‘It’s fine,’ Luke interrupted. ‘You don’t need to explain your movements to me.’
Only she wanted to.
Wanted to be more important in his life as much as she wanted him to have a bigger place in hers.
Still, there wasn’t time to dwell on it. By the time the ward was settled for the night Carl had arrived. Molly could hear him wheezing from the other end of the corridor as the paramedics wheeled him in.
‘Young Carl.’ The paramedic smiled as Molly approached. ‘You’re expecting him?’
‘We are.’ Molly smiled a welcome, but one glance at her new patient and she was reaching for the phone in her pocket. Carl was beyond being anxious, he was too exhausted with concentrating on his breathing to even notice his surroundings. Leaning forward on the stretcher, he was using his accessory muscles to breathe, and his eyes were closed, his whole body clearly drained from the exertion. This was one sick little boy, and the treatment room was the best place for him—all the equipment was to hand, and on a children’s ward any procedures tended to be undertaken there so as to minimise distress to the other children, especially at night when hopefully the ward was sleeping.
‘He’s gone downhill in the ambulance…’ The paramedic met Molly’s eyes and she gave a brief nod. ‘Let’s pop him into the treatment room. Hello, Mrs Adams, I’m Molly, the nurse in charge tonight.’
‘Where’s the doctor?’ Mrs Adams didn’t return the greeting. ‘I thought you were expecting us?’
“We are,’ Molly responded. ‘Dr Williams is over in Intensive Care at the moment. I’ll let him know that you’re here.’
‘But he knew that we were coming.’
Two hours ago, Molly wanted to point out, tempted to tell Mrs Adams that her son wasn’t the only patient under
Luke’s care but knowing that the woman’s rather brusque manner was probably masking her anxiety.
‘Anything I can help with?’ Anne Marie’s face was welcome as she came into the treatment room.
‘Could you settle Carl and take the handover from the paramedics?’ Molly answered with just a hint of raised eyebrows as the phone trilled in her hand. ‘I’m just going to let Doctor Williams know that his patient is here.’
‘Carl Adams is here,’ Molly said, stepping outside.
‘How is he?’
‘Not good,’ Molly answered. ‘We need you here.’
‘I’m just in the middle—’
‘Luke,’ Molly interrupted, ‘you accepted a direct admission.’
‘His GP said—’
‘I don’t care what his GP said two hours ago,’ Molly said crisply. ‘I’ve got a seriously ill child just landed on my ward, and if he’d gone through Emergency he’d have been triaged to Resus—the emergency doctor would be seeing him, stat. We need you now.’
‘I’m on my way.’
‘Good,’ Molly answered.
‘Start him on some nebulised salbutamol.’
‘I will, and can you arrange an urgent portable chest X-ray while you’re running?’
Anne Marie had already set up the nebuliser. Normally Ventolin was given via a spacer, but Carl’s air entry was poor and Molly spoke to Carl’s mother as she replaced Carl’s oxygen mask with the nebuliser and turned it on.
‘Dr Wilson will be here in just a moment, Carl.’ Molly helped him lean forward and placed a couple of pillows on his lap. ‘Rest on these, that’s a good boy. This medicine will start helping soon.’ Anne Marie brought over the IV trolley and pulled out some local anaesthetic cream to numb his arm, but Molly shook her head. The cream took a while to work, and there was no point in telling Carl they were giving him cream to numb him before the needle when it wasn’t going to have time to take effect.
‘Hi, there, Carl.’ Luke breezed in and set straight to work, taking a history from the mother as he slipped a tourniquet over Carl’s thin arm.
‘Carl, I’m just going to put a small needle into your arm. It’s going to hurt just a bit, but I’ll be as gentle as I can.’
‘Are you taking some blood?’ Mrs Adams asked.
‘Yep, and we can get an IV started and give him some medicine. It will just be the one needle,’ Luke reassured them both. ‘I’m a pretty good aim.’
He was. Working in paediatrics, he was more than used to the tiny veins of the smallest of babies, but even so Carl barely grimaced as the needle went in, which was worrying. ‘We’ll need IV hydrocortisone. When did he start his prednisolone?’ Luke asked Carl’s mother.
‘I’m sorry?’ Mrs Adams was concentrating on her son.
‘Your GP said he started him on a reducing course of prednisolone on Wednesday. When did he have his last dose? I need to work out how much to give him.’
‘Is it really necessary?’ Mrs Adams gave an agitated shake of her head. ‘He’s on the nebuliser. He’s already had two courses of steroids in the last couple of months.’
‘Mrs Adams.’ Luke’s voice was calm and even, but there was absolutely no doubt of the seriousness of his question. ‘Is your son on the medication your GP prescribed him?’
‘He gave me a script and said that if it got worse…’ Her voice trailed off for a moment, and Luke did nothing to fill the silence except stare over at the boy struggling to breathe. ‘He wasn’t like this!’ Mrs Adams insisted. ‘He actually seemed a bit better, but when he got worse this evening I was going to go and get the prescription dispensed. I don’t like him to have steroids. I’m aware what the side effects are.’
Luke didn’t even deign to give a response, just called his orders to Molly and administered the essential steroids, all the while talking in reassuring tones to Carl, whose breathing was starting to get a little easier with the cocktail of drugs being delivered via the nebuliser. The radiographer arrived to do a portable X-ray.
‘Any chance you could be pregnant?’ he asked Molly as he handed her the heavy lead gown. Carl was too ill to be left alone and needed some reassurance and support to sit up and hold his breath while the X-ray was taken.
‘No, none,’ Molly answered automatically, pulling the heavy gown over her head.
‘Actually, I’ll stay with him.’ Luke took the gown from her. ‘Molly, could you ring the nurse-co-ordinator? There aren’t any ICU beds. You’ll need to let her know that unless he picks up soon, I’m going to have to arrange a transfer.’
It made perfect sense. In fact, transfer or no transfer, she needed an extra nurse out on the ward floor or an experienced nurse to stay with Carl, as his sudden arrival had spread the ward staff thinly and already the routine was falling behind. But Luke had given her a look as she’d taken the gown—just that tiny frown at her carelessness—because until she got her period Luke wouldn’t think she was out of the woods.
As Molly headed out of the room there was an uneasy wobble in her throat, a realisation that even if she hadn’t outright lied to Luke, she hadn’t told the truth.
Hadn’t let the man who was closest to her in on the painful truth. It had seemed right at the time—right not to burden him with it.
Only now…
Now somehow she wished that she had.
‘Are you OK?’ Anne Marie frowned at her pensive face.
‘Fine.’ Molly nodded, picking up the telephone and putting her personal problems firmly aside.
‘This is one sick kid.’ Luke’s face was grim when he came out of the treatment room. ‘What the hell was his mother thinking?’
‘I’ve no idea,’ Molly replied. ‘I’ve spoken to the nursing supervisor and she’s going to send me a nurse from HDU. Do you still want him to have aminophylline?’
‘Not yet.’ Luke wrote up his orders on the drug sheet. ‘Hopefully he’ll start picking up now that he’s getting the right medication. For now he needs hourly nebs, but if he doesn’t improve soon I’m going to have to transfer him,’ Luke said grimly. ‘I’m going to talk to the mother.’
‘I’ll come with you.’
Luke took a long and detailed history from
the mother, listening without comment at first when she explained her reasons for not giving the medication.
‘He only gets asthma during hay-fever season. Last year they gave him three lots of steroids and this year he’s already had two. I just think the doctor hands out the script automatically. I just thought it better to hold off—to see if he improved without them.’
‘Why?’
‘Because I’m aware of the side-effects.’
‘Such as?’ Luke frowned.
‘Well, it can affect their growth,’ Mrs Adams said. ‘And Carl’s a bit on the short side.’
‘Are you aware of the side-effects if he doesn’t have them?’ Luke asked, and Molly watched Mrs Adams’s face tighten. ‘Are you aware how sick your son is tonight—that if he doesn’t improve in the next couple of hours, or if he deteriorates any further, he’s going to have to be transferred to an intensive care bed?’
‘I honestly thought I was helping.’ Mrs Adams’s face crumpled, but Luke’s didn’t—and because she knew him, Molly knew he was angry. A muscle was leaping in his cheek, his shoulders rigid as he stared coolly at the woman in front of him. ‘I just thought if we held off, if I upped his puffers, he’d be OK.’
‘If,’ Luke said crisply, ‘you believe your doctor is over-prescribing, or you don’t have faith in him, I suggest you look around for another doctor you can discuss your concerns with, one you feel comfortable with. Do that, Mrs Adams, before you start practising internet medicine or testing your theories on your son.’
‘I will.’ Clearly shaken, Mrs Adams stood up. ‘Can I go and sit with him?’
‘Of course,’ Molly said. ‘We’re going to keep him in the treatment room for now, where all the equipment is, with a nurse specialling him. I’ll take you down to him.’
Luke was still in his office when she came back, his anger still palpable—and he was right to be angry, right to be frustrated, but it was how angry he was that concerned Molly. Not white-hot, raging angry, and most wouldn’t have even picked up on it, only Molly could feel it.
‘Luke—’
‘Stupid, stupid woman.’ Luke’s mouth twisted on the words. ‘I don’t know whether to report her.’
‘She made a mistake,’ Molly pointed out.
‘And if she makes it again, it could cost her son’s life.’
‘I think she got that message.’
‘What—you think I was too hard on her?’
‘No!’ Molly shook her head. ‘She needed to be told and she was. I don’t think she’ll play with his health again. But maybe you should discuss it with her GP—or your consultant. Luke…’ She was genuinely concerned. They’d sat in this very room with child abusers, had had to listen to the most heinous of things—but his reaction today was extreme. ‘Is there something I’m missing here?’
‘Like what?’ he snapped.
‘Well, we all have our buttons,’ Molly said slowly, ‘and this seems to be yours. Do the twins have asthma?’
‘This has nothing to do with the twins, Molly!’ Luke glared past her shoulder, then took a deep breath, the anger seeping out of him. ‘I’m fine.’
‘You’re sure?’
‘Sure.’ He gave a pale smile. ‘I’ll talk to her again in the morning. I’ll go over his asthma plan with her and make sure she’s got the message.’
Which he did—only it was Mrs Adams who instigated it.
By seven a.m. Carl was on the main ward, with the nurse special back in her own ward.
‘How are you doing?’ Luke listened carefully to his chest. ‘That sounds a lot better.’
‘I feel a lot better.’
‘He’s tired.’ Mrs Adams gave a worried frown. ‘He really hasn’t slept much.’
‘He’ll soon catch up on that. We’ll probably keep him here over the weekend, just to make sure we’re on top of it.’
‘Actually, Doctor…’ Mrs Adams cleared her throat. ‘I was wondering if I could have a word.’ She barely got to the ward door before she burst into tears. ‘I feel so stupid. I had no idea how bad he’d get.’
‘Come on,’ Luke said kindly. ‘We’ll go in my office and have a talk.’ He glanced at his watch. ‘Er, Molly…’
‘No problem.’ Molly smiled, but her heart was fluttering at the prospect of meeting his kids. ‘I’ll keep an eye on them.’
CHAPTER EIGHT
THE office door hadn’t even closed before they arrived.
Mrs Williams was holding the twins firmly by the hands, as if she expected them to suddenly run off, as Molly introduced herself.
They were gorgeous.
Blond-haired and blue-eyed, they didn’t say a word as Molly led the trio to the playroom. ‘You’re to sit here and you’re not to disturb the staff!’ Mrs Williams said sternly to her grandchildren, who were sitting on the sofa, both washed and dressed, Amelia with a pair of fairy wings, and little backpacks at their feet and looking just adorable.
Luke was definitely his mother’s son—tall, her blonde hair now streaked with silver, with the strong features that worked better on a male, she was certainly quite a formidable-looking woman, but her eyes were kind.
‘I’m terribly sorry to impose!’
‘It’s not a problem,’ Molly assured her, then turned to the twins, who were staring at their feet. ‘Your dad’s just with a patient at the moment, but he knows that you’re here and will try and come along soon. If you need anything, just ask. They’ll be fine,’ Molly added to the rather anxious Mrs Williams.
‘Oh, they’ll be fine,’ Mrs Williams said, after kissing the children and walking with Molly back out to the ward. ‘It’s your playroom I’m worried about! They may look as if butter wouldn’t melt but they can be a couple of little minxes. They’re way too used to running wild.’
Which Molly doubted—Luke was so insistent on respect and good manners, and Molly could now see where it came from. Mrs Williams really was an imposing woman and no doubt ran a tight ship. ‘Again, I really do apologise for the inconvenience.’
‘Happens all the time!’ Molly said cheerfully, walking her out of the ward. Well, maybe not all the time, but a staff member’s child sitting in the playroom, waiting for their parent to finish their shift wasn’t a unique occurrence on the children’s ward, though usually it was their mother they were waiting for, and that fact alone meant that the staff would give them just a little bit more fuss than usual.
‘What are they like?’ Anne Marie asked, coming out of the kitchen with a baby bottle.
‘Gorgeous,’ Molly said. ‘Come and say hi!’
Only the two little angels she’d left sitting not two minutes ago seemed to have left the building—toys were everywhere, the television blaring, Amelia jumping up and down on the sofa as Angus sped around on a tricycle that was way too small for him.
‘Hey, guys…’ Anne Marie barked over the noise of the television. ‘Time to settle down.’
‘You talk funny!’ Amelia giggled, jumping up and down on the sofa. ‘Doesn’t she, Angus?’
‘Yeah.’ Angus zoomed the tricycle to a stop. ‘You talk funny!’
‘Gorgeous!’ Anne Marie rolled her eyes. ‘And such lovely manners, too!’
Anne Marie, in fact, ended up feeding her patient in the playroom so she could keep an eye on the twins. The other nurses watched the ward while Molly gave handover to the day staff, which took for ever as Rita had been off for two days and didn’t know most of the patients.
‘How’s Bernadette’s mood?’
‘She’s perked up,’ Molly said. ‘She’s getting on well with young Nathan, so she’s got a friend now, but it’s the school disco this weekend, apparently—she really feels she’s missing out.’
‘She is missing out,’ Rita sighed. ‘She’s been here for weeks now.’
‘And that one!’ Anne Marie was giving her orders, and the playroom was a lot tidier by the time Molly came back. ‘Go on, put it back in the toy box!’
‘Ready for the off?’ Molly grinned.
‘Daddy!’ Two squeals of delight went up and the twins hurled themselves at him.
‘How have they been?’ Luke asked. ‘Not too much trouble, I hope?’
‘They were great.’ Anne Marie beamed through gritted teeth. ‘Full of beans!’
‘Well, thank you.’ Luke gripped the twins’ hands tightly as he headed off, and this time Molly knew why. With Anne Marie ringing her husband, Molly walked out with Luke.
‘How was Mrs Adams?’ Molly asked.
‘Good.’ Luke nodded. ‘I’ve handed it over to Tom, and I’m sure it won’t happen again—she just didn’t realise how serious it could get. I’ve gone over everything with her, and in fairness I don’t think her GP really had explained things very well. She had no real idea about peak-flow recordings and how important they were.’ Luke held onto the twins rather than smother the loud yawn that hit him.
‘Are you going to get any sleep?’
‘Nope…’ Luke yawned again. ‘Not till Mum gets back from her appointment.’
‘What about kinder?’ Molly asked, then answered her own question. ‘Oh, that’s right, they don’t have it on Friday. Will you be OK for work tonight?’
‘I’ll have to be!’
‘Luke…’ They were at the car park, his eyes so red it looked as if he’d been swimming in chlorine. She actually opened her mouth to offer to come over and watch them till his mum got back. After all, she didn’t have to work tonight—it made perfect sense, what any friend would do…
‘What?’ He was holding two little hands in one big one as he fumbled in his pocket for his car keys.
‘Oh, nothing… See you, then.’
‘See you, Molly.’
‘See you, guys!’
And it was as much of a goodbye as they could have with the twins there. Only it hurt, actually felt wrong to be walking away when she didn’t want to. To know she wouldn’t see Luke till Monday, to know he was exhausted and she could do something to help.
But that meant crossing the line.
That meant getting involved.
A Doctor, a Nurse Page 7
