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‘Don’t care.’ He bit into the sandwich. ‘Oh, yes. This is seriously good.’ He nodded towards the half-sandwich on his plate. ‘Sure you don’t want to share?’
Vicky adored bacon sandwiches. Had it been Seb or Charlie opposite her, she wouldn’t even have waited to be asked. But sharing a sandwich was intimate. She barely knew Jake—and it was going to stay that way. She couldn’t afford a relationship. Not when she was so close to getting a consultant’s post. If she let herself get distracted, her career would go straight down the plughole. She’d worked too hard, too long, to let that happen now. ‘Quite sure, thank you.’ She poured yoghurt over her fruit. ‘So what did you want to talk to me about besides Declan?’
‘I did the getting-to-know-you bit with the rest of the staff on team nights out.’
And because she’d been covering the ward, he hadn’t had the chance to have that kind of chat with her. She sighed. ‘I’m sure my personnel file will tell you all you need to know about me.’
‘That you’re a senior registrar, that your exam results were superb, that your appraisals have always been excellent, and you’re tipped for the next consultant’s post.’
If he’d already reviewed her files, what else did he want to know?
The question must have shown on her face, because he said softly, ‘I don’t know you. I’ve seen how you are with patients and staff, and I’m impressed.’
Please, don’t let him be trying to come on to her. She knew her willpower was strong, but she didn’t need the extra temptation. Jake Lewis, with his dark eyes and the floppy hair that made him look like a disreputable cherub, could be a temptation. Like rich, dark chocolate. Addictive. ‘You’ve reviewed my files and you’ve seen me work. That’s all you need to know,’ she said primly.
‘Wrong. If I’m to develop the staff on my team—so they’re happy in their jobs and work well for me—I need to know what they want out of their job. Where they want to be in five years’ time, and what they think they need to get there. Where they think they’re weak and need more experience or more training. Things that aren’t written in files.’
Was he serious?
She risked a glance. He looked serious enough.
Though he also looked good enough to eat, with his hair still slightly damp from the shower. She thought of rich, dark chocolate again and suppressed a groan. Jake Lewis was dangerous. Someone she needed to avoid.
‘So what do you want, Vicky?’ he asked. ‘To be head of department? Professor?’
‘Both.’
He nodded. ‘From what I’ve seen, you’ve got the skill and the dedication to make it.’
Was he trying to curry favour? No, he looked completely sincere. ‘Thank you.’
‘So your plan is?’
‘Consultant next year. Then a part-teaching, part-practising post—I want to do the academic side and work on some research, but I like working with patients too much to give it up. Plus, theory’s worth nothing if it’s unworkable in a real-life situation.’
‘And what experience do you think you need now?’
‘More surgery.’
‘Noted,’ Jake said. ‘When you’re in Theatre with me, I’ll try to give you the chance to lead as much as possible.’
‘Thank you.’
‘And let me have a list of the training courses you want to go on.’
‘There’s a small thing known as the departmental budget,’ Vicky said.
‘Which is why I’m not promising to send you on every course you want to go on. But when I know what everyone’s skills are, and where there are training needs, I might be able to arrange interdepartmental training. Shadowing, mentoring, that sort of thing.’
‘Provided our head of department agrees.’
‘He’ll agree,’ Jake said softly. ‘I can be very persuasive.’
Vicky looked at his mouth and thought, I just bet you can. Then she stifled the idea. She was not going to start thinking about Jake Lewis in that way.
‘And I find a cost-benefit analysis usually does the trick,’ he added.
He understood admin as well as medicine? Interesting. In Vicky’s experience, most doctors were either people-oriented or paper-oriented. They couldn’t do both. That made Jake a rarity.
‘Why did you become a doctor?’ he asked conversationally, as he added sugar to his coffee.
‘Because medicine was interesting.’ And because it was a challenge.
‘Anyone else in your family a doctor?’
Why did he want to know? It had no relevance to the way she did her job. ‘My brothers,’ she said shortly.
‘Which specialty?’
That definitely wasn’t relevant. And why did he want to know about her brothers? Charlie, with his rose-tinted glasses, would’ve said Jake was trying to be friendly. Seb—well, pre-fatherhood Seb—would’ve said Jake was a social climber, hoping that by making friends with her he’d get an introduction to the baron and invites to swish parties. Vicky was somewhere in the middle—and she wanted her brothers left out of this. ‘Not neurology.’
She’d been short with him—rude, even—but he didn’t have that you’ve-just-slapped-me-down look.
But before he could say anything else, her pager bleeped.
Perfect timing.
She glanced at the display. ‘Thanks for breakfast. I’m needed in ED.’
‘You’re not on duty yet.’ He frowned. ‘Do you always have your pager switched on?’
‘No.’ Not always. Just ninety-odd per cent of the time.
His dark eyes held a hint of amusement, almost as if he didn’t believe she’d been paged. As if he thought she’d called one of her friends from the changing room at the gym and asked them to bleep her in fifteen minutes’ time—to get her out of a potentially difficult situation.
She’d thought about it, admittedly, but she also knew it would have fuelled gossip: why did Vicky Radley want to wriggle out of having breakfast with Jake Lewis? People would speculate. Rumours would start running round the hospital. So having breakfast with him had been the lesser of two evils. And it had been work-related, anyways. ‘See you on the ward,’ she said, and headed for the emergency department.
‘Hello again,’ Hugh Francis said with a smile when she reached ED. ‘I was hoping it’d be you.’
‘What’s the problem?’
‘Mrs Carter, seventy years old, suspected TIA—but I’m not sure if it’s a very early stroke.’
‘OK. I’ll have a look. If I’m worried, I’ll admit her to our ward.’
‘Thanks.’ Hugh took Vicky through to the cubicle where Violet Carter was sitting on the bed, and introduced her.
‘I’m perfectly all right, you know. You don’t need to fuss over me—you go and see someone who’s really ill,’ Mrs Carter said.
Vicky smiled at her. ‘That’s very public-spirited of you, but I’d like to check you over.’
‘It was just a funny turn.’
‘Tell me about it,’ Vicky invited.
‘It was like a curtain coming down over one eye. But it’s gone now.’
Mrs Carter was describing a textbook case of amaurosis fugax, a typical symptom of a TIA or transient ischaemic attack, Vicky thought. ‘Anything else?’
‘I banged my knee when I answered the door, but that’s just clumsiness. Old age.’
Or another symptom of a TIA. ‘How about talking?’
‘Perfectly normal. I think our postman’s deaf, you know—he kept asking me to repeat things.’ Mrs Carter sighed. ‘I don’t know why he insisted on bringing me here.’
Vicky glanced down at the notes. ‘He was just worried about you. I think you might have had something called a transient ischaemic attack—called a TIA for short. It’s where the supply of oxygen is cut off to part of your brain, usually by a blood clot. Your body can restore blood flow and break down any little clots, so that’s why you feel perfectly all right now.’
‘So I can go home?’
‘Soon,’ Vicky said. ‘The thing is, if you’ve had a TIA it means you’re likely to be at risk of having a stroke in the future, so I want to check you over thoroughly before I let you escape. May I ask you a few questions?’
Mrs Carter nodded.
‘Have you had a stroke before, or any recent surgery?’
‘No.’
‘Has anyone in your family ever had a seizure or a fit?’
‘Not that I know of.’
‘Have you had a virus or infection lately?’
‘No.’
‘Are you taking any medication?’
‘I take water pills—the doctor says my blood pressure’s too high—but I never forget to take them, because I’ve got one of those little boxes you put your week’s supply in. My daughter got it for me.’
‘And she lives near?’
Mrs Carter sighed. ‘Yes. And she’s a worrier, so don’t you go telling her about this. I just stood up a bit too quickly when the postman rang, that was all.’
‘Did you have any pain?’
‘Not really.’
‘Where was it?’ Vicky asked.
‘You’re as bad as my daughter. She never gives up either,’ Mrs Carter grumbled. ‘Just a little bit in my chest. It’s gone now. And, before you ask, I gave up smoking years ago and I eat proper meals. None of that microwave ready-meal junk.’
Vicky grinned. She could see herself being like Violet Carter in forty years’ time. Dressed in purple and outrageously independent. ‘Mrs Carter, I respect the fact you can look after yourself perfectly well. But I need to be sure you’re not just being brave. If you do have any problems, I can give you medication for it and you’ll be fine—but if you’re not telling me something, you could end up being very ill.’ When the old lady looked recalcitrant, she added her trump card. ‘Which means I’d have to talk to your daughter, and she’d probably want you to live with her so she can keep an eye on you.’
‘God forbid!’ Mrs Carter exclaimed. ‘I’d be up in front of the bench within a week.’
‘The bench?’
‘On a murder charge. I can’t bear all that fussing. Not to mention putting up with teenagers slamming doors and listening to that rubbish they call music nowadays.’
‘Me neither,’ Vicky said feelingly. ‘So is there anything you’re not telling me?’
‘I was a bit breathless. But I told you, I just stood up too quickly.’
‘Would you let me examine you and run some tests, then?’
Violet rolled her eyes. ‘If it means you won’t tell my daughter, yes.’
Vicky smiled. From their discussion, she’d already been able to assess Violet Carter’s attentiveness, ability to interact, language and memory skills—and they were all fine. But she checked the blood pressure in each of Violet’s arms, then her respiratory rate and her temperature.
‘I’m going to look into your eyes, if you don’t mind.’ She checked for retinal plaques and the pupils’ reaction to light. Everything was fine.
Nerve testing was equally inconclusive. She started with the cranial nerves: there were no problems with Mrs Carter’s eye movements and her eyelids closed normally; there were no problems with swallowing or the movement of her tongue; and the wrinkles on her forehead were symmetrical—no sign of drooping. Somatic motor testing told her a little more—there was no sign of tremor or any problems with the major joints or shoulder girdle, though there was a slight weakness on the left-hand side. When Vicky asked Mrs Carter to walk a few steps, her movements looked fine. She was able to put her finger on her nose and her heel to her knee.
‘So are you satisfied I’m all right now?’ Mrs Carter asked.
‘Nearly. I’m going to send you for a CT scan—that’s just so I can get a better look at what’s happening inside your head.’
Mrs Carter snorted. ‘If you could read my mind right now, young lady, I think you’d be shocked.’
Vicky laughed. ‘No. I wish more people were as independent and determined as you are.’ Mara certainly wasn’t. Never had been, never would be, and Vicky was guiltily aware that too often she left Charlie to deal with their mother. Though so did Seb.
‘As well as the CT scan, I’m sending you for an ECG—that’s to check how your heart’s working.’
‘There’s nothing wrong with my heart.’
‘Good. But I’m still sending you for the tests. I want to know what caused you to have your “funny turn” —and I don’t think it was anything to do with standing up too quickly. I’d like to make sure there isn’t a clot hanging around that might give you a full-blown stroke or a heart attack.’ At Mrs Carter’s mutinous look, she added, ‘Or I could just phone your daughter.’
Mrs Carter grimaced. ‘You win. And I’d never play poker against you.’
‘Chess is my game.’
‘Never played it.’
‘If your tests make me keep you in for observations, I’ll teach you,’ Vicky promised. ‘And then you can extort promises from your grandchildren. If you beat them at chess, they have to turn the volume down and not slam doors.’
Mrs Carter gave her a narrow look, then grinned. ‘You’re on.’
‘OK, Mrs Carter. I’ll come and see you when your test results are in.’
