Prognosis Incompatible

by Andrews, Amy

  He made an effort to concentrate on his patient as she talked about her symptoms of indigestion and then an episode of acute abdominal pain. He looked at the ultrasound images online, examining them closely, and then read the report.

  ‘I’ve heard there is a natural way to dissolve gallstones. Do you know anything about that?’

  He smiled at her reassuringly. ‘Yes, I’ve had a lot of success with it in my practice. But I warn you, it’s not easy or very palatable and it’ll be a good couple of weeks before you can try it. You may be better off having a quick laparoscopic day procedure if you’re experiencing frequent attacks of cholecystitis.’

  ‘As long as I don’t eat anything too fatty, it’s usually OK. Why will I have to wait that long?’ she asked.

  ‘We need to make some dietary adjustments first to detoxify your system and prepare the gall bladder properly to pass the stones.’

  ‘Like what?’

  Marcus took a detailed history of Gail’s dietary habits, formulating her detox plan.

  ‘Well, you’ve eliminated most fatty foods so that’s good, but you’ll need to also eliminate the hidden fats like those naturally occurring in dairy foods. You need to halve your protein intake and substantially increase your fruit and veg consumption. And it’s very important to increase your water intake to between two to three litres a day so you can flush out the toxins.’

  They talked extensively about meal planning and strategies to cope with the detox phase.

  ‘So I’m going to have to do this for ever?’ she asked gloomily.

  He chuckled. ‘No, this is just for the two weeks prior to the elimination procedure. But it is probably a good idea to look at what dietary habits you can modify so the stones don’t re-form. It’s not about denying yourself, Gail. Just about moderation.’

  He wrote on a piece of paper and tore it off and gave it to her.

  ‘Go to the health-food shop and get yourself some lecithin granules. Add them to your meals — it helps to emulsify the cholesterol and reduce the size of the stones. This is really important as bigger stones can damage the neck of the gall bladder.’

  ‘OK.’ She nodded. ‘So, after the two weeks, what happens then?’

  ‘You can start the procedure. I usually recommend that you do it before going to bed and hopefully you’ll sleep through the worst of it. Take a dose of Epsom salts a few hours before that to ensure that once the contents of the gall bladder are emptied into the intestine, they are eliminated quickly. Mix three-quarters of a cup of safflower oil with half a cup of fresh lemon juice —’

  ‘Hmm, yummy,’ she said, wrinkling her nose.

  ‘Yes, it’s not very palatable but it is effective. As soon as you’ve taken it, lie on your right side with your knees bent. This is the most anatomically correct position to ensure the oil and lemon juice penetrate the gall bladder. And then, fingers crossed, the bile duct will dilate to expel the oil and the stones will go with it. You should pass the stones in your next bowel motion. Sometimes a repeat procedure is needed if all the stones don’t clear first time.’

  ‘Will it hurt?’

  ‘There may be abdominal discomfort and nausea. It shouldn’t be unbearably painful. If it is, ring me. But I’ll get you to come back in a week and we can talk about how you’re going. What do you think?’

  ‘Sounds better than an operation.’ She smiled. ‘I’m willing to give it a try.’

  He smiled and stood. ‘Good, we’ll make an appointment for next week. Any troubles in the meantime, don’t hesitate to ring.’

  Marcus whistled a happy tune as he waltzed back into his office. Another satisfied customer. He was confident that Gail would be able to pass her gallstones naturally and pleased that he could make a real difference in people’s lives.

  And then he walked into his office and Maddy’s perfume hit him again and Gail became completely insignificant. He hardened again, thinking about what Maddy had done to him in this very room and, better still, what would happen that night.

  The old sensible Marcus warned him against getting too into her and their incredible chemistry. But the new Marcus, the one who had looked down at his chest that morning and seen it covered in her red curls, wanted to throw caution to the wind and follow wherever this thing led.

  Maddy Harrington was making him lose perspective. When he was around her it was easy to forget about the commitment-phobe Hunt genes — his divorce-prone parents, his three sisters who had made complete screw-ups of their partnerships and his own failed attempt.

  Madeline Harrington blinded him to it all. And that made her dangerous but he didn’t care.

  He just didn’t care.

  CHAPTER EIGHT

  THE next six weeks flew by and they were the most incredible of Madeline’s life. She and Marcus were pretty much inseparable. He would call in and pick her up from work each evening and they would rush to her place, the closest, falling on each other the second they were alone, like lovers who hadn’t seen each other for a century instead of only eight hours.

  He was perfect. Life was perfect. It had gone from being in the doldrums and her vigilantly guarding herself from life and love and hurt to being spectacularly wonderful. He didn’t put a foot wrong. He was funny and sexy and kind and patient. He was a good cook, a great masseur and a fantastic listener. A true gentleman who opened her door and picked up the cheque.

  And, in bed, he was adventurous and generous and he just couldn’t get enough of her.

  Nor could she of him.

  She hated being apart from him and when he kissed her after a day’s absence it was like that first night all over again. Sweet and desperate, lustful and greedy. She never knew she was capable of such passion. Or that she could throw all caution to the wind and allow herself to live in the moment.

  It was liberating.

  And she steadfastly avoided thinking about where she and Marcus were headed, preferring to think only in terms of what they were doing today. Because, whether they admitted it or not, they’d moved far from the realms of rebound sex. In fact, they had broken every rebound sex rule that apparently existed.

  They were in a relationship for crying out loud. And Madeline was going to enjoy the perks while it lasted.

  Everyone had been surprised. Veronica had been ecstatic. She kept grinning stupidly at Madeline and muttering stuff like, “You go, girl,” and “Hubba hubba,” as she passed by.

  Mary adored him. ‘I knew he’d be right for you. About time you found yourself a young man who couldn’t keep his hands off you,’ she had declared to a pink-faced Madeline a few hours after she had sprung them kissing in her office.

  Not that long ago Madeline would have been mortified by her behaviour but now she revelled in it, enjoying the carefree flush of being desired.

  Marcus ushered in his first patient of the day. His practice had been building nicely. He was three-quarters booked most days. And his nights were just as full. Maddy was amazing. Life was pretty damn good at the moment.

  Jenny Smith entered the room, carrying her six-year-old son, Trent and sat on the chair opposite.

  ‘Hi,’ said Marcus, noting the boy’s pallor instantly.

  ‘Ouch,’ said Jenny, indicating the specimen jar on his desk, full of gallstones.

  Marcus laughed. ‘Yes, indeed,’ he said holding up Gail Wust’s successfully passed stones. ‘Thirty of the blighters. Better out than in.’

  He remembered how excited she had been when she had come to see him and had given him the stones as a memento. A further ultrasound had showed no evidence of any remaining gallstones and she had been one very happy customer.

  So too had Connie who, after two weeks, had more energy than she’d known what to do with. He remembered how emotional she’d been when she’d thanked him and every couple of days she’d pop in with some home-made cake or biccies to show her appreciation.

  ‘Enough,’ he’d groaned at her good-naturedly when she had brought him some mouth-watering Anzac biscuits the
other day. ‘I’ll be as fat as a house,’ he laughed.

  ‘Oh, I don’t know.’ She winked. ‘I hear you’re getting plenty of exercise these days.’

  It seemed as if everyone knew about him and Maddy. The fact that he didn’t seem to care should have rung rather large alarm bells. Were they heading into a relationship?

  And would that be so bad?

  ‘Are you OK, Dr Hunt?’ asked Jenny.

  Marcus pulled himself out of his reverie. ‘Sorry, I was miles away.’ He pushed thoughts of Maddy aside. ‘What can I do for you today?’

  ‘It’s Trent,’ she said. ‘I think he may need some more vitamins. He’s been very lethargic the last few days. We’ve just moved and I’ve been putting it down to that and him being off his food again. The naturopath in our old place had him on a vitamin cocktail because he’s always been a fussy eater, appetite of a sparrow, and I worry about his nutrition.’

  ‘He is a bit of a skinny Minnie,’ said Marcus. ‘Pale, too.’

  She shrugged. ‘He’s always been pale.’

  Marcus rose from his chair and came around to squat in front of Jenny and Trent.

  ‘Hey, little mate,’ he said quietly.

  Trent looked at him solemnly and tucked his face shyly into his mother’s breast.

  Marcus didn’t have a good feeling about Trent. Close up he looked paler still. He looked far beyond the ‘pale-child’ label. He looked anaemic. ‘I’ll just have a little look at him,’ he said to Jenny, and indicated that she should lay him on the couch.

  Trent lay docilely as Marcus examined him. It was hard to believe that he and Connor were the same age. The boy didn’t feel feverish at all but Marcus noted the pallor of his inner lower eyelids and the mucous membranes of his mouth. He felt some enlarged lymph nodes in his neck and lifted the boy’s shirt to listen to his chest.

  That was when he noticed the bruising. And his bad feeling intensified. He had multiple small bruises over his stomach. ‘Has he had these for long?’ he asked.

  Jenny gasped. ‘I noticed a couple when I was dressing him this morning. But he didn’t have this many. And he has a couple on his arms and legs, but he’s six. He’s always falling over and hurting himself.’

  Marcus pushed up Trent’s sleeves and noted the bruises on his arms and then inspected his legs. He felt in Trent’s armpits and groin and found further lumps. A six-year-old with lethargy, pallor, bruising and enlarged lymph nodes. He shut his eyes briefly and hoped to God that he was wrong.

  Pulling Trent’s shirt down, he indicated that Jenny could bring him back to the desk.

  ‘I want you to take Trent and have these blood tests done right away,’ he said to Jenny, writing out a pathology form. ‘The nearest place is two blocks away.’ He circled the box on the form that said ‘Urgent’ several times. ‘I’ll ring them and let them know you’re coming and to put a rush on it.’

  Jenny took the slip from him, worry marring her features. ‘What’s wrong?’

  Marcus chose his words carefully, not wanting to alarm her too much at this stage and certainly not when she had to get in her car and drive. ‘I think he’s anaemic. I want to know why.’

  ‘So...’ She looked confused. ‘Can’t vitamins help with anaemia?’

  Marcus’s heart went out to her. If Trent had what he thought he had, he was going to need much more than vitamins. ‘Let’s just get the blood results first and then we’ll talk about how to treat it,’ he said gently.

  Marcus saw fear flit through Jenny’s eyes as it started to dawn on her that there might be something seriously wrong with her son.

  ‘There’s something you’re not telling me,’ she said. ‘I need to know what you’re thinking.’

  Marcus wavered for a moment. This was always the difficult part. To share his suspicions before they were confirmed to prepare her a little or to keep mum until he knew for sure and completely knock the wind out of her.

  ‘There are lots of things that can cause anaemia,’ he prevaricated.

  ‘Yes, but what do you think it is?’ she insisted.

  He looked at her worried eyes and the way she was clutching her now sleeping son to her chest and knew that people always preferred honesty. Marcus sighed. ‘I’m concerned that Trent may have leukaemia.’ He ploughed on through her shocked gasp. ‘But I can’t be sure until the results are back.’

  ‘Leukaemia? But he’ll die,’ she said frantically.

  Marcus felt the panic roll off her in a tangible wave. Who could blame her? How would he feel if someone was telling him that Connor had leukaemia?

  Fun-loving, skateboard-riding, daredevil Connor?

  ‘Please, don’t let’s get ahead of ourselves here. Let’s get the tests done and go from there. If he has it then we’ll admit him straight to hospital and he can begin his treatment immediately. There is a very good cure rate, Jenny.’

  She nodded. ‘Will he need chemotherapy?’

  ‘That is the treatment.’

  ‘What about natural therapies? I’ve heard enough stories about chemo to know that it’s not very nice.’

  ‘No. It can have some awful side-effects,’ Marcus agreed, ‘but it’s the only course of action I would recommend.’ Marcus knew that there were complementary methods employed by some alternative medicine practitioners to treat cancers, but the medical doctor in him never took any chances with cancer.

  ‘Oh, God,’ she said, her voice cracking. ‘I can’t believe this is happening.’

  Marcus smiled sympathetically, a sudden horrible vision of Connor limp and pale keeping it real for him. ‘As I said, let’s just take this one step at a time. OK? Blood tests first. Then in two hours I want you to go next door, to Dr Madeline Harrington. I’m going to get the lab to phone the results through to her. I’m referring Trent’s case to her.’

  ‘But I want you,’ she said.

  Marcus could see Jenny was trying really hard to hold it together. ‘I’ll be there, too, I promise, but as I specialise in natural therapies I think it’s more appropriate for you to have a traditional GP to take over Trent’s case.’

  Jenny stood, barely disturbing Trent. ‘Right. Okay. Right. I’ll go, then.’

  Marcus led her out gently. She looked totally frozen, like she was registering nothing in her brain other than the words ‘childhood leukaemia’ in big tall letters. He helped her buckle Trent into his booster seat and handed her the car keys. ‘Drive carefully,’ he told her, and waited until she looked at him and nodded.

  Marcus sat back down at his desk. He wished he felt more positive about Trent’s chances. But he’d seen this presentation a little too often to doubt himself.

  He dialled Maddy’s number and she said, ‘Well, hello,’ as she picked up.

  Marcus’s lips lifted into a slight smile as her voice curled into his ear. ‘Hello to you, too,’ he said softly.

  Ordinarily he’d ask her something outrageous like what she was wearing and laugh when she acted all prim and proper in front of a client. But today, despite the delicious lurch of his stomach when he’d heard her voice, he just wasn’t in the mood.

  ‘To what do I owe the pleasure?’

  He could hear the smile in her voice and pictured her holding the phone, her lips against the receiver.

  ‘Business, I’m afraid. Can you clear a space in your schedule for two hours’ time? I have a six-year-old boy that I suspect has leukaemia. His mother is getting his bloods done now.’

  Madeline squeezed her eyes shut briefly, her heart going out to the anonymous little boy. ‘Are you okay’ she asked, knowing that imparting news such as this also took it out of a practitioner. Knowing how close he was to his six-year-old nephew, cases like these could be a little too close for comfort.

  Her low voice tinged with empathy was soothing. On days like this Marcus wished he wasn’t at work. That he was home in bed with her and she was whispering scandalous things in his ear instead.

  He sighed. ‘Yep. Can you swing it?’

  Madel
ine looked at her appointments. She’d swing it somehow. ‘Sure. You coming, too?’

  ‘Yep.’

  ‘All right. I have a patient. I’d better go. I’ll see you then.’

  ***

  Two hours later Marcus walked into the surgery, past a grinning Veronica and straight into Madeline’s office and directly into her open arms. It felt good to be there.

  She felt good.

  ‘What are the results?’ he asked, pulling back reluctantly.

  ‘White cells astronomical. Critically low platelets and red cells.’

  ‘A.L.L.,’ he said despondently.

  She nodded. ‘Fill me in.’

  Marcus went over Trent’s case for a few minutes. Then the intercom buzzed. ‘Jenny and Trent Smith are here,’ Veronica announced.

  ‘I’ll bring them through,’ he said.

  Marcus made the introductions and sat himself on the edge of Madeline’s desk. ‘I’m sorry, Jenny. The blood tests have confirmed it. Trent has A.L.L — acute lymphoblastic leukaemia.’

  There was silence as they watched the confirmation slowly sink into Jenny’s head. She looked at them with tears in her eyes. ‘What is that, exactly?’

  ‘A.L.L is a cancer of the bone marrow,’ Madeline said, stepping in. ‘Something goes wrong, we don’t know what, that causes an overproduction of immature white blood cells. These crowd the bone marrow, preventing it from making normal cells, like red cells, which is why he’s so pale, and platelets, which is why he has bruises everywhere.’

  Jenny hugged a listless Trent to her and rocked him, a tear tracking down her face. ‘So, what happens now?’

  ‘We want you to go home, pack a bag and take Trent straight up to the children’s hospital. I’ll ring ahead and let them know you’re coming,’ she said. ‘You’ll be seen by an oncologist and treatment will commence immediately.’

  ‘Chemotherapy?’ Jenny asked.

  Madeline nodded. Poor little Trent, he was going to be put through hell in the next few months, trying to force his body into remission.