âWOULDNâT it be nice to be pamperedâ¦â
âPampered?â Andrew flipped the file shut, put the cap on his fountain pen and sat back in his chair, locking his hands behind his head and stretching his long body. âI suppose it would.â He chuckled. âI havenât really thought about it. Too busy.â
Jennifer gave a rueful little laugh. âMmm â and weâre only halfway through. Would you like a cup of tea?â
âLife-saver,â he said with a grin. âI missed my lunch. Are you having one?â
She chuckled. On the sly. If the patients and their parents see me sitting down with a cup in my hand while they wait for another ten minutes Iâll be lynched!â
âMessy â bring it in here and weâll tell them weâre having a case conference â on second thoughts, bring in the cup and the next patient. It would be nice to get home tonight.â
âMy thoughts exactly,â she said with a laugh. âWhat is it they call Friday? Poetâs Day?â
âPush off early, tomorrowâs Saturday.â He snorted. âFat chance.â
Jennifer picked up the stack of files and went out into the crowded waiting-room to be greeted by a chorus of dissent from the ranks.
âSister, are we going to be waiting much longer? Weâve got people for the weekend and we have to meet them off the train,â one woman asked anxiously.
âYeah, if we sit here much longer weâll be needing geriatrics, not paediatrics,â a man put in.
She smiled assurance at the bored children and disgruntled parents. âIâm sorry weâve had to keep you so long; Dr Barrett had to deal with an emergency earlier and itâs put him back. Heâll be with you all as soon as he can.â She gave the secretary the pile of notes and picked up the next few, then went into the kitchen and found one of the domestic staff. âBeattie, do me a favour, could you? Dr Barrett would love a cup of tea in his office, and I could do with one, but for heavenâs sake donât take it out of here!â
âAfter you, are they?â
Jennifer laughed and tucked an escaping strand of red-brown hair back under her frilly cap. âArenât they always? Thereâs a joker out there, too. âWeâll be needing geriatrics soonâ,â she mimicked wickedly. âJust leave my tea on the side, Iâll come and grab it when I can.â
She went back into Andrewâs office and handed him the stack of files. âHere you go. William Griffin first.â
âAh, right, our little man whoâs failing to thrive. Letâs see what the results turned up.â
They opened the file and pored over the notes. âStool, urine and blood cultures all sterile, no blood in the stools, blood chemistry and liver function all normal, and thyroid, and sweat sodium. That rules out thyroid problems or cystic fibrosis, or any nasty liver problems. The serology all looks good â no sign of infection. Did we get a chest X-ray back? And there should have been a barium meal and follow-through.â
âYes, here we are, hereâs the radiologistâs report.â Jennifer pulled it out and handed it to him just as Beattie brought in the tea.
âWonderful, thank you.â He flashed her a grateful smile and slipped it while he frowned at the report. âDo you know what I think?â he said after a moment. âI reckon heâs got an intussusception.â
âReally? What about the stools? No sign of occult blood, or abdominal pain or vomiting. I know he had diarrhoea, but what about the cough? And the weight loss?â
âThat could be due to the anorexia â if heâs off his food, he will lose weight. Anyway, the pain and vomiting and bloody stools are typical of acute, not chronic intussuseption. I think weâll have another look, perhaps under sedation. Is there a surgeon we can call down?â
âYes, I think itâs Ross Hamilton today. Shall I get him paged?â
âNot for a bit. Iâd like an ultrasound of that bowel, and Iâd like to examine him to see if I can feel anything this time. Could you call him for me?â
âSure.â She popped her head round the door. âWilliam Griffin, please?â
His mother carried him in, a little boy of two and a half who looked at least fourth months younger.
âSorry, heâs dozed off,â the mother explained.
Andrew smiled apologetically at her. âIâm sorry I kept you waiting; we had a prem baby at lunchtime that needed my attention. Let him sleep for a minute while you tell me how heâs been getting on.â
âOh, I can see him going downhill in front of my eyes â heâs very reluctant to eat, and heâs been sick a couple of times now. Iâm so worriedâ¦â
Andrew laid his large hand over hers and squeezed gently. âDonât fret. Weâve managed to rule out a lot of very nasty things. There are a couple of other possibilities that I want to eliminate with a few more tests. Has he had any abdominal pain?â
âOnce or twice heâs complained about tummy-ache, and then a while later heâs had diarrhoea.â