Dr. Carlisle's Child

by Carol Marinelli

  Lucinda gave a small chuckle. ‘So he’s definitely turned the corner. Has his mum been in?’

  Ann gave a knowing look. ‘Yes, she’s making the occasional appearance—dressed to the nines with not a hair out of place, unlike most of the other mums in this place who hardly manage to pull on a pair of leggings and a T-shirt and run a comb through their hair. Mrs Carlisle certainly doesn’t let her son’s illness curtail her. Hard to understand, isn’t it?’ she said glumly. ‘He’s so cute you just can’t imagine her not wanting to be with him.’

  ‘Ours is not to reason why,’ Lucinda said matter-of-factly, although privately she agreed with every word.

  ‘I know, I just worry for Seb. You were right to say something about the way the staff were treating Gemma. I try not to let my feelings for Seb show but, well, we’ve been friends for years, and it’s hard seeing him go through the mill. Not that Seb ever complains. As close as we are, I never really know what he’s thinking. He keeps his emotions pretty much under lock and key.’

  After Lucinda’s reprimand Ann had addressed the ward staff, making things easier not only for the Carlisles but for the nursing staff, too. Ann had apologised to Lucinda for letting things get so out of hand but Lucinda had only been grateful the problem had been so easily sorted. From this unsteady beginning a firm friendship was being forged.

  ‘Seb seems to be coping. I mean, I spoke to him after the operation and he was pretty upset, but any parent would be.’

  Ann gave her a surprised look. ‘Seb was upset? In front of you?’

  Lucinda nodded. ‘But it’s only to be expected. Billy had just had major heart surgery. You seem shocked—why?’

  Ann gave a small shrug. ‘Like I said, I’ve known Seb a long time, and I’ve never seen him with his guard down.’

  Lucinda thought for moment. ‘Professor Hays apparently went into rather a lot of detail about the procedure. Maybe it was that.’

  ‘Maybe,’ Ann replied, but she didn’t sound convinced. ‘I’m just glad someone was there with him when he was upset.’ She gave Lucinda a smile. ‘He doesn’t deserve to be alone.’

  Under Ann’s beady eyes Lucinda felt the beginnings of a blush, and she hastily changed the subject—the last thing she needed was Ann to realise she had a crush on Sebastian Carlisle. What would that do to her reputation? ‘Any other concerns on the ward?’

  Ann gave a worried frown. ‘I’m a bit concerned about Bianca Moore. I know she’s not strictly your patient until she has her transplant.’ Ann automatically touched the wooden desk. ‘And let it be soon, please, God. But I can’t get hold of the intern. Her parents brought her in a burger and chips and normally she’d wolf it down, but she hasn’t touched it, though there’s nothing I can put my finger on. For all I go on about Pete Hughes, he’s been good enough to look over her notes—that’s what he’s doing now.’

  At that moment Pete walked in. Dressed casually in jeans and a white T-shirt, he still looked immaculate.

  ‘Evening, Lucinda. How’s Kimberley?’ His comment was professional but the trace of bitterness in his voice didn’t go unnoticed by either woman.

  ‘She’s had some more Lasix and we’ve digitalised her. She’s not too good, though. How’s Bianca?’

  Pete placed the file on the desk in front of Ann. ‘I’ve had a look and she seems fine. Maybe she just wasn’t hungry.’

  ‘Thanks for looking anyway.’ Ann gave a small shrug but Lucinda could tell she was still worried.

  A pretty young nurse knocked on the office door. ‘I’ve handed over my patients to Sister Spencer—they all seem fine. Billy Carlisle is just having another nebuliser.’

  ‘Is his mum there?’ Ann asked.

  ‘No, she just left, but his dad’s with him. He’s going to stay the night again in the doctors’ on-call room next door once Billy’s asleep. He said to call him any time Billy wakes up.’ She smiled at Pete. ‘Are you done?’

  Pete nodded. ‘See you, ladies—hopefully not till Monday,’ he added half-jokingly. Lucinda gave a rueful smile. Weekends on call, even as a consultant, were rarely if ever that quiet.

  ‘Was that Kimberley Stewart you were talking about?’ Ann asked, pouring two coffees.

  Lucinda nodded. ‘Do you know the family?’

  ‘No, it’s just my nosy nature. She’s the micro-prem on NICU, isn’t she?’ As Lucinda nodded Ann pulled a worried face. ‘Any chance she’ll make it, I mean realistically?’

  Lucinda took a sip of her coffee before she answered. Kimberley and her family had been causing a great deal of anxiety and it was actually nice to be able to talk about it with Ann. ‘If she doesn’t it won’t be for the want of trying, but realistically, no, I don’t think there’s much hope.’

  Ann didn’t say anything and Lucinda found herself continuing. ‘It’s such a shame. Her mother has idiopathic infertility.’

  ‘In English, please,’ Ann said. ‘I’m on a cardiac ward, remember?’

  ‘There’s no reason that can be found as to why she can’t get pregnant,’ Lucinda explained. ‘Apparently they’ve been trying for years. This pregnancy was after their sixth and final attempt at IVF.’

  ‘Final?’ Ann questioned. ‘Why?’

  ‘They can’t afford to do it any more, either emotionally or financially. Their marriage is under a terrible strain. I went to the team meeting about them, and from what Sue Washington was saying they’re hardly talking. Janine, the mother, is completely wrapped up in Kimberley. Mark, the father, has to head back to work on Monday. It’s not the ideal situation but Kimberley’s seven weeks old now.’

  ‘And the bills don’t stop coming in just because you’ve got a sick child,’ Ann added.

  ‘Exactly. The nurses were just telling me it’s their wedding anniversary today. Ten years, can you imagine? I don’t seem to be able to manage ten weeks in my relationships.’

  Ann laughed. ‘You just haven’t met the right man yet. Tod and I have been together twenty-five years now and I couldn’t imagine it any other way.’ She thought for a moment ‘It’s a shame they can’t go out for their anniversary, get away from the hospital for a while.’

  Lucinda nodded. ‘It’s a shame all round. Anyway, there’s not much I can do about it. I’m a doctor, not a marriage guidance councillor. Who am I to offer advice?’ She stood up to go. ‘Thanks for the coffee. Do you want me to have a look at Bianca for you before I go? I can tell you’re still not happy.’

  Ann gave a relieved smile. ‘Please. I don’t want to go worrying her. She knows more about her condition than us, but I’m sure she’s not right.’

  Lucinda made her way down the darkened ward. By seven-thirty the lights were down and the children were being settled. There was strange background music coming over the intercom with the sound of running water and birds chirping. Ann had been given some CDs to try out that supposedly relaxed children. Lucinda wondered if she’d be burning incense next!

  Seb hadn’t made it to the on-call room and lay sound asleep next to Billy, his long legs dangling uncomfortably from the small bed. Billy was held firmly in the crook of his father’s muscular arm with his head resting on Seb’s broad chest. They looked the picture of contentment. It was hard to believe, seeing them lying there so peacefully, the problems they had both faced.

  ‘You still awake?’ Lucinda stood at the side of Bianca’s bed. The young girl gave her a suspicious look.

  ‘What are you doing here?’

  ‘Just checking on my patients.’

  ‘Why? You’re a consultant. Shouldn’t you be at some fancy ball on a Saturday night?’

  Lucinda gave a small laugh. ‘You make it sound very glamorous. I’m new. I like to make sure of things myself— I’ll go home later.’ Lucinda looked at the take-away cartons. ‘Didn’t fancy your burger, huh?’

  Bianca shook her head. ‘No, but I’m starving now. I could murder a pizza. I might ring out for one.’ She leant over to her drawer. ‘Mum didn’t leave any money.’ Bianca lay back dejected
ly on the pillows.

  Children this ill were invariably and understandably spoilt by the staff. If their day could be made easier with a new video game or something nice to eat, the ward funds covered it, and Lucinda had no doubt that this case would be no exception.

  ‘I’m sure we can stretch to a pizza. Do you want me to ask Ann to order you one?’

  Bianca shook her head. ‘I can ring myself. I’ve got my own phone,’ she said importantly. ‘But the nurses are all busy and all the other kids are asleep. I’m the oldest on the ward except for Toby and he’s too sick. It’s no fun eating pizza on your own.’

  Whether it was some sixth sense of Ann’s that she heeded or not, for some reason Lucinda didn’t ignore Bianca’s hidden plea.

  ‘I guess I haven’t eaten yet. All right, then, you ring for a pizza and I’ll stay for a slice—on one condition, though.’

  ‘Name it,’ Bianca wheezed.

  ‘You let me take some blood and have a quick listen to your chest.’

  Bianca rang for the food while Lucinda collected the various pieces of equipment she would need to take Bianca’s blood. Wheeling the stainless-steel trolley to the bedside, she smiled as Bianca grudgingly offered her arm.

  ‘I’m going to listen to your chest first.’

  Bianca sat forward and matter-of-factly lifted her gown. Her chest sounded as bad as ever but not worse, as far as Lucinda could tell.

  ‘I’ll do the blood now. What did you order?’ she asked by way of distraction as she swabbed the area and slipped the needle in.

  ‘Supreme, but with no anchovies. How much are you taking?’ Bianca yelped. ‘I’ll have none left the way you lot carry on.’

  ‘I haven’t finished yet.’ Lucinda transferred the blood from the syringe into the various tubes and bottles she had selected. ‘I’m going to do some blood gases as well.’

  ‘What tests are you doing?’

  ‘The usual—a full blood examination to check for any anaemia or signs of infection, U and Es to check for any electrolyte imbalance, and also some blood cultures.’

  ‘They normally only take them when I’ve got a temperature,’ Bianca said knowingly.

  Lucinda nodded as she took the arterial blood gases from the young girl’s wrist. ‘That’s right, there’s supposed to be more chance of isolating bugs when the temperature’s high and the infection is particularly active, but sometimes an infection still shows up when the temperature’s normal and you’re least expecting it. Now, you press on that for a few minutes while I get rid of these.’

  Lucinda popped the blood gases into a bag of ice and wrote the pathology slips in her extravagant scrawl. Having labelled all the bloods, she placed them in the pathology bags and made her way back to Ann’s office.

  ‘I’ve taken some bloods,’ she said to Ann. ‘They’ll need to go straight down as I’ve taken blood gases.’

  ‘I’ll ring for a porter. What do you think?’ Ann asked.

  Lucinda retrieved the slips from the bags and wrote ‘Urgent’ on each order. Shaking her head, she looked up at Ann. ‘That you’re not happy and that’s good enough for me. Everything seems all right on examination, but she is a bit pale and she does seem…’ Pausing, Lucinda tried to think of the right words ‘A bit clingy perhaps. She’s apyrexial and she’s on just about every antibiotic we’ve got in the pharmacy. Still, it’s worth doing some blood cultures just in case she’s brewing something.’ Lucinda hesitated a moment. ‘Bianca’s ordered a pizza. I said I’d stay for a slice,’ she said rather too casually as she made her way out of the office.

  ‘As soft as butter,’ Ann called after Lucinda. ‘As soft as butter.’

  Half an hour later Lucinda pulled the curtains and settled into a seat at Bianca’s bedside.

  Bianca handed her a slice of pizza, her pale face beaming. ‘There you go, Miss Chambers.’

  Lucinda felt a stab of pity as she watched Bianca swallow a handful of the enzyme capsules cystic fibrosis patients needed to take before eating in order to help their bodies digest food.

  ‘You can call me Lucinda as we’re sharing a pizza,’ Lucinda said. ‘But tomorrow morning its back to Miss Chambers,’ she added sternly as Bianca smiled happily, not remotely bothered by her tone.

  ‘You’re very pretty,’ Bianca said suddenly.

  ‘Thank you.’

  ‘I wish I was pretty.’

  ‘But you are.’ Lucinda said truthfully. ‘You’re gorgeous.’

  ‘I’m too thin and spotty, and these disgusting braces. Yuk.’ She made a face.

  ‘I know how you feel, I had braces at your age but they’ll come off soon and it will be more than worth it. Being cooped up in here doesn’t help, and once you get the transplant you’ll fill out and the spots will go before you know it. You really are going to be very beautiful.’

  ‘If I get the chance,’ she said poignantly, and she turned her face to the television screen.

  Lucinda had finished her slice of pizza but absent-mindedly she picked up another as she became engrossed in the film Bianca had turned on. The speaker lay on Bianca’s pillow, forcing Lucinda to strain to catch all of the words, but it didn’t mar her enjoyment—after all, it was one of Lucinda’s all-time favourites. They watched in amicable silence, until the young boy on the screen movingly asked his widowed father things to remember about his dead mother. Lucinda turned and saw silent tears pouring down Bianca’s face.

  ‘Why don’t you turn it over?’ she suggested.

  Bianca shook her head. ‘No, I’m enjoying it, believe it or not.’ She gave a loud sniff. ‘I’m not afraid of dying for myself. It’s just Mum and Dad and my brother, Lewis. I feel so sorry for them. I know how sad they’ll be. I just wonder how they’ll manage.’

  Lucinda sat very still. There were times in medicine for platitudes and optimism in the face of the worst odds. But there was also a time when the possibility of death, however unwelcome, however vehemently opposed, needed to be faced. Just because they were talking about it, it didn’t mean they were accepting or giving in. Bianca simply needed to talk.

  ‘They’d be sad, of course,’ Lucinda said after a while. “Devastated, no doubt, but in time things would get better. They’d have wonderful memories, and go on loving you and talking about you. They’d be all right. Have you spoken to them about it?’

  ‘I’ve tried, but they just get so upset. I want to tell them I’m not scared and how much I love them, but they just change the subject.’

  ‘It’s hard for them, Bianca, but they know how much you love them. Sometimes that’s the one thing that doesn’t need to be said.’

  ‘Am I going to die?’ The question, though half-expected, still tore through Lucinda.

  ‘Bianca, I can’t say no. I want to but I can’t, the same way I can’t make that sort of guarantee to any of my patients. But I can promise that I’ll do my very best to make sure you don’t, and you have to promise to keep fighting.’

  ‘I lie here at night and I wish more than anything for new lungs and heart, and then I feel awful because it means I’m wishing someone dead.’

  Lucinda shook her head fiercely. ‘No, you’re not. You’re wishing you could live and that’s entirely different. And, anyway, wishing doesn’t make a scrap of difference. Terrible things happen, accidents happen. You lying here, wishing for a new heart and lungs, doesn’t change fate. It would happen anyway. You mustn’t feel guilty for wishing you were well.’

  Bianca coughed. ‘Not well exactly. I’d still have CF, but at least I’d have a clean slate to start with. A new set of lungs for this horrid disease to ruin.’

  Lucinda gave her a smile. ‘Maybe it won’t. There’s a lot of progress being made with the treatment of CF but you don’t need me to tell you that.’ She pointed to the pile of books by the bed. ‘I’d better watch my back if you decide to take up medicine. It might be me having to call you Miss Moore.’

  Lucinda stood up ‘Now, I’m off home. You get some sleep after the film finishes.’
She made her way to the curtain, but Bianca called her back.

  ‘Lucinda, is there a happy ending?’

  ‘You’ll just have to wait and see,’ Lucinda said matter-of-factly, but, seeing Bianca lean back on the pillows, her face softened. ‘Of course there’s a happy ending,’ Lucinda said gently, wishing silently that her words didn’t just apply to the film.

  Popping her head into the office to say goodnight, she saw Ann tapping away on the computer.

  ‘Are you still here?’ Lucinda asked.

  ‘I could say the same for you. I’m just looking to see if any of Bianca’s bloods are back. Then I’ve just got to check the drugs and hopefully then I can get home. Here we are,’ she added as the results popped up on the screen. Lucinda looked over her shoulder.

  ‘Nothing out of the ordinary yet for Bianca. I’m off, then. Goodnight.’

  Tired now, Lucinda took the lift down one floor and made her way to NICU to check on Kimberley, promising herself a lie-in next morning if her pager didn’t go off.

  The all-too-familiar sound of the overhead display system crackling into action stopped her in her tracks. As a consultant she wasn’t on the cardiac arrest or medical emergency teams, but the hospital had an overhead visual display board that gave information as to where any such emergency was located. The protocol was such that all doctors in the vicinity were to proceed to the area to enable a rapid response. Even before the numbers flickered onto the screen Lucinda just knew what to expect. ‘000 1 PCUG.’ Which translated to ‘cardiac arrest, 1st floor, Paediatric Cardiac Unit, General Ward.’

  The lifts were out of bounds during any hospital emergency, so Lucinda ran to the stairwell beside the lift, taking the stairs two or three at a time. Coming out onto the corridor, she only just avoided colliding with Seb as he burst out of the spare on-call room. One look at his stricken face told her exactly what he was thinking, and she longed to comfort him.

  ‘I just left the ward,’ she said somewhat breathlessly as she ran along with him. ‘Billy was fine.’ But she knew Seb wouldn’t be reassured until he saw his son for himself.

  Running onto the ward, they found that ordered chaos reigned. Curtains had been pulled around all the children’s beds, leaving only Bianca’s exposed. The headrest was off and a nurse was inflating Bianca’s lungs with an ambu-bag as Ann knelt astride the young girl, massaging her chest. Another nurse was pulling up drugs and a third was attaching electrodes to Bianca’s chest.