The Doctor's Tender Secret

And she was lost.

Somehow—she wasn’t even aware of moving—she worked her way to the front of the crowd. Met Brad’s eyes over the top of the piano as he crooned the words.

Insane. He must be going completely insane. Zoe Kennedy was off limits. And here he was, singing one of the most romantic songs ever written. To her. And he really was singing just to her, not to the appreciative crowd.

She must know it. She had to know it. Why else would she be standing there at the front, smiling back at him?

Unless she was smiling at the boyfriend.

Brad scanned the room. He couldn’t see anyone who looked as though he was with Zoe. Nobody with his arm round her waist, holding her against him and humming those same words to her, a tribute to a woman who could wipe away his sadness and fill his heart with love. Zoe was standing there alone, looking at him. And Brad was looking right back at her.

Was Zoe the one who could wipe away his sadness?

It was stupid to feel jealous, Zoe told herself crossly. Jude was only singing with Brad to raise money. So why was she wishing that she was the one up on stage with him instead of her best friend? Why was she wishing that Brad and Jude didn’t look quite so good together? Why was she panicking that Jude might decide that her career wasn’t enough after all, and Brad was what she wanted? And that Brad would, of course, fall for the most gorgeous woman in the hospital, five feet eleven with legs up to her armpits, long red hair, clear skin and blue eyes, who sang like an angel and had a lot more in common with him than Zoe did?

This really, really wasn’t good. Zoe never panicked about men. Ever. She didn’t have a love life to upset her equilibrium; she didn’t do more than smile with her friends about the latest heart-throb actor or singer or sports star. So why was she feeling like this about Brad Hutton?

Then the music changed tempo again as someone requested something upbeat, fun and frothy. Relieved that she hadn’t quite made a fool of herself, Zoe escaped back to her table duties, topping up the empty platters from the boxes she’d stored in the kitchen cooler.

When the evening was over and the crowds had gone, Zoe started clearing up. A voice said beside her, ‘Anything I can do?’ and she dropped the stainless-steel dishes she was holding.

Lucky they weren’t glass, she thought as they clattered loudly onto the table.

‘Sorry. I didn’t mean to startle you,’ Brad said.

‘No. I was miles away. Just thinking about how well it went tonight.’

‘Did you make a lot?’

‘Dunno. Ask Holly—she’s doing the tally.’

‘Didn’t your boyfriend stick around to help?’

Zoe felt her cheeks grow hot. ‘He couldn’t make it tonight,’ she mumbled. Well, of course her boyfriend hadn’t been able to make it. He didn’t exist!

‘Do you want a hand with the washing-up?’

‘I’m fine. I’ve got a deal with the kitchen staff,’ she said. ‘They let me use the dishwasher in exchange for cake.’

‘You’ve really got a network here, haven’t you?’ he asked admiringly.

She shrugged. ‘I’m just part of the hospital. A small part.’

A big part, he’d say. Hurricane Zoe might be bossy, but her heart was solid gold and he hadn’t met a single person who didn’t adore her. Which was yet another reason why he should stay away from her. If he so much as laid a finger on her, most of London City General would be baying for his blood, as the man who’d wrecked her relationship and broken her heart.

And he’d hate himself just as much, for hurting her. For her sake, he had to stay away.

‘What do you want me to do?’ he asked.

She shook her head. ‘You’ve done your bit. Look, I saved some food for you and Jude. You must be hungry. Go and eat.’

‘OK, boss,’ he said, and wandered over to join Judith and Holly. ‘How did we do?’ he asked Holly.

‘Brilliantly.’ Holly told him the total and his jaw dropped.

‘We made all that in one night?’

‘Donations, ticket sales and half the bar profits. Thanks to you.’

‘Hey. I’m not the one who set it up.’

‘No, but you were a good enough sport to let Zo persuade you into singing with Jude. And it takes a lot of nerve to stand up on stage and do what you did. I couldn’t do it.’

‘Here. Have one of Zo’s brownies,’ Judith offered. ‘Before I scoff them all. They’re seriously good.’

Brad decided not to admit he’d already had three—and that Zoe had brought them to the ward that morning, especially for him.

That she’d made them on his request.

‘Thanks.’ He took a brownie. ‘Mmm, you’re right, these are really good.’

‘Yet another of Zo’s talents. She’s good at everything,’ Judith said.

‘Except singing,’ Holly corrected with a grin. ‘She’s got a tin ear. Worse than mine!’

Brad didn’t care. He didn’t want Zoe to sing to him anyway. There were other, much more pleasurable things he could imagine her sweet mouth doing.

‘Is Zoe’s boyfriend a doctor?’ he asked, as casually as he could.

‘Zoe’s boyfriend?’ Judith asked, sounding mystified.

‘Mmm. The guy she hangs round with.’ He shouldn’t be asking. It was none of his business. But he couldn’t help wanting to know—wanting to be sure that the man Zoe loved deserved her. Her best friends would know that, wouldn’t they? ‘She said he couldn’t make it tonight—that he usually helps. Did he get called back to his ward or something?’

He saw the glance pass between Judith and Holly, and frowned. ‘What am I missing?’ Oh, no. Please. Don’t let her have fallen for a selfish jerk who resented the time she spent on other people and left her to do everything on her own.

‘Um, nothing,’ Judith said, a little too brightly.

‘You’re interested in our Zoe, aren’t you?’ Holly asked.

Brad swallowed. Was it that obvious? ‘What makes you think that?’ he prevaricated.

‘Because you were singing to her tonight,’ Judith said.

Brad rubbed his hand across his face. Hell. It really was that obvious. Judith and Holly knew, too. ‘I…um…’

As if she’d guessed his worries, Holly added, ‘Don’t worry. No one else noticed. We only did because—Ow.’ She rubbed her ankle.

‘Because what?’ Brad asked. Had Zoe said something to them about him?

‘Because we’re her best friends,’ Judith said.

Maybe he’d got it wrong. He backtracked, fast. ‘Look, I’m not going to hurt her. I promise. I know she’s in love with this boyfriend of hers and I’m not going to interfere.’

‘For a consultant,’ Holly said, ‘you’re not very bright, are you?’

Brad frowned again. ‘How do you mean?’

‘Zoe doesn’t have a boyfriend,’ Judith told him quietly.

This didn’t make sense. Not at all. ‘But why would she say she did, when she doesn’t?’

‘Because she—’ Holly stopped and glared at Judith.

Whatever she’d been about to say, Brad thought, Judith had guessed and hadn’t wanted Holly to tell him. She’d obviously kicked Holly under the table to stop her talking. ‘What?’ he pressed.

Holly shrugged. ‘Maybe she thinks having a relationship means that no one will take her seriously in her career.’

‘So she’s single.’

‘Yes,’ Judith confirmed.

‘And you think she’d be interested in me? If I…?’ Brad’s thoughts were whirling. Zoe wasn’t seeing anyone else. Zoe wasn’t off limits. They could…

‘Just talk to her,’ Holly said.

Talk to her. Talk to her. Well, that was easier said than done, Brad thought two days later. Zoe refused point-blank to have a personal conversation with him. She’d spend any amount of time with him discussing patients or treatments or clinical protocol, but the minute he tried to switch the conversation onto a more personal level, she switched it right back.

‘Are you busy tonight?’ he asked her.

Zoe picked up a file. ‘I was wondering about PKU,’ she said.

‘PKU?’

‘Phenylketonuria. A genetic enzyme deficiency.’

He smiled. ‘I know what PKU is.’

‘I had a patient today. A little girl, fifteen months old. She was very fair, though both her parents were dark. She has eczema. And she’s not talking much—she’s hardly babbling. She pushes other children away if they go anywhere near her. And I was wondering if the developmental delay could be a side-effect of PKU.’

‘I thought all newborns were screened here for PKU?’

‘They are. Well, they’re supposed to be. You know some always slip through the net,’ Zoe said.

‘Hmm. Did she smell a bit odd—a bit like mice?’

Zoe nodded. ‘And the fairness, given her parents’ colouring—I wondered if it was tyrosine deficiency.’ With PKU, the body didn’t have enough phenylalanine hydroxylase so it could only convert some of the amino acid phenylalanine into tyrosine. Phenylalanine then built up in the blood and brain, and could cause severe damage.

‘So what’s the plan?’

‘I did a blood sample to check her plasma levels of phenylalanine and tyrosine. If they’re low…I’d say it’s PKU. I know you’ve done a lot of work on paediatric endocrinology. I wondered if you’d oversee the tests and treatment.’

‘Sure. If you’re right, the parents are going to have to learn to read labels and cut out anything with aspartame in it—phenylalanine’s one of its main components, and it’s in some medicines as well as sweetened foods and soft drinks. And you’ll need to bring in a dietician—they’ll have to cut out high-protein foods and restrict starches. A slice of bread can contain over half a day’s intake of phenylalanine.’ He looked thoughtful. ‘She’ll need dietary supplements for essential amino acids, vitamins and minerals, and she’ll need specially formulated substitute for protein foods. She’ll probably also have some attention problems, even with treatment.’

‘And if they don’t treat it or let her snack on chips and high-protein foods?’

‘They’ll start seeing behaviour problems, and she’ll have problems coping with school.’

‘When’s it safe to drop the diet?’ Zoe asked.

‘In theory, once the brain has finished growing and developing. But it’s pretty controversial—I’d say right now it’s a long-term thing. For the rest of her life. And especially if she decides to have a family when she’s older—during pregnancy, if she doesn’t keep her levels stable it’ll expose the foetus to high levels of phenylalanine, which could cause birth defects, brain damage, or even a miscarriage.’

Good. It had worked. She’d headed him away from personal subjects and onto something safe.

She was just starting to relax again when he said, ‘So what are you doing tonight?’

Cleaning the house. Tackling the ironing mountain. Anything to stop herself thinking about Brad Hutton. ‘I’m meeting Tom.’

‘Tom?’

‘My boyfriend. The one I was telling you about,’ she gabbled.

He raised an eyebrow. ‘You don’t have a boyfriend.’

How did he know? Unless…No. Judith and Holly wouldn’t have told him. Surely they wouldn’t. ‘Yes, I do,’ she lied.

‘Zoe—’

‘And I’d better get going or I’ll be late for our date. It’s Friday night, after all. See you later.’ And she left before he had a chance to say anything else.

CHAPTER FOUR

ALTHOUGH they were both on duty that weekend, Zoe avoided Brad, except on the ward rounds—and she made sure that he didn’t get a chance to speak to her privately about anything.

It drove him bananas. What was it going to take to make her talk to him, tell him the truth? Because he still couldn’t work out why she was lying to him, why she was pretending to have a boyfriend. Had she been hurt by someone in the past and no longer trusted men? Or was it something about him that worried her? But, if so, what?

Judith and Holly were no help either. He tried asking them. They both shrugged and said, ‘Ask Zoe.’ Either they really didn’t know or they were protecting her. Either way, he was no further forward.

He was still brooding about it on the Monday afternoon—in the guise of doing paperwork in his office—when his phone rang.

‘Brad Hutton,’ he said, a little more brusquely than he’d intended.

‘Hello, Brad. It’s Jude. Sorry to bother you—I know you’re busy—but I need a paediatrician in Theatre. Like now. Can you send Zoe along, please?’

‘No can do.’

There was a second’s pause. ‘Why not?’

‘She’s in Theatre already.’

‘Oh, no.’ The dismay in Judith’s voice was palpable. ‘Is anyone else available?’

‘What’s up?’

‘I’ve got a mum with eclampsia.’

The world tilted sharply on its axis. Eclampsia. Of all the conditions Brad could have faced in the hospital, it would have to be that one.

‘Brad? We’re doing an emergency section because the baby’s in distress. I need someone over here. Fast,’ Judith prompted.

There wasn’t anyone else. He couldn’t drag Zoe out of Theatre without a lot of explanations he didn’t want to give. There was no point in paging his SHO, because she wouldn’t be back from her lunch-break on time to make it to Theatre. And he couldn’t leave something like this to a house officer who probably hadn’t ever seen a case of eclampsia and wouldn’t know what to look for in the baby.

So he had to face it himself.

Face the demon that had haunted him for nearly a year.

He felt as if he were talking through a mouthful of sawdust but he managed to force the words out. ‘OK. I’m on my way.’

‘Thanks. I’m in the delivery suite. Theatre Four,’ Judith told him.

Eclampsia. A bolt from the blue because it was impossible to predict who would get it. Although most cases of eclampsia developed from pre-eclampsia, there were also documented cases where the mother hadn’t had any signs of pre-eclampsia beforehand. Nobody really knew what caused pre-eclampsia either, though one theory was that it was an abnormality in the body’s immune response to pregnancy. It was once called toxaemia of pregnancy but nowadays was known by a longer name reflecting the symptoms, ‘hypertension of pregnancy with proteinuria’—in other words, high blood pressure plus protein in the urine.

It had certainly been a bolt from the blue for Lara. She hadn’t been in any of the high-risk groups and she’d had good antenatal care. There had been no family history of pre-eclampsia, she hadn’t had hypertension, kidney disease or systemic lupus erythematosus before her pregnancy, she had only been having one baby and there had been no problems with the foetus at all during her pregnancy.

Worse still, Lara hadn’t actually had pre-eclampsia. No signs of protein in her urine, no swollen fingers or ankles, no signs of high blood pressure. The first either of them had known about it had been when Lara had complained of a headache one afternoon at the office. And then she’d collapsed, had a seizure. By the time she’d been taken to the emergency department and Brad had been paged from Paediatrics, Lara had had two further seizures. Despite the best efforts of the team, the baby hadn’t had enough oxygen and she’d died in Lara’s womb. His beautiful daughter, the little girl they’d both so looked forward to meeting—dead.

Bile rose in Brad’s throat. As if losing his daughter hadn’t been enough, that day had turned into his worst nightmare. Because, along with just over a third of women with eclampsia, Lara had developed a complication after delivering their baby. The most common one—a brain haemorrhage—and also the most fatal one.

And so he’d had to arrange a double funeral. His wife and his child. Two coffins—one of them impossibly tiny—that together had contained his whole life. Ashes to ashes, dust to dust…

He shook himself. He couldn’t go to pieces. Not now. He was a professional, a paediatric consultant, and he had a job to do. He had to look after this baby. Make sure that this one didn’t die like Cassandra had.

He scrubbed up and went into Theatre Four.

‘Thanks for making it so fast, Brad,’ Judith said. ‘This is Susie Thornton. She’s thirty-seven weeks, it’s her first baby and she’s thirty-seven.’

Worse and worse. Exactly the same as Lara had been when she’d died. Three years older than he was. First baby, thirty-seven weeks gestation.

‘She had moderate pre-eclampsia so we’ve been keeping a close eye on her on the ward for the last couple of weeks. She’s been on bed rest and antihypertensive drugs. She had a bit of a headache, then said it hurt just under her ribs and she thought it might be contractions.’

Brad forced the words through his dry lips. ‘And then she had a seizure?’

Judith nodded. ‘Textbook case, according to the midwife—thank God she was in the room at the time. Susie stopped breathing, her face twitched, her body became rigid and her muscles started contracting. Then phase two. Convulsions started in her jaw, moved through the muscles of her face and eyelids and spread through her body. The whole thing lasted for just over a minute. She was unconscious for a couple of minutes afterwards, and started hyperventilating when she came round—though she couldn’t remember collapsing or having a fit.’

Neither had Lara. When he’d been in the emergency department with her, holding her hand, she’d been distraught. ‘What’s happening to me, Brad? What happened? I—I can’t remember anything. I want our baby to be all right. Promise me our baby will be all right. Don’t let anything happen to her.’

Her words echoed through Brad’s head, over and over. Promise me. And, being a hotshot paediatrician, he’d promised. Of course their baby would be all right. He wouldn’t let anything happen to their precious child.

And when it had come to the crunch, he hadn’t been able to do a damned thing.

He realised that Judith was still talking him through her patient’s history.

‘We cleared her airway, made sure she had enough oxygen and put her on her left side so there was a good blood flow to the baby. She’s had intravenous magnesium sulphate to prevent any further seizures—it’s better than intramuscular, which hurts and leads to abscesses, plus it helps the blood flow to the foetus. I asked for ten-minute obs on her blood pressure and regular checks on proteinuria. I thought she’d stabilised and I was planning to give her oxytocin to induce labour. Susie really wanted a natural birth. But we were monitoring the foetal heart rate, too, and the baby went into distress. Probably because of the antihypertensives. My consultant agreed that we had to deliver. Now.’

‘Sure.’ Brad’s voice was hoarse with effort. ‘You’d better keep an eye on her afterwards. In case there’s a…’ He couldn’t say it. Couldn’t say the words that had broken his heart. An intracranial bleed.

‘Complications.’ Judith grimaced. ‘I’m more worried about the baby. Less than five mums a year die of eclampsia in this country—but it kills ten or eleven babies every week.’

Yeah. He knew that. Knew that the hard way.

This wasn’t going to be the same, he told himself fiercely. It wasn’t. Yes, it would be another emergency section of a mum with eclampsia. But this time the baby would live. The baby would be fine. The mother would be fine. Nothing was going to go wrong.

He watched the anaesthetist checking all the vital signs. Watched Judith make the small incision along the bikini line, watched her partner press down on Susie Thornton’s abdomen, watched Judith guide the baby out.

And all the time, he was seeing a different woman. A tall, beautiful blonde who’d held his hand so tightly, so desperately, willing everything to be all right. A woman whose panic had grown in those first seconds after the baby had been delivered—those long, agonising seconds when they’d waited for their little girl to cry. Waited for a sound. Heard the suction as they’d cleared the baby’s airways. Waited again for a sound. Still waited as the paediatric team had started CPR. Nothing. Nothing. Nothing.

The baby’s cry shocked him into action. Brad forced the bitterness of the past out of his mind and took the baby from Judith’s hands.

A little girl. A beautiful little girl. Covered with vernix, the greasy white substance that protected the baby’s skin from the amniotic fluid, just as Cassandra had been. But the big difference was that this little girl was crying. Her heart rate was fine. Her muscle tone was fine. She was starting to pink up nicely. She was breathing. He went through his mental checklist and smiled. ‘She’s got an Apgar of nine,’ he said.

A more detailed examination of the baby stopped the panic that had started to beat through him, silenced all the ‘what ifs’. ‘She’s absolutely fine,’ he said, handing her to the midwife to be weighed. ‘Though I think mum and baby should be in Special Care for the first twenty-four hours. Just to be on the safe side.’

‘Standard procedure,’ Judith said with a smile. ‘Susie’s blood pressure should be back to normal within a week, and the protein in her urine should have cleared within six weeks. All being well.’

‘Yeah.’ Concentrate on the here and now, he told himself, forcing himself to smile back. ‘I’d better be getting back to my paperwork,’ he said.

‘Thanks for your help, Brad.’

‘Pleasure.’

Though his smile faded when he left Theatre. Even though this case had turned out all right, hadn’t turned into the nightmare he’d lived through last year, it had still unsettled him. Brought back all the memories. Lara’s tortured face when she’d learned that their little girl hadn’t made it. The bleakness in her eyes. The bitterness in his mouth every time he’d had to explain that, no, he didn’t have good news. Their little girl had been stillborn. Phone call after phone call. The more often he’d said it, the more he should have got used to it. But every time the words had cut out another piece of his heart, left him bleeding inside. And when he’d lost Lara as well…

All my pretty chickens and their dam, at one fell swoop?

She’d said it was the most heartbreaking line in Macbeth. And he’d learned that the hard way.

He couldn’t face the ward. Not right now. Maybe a strong, dark coffee would revive him enough to let him carry on as if nothing was wrong. Maybe.

But when he reached the doors of the staff restaurant, he turned away. He couldn’t face that either. Sitting all alone with a cup of coffee while people walked right by him. Here, it would be because they didn’t know him. In California, it had been because they hadn’t known what to say, and walking straight past him without a word had been easier than trying to stumble through some form of condolences. Some people had even crossed the road rather than talk to him.

A muscle flickered in his jaw. He’d known he’d have to face this at some point in his career. Statistically, he knew he’d face at least one case of eclampsia a year in a major hospital. He’d thought he could handle it, because London City General was a different hospital in a different country, not the one where Lara and Cassandra had died. He’d thought he’d been prepared for it.

How wrong he’d been.

Brad returned to his office on autopilot. Started working through the reports, doggedly concentrating on the words and willing the pain to stay away. He didn’t hear the knock on his door. Or the second, louder knock.

Zoe opened the door. ‘Are you all right?’ she asked.

Of course he wasn’t. But he also wasn’t up to explaining why.

‘What’s happened?’

He shook his head.

Zoe closed the door behind her, pulled his blind down and crossed his office in two paces. ‘It’s better out than in,’ she said softly. ‘And if you’re worried about the office grapevine, I should tell you now that I don’t do gossip.’

Yeah. He knew that without having to ask. She might tell Holly and Judith in confidence, if she thought it would help him, but she’d make very sure they kept her confidence.

Even so… ‘I’m OK,’ he muttered.

‘You don’t look it.’ She took his hand. ‘What is it? Bad news from home?’

Home? He didn’t have a home any more. He’d sold the house he’d shared with Lara, put most of his things into storage and come over here. To a rented, anonymous flat. A place to live—not home.