‘Just that I really did appreciate you rescuing me.’
She sounded sincere. And her body language matched her words. Now he felt horrible. Perhaps Miranda Turner wasn’t the hard, manipulative woman he’d assumed she was. Or maybe his judgement was just out of kilter. She might seem nice now—but, then again, so had Jessica.
‘And I’d like to join you on the ward round, if that’s OK with you, Dr Sawyer.’
She’d clearly read his name from his badge, and he could tell she was waiting for him to say, ‘Call me Jack.’ Well, she’d have to wait a bit longer, until he could see what she was really made of. Whether she’d really got the job on merit.
‘And I’m perfectly happy for you to lead—you know the patients and the staff better than I do.’
She didn’t say it but he knew what she meant. At the moment. ‘Right.’
‘Shall we?’
‘In Room One, we have Imogen Parker. She has unstable angina,’ Jack said.
Unstable angina. No. Oh, no. Of all the things she had to face, why did that have to be her first case on her new ward? Miranda shook herself, knowing that she had to put the memories behind her. Now wasn’t the time or place to think about what had happened to May. Her patient had to come first.
With angina pectoris, the heart muscle didn’t get enough blood and oxygen to meet its needs, so the patient felt tightness or a burning sensation in the chest when climbing stairs or walking. In more severe cases, known as unstable angina, the patient felt pain on resting, too. ‘She had an ECG when she came in, and a cardiac stress test a while back,’ Jack told Miranda. An ECG or electrocardiogram measured the electrical activity in the heart; the stress test was a second ECG while the patient walked fast enough on a treadmill to cause chest pain. Both could show up current heart problems or previous heart attacks. ‘They were both normal.’
‘What about blood tests?’ Miranda asked. They might show an underlying cause for the angina.
Jack nodded. ‘They’re clear. No signs of polycythaemia, thyrotoxicosis or hyperlipidaemia.’ So Imogen Parker’s blood didn’t have an abnormally large amount of red blood cells, she didn’t have an inflamed thyroid gland and there weren’t abnormally high levels of fat in her blood. ‘Not diabetes or anaemia either,’ he added.
‘What about her angiography?’ Miranda asked. It was standard procedure in these cases to take an X-ray of the blood vessels around the patient’s heart.
‘It showed a slight narrowing of a couple of the blood vessels.’
‘Is she on GTN?’ GTN, or glyceryl trinitrate, increased the flow of blood through the heart muscle and controlled the symptoms of angina.
‘It gave her headaches, so she’s on beta-blockers,’ Jack said. ‘Her GP’s worried as the drugs weren’t working that well and she’s still getting pain on rest, so we’re keeping an eye on her.’
‘So you’re thinking about surgical intervention?’
‘Possibly.’
They went into the room. ‘Good morning, Miss Parker,’ Jack said with a smile. ‘I’d like to introduce our new consultant, Miss Turner.’
‘Miranda,’ she corrected. ‘May I?’ She indicated the edge of the bed.
‘Of course, Doctor,’ the old lady said.
‘May I call you Imogen?’
Imogen nodded.
Miranda sat down and held the elderly woman’s hand. Imogen Parker was even around the same age that May would have been—in her late seventies. This was way too close for comfort. ‘Jack tells me we’re keeping an eye on the pain you’ve been having lately. How are you feeling today, Imogen?’
‘Not so bad,’ Imogen said quietly.
The slight greyness in her face told Jack and Miranda otherwise. Jack flicked quickly through her chart. ‘You had another two attacks last night?’
‘It was nothing, really.’ Imogen made a dismissive gesture. ‘I don’t like to bother the nurses. They’re busy.’
‘They’d be a lot more bothered if they thought you weren’t feeling well and hadn’t told them,’ Miranda said. That was precisely what May had done. And then it had been too late. ‘Imogen, trust me—you’re not making a nuisance of yourself if you call them. They’re here to help you.’
‘So when can I go home?’ Imogen asked.
‘I can’t tell you right now,’ Miranda said. ‘Dr Sawyer and I need to talk about how your drugs are working and what we can do to stop the pain coming back so frequently. Do you have anyone to look after you at home?’
‘My Floss—she’s my little Westie. She hates being in kennels.’
Jack and Miranda exchanged a glance. ‘If you tell me where she’s staying, I’ll ring the kennels for you and find out how she’s doing,’ Miranda said.
‘She’s at Berrybank, on the other side of Calderford.’
‘I’ll ring them at lunchtime for an update, and I’ll get a phone brought in so you can hear it for yourself.’
‘Would you?’ Imogen’s eyes glittered with tears. ‘Thank you, love.’
‘No problem.’ Miranda squeezed her hand. ‘We’ll be back to see you a bit later on. And if you feel even the slightest twinge, promise me you’ll press your buzzer.’
‘I will.’
‘Thank you. Is there anything you’d like to add, Jack?’
He shook his head. ‘We’ll see you later, Miss Parker.’
‘Does she have any relatives nearby?’ Miranda asked as they left the room.
‘There’s a great-niece who’s either phoned or popped in every day.’
Oh, yes. Miranda knew all about great-nieces being the only ones in the family who cared enough to check on their elderly great-aunt.
‘But apparently she has three under-fives.’
‘So Imogen can’t stay with her—the niece already has enough on her plate, and you can’t expect small children to give an elderly woman the peace and quiet she needs while she recovers.’
‘You’re really going to ring the kennels?’ Jack asked.
‘If she’s worrying, it’s likely to bring on another angina attack,’ Miranda said. Jack didn’t need to know the other reason: that she wanted to do for Imogen what she’d failed to do for May. ‘I’ll go and see the dog myself, if it’ll help her—maybe bring her a photograph so she doesn’t feel quite so alone.’
This definitely wasn’t the attitude he’d been expecting. Jack had a nasty feeling that he’d underestimated Miranda Turner. ‘Maybe,’ he said, wishing he’d thought of it in the first place. One little phone call would make a big difference to their patient’s mental state—and that would make an even bigger difference to her ability to deal with the physical problem. He really should have thought of that himself.
‘Next, we have Sidney Patterson. He has a thoracic aortic aneurysm,’ Jack continued as they stood outside Room Two. ‘He hadn’t had any specific symptoms but he’d gone for a routine check-up and the GP suspected something was up and sent him for a CT scan.’ An aortic aneurysm—a bulge in the wall of the main artery carrying blood from the heart—didn’t always cause symptoms, depending on which part of the artery it affected. Sometimes the patient had difficulty swallowing or was hoarse because it pressed on a nerve controlling a vocal