And, then I would reassure her; would say: Don’t worry. You know you shouldn’t leave her even for a moment at this age, but we all know that accidents happen. We know it’s just an accident. But, perhaps this is a wake-up call, a reminder that it can happen, even to a mother who’s already had three kids.
But she doesn’t say any of this. She just looks at me, her wide, sensual mouth in a straight line, her defensiveness swapped for a weird blankness as if her usual emotions have shut down.
She plays with her rings, twisting them round and round the third finger of her right hand, and I realise that her look of blankness is really an expression of denial, motivated by fear. It’s the same look she had when I tried to raise the issue of Frankie’s hyperactivity and whether he should be assessed for a possible diagnosis of ADHD. A look that says she has absolutely no intention of taking on board what I’m saying.
Her mouth twitches.
‘No, there’s not,’ she says.
LIZ
Saturday 20 January, 8.30 a.m.
Five
Neil is spoiling for a fight.
I can tell from the way in which he comes into the room where we hold the handover meeting: all bristling energy and brisk movements
‘So – Betsey Curtis,’ he says, flinging himself into his chair.
Fousia, the registrar who’s taking over my on-call, and Rupert, the most junior member of the team, look at me enquiringly and I fill them in on Betsey’s history, detailing the results of the scan, my discussion with the radiologist, and my conversations with Jess.
‘And you’ve put in that call to social services?’ Neil says, his tone light as if he’s mentioning this in passing because of course I’ll have done so.
‘Um, no. I haven’t.’
‘You haven’t?’ He raises an eyebrow. He has particularly bushy eyebrows, like a horned owl’s, and while this might sound grandfatherly, they just make him seem more formidable than ever.
‘I wanted to discuss it further. I’m still not convinced there’s a safeguarding issue here.’
He leans back in his chair and rolls his Cross pen in and over his fingers. Most of us use biros: Neil has this glossy black fountain pen which he fiddles with whenever he’s thinking or irritated, his two regular states of mind. Over and over it goes now. It’s both annoying and strangely mesmerising.
‘So let’s get this straight . . .’ His voice drips sarcasm. ‘Mum delays bringing baby in; she claims not to have seen the trauma to the back of the head; her explanation for how it happened doesn’t necessarily fit – and yet you don’t think it’s a safeguarding issue?’
Put like this, my judgement sounds skewed. But Neil’s determination to think the worst of Jess makes me want to defend her. If medicine’s a science, it’s also an art: one in which personal judgement and intuition play a part in determining how you act. And I’ve known Jess for a decade. Surely I would have an inkling if I thought she might harm her own child?
‘I hope you’re not letting your personal feelings for your friend get in the way of your professional responsibilities?’
‘No, of course not.’
And yet that’s precisely what I am doing.
‘I have to say I’m concerned about your judgement here,’ my consultant says. A pause. ‘It’s not the first time, is it?’
At that moment I think I might actually hate him. That he would do this to me in front of my colleagues is mortifying. Rupert is sniggering – the nervous laugh of a new boy trying to ingratiate himself with the boss – and even Fousia looks embarrassed. She shoots me a look of sympathy that I fail to acknowledge, wary of appearing weak in front of Neil.
‘I have never made an error of judgement over safeguarding,’ I manage to say.
‘Not over safeguarding,’ he concedes. ‘But none of us are infallible. We all make mistakes and your judgement’s been off before.’
And here it is. That mistake I made when I was a very junior doctor in that first A&E job, just twelve months after finishing medical school. A potentially fatal error that he can use as collateral and that even now is proving hard to shake off.
The meningitis rash is harder to detect on darker skin and I didn’t spot it on eighteen-month-old Kyle Jenkins, misdiagnosing the markings on the soles of his feet and his hands as a common virus: hand, foot and mouth disease. With the memory of Neil’s JFDI still fresh in my mind, I didn’t want to bother him and was about to discharge Kyle when Kate, one of the senior paediatric nurses, recognised the rash for what it was and called Neil herself. Being saved by a nurse is something that’s always remembered. An indelible black mark. But I was just relieved Kate spotted my mistake in time. And I learned never to put my fear of being humiliated before my concerns about a patient again.
‘I acknowledge I made a terrible mistake then but I think my judgement has been sound ever since.’
He raises one of those intimidating eyebrows and glances at the others as if to shore up his argument. Rupert simpers; Fousia looks steadfastly down at her lap.
‘If you’re not being swayed by personal loyalty, I can’t for the life of me see why you don’t believe this merits investigation. I’d argue it’s negligent not to do so. Let’s not forget to whom we owe a duty of care. Referring this on doesn’t mean we think someone fractured this baby’s skull. All we’re saying is that we think there’s something that needs investigating.’
And he’s right; much as I hate to admit it, of course he’s right. Putting in that call doesn’t mean we’re blaming Jess – just that red flags are fluttering fiercely. And, deep down, I can’t be one hundred per cent certain that no one hurt this child. I can’t imagine it was Jess or Ed – but parents can do terrible things in a moment of frustration, as I know from my own mother. Is it completely inconceivable that something like that happened here?
I rub my eyes. My mind tilts with tiredness, those four consecutive night shifts weighing down on me so that my brain feels smudged.
‘All right,’ I say, swallowing down a lump that feels like a physical manifestation of my betrayal. I know that if I don’t Neil will put in that call to social services anyway. But, in his not-so-subtle power play, he wants consensus. This is a decision that will impact dramatically on this family. If we all shoulder the responsibility, it will feel a little easier.
‘All right,’ I repeat, looking at Neil, and hating myself for doing this. ‘I’ll make the call.’
JESS
Saturday 20 January, 9 a.m.
Six
‘Would you like some tea, love?’
A healthcare assistant pushing a trolley with a vast metal pot hovers near Jess.
‘Toast?’ She gestures to pieces of dried white cardboard-like bread and sachets of margarine and Marmite.
‘Tea, thank you.’ Jess takes a cup, teak in colour, and puts it by the side of Betsey’s bed.
The tea and toast are reassuringly ordinary in this world where nothing feels normal. Not the wires and buttons, or the rest of the hospital paraphernalia: the oxygen canisters and drips. Not the children, either. Very old people should be in hospital, or pregnant women – or, occasionally, as she knows herself, postnatal mothers. Not children. That subverts the natural order of things.