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‘Any experience of doing a pleural effusion in a five-year-old?’
He nodded. ‘I specialised in paediatrics before training as a GP.’ He gave her a steady look. ‘I’ve got this. But I’m happy for you to stay if you’d like.’
He didn’t seem defensive or annoyed, but it felt like a bit of a line in the sand. He already knew she’d questioned his diagnosis. Now she’d asked about his experience. Lots of other clinicians that she knew might have been annoyed by this, but Joe just seemed to have accepted her actions without any discomfort. Still, the tone in his voice had changed a little, as if he was getting a bit tired of her.
She pressed her lips together. If he’d expressed any anxiety about the situation she would have been happy to take over. But he hadn’t, and she knew it was time to step back. She had enough patients of her own to see still in the waiting room.
She glanced at the nurse and interpreter. She had confidence in both of them. Either of them would come and find her if they were worried. She tried her best to look casual. ‘I’ll leave it with you. Shout if you need anything.’
Joe watched her retreat, knowing exactly how hard it was for her. Was his counterpart a bit of a control freak? Or maybe she just second-guessed everyone she worked with?
He tried to understand, even though he couldn’t help but feel a little insulted by her lack of faith in him. It’s not like he hadn’t experienced this himself. He’d worked with plenty of other doctors, in a variety of settings over the years, and it always took a bit of time to reassure himself about a colleague’s skills and competencies.
It was clear she loved this place. She’d more or less told him that already. There was also the added responsibility of her employers not being here right now, so the well-being of May Mắn hospital was really in her hands.
He gave some instructions to the nurse, who seemed to understand his English, then knelt down beside the little girl and her mother with Mai Ahn, the interpreter, to explain what would happen next.
Thirty minutes later the procedure was complete, with some hazy yellow fluid in a specimen bottle for the lab. The little girl’s cheeks and lips had lost their duskiness, the oxygen saturation monitor showed improvement, and when he listened to her chest he could hear the improved inflation of her lung. He gave instructions to the nurse for another X-ray, and to further monitor for the next few hours.
‘I’ll come back and have a follow-up chat about the medicines,’ he said. Something came into his head. ‘Do doctors make home visits here?’
The nurse frowned for a second as if she didn’t quite understand what he’d said, then shook her head. ‘No. Never.’
Joe sat back in his chair for a moment. He didn’t want to send this child home with just a prescription in her hand. The rest of the family were important too. The mother had already told him that both her husband and father-in-law kept forgetting to take their tuberculosis meds. Only her own mother remembered. If he could just see them, and persuade them how important it was, it might stop other family members being infected. He glanced out to the waiting room. He still had a whole host of patients to see, some of whom would need vaccinations, and some might need tuberculosis testing. He went to the waiting room with Mai Ahn to call the next patient, while his idea continued to grow in his head.
‘He went where?’
Ping, one of the nurses, shrugged. ‘He talked kind of strange. Something about a home visit. Apparently they do them in Scotland a lot. He persuaded Mai Ahn to go with him.’
Lien walked over and looked at the notes, checking the address on the file, then grabbed her jacket. She’d nearly made it to the front door, when her brain started to become a bit more logical. All she was feeling right now was rage. She went back and scanned the rest of the notes, checking to see what other family members were affected. ‘Did he take prescriptions, or did he take the actual medicines?’ she asked Ping.
Ping gave her a smile as she carried on with her work and brought a single finger to her lips. ‘I couldn’t possibly say.’
Lien nearly exploded. It was obvious that the Scottish charm was already working on her staff. What on earth was he thinking? They had to account for every dose they used. They weren’t a dispensary. On a few occasions they gave out enough medicines to see a patient through the night, but they didn’t give out medicines on a regular basis.
She snatched up her bag and made her way out into the streets. It was around six now, and the pavements were filled with people making their way home from work, the streets filled with traffic. She did her best to dodge her way through the crowds and cross the few streets. The home address wasn’t too far away, but the walk did nothing to quell her temper.
By the time she’d reached the address her heart was thudding in her chest. This wasn’t exactly the best part of town. She had no idea how he’d managed to persuade Mai Ahn to bring him here, but she would make sure it wouldn’t happen again.
The house was on the second floor of an older block of flats, where each storey looked as if it squished the flats beneath it even more. She climbed the small stairwell and walked swiftly along, checking the number before she knocked on the door.
‘It’s Dr Lien, from the hospital,’ she said.
She held her breath for a few moments, and then frowned. Was that laughter she heard inside? The door creaked open and the elderly grandmother of the household gave a little bow as she ushered Lien into the house.
Lien walked through to the main room, where the majority of the family was sitting on bamboo mats on the floor, Joe amongst them.
Mai Ahn was by his side, translating rapidly as he spoke. He had laid the complicated drugs for tuberculosis out in front of the elderly grandfather, instructing Mai Ahn to draw a paper chart with dates and times.
Lien stopped the angry words that were forming in her mouth. Back when she’d worked in the US, dispensary boxes had been commonplace for patients who were on several drugs. But they weren’t widely used here at all. That was what he was doing. He was making a do-it-yourself chart and placing the individual tablets on it.
He looked up and caught her eye. ‘Lien, oh, you’re here.’ His eyes shot protectively to Mai Ahn, whose face revealed she thought she was in trouble. The little girl from earlier was sitting curled into her mother’s lap. She’d done well, had been sent home with a prescription for her own meds, and if they were administered to her, she should do well.
Joe stood up. ‘I was just explaining to the family the problems with drug resistance and how important it is to keep taking their medicines.’
There was a shout behind Lien and she turned to see another two children playing in another room. She swallowed and took a deep breath. ‘This might be common practice for Scotland, Dr Lennox, but it’s pretty unconventional for Vietnam.’
He stood up casually and shook hands with the grandfather, and then the little girl’s father, who also had a chart in front of him. He nodded towards Mai Ahn to get her to translate for him again. ‘Thank you so much for seeing me.’ He nodded to the little girl’s mother. ‘Make sure you collect that prescription tomorrow, and if you think there are any problems, feel free to come back to the clinic and see me again.’ He gestured towards the kids in the other room. ‘And remember to come in for the testing. Remember, we can vaccinate too.’
Lien didn’t know whether to be angry or impressed. He hadn’t just covered the delivery of the prescriptions, he’d covered the public health issues they’d talked about earlier, taking into account multi-resistant TB, contact tracing, further testing and immunisations.
She bowed in respect to the family and spoke a few extra words of reassurance before leading the way out of the house. She waited until the door had closed behind them, and Mai Ahn had hurried on ahead, before spinning around to face him. ‘What on earth were you thinking?’
His brow creased. ‘I was thinking about patients and their medicines. I was thinking about stopping the spread of disease.’
‘We don’t do this.’ She almost stamped her foot. ‘We don’t visit people at home.’
He held up his hands. ‘Why not? Particularly when it’s a public health issue? That mother told me back at the clinic that both the father and grandfather were struggling with their meds. You don’t need to be a doctor to know that’s how the little girl got infected. What about those other two kids? I didn’t even know about them before I got here. Are we just supposed to sit at the clinic and wait another few months until they turn up sick too?’
She could see the passion on his face. It was the first time she’d seen him worked up about anything. ‘Have you any idea about this area?’ she shot back. ‘Have you any idea about any of the areas around here—how safe they are?’ She wrinkled her nose. ‘Aren’t there places in Glasgow city that you shouldn’t really walk about alone?’
Now he frowned. ‘But you walked here alone,’ he said.
She threw up her hands. ‘But I’m from here,’ she emphasised. ‘You,’ she said, pointing at him, ‘are clearly not.’
She was furious and he’d obviously played this wrong.
Joe looked down at his trousers and the long-sleeved shirt he’d changed into. He knew with his tall build, pale skin and light brown hair he must stand out like a sore thumb. But instead of venting more frustration on his new workmate, he took a different tack and gave her a cheeky smile. ‘I don’t know what you mean.’
He watched her erupt like a volcano. ‘It’s not funny!’
Maybe he should wind it back in. He leaned against the wall and folded his arms. ‘No, you’re right, it’s not. But neither is the fact that there could be two more children in that household with tuberculosis and two adults risking developing drug-resistant tuberculosis.’ He gave a sigh. ‘I’m just trying to do my job, Lien. I know things are different here. I know the systems aren’t the same as the UK. But I still want to treat patients to the best of my ability.’
There was a noise in the stairwell beneath them, and Mai Ahn rushed back up towards them with a stricken expression on her face. She muttered something to Lien, whose face became serious.
She turned swiftly. ‘Other way,’ she said quietly, pointing to the stairwell at the opposite end of the passage.
‘Something wrong?’ he asked, as the women hurried ahead of him.
Lien’s expression was a mixture of worry and anger. ‘You’ve made us a target, Joe. A Western doctor—rumoured to be carrying drugs in a poor area of town—is always going to cause problems.’
A cold shiver ran over his body. He hadn’t thought about this at all. He tried to relate this to back home. Would he have gone out alone to one of the worst areas in Glasgow? He didn’t even want to answer that question in his head, because the truth was that he had done it before, and would probably do it again. Some parts of Hanoi didn’t seem that different from Glasgow. But he hadn’t meant to put either of his new colleagues at risk. Anything he could say right now would just seem like a poor excuse. He followed them both, turning rapidly down a maze of side streets until they were back on one of the main roads.
Lien didn’t say another word to him until they reached the hospital again. A reminder sounded on his phone and he pulled it from his pocket.
‘Apologies, Lien, I need to collect Regan.’ He hesitated for a second, knowing that things couldn’t be ignored. ‘Can we talk about this later?’
Lien’s face remained stony. She gave a nod to Mai Ahn. ‘Thanks so much, I’ll see you tomorrow. Sorry about the extra work today.’
The words felt pointed. Part of him was cringing and the other part was annoyed.
Lien turned back to face him. ‘I’ll walk with you,’ she said firmly.
It was clear he was about to be told off. First day on the job and he was already in her bad books. It wasn’t the best start. He could easily defend his position, but did he really want to get onto the wrong side of his work colleague, who was also his next-door neighbour?
He decided to be direct, since Lien seemed to like that approach herself. ‘I’m sorry about today. I wasn’t aware there are areas in Hanoi that aren’t particularly safe. I shouldn’t have taken Mai Ahn with me. I’ll get a better grasp of the language soon.’
He could see her grip tightening on the handle of her shoulder bag. ‘You shouldn’t have gone at all, Dr Lennox.’ Her voice was clipped.
He took a deep breath, resisting the urge to snap back. ‘You should let me know now—since we’ll be working together for the next six months—are you always going to call me Dr Lennox when you’re mad at me, and Joe all the other times?’
She must have been expecting some kind of argument, because his response made her stumble for just a second. She stopped walking and looked him in the eye. ‘Why do you do that?’
‘Do what?’
People were stepping around them in the busy street.
‘Try and interrupt my train of thought.’
He gave a half-smile. ‘Because your train of thought was going down an angry rail. Can we pause at a station and back up a bit?’
She shook her head at his analogy.
He shrugged and held up his hands. ‘What can I say? I’m the father of a four-year-old. Train and spaceship examples are the ones that usually work.’
She closed her eyes for a second. Her grip on the bag was becoming less pinched. When she opened her eyes again, her pupils were wide. ‘You don’t get it,’ she sighed. ‘The staff and patients at the hospital are my responsibility. Mine.’ She put her hand on her chest. ‘Can you imagine if I had to phone Khiem and Hoa and tell them that our new doctor had been attacked on his first real day of work and now wanted to head back home to Scotland?’
His hands went to his hips. ‘Do you really think I’m the kind of guy to leave at the first hurdle?’
Her gaze was steady but sympathetic, and he could tell from that glance alone that she did think that about him. Disappointment swelled in his chest. Her voice was hushed on the crowded street. ‘What if that first hurdle results in Regan having no parents?’
He flinched as if she’d just thrown something at him. The words were harsh. They were also something that he hadn’t even considered.
Ever. He’d spent the first year after Esther had died wrapping his son in cotton wool, worrying about every minor accident, rash or childhood sniffle. In every thought his worst-case scenario had always been about something happening to Regan—not about something happening to him.
He stood for a second, not quite sure how to respond, and then he just started walking, lengthening his strides as he hurried to reach the nursery.
All of a sudden he had to set eyes on his son again. He’d already paid a quick visit at lunchtime, spending his break time with his son and making sure he was settled and happy in his new nursery school. But that had been five hours ago.
Lien walked in short, brisk steps alongside him. If she was struggling to keep up she didn’t complain.
‘I’m sorry,’ she muttered. ‘That came out a bit…’
‘Wrong?’ He raised his eyebrows.
‘Direct,’ she countered.
‘Is crime around here really that bad?’ he asked. His brain was whirring. He’d read a lot about Vietnam before coming here—although most of what he’d read had been health related. He couldn’t remember reading anything about crime.
‘No,’ she admitted. ‘Hanoi isn’t any worse than any other major city. But home visits by doctors are just not done here. Particularly when the doctor might be taking out medicines to patients. Surely you can see that if word got about, it could be dangerous for you, and for anyone around you.’
He wasn’t happy. ‘So you exaggerated?’
She pressed her lips together. ‘I protected my staff,’ she said.
‘Then who was at the bottom of the stairs?’
‘Some members of a local gang. Mai Ahn and I know them, they’ve attended the hospital before—usually for emergency treatment, you know, stitches for fighting or stab wounds.’
The flare of anger abated. Maybe she hadn’t been exaggerating after all. ‘Surely they wouldn’t hurt you, then?’ he asked carefully.
Her gaze met his. ‘But they would probably hurt you,’ was her reply.
He swallowed. It seemed he’d need to get to know this city a little better. In Glasgow even the worst kind of people would generally leave a doctor alone. Most people had a moral code when it came to healthcare professionals, knowing that they would likely need help from them one day. But there had been attacks. One of his good friends had been assaulted and his bag stolen when he’d been visiting a terminally ill patient, so it did happen.
She sighed and put her hand up, tugging her ponytail band from her hair and shaking it out. ‘Sorry, headache,’ she explained. ‘They probably wouldn’t hurt you. But the truth is I do know them, and they drink. Heavily. They’re all fairly young, and some of them think they have something to prove.’
‘So you were erring on the side of caution?’
She gave him the first smile he’d seen since she’d come looking for him. ‘That’s the polite way to say it.’ She shook her head again as they approached the international school. ‘I’m not trying to scare you off. This is a fantastic city. But like all cities, there is good and bad, and until you familiarise yourself a little better, or at least get a hang of the language, can you try not to get into trouble? Believe me, I’ve got enough to worry about without having to check on you.’
She was trying to pretend the words were light-hearted but he could sense the sincerity behind them. They reached the door of the school. ‘Can you give me five minutes?’ he asked.
She nodded and waited outside as he went in to collect an excited but tired Regan, getting a full report from his teacher.
He walked back out with Regan in his arms. ‘It seems nursery was a big success,’ he said with a smile, conscious of how relieved he felt. Knowing that Regan had had a good day always made him happy. He’d be able to text his mum and dad tonight to tell them that things were good, and he knew they’d be relieved too.
‘Tell you what, let me try and make amends. How about I buy you dinner?’
Lien looked a bit surprised. ‘Dinner?’ she repeated.
He nodded and looked around. ‘You choose. Somehow I haven’t managed to get to the market today, and we devoured the food in the fridge last night. Show us somewhere we can eat on a regular basis.’ He raised one eyebrow. ‘Familiarise me with the area.’
She let out a laugh and shook her head, looking at Regan. She moved closer to talk to him. ‘Big day at nursery?’
Regan nodded in a tired kind of way. ‘It’s cool,’ he whispered.
Joe gave his back a rub. ‘I suspect Master Lennox is struggling with jet-lag. Once we’ve eaten I think I’ll get him straight to bed.’
Lien looked up and down the street. ‘What does Regan like? Are there foods he doesn’t eat? Or is he allergic to anything?’
Joe gave a brief shake of his head. ‘Take us somewhere you like, somewhere good. The wee man will more or less try anything.’
Lien let out a laugh.
‘What?’ Joe’s brow creased. ‘What is it?’
Her eyes were gleaming. ‘Have you any idea how Scottish you just sounded?’
