She glanced around the surgery. Enough of that sort of thinking. What now? He had left her his Dictaphone with his notes about the patients he had seen, so she could type them up and have them ready for him to sign on his return. And as for the rest of the afternoon? There were three home visits marked down in the book. What was she supposed to do while he was away? She swallowed a sigh. It was going to be a long day.
As she’d expected, it only took her thirty minutes to type up the letters on the computer. The note paper was as grand as the rest of the consulting rooms.
Just as she was preparing to eat her lunch, there was a frantic knocking on the door. She opened it to find a woman about her age with a young child of about two in her arms.
‘Please,’ she gasped. ‘Is there a doctor around? My daughter’s having difficulty breathing. I don’t know what happened—one minute she was okay then she started wheezing. My mobile’s battery’s flat or else I would have called an ambulance. Then I looked up and saw the doctor’s name on the door. Please help me.’
Rose could see that the young mother wasn’t far off hysteria. The little girl was having difficulty breathing but at least her lips were pink and the muscles in her neck weren’t standing out with each breath. The little girl was clutching a teddy bear as if her life depended on it.
She gripped the woman’s shoulder. ‘I know it’s difficult,’ she said, ‘but you have to calm down. Your little girl will get more distressed if she sees you panicking. Now what’s her name?’
‘Sally,’ the woman replied after taking a couple of deep breaths. ‘I’m Margaret.’
‘Could she have choked on anything? Inhaled something? A button? A peanut? Anything?’
‘Not as far as I know.’
‘Sally, I’m just going to look inside your mouth. Okay?’ Rose said calmly. The little girl looked at her with frightened eyes. Rose gently checked inside her mouth. There was nothing obvious blocking the little girl’s throat. If there had been, her breathing would have been much noisier. It was still an emergency, but not one that was immediately life threatening.
‘Okay, Margaret, come with me,’ Rose said, taking the little girl from her mother’s arms and walking briskly to the treatment room.
‘I was just having a coffee in the café round the corner and she was fine then.’ Margaret had calmed down a little, although anxiety and fear were still evident in her eyes.
‘Has this happened before?’ Rose asked. ‘Any history of asthma or allergies?’ There were two obvious possibilities as far as Rose could tell. Either Sally was having an asthma attack, in which case she needed a nebuliser, or she was having a severe allergic reaction, in which case she needed adrenaline. But which one was it?
‘Could you open your mouth as wide as you can, Sally? I’m just going to shine a torch down your throat. It won’t hurt at all, I promise.’
The little girl did as she was told. Rose shone the torch. As far as she could see, there was no swelling of the throat.
‘Is it possible she’s eaten a peanut? Or some other food she’s not had before?’
The mother shook her head. ‘She was in her high chair. All she had was the juice I gave her.’
In the background Rose heard the slamming of the door and then a voice calling her name. A wave of relief washed over her. It was Jonathan. At least now she’d have help.
‘In the treatment room,’ she called out. ‘Could you come, please?’
He appeared at the door of the room and took the situation in at a glance. He crouched next to the chair where Rose had plonked Sally back on her mother’s lap.
He touched the little girl lightly on the cheek. ‘Hello, there,’ he said softly. ‘What’s all this, then? You’re having difficulty breathing?’
While he was talking to the girl, Rose had located a nebuliser and some liquid salbutamol. As he started to listen to the little girl’s chest she held the vial up to him and he nodded approvingly towards her.
‘Margaret, do you know how much Sally weighs?’ Rose asked. ‘It’ll help us work out how much medicine to give her.’
‘I’m not sure, maybe about twelve kilograms. I haven’t weighed her recently. There’s been no need.’
Now that Margaret knew her daughter was getting the help she needed, some of the terror had left her voice.
‘It’s okay. We can make an estimate.’
Rose reached for a pulse oximeter. ‘I’m just going to put this on your toe,’ she said to Sally. ‘It won’t hurt either. It’s just a little toy I have to help me. Okay?’ Rose turned to Margaret. ‘It’ll monitor Sally’s blood oxygen levels. Tell us how much oxygen she’s taking in.’
The child was still having problems with her breathing, but now that her mother had calmed down, some of the panic had subsided and her breathing was becoming easier. Nevertheless, she still needed treatment.
‘I think your daughter is having an asthma attack,’ Jonathan said, taking the nebuliser from Rose. ‘I’m just going to put this over your mouth, Sally, and I want you to take slow, deep breaths.’
The little girl shook her head from side to side, the panic beginning to return.
Frantically Rose looked around then she had an idea. She lifted the teddy from the little girl’s arms and placed a second nebuliser over the toy bear’s mouth. Rose crouched by Sally’s side and, placing her hands on either side of the little face, forced her to look into her eyes.
‘Watch me, Sally. We’re going to play a game. Every time I take a breath, like this, Teddy’s going to take a breath. You copy us, okay?
It seemed to work. Her eyes fixed on Rose and the teddy bear, Sally copied every breath Rose took. Jonathan watched carefully not saying anything. Slowly, Sally’s breathing returned to normal and after a while Jonathan removed the mask from the little girl’s face.
‘Your breathing should be all right now, Sally.’ He turned to her mother.
‘This is the first time it’s happened? Never before?’
Margaret shook her head.
‘It probably didn’t seem that way to you but I think that some of the problem was that Sally was getting quite panicky when she felt her breathing was tight. We could tell from looking at her breathing that she was still managing to take plenty of air into her lungs—her oxygen reading was ninety-eight per cent, which is pretty good, even when she was at her most distressed. Even so, it was a very scary experience for you both,’ Jonathan explained.
Sally’s mother looked weak with relief. The little girl hid her head in her mother’s neck and closed her eyes. Rose knew that sleep would be the best thing for the child now.
‘We had been to the park to feed the ducks with a friend. Sally was sleepy so she went for a nap in my friend’s arms. When she woke up she needed to go to the bathroom, so I took the chance to have a coffee. She had been coughing in the park a little, but I didn’t think anything of it. It was only when we were in the coffee shop that she seemed to have difficulty getting her breath. I thought she’d be better in the fresh air but she kept on getting worse. Then I saw the name on the door. I hoped there would be someone who could help.’
She looked at Jonathan and Rose, her eyes glistening. ‘Thank you, both. I don’t know what I would have done if you hadn’t helped me.’
‘I think it’s Rose who deserves most of the thanks,’ Jonathan said, straightening. He looked at her as if she puzzled him—as if she were a crossword and he was missing several clues.
‘You should see your own doctor as soon