quite common in people who have a Mediterranean origin. If you don’t have enough G6PD, then if you get a fever or take certain medicines or eat broad beans—what they call fava beans in America, which is why it’s called “favism”— then the body can’t protect your red cells properly and you become anaemic.’
‘With this condition, you might also get jaundice—and the symptoms mean you get backache and your urine looks the same colour as tea before you add the milk,’ Katrina added.
Mrs Smith nodded in understanding. ‘Like Petros’s does right now.’
‘Obviously we need to check the results of the blood tests,’ Katrina said, ‘but I think Rhys is right.’
‘So can you give him this G-whatever stuff in tablets or something?’ Mrs Smith asked.
‘I’m afraid there aren’t any supplements,’ Rhys said. ‘We’ll check how much iron is in his blood, and if there isn’t enough he might need a transfusion—but the good news is that Petros will feel a lot better with some rest and a little bit of oxygen to help him breathe more easily.’
‘The condition’s not going to affect him day to day,’ Katrina explained, ‘but he’ll need to avoid certain medications—aspirin, some antibiotics and some antimalarial drugs. I can give you a leaflet explaining all that so you know what to avoid.’
‘You’ll need to tell your GP as well so it’s on his medical record and he isn’t given any of the medications he needs to avoid by mistake,’ Rhys added. ‘And we should warn you now that if he gets an infection in future, it might mean his red cells are affected and he’ll get anaemia and jaundice again.’
‘And definitely no more broad beans,’ Katrina said.
‘Best to avoid Chinese herbal medicines, too,’ Rhys continued. ‘And, would you believe, mothballs? They contain a chemical in that can affect people with G6PD deficiency.’
Mrs Smith looked anxious. ‘But he’s going to be all right?’
‘He’s going to be absolutely fine,’ Katrina reassured her, ruffling Petros’s hair.
‘You said earlier it’s common in people from the Mediterranean—so I might have it too?’ Mrs Smith asked Rhys.
‘No, it’s more likely that you’re a carrier—the condition is linked with the X chromosome, so women tend to be carriers but because men only have one X chromosome they end up developing the disease,’ he explained.
Mrs Smith bit her lip. ‘So it’s my fault my son’s ill.’
‘Absolutely not,’ Rhys said emphatically. ‘It’s a medical condition and you had no reason to suspect there was a problem. Whatever you do, don’t blame yourself.’
‘And, anyway, you were the one who took him to the doctor—you did exactly the right thing,’ Katrina added. ‘Now, Petros, I need to take a little tiny sample of your blood so I can test it—but I have magic cream that means it won’t hurt at all. Is that OK?’
The little boy looked up at his mother and then, at her encouraging smile, nodded.
‘Wonderful. Now, you have to say a magic word as I put the cream on. Do you know a magic word?’
‘Please,’ Petros said.
‘Oh, honey. That’s lovely.’ Katrina’s heart melted. ‘And do you know another one that a magician might say?’
‘Abracadabra?’ the little boy suggested.
‘That’s perfect. Now, let’s say it together. After three. One, two, three…’ She took the pot of local anaesthetic gel. ‘Abracadabra.’ She applied it to his inner elbow. ‘Now, it takes a little while to work, so I’m going to let your mummy tell you a story while I see someone else who’s feeling a bit poorly, and then I’ll come back and see you, OK?’
The little boy nodded.
‘You might see a bit of redness on his skin,’ Rhys said to Mrs Smith, ‘but that’s nothing to worry about—it’s part of the way the anaesthetic works.’
‘Thank you both so much.’ Much of the strain had gone from Mrs Smith’s face.
‘That’s what we’re here for,’ Rhys said with a smile.
Mrs Smith took Petros back over to the waiting area. After Katrina had seen her next patient, she called Petros back and took the blood sample, chatting to him and telling him some of the awful jokes she’d learned from Will to keep him distracted while she slid the needle into his vein. ‘All done. That’s brilliant,’ she told the little boy, pressing a piece of cotton wool over the site and holding it there for a few seconds before taping it on. ‘Did it hurt?’
He shook his head.
‘Good.’ She turned to Mrs Smith. ‘The results should be back later this afternoon—then I’ll know a lot more and we can talk it through. I’ll come and find you as soon as they’re back. I know it’s a pain having to wait around, and I’m sorry we can’t speed the procedure up at all. But there’s a coffee bar just outside the department if you want to go and get a drink, and across the corridor there’s a play area—there are loads of books and toys and what have you there.’ She smiled at Petros. ‘So we’ll see you a bit later on, OK, sweetheart?’
He nodded.
‘And then I’ll be able to make you feel a lot better,’ she said.
After the clinic had finished, Rhys looked round for Katrina. She wasn’t there, but when he stepped into the corridor he saw her near the double doors. ‘Katrina,’ he called, ‘are you heading for the canteen?’
She ignored him completely, letting the doors swing shut behind her.
Rhys stopped in his tracks, staring after her. She’d just blanked him. Had he upset her by butting in on her patient that morning? She hadn’t seemed upset at the time…but maybe she’d put on a professional front for the patient’s sake. Fine. He’d have a word with her later, explain that he hadn’t intended to cast any aspersions on her ability. From what he’d seen, Katrina was good at her job, and the last thing everyone needed was a personality clash to disrupt the harmony of the ward.
Rather than going to the canteen, he went to the ‘grab and go’ bar for a coffee and a sandwich that he ate at his desk while sorting out some paperwork.
Mid-afternoon, the same thing happened: he saw Katrina about to enter the staff room, called her name—and she completely ignored him.
Oh, great.
Was she still sore about that morning? Or maybe from the previous day, when he’d reminded her about the importance of professional detachment?
He couldn’t let this go on. He didn’t want to tackle her about it in the staffroom, though. It would be too public and embarrassing for both of them. No: after their shift, he’d have a quiet word with her in his office and hopefully he’d be able to reach some kind of truce with her.
Lynne called him to examine a patient; on his return, he saw Katrina sitting on the bed next to one of their patients, talking to the parents. Both parents had red eyes, and the child was white-faced. He frowned. Ruby Jeffers had been admitted with meningitis the previous week. He knew she’d been having some hearing problems and she’d had an appointment in the audiology department earlier that day in case the virus had caused damage to the cochlea or inflammation of the auditory nerve. Clearly the news wasn’t good, and he wasn’t that surprised because he knew that meningitis caused deafness in around seven per cent of children who’d had it.
But what did surprise him was when Katrina pushed her hair up on her left side. What was she doing, showing the little girl a pretty earring or something? Or maybe doing some kind of distracting magic trick, because she pulled something from her ear.
But the little girl still wasn’t smiling.