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There was passion and enthusiasm in her voice. There was also a hint of anger. She was angry at what this disease was being allowed to do to people all around the world. He liked that about her.
‘We’ve been using the same archaic test for the last one hundred and twenty years and the test is only accurate half of the time—even less so if the patient has HIV. I hope you’re comfortable with kids. We have a new test for TB but it’s not suitable for kids. They need the traditional test and we have the facility for chest X-rays if necessary. Mainly, we go on clinical presentation and history.’
He nodded. He’d read more notes after Gabrielle had gone to bed. He was happy to do something to pass yet another long night when he couldn’t sleep.
She kept talking, her voice going at a hundred miles an hour. ‘You know the clinical presentation, don’t you? A persistent cough, fever, weight loss, chest pain and breathlessness. The nurses will bring through anyone who has tested positive and is showing resistance to rifampicin. You’ll need to check them over clinically before starting their prescription.’ She pointed to a printed algorithm. ‘We have a chart for adults and a chart for paeds. The new test also doesn’t show anyone who has non-pulmonary TB. The nurses will bring through anyone with a history who gives concern.’
He blinked as he looked at the clinic list. ‘You see this many patients every day?’
She nodded, her brown hair bouncing. It was tied up on her head again. She was wearing a high-necked, long-sleeved shirt and long trousers, even though the temperature was soaring. He was lucky. He had on shorts and a T-shirt, but even so the heat was causing trickles of sweat to run down between his shoulder blades.
She gave a little tug at her neck. ‘Okay?’ he queried.
She gave a nod. ‘Let’s just get started. We need to see as many patients as we can.’
She wasn’t joking. It was only seven a.m., but news of their clinic must have spread because there was already a queue forming outside.
Four hours later he’d seen more kids in this TB clinic than he’d ever want to. Doctors Without Borders might be there to try and tackle the TB epidemic, but to the people of Narumba he was just a doctor. His surgical highlight of his day so far had been grabbing some equipment and a scalpel to drain a few abscesses. He’d also seen a huge variety of skin conditions, variations of asthma, diabetes, polio and sleeping sickness. He’d seen multiple patients with HIV—mixed with TB it would be deadly for many of the people he’d seen today. He could barely keep track of how many patients he’d actually seen. And the queue outside? It just kept getting longer and longer.
Long queues were good. He had never been work shy. Long days were much more preferable to long nights. If he exhausted himself with work, he might actually get a few hours’ sleep tonight.
He kept a smile on his face as another mother came in, clutching her child to her chest.
He nodded towards her, speaking in Narumbi. ‘I’m Dr Darcy, one of the team. What’s your name, and your son’s name?’
She gave an anxious smile at his good grasp of the language. ‘I’m Chiari. This is Alum, he’s sick.’
Sullivan nodded and held out his hands to take the little boy. ‘How old is he?’
‘Four,’ she answered quickly.
He blinked. The little boy resembled a two-year-old. The weight loss of TB had clearly affected him. He took out his stethoscope and gently sounded the boy’s chest. The rattle was clear and he had the swollen and tender lymph nodes around his neck. He asked a few more questions. ‘Does anyone else in the family have symptoms?’
The woman’s face tightened. ‘My husband died last month.’
He nodded in sympathy. There was a little pang in his chest. He recognised the expression in her eyes. He’d seen that loss reflected in his own eyes often enough when he looked in the mirror. But there was no time for that here. He had a job to do.
‘What about you? Have you been tested?’
She shook her head and looked anxiously at her son. ‘I don’t have time to be tested. I need to take care of Alum.’
Sullivan reached over and put his hand on her arm.
‘I understand. I do. I’m sorry for your loss. We need to make sure that you are well enough to take care of Alum. We can treat you both at the same time.’ He glanced outside the tent. ‘I can get one of the nurses to do the test. It’s a new kind. Your results will be available in a few hours. We can start you both on treatment immediately.’
He sent a silent prayer upwards, hoping that her test didn’t show multi-resistant TB. Chances were if she had it, her son had it too. Normal TB took a minimum of six months to treat. But if Chiari showed signs of resistance to rifampicin and isoniazid she’d be considered to have MDR-TB. The MDR-TB drug regime was an arduous eight months of painful injections and more than ten thousand pills, taking two years to complete. The side effects could be severe—permanent hearing loss, psychosis, nausea, skin rashes and renal failure had all been reported. But the worse news was there was only a forty-eight per cent cure rate.
He pressed again. ‘What about Alum? Has he been eating? Has he had night sweats or lost weight?’
Chiari nodded slowly. He could see the weariness in her eyes that was obviously felt in her heart. She’d likely just nursed her husband through this disease. Now there was a chance she could have it herself, and have to nurse her son through it too.
He stood up, holding Alum in his arms. ‘Let’s go and see one of our nurses. I’d like to try and give Alum some medicine to help with his weight loss, and start some medicine for TB. Our pharmacist, Gretchen, will give you the medicines and teach you how to give them to Alum. Then we can arrange to get your test done.’
After a few moments of contemplation Chiari stood up and nodded. Sullivan carried the little boy into the next tent. The nurses Lucy and Estelle nodded towards a few chairs in the corner. This was the fiftieth child he’d taken through to them this morning. They knew exactly what to do.
He filled out the electronic prescription for Gretchen and left her to explain to Chiari how to dispense the medicines for Alum. The reality was that children had to take adult pills, split or crushed. There were no TB medicines ready for kids in the field.
Gabrielle appeared at his side. ‘Everything okay?’ Her hand touched his shoulder.
He reached up automatically and his hand covered hers. He appreciated the thought. She was looking out for him. He met her dark brown eyes. ‘It’s a steep learning curve.’
She looked a little surprised. ‘I thought it would only take someone like you an hour to ace.’
Was she joking with him again? He shook his head. ‘Maybe after the two weeks. But not on the first day.’
She tilted her head to the side. ‘I heard you talking there. You really do have a good grasp of the language. How do you do that?’
‘It’s similar to Farsi. It was a necessary skill when I was in the army. We treated a lot of civilians as well as servicemen. It doesn’t matter where you are in life—or what you do—communication is always the key.’
She gave a careful nod. He folded his arms across his chest. ‘There are a few cases we might need to chat about later. Adults. They’re being tested but I’m almost sure that both of them are non-pulmonary TB.’
He could tell she was trying her best not to look surprised. Non-pulmonary TB was the hardest catch. The normal test didn’t work, neither did a chest X-ray. There were so many variations that the symptoms were often mistaken for something else.
‘No problem. If you give me the notes I’ll check them over.’
He picked up the two sets of notes he’d started to write, his hand brushing against hers as she reached for them. ‘Actually,’ he said, ‘I’d kind of like to be there to see what you think. Let’s just call it part of the learning curve.’
The edges of her lips turned upwards. She really was cute when she smiled.
‘You want a teaching session?’ There was a definite glint in her eye. He leaned forward a little. He could think of a whole host of things that Gabrielle could teach him.
She was close. She was so close that he could glimpse a few little freckles across the bridge of her nose. Her brown eyes were darker than any he’d seen before and fringed with long dark lashes. It was clear she wasn’t wearing any make-up—but she didn’t need it. He could quite happily look at that face all day.
‘Sullivan?’ She nudged him with her elbow.
He started. ‘Sorry, what?’
Her smile spread. She raised her eyebrows. ‘You were staring.’
It was a statement that sounded like a bit of a satisfied accusation. Nothing could dampen the sparks that were flying between them.
He could feel them. She could feel them. He’d been here less than twenty-four hours. How on earth would he manage a whole two weeks around a woman like Gabrielle Cartier?
He was still getting over the wonder of actually feeling...something again. There had been a number of women over the last three years—but no relationships. He wasn’t in a relationship kind of place. But now he could feel the buzz in the air. It felt alive around him, pulling him from the fog he’d been in. Gabrielle Cartier was like the freshest air that had swept over his skin in the last three years.
Two weeks could be perfect. It was just long enough to be familiar with someone but not long enough for any expectations.
He smiled back. ‘I wasn’t staring.’
‘Yes, you were.’
He nudged her back. ‘I wasn’t. I was contemplating life.’
She laughed. ‘I don’t even want to take a guess at what that means.’
She was right. She didn’t. But he couldn’t stop staring at that smile.
She glanced at the notes. ‘How about we see these two patients now? It doesn’t really work well if the two doctors are seeing patients together.’ She took a hesitant breath. ‘We just have too many patients.’
He nodded carefully. ‘I get it, you don’t like having to teach the rookie.’ He shrugged. ‘Ten minutes. That’s all. Then hopefully I won’t need to ask for a second opinion again. I’ll be confident to make the diagnosis myself.’
He wasn’t joking. He would be confident. Sullivan had never needed to be shown anything twice in his whole career. He’d embraced the doctor’s motto of see one, do one, teach one.
Gabrielle’s gaze narrowed a little. She gave a quick nod. ‘No problem.’
* * *
The next few days passed quickly. Every time she turned, Sullivan Darcy was at her back. Or maybe it just seemed like that.
He hadn’t exaggerated. He picked up things quickly. He’d diagnosed more patients with non-pulmonary TB. He’d adjusted antibiotic regimes for patients who were struggling with side effects. He’d spent hours and hours with patients with the dual diagnosis of HIV and TB.
His only tiny flash of frustration had been with a young child who was suffering from appendicitis. They had no real surgical equipment in the field. No theatre. No way to sterilise the tools that would be needed for surgery.
The nearest hospital was four hours away across a dry and bumpy road. Finding transport was a problem. All they could do was give the child some pain relief and a shot of antibiotics in the hope it would stave off any potential complications before sending him off in the back of a worn-out jeep. As the jeep disappeared into the distance Sullivan kicked an empty water canister clean across the camp, his hands balled tightly into fists.
She watched from a distance.
There was something about him that was so intriguing. Ask him anything medical and he could talk for ever. Ask about training placements, hospitals, work colleagues and experiences with Doctors Without Borders and he’d happily share all his experiences.
But ask about his time in the army or his family and he became tight-lipped. And there was something else Gabrielle had noticed about Sullivan Darcy.
He had the same skill that she’d developed over the years—the art of changing the subject. She’d recognised it instantly. And it intrigued her.
Had he noticed the same skill in her?
It was late. The sun was starting to set in the sky. They’d stayed much later at this site. It was one of the furthest away from their camp—which meant that the people in this area rarely saw medical staff. It made sense to do as much as they possibly could while they were there.
There was a noise to her left and she looked up. The heat of the day rarely dissipated and she’d undone the first few buttons on her shirt and pulled it out from her trousers. One of the tribal leaders had emerged from behind some scrub trees and was scowling at her.
There were a few other men behind him, all talking rapidly and gesturing towards her.
She glanced around. Lucy and Gretchen were nowhere in sight. Estelle was at the other end of the site, loading their transport. In the dim light it was difficult to see anyone else. Their local translator had already left.
The tribal leader strode towards her, gesturing and talking loudly. She’d almost baulked when Gibbs had refused to leave the female staff alone on the mission. But the truth was there had been a few incidents when a traditional tribal leader had refused to allow the women access to their tribes.
It had only happened twice. But Asfar Modarres had played a vital role in negotiating access to the people suffering from TB.
The tribal leader marched straight up to her face, his voice getting louder by the second. She quickly started tucking her shirt back in. No skin around her waist had been on display, but it was clear that something was making him unhappy.
The rest of the men crowded behind the leader. She swallowed. Her mouth was instantly dry.
In the distance she could see Estelle’s head jerk up, but Estelle was too far away to offer any immediate assistance. Gabrielle had never been a woman who was easily intimidated. But she’d never been crowded by a group of angry men. The others had started to fan out behind their leader, surrounding her on all sides. Her automatic reaction was to start to step backwards, trying to maintain some distance between her and them.
Any Narumbi words that she’d picked up from the interpreter flew from her brain. ‘I’m a doctor. Wh-what do you want?’ She could only stammer in English.
The tribal leader poked her in the shoulder with one finger. It wasn’t a violent action. But that one firm poke was enough to make her stumble over her own feet and thump down onto the ground, a cloud of red dust puffing around her.
The noise came from behind. It wasn’t a shout. It was a roar. She recognised Sullivan’s voice instantly, although she had no idea what he’d just said in Narumbi.
All the men looked up immediately. She could hear the thuds and a few seconds later the men were pushed roughly aside, several landing in the dust like she had.
Strong hands pulled her up roughly. She hadn’t even had time to catch her breath. One arm wrapped tightly around her shoulder, pulling her close against his rigid muscles. The words were flowing from his mouth in fury.
She didn’t have a clue what Sullivan was saying, but it was clear that the men could understand every single syllable. The tribal leader looked annoyed for a few seconds and tried to answer back. But he was stopped by the palm of Sullivan’s hand held inches from his face.
Sullivan’s voice lowered. The tone changed. Became threatening. A kind of don’t-even-think-about-it message emanating from every pore in his body. She could feel the vibrations coming from his chest, shoulders and arms. But Sullivan wasn’t shaking through fear or intimidation. She knew straight away he was shaking with rage.
It was a whole new side of him. She’d seen the cheeky side. She’d even seen the flirtatious side. She’d seen the professional side, his willingness to adapt to a situation outside his normal expertise and practise effectively.
Now she was seeing something else entirely. This was the man who’d served in the military. This was the man who left her in no doubt about how vested he was in protecting the people he worked with. Part of her had felt a little resentful when Gibbs had told her he was sending a man to work with them. Right now, she’d never been so glad that Sullivan Darcy was right by her side.
The palm of Sullivan’s hand hadn’t moved. He was still speaking in his low, dangerously controlled voice.
The men exchanged nervous glances. It didn’t seem to matter that Sullivan was outnumbered. His tall, muscular frame and no-nonsense approach left no one in doubt about his potential.
The tribal leader shook his head and muttered, casting a sideways glance at Gabrielle again. After what seemed like an endless silence—but must only have been a few seconds—he spun around, his cloak wide as he stamped back off into the scrub.
Her chest was tight. She hadn’t even realised she was holding her breath until Sullivan released the firm grip on her shoulders and blocked her line of vision.
She jolted and gave a shudder. Sullivan crouched down, his face parallel with hers. ‘Gabrielle, are you okay? Did they hurt you?’
His hands were on her, pushing up the sleeve of her shirt, checking first one arm and then the other. He knelt down, reaching for her trouser leg.
She grabbed his hand. ‘Stop it. Don’t.’
Every muscle in her body was tense, every hair on her skin standing on end.
His dark green eyes met hers and she saw a flash of understanding. She was still gripping him tightly, her knuckles turning white.
He put his other hand over hers and rubbed gently. It was comforting—reassuring. The thud of other footsteps sounded. It was Estelle, quickly followed by Lucy and Gretchen. ‘Gabrielle? What happened? Did they hurt you?’
She could hear the panic in their voices.
Her eyes were fixed on Sullivan’s hand rubbing hers. A warm feeling was starting to spread up her arm. She sucked in a deep breath, filling her lungs and trying to clear her head.
Sullivan seemed to sense the tension leaving her body. He kept hold of her hand but straightened up, glancing around at the other women.
‘Have you finished packing up? I think it would be a good idea to make the journey back to camp now. It was a misunderstanding. A language thing. He misunderstood something that Gabrielle had told his wife. He was unhappy and was angry when he realised she couldn’t speak Narumbi. We’ve done all we can do here today. I’ll need to file a report.’
