lunch.’ She turned quickly to Ama and smiled at the girl, who was still a bundle of nerves. ‘It’s okay,’ she assured her, and Dali, the interpreter, repeated the assurances to Ama and her mother in their own language. ‘This is the doctor I was telling you about. Dr Ethan.’
Ethan smiled as Ama peeked out at him from her mother’s shoulder. ‘Very pleased to meet you, Ama,’ he said, bowing slightly.
The girl’s gaze darted to Olivia, and Olivia nodded and smiled again. She moved closer to Ethan, conscious of his tall breadth in her peripheral vision, trying to divorce herself from the sexual pull of him as she placed her hand on his forearm. ‘We are old friends,’ she said to Ama. ‘We did our training together, here at this hospital.’
Ethan nodded. ‘We sure did. Olivia used to tell us stories about having a pet kangaroo at home in Australia.’
That elicited a small smile from Ama and Olivia gave Ethan a grateful squeeze on the arm before she dropped her hand. Ethan’s bedside manner had always been fantastic, but it had been a long time since she’d been familiar with his doctoring skills. A lot of surgeons tended not to be very good with their people skills.
Olivia introduced Ethan to Dali and to Ril, Ama’s mother. He was at his charming best, but she was still nervous as to how he was going to go forward with Ama. Olivia knew he needed to see her face, but she also knew he needed to approach it very carefully.
‘You like chequers?’ Ethan said to Ama.
She gave a slight nod after Dali had translated.
‘Do you mind if I watch while you and Olivia play?’
Ama looked at her mother, as the interpreter translated, and then at Olivia, who smiled. Very slightly she nodded her head.
‘Excellent,’ he said, smiling down at Ama.
Ethan drew up a chair opposite Dali on the same side of the bed. It was the side of Ama’s defect and he was hoping that she’d become engrossed enough in the game to drop the fabric so he could get a good look. He was going to need a much closer examination before he operated, but for today he had to build some trust and he was happy to stay hands-off.
Two hours later Ethan knew a lot more than any photo could tell him about Ama’s defect. Sure enough the girl had forgotten about trying to shield her face from him after about fifteen minutes, and he’d been able to get a much more thorough feel for the mechanics of what he was dealing with as the scarf slackened.
The extent of the destruction of her facial tissue and the functional impairment of her mouth and jaw were clinically challenging. He was going to need extensive imaging, but he was sure it was going to involve maxilla and palate losses as well.
It was shocking to look at. Ama essentially had a huge hole in the right side of her face, exposing the inside of her mouth, her jaw and nasal cavity. It was all the more shocking because it was a perfectly treatable condition caught early enough.
He knew from Olivia’s briefing and studying Ama’s chart that her NOMA had started the way it always did—with a simple mouth ulcer when she’d been four years old. But poor nutrition and poor oral hygiene had led to the ulcer developing quickly into full-blown NOMA. Her cheek had begun to swell and over the course of a few days it had developed blackish furrows as the gangrene set in. It had festered over weeks, forming horrible scabs. When the scabs had finally fallen away, she’d had a gaping hole in her face.
But Ama was one of the lucky ones—she’d survived. Ninety per cent of sufferers—usually children—didn’t.
Just looking at Ama as she played chequers with Olivia swamped Ethan with a sense of hopelessness. NOMA was the face of poverty in poor, underdeveloped countries. And young children living in such extreme conditions where malnutrition was rife were at the highest risk.
He glanced at Olivia. The jacket she’d worn this morning to the debrief had long been discarded and her pencil skirt had rucked up her thighs slightly as she sat on the bed with her legs tucked up to one side. Her long-sleeved blouse fell softly against her breasts and was rolled up to the elbows. The top three buttons, which had been primly fastened all the way to the collar this morning, were now undone and gaping occasionally to reveal flashes of cleavage.
She looked perfectly at home and one hundred per cent unaffected by Ama’s facial deformity as she played chequers. As if Ama was just another of her patients. But he knew Olivia’s gooey centre well, and he knew she would be distressed by what this little girl had been through and the suffering she must face on a daily basis.
She glanced at him then and it was confirmed. Her gaze was a melted puddle of warm chocolate and it was begging him for help. To do something. To fix it.
And in that moment he’d have fixed it with his own bare hands if it had been within his power.
Instead he smiled at her and nodded.
He stood and smiled down at Ama and her mother. ‘I’m going to get some tests organised,’ he said, nodding reassuringly. ‘They’ll do them after lunch and Olivia will be with you the whole time, right?’ he said, glancing at Olivia who had scrambled off the bed and was standing next to him.
‘Right,’ Olivia said, also smiling and nodding at Ama. ‘I’m just going outside with Ethan for a moment,’ she said. ‘I won’t be long.’ She narrowed her eyes and wagged her finger playfully at Ama. ‘Don’t you cheat.’
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