the little boy and finished her examination. ‘His skin’s starting to peel at the fingertips.’
‘He doesn’t suck his thumb or anything,’ Mrs Morley said. ‘Never has.’
‘I think Ross has Kawasaki disease,’ Natalie said. ‘Peeling skin’s one of the signs, plus he has the rash, the redness and slight swelling in his hands, his eyes are red, his lips are dry and cracked, and he has a fever.’ Kawasaki disease tended to be diagnosed clinically rather than through blood tests, and Ross Morley’s case ticked all the boxes. She glanced at Kit for confirmation.
He nodded, and mouthed, ‘Good call.’
She damped down the feeling of pleasure. She was doing this to help people, not to prove something to Kit.
‘So what happens now?’ Mrs Morley asked.
‘We’re going to admit him to the ward,’ Natalie said. ‘The good news is we can treat the disease. We’ll give him aspirin and a drip with immunoglobulin drugs to fight the disease. Over the next few days, the fever and the swollen glands in his neck will go down and the rash will disappear, but Ross’s eyes will still look a bit red and sore and the skin’s going to continue peeling around his fingers, toes and the nappy area. He might feel some pain in his joints and you’ll probably find he’s a bit irritable, but the good news is that you’ll be able to take him home next week and all the symptoms will gradually disappear. It’ll take him another three weeks or so after that before he’s completely over it, though.’
‘Will there be any complications?’
Possibly myocarditis—inflammation of the heart muscle—but although Natalie’s mouth opened, the words just wouldn’t come out. Couldn’t. The lump in her throat was too big.
‘There can be complications with Kawasaki disease,’ Kit said softly. ‘Some children have arthritis afterwards, and some develop heart problems, but we’ll send him for a follow-up echo to make sure—that’s an ultrasound scan of the heart and it won’t hurt at all, plus you can be with him while it’s being done.’
Mrs Morley swallowed hard. ‘Could he die?’ she whispered.
‘Most children make a full recovery,’ Kit reassured her.
Most children. But myocarditis could be deadly. Sometimes there weren’t even any symptoms. In very small children it was difficult to tell the problem—they couldn’t tell you if they had chest pain, were tired or had palpitations. You just noticed the difficulty in breathing, which could be caused by just about any of the viruses causing a cough or cold in a little one. The over-fast heartbeat could only be picked up by monitoring. And the average person in the street wouldn’t even know what S1 and S4 were, let alone that S1—the first heart sound, when the mitral and tricuspid valves closed—was soft if there was myocarditis, and S4— the fourth heart sound—made a galloping noise, like ‘Tennessee’, when tachycardia was involved. And then the heart stopped pumping efficiently. Failed. And finally stopped.
Just as Ethan’s had. And all she’d been able to do had been to hold her little boy in her arms as his heart had finally given out and the life had seeped from his body. Natalie clenched her fists hard, willing herself to stay strong.
Though she was sure that Kit was thinking of Ethan, too. Especially because she noticed the tiniest wobble in his voice when he added, ‘We’ll get Ross booked onto the ward, Mrs Morley, and one of the nurses will take you up and help you settle him in.’
‘Can I—can I ring my husband? He’s at work. I was just so worried about Ross this morning, I couldn’t wait for him to get home.’
Oh, yes. Natalie had been there, too. So sure that something was wrong, she hadn’t waited for Kit. She’d left a message for him at work and taken Ethan to the emergency department. A mother’s instinct was usually right: it was one of the things she’d been taught at med school. Parents knew when something was wrong with their children—they couldn’t always put their finger on it, and the words ‘he’s just not right’ were usually justified, on examining the child.
‘No problem,’ Kit said. ‘I’ll get our nurse to show you where the phone is. There’s a special phone on our ward, too, which we keep as the parents’ phone—you can give the number out if people want to ring you for an update, and you don’t have to worry about blocking the ward’s main line.’
When they handed Mrs Morley and Ross over to the liaison nurse, Kit turned to Natalie. ‘Are you OK?’
‘Sure,’ she lied. ‘Why shouldn’t I be?’ Though she could hear the cracks in her own voice. Ha. At least he wasn’t bawling her out for not doing her job properly. He could have picked her up on the fact that she hadn’t told Mrs Morley what the complications were. But he clearly understood how hard she found it to say the words. How she could barely breathe—it felt as if someone had put her whole body in a vice and was slowly, slowly squeezing it.
‘If you want to take five minutes, have a glass of water or what have you, that’s fine,’ Kit said.
But that would be showing weakness. As good as saying that she couldn’t cope with her job. And she could. It had just caught her unawares this time. Next time she’d handle it better. ‘No, I’m fine,’ she said tightly. ‘I’m doing my job. I don’t need mollycoddling.’
Perhaps she was being a little bloody-minded. But it jarred that Kit was trying to soften things for her now. When she’d needed his support, six years ago, he hadn’t been there.
‘If you’re sure.’
She couldn’t stand him being so nice to her. Kindness wasn’t what she wanted from Kit.
Though she wasn’t going to think about what she did want from him.
‘Tally. Natalie,’ he corrected himself quickly, ‘paediatrics is a tough option. Especially at this time of year. You’re going to come across cases that remind you. Cases that have parallels. And some days you’ll find it harder to deal with than others.’
Meaning that he did, too? She’d noticed that he hadn’t actually said Ethan’s name aloud. Would the word choke him, too?
Kit laid his hand on her shoulder. Squeezed it, giving the lightest of pressure. ‘Natalie, if you need—’
No. She didn’t need anything from Kit. ‘We have a full list. Let’s move on,’ she cut in quickly. If he offered her a shoulder to cry on now, nearly six years too late, she couldn’t bear it. She shrugged his hand off her shoulder, too—a white coat and her sweater weren’t enough of a barrier between them. Right now she couldn’t cope with feeling the warmth of his touch.
His voice cooled noticeably. ‘Of course, Dr Wilkins.’
Somehow she got through the rest of the afternoon. But the more she saw of Kit working—the way he was able to soothe the most fretful child—the more she realised how good he was with kids. They responded to him, to his strength and calmness, someone who was clearly going to take the pain away and make them feel better.
He didn’t rush through diagnoses either. He’d read a story if it was needed, or start telling a series of truly terrible jokes—jokes she’d had no idea he even knew—and made a game out of examinations. Let children listen to his heartbeat through his stethoscope. Took time to calm the worries of parents. Explained exactly what he was doing in terms the parents would understand, without frightening the child.
And she couldn’t help thinking what a great dad he would have made. How he would have been with his own children, dealing with tantrums and tears without letting them fray his temper. He’d still have kept his fun side, too, flying kites and racing round on a bicycle and playing boisterous games with them.
What a waste. What a bloody, bloody waste.
Or was it? Did Kit have another family now? Another son to replace the one he’d lost? A daughter, perhaps, one who looked like his new wife?
Natalie wasn’t sure what