Knight on the Children's Ward

by Carol Marinelli

  ‘How can they not know?’ Cassie asked.

  ‘Because they know no different,’ Ross said patiently. ‘This is particularly the case with emotional abuse, which is hard to define. Neglect is a hard one too. They are used to being neglected. They have grown up thinking this is normal.’

  It was a complicated talk, with lots of questions. None from Annika, of course. She just took her notes and sometimes gazed out of the window or down at her hands. Once she yawned, as if bored by the subject, but this time Ross didn’t for a moment consider it rude.

  He remembered the way she had sat at the charity ball, ignoring the speaker, oblivious to his words. Now, standing in front of everyone, he started to understand.

  ‘A frozen look?’ Cassie asked, when he explained what he looked for in an abused child, and Ross nodded.

  ‘You come to recognise it…’ he said, then corrected himself. ‘Or you sometimes do.’

  There were more questions from the floor, and all of a sudden he didn’t feel qualified to answer, although he had to.

  ‘These children sometimes present as precocious. Other times,’ Ross said, ‘they are withdrawn, or lacking in curiosity. You may go to put in an IV and instead of resistance or fear there is compliance, but often there is no one obvious clue…’

  He wanted his lecture over; he wanted a moment to pause and think—and then what?

  He felt sick. He thought about wrapping things up, but Cassie was like a dog with a bone, asking about emotional abuse—what did he mean? What were the signs?

  ‘“Just because I can’t see it, I still know you are hurting me.”’ He quoted a little girl who was now hopefully happy, but had summed it up for so many.

  And you either understood it or you didn’t, but he watched Annika’s mouth tighten and he knew that she did.

  ‘How can you get them to trust you?’ another student asked.

  ‘How do you approach them?’ Cassie asked.

  But Ross was looking at Annika.

  ‘Carefully,’ he said. ‘Sometimes, in an emergency, you have to wade in a bit, but the best you can do is hope they can trust you and bit by bit tell their story.’

  ‘What if they don’t know their story?’ Annika asked, her blue eyes looking back at him, and only Ross could see the flash of tears there. ‘What if they are only just finding out that the people they love have caused them hurt, have perhaps been less than gentle?’

  ‘Then you work through it with them,’ Ross said, and he saw her look away. ‘Or you support them as they work through it themselves. It’s hard for a child to find out that the people they love, that those who love them—’

  ‘They can’t love them…’ Cassie started. ‘How can you say they love them?’

  ‘Yes,’ Ross said, ‘they can—and that is why it’s so bloody complicated.’

  He had spoken for an hour and barely touched the sides. He didn’t want her to be alone now, he wanted to be with her, but it was never that easy.

  ‘Sorry to break up the party.’ Lisa’s voice came over the intercom. ‘They need you in Emergency, Ross. Two-year-old boy, severe asthma. ETA ten minutes…’

  And the run to Emergency would take four.

  As everyone dispersed Annika sat there, till it was only the two of them left.

  ‘You have to go.’

  ‘I know.’

  Her head was splitting.

  Don’t tell. Don’t tell. Don’t tell.

  Family.

  No one else’s business.

  How much easier it would be to walk away, to shut him out, to never tell rather than to open her heart?

  ‘You know that my brother, Levander, was raised in the orphanages…’

  He did, but Ross said nothing.

  ‘We did not know—my parents said they did not know—but now it would seem that they did.’ It was still so hard to believe, let alone say. ‘I thought my parents were perfect—it would seem I was wrong. I was told my childhood was perfect, that I was lucky and had a charmed life. That was incorrect too.’

  ‘Annika…’

  ‘You want me to be open, to talk, and to give you answers—I don’t know them. When I met my brothers’ wives, when I saw what “normal” was, I realised how different my world was…’ She shook her head at the hopelessness of explaining something she didn’t herself understand. ‘I was sheltered, my mind was closed, and now it is not as simple as just walking away. Every day it is an effort to break away. I don’t like my mother, and I hate what she did, but I love her.’

  ‘You’re allowed to.’

  ‘I realise now my parents are far from perfect. I see how I have been controlled…’ She made herself say it. ‘How conditional their love actually was. I am starting to see it, but I still want to be able to sustain a relationship with my mother and remember my father with love.’

  ‘I’m sorry.’ He had never been sorrier in his life. ‘For rushing you, for…’

  ‘It can’t be rushed,’ Annika said. ‘And I am not deliberately not telling you things. Some of it I just don’t know, and I don’t know how to trust you.’

  ‘You will,’ Ross said.

  She almost did.

  His pager was shrilling, and he had to run to the patient instead of to her. He had to keep his mind on the little boy and, though he was soon sorted, though the two-year-old was soon stable, it was, Ross decided, the hardest patient he had dealt with in his career.

  So badly he wanted to speak with her.

  CHAPTER NINETEEN

  ‘HI, ANNIKA?’

  ‘Yes.’

  ‘I’m ringing for a favour.’ Now that he understood her a little bit, he could smile at her brusqueness. ‘A work favour.’

  ‘What is it?’

  ‘I’ve got this two-year-old with asthma. Emergency is steaming. There’s some poor guy in the next bed after an MVA, and the kid’s getting upset.’

  ‘Bring him up, then.’

  ‘The bed’s not ready. Caroline says you need an hour,’ Ross explained. ‘Look, can you ring Housekeeping and ask them…?’

  ‘Just bring him up,’ Annika said. ‘I’ll get the bed ready. Caroline is on her break. It can be my mistake.’

  ‘You’ll get told off.’

  ‘I’m sure I will survive.’

  ‘It will be my mistake,’ Ross said. ‘Just make sure the bed’s made—that would be great.’ He paused for a moment. ‘I need another favour.’

  ‘Yes?’

  ‘This one isn’t about work.’

  ‘What is it?’

  ‘I’d like…’ He was about to say he’d like to talk, but Ross stopped himself. ‘I’d like to spend some time with you.’

  The silence was long.

  ‘Tonight,’ Ross said.

  And still there was silence.

  ‘You don’t have to talk,’ he elaborated. ‘We can listen to music…wave to each other…’ He thought he heard a small laugh. ‘I just want to spend some time with you.’

  ‘I’m busy on the ward at the moment. I don’t have time to make a decision.’

  She was like no one he had ever met, and she intrigued him.

  She would not be railroaded, would not give one bit of herself that she didn’t want to, and he admired her for that. It also brought him strange comfort, because when she had been with him she had therefore wanted to be there—the passionate woman that he had held had been Annika.

  He had wanted more than she was prepared to give.

  And now he was ready to wait. However long it took for her to trust him.

  ‘He can go up…’ Ross said to one of the emergency nurses. ‘I’ve cleared it with the ward.’

  The emergency nurse looked dubious, as well she might. The children’s ward had made it perfectly clear that it would be an hour at least, but the resuscitation area was busy, with doctors running in to deal with the patient from the car accident, neurologists, anaesthetists… The two-year-old was getting more and more distressed.

  He could hear th
e noise from behind the curtains and gave the babe’s mum a reassuring smile, blocking the gap in the curtains just a touch with his body as the toddler and his mother where wheeled out.

  ‘Thanks so much for this.’

  ‘No problem.’ He gave her a small grimace. ‘They might be a bit put out on the ward when you arrive, but don’t take it personally—he’s better up there than down here.’

  He’d left his stethoscope on the trolley and went over to retrieve it. He considered walking up to the paediatric ward to take the flak, just in case Annika was about to get told off on his account, but then he smiled.

  Annika could take it, would take it—she had her own priorities, and a blast from Caroline… The smile froze on his face, everything stilled as he heard a colleague’s voice from behind the curtain.

  ‘Kolovsky, Aleksi…’

  Ross could hear a swooshing sound in his ears as he pictured again the mangled, bloodied body that had been rapidly wheeled past twenty minutes or so ago. His legs felt like cotton wool as he walked back across the resus unit and parted the curtains.

  The patient’s face had been cleaned up a bit, though Ross wasn’t sure he would have recognised him had he not heard his name, but, yes, it was him.

  His good friend Iosef’s identical twin.

  Annika’s brother.

  ‘Aleksi…’ His voice was a croak and he had to clear it before he continued. ‘Aleksi Kolovsky.’

  ‘His sister works here, doesn’t she?’ A nurse glanced up. ‘Annika? One of the students…?’

  He stood and watched for a few moments, more stunned than inquisitive. He watched as the powerful, arrogant man he had met just the once extended his arms, indicative of a serious head injury, and grunted with each breath. The anaesthetist had decided to intubate, but just before he did, Ross went over.

  ‘I’m going to get Annika for you,’ he said, ‘and you’re going to be okay, Aleksi.’

  CHAPTER TWENTY

  THE hospital grapevine worked quickly, and Ross was aware not just that he had to let Annika know, but his good friend Iosef too.

  The Kolovskys were famous. It would be breaking news soon—not just on the television and the internet, but the paramedics and emergency personnel would be talking, and both Iosef and his wife Annie worked in another emergency department across the city.

  As he walked he scrolled through his phone. He didn’t have Annie’s number, only Iosef’s, but, deciding it would be better for his friend to hear it from his wife, he called their emergency department. He found out that Iosef was just being informed and would be there to see Aleksi for himself shortly.

  Ross moved faster, walked along the long corridor at a brisk pace, bracing himself for Annika’s reaction and wondering what it would be.

  He spoke briefly with Caroline, informed her of the news he would be imparting, and then headed down to room eleven.

  ‘He’s settled.’ She was checking the asthma baby’s oxygen saturation; he was sleeping now, his mother by his side.

  ‘That’s good,’ Ross said. ‘Annika, could I have a word, please?’

  ‘Of course.’ She nodded to the mother and stepped outside. ‘There was no trouble with Caroline—the cot was prepared…’

  ‘Thanks for that. Would you mind coming into my office?’

  Her eyes were suddenly wary.

  ‘It’s a private matter.’

  ‘Then it can wait till after work,’ Annika said.

  ‘No, it’s not about that…’ He blew out a breath, wondered if perhaps he should have taken up Caroline’s suggestion and let her be the one to tell Annika, but, no, he wanted it to come from him—however little he knew her, still he knew her best. ‘Just come into my office, please, Annika.’

  She did as told and stood, ignoring the seat he offered, so he stood too.

  ‘There was a patient brought into Emergency,’ Ross said. ‘After a motor vehicle accident. It’s Aleksi, Annika.’

  ‘Is he alive?’

  ‘Yes.’ Ross cleared his throat. ‘He’s unconscious; he has multiple injuries and is still being assessed.’ She was pale, but then she was always pale. She was calm, but then she was mostly calm. She betrayed so little emotion, and for Ross it was the hardest part of telling her. She just took it—she didn’t reach out, didn’t express alarm. It was almost as if she expected pain.

  ‘I’ll tell Caroline that I need to…’

  ‘She knows,’ Ross said. ‘I’ll take you down there now.’

  Annika only wavered for a second. ‘Iosef…’

  ‘He’s been informed and is on his way.’

  They walked to Emergency. There was no small talk. He briefed her on the little he knew and they walked in relative silence. A nurse took them to a small interview room and they were told to wait there.

  ‘Could I see my brother?’ Annika asked.

  ‘Not at this stage,’ the nurse said. ‘The trauma team are trying to stabilise him. As soon as we know more, a doctor will be in to speak with you.’

  ‘Thank you.’

  And then came Iosef and Annie, and Nina, their mother, who was hysterical. Iosef and Annika just sat there, backs straight, and waited as more and more Kolovskys arrived.

  And still there was no news.

  A doctor briefly popped in to ask the same questions as a nurse had ten minutes previously—was there any previous medical history that was relevant? Had Aleksi been involved in any other accidents or had any illnesses?

  ‘Nothing!’ Nina shouted. ‘He is fit; he is strong. This is his first time sick—please, I need to see my son.’

  And then they went back to waiting.

  ‘Do we keep relatives waiting as long as this?’ Iosef’s patience was finally running out. ‘Do they know I’m an emergency consultant?’

  ‘I’ll ask again,’ Annie said.

  ‘I’ll come with you.’ Ross went with her.

  ‘God!’ Annie said, once they were outside, blowing her dark curls to the sky as she let out a long breath. ‘I can’t stand it in there—I can’t stand seeing Iosef…’ She started to cry, and all Ross could do was pull a paper towel out of the dispenser and watch as she blew her nose. ‘It was the same when his dad died. You know he’s bleeding inside, but he just won’t say…’

  ‘He will,’ Ross said. ‘Maybe later—to you.’

  ‘I know.’ Annie nodded and forced a smile. ‘I should warn you. They’re bloody hard work, that family.’

  ‘But worth it, I bet?’ Ross said. Then he crossed a line—and he would only do it once. He looked at Annie, and stared till she looked back at him. ‘Annika isn’t a lightweight.’

  ‘I know she’s not.’ Annie blushed.

  ‘That family is bloody hard work, and Annika’s right in the thick of it…’

  He watched her cheeks redden further.

  ‘Imagine if you woke up and found out that the grass was red and not green.’

  ‘I don’t get you.’

  ‘Imagine if you’d been told all your life how lucky you were, how spoiled and indulged and precious you were, how grateful you should be.’

  Annie just frowned.

  ‘Grateful for what?’ Ross demanded, and he wasn’t sure if he and Annika would make it, because at any moment she was likely to turn tail and run, so he took the opportunity to tell Annie. ‘Go and tell your doctor husband, my good friend, to look up emotional abuse. I can’t stand the board at the hospital, but maybe on this they’re right—there are charities closer to home. Tell him to wake up and see what’s been going on with his own sister.’

  He watched her face pale.

  ‘They controlled what she ate, how she spoke, what she thought—have you ever stopped to think how hard it must be to break away from that?’

  ‘We try to help!’

  ‘Not good enough,’ Ross said. ‘Try harder.’

  CHAPTER TWENTY-ONE

  THEY could get no information at the nurses’ station, so, before Iosef did, Ross pulled rank. He sent Annie ba
ck to the relatives’ room and walked into resus, past the huddle around the bed, and up to Seb, the emergency consultant, who was also a friend. He was carefully examining X-ray films.

  ‘How’s it looking?’

  ‘Not great,’ Seb said, ‘but there’s no brain haemorrhage It’s very swollen, though, and it’s going to be a while till we know if there’s brain damage.’

  He was bringing up film after film.

  ‘Fractured sternum, couple of ribs…’ Seb was scanning the X-rays and he looked over to Ross, who was scanning them too, looking at the fractures, some old, some new. ‘His left leg’s a mess, but his pelvis and right leg look clear…’ Seb said. The X-rays were just a little harder to read than most. There was an old fracture on Aleksi’s right femur, and when he pulled up the chest film Ross looked again and there were a few old fractures there too.

  ‘Any skull fracture?’

  ‘One,’ Seb said. ‘But, again, it’s old.’

  ‘How old?’

  ‘Not sure—there’s lots of calcification… The mum says he’s never been in hospital. Poor bastard.’ Seb cleared his throat. ‘Twenty years ago I’d have been calling you.’

  ‘And Social Services,’ Ross said, his lips white. ‘What happens when it’s all these years on?’

  ‘Look, he could have been in an accident they don’t know about…’ But these fractures were old, and in a child they would have caused huge alarm. ‘Let’s get him through this first,’ Seb said. ‘I’ll come and talk to the family.’

  Nina sobbed through it; the aunts were despairing too. Iosef and Annika just sat there.

  Seb was tactful, careful and thorough. He mentioned almost in passing that there were a couple of old injuries, and Nina said he had been in a lot of fights recently, but Seb said no, some looked older. And Iosef remembered a time his brother was ill, the time he came off his bike…

  Nina remembered then what had happened.

  ‘Oh, yes…’ she said, but her English was suddenly poor, and an aunt had to translate for her.