I shrug off the hint of reproach – I don’t know this baby like I know her other children; work this year’s been particularly busy – and slip a thermometer under Betsey’s armpit.
‘I’m just going to have a look at her while we carry on talking,’ I explain. ‘Can you put your arm up for me, Betsey?’ She bleats, her bottom lip quivering as she looks to Jess for reassurance.
‘It’s all right, darling. It’s Mummy’s friend, Liz.’ Jess removes her hand from Betsey’s to make it easier for me, but I sense her reluctance. She’s never liked anyone else handling her children, not even when Kit and Rosa were learning to walk and I’d automatically pick up her boy if he fell nearest to me.
I remove the thermometer.
‘Her temperature’s normal. Has she had any pain relief ?’ ‘Ed gave her some Calpol after she threw up.’
‘When was that?’
‘Just after ten. Before we came in.’
‘And you hadn’t given her any before then?’
‘No . . . Perhaps I should have but, well, you know how I feel about giving them drugs . . .’
Jess is suspicious of any medicine. It’s one of the things we’ve clashed about. Betsey hasn’t had her MMR, Jess erroneously believing that the vaccine is linked to autism, and I was both incredulous and angry when she told me about this. It partly accounts for our recent distance: I can’t bear the fact she’s relying on the ‘herd’ effect: other people’s children being vaccinated to protect her own. But I can’t be irritated now. I’ve more immediate concerns.
‘Because I know you and Betsey I’m going to call my colleague, Ronan, in while I examine her properly, OK? There’s nothing to worry about. It’s hospital protocol. Then I’m going to look at your tummy, Betsey.’ I speak in my soft, no-nonsense voice to the baby, who is whimpering raggedly, a bead of spittle on her lips.
‘Ronan?’ I pull back the curtain and half-duck out. The junior doctor looks terrified, either of making a mistake or of me. ‘Could you join us?’ He slides into the cubicle beside me, his long, gangling limbs folding into the space.
‘I’m just examining Betsey’s chest,’ I explain to both of them, as I unbutton her Babygro. There’s no rash on her torso. No indication of meningitis. But my immediate relief is temporary. Betsey is grizzling properly, now, and her cry intensifies as my fingers caress the crown of her head. She flinches. A head injury? It’s something I’m automatically concerned about. I stop and part her mass of dark hair.
‘Did you know there’s a slight swelling at the back of her head?’
It’s not an obvious bump but I can feel a slight bogginess obscured by Betsey’s damp, dark curls. I watch Jess closely.
‘Umm, no I didn’t.’
I’m surprised. It feels like rolling your fingers over a waterbed. Was she really so distracted she didn’t notice when she’d placed Betsey in her car seat, or transferred her to her buggy? Surely she would have felt it, or Betsey would have cried out, just as she did when I tried to examine her now?
But Jess looks at me blankly. Her face is closed as if she’s blocked off her emotions. A chill of unease creeps up my spine.
‘Is she crawling?’ I ask.
‘She’s just started – and pulling herself up.’
‘It looks as if she’s knocked it . . .’
My friend looks – there’s no other word for it – shifty.
‘Oh,’ she says, her tone bright and high.
And then she clears her throat as if she’s suddenly thought of something she should have mentioned at the start. ‘Look. She did bash it earlier.’
‘She bashed it earlier? Oh, Jess, why didn’t you mention it? This could explain the sickness. When did this happen?’ Relief flows through me, in a sudden flood. Jess – always so perfectionist when it comes to parenting – will have feared being judged. But there’s no need for that because it sounds as if there’s a perfectly innocent explanation, after all.
‘It was around four o’clock,’ she begins. ‘Just after we’d got back from picking up Frankie. She was crawling in the kitchen and she slipped and hit her head.’
‘So how did she fall, exactly?’ I perch on the side of the bed, the paper towel puckering under my bottom. I’m listening and I’ve all the time in the world, my posture says. I haven’t, of course – I’m concerned that we might need to scan Betsey, but I need to take a comprehensive history first.
‘I was getting Frankie a snack,’ Jess says. Her voice is constricted, as if she’s about to cry. ‘Betsey was crawling around. The floor was clean but slippery for some reason. I wasn’t really concentrating; I was getting things ready for the kids’ tea. And then I heard a sort of gentle thud, and Betsey was lying on the floor, pulling the kind of face she does when she’s wondering whether or not to cry.’
She pauses. It’s a perfectly adequate explanation and yet she watches me as if to check she’s given the right answer.
‘I just turned my back for a moment. I can’t be watching her every second!’ She is suddenly strident in her self-defence.
‘It’s all right. I know what a good mum you are. It’s just – it’s quite a bang: not something that would happen from crawling and falling. I’m wondering whether she hit anything when she fell? If she could have struck anything?’
‘I don’t know. I assumed she just hit her head on the floor but she was right by the fridge . . . I suppose she could have pulled herself up on the edge of it and hit her head on that as she fell . . .’
‘Yes, that’s possible.’
I look at the back of her head again. I don’t like this. I don’t like it all. It’s Jess’s evasiveness and defensiveness that bothers me. Why is she behaving like this? As if this accident is an afterthought? As if there’s something that she needs to hide?
‘I’m just going to check the rest of her, but there’s absolutely nothing to worry about: it’s standard practice,’ I say, and I peel away the arms and legs of Betsey’s Babygro, scrutinising her body thoroughly. There’s no sign of bruising: no bluish hues; no greens or yellows; no redness either. Not a single indication that she has been harmed. Slowly, methodically, I ease off her heavy nappy and lift up her legs. Her bottom has an angry pimpling of nappy rash, a smear of Sudocrem, but – thank God – there’s nothing sinister around her vagina or anus.
‘What are you doing? Betsey hasn’t been interfered with!’
‘We just check babies all over. It’s completely routine,’ I try to reassure her.
‘My God! You think she’s been molested!’
‘No. No, I don’t at all. There’s a little nappy rash but there’s nothing to worry about. She’s absolutely fine.’
She is momentarily relieved.
‘And she will be OK, won’t she?’
I pause.
‘With any head injury we have to be careful and so I’d like to run a couple of tests.’
‘What tests?’
‘Blood tests, and probably a scan to check if her skull’s been damaged.’