Unknown (15 page)

'Actually, Dr Stuart, I was just thinking that
you
and Professor Geddes look good together,' Daisy said innocently. 'Do you like him?'

'He's an excellent physician,' Annabel said neutrally. 'Deep breaths, Daisy.' She drew her stethoscope out. 'Another breath in.' She examined Daisy's heart and chest briefly and elected to continue her current treatment, including the dopamine infusion into the venflon Luke had inserted the night before. 'Hannah and I are on call tonight. If you're feeling worse or there's anything you need just ask one of the nurses to bleep us.'

By the time she got back up to Harry's old office, Luke had Daisy's earliest X-rays up on the screen on the far wall and several sets of notes spread open on the desk in front of him. 'I can't find her initial heart biopsy results,' he said when Annabel put down the load she was carrying on one of the chairs. He searched though a couple of pages, sounding preoccupied.

'I see there's a note here on a verbal report on one in your handwriting so that must have been when you were a registrar, but I can't find the official histology. Did you rely on just one biopsy or did you repeat it?'

'We did another two years ago, the first time she went into failure,' Annabel told him, looking through the notes she'd just retrieved to try and find it. 'Just in case we'd missed something with the first one. Here's this one.'

She passed across the blue report for him to read then took over the notes he'd been searching through to see if she could find the original biopsy result. 'Neither showed any inflammation or viral particles,' she murmured. 'Here it is.' Having found what he'd been looking for, she slid that across the desk, too. 'They're pretty similar.'

'And her first presenting symptoms were fatigue on exercise at school?'

'She stopped being able to play hockey,' Annabel confirmed. 'Until she was about fifteen she was brilliant at sport. She represented her school and district at sprinting for several years and she was captain of the school's first hockey team. Until she had to give up all sport, the school had been confident she had the talent to go even as far as national-level hockey. She found herself losing stamina and growing gradually weaker. She had to withdraw from games and her aunt took her to her GP who noticed her heart was large. He did a few preliminary investigations, including an ECG, which was abnormal, then sent her immediately to us.'

'Aunt?'
Luke questioned.

'Daisy's parents died before she was five,' Annabel explained. 'We don't know for sure,' she added, in response to his sharply enquiring look, 'but we don't think so. Her father was killed in some sort of chemical explosion at work and her mother died six months later aged twenty-nine.

'Daisy says it was accidental but Caroline—that's Daisy's aunt and her mother's sister—has hinted there was an overdose involved. There's no known history of cardiac disease with either of them. Daisy was an only child. There's no other family on her father's side and I've screened her aunt and her four children and their children and found nothing.'

'I see things were fairly stable with Daisy for the first two and a half years.'

'She was able to finish college,' Annabel confirmed. 'She's always been bright so even when she needed time in hospital she didn't seem to have any trouble catching up. She went into heart failure for the first time soon after her eighteenth birthday, and that's when we referred her for transplant. We realised then that her disease was going to be rapidly progressive. She's been waiting two years now.

As you saw on Tuesday, we've lost the luxury of being able to wait much longer.'

'Who did this one?' Luke drew out Daisy's initial ECHO pictures. 'You?'

Annabel shook her head and checked the initials along the bottom of the scan. 'My predecessor,' she explained. She moved quickly out of the way as Luke swung out of his chair and came round to put up another X-ray. 'That scan was done before I came here as a registrar.'

Working together, they moved methodically though Daisy's history and serial tests from the time of that first scan to her latest presentation, taking the information from the notes where it was available with Luke questioning Annabel when he needed to.

At the end of that, after almost an hour and a half of thorough, detailed examination, looking at every small piece of information, every chart, X-ray, ECG and ECHO result, he took Daisy's ECG from that day, studied it, then sat back in his chair and regarded Annabel steadily.

Annabel tensed. 'I've missed something,' she said huskily, trying to read his expression. 'Haven't I?'

Instead of answering that, he merely said quietly, 'What made you choose cardiology in the end, Annie? When we were married you used to talk as if you were determined to go either into your father's general practice or give up medicine altogether.'

She blinked a little. 'Temporarily,' she agreed. 'But that was because I wanted to have children. Since I was thinking about giving up work for a few years I decided that finding a job afterwards would be easier with some training in general practice behind me, rather than just hospital medicine.

'But I was always more interested in hearts. I found your enthusiasm for the field and your teaching incredibly inspiring. Obviously, when the time came for me to make real decisions about my career I was single again and I didn't have to think about the best way to raise a family. I could do what I wanted and I did.'

'Have you given any thought to completing a doctorate?'

'A PhD?' She blinked at him. 'Oh, Luke,' she exclaimed mildly. 'Of course not. I'm quite content where I am, thank you very much. I don't harbour any secret ambition to conquer the scientific world. I'm not like you. I don't want great trails of letters after my name and I'm very happy being a little cog around this place.'

'But no regrets about your choice of career?'

'None.' Although if their lives had worked out the way she'd once hoped she'd have been very happy combining general practice and a family. 'Why?' She sat back in her chair and folded her arms nervously. 'Should I have regrets?'

'Not according to this.' He moved his hand to indicate the now disordered stacks of notes. 'Your management of Daisy has been nothing short of world class. You haven't missed anything, Annie. On the contrary, you've been extraordinarily diligent and thorough. I might have done one or two things differently.

'At Brigham I'd have been more interventionist at the time of first diagnosis,' he said, referring, she knew, to the hospital he'd worked at in Boston, 'because, for better or worse, that's the way we operated there. I'd certainly have wanted to include her in some of the trials we were running. Some of my drug choices might have been subtly different, but they're the only differences. In the long term I doubt they'd have changed anything. There's no magic bullet here.

'In my opinion, a transplant's been Daisy's only realistic chance for survival for three years now. How long she lives without one is out of our hands.'

Annabel sighed tiredly. She rested right back in her chair, her hands on each arm, and closed her eyes. 'That's what I thought,' she admitted sorrowfully. 'I don't know what to do. I'm relieved you don't think I've missed anything in the past but I still feel inadequate. We should be able to help, Luke.' She opened her eyes and looked directly at him, her frustration unconcealed. 'It's paralysing to realise there's nothing else we can do.'

'How much does she understand?'

'Daisy doesn't miss a thing, but her particular brand of cheery optimism is a precious trait, I think. I tend to let her guide our discussions and she only occasionally asks directly how much time I think she has. But she is aware that things are bad now. We talked seriously a couple of admissions ago when she was worried, and she knows her heart's deteriorated since then. She wrote her will two years ago and Caroline mentioned a few weeks ago that she'd told her she'd updated it.'

She looked down at her hands. 'Heavy stuff for a twenty-year-old,' she said sadly. 'When I was her age I was still a child.'

'I doubt it.' Luke sounded amused. 'I remember you being not so much older and you were light years away from childhood then.'

Annabel looked up swiftly. 'Did I embarrass you then, Luke?'

He tilted his head. 'What are you talking about?'

'Did I embarrass you with the way I used to chase you around the hospital?' she said roughly. 'I've often wondered what your colleagues must have thought about you being pursued so ardently all that year by a little medical student. In those early days all I knew was how desperately I wanted you to notice me. I was too naive to understand about subtlety and playing it cool. Did your friends find me funny? Did they tease you? I expect they were incredulous when you married me. Did you all secretly laugh about me?'

'Of course not.'

Annabel didn't believe him. 'It's really not necessary to protect me.' Fixing a brittle smile on her face, she retrieved her white coat from where she'd discarded it earlier across a spare chair. She stacked Daisy's files into order and collected as many of the current ones as she could in one armful. 'If you ever agree to acknowledge the truth about our relationship, trust me, I'll cope.'

He frowned at her. 'What are you talking about?'

'It doesn't matter.' She met his narrowed regard with deliberate neutrality. 'I must go. Hannah will be expecting to see me on the ward. Thank you...' she waved at the remaining notes on his desk '...for your help with Daisy. I'll fetch the rest from your secretary tomorrow.'

She pulled the office door shut behind her as she left, but he reached it just after her and called her name before she was even ten yards along the corridor. 'You're wrong about my friends laughing at you,' he said grimly. 'You were a very sexy girl, Annabel. Any one of them would have crawled over broken glass if he'd thought it'd mean getting you into bed.'

'What a pity you were never so eager,' she said wanly. She turned away. 'Goodnight, Luke.'

Luke
came to the house the next night. Annabel opened the door without surprise. The shape of him had been obvious through the glass and she'd been half expecting him anyway. 'Have you decided to come and stay?' she asked, looking behind him towards the street. 'Did you bring a suitcase?'

'I left messages with your secretary for you to call me this afternoon.' Ignoring her questions, he walked past her inside, his size immediately making the hallway feel small. 'What happened?'

'Do, please, come in,' she said ironically, sending his broad back a flat look. 'I was held up because my clinic ran over time and I couldn't imagine you needing to talk to me being about anything that couldn't wait until tomorrow.' She followed him into her sitting room. 'I was planning to call you in the morning after my round. I can offer you tea, coffee or juice, but I'm afraid the only alcohol I have is a bottle of chocolate liqueur which one of my patients gave me for Christmas.'

'I'm not thirsty.' He cast a rapid, disparaging look around the room and she saw his eyes focus on the shelf above the gas fire as he registered the absence of the photograph he'd studied on his last visit. 'Contaminated, was it, Annie? Straight into the bin the minute I left?'

'If you're referring to my graduation-day photograph, I posted it to my father,' she said huskily. She hadn't quite been able to bring herself to destroy it. 'He seems to enjoy surrounding himself with memorabilia.'

'A characteristic you clearly don't share,' Luke observed coolly.

'Perhaps my past isn't as pleasant to remember as his is.' She kept her head up and her eyes steadily meeting his. 'Is there a point to this, Luke, or are we having social calls now?'

Her pointed parroting of his comment the evening before seemed to amuse him. 'Quit stressing out,' he commanded softly. 'Perhaps I've come to inspect the accommodation.'

'I'll show you the room.' Now she'd had time for second thoughts, she regretted having made the offer to Luke, but after his help with Daisy she would have felt mean-spirited and churlish withdrawing it. Still, she was keeping her fingers crossed that he'd decide he preferred the comforts of his hotel after all.

Without waiting to see if he followed her, she returned to the door and walked up the stairs. 'I've kept my study and turned your old one into a spare bedroom. I think if you decide to stay you'll find it comfortable. Of course, there's only one bathroom but, as I mentioned, I'm expecting to be at St Peter's most of the weekend.'

He did follow her, and when she opened the bedroom door and stepped back he walked past her and inside. He looked around at the unremarkable decor and bedroom furnishings with a neutral expression. 'What happened to the desk?'

'Sold to a junk shop.' The antique bureau had been in superb condition and she knew he'd loved it, but at the time she'd wanted to get rid of it. There'd been no room in her life for sentimentality.

'Such an unemotional little creature you've turned yourself into,' he accused softly. 'What did you mean with that crack last night?'

'I was curious,' answered Annabel sharply. 'Oh, I'm sure your friends were suitably circumspect once you actually married me, but I've often imagined the way you all must have laughed about me being so mad for you in the beginning.'

'I told you last night, no one laughed.' He put his hands behind him and braced them on the doorhandle, the movement disturbingly highlighting the strong outline of his thighs beneath the trousers of his immaculate dark suit. 'I told you what they thought of you.'

'Broken glass,' she remembered. 'Yes.' But she didn't believe him.

'You think it was easy for me, keeping my hands off you back then?'

'You didn't seem to find it particularly difficult.'

'It was hell.'

'Liar.' She met his flat green gaze without flinching. 'I threw myself at you for almost a year before you deigned to even notice.'

'The way you used that soft little voice on me used to put my temperature up five degrees,' he said roughly. 'The way you used to comer me and press yourself against
me,
trying to kiss me, begging me to touch you, drove me practically out of my mind that year. I wanted you but I held off, Annie.' His eyes bored into hers. 'I kept you at a distance for
your
sake, not mine. I didn't want you distracted. I
wanted to see you through your exams
and qualified. If you think any of that was easy for me, you're nuts.'