save a life.’
‘And you saved two.’
‘And lost my job.’
‘You shouldn’t have resigned.’
It was a question she’d asked herself over and over again. ‘I couldn’t work with the man a moment longer. He was the sort who thought women should be nurses, not doctors. Basically he’s a—a—’ She bit off the word and Josh gave a faint smile.
‘I get the picture. Has it occurred to you that you might be too idealistic, Tasha?’
‘No. Not too idealistic.’ The conviction came from deep inside her. ‘Isn’t that why we’re doctors? So that we can push things forward? If we all did what doctors have always done and no more, we wouldn’t have progress.’
‘There are systems—’
‘And what if those systems are wrong? I can’t work for someone like that. Sooner or later I would have had to inject him with something seriously toxic...’ Tasha gave a cheeky smile ‘...but first I would, of course, have made sure it was approved by the formulary committee.’
‘You’re incorrigible.’
‘No, I’m a doctor. I can accept that there are some patients I can’t help. What I can’t accept is that there are some patients I’m not allowed to help because someone has decided the treatment is too expensive! I mean, who decides what’s important?’ Tasha paced across his office, her head swirling with the same arguments that had tormented her for weeks. ‘I told him that if the chief executive took a pay cut we’d be able to easily fund this drug for the few
babies likely to need it.’
‘I’m beginning to see why you felt the need to resign.’
‘Well, what would you have done?’
‘I have no idea.’ Her brother spread his hands. ‘It’s impossible to say if you’re not in that situation. Why didn’t you wait for the blood cultures? Or use the first-line choice?’
‘Because the twins were getting sicker by the minute and I felt that time was crucial. If we’d waited for that one drug, only for it to fail... My instincts were shrieking at me, Josh. And even while I was running tests, my consultant was telling me it wasn’t sepsis and that the twins were suffering from something non-specific caused by the stress of delivery.’ And she’d spun it around in her head, over and over again, looking for answers. ‘Sometimes you see a patient and you’re going through the usual and it all seems fine, except you know it isn’t fine because something in here...’ she tapped her head ‘...something in here is sending you warnings loud and clear.’
‘You can’t practise medicine based on emotion.’
‘I’m not talking about emotion. I’m talking about instinct. I tell you, Josh, I know when a child isn’t well. Don’t ask me how.’ She held up her hand to silence him. ‘I just know. And I was right with the twins. But apparently that didn’t matter to Mr Tick-All-The-Boxes Consultant. He has to play things by the book and if the book is wrong, tough. Which is a lame way to practise medicine.’
‘And no doubt you told him that, too?’
‘Of course. By the time he’d had all his evidence, he would have had two dead bodies. And he was angry with me because I saved their lives. He could have had a lawsuit on his hands, but did he thank me?’ The injustice of it was like a sharp knife in her side, digging, twisting. ‘Haven’t you ever used instinct when you treat a patient?’
‘If by instinct you mean clinical judgement, then, yes, of course, but, Tasha—’
‘Wait a minute.’ Tasha interrupted him, her brain working and her eyes wide. ‘That little girl—’
‘What little girl?’
‘The one waiting to be seen in the main area. I heard the mother say that hay fever was making her asthma worse, but her eyelids were swollen and her face was puffy. I thought at the time that something wasn’t right—just didn’t seem like allergy to me—and—’
‘That little girl is not your patient, Tasha.’
‘She was wheezing.’
‘As she would if she had asthma.’
‘As she would if she had left-sided venous congestion. I knew there was something about her that bothered me.’ Tasha picked up his phone and thrust it at him. ‘Call the doctor in charge of her, Josh. Tell her to do the tests. Maybe she will anyway, but maybe she won’t. In my opinion, that child has an underlying heart condition. Undiagnosed congenital anomaly? She needs an ECG and an echo.’
‘Tasha—’
‘Just do it, Josh. Please. If I’m wrong, I’ll give up and get a job in a garden centre.’
With a sigh, Josh picked up his phone and called the doctor responsible for seeing the child.
While he talked, Tasha stood staring out of the window, wishing she didn’t always get so upset about everything. Why couldn’t she be emotionally detached, like so many of her colleagues? Why couldn’t she just switch off and do the job?
‘She’s going to do a full examination, although she thinks it’s asthma and allergy combined. We’ll see. And now you need to relax.’ Josh’s voice was soft. ‘You’re in a state, Tasha.’
‘I’m fine.’ It was a lie. She’d desperately wanted a hug but was afraid that if someone touched her she’d start crying and never stop. ‘But I do find myself with a lot of free time on my hands. I thought...’ She hesitated, hating having to crawl to her brother. ‘You’re important. Can you pull a few strings here? Get me a job? The paediatric department has a good reputation.’
‘Tasha—’
‘Paediatrics is my life. My career. I’m good, Josh. I’m good at what I do.’
‘I’m not debating that, but—’
‘Yes, you are. You’re worrying I’ll mess things up for you here.’
‘That isn’t true.’ Josh stood up and walked over to her. ‘Calm down, will you? You’re totally stressed out. Maybe what you need is a break from hospitals for a while.’
‘What I need is a job. I love working with kids. I love being a doctor. And then there’s the practical side. I was living in a hospital flat so now I’m homeless as well as jobless.’ Tasha felt as though she had an enormous mountain to climb. ‘Resigning seemed like the only option at the time. Now I realise why more people don’t resign on principle. It’s too expensive.’
‘I can’t pull strings to get you a job at the hospital, Tasha. Not at the moment. We’ve spent a fortune opening a new paediatric burns unit. There’s a head-count freeze.’
‘Oh.’ Her stomach swooped and fell as another door slammed shut in her face. ‘No worries. I’ll sort something out.’ She tried to subdue the niggling worry that her last consultant wouldn’t give her a decent reference. ‘Sorry, I shouldn’t have asked you. I shouldn’t have just shown up here.’
