nerves must have shown, because the nurse gave her a beaming smile. ‘Hello, love. Welcome to Nightingale Ward. I’m Debbie Jacobs, the senior sister—I was off duty when you came for interview. You’ve got a few minutes until Lenox arrives, so let me show you where everything is.’
‘Thanks.’
Fifteen minutes later, Natalie had a key to her own locker in the staffroom, knew where the parents’ rooms and isolation cubicles were as well as the general bays, had gulped down her first cup of coffee on the ward, had been introduced to ten people whose names she was sure she’d never remember, and had started a ward round with Lenox Curtis, the consultant.
In at the deep end.
Doing observations, checking medication and treatment plans, venturing her opinion when it was asked for. Hesitantly, at first, but the more she got right, the more her confidence blossomed. By the end, she was able to reassure the anxious parents of a seven-month-old girl who’d been brought in with abdominal pain.
‘Maia was always a colicky baby, but she seemed to be getting better. Then she started drawing her legs up again and screaming for two or three minutes.’ The little girl’s mother was shaking. ‘She’s been off her food the last day. And then I saw this red stuff in her nappy.’
‘A bit like redcurrant jelly?’ Natalie asked.
‘Yes.’
Natalie examined the little girl gently. The baby’s stomach was distended, and Natalie could feel a sausage-shaped mass, curved and concave to the umbilical cord. As Natalie gently pressed the mass, Maia lifted her legs and screamed again.
‘All right, sweetheart.’ Natalie soothed the baby gently, stroking her face and calming her down. She noted that the soft spot on the top of the baby’s head had sunk a bit, showing that the little girl was dehydrated.
‘What’s wrong with her?’ Maia’s father asked.
‘It’s something called intussusception—it’s where one segment of the bowel telescopes into another segment and constricts the blood supply. That’s why you see the redcurrant-jelly-like stuff—it’s a mixture of blood and mucus. But it’s nothing either of you have done,’ she reassured them both swiftly. ‘It just happens. It might be that she has a polyp—a non-cancerous growth—that started it off. Quite a lot of children get intussusception before they’re two, so we’re very used to treating it here. I’m going to send her for an ultrasound in a minute so we can see exactly what we’re looking at—it doesn’t hurt and it’s the same sort of scan you had when you were pregnant.’
Maia’s father turned white. ‘Is she going to have to have surgery?’
‘Hopefully not. You’ve brought her in early, so we might be able to sort it out by an air enema—what we do is put a pipe in her bottom and blow air in to gently manoeuvre the bowel back to where it should be. If that doesn’t work, we’ll need to sort her bowel out surgically, but the good news is she’s got an excellent chance of a full recovery.’ She smiled at them. ‘I’ll book Maia in for an ultrasound now, and because she’s a bit dehydrated I’m going to put her on a drip so we can get some fluids into her. In the meantime, to make her a bit more comfortable, I need to put a tube into her nose and down into her tummy—that will help get rid of any air that’s built up.’ It also drained the stomach contents, which made the procedures easier. ‘I’ll be able to give you a better idea of how we’re going to treat her when I’ve seen the scan.’
‘But she’ll be OK?’ Maia’s mother asked.
‘She’s going to be fine,’ Natalie promised. Had the problem been left a few weeks longer, gangrene might have set in, and the outcome would have been very different. But she was confident that this case would be absolutely fine.
And it felt good, so good, to help people. To make a difference to people’s lives. To make things right again.
‘So did you enjoy your first ward round here?’ Lenox asked when they’d finished.
‘I think so,’ Natalie said with a smile. ‘It was a bit nerve-racking to start with, but it got easier towards the end.’
He smiled back. ‘You’ll do fine. Give it a week and you’ll feel as if you’ve been here for ever. And tomorrow you won’t even be our newest recruit.’
‘You’ve got another house officer starting?’ Natalie asked, interested.
‘Special registrar,’ Lenox explained. ‘We were lucky to poach him from London—he’s quite a whiz. His name’s Christopher Rodgers.’
Ice trickled down Natalie’s spine. Christopher Rodgers.
No, it had to be a coincidence. Rodgers was a common enough surname, and Christopher was a popular first name. There was more than just one Christopher Rodgers in the world.
‘Though it seems everyone calls him Kit,’ Lenox added.
Kit?
Most Christophers were known as Chris. Kit was the posh diminutive. A much, much less common diminutive.
Kit Rodgers.
From London.
No. It couldn’t be him. Surely.
The Kit she’d known had been training as a surgeon, not as a paediatric specialist. Then again, Natalie had been a history teacher and she’d retrained. Kit might have done the same thing…for the same reasons.
Well, she’d deal with it tomorrow.
If she had to.
She managed to put Kit out of her mind when she took Maia for an ultrasound. The results showed the double ring she was expecting. ‘Definitely intussusception.’
‘Anything else?’ Lenox asked.
She looked carefully at the scan. ‘It doesn’t look as if there’s any perforation or significant ischaemia. So I’d say it would be safe to go ahead with the air enema.’
‘Good call,’ he said. ‘Would you like me to talk you through it, or would you prefer to watch me do it?’
‘I’ve seen one done before, though I haven’t actually performed one,’ she said. ‘I’d like to try myself, if that’s all right with you.’
‘That’s fine.’ He smiled. ‘I think you’re going to be an asset to the team—you’re prepared to try things rather than hang back. Good.’
He talked her through the procedure. As the pressure-regulated air gently pushed into the bowel, the bowel began to expand and the constricted part finally untelescoped.
‘Bingo,’ Lenox said with a smile. ‘You’ve done it. Happy about managing the after-care?’
‘Yes.’
‘Good. You can go and talk to the parents on your own.’
She smiled at him, and went to see Maia’s parents. ‘You’ll be pleased to know the procedure was a complete success, so Maia won’t need to go for surgery. We’re going to keep her in for a day or so, just to keep
