‘But if there is a problem, where’s it likely to be?’ Madison asked.
‘Are you asking as a doctor or as a mum?’ Sanjay asked.
‘Doctor,’ Theo said.
‘Kidneys,’ Sanjay said. ‘Absent, enlarged, or not developing properly.’
‘Or it could be a blocked urinary tract, or a congenital heart defect,’ Nita added.
Theo smiled. ‘Excellent. You two really know your stuff.’
‘Thanks to Maddie,’ Sanjay said. ‘She’s been brilliant at spending time with us and talking about differential diagnoses.’
Madison glanced at her watch. ‘Thanks for the compliments, guys, but we’re running short on time. Now, you’ve sent me for an ultrasound. The placenta’s normal but the fluid’s definitely low and the baby’s growth rate is poor. You’ve examined me and the membrane’s fine so you don’t have to keep monitoring me and the baby for signs of infection. What are you worried about now?’
‘Delivery, definitely,’ Nita said. ‘Speaking to you as a doctor rather than a mum—without enough fluid, the baby’s likely to end up in the breech position. And I’d be really worried about cord compression.’
‘So would I,’ Iris said feelingly.
‘So what would you do?’ Theo asked.
‘It depends on how little fluid there was,’ Sanjay said. ‘Ideally we’d go for conservative management, keeping a close eye on things and checking the baby’s heart rate to make sure he’s not distressed, and regular ultrasounds to check the baby’s development.’
‘But if the fluid’s really low and the scan shows the baby’s growth is affected,’ Nita said, ‘we’d have to deliver early. So we’d give steroids to mature the baby’s lungs and do a section.’
‘What would you notice about the baby after delivery?’ Iris asked.
Sanjay and Nita looked at each other. ‘Um—lots of vernix because it’s early?’ Nita suggested.
‘Actually, the baby’s skin is more likely to be dry and leathery because of the lack of fluid,’ Iris explained. ‘And the face might look a bit squashed.’
‘And because the baby’s been compressed in the womb, you also need to check for club foot,’ Theo added. ‘Good work, team. Same again on Monday morning?’
‘Yes, please,’ Sanjay said, smiling.
‘Definitely,’ Nita added. ‘Working with you like this—well, it’s made me realise that this is what I want to do when I qualify, Theo.’
‘You don’t have to make up your mind just yet. You’ll have other placements in other departments,’ Theo said gently. ‘It’s lovely to see you both so enthusiastic, but don’t close yourself off to other opportunities just yet.’
‘I was wondering,’ Nita said, shifting from foot to foot, ‘if I could ask your advice about my next placement.’
‘Sure. We could have lunch today, if you like. Maddie, you’re free as well, aren’t you?’
‘Emergencies permitting, yes.’
Theo smiled. ‘That goes for me, too, so you might end up with just Maddie or neither of us. But we’ll fit something in.’
‘Thanks.’
‘Now, I have clinic—and you two are with the gynae team today, aren’t you?’ Theo asked.
Sanjay glanced at his watch. ‘Yes, and we’d better be on time. Thanks for today, Mr Petrakis.’
Iris and the students disappeared; Madison was about to go to her own clinic, but Theo caught her hand. ‘Promise me something,’ he said.
‘What?’
‘If you can’t make lunch today, page me early so I can make an excuse.’
She frowned. ‘Why?’
‘Because I don’t think it would be a good idea to have lunch on my own with Nita,’ he said softly.
She knew exactly where he was coming from. She’d seen the way the student looked at him, too. ‘You’re the consultant. All you have to do is tell her you’re not allowed to date students.’
‘So I meet her for lunch and tell her I’m not interested in a date.’ He raked a hand through his hair. ‘Which makes me sound like an arrogant bastard who thinks anyone female will be desperate to go out with me.’
She laughed. ‘Theo, all the single women in the hospital want to go out with you. Do you have any idea how many of them have asked me to lunch and grilled me about you?’
He looked surprised. ‘Why would they grill you?’
‘They want information so they can work out how to seduce you.’
Surprise turned to worry. ‘Oh, lord. I hope you’ve told everyone I don’t mix business and pleasure.’