had been equally unforeseen and overwhelming.

  Snapping back to the problem at hand, Ruth nibbled her lower lip in indecision, wondering for the umpteenth time whether to change into something else. Turning round, she cast a nervous glance at her reflection in the hotel room’s full-length mirror. The hem of the dress brushed her knees, while the sleeves were three-quarter length and the neckline demure. More than respectable. Not at all revealing. Her freshly washed hair had been left loose, and she was wearing flat shoes, dark tights and the bare minimum of make-up. With her watch and her late grandmother’s locket on a chain around her neck her only additions, she should have looked stylish but unnoticeable. Not like a maiden schoolmarm, exactly, but far removed from the sensual siren who now gazed back at her. Her eyes looked huge and startled as she studied her alien image, awed and alarmed at the way the fabric hugged her body, subtly hinting at every curve.

  This was not the effect she had intended. She had no idea what had gone wrong. And she was certainly nothing like the stranger she saw in the mirror. It had been a while since she had last worn the dress but she didn’t remember it ever looking this provocative. Had she realised, she never would have packed it, no matter what Gina and Holly had said.

  A sudden knock at the door made her jump and warned her that there was no more time for indecision. Or to change her clothes. Pressing her palms to her cheeks, finding them unusually warm, she walked towards the door, wishing now that she was meeting Rico downstairs amongst the other delegates instead of agreeing that he call for her at her room. Sucking in a steadying breath, sure he would hear each rapid beat of her heart, she opened the door, only for all the air to leave her lungs in a rush when she sa
w him.

  Wearing designer jeans, a black crew-neck sweater and a mid-brown leather jacket, Rico looked casual but smart…and devastatingly handsome. He hadn’t shaved, so still had the roguish, bad-boy edge she had uncharacteristically found so sexy when she had first seen him. Her gaze clashed with his and the hunger in gold-flecked hazel eyes seared her to her soul. He took his time looking over her from head to toe and back again, his appreciation so blatant that even she, with her total lack of self-confidence, could not fail to grasp that he liked what he saw.

  Ruth shivered. Rico looked as if he wanted to forget all about dinner and would rather stay and feast on her instead. The knowledge weakened her knees. And her resolve. An unrecognisable part of her willed her surrender. A wild and wicked side she had never known she possessed had been fighting for freedom ever since she had met Rico. She had never found pleasure with a man, and her failings as a woman had been well and truly drummed into her, so this new and sudden desire was shocking and bewildering. Her attraction to Rico scared her—almost as much as his apparent attraction to her.

  ‘Good evening, Ruth.’ Taking her by surprise, his hands settled on her upper arms and drew her closer so he could place a kiss on each cheek. Her skin tingled from the brush of his lips and her hastily indrawn breath was fragranced with his arousing cedar-wood scent. ‘You look beautiful.’

  She didn’t believe his extravagant compliment, but politeness demanded her response. ‘Th-thank you.’

  ‘You are ready to go?’ he queried, his hands gliding slowly down her arms before releasing her.

  ‘Yes. I’ll just get my things.’

  Turning away to pick up her bag and room key, Ruth used the few seconds to try and regain some measure of composure. She only had to be near Rico and her body betrayed her. That the phenomenon had been happening all day, from the first moment they had looked at each other, in no way made it easier for her to understand. Why now? Why this man when no other had ever stirred her interest?