They swapped tablets. ‘You tell me yours, and I’ll tell you mine.’
‘Aryssa Maia, forty-seven, hypertrophic cardiomyopathy. She’s had unsuccessful ablations for atrial fibrillation and she can’t tolerate the usual drugs. She also has a permanent pacemaker in place. I’ve checked her previous scans and just listened to her chest. I think her ventricle is getting to the stage it is barely functioning. She’s symptomatic, breathless and tired, with swollen extremities.’
She nodded. ‘I have a similar case. Jonas Delphine is eighty-six, with existing COPD and chronic heart failure. I think I’m going to have to take him off the study and put him on IV steroids and diuretics. In the space of one day he’s gone downhill fast.’
Gene nodded slowly. She knew he understood. The patient’s welfare was always their prime concern. But the regulations for any research study were strict. They didn’t want any findings skewed. If they used certain other drugs on patients then they were taken off the study programme. It was important that any improvement in a patient’s current condition was only attributed to the drug being studied—not to any other intervention made.
Cordelia sighed as she looked at Aryssa’s chart. ‘She was doing so well,’ she said sadly. ‘I really thought that this might be the one drug that could make a difference for her.’
Gene ran his fingers through his hair. ‘I get that. But my gut is telling me that something else is going on. I almost feel as if her pacing wire has moved. Her heart just isn’t functioning the way it should be.’
He glanced at Jonas’s chart and smiled. ‘Why do I feel as if this guy could teach me everything I need to know about life?’
‘He probably could. I’m not ashamed to say I love him and have a completely unnatural bias towards him.’ She lifted her hand. ‘That’s why I’m checking for a second opinion. I need someone who can just look at the clinical signs.’ She gave a slow nod and handed back Aryssa’s notes. ‘And as for your patient, I agree, she needs an ECG and a cardiac echo. I suspect her pacing wire has moved too. That’s what fits the symptoms, rather than anything happening within the trial.’
He gave a nod. ‘I ordered the tests. Just wanted to double check.’ He kept a hold of Jonas’s tablet. ‘Now, let’s go meet your patient, while mine has her investigations.’
* * *
Things moved so swiftly here. He was secretly pleased that Cordelia had come to him for a second opinion. By the time he’d sounded Jonas’s chest and looked at his hands and ankles, the nurse from his part of the clinic had brought along Aryssa’s ECG. It couldn’t be clearer. The pacing wire definitely wasn’t capturing, meaning Aryssa’s heart rate was erratic and low. Both he and Cordelia nodded.
‘I’ll come back and speak to her. But can you attach her to a portable cardiac monitor in the meantime and ask them to put a rush on that cardiac echo?’
The nurse gave a nod. ‘I’ll take her for the echo now.’
He gave Cordelia a nod and walked through to the treatment room. ‘It looks like we’re both about to lose patients from our trials. Jonas needs some IV steroids and diuretics.’
Her eyes were downcast for a moment. It probably wasn’t what she wanted to hear. But he knew she would always put the patients first. That’s the way it should be. Research work always brought these challenges and any medic who worked on the trials knew that.
She looked back up, nodding and opening the drug cupboard. ‘I’ll draw them up. Can you prescribe them on the tablet? Thanks.’
He gave her a nod and checked the bottles with her as she drew up the medicines. He couldn’t pretend not to notice the slight shake of her hands. ‘How about I do this for you? You can distract Jonas and persuade him this is a good idea.’
She sucked in a deep breath and let her hands rest back down on the counter top. ‘Do you know what? I’d like that. Thank you.’ She gave him a small smile and his insides clenched. He got the distinct impression that Cordelia Greenway didn’t normally let anyone help her. But from the way her jaw had been clenched and the shake in her hands he knew she was emotional about this. He knew she felt connected to this old guy. She’d worked here for four years. She might even have known him that long.
It was hard not to get attached to patients you saw on a regular basis, let alone nearly every day. It was harder still if those patients condition got worse—which inevitably frequently happened to doctors.
He understood. He’d been there and felt it himself. For the last few years he’d moved from place to place. All of his emotional investment had been in Rory. That’s the way it had to be. He’d had to learn to be mom and dad to the little guy. He’d always done a good job by his patients, but he hadn’t been around long enough to form lasting relationships.
And he missed that. He couldn’t pretend that he didn’t.
He moved his hand to lift the tray with the syringe and Venflon but Cordelia’s was still there. His first instinct was to pull away, but instead he put his hand over hers and left it there as she gave a little sad sigh.
She didn’t object. She didn’t jerk away. The heat of her hand filled his palm in a way he hadn’t expected.
It had been a long time since he’d touched a woman—held a woman. Of course he touched patients every day. But relationships in the last three years just hadn’t been possible. He didn’t want to be the guy who introduced Rory to a new girlfriend every few months so it had been easier just to let that part of his life slide.
So...this was different. Not new exactly, but just different. And up until this moment he hadn’t realised how much he’d missed connecting with someone.
She gave the briefest nod of her head and he knew it was time to pull away. He lifted his hand and let hers slide out from underneath his, picked up the tray, and gave her a conciliatory nod. ‘Let’s go and make Jonas feel better.’
* * *
It was the little things that made you realise how thoughtful someone could be. Her insides had twisted and turned at the thought of being the person who would deliver the treatment to end Jonas’s time on the trial. She knew it was essential. She knew it was the right thing to do. But part of her had ached, knowing she would have to be the one to do it.
The thought of not seeing him five days a week made her sad. After four years she was sure Jonas still had a world of stories to tell her. His cheery nature in the face of his heart failure made her feel more positive about her own condition.
She had to have hope. She had to feel as if one day her Wolff-Parkinson-White syndrome wouldn’t cause some odd arrhythmia that would send her heart into a whole host of problems. For some people with her condition it could lead to death.
Five years ago her physician had sat her down and given her the news she’d known would be coming. She should look at a permanent contraception choice. Her Wolff-Parkinson–White syndrome was progressing. Her condition was unpredictable. What was certain was that the extra stress and increase in pressure of a pregnancy would cause huge strain on her already struggling heart. Pregnancy was out of the question. She’d never have a family of her own.
She’d been living with a fellow researcher then. Han. They’d been working together in London and their relationship had just developed slowly. She’d liked that. He’d known about her condition and had helped her through difficult spells.
But the news from the consultant had been a turning point. Han had backed off, slowly but surely. Never with malice. But his plans for the future included a family. And as he’d drifted away she’d felt more and more hurt. More and more like less of a woman. Less of a partner.
She’d had to learn to accept that a family wouldn’t be in her future. She’d had to accept that any potential relationship would have to be one where she had that difficult up-front conversation. The one where she’d have to admit she was