The Greek Children's Doctor(13)

'Hi, there. I'm glad to see you. It means I can go home to bed.'

Libby smiled and looked at the child. 'How is she? She looks a little better.'

'Her temperature is down a bit so I think the antibiotics must be  working. Dr Christakos checked on her in the night and he thought she  seemed to be showing a response even though it's only been twenty-four  hours. He thinks it's definitely a urinary tract infection.'



'He saw her in the night?' Given that he'd dropped her off fairly late,  Libby was surprised to hear that he'd paid a visit to the hospital.

The other nurse smiled dreamily. 'He's so impressive. He was worried  about the little girl who had the asthma attack last night. Apparently  it was touch and go for a while in A and E and when he admitted her to  the ward he was concerned that she could go off again.'

'So he came in to check her?'

'Yes. At about eleven o'clock.'

Just after he'd dropped her home.

Libby cleared her throat, trying to keep her voice casual. 'Has he been in this morning yet?'

Her colleague nodded. 'Oh, yes. He wanted to take some bloods from  Rachel and while he was here he checked Marcus because he's due for  discharge today.'

Libby hid her surprise. He certainly wasn't afraid of hard work. His  team was really stretched and he was obviously more than happy to roll  up his sleeves and help out.

On the other hand, his diligence was going to make it harder for her to  avoid him. She could have done with a consultant who sat in his office  and delegated.

'I'll finish off here. You go home. Where's her mum?'

'Having a wash. Apparently Rachel was awake quite a bit in the night so she didn't get much sleep.'

'Wet nappies?'

'Plenty, but I have to confess she didn't drink much in the night.'

Libby nodded. 'OK. I'll make a real effort to get her drinking today and then hopefully we can take that drip down.'

She smiled as Rachel's mother arrived back in the room, clutching a wash-bag and looking incredibly tired.

'Good morning. She looks a little better.'

Alison looked at her daughter anxiously. 'Do you think so? She certainly  seems a little cooler but she was very fretful in the night.'

'It's early days yet,' Libby agreed, 'but hopefully she'll start to pick  up today. We need to get her drinking so that we can get that drip  out.'

The mother looked at her doubtfully. 'I suppose I could try her with a bottle now … '

'Let's give her another half-hour and see if she wakes up a bit,' Libby suggested, breaking off as Andreas walked into the room.

'Good morning.'

His voice was warm and intensely masculine and Libby felt her whole body hum with sexual awareness.

Colour warmed her cheeks. 'I need to check her temperature, but she's  sleeping at the moment,' she explained quickly, as he picked up the  chart. 'She seems to be picking up and I thought she'd be better off  being left to rest. We'll try her with a bottle in half an hour.'

He scanned the chart briefly, looking at the readings the night shift  had recorded. 'Let me know what her obs are when you've checked them and  keep her fluids up. If there's a problem, call me. I've got to go down  to A and E to see a child.'

Breathing a sigh of relief that he was going to be absent from the ward for at least a short time, Libby got back to work.

She checked on the patients who were her responsibility and then went  back to Rachel and found her sitting on Alison's lap, looking much more  alert.

'Oh, she's definitely a bit better,' Libby said, pleased by the change  in the child in such a short time. 'I'll just check her temperature  again and then we'll try and get that bottle down her.'

The temperature reading was down considerably and the baby took the bottle eagerly.

Alison was delighted. 'She wouldn't touch it yesterday so she must be feeling better.'

Libby nodded. 'We'll keep the drip up for now and I'll speak to Dr  Christakos about it later. I expect he'll want her to carry on having  her antibiotics into the vein for now, but hopefully if she carries on  drinking plenty then we can take that drip out later today.'                       
       
           



       



Making a mental note to discuss it with Andreas next time he appeared on  the ward, Libby recorded the results and went to check on her next  patient.

Her morning was horrendously busy and she was just starting to hope that  she might actually be able to stop for a coffee when a five-year-old  child was admitted with vomiting and fever.

Andreas appeared on the ward just as she arrived and Libby grabbed him immediately.

'Her GP sent her in because she's not keeping anything down and she's  becoming dehydrated,' she told him as she briefed him about the patient.  'I've put her in a side ward for now, until we know what it is. If it's  something infectious then we obviously don't want it spreading over the  whole ward.'

He nodded and scanned the letter. 'OK-let's take a look at her.'

Melanie Palmer was lying on the bed, crying and clutching her stomach.

Her mother was sitting next to her, her face drawn with worry. She stood up when Andreas entered the room.

'She's been like this since yesterday morning, and she's getting worse,'  she told them, her eyes pleading. 'What do you think it is?'

'I'm going to take a look at her now,' Andreas said immediately, walking  over to the sink to wash his hands. 'How did it start, Mrs Palmer?'

The mother closed her eyes briefly, battling with tears. 'Sorry,' she muttered, 'but I've been up all night with her … '

Her face crumpled and Libby slipped an arm around her shoulders. 'Don't  apologise. We understand how stressful it is when your child is sick.  Take your time.'

'It started yesterday,' Mrs Palmer told them. 'She seemed a bit tired  when I left her at Sunday school but nothing that made me anxious.'

'And when you picked her up, how did she seem?'

'She was white as a sheet and complaining of pain in her stomach, but I  assumed that was because of the vomiting,' Mrs Palmer said. 'I left it  for a few hours, but then her temperature shot up and she seemed so  poorly I called the GP. He just said it was a stomach bug and to give it  twenty-four hours to settle.'

Andreas walked across to the bed. 'But evidently it didn't settle.'

'She was dreadful in the night. Moaning and crying and clutching her  stomach. And her stomach seemed really swollen.' Mrs Palmer bit her lip.  'I didn't know what to do with her so I called the GP again this  morning. I think he's probably going to strike me off his list for being  such a nuisance.'

'You were right to call him again.' Andreas caught Libby's eye and she  knew that he was thinking the same thing as her. That the GP had been  too dismissive of Melanie's symptoms.

'Whereabouts was the pain in her stomach?' Andreas asked. 'Did she tell you?'

Mrs Palmer shrugged helplessly. 'Everywhere, I think.'

Andreas nodded and settled himself on the edge of the bed.

'Hello, Melanie.' He spoke softly to the little girl. 'Mummy tells me you've got a tummyache. Can I take a look?'

Libby watched him, full of admiration for the way that he dealt with  children. She'd worked with so many doctors who didn't have the first  clue how to relate to children. They just waded in with their tests and  examinations and then wondered why the child wouldn't co-operate.

But fortunately Melanie was obviously smitten with the handsome Greek doctor.

She looked at Andreas trustingly. 'I've got a poorly tummy.'

Andreas nodded, his dark eyes warm. 'I know you have, sweetheart.'

'Are you going to make it better?'

'I'm certainly going to try, but you'll have to help me.' He lifted his  stethoscope out of his pocket. 'First I'm going to listen and then  you're going to listen.'



A brief smile touched the little girl's pale face and she lay still as  Andreas started to examine her, whimpering occasionally with pain.

Libby watched as he used his fingers to gently palpate the child's abdomen.

'She has oblique muscle rigidity,' he murmured, 'which is a sign of peritoneal irritation.'

Libby looked at him, trying to read his mind. He obviously didn't think that Melanie had gastroenteritis.

Mrs Palmer was biting her nails in agitation. 'What does that mean?'

'I don't think she has a stomach bug, Mrs Palmer,' Andreas said gently.  'I think that she has appendicitis and unfortunately it has burst, which  is why her stomach is so very painful and swollen. Libby, can you bleep  the surgeons urgently, please, and then come back and help me? I need  to get a line in. Mrs Palmer, when did she last have something to eat or  drink?'                       
       
           



       

'She had a few sips of water in the night,' Mrs Palmer told them, 'but nothing to eat since breakfast yesterday morning.'

Leaving Andreas to finish his questioning, Libby hurried out onto the  ward and rang the switchboard, asking them to bleep the on-call  surgeons.

While she was there she gathered up the distraction box and the rest of the equipment she needed and then returned to the room.

Andreas was talking to Melanie, his deep voice gentle and soothing. 'I need to put a plastic tube in your arm, sweetheart.'