little worse, and the whites of his eyes were also starting to show the effects of the bilirubin in his system.
And then there were the neurological symptomsâ¦
âWill Dr Croft be coming to give me the results of the scan, do you know?â the man asked as James covered him again.
âI expect so. Iâll ask him to keep me informed.â He paused and met his eyes. âIt may be nothing, you know. Donât borrow trouble.â
He smiled wearily. âNo. Iâve been feeling a little light-headed and woozy off and on for weeks. I thought it was because I wasnât keeping much down or eating very much, but I doubt it. Is there any way I can get the results before my wife gets here for visiting at three?â
âIâll chase it up,â James promised, and, leaving him, he went back to the nursing station and got the switchboard to page Guy.
âAny news on Symes?â
âYesâI was just coming up. Not good, Iâm afraid.â
James sighed. Heâd thought as much. âOK. Iâll be on the ward.â
âIâll come and find you before I tell him, show you the photos.â
âCheers.â
Guy took a few minutes, and in that time James chased up some lab results for another patient and requested a nasogastric tube to aspirate a nauseous patient in under observation for query appendix with a very atypical presentation.
Heâd just finished writing up the notes when Guy arrived at his elbow and snapped the film onto the light box. âThere you go. Three of the little bastards,â he said softly, pointing out the small white blobs on the plate.
âWill you do anything?â
He shrugged. âWe could give him radiotherapy, but it needs a head mask to hold him in the same position every time and he struggled with the scanner, apparently. A bit claustrophobicâand the mask is worse, as you know. Iâll talk to him, see how he feels. He might think itâs not worth the hassle, given the odds. I donât need to elaborate, I take it?â
James shook his head and took a nice, slow breath. âNo. Itâs all utterly familiar.â
Guy cocked his head on one side and studied him searchingly, so that he felt like a bug under a microscope. âAre you OK with this? Do you want me to handle it alone?â
âNo, and no,â James said frankly, and Guy gave a wry, understanding smile and laughed without humour.
âLetâs go and tell him, then.â
Â
âI gather Stephen Symes has got brain mets.â
âYup.â
Kate studied him for anything further, but there wasnât a flicker. He could have been utterly indifferent, but she just knew he wasnât. âHow sad,â she prompted.
There was a flicker then, a tiny one, gone before she could analyse it. âYou think? In his shoes Iâd welcome it. At least itâll get it over with.â
Kate sighed inwardly. Sheâd have to see if she could get some information out of Guy. So far heâd been disappointingly unforthcoming, but she didnât want to come right out and ask James where his wife was and what had happened to her. She had a horrible feeling she knew the answer.
âClinic this afternoon,â she said, changing the subject. âThereâs a teenage girl with vomiting, weight loss and a small mass in the upper abdomen. I was going to see her, but Iâm busy with follow-ups on patients I really want to see, and Iâm feeling generous, so Iâll let you have herâsee what you make of it. You might want to do a gastroscopy. And if you have any difficultiesâif you feel I need to see herâ¦â
âIs that likely?â he asked, and she had to convince herself to let go. She liked to see the kids herself.
âProbably not. But just in case. Thereâs also a patient with Crohnâs who might need surgery tomorrow, and Iâll give you a few others. I know youâre more