The Children's Doctor and the Single Mum

‘Work it out? Just like that?’ It was cheerful, just a tiny bit reproachful, as if he was presuming too much on very slight acquaintance, which he probably was. Just because they’d saved a life or two together a couple of days ago. How dared he make the assumption that she was that good at her job? said the twinkling blue eyes.

‘I’ll buy you coffee,’ he said, surprising both of them, then added, to make it clear he’d been joking…half, anyway, ‘Provided your diagnosis is correct, obviously.’

She kept it light, too. ‘Deal! Coffee it is. And not bad coffee in a paper cup either, or it doesn’t count. The proper stuff, in good china. You want me to diagnose via the laying on of hands? Or are we more into reading animal entrails at this hospital?’

‘You’re good with that?’

‘I was seconded to the animal entrail department at Royal Victoria for a whole week.’

‘Mmm, and I’ve heard their facilities are state of the art.’

‘I’ll do what I can, Dr Burchell, but, you know, apparently this hospital does do tests occasionally.’ Her blue eyes were still teasing him, inviting him to share the joke. ‘You could order a couple of those.’

OK, time to reassert his authority before this whole exchange got out of hand. ‘I’ll do that,’ he said, ‘when I’ve narrowed down the options. That’s what I need you for.’

Great, Tammy thought. What have I just promised? And why did I keep smirking at him like that, and trying to make him laugh?

Because you wanted to see him smile, said a sneaky little voice inside her.

He’d smiled at her just now from the doorway of the break room, and she’d smiled back, as if they knew each other quite well. She hadn’t noticed in the delivery suite on Thursday night how good-looking he was—not exactly male model material, because he was too seasoned for that and he frowned too much, she could tell from the lines that had begun to etch into his forehead, but definitely at the more attractive end of the male doctor spectrum.

She had only looked after the Thornton baby during Eleanor’s break, and hadn’t taken much notice of little Cameron or his mum, except to note that he looked far too big and strong for this unit, while Mrs Thornton looked too experienced and sensible to be worrying this much.

Hmm. So maybe that meant that she was right.

As a mother of five herself, Tammy trusted the great unwritten rule of paediatrics—listen to the mothers. She’d known her third pregnancy was different two days after she had missed her period. And she’d picked up Ben’s prematurity-related eye problems when his next follow-up test was weeks away.

The day around six years ago when Sarah, her eldest, then aged almost three, had innocently entertained herself by heaping three thick feather pillows on top of four-month-old Lachlan in his bassinet while Tammy had been in the bathroom, something about the quality of the silence coming from the baby’s bedroom had alerted her. She’d stopped mid-moisturise, so to speak, with three blobs of white goo dotted on her face.

She’d raced down the passage and snatched the sound-muffling pillows out of the bassinet, while Sarah had started to giggle at such a funny joke—Mummy looked so silly, throwing the pillows on the floor—to find the baby red-faced and screaming healthily, thank heaven, before any damage had been done.

Yes. Very often, a mother knew.

But what did Mrs Thornton know?

She couldn’t say. ‘Something,’ she repeated stubbornly.

Tammy began to understand why the highly intelligent, highly capable, highly non-vague and non-intuitive Dr Laird Burchell had found this particular mother so irritating and why he had opted for the doctor’s privilege of passing the problem on to a lower hospital life form such as Tammy herself.

The Parry boys were behaving themselves at the moment, and she had a window of eight whole minutes before their next clustered care routine. She decided to stop for a chat beside Cameron’s special premmie crib.

The rest of the unit was humming along in its usual way, the bulky pieces of medical equipment with their lines and screens and alarms dwarfing the tiny babies over whom they kept guard. There were softening touches, though. A bright toy nestled in a humidicrib or a picture taped to the transparent sides. Cards and balloons. A wall of photos of their ‘graduates’—smiling toddlers who couldn’t possibly have ever been so small.

‘How was the pregnancy, Mrs Thornton?’

The mother nodded, understanding the intention behind the question. She was an intelligent woman. ‘It was trouble-free.’ She was standing, too, and rubbed her lower stomach as she spoke. She still seemed fairly sore and stiff after a powerful labour that had been abruptly ended by the emergency Caesar. ‘We were in Japan for the first half of it, though, if that makes any difference.’

‘Wow, Japan. That must have been interesting!’ Tammy said sincerely. She’d been as far as New Zealand, on her honeymoon ten years ago, but that was about it. ‘And not easy, with five kids.’

‘It’s a fascinating country. There was a lot to love, and a lot to adjust to, especially with the kids, as you say.’

‘What were you doing there?’

‘Alan—my husband—had a sabbatical. Someone organised a terrific house for us, out in the countryside. He commuted into the city. When we discovered I was pregnant again, we found a doctor who spoke English, but I found him difficult to understand. And I don’t think he understood me much either.’

‘Was the prenatal care similar to what we have here?’

‘Mostly. As I said, it was an easy pregnancy. I only saw the doctor three times, I think, for routine checks, then we came back here when I was at about five months. I did have an ultrasound there.’

‘At eighteen weeks, like we do here?’

‘Yes, just under.’ Mrs Thornton frowned. ‘Actually, I guess it was more like fifteen weeks, if Dr Lutze was right that Cameron was at thirty-four weeks when he was born, not thirty-six weeks, like we thought. I should change his nappy,’ she added.

She looked tired and uncomfortable, and Tammy found herself offering to do the change, even though she usually breathed a sigh of relief whenever a parent’s help lightened the workload.

‘Thanks,’ Mrs Thornton said. She sat down, and confessed, ‘I skipped the postnatal exercise class this morning. I’m slack!’

‘You know all too well what’s waiting for you at home.’ Tammy grinned. ‘I have five kids myself.’ She was working as she spoke, deftly untaping the sides of the nappy, gently lifting the little legs and bottom.

‘Then you understand!’ Mrs Thornton said with feeling.

The nappy felt very light. You became pretty skilled at estimating urinary output by the weight in your hand. Dry, versus slightly wet, versus nicely soaked. This one felt dry.

‘When did you last change him?’ she asked his mother.

‘Oh, it would be a couple of hours ago. What’s the time now?’

‘Almost seven-thirty.’

‘That late! In that case, it’s about four hours since I changed him.’

‘Was he very wet then?’

‘The nurse weighed the nappy. Just a few mils, she said. I think she wrote it down.’ She didn’t ask if the low output could be a problem, but Tammy could see she’d gone on the alert.

‘Let’s get you into a new one, little man,’ she murmured to the baby, wondering if this could be the source of Mrs Thornton’s nebulous worry. He shouldn’t be dehydrated. There was no obvious distension in his lower abdomen. And newborns often didn’t pee very much at first.

Still… She took his temperature, although he wasn’t due for it, and found that it had gone up a few points—38.1 degrees Celsius. He was officially febrile now, and fever in a premmie newborn wasn’t something you ignored.

She found Dr Burchell at the far end of the unit, studying the notes of a baby girl with a serious heart defect, and told him, ‘I’m not sure if this earns me that coffee you mentioned…’

‘Good coffee, right? Freshly brewed, in a china cup.’

‘That’s the one… Could there be a kidney problem? He doesn’t seem to be putting out much urine.’

‘Newborns don’t.’ Dr Burchell’s mind was clearly still on the heart baby, whose blood gases were getting worse.

The tiny girl needed surgery, Tammy knew, but she really wasn’t strong enough. They’d wanted to get her weight up higher, but it was going in the opposite direction, and her little body was exhausting itself getting that tiny, damaged heart to work.

‘He’s five days old,’ Tammy persisted, even though she understood Dr Burchell’s tight face and the frustrated way he paged through the notes and looked at the heart baby. He wanted to focus on the more serious case. ‘He’s started feeding. And his temp’s over 38.’

OK, she had his attention now. Hopefully he wouldn’t ask how much over 38 degrees. His grey eyes—a deep, liquid grey—fixed themselves on her cap, narrowing with something that was probably annoyance, and she wondered if bits of her hair were making an unauthorised escape bid. They often did.

‘You’re thinking there’s a partial blockage, and he’s having urinary reflux?’ he asked. Grey eyes, but possibly with some chips of green in a different light, Tammy mentally revised.

‘Giving him an infection, yes, that’s what I’m wondering.’

He was already looking back down at the heart baby. ‘Look, we’ll do an ultrasound. Rule it out.’

Rule it out.

His faith in her diagnostic skills clearly wasn’t high. It didn’t look as if she was getting that coffee any time soon.

‘Thanks, um, Tammy,’ he added.

‘No worries,’ she told him cheerfully, and went back to her charges, prepared to think no more about it.

Eleanor had returned from her break and was gently urging Mrs Thornton to have a relaxing shower. Little Cameron’s next nappy would probably weigh twice as much as a dry one, and Tammy would feel like an idiot for her rash diagnosis.

Yeah, that would be good.

She had a nagging suspicion that the kilos on her butt, the zeros in her bank account and the five kids at home might not be quite enough to keep her safe from a man like Laird Burchell. Tall, broad-shouldered, lovely neck, not a hint of a receding hairline, intelligent and caring and capable…and then there were those deep, perceptive eyes.

He was—if you had time to take notice of such things—gorgeous. If he decided she was an idiot, therefore, so much the better.

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