Their Christmas Dream Come True

‘Yes,’ she admitted.

‘OK. You lead. I’ll be here for back-up, if you need me.’

Being supportive? Kit? Well. Maybe he’d grown up in the last six years. He was thirty now, after all. And he was the more experienced doctor out of the two of them. Several rungs higher than she was. He was just doing what she’d do if the positions were reversed. Giving a junior doctor a chance to gain experience, with a safety net if it was needed.

But this was her first proper clinic. And he wanted her to lead. Take responsibility. ‘What if I miss something?’ she asked.

He shrugged. ‘Then I’ll bring it up in conversation with the parents. But I won’t tear you off a strip in front of them or make you look incompetent, if that’s what you’re thinking.’

She felt her skin heat. ‘I wasn’t sniping at you. What I meant was, I might get something wrong, put a patient at risk.’ She was worried that she wasn’t totally ready for this, that maybe in her first clinic she should take a supportive role rather than a lead. ‘Are you going to take everything I say personally, for goodness’ sake?’

He raked a hand through his hair. ‘No. Sorry.’

It had probably been gut reaction. She supposed it must be just as difficult for him, having to work with her and ignore their history. And there had been plenty of sniping in their last few months together. Mainly by her—because Kit hadn’t been there often enough and the frustration and misery had made her temper short.

‘You’ll be fine in clinic. You’re qualified, so you obviously know your stuff. If it’s something with a tricky diagnosis, something that could easily be mistaken for a different condition, I’ll be here to take a look. I’ll give a second opinion when you ask for it, and I’ll back you up,’ Kit said.

Just what she needed to hear. And if only he’d been that supportive all those years ago, when she’d really needed him. Someone she could have leaned on when her strength had deserted her.

But you couldn’t change the past. Mentally, Natalie slammed the door on it and locked the key.

The first parent on their list was Ella Byford. She was reading a story to two rather grubby children who seemed to be squabbling about who was going to get the best place on her lap, while rubbing her back in the way that most heavily pregnant women did.

Something Natalie had once—

No. She clenched her teeth hard, just once, to relieve the tension, then reminded herself to keep her personal life out of this. She was a doctor. A paediatrician in training. This was her job. And she was going to do it well. She pinned a smile on her face. ‘Hello, Mrs Byford. I’m Natalie Wilkins and this is Kit Rodgers. We’re holding the paediatric clinic today. What can we do for you?’

‘It’s Charlene. Jayden’s all right, he’s doing fine.’ Ella waved a dismissive hand towards her son. ‘But Charlene’s so skinny. She’s not doing as well as she should. She’s always been small for dates, but she’s getting worse.’ Ella bit her lip. ‘I went to see my GP about her, and he sent me here.’

‘Let’s have a look at her,’ Natalie said. She knelt on the floor so she was nearer to the little girl’s height. ‘Hello, Charlene.’

‘’Lo.’ The little girl looked at her and scowled.

OK, she could do this. Thin, small for dates. The little girl was quite pale—perhaps she just didn’t get to play outside very much, or her mum was rigorous with a high protection factor suncream. Or maybe it was anaemic pallor. Natalie needed to check for icterus—or a yellowish colour—too. Starting with the child’s fingernails, palms, mucous membranes of the mouth and the conjunctiva. The conjunctiva would be the tricky part—children hated having their eyes fussed with.

‘Can you open your mouth for me and say “a-ah”?’ she asked.

A-ah.’ It lasted all of half a second, but it was enough to show Natalie that there was slight pallor in Charlene’s mouth but no icterus. It didn’t look as if there were any ulcers, but if Natalie saw any other sinister signs in the rest of the examination she’d try for a second look.

‘And can I look at your hands now?’

Charlene scowled at her and tried to climb back on her mother’s lap.

‘Charlene, be nice for the doctor,’ Ella admonished her.

‘It’s not fair. I want to sit on your lap. He always does.’ Charlene shoved at her brother, who promptly fell off Ella’s lap and started howling.

Kit stepped in smoothly. ‘Hey. How about I read you a story, Jayden, while the doctor talks to your mum and your sister?’ He took two shiny stickers from his pocket. ‘And if you can both sit really still while the doctor’s talking— and while the doctor’s looking at you, Charlene—you can both have a special sticker.’

Why hadn’t she thought of that? Natalie wondered. And as a distraction technique it clearly worked, because Charlene immediately nodded, climbed onto her mother’s lap and sat still, while Jayden plonked himself on Kit’s lap so he could see the pictures in the story book. Ella, who’d looked close to tears, suddenly relaxed.

Teamwork. Good teamwork. And Natalie wasn’t going to let herself think about the fact that Kit was reading a story to a little boy.

‘OK, Charlene. Shall we see if your hands are bigger than mine?’

‘Don’t be silly. They’ll be smaller.’

‘Bet they’re not,’ Natalie said, putting her own hands behind her back.

Charlene giggled. ‘They are.’

‘Show me, then.’

To Natalie’s relief, when she brought her hands round again, Charlene splayed her palms and pressed them against Natalie’s.

‘Side by side now. Palm up,’ Natalie said.

The little girl, clearly thinking it was a game, did as she asked. Her palms were definitely pale, though at least there was no sign of yellowness.

‘And the back, to see if you have princess nails?’

‘You haven’t got princess nails. They’re not glittery,’ Charlene said.

Natalie was glad that Charlene’s weren’t either: it gave her the chance to notice that the little girl’s fingernails were concave.

‘Can I look at your tummy now?’

‘Can I look at yours?’ Charlene asked.

‘Not this time,’ Natalie said with a smile. She definitely wasn’t baring any flesh in front of Kit. ‘But if you want to play doctors while I talk to your mummy, you can look at a doll’s tummy and see what you can hear through my stethoscope.’

Charlene wriggled a bit, but submitted to an examination. Natalie palpated her abdomen gently. She didn’t think there was a problem with the spleen, but maybe she should ask Kit for a second opinion. No sign of petechiae, reddish-purple pinhead spots, which would lead to a more sinister diagnosis. And, she was pleased to note, there were no signs of enlarged lymph nodes in Charlene’s neck.

As soon as she’d finished, Charlene was wriggling around on Ella’s lap again, and Ella pressed one fist into her lower back for support. Natalie gave Ella a sympathetic smile. It must be hard, dealing with small children when you were heavily pregnant and tired.

‘She’s a handful for such a little scrap,’ Ella said, looking embarrassed.

Oh, no. That hadn’t been what she’d intended at all. Or maybe Ella was just used to being defensive about her little girl. ‘Lively, the medical term is,’ Natalie said with a smile. ‘How’s she eating?’

Ella grimaced. ‘She’s picky. She won’t eat any vegetables—she just throws them on the floor—and she doesn’t like anything with meat in it, even if I try to hide it. But I can get her to eat potatoes and eggs, and she drinks milk and fruit juice.’

It was nowhere near a balanced diet, and Ella was clearly aware of it—distressed about it, too, so Natalie decided to take the gentle approach. ‘Kids are notorious for that—one day they’ll eat something, and the next they won’t touch it,’ she said reassuringly. ‘How about you take me through right from the start, from when she was first born?’ She could already see that Charlene had had a low birthweight, something that could predispose her to anaemia. ‘Did she have any jaundice afterwards?’

‘She was a bit yellow, but the midwife said it was normal.’

Natalie nodded. ‘Most babies have it to some extent.’ Though Ethan hadn’t. He’d been a perfect seven and a half pounds. No problems at all. Prolonged jaundice in the newborn could suggest congenital anaemia. ‘How long did it last?’

‘A week or so.’