‘That’s really necessary?’
‘I think so, and I’d like to keep her in a little longer, just in case she’s sick again.’
She hasn’t anticipated any of this. She glances at her baby, then ducks her head and starts fiddling with her rings. Is she embarrassed? Perhaps if I tread carefully she’ll tell me what’s wrong.
‘I know you, Jess. You’re protective. Perhaps even a little overprotective – is that fair?’
She nods.
‘But you left it a while before bringing her in, which seems uncharacteristic . . . I suppose I’m wondering why you didn’t think to bring her in before?’
Fiddle, fiddle with her rings.
‘I suppose I didn’t think it was that serious,’ she says at last. ‘You know what toddlers are like. Kit and Frankie have had worse bangs – so have Sam and Rosa, haven’t they? They fall over all the time when they’re that age. It didn’t seem that bad compared to knocks the boys had when they were starting to crawl. There wasn’t a bump. I didn’t think there was a problem. It was only when she started to be sick that we thought we should bring her in.’
‘That makes sense,’ I say, and of course it does, but I remain uneasy as Ronan begins to take Betsey’s blood and I arrange for her to be admitted to the ward.
Because when any parent presents with a child with an injury, I’m trained to be alert to the possibility that it may not be accidental. That the parent may have harmed their child. Of course I don’t want to think this of my friend. I’ve trusted her with my own children, and I know how she parents; but still, I’m conditioned to ask that question, and it nudges at me, at the back of my mind.
And so I find myself running through my checklist: am I happy with the interaction between parent and child; was there a delay in presentation; is the parent overly defensive or strangely unconcerned? Do I suspect them of lying? Most importantly: does the mechanism – the way in which the accident is said to have happened – match the injury? Does the story fit?
I stand by the desk, waiting for the paeds team to pick up the phone and I feel troubled. Why was Jess so shifty when I pointed out the trauma to the back of the head? Why did she hesitate when I asked if Betsey had only thrown up the once? And why – given how conscientious she is about all aspects of parenting – did she wait six hours to bring in her baby, and only then when Ed suggested it?
I twist the lead of the phone around my fingers, creating welts. With any other parent these would be clear red flags signalling that we should be concerned, but this is someone I know well. A long-term friend. The woman who looked after Rosa when she and Kit had chickenpox and the hospital nursery still deemed her infectious; the friend who searched for obsolete Lego for Sam’s birthday then insisted I give it to him; the mother who loves her children beyond all else; who’s ferocious in her defence of Frankie, once accusing Mel of demonising him when she suggested he’d been too rough with her son Connor, turning on her with a flash of surprising anger; the mother who is so proud of sporty, good-natured Kit.
I know all this as deeply, as instinctively as I know that Nick won’t be unfaithful. I’m almost completely sure of it, that is to say.
And yet here I am, admitting her daughter for a suspected skull fracture and perturbed by her behaviour.
Am I seriously thinking the very worst of Jess?
LIZ
Saturday 20 January, 12.15 a.m.
Four
Betsey has been admitted and is now lying in a bed by the window, the sides up to prevent her falling. An infant in a protective cage.
Jess has left the ward to ring Ed. Her daughter’s been crying for her, though: ‘Mum-mum’ the only words she’s uttered. Kath, the nurse in charge of this bay, administers some liquid ibuprofen, the drug and perhaps her gentle reassurance easing her pain.
I need to ring my boss. A head injury in an infant is something my consultant will want to know about, even though he’ll hate me for waking him to discuss it. At sixty-two, Neil Cockerill’s had enough of the NHS; has no desire to have to come into hospital in the early hours of the morning, or to have his sleep broken by a registrar who should be able to stand on her own two feet. You could argue that’s fair enough: he’s dedicated forty years of his life to this job; has had his fill of departmental politics, not to mention the bureaucratic demands of a government hellbent on raising expectations beyond what their money can buy. He’s tired, too, of the relentless grind that comes with looking after sick, sometimes dying children. I understand, and I could accept his hands-off attitude if I rated him as a colleague. But I don’t – and the feeling is mutual: unfortunately, he doesn’t rate me.
I first came across Neil when I was twenty-five and a very junior doctor, just a year into the job, and doing my obligatory six months in this hospital’s A&E. I heard him before I was introduced: a tall, patrician man with thick, sweptback hair (he was in his late forties by then and this was his vanity) bellowing across the department at his reg.
‘In my day, registrars ran the show – they didn’t scamper to their consultants at every opportunity!’ he blazed as he stormed out of paediatric A&E and all the parents in the waiting room craned their necks to see who was so furious. ‘JFDI!’ he’d added. Justin, the registrar who’d been mauled, was puce with embarrassment.
JFDI? Just fucking do it.
My perception didn’t improve when I came back to the hospital and worked for Neil, three years later. I’d had the temerity to get pregnant and two months of my maternity leave coincided with the end of my attachment with him. The trust didn’t replace me, which doubled his workload in clinics and on the wards, and even when I returned to work, he thought me unreliable and not a team player. It didn’t help that Rosa had glue ear when she was tiny and so I was forever being called to the hospital nursery, where she spent each day from 8 a.m. to 6 p.m.
Perhaps if Neil had liked me he’d have been more tolerant but he didn’t understand me. I wasn’t like the nurses who flirted with him or indulged him; and I wasn’t like him: a self-confident man from a dynasty of doctors, with a broad cultural hinterland and the ability to converse about cricket and fine wine. I was a nervous young woman from a working-class background who had made his life more complicated and his workload more onerous by becoming a mother.
And he resented this. There was no reason for him to empathise with me because he had never experienced the tug between work and parenthood. His wife stopped nursing when she had their first son and so never had to walk that tightrope nor ask him to make compromises in his career. I want a wife, I think, when I note his crisply ironed shirt; when he mentions a holiday – something Rosie’s organised in Italy, he’s not quite sure where, that’s her domain, he just pays for it (this said with the self-indulgent chuckle of a man who bought his west London home thirty years ago and has paid off the mortgage). I want a wife, I think, when, at the end of a long shift, I know he’s returning to a freshly cooked meal. I want a wife, whenever the fact that I am a mother, and the subsequent occasional rota swap to accommodate a parents’ evening, prompts him to wrinkle his nose as though he smells something noxious. This is real life with all its messy demands, I want to tell him. But of course I don’t because I don’t want to rock the boat; I need a good reference; and I need a consultant’s post, preferably his when he reaches retirement in a couple of years.