Italian Doctor, No Strings Attached. Kate Hardy

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СКАЧАТЬ and you can pay double if you make any more abseiling jokes,’ she threatened, laughing back. ‘Though I’ve got one for you. Two drums and a cymbal abseiled down a cliff. Boom, ba-doom, tssssh.’

      ‘Oh, that’s brilliant.’ Pete gave her a high five. ‘If I have any kids on my list today, I’m so going to use that one.’

      Yet more things to like about her, Marco thought. Sydney didn’t overreact to good-natured teasing, and she thought on her feet. The more he saw of her, the more he liked.

      He knew that she liked him, too, from the way she’d responded to his kiss last night. Then something had spooked her. Bad memories, maybe? Perhaps he could get her to open up to him.

      Though that made him the biggest hypocrite in the world, because no way was he planning to open up and talk about Sienna.

      Later, he told himself. Work, first.

      Their first patient that morning was an elderly woman complaining of abdominal pain. It was a symptom common to a very wide range of conditions, making it difficult to diagnose what the problem was.

      ‘Mrs Kane, I’m Marco Ranieri and this is Sydney Collins,’ he said. ‘We’re going to find out what’s making your stomach hurt, and make you much more comfortable. How long have you been feeling like this?’

      ‘A couple of days. I wasn’t going to bother you, but then it started hurting when the postman came, and he called the ambulance.’

      ‘May we examine you?’ he asked. ‘We’ll be as gentle as we can, if you can tell us where it hurts most.’

      ‘Yes,’ she whispered.

      Gently, Marco examined her. There wasn’t any guarding or localised tenderness: just general abdominal pain.

      Sydney checked her temperature. ‘You don’t have any sign of fever, Mrs Kane.’

      Which ruled out a couple of things, but he still had a few questions. ‘I know this is personal, and I’m sorry, but may I ask when you last went to the toilet and passed a stool?’

      Mrs Kane thought about it. ‘A couple of days ago. I tried yesterday and couldn’t,’ she said.

      Constipation could cause stomach pain; but Marco instinctively knew it wasn’t that. There was more she wasn’t telling them.

      ‘Can I ask what you’ve eaten lately?’

      Mrs Kane made a face. ‘I haven’t really been hungry.’

      ‘Have you been sick at all, Mrs Kane?’ Sydney asked.

      ‘No. I thought I was going to be, yesterday, but then I had a drink of water and I was all right.’

      ‘Again, I apologise for the personal question, but have you needed to wee more often?’ Sydney asked.

      ‘A bit.’ Mrs Kane wrinkled her nose. ‘But that’s my age, isn’t it?’

      ‘Could be,’ Sydney said with a smile. She caught Marco’s eye. ‘Quick word?’ she mouthed.

      ‘Mrs Kane, we just need to check something out, and then we’ll come back to see you, if that’s OK?’ Marco asked.

      At her nod, he followed Sydney out of the cubicle.

      ‘I know appendicitis is much more common in teenagers and young adults, but I have a feeling about this,’ Sydney said.

      ‘I agree. The presentation of appendicitis doesn’t tend to be typical in very young or elderly patients—and if her appendix is retrocaecal, then it won’t show up as pain moving from around her navel to the right iliac fossa.’

      ‘And needing to wee more frequently—it could be an inflamed appendix irritating her ureter.’

      ‘We’re going to have to do a PR exam,’ Marco said.

      ‘It’d be more tactful if I do it,’ Sydney said.

      ‘Do you mind?’

      She shrugged. ‘That’s what teamwork’s for. Keeping our patient as comfortable as possible.’

      They went back into the cubicle. ‘Mrs Kane, we need to give you an internal exam,’ Marco said, ‘and then maybe a blood test and possibly a scan to give us a better idea of what’s causing your pain—we want to rule out a couple of possibilities.’ Diverticulitis and cancer were uppermost in his mind, though he wasn’t going to alarm his patient by mentioning them at this stage.

      ‘As an internal exam’s a bit personal,’ Sydney said. ‘Would you prefer me to do it?’

      Mrs Kane looked grateful. ‘Thank you.’

      ‘Marco, if you can excuse us a moment?’ she asked.

      ‘Of course. Give me a shout when you need me,’ Marco said, and left the cubicle.

      ‘Ow, that makes my tummy hurt,’ Mrs Kane said during the exam.

      Bingo: just what Sydney had expected to hear. ‘Sorry, I wasn’t intending to make it hurt. Let’s make you more comfortable.’ She helped the elderly lady restore order to her clothes and sit up. ‘I think your appendix is inflamed and we’re going to need to take it out.’ She wasn’t going to worry Mrs Kane by telling her, but elderly people were more prone to complications—and there was a higher risk of dying from a perforated appendix. ‘Though sometimes we suspect appendicitis and it turns out that the appendix is perfectly healthy, so before I send you off to the surgeon I want to do a couple more tests, if that’s OK?’

      ‘Are they going to hurt?’

      ‘You might feel a scratch when I take some blood,’ Sydney said, ‘but the scan definitely won’t hurt.’

      The blood tests came back with a high white cell count, and the CT scan showed Marco and Sydney exactly what they’d expected. ‘Definitely an inflamed appendix,’ Marco said.

      They reassured Mrs Kane that the operation was done by keyhole surgery nowadays, so she’d recover relatively quickly, and introduced her to the surgeon, who also spent time reassuring her before taking her up to Theatre himself.

      ‘Good call,’ Marco said to Sydney.

      ‘Thanks, but I could’ve been wrong—you know as well as I do how difficult it is to diagnose abdominal pain in elderly patients.’ She shrugged. ‘I just happened to read a few journal articles about it recently and they stuck in my mind.’

      ‘Still a good call,’ he said with a smile.

      There was barely time for a break during the day; at the end of their shift, Marco caught Sydney just as she was leaving the hospital. ‘What shift are you on tomorrow?’

      ‘Late,’ she said.

      ‘Me, too.’ He smiled at her. ‘Do you fancy going to the cinema tonight?’

      This was where she should make some excuse. Especially СКАЧАТЬ