Surgeon On Call. Alison Roberts
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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.
‘‘‘Woof Woof Snowball’’,’ Felicity repeated with some relish. ‘That’s a great name.’ She peered more closely at the toy. ‘He’s a rather grubby snowball right now, though. Did he fall out of the swing, too?’
Samantha nodded.
‘Did he hurt himself, do you think?’
The head shook this time. The tears were gone again and Samantha tried to smile. ‘I think he just got dirty.’
‘Maybe he needs a bath.’
‘I’m not allowed to have squashy toys in the bath. Mum says they take too long to dry.’
‘Ah.’ Felicity digested the information offhandedly as she began to record her medical observations on Samantha’s chart. So there was a mother. Joe’s wife, presumably. Maybe there were brothers and sisters as well. A whole family, in fact, including some cute, fluffy dog. ‘Have you got a real dog at home, too, Sam?’
‘No. Mum doesn’t like dogs.’
‘Oh.’ Felicity continued her rapid note-taking. ‘Does Daddy like dogs?’
‘I don’t know.’
Felicity’s glance was too automatic and too quick to hide her astonishment. How could Samantha not know whether her father liked dogs? Joe was frowning.
‘Of course I like dogs, Sam.’
Felicity tried to dismiss the notions that flitted through her head as she charted some oral analgesics for Samantha and filled in a requisition form for an X-ray. She needed a bit of time to think about this one. Standing up, she smiled brightly at Samantha.
‘I like dogs, too,’ she told her. ‘In fact, I’ve got a real dog. He’s an Irish setter called Rusty.’ Her smile widened. ‘Maybe I should have called him ‘‘Woof Woof Rusty’’.’
Samantha giggled. It was a delightful chortle that prompted Felicity to reach out and gently ruffle the child’s curls. ‘Rusty is a lovely dark auburn colour,’ she continued. ‘But he has long hair on his tail which is much lighter. On the ends it’s exactly the same colour as your hair.’
Samantha looked delighted with the information. ‘Sometimes Daddy calls me Nas—Nas...’ She struggled with the word. ‘Nastagmus,’ she managed triumphantly. ‘He says that’s what my hair reminds him of.’
‘Really?’ A nystagmus was a word used to refer to an abnormal and rapid type of involuntary eye movement. She caught Joe’s gaze and a lopsided smile appeared on his face.
‘She means ‘‘nasturtium’’.’
‘Oh!’ Felicity grinned. She loved the amusing verbal errors children often made, though she was usually careful not to show her amusement in front of them. It was difficult to hide her delight at present, however, and Felicity knew quite well that Samantha’s mistake had only provided part of the pleasure she was experiencing.
That lopsided twist of his lips was the first time she had seen anything like a smile on Joe’s face, and its effect was dramatic. His features softened and crinkles appeared around his eyes. The dark brown eyes were exactly the same colour as Samantha’s. In fact, Samantha looked very much like her father, and while their relationship was oddly formal for a parent and child there was really no doubt about their genetic bond.
Maybe there wasn’t anything too odd about their interaction either. Samantha’s face lit up at the sight of her father’s smile and the look that passed between the pair suggested a genuine closeness. Warmth, even. Felicity had the fleeting and rather disturbing thought that she would like just such a look directed at her from this man.
She excused herself hurriedly. She had no time to ponder the intricacies of this particular family’s relationships with each other and she certainly didn’t want to be distracted by any peculiar reactions to Joe. There were other patients waiting to be seen.
The potential heart-attack patient from out of town had arrived in the department. Felicity accompanied the man during his rapid transfer to a resus area. Geoffrey Pinnington was a forty-year-old farmer from a rural area well north of the city.
‘I’d been feeling a few niggles all morning,’ he told Felicity in response to her first query. ‘I thought I must have pulled a muscle, heaving hay bales around. I’d just finished my lunch when I started feeling really terrible. I went all sweaty and lost my lunch and this awful pain started up.’
‘Where was the pain?’
‘Right here.’ Geoffrey slapped a hand on the centre of his chest. The nurse attending to the 12-lead ECG hastily reattached a dislodged electrode.
‘Try and keep still for a moment, please, Mr Pinnington,’ the nurse requested.
‘Was the pain just in the one spot?’ Felicity asked.
‘No. It went into my neck and then all the way down my left arm.’
‘Given a scale of zero to ten, with zero being no pain and ten being the worst you could imagine, what score would you have given it?’
‘Twelve.’ Geoffrey smiled wryly. ‘I’ve never felt so bad in my life. I really thought I was about to die.’
Felicity nodded sympathetically. A feeling of impending doom was a common symptom of a heart attack. ‘What time did the pain come on?’
‘One o’clock or thereabouts. Maybe a quarter past.’
‘OK.’ Felicity glanced at her watch. Nearly three hours ago. They were still well within the therapeutic window for an angioplasty procedure which could abort the damage being caused by the lack of coronary blood flow.
‘Give Cardiology a call,’ she directed the registrar beside her. Felicity picked up the ECG trace and scanned it rapidly. The changes were abnormal and clear-cut. ‘Tell them we have a probable anterior infarct in progress here.’ She turned to the junior doctor who was drawing blood from the IV line already in Geoffrey’s arm. ‘We need cardiac enzymes, CBC, electrolytes and lipids done, Sarah.’ Her attention returned to her patient. ‘How’s the pain at the moment?’
‘Not too bad. The stuff the GP gave me was good.’
Felicity nodded. She’d read the ambulance patient report form as she’d walked into the resuscitation area. After a half-hour drive to the local doctor, Geoffrey had been given treatment consisting of oxygen, pain relief, an anti-nausea agent, aspirin and GTN. The GP had then called for an ambulance for urgent transfer to hospital. All the right things had been done and the GP’s note included baseline measurements and a brief medical history that didn’t indicate any risk factors for heart disease. But Felicity wanted to double-check.
‘So you’ve never had any problems with your heart before this, Geoffrey?’
‘No.’
‘No other medical conditions you’re treated for?’
‘No, nothing.’
‘Blood pressure’s always been OK?’
‘As far as I know.’
‘Have you ever had your cholesterol levels checked?’
Geoffrey nodded. ‘Always