To Save My Child
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Synopsis
Only two days ago, Anna had been remarking to Libby how grown up she looked, standing in the kitchen in her school uniform. Now, on the hospital bed, she looked so tiny. So vulnerable. Anna kept hold of her hand, whispering a promise under her breath – a promise that felt like a prayer: ‘I will do anything if you just get well again, baby girl. Anything at all.’
Anna and Libby. Libby and Anna. It’s just been the two of them since Anna escaped a marriage that was threatening to destroy her.
She’d thought being a single mother would be hard, and if she was honest – sometimes it was. Looking after her little girl could be exhausting. But it wasn’t nearly as hard as being a parent in an emotional warzone. And when Libby smiled in her innocent way, it made Anna light up inside.
She’d look at Libby and think it’d all be okay. That she’d make sure it was. For her daughter, and for them both.
But then Libby gets ill, with a rare disorder that means she needs a kidney transplant. And there’s only one person Anna can turn to if she’s going to save her precious child’s life.
The man she once ran from. The man who she once thought would break her. Her daughter’s father…
Could you put your own life at risk, if it meant there was a chance you’d be able to save your daughter? Emma Robinson’s utterly unforgettable and heartbreaking story is perfect for fans of Jodi Picoult, Diane Chamberlain and Jojo Moyes.
Readers love Emma Robinson:
‘Wow!!! Where to even begin?? Mind you, it’s hard enough to write this with blurry eyes through tears!!… It really dragged me deep into the story until I came out the other end with tears streaming down my face… An absolutely page-turning, tear-jerking beautiful story.’ Bookworm86 ⭐⭐⭐⭐⭐
‘OMG. OMG. OMG. The author made me cry. I still had a book hangover when I started writing this review. There was still a lingering lump in my throat all through the day.’ Shalini’s Books and Reviews ⭐⭐⭐⭐⭐
‘WHAT A TEAR JERKER… Keep the tissues really close to your side throughout… Will pull hard on your heart strings… If I could give this 10 stars I definitely would.’ Goodreads reviewer ⭐⭐⭐⭐⭐
‘I don't even know where to begin to review this absolutely gut-wrenching, beautiful story… I have never audibly sobbed or struggled to read a book through tears, but this one was tough…. I cannot express the need for everyone to read this book… It is just beautiful and I think it gives a lot for people to learn from in their own lives too.’ Goodreads reviewer ⭐⭐⭐⭐⭐
‘Wow. Wow… It has been a long time since I have read a book in one sitting… but I could not put this down! I absolutely loved it from start to finish…
Release date: October 26, 2021
Publisher: Bookouture
Print pages: 350
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To Save My Child
Emma Robinson
Is there anyone in the world more full of joy than a six-year-old with a feather boa? Libby was strutting up and down the gift shop in her bright yellow boots, green bobble hat and – now – a cheap pink feather boa which she’d borrowed from a display of hen party paraphernalia. All she was missing was a catwalk and an audience.
Anna used her phone to take a couple of photos of her pirouetting daughter. Libby, never one to turn down an opportunity to pose, held her arms out and blew Anna a kiss, which made her laugh. ‘Come on, you. We’re supposed to be here for party invitations. Not fashion shows.’
Having reached a display of overpriced teddy bears holding heart-shaped messages, Libby spun on her heel and wiggled her hips before dancing back towards Anna. ‘Please can I have it, Mummy? Please?’
When she looked at that face, Anna could understand how men made absolute fools of themselves for a pretty girl. Soft blonde curls, long eyelashes and a mouth that was quick to laugh. And pout. It was difficult to deny her anything.
Beyond an early display of Valentine’s cards, she could see the young woman behind the cash register watching them with an expression of disapproval. Probably about to tell them they had to buy it now, anyway. ‘How much is it?’
Libby screwed up her face as she tried to read the price tag. ‘Twelve dot ninety-nine.’
Nearly thirteen pounds? For a bit of fluff? ‘That’s too much, Lib. We have to get the invites and the balloons yet. You want balloons, don’t you?’
Reluctantly, Libby took the string of pink feathers from around her neck and passed it back to Anna. ‘I just want to look pretty at my party.’
Anna glanced to see if the assistant was still watching them, then hooked the boa back onto the rail and bent down in front of her daughter. ‘You don’t need that thing to make you look pretty. You’re the most beautifullest girl in the world.’
Libby grinned, old enough to know that wasn’t a word, but still young enough to enjoy it. She placed her cold little hands onto Anna’s cheeks. ‘And you’re the beautifullest momma in the world.’
Anna pressed her lips and nose into the softness of Libby’s cheek. That was cold too. Outside, it was an icy January morning, but the heating was up so high in here that they’d both taken their coats off. ‘Are you feeling okay, Lib?’
Ignoring the question, Libby grabbed Anna’s hand and pulled her over to the carousel of party invitations. ‘Come on, Mummy. Let’s get my invitations. Can I have pink ones?’
For now, Anna didn’t push her to answer. In the last couple of months, she’d taken her daughter to their new doctor three times and she got the impression that he thought she was wasting their time. Even her mum had gently suggested that Libby might just be getting used to her new school, new house, new life. ‘Kids are very resilient,’ she’d been quick to add. ‘She’ll be fine.’
Libby had been extra-tired the last couple of days though, and had complained of a bit of a stomach ache. But Anna had put that down to the excitement about her upcoming seventh birthday. This was the first time they’d have a party at home. Their new living room was small, so there were only four of her friends coming over, but Libby had barely been able to sleep with excitement when Anna had suggested it a couple of months ago.
‘Really, Mummy? Really? Will we have cake and everything?’
Anna had smiled at her eagerness. ‘Yes. And maybe some games and we could get some craft stuff and, well, whatever you want really.’
She’d paused at that. ‘Will Daddy be coming?’
Anna hadn’t been able to work out from Libby’s face whether she was hoping that the answer would be yes or no. How much did she remember about the last time they’d seen Ryan? How much had she overheard? ‘No, sweetheart. He won’t be there.’
Was it even sadder that Libby didn’t look surprised at the answer? ‘But my friends can definitely come? You won’t change your mind?’
Guilt tugged at the edges of Anna’s mouth. A memory of Libby’s birthday last year. In a different place. A ruined cake. Smashed plates. Hurried text messages to cancel friends before they left home. She forced herself to smile. ‘I promise. You can give out the invitations this week if you want?’
Which was why they were here to choose them. Libby’s face was a picture of concentration as she perused the carousel of invitations, pressing her finger onto each one as she gave it grave consideration. Last year, Anna had picked them out for her: pale blue with a clutch of balloons in the corner. Her friend Nicole had been with her that time, mocking her indecision and complaining about the minutes they were losing from the bottomless Prosecco lunch she’d booked for them both. Who was Nicole having lunch with these days? They’d barely spoken since Anna and Ryan broke up.
Libby was waving a packet of pearly pink cards in front of her eyes. ‘Can I have these, Mummy? They’re so pretty.’
Anna looked closer. There was a tiny stork carrying a baby in a bundle. It made her stomach twist. ‘They’re birth announcements for a new baby, sweetheart, not party invites. What about these ones with the little cats on? You like cats.’
Libby frowned. ‘I want these ones. I like birds and babies, too.’
As much as she loved that face, the crease at the top of her nose looked just like Ryan’s when he wouldn’t back down. ‘But they aren’t for birthday parties.’
Libby clutched the invites to her chest. ‘Please, Mummy. I really want these ones. Please.’
Anna could almost hear her mother’s words. Choose your battles, Anna. You don’t want to squash the spirit out of her. She held up her hands. ‘Okay. If they are the ones you want.’
In the five minutes it took to pay for the invitations, Libby managed to tell the assistant – who was now smiling – that she would be seven in three weeks, that she was having a ‘proper birthday party’ and that the names of her best friends were Karis, Mary, Busola and Emily. She then quizzed her on whether she preferred chocolate or sponge cake.
The assistant laughed. ‘I like all cake, to be honest.’
Libby was delighted with that response. ‘My mummy is a chef. She makes the best cakes. She can make you one if you want. Can’t you, Mummy?’
She looked up at Anna for confirmation. What was she going to say now? ‘Well, I… I mean…’
The assistant winked at Anna. Maybe she’d misread the disapproval in her face earlier; she seemed perfectly friendly now. ‘It’s okay. I’m on a diet. I’m getting married in the summer.’
Libby’s eyes widened. ‘Are you? Have you got a bridesmaid?’
Anna needed to get her daughter out of the shop before she pitched for her lifelong dream of being a bridesmaid and offered Anna to cater the wedding and make this woman’s wedding cake too. Her friendly nature had made the transition to her new school remarkably painless, but it got Anna into some sticky conversations at times. ‘Come on, Libby. Let this poor lady serve some other customers.’
Before braving the frosty January air, Anna bent down to help Libby into her warm blue coat. Was she imagining it, or had her little girl’s face paled in the last five minutes? ‘Libby, are you sure you feel okay?’
Libby shuffled from one foot to the other. ‘I feel a bit sleepy.’
It was only ten o’clock in the morning and she’d slept for twelve hours last night. She’d always been a good sleeper, right from when she was tiny. She shouldn’t be tired.
‘And how does your tummy feel?’
Libby paused as if to think about it. ‘A bit funny. And my head is a bit fuzzy.’
It didn’t matter what anyone said, Anna knew that something wasn’t right and she needed to do something about it. ‘Okay, baby girl. I think we need to go to—’
But, before she could finish, Libby collapsed into Anna’s arms.
On the way to the hospital, Anna had to force herself to keep her eyes on the road and not in the rear-view mirror checking on Libby. Please let her be okay. Please let her be okay.
The friendly shop assistant had offered to call an ambulance, but Libby didn’t seem to have actually lost consciousness and Anna knew it would be quicker to drive her straight to the Emergency Department herself. With every inch of her, she prayed that when they got there, someone would just check Libby over and tell her that everything was fine. Maybe she had a bug or had picked up a little infection? At this stage, Anna would have taken food poisoning or gastroenteritis – or anything that was easily and quickly remedied with a prescription from the hospital pharmacy and some bed rest.
From the back seat, Libby’s voice was quiet and weak. ‘I feel okay now, Mummy. I don’t need to go to the hospital. I want to go home and write my invitations.’
Anna glanced back at her again. Head propped up in her car seat, she looked so pale, so small. ‘That’s great, Lib. But we just need to get you checked over before we go home.’
The Emergency Department was mercifully quiet and they were taken straight through after triage. After that, everything happened fast. Libby was given a full examination and then her blood and urine were tested. That was when it got even more scary.
The emergency doctor’s face was professionally devoid of either positivity or concern. ‘We need to take Libby to the renal centre. They’ll be able to run some more specific tests there.’
Anna’s mouth was dry. The renal centre? That was kidneys. Was this something serious? Please, no. ‘What kind of tests?’
But the doctor was already being paged to see to another patient and backed away with a wave. ‘They’ll explain everything when you get up there.’
The renal centre was in another building and was ‘all-singing, all-dancing’ according to Danny, the cheerful orderly with a waist-length ponytail who pushed Libby there in a wheelchair. She would have been okay to walk, but – despite still feeling poorly – she had jumped at the chance when he’d offered her a ride. In the five minutes it took to get there, he kept her entertained with jokes which he must have learned from Christmas crackers. Anna was very grateful to him: she was so nervous she’d almost lost the ability to speak.
Within minutes of their arrival, they were seen by the consultant on call. Mr Harris had enough grey in his hair to look experienced; his lined face was both serious and kind. He smiled as he crouched down to Libby in the wheelchair. ‘I can see that Danny here has been giving you our five-star service. Shall we ask him to take you to our VIP scanner suite so that I can have a look at what’s going on inside your tummy?’
Libby looked up at Danny, who winked at her. ‘Off we go again, then.’
As they wheeled away, Mr Harris held up a hand for Anna to wait. Once they were out of earshot, he spoke quietly. ‘I’ve seen Libby’s urine and blood test results and I want her to have an MRI scan straight away. I’ll come over there with you now and we can go through some extra questions that I have.’
Anna followed him down the corridor like a small child. As much as she was grateful for his personal attention, it surely wasn’t normal to be seen this quickly. It must be serious.
They caught up with Danny and Libby before they entered the MRI suite. Mr Harris held the door open and they walked into a small antechamber where a technician sat in front of a screen. On the other side of the window before them, the MRI scanner looked monstrous. Anna reached for Libby’s hand and squeezed it.
A smiling nurse took control of the wheelchair from Danny. ‘I’ll take you inside, Libby. Mummy will wait for you on the other side of the window.’
Anna didn’t want to let go of her hand, but Libby smiled up at her. ‘Don’t worry, Mummy. I’ll be back in a minute.’
It was all Anna could do not to sob as she watched the nurse wheel her little girl through and settle her onto the scanner bed. Only two days ago, Anna had remarked to Libby how grown up she looked, standing in the kitchen in her school uniform, able to reach the bottom shelf of the wall cupboard on her own. Now, watching through the window as she disappeared into that huge plastic tunnel, she looked so tiny. So vulnerable.
Behind Anna, Mr Harris was speaking quietly to the technician. Anna caught the words immediate and urgent before Mr Harris turned towards her with a smile which was clearly meant to be reassuring. ‘I know that you have already been through this with my colleague, but can I check again how long Libby’s been experiencing these symptoms?’
He wasn’t trying to make her feel guilty; she was doing that to herself. ‘We’ve been to the doctor several times in the last year with similar symptoms. Yesterday morning, she told me that she had a sore stomach. Then in the afternoon she said it was hurting when she went to the toilet. Normally I would take her to our doctor. She’s had antibiotics for cystitis in the past and I thought it might be that, but they’re not open on a Saturday and I was going to wait until Monday and then… then…’
If she had taken Libby to the emergency doctor yesterday, maybe she wouldn’t have passed out in the gift shop. Mr Harris was frowning at the paperwork on his clipboard and, when he spoke, she wasn’t sure if he was addressing her or the medical notes. ‘It’s not usual for a child this young to suffer with repeat cystitis. Her blood tests show some issues with her kidney function. We should have seen her earlier than now.’ He raised his head and nodded towards the MRI scanner on the other side of the screen. ‘As we explained, you are very welcome to stay here with her. That way you’ll be able to reassure her over the microphone if she gets upset. Once we have the scan results, we can sit down in my office and discuss what happens next.’
As soon as the doctor left, the technician pushed a blue chair on wheels towards Anna and smiled. ‘You’re in good hands with Mr Harris. He’s very experienced. And the centre here is the best in the country. Everything under one roof: diagnostics, dialysis, transplants. You couldn’t be in a better place.’
Anna’s legs wobbled as she sank down into the chair. He was trying to make her feel better, but those words hung in the air like threatening storm clouds. There was something wrong with Libby’s kidneys? That’s what the doctor had said. We should have seen her earlier. She wanted to throw up. Why hadn’t she realised that her daughter was so poorly?
The nurse closed the door behind her and the technician clicked on his microphone. ‘Okay, Libby, we’re going to start the scan now, so if you can keep really still for me, it will all be over really quickly. Is that okay?’
‘Yes, thank you.’ Libby’s voice was so small and hesitant, Anna had to clutch the hard plastic arms of the chair to prevent herself from running into the room and pulling Libby out of there. Instead, she fixed her eyes on the top of Libby’s head, which was pointing towards the window. Please let her be okay. Please let her be okay. Please let her be okay.
Once the scan was over, the same nurse showed them to a play area where they could wait for the results. She introduced them to the playworker on duty, whose broad smile, bright floral shirt and upward lilt to her voice were a welcome splash of colour in the grey of the last few hours. ‘Hi. I’m Corinne. Would you like to come and look at some of the games we have, Libby? You can stay here and play when Mum goes to see the doctor?’
Was it good or bad that Mr Harris didn’t keep her waiting for long? As Anna entered his office, he motioned towards the chair opposite a large desk, empty except for a computer screen, a pen pot and a dark green folder. Judging by the look on his face, Anna wasn’t ready for the news he was going to give her. As fear coursed through her, she wished she’d called her mother from the Emergency Department – she would have come straight to join them, and then Anna wouldn’t have to hear this alone.
Mr Harris’s voice was kind and gentle, but he cut straight to the point. ‘As I suspected, there is a major problem with Libby’s kidneys. We need to get her onto dialysis as a matter of some urgency. I’m going to admit her to the renal ward today.’
He paused, as if to let the news sink in. Anna could hear what he was saying, but it wasn’t making sense. She just repeated it back to him. ‘Dialysis?’
‘I’m afraid so. The tests show that her kidneys are failing. The medical term is chronic kidney disease.’
The words felt like they were bouncing off Anna. She tried to focus, think about a question to ask, anything… But all she could process was that her little girl was ill. Really ill. Her little Libby, her only child. Her everything.
The doctor was still talking: ‘Eventually and ideally, given her age, we would like to consider her for a transplant, but the immediate issue is improving her kidney function, hence the dialysis. Do you know what dialysis is?’
Anna was vaguely aware of it from watching TV dramas. ‘I think so. Is it like cleaning the blood?’
‘Yes, exactly. Basically, dialysis performs the functions of the kidney. When your kidneys are damaged by accident or, as in Libby’s case, by kidney disease, they are no longer able to remove waste or fluids from your bloodstream. The dialysis takes the blood from the body, removes the waste, and then puts it back in again. It can be a very effective treatment for a long period of time, but the fact is that a transplant is better, and the need for that may become more urgent in due course. Transplants are particularly effective when the disease is found in someone as young as Libby.’
Again, all she could do was repeat the word that her brain was struggling to take in. ‘Transplant?’
Mr Harris leaned forwards on his desk, his hands clasped. A pale blue shirt cuff peeped out from beneath his suit jacket. ‘I know that this is a lot to absorb.’
Even now, Anna was desperately hoping that somehow, magically, he was going to say that this could all be avoided. ‘You said that you should have seen her earlier. Is that why it’s serious? Should I have brought her in before now? Is this worse for her because I didn’t?’
Mr Harris didn’t directly answer her question. ‘With chronic kidney failure, there can be no rhyme or reason to it. For some patients, it’s a gradual decline; for others, they can be fine for several years and then suddenly it’s serious. Looking at Libby’s results, we don’t need to panic, though. We expect she can be treated effectively on dialysis for a long time, although it will obviously be quite intense for her to have to be in hospital three times a week. Especially at her age, and missing school. However, we’re getting ahead of ourselves. Let’s get her admitted and then we can discuss again.’
He pushed back his chair as if he was about to get up and leave. Anna’s stomach lurched with the squeak of the chair wheels. Not knowing was more terrifying than hearing it all in one go. ‘Admitted? I don’t understand. Please. Can you tell me everything now? She has to have dialysis three times a week? How does that work? And you want her to have a transplant? How does that happen? What can I do?’
She knew how manic her voice must sound, but she wasn’t going to make the same mistake of not knowing again. Mr Harris seemed to understand. He spread his hands out on top of Libby’s file and paused before he spoke. ‘Okay. Well, I can give you some general information, but we’ll know more after we’ve started Libby on haemodialysis and seen how she responds. The good news is that this is one of the best centres for renal medicine in the country, and Libby will be able to come here for every stage of her treatment. The dialysis will happen three times a week and takes around four to five hours. Where possible, we will fit around her schooling. She will need a small procedure so that we can access her bloodstream for dialysis. There are a couple of options, but I believe that our best option for Libby is an arteriovenous graft. We’ll connect an artery and a vein with synthetic tubing. We can do that tomorrow morning. I’d like her to be admitted for that procedure now.’
Anna’s heart was beating so fast that it was difficult to breathe. ‘Will that hurt? Will she be in pain?’
‘It might be a little tender to begin with, and she’ll need to wear loose clothing on that arm for a couple of weeks. But once it has healed, you’ll just need to ensure that the site is kept clean and check that it is working. But we will teach you both about that before she goes home. All being well, she’ll be back home on Tuesday evening with a schedule of her dialysis appointments.’
All being well. It didn’t feel as if anything was going to be well, ever again. ‘And the transplant?’
Mr Harris was calm and patient. ‘Again, we can talk about this in a couple of days. But, yes, I would want to discuss transplant options with you. We can, of course, put Libby on the transplant list. However, a living donor is preferable to a donation from a deceased patient because there is likely to be a much greater life expectancy in the kidney. Libby is young and, although we can transplant another kidney further down the line, and even a third or fourth time, each subsequent transplant is more complicated and the kidney would have a reduced life expectancy.’
A living donor? That, then was something she could do. ‘So, I can give her one of my kidneys?’
‘We can certainly test you for compatibility if you are willing to be a donor. Yes.’
Was she willing? She would give both kidneys, her lungs, he. . .
Anna used her phone to take a couple of photos of her pirouetting daughter. Libby, never one to turn down an opportunity to pose, held her arms out and blew Anna a kiss, which made her laugh. ‘Come on, you. We’re supposed to be here for party invitations. Not fashion shows.’
Having reached a display of overpriced teddy bears holding heart-shaped messages, Libby spun on her heel and wiggled her hips before dancing back towards Anna. ‘Please can I have it, Mummy? Please?’
When she looked at that face, Anna could understand how men made absolute fools of themselves for a pretty girl. Soft blonde curls, long eyelashes and a mouth that was quick to laugh. And pout. It was difficult to deny her anything.
Beyond an early display of Valentine’s cards, she could see the young woman behind the cash register watching them with an expression of disapproval. Probably about to tell them they had to buy it now, anyway. ‘How much is it?’
Libby screwed up her face as she tried to read the price tag. ‘Twelve dot ninety-nine.’
Nearly thirteen pounds? For a bit of fluff? ‘That’s too much, Lib. We have to get the invites and the balloons yet. You want balloons, don’t you?’
Reluctantly, Libby took the string of pink feathers from around her neck and passed it back to Anna. ‘I just want to look pretty at my party.’
Anna glanced to see if the assistant was still watching them, then hooked the boa back onto the rail and bent down in front of her daughter. ‘You don’t need that thing to make you look pretty. You’re the most beautifullest girl in the world.’
Libby grinned, old enough to know that wasn’t a word, but still young enough to enjoy it. She placed her cold little hands onto Anna’s cheeks. ‘And you’re the beautifullest momma in the world.’
Anna pressed her lips and nose into the softness of Libby’s cheek. That was cold too. Outside, it was an icy January morning, but the heating was up so high in here that they’d both taken their coats off. ‘Are you feeling okay, Lib?’
Ignoring the question, Libby grabbed Anna’s hand and pulled her over to the carousel of party invitations. ‘Come on, Mummy. Let’s get my invitations. Can I have pink ones?’
For now, Anna didn’t push her to answer. In the last couple of months, she’d taken her daughter to their new doctor three times and she got the impression that he thought she was wasting their time. Even her mum had gently suggested that Libby might just be getting used to her new school, new house, new life. ‘Kids are very resilient,’ she’d been quick to add. ‘She’ll be fine.’
Libby had been extra-tired the last couple of days though, and had complained of a bit of a stomach ache. But Anna had put that down to the excitement about her upcoming seventh birthday. This was the first time they’d have a party at home. Their new living room was small, so there were only four of her friends coming over, but Libby had barely been able to sleep with excitement when Anna had suggested it a couple of months ago.
‘Really, Mummy? Really? Will we have cake and everything?’
Anna had smiled at her eagerness. ‘Yes. And maybe some games and we could get some craft stuff and, well, whatever you want really.’
She’d paused at that. ‘Will Daddy be coming?’
Anna hadn’t been able to work out from Libby’s face whether she was hoping that the answer would be yes or no. How much did she remember about the last time they’d seen Ryan? How much had she overheard? ‘No, sweetheart. He won’t be there.’
Was it even sadder that Libby didn’t look surprised at the answer? ‘But my friends can definitely come? You won’t change your mind?’
Guilt tugged at the edges of Anna’s mouth. A memory of Libby’s birthday last year. In a different place. A ruined cake. Smashed plates. Hurried text messages to cancel friends before they left home. She forced herself to smile. ‘I promise. You can give out the invitations this week if you want?’
Which was why they were here to choose them. Libby’s face was a picture of concentration as she perused the carousel of invitations, pressing her finger onto each one as she gave it grave consideration. Last year, Anna had picked them out for her: pale blue with a clutch of balloons in the corner. Her friend Nicole had been with her that time, mocking her indecision and complaining about the minutes they were losing from the bottomless Prosecco lunch she’d booked for them both. Who was Nicole having lunch with these days? They’d barely spoken since Anna and Ryan broke up.
Libby was waving a packet of pearly pink cards in front of her eyes. ‘Can I have these, Mummy? They’re so pretty.’
Anna looked closer. There was a tiny stork carrying a baby in a bundle. It made her stomach twist. ‘They’re birth announcements for a new baby, sweetheart, not party invites. What about these ones with the little cats on? You like cats.’
Libby frowned. ‘I want these ones. I like birds and babies, too.’
As much as she loved that face, the crease at the top of her nose looked just like Ryan’s when he wouldn’t back down. ‘But they aren’t for birthday parties.’
Libby clutched the invites to her chest. ‘Please, Mummy. I really want these ones. Please.’
Anna could almost hear her mother’s words. Choose your battles, Anna. You don’t want to squash the spirit out of her. She held up her hands. ‘Okay. If they are the ones you want.’
In the five minutes it took to pay for the invitations, Libby managed to tell the assistant – who was now smiling – that she would be seven in three weeks, that she was having a ‘proper birthday party’ and that the names of her best friends were Karis, Mary, Busola and Emily. She then quizzed her on whether she preferred chocolate or sponge cake.
The assistant laughed. ‘I like all cake, to be honest.’
Libby was delighted with that response. ‘My mummy is a chef. She makes the best cakes. She can make you one if you want. Can’t you, Mummy?’
She looked up at Anna for confirmation. What was she going to say now? ‘Well, I… I mean…’
The assistant winked at Anna. Maybe she’d misread the disapproval in her face earlier; she seemed perfectly friendly now. ‘It’s okay. I’m on a diet. I’m getting married in the summer.’
Libby’s eyes widened. ‘Are you? Have you got a bridesmaid?’
Anna needed to get her daughter out of the shop before she pitched for her lifelong dream of being a bridesmaid and offered Anna to cater the wedding and make this woman’s wedding cake too. Her friendly nature had made the transition to her new school remarkably painless, but it got Anna into some sticky conversations at times. ‘Come on, Libby. Let this poor lady serve some other customers.’
Before braving the frosty January air, Anna bent down to help Libby into her warm blue coat. Was she imagining it, or had her little girl’s face paled in the last five minutes? ‘Libby, are you sure you feel okay?’
Libby shuffled from one foot to the other. ‘I feel a bit sleepy.’
It was only ten o’clock in the morning and she’d slept for twelve hours last night. She’d always been a good sleeper, right from when she was tiny. She shouldn’t be tired.
‘And how does your tummy feel?’
Libby paused as if to think about it. ‘A bit funny. And my head is a bit fuzzy.’
It didn’t matter what anyone said, Anna knew that something wasn’t right and she needed to do something about it. ‘Okay, baby girl. I think we need to go to—’
But, before she could finish, Libby collapsed into Anna’s arms.
On the way to the hospital, Anna had to force herself to keep her eyes on the road and not in the rear-view mirror checking on Libby. Please let her be okay. Please let her be okay.
The friendly shop assistant had offered to call an ambulance, but Libby didn’t seem to have actually lost consciousness and Anna knew it would be quicker to drive her straight to the Emergency Department herself. With every inch of her, she prayed that when they got there, someone would just check Libby over and tell her that everything was fine. Maybe she had a bug or had picked up a little infection? At this stage, Anna would have taken food poisoning or gastroenteritis – or anything that was easily and quickly remedied with a prescription from the hospital pharmacy and some bed rest.
From the back seat, Libby’s voice was quiet and weak. ‘I feel okay now, Mummy. I don’t need to go to the hospital. I want to go home and write my invitations.’
Anna glanced back at her again. Head propped up in her car seat, she looked so pale, so small. ‘That’s great, Lib. But we just need to get you checked over before we go home.’
The Emergency Department was mercifully quiet and they were taken straight through after triage. After that, everything happened fast. Libby was given a full examination and then her blood and urine were tested. That was when it got even more scary.
The emergency doctor’s face was professionally devoid of either positivity or concern. ‘We need to take Libby to the renal centre. They’ll be able to run some more specific tests there.’
Anna’s mouth was dry. The renal centre? That was kidneys. Was this something serious? Please, no. ‘What kind of tests?’
But the doctor was already being paged to see to another patient and backed away with a wave. ‘They’ll explain everything when you get up there.’
The renal centre was in another building and was ‘all-singing, all-dancing’ according to Danny, the cheerful orderly with a waist-length ponytail who pushed Libby there in a wheelchair. She would have been okay to walk, but – despite still feeling poorly – she had jumped at the chance when he’d offered her a ride. In the five minutes it took to get there, he kept her entertained with jokes which he must have learned from Christmas crackers. Anna was very grateful to him: she was so nervous she’d almost lost the ability to speak.
Within minutes of their arrival, they were seen by the consultant on call. Mr Harris had enough grey in his hair to look experienced; his lined face was both serious and kind. He smiled as he crouched down to Libby in the wheelchair. ‘I can see that Danny here has been giving you our five-star service. Shall we ask him to take you to our VIP scanner suite so that I can have a look at what’s going on inside your tummy?’
Libby looked up at Danny, who winked at her. ‘Off we go again, then.’
As they wheeled away, Mr Harris held up a hand for Anna to wait. Once they were out of earshot, he spoke quietly. ‘I’ve seen Libby’s urine and blood test results and I want her to have an MRI scan straight away. I’ll come over there with you now and we can go through some extra questions that I have.’
Anna followed him down the corridor like a small child. As much as she was grateful for his personal attention, it surely wasn’t normal to be seen this quickly. It must be serious.
They caught up with Danny and Libby before they entered the MRI suite. Mr Harris held the door open and they walked into a small antechamber where a technician sat in front of a screen. On the other side of the window before them, the MRI scanner looked monstrous. Anna reached for Libby’s hand and squeezed it.
A smiling nurse took control of the wheelchair from Danny. ‘I’ll take you inside, Libby. Mummy will wait for you on the other side of the window.’
Anna didn’t want to let go of her hand, but Libby smiled up at her. ‘Don’t worry, Mummy. I’ll be back in a minute.’
It was all Anna could do not to sob as she watched the nurse wheel her little girl through and settle her onto the scanner bed. Only two days ago, Anna had remarked to Libby how grown up she looked, standing in the kitchen in her school uniform, able to reach the bottom shelf of the wall cupboard on her own. Now, watching through the window as she disappeared into that huge plastic tunnel, she looked so tiny. So vulnerable.
Behind Anna, Mr Harris was speaking quietly to the technician. Anna caught the words immediate and urgent before Mr Harris turned towards her with a smile which was clearly meant to be reassuring. ‘I know that you have already been through this with my colleague, but can I check again how long Libby’s been experiencing these symptoms?’
He wasn’t trying to make her feel guilty; she was doing that to herself. ‘We’ve been to the doctor several times in the last year with similar symptoms. Yesterday morning, she told me that she had a sore stomach. Then in the afternoon she said it was hurting when she went to the toilet. Normally I would take her to our doctor. She’s had antibiotics for cystitis in the past and I thought it might be that, but they’re not open on a Saturday and I was going to wait until Monday and then… then…’
If she had taken Libby to the emergency doctor yesterday, maybe she wouldn’t have passed out in the gift shop. Mr Harris was frowning at the paperwork on his clipboard and, when he spoke, she wasn’t sure if he was addressing her or the medical notes. ‘It’s not usual for a child this young to suffer with repeat cystitis. Her blood tests show some issues with her kidney function. We should have seen her earlier than now.’ He raised his head and nodded towards the MRI scanner on the other side of the screen. ‘As we explained, you are very welcome to stay here with her. That way you’ll be able to reassure her over the microphone if she gets upset. Once we have the scan results, we can sit down in my office and discuss what happens next.’
As soon as the doctor left, the technician pushed a blue chair on wheels towards Anna and smiled. ‘You’re in good hands with Mr Harris. He’s very experienced. And the centre here is the best in the country. Everything under one roof: diagnostics, dialysis, transplants. You couldn’t be in a better place.’
Anna’s legs wobbled as she sank down into the chair. He was trying to make her feel better, but those words hung in the air like threatening storm clouds. There was something wrong with Libby’s kidneys? That’s what the doctor had said. We should have seen her earlier. She wanted to throw up. Why hadn’t she realised that her daughter was so poorly?
The nurse closed the door behind her and the technician clicked on his microphone. ‘Okay, Libby, we’re going to start the scan now, so if you can keep really still for me, it will all be over really quickly. Is that okay?’
‘Yes, thank you.’ Libby’s voice was so small and hesitant, Anna had to clutch the hard plastic arms of the chair to prevent herself from running into the room and pulling Libby out of there. Instead, she fixed her eyes on the top of Libby’s head, which was pointing towards the window. Please let her be okay. Please let her be okay. Please let her be okay.
Once the scan was over, the same nurse showed them to a play area where they could wait for the results. She introduced them to the playworker on duty, whose broad smile, bright floral shirt and upward lilt to her voice were a welcome splash of colour in the grey of the last few hours. ‘Hi. I’m Corinne. Would you like to come and look at some of the games we have, Libby? You can stay here and play when Mum goes to see the doctor?’
Was it good or bad that Mr Harris didn’t keep her waiting for long? As Anna entered his office, he motioned towards the chair opposite a large desk, empty except for a computer screen, a pen pot and a dark green folder. Judging by the look on his face, Anna wasn’t ready for the news he was going to give her. As fear coursed through her, she wished she’d called her mother from the Emergency Department – she would have come straight to join them, and then Anna wouldn’t have to hear this alone.
Mr Harris’s voice was kind and gentle, but he cut straight to the point. ‘As I suspected, there is a major problem with Libby’s kidneys. We need to get her onto dialysis as a matter of some urgency. I’m going to admit her to the renal ward today.’
He paused, as if to let the news sink in. Anna could hear what he was saying, but it wasn’t making sense. She just repeated it back to him. ‘Dialysis?’
‘I’m afraid so. The tests show that her kidneys are failing. The medical term is chronic kidney disease.’
The words felt like they were bouncing off Anna. She tried to focus, think about a question to ask, anything… But all she could process was that her little girl was ill. Really ill. Her little Libby, her only child. Her everything.
The doctor was still talking: ‘Eventually and ideally, given her age, we would like to consider her for a transplant, but the immediate issue is improving her kidney function, hence the dialysis. Do you know what dialysis is?’
Anna was vaguely aware of it from watching TV dramas. ‘I think so. Is it like cleaning the blood?’
‘Yes, exactly. Basically, dialysis performs the functions of the kidney. When your kidneys are damaged by accident or, as in Libby’s case, by kidney disease, they are no longer able to remove waste or fluids from your bloodstream. The dialysis takes the blood from the body, removes the waste, and then puts it back in again. It can be a very effective treatment for a long period of time, but the fact is that a transplant is better, and the need for that may become more urgent in due course. Transplants are particularly effective when the disease is found in someone as young as Libby.’
Again, all she could do was repeat the word that her brain was struggling to take in. ‘Transplant?’
Mr Harris leaned forwards on his desk, his hands clasped. A pale blue shirt cuff peeped out from beneath his suit jacket. ‘I know that this is a lot to absorb.’
Even now, Anna was desperately hoping that somehow, magically, he was going to say that this could all be avoided. ‘You said that you should have seen her earlier. Is that why it’s serious? Should I have brought her in before now? Is this worse for her because I didn’t?’
Mr Harris didn’t directly answer her question. ‘With chronic kidney failure, there can be no rhyme or reason to it. For some patients, it’s a gradual decline; for others, they can be fine for several years and then suddenly it’s serious. Looking at Libby’s results, we don’t need to panic, though. We expect she can be treated effectively on dialysis for a long time, although it will obviously be quite intense for her to have to be in hospital three times a week. Especially at her age, and missing school. However, we’re getting ahead of ourselves. Let’s get her admitted and then we can discuss again.’
He pushed back his chair as if he was about to get up and leave. Anna’s stomach lurched with the squeak of the chair wheels. Not knowing was more terrifying than hearing it all in one go. ‘Admitted? I don’t understand. Please. Can you tell me everything now? She has to have dialysis three times a week? How does that work? And you want her to have a transplant? How does that happen? What can I do?’
She knew how manic her voice must sound, but she wasn’t going to make the same mistake of not knowing again. Mr Harris seemed to understand. He spread his hands out on top of Libby’s file and paused before he spoke. ‘Okay. Well, I can give you some general information, but we’ll know more after we’ve started Libby on haemodialysis and seen how she responds. The good news is that this is one of the best centres for renal medicine in the country, and Libby will be able to come here for every stage of her treatment. The dialysis will happen three times a week and takes around four to five hours. Where possible, we will fit around her schooling. She will need a small procedure so that we can access her bloodstream for dialysis. There are a couple of options, but I believe that our best option for Libby is an arteriovenous graft. We’ll connect an artery and a vein with synthetic tubing. We can do that tomorrow morning. I’d like her to be admitted for that procedure now.’
Anna’s heart was beating so fast that it was difficult to breathe. ‘Will that hurt? Will she be in pain?’
‘It might be a little tender to begin with, and she’ll need to wear loose clothing on that arm for a couple of weeks. But once it has healed, you’ll just need to ensure that the site is kept clean and check that it is working. But we will teach you both about that before she goes home. All being well, she’ll be back home on Tuesday evening with a schedule of her dialysis appointments.’
All being well. It didn’t feel as if anything was going to be well, ever again. ‘And the transplant?’
Mr Harris was calm and patient. ‘Again, we can talk about this in a couple of days. But, yes, I would want to discuss transplant options with you. We can, of course, put Libby on the transplant list. However, a living donor is preferable to a donation from a deceased patient because there is likely to be a much greater life expectancy in the kidney. Libby is young and, although we can transplant another kidney further down the line, and even a third or fourth time, each subsequent transplant is more complicated and the kidney would have a reduced life expectancy.’
A living donor? That, then was something she could do. ‘So, I can give her one of my kidneys?’
‘We can certainly test you for compatibility if you are willing to be a donor. Yes.’
Was she willing? She would give both kidneys, her lungs, he. . .
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