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‘Like Jack and the Beanstalk? Wow. Did you meet the giant?’ Katrina asked.
The little boy didn’t even crack a smile, merely rubbed at his back.
‘OK, sweetheart. I’m going to give you something to take that pain away,’ she said gently, and gave him two spoonfuls of children’s paracetamol syrup. ‘This will help you to stop feeling quite so hot, too. Do you like your granddad’s garden?’
Petros nodded.
‘My father-in-law got an allotment this summer,’ Mrs Smith explained. ‘He’s been growing vegetables and Petros has been helping him. We call the broad beans “magic beans”—you know what it’s like, trying to get little ones this age to eat vegetables.’
‘Don’t I just.’ Katrina had played the ‘magic’ card herself before now with a variety of vegetables and a variety of patients.
‘Can I interfere?’ Rhys said, coming over to Katrina’s workspace.
Well, he was her senior. He had several years’ more experience than she did. And if he had any bright ideas, she was willing to listen: in Katrina’s view, the patient took priority. ‘Be my guest.’
He introduced himself swiftly. ‘Mrs Smith, these broad beans you mentioned—has your little boy eaten them before?’
‘No. Do you think he might be allergic to them?’
‘Not allergic, exactly. Petros is a Greek name, yes?’
She nodded. ‘It’s my grandfather’s name.’
He smiled at her. ‘May I ask, which part of Greece does your family come from?’
‘My husband’s from the East End—well, with a name like Smith that’s pretty obvious,’ she said wryly, ‘but my family’s originally from Cyprus. My grandparents came over to London just after the war and started a restaurant.’
‘Katrina, when you do that blood sample, can you get it tested for G6PD as well?’ Rhys asked.
‘Of course.’ The pieces clicked into place. ‘You think it’s favism?’
‘Yes—I’ve seen a few cases in Wales,’ he said.
‘What’s favism?’ Mrs Smith asked. ‘And what’s G6PD?’
‘G6PD is a chemical in your body—it stands for glucose 6 phosphate dehydrogenase, but it’s a bit of a mouthful so it’s known as G6PD for short,’ Rhys explained. ‘Some people have less than normal amounts in their red blood cells, and it’s quite common in people who have a Mediterranean origin. If you don’t have enough G6PD, then if you get a fever or take certain medicines or eat broad beans—what they call fava beans in America, which is why it’s called “favism”—then the body can’t protect your red cells properly and you become anaemic.’
‘With this condition, you might also get jaundice—and the symptoms mean you get backache and your urine looks the same colour as tea before you add the milk,’ Katrina added.
Mrs Smith nodded in understanding. ‘Like Petros’s does right now.’
‘Obviously we need to check the results of the blood tests,’ Katrina said, ‘but I think Rhys is right.’
‘So can you give him this G-whatever stuff in tablets or something?’ Mrs Smith asked.
‘I’m afraid there aren’t any supplements,’ Rhys said. ‘We’ll check how much iron is in his blood, and if there isn’t enough he might need a transfusion—but the good news is that Petros will feel a lot better with some rest and a little bit of oxygen to help him breathe more easily.’
‘The condition’s not going to affect him day to day,’ Katrina explained, ‘but he’ll need to avoid certain medications—aspirin, some antibiotics and some antimalarial drugs. I can give you a leaflet explaining all that so you know what to avoid.’
‘You’ll need to tell your GP as well so it’s on his medical record and he isn’t given any of the medications he needs to avoid by mistake,’ Rhys added. ‘And we should warn you now that if he gets an infection in future, it might mean his red cells are affected and he’ll get anaemia and jaundice again.’
‘And definitely no more broad beans,’ Katrina said.
‘Best to avoid Chinese herbal medicines, too,’ Rhys continued. ‘And, would you believe, mothballs? They contain a chemical in that can affect people with G6PD deficiency.’
Mrs Smith looked anxious. ‘But he’s going to be all right?’
‘He’s going to be absolutely fine,’ Katrina reassured her, ruffling Petros’s hair.
‘You said earlier it’s common in people from the Mediterranean—so I might have it too?’ Mrs Smith asked Rhys.
