The Italian Doctor's Perfect Family

‘Oh?’ The extra distraction from professionalism was unavoidable. ‘How strange!’

Pip’s gaze was shuttered and her tone guarded. ‘Is it?’

‘Only to me, maybe.’ Toni smiled reassuringly. ‘I was largely brought up by my grandmother. Nonna.’

‘Was her name Shona, too?’ Alice sounded fascinated. ‘How weird!’

Toni shook his head. ‘No. Nonna is Italian for grandmother.’

And that was more than enough personal stuff. So odd that sharing something so private had seemed compelling. Almost as odd as the glance now passing between the Murdoch sisters. Toni stood up in an attempt to get completely back on track.

‘Now, cara, it’s time I had a good look at this tummy of yours. Can you climb up onto the bed for me?’

But Alice was staring at him now. ‘Why did you call me Cara? My name’s Alice.’

‘Sorry, it’s Italian. It means…sweetheart.’

‘Oh…’ Alice dropped her gaze shyly as she moved to climb onto the examination couch. ‘That’s all right, then.’

There weren’t many people that could have won Alice Murdoch’s full co-operation so easily. Pip stayed where she was, seated by the desk, while Toni began his examination. Close enough for support but far enough away to allow closer interaction between doctor and patient. Pip was more than happy to observe an examination that was thorough enough to be both impressive and a learning experience for her. She would make sure she remembered to apply the same principles for her next paediatric patient.

Toni did a head-to-toe check of Alice with astonishing efficiency, covering a basic neurological, cardiovascular and respiratory assessment before concentrating on Alice’s abdomen. He also fired questions at Pip. Fortunately, the focus of his attention and the distance across the consulting room meant he probably didn’t notice anything unusual in her responses.

But, then, he wouldn’t be expecting her to be able to answer them easily, would he?

‘Do you know if there were any difficulties associated with Alice’s birth and the pregnancy?’

‘Ah…’ Pip had to stifle a kind of incredulous huff of laughter. ‘Difficulties’ couldn’t begin to cover the emotional and physical trauma of a sixteen-year-old girl discovering she was pregnant.

Having the father of that baby abdicate any kind of responsibility or even acknowledgement of his child.

Being forced to burden her own mother who was still trying to get her life back together after the tragic loss of her husband and Pip’s father only the year before.

Suffering a labour that had been so badly managed, prolonged and horrendous that Pip had known ever since that it was an experience she could never face repeating.

Her hesitation was interpreted as a negative response, but Toni’s nod indicated it was only to be expected. ‘I imagine you would have known if there had been anything seriously amiss.’

‘Yes, I think I would have.’

‘Normal milestones?’ he asked, after listening to Alice’s chest and heart with a stethoscope. ‘Do you remember what age Alice started walking, for instance?’

‘She was just over twelve months old.’

Twelve months that had been the hardest in Pip’s life. The responsibility and practical skills of caring for a baby would have been totally overwhelming and dreadful if it hadn’t been for Shona. In a way, though, it had been a wonderful twelve months because Shona had forged an even closer bond with her daughter and then rediscovered her joy in life through her granddaughter. That she had become more of a mother to Alice than Pip had been gradual but inevitable as Pip had been encouraged to finish her schooling and even chase her dream of going to medical school.

‘What about talking?’ Toni asked, as he let down the pressure from the blood-pressure cuff around Alice’s arm.

‘I’m not so sure about that. Around two, two and a half.’ Hard to confess her lack of certainty but it was true—she wasn’t sure. Alice hadn’t been stringing more than a few single words together when Pip had headed away for her first term at university, but she had been chattering by the time she’d headed home for her first holiday break.

‘Childhood illnesses? Measles, mumps, chickenpox and so on?’

‘She’s fully vaccinated. She had chickenpox when she was…oh, about four. The whole kindergarten class came down with it, I seem to remember.’

Not that Pip had been there to help run baths with soothing ingredients or apply lotion or remind Alice not to scratch. The letters and phone calls from her mother had made her feel guilty she hadn’t been there to help and share the worry. Worse than the poignancy of missing the joy of other milestones. But, as Shona repeatedly said, it wasn’t because she didn’t love Alice. She was doing what was best for both of them. For their futures. It couldn’t be helped that she had to be away so much.

No wonder their relationship worked so much better as sisters now. They all knew the truth, of course, but it worked so well for all of them the way it was.

Pip had the niggling feeling that Dr Toni Costa might not think it was an ideal arrangement. He already thought it strange that Alice called her mother ‘Nona’ and there had been something hidden in the tone which with he’d shared the information that he’d been raised by his grandmother. She wasn’t about to try and analyse why she didn’t want to be thought less of by Alice’s paediatrician but it was enough to prevent her correcting his initial assumption that was now making answering his questions rather uncomfortable.

It was a relief when he concentrated totally on Alice again for a few minutes.

‘Show me where you feel the pain in your tummy.’

Alice pointed vaguely at her midriff.

‘Does it hurt if I press here?’ His hand was on the upper middle portion of Alice’s abdomen.

‘A little.’

Pip could see how gentle he was being, however. How sensitive his touch was. It was hard to look away from that hand, in fact. The olive skin with a dusting of dark hair. Long fingers and neatly manicured nails. Movements that were confident but careful.

‘What about here?’ He was trying the upper right quadrant now. The area that pain would be expected if Pip’s suspicions had any grounds.

‘Yes,’ Alice said quickly. ‘That hurts.’

‘A little or a lot?’

‘Not too much. But that’s where it gets really sore when I get sick.’

The strident beeping at that point made Toni glance at the pager clipped to his belt. Then he raised his eyebrows in Pip’s direction.

‘Sorry. I think ED’s trying to contact me.’

‘Feel free to use the phone on the desk if you wish.’

‘Thanks.’ Pip was embarrassed to interrupt the examination but she couldn’t not take the call. What if her Mr Symes was busy having a cardiac arrest in a side room or something?

Suzie sounded apologetic as well. ‘I’m sure it’s nothing, but Mr Symes is complaining of chest pain now. Says it’s a crushing, central pain that’s radiating to his left arm.’

Classic symptoms. Almost too classic. ‘Any associated symptoms?’

‘Not really. He’s been complaining of nausea since he came in, along with all those aches and pains, but he’s not vomiting or sweating or anything. He reckons this came on suddenly.’

‘I don’t suppose he gave you a pain score without being asked, did he?’

Suzie laughed. ‘Ten out of ten. Do you think he’s been reading the right textbooks?’

‘We can’t afford to make assumptions. Can you do a twelve-lead ECG and put him on telemetry?’