The next day was one of Bailey’s clinic days at the London Victoria. Her first patient was a teenager who’d been injured playing tennis.
‘Viv landed awkwardly in training,’ Mr Kaine said. ‘She said she felt her knee give and heard a popping sound. And her knee’s started to swell really badly.’ He indicated his daughter’s knee. ‘It hurts to walk.’
‘It’s just a sprain, Dad. It’ll be fine,’ Vivienne said. ‘Let’s stop wasting the doctor’s time and go home.’
‘No,’ he said firmly. ‘You’re going to get this checked out properly.’
It sounded as if Mr Kaine was putting his daughter’s welfare first and would support her through any treatment programme—which was a good thing, Bailey thought, because what he’d just described sounded very like the injury that had finished Jared’s career. Damage to the anterior cruciate ligament.
She pushed Jared to the back of her mind. Not here, not now. Her patient came first.
‘Thank you for giving me the background, Mr Kaine. That’s very useful,’ she said cheerfully. ‘Vivienne, would you mind if I examine your knee?’ she asked.
The girl rolled her eyes, as if she thought this was a total waste of time, but nodded. She flinched when Bailey touched her knee, so clearly it hurt to the touch and Bailey was very, very gentle as she finished examining the girl’s knee.
‘I’m going to send you for an MRI scan to confirm it,’ she said, ‘but I’m fairly sure you’ve torn your anterior cruciate ligament. I’m afraid you’re going to be out of play for a little while.’
Again, she thought of Jared. He must have had a similar consultation with a doctor at a very similar age.
‘What? But I have to play! I’ve got an important tournament next week,’ Vivienne said, looking horrified. ‘I’ve been training for months. I can’t miss it!’
However bad the girl felt about it, she had to face up to the severity of her injury. She wouldn’t even be able to have a casual knockabout on the court for a while, let alone play an important match on the junior tennis circuit. Not even if her knee was strapped up.
‘Viv, you have to listen to the doctor. She knows what she’s talking about,’ Mr Kaine said. ‘I’m sorry, Dr Randall. You were explaining to us what Vivienne’s done to her knee.’
Bailey drew a couple of diagrams to show Vivienne how the ligaments worked and what had happened to her knee. ‘You have a complete tear of the ligament—it’s the most common type, and I’m afraid it also means you’ve damaged the other ligaments and your cartilage.’
‘Will it take long to fix?’ Vivienne asked. ‘If I miss this tournament, can I play in the next one?’
‘I’m afraid that’s unlikely,’ Bailey said. ‘You’re going to need surgery.’
‘Surgery?’ The girl looked totally shocked. ‘But—but—that means I’ll be out for ages!’
‘The injury won’t heal on its own and unfortunately you can’t just stitch a ligament back together. Vivienne, I’ll need to send you to a specialist surgeon. I know Dr Martyn here quite well, and he’s really good at his job, so I promise you’ll be in the best hands.’ She looked up at Vivienne’s father and gave him a reassuring smile, too. ‘He’ll replace your torn ligament with a tissue graft, which will act as a kind of scaffolding for the new ligament to grow on. You’ll be on crutches for a while afterwards.’
‘Crutches. I can’t play tennis with crutches.’ Vivienne shook her head. ‘This can’t be happening. It just can’t.’
‘Crutches will stop you putting weight on your leg and damaging the structure of your knee further,’ Bailey said. ‘I can also give you a brace to protect your knee and make it more stable. But I’m afraid it’s going to be at least six months until you can play sports again. After the surgery, you’ll need a rehab physiotherapy programme—that means exercises tailored to strengthen your leg muscles and make your knee functional again.’
‘Six months.’ Vivienne closed her eyes. ‘Oh, my God. My life’s over.’
‘Viv, it’s going to take six months for you to get better. I know it feels bad, but it’s not the end of the world. You’ll come back stronger,’ Mr Kaine said.
It was good that her dad was so supportive, Bailey thought. But Vivienne was clearly finding it hard to adjust.
‘If you go back to playing too soon, you might do more damage to your knee and you’ll be out of action for a lot longer,’ Bailey said. ‘The good news is that the way they do surgery today is a lot less invasive. It’s keyhole surgery, so that means you’ll have less pain, you’ll spend less time in hospital and you’ll recover more quickly.’
‘When will the surgeon do it?’ Mr Kaine asked. ‘Today? Tomorrow?’
‘Not straight away,’ Bailey said. ‘We need the inflammation to go down a bit first, or there’s a risk of scar tissue forming inside the joint and you’ll lose part of your range of motion.’
‘And that means I won’t be able to play tennis the way I do now.’ Vivienne bit her lip. ‘Not ever.’
‘Exactly,’ Bailey said. ‘What you do next is going to make the biggest difference. For the next seventy-two hours you need to remember RICE—rest, ice, compression and elevation.’ She talked Vivienne through the treatment protocols.
‘What about a hot-water bottle to help with the pain?’ Mr Kaine asked.
Bailey shook her head. ‘Not for the first three days—and no alcohol, either.’
Vivienne rolled her eyes. ‘Fat chance of that. Dad’s part of the food police. We were told in sixth form that as soon as you’re sixteen you’re allowed a glass of wine with your meal in a restaurant. But Dad won’t let me.’
‘Alcohol slows your reactions and you can’t play tennis with a hangover,’ he said. ‘At least, not well—and I should know because I’ve tried it.’
Bailey smiled at him. He was definitely going to need a sense of humour to help coax Vivienne through the next few months of a total ban from tennis. ‘No running or massage, either,’ she said. ‘But I can give you painkillers—ones that will help reduce the inflammation as well as the pain.’ She looked at Mr Kaine. ‘Are there any allergies I need to know about?’
‘No,’ he confirmed.
‘Good.’
‘Six months,’ Vivienne said again, making it sound like a life sentence.
‘Better to make up a bit of ground in a couple of months,’ Bailey said softly, ‘than to go back too soon, do more damage and then have to spend even more time recovering.’
‘She’s right, love.’ Mr Kaine rested his hand briefly on his daughter’s shoulder. ‘So what happens after the operation?’
‘For the first three weeks the physio will concentrate on increasing the range of motion in the joint but without ripping the graft,’ Bailey said. ‘By week six Vivienne should be able to use a stair-climber or a stationary bike to maintain the range of motion and start strengthening her muscles, and then the plan will be to work to full rehab over the next few months. You need a balance between doing enough to rehabilitate the knee,’ she said gently to Vivienne, ‘but not so much that you damage the surgical repair and make the ligament fail again.’
‘Six months,’ Vivienne said again, looking totally miserable.
‘There are other things you can work on that won’t involve your knee,’ Mr Kaine said cheerfully. ‘Chin up.’
Vivenne just sighed.
Once