One Weekend in Prague, page 13
Mac could feel his control slip a notch. Because this was Hanna. Because she was holding a baby, which tapped into everything he’d been thinking about so much. Because seeing her look so concerned made him want to step in instantly and help. But this wasn’t about Hanna. Or himself. It was about a very vulnerable small person who’d been brought into the emergency department.
Instantly using the assessment tool of the paediatric triangle was as automatic as taking his next breath. Within taking a couple of steps closer, Mac was not alarmed by the general appearance of this baby and couldn’t see any obvious signs of poor circulation like mottled hands or a blueish tinge to the face. He could, however, hear the sounds of a baby who was in respiratory distress with overly rapid breathing and audible wheezing. And he would never forget the golden rule that adequate evaluation was impossible if a child was fully clothed.
‘Follow me,’ he directed. ‘Resus One’s free. What’s going on?’
‘His grandma’s just brought him in because he wasn’t feeding properly and wouldn’t settle. He’s not running a temperature and hasn’t got a runny nose, but she noticed a sudden onset of wheezing and his breathing’s got noticeably worse in the few minutes I’ve been with them.’
Mac let Hanna go ahead as he spoke to the woman following her. ‘Any chance that baby’s inhaled or choked on anything?’
‘I don’t think so.’ The woman shook her head. ‘Except he did seem to be having trouble swallowing his milk an hour or so ago. That was when he started coughing and I thought his breathing didn’t sound quite right.’
‘Has he been unwell in any other way before this?’
‘No... A bit unsettled, maybe, but he has been, right from the start. And he’s never been a good sleeper. That’s why I told my daughter and son-in-law I’d take him for the night—so they could get a decent sleep themselves.’
‘How old is he?’
‘Four months. His name’s Taika.’
Hanna was gently putting the baby down on the bed in the middle of the room. She began unbuttoning the stretchy sleep suit he was wearing, distracting and soothing him with a constant singsong explanation of what she was doing.
Mac was fitting his stethoscope to his ears.
‘Any family history of allergies or asthma?’
‘I’m not sure.’
Mac froze, blinking slowly. ‘Sorry?’
‘Taika’s adopted,’ she said. ‘Sorry, I should have told you this before, shouldn’t I? I do actually forget sometimes. He’s such a wanted baby and he couldn’t be loved any more—by any of us. Oh, my...’ She was reaching for her tissues again. ‘I didn’t want to wake them up before I had to but I should ring them now, shouldn’t I?’
Baby Taika began crying as Mac approached with his stethoscope, which wasn’t a bad thing when assessing a baby’s appearance or reactions but it made it impossible to auscultate a chest effectively. Hanna picked him up and held him against her shoulder with one hand cradling his head and he settled enough for Mac to listen to some worrying lung sounds, with the possible causes and more questions that needed answering lining up in his head.
Was this a case of a viral illness like bronchiolitis or RSV even though he wasn’t yet showing other symptoms of a respiratory infection? Was it an allergic reaction that might lead to his condition deteriorating rapidly? Or was it an aspiration pneumonia from milk or a foreign object? The wheeze that was getting louder suggested obstructive pathology and a chest X-ray was high on the list for investigations to rule out something caught in tiny airways.
There was another reason to take an X-ray that became apparent as Hanna put the baby down again so that he could look for other indications of respiratory distress like the retraction of the muscles between ribs.
Bruises.
Just faint marks on his ribs but Mac’s focus narrowed sharply as another automatic thought process was triggered by a solidly embedded alarm system.
If they can’t cruise, they can’t bruise...
He couldn’t let that alarm bell sound so loudly it drowned anything else out, however. Tunnel vision, thanks to one sign or symptom standing out enough to disguise others, was a trap for the unwary. Mac always had mental checklists available to cover possibilities for a differential diagnosis and he wasn’t about to jump to any conclusions.
But Hanna had noticed the bruises as well. She only caught his gaze for a heartbeat but he couldn’t miss the sudden change in the atmosphere in this room as Mac felt a nasty knot forming in his gut. Was she thinking the same thing he was—that Taika’s grandmother had potentially given them cause to be on alert by saying that his parents were suffering from sleep deprivation? That this baby was not their biological child?
When the X-ray images were available a short time later, that knot in Mac’s gut expanded so fast he actually felt sick.
‘There,’ he said quietly, his finger on the screen as Hanna looked over his shoulder. ‘And there...’
‘Oh, my God,’ Hanna breathed. ‘Those marks are all fractures?’
‘Very recent ones,’ Mac said grimly. ‘On both the clavicle and these ribs. It could well be the reason his breathing is affected.’
‘But his grandmother’s so involved with his care and she obviously loves Taika. She says her daughter, Gemma, is finding things tough but she adores her son. She’s apparently worried sick. She’s on her way here now.’ Hanna was biting her lip. ‘Do we need to bring Social Services in?’
‘Not just yet.’ Mac took a slow breath in. There were steps to this process. A case of child abuse couldn’t be allowed to slip through but, on the other hand, a mistaken accusation was also unacceptable. ‘I’d like to do a much more thorough physical assessment. But we’ll get some more images done. Of his long bones and spine.’
‘To look for other fractures?’
Mac nodded. ‘But also to look for any evidence of underlying bone disease. I can’t see any beading on the ribs in these images, but it’s quite possible to have a mild form of osteogenesis imperfecta that won’t be that easy to diagnose. It’s a shame we can’t find out if there’s any family history of scoliosis or fractures or dislocations, but we might see thinning of the long bones if there is inherited disease. There are other investigations that can be done like skin and bone biopsies. We’ll keep Taika in, and I’ll get a specialist orthopaedic consult booked as early as possible in the morning. I need to talk to his parents, too.’ His heart was sinking even further at the thought of a conversation that could be distressing for everybody involved. ‘It’s going to be a long night, I think.’
* * *
The case of baby Taika cast a pall over the rest of the night shift, especially after his parents arrived and were so clearly shocked to be faced with what had already been discovered about their son’s condition. Hanna spent much of her time with the family and watched their care of the baby as he was treated with pain relief for his fractures and oxygen along with an inhaler for his breathing. She became more and more convinced that this wasn’t a case of a child who was being abused.
She completely understood why Mac was being so thorough, however. This was beyond important to him. Hanna only had to remember that opening address he’d given at the Prague conference to be reminded of that little boy who thought an emergency department was his ‘safe’ space. She’d told him how heartbreaking the story had been and how much she had wanted to cuddle that little boy herself but there was nothing about Taika that struck the same kind of chord. Her instincts told her that he was a longed-for and much-loved baby.
‘They’re beside themselves with worry,’ she said to Mac as their shift was finally ending. ‘How long will it be until they get some answers?’
‘I’ve spoken to the paediatric orthopaedic guy who will be reviewing the initial X-rays. He’s going to meet the family at nine o’clock and he’ll call in anyone else he deems necessary.’ Mac glanced at his watch. ‘I might hang around and see what he has to say.’
‘That’s two hours away.’ Hanna looked at the deep creases around Mac’s eyes. She knew how tired he had to be, but she could also sense how tightly strung he was. ‘I don’t suppose you’re going to try and catch some sleep first?’
Mac simply shook his head. ‘I’ll go and find some coffee. Take a walk, maybe. It should be getting light outside soon.’
‘Want some company?’
Another shake of his head was accompanied by a smile this time. ‘You need to sleep.’
‘Not going to happen,’ Hanna said quietly. ‘Not when I’m worried about you.’
The beat of silence that fell between them made it feel as if she’d just told Mac exactly how she felt about him and, in a way, she had. She’d let him know that his wellbeing was just as important, if not more so, than her own.
The hesitation before he caught her gaze was telling. A hollow feeling inside Hanna’s chest was expanding to the point where it was difficult to take a breath and it only got worse when Mac spoke.
‘Okay...come for a walk with me,’ he said. ‘It’s been a while since we’ve had a chance to talk properly.’
His gaze slid away from Hanna’s as he spoke and she was aware of a heaviness—as though there was too much air inside that hollow space. People usually only said they wanted to ‘talk’ when they had something to say that the other person was not going to like. Chillingly, this took her back to that moment in the park in Barcelona, after that amazing dance under the tree, when she had sensed that the heat of the passion they’d discovered was burning itself out and Mac was either pulling away or putting some kind of barrier in place.
That, for whatever reason—probably because there was too much emotion involved—he needed to escape into his safe, buttoned-up space where everything was under control.
Hanna swallowed hard. Something had changed for Mac as well, hadn’t it? But when? Had it been the birth of Oli, as it had been for her, or was it the case of baby Taika tonight that had got under his skin so much? Whatever it was, Hanna knew that it was going to affect her as well.
‘Where would you like to go for a walk?’
Mac shrugged. ‘Doesn’t matter. You choose.’
Hanna could feel the chill of the frosty dawn approaching as they walked outside. It did matter, she thought. This might be one of the most significant decisions she’d made in a long time.
* * *
‘Where are we?’
‘A special place,’ Hanna told him. ‘Tunnel Beach.’
The idea of bringing Mac here had occurred to Hanna the moment she’d turned out of the hospital car park, knowing they had a couple of hours up their sleeves. This was where she had come to take part in a very significant event not so long ago when she’d been the bridesmaid for her best friend. Given the even more significant event of the birth of their child that both she and Mac had been a part of, it seemed exactly the place they needed to be.
‘I can’t see the beach.’ Mac turned his head as he looked through the windscreen. ‘But it looks like the apocalypse is about to happen.’
Dramatic blood red and tangerine orange streaks outlined their uninterrupted view of the horizon above a still inky black ocean.
Hanna grinned. ‘I was hoping it was going to be a stunning sunrise. They often are with a frosty start to the day. And it’s kind of a secret beach,’ she added. ‘It’s where Jo and Cade got married. Where they had their first date, in fact. You have to climb down steps through a tunnel, which probably isn’t the best idea while it’s still dark, but we can watch the sunrise and then have a walk if you don’t mind getting cold.’
‘It would certainly keep me awake.’
‘I don’t think you need anything more to keep you awake, do you?’
It wasn’t just the deep crinkles around Mac’s eyes, or the dark shadows beneath him. Hanna could feel how tense he was and the need to offer him comfort or support or whatever it was that he needed was a glow as strong as the sunrise unfolding in front of them. She reached to touch his face softly with her fingertips and, when he turned and smiled at her, she felt a little piece of her heart crack.
‘What is it?’ she whispered. ‘Is this about Taika? About his injuries? Or is it because he’s adopted that makes you feel so involved?’
Mac looked away. He let his eyes drift shut. ‘Both,’ he admitted quietly.
Hanna stared at him. She couldn’t say anything. She could feel the silence in the car folding in on her as she realised what had been there in front of her all along. Hidden in plain sight.
‘Oh, my God.’ Her voice shook. ‘That little boy in your story...who only felt cared for when he was being taken care of in hospital... It was you, wasn’t it?’
Mac didn’t say anything. He didn’t need to. Or maybe he guessed that Hanna was shocked enough to need a moment to process things.
So much was suddenly making sense to her. Like why Mac was so buttoned up. That being so organised and predictable and never putting a foot out of place might have been the only way to try and keep himself safe as a child. That the need to protect his own unborn child must have been overwhelming and to be told that baby no longer existed would have seemed like the ultimate failure when he’d been determined to take responsibility.
No wonder this man had never simply followed his nose to find an adventure. Or let himself get close enough to anyone to contemplate marriage or the responsibilities of bringing children into the world. Why would anyone make themselves vulnerable to yet another instance of being abused? Letting themselves feel unwanted. Rejected.
Unloved...
That crack in her heart was growing into a full-on break. Like the way she’d wanted to cuddle that little boy in his story, all Hanna wanted to do was to gather Mac into her arms and hold him tight.
To let him know how much he was loved.
But that would be the worst thing she could do, wouldn’t it?
Deep inside this intelligent, skilled, perceptive and sensitive man, who had a wonderful sense of humour and the ability to be the most generous lover ever, was a small boy. One who’d been hurt often enough to learn not to trust the people who should have loved him. Who might have even said that they loved him but acted very, very differently. And there was a young man, about to grasp the freedom of making his own choices and willingly stepping up to make sure his own child didn’t feel unwanted or unloved, who’d been hurt again, so badly he’d chosen to travel alone through life.
She’d known she couldn’t ask for his trust or a commitment of any kind. He had to be the one to offer it. Right now, it felt like he was moving further away from her rather than closer and it also felt like there was nothing she could do about it. If she went after him, in an emotional sense, she knew he would only run faster. Because that was the only way he could feel safe? If she stayed very still, maybe he would slow down enough to think about things. Perhaps, if he was allowed to choose himself, he might turn around and come back?
Even the spectacular sunrise was fading in front of them now.
It was Mac who broke the silence in the end. ‘It’s ancient history,’ he said. ‘But you’re the only person I’ve ever talked to about it.’
Hanna swallowed carefully. ‘Thank you,’ she said softly. She waited until he turned his head to meet her gaze and then she waited for another heartbeat, just to hold his gaze. To try and tell him what she couldn’t say aloud.
‘What for?’
It felt like Mac was holding onto her gaze as if he was searching for something. He had that focused, narrow-eyed expression that told Hanna she was the only thing that mattered in that moment.
She loved that.
It felt like love, even if Mac still couldn’t let himself admit it.
Hanna smiled at him. ‘For trusting me...’
She broke the eye contact, before the moment could get any heavier, by looking out of the window. ‘It’s light enough to be safe to walk along the top of a cliff,’ she said. ‘We could even go down the tunnel.’
Mac checked his watch. ‘Maybe we should head back. I’d hate to miss that meeting. We could come back another day?’
‘We could...’
Hanna was smiling as she started the car again. Because this way, it was easy to do that standing still thing and not push Mac somewhere he wasn’t ready to go. And ‘another day’ suggested he wasn’t going to run too far, too soon.
It was a reprieve.
Wrapped up in hope...
CHAPTER ELEVEN
FINDING WHAT FELT like a justifiable reason to avoid doing something difficult or unpleasant—like telling someone that a relationship couldn’t continue—made it easier to continue doing it.
It also felt like a much kinder option and there was no one else on earth that Mac would want to be kind to more than Hanna Peterson.
Fate was also lending a helping hand. Jo’s decision not to return to work full time after her maternity leave led to an almost instant offer of a permanent position for Mac, apparently due to the glowing reports of the time he had already spent in the Princess Margaret’s emergency department.
‘I can’t take it, of course,’ Mac told Hanna that evening, when they found time to be together in Jo’s little house, relaxing on the couch in front of the fire. ‘I’ve got far too many commitments, including a job in Edinburgh and research projects I’m involved with in Europe and the States. I’ve loved being here but it was never going to be for ever.’
‘I know...’ Hanna snuggled in under his arm to tuck her head against his chest. ‘I doubt anyone expected the world-famous Dr MacMillan to emigrate to a wee town at the bottom of the world. We’re lucky you decided to come for a busman’s holiday.’
