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Grace watched with round eyes as Anna pretended to look inside the puppet’s ears, then she sat still while Anna gently used the auriscope to examine her.
‘I’m just checking that there’s no wax or foreign bodies,’ she murmured as she examined the eardrum. ‘Oh, yes, there’s the problem. I see it. The eardrum is very dull and looks indrawn. She definitely has glue ear.’
‘Glue ear?’ Heather frowned. ‘What exactly is that?’
‘It’s a condition where the child has fluid deep in the ear,’ Anna explained, ‘but without signs of infection. It’s called glue ear because the fluid tends to be like runny glue—thick, clear and sticky.’
Heather pulled a face. ‘Sounds awful. But why does that make her shout?’
‘Because I suspect it is affecting her hearing.’ Anna reached for a pad and scribbled a simple diagram. ‘People can hear because sound waves are transmitted via their eardrums and tiny bones inside the middle ear. The eardrum and bones vibrate.’
Heather stared at the diagram and pulled a face. ‘I was always bottom in biology.’
Anna smiled and put the pencil down. ‘Doesn’t matter. All you need to know is that in glue ear the middle ear, which is usually full of air, becomes filled with a sticky fluid and that damps down the vibrations.’
‘And stops the child from hearing?’
‘It can do.’ Anna stood up. ‘It’s very common in children so don’t think Grace is the only one. Speech is affected because she isn’t hearing well.’
‘So what do we do about it?’
‘Fortunately glue ear almost always settles down of its own accord but if Grace’s hearing gets worse then we may need to look at referring her to an ENT specialist. But at the moment I don’t think we should do that. I’m going to refer her to the audiology department for an assessment of her hearing and we’ll take it from there.’
‘So she doesn’t need antibiotics or anything now?’
Anna shook her head. ‘She doesn’t have an infection so they won’t work. I’m fairly confident that if we leave it alone it will go by itself, but we’ll keep a close eye on it and if we’re worried at any point then we can refer her.’
‘I’m not wild about her having an operation,’ Heather admitted, and Anna smiled sympathetically.
‘I doubt it will be necessary so let’s cross that bridge when we come to it. I’ll refer her to Audiology today and you’ll get a letter from them in the next month or so, inviting Grace to come for a test.’
‘Thanks, Anna.’ Heather stood up and brushed her curls away from her face, her cheeks slightly pink. ‘I heard a rumour that our Sam’s back. Is it true that he’s going to be working here for the summer?’
Anna stiffened. Not if she could find a way out of it. ‘Well, he’s here at the moment, but he may not be able to stay for the whole summer.’
At least, not if she had anything to do with it.
‘Oh, I hope he can,’ Heather enthused, shifting the toddler more comfortably in her arms. ‘I mean, it’s so brilliant having him. I never miss him on the telly. He’s so sympathetic, isn’t he? So warm. Can’t believe it’s our Sam, really.’
Our Sam.
Anna clamped her jaws together and resisted the temptation to point out that Sam McKenna was a gifted actor and was warm when it suited him to appear that way. With her he was about as warm as the polar icepack.
Then she remembered that Heather had had a massive crush on Sam when they’d been at school. As had most of the girls. Except her.
Anna rolled her eyes. She and Sam had been thrown together a lot because of their parents’ working relationship and at one time she knew that both sets of parents had harboured a fond hope that they might take over the practice. But that had never been an option for Sam. He hadn’t been able to wait to get away.
And just as well, she thought briskly, otherwise there would have been bloodshed. She and Sam would not have made a good partnership. They clas
hed on just about everything.
Heather was still talking. ‘Everyone thinks it would be great if he stayed permanently,’ she gossiped happily. ‘I mean, it used to be both your dads, then it was you and his dad and now it could be the two of you.’
‘I don’t think so.’ Anna rose to her feet so rapidly she almost knocked the chair over. Aware that Heather was looking at her in surprise, Anna produced a smile. ‘You’re jumping the gun, Heather. This is temporary. Just temporary.’
And she certainly didn’t want that sort of gossip and speculation spreading around the village.
‘Well, you never really know how things are going to turn out, do you?’ Heather said sagely, standing up and reaching for her bag. ‘Thanks, Anna. See you soon.’
