The Royal House of Niroli Collection. Кейт Хьюит

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СКАЧАТЬ would you like Alex to look at you now?’ she asked. ‘He might be able to do something to ease your suffering.’

      After another bout of gut-wrenching coughs, Alex exchanged a glance with Amelia before he bent to his bag on the floor and retrieved his stethoscope.

      ‘Amelia, help take off your father’s shirt so I can examine his chest,’ he directed.

      Once the shirt was removed Alex looked at the degree of chest expansion as Aldo took in a few breaths and then percussed the chest and listened with his stethoscope.

      ‘You have a very large pleural effusion on the right side of your chest, Signor Vialli. That is making it hard for you to breathe, and may be precipitating a lot of the coughing. I may be able to at least temporarily relieve some of your symptoms by draining off the fluid with a needle,’ he said.

      ‘I am not going to go to the hospital. I will die here in my house, not in some institution, where everyone will know who I am, what I have done,’ Aldo said.

      ‘Signor Vialli—’ Alex’s voice deepened with professional authority ‘—performing a pleural drainage here would be too risky. For one thing there’s the risk of infection, and secondly there’s the possibility of me pricking the lung and causing a pneumothorax—puncturing the lung, I mean. If that were to happen, you could be worse off. We could go to the hospital now and do it without anyone but the night staff knowing about it. The procedure is relatively simple and will give you a few weeks’ relief.’

      ‘Papà, surely it’s worth letting Alex try to help you,’ Amelia pleaded.

      Aldo let out a broken sigh. ‘Very well…I will have the procedure done…but I do not want to stay in hospital.’

      ‘That shouldn’t be necessary if all goes well,’ Alex said and helped the ill man from the chair, taking most of his weight on his arm.

      Amelia sent him a grateful glance as they made their way out to Alex’s car, her father’s coughing increasing with every shuffling step he took.

      The drive down to the Free Hospital was mostly silent. Alex tried once or twice to make conversation with Signor Vialli, but it was obvious both breathing and talking caused him too much discomfort.

      Their arrival at the hospital was met with some slight surprise on the part of the night staff nurse on duty, but once Alex explained what he intended to do she organised the equipment for him and led him to one of the treatment bays and drew the curtains around them.

      Amelia helped her father into a sitting position on the bed at Alex’s direction and supported his leaning-forward position by holding his shoulders.

      Alex pulled on a pair of sterile gloves after washing and drying his hands, and, using the swabs from the disposable dressing tray, cleaned an area on the right side of Aldo’s chest, his ribs clearly obvious because of marked weight loss.

      ‘I’m going to put in some local anaesthetic so it doesn’t hurt too much,’ Alex explained.

      He injected ten milligrams of one per cent xylocaine with adrenaline into the area for the pleural tap. Then, taking a fourteen gauge IV canula, to the end of which he attached a three-way tap and a twenty-mil syringe, Alex punctured the right pleural space just lateral to the tip of the right scapula, and aspirated 20ml of blood-stained pleural fluid. He then withdrew the IV needle, leaving the plastic canula in the pleural cavity, and aspirated the pleural effusion 20ml at a time, discarding each aspirate by using the three-way tap, into the stainless steel container the nurse had provided.

      ‘You may feel like coughing as the fluid comes out, Signor Vialli. Try to suppress coughing as much as possible, just do little coughs if you have to, and try to keep as still as possible while I remove the fluid,’ Alex said.

      For Amelia, it seemed as though the fluid would never end; so far Alex had removed two litres of blood-stained effusion. But at about three litres, the pleural cavity was drained, and Alex removed the needle, taping a dressing over the puncture site.

      ‘How does that feel? Can you breathe any easier?’ Alex asked.

      Aldo took a deep breath, and let it out slowly. This time there was no hacking cough.

      ‘This is much better, Dr Hunter. I can breathe freely again. How long will this last?’ Aldo asked.

      ‘I can’t really say,’ Alex said. ‘The fluid may come back very quickly, and you’ll be thirsty and have to drink. Or it may accumulate very slowly, maybe over a few weeks. When much of the fluid comes back, I can drain it off again.’

      ‘Do you think there will be any problems from the tap, Alex, infection or a pneumothorax?’ Amelia asked, moving just out of her father’s hearing.

      Alex moved back to listen to Aldo’s chest again with his stethoscope. ‘The air entry is much better, and there isn’t clinical evidence of a pneumothorax. I’ll give him some sample packs of amoxicillin. He should start those now, and we’ll get some more from the pharmacy tomorrow.’

      ‘Thank you, Dr Hunter,’ Aldo said as Amelia helped him to his feet once more.

      ‘No problem.’ Alex smiled. ‘Let’s get you home and into bed.’

      Once her father was settled back at the cottage Amelia walked out with Alex to his car to see him off.

      ‘Your father should really be in hospital,’ he said as he drew her closer. ‘He’s in a bad way and it’s only going to get worse.’

      ‘I know.’ She let out a tiny sigh and looked up at him. ‘Thank you for what you did for him tonight.’

      ‘I didn’t do much.’

      ‘You did more than you realise,’ she said. ‘Apart from relieving the pressure in his chest, you listened to his reasons for doing what he did without judgement and yet you of all people should be angry. He took your childhood away and exchanged it for another.’

      ‘Maybe, but who’s to say the one I got in exchange wasn’t as good? I don’t have a single bad memory of my childhood, that’s more than what most people can say these days. It might have been a completely different story living a royal life. Who knows? I might have become horrendously overindulged and totally obnoxious.’

      She smiled at his self-effacing humour. ‘I can’t imagine you ever being any such thing.’

      He lifted her hand to his face and pressed a soft kiss to her palm, his eyes still locked to hers. ‘You didn’t like me the first time you met me, though, did you?’

      ‘I didn’t know you the first time I met you.’

      ‘And you do now?’ he asked after a protracted silence.

      ‘I know you’re a very special person….’

      He narrowed his eyes at her playfully. ‘If you mention the P word again I won’t be answerable to the consequences. As far as I’m concerned I’m still Alex Hunter. Even if someone hands me a pedigree several centuries long I will still always feel like Alex Hunter, no one else.’

      ‘But you’ll have to face it soon,’ she said with a troubled frown.

      ‘Not СКАЧАТЬ