He squared his shoulders, refusing to let himself be sidetracked again. He had spent enough time thinking about Leanne Russell for one day. He hurried back to his office but he had barely sat down when there was a knock on the door and Robert Ashford, one of the duty doctors, poked his head into the room.
‘Sorry to bother you, Nick, but I’ve got a guy with me I’d like you to take a look at.’
‘What’s the problem?’ he asked, immediately getting up.
Robert was from Tennessee and he was spending six months in the UK before he took up a residency at a hospital in his home town. Nick had found him to be extremely competent and didn’t doubt that there was a genuine problem if Robert had seen fit to ask for his opinion.
‘It’s very vague—fever, lassitude, quite noticeable enlargement of the glands in his neck.’ Robert shrugged. ‘He’s obviously unwell, there’s no doubt about that, but I can’t put my finger on the problem.’
‘Have you ordered blood tests?’ Nick asked, accompanying him from the room.
‘Yessiree. I’m waiting on the lab. They’ve promised to get back to me a.s.a.p. I just thought it might help if you had a look in case I’ve missed something,’ Robert replied laconically.
Nick nodded. ‘Fine by me.’
He followed the younger man into one of the treatment rooms and introduced himself to the patient. ‘I’m Nick Slater, acting head of the clinic. Dr Ashford has asked me to take a look at you.’
‘Take as many as you like,’ the middle-aged man replied, making an obvious effort to sound cheerful. ‘If you can work out what’s wrong with me, I’ll be eternally grateful. I’ve felt like hell these past few days, I can tell you.’
Nick smiled as he picked up the chart Robert had filled in. ‘We shall give it our best shot. It’s Mr Jacobs, is it, and you work for the Foreign Office?’
‘That’s right. Been with them for twenty years now. I’ve been working on overseas aid and development for the past three,’ Ian Jacobs replied.
‘Really? That must be interesting. Do you get to go overseas a lot, or is it mainly a desk job?’ Nick carefully checked the man’s neck. He nodded to Robert when he felt how enlarged the glands were.
‘A bit of both, actually. I’ve been to quite a lot of places in the past few years—India, Africa, places like that.’
‘And were you ever ill when you were away on any of these trips?’ Nick asked, trying to get a full picture of what might be wrong with the man.
‘Not that I can remember…’ Ian Jacobs frowned. ‘A bit of a tummy upset in India, but several members of the party suffered with it, as I recall. The sanitation where we were staying left a lot to be desired.’
‘That’s the problem with so many of these Third World countries,’ he observed lightly. ‘Anything else? Were you bitten by a dog, scratched by a cat, made a meal of by mosquitoes?’
Ian laughed ruefully. ‘The mosquitoes had a field day with me! I was covered in bites most of the time. But I was very careful about taking precautions, Dr Slater. I was on anti-malarial tablets throughout each trip and continued using them after I came home as per instructions. Do you think it’s possible that I might have contracted malaria?’
Nick shook his head when he heard the worry in the man’s voice. ‘Not if you took the medication exactly as you were advised to do. Most modern antimalaria treatment is effective. I assume that you used the ones best suited to the countries you were visiting? There are different strains of malaria so any preventative medicine must take account of that.’
‘Oh, yes. We were given the most up-to-date information before we travelled. One thing the Foreign Office is good at is looking after their employees when they are in the field,’ Ian Jacobs assured him.
‘That’s good to hear. Now, just to recap. Dr Ashford told me that you’ve been suffering from bouts of fever; is that right?’
‘Yes. I can’t recall ever experiencing anything like it, not even when I came down with flu several years ago. And I feel so worn out all the time, as though I can barely make the effort to do anything,’ the man confessed.
‘I see. And there’s nothing else at all that you can add? Something quite insignificant, perhaps.’ Nick smiled reassuringly but he was as puzzled as Robert was about the case. ‘We work a bit like Sherlock Holmes—if we eliminate the possible and find ourselves left with the improbable, then it is quite often the answer.’
‘Well, there’s an insect bite which has been a bit of a nuisance…But I really can’t see that it’s the cause of how ill I’ve been feeling.’
‘Let’s take a look. It would be silly not to check it out, wouldn’t it?’ Nick bit back a sigh. It never failed to amaze him how reluctant people were to impart information.
‘It’s here on my hip.’ Ian pulled down his underwear so that Nick could see the small lump on his hip. ‘It’s quite painful, actually. So much so that I find myself lying on my other side at night in bed.’
Nick gently probed the nodule, murmuring an apology when he felt Ian wince. He glanced at Robert and raised his brows. ‘What do you think?’
‘I’m not sure, but it doesn’t look like any mosquito bite that I’ve ever seen,’ the younger doctor told him doubtfully.
‘Exactly what I thought. If I’m not mistaken, it’s a tsetse fly bite.’ He glanced at the patient again. ‘Which part of Africa did you visit and how long ago were you there?’
‘We were on the west coast about a month ago. Doesn’t the tsetse fly carry sleeping sickness?’
‘That’s right.’ He patted Ian Jacobs’s shoulder when he heard the alarm in his voice. ‘However, even if I’m right—and we’ll need the results of the blood tests to confirm that—then sleeping sickness is curable if you catch it early enough. As soon as we can establish if that is what’s wrong with you, you will be started on a course of drugs to kill the parasites that have got into your bloodstream.’
He paused as a thought occurred to him. Leanne had worked on the tropical diseases ward of the Sydney hospital so maybe she could help to confirm his diagnosis? Obviously, his sole reason for involving her was the patient’s welfare, he told himself quickly when alarm bells started to ring inside his head. It had nothing whatsoever to do with the fact that he wanted to see her again.
‘We have a new nurse working here who was a sister on the tropical diseases ward at the Royal Free Hospital in Sydney,’ he explained before he thought better of it. ‘Would you mind if I asked her to take a look, Mr Jacobs?’
‘Not at all,’ the man said quickly. ‘The sooner you establish what this is, then the faster I can be treated.’
‘Exactly.’ Nick excused himself and left the room. He made his way to Reception but Melanie was behind the desk. She looked up when he appeared.
‘Did you want me, Nick?’
‘I was looking for Leanne, actually,’ he explained, trying to quell the shiver that ran through him when he said her name. It was so ridiculous for a grown man of thirty-five to be acting that way that his mouth compressed and he saw Melanie frown in concern.
‘There’s nothing wrong, is there? Leanne hasn’t done anything to upset you?’
‘Of course not.’ He fixed a smile to his mouth but it was an effort to hold it in place. Get a grip, Slater! he told himself sternly. Stop acting like a moron and start acting like a doctor.
It was good advice but as he made his way to the supply room, where Leanne was checking in a delivery, he knew how difficult it was going to be to follow it. Leanne and being sensible were two concepts his mind had difficulty