Her Consultant Boss

He showed them where they could stand and watch the proceedings. Megan stood to one side of the view panel, ignoring the case notes for a moment while she watched the little boy work his way around the room.

At this moment he appeared more confident and was rushing around from one table to another, but then he stopped and sat down, seeming to be momentarily unsure of himself. The therapist spoke to him but he didn’t appear to be taking much notice of what she was saying. After a minute or two, though, he suddenly stood up and swerved away from her and swooped on a table where soft toys had been set out. He picked them up one by one and danced them round the table.

It wasn’t long before he lost interest in that exercise, too, and turned to see what else there was for him to do.

At the side of the room, a jigsaw caught his attention. He began to chuckle and gathered the pieces up in his hands, dropping them like a shower of confetti on to the table so that some of them fell to the floor. Then he sat down and simply stared at them until the therapist came to stand beside him.

She spoke to him but once again he ignored her and after a moment or two he began to pick at his clothes in an odd fashion, before continuing to study the pieces on the table.

Megan briefly turned her head towards Sam Benedict and asked quietly, ‘Has he been here before? Is the room familiar to him?’

He shook his head. ‘No, this is his first visit.’

They watched him for a few minutes more, and then Sam looked at David Jones and James Morgan and asked, ‘What do you think? Any suggestions as to what might be his problem?’

‘I think it’s probably a case of attention deficit disorder,’ Dr Jones said confidently. ‘He totally ignored what the therapist was saying to him at one point.’ He was a young man with a shock of fair hair that tumbled over his forehead and caused him to push it back from time to time.

‘And possibly hyperactivity as well,’ Dr Morgan added, rubbing a hand thoughtfully over his jaw. ‘He seems excitable at times, with all that rushing about, and then at others he appears to dismiss what the therapist is saying to him and does what he pleases instead.’

He was a year or two older than Dr Jones and Megan had found that she got along well with him. He had a wry sense of humour that she appreciated.

‘And what treatment would you recommend?’

‘Given that the school has noted his lack of attention and excitability, I would suggest that he attends a child guidance clinic. We should probably ask for social worker involvement, too,’ James responded. ‘There may be a problem at home that needs to be looked into. According to the case notes, there’s a younger brother, so there may be some sibling rivalry.’

David added, ‘It might be a good idea to bring in an educational psychologist to liaise with the school.’

‘Hmm… Is there anything else?’

‘Well, they do say that some cases respond to treatment with Ritalin, though I don’t know what the long-term situation would be if we went down that road,’ James murmured. ‘I imagine that we would assess him every six months or so to check on his progress.’

‘And what is your opinion, Dr Llewellyn?’ Sam Benedict turned to Megan, his grey eyes narrowing sharply on her. ‘You’re keeping very quiet. Are you in agreement with what has been said so far? What do you think should be done?’

Megan swallowed carefully. ‘I wouldn’t like to say, at this stage,’ she returned evenly. Dr Benedict lifted a dark brow, and she added cautiously, ‘I would prefer to talk to the child myself before I made any decision, especially one that would involve a barrage of specialists invading his life.’

His mouth made a wry shape. ‘If that’s what you want, by all means go in and spend some time with the child. While you’re occupied with him, the rest of us will sit here and talk for a while.’

He probably thought that she was wasting everybody’s time, but she went ahead anyway, leaving them to it. She had never believed in practising medicine at a distance. To her mind, you needed to talk to a patient to be able to really understand what was going wrong.

Matthew studied her suspiciously as soon as she entered the room, glaring at her from under dark lashes. He had dark hair, cut short and spiky, and to her he looked like a very young and vulnerable little boy who was unsure of the adults around him.

She gave him a smile. ‘Hello, Matthew,’ she said gently. ‘Don’t mind me. I’ve never been here before, and I thought I would come and have a look around. There are lots of things in here to play with, aren’t there? I don’t know which I would choose for myself. What sort of toys do you like best of all?’

‘Trains,’ he said. Then, clearly warming to the subject, he went on, ‘You put them on the track and they whizz round and round and up and down over the bridge, and then they crash off the lines and everything falls over.’ He paused for a moment, then added grumpily, ‘They haven’t got one here.’

Megan looked around. ‘No, you’re right. I can’t see one. That’s a shame, isn’t it? Do you have a train set at home?’

He didn’t answer, appearing to lose interest in the conversation. He stared straight ahead at the pieces of the jigsaw. Megan tried again. ‘What do you like playing with when you’re at home?’

There was still that blank stare, then after a moment or two he picked up a couple of pieces of the jigsaw and slotted them into place. He selected another piece and studied it carefully. ‘This one’s part of the slide—see? It’s red, and the children like playing on it,’ he said seriously.

The picture on the jigsaw box showed a children’s playground, and she guessed that he was imagining the scene.

‘They look happy, don’t they?’ She glanced at his face, and asked, ‘Do you like doing jigsaws?’

He shrugged his shoulders, and at that moment she became aware of Sam Benedict standing by her side. She had been absorbed in her conversation with Matthew, and didn’t know how long Sam had been standing there.

She looked up at him. ‘Sorry—have I been too long?’

‘Not at all. You should take as long as you think you need.’ He pulled up a seat and sat down next to Matthew. ‘Have you been all right, here, Matthew? Is everybody looking after you properly?’

‘They haven’t got a train set,’ the little boy complained. ‘I’m not coming here again.’

‘Haven’t they? I’ll have a word with Miss Maxwell about that,’ Sam said, his face taking on a serious expression. ‘What about everything else here? Is there anything else you would like to do—what do you like doing most of all?’

‘I like going to the playground with Mummy and my little brother.’ Matthew’s brown eyes widened. ‘We go up and down the slide and we go on the roundabout. I like that.’

Sam grinned. ‘Yes, it’s fun, isn’t it? I remember doing that when I was your age.’ He winced. ‘It seems a long while ago now.’

Thinking about Sam Benedict whooshing down a slide in his impeccable grey suit, Megan tried to hide a smile and failed miserably. Looking up, she caught his lancing grey gaze fixed on her and she quickly tried to turn the smile into a cough, without much success.

He looked down at the slim gold watch on his wrist and said, ‘Matthew, I’m sorry, but Dr Llewellyn and I have to go now. I’ll come and talk to you again if you decide to come in and see us another day. I would really like to see you again, you know, and if you like I’ll have a word about getting that train set for you to play with next time you come in. What do you think? Would you like to give it a try?’

Matthew pursed his lips for a moment, and then relaxed. ‘All right,’ he agreed. ‘I’ll see what my mummy says.’

Sam nodded. ‘Good, I’m glad to hear it. I’ll look forward to seeing you again.’

He and Megan left a minute or so later, going back to the observation lounge. Megan looked around and was surprised to see that David and James were no longer there.

Following her glance, Sam murmured, ‘I’ve sent them off to deal with some case notes. I thought perhaps you and I might talk for a while longer.’

‘If that’s what you want.’ She hoped he wasn’t going to persuade her that the boy needed to go down the route of assessment at a child guidance clinic, or that he needed to be on medication such as James had suggested. ‘I should tell you now,’ she said cautiously, ‘I don’t like the idea of using Ritalin with young children.’

‘Nor do I, and it isn’t common medical practice here to use such drugs.’ He waved her towards the double doors, holding one open to allow her to walk through. ‘Are you saying that you agree with James’s and David’s diagnosis now?’

Megan shook her head. ‘No, I’m not. In fact, after seeing Matthew, I believe that we should do some tests before we go any further.’

‘What sort of tests did you have in mind?’

‘Blood tests and an EEG.’ The electroencephalogram was a painless procedure, and it would give her a measurement of the tiny electrical signals produced inside the brain.

‘Is this your experience as a paediatrician coming to the fore,’ he remarked drily, ‘or are you reluctant to believe that a seemingly disruptive and inattentive child could have psychiatric problems?’

She flashed him a cool blue glance. ‘Perhaps it’s just that I prefer to make a decision based on all the facts. I can’t see that it would do any harm to take a simple blood test, and at least it would serve the purpose of eliminating other possibilities.’

Sam’s eyes darkened. ‘I can see that you’re a woman who’s prepared to stick to her guns.’ He made an expansive gesture with his hands. ‘OK, go ahead. Do your tests, and report back to me with the results—just make sure that you get on to the lab to hurry things along. I don’t want to keep Matthew and his parents waiting for any longer than I have to.’

Her eyes widened. ‘Oh—right, yes, I’ll do that.’ His answer had caught her by surprise. She had been expecting an argument.