Duplicity (Seraph #2)

1. Marlowe

CHAPTER 1

Marlowe

T he skin around her little rosebud mouth is tinged with blue.

It’s visible even on my phone screen, as are the tear tracks and the ominous pallor of her cheeks, and it makes my stomach lurch.

‘It’s going to be okay, my love, I promise.

’ That’s all the reassurance I have time for.

In this moment, getting my daughter to the hospital is more urgent than talking her through this.

‘Have you called an ambulance?’ I bark at the unlucky teaching assistant who placed the video call to me.

Miss Lewis, her name is.

She’s new to the school, which means she’s new to dealing with Tabby’s condition, and nothing about that is good.

The phone screen jerks back to the TA’s face: young and terrified.

I get it. Believe me.

‘Yes. Miss Conway told me to?—’

I cut her off.

‘Good. Will you go with her to the hospital?’

She blinks.

It’s clear she hasn’t thought this far ahead, but it’s not really a request she can decline.

Sending an eight-year-old girl off in an ambulance by herself is not an option.

‘Yes. Yes, of course.’

As long as an ambulance is en route, I can talk this woman through the rest of our well-practised protocol.

Tabby’s class teacher, Miss Conway, has far more experience of dealing with her condition, but I’m all too aware that she’s responsible for twenty-nine other kids, too.

‘Listen to me. Get her to the school office as quickly as you can. Mrs Hopkins knows the score. Put Tabs back on, can you?’

As I talk, I push back my chair and get on my knees, pulling my tote bag from beneath my desk before reaching further back for Tabby’s A healthy snacks; a phone charger; toothbrushes; PJs for Tabs and clean underwear for both of us in case they end up admitting her overnight, plus the obligatory earplugs.

There is nowhere on the planet less conducive to a night’s sleep than a paediatrics ward in a busy London hospital.

We’re old hands at this routine by now.

‘Yes. Okay, I’ll—hang on.

’ The TA sounds even more out of breath than the little girl currently suffering from oxygen deprivation.

My daughter’s face reappears, and I force my expression into a smile I hope is confident, competent, and reassuring in equal measure.

‘Hi again, my love. The ambulance is going to come and get you, and Miss, er, Lewis is going to go with you. But you need to get to the office so Mrs Hopkins can take your sats, okay? Do you think you can walk there? Are you feeling dizzy?’

I already know the answer to that.

Her deathly pale complexion is evidence enough that she’ll be feeling lightheaded, but she nods.

‘Yeah, but I can walk.’ Her voice is so quiet.

‘That’s my brave girl.

’ I kick off my heels and push my feet one by one into a pair of trainers, slamming my laptop shut as I do and then shoving it into the tote.

‘Will you come in the ambulance too, Mummy?’

‘I can’t, angel.

I’m at work. I’ll have to get the tube straight to the hospital and meet you there.

But I’ll stay on the line until the paramedics turn up, I promise.

’

No way in hell am I risking going underground until I know Tabby’s in the hands of professionals.

I tug my long hair over one shoulder so I can toss both bags over the other.

‘Hang on a sec,’ I tell my daughter, and I clamp the phone to my boob for a little privacy.

My boss, Dean, is preemptively glaring at me.

‘Tabby needs to go to hospital. I’m sorry.

I’ll log in when I get there.

’

He stands up and crosses his arms over his chest. ‘We’ve talked about this, Marlowe.

You know you’re on your last strike here.

’

I widen my eyes in disbelief and hold the phone tighter against my body, hoping Tabs can’t hear any of this.

‘Tabby’s heart didn’t get the last strike memo, I’m afraid.

I’m sorry to leave you in the lurch, but this is actual life or death.

You know that.’

He flinches slightly at the D word but recovers his inner arsehole pretty quickly.

‘That’s unfortunate, but I’m not running a charity here.

’

I can’t help a small scoff, because the Royal Academy of Arts, for whom I’m a strategist, is literally a registered charity.

He picks up what I’m putting down.

‘You know what I mean. I have a business to run. If you walk out that door, don’t bother coming back.

Got it?’

‘Jesus Christ, Dean,’ someone says behind me.

I point the index finger of my free hand at him.

My body started pumping adrenaline out as soon as Miss Lewis called me, and now it has me in a dangerous haze of laser focus.

If this prick thinks his ultimatum will slow me down for a single second in my singular mission to get my daughter to A&E and meet her there, then he is fucking deluded.

Yes, I take the piss in terms of scarpering every time I get an emergency call from the school, but I’m also that employee feverishly answering emails from a plastic chair in the bowels of our local hospital at 2 am, and he bloody well knows it.

‘That you think you’re giving me a choice here tells me everything I need to know,’ I spit out.

I don’t spare him or his threat a second glance.

In this second, I’m not the usual eager-to-please employee who is horribly aware of how crucial this salary is.

I’m a mama bear harnessing the full power of every maternal instinct I’ve honed over eight years of managing a child with a congenital heart defect, and woe betide anyone who tries to get in my way.

With what I hope is some devastating side-eye, I sweep towards the exit and unplug my phone from my boob.

‘Have you got to the office yet?’

‘Yeah,’ Tabs pants.

‘Excellent. Great.’ Adrenaline is a dangerous drug.

I’m not panicked—I’m invincible.

I’ve got this. ‘Put me onto Mrs Hopkins.’

Mrs Hopkins, the receptionist, is first-aid trained and a huge fan of Tabs.

‘She’s here,’ Tabby tells me faintly.

‘Mrs Hopkins?’ I sprint, unseeing, through the stunning foyer of Burlington House, where the Royal Academy is housed, and emerge out into the spectacular courtyard.

‘Do you have the oximeter?’

‘Yup.’ Her confident tone is music to my ears.

‘Hold tight, Miss Winters.’

Tabby is still holding onto her teacher’s phone, though she’s not doing a great job of keeping it still.

My current view as I cross the courtyard and take a left on Piccadilly is of the school crest on her royal blue sweatshirt and a segment of her plaited hair, long and blonde like mine.

‘Seventy-nine,’ Mrs Hopkins announces.

Fuck, fuck, fuck. Those oxygen levels are way too low.

‘Knees to your chest, sweetie. What were you doing when you started to feel bad?’ I ask Tabs as I speed-walk along Piccadilly.

I’ll duck underground as soon as I’ve handed her over, but we’ll need to give the paramedics as much context as possible.

I get a shaky image of her pulling her bare knees up to her chest. By curtailing blood flow to the lower half of her body, her heart can focus on directing more of its limited supply to her lungs.

The TA’s voice sounds through my phone.

‘We were just rehearsing for the class assembly. The kids were doing a dance routine, and Tabby said she felt dizzy.’

Tabby’s condition, Tetralogy of Fallot, sounds like something from the Legend of King Arthur but is, in fact, a congenital heart defect.

The pulmonary valve sending blood from her heart to her lungs was too narrow at birth, constraining her oxygen supply.

She’s endured two open-heart surgeries to replace the valve, one at birth and one aged three, but she’s once again outgrown her current valve.

Right now, it only takes a small amount of physical exertion to bring on what Tabs and I call a “blue spell”, where blood flow to the lungs decreases and oxygen levels plummet.

‘Got it. Mrs Hopkins, can you grab a fact sheet, please?’

‘Absolutely,’ I hear.

‘Don’t you worry. We’ve got this little pixie, don’t we, Tabs?

’

Thank God for people like Mrs Hopkins, who treat everyone else’s kids with as much love and attention as their own.

She keeps a stack of printed sheets that I’ve put together and filled with all of Tabby’s salient information—contact details for me, an overview of her condition and surgical history, her meds, and contact details for her cardiac team at Great Ormond Street Hospital, or GOSH, London’s preeminent and wildly under-resourced children’s hospital.

If my maths is right, we’ve handed over eight fact sheets since January, and it never gets easier.

T he hours following my arrival at the hospital are the usual blur of doctors and machines and beeping.

Tabby was given beta blockers and an oxygen mask when she was admitted, and both her oxygen saturation and heart rate have normalised, thank fuck.

She’s had a chest X-ray as well as an ECG to assess the functionality of her pulmonary valve.

Between treatments, I’ve sung to her softly, and we’ve read from the Anne of Green Gables paperback we keep in her hospital backpack.

We’ve been given a bed in one of the main A&E wards so that the doctors can observe Tabby before discharging her.

As I read to her, my gaze keeps drifting to a little girl in one of the bays across from us.

She’s probably a couple of years younger than Tabby.

I’m not sure what’s wrong with her, but she was vomiting and crying in pain earlier.

She’s happier now, thank God, but the thing that grabs my attention over and over is the two parents flanking her.

Her mother and father sit on plastic chairs on either side of her bed like two adoring guardian angels.

They haven’t left her side.

As I watch, they interlace their fingers on her lap, and the gesture is so tender, so natural, that I have to look away.

Those three are thick as thieves, and it couldn’t be any more obvious.

It’s not that I want someone here for me .

I’m an A&E expert by now, and I’m used to being the grown-up, to acting like I’m not falling apart without having anyone to rub my back and tell me it’s all going to be okay.

But it’s not fair that a little girl as brave and amazing as Tabs should have to make do without a father figure in her tough little life.

It’s not fucking fair.

Fucking Joe.

The only silver lining is that I’ve had no time at all to ruminate over being fired.

I had a text from my colleague Jake— You can appeal this, you know —but I’m too damn exhausted, as the adrenaline vacates my nervous system, to even consider that option.

I’m too overwhelmed with emotion to have any capacity for the financial worries that I know are waiting to flood my brain.

Right now, my only focus is the frail little girl on the bed next to me.

The colour has returned to her cheeks, and that terrifying blue tinge has faded for now.

Miss Lewis told me when I arrived that the dance they’d been rehearsing for their assembly wasn’t even particularly high energy, and the knowledge terrifies me.

I don’t need a doctor to tell me what I already know, but a paediatric cardiologist swings by and pulls me aside just to ram home the incontrovertible truth anyway.

‘The ECG has shown a further deterioration in her pulmonary valve,’ she tells me gently.

‘We spoke to her cardiac team at GOSH. I understand she’s waitlisted for a valve replacement surgery, but not until November?

’

‘That’s right.’

November is six months from now, and the doctor’s grimace says it all.

It’s too far away.

‘If this pattern continues, I’d expect she may be in need of an emergency replacement sooner than that.

So far, the right ventricle is holding up remarkably well, but I’d expect to start seeing a thickening of the wall given the strain it’s under.

If you find that her tolerance for exertion declines further, or the tet spells become more severe or frequent, or her sats start to worsen when she’s resting, we’d conclude that the heart is struggling to cope.

‘An emergency surgery is far from ideal for many reasons that I’m happy to expand on, but I’m afraid Tabby’s heart may not be equipped to last another six months with a profoundly inadequate valve.

’

Each sentence is a blow to the stomach.

I have never in my life felt so powerless.

So sickened. Every single day, I watch my daughter, so small and frail for her age, navigate the art of surviving life rather than thriving on it because one of her body’s most basic functions is compromised.

I’m forced to decline her pleas for gym classes and ballet classes.

I’m the mother who hands over medical fact sheets to any parent who hosts her for a playdate.

She needs a new fucking pulmonary valve, and she needs it now, and I don’t have the hundreds of thousands of pounds required to get it for her privately.

So I’m stuck here, hopelessly dependent on our overstretched National Health Service to shuffle us along in its never-ending queue of equally deserving, equally sick children until we one day reach the front.

‘I know how frustrating it is,’ the doctor tells me softly.

‘Perhaps this is something you and your partner can discuss, so that if emergency surgery is the only option, you feel better prepared for?—’

‘There is no partner,’ I say quickly.

‘I mean, Tabby’s father’s not in the picture.

It’s just me and her.

’

I swear the compassion on her face ratchets up a notch.

‘Of course. I apologise. This is a lot to bear alone. We have support services available to the parents of children with these conditions. I can give you a leaflet…’ She trails off.

I don’t need a leaflet.

I need a Hail Mary.

Such an unfortunate turn of phrase when the only possible Hail Mary available to me is to sell my soul to some guy who may as well be the Devil himself for the price he’ll demand.

But God knows, I’ll pay it.

I pull out my phone and shoot off a few texts.

At the hospital

Tabs had another blue spell

And Dean fired me for leaving early

Looks like Seraph is the only card I have left to play