To the Doctor: A Daughter Page 3

  He thought that through. It had distinct appeal. What he needed desperately here was space. ‘I suppose I could…’

  ‘Of course you could. The nurses there are trained to take care of babies.’ Donna’s tone said that such things were unfathomable. Taking care of babies was something to be handled by experts. Like bomb detonation. ‘And we don’t want her to spoil our evening.’

  ‘Donna, I-’

  ‘Look, you’re surely not suggesting we stay home and stare at a baby all night?’

  He caught himself at that. It did seem ridiculous. And the hospital was quiet. There were places available in kids’ ward.

  He’d shelve the problem until tomorrow, he told himself. He’d give himself time to think.

  ‘Maybe it’s a good idea.’

  ‘Of course it’s a good idea.’

  But as Nate lifted the tiny pink bundle into his arms-as he smelled the newborn milkiness of her and as he felt her nuzzle contentedly into his shoulder-he thought…

  Stay at home and stare at a baby all night?

  Suddenly it didn’t seem such a crazy idea at all.

  ‘My legs feel funny.’

  Gemma bit her lip. She really had stretched Cady’s patience to the limit. He was four years old, he was exhausted and he was very, very hungry.

  She’d stretched him to the limit time and time again in the past few weeks, she thought bitterly. That was half the reason she was demanding that Nate take responsibility for Mia. Fiona had left a pile of bills a mile high. Gemma had needed to drop everything to be with her during the birth. And then afterwards-the funeral arrangements-everything had fallen to her. And all this time Cady had struggled uncomplainingly by her side.

  She lifted him high into her arms and hugged him hard.

  ‘It’s over now, sweetheart. We’re back to being just you and me.’

  ‘I liked the baby.’

  ‘I know. And she’s your sister. When you get a bit bigger you’ll be able to spend some time with her. I hope. But for now she’s better off with her daddy. And I’m better off with you.’

  ‘He was nice. I’d like a daddy like that.’

  Yeah, right. As if. Gemma hugged harder as she carried the little boy into the roadhouse. The place was down at heel and looked distinctly seedy but its upside was that it also looked cheap. She could feed Cady enough to get them on the road back to Sydney.

  He’d like a daddy like that?

  She’d like one, too, she thought. She couldn’t remember her own father. For the last few years her mother had leaned on her, and the responsibilities for Fiona had all been hers.

  And Alan was still there-a nightmare in her background.

  Sometimes the responsibilities were far, far too much.

  ‘Let’s just concentrate on food,’ she told Cady. ‘One step at a time.’

  ‘Why can’t he be our daddy?’

  Because he’d never look sideways at the likes of me, she thought bitterly. What man would? A woman encumbered with debt and child and responsibility up to her ears. And Alan…

  Damn. To her horror she felt tears stinging the back of her eyes and she blinked them back with a fierceness that surprised her.

  She must be more exhausted than she’d thought.

  ‘We’ll just get food and then we’ll go,’ she told him, and set him down at the first table she came to.

  And he swayed.

  ‘Cady…’ Her hands came onto his shoulders to steady him. What was wrong? ‘Are you OK?’

  ‘N-no,’ he whispered, and she had to stoop to hear him. ‘Gemma, the room’s doing funny things. My eyes are doing funny things. Make them stop.’

  ‘Sure, we can keep her overnight.’ Jane, the cheerful night charge nurse accepted Mia with easy equanimity. ‘What’s wrong with her?’

  ‘As far as I know, nothing.’

  ‘She’s been abandoned,’ Donna chirped in from behind. She’d accompanied Nate across the road to the hospital and stood waiting-still bearing his dinner suit. ‘And we need to go to the Jazzfest.’

  ‘Of course you do. But…did you say abandoned?’ And then Jane lifted away the blanket covering the baby’s head and her breath sucked in with astonishment. Her eyes flew from the baby’s head to Nate’s and then back again.

  Gemma was right. He’d never be able to disown this baby, Nate thought grimly. And the news would be from one end of the valley to the other by the morning. Dr Ethan’s baby, abandoned in Terama.

  ‘Just look after her for me for the night,’ he told Jane wearily. ‘I need to sort out a few things-in the morning.’

  ‘I’d imagine you do.’

  His eyes flashed anger. ‘There’s no need to jump to conclusions.’

  ‘No?’ Jane was in her mid-forties. Nate was thirty-two so Jane was certainly not old enough to be his mother-but she sure acted like it.

  ‘No!’

  ‘Whatever you say, Dr Ethan.’ She hugged the baby close. ‘Oh, aren’t you just delicious? Looking after you will be pure pleasure.’ She waved Nate and Donna away. ‘Off you go, and enjoy yourselves. And then come back to one gorgeous baby.’

  How the hell was he supposed to enjoy himself after that?

  Nate somehow managed to respond to his friends and he tried to eat his dinner but only half his mind was on what he was doing. Or less. Maybe less than ten per cent of his mind. The rest was back in the children’s ward with a baby called Mia.

  And maybe…maybe part of his mind was travelling up the highway toward Sydney, with one very weary doctor called Gemma and a little boy called Cady.

  Oh, for heaven’s sake, he couldn’t worry about them. He had enough to worry about with Mia.

  His daughter.

  The knowledge went round and round his heart, insidious in its sweetness.

  He should be panic-stricken, he thought, and a part of him was. The other…the other part remembered how his tiny daughter had felt snuggling into his chest. The way her fingers had curled around his. The feel of her soft curls under his chin…

  Mia. His daughter.

  And Gemma…

  She was still in his thoughts. Try as he might, he couldn’t stop thinking about her. She’d looked too damned tired to face the highway to Sydney.

  He should have insisted she stay the night.

  She’d be sacked if she stayed. What had she said? She’d used all her sick-pay entitlements and then some.

  She’d taken on so much!

  He could guess how it had been, he thought grimly. She’d coped with the responsibilities of a dying sister and her two children.

  She’d handed over one. He should be angry.

  He couldn’t be angry. Whenever he tried, he kept thinking back to the feel of Mia against his chest and the anger dissipated, to be replaced by something that was akin to wonder.

  He had a daughter.

  And finally he could bear it no longer. He pushed away his half-finished plate of food and gave Donna an apologetic smile.

  ‘I’m sorry, Donna, but I need to go.’

  She was astonished. ‘But you haven’t been called and the dancing hasn’t even started.’

  ‘I need to go back to kids’ ward.’

  ‘To the baby?’

  ‘To the baby. Yes.’ He took a deep breath and accepted reality. ‘To my baby.’

  She stared at him in amazement. ‘You’re not going to keep it?’

  ‘If I can. Yes. I think so.’

  Her lovely eyes widened in astonishment. ‘You surely can’t be serious?’ And then another thought hit her. ‘You don’t expect me to help, do you?’

  ‘No, Donna, I don’t expect that.’

  ‘I don’t think I’d be very good with babies.’

  ‘That’s fine.’

  ‘And you really want to go?’ Her lips pouted in displeasure. ‘Go on, then. If you must. There’s plenty of other men to dance with and to take me home.’

  He knew that. Damn, he knew.

  Maybe he was being stupid. He waver
ed, just for an instant, and in that instant the buzzer sounded on his belt. He lifted his cellphone and saw who was calling. The hospital charge nurse.

  ‘Jane?’

  ‘Nate, you’d better come. I need you here now.’ She sounded rushed and that was all she had time for. The phone went dead before he learned any more.

  Mia? Was there something wrong with Mia? His feet were taking him out the door before his phone had been clipped back on his belt. What was wrong?

  When he had a call there was always tension-but not like his.

  His daughter…

  But it wasn’t his daughter. It was Cady.

  ‘I don’t know what’s wrong.’ Gemma was beside herself. She was sitting in Emergency looking as sick as the child in her arms. ‘He’s just… Nate, he’s hardly conscious. I thought it was weariness but this is much more than weariness.’

  Nate was still in his dinner suit. He looked handsome-absurdly handsome-but Gemma didn’t notice. She didn’t see Nate the man. She saw Nate the doctor, and the doctor was what she needed most at this moment. A doctor with skills. Please…

  ‘Tell me what happened.’ Nate’s voice was curt and decisive, cutting through her fear. Or trying to. She might be a doctor herself but this was her beloved Cady and her medical judgement couldn’t surface through her terror.

  Somehow she forced herself to be calm. To give Nate the facts.

  ‘We stopped a few miles down the road. I wanted to get a little distance between us…between the baby and us…before we ate. And Cady was really, really quiet but I thought, well, it was his little sister we’d just left. And we’d grown so fond… Regardless of what I told you…’

  She was almost incoherent, Nate thought. She was hugging the little boy to her as she spoke and their faces were a matching chalky white. Jane had pressed Gemma into a chair and was taking Cady’s blood pressure. She’d called Nate as soon as she’d seen Cady. The dance hall was only a few hundred yards from the hospital so he’d arrived there in minutes.

  Nate listened to the fear in Gemma’s voice. He stooped before them, lifting the boy’s wrist and feeling his racing pulse. His breathing was deep and gasping-as if it hurt.

  ‘OK, Cady, we’ll have you feeling better in no time,’ he told the little boy, sensing the rigid fear in the child’s body. Obviously there were things happening that Cady didn’t understand.

  Neither did Gemma. ‘OK, Gemma, just take it slowly,’ he told her. ‘Calm down.’ His voice insisted she do just that. ‘Tell me what happened next.’

  She hiccuped on a sob. ‘He said he couldn’t see. He said everything was fuzzy. And then…he was violently ill and now he’s limp…’

  ‘OK.’ This could be a number of things. The tension of the past hour had fallen away now to be replaced with a different sort of tension. Nate was back in medical mode and nothing else mattered. What was happening here? What did he have? One limp kid?

  Meningitis? Maybe it was, and he could tell by the fear in Gemma’s voice that that was what she was terrified of.

  Okay. Worst case scenario first. Rule of thumb-look for the worst and work backwards.

  ‘There’s no temperature,’ Jane told him, showing him the thermometer. ‘High blood pressure. Rapid pulse. But no temp.’

  OK. Breathe again. That should rule out meningitis.

  But Cady certainly looked sick.

  The child was thin, Nate thought, sitting back on his heels and really looking. Taking his time. He’d learned in the past that unless airways were threatened, such examinations were important. So he took the child in from head to toe-examining him with his eyes instead of his hands.

  What did he have?

  Thin child. Fuzzy vision. Sick. Tired, and drifting into semiconsciousness.

  Diabetic mother…

  And a little voice was recalled from nowhere. The memory slammed home.

  ‘Gemma, I’m thirsty.’

  Click.

  ‘Jane, I want a blood sugar,’ he said curtly. He put his hand over Cady’s and gripped, hard. ‘Cady, your eyes are a bit funny, are they? Can you hear me, Cady? Can you tell me what’s happening?’ The little boy seemed as if he was drifting in and out of consciousness.

  ‘I can’t… Everything looks funny.’ Cady’s voice was a bewildered whisper and Nate’s eyes met Gemma’s. The child’s confusion was reflected in hers.

  ‘Cady, I’m going to take a tiny pinprick of blood,’ he told the little boy. ‘Not much. It’ll be a tiny prick. I think you might have too much sugar in your blood and I want to find out if I’m right. If that’s what’s making you sick.’

  ‘Oh, no…’ Gemma’s voice was so distressed he could tell she was near breaking point, but she’d realised where he was headed. Blood sugar… ‘Of course,’ she whispered, distressed beyond measure. ‘How can I have been so stupid…? It’ll be ketoacidosis.’

  Diabetic ketoacidosis.

  Nate thought it through, but the more he thought the more it fitted with what was happening. Diabetes meant the pancreas stopped producing insulin-and if insulin wasn’t available the body couldn’t absorb food and started using its own fat for energy. The result was a poisonous accumulation of ketones. Ketoacidosis. And in its early stages ketoacidosis looked just like this.

  ‘We don’t know yet,’ he told her.

  But Jane was moving as he spoke, fetching the equipment he needed. A urine sample would check for ketones, but taking a urine sample from Cady now would be difficult. So he’d test the blood sugar and assume the rest.

  The sugar reading took seconds. He took a drop of blood from the little boy’s listless hand, placed it on the testing strip and set the machine in motion.

  And five seconds later there was the answer.

  ‘Thirty-two…’

  They had their diagnosis.

  ‘Dear God!’ Gemma was rocking the little boy back and forth in her arms with anguish. Thirty-two! She knew all too clearly what that meant. A normal range was from four to eight. No wonder his vision was blurred. No wonder he was sick. ‘He’s diabetic. Dear God… How could I not have known? How could I not have guessed?’

  ‘You’ve had just a bit on your mind lately,’ Nate said gently. She certainly had, and here was another load for her to bear. What on earth had her sister landed her with? ‘But let’s not worry. Let’s just get Cady feeling better. I need to ring a specialist paediatrician for some up-to-date advice but I think I can handle this here.’ He smiled down at the bewildered Cady. Even though he wasn’t sure whether the little boy could hear him he spoke anyway, and maybe it was more for Gemma than for Cady.

  ‘Cady, there’s something in your tummy called a pancreas. It isn’t doing its job so we’ll have to fix that. The pancreas makes stuff called insulin that keeps you well, and because your pancreas isn’t making any insulin I’m going to pop a tube into your arm so we can give you some.’ Heaven knew if the child could make sense of this.

  But Cady was one brave kid and he was trying. He was struggling to focus on Nate’s face but it was beyond him. ‘Will it hurt?’ he quavered, and Gemma hugged him tight and kissed him on the top of his head.

  ‘It’ll be a small prick just like the last one-and it’ll make you feel so much better,’ she told him. He’d need a drip, she knew. They had to get some nourishment into the child to stop the deadly breakdown of body fat and they’d need intravenous insulin to get the blood-sugar level down. ‘Dr Ethan will pop a tube into your hand so the medicine can go in really quickly.’ There were myriad blood tests to be done but the blood could be taken as the IV line was put in. ‘Then we’ll pop you in bed and let you sleep, Cady. For just as long as you need to sleep to be well again.’

  ‘You won’t be taking him back to Sydney any time soon.’

  ‘I know.’ With Cady safely tucked into a ward bed Gemma seemed to have lost the last of her energy. She slumped forward on her chair, her shoulders sagging and her whole body spelling defeat. ‘I almost killed him.’

  ‘You d
id no such thing.’

  ‘I’m a doctor.’ She was very close to tears, Nate thought. She was very close to breaking down altogether. ‘I should have noticed. Of all the stupid…’

  ‘You know as well as I do that diabetes is insidious,’ he said gently. ‘He’ll have been eating and doing everything he normally does… There are no overt signs.’

  ‘But he’s thin. I thought… I thought he was just having a growth spurt.’

  ‘And you were taken up by a dying sister and a newborn baby.’

  ‘I let it go so far. I could have killed him.’

  ‘No!’ He stooped and took her shoulders and gripped, hard. ‘You didn’t. Diabetes in children is hard to pick before it becomes an acute problem. You think a kid’s having a growth spurt-they’re suddenly taller and thinner and tired, and you put two and two together and get four-but the answer’s six. I’ve seen this before, Gemma.’

  ‘As bad as this?’

  ‘Worse.’ His hands still gripped her too-thin shoulders. Did she have any time to look after herself? he wondered. And then he thought… What was her blood sugar?

  ‘Can we test you?’ he asked, and she gave a laugh that was almost hysterical.

  ‘I’m not diabetic.’

  ‘How do you know?’

  ‘I…’ She took a grip. ‘I guess I don’t. But I’m not thirsty like Cady. And I’m not losing weight.’

  ‘You mean you’ve always been this thin?’

  ‘I eat on the run,’ she told him. ‘But Cady…’

  ‘Will be fine.’

  ‘His body must have been producing ketones for weeks.’

  ‘Kids get sick fast,’ he told her. ‘It’s my guess that further blood tests will tell us this is recent. You would have noticed if he’d been tired for months.’

  ‘But not weeks. I’ve been so caught up-’

  ‘With your sister and the baby.’ He was still holding her. She hadn’t noticed-or rather she had, but she needed the contact. She needed the warmth.

  ‘I…’ For the first time she seemed to surface. She shook herself like she was clearing fog and she looked at him. And saw Nathan for the first time. Really saw him.

  ‘You’re in a dinner suit,’ she said stupidly, and he grinned. It really was the most gorgeous grin. It warmed places in her heart she hadn’t known were cold.