Sarah Morgan Summer Collection. Sarah Morgan
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had them?’
‘They’ve just come up in the last few days,’ Shelley muttered. ‘At first I thought I’d just banged myself, but now they’re everywhere so I don’t think it’s that. I didn’t fall or anything.’
‘Have you been ill, Shelley?’ Kyla reached for a thermometer and checked the girl’s temperature.
‘No. Nothing.’
Mary looked anxiously at Kyla. ‘Does she have a temperature?’
Kyla shook her head and forced a smile that she hoped was reassuring. ‘No. Her temperature is fine. Why don’t we ask the doctor to take a look at her? I’m just going to pop across to Dr Walker and see if he can fit her in.’
She left the room but Mary caught up with her in the corridor. ‘Nurse MacNeil …’
Kyla turned and saw the worry in the other woman’s face. She reached out and touched her on the arm, acknowledging the concern. ‘I doubt it’s what you’re thinking, Mary,’ she said softly, ‘but we’ll get it checked out immediately. Dr Walker is very, very good. If there’s anything for us to be worrying about, he’ll tell us soon enough. He trained at one of the top London hospitals, you know. You go back to Shelley or she’ll pick up on your worry.’
Mary bit her lip but gave a nod and returned to the treatment room.
Kyla knocked on Ethan’s door and walked in.
He was reading something on the computer screen and had a pen in his hand. ‘Yes?’
‘It’s me. And you can put that frown away, Dr Walker, because I don’t scare easily.’ She kept her tone light and saw a glimmer of a smile in his eyes.
‘I’m sure you don’t. Can I do something for you?’ He was wearing a dark, well-cut suit and he looked formal and more than a little remote.
‘I hope so.’ Trying not to be intimidated by the suit, Kyla came straight to the point. ‘I’ve a patient I’m worried about. Eleven-year-old girl with bruising all over her body. My first reaction is to panic and think meningitis, but she looks well, apart from a bit tired, perhaps. Her temperature is normal and she’s not been ill.’
‘If meningitis even floats through your head, I’ll see her straight away.’ Ethan put the pen down on the desk and stood up. ‘What’s your second reaction?’
Relieved and impressed that he was taking her so seriously, Kyla came straight out with it. ‘Leukaemia. I don’t want to be dramatic but it has to cross your mind, doesn’t it?’
‘There are many possible diagnoses,’ Ethan said calmly as he walked round the desk. ‘Leukaemia is just one.’
‘I know, but—’ Kyla broke off and bit her lip. ‘You should know that Shelley’s mother, Mary, had a sister with leukaemia. She died about three years ago. Mary hasn’t asked a direct question and obviously she doesn’t want to frighten the child, but I can see from her eyes that she’s frantic with worry.’
Ethan walked towards the door. ‘Then the sooner I see her, the better. I’ll have a better idea once I’ve examined her and obviously I’m going to need to do some blood tests. Bring her in.’ His tone was crisp. Direct. ‘I’ll examine her here. And you’d better stay, if you have the time, given that you know the history.’
‘I’ll stay.’ She wasn’t going anywhere until she knew what was happening.
Ethan examined the child thoroughly, aware of the tension in Mary’s body as she stood to the side of him, watching.
He questioned Shelley at length and then smiled at her. ‘I’m going to need to take some blood from you, just to run a few routine tests. Is that all right?’
Shelley pulled a face. ‘Will it hurt?’
‘A bit,’ Ethan said honestly, reaching behind him for the tray he’d prepared. ‘But not much and not for long. Kyla?’
Kyla handed him a tourniquet and he tightened it round the girl’s arm, stroking the skin as he searched for a good vein.
Kyla kept up a steady stream of chat. ‘So did your netball team go over to the mainland and play the girls at St Jude’s last week?’
A smile spread across Shelley’s face. ‘We thrashed them. Sixteen to one.’
‘Brilliant.’ Kyla turned to Ethan. ‘The school is so small here that every single girl is in the netball team!’
‘But we’re still the best,’ Shelley said quickly, and Ethan smiled, mentally blessing Kyla for her distraction skills.
‘Sharp scratch coming up, Shelley,’ he said smoothly, and slid the needle into the vein.
Shelley didn’t stop talking. ‘Mia Wilson was the best. She got it in the net about fourteen times.’
‘Well, she’s tall, of course, so that helps,’ Kyla murmured, handing him a piece of cotton wool. ‘And her mum is the sports teacher, which is another distinct advantage.’
Shelley laughed and Ethan withdrew the needle and pressed with the cotton wool.
‘I’ll do that while you sort out the sample,’ Kyla murmured, her fingers sliding over his as she took over the pressure.
Her hands were so much smaller than his, her fingers slim and delicate and Ethan felt a sudden burst of heat erupt inside him.
Gritting his teeth and rejecting the feeling, he turned away and labelled the samples carefully. ‘I’m going to send these off. As soon as I get a result, I’ll be in touch.’ Seeing the anxiety in Mary’s eyes, he turned to Kyla. ‘Can you take Shelley to your treatment room and find her a plaster, please? I don’t seem to have one here.’
To her credit, Kyla immediately picked up on his intention. ‘Useless doctors,’ she said cheerfully, slipping her arm through Shelley’s and leading her towards the door. ‘They can do all sorts of fancy, complicated things but when it comes to something simple like a plaster, you can forget it. We girls will see you in Reception in a minute.’
Ethan waited until the door closed behind them and then turned to Mary. ‘I understand that you’re very worried about this.’
Mary was stiff, her fingers gripping her handbag. ‘Do I have reason to be?’
‘Obviously, until I have the results back, I can’t be sure what it is, but I’m pretty confident that it isn’t leukaemia.’
Mary’s teeth clamped on her lips and he could see that she was battling with tears. ‘If it is—’
‘I don’t think it is,’ Ethan said firmly. ‘There are other things that it can be, Mrs Hillier. I’m going to get these results back as fast as possible and then I’ll call you. Is it useless to tell you not to worry?’
‘Completely useless.’ Mary gave a wan smile. ‘But thank you for your thoughtfulness.’
‘So you don’t think it’s leukaemia?’ Kyla closed the door of his consulting room and stood with her back to it. ‘Really?’
‘Shelley looks well and there’s no history of trauma. I’ve examined her thoroughly and her liver and spleen feel normal and there’s no evidence of lymphadenopathy.’
‘So what are the bruises?’
‘Obviously until I see the results of the blood count I can’t be sure, but I think she probably has ITP. Idiopathic thrombocytopenic purpura.’
Kyla frowned. ‘I’ve heard of it but I don’t know much about it and we’ve certainly never had a patient. What’s the treatment?’
‘Depending on the platelet count, it may just be a case of watchful waiting. In someone of Shelley’s age the condition will probably be acute and it will resolve over a few months.’
‘And