‘I’m glad you’re going.’ She braced herself and smiled. ‘Everyone will be thrilled to see you there.’ She backed towards the door, wondering why he was studying her so intently. ‘I’ll just fetch Helen and her mother.’
When she returned, Logan was thorough and professional, questioning Jenny in detail and then examining the little girl.
Finally he unhooked the stethoscope from his ears and gave a brief smile as he handed Helen a colouring book and crayons. ‘Do you want to colour that for me, Helen? I just need to talk to your mum.’
Helen grabbed the book with a delighted smile and a mumbled, ‘Thank you,’ and immediately lay on her stomach on the floor and started colouring.
Logan sat back down at his desk. ‘Has anyone ever mentioned to you that she has a murmur?’
‘A murmur?’ Jenny stared at him. ‘You mean a heart murmur?’
‘That’s right.’ Logan’s voice was quiet as he tucked the stethoscope into his pocket. ‘When I’m using the stethoscope on her chest I’m listening to the sounds that her heart makes. A heart murmur is basically an extra sound.’
‘Are you telling me that you think she has something wrong with her heart? Oh, my gosh.’ Jenny’s face drained of colour and she lifted a hand to her mouth. ‘How can you possibly know that from just listening?’
‘I don’t know, for sure. And a number of young children would be found to have heart murmurs and yet have structurally normal hearts. But given her history of breathlessness and the fact that her weight is lower than average for her age, I’d like to refer her for some more tests. I think we do need to check this out further.’
‘I thought it was asthma,’ Jenny whispered. ‘She gets all these chest infections.’
‘Yes. I read that in her notes.’
‘No one ever mentioned her heart before. Are you saying that chest infections can be linked to heart disease?’ Jenny’s eyes were wide. ‘What exactly do you think is wrong?’
Logan hesitated. ‘It’s impossible for me to give a definitive diagnosis just by listening to her chest. I’d like you to go to the mainland and see the paediatric cardiologist. He’ll do an echocardiogram, which will allow him to look at the structure of the heart. He’ll also probably do a chest X-ray and an ECG, to see how the heart is working. All of that is non-invasive and won’t hurt Helen at all.’
‘I can’t believe this.’ Jenny ran a hand across her face and took several deep breaths. ‘I.’ She struggled with tears and Evanna reached across to borrow Logan’s phone.
‘Janet?’ She quickly spoke to the receptionist. ‘Can you come and take Helen and show her some interesting toys, please? It’s very boring in here for her and she’s finished the colouring Logan gave her.’
Jenny shot her a grateful look and moments later Janet appeared, a wide smile on her motherly features. ‘You come with your Aunty Janet. I’ve all the plants to water and I really need some help,’ she said happily, holding out a hand to Helen, who scrambled to her feet and glanced towards her mother doubtfully.
‘You go, sweetie,’ Jenny breathed, her smile just a little forced. ‘Help Janet with the plants. Then Mummy will come and get you.’
Helen slipped her hand into Janet’s and went without protest.
Jenny reached into her bag for a tissue. ‘That was kind of you,’ she whispered, blowing her nose hard. ‘You try so hard to protect them, don’t you? And then something like this happens. I’m sorry to be a baby, but it’s such a shock.’
‘I can understand that.’ Logan’s voice was kind, his gaze sympathetic. ‘But I’d really like you to try not to worry until you know exactly what there is to worry about. That’s easier said than done, I know, because once you’re a parent all hope of being calm and rational goes out of the window.’
‘Do you have children?’
Logan gave a crooked smile. ‘Little girl. Thirteen months. So I know all about parental worry.’
‘Oh. Yes.’ Jenny blew her nose again. ‘So what happens now?’
‘I’d like to ring a good friend of mine who is a paediatric cardiologist. He’ll arrange for you to have those tests that I described. Then you come back to me and we’ll talk.’
‘But you definitely think there’s something wrong with her heart.’
‘Yes, I do,’ Logan said quietly, ‘and I’m not going to lie to you about that. But she’s a bonny little girl who has obviously done very well up until now. This may be something that is easily solved. They may even decide to wait and do nothing.’
Jenny was still struggling with tears. ‘My husband, Bobbie, is away so I can’t even talk to him.’
Logan leaned forward and covered her hand with his. ‘You can talk to us,’ he said gruffly, glancing towards Evanna. ‘Anything. Any time.’
Jenny gave a dismissive laugh. ‘You’re suggesting I make an appointment just to discuss how worried I am about my daughter’s heart?’
‘Yes. Why wouldn’t you? Being a GP is about caring for the whole family.’ Logan’s eyes were kind. ‘Let’s have those tests done and then talk again. If there are any decisions to be made, I’ll help you weigh up all the pros and cons.’
‘You’re incredibly kind.’ Janet shook her head. ‘I—I’m just not used to having a GP who encourages me to come back. The practice we were in before had eighteen GPs. I never saw the same person twice and they were never interested in anything other than hurrying me out of the door as fast as possible.’
Logan nodded. ‘Different pace of life,’ he said easily, ‘and different priorities. Glenmore is a small community, Jenny. And when you moved here, you became part of that. I’m going to call the cardiologist now and I’ll phone you with an appointment time. Will you be able to get her to the mainland?’
‘Oh, yes, I have a car and I travel across once a week anyway, to see my sister.’
‘Good. Here’s my home number and my mobile.’ Logan scribbled on a piece of paper. ‘Call me if you need to. Otherwise I’ll see you when we have some results.’
Jenny slipped the piece of paper into her bag and stood up. ‘Thank you.’ She looked at Evanna and gave a faltering smile. ‘And thank you, too.’
‘You’re very welcome.’
Evanna took Jenny to find her daughter and then returned to Logan. ‘You really think she has a heart defect?’
‘Yes. But obviously it needs to be confirmed by the cardiologist. She needs an echo.’
Evanna looked at him. ‘But now that it’s just you and me—tell me what you think.’
He didn’t hesitate. ‘I think she has an ASD. Atrial septal defect.’ He was sure and confident. ‘The second heart sound is split. It’s fairly characteristic.’
‘But why hasn’t it been picked up before now?’
‘There are often no symptoms in early childhood. But in Helen’s case I’m fairly sure that her breathlessness, the chest infections and the fact that her weight is below the tenth percentile …’ He shrugged. ‘I could be wrong.’
‘You’re