The Greek Children's Doctor(46)

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.'

Melanie stared at him. 'Will it hurt?'

'Yes, a bit,' Andreas said honestly. 'But we need to do it to make you better.'

Libby looked at him. 'We could use a local anaesthetic cream.'

'No time.' Andreas reached for a swab and a venflon. 'It takes at least  half an hour to work and I need to get this line in now. She needs to go  to Theatre.'

Libby looked at the mother. 'If you find this too upsetting you could go and get a cup of coffee while we put the drip up.'

Mrs Palmer shook her head, her eyes glistening with tears. 'No. I can't leave her. Do whatever you have to do.'

'Right, then, Melanie.' Libby sat on the bed and put the distraction box  next to the little girl. 'Let's have a look in here and see what we can  find.'

'Balloons!' Melanie reached into the box and pulled out a pink balloon. 'Can I have it?'

'Of course. Why doesn't Mummy blow it up while we sort you out?'

Libby handed the balloon to Mrs Palmer who obligingly took it and blew.

Seeing that the child was distracted, Andreas searched for a vein.

'OK-squeeze there for me, Libby, and don't let go.'

Libby knew what he was saying. If they missed the vein on the first  attempt, it would be doubly difficult to persuade a child of this age to  co-operate, and it was distressing for everyone.

She hoped Andreas was good at finding tiny veins in tiny hands.

He was.

He swabbed the skin, grabbed the child's hand firmly and slid the needle in with the minimum of fuss.

Melanie was so busy watching the balloon grow bigger and bigger that by  the time she opened her mouth to protest the cannula was safely taped in  place.

Despite all her intentions about keeping her distance, Libby smiled at him. 'You're a genius, Dr Christakos.'

He grinned. 'So are you. I loved your distraction box.'

'It usually helps, but not always.'

Andreas turned to Jonathon, who had just appeared. 'OK, can you take some bloods while we're waiting for the surgeons, please?'

Melanie stared down at her hand. 'What does that do?'

'It means that I can give you medicines straight into your body,' Andreas explained, his voice gentle.

'I haven't listened to your chest yet,' she reminded him, and Andreas smiled.



'That's right. You haven't.' He undid a few of the buttons of his shirt  and sat still while Melanie lifted the stethoscope to his chest.

Libby suddenly found she couldn't look away, her eyes riveted to the  curling dark hairs that covered the hard muscle of his chest. He was  incredibly masculine and she felt a kick of sexual reaction deep inside  her. Suddenly she felt an overwhelming desire to touch him. To run her  fingers over his tanned skin and downwards …

Shocked by her own thoughts, she dragged her eyes away, thoroughly relieved when the surgeons arrived.

Andreas smiled at the little girl and gently retrieved his stethoscope,  totally relaxed as he briefly described his findings to Mr Jenner, the  surgeon.

'I'll take her down straight away,' Dave Jenner said, after examining the child himself.

Libby collected a consent form and hovered by the bed, her gaze drawn  again to the tantalising vision of Andreas with his shirt still undone.