He had been surprised at first, when she had asked for advice on a cardiac patient – after all, she was a brilliant heart specialist and she had taught him everything he knew. But she had since retrained in emergency medicine – so maybe she just felt that she was a bit rusty. Anyhow, he was glad to be given an extra excuse to spend some time with her – since she didn't normally want to be seen dead with him.

After her initial action of drawing him into the case, it never seemed strange to him when they had further discussions about the cardiac patient – even daring to probe her about it when the information wasn't offered.

But then he started noticing things – and it rang alarm bells...

Sam

"Ok, we're ready to go – scalpel, please." I hear Connie say to Robyn. There's a clatter and I look up from my patient.

The scalpel is on the floor between her feet – her hand still out-stretched towards Robyn, ready to take possession of the implement. She's dropped it – or couldn't get a grip on it – or something and she looks as stunned as I am – so does Robyn.

Connie pulls herself together quickly -it wouldn't do for Robyn to see her 'weak' side – to see that she's just human, like everyone else. "Mr Strachan, take over." She commands, bossily shaking her hair out the way.

"I'm about to..." I begin to explain, but she cuts across me and the 1st bell rings. Connie and I argue a lot and we don't always see eye-to-eye, but generally, she does have the decency to be respectful when we're in resus nowadays.

"No, I'll deal with the referral. It's just a chest drain." She tells me sharply and I know that she wouldn't have asked if she didn't need to. She normally hates it when I interfere.

When I go to her office after, to check she's ok – not that I think she'd confide in me if she wasn't, she seems to be taking some tablets. Her bag is open on her desk, and to my horror, I see what her medication is. That's when the 2nd bell rings.

"Yes, Sam – what is it?" She asks with a hint of irritation. She suspects I'm there to ask what the matter was in resus.

"Everything went fine with the chest drain." I answer. I can tell it's not the right time to ask if she's ok.

She leans over and hastily picks up her bag off the desk – though it's not clear whether she's realised what I've seen. I notice that while she does this, she keeps her right arm – the one that she would normally use to pick up her bag, strangely rigid by her side. It's as though she's lost confidence in it, but I think the better of drawing attention to it. It's safer if she thinks I haven't noticed.

"Ok. I just thought it was a good training opportunity." She lies – another bell. Connie knows perfectly well that I am highly experienced in such procedures. "There's nothing wrong with going through the basics." She continues – clearly noticing my look of scepticism.

I try a subject change – referring back to our last discussion. "Your Myxoma patient. Did they reach a decision about surgery?"

"They decided against it."

"Ok." I turn to leave, but she hasn't finished.

"...although, now they're complaining of intermittent loss of sensation in the dominant hand." She waits and I realise that she's indirectly asking for my opinion again. It's never a case of her simply 'asking' me – it has to be indirect.

I hesitantly sit down, sensing that she wants another discussion, but knowing that she never 'invites' me to sit down in her office. "Have they been referred for an Angiogram?" I ask. "It could be an Embolus."

I can tell that surprisingly, she hasn't considered that possibility, but of course, being the boss, that's not something that's allowed to be outwardly acknowledged, so she shuns my suggestion by replying hauntily, "Or simply a case of paraesthesia."

I take a deep breath. "I understand the the patient's fear when it comes to surgery..." I notice her tensing up – strange. "...but an Embolus – if an Embolus is obstructing an artery, the hand could become ischemic." Surely she knows this? "If left untreated..." I continue. "They could lose an arm." Was that a flicker of fear? If it was, it was gone as quickly as it appeared.

I can tell she doesn't like what she's hearing though – because she tries to argue, even though she asked for my opinion – and my suggestion makes sense. The bells are growing louder. The woman in front of me, is not the Connie I know - she wouldn't put a patient in danger by ignoring the obvious like this. "Why put her through another unnecessary test just for pins and needles?" Unnecessary? She seems to be looking through rose-tinted spectacles – and that's not like her. Connie Beauchamp tells it like it is.

"Connie..."

"No. That's enough, Sam." She snaps sharply, cutting the conversation short, abruptly and it suddenly occurs to me that she said 'her' by accident – 'why put her through another unnecessary test...'.

"Right, I think you need a day in cubicles – get back to basics." She tells me. This is her way of reminding me that she's in charge – and warning me not to ask questions, but I can see that I've given her food for thought.

I glance back through the closed door after I leave and see her nervously massaging her right hand. The bells ring again – louder than ever.

At reception, Noel asks me to sign Alicia's good luck card for her driving test and I decide to chance it. "Noel, do you know if Mrs Beauchamp has had a cardiac patient in recently?" I try to make it sound as matter-of-fact as possible.

"Doesn't ring a bell, why?"

Not the answer I was hoping for. There are too many bells ringing in my head at the moment – but that was the only one I actually wanted to hear. "I don't know why you'd remember, don't worry." I shrug – and then realise that Connie is standing just behind me. Her face is unreadable and I can't tell whether she heard me or not.

"Tell Dr Keogh he's needed in resus." she tells Noel.

Asking for someone who isn't here is unusual – Connie prides herself on knowing all of the ED's shift patterns.

"I'm sorry, he's not in." Noel informs her. "but Mr Strachan is free." He adds brightly.

She eyes me distastefully as I add: "Dr Chao has cubicles covered.", but the casualty has just been brought through the doors and the decision is taken out of her hands – it's a case of needs-must.

"Fine. With me, then."

The next bell starts ringing during the handover. As she helps to move the patient from the trolley, she gasps sharply and withdraws her hand, clearly in pain – though no one else seems to notice. I see her flexing it – obviously checking the movement, as well as trying to work through the pain.

"Are you ok?" I ask her in hushed tones, she wouldn't thank me for bringing it to anyone else's attention.

"I'm fine." She answers – not bothering to hide her irritation at me for questioning her.

"Do you want me to take over?" I offer – but she shuns me again.

"I said I'm fine." she repeats stubbornly and tries to carry on like nothing happened, despite being visibly shaken by it – visible to me, anyway.

She's as stubborn as an ox – my Connie, but when the patient, who has an end-stage, life-shortening condition, grabs her hand, and begs Connie to let her die, I see the effect it has. It's written all over Connie's face.

She tries to explain to Naomi's husband that any treatment we give her will just prolong the inevitable and draw out Naomi's suffering, but he's having none of it. I can see that Connie is trying to remain detached and keep her frustrations at bay, but they are gradually becoming more obvious. She's letting this case get to her.

"Why don't you ask your wife what she wants?" Connie eventually retorts to the distraught relative. It's a sign that she's losing patience. It's especially dangerous when Naomi tells her husband that she wants to sign a DNAR and he accuses Connie of putting ideas into his wife's head.

"Is this your doing? Are we using up resources, taking up precious beds? You're a doctor! You're supposed to help her – not write her off!"

"It's her decision." Connie firmly points out and the man looks like he wants to hit her. This is dangerous territory now – actually, I'm surprised that Connie is still speaking so calmly, given the way her eyes are flashing. If it was me she was having a conversation with, she would have exploded by now. I know the signs.

"She's my wife!" The man yells at her.

"And you have no idea what she's going through." She tells him through gritted teeth. I know I have to intervene before she loses it, so I do.

Connie looks heartbroken when her patient agrees to prolong her suffering as a way of comforting her despairing husband, but Connie's hands are tied. "Let's start her IV antibiotics. Increase diuretic intravenously. Let's try her on a BIPAP mask." she states robotically.

It all but confirms my worst fears. As I suspected there is no cardiac patient – it's her. That's the only reasonable explanation. My Connie has a heart tumour. She looks crushed – utterly broken and I want to help her so much, that's why I tried to intervene – but I over-stepped the mark. Again.

"Mr Strachan, a word." She orders as she leaves resus.

My mind drifts back to earlier, when she answered my question regarding surgery. I feel like I've been drenched with icy water as her words hit me again. 'They decided against it.'...decided against it...against it...

I follow her up the stairs, away from prying eyes and listening ears.

"Don't you ever question me in front of a patient again!" She snaps angrily. "Do you understand?"

"Yes. I'm sorry." Normally I'd argue back – but now is not the time.

"Ohhh!" She gasps suddenly, clutching her arm as we reach the top of the stairs and for a second, I worry that she is having a heart attack or a stroke, but it's not either.

"Connie?" I try to put my hand comfortingly on her back, but she shakes it off. She's not going to be happy with me for asking questions, but I need confirmation from her – and not just because she's the mother of my daughter. I need to know for me too – I need to know because I care. "In resus, you were in pain with your hand..." she glances around as though she's terrified someone might overhear, but I carry on. "...and it's happening again now."

"It's a cramp." She hisses, stubbornly.

"And I saw your medication in your bag..."

She cuts me off – warning me to stop. "Be very careful, Mr Strachan..."

Her eyes flash at me and I know I'm pushing my luck now. The fact she didn't used my first name is a sure sign of that – but I need to know, so I ignore it and carry on.

"Your Myxoma patient. I don't think they exist – I think the scans you showed me are yours. That's why you needed my help with the chest drain." The training opportunity excuse was feeble – and she knows it. "It's why you're taking Naomi's case so personally – because you have cancer." I see the realisation hit her as it dawns on her that she has been well and truly caught out.

"Might." She mutters. "Might have cancer."

That was the confirmation I needed, but I feel sick to my stomach – especially when I realise what she's been dealing with alone. She avoids looking at me as I answer, "I'm so sorry."

What else can you say in such situations? Years of giving bad news to patients and relatives – or even being told about my own cancer could not have prepared me for this. The moment when the beautiful, strong woman in front of me confirmed my worst fears.

"I don't want your pity." She mutters. "And I don't want anyone else to know."

By that, I know she's not just talking about work colleagues – she doesn't want Grace to know either and she's looking for my reassurance that Grace will be kept in the dark.

"No, no – of course not." I agree – knowing it's the only way to ensure that she doesn't shut me out again. "...but have you thought about the surgery properly? This tumour – it's likely to be benign...but the paraesthesia complications..." I'm imploring her to change her mind – to see reason, but she cuts me off.

"The risks of surgery far outweigh the benefits." She claims and I realise to my horror, that she completely believes in her statement.

"No..."

"I know the stats better than anyone, ok?" She snaps. "Please just let me do my job!"

At the moment, this is an argument I can't win, but the obstacle that is imminent is still worrying me – and I can't let it go. "I'm not trying to pressurise you, but the paraesthesia..."

"It's pins and needles!" she hisses at me. "A side effect of the medication."

I realise that she is in complete denial over her condition – she's convinced herself that if she ignores it, it will go away. I'm desperate now, desperate to make her listen to me – but I know I'm fighting a losing battle. "Connie, please..."

She swallows and practically forces the next words out. "It's Mrs Beauchamp, when we're at work! - and I'll deal with this in my own way. It's none of your business!"

It is my business, of course – if only to stop our daughter from losing her mother, but I can see that it's not a helpful point to bring up at the moment. "Ok, then. I understand." She looks surprised that I've backed down.

There are so many ways I could take this – for a start, how her refusing treatment will effect Grace – and me – the other people in her life, but Connie is scared and she doesn't need that right now, so I try a softer approach.

"You're not coping with this as well as you think you are." I whisper as she turns to leave and I can see that she'd thinking about what I'm saying now. The softer approach is what she needed. "You need to talk to someone, ok? If not me – then Charlie. You don't have to do this on your own."

I leave her to pounder my words as I head back down the stairs.