Paddington Children's Hospital Complete Collection. Kate Hardy

than rushing in with guns blazing, she’d totally agreed with Alistair’s conservative treatment plan. They’d worked closely with Rupert Emmerson, the anaesthetist, who’d sedated and ventilated Ryan. Alistair had inserted an intracranial pressure monitor and she’d inserted a central line, administering a mannitol infusion to decrease any associated brain swelling from the injury. The small haematoma hadn’t diminished in size but neither had it grown. As a result, Ryan remained ventilated and his condition was still in a state of flux.

      Yesterday morning, in a moment of frustrated despair during teaching rounds, she’d asked Alistair if she’d missed anything. Despite the large group of students gathered around the little tacker’s bed, Alistair’s pewter-grey eyes had zeroed in on her as if they were the only two people in the room.

      ‘If you’ve missed something, Mitchell, then so have I.’

      ‘Shall we do another MRI?’

      ‘He had an MRI two days ago. While his observations remain the same it’s not warranted. You have to ask yourself why you’re doing the test.’

      Because I have to do something. Doing nothing feels like giving up.

      ‘Surely there’s another option?’

      Something she’d been momentarily tempted to think was sympathy had crossed his face but it vanished the moment he opened his mouth.

      ‘There is. We wait.’

      Wait? That wasn’t something. That was sitting on their hands. ‘And what if he doesn’t improve?’

      His shoulders had risen and fallen. ‘That may be the reality.’

      No. ‘I don’t like that reality,’ she’d said briskly as if being terse would change it.

      He’d given her a brief sad smile before returning his attention to the group of students. ‘Who can tell me the elements of the Glasgow Coma Scale?’

      ‘I swear he squeezed my hand before,’ Ryan’s mother said, her voice breaking into Claire’s thoughts. Louise’s anxious face was lined with two weeks of worry. ‘That’s a good sign, isn’t it.’

      It wasn’t framed as a question—it was a solid statement. Louise needed to reassure herself that her little boy really was showing signs of improvement when in fact he was neither improving nor deteriorating. It was the limbo that was so disconcerting and heartbreaking, especially when neither she nor Alistair could pinpoint the reason.

      Claire didn’t want to upset the traumatised woman but she didn’t attach the same significance to what was likely a muscle spasm. ‘He’s very heavily sedated, Louise.’

      Claire checked his vital signs as she did twice each day. No change. She wrote up a drug order to override the one that was about to expire and then she turned her attention to Louise. Gunmetal-grey shadows stretched from the mother’s eyes down to her cheekbones. Claire was familiar with the signs of relatives at the end of their rope.

      ‘How are you sleeping?’ she asked, despite the signs that the woman wasn’t sleeping very much at all.

      The exhausted mother shrugged and tilted her head towards the rollaway bed. ‘It’s got springs in interesting places.’

      ‘We can get you another one,’ Claire offered, having no idea if that was even possible. With all the talk of the probable sale of the hospital land and relocating the facility to one of the home counties, the powers that be weren’t spending any money. If push came to shove, she’d buy a rollaway bed herself. At least it would feel like she was doing something other than this interminable waiting.

      Louise sighed. ‘To be fair, it’s as much the disturbed sleep as anything. I wake up every time the nurses do their hourly check.’

      ‘Would you consider taking a night off?’ Claire asked carefully. She’d learned to tread very gently with families.

      ‘I doubt I’d sleep any better at home.’

      ‘Your GP can prescribe some sleeping tablets. Believe me, eight hours sleep in your own bed would do you the world of good.’

      Louise gave her head a brisk shake. ‘I want to be here when he wakes up.’

      ‘I understand.’ She pulled up a chair and sat, putting herself at eye level with Louise. ‘The thing is, Ryan doesn’t have to be alone. I’m sure there’s someone in your extended family you could ask to give you a break? You know, so both you and Colin can get a full night’s sleep.’

      Louise glanced between Claire and her redheaded son, whose freckles seemed darker than ever against his porcelain-white face. A tear spilled over and ran down her cheek. ‘I’m beyond making decisions. My mind feels like it’s encased in a wet, London fog.’

      ‘Then let me make the decision for you.’

      She looked uncertain. ‘I’ve never felt this exhausted in my life. It’s like fatigue’s not only invaded my soul but it’s set up residence. All I want to do is curl up under the duvet and sleep for a week. I want to forget about the fire and how it turned my life on its head in an instant. But how can I? This is my new reality. Ryan can’t leave and forget. If I go home, aren’t I letting him down?’

      Claire had heard variations of this story from grieving parents many times before. She gave the woman’s knee a gentle pat. ‘If you don’t look after yourself, Louise, you risk getting sick. If you fall apart, then you’ll be away from Ryan a lot longer than twelve hours.’

      The enervated mother suddenly sagged as if utterly defeated by a fortnight’s emotional trauma and associated sleep debt. Her weary moss-green eyes met Claire’s. ‘If he wakes up while I’m at home, you must call me.’

      ‘Of course.’

      ‘Thank you.’ The woman visibly brightened. ‘Perhaps my leaving will trigger him waking up. You know, like when you take an umbrella with you every day and it’s always dry but the moment you leave it at home it rains.’

      Claire couldn’t quite see the connection.

      ‘I’ve been here for days,’ Louise explained, ‘and nothing’s changed. It stands to reason that if I leave, he’ll sit up and start talking.’

      A worrying sensation roved along Claire’s spine and she had to resist the urge not to wince. ‘Medicine doesn’t really work that way, Louise,’ she said gently. ‘Would you like me to contact your GP about the sleeping tablets? And I can ask the ward clerk to call you a taxi.’

      ‘Thank you. That would be great.’ Louise leaned over, brushed the hair from Ryan’s forehead and kissed him. ‘See you soon, buddy.’ She smoothed his hair back into place and then stood up. ‘Promise me, Claire, you’ll telephone if he wakes up.’

      ‘I promise,’ Claire said easily. ‘Wild horses couldn’t stop me from giving you good news like that.’

      * * *

      Alistair high-fived Tristan Lewis-Smith. ‘Way to go, Tris,’ he said with a grin.

      The kid had just whooped him at virtual tennis—twice—but he didn’t care. He was too busy rejoicing in the fact that the ten-year-old had been seizure free for a week. That hadn’t happened in two years and it was moments like these that reminded him that what he did each day mattered. Hell, it reinforced his mantra that every single day mattered and life should be lived to the full.

      He’d almost lost the opportunity to do that, and when he’d woken up in the coronary care unit, he’d vowed never to forget how life could change in a heartbeat—or the lack of one as the case may be—and how close he’d come to death. He’d been blessed with a second chance and he never took it for granted. He was thrilled to be able to give Tristan a second chance at a normal life.

      ‘Right-oh, mate.’ He pulled down the sheet and patted the centre of the bed. ‘Time to tuck in and pretend to read or the night sister will have my guts for garters.’