Christmas On The Children's Ward

‘What’s the problem, Priscilla?’ Eden asked, smiling as she made her way over to the bed.

‘This isn’t the dinner I ordered.’ Frowning down at her plate, Priscilla stabbed at a defenceless piece of roast chicken and vegetables. ‘Mummy ticked the chicken nuggets for me—look.’ She held out the menu card for Eden, but Eden didn’t need to read it to know what was on it.

‘You had nuggets for dinner last night,’ Eden explained patiently, ‘and the previous night as well.’

‘Because I like nuggets.’

‘Do you remember that Dr Nick said you were to have more variety in your diet? Well, instead of having chicken nuggets, why not try having some roast chicken and some of the lovely vegetables?’

‘I don’t like vegetables.’ Priscilla pouted, her bottom lip wobbling, tears filling her big blue eyes, and Eden was grateful that Priscilla’s mother wasn’t there because it was at about this point that Priscilla was used to adults giving in. But Eden stood her ground, undoing the little pack of fruit juice and pouring some out for Priscilla.

‘When Mummy comes I’ll tell her to go and get me some nuggets from the take-away.’

‘You’re going to turn into a nugget one of these days.’ Nick was there, ruffling Priscilla’s hair, grinning broadly and completely ignoring her tears. ‘I told Eden that you were going to eat some veggies for me tonight, Priscilla. Now, you’re not going to make me look silly, are you?’

‘I hate veggies,’ Priscilla snarled, slamming down her knife and fork with a clatter that alerted her fellow patients to the start of yet another of Priscilla’s rather too frequent dramas.

‘Come on Princess, eat your veggies,’ Rory, a cheeky ten-year-old with his leg in traction, called out.

‘Yeah, come on, Princess,’ Declan, a five-year-old post-tonsillectomy patient chimed in.

‘Cut it out, guys,’ Eden warned, pulling the curtains and shutting out the delighted audience while Nick stood firm with his patient.

‘Roast chicken and vegetables are what’s for dinner tonight—’ He didn’t finish. Priscilla’s meal tray crashing loudly to the floor, courtesy of a flash of temper, interrupted the conversation. Her angry face stared defiantly at both Eden and Nick, awaiting their reaction as a few cheers erupted from the other side of the curtains.

‘Whoops,’ Nick said calmly, which clearly wasn’t the reaction Priscilla had been expecting. Her angry face puckered into a frown, her expression changing from fury to utter indignation as Nick calmly continued talking. ‘Not to worry. Accidents happen. Eden can ring down to the canteen and order you another dinner.’

The tears started again, angry furious tears, her pretty face purple with rage.

‘Do you need a hand?’ Becky asked, arriving with the mop and bucket as Eden picked the remains of the meal off the floor. ‘Her mother has just arrived,’ she added in a low tone to Nick as she bent down to help Eden.

‘What’s going on?’ Rose Tarrington clipped into the ward on smart high heels, her petite frame in an expensive chocolate brown suit, well made-up eyes frowning as she pulled open the curtains and surveyed the mess.

‘Priscilla knocked over her dinner,’ Nick responded calmly. ‘Sister’s just going to order her another one.’

‘But she won’t eat that.’ Rose pointed a manicured finger at the messy remains. ‘I know you want her to have some variety, but you can hardly expect her to suddenly start eating roast meat and vegetables overnight!’

‘The other children are,’ Nick broke in, staring around the ward at the other three children, all eating their dinners.

‘Look, Princess.’ Rose made her way over to her daughter’s bedside and cuddled the distraught child. ‘Why don’t you do as the doctor and nurses say? Eat your dinner and then, if you do, I’ll go over the road and get you some ice cream.’

‘Could I have a word at the nurses’ station, please, Ms Tarrington?’ Nick broke in, and Eden watched as the woman stiffened.

‘I’m just talking to my daughter.’

‘It won’t take long.’ Nick’s voice was even but it had a certain ring to it that told everyone present he wasn’t about to take no for an answer.

‘Becky can stay with Priscilla,’ Nick instructed. ‘Eden, would you mind joining us, please?’

Eden rather wished he’d allocated her to clean up the mess and sort out Priscilla. A nine-year-old throwing a tantrum she could deal with blindfolded, but a brutal dose of honesty, as only Nick could deliver it, wasn’t going to be particularly pleasant, though it was called for.

The endless talks with the nursing staff, doctors and dieticians clearly hadn’t made the slightest bit of difference to Rose or Priscilla’s behaviour and now, Eden guessed as she followed Nick to the nurses’ station, the kid gloves were off. Nick’s only priority was his patients.

‘Have a seat.’ Nick gestured to the tense woman, barely waiting till she was seated before diving in.

‘I’ve asked Sister Hadley to sit in so that we can all be on the same page,’ Nick explained. ‘For Priscilla’s sake, we all need to be taking the same approach.

‘We don’t seem to be getting very far, do we, Rose?’ Nick started softly, but Rose Tarrington clearly wasn’t in any mood for a gentle lead-in. Brittle and defensive, she stared angrily back at Nick.

‘Perhaps if you stopped focussing on my daughter’s diet and found out just what the hell the problem is with her stomach, we’d start to make some progress. Priscilla’s been in here a week now and apart from a few blood tests and an X-ray, she’s had nothing done for her.’ Rose’s hands clenched in frustration, her legs tightly crossed. She was the complete opposite to Nick, who sat relaxed and open in the chair opposite. ‘Oh, and an ultrasound,’ Rose spat, more as an afterthought. ‘We could have done all that as outpatients. I’m not asking for favours, but given the fact my daughter’s a private patient…’

‘That has no bearing.’ Nick shook his head. ‘I have a mixture of private and public patients on my list, Rose, and I can assure you they all receive the same treatment from both me and the staff on the ward. Yes, as a private patient Priscilla could, no doubt, have had all these investigations done speedily as an outpatient, but, as I explained to you in Emergency when I admitted your daughter, given that Priscilla has already missed out on a third of her schooling this year, it really is imperative that we find out what’s causing her abdominal pain and causing her to miss so much school. Which…’ As Rose opened her mouth to argue, Nick shook his head, speaking over the angry woman. ‘Which we have,’ he said firmly. ‘The abdominal X-ray showed that Priscilla was chronically constipated, the ultrasound told me that there was nothing acutely wrong and her blood work confirmed my clinical diagnosis. Priscilla is anaemic, her cholesterol is high…’ He paused for a second, only this time Rose didn’t jump in to argue, this time Rose closed her eyes as Nick gently but firmly continued. ‘Now, I could put on her on some iron tablets. However, that would only cause further constipation. To counter that, I could prescribe a fibre supplement, but I don’t think Priscilla would drink it. I could, of course, give her laxatives, but the thing is I’m not prepared to do that when all she needs is a varied, healthy diet and an increase in her physical activity.’

‘That’s all she needs, is it?’ Rose’s tired, angry eyes were bulging as she spoke. ‘You’ve seen what she’s like when she doesn’t get her own way. I work ten-hour days and, yes, it’s easier to pick up a take-away than to start cooking, but what am I supposed to do when it’s the only thing she’ll eat. I can hardly let her go to bed without eating…’

‘You could,’ Nick replied, but Rose just scoffed.

‘You obviously don’t have children, Doctor. Don’t you think I already feel guilty enough about the hours I work, without spending every evening fighting with my daughter over what she wants for dinner and sending her to bed hungry? No doubt you’ll be telling me soon to cut down my hours and start spending more quality time…’ Tears came then, choking, angry tears, her tiny, exhausted frame heaving, her hand pressing on her mouth as she tried to hold it all in. Nick still calmly sat there, not remotely embarrassed, pulling a couple of tissues from the box on the desk and handing them to her before pressing on.

‘I wouldn’t dream of telling you to cut down your hours, Rose. I’m aware that you’re a single parent. You’re doing an amazing job—’

‘Don’t patronise me,’ Rose snarled as she blew her nose. ‘Don’t try and tell me I’m doing well when you clearly think I’m an unfit mother.’

‘No one thinks that.’ Eden said, her voice a gentle interlude from the painful conversation. ‘We’re not ganging up on you, Rose, we all just want to do the best we can for Priscilla. Nick isn’t suggesting that you’re an unfit parent. If that were the case, we’d be having this conversation in an office with a case worker present so, please, let’s try and not go there.’

Standing, Eden fetched a drink of water for Rose from the cooler, a tiny nod the only response from Rose as she handed it to her. Nick waited as Rose had a drink and then continued.

‘Eden’s right. I don’t think that for a moment.’ Nick shook his head. ‘And you’re right as well. I don’t have kids, but my sister is a busy GP with three little ones and is in the process of getting a divorce. I’ve heard from Lily all about the guilt, the endless juggling and the pressures of trying to do the right thing.’

‘It’s just so hard,’ Rose choked.

‘If it carries on like this, Rose, it’s going to get harder,’ Nick said as Rose frowned. ‘Priscilla is so constipated that if the situation continues, very soon she could end up with some overflow.’ When Rose frowned, Nick clarified his words and Rose closed her eyes as he did so. ‘She could have episodes of faecal incontinence. Priscilla has already told some of the nursing staff that she gets teased at school about her weight. Can you imagine how much harder it will be for her if she starts to soil her pants as well?’

Eden half expected an argument, but all the fight seemed to go out of Rose. The hotshot lawyer was gone, leaving just a terrified mum sitting on the chair. ‘She already has,’ Rose whispered through pale, trembling lips. ‘Only once, but…it’s all my fault, isn’t it?’

‘We’re not going there, remember? We’re here to deal with the things we can change, and the past isn’t one of them.’ Nick gave a very nice smile, peeling another wad of tissues out of the box. ‘Come on, Rose, blow your nose and stop the tears and let’s work out what we’re going to do.’ He glanced over at Eden and she took her cue.

‘At the moment Priscilla’s used to getting food as a reward and she’s using it to her advantage,’ Eden explained. ‘For example, you said to her tonight that if she ate her dinner then you’d get her an ice cream.’

‘It’s all I could think of to get her to eat her dinner,’ Rose admitted.

‘How about, leaving out the “if”,’ Eden suggested. ‘Try “Eat your dinner, Priscilla, and then I’ll read to you” or “then we’ll watch a movie together” or “then I’ll help you with your homework”.’

‘Spend some quality time with her?’ Rose asked, only this time it was said without contempt.

‘For want of a word, only in this case it’s time you would usually spend arguing,’ Eden responded. ‘In the morning, you can do the same: “Eat your breakfast and then you can watch some television.”’

‘Make it non-negotiable,’ Nick said, ‘but at the same time make out it’s no big deal. Be matter-of-fact about it—she has to eat her meals, and by that I mean the meals you provide for her, not the ones she demands.