‘What’s he seeing us about?’ Leo asked.
‘He has CAPS.’
Cryopyrin-Associate Periodic Syndrome. Leo knew it was an auto-inflammation disorder where the immune system was overactive and caused prolonged periods of inflammation, rather than the body producing antibodies against itself. ‘That’s rare,’ he said. ‘About one in a million. Actually, I’ve only seen one case before.’
‘Sammy’s my only case, too,’ she said. ‘Most patients with CAPS in the UK have Muckle-Wells Syndrome, and that’s the variant Sammy has.’
‘Tell me about him,’ Leo invited. Sure, he could read the file, but this way he got the chance to interact with Rosie. And he liked how quick her mind was.
‘He’s eight years old and he’s been coming here for nearly a year. He comes to clinic with his mum roughly every eight weeks. We check his knees and ankles and do bloods to measure the inflammation levels, and then we give him an injection of the drug that keeps his MWS under control,’ she explained.
‘That’s the drug that blocks interleukin 1β, yes?’ he checked.
‘Yes,’ she confirmed. ‘The treatment’s still new enough that we don’t know the long-term effects, but we’re hoping that it will stop more severe problems developing as he grows older.’
‘Such as deafness?’
‘Exactly,’ she said. ‘Are you ready to see him now?’
He nodded. ‘Absolutely.’
Rosie went out into the reception area and came back with Sammy and his mother.
Leo smiled at them. ‘Hello. I’m Dr Marchetti—you can call me Dr Leo, if you prefer. And you’re Sammy?’
The little boy nodded.
‘Tell me how you’re doing, Sammy,’ Leo invited.
‘Sometimes I have good days, and sometimes I get bad days,’ Sammy said, shrugging.
‘OK. What happens when you have a bad day?’
‘Mum says it’s a flare-up. It affects my tummy, my knees and my head. I get a rash, and it’s always at night.’ Sammy grimaced. ‘Show him, Mum.’
Mrs Kennedy took out her phone and showed them a picture of the nettle rash on Sammy’s stomach.
‘How often do you get flare-ups?’ Leo asked.
‘Every couple of weeks. But it’s not been so bad, lately.’
‘Are you happy for us to examine you?’ Leo asked.
Sammy gave him a rueful smile. ‘I know the drill. You ask me questions, look me over, take blood and then give me the injections.’
‘That’s a pretty good summary,’ Leo said, smiling back.
‘I don’t like the injections,’ Sammy said. ‘They sting and they make my skin sore. But I guess it’s better than the rash.’
‘A lot of people don’t like injections, so you’re not alone there,’ Leo said. ‘Is there anything you’d like to add or ask, Mrs Kennedy?’
‘We’re getting to be old hands at this, now,’ she said. ‘It’s fine.’
Between them, Rosie and Leo examined Sammy, and she took a blood sample. Then Leo administered the drug.
Sammy flinched.
‘I’m sorry it stings,’ Leo said.
‘It’s all right,’ Sammy said, clearly trying to be brave.
‘I have something for you,’ Rosie said. ‘That is... Unless you’re too old to have a lolly for being brave?’
Sammy grinned when he saw the red and white lolly. ‘As if I’m going to turn down a lolly. Especially when it’s in my team’s colours!’
‘You’re a football fan?’ Leo asked.
Sammy nodded. ‘I’d like to be a footballer, but my CAPS is going to get in the way a bit, and I don’t want to let my team down. But I guess I could be a scientist when I grow up and invent a needle that doesn’t hurt when you give someone an injection.’
‘That,’ Leo said, ‘is a brilliant idea, and I think it deserves something extra.’ He produced another red and white lolly. ‘Don’t tell Rosie I raided her lolly jar,’ he said in a stage whisper.
Sammy laughed. ‘See you in a couple of months, Dr Leo.’
‘See you,’ Leo returned with a smile.
When the Kennedys had left, he looked at Rosie. ‘Sammy’s a nice kid.’
‘He is,’ she agreed. Then she paused. ‘I was a bit abrupt with you yesterday. Sorry. So, um, I was wondering, would you like to have lunch with me today? Just as colleagues,’ she added hastily.
Again he glanced at her left hand and saw no sign of a wedding ring. Did she really mean having lunch together just as colleagues, or did she feel the same pull of attraction towards him that he felt towards her?
It might explain why she’d been so prickly yesterday; she might be just as spooked by her reaction to him as he was by his reaction to her. Though quite where they went from here, he had no idea. What he’d seen of Rosie so far told him that she was very professional—straight-talking, yet deeply caring towards her patients. He liked that. A lot.
But he also had the strongest impression that Rosie Hobbes wasn’t the sort to have a casual fling. Which meant she was off limits, because he wasn’t looking for something serious and long-term.
‘Just as colleagues,’ he agreed.
Once they’d seen the last patient at the clinic, they headed for the canteen. Leo noted that she chose a healthy salad and a mug of green tea—not that his own sandwich and coffee were that unhealthy. But Rosie clearly looked after her health.
‘So how are you settling in?’ she asked when they’d found a table.
‘To the hospital or to London?’
‘Both, I guess.’
‘Fine,’ he said. ‘The staff all seem really nice here, and I trained in London so I feel pretty much at home in the city.’
‘That’s good.’
There was a slightly awkward silence, as if she didn’t really know what to say to him next. It might be easier to keep the conversation going, Leo thought, if he asked her to tell him more about Paddington Children’s Hospital and its predicament.
‘Obviously Robyn told me about the Board of Directors and their plans, when she asked me to come and work here,’ he said, ‘so I understand why we’re so short-staffed at the moment. But I gather there was a fire at a local school which made things a bit trickier?’
She nodded. ‘It was about a month ago. The fire started in the art department, apparently. I’m not sure if it was a broken heater or something that caused the initial fire, but some of the paper caught light.’
‘And everything else in an art department tends to be on the flammable side,’ he said.
‘Exactly. It was pretty scary. The school did what they could to get the kids out, but we were overflowing with patients suffering from everything from smoke inhalation to burns. Simon Bennett had severe facial burns; he’s due for some reconstruction surgery, so he’s in and out for check-ups at the moment, poor lamb.’ She winced. ‘And then there’s little Ryan.’
‘Ryan?’ he asked.
‘Ryan Walker. He was one of the last to be rescued.