The Family Practitioner Page 9

‘Let’s go in here,’ Matt said shortly, and Joanna accompanied him into one of the small conference rooms. He folded his arms and leaned back against the wall. ‘I take it this is about Sasha?’

  ‘I have Mrs Wardell’s permission for us to treat her. She’s seriously worried—and with reason, I think.’

  ‘Let’s go ahead, then.’

  Joanna dragged in a steadying breath. ‘Do you want to sit in as an observer?’

  Matt’s jaw clenched. ‘No, I don’t.’

  ‘Oh.’

  He gave a click of annoyance. ‘You’re not on trial here, Joanna.’

  ‘Funny.’ Her lashes flickered up. ‘I thought I was.’

  Matt wanted to shake her. Make love to her. And everything in between. Why had he ever thought this would work? ‘What have you done with Mrs Wardell?’

  ‘Sent her off uptown for a coffee.’ Joanna ignored his dark look. ‘I’ve told her to come back in an hour.’

  ‘I’ll leave things in your capable hands, then,’ he said, his voice clipped and impersonal. ‘Now, if there’s nothing else, I’ll get back to my client.’ He pushed himself away from the wall and reached for the doorhandle. ‘Brief me later, please.’

  Watching him walk away, Joanna felt her spirits sink to the floor. His back was forbiddingly straight, leaving no doubt that on a personal level he was shutting her out.

  Oh, Matt.

  She blinked the sudden dampness away from her eyes. She wouldn’t play these games. Couldn’t. Suddenly, she felt about a hundred years old.

  She gave herself a mental shake. For heaven’s sake! She wasn’t about to cave in on her first day. She couldn’t afford to anyway, she thought dryly. She had to keep this job no matter how tough it got. She had a growing son to feed and clothe. Hauling in a long, calming breath, she made her way back to the physio department.

  Elle was just tidying up after her session with Sasha. ‘Hi.’ She greeted Joanna and actually managed a brief smile.

  ‘I’m looking for Sasha.’ Joanna looked quickly around. Surely the child hadn’t gone!

  ‘She’s in the loo.’ Elle threw several towels into a waiting receptacle. ‘I’ve told her we need a medical profile and that you might want a word. Well, Matt said you probably would.’ She added the rider with a little shrug.

  ‘Well spotted, by the way.’ Joanna sent out the warmest vibrations she could muster, not really expecting the other woman to respond.

  But Elle did. Her teeth caught on her bottom lip as she looked down at the bundle of linen she’d stripped off the couch. ‘I hope you can help her, Joanna. She’s a really sweet kid.’

  Joanna drew confidingly closer. ‘Hadn’t her coach noticed anything?’

  Elle shook her head. ‘Adolescents are pretty good at camouflage.’

  And not only adolescents, Joanna thought darkly. Adults made a pretty good job of it as well.

  ‘You could talk to Sasha in my office, if you like.’ Elle seemed to be going out of her way to be helpful. ‘It’s a pretty non-threatening environment and everything’s there that you’ll need.’ She twitched a shoulder. ‘I know you won’t have had time to get your own domain set up yet.’

  ‘Thank you.’ Joanna drummed up a warm smile. ‘That’s very generous of you.’

  ‘Matt’s aim here is to promote a harmonious work-place.’ Elle tucked a frond of hair behind her ear. ‘I’d like to think it could continue.’

  Joanna took in a long breath and let it go. ‘Well, that’s certainly put me on my mettle,’ she murmured, her eyes narrowing on the physio’s long easy stride towards another curtained-off cubicle and another of her clients.

  Joanna recorded Sasha’s blood pressure, not surprised at the low reading. Equally worrying, her pulse at ninety was very fast, indicating dehydration and malnutrition. Joanna’s medical antennae were immediately on alert.

  But softly, softly, she cautioned herself. First she would have to get Sasha’s trust, and then and only then could they work towards a successful outcome.

  ‘When did you last eat, Sasha?’

  ‘Breakfast.’ Almost defensively, the fifteen-year-old clutched her little bright red bucket bag to her chest.

  ‘Mind telling me what you had?’

  Sasha twitched a thin shoulder. ‘The usual stuff.’

  ‘I see.’ Joanna kept her voice pitched to a warm neutrality. ‘Fruit, cereal, toast? Any of those?’

  The girl’s throat moved convulsively as she swallowed. ‘Some fruit, I think.’

  ‘What was it?’ Joanna asked carefully.

  ‘Can’t remember.’

  No joy there. After the tiniest pause, Joanna smiled and drew back into the softness of the leather chair. ‘So, Sasha, how long have you been doing gymnastics?’

  The youngster’s face brightened at the change of subject. ‘My dad took me to classes when I was seven. He was a brilliant gymnast. He trained under the Russian coach, Serge Mishcof,’ she added proudly.

  It could have been under Mickey Mouse and Joanna would have been no more enlightened. Nevertheless, she strove to look impressed. ‘Did he get to any of the big games?’

  The girl shook her head. ‘He had to give up when he was nineteen. He got too heavy…’

  Joanna’s intuition sharpened. Was the child trying to take over where her father had had to leave off? It could be as simple as that. Or as complicated, she warned herself silently.

  On the other hand, as Sasha’s doctor now, she had to make a snap decision. There wasn’t time to second guess if they were to avoid a crisis with the youngster’s health. If they didn’t act now, her young life could very well go down the plughole, along with her baby-blonde hair.

  Joanna switched back into professional mode. ‘I’d like to take some blood from you now, if that’s OK.’

  ‘Why?’

  ‘Just as a precaution.’ Joanna wound the cuff around Sasha’s thin upper arm. ‘You appear quite a bit underweight for your height. Flex your fingers for me now, please, so I can tap a vein.’ It was a struggle but Joanna finally got enough blood sample to be sent off for testing. If the result didn’t come back showing Sasha’s iron stores were drastically low, she’d take her medical-degree certificate out of its frame and eat it.

  ‘How are your periods, Sasha?’ Joanna secured the vial and labelled it.

  Silence.

  Then, slowly and almost too low for Joanna to hear, she mumbled, ‘I…haven’t had them for ages…’ She raised stricken eyes. ‘Are you going to tell my mum?’

  Joanna leaned forward and took the youngster’s slender wrist. ‘She knows already, Sasha. And thank you for being honest with me. I know it took a lot of courage.’

  ‘Am I in big tr-trouble?’ The child began to blink rapidly.

  ‘Not so big we can’t find a way out of it.’ Joanna squeezed and then let go. Standing, she went to the cooler and got them both a glass of water. ‘Mind telling me why you’re not eating?’

  After the longest pause, the youngster lifted her glass and took an agonisingly slow mouthful of water, swallowing it as though it hurt her throat. ‘The other gymnasts are younger—and skinnier.’ Her teeth came down to clench on her bottom lip. ‘If I put on weight, I’ll get chucked out of the elite squad. I want to get to the Athens Games. Dad could come and watch me and—’

  ‘Be proud of you,’ Joanna finished quietly.

  Eventually, Sasha nodded.

  Joanna felt a cold river of warning run up her spine. They were swimming in very deep waters here. It was obvious Sasha had unresolved feelings about her father leaving the family and her parents’ subsequent divorce. Did she see herself responsible in some way and was she perhaps seeking a way to win back his approval through her sport?

  Whatever the reason, the child needed skilled counselling and that was right out of Joanna’s territory. But first and foremost was Sasha’s physical health and well-being and that, Joanna knew she could handle.

  ‘Right, Sasha,’ she said briskly, pulling a scribble pad
towards her. ‘You’ve been honest with me so I’ll be honest with you. Healthwise, you’ll be in serious trouble if you don’t change your lifestyle. Because you’ve been starving yourself, your whole system’s out of whack. Your body is like a delicately balanced machine—you have to take care of it if you want it to work properly. That sounds reasonable, doesn’t it?’

  ‘I guess…’

  ‘Now, as a priority,’ Joanna continued, ‘I want you and your mum to talk to one of our dieticians here. For starters, you need to begin eating meat—or pasta if you prefer—lots of fresh fruit and veg and high-energy protein-supplement drinks.’

  Sasha’s pretty mouth flattened in resignation. ‘What if I get too heavy for my routine on the parallel bars?’

  ‘Initially it might be disappointing but it won’t be the end of your life. The main thing is you’ll be fit and healthy again.’

  Sasha seemed unconvinced.

  ‘Talk to Dr McKellar or one of the coaches here.’ Joanna spread her hands in a philosophical gesture. ‘Even if your bone and muscle mass increase to an extent you aren’t suited to gymnastics, there must be a dozen other sports disciplines you could excel at.’

  A tiny dimple flickered in Sasha’s cheek. ‘Like sumo wrestling?’

  Joanna’s snip of laughter was spontaneous. She wanted to hug the child for rising so quickly to the surface, after nearly drowning.

  Good for you, sweetheart, she thought in admiration. If the youngster could keep her sense of humour to that extent, she was already halfway to recovery.

  Joanna could hardly believe it was almost lunchtime. The morning had simply flown. In their initial meeting that morning, Matt had told her to take a break whenever she needed it. There were no hard and fast rules.

  Oh, help. She placed a hand hastily on her tummy as it grumbled. She’d better eat sooner rather than later.

  The staffroom was deserted. Joanna didn’t know whether to be disappointed or glad. On one hand she wanted to be quiet, on the other she was dying to unload the details of her morning so far with Matt. As if her thoughts had conjured him up, he stuck his head around the door.

  ‘Oh, good. You’re here. Mind if I join you?’

  ‘Of course not.’ Joanna managed a tentative smile. Going to the fridge, she took out the salad she’d brought for her lunch and then moved to plug in the electric kettle. ‘Can I get you a coffee?’

  ‘Ah, no, thanks.’ He peered in the fridge and pulled out a carton of chocolate-flavoured milk. ‘Energy hit.’ He tossed her a wry grin, before ripping the carton open. He took up his stance by the window. ‘How’s your morning been?’

  ‘Very full on.’ Joanna ran her eye over the selection of herbal teas and chose a peppermint.

  His head came round, the light from the window illuminating the hard line of his jaw. ‘Is this a good time for debriefing?’

  Joanna left her teabag to infuse. ‘Are we likely to be interrupted?’

  Matt glanced at his watch. ‘Possibly. My office, then?’

  ‘Fine.’ Joanna picked up her tea-mug and plastic lunchbox and followed him.

  It was almost déjà vu, she thought. They were sitting at the window as they’d done on that first morning they’d met, when she’d come to sort out the nude calendar business. And so much had happened since then…

  ‘Why the big sigh?’

  Joanna looked uncertainly at him. ‘Nothing.’ She aimed her salad fork at his carton of milk. ‘Is that all you’re having?’ Good grief, she groaned inwardly. She sounded like his wife! That thought brought a flush to her cheeks and she hastily speared a wedge of tomato and lifted it to her mouth.

  ‘I’ve stopped growing.’ Legs comfortably outstretched and feet crossed at the ankles, Matt studied the soft curve of her mouth, stifling the urge to whirl her up from her chair and kiss her senseless. Instead, he drew his thoughts up sharply, running a professional eye over her instead. So far today, she’d used up a large amount of nervous energy, he’d do better to let her refuel.

  Joanna finished her salad, hardly tasting it. How could she, she fretted, with him sitting there? He was pretending to be engrossed in a report but Joanna knew he wasn’t. The goose-bumps on her arms were telling her that!

  She carefully placed the lid back on her container and pushed it to one side. ‘I’ve had a breakthrough with Sasha.’

  Matt’s dark head came up and he looked at her keenly. ‘You’re that certain?’

  ‘Practising as a GP gives you an instinct about these things. I don’t believe Sasha is a classic anorexic.’

  He merely raised an eyebrow.

  ‘I’ve scheduled another appointment with Gerri Wardell tomorrow.’ Joanna eyed him steadily over her mug. ‘I want to allay her fears. Sasha doesn’t appear to be driven by body image as such but she’s certainly starving herself.’

  ‘To what end?’ Matt asked carefully.

  ‘It’s all to do with her sporting aspirations and the very fixed idea she has of being too heavy to continue in the elite squad. Apparently her father had high hopes in his youth of pursuing gymnastics but matured quite early and had to give up.’

  Matt scraped his fingers around his jaw. ‘So she’s trying to take up where her father left off. Trying to please him in her childlike way?’

  ‘Seems like it.’ Joanna made a small face. ‘There’s obviously some post-divorce mopping up still to be done. Sasha’s anxiety has to be addressed. I’m going to suggest family counselling as a priority—even if the child’s father has to fly up from Sydney to take part.’

  Matt’s mouth drew in. ‘That’s a big call. I understand he’s remarried. But, on the other hand, if his daughter’s health and emotional well-being are at stake, we should do everything to encourage him to resolve things.’

  Joanna felt her spirits lift, relieved he understood.

  ‘Who did you have in mind for the sessions?’ he asked, and felt her hesitation.

  ‘I’ve looked over your names here but if you’ve no objection, I’d like to refer the family to Sally Ekersley. She’s outstanding in her field, sensitive, approachable…’ She broke off. ‘I think she could really help this family function again, even if they have to do it apart.’

  ‘You sound as if you’ve taken the Wardells to your heart,’ Matt said deeply.

  She brought her chin up. ‘I know how to stay at a professional distance, Matt. But all the time I was treating Sasha, I couldn’t help thinking it could just as easily have been Jason sitting there all screwed up and desperate.’

  ‘I can’t imagine that, Joanna.’ Matt’s gaze became shuttered. She was sitting so still, looking soft and so vulnerable, and with everything in him he wanted to reach for her, wrap his strength around her. But right now he wasn’t certain if she’d want him to do that. Wasn’t certain about her in any direction for that matter. ‘Your relationship with your son is very tight.’

  She glanced at him quickly. It hadn’t sounded like a compliment. In fact, rather the opposite. His voice had had an edge to it and the faintest thread of—what? Bitterness? Resentment? Criticism?

  ‘No disrespect, Matt.’ Joanna chose her words carefully. ‘But you’ve never been a parent.’ She took a deep breath and let it go.

  For a second Matt’s eyes seemed to lose their colour, glaze and go distant. His jaw worked. Giving an almost imperceptible inclination of his head, he picked up his report again and began to turn the pages.

  Watching him, feeling the atmosphere between them tightening like the strings of a violin, Joanna knew why she’d avoided getting involved with anyone for the last umpteen years. When it happened, it was like trailing through fog. Because once that person was there, a part of your life, it changed the balance of your whole world. Except Matt wasn’t a part of her personal life at all. And never would be if Jason had anything say in the matter.

  A tiny frown pleated her forehead. Perhaps she should have tried harder at this relationship business when Jason had been younger. If she’d found someone, he c
ould have slipped more easily into their lives, been a decent stepdad, a role model for her son. She stopped, wearied by the futile backtracking of her thoughts.

  But they wouldn’t let go.

  It wasn’t as though she’d sought to keep her son entirely to herself. She had tried to meet people. All right—prospective husbands, or partners as they were called now. But she’d been much younger then and so had the men she’d dated. There had been several special ones—but they’d been busy with life and getting established in their chosen careers. And once they’d realised she came with a child attached, it had all got too difficult, too onerous. Bring up someone else’s kid? Ah, don’t think I’m ready for that, Joanna—sorry.

  Her shoulders lifted in a dispirited little sigh. ‘I’ve left my notes on Sasha for you. They’re fairly detailed but obviously if you want to discuss anything—’

  ‘I’m sure they’ll be fine,’ he broke in, his voice professionally clipped. ‘Now, I don’t want to rush you, but we’ve still a lot of work to get through before we can call it a day.’

  ‘Mind if I take a minute to freshen up?’

  ‘Go ahead.’ Matt got to his feet and pushed his chair in. ‘How do you feel about looking in on one of our quit-smoking sessions?’

  ‘Fine.’ What else could she say? It was apparent he wanted her there, and after all she was here to learn.

  ‘These are a group who decided to quit a couple of weeks ago,’ Matt said, as they left the office and began walking down the stairs. ‘We’ll chat to them informally both as a group and individually. See what progress they’ve made and how they’re feeling about things generally.’

  ‘Sounds interesting.’ Joanna’s enthusiasm was a trifle forced and her smile didn’t quite reach her eyes.

  CHAPTER SEVEN

  IT WAS so good to be home.

  Joanna nosed her car into the garage and cut the engine. Blocking a yawn, she raised her arms to shoulder height, stretching to relieve the ache in her neck and the small of her back.

  After a few seconds, she lowered her arms, fumbling across to the passenger seat to retrieve her shoulder bag, decrying the fact she had hardly enough energy to do even that, let alone get out of the car.