‘Dr Carmichael,’ she said.
They were obviously on professional ground here. OK, he could do that. He nodded. ‘Dr Turner.’ He nodded to Charles. ‘Dr Wetherby.’
He looked down into the cot. Megan was lying on her side, one thumb pressed hard into her mouth. She wasn’t asleep. But …
She was quiet. She was oddly still. First rule for care of children. Worry about the quiet ones.
And she looked so small. Malnourished? Probably. The cigarette burn on her hand looked stark and raw, and once again his gut clenched in anger.
No. Put emotion away. He was there for a reason.
‘How’s her mother?’ he asked, still watching the little girl. They’d called him for something and he needed to figure out what. He was switching into professional mode, checking visually with care. Yesterday Megan had seemed lethargic. This morning he’d have expected her to be brighter. But she seemed apathetic. When he put his hand down in front of her eyes she blinked but didn’t otherwise respond.
Hell.
‘Lizzie’s good,’ Georgie said softly into the stillness. She was watching Megan’s reactions as well. ‘She’s even managed a little breakfast. We’ve put Davy and Dottie into the ward beside her so they can see her as she sleeps, and she’s a hundred per cent better than yesterday. Certainly she’s out of danger. And so is Thomas.’
This was the benefit of a country hospital, Alistair thought. To combine medicine with family … It’d be great to be able to do these things.
‘But you’re worried about this little one,’ he said.
‘We are.’
‘Tell me all you know.’
‘It’s not a lot but it’s more than yesterday. Damn, we should have picked this up on admission.’ Charles’ words were almost a growl as he wheeled away from the cot to bring an X-ray back from the desk. He handed it to Alistair without a word.
Silence.
The X-ray showed the little girl’s skull. With damage. The fracture was only hairline—no worse than the fracture of Georgie’s cheek. But under Georgie’s fracture lay muscle which could bear damage. Under Megan’s skull fracture lay her fragile brain. Internal bleeding would be a catastrophe.
Internal bleeding may well be causing the symptoms they were worried about.
‘Can I check?’ he asked at last, and got three sharp nods for assent.
He crossed to the sinks and washed, carefully. Megan had survived the squalid circumstances of the hut. There was no way Alistair was risking infection now.
What infections did chicken bones carry? He washed twice as diligently as he normally did, and then he washed again.
Then he examined her. Cal left them, obviously needing to be elsewhere, but Georgie and Charles stayed. He ignored them. Instead, he talked to Megan, explaining gently that he was looking at her head, trying to find what was hurting her, trying to find a way to make her feel better. He wasn’t sure that she was taking in anything.
He could see no retinal haemorrhage. That had to be a good sign. There was no obvious swelling.
‘No fever?’ he asked.
‘No,’ Georgie whispered. ‘But … Charles didn’t like the look of her. It was more on a hunch than anything that we did the X-ray.’
‘Good hunch.’
‘Which is when we bailed out and called you,’ Charles said.
‘Do we have the facility to do a CT scan?’
‘Our radiotherapist is on his way in,’ Charles told him. ‘He’s boarding up his mother’s windows or he’d be here now.’
‘Send someone else to board windows. I want him here now,’ Alistair snapped. He closed his eyes, thinking things through. But his decision was inevitable. ‘This little one was talking and responding normally last night. The provisional diagnosis is that she’s bleeding internally, but slowly. If I’m right then we get in there now to try to stop lasting damage. There’s no choice.’
We? Him.
He was under no illusion as to why Georgie had called him. He was a neurosurgeon.
But here …
He wanted a major city hospital. He wanted MRI scans. He wanted …
‘We can’t fly her out,’ Charles said, sounding apologetic. ‘Even by road we’re starting to get worried. We’ve had a couple of big trees come down already, and the road’s getting dangerous. They’re saying it’s worse down south—not better. With this level of wind it might be a few days before we can evacuate.’
‘But we can’t wait,’ Georgie said. She looked terrified, he thought. She looked a far cry from the cocky, gum-chewing, bike-riding Georgie who’d greeted him at the airport yesterday. This morning she was wearing a professional white coat over jeans, T-shirt and sandals. Her sandals were crimson, matching her toenails. There were little gold crescent moons on each toenail. Despite her bruising, she’d gone to some trouble with her make-up—her lips matched her toenails.
There were traces of yesterday’s Georgie left, but she looked young, vulnerable and afraid.
How could he ever have thought she was a tart?
‘I don’t want her brain damaged,’ she said fiercely. ‘I’ll operate myself if I have to.’
She knew what the score was. Internal bleeding could cause—would cause—irreparable damage. The only option was to operate to relieve pressure, a tricky operation at the best of times, but here …
‘You’re not doing anything while we have Alistair. Gina says you’re good,’ Charles said grimly.
‘Let’s run a CAT scan first,’ he said. ‘I’m not doing anything on the basis of one X-ray. I don’t have a clue where the bleeding is. We need to get a definitive diagnosis and I’m not moving without it. And then I need the equipment.’
‘I suspect we have most of what you need,’ Charles told him. ‘Many of our indigenous people refuse to go elsewhere for treatment so if someone’s available, we fly in specialists and they operate here. We’ve had a couple of neurosurgeons who’ve done locum work here, and they’ve set up a store of surgical equipment. If you weren’t here, I’d have to ask Cal to do it. But he’s a general surgeon. He doesn’t have your level of expertise.’
‘He’d still do it,’ Georgie said bluntly. ‘Will you?’
And the thing was decided. ‘Of course,’ he said. ‘OK, get this radiologist here now. I’ll check the scans, the equipment and the personnel available, and then we go. Let’s move.’
If anything could take Georgie’s mind off Max, this was it. Urgent, lifesaving surgery.
It had to be done. The CT—computerised tomography—scan showed very clearly a build-up of fluid, and when they shaved Megan’s hair they could see swelling. Not huge swelling, but it was there.
Then there was a swift family conference. Lizzie was exhausted, but fully conscious and aware. She was appalled at what was happening to her daughter—but at first she couldn’t believe Smiley would have done such a thing.
But the evidence was irrefutable. The white-faced woman held Davy’s hand and trembled while Davy answered Georgie’s questions.
‘It was when Megan was hungry and Mummy was asleep,’ Davy said, faltering. ‘Megan started crying. Dad burned her with his cigarette and then when she wouldn’t stop he hit her hard against the wall.’
For a moment Lizzie looked like she was about