identify the problem.
He was a brilliant doctor.
Had he dismissed Carol? No. He’d taken her concerns really seriously.
‘Temperature?’
‘His temperature is normal.’ Ella wondered if he was finding it as hard to concentrate as she was. ‘Do you think it’s a virus?’
He didn’t answer for a moment, his expression thoughtful as he felt the toddler’s abdomen with gentle fingers. ‘No,’ he said finally. ‘I don’t. The signs aren’t classic, but…’ his eyes narrowed thoughtfully as he studied the pale, listless child. ‘I wonder…? Ella, ring Ed Green for me. Ask him to come down.’
Ed Green was the paediatric surgeon and Ella hurriedto the phone and made the call, wondering what was going through Nikos’s mind.
Nikos was talking to Carol. ‘You were right to bring him,’ he said quietly, ‘and to trust your instincts.’
Carol looked at him anxiously. ‘It isn’t a tummy bug?’
‘No. Harry has something called intussusception.’ He reached for a pen and a piece of paper and quickly drew a diagram. ‘This is the bowel, yes? Sometimes one segment of the bowel can telescope into the next part—this is what we call intussusception.’
‘And Harry is showing signs of that?’
‘Actually no,’ Nikos conceded, returning the pen to his pocket. ‘He isn’t showing any of the classic signs.’
‘Then how do you know what it is?’
‘I just know.’ Nikos gave a ghost of a smile. ‘You have maternal instincts that told you something was wrong, and I have instincts also. Doctor instincts. A gut feeling, I think you call it.’
‘Is it something serious?’
‘It can be,’ Nikos said carefully, ‘but in this case I think we have caught it early, thanks to those instincts of yours. My colleague is on his way now, and—’
‘Nikos?’ Ed, the paediatric surgeon, strode through the door, a slight man with glasses and sandy-coloured hair. ‘What can I do for you?’
Nikos briefly outlined the history and Ed walked to the side of the trolley.
‘Intussusception?’ He checked the observation chart that Ella had completed.
‘Harry is displaying none of the classic signs,’ Nikos said in a cool tone. ‘No temperature, a small amount ofdiarrhoea yesterday, but nothing since, one episode of vomiting and no abdominal mass.’
‘So you’re making an educated guess.’ Ed examined the child’s abdomen himself. ‘Could be appendicitis.’
Nikos shook his head, confident and sure of himself. ‘It’s intussusception. And it’s not a guess.’
Ed lifted an eyebrow, his gaze challenging. ‘You can’t be sure, Mariakos.’
Nikos met his gaze full on. ‘I’m sure. As he’s showing no signs of perforation, a barium enema is probably the most appropriate choice.’ He walked away from the trolley and took Carol to one side. ‘Mr Green is going to sort out the problem. And I will phone your GP.’
‘Thank you so much.’ She was tearfully grateful, visibly worried about Harry, and Nikos closed a strong brown hand over her shoulder in a gesture of support.
‘It took great courage for you to come here, having already been told that he was fine,’ he said softly. ‘You were very brave and you have done Harry a great service because if the condition had been left too much longer, the outcome might not have been so good. You are an excellent mother and Harry is a lucky boy.’
Carol’s cheeks grew pink but his words seemed to give her an extra boost of strength and she was calm as Harry was transferred into the care of the surgeons.
A few hours later Ella caught up with Nikos as he worked his way through the long queue of children waiting to be seen. Two more doctors had come over from the main emergency department to help, but it was Nikos who saw the difficult cases.
‘Ed Green just called.’
Nikos looked up from the set of notes he was writing. ‘How is Harry? Did Ed leave a message?’
‘Yes.’ Ella hesitated. ‘He said to tell you that you’re an arrogant
He was a brilliant doctor.
Had he dismissed Carol? No. He’d taken her concerns really seriously.
‘Temperature?’
‘His temperature is normal.’ Ella wondered if he was finding it as hard to concentrate as she was. ‘Do you think it’s a virus?’
He didn’t answer for a moment, his expression thoughtful as he felt the toddler’s abdomen with gentle fingers. ‘No,’ he said finally. ‘I don’t. The signs aren’t classic, but…’ his eyes narrowed thoughtfully as he studied the pale, listless child. ‘I wonder…? Ella, ring Ed Green for me. Ask him to come down.’
Ed Green was the paediatric surgeon and Ella hurriedto the phone and made the call, wondering what was going through Nikos’s mind.
Nikos was talking to Carol. ‘You were right to bring him,’ he said quietly, ‘and to trust your instincts.’
Carol looked at him anxiously. ‘It isn’t a tummy bug?’
‘No. Harry has something called intussusception.’ He reached for a pen and a piece of paper and quickly drew a diagram. ‘This is the bowel, yes? Sometimes one segment of the bowel can telescope into the next part—this is what we call intussusception.’
‘And Harry is showing signs of that?’
‘Actually no,’ Nikos conceded, returning the pen to his pocket. ‘He isn’t showing any of the classic signs.’
‘Then how do you know what it is?’
‘I just know.’ Nikos gave a ghost of a smile. ‘You have maternal instincts that told you something was wrong, and I have instincts also. Doctor instincts. A gut feeling, I think you call it.’
‘Is it something serious?’
‘It can be,’ Nikos said carefully, ‘but in this case I think we have caught it early, thanks to those instincts of yours. My colleague is on his way now, and—’
‘Nikos?’ Ed, the paediatric surgeon, strode through the door, a slight man with glasses and sandy-coloured hair. ‘What can I do for you?’
Nikos briefly outlined the history and Ed walked to the side of the trolley.
‘Intussusception?’ He checked the observation chart that Ella had completed.
‘Harry is displaying none of the classic signs,’ Nikos said in a cool tone. ‘No temperature, a small amount ofdiarrhoea yesterday, but nothing since, one episode of vomiting and no abdominal mass.’
‘So you’re making an educated guess.’ Ed examined the child’s abdomen himself. ‘Could be appendicitis.’
Nikos shook his head, confident and sure of himself. ‘It’s intussusception. And it’s not a guess.’
Ed lifted an eyebrow, his gaze challenging. ‘You can’t be sure, Mariakos.’
Nikos met his gaze full on. ‘I’m sure. As he’s showing no signs of perforation, a barium enema is probably the most appropriate choice.’ He walked away from the trolley and took Carol to one side. ‘Mr Green is going to sort out the problem. And I will phone your GP.’
‘Thank you so much.’ She was tearfully grateful, visibly worried about Harry, and Nikos closed a strong brown hand over her shoulder in a gesture of support.
‘It took great courage for you to come here, having already been told that he was fine,’ he said softly. ‘You were very brave and you have done Harry a great service because if the condition had been left too much longer, the outcome might not have been so good. You are an excellent mother and Harry is a lucky boy.’
Carol’s cheeks grew pink but his words seemed to give her an extra boost of strength and she was calm as Harry was transferred into the care of the surgeons.
A few hours later Ella caught up with Nikos as he worked his way through the long queue of children waiting to be seen. Two more doctors had come over from the main emergency department to help, but it was Nikos who saw the difficult cases.
‘Ed Green just called.’
Nikos looked up from the set of notes he was writing. ‘How is Harry? Did Ed leave a message?’
‘Yes.’ Ella hesitated. ‘He said to tell you that you’re an arrogant
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