The Doctor's Secret Family

Jadine shook her head.

‘Good girl. That way we can do another check to make sure there’s no bugs hiding in your waterworks that might be making your tummy sore.’ And it might give Hannah a chance to have a talk to Jadine’s mother privately. ‘You tell me when you think you might be ready to go to the toilet.’

‘I want to go now.’

‘Do you? That’s great.’ Hannah stood up. ‘I’ll call Nina to come and look after you. She’s your nurse today, isn’t she?’

Jadine smiled. ‘Nina’s nice. She likes Barbies.’

‘She looks a bit like Barbie, doesn’t she, with that pretty blond hair?’ Hannah smiled. ‘It’s just like yours, isn’t it?’

Jadine returned the smile happily, which only reinforced Hannah’s impression that there was nothing seriously wrong with this child. ‘I’m going to take Mum off for a cup of tea while Nina’s looking after you,’ she told Jadine. ‘Is that OK?’

‘Sounds good to me,’ Caroline said. ‘I’d love a cup of tea.’ She eyed the notes Hannah was carrying anxiously, however, as the two women took their tea into Hannah’s office a few minutes later. ‘You’ve found something wrong with her, haven’t you? Something you didn’t want to talk about in front of Jadie.’

‘Not at all,’ Hannah said promptly. ‘It was time I had a break and I’m sure you could use one. It’s pretty stressful having your child unwell.’

Caroline sat down on the spare chair in the office. ‘How old is your daughter?’

‘Four and a half.’

‘Ah…nice age.’ Caroline’s smile was poignant. ‘Make the most of it.’ She caught Hannah’s glance. ‘It won’t be long till she starts school,’ she added. ‘And that’s when you really lose your baby.’

‘It’s a big milestone,’ Hannah agreed. ‘But we’re both looking forward to it.’

‘Are you?’ Caroline sounded surprised. ‘I cried for days. It wasn’t until I started being a mother help at school every day that things started to get better.’

‘Oh?’ The sound was intended to be encouraging but a warning bell was going off for Hannah. Just how deeply centred on her child was Caroline Briggs’s life? Munchausen syndrome by proxy was an unusual and bizarre form of child abuse that could possibly be triggered by a parent’s need for some form of attention. Was Jadine Caroline’s primary source of relationships with others?

Given Caroline’s concern about a prolonged and unexplained illness in her child, the syndrome needed consideration. And hadn’t Jadine said her symptoms disappeared when she stayed with her grandmother? It was highly unlikely that she was being cured by some magic ingredients in the puddings. Hannah would need to seek assistance from other medical professionals, as Peter had suggested. A conversation with the grandmother was probably overdue as well but now seemed like a good opportunity to gather some more background history.

‘Tell me about Jadine when she was a baby,’ Hannah invited. ‘Did everything go well with your pregnancy and her birth?’

‘Depends what you mean by ‘‘well’’,’ Caroline said heavily. ‘Getting pregnant was an accident, you know. I was only eighteen.’

Hannah nodded sympathetically. She had been twenty-eight and old enough to have known better, but she had learned the hard way about accidental pregnancies herself.

‘Dave, my boyfriend, wanted me to have an abortion but it was too late by then and, anyway, I didn’t want one.’

Hannah nodded again. It was an issue that had to be confronted by virtually every woman with an unplanned pregnancy but it had never rated more than a dismissive thought from herself. Maybe it had been easier being the only person involved in the decision-making process.

‘And I really wanted to marry Dave. I thought the baby would keep us together.’

Maybe the pregnancy hadn’t been so accidental in Caroline’s case. Hannah couldn’t imagine wanting to marry the father of her child. In the weeks before she had discovered she was pregnant, she had been more than happy with the thought that she would never have to see or speak to him again.

‘I never did well at school,’ Caroline continued. ‘Dropped out when I was fifteen. I knew I could be a good mum, though. It was all I ever really wanted to be.’

Hannah was silent. If feelings of self-worth came only from motherhood then a child starting school and beginning to move towards independence could present a problem. Not one that Hannah had ever had to face, however. She had worked hard at school and done exceptionally well. Her dream of going to medical school and becoming a doctor had been too much a part of her to be anything but temporarily superseded by becoming a parent. Not that Livvy wasn’t just as important in her life as her career but they represented totally different parts of who she was. And it didn’t make her a bad mother. Hannah knew she did both her ‘jobs’ well.

‘It worked for a while,’ Caroline sighed, ‘but he walked out on us when Jadie was two.’

‘That must have been tough.’

‘Yeah.’ The tone was bitter. ‘If it hadn’t been for my mum, I wouldn’t have survived.’

‘You were lucky to have her, then.’ Hannah had had no family to help her. She had had to cope on her own. Emotionally, financially, physically. It hadn’t been easy but it had made her strong and in retrospect Hannah was glad it had been that way. She could handle whatever life chose to throw at her now, which was why the odd feeling that there was something looming to be afraid of was so disconcerting. She had been through so much— what could happen that would be worse?

She tuned out the sound of Caroline’s voice listing the various crises with unpaid bills and the usual medical woes involved in raising a child as the horrible thought struck. Had she been tempting fate telling William about her daughter’s fantastic immune system? Or boasting that she never got sick? Livvy could get sick. Really sick. That would be the worst thing that could happen. A need to see her child and reassure herself followed hot on the heels of acknowledging that fear, and Hannah stole a glance at her watch. At this rate it might be hours before she could leave to collect her daughter.

‘I did most of it by myself.’ Caroline sounded defensive now. ‘I’m a good mother. I never put Jadie in child care. I did everything for her. I still do.’

Hannah simply nodded again. She wasn’t going to allow her own guilt buttons regarding child care to be pushed. She’d never been lucky enough to have a choice. Not with the kind of debt that medical training had left her with. She focused on Caroline as she finished her cup of tea. There were enough clues to make Hannah believe that a psychiatric evaluation of Jadine’s family circumstances would be worthwhile.

‘Jadine should be back in her room by now.’ Hannah stood up to signal an end to the conversation. ‘Will you be staying in with her tonight?’

‘I can’t.’

Hannah couldn’t help looking surprised. During the previous three admissions, it had been an uphill battle to persuade Caroline to even take an extended break from being with her daughter.

‘I’ve got a…date,’ Caroline confessed as she followed Hannah from the office. ‘He lives in Wellington and doesn’t get down this way very often. I’ll be back first thing in the morning, though.’

‘That’s fine,’ Hannah said calmly. ‘We’ll take good care of Jadine.’

She tucked the additional snippet of information away. So Caroline’s attention was being diverted to some extent away from her daughter. Munchausen’s was still a possibility but maybe it wasn’t by proxy. Perhaps Jadine was trying to find a way of dealing with the competition or a perceived rejection by her mother. Hannah’s query as the two women neared Room 4 was deliberately casual.

‘Does Jadine’s father still see her at all?’

‘No.’ The response was vehement. ‘And I intend to keep it that way, thanks.’

Hannah was quite grateful for an interruption from William, which precluded digging any further into the new can of worms she had opened regarding Jadine Milton’s family problems. He waited until Caroline had gone through the door of Room 4.

‘I’ve got Jamie’s serum electrolyte results. Sodium’s well above 150 mmol per litre so he’s hypernatraemic.’

‘Have you adjusted the IV solution?’

‘I’ve started 0.2 normal saline in 4.3 per cent glucose.’

‘Plus KCl?’

William nodded. ‘Thirty to 40 mmol per litre.’

‘Good. Restrict fluid to 150 mmol per kilo for the first twenty-four hours. We need to aim for total correction over about forty-eight hours. How’s he looking?’

‘A lot better.’

‘That’s good.’ Hannah was eyeing her open office door and thinking of the phone on her desk. A quick call to the Maysfield Child Care Centre to set her own mind at rest would make her feel a lot better. ‘Anything else going on that I should know about?’

‘No. Things are pretty quiet generally. About time you headed home, isn’t it?’