ones, even though the difficult ones are much rarer. There is a possibility that Poppy might grow out of the condition, but I’d like to examine her properly and then do an ultrasound scan to check how her hip is developing.’ She smiled. ‘I promise what I do isn’t going to hurt her, but she might not appreciate being manipulated and might grumble a bit.’
‘All right,’ Ms Byford said.
‘Have you noticed when you change her nappy that one hip doesn’t open out quite as much as the other?’ Anna asked.
Ms Byford wrinkled her nose. ‘Not really. I thought everything was normal. I mean—she’s my only one.’
‘So you don’t have anything to compare her with. That’s fine.’ Anna gave her a reassuring smile. ‘Could you take her tights off for me, please?’
Once Ms Byford had taken the tights off the baby, Anna examined Poppy and cooed at her while she manipulated the baby’s joints, blowing raspberries to make her laugh.
‘So do you think she has this clicky hip thing?’ Ms Byford asked.
‘I felt a bit of a clunk when I moved her legs just now, so yes,’ Anna said. ‘I can see that her right leg is slightly shorter than the left, and basically I think her thigh bone isn’t moving properly in the socket of her pelvis. We’ll do the scan, and then we can think about treatment. It might be that we do a watch-and-wait thing, or we might put her in a special harness to treat the hip dysplasia, but I’ll be in a better position to know what’ll work best once I’ve seen the scan results. And the scan’s like the one you had when you were pregnant with her, so it won’t hurt,’ she added reassuringly.
While Poppy was having her scan, Anna saw her next patient. The scan results definitely showed a problem with Poppy’s hip, but whether the harness would be enough or the baby would need treatment with traction, she wasn’t sure.
‘I’m going to have a word with one of my colleagues,’ she said to Ms Byford. ‘He’s a specialist in children’s bones, and I’d like to check a couple of things with him. I’m sorry, I’m afraid it means a bit more waiting about for you, but please try not to worry because this really is something we can sort out for Poppy.’
To her relief, the new paediatric orthopod was in one of the offices, reviewing notes for his operating list the next day. She rapped on the open door. ‘Mr Thurston?’ she asked. ‘I’m Anna Maskell, one of the special regs on the ward, and I’ve got a baby with clicky hip. She’s a borderline case and I’m not sure if she needs an op, so would you mind reviewing her scan and treatment plan with me, please?’
‘Sure,’ he said, looking up from his notes.
His eyes were the most piercing cornflower blue, and Anna felt her pulse leap.
How completely inappropriate.
For a start, they were at work, and her patients always came first. Secondly, given that Jamie Thurston looked to be in his mid-thirties, he was probably already involved with someone; but, even if he wasn’t, Anna wasn’t looking for a relationship. Love wasn’t on her list of things to do, not any more. It had taken her two years to put her heart back together since Johnny’s affair and the disintegration of her marriage, and she wasn’t planning to risk her heart breaking ever again.
‘Thank you. Robert asked me earlier if I would show you around,’ she added. ‘I was due in the Paediatric Assessment Unit before you arrived, so I asked Lacey to pass on a message inviting you to lunch, as it’s your first day and you probably haven’t had a chance to find your way around yet.’
So this was Anna Maskell, the woman who’d left him that kind message, Jamie thought.
She was taller than average with broad shoulders, a shock of dark curly hair she’d tied back at the nape of her neck, and eyes the same green as the sea on a summer day; she was more like an Artemis than a delicate nymph, though it shocked him he was even thinking that way. For a moment, his tongue felt as if it had stuck to the roof of his mouth. Then he pulled himself together. ‘Yes, she did tell me. Thank you. That was kind.’
‘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