Crying for Help (4 page)

Less inclined to stampede down the corridor than Sophia was, we kept her in sight but still failed to keep up, and by the time we reached the correct clinic’s reception she was already charming the receptionist.

‘Ah, you must be Mr and Mrs Watson,’ the young woman said. ‘I’m Wendy, by the way. Me and Sophie go back a long way, don’t we, honey? Do take a seat. Dr Wyatt will be with you very shortly.’

Mike and I sat down on the leather sofa we’d been assigned to, leaving our young charge gaily chatting to the receptionist. But we didn’t have to wait for very long. After only about thirty seconds a man emerged from behind a door, and promptly bellowed ‘Sophie!’ as if greeting a dear friend who’d been thought lost at sea and had unexpectedly fetched up. I noted that he, like Wendy, hadn’t called her Sophia. They were obviously all very close.
Very
close.

Sophia’s response was equally enthusiastic. ‘Oh, it’s so nice to see you!’ she cried, leaping upon him, and so forcefully that I thought she might topple him over, or, even worse, jump up into his arms and swing her legs round him. Thankfully, neither happened, but most astonishing to my mind was that the doctor didn’t even seem to flinch. ‘Nice to see you too!’ he said, when she finally put him down. ‘I’m Steve Wyatt,’ he then said to us, coming to shake our hands. ‘Paediatric endocrinologist. Very nice to meet you both as well.’

Mike and I began to rise, but he flapped a hand to indicate we should stay where we were. ‘No, no. You can sit a while longer,’ he explained. ‘Sophia likes to have her consultation in private – just myself and her nurse, if that’s okay?’

He could probably tell from our expressions that this seemed a little irregular – after all, we were
in loco parentis
. ‘I know it seems a little strange,’ he added, rather less confidently, ‘but it’s what Sophia wants and we have to accept her wishes. But it should only take around fifteen minutes and then of course you can come in so we can go through the management and so on. Okay?’

‘Well, if that’s the way it has to be …’ Mike answered. ‘Is that okay with you, Sophia?’

‘Well, I do like to see my doctor in private,’ she nodded, and then they turned around and went back into the room.

‘How bizarre,’ I said to Mike, once we were alone. ‘We should have insisted on being allowed in with her, shouldn’t we? Don’t you think? It feels all wrong not to be in there. How odd.’

Mike shrugged. ‘What’s new? Everything seems bizarre about this child. Run of the mill, she isn’t. Why should this be any different?’

‘But why the “private” thing? What’s he privy to that we’re not allowed to know about? I mean, I understand the whole business of patient confidentiality. But she’s a child. And she’s in care. And it’s our job to care
for
her. So if there are things we should know and which are important and no one’s telling us …’

Mike squeezed my knee. ‘Don’t fret, love. We’ll be in there soon enough. And we can ask. Perhaps we’ll get a chance to have a word with the doctor on our own at some point. In the meantime, I need a coffee. The heat in this place is making me sleepy … You want one?’

‘Do bears live in the woods?’ I asked him, grinning.

While Mike wandered off in search of a vending machine, I idly flicked through the magazine I’d brought with me. But only a couple of minutes later the doctor’s door flew open and a stressed-looking nurse came rushing out, clutching a purse. I was then shocked to see her rushing back, only half a minute afterwards, now holding a bottle of water and a bag of peanuts. Blimey, I thought, poor love. Talk about NHS cutbacks – were their tea breaks now measured in seconds, or what? Mike ambled up with our coffees soon after, and I was just about to share my little witticism with him when he said, ‘You see that?’, nodding towards Dr Wyatt’s consulting room. ‘That was apparently for Sophia. Had a bit of a turn, by all accounts. Brain fog, the woman called it. Needed an immediate protein boost.’

‘Oh, my God,’ I said, panicked. ‘Should we go in?’

Mike shook his head. ‘Apparently not. I did ask her at the machine. But she said she’d fetch us in once they’d sorted things out.’

I took the coffee from him. ‘I don’t know about you,’ I said, ‘but this Addison’s thing scares me. It’s clearly a serious illness and we know nothing about it.
Nothing
. How on earth are we going to cope when it’s just her and us?’ I meant it, as well. Just how
would
we cope? I had no confidence that half an hour with Dr Wyatt was going to help much. This was obviously something that could come on and be life threatening at any moment, and for the third time in as many days I repeated the same mantra – that I mustn’t fret, that it was short term, that we wouldn’t have her long … but how dreadful, I thought guiltily, to be wishing a kid away when she’d only been with us five minutes!

Mike, who could read my mind – well, most of the time, anyway – put a reassuring arm around my shoulder. ‘Stop worrying, love, eh? Think about it logically. They wouldn’t have trusted us to care for her if they didn’t think we could cope, would they? Let’s just see what the doctor says and take it from there. And remember what they say about women and teabags …’

I laughed. He was right, as I’d proved to myself often. You really
didn’t
know how strong you were till they put you in hot water. And becoming a foster carer, above all, had proved to me that I was one hell of a lot stronger and more capable than I could ever have thought.

I sipped my coffee, awaited our summons and tried to think positively about things. But I didn’t know then, though I very soon would, just
how
hot this water was going to turn out to be …

Addison’s, clearly, was a very frightening disease. Despite Dr Wyatt’s cheerful, matter-of-fact manner, this wasn’t something Mike and I could listen to lightly.

Our all-you-need-to-know lesson wasn’t long, but it was complex, so I was grateful that the doctor passed us various leaflets and brochures as he spoke, which we could take away to digest more fully later, along with a big box of medication, which included the steroid injection paraphernalia I’d read about and which scared me. I hated everything about injections.

But the reality of the disease hit home straight away. Sophia’s Addison’s disease meant her adrenal glands no longer functioned, which had implications for all sorts of bodily processes. The two vital hormones she needed – cortisol and aldosterone – had to be replaced by taking daily medication – several times a day – and though it seemed this was usually sufficient to manage it, all sorts of things could affect how much she needed, including eating patterns, how well she was and how much stress she was under. If she didn’t get those hormones, via the tablets she was taking, she would die – it was as stark a fact as that. She had, therefore, to be mindful of taking her tablets at all times; an onerous responsibility for anyone, let alone a child – and when you factored in the appalling circumstances of this particular child’s life … well, it was a pretty sobering thing to even think about.

On a practical level, it was all about discipline. She had to eat regularly, and follow a diet that, though not that restrictive generally, prohibited the sort of random snacking on junk that other children of her age so often tended towards. Her medication did, as Jean had said, mean she could easily put on weight, something that would make her condition even harder to manage, as well as having negative psychological effects.

The worst-case scenario, the doctor pointed out, would be the onset of an ‘Addisonian crisis’, as it was called. If she had one of them, as a result of either a high temperature or other stress, it really was a life-and-death situation. Hence the injection kit he’d given us. I could only hope we’d never have to use it.

It was a hell of a lot to take in at one sitting, but we needed to try to get our heads around it all because, as Sophia’s carers, for however short a time, we had to have the means and knowledge to be able to put it into action.

Sophia wasn’t with us now. When we’d been invited into the doctor’s office, where he sat behind an enormous desk, Sophia perched on a stool to one side, he’d suggested that she might like to go off with the nurse for some fresh air. After all, as he pointed out, grinning at both her and us, she was already something of an expert on Addison’s disease and didn’t need to sit through all the boring stuff.

We’d taken the opportunity to bring up the slightly odd business of her being so adamant about seeing him alone. Wasn’t it all a bit cloak and dagger?

‘I know it seems that way, Mrs Watson,’ he’d agreed. ‘But unfortunately my hands are tied. There are certain parts of Sophia’s file that she doesn’t want disclosed, and I’m afraid that I have to respect that. All I can say is that they in no way affect her condition, nor do they hamper your ability to care for her.’

Which, frustratingly, left us none the wiser.

‘The main thing,’ Dr Wyatt explained now, his medical briefing complete, ‘is, of course, that you become attuned to the symptoms of a steroid insufficiency. Headache and/or dizziness, nausea and/or vomiting, wobbly knees, fuzzy thinking – the thing is,
at all costs
, to avoid a full-on emergency, so it’s always better to be safe than sorry. Increasing her steroids temporarily won’t cause her any harm, though long term they very much can. But it’s all in the literature,’ he finished up, cheerfully. ‘And you can call us any time you have concerns. Oh, but one more thing.’ He nodded towards the door now. ‘There’s also low blood sugar to look out for. It’s another common problem with Addisonians, but easily dealt with. As happened just now, give her a small bag of peanuts or something. Some of my patients swear by things like scrambled eggs, too. It’s the protein boost that helps. You’ll find she craves salt as well. Just the one thing …’ He paused again.

‘What’s that?’ Mike asked him.

‘The one thing, of course, as you’ve no doubt been told, is that Sophia’s been known to fake crises and low blood sugar. In fact, that’s probably what she did just then. For effect.’

I tried to take this in. ‘But why?’ I asked.

‘She’s a 12-year-old girl,’ the doctor said. ‘One who must take pills all the time and eat sensibly. Which must be galling. Especially when her peers can chow on what they like. But if she says she feels sick or dizzy … well, she’s learned, of course, hasn’t she? That it’s a sure route to getting attention.’

‘But how are we supposed to know if she’s faking or not?’

Dr Wyatt shook his head. ‘Please don’t stress overly,’ he said. ‘It’s just a question of making sure she follows her routine. If you make sure from the outset that she takes her pills in front of you – when she’s with you, that is – give her a healthy packed lunch and a well-balanced evening meal, there’s no reason at all why she should have problems. Oh, and get her school on board, of course. If you’re really very lucky, they might have someone on the staff who’s familiar with the condition. But if not – and it’s doubtful – then it’s really just a case of them exercising vigilance as well.’ His tone was reassuring, but I wasn’t reassured. I had no idea the condition could be manipulated like this and how much of a close eye we would have to keep on her. ‘And this could
really
be life-threatening – this crisis thing?’ I asked him.

He nodded. ‘They happen only very rarely,’ he said, ‘but potentially yes, one could be. The trick is to stave it off before it even looks like happening. Prevention is always so much better than cure.’

I thought grimly about the average adolescent’s mind. Being told you might do some damage to yourself in the long term never stopped armies of kids taking up smoking, trying drugs and getting drunk as skunks, did it? But for attention? Mr Wyatt seemed to read my mind. ‘The problem with Sophia,’ he said quietly, ‘is that she resents her condition and wants to prove she controls
it
, rather than the other way around.’

‘Or maybe she’s just manipulative,’ Mike suggested. ‘And likes to control those around her.’

Dr Wyatt nodded. He looked slightly taken aback by Mike’s comment, but I got the feeling he did understand. ‘It’s certainly true that some young people with chronic illnesses can be manipulative,’ he agreed. He then looked at his watch. Quite a lot of time had passed now. There were obviously more patients waiting. ‘But unless she tells us how she feels, I’m afraid we just don’t know,’ he finished. ‘But please do get in touch,’ he said, rising, ‘if you have further questions or need help. That’s what we’re here for …’

We were all quiet, lost in our own thoughts, during the journey back home. I was busy going through everything again in my head: the complicated nature of this new routine. I was expecting each child to be different, of course; with my first foster child, Justin, who counted major food issues among the many manifestations of how badly he’d been damaged, I’d had to create a wall chart and update it on a regular basis, detailing every aspect of all our upcoming meals. Not only did I have to write up exactly what we were having, but also when we were having it, almost to the minute. If I didn’t do this, he got terribly anxious and difficult, especially in the early days and weeks he was with us. It did improve, but it would create tension, even months down the line, if we ever deviated from it. Deciding on an impromptu take-away instead was, we soon realised, not an option.

This new routine, though, was a whole other ball game. This was medical and complex and stressful. I had to observe Sophia’s daily tablet taking, keep a track of her supplies, ring up for regular repeat prescriptions and collect them, and keep two emergency kits – one at home, and one for school trips and so on – to hand and ready for action at all times. Not such a huge amount really, but that wasn’t the point – it was just the enormity of the responsibility. I had honestly not realised until that very moment quite how serious a chronic disease like this could be.

I sighed heavily. Blow the long-term health implications for me – I was stressed and I really craved a cigarette.

I turned to Mike. ‘Could we stop at the next services?’ I asked him. ‘I need to pick up a few bits.’

‘And a cig?’ he said, grinning. ‘Course we can, love.’

We stopped at the next services – about an hour away from home – and all got out of the car. After such a long time in the car it was good to be able to stretch our legs, but Sophia, once she’d done so, climbed straight back in. ‘I don’t need to go in, do I?’ she wanted to know. ‘I’m tired. I think it’s the heat. Plus the stress of the journey.’

‘You go on, love,’ Mike said to me. ‘I’ll stay here with Sophia. Get your bits. See you back here in a bit.’

I bought the bread and milk I needed and ducked round to the corner of the building to the smoking area. I really must research this disease properly, I decided. I didn’t feel comfortable not knowing everything I could know about it. If I was going to be able to look after Sophia properly, then I needed to know when the wool was being pulled over my eyes.

I stubbed out my cigarette and walked back to the car, and the rest of the trip home passed without incident. Sophia, true to her word, seemed sleepy indeed. She didn’t stir for the rest of the journey.

Happily, for all concerned, the rest of the day went pretty well. When we got home Kieron had already arrived back from college, and their first meeting seemed a success all round. Sophia took to Kieron instantly, it seemed to me, and our evening meal felt as relaxed as it would have done usually, Sophia laughing and chatting and being generally very sweet.

But there was still
something
– a vague sense of unease I couldn’t shake. I’d definitely been rattled by the doctor’s revelations about Sophia having been known to fake symptoms, but not
that shaken
. After all, I’d spent almost all of the previous year with a much more obviously distressed and challenging child under my roof. I’d also had years of experience working with difficult children; it was almost in my blood to tease out what made these kids tick. But this one, I thought, was somehow different; more unfathomable. And so chameleon-like, it was frankly spooky.

Still, I thought, waking slowly and strangely serenely on Thursday morning, another day, another chance to get to know Sophia better, another opportunity to make a difference to the world. But my serenity didn’t last long. ‘Damn!’ I thought, seeing the alarm clock beside the bed. Nine o’clock and I’d only just woken up!

I’d have to get my act together, I thought grimly, as I threw off the duvet and registered that, once again, Mike seemed to have forgotten to switch the heating on. But no bad thing, perhaps, to be driven from my bed. This time next week we’d be back in the thick of a new school term. I had to snap myself out of this post-Christmas languor, and
fast
.

I dragged my dressing gown around me and hurtled downstairs, fully expecting to be greeted by the sight of my young charge, looking fed up and abandoned, in the kitchen. Or worse, waiting to take her tablets – it had to be in my sight, of course, and she knew that – and going rapidly downhill even as I slept.

But I needn’t have stressed. A quick glance around confirmed she wasn’t downstairs, and another back upstairs – for I was now, of course, going to have to be hyper-vigilant – confirmed that she was still sleeping soundly.

Time, then, to relax for a short while in the conservatory, with my own company, the paper, a sneaky cigarette or two and my sheaf of Addison’s disease information pamphlets. Pausing only to flick the heating switch and grab a mug of coffee, I opened the back door and went out into the conservatory.

But I’d not been in there two minutes when Bob trotted in, tail going nine to the dozen, closely followed by footsteps, which I assumed must be Kieron’s. Bob slept on his bed every night, so it made sense. But then he spoke and it wasn’t a he. It was Sophia.

‘Wow, it’s so cold in here!’ she observed, not inaccurately. I was pretty cold myself. After all, it was January. And this was a conservatory.

‘It’ll warm up soon,’ I said, turning round to greet her properly. ‘I just put the heating back on, so –’

I stopped and gaped then, on seeing her, pretty much lost for words. She’d come down in what’s generally described as ‘baby doll’ pyjamas. But there was nothing doll-like about them, and certainly nothing babyish, either. They were not only very short and frilly, and fashioned from scarlet nylon, they were also very, very transparent.

‘Good Lord!’ I said. ‘No wonder you’re cold, dressed like that! Haven’t you got anything more suitable to put on?’

‘What d’you mean?’ she asked, innocently, looking down at the wisps of material. ‘It’s a nightie. All my nighties are like this.’

‘Then we’ll need to get you some new ones. Do you at least have a dressing gown?’

She shook her head. ‘I don’t wear them. Anyway, what’s wrong with this? Jean lets me wear these.’

I put my stash of leaflets down and stood up to return to the kitchen. It was making me feel cold just looking at her. ‘Sweetie,’ I said, ‘quite apart from the fact that you’ll catch your death, there are no men at Jean’s house, are there? But here …’ I thought instantly of the rapport she’d struck up with Kieron, and how he might react, faced with such a sight. He wouldn’t know where to look. He’d be mortified. ‘Well, it’s just not appropriate, love, okay? Though, I have to say –’ I couldn’t help voice what I was thinking. After all, the child was
12
. ‘I’m surprised she let you wear those sort of nightclothes, in any case.’

Sophia stuck her lip out. ‘Well she
did
.’

Best, perhaps, I thought, to let this go for now. She was bound to be sensitive about Jean, after all. ‘Well, we’ll see what we can find when we go shopping.’