‘Celebrated his seventh birthday last week. Cheeky as ever. Addicted to superheroes. Batman, Superman, Spiderman—you name it. He saves the world at least a hundred times a day. Ah—here’s Dr Zinetti right now.’
Dino strode into the room, noticing that Meg’s anxiety and stiffness appeared to have vanished. She even looked pleased to see him.
Whatever else she might think of him, at work they were a good team.
‘Dino, she’s had a cold and runny nose for twenty-four hours and it’s been getting steadily worse. She hasn’t fed at all today, she has nasal discharge and a wheezy cough. Sats are ninety-four per cent so I’ve started her on oxygen because I can see she’s struggling.’
‘I can’t believe how quickly she’s got worse.’ Abby’s mother looked terrified, her face almost grey from lack of sleep and worry. ‘Is she going to be all right?’
‘I’m going to take a look at her right now.’ Dino gently lifted the baby’s vest so that he could look at her chest. He watched for a moment, noticed that the chest was visibly hyperinflated and that there were signs of intercostal recession. ‘Was she born at full term?’ He asked the mother a number of questions and then listened to the baby’s chest.
‘Is she bad?’ The mother was hovering, stressed out of her mind. ‘I’m worrying that I should have brought her in sooner but I thought it was a cold.’
‘You’ve done the right thing. Because she is little and she has tiny airways, she is struggling at the moment.’ Dino folded the stethoscope. ‘I can hear crackles in her lungs, which suggests that this could be bronchiolitis. It’s a respiratory infection caused by a virus. It’s quite common at this time of year. There’s nothing you could have done to prevent it.’
She looked at him, desperate for reassurance. ‘You’re sure?’
‘Positive. But in Abby’s case it is quite severe so I’m going to run some tests and keep her on oxygen for now. I’m also going to contact the paediatric team because she’s going to need to be admitted for a short time.’
‘She needs to stay in hospital? It’s nearly Christmas.’
‘Hopefully it will only be for a few days.’ Meg’s voice was gentle. ‘She’s having to work quite hard to breathe, and if she isn’t feeding then we need to keep her here and give her some help. Honestly, it’s the best place for her to be. Whatever treatment she needs, we can give it right here. You know you wouldn’t be able to relax if she was ill like this at home. You’d be hanging over her cot, listening to her every breath and just worrying.’
‘Oh, yes, that’s exactly what I’ve been doing.’ The baby’s mother looked dazed. ‘I need to phone my husband—he’s gone into work. He didn’t realise she was this bad—neither of us did.’
‘Why don’t you do that right now? We’re going to take some blood samples,’ Dino took the tray that Meg had already prepared. ’That will help us work out exactly what’s wrong with her and how we’re going to treat her.’
‘You’re going to stick needles in her?’ The mother looked appalled, her eyes full of tears. ‘I should be there for her, hold her…’
Dino took one look at her ashen face and knew that if she stayed, she’d probably pass out. He was about to say something when Meg spoke.
‘I think the most important thing right now is to call your husband. That’s a bigger priority. You need the support. The weather isn’t great out there so it might take him a while to get here. I’ll hold Abby while Dr Zinetti takes the bloods.’
In one sentence she’d given the mother permission to leave and not to feel guilty. Admiring her skill, Dino waited while Abby’s mother left the room. ‘You’re so good with worried mothers.’
‘There’s nothing worse than watching someone stick needles into your child. Can I ask why you’re taking bloods? I got the tray ready just in case, but we don’t usually do that for bronchiolitis. I thought it was a clinical diagnosis.’
‘I want to check her blood gases. She has marked chest wall retraction, nasal flaring, expiratory grunting and her sats are dropping, despite the oxygen.’
‘She’s certainly a poorly girl.’ Meg slid her hand over the baby’s downy head. ‘All right, sweetie, we’re going to do this together and Uncle Dino is going to get that nasty needle in first time and not miss.’
‘No pressure, then.’ Dino ran his finger over the baby’s tiny wrist and arm. ‘If I manage it first time, I get to choose the time and the place.’
‘For what?’ She handed him a tourniquet.
‘For our first date.’
Her cheeks flushed, Meg squeezed the baby’s arm gently. ‘I don’t go on dates.’
Neither did he. Usually. He wondered what she’d say if she knew he was every bit as wary as she was. For the past two years he’d kept his relationships superficial. It was a measure of how much he liked Meg Miller that he was willing to risk the next step. ‘Perhaps it’s time you did.’ Dino stroked his finger over the baby’s skin, found what he wanted. Smoothly and confidently he slid the tiny needle into the vein. ‘There. First time. I win the challenge.’ He murmured softly to the baby in Italian and glanced up to find her watching him.
‘I’m glad.’ Her cheeks were flushed. ‘I would have hated you to have missed, but I don’t want you to take that the wrong way.’ Meg turned her head to check the baby’s pulse and blood pressure on the monitor. ‘She really is very sick. I’ve rung PICU and warned them that they’ll need to isolate her.’
Dino took the samples he needed and dropped them onto the tray, his eyes on the baby. ‘I’m still not happy with her breathing. She may have to be ventilated.’
‘Paediatric team on the way, including the anaesthetist.’
‘The problem with working with you,’ Dino drawled, ‘is that you’re so efficient there is no opportunity for me to impress you.’