‘That’s what we’re going to try and find out.’ Toni Costa folded his hands on his lap and leaned forward a little. ‘Tell me all about these sore tummies you’ve been getting.’
It was a relief to slide into a routine initial assessment of a new patient. Toni could now completely ignore the slightly odd atmosphere in his consulting room.
‘And how often do you get the sore tummy, Alice?’
The young girl screwed up her nose thoughtfully. ‘The last time was the same day as Charlene’s party because I couldn’t go.’
‘And how long ago was that?’
‘Um…well, it’s Jade’s party this weekend and she’s exactly a month older than Charlene.’
‘Older?’
‘I mean younger.’
Toni nodded. ‘So the last episode was a month ago. And the one before that?’
‘I had to miss school and they were going on a trip to the art gallery that day.’
Toni raised an eyebrow at Alice’s sister and could see the smile in her eyes. She had to know exactly what it was like, chasing the information he required, and how frustrating the process could be sometimes.
‘They’re happening at four-to-six-week intervals,’ she supplied readily. ‘And it’s been ongoing for nearly six months now.’
With a quick, half-smile by way of thanks, Toni turned his attention back to his patient. ‘It must be annoying to miss special things like your friends’ parties,’ he said sympathetically.
‘Yes,’ Alice agreed sadly. ‘It really is.’
‘So the pain is quite bad?’
‘Yes. It makes me sick.’
‘Sick as in being sick? Vomiting?’
‘Sometimes.’
‘Is the pain always the same?’
‘I think so.’
‘How would you describe it?’
The girl’s eyes grew larger and rounder as she gave the question due consideration. Pretty eyes. A warm, hazel brown with unusual little gold flecks in them.
Her sister had eyes like that as well. Very different.
Intriguing.
Toni cleared his throat purposefully. ‘Is it sharp?’ he suggested helpfully into the growing silence. ‘Like someone sticking you with a big pin? Or is it dull, like something very heavy sitting on you?’
Alice sighed. ‘Kind of both.’
Toni gave up on getting an accurate description for the moment. ‘Is it there all the time or does it go away and then come back—like waves on a beach?’
‘Kind of both,’ Alice said again. She bit her lip apologetically and then tried again. ‘It doesn’t really go away but it gets worse and then not so worse.’ She shook her head. ‘It’s really hard to remember.’
‘I know, but it’s important you tell me everything you can remember about it. Does it stay in one place?’
‘Yes. In my tummy.’ Alice gave him a long-suffering and eloquent look. Did he really expect a tummy pain to go somewhere else—like her head, maybe?
Toni smiled. ‘What I meant was, does it stay in exactly the same place? Does it get bigger and go to more places in your tummy, or does it make your back feel sore?’
Alice’s face brightened. ‘Sometimes it helps if I put the hottie on my back instead of my front. Is that what you mean?’
‘Yes. Knowing that sort of detail is very helpful.’
Radiation of abdominal pain to the back could well point to something like pancreatitis and the thought automatically took Toni’s gaze back to the older woman sitting in front of him.
She had to be quite a lot older than her sister. Late twenties probably, which was why he had been initially hesitant in querying their relationship to each other. Far better to assume they were siblings than to insult a woman by suggesting she looked old enough to be someone’s mother.
The resemblance was certainly marked enough to make them believable siblings. Pip had those same astonishing eyes. Her hair was a lot darker—a real chestnut instead of red-gold—but the genetic inheritance in the soft waves was also apparent.
And should be of no interest whatsoever in this interview.
‘Any associated symptoms other than the vomiting?’ he found himself asking steadily. ‘Diarrhoea, headache, temperature?’
Pip shook her head.
‘And no family history of migraine?’
‘No.’
‘Peptic ulcers? Gastrointestinal reflux?’
‘No. And she’s been trialled on antacid medications.’
‘Any unusual stress factors or family circumstances?’
Pip looked startled. Almost taken aback.
How curious.
‘I don’t have an ulcer,’ Alice said firmly. ‘That’s silly. Only old people get ulcers. They thought Nona might have one once.’
‘Nona?’
‘Mum’s name is Shona,’ Pip put in quickly. ‘For some reason, that’s what Alice started calling her when she learned to talk, and it stuck.’
‘Oh?’ The extra distraction from professionalism was unavoidable. ‘How strange!’
Pip’s gaze was shuttered and her tone guarded. ‘Is it?’
‘Only to me, maybe.’ Toni smiled reassuringly. ‘I was largely brought up by my grandmother. Nonna.’
‘Was her name Shona, too?’ Alice sounded fascinated. ‘How weird!’
Toni shook his head. ‘No. Nonna is Italian for grandmother.’
And that was more than enough personal stuff. So odd that sharing something so private had seemed compelling. Almost as odd as the glance now passing between the Murdoch sisters. Toni stood up in an attempt to get completely back on track.
‘Now, cara, it’s time I had a good look at this tummy of yours. Can you climb up onto the bed for me?’
But Alice was staring at him now. ‘Why did you call me Cara? My name’s Alice.’
‘Sorry, it’s Italian. It means…sweetheart.’
‘Oh…’ Alice dropped her gaze shyly as she moved to climb onto the examination couch. ‘That’s all right, then.’
There weren’t many people that could have won Alice Murdoch’s full co-operation so easily. Pip stayed where she was, seated by the desk, while Toni began his examination. Close enough for support but far enough away to allow closer interaction between doctor and patient. Pip was more than happy to observe an examination that was thorough enough to be both impressive and a learning experience for her. She would make sure she remembered to apply the same principles for her next paediatric patient.
Toni did a head-to-toe check of Alice with astonishing efficiency, covering a basic neurological, cardiovascular and respiratory assessment before concentrating on Alice’s abdomen. He also fired questions at Pip. Fortunately, the focus of his attention and the distance across the consulting room meant he probably didn’t notice anything unusual in her responses.
But, then, he wouldn’t be expecting her to be able to answer them easily, would he?
‘Do