A Mother's Secret (Mills & Boon Medical)

by Scarlet Wilson

  Claire nodded. ‘I’m lucky. I do accounts. So most of the time I can work from home and do things online.’

  ‘That’s great. But I guess just about everyone that knows you wants a little advice for free.’

  Claire nodded. ‘Oh, yes, just like everyone who meets you will tell you the list of symptoms they’ve got, usually as you’re buying a drink at the bar or just about to eat dinner.’

  ‘Have you been camping out in my life?’

  She shrugged. ‘Happens with Logan all the time. It drives me nuts.’ She topped up the tea. ‘Do you read, Gemma? Fancy joining a book club?’

  Gemma felt her heart flutter. She’d spent the last few weeks focusing on settling in. She hadn’t had much of a chance to meet other women—except at the surgery. ‘I love reading. I was part of a book group in Glasgow.’

  Gemma nodded. ‘The book group in Brodick is a real mix. We range in age from twenty-two to eighty.’

  ‘Wow. How do you pick your books?’

  ‘We all just take a turn. You’re never going to please everyone. So we just ask that people pick something that they couldn’t put down.’

  ‘Sounds fabulous. What do I need to do?’

  ‘Not much. We meet every fortnight at someone’s house and...’ she nodded at Isla ‘...kids are welcome. There’s always someone to play with. When it’s your turn to host you just supply the wine and the cakes.’ Claire leaned across the table. ‘I’ll let you into a secret. I never bake. Mum makes me something when it’s my turn. I just buy the wine. I’ll bring you the book list and you can order online. The next meeting is a week on Thursday. Don’t worry if you’ve not had a chance to read the book—just come and drink the wine.’

  At last. A chance to meet some female friends on the island. She didn’t care what age they were. She just wanted to have people she could have a laugh and a conversation with. And Claire seemed like one of those people. Even though she had a sadness around her eyes, she was trying to get on with things.

  She could see her watching Isla from the corner of her eyes. But it was nice. She obviously appreciated the relationship her mother had with the little girl and could see that it benefited them both. Thank goodness.

  Claire was still smiling at her. ‘Think you’re up to it? A hard night’s reading?’

  Gemma laughed. ‘I think I’ll cope.’ She reached over and gave Claire’s hand a squeeze. ‘Thanks, Claire.’

  She was taking the first steps towards making some new friends on the island. And it felt good.

  * * *

  Gemma stared at the screen. Twenty-five patients this morning already. And that was before she’d even had a chance to look at the list of emergencies added on at the end.

  She straightened up and stretched her back. If she could grab a quick cup of coffee, it might give her some energy for the next onslaught of patients.

  In some respects Arran was working out better than she could have hoped for. The island was beautiful, the people warm and friendly. It was inevitable that some would be a little set in their ways, but that was to be expected.

  Isla loved it here. And she especially loved Logan’s mum. Her excitement was almost palpable in the mornings when she was dropped off, and she spent most of the evening telling Gemma everything that she and Granny Scott had got up to. Mrs Scott had introduced Isla to another couple of little girls who would be starting school after the summer and they had become instant playmates.

  If only she could make friends so easily.

  For the last fortnight it had been clear that Logan was avoiding her. The strawberry tarts had never appeared and, unless it was to do with work, their conversations were short and stilted. Surely he couldn’t be annoyed about having to do some extra on-calls? If she hadn’t been here, there would have been no one to help out with the surgery, which would have put even more pressure on him.

  Yesterday she’d gone to ask him something about a patient and he could barely look her in the eye. It was as if all the slightly flirtatious behaviour had disappeared in a big puff of smoke. What on earth could she have done to offend him?

  She grabbed some coffee from the staffroom and went to the reception desk to speak to Julie. ‘How many extras do we have?’

  Julie glanced over her shoulder into the waiting room. ‘There’s only an extra five patients so far. But Logan still hasn’t finished his surgery. He’s actually running a bit behind and still has three more to see. Then he’s got the home visits too.’

  ‘That’s fine. I’ll take them all.’

  ‘Are you sure?’

  Gemma nodded. ‘Unless there’s any patient that would rather see a male GP then I’m happy to see them.’

  Julie nodded. ‘That’s great. I’ll put them on your list and you can pull up their files on your computer.’

  Gemma took a quick gulp of coffee and headed back to the surgery room. Logan’s door was still firmly closed. Two bouts of tonsillitis, one episode of gout and what looked like a slipped disc later, she only had one patient left to see.

  She pulled up his file. David Robertson, twenty-six. No previous medical history to speak of—in fact, the guy never usually set foot in the surgery. She stepped out to the waiting room to call his name.

  It was clear exactly who David Robertson was. He was the only male left in the waiting room, with an anxious-faced female holding his hand.

  ‘Hi, there. I’m Dr Halliday. Would you like to come through, David?’ she asked.

  She watched as he grimaced as he stood up and gave a slight stagger. She was at his side in an instant. ‘Are you okay?’

  He nodded through gritted teeth and walked slowly through to the surgery room, easing himself into a chair.

  He had a glorious tan. But his complexion was almost grey. This young man was clearly unwell. ‘Can you tell me what’s wrong?’

  ‘We’ve just come back from our honeymoon,’ his wife said quickly, her eyes shining with tears.

  ‘Where were you?’ Gemma’s brain was whirring, trying to decipher what could be wrong with this young man. Please, don’t let it be some weird and wonderful tropical disease she’d never heard of. The crossover into GP land had been a little easier than she’d expected. Lots of conditions that affected kids also affected adults, making her breathe a sigh of relief and not feel so out of her depth.

  The young woman spoke. ‘We were in Egypt. We just got off the plane at Glasgow Airport and got the boat home. David has been sick the whole way.’

  Egypt. Her brain clicked into overtime. Were there any specific diseases from there?

  ‘Vomiting or just nausea?’ Could he have picked up some weird stomach bug on holiday?

  David had closed his eyes. He seemed happy to let his new wife do all the talking. Another sign of how unwell he was feeling.

  ‘Both. He started feeling really dizzy and sick then he started vomiting on the plane. He said his joints were all sore.’

  Gemma had lifted her pen and was noting the symptoms as she watched her patient. She didn’t like this. She didn’t like this at all.

  At first glance it was a list of indiscriminate symptoms that could be related to almost anything. But the patient was sitting right in front of her and he was the sickest person she’d seen since she’d got here.

  ‘Were either of you unwell while you were on honeymoon? Did you have gastric symptoms?’

  The young woman shook her head. ‘I know lots of people say that’s normal if you go on holiday to Egypt, but we were both fine. It was literally just as we got on the plane that David started to feel unwell.’

  ‘Any injuries on holiday? Bumps, scrapes, bites or falls?’ She was trying to cover all her bases here. Could he have picked up some kind of infection or blood disorder?

  But both husband and wife shook their heads.

  What she really wanted to do was look up bugs and insects and see what kind of things the ones in Egypt carried. Tropical diseases. That’s what she’d need to study tonight. The variety of thi
ngs in GP practice was going to make her brain explode.

  Gemma pulled out her stethoscope and BP cuff. She took a few seconds to wrap the cuff around his upper arm, noting him wince as she touched his elbow joint. He hadn’t even opened his eyes.

  ‘This will just take a few seconds, David.’ She inflated the cuff and watched the figures on the digital monitor. His blood pressure was quite low, but that couldn’t account for all his symptoms. She put her stethoscope in her ears. ‘David, if you don’t mind, I’m just going to have a listen to your chest. Can you sit forward for me?’

  He gave a little groan and sat forward. She pulled up his shirt a little to get a look at his skin and see if there were any strange rashes. Nothing obvious. Just more of the glorious tan.

  ‘This isn’t like him at all. David’s never unwell. He’s as fit as a fiddle. I don’t understand what’s happened.’ His wife couldn’t stop talking, her nerves obviously getting the better of her.

  Gemma gave a little nod of her head and then gestured towards David’s chest. ‘Can you give me a sec to listen?’

  His wife blushed then looked as if she was about to burst into floods of tears.

  Gemma frowned. She couldn’t quite decipher what she was hearing. One part of his lung sounded as if it wasn’t inflated properly. Could he have a pneumothorax? And why on earth would a fit, healthy young man have a collapsed lung if he’d had no injury? Could it be undiagnosed TB or some other kind of chest condition?

  He started to move, scratching at his skin, first lightly and then with more venom, as if the itch was getting worse. She was missing something here.

  She pulled over the oxygen saturation monitor and put it on his finger. His level was way too low. Instantly she pulled over the oxygen cylinder that was kept in the room. ‘No history of asthma or chest conditions as a child?’

  It would be dangerous to put pure oxygen on someone with asthma.

  David gave the slightest shake of his head. She turned the oxygen on full and slipped the mask over his face. ‘I’m just going to try and make your breathing a little easier. Rest back in the chair.’

  The truth was she really needed a chest X-ray to get a clear picture of what was happening. But that would involve transporting David over to the hospital—and, to be honest, he didn’t look fit for that.

  Then again, maybe he would be better over at the hospital?

  Panic was starting to fill her. Her inexperience in general practice was starting to feel like a weight around her chest. She was used to paediatric emergencies. They were part and parcel of her previous life. But this was entirely different.

  All her paediatric emergencies had been dealt with in a hospital environment, with a whole host of equipment, drugs and other staff to help. As an experienced paediatrician, even when chaos was erupting around her, she was confident in her abilities to deal with the situation. Right now she had no idea what was wrong with this young man. But he was looking sicker by the second.

  Maybe she should go and see if Logan or one of the other partners was around?

  Logan. She really, really wanted to talk to him. She was starting to feel a bit sick herself right now. But she pasted a composed smile on her face.

  ‘Mrs Robertson, can you tell me more about your holiday? Did you take part in any unusual activities? Eat anything different? Get bitten by an insects?’

  Her questions were starting to sound desperate. Just like the way she was feeling.

  Mrs Robertson looked a bit confused for a second. ‘Well, we went on a camel ride one day. And we ate out in the desert one night at a special restaurant.’

  ‘Any unusual foods you haven’t eaten before?’

  She shook her head. ‘I don’t think so, and call me Pam. I can’t get used to Mrs Robertson.’ She lifted her eyes, clearly racking her brain for the rest of their activities, as her other hand anxiously twisted the new wedding ring on her finger. ‘We did a tour inside the pyramids, oh, and I bought David some diving lessons. He did them too.’

  Diving. Her brain started to go mad. She’d been reading all about this just the other day. ‘When was the last time he dived? Was it a few days before you came home?’

  Pam shook her head again. ‘Oh, no. It was just a few hours before we got on the plane. He had three lessons to fit in, and we’d been so busy that it was the only time he could fit the last one in.’

  No. It couldn’t be. The thing she’d researched just the other day because she didn’t know a single thing about it. But all these little symptoms were starting to look horribly familiar.

  ‘Let me just check with you. Nausea and vomiting. Joint pains. Dizziness. Itching. Anything else you can think of?’

  Her head was adding in the clinical symptoms she was seeing. Hypotension. Low oxygen saturation. The strange-sounding lungs.

  She was trying to remember the recommendations for flying after diving. Was it wait twelve hours after a single dive and eighteen hours after multiple dives? There had been so much information she couldn’t recall all the details.

  But there had been a checklist of symptoms and a neurological assessment.

  She crossed over to the computer and checked her browsing history, pulling up the pages she needed.

  Her heart was starting to race. One thing was clear. She needed to act quickly or this young man could die. The diving lessons his new wife had bought him could be the death of him.

  Logan. She needed to speak to Logan.

  ‘Can you excuse me both a second?’

  Hoping her face wasn’t betraying her and her demeanour was remaining calm, she crossed over to the door. The waiting room and surrounding area was empty. The door to Logan’s door was open with no one around.

  Julie was in the staffroom, her sandwich just heading to her lips. ‘Where’s Logan?’

  Her eyes widened. ‘What’s wrong?’

  ‘Is he here? Are any of the other partners here?’

  Julie shook her head. ‘Logan’s on his way to Shortbank Farm, Mr Gallacher’s got some kind of injury—and that’s out of range for the mobile. I can’t even phone him for you.’

  ‘Is anyone else around?’

  Julie shook her head. ‘Dr King is away to the mainland. He had a hospital appointment in Glasgow this afternoon.’

  Gemma couldn’t help the words that streamed out of her mouth.

  Julie put down her sandwich and stood up. ‘What can I do to help? Is it David Robertson?’

  Gemma took a deep breath. Julie hadn’t exactly been over-friendly before, but she could obviously be counted on in a moment of crisis. She’d worked in the surgery for a few years, so must have a good handle on how things were dealt with in an emergency.

  ‘I think David Robertson is showing signs of decompression sickness. He was diving just before getting on the plane. But I haven’t done the neurological assessment yet, so I’m not entirely sure.’

  Julie shook her head. ‘Time is what matters here. I’ll page the consultant at Aberdeen and you can speak to him while you do the assessment on the patient. He’ll arrange the emergency transport and getting the hyperbaric chamber at Millport ready.’ She waved her hand at Gemma. ‘I’ll put the call through as soon as I get him, and I’ll keep trying Logan on the other line.’

  ‘Has Logan treated a patient with decompression sickness before?’

  Julie’s nose wrinkled. ‘I’m not sure. But he did some specialist training over at the hyperbaric chamber last year. So he’ll be able to tell you everything you need to know.’

  Gemma felt a tiny glimmer of relief. She went back through to the consulting room. It was obvious that there had been no improvement.

  She sat down beside Pam and reached over and touched David’s hand. ‘Okay, the signs and symptoms that you’re showing, David, are causing me some concern. I’m wondering if there’s a connection between you diving and then flying quite so soon afterwards. It can cause something called decompression sickness and I’m just going to run through a checklist. There i
s a specialist who deals with this condition and I’m waiting for him to call me back, so I might have to talk to him as we are doing this.’

  Tears started to fall down Pam’s face. ‘Decompression sickness? Isn’t that what the people who do diving for a living get? The nitrogen bubbles floating around their body?’

  Gemma nodded as she started to quickly fill in the form that appeared on her screen, Name. Age. Date. Gas used...

  ‘Do you know any details of the dive?’

  David shook his head. Pam’s eyes widened. ‘What do you mean?’

  ‘The type of gas used? How deep it went? How long the dive was?’

  Pam was starting to sob now. ‘I don’t know any of that. David just did the same as everyone else that was there. It was a dive school in Egypt. I’d bought the package online.’

  Gemma nodded. ‘Can you remember the name of the company? I might be able to contact them later and get some details.’

  Pam pulled a bent card from her purse. ‘I picked this up in the office when we went to book the lessons.’

  At least it was something. She could deal with that later.

  ‘Can you remember how long the dive lasted?’

  Pam took a deep breath. ‘Over an hour? Maybe an hour and a half?’

  Gemma kept quickly typing. David wasn’t talking right now. She was going to have to keep getting all information from his wife. ‘Do you know if David stopped on the way up?’

  Pam shook her head.

  ‘And how many dives did he do? Was it three?’

  She nodded her head.

  Gemma checked the last question. ‘This is really important. Can you remember when the last dive finished?’

  Pam checked her watch and screwed up her face. ‘Our time or theirs?’

  Gemma reached over and gave her hand a squeeze. ‘I’ll work out the time difference. How long ago was it?’

  ‘About ten hours?’

  Gemma noted it on the record and turned back to face David just as the phone rang. It only took a few moments to introduce herself and the background of her patient to the hyperbaric consultant. She gave the signs and symptoms she’d already noted, the dive details and his blood pressure, oxygen saturation and current treatment.