THE MAVERICK DOCTOR AND MISS PRIM/ABOUT THAT NIGHT... (22 page)

He looked down at Violet. She was watching him carefully and he knew instantly that she understood. She understood his frustration about all the things that were outside their control. She understood that he was going to spend the rest of the night worrying about that little boy and whether he would make it through till morning.

And he didn’t need to say any more. Because Violet just moved. And it happened naturally.

She shifted her feet and leaned against him, making it seem like the most natural thing in the world to rest his arm around her shoulder.

She rested her head against his chest. Could she hear the beating of his heart?

Her voice was quiet. “The things we can’t control will always be the hardest. Particularly when we can’t even understand some of them.”

There was something else. Something he hadn’t heard before.

For the first time he felt as if he’d picked away at one of Violet’s unending layers. She wasn’t just talking about here and their situation. Yes, it was part of it, but she was also talking about something else.

It was so calm, so peaceful right now. And he didn’t want to destroy this. He didn’t want to destroy this moment. It would be so easy to ask her if something was bothering her. It would be so easy to pry. But he didn’t want to take a chisel and chip away at her layers. He didn’t want to back her into a corner. He had to let her unpeel her layers herself.

Maybe he’d never reach the center of Violet Connelly. But it might be nice to wait around and see.

He chose his words carefully. “Maybe we’re not meant to understand everything, Violet. Maybe we’re not here to change the world. Maybe we’re just meant to learn how to live through it.”

She gave a quiet murmur and lifted her hand and placed it on his chest.

And the two of them stood, watching the sun set over the wide landscape in front of them.

CHAPTER SIX

T
HE
 
MEETING
 
ROOM
 
was crowded. Evan’s meticulous planning for the polio campaign was going well. The huge map on the wall and the corresponding graph with the number of vaccines delivered was impressive by anybody’s standards.

But it wasn’t good enough for Evan. And Violet wasn’t surprised.

He clapped his hands together to draw the chattering crowd to attention. “Thanks for coming, everyone. I wanted to look at a few ways we can improve the total uptake of the polio vaccine and give added protection to the people of Natumba.”

He pointed to a certain area on the map on the wall. “There are a few villages where there is a high rate of refusal.” He nodded to one of the community volunteers. “I’ve arranged a series of meetings between the volunteers, ourselves and some of the village elders. We need to work in partnership with these people if we want to make any lasting improvements.”

Violet heard the mutterings around her. Lots of attempts had been made in the past to try and increase the uptake of polio in these villages but Evan’s persistence might pay off. He’d spent time in these villages in the past few weeks, taking time to get to know the elders and some of the health issues facing the inhabitants. He was slowly but surely gaining their trust and that had to help.

He pointed to another area on the map. “We still haven’t made much headway mapping the Fulani nomadic routes. Most of the Fulani people haven’t been vaccinated and they have a high rate of individuals affected by polio. It’s always difficult to try and target a group of people who are constantly on the move. But we’ve had some news that they are about to arrive in our local area and we want to be ready.”

He nodded to one of the Healthy World Federation members of staff in the room. “Dr. Brasi will be leading the team this week that will be attempting to make contact with the Fulani people and vaccinate them.”

Violet smiled. It all made sense. Evan was being methodical and consistent in his approaches. The number of people vaccinated was rising every day. Surely they would meet the targets they had been given?

“And finally...” He paused, his eyes meeting Violet’s for a second. She felt her heart flutter a little. They hadn’t been alone together since that night when they’d watched the sunset. Once the sky had darkened he’d given her hand a little squeeze and walked her to her room.

Her heart had sunk a little when she’d realized he wasn’t going to attempt to kiss her. Then she’d lain awake wondering why she wanted him to kiss her. Nothing made sense to her anymore. Her head kept telling her she wasn’t ready for any of that kind of thing, but her body was reacting differently.

He gave her a little smile. “One of the areas we need to improve on is new births. Newborns need to be tracked and immunized through the midwife service scheme, with oral polio vaccine being placed in delivery rooms to ensure administration of a dose at birth. We need to strengthen links with traditional birth attendants and traditional leaders.” He paused for a moment. “And I’m going to ask Dr. Connelly to lead on this.”

What?

Her smile froze in place. Why hadn’t he talked to her about this beforehand? He gave her a little nod and continued talking, totally unaware of what he’d just unleashed.

Violet couldn’t move. Her brain was mush. Her heartbeat was quickening in her chest—and not in a good way. She felt sick.

He had no idea. He had no idea at all at what he was asking of her.

But, then, how could he? Because she hadn’t told him what had happened to her. He couldn’t possibly know that the last time she’d been in a delivery room had been the worst day of her life.

The day she had welcomed her daughter into the world and then bid her farewell.

How on earth could she cope with being in that environment every day?

She took a deep breath.

She was a doctor. This was her job. She had wanted to come here—she wanted to move on.

It had been three years, and a birthing room here would be nothing like a delivery room back home. How could it evoke the same memories and experiences?

All she was being asked to do was set up links with local midwives and birth attendants. She wasn’t being asked to
be
in the delivery rooms.

But that thought didn’t stop her thudding heart. She wasn’t stupid. She’d done her research before she’d arrived in Nigeria.

The stillbirth rate in Nigeria was one of the highest in the world, with half occurring while the woman was in labor. It was inevitable that she would come across one at some point in the three months that she was here.

Evan was still talking. And people were listening. He was captivating his audience with his enthusiasm and passion for the tasks ahead. Heads were nodding all around them and people were shouting out suggestions and ideas.

Would she be able to face the challenges ahead with the same enthusiasm and passion?

Her eyes fixed on her hands. It was easier than looking at Evan. Most of her nails were broken and her skin was starting to tan lightly in spite of the sunblock she was constantly applying. Back home she’d had her nails manicured every month. But the truth was she didn’t even miss it.

While the lifestyle out here was tough—no hot running showers, no wide array of facilities, no hair salons, no easy transport—the experience she was gaining was far outweighing the negatives. Even working with Evan wasn’t as bad as she’d feared.

Why had she wanted to get away from him so badly? Was it really because of the issues with her brother? Or was it the fact that she didn’t want to face up to how she felt about him?

Whatever it was, she didn’t have brain space for it right now. Getting through the work with the midwives would be a tough enough challenge.

And one that would take up all her emotional energy and spirit.

* * *

He’d noticed it. Even though she didn’t realize.

But, then, he noticed everything about her.

That fleeting moment, that wave of fear that had seemed to pass over her eyes.

What did it mean? Or had he just imagined it?

He couldn’t trust anything he felt around Violet Connelly. His instincts seemed to be completely wrong around her. She messed with his mind. Ten minutes in Violet’s company and all rational thought went out the window.

He’d thought she’d be happy that he’d assigned her a specific task she could get her teeth into. Something she could lead and tackle on her own. Giving her the midwifery role had seemed to make sense.

He’d been watching her. She was wonderful around babies and children. She seemed to come into her own. She excelled at dealing with them. This job should have been perfect for her.

So why the fear in her eyes?

But something else was bothering him. Something else was eating at his stomach.

Was that really the reason he’d given her this task?

Or had he just wanted to avoid it himself?

Evan had no reason to avoid children or babies. But he did have a reason to avoid pregnant women.

Helen. Sawyer’s wife.

She’d died of an ectopic pregnancy. No one had known she was pregnant. Not Sawyer, and apparently not Helen.

And seeing pregnant women immediately brought Helen to mind.

It hadn’t been as though she’d looked pregnant—not as if a glance at a pregnant woman reminded him directly of Helen.

No, it just reminded him of what
should
have been Helen.

And that’s what made him sick to his stomach.

He’d spent the past few years thinking that Sawyer must have known his wife was pregnant. They both must have known and kept it secret, otherwise Helen would never have been allowed to go on the mission in the first place.

But that was an excuse. And it was a poor excuse.

It was so easy to push the blame onto Sawyer and not to take any responsibility himself. But he had been the team leader. He had been the one responsible for the health and wellbeing of everyone in his team. And Helen had told him she wasn’t feeling one hundred percent.

It had been a fleeting comment. An unremarkable conversation. And if Evan hadn’t been so caught up in the details of the mission he might have stopped for a minute to consider what she’d said.

He could have asked her a few questions about what was wrong, and to specify exactly how she was feeling. And he knew, deep down, that at some point there was a tiny chance he might have asked her if there was a possibility she was pregnant.

And even though Helen hadn’t known herself, it might have given her pause to stop and think and consider the possibility. It might have made her stop for a second and do a pregnancy test.

Bottom line. It might have saved her life.

The ectopic pregnancy had been a horrible inevitability for Helen. But where it occurred wasn’t.

If she’d been in Atlanta when she’d had the symptoms, she would have gone to the nearest hospital and undergone surgery. And lived.

But none of that had happened. And the sight of Helen lying in her husband’s arms, with the life slowing but surely seeping out of her, had haunted Evan for the past six years.

He had been the team leader. Helen had been his responsibility.

He’d never shared this with anyone. And he never would. Least of all with a member of Sawyer’s family.

He watched as the team assembled around him, Violet among them, talking quietly with some of the voluntary workers.

Another team he was responsible for. Another team whose lives were in his hands.

He could do this. He could. He just had to focus and keep his mind on the job.

He had to keep his eyes and ears open to the health and wellbeing of his team. Which meant he had to get to the bottom of what was wrong with Violet. She was his responsibility—whether she liked it or not. And he couldn’t ignore the fact that something could be going on with her. He wouldn’t be able to live with himself if he missed something in a team member again.

He watched for a few seconds. Violet was fidgeting with her flower-covered notebook, picking away at the edges as she spoke to someone. Every few moments she would bite her lip. She put her notebook down and her fingers went automatically first to her ear then to a strand of hair that she wound round and round one of her fingers.

The person she was talking to seemed oblivious to Violet’s nerves. They were talking quickly, gesturing with their hands, only taking notice of her occasional nods.

Was that how he’d been with Helen? So wrapped up in other things that he hadn’t looked at what had been right in front of him, or listened to her words?

It made him feel sick to his stomach.

Violet looked over and for a second those pale green eyes met his. Every muscle in his body tightened but she instantly averted her gaze, reluctant to let him read anything at all.

It only made him more determined.

He couldn’t decide if he’d given her the midwifery role because he wanted to avoid it himself or whether he’d given it to her to show how much he valued her as a part of the team. But that was irrelevant.

What was important was what happened next. What
he
did next.

And that was the one thing that he could control.

CHAPTER SEVEN

E
VAN
 
WAS
 
IN
 
a good place. They’d immunized over one hundred people today, the majority of them children.

It was a good outcome for the team, giving them the boost that they’d needed. The past few days had been tough on them. Several visits to villages had been unproductive, with hours spent going from house to house, even though most people were still refusing to be vaccinated. It was heartbreaking. All around them there were signs of the destructiveness of polio and its lasting effects. Some elderly villagers, struggling for every breath, their chest muscles virtually paralyzed by polio. The first sign of an infection would wipe them out.

Children of various ages with one weak, wasted limb affecting their mobility—and parents still wouldn’t immunize their other children.

It didn’t help that the one thing he’d dreaded had finally happened. One of the few families that had been vaccinated had actually given vaccine-associated paralytic polio to one of their distant adult cousins. It was a rare complication, usually caused by an adult changing the nappy of a recently vaccinated child and picking up the disease due to poor hand washing. But it was a blow the team didn’t need.

Evan felt as if he were banging his head on a brick wall. Things had to be better than this.

And now they were here. This village had welcomed them with open arms. People had queued for hours to be vaccinated, bringing family members of all ages. And the community workers had come back with a list of houses to visit where people were unable to come to the clinic but still wanted to be vaccinated.

It didn’t matter that it was more time-consuming and difficult. Evan didn’t care. He would happily walk around every home in the village individually if that’s what it took to get everyone vaccinated.

Time was marching on. It had been a long day—they’d been here nearly ten hours and they still had an hour’s drive back home.

He approached one of the final houses, a lightweight structure made of a mixture of wood, bricks and mud. Jaja, his community worker, gave him a smile as they approached the house. “This lady has four children she wants vaccinated. She would have come to the clinic but one of her sons, Dumkata, has been very sick these past few days.”

Jaja pushed opened the door to the house and engaged in a long conversation with the mother, who seemed more than happy to see them.

But Evan’s eyes were drawn to the corner of the room, where a small boy was lying on a makeshift bed. His siblings were playing around him and he seemed oblivious to the noise in the room. Evan’s instincts were automatic and he went to the bed of the sickly child.

“Hi, there, Dumkata.”

The dark eyes flickered open at the sound of the foreign voice. The little boy’s hands automatically started scratching at his skin, as if he had an uncontrollable itch. It was almost as if Evan’s voice had broken him out of the half-slumber he’d been in.

Evan turned to face Jaja. “Can you ask the mother if she minds if I take a look at her son?”

Jaja answered quickly. “She was just asking me the same thing. She knows you’re only here to give the vaccinations and didn’t want to take up your time.”

“It’s no problem. I’m happy to look at him. Can you organize the polio vaccination for the rest of the family, Jaja?”

The community worker nodded and pulled out the vaccine carrier and flip book to explain things to the family.

Evan touched Dumkata’s forehead. It was just as he’d expected. Burning hot. He pulled his medical bag over and took out the tympanic thermometer. It beeped within a few seconds. It indicated that the boy had a temperature.

He pulled out his stethoscope to sound the little boy’s chest. Dumkata barely responded, he still seemed fixated on the itch in his skin. “Can you ask the mother what he’s been complaining of?”

Jaja took a few moments to reply. “She says he’s had a terrible headache for the past few days and his joints are painful and sore. Dumkata is usually running about constantly. She says this is not like him.”

Evan nodded and gestured to Jaja. “Could you help me sit him up for a moment, please?”

Something was setting off alarm bells in Evan’s head. He had the strangest feeling, and experience told him to go with his instincts.

He spent some time examining Dumkata’s skin. There were a few angry marks—just like bee stings—along with a rash that was difficult to see on Dumkata’s dark skin and some swelling in the subcutaneous tissues.

He pressed his fingers gently around Dumkata’s neck and groin, checking the lymph glands and finding them enlarged. It was clear that some type of infection was circulating around the child’s body.

“Can you go and find Violet for me, please? I’d like to have a chat with her.”

Jaja nodded and slipped out of the door. Violet had been working in the village today too but their paths had barely crossed. They’d mapped out the village and decided on separate routes to try and cover the majority of people who had requested to be seen. It made more sense for them to split up than work together.

It also prevented any awkward conversations or, more likely, awkward silences.

It was almost as if she was deliberately avoiding him. She’d never complained about working with the midwives and birth attendants. She’d just put her head down and got on with the job.

But he hadn’t forgotten the look in her eyes. Or the way she’d realized that he’d noticed. At some point they were going to have to have that conversation. If he’d learned anything these past few years it was he needed to be sure about the welfare of his team.

The little form moved on the bed in front of him. He tried to focus on the matter at hand. The niggling feeling he had in his gut about this little boy.

Violet appeared in the doorway. “Evan? You were looking for me?”

Pretty as a picture—even after ten hours on the job. She was wearing another of Olibasi’s outfits, this time in pale pink instead of the brighter colours. Her blond hair was swept up in a clip and her normally pale skin was starting to tan slightly.

Olibasi had been right about the effect of wearing local clothes. Violet seemed to be widely accepted wherever they went. Some reports on previous villages had been a little alarming. But in the past few weeks Violet seemed to be getting good results. The uptake of the polio vaccine was rising in places where it had previously stalled.

It didn’t make sense that it was all down to the type of clothes that the doctor wore. Violet’s quiet, easy nature and never-ending patience was obviously a major factor. But the fact she wore the clothes so well wouldn’t exactly be a hindrance. He tried to keep the smile from his face.

“Thanks, Violet. I know we’re just about to finish up but I wondered if you’d mind brainstorming with me for a minute.”

She looked a little surprised but took it in her stride. “No problem.” She crossed the room and kneeled down next to him at the side of the bed. “Who do we have here?”

“This is Dumkata—he’s seven. According to his mom he’s usually the life and soul of the party, but he’s been unwell these past few days. He has a temperature, a headache, sore joints with some noticeable swelling, some bites and swollen lymph glands.” He caught Dumkata’s hand as it started to scratch again. “He also seems to have an irritating itch.”

Violet nodded. “Well, it could be whole host of things with those symptoms. What’s worrying you most?”

Evan scratched his chin. “Probably the bites.” He turned to face her. “Probably my gut instinct.” He shook his head. “I’m just not happy.”

She nodded. “Then let’s be methodical about this. Is anything springing to mind?”

She bent over Dumkata and started examining his skin. The rash was difficult to determine but was widespread across his skin. It appeared mainly to be speading out from the two bite marks on his skin. “Does the mom know what caused these bites? Is there something in particular we should be considering?”

Evan wrinkled his nose. “Probably. It’s frustrating. Back home we’ve got everything to hand. Out here it’s much more difficult.”

Violet gave him a little smile. She understood completely. Back at the DPA they had a computer program for everything. Every tiny sign or symptom all calculated and computed to tell you any possibilities and what to look for next. She pulled a tiny pocketbook from under her traditional skirt. “Want a look at this?”

It was a copy of a tropical disease handbook—ten years old and obviously well worn. She’d had it since she’d been a student and had hardly looked at it in recent years. But it had been a last-minute addition to her suitcase.

As Evan turned the pages, one fell out in his hands. “Sorry,” she muttered. “I’m sure I’ve got some sticky tape somewhere.”

Jaja walked over to them. “The mother has no idea what the bites are. Her son was playing out near the fields a few days ago. He came home with the bites. She hasn’t seen them before and Dumkata just said they were bee stings.”

Evan’s head shot up. It was almost as if a little light had just gone on in his head. He started muttering and flicking through Violet’s book, “Fields...flies...” His eyes met hers.

“What about tsetse flies? What about the first signs of sleeping sickness?”

“Really? I thought that had almost disappeared?”

Evan pulled out his PDA and looked up some files. He frowned. “Only two cases reported in Nigeria last year. Could it really be something like that?”

Violet shook her head. “You’ll have to remind me about it. I can’t remember that much.”

His eyes scanned between the screen and the book he held in his hands. “African trypanosomiasis is a vector-borne parasitic disease, known as sleeping sickness. The parasites are transmitted to humans by the bite of the tsetse fly. Most common in areas of fishing, animal husbandry or—” he lifted his eyes to meet hers “—agriculture.”

“What do the flies look like?”

He shook his head. “There aren’t any pictures. It just says they are about the same size as bees and quite aggressive.”

Violet looked over at the mother. Jaja was doing his best to relay their conversation to her and the distress on her face was visible. She rushed over and put her arm around her child.

“Help my baby.”

Violet could feel her stomach muscles clench at her reaction. The instant fear that something could happen to her child—something completely out of her control.

She took a slow breath. “We need to stay focused. Does it list the signs and symptoms?” She lowered her voice slightly. “How serious is it? Do we have anything to treat it?”

Evan’s eyes were still flickering back and forth between the book and the screen. “The signs and symptoms are compatible with the first stage. The temperature, itching, joint pains and headaches. They are all signs that the trypanosomes are multiplying in the subcutaneous tissues. It’s called the haemolymphatic phase.”

Violet could almost feel her own skin start to itch at the thought of parasites circulating around the little boy’s body. It was horrible.

She tried to pull her doctor’s head back into focus. She was finding it so hard not to look at Dumkata’s mother and see the pain and fear in her eyes. Even though this was an entirely different situation from her own she wanted to reach out and tell her that she understood. That she knew the fear of the unknown, the protectiveness she was feeling and the helplessness at things being out of her control.

“How do we diagnose this?”

“We need to take a blood test. It used to be really difficult to diagnose because the number of parasites in the blood can be low and they need to be separated from the red blood cells.” He pointed to something on the screen. “There’s a pan-African campaign on the eradication of trypanosomosis. Let me see if can get some more details.” He pulled out his satellite phone and pressed in a number as he headed toward the doorway. “Give me a few minutes.”

Violet nodded as she watched him leave. “Jaja, can you come and sit with us? I’d like you to translate for me, please.”

Violet’s eyes flickered over the screen as she picked up some more details. She finally had the courage to meet Dumkata’s mother’s eyes. “Tell her we need to make a diagnosis and Dr. Hunter is just finding out the best way to do that.” She watched as Jaja rapidly translated. “Tell her we think that if it is sleeping sickness, then it’s been caught at an early stage—a stage that can be treated.”

Within a few seconds she could see the relief as the woman relaxed her shoulders and shot some rapid questions at Jaja. He gave her a few answers, obviously trying to reassure her, then turned back to Violet. “She wants to know how long it takes and what the treatment is.”

Violet nodded. It’s the kind of thing she’d want to know too. Evan appeared back in the doorway. He gave her a wide smile—obviously good news. His broad shoulders filled the door way and the tired look that had haunted him for the past few days had disappeared.

The African sun was agreeing with him. His skin had already been a light golden-brown that was deepening with every day. It only succeeded in making his teeth look whiter than ever and his blue eyes more prominent. His brown hair was lightening in the sun, giving the ends blond tips. She couldn’t have achieved that look even if she’d spent ten hours in the hair salon. Her hair was becoming more brittle day by day. The leave-in conditioner she was using every other day in an attempt to waylay the damage made her hair feel slimy. Hardly a good look, by anybody’s standards. Why did men have things so much easier?

She was still struggling with the task he’d given her last week. Not that she wanted anyone to know that.

By anyone else’s standards she was doing fine. She’d reached out to the midwives in the neighboring villages and arranged to spend time with them all.

But a few had made it clear she’d need to see them on their own terms. Which was likely to mean in the middle of someone’s home or the local birthing room.

All things that made her bristle with nerves and wonder if she could manage this.

Having Evan here today had been a welcome break from her other work. Even though they hadn’t been working side by side today it was almost a comfort to have him around. To know that another doctor had her back in case they got into any difficulties.