This had become the hardest case since he’d returned to Paddington’s. A little girl who made it almost impossible to keep a safe distance. Six-year-old Penelope Craig didn’t just touch the hearts of people who came to know her. She grabbed it with both hands and squeezed so hard it was painful.
It wasn’t that he needed a moment to remind himself how important it was to keep that distance, because he had been honing those skills from the moment he’d stepped back through the doors of this astonishing, old hospital and they were already ingrained enough to be automatic. He just needed to make sure the guardrails were completely intact because if there was a weak area, Penny would be the one to find it and push through.
And that couldn’t be allowed to happen.
With a nod, as if he’d read an important message on his pager, Thomas lifted his head and began moving towards the nearest door. There was no hesitation as he tapped to announce his arrival and then entered the room with a smile.
His smile faltered for a split second as Julia Craig, Penny’s mother, caught his gaze with the unspoken question that was always there now.
Is today the day?
His response was as silent as the query.
No. Today’s not the day.
The communication was already well practised enough to be no slower than the blink of an eye. Penny certainly hadn’t noticed.
‘Look, Dr Wolfe! I can dance.’
The fact that Penny was out of her bed meant that today was one of her better ones. She still had her nasal cannula stuck in place with a piece of sticky tape on each cheek, the long plastic tube snaking behind her to where it connected with the main oxygen supply, but she was on her feet.
No, she was actually standing on her tippy-toes, her arms drooping gracefully over the frill of her bright pink tutu skirt. And then she tried to turn in a circle but the tubing got in the way and she lost her balance and sat down with a suddenness that might have upset many children.
Penny just laughed.
‘Oops.’ Julia scooped her daughter into her arms as the laughter turned to gasping.
‘I can...’ Penny took another gulp of air. ‘I can...do it. Watch!’
‘Next time.’ Julia lifted Penny onto her bed. ‘Dr Wolfe is here to see you and he’s very busy. He’s got lots of children to look after today.’
‘But only one who can dance.’ Thomas smiled. ‘Just like a Ballerina Bear.’
Penny’s smile could light up a room. Big grey eyes turned their attention to the television on the wall, where her favourite DVD was playing and a troupe of fluffy bears wearing tutus were performing what seemed to be a cartoon version of Swan Lake.
‘I just want to listen to your heart, if that’s okay.’ Thomas unhooked his stethoscope from around his neck.
Penny nodded but didn’t turn away from the screen. She lifted her arms above her head and curled her finger as she tried to mimic the movements of the dancing bears.
Thomas noted the bluish tinge to his small patient’s lips. Putting the disc of his stethoscope against a chest scarred by more than one major surgery, he listened to a heart that was trying its best to pump enough blood around a small body but failing a little more each day.
The new medication regime was helping but it wasn’t enough. Penny had been put on the waiting list for a heart transplant weeks ago and the job of Thomas and his team was to keep her healthy for long enough that the gift of a long life might be possible. It was a balancing act of drugs to help her heart pump more effectively and control the things that made it harder, like the build-up of fluid in her tissues and lungs. Limiting physical activity was unfortunately a necessity now, as well, and to move further than this room required that Penny was confined to a wheelchair.
The odds of a heart that was a good match becoming available in time weren’t great but, as heartbreaking as that was, it wasn’t why this particular case was proving so much more difficult than other patients he had on the waiting list for transplants.
Penny was a direct link to his past.
The past he’d had to walk away from in order to survive.
* * *
He’d met Penny more than six years ago. Before she was even born, in fact—when ultrasound tests had revealed that the baby’s heart had one of the most serious congenital defects it could have, with the main pumping chamber too small to be effective. She’d had her first surgery when she was only a couple of weeks old and he’d been the doctor looking after her both before and after that surgery.
He’d spent a lot of time with Penny’s parents, Julia and Peter Craig, and he’d felt their anguish as acutely as if it had been his own.
That was what becoming a parent yourself could do to you...
Gwen had only been a couple of years older than Penny so she would have been eight now. Would she have fallen in love with the Ballerina Bears, too? Be going to ballet lessons, perhaps, and wearing a pink tutu on top of any other clothing, including her pyjamas?
The thought was no more than a faint, mental jab. Thomas had known that working with children again might stir up the contents of that locked vault in his head and his heart but he knew how to deal with it.
He knew to step away from the danger zone.
He stepped away from the bed, too. ‘It’s a lovely day, today,’ he said, looping the stethoscope around his neck again. ‘Maybe Mummy can take you outside into the sunshine for a bit.’
A nurse came into the room as he spoke and he glanced at the kidney dish in one hand and a glass of juice in the other. ‘After you’ve had all your pills.’
‘Are you in a rush?’ Julia was on her feet, as well. ‘Have you got a minute?’ She glanced at her daughter, who was still entranced by the dancing bears on the screen. ‘I’ll be back in a minute, Penny. Be a good girl and swallow all those pills for Rosie, okay?’
‘’kay.’ Penny nodded absently.
‘Of course she will,’ Rosie said. ‘And then I want to know all the names of those bears, again. Who’s the one with the sparkly blue fur?’
‘Sapphire,’ Thomas could hear Penny saying as he held the door open for Julia. If she had concerns about her daughter’s condition, they needed to go somewhere else to discuss it. ‘She’s my favourite. And the green one’s Emerald and...the red one’s Ruby...’
The relatives’ room a little further down the corridor was empty. Thomas closed the door behind them and gestured for Julia to take one of the comfortable chairs available.
‘Are you sure you’ve got time?’
‘Of course.’
‘I just... I just wanted to ask you more about what you said yesterday. I tried to explain to Peter last night but I think I made it sound a lot worse than...than you did...’ Julia was fighting tears now.
Thomas nudged the box of tissues on the coffee table closer and Julia gratefully pulled several out.
‘You mean the ventricular assist device?’
Julia nodded, the wad of tissues pressed to her face.
‘You said...you said it would be the next step, when...if...things got worse.’
Thomas kept his tone gentle. ‘They sound scary, I know, but it’s something that’s often used as a bridge to transplant. For when heart failure is resistant to medical therapy, the way Penny’s is becoming.’
‘And you said it might make her a lot better in