need to talk about how your drugs are working and what we can do to stop the pain coming back so frequently. Do you have anyone to look after you at home?’
‘My Floss—she’s my little Westie. She hates being in kennels.’
Jack and Miranda exchanged a glance. ‘If you tell me where she’s staying, I’ll ring the kennels for you and find out how she’s doing,’ Miranda said.
‘She’s at Berrybank, on the other side of Calderford.’
‘I’ll ring them at lunchtime for an update, and I’ll get a phone brought in so you can hear it for yourself.’
‘Would you?’ Imogen’s eyes glittered with tears. ‘Thank you, love.’
‘No problem.’ Miranda squeezed her hand. ‘We’ll be back to see you a bit later on. And if you feel even the slightest twinge, promise me you’ll press your buzzer.’
‘I will.’
‘Thank you. Is there anything you’d like to add, Jack?’
He shook his head. ‘We’ll see you later, Miss Parker.’
‘Does she have any relatives nearby?’ Miranda asked as they left the room.
‘There’s a great-niece who’s either phoned or popped in every day.’
Oh, yes. Miranda knew all about great-nieces being the only ones in the family who cared enough to check on their elderly great-aunt.
‘But apparently she has three under-fives.’
‘So Imogen can’t stay with her—the niece already has enough on her plate, and you can’t expect small children to give an elderly woman the peace and quiet she needs while she recovers.’
‘You’re really going to ring the kennels?’ Jack asked.
‘If she’s worrying, it’s likely to bring on another angina attack,’ Miranda said. Jack didn’t need to know the other reason: that she wanted to do for Imogen what she’d failed to do for May. ‘I’ll go and see the dog myself, if it’ll help her—maybe bring her a photograph so she doesn’t feel quite so alone.’
This definitely wasn’t the attitude he’d been expecting. Jack had a nasty feeling that he’d underestimated Miranda Turner. ‘Maybe,’ he said, wishing he’d thought of it in the first place. One little phone call would make a big difference to their patient’s mental state—and that would make an even bigger difference to her ability to deal with the physical problem. He really should have thought of that himself.
‘Next, we have Sidney Patterson. He has a thoracic aortic aneurysm,’ Jack continued as they stood outside Room Two. ‘He hadn’t had any specific symptoms but he’d gone for a routine check-up and the GP suspected something was up and sent him for a CT scan.’ An aortic aneurysm—a bulge in the wall of the main artery carrying blood from the heart—didn’t always cause symptoms, depending on which part of the artery it affected. Sometimes the patient had difficulty swallowing or was hoarse because it pressed on a nerve controlling a vocal cord; if it was further down in the abdomen, it sometimes caused backache. ‘It’s around seven centimetres in diameter, so he’s booked in for surgery on Friday afternoon.’
Miranda nodded. Aneurysms of that size were more prone to rupture, and there was a high mortality rate. She glanced at his notes. ‘He’s a prime candidate, isn’t he? Mid-fifties, male, high blood pressure, atherosclerosis.’ She paused. ‘We ran some trials in my last hospital to repair aneurysms without major open surgery. One was on keyhole surgery, and the other was putting a catheter into the artery at the groin which carried an endovascular stent to the aneurysm.’
‘Then you leave the stent in place to support the aneurysm,’ Jack said thoughtfully. ‘I’d like to see some studies on that. But here we take the open-surgery approach, using Dacron tubing.’ The tubing supported the aneurysm and stopped it growing any bigger.
‘Fair enough,’ Miranda said. ‘Keyhole surgery and endovascular stents are still fairly experimental and need controlled trials. But maybe we can consider them as options in the future.’
So much for her speech about new brooms. She really was trying to prove herself the hotshot, wasn’t she? ‘If the clinical director agrees to a research proposal,’ he reminded her.
She gave a rueful smile. ‘He’s going to need a lot of persuasion.’
Jack couldn’t help himself. ‘Then you’re the right person to do it, aren’t you?’ And then he wished he hadn’t said it when he saw her flinch. Just momentarily. Nothing in her manner changed—but he knew he’d hurt her. He might just as well have said to her straight that she’d only got her job because of who she was.
She made no comment, simply went into Room Two. And Sid was as charmed by Miranda as Mrs Parker had been. ‘So are you going to be the one with me under the knife, Dr Turner?’
Jack noticed that she didn’t correct him that she was ‘Miss’. ‘Fraid not,’ she said with a smile. ‘You’re in Dr Sawyer’s very capable hands—actually, I’m assisting him.’
She was going to assist him? Since when? Or was she trying to prove that she wasn’t going to take over completely?
‘So tell me, Mr Patterson, how are you getting on with keeping your blood pressure down?’
He shrugged. ‘I’m taking the tablets, love.’
She grinned. ‘How many times do you forget them?’
‘Ooh, let me see—I forget,’ he teased back.
‘And you’re cutting your cholesterol levels?’
‘The wife’s in charge of that. Though I miss my bacon sandwiches at lunchtime.’
‘The odd one won’t hurt you. Dieting’s tough,’ Miranda said, ‘and if you feel deprived, you’re more likely to crack and have a binge.’
‘Especially when you smell bacon cooking.’
She chuckled. ‘Tell me about it. But make sure it’s grilled, it’s lean and any visible fat’s removed, and the bread’s wholemeal.’ She glanced at his fingers. ‘And I don’t have to nag you about the cigarettes, do I?’
‘My daughter threw away all my duty-frees,’ he said ruefully. ‘No one else in the house smokes, so they can smell if I’ve slipped up. And I know I won’t hear the end of it if I do.’
‘Sounds as if you’re in good hands,’ she said with a grin.
Then they saw the rest of the patients on the unit, starting with a woman who’d contracted bacterial endocarditis following a routine tooth extraction—she was near the end of a six-week course of antibiotics and the unit was checking to see whether her heart valve would need surgery. The other patients had recently had heart attacks—one was still very recent so he was under observation in Room Four and the man in Room Five was ready to move down to the general ward.
‘Right. Coffee and a quick confab?’ Miranda asked when Jack had signed the discharge notes.
‘Sure.’
