Mistletoe Magic

‘You should check them first.’ Nick’s voice caught her unawares and she swung around too quickly, embarrassed but grateful that, almost like a reflex action, he reached out his arm to steady her. ‘Careful, Eden,’ he warned, and Eden was grateful for the semi-darkness, which meant that Nick couldn’t see her blushing, which she was—furiously. His fingers tightened around her wrist. ‘Do you want me to do it?’

‘Do what?’ Eden blinked, her mind having wandered well away from the subject.

‘To check the lights for you,’ Nick explained patiently. ‘Before you go to all the trouble of decorating the tree, first you ought to plug them in to make sure they’re working.’

‘Oh, Nick!’ Eden simpered. ‘What on earth would we do without you?’

‘That’s why he’s a doctor,’ Becky said in a proud, village-idiot type of voice, and Nick started to realize he was being teased. ‘Because he’s so clever.’

‘I was only trying to help.’ Nick moaned, finally getting around to his coffee and cake. ‘I’ll keep my mouth shut next time.’

‘Please.’ Eden grinned, resuming the difficult task as Nick picked up his cake and eyed it greedily.

‘I’ve just realised that I’m starving.’

‘Well, enjoy.’ Becky smiled. ‘Eden didn’t want any so there’s another piece here if you fancy it.’

Quite simply, Eden couldn’t resist it. Still on the footstool, the fairy lights poised in her hand, she turned her head to watch Nick’s face as he took a bite of the moist chocolate sponge and Becky pushed the container holding Eden’s slice towards him. ‘Help yourself, Nick.’

It was sheer poetry in motion. Nick closed his eyes, just as one did when one was about to sink teeth into something divine. Eden watched as he took a very generous bite of the chocolate cake and then witnessed his eyes snapping open. The public school system had certainly done its job when they’d taught young Nicholas his manners because his moan of horror turned in an instant to a groan of approval.

‘What ingredients do you use, Becky,’ Eden asked innocently, turning her attention to the tree and smothering a smile, ‘to get it so moist?’

‘Tofu,’ Becky smiled. ‘Though I swear a good soy milk helps—none of that genetically engineered rubbish. And Hamish has found a store that does the most delectable vegan chocolate chips. I’m going to make one of those for Christmas—this was just a practice run. You will come,’ Becky checked, jumping up as a buzzer went off. ‘I’ll get it.’

‘What the hell is it?’ Nick choked, using the paper towel Becky had thoughtfully provided but for a reason she had never intended!

‘It’s awful, isn’t it?’ Eden giggled. ‘All her food’s the same. It looks fantastic, but when you taste it. Don’t!’ Eden yelped as Nick went to toss the rest of his cake in the waste-paper basket. ‘She’ll see. Use the sharps bin.’

‘I gather that you’ve done this before,’ Nick said in a loud whisper, shoving the remains into the sharps bin, which had a closed lid that hid the contents from sight.

‘Many times,’ Eden admitted.

‘You absolutely cannot go there for Christmas. It’s no wonder Conner and Hamish are throwing tantrums if that’s what Becky’s trying to feed them!’

‘What can I say to her?’ Eden giggled again. ‘She knows that I can’t get home and, given she was there when I found out, it’s not as if I can pretend I’ve got other plans.’

‘You could have,’ Nick reminded her, but thankfully her pager bleeped, giving Eden an excuse not to get into the uncomfortable topic. Glancing down at her neon yellow pager, the numbers displayed were instantly recognisable as Accident and Emergency. As Eden was the admitting nurse for the paediatric unit that evening and all admissions had to come through her in order to be allocated, it could only mean one thing—a new admission was on the way.

‘Eden Hadley, admitting nurse for Paeds,’ Eden said as she was connected, listening to an unfamiliar nursing sister and scribbling down an initial diagnosis as Nick looked on. ‘Chest infection or difficulty feeding.’ She shared a wry grin with Nick as Emergency attempted to shuffle their patient to the top of the list. ‘And he’s three years old. Have we had him before?’

An incredibly long wait ensued as the nurse attempted to locate the patient’s history, reeling off a long list of complaints until finally Eden halted her.

‘Ben!’

‘No,’ came a hesitant voice down the line. ‘The name I’ve got is Maxwell Benjamin Reece, he’s a three-year-old with Down’s syndrome. He’s also…’ The nurse lowered her voice and Eden rolled her eyes, finishing the sentence for her.

‘HIV positive. He’s familiar to the ward, but he goes by the name of Ben. Could you let the staff who are dealing with him know that, please? Who’s with him?’

The frantic scribbling on her notepad had stopped—Ben was familiar to anyone who worked on the paediatric unit and Eden didn’t need to write down his past history. She gave a frown as the emergency nurse cheerfully declared that he had come in accompanied by Lorna, a social worker. It became clear that, yet again, little Ben was a ward of the state, that he’d had a chest X-ray and that they wanted to send him up soon as they were getting pretty full. Maybe it would be better if he was in familiar surroundings.

‘Send him straight up,’ Eden said, replacing the phone in its cradle.

‘Ben?’ Nick checked.

‘Minus his new foster-parents.’ Eden ran a hand through her hair, pulling out her tie and collecting all the loose curls that had fallen out and replacing them, an automatic gesture she did ten, maybe twenty times a day,

‘What’s the diagnosis?’

‘They’re fumbling to get one.’ Eden gave a tight smile. ‘Why don’t they just admit that little Ben’s too much like hard work?’ Closing her eyes for a moment, she instantly regretted her words. It wasn’t for her to judge. Ben wasn’t just her favourite patient. Everyone, from cleaner to consultant, adored Ben, but, as cute as he was, he had been dealt more than his fair share in life. Genetic, social and hereditary problems seemed to have aligned when he had been conceived. ‘I’m just sick of seeing him passed around, Nick. It just doesn’t seem fair that one little boy should have to put up with so much.’

‘He’s happy,’ Nick said soothingly.

‘Is he?’ Eden wasn’t so sure. ‘He just doesn’t know any better, Nick. He’s never been given a chance.’

And though no one could have expected a drug-addicted teenage mum to deal with a Down’s syndrome baby, if Ben’s mum had only revealed her pregnancy earlier than in the labour ward, had received antenatal care and been diagnosed as HIV positive, then she could have taken some measures that could have lowered the chances of her transmitting the disease to her son. Sophisticated antiretroviral drugs could have been given during pregnancy and labour, even in the period following birth, but Ben had received none of these. Only when his mother’s results had come back ten days post-birth had her HIV status been revealed, and despite the best preventative treatment her HIV status had been passed on to her son. As the weeks had dragged by into months, as endless foster-parents had tried and failed, little Ben was constantly returned to the hospital. It would seem that hospital was the only home this little boy knew. But Nick seemed to understand how Eden was feeling.

‘Someone will come along soon for him.’

‘When?’ Eden asked, not even attempting to hide the bitterness in her voice. ‘He’s not going to live long, Nick—you and I both know that. I just really hoped…’ She didn’t finish, couldn’t, tears stinging her eyes.

‘Really hoped what?’

‘That he’d get one Christmas with a family, that this foster-placement would work out…’ Eden choked, ‘One Christmas of being of spoilt and cuddled, one Christmas being loved…’

‘Ben doesn’t go short of cuddles,’ Nick pointed out, ‘All the staff love Ben. He’ll get all that here.’

Eden shook her head. ‘Twenty-eight kids will get that here, Nick—the nurses will make sure of it—but most kids that are here over Christmas are here because they’re very sick. We’re stretched to the limit normally, but especially over Christmas. Most of the children will have parents and siblings, aunties and uncles to dote on them, and Santa will come and visit. We’ll do our very best for Ben, but no matter how hard we try it’s not the same as…’ she took a deep breath ‘…a family Christmas. As much as you mock it, Nick, as much as we all grimace sometimes at the thought of it, we wouldn’t have it any other way. And that little guy has never had it, not even once.’ Eden shook her head, more to clear it. She couldn’t allow herself to get so involved, it wasn’t healthy for anyone. ‘I’d better go and get a cot ready—he’s already on his way up.’

One look at those big brown eyes and Eden was instantly reminded why Ben was everyone’s favourite—it wasn’t just sympathy for his ailments that evoked such a response, it was all to do with a little guy who could melt the hardest heart at fifty paces. His dark hair was a wild mop around his little face, his almondshaped eyes were always expressive, and his cute mouth broke into a wide grin despite the bottle he was halfheartedly sucking on as Eden greeted him.

‘Hey Ben, we’ve missed you!’

‘Den!’ Ben answered, and Eden was thrilled that he remembered her name. He’d only just started to talk a few weeks ago when he’d last been admitted as a patient, and Den had been one of his early words, more being near the top of the list.

More milk.

More chocolate.

More cuddles.

But his first word had been the one that had torn at Eden. Whereas most children started their vocabulary with a gummy mum or dada, Ben’s first word had been no.

No to the endless drips and IVs, no to the mountain of medicine he had to take and, saddest of all, no, when his favourite nurses’ shifts ended and they popped in to say goodnight.

Lifting him up off the trolley, Eden expertly negotiated the oxygen tubing and carried him to his freshly made-up cot. She propped Ben up on a couple of pillows she had prepared so that he remained semiupright to allow for greater chest expansion and strapped an oxygen saturation probe to his fat foot. There was no murmur of protest. Ben was way too used to the procedure to fuss, as most toddlers would have.

‘I’m just going to speak to the nurse and then I’ll be back, Ben.’

The nurse giving handover didn’t have much more information to give than she’d had over the telephone. ‘He’s reluctant to take fluids and mildly dehydrated and his ears are clear. But he wasn’t about to let us look down his throat…’

‘Typical Ben.’ Eden smiled, knowing how much Ben hated having his throat examined. ‘Why hasn’t he got an IV?’

‘The doctor thought we should rehydrate him via a nasogastric tube first.’

‘But he hasn’t got one in,’ Eden pointed out.

‘We tried to put it down but he got very distressed. We’re trying him with his bottle.’ The nurse didn’t quite meet Eden’s eyes as she answered and even before her next question came, Eden already knew the answer.

‘Has he been given any antibiotics?’

‘Oral,’ the nurse said, pointing to the prescription chart. ‘He’s only got a mild infection—this admission seems more social.’

Lorna, the social worker, gave a murmur of agreement. ‘The family just couldn’t cope. We’re going to have to look for some alternative type of placement. Ben’s just proving too hard to place with a family. His medical needs are so time-consuming and behaviourally he’s very demanding as well…’

‘Because he’s confused,’ Eden argued futilely. ‘Once he settles into a routine he’s fine. Look how good he is here.’

‘I know,’ Lorna sighed. ‘But it’s looking more and more likely that Ben’s going to end up in a residential unit—there aren’t many foster-families out there capable of looking after a child with Ben’s needs. I’ll speak to Donna first thing tomorrow and pencil in a team meeting for the end of this week. We really do need to look at some other options for Ben.’

‘Donna?’ The emergency nurse asked.

‘She’s the paediatric unit manager,’ Eden explained as she took the admission notes and X-ray films, her heart sinking at the thought of Ben living out his short life in a long-stay residential facility. ‘As you can probably tell, we all know Ben pretty well. What bloods have been done?’

‘None.’ The emergency nurse gave a rather too casual shrug. ‘It was a locum and he’s not used to taking blood from a child. He thought it might be better for Maxwell, I mean Ben, if the paediatrician did it on the ward.’

It would have been easier to say nothing, to just take the notes and say goodbye, but Eden simply couldn’t just walk away.

‘Did you remind the doctor about universal precautions?’

‘I’m sorry?’ Confused, the nurse frowned back at her.

‘Did you remind the doctor that every patient, regardless of their symptoms or status, should be treated as if they have a communicable blood disease?’

‘I don’t know what you mean,’ the nurse said, but from the colouring in her cheeks she clearly did.

‘We know Ben’s HIV positive,’ Eden said tersely. ‘Remind the doctor for me that it’s the patients we don’t know about that should cause us the most concern.’

‘Eden.’ As the emergency nurse stormed off, Lorna touched her arm. ‘Don’t go getting upset.’

‘Why don’t they just admit that they didn’t want to put an IV in, rather than coming up with all that nonsense about pushing fluids and the doctor wasn’t used to taking blood from children? What the hell’s he doing a shift in Emergency for? It’s a cop-out and everyone knows it!’

‘Just who are you really cross with here, Eden?’

‘Don’t try your psychobabble on me, Lorna,’ Eden said, running a worried hand over her forehead. ‘Do you really think he’s going to end up in residential care?’

‘He might,’ Lorna said warily. ‘Look, Eden, there’s nothing you can do. We’ve been over and over the options and there’s just no way that you can manage—’

‘Manage what?’ Nick’s voice had both women jumping, and Eden shot an urgent look at Lorna as Nick frowned at the two of them, clearly expecting to be brought swiftly up to date.

‘We were just discussing Ben’s long-term care,’ Lorna said warily. ‘Discussing his options.’

‘And what exactly is it that Eden can’t manage?’ Nick asked, his question direct, his eyes swinging between the two women who were both taking great interest in the floor all of a sudden.

‘Nothing,’ Eden mumbled. ‘I was just moaning about the staff in Emergency, how they didn’t take any blood or put in an IV. Lorna just pointed out there was nothing I could really do to change things, that technically they’d done nothing wrong.’ A lousy liar at the best of times, Eden scuffed the floor with her foot, only letting out a relieved breath when Nick, clearly not impressed, stalked off.

Eden looked anxiously at Lorna. ‘You won’t say anything?’

‘Why would I?’ Lorna shrugged. ‘You’ve done nothing wrong.’

‘Thanks.’ Eden gave a tense nod. ‘It’s just if anyone found out, they’d think…’

‘That you were too involved?’ Lorna finished for her. ‘Which you are, Eden.’

‘I can handle it,’ Eden said stiffly, but Lorna didn’t look particularly convinced.

‘You know my pager number—if you need to talk any time, call me.’

Nick was already midway through his examination by the time Eden arrived at the cot-side. She smiled down at Ben as Nick gently probed his abdomen.

‘Could you hold him for me while I check his ears and throat?’ Nick asked.

Eden happily obliged. She picked Ben up and took a seat, holding his head against her chest as Nick carefully checked one ear and then deftly turning Ben around so that the check could be repeated on the other side.

‘Now for the fun bit,’ Nick said in a dry tone.

Eden held Ben tightly, one hand clamped on his forehead, as Nick attempted to check his throat. But this was the part Ben hated. Instantly he clamped his jaws tight, shaking his little head furiously as Nick waited with his lolly stick and torch poised for when he finally gave in and opened his mouth.

‘Come on, buster,’ Nick coaxed. ‘It’s only going to take a second.’

And as Ben finally gave in, his mouth opening in a sob of fury, Nick pushed down his tongue and peered down his throat. Ben squealed his protests and Eden waited, waited for the cursory examination to be over, for the torch to flick off and for Nick to throw the lolly stick into the plastic bag, but instead Nick was pushing the stick harder. Ben gagged and Eden’s knuckles were white as she struggled to hold his head still. Nick peered around the child’s mouth. For an appalling second Eden thought she might let go, that she might just rip that blessed lolly stick out of Nick’s hand, might tell him to stop looking for things that she didn’t want him to see.

But she didn’t.

Instead, she held Ben firmly, fear—pure, naked fear—growing in the pit of her stomach. Cold fingers of terror touched her heart as Nick finally pulled out the lolly stick, but instead of taking Ben from her as he always did, instead of comforting the sobbing child, he pulled off his gloves and gently probed the little boy’s neck, his fingers working their way slowly down to his axilla.

‘Lay him on the cot for me.’

Nick’s voice was flat, his eyes not meeting Eden’s as she did as she was told. She watched as he pulled off Ben’s nappy and carefully examined his groin.

‘He’s a bit dehydrated. We should put in a drip and do some bloods.’

‘I can try and give him a bottle. Maybe once he’s settled…’ She stopped talking as Nick almost angrily shook his head.

‘He isn’t drinking because his mouth is sore,’ he explained. ‘He’s got oral candida.’ Children the world over got thrush—there were two babies on the ward at this very minute with the same condition—but the huge difference was that Ben was three years old and was HIV positive, and thrush was one of the warning signs in a child like Ben that his condition could be tipping over into full-blown AIDS. ‘He’s got enlarged lymph nodes, Eden.’ Nick’s voice bordered on the apologetic, as if the news he was delivering was somehow his fault. ‘And from his notes he’s lost weight since his last admission. We need to do a full lab screen and see exactly where we are.’

The treatment room was the place of choice for performing procedures. Any child upset on the ward made the other children anxious and where possible patients were moved to the treatment room well out of earshot of the other children. Even though Ben’s skin would be numbed, the insertion of an IV and taking of blood was distressing for a small child, especially one like Ben who, even if he couldn’t feel it, knew exactly what was happening and his tears and distress would upset the other children on the ward. But Ben had passed through the doors many times and Eden felt him stiffen in her arms as she carried him along the corridor. ‘It’s OK, sweetheart,’ Eden said softly. ‘Dr Nick’s just going to fix you up with a drip so we can make you feel better very soon. He’ll be very gentle.’

They worked well together. Eden held the reluctant toddler firmly as he bucked and struggled to get off the treatment bed, one hand gripping his arm tightly as Nick attempted to bring up a vein. She talked to Ben all the while, smiling down at him as Nick cut up tape, knowing full well that IV access in a child had to be secured very firmly if a repeat procedure was to be avoided.

‘I’m in,’ Nick said, but Eden didn’t move, just held on tightly to Ben while Nick secured the bung then put an arm splint in place, immobilising Ben’s little arm and then applying a huge bandage.

‘Leave a gap,’ Eden reminded Nick, because the IV site needed to be checked regularly to ensure that the line was patent and there were no signs of infection.

‘Done.’

Only when Nick had said that word did Eden relax. At that point a child would normally be handed to his parents for a well-earned cuddle and Eden was more than happy to fill in, but Nick did the honours, scooping up his patient and holding him firmly.

‘I’m sorry, Ben, but that nasty old drip is going to make you feel much better soon.’

His clipped public school voice was supremely gentle and his firm grip still tender. Eden watched as Ben relaxed under Nick’s touch, the exhausting day catching up with him. His sobs became less urgent, fading into a hum, each blink of Ben’s eyes lengthening in time as Nick cuddled him to sleep.

‘He’s going to sleep,’ Nick said. He didn’t lower his voice but kept it steady. Most babies were soothed by background noise, comforted by an adult presence, but Ben in particular was more than used to the constant hum of a busy hospital ward.

‘Keep on doing what you’re doing, Nick. Ben’s almost impossible to get to sleep. I’ll go and prepare his cot and set up the IVAC. You’ve got time?’ she checked, knowing a lot of doctors didn’t list rocking babies in their job description.

‘I’ll make time,’ Nick said, not looking up, just holding the little guy tight. Eden had anticipated his answer—Nick’s patients came first always.

Of course, as soon as they laid him down, Ben awoke and, despite his sore throat, screamed loudly, his face purple as he simultaneously coughed and wept. All Eden could do was hold his hand and rub his forehead. She willed sleep to arrive for him so that his tortuous day would be over, but again and again Ben fought sleep. Every time Eden thought he was, and attempted to slip out of the room and check on the rest of her patients, Ben would break into distraught sobs, his oxygen saturation dropping markedly as he vomited.

‘Should you give him something to settle him?’ Eden asked, watching anxiously as Becky and Rochelle ran the length of the ward. She knew that she really ought to be out there, helping.

‘I’d rather not when all he wants is a cuddle.’ Nick let out a weary sigh, but suddenly his voice brightened. ‘I’ve got an idea. Wait here!’

As if she had a choice!

Turning her attention back to Ben, Eden offered him his soother again, gently pushed him back down on the pillow, feeling resistance in every muscle. But suddenly he relaxed, the soother in his mouth slipping as his red, chafed face broke into a smile that could only be described as wondrous.

‘Hey!’ Eden grinned back. ‘What do you see, little guy?’ Turning around, following Ben’s gaze, a smile broke out on her own face as she stared at the still crudely decorated Christmas tree, naked of tinsel and with the star at the top missing. But the lights she’d draped were turned on now, twinkling and flashing, and, Eden decided as Ben’s sobs gave way to tiny whimpers, never had a tree looked more beautiful.

‘See the lights,’ Eden whispered. ‘They’re all little fairies, little fairies looking out for Ben…’ She couldn’t go on, the words that normally came so easily as she soothed a distressed child off to sleep just too hard to say tonight. The words stuck in her throat as she wrestled with her tears, sniffing loudly and trying to smile down at the little boy.

But Nick was there now, tucking in the sheet around a now sleepy, docile Ben. Taking Eden’s arm, he led her out of the room and into the first private available space, which happened to be the store cupboard.

‘He’s got full-blown AIDS, hasn’t he?’ Eden gulped, waiting, hoping for Nick to deny it.

Instead, he gave a tired shrug. ‘We won’t know that until the blood results comes back but, I have to admit, it doesn’t look great.’

‘It could just be a simple case of thrush, though,’ Eden said hopefully. ‘And just because—’

‘Eden?’ Nick broke in, his voice questioning, his eyes narrowing as he stared down at her, taking in the swollen reddened eyes, the trembling hands, her top teeth biting her bottom lip as she made an effort to keep from breaking down. ‘Why don’t I feel like I’m talking to Ben’s nurse here? Why do I feel like I’m comforting a parent?’

‘I’m allowed to be upset,’ Eden retorted, pulling a tissue out of her pocket and blowing her nose. She pulled herself together and forced a smile. ‘Look, I’m fine. It was just a bit of a shock, that’s all. I really was expecting this to be a social admission. When you looked down his throat, I wasn’t expecting you to find what you did. It just threw me.’