frowned. What was wrong with him? Where had that come from?
Lien tilted her head. ‘Something wrong?’
He shook his head too quickly. ‘No, nothing.’ He pushed himself up from the chair. ‘Where do you want me?’ He was anxious to get this day started.
The few seconds of silence was slightly uncomfortable. He flashed back to being a junior doctor and the nurse in charge of the ward shooting him a glance to say she doubted he should even actually touch a patient.
A figure appeared in the doorway and Lien stood up. ‘Perfect. Mai Ahn, this is Joe. Joe, this is Mai Ahn, your interpreter. She’ll help you with the children’s clinic.’
‘Children’s clinic it is,’ he said with a nod, before reaching out to shake hands with Mai Ahn. ‘Lead the way.’
She was unsure of him. Of course she was. Did he even notice he occasionally glanced at his mobile clipped onto his belt? It was only natural that he was worried about how his son was settling in on his first day of nursery, she only hoped it wouldn’t distract him from the job he had to do.
The children’s clinic wasn’t for the faint-hearted.
She couldn’t help but be automatically protective of the place she loved working in. At least he’d been honest last night. He’d told her that he and his son needed a change after losing his wife. He’d said it had been three years. But she’d seen the glint of pain in his eyes. Was he really ready to move on?
She still had doubts.
It was a shame. Because he was undoubtedly handsome. The burr of the Scots accent was almost melodic—even though she had to concentrate hard. And it was clear that he doted on his son. Just as she’d expect him to.
She gave herself a shake. It was a ridiculous observation. She was used to doctors coming here on short-term contracts, and she’d never considered any kind of relationship. She was too busy. Too dedicated to her work. She’d had her heart broken once, and that was enough for her.
Too poor. Not the words he’d used, but those were the words he’d meant. Lien had never pretended to be anything she wasn’t. As a child she’d always been well mannered and as well presented as she could be. She’d been bright, and her teachers had noticed. They’d encouraged her to study hard, and eventually helped her to seek out scholarships so she could attend medical school.
At medical school she’d got along with most of her classmates. Reuben had come from a rich family in another city. He’d never asked her where she lived—he’d just made assumptions. Then, when he’d found out, after two years, she’d been dumped quicker than a hot brick.
Her family was proud of her, and she was of them. She’d hated the way it had made her feel. Not good enough. Not rich enough.
She came from one of the poorest areas in the city. Her family still lived there—no matter how much she’d tried to assist them since she’d qualified as a doctor. But even now they wouldn’t accept any financial help from her.
They liked where they lived. They still worked hard. They didn’t want change, in any form.
Lien lifted the pile of patient notes from the desk. They were all people who were due back at the clinic today to be reviewed.
One of the nurses gave her a smile as she walked into the waiting room. There were already ten people waiting. She gave a nod of her head and smiled, speaking in Vietnamese. ‘Okay, who is first?’
The only person having trouble concentrating today was her. She kept casting her eyes through to the other waiting room. She knew that Mai Ahn, the interpreter, would come and find her if he had any concerns. But she didn’t. Instead, she saw an occasional glance of Joe carrying babies and toddlers through to the examination room for assessment or vaccinations. Through Mai Ahn, he chatted to the mothers. Most of them seemed happy to talk to him and from the looks on their faces the Scottish doctor was proving a hit.
After a few hours he came through and knocked on her door.
‘Lien, can we have a chat about a child?’
She nodded, pleased that he’d come to talk to her.
‘I think I’ve got a little one with complications of tuberculosis. I can’t find any previous notes, and there’s no X-ray.’ His brow wrinkled. ‘Don’t most babies get immunised against tuberculosis shortly after birth?’
‘They should. Unfortunately, tuberculosis is common around here. If babies are born in hospital they are immunised if the parents consent. But not all babies are born in hospitals. What do you think are the complications?’
He ran his hands through his hair. ‘She’s losing weight, even though she’s feeding. Her colour is poor, she’s tachycardic, and I suspect her oxygen saturation isn’t what it should be. Her lungs don’t sound as if they are filling properly. She has a temperature and a cough. I suspect a pleural effusion. Do you have a paediatric monitor I could use while I order a chest X-ray?’
Lien stood quickly and gave him a serious kind of smile. ‘Let’s do this together.’
He raised one eyebrow. ‘Don’t you trust me?’ He didn’t seem annoyed by the fact she was effectively second-guessing him. He might even have looked a little amused.
‘You asked for a second opinion, Dr Lennox. I’m going to give you one.’
The amused look stayed on his face. ‘Absolutely. I haven’t seen many kids with tuberculosis in Scotland.’
She gave a nod as they walked through to the paediatric treatment room. As soon as they reached the door, Lien could almost verify his diagnosis. She switched to Vietnamese and introduced herself to the mother and her five-year-old daughter, who was clearly sick.
Joe’s notes were thorough. Three other members of the family had active tuberculosis. Only one complied with their treatment. It was no wonder the little girl was affected.
Five minutes later they were looking at a chest X-ray. Joe was right at her shoulder. She held her breath and caught a slight whiff of the aftershave he was wearing, even though it was overshadowed by his insect repellent. She wanted to know if he’d recognise what she needed him to on the X-ray.
She needn’t have worried. He lifted one finger and pointed to the film. ‘Pleural effusion without any parenchymal lesion.’ He didn’t finish there. ‘I know there’s some mixed feelings, but because of how this little girl has presented, I would be inclined to drain the effusion rather than leaving it.’
She took a few minutes to recheck things. This was the first time he’d seen a child with tuberculosis, never mind the added complications, and he’d picked it up straight away. She couldn’t help but be impressed.
She turned to face him. ‘I think you’re right. Let’s put our public health heads on and try to persuade the rest of the family to comply with their medications. We can use a sample of the effusion to diagnose the tuberculosis. A pleural biopsy would likely be too traumatic right now.’
He
