‘I CAN’T stand this itching,’ Letitia said, rubbing at her hands. ‘It’s driving me bananas. My midwife said pregnant women get a bit itchy, especially in hot weather, but this is keeping me awake all night. So she sent me here.’
‘How long has the itching been going on?’ Judith asked.
‘About a week. I can’t take much more of it. My husband gets eczema and he said I ought to use his cream, but I didn’t want to risk it in case it hurt the baby.’
‘Emollients are fine—you might find that aqueous cream helps. Have lots of tepid baths, try to keep as cool as you can, wear cotton and avoid wool, try calamine lotion or rub your skin very gently with a baby’s hairbrush. But I expect you already know all that,’ Judith said wryly. ‘Is the itching anywhere in particular?’
‘My hands.’
Warning bells started to ring in Judith’s head. ‘Have you got a rash anywhere?’
Letitia shook her head. ‘So what’s causing it?’
‘I’ll need to do a couple of blood tests to find out,’ Judith said, ‘but it could well be something called obstetric cholestasis.’
‘And in English, that means?’
‘A liver problem. We don’t actually know what causes it, but it’s possible that your liver isn’t coping with the high levels of pregnancy hormones, so it’s not doing its normal job. Your liver makes bile, to help your intestine digest your food—but with obstetric cholestasis the bile flows too slowly, so it builds up in your bloodstream and causes the itching. Is it worse at night?’
‘Is it ever!’ Letitia pulled a face.
‘Did you bring me a urine sample?’
‘Yes. At twenty-eight weeks, I’ve got it down to a fine art,’ Letitia said. She fished in her handbag for the little sample tube. ‘Here.’
The urine was dark, Judith noted as she tested it for sugar and protein. ‘OK, Letitia. How are you with needles?’
‘If you can stop the itch, you can stick a hundred needles in me,’ Letitia said feelingly.
Judith chuckled. ‘It’s not going to be that bad. I’m going to take a blood sample and send it for liver function tests and serum bile tests. I’m also going to do a test for viral hepatitis and send you for a scan, just in case it’s gallstones.’
‘What happens then?’
‘If it’s obstetric cholestasis, certain chemicals will be raised.’ Namely bile acids, bilirubin, serum alkaline phosphatase and enzymes known as transaminases.
‘And you can give me something for it?’
Judith nodded. ‘We can give you something called ursodeoxycholic acid. It hasn’t been licensed for use in pregnancy, simply because it hasn’t undergone the usual rigorous testing, but studies show that it helps stop the itch and brings the liver function back to near normal.’
‘And it won’t hurt the baby?’
‘All the studies so far say it won’t. But, as I said, ursodeoxycholic acid isn’t licensed for use in pregnancy, so if you want to try it you’ll need to sign a consent form.’
‘I’ll go mad if I keep itching like this,’ Letitia groaned.
‘If you want to see the consultant and talk it through with him, I can arrange it,’ Judith said.
‘No. You sound as if you know your stuff. I’ll sign the form.’
‘OK. Though obviously I can’t give it to you until we’ve got the results of the liver tests back. We’ll also need to give you a tablet of vitamin K, to make sure that your blood’s clotting properly before you give birth.’
‘What about the baby? Is it going to affect him?’
‘If we don’t treat the obstetric cholestasis, there’s a risk you’ll go into labour early, that the baby might be in distress, or even that you might have a stillbirth. But if we know about the problem, we can keep a close eye on you—we might suggest giving you steroids to help mature the baby’s lungs, then induce you at around thirty-seven weeks.’
Letitia looked thoughtful. ‘Is it very common?’
‘No. It affects one or two in a thousand. And it’s nothing you did, though there’s a chance your mum or your sister or your grandmother might have had it.’
‘If I have another baby, will I get this again?’
‘It’s fairly likely,’ Judith told her. ‘But at least we know about it and can keep a check on you. It doesn’t usually leave any lasting damage, though you may find that you start itching when you ovulate or just before your period starts. ‘
‘What about if the tests come back clear?’
‘Sometimes you start itching before it shows in the liver tests. If they’re clear but you’re still itching, we’ll test you again,’ Judith reassured her. ‘The itching should stop within a couple of weeks after the birth, but you’ll need to look at the sort of birth control you want to use—oestrogen-based oral contraceptives can cause a bit of a problem.’ She took the blood samples and labelled them. ‘I’ll just check your blood pressure and the baby’s heartbeat.’ She quickly put the cuff of the sphygmomanometer on Letitia’s arm and began to pump it up. ‘Yep, that’s pretty good.’
‘And itchy,’ Letitia grumbled.
Judith soaked a paper towel in water, squeezed the excess water off and handed it to Letitia. ‘For the time being,’ she said with a smile.
‘Just knowing I don’t have to put up with this for much longer makes it better.’
‘Of course it does. I’ll ring you as soon as the results are through. Are your contact numbers still the same?’
‘Yes.’
‘Good.’ She bared Letitia’s abdomen. ‘I take it you’d like to hear the heartbeat as well?’
Letitia nodded.
‘Good. Because I really, really hate using the Pinard stethoscope. The Sonicaid’s so much clearer.’ She put the transponder against Letitia and the quick, steady beat of the baby’s heart filled the room. ‘Sounds good.’ She palpated Letitia’s abdomen. ‘And it feels as if the baby’s progressing nicely for dates.’ Judith smiled as Letitia restored order to her clothes. ‘I’ll ring you when the results are back, but if you’re worried about anything in the meantime, ring your midwife or call the ward and ask for me.’
The rest of Judith’s antenatal clinic went swiftly. She was on her way back up to the ward when she saw Kieran coming towards her.
‘You’re due a break, aren’t you?’
She nodded.
‘Have lunch with me?’
‘Sure.’
‘If anyone sees me gazing into your eyes, I’ll tell them I’m fascinated with one of your case histories,’ he said with a grin.
‘Actually, I do have one—a possible case of obstetric cholestasis.’ She gave him a brief run-through.
‘Isn’t your dad doing a trial on ursodeoxycholic acid?’
‘Yes. I might refer her to him, actually—depending on the test results, and if Bella doesn’t mind.’
‘I’m sure she won’t.’
They bought sandwiches in the café, then found a quiet table in the corner.
‘So how’s your day been?’ she asked.
‘OK.’
‘But?’
He sighed. ‘Tess. I nagged her into seeing her GP. She wasn’t very happy about it but she finally agreed to go. Now she won’t tell me what he said or show me what he prescribed her. If anything, she’s got snappier with me than before she went.’
‘Probably because you’re fussing too much,’ Judith said. ‘You’re being paranoid. Let her tell you when she’s ready—if you put pressure on her, she’s less likely to talk to you.’
‘How did you get to be so wise?’ he asked.
‘About siblings, when I’m an only child?’ She grinned. ‘Because I get to hear all the sob stories from my friends.’
‘Right.’ He slid one foot between hers. ‘Mmm. That’s better.’
Actually, it wasn’t. Because it wasn’t nearly enough. ‘When’s your next day off?’ she asked.
‘Friday. Yours?’
‘Tomorrow.’
He sighed. ‘Somehow we need to co-ordinate our off-duty days. But if we change them, someone’s bound to notice that we’re off together—and guess that we planned it that way.’
‘Patience,’ she counselled.
‘It’s not my strong suit.’
‘It’s not for long. Just until Tess is coping better and won’t feel threatened by me.’ She bit her lip. ‘I did ask her if she wanted to go for a pizza with me, Zo and Holls—when she came in with Charlie, I mean. Maybe I ought to ring her…But I don’t want her thinking that I was just using her to get to you, when we tell her about us.’
‘Now who’s being paranoid?’ he asked wryly.
‘I suppose.’ She smiled at him. ‘Are you coming to the fundraiser next week?’
‘If you promise to sing something for me.’
“‘Rainy Days and Mondays”,’ she said with a grin. ‘Bring Tess with you.’
‘I will.’ He paused. ‘Are you busy tonight?’
‘Why?’
‘We’re both on an early. I wondered if you fancied trying one of my world-famous omelettes.’
‘Small problem. Somebody threw my eggs out last week.’
‘Eggs that were past their sell-by date,’ he reminded her. ‘They’d be suppurating by now.’
‘No eggs, no omelette.’
‘I suppose you wouldn’t have any rocket either. Or vine tomatoes. Or apple balsamic vinegar.’
‘You are such a food snob,’ she said, laughing.
Kieran laughed back. ‘Jude, anyone who doesn’t live on take-aways is a food snob in your book.’
‘What’s this about food snobs?’ a voice asked beside them, and they both jumped.
‘You’ll be on my side, Margot. Tell her that her diet’s unhealthy. She can’t preach to our mums when she lives on junk,’ Kieran protested.
‘By rights,’ Margot said, ‘with what she eats, she ought to be the size of six houses. But she’s not. So she can get away with it.’
Judith breathed on her nails, polished them on her sleeve and pulled a face at Kieran. ‘See?’
‘Ha.’ He glanced at his watch. ‘I’d better get back to the ward. Let me know if you need a second opinion on those liver function tests.’
‘Will do. See you later.’ Judith sketched a salute to him, then smiled at Margot. ‘So was it a boy or girl?’
‘Girl. And she was gorgeous.’
‘Margot, you say that about all your babies,’ Judith pointed out. ‘Even the ones with forceps marks.’
‘That’s because they’re all gorgeous.’ The midwife smiled back at her. ‘Liver function tests? Sounds like you had a mum in clinic with obstetric cholestasis.’
‘Suspected.’ Judith nodded. ‘But our revered consultant insisted on having lunch before he’d talk about my proposed treatment plan.’
‘Fair dues, Jude. He’s been on for five hours without a break.’
‘And you must have been in the delivery room for six.’ Judith grimaced. ‘Which means I’m a total slacker, compared to you two, so I’d better get back to the ward.’ Right now. Before she said something incriminating about Kieran. She only hoped that Margot hadn’t overheard their conversation immediately before Kieran’s remark about food snobbery. One word in the wrong place, and the whole thing could explode.
‘I’ve taken up gym membership,’ Kieran informed Judith on the phone that evening.
‘Since when?’
‘Since it buys me time with you. An hour for a workout.’
She collapsed in giggles. ‘That’s one word for it, I suppose.’
Kieran suddenly realised what he’d said. ‘Oh, hell. I didn’t mean it like that. I meant an hour I could spend at the gym, plus travelling time, means an hour I can spend with you, plus travelling time. I’ll run home from yours, so I can truthfully say I’ve been pounding the deck.’
‘Just not at the gym. Kieran, I hate all these lies.’
‘So do I. But what else can we do?’
‘I suppose. So when are you training tomorrow?’
‘About the same time you get off your shift. Meet you at your place?’ His voice softened. ‘And I’ll cook you that omelette.’
‘The omelette that very nearly got us into trouble today,’ she reminded him.
‘Did Margot say anything?’
‘No. But I don’t think we should have lunch together again. Not on our own anyway. It’s not safe—we’ll start making mistakes.’
He groaned. ‘This is driving me crazy.’
‘Me, too,’ she said softly.
‘You’re on an early tomorrow, aren’t you?’
‘Yes.’
‘Then I’ll see you at six. With my six-pack. Of eggs, that is.’
Judith chuckled. ‘So you’re not really telling lies. It’s just…semantics.’
‘Eggs-actly.’
She groaned. ‘That’s terrible. I’m going.’
‘Jude?’ He paused. ‘I…’ I love you. He couldn’t say it. In case it made everything go wrong. ‘I’ll see you tomorrow.’
Somehow Judith managed to keep her mind on her job the following day. And then her shift was over. She almost ran home. Showered. Changed. And three minutes later, her doorbell rang.
‘Dinner is served. Or it will be in ten minutes,’ Kieran promised.
‘Make that twelve,’ Judith said as she closed the door. ‘First…’ She kissed him.
Time stopped. Her senses were filled with Kieran, the way he touched her, the way he tasted, his clean male scent, the sound of his heartbeat. And if she opened her eyes, she knew all she’d be able to see was Kieran.
‘You drive me crazy, Jude,’ he whispered as he broke the kiss. ‘And I haven’t got time to make love to you the way you really deserve.’
I’d settle for a quickie.
Then her face burned. She really, really hoped she hadn’t said that aloud. It made her sound too needy, too desperate. And, given what he’d already told her about leaving before things got too deep, she had to play this cool. ‘You were going to make me an omelette.’
‘Not just an omelette.’ He slid his arm round her shoulders and shepherded her into her kitchen. ‘Are we eating here?’
‘Unless you want me to set the table in the dining room?’
‘Here’s fine.’
She sat on one of the chairs next to the small mosaic-topped table in her kitchen and watched as he started removing things from his gym bag.
‘Isn’t that meant to be for your gym kit?’
‘That’s in there, too.’ He gave her a little-boy grin that made her glad she was sitting down. Her knees definitely went weak. ‘I made our first course at my place.’
‘Didn’t Tess notice?’
‘I made some for her, too.’ He opened her freezer and slid a package inside, set out the rest of the things he’d bought from the supermarket, then took out a sealed plastic box. ‘Where’s your crockery?’
‘Top right-hand cupboard,’ she directed. ‘Are we having white or red wine?’
‘White.’
‘New Zealand OK?’
‘More than OK.’
‘There’s a bottle chilling in the fridge.’ There usually was, on the off chance that Holly or Zoe would pop round. But, please, not tonight. Or at least not until Kieran’s left, she begged inwardly. ‘I’ll open it. How do you want me to set the table?’
And this was meant to be a quick meal?
But two minutes later they were sitting down with a glass of wine and a plateful of prawns mixed with mango, on a bed of baby oak-leaf lettuce.
‘This smells gorgeous,’ Judith said.
‘It’s marinaded in ginger, garlic, lime and a little nam pla. Thai fish sauce,’ he added, seeing the puzzlement in her face.
‘Mmm. And it tastes as good as it smells,’ she said after the first mouthful.
‘It gets better. I promise.’
She watched as he whipped up a soufflé omelette filled with mushrooms and blue cheese. While the top of the omelette was setting and the cheese was bubbling under the grill, he sliced some vine tomatoes and spread them over a bed of rocket, added a drizzle of balsamic vinegar and oil, then set some Italian rosemary bread and a small dish of olive oil on the table.
Judith closed her eyes in bliss at the first taste. ‘This is wonderful. I could get used to healthy food.’ Especially if he was the one to cook it for her.
‘It’s faster than a take-away, too.’
Which didn’t mean she wanted to do it for herself. A sandwich was her limit, and even then she’d rather buy one than fuss around slicing things and spreading things and using time she could spend at the piano. ‘I can’t believe you brought your own omelette pan with you.’
‘Have you got one?’ he asked.
She grinned. ‘What do you think?’
‘Exactly.’ He raised an eyebrow. ‘Maybe I can teach you to cook. Teach you that it can be fun, not just a chore.’
‘Maybe we can teach each other a lot of things,’ she said softly.
He reached across the table and took her hand. ‘Maybe.’
The omelette was followed by fresh raspberries and best-quality vanilla ice cream.
‘Bliss. This is as good as Zoe’s home-made ice cream,’ Judith pronounced.
‘I’m not claiming that. Though I do a mean chocolate mousse.’
Judith beamed at him. ‘Next time. That’s a definite.’
She made coffee afterwards and rummaged in the fridge. ‘Now, this is the kind of fast food I really like,’ she said, setting the tiny gold-wrapped parcels on a plate. ‘I think even you might agree that it’s good.’
‘What is it?’
‘Wait and see. Let’s go and sit in the living room.’ He carried the tray in while she lit vanilla-scented candles. She sat on one corner of the sofa and patted the seat next to her. ‘After cooking me that fabulous meal, I think you deserve a head massage.’
‘Sounds good to me.’ He lay down with his head in her lap and let her fingertips massage the tension away from his scalp.
‘The suspense is killing me. What’s in those parcels?’ he murmured drowsily.
‘Keep your eyes closed,’ Judith directed. She leaned forward and unwrapped a piece of gianduja. ‘Now open your mouth.’ He did, and she popped the gianduja into his mouth.
Kieran’s tastebuds were in heaven. In fact, Kieran thought he probably had died and gone to heaven. Lying here like this with the woman who occupied rather more of his mind than she ought to do, this was the perfect way to wind down at the end of the week.
The chocolate was good, too.
But he’d settle for just Jude.
‘OK, I admit it’s fabulous,’ he said softly when he’d finished the chocolate. ‘What is it?’
‘Gianduja. Otherwise known as toasted hazelnuts and cocoa butter.’
He grinned and opened his eyes again. Trust his beautiful junk-food addict to pick something like this. ‘I might have guessed you couldn’t really class it as healthy. And before you start quoting the health benefits of monounsaturated fat at me, I think the cocoa butter definitely cancels out the hazelnuts. It’s not the seventy per cent solids stuff.’
‘Spoilsport. I’ll have to eat it all myself, then,’ she threatened. But her eyes were laughing.
And this, Kieran realised, was what he wanted for the rest of his life. To be with Judith. He wanted to live with her, love her, grow old with her. ‘Sing something for me?’ he asked.
‘Any requests?’
‘I don’t mind. I just love hearing you sing.’
She stroked his cheek and he captured her hand, pressing a kiss into her palm and folding her fingers over it.
And then at last she began to sing. A slow, haunting, a cappella version of ‘The First Time Ever I Saw Your Face’. He’d heard the song before, but this was the first time it had ever meant anything. The first time it had moved him so much that there were tears in his eyes when she finished.
There were tears in her eyes, too. Tears of longing and wistfulness. Of something her face said she really wanted to say, but was holding back for his sake.
He shifted to a sitting position, so he could look into her eyes properly. What she’d just sung was the most beautiful song he’d ever heard. And she’d meant every single word. It was her way of saying the words that were straining at his own heart. The words he needed to say, right here, right now. And to hell with the risks.
‘Jude. That was…’ His voice cracked and he shook his head. ‘It was incredible. You’re incredible.’ He cupped her face. ‘I…I’m not sure how to say this.’
Fear flickered in his eyes and he could tell that her breathing had become shallow. Worried. ‘I’m listening,’ she said. The words were cool, but her voice had a slight tremor.
She thought he was going to leave her.
For her sake, maybe he should leave her.
But, heaven help him, he couldn’t. He wanted her too much.
‘I…’ He was talking through sand. The words wouldn’t come out. Why couldn’t she just be a mind-reader and know what he wanted to say?
His thumb caressed the corner of her mouth. ‘I love you, Jude,’ he breathed.
He kissed her, pouring his soul into the kiss, wanting her to know just how deeply he felt it. And when he broke the kiss, he realised his face was wet. ‘You’re crying,’ he whispered. ‘Don’t cry.’
‘I’m not crying because I’m sad,’ she told him. ‘It’s because…’
‘I know.’ He held her close. ‘I’ve never felt like this. I’ve never wanted for ever before. But now I do. I want it with you.’
‘Me, too. I love you, Kieran.’
‘We’ll have for ever,’ he promised. ‘One day. Soon.’