Penny grimaced. She did not want to make a fool of herself in front of her nephew as it would terrify him. Simon, like his mother, was very sensitive. Still, there was no choice.
There really wasn’t time to worry about her upcoming jab. The department was busy enough to keep her mind off it and she smiled when she saw her next patient, an eight-week-old named Daniel.
‘He’s had a bit of a cold,’ Laura, the mother, explained. ‘I took him to my doctor yesterday and he said that he didn’t have a temperature and his chest sounded fine. I’ve been putting drops up his nose to help with feeding,’ Laura continued. ‘But this afternoon I came in from putting out the washing and went to check on him and he was pale, really pale, and he’d been sick. I know he’s fine now …’
He seemed fine and Penny examined Daniel thoroughly, but apart from a cold and a low-grade temperature there was nothing remarkable to find.
‘Has he been coughing?’
‘A bit,’ Laura said, as Penny listened carefully to his chest, but apart from a couple of crackles it was clear.
Still, Penny was concerned and it did sound as if he might have had an apnoeic episode so she decided to ring the paediatricians, who were very busy on the ward.
‘They’re going to be a while,’ Penny explained to the mum. ‘I’m going to take some bloods and do some swabs, so hopefully we’ll have some results back by the time they get down here. And I’ll order a chest X-ray.’
To show that she wasn’t, in fact, too up herself to value Ethan’s opinion, late in the afternoon when she was concerned about the baby and the paediatricians weren’t anywhere around, instead of speaking with Mr Dean, Penny decided that she would ask Ethan.
He barely looked up from the form he was filling out when Penny asked if she could have a word.
‘Sure.’
‘I’ve got an eight-week-old I’m concerned about.’ He glanced up. ‘Mum found him very pale in his cot after his nap and he’d vomited, but he picked up well. He’s had a cold, struggling to feed, he’s a bit sniffly, just …’ She moved her hand to show she was wavering. ‘His chest is clear, and he’s got a small cough, which is unremarkable. I’ve done some swabs and some bloods.’
‘What did paeds say?’ Ethan asked.
‘They’ll come down when they can, but they’re busy and they’re going to be ages,’ Penny said. ‘Mum just wants to take him home now that he’s had the tests and wait to get the results, but I’m not sure.’
Ethan came and though he had been scowling at Penny, he was lovely with the mum. He carefully checked the infant, who was bright and alert and just hungry. Penny put some saline drops in his nose and they watched as the baby latched on and started to feed happily, but just as Ethan was about to go, Daniel spluttered and broke into a coughing fit. As he came off the breast Ethan took him and held him and Penny watched, the diagnosis becoming more and more evident as he broke into a prolonged paroxysmal cough and then struggled to inhale and then cough again. Ethan was holding him up and tapping his back as Penny turned on the suction, but thankfully it wasn’t needed.
‘He wasn’t doing that.’ Laura was beside herself, watching her son. ‘He’s just had a little cough.’
‘That might have been what happened this afternoon,’ Penny said, ‘when you found him in his cot.’ She had to explain to the mother that it would seem her baby had whooping cough.
‘He’s not making any noises, though.’
‘People, especially babies, don’t always, but he’s struggling to get air in during the coughing attack,’ Penny explained. ‘It’s not evident straight away but he’s moved into the coughing stage now.’ She looked at the baby Ethan was holding—he had stopped coughing and was again desperate to be fed. ‘I’m going to call the paediatricians …’
‘Can I feed him?’
‘I’ll watch him feed while you go and call Paeds,’ Ethan said to Penny, handing the crying baby back to his mum. ‘Wait one moment before you feed him.’ He stepped out with Penny. ‘He’s to be transferred. I know he seems fine at the moment but, given his age, he needs to be somewhere with PICU.’
‘I know.’ Penny nodded.
‘Can you get Lisa to come in and watch him feed? I’ll stay in for now.’
Penny nodded. The coughing episodes were scary at best and someone calm and experienced needed to be in with the mum to help deal with them. ‘I’ve never actually seen whooping cough,’ Penny said to Lisa.
‘I’ve had it,’ Lisa said. ‘Hundred-day cough they call it and I know why. Poor baby and poor mum having to watch him. I’ll go and relieve Ethan.’
Penny spoke again to the paediatrician and started the baby on antibiotics, but really there was no treatment that could stop the coughing attacks and, as Ethan had said, given his tender age, he really did need to be somewhere with paediatric intensive care facilities in case he suddenly deteriorated.
‘They’re going to come down and see him just as soon as they can,’ Penny said when Ethan came out. ‘I’ll go and let mum know.’
‘She’s in for a tough time,’ Ethan said. ‘Are you immunised?’
‘All up to date,’ Penny said, because though she was terrified of injections, before embarking on IVF she had made herself get all her immunisations up to date and poor Jasmine had been the one who’d had to do them. Still, it was worth it, Penny realised, for days such as this.
‘Right.’ Ethan glanced at his watch. ‘I’m going home.’
‘See you tomorrow,’ Penny said, but Ethan shook his head.
‘I’m on days off now.’
‘Enjoy them.’
He didn’t answer. In fact, since her attempt to apologise, unless it was about a patient, Ethan had said nothing at all to her and she felt like poking her tongue out at his back as he and his bad mood walked off together.
Maybe it was just as well he was on days off. Hopefully by the time he was back they could put yesterday’s incident behind them and start again.
And she’d hopefully be finished with the hot flashes by then.
As predicted, there wasn’t a hope of her getting away at six, but when it neared, Penny told Lisa she was taking a short break and, seeing Jasmine walking down the corridor with Simon in his stroller, the moment she had been silently dreading all day was finally here.
‘I don’t want Simon seeing me upset.’ Penny was starting to panic. ‘It could make him as terrified of needles as I am.’
‘There’ll be someone in the staffroom who can watch him for five minutes,’ Jasmine said. ‘You go on and get everything ready and I’ll come in.’ They both knew it wasn’t a question of Penny being brave because her nephew was there—it was the one thing, apart from her fertility, that Penny couldn’t control, and her response to injections was varied and unpredictable.
‘Vanessa’s watching him,’ Jasmine said when she came into the office a few minutes later.
‘I don’t know if I can do this again,’ Penny said. Her hand was shaking as she checked the doses the IVF nurse had given her.
‘In a couple of moments you’ll be one evening down.’
‘With God knows how many more to go,’ Penny said. She took a deep breath and undid her skirt. ‘Just do it.’
She closed her eyes but could not stop shaking as Jasmine walked over. She had hoped so much that things would be different this time, but she was crying again, just as she had that morning