Surgeon On Call. Alison Roberts
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pulled the curtain closed around the cubicle to create a more private examination area.
‘Hi, there, sweetheart.’ Felicity smiled at the child whose right arm was clutching a soft toy that looked like some kind of floppy dog. ‘What’s your name?’
Small lips pressed together tightly but the movement was not enough to stop a noticeable chin wobble. Large, frightened brown eyes were fixed on Felicity.
‘Tell the nurse your name, Samantha.’ The order was given in a kindly voice but the only effect was to make the child’s eyes swim with tears.
Felicity flicked Joe a brief glance. Nurse indeed. This was going to be even better than she had anticipated. She smiled at Joe’s daughter again.
‘My name’s Fliss,’ she told the child. ‘Do you go to school, Samantha?’
‘She’s not old enough for school. She goes to kindergarten.’ Joe’s tone was wary. Felicity knew he had recognised her now. His brain was ticking over, probably remembering their encounter with the spinal injury patient. Maybe he was wondering if he might have insulted her by not knowing she was a nurse. Nurse, ha! Felicity bit back a tiny smile. Joe would keep for the moment.
‘Do they call you Samantha at kindy, sweetheart?’
This time Felicity was rewarded with an almost imperceptible head shake.
‘What do they call you? Sam? Sammie?’
The slight movement changed to an affirmative direction. Felicity mirrored the nod as she perched casually on the bed beside the small girl.
‘Which do you like better? Sam or Sammie?’
‘Sam.’ The response was a whisper.
Felicity lowered her own voice to a similarly conspiratorial level. ‘Can I call you Sam?’
‘OK.’
‘Cool.’ Felicity winked at Samantha. ‘I’ll call you Sam and you can call me Fliss. Is that a deal?’
The smile was worth winning. It brightened up a pale little face which was dusted with freckles that matched the luxurious reddish blonde curls. Felicity’s visual impression had included more than the skin colour of her patient, however. She had, by now, assessed the level of the child’s responsiveness and distress, noted her respiration rate and seen the slight but obvious deformity of the left forearm that lay limply on the child’s lap. The right arm still clutched the tattered toy dog.
‘How did you hurt your arm, Sam?’
‘I...I fell out of the swing.’ The child’s glance towards her father made Felicity blink. Was Samantha afraid of giving the wrong answer? Was she afraid of her father? The continuation of the hesitant response raised Felicity’s suspicions another notch.
‘I...I didn’t hang on tight enough.’ A huge tear escaped and rolled down a freckled cheek.
‘It was an accident.’ Was Joe Petersen annoyed with the child or the inconvenience of a trip to the emergency department? Whatever the reason, the tone was inappropriate and not the normal interaction between a parent and child in such a situation. Felicity had already noted the lack of physical contact between the pair. What was going on here?
‘It doesn’t matter how it happened,’ she told Samantha gently. ‘What matters is that we fix up your arm. Does it hurt at the moment?’
Samantha nodded.
‘Did you hit your head when you fell out of the swing?’
‘She wasn’t KO’d,’ Joe said.
Felicity ignored him. ‘Does anything else hurt you, Sam?’
‘No.’ Again Joe answered on behalf of his daughter.
Felicity drew in a deep breath. She spoke calmly. ‘I think Samantha might be better qualified to answer that question than you, Mr Petersen.’
The muscular twitch in the man’s face gave away the incredulity his tone managed to conceal. ‘I believe my daughter has a greenstick fracture of the left radius. Perhaps you could do whatever baseline measurements your protocols dictate and then find a doctor who can authorise the necessary pain relief and treatment this injury requires.’
Felicity met the stare with equal directness. ‘I am a doctor, as a matter of fact. I’m one of the consultants in this emergency department.’ She allowed only a moment to let the implications sink in before adding a punchline she couldn’t quite resist. ‘And don’t worry, Mr Petersen. I may not be a neurosurgeon but I do know what I’m doing.’
She turned back to Samantha, satisfied that the stunned and distinctly discomfited expression on Joe’s face would take some time to dissipate.
‘I know your arm is sore, sweetheart, but I want you to try and wiggle your fingers for me. Can you do that?’
The movement produced was tentative but reassuring. ‘Good girl, Sam. That’s fantastic. Now, I’m going to hold your hand—just gently. Can you feel me touching your fingers?’ Felicity noted the temperature and colour of Samantha’s hand as she responded affirmatively. ‘OK, see if you can squeeze my fingers.’
Felicity compared the responses with Samantha’s uninjured limb. She could still feel Joe’s stare. She checked the radial pulses on both wrists before glancing up. ‘No neurological or circulatory deficit. That’s good.’
‘Why didn’t you tell me before?’
‘I hadn’t done the necessary examination.’ Felicity gave in to the temptation to be deliberately obtuse.
‘I meant, why didn’t you tell me that you were a doctor?’
‘I’ve only been in here a few minutes.’
‘I’m not talking about now. I’m talking about last week.’ Joe Petersen’s tone suggested he was unamused by this verbal sparring.
Felicity shrugged as though it was a matter of little importance. ‘I don’t remember having the opportunity,’ she said thoughtfully. ‘You had the situation well controlled—and, anyway,’ she added mischievously, ‘stabilising the head and neck of a spinal injury patient is a pretty useful thing to do.’ She turned back to Samantha.
‘We’re going to get a special picture taken of your arm,’ she told the child. ‘An X-ray. It looks at the inside of your arm. Do you know what there is inside there?’
Samantha shook her head. The fearful look returned to the large, brown eyes.
‘It’s nothing to worry about,’ Felicity reassured her. ‘An X-ray doesn’t hurt. It’s just a special camera that can see what we can’t see. Bones. They’re the hard bits inside your arms and legs.’ She was debating whether the trauma of inserting an IV line to give some narcotic pain relief was justified, given how easily Samantha could be distracted from her injury. She still looked ready to cry again so Felicity decided to test the distraction level once more.
‘Does your dog have a name?’
‘Snowy.’ The firm response came from Joe.
Felicity saw the expression on Samantha’s face and sighed inwardly. The little girl might be distracted from the pain but upsetting her wasn’t going to help. Maybe she needed to push a little harder and find out what was going on in this relationship. The vibes she was getting were making her distinctly uneasy now.
‘He looks pretty special,’ she told Samantha quietly. ‘Is his name really Snowy?’
Samantha shook her head slowly and dislodged another tear. Then another. ‘His name’s not Snowy,’ she sobbed. ‘His name is Woof Woof Snowball.’
Felicity bit her lip. Her peripheral vision caught the wince on Joe’s face and it was extremely hard not to laugh aloud. The neurosurgeon was acutely embarrassed by the childish name for the toy.