‘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 to try a Pavlik harness for a couple of months or whether traction would be a better option—I’m hoping we might be able to get away without an operation, but I could really do with an orthopod’s view. As I said, she’s borderline.’
Jamie liked the way she was so clear in giving him the information he needed to help him make the clinical decision—and that she’d clearly thought the treatment options through before coming to see him.
‘I agree, it looks borderline,’ he said. ‘As she’s younger than six months, I agree that it would be better to start with something less invasive than an operation. Let’s try a harness for three months,’ he suggested, ‘and we can give an ultrasound review of how her hips are developing every month.’
‘Great. Thank you.’ She smiled at him.
How strange that a smile could almost make him feel warm inside.
He hadn’t felt warm since Hestia had died, three years ago.
Before he realised what he was doing, Jamie found himself looking at Anna’s left hand. Ridiculous. Apart from the fact that not wearing a ring didn’t mean she wasn’t already committed elsewhere, he wasn’t looking to get involved with anyone. No way could he face the emptiness of losing someone again and having to try to put his life back together again afterwards.
Work.
This was strictly work. End of.
‘Would you like me to come and talk to Poppy’s mum and fit the harness?’ he asked.
‘Would you mind?’
‘Sure. I was only reviewing tomorrow’s list, and that can wait. I’ll come now.’
In the assessment unit, Anna introduced him swiftly to Poppy and her mum.
‘The good news is,’ Jamie said, ‘we’re not necessarily looking at an operation to help Poppy’s hips. We can fit something called a Pavlik harness; it will keep her hips in the right position so they can develop properly.’
‘Will it hurt?’ Ms Byford asked.
‘No. It’s lightweight and made of fabric,’ Anna said. ‘You might find it a bit upsetting to see it, and Poppy might be a bit grizzly for the first few days, but it won’t hurt her and she’ll soon get used to it.’
‘She’ll need to wear it all the time,’ Jamie added. ‘It will be easier for you to put her in loose clothes while she’s got the harness fitted.’
‘Do I take it off when she has a bath?’ Ms Byford asked.
‘No. Just top and tail her rather than giving her a full bath,’ Jamie said. ‘We’ll see you every week to adjust the harness as she grows, and she can have a proper bath here when we take the harness off, before we do the adjustment.’
‘So how long will she have to wear this harness?’ Ms Byford asked.
‘Maybe for two or three months,’ Jamie said. ‘We’ll give Poppy an ultrasound scan every month to see how her hips are developing, and you’ll see a physiotherapist with her here every week.’
Ms Byford frowned. ‘What if the harness gets dirty?’
‘The harness can be sponge cleaned,’ Anna said. ‘And some of my parents have put long socks over the baby’s legs to protect the harness during nappy changes.’ She smiled. ‘One of my mums calls them the “poo socks”.’
Ms Byford looked close to tears. ‘Only a few days ago, everything was fine. And now…’
‘The good news is that Poppy might not need an operation,’ Jamie said gently. ‘And a harness is a lot easier to manage than a plaster cast. Hopefully, wearing the harness will encourage her joints to develop as they should. I know this has been a shock to you, but she’s going to be fine. The earlier we pick up something like this, the quicker it is to treat.’
‘And she’ll be all right?’ Ms Byford asked.
‘She’ll be absolutely fine,’ Anna reassured her. ‘I know right now it feels as if you don’t know anyone else going through this and it’s a bit daunting, but Poppy’s not the only baby I’ve seen with clicky hip, and all my former patients with it have gone through treatment and are just the same as their peers now. The next thing you know, Poppy will be crawling and you’ll be shocked at just how fast a determined baby can move.’
Between them, Jamie and Anna fitted the harness. Poppy protested, and her mum watched them with silent tears rolling down her cheeks, looking anxious.
Anna gave her a reassuring hug. ‘I know right now it feels a bit scary and overwhelming, but you’ll both get used to it and she’ll be back to her usual smiley self before you know it. I’ll book you in with the physiotherapist and my clinic for a week’s time, and in the meantime if you’ve got any questions just ring in.’ She took a leaflet from a drawer. ‘This will tell you all about the harness and what it does, if anyone asks you and it’s gone all fuzzy because right now you’re worrying too much about Poppy to take everything in.’
Jamie glanced at her. Anna Maskell was kind as well as professional. And he could already see the difference that kindness had made to the patient’s mother; Ms Byford had stopped crying and was asking questions.
Anna, he thought, was going to be good to work with.
Not that he intended getting close to her or to any of his other colleagues in the Muswell Hill Memorial Hospital. He’d agreed to cover maternity leave here for three months, and that was all. He didn’t need to make new friends. He was absolutely fine on his own.
‘All the best, Ms Byford. I’ll see you later, Dr Maskell,’ he said. And he left the room before he was tempted to blow a raspberry at Poppy and make the baby laugh.
Babies.
How ironic that this was his vocation, the job he loved so much.
After losing Hestia and the baby, Jamie hadn’t wanted to see another baby or child ever again. But he wasn’t going to throw all those years of hard work and studying away and change his career. Hestia would never have forgiven him for that. But, unable to face the pity of his team at the hospital where he’d worked in south London, he’d switched to working as a locum. No involvement, no closeness, no risk of heartache. He stayed for no longer than three months in one place; as soon as his locum cover was finished, he moved on to the next job. That was how his life had been for the last two and a half years, and that was how he intended it to stay. Utterly within his comfort zone.
Anna finished writing up her notes for the last patient of her morning’s clinic, then headed to the office where she’d met Jamie Thurston earlier. ‘Ready?’ she asked from the doorway.
‘Yes.’ He logged out of the files he’d been reviewing, then came to join her.
‘Did Robert introduce you to everyone when you started this morning, or would you like to meet everyone now?’
‘Robert