Robert held up both hands in a ‘stop’ gesture and laughed. ‘Anna, you know why I can’t do it this year. I’d have to fly back from New York. And that’s more than my life is worth, on my silver wedding anniversary.’
‘Even for the ward? Even for me?’ she teased.
‘Even for the ward and even for you,’ Robert said. ‘Actually, Anna, I did want to ask you a bit of a favour. Jamie Thurston—the new paediatric orthopod who’s covering Nalini’s maternity leave for the first three months—is joining us today.’
‘And you want me to show him around and help him settle in?’ Anna guessed.
‘Would you?’ Robert asked.
‘Of course.’ She smiled at him again. ‘I’m in the PAU this morning. I’ll leave a message with whoever is on the desk to ask him to meet me at one and I’ll take him to lunch.’
‘Great.’ Robert patted her shoulder. ‘Thank you.’
‘Pleasure,’ Anna said, and had a quick word with Lacey on the reception desk before she headed for the Paediatric Assessment Unit.
Her third patient of the day was a four-month-old baby who had been referred to her clinic by the health visitor, on the grounds of possible DDH—developmental dysplasia of the hip. A quick read through the notes ticked all the boxes of a higher risk: Poppy Byford was a first baby, a girl, born at thirty-six weeks and had been in the breech position. So Anna was pretty sure that the health visitor had picked up the problem.
‘Good morning, Ms Byford. Do come in and let’s have a look at Poppy,’ Anna said. ‘Hello, you gorgeous girl.’ She cooed at the baby, who giggled and waved her hands. ‘She’s beautiful,’ Anna said, and stuffed the little twinge of longing right back down out of the way. She could enjoy being an aunt and enjoy working with her young patients, and that was enough. Wanting more was greedy and pointless—and the quickest way to get her heart broken.
‘Thank you.’ Poppy’s mum looked nervous.
‘Your health visitor asked you to bring Poppy to see me because she thinks Poppy might have something called developmental dysplasia of the hip—you might hear it called DDH for short, or “clicky hip”,’ Anna explained. ‘Usually it shows up in a newborn examination, and I can see in Poppy’s notes that the doctor did a hip test at her six-week check and it seemed normal. But the health visitor’s concerned and wants me to do another check.’
‘Is Poppy going to be all right?’ Ms Byford asked. ‘I did start looking it up on the Internet, but…’ She grimaced.
‘The Internet is a very scary place where medical problems conditions are concerned,’ Anna said. ‘It’s like when you’re pregnant with your first child, and you always hear the horror stories about difficult labours rather than the smooth ones, even though the difficult ones are much rarer. There is a possibility that Poppy might grow out of the condition, but I’d like to examine her properly and then do an ultrasound scan to check how her hip is developing.’ She smiled. ‘I promise what I do isn’t going to hurt her, but she might not appreciate being manipulated and might grumble a bit.’
‘All right,’ Ms Byford said.
‘Have you noticed when you change her nappy that one hip doesn’t open out quite as much as the other?’ Anna asked.
Ms Byford wrinkled her nose. ‘Not really. I thought everything was normal. I mean—she’s my only one.’
‘So you don’t have anything to compare her with. That’s fine.’ Anna gave her a reassuring smile. ‘Could you take her tights off for me, please?’
Once Ms Byford had taken the tights off the baby, Anna examined Poppy and cooed at her while she manipulated the baby’s joints, blowing raspberries to make her laugh.
‘So do you think she has this clicky hip thing?’ Ms Byford asked.
‘I felt a bit of a clunk when I moved her legs just now, so yes,’ Anna said. ‘I can see that her right leg is slightly shorter than the left, and basically I think her thigh bone isn’t moving properly in the socket of her pelvis. We’ll do the scan, and then we can think about treatment. It might be that we do a watch-and-wait thing, or we might put her in a special harness to treat the hip dysplasia, but I’ll be in a better position to know what’ll work best once I’ve seen the scan results. And the scan’s like the one you had when you were pregnant with her, so it won’t hurt,’ she added reassuringly.
While Poppy was having her scan, Anna saw her next patient. The scan results definitely showed a problem with Poppy’s hip, but whether the harness would be enough or the baby would need treatment with traction, she wasn’t sure.
‘I’m going to have a word with one of my colleagues,’ she said to Ms Byford. ‘He’s a specialist in children’s bones, and I’d like to check a couple of things with him. I’m sorry, I’m afraid it means a bit more waiting about for you, but please try not to worry because this really is something we can sort out for Poppy.’
To her relief, the new paediatric orthopod was in one of the offices, reviewing notes for his operating list the next day. She rapped on the open door. ‘Mr Thurston?’ she asked. ‘I’m Anna Maskell, one of the special regs on the ward, and I’ve got a baby with clicky hip. She’s a borderline case and I’m not sure if she needs an op, so would you mind reviewing her scan and treatment plan with me, please?’
‘Sure,’ he said, looking up from his notes.
His eyes were the most piercing cornflower blue, and Anna felt her pulse leap.
How completely inappropriate.
For a start, they were at work, and her patients always came first. Secondly, given that Jamie Thurston looked to be in his mid-thirties, he was probably already involved with someone; but, even if he wasn’t, Anna wasn’t looking for a relationship. Love wasn’t on her list of things to do, not any more. It had taken her two years to put her heart back together since Johnny’s affair and the disintegration of her marriage, and she wasn’t planning to risk her heart breaking ever again.
‘Thank you. Robert asked me earlier if I would show you around,’ she added. ‘I was due in the Paediatric Assessment Unit before you arrived, so I asked Lacey to pass on a message inviting you to lunch, as it’s your first day and you probably haven’t had a chance to find your way around yet.’
So this was Anna Maskell, the woman who’d left him that kind message, Jamie thought.
She was taller than average with broad shoulders, a shock of dark curly hair she’d tied back at the nape of her neck, and eyes the same green as the sea on a summer day; she was more like an Artemis than a delicate nymph, though it shocked him he was even thinking that way. For a moment, his tongue felt as if it had stuck to the roof of his mouth. Then he pulled himself together. ‘Yes, she did tell me. Thank you. That was kind.’
‘Pleasure. My patient?’ She sounded businesslike, but kind rather than snippy.
‘Of course.’ He logged out of his screen and shifted his chair so she could draw up the scan for her patient.
‘Poppy Byford is four months old,’ Anna said. ‘She has all the risk factors for DDH, but her newborn and six-week checks were completely normal. The health visitor was concerned that one hip wasn’t opening out properly and referred her. I definitely felt a clunk when I manipulated her legs, and I don’t think watch-and-wait is the right way forward for her, but I’m not sure whether