Eight thirty on a Monday morning and whilst the world is stuck in traffic, a lone phone rings in an empty open-plan office.
There's a hurried clicking sound as a code is entered, a door opens and a thin dark haired woman lunges across a desk to pick up the receiver.
"Hello, Castel Health Protection unit, how may I help you?" Rose robotically answers. After the last week's outbreak, she had hoped that today would have been quiet. It was just the on-call doctor public health doctor, nothing to report. Rose sighed with relief. She settled into her swivel chair. These were the moments she savoured, the moments of selfish serenity before the health protection nurses bustled in and the office heated up with chatter and the endless clicking of computer keys. She could hear Mike Burton, the Consultant in Communicable Disease Control, fiddling with his keys trying to open his office door. In on time today, she thought, glancing at her watch. Wonder what's that all about? Of course, there was a new girl starting today. Rose switched on her computer and pulled out her notepad. She had to sort out a username and password if the new girl was to access their online risk analysis system.
Beep! Beep! Cynthia threw her hands against the car wheel in desperation. It was her first day and she was late. Just her luck, she thought to herself, to get caught in the traffic on the motorway the one day she had to make a good impression. She stood up as far as her safety belt would let her and peered anxiously over the dashboard. The motorway was backed up as far as the eye could see. The radio traffic update had reported that there had been an accident at junction seven. A lorry had run into the back of a Vauxhall car. All passengers were believed to be dead. She could be here some time.
"Where's Ishani?" Mike burst out of his office into the main office area of the Health Protection Unit.
"She's still on annual leave", Rose replied. "Why?"
"Could you give her a call anyway?"
"I would but she's in India visiting relatives. Why? What is it?"
"There's been an accident at junction seven on the motorway. A lorry carrying a hazardous chemical, UN number 1992 has crashed into the back of car. It would be a very good exercise for Ishani. I don't think she's had a chemical incident to deal with yet."
"Oh well! She's not here. Maybe next time."
Mike frowned. "It's not often that something like this comes up in this patch. How about the new girl? What's her name again, Cynthia?"
"Mike, you can't throw this at her on her first day."
"Why not? It's straight forward. Get the weather and winds report from the Met office, find out how hazardous the substance is and what threats it poses to the public, get advice from the Chemicals and Hazards Division and liaise, liaise, liaise."
Gillian, the health protection nurse, swung round in her chair to face Mike.
"Do you need some assistance, Mike?" she purred.
Mike stopped himself from retorting. It was better to ignore that woman. He grabbed his post and marched out of the office, banging unapologetically into Rhonda and the two lattes she was carrying.
"In one of his moods again?" Rhonda grimaced as she temporarily placed the coffees on Rose's desk while she wiped the coffee off her top with a napkin.
"Really, you have to stop winding him up," Rose looked over her shoulder at Gillian.
"Oh we're fine", Gillian responded waving her hand. "We go back years. I was senior nurse on Mike's very first ward as a house officer. Bless him! He really didn't have a clue and I had to take him in hand. Long may it continue!"
Gillian and Rhonda heartily laughed.
"Isn't there a specialist register joining us today?" Rhonda asked Rose as she handed Gillian her morning latte.
"Not a registrar, a trainee".
"What's the difference?"
"A specialist registrar in public health is a medic, doing their 5 years training to become a Consultant in Public Health Medicine or a Consultant in Communicable Disease Control. A specialist trainee in public health is what you call a non-medic who's doing the very same training. When the trainees qualify they're called Consultants in Public Health."
"It's the same post?"
"Yes."
"So we have another Ishani", Gillian added.
"A baby one", Rose continued. "Ishani is near the end of her training and has decided to specialise in health protection as she wants to be a CCDC. Cynthia is in her first year of training and is coming her to do her obligatory 3 month training in health protection. I know it's before your time Rhonda but Gillian, you must remember, we've had the registrars here in the past".
Gillian nodded.
"So will she be taking queries?" Rhonda asked.
"That's the plan," Rose continued. "She's an extra member of the team".
"Good, we're short staffed," Rhonda sipped her latte. "Where is she anyway?"
Rose glanced at her watch. "I don't know. She should have been here by now".
Cynthia was delighted when the Castel Technological Park finally appeared on the horizon. She had the initiative to pull off the motorway early but her slapdash map reading had landed her in a series of dead ends and one way systems and she somehow managed to turn the ring road circulating the city into a carousel for a half hour. Flicking her left indicator on and moving down into first gear, Cynthia drove through the entrance to the technological park. Mike's personal assistant, Rose had emailed her directions to the health protection unit the previous week. Not a bad place to work, Cynthia smiled to herself. All the units in the park were a few years old and all were dazzling glass and chrome in the early morning sun. Across the road was a large shopping centre and the city centre was a mere twenty minute walk away and was on several bus routes. She finally pulled up in front of a two storey brick building with gabled windows on the top floor and large red painted columns flanking the porch. A blue and white NHS sign declared the Castel Health Protection Unit. Cynthia pensively paused in front of the sliding glass panel doors. She had no idea what lay ahead of her and indeed if she was capable. Clutching her portfolio, she was about to take a step into the unknown when she realised she may not have locked her car. Turning round, Cynthia pressed her key and the side lights on her ford fiesta flashed twice. Seeing the shiny 'thistle' colour induced a memory flash of how she had adamantly corrected people that the purple car was in fact termed nettle coloured. "They had no idea what they're letting themselves in for", she chuckled to herself as the doors slid back and she crossed over the steel bar that secured the carpet at the doorway and marked the boundary between daylight and the shadows of the reception area.
Rose knocked on Mike's office door, despite the door being held back by door stopper. From where she was standing behind Rose, Cynthia got a glimpse of a tanned dark haired man at his desk, dapperly dressed in a pale blue Yves San Laurent shirt and co-ordinating tie.
"Sorry, to disturb you Mike", Rose said. "I thought you'd like to know that Miss Cynthia Taylor is here to see you. It is Miss, isn't it?"
"Yes". Cynthia replied.
Mike looked up from the computer screen and away from the e-group emails on vaccinations that he had been trudging through. Rose stepped away to reveal a very attractive petite blonde haired woman. Gosh, they don't make them like they used to, he thought to himself. His last trainee had been old enough to be his mother and the others he had come across had all been drab suited former NHS senior mangers striving to become directors of public health. He quickly came to his senses and extended his hand to shake Cynthia's. "Welcome to the HPU".
Cynthia stood opposite him briefly until he directed her to the round discussion table in the corner. "Please take a seat", he said, grabbing a refill pad. "Would you like any tea or coffee?"
"Coffee would be good", Cynthia replied.
"Two coffees please", Mike handed his cup to Rose.
"Filter? Instant? Percolated? Out of the machine?" Rose teased
Mike just smiled. "I'm a bit indecisive to how I want my coffee", he explained to Cynthia. "We share these premises with another NHS trust so we have choices."
"Milk? Sugar?" Rose interrupted.
"Milk for me please" Cynthia replied.
"When was the last time you washed your cup?" Rose examined the inside of the cup. "Or have some of Dr Doyle's micro-organisms escaped the lab?"
Mike smiled again and gestured Rose towards the door. "Don't you know he's out to get me!"
Mike cleared his throat. "I see from your CV, you used to be a dietician".
"That's right".
"So what brings you to public health?"
"Well, while I was working in London, I came across quite a few obese children and I wanted to take a more preventive, a more pro-active stance so I got interested in public health. I did my Masters in public health and following that I took a post as researcher and then later as a public health manager working mainly on physical activity and changing dietary practices."
"Which are main areas of concern in the latest public health white paper, Choosing Health." Mike added.
"Yes, and my trainer, my director of public health, is working hard to secure the funding and avoid it being swallowed up repaying the PCT's debt."
"Why did you become a specialist trainee?"
Cynthia pursed her lips into a smile. "I'd like to be a consultant in public health".
Why not indeed, Mike thought. On paper, Cynthia was a high achiever, top of her class throughout her degree and in person, she came across as shy yet quietly confident. Quite a contrast to Ishani's pushiness but Mike now had two ambitious women to content with.
"I brought my portfolio", Cynthia said sliding a black A4 lever arch file across the table. "Although, I'm concentrating on completing my competencies 2 here". Mike nodded in agreement. Every specialist trainee and registrar in public health had to attain 10 areas of competencies before receiving their certificate of completed training at the end of the five years (or equivalent for non-medics). Evidence towards each competency was complied in a record of assessment, known as a portfolio. The second area of competencies pertained to health protection or communicable diseases and Cynthia would have complete 14 competencies in this area, such as demonstrating knowledge of emergency planning, outbreaks and chemical incidents as well as dealing with cases of communicable diseases such as meningitis, and legionnaire's disease.
Mike flicked through the portfolio. "You've done quite a lot for someone in their first year".
"I wanted to do a year before my health protection attachment".
"I see you started the training programme before coming to Castelshire"
Cynthia paled. "I changed Deaneries".
"It's rare to see inter-deanery transfers these days".
"I had good reason."
Mike saw Cynthia looking nervously down at her hands on her lap. She was hoping he wouldn't ask. "Aah, the coffees! Perfect timing Rose as always! I was just about to instruct Cynthia in what we do here and what her role will be".
A relieved Cynthia took a sip from the steaming cup and watched Mike do the same. He was younger than she had expected, in his late thirties with a boyish grin and intense blue eyes that made you feel like he was really listening to you. A few lines under his eyes belied experience and although he wasn't long finished the training programme himself, he had already become a legend as a CCDC. Mike picked up a pen in his left hand and starting scribbling some notes. His gold wedding band caught Cynthia's eye and she was somewhat surprised at herself to feel disappointed that he was a taken man.
Mike put his pen down.
"Right, I can think of a few projects that I'd like you to get involved with here. Of course, you'll have to run this by your trainer because although I'm supervising you for this component, I'm really only the project manager to his educational supervisor role.
Okay, I better explain a few things first. We're a small team but we have responsibility for all of Castelshire, which is roughly about 1 million people. Castel itself is a large city with a sizable population of immigrants and asylum seekers. As a result, we see quite a lot of travel related disease such as campylobacter and shigella flexneri and in recent years, increases in TB. Like all cities, Castel has a drug problem and we've seen a rise in blood borne viruses like HIV and Hepatitis B. This team has only one CCDC – me. I am hoping though that in the future - funding depending – to have a second CCDC. I have two health protection nurses Rhonda and Gillian, who deal with immunisation queries and follow up all cases notified to us or to Environmental Protection at Castel Local Authority. As you know, there is a list of infectious diseases that are notifiable by law and clinicians who suspect that a patient is suffering from a notifiable infectious disease are legally required to notify me as I'm the proper officer. For gastrointestinal diseases, environmental health officers at Environmental Protection must be told as they can inspect premises and prosecute if necessary. I'll arrange for you to spend some time with Environmental Protection - or EP as we call it - at a later stage. For the moment, I would ask that you join our weekly review meetings with EP. It will give you a good chance to see the types of gastrointestinal diseases we deal with and expose you to how EP follows up an individual case or outbreak.
Now, I don't believe in letting people in gently. You only learn by doing things. I would expect you to start taking calls immediately but for the moment, work closely with the nurses. What else should I tell you?"
Mike took a gulp of coffee. Cynthia stifled a yawn. It had been an early rise for her this morning.
Mike continued. "Oh, you'll need to arrange to spend some time with Paul".
"Who's Paul?"
"And Phil".
Cynthia shook her head.
"Phil is our consultant microbiologist. He's one of the good guys. Paul is our information manager. He's an epidemiologist by training and an absolute God send during outbreaks. No one can compile evidence like this guy. We're so lucky to have him. It was personal circumstances that brought him to Castel. I'm so glad they did and that we can have him and not headquarters in London! Anyway, I think I've rattled on enough. It's time for Rose to show you your desk. Everything you need to know about taking calls is there – the Communicable Disease Control Handbook, procedures for dealing with chemical incidents and you'll have access to our risk analysis system and green book online."
"Green book?"
"Information on vaccines. Oh, about our risk analysis system. We've finally been given money to load all our cases onto a computer system. It really helps us to track trends and see clusters and of course, help pinpoint outbreaks early. Rose will give you a username and password. Have a good look, it will give you an idea of what we deal with. Okay, any questions?"
"No."
"Good." Mike stood up and moved towards the door. He suddenly stopped and turned around. "I do have one rule that I want you to remember. Sometimes, you'll hear various people grumbling about non-medics doing health protection work but I always think that you guys are much better at keeping this rule. Don't get into a discussion about the diagnosis. Let the doctor or doctors calling you treat the patient. That's their problem. Your patients are the population who are at risk from this patient. Your concern is preventing the spread of disease and protecting people's health."
Rose pressed the mute button on her telephone. "I've a Dr Moore on the line. He has a 5 year old girl with suspected rubella. Any takers"
"I'll take it", Rhonda replied as she finished munching her scone and brushing the crumbs off her lap. "Hello, I'm Rhonda Oloo, Health Protection nurse, how may I help you?"
With that, the fax machine beeped and a sheet of paper chucked its way out onto a tray. Rose wheeled her chair back and picked it up. She got up and walked over to Cynthia's desk in the far corner and placed it in front of her.
"Your first case", Rose chirped.
"It's from the Met Office.", Cynthia remarked as she glanced at a map and reports of wind directions. "What do I do with this?"
"You'll need that for the motorway accident on junction seven". A male voice stated from beside her. Cynthia looked up and was greeted by a tall, somewhat plump man in his late twenties.
"I'm Paul Simmons," Paul smirked, "Information manager extraordinaire!"
Rose giggled. "You are when you turn up!"
"Hey!"
Rose placed her hand on her hip. "Well, what time do you call this?"
"I had the morning off", Paul retorted jovially. "I had a big night last night".
"Oh really?"
"I did think of you and I brought you back something". He handed Rose a plastic edelweiss.
"You went to the sing-a-long Sound of Music?" Rose raised her eyebrow in disbelief.
"Yep, Shirley and I went as hills".
"Hills?"
"Hills are alive...."
"You're sad."
"How is a Met report related to a motorway accident?" Cynthia interrupted.
Paul picked up the fax. "When there is an incident or accident involving chemicals, we get a met report so we know what way the wind is blowing. As you can see here, they've indicated what towns and villages are currently in the path of the wind. If the chemicals have become airborne, this gives you an idea of who's at risk from them."
Cynthia paled. "Do I have to warn people? There could be loads and there isn't time. This accident happened this morning".
Paul shrugged. "You better get onto it then".
"Oh my God! What do I do?"
"Here, have some chocolates". Paul thrust a box of Celebrations into Cynthia's face. " As they sing in the Sound of Music, 'When the job bites, when Dr Mike stings, when I'm feeling sad, I simply go 'n eat my favourite things and then I don't feel so bad'".
Rose and Paul laughed. Unimpressed, Cynthia put her head down and scanned the notes she took during her health protection training course. She collected her thoughts and then marched into Mike's office.
"I got the report from the Met Office, regarding the accident on the motorway this morning".
Mike sat back in his chair. "So, what do you intend doing now?"
"Well, I checked the UN number and got some details on the chemical. There isn't a chemical abstract number so all I could find out was it's a flammable poisonous chemical. I don't know what the situation is other than a lorry carrying UN1992 ran into the back of a car. I don't know if any cargo was spilt or not. I was wondering should I call the Chemical and Hazards Division?"
Mike nodded. "Exactly."
Cynthia slightly hesitated before heading back to her desk. "Surely, this incident isn't serious?", she could hear a little voice in her head expressing doubts. "Dr Mike wouldn't allow you of all people to take charge of this if it was serious, or would he?" Cynthia began to panic.
Rhonda grabbed a saliva swab kit from the cupboard.
"Heading off?" Gillian looked at Rhonda over the top of her glasses.
"Yes", Rhonda answered. "I've got a suspected rubella case in the Southside." Rhonda looked at her print off of a map she had downloaded from the web. "I've no idea where it is. Silver Street? Do you know it?"
"Nope, afraid not. Take the stat-nav. Are you sure it's rubella? We haven't had a case of rubella in this patch for five years."
"I know but the child has never had her MMR and they were at the fun-fair last Sunday and her GP, Dr Moore thinks that she could have been in contact with the gypsy community."
"The fun fair lot are different to the gypsy community".
"I know but I've got to check it out. See you later".
Rose's phone rang. She hurriedly placed her head-set on her head and hovered her fingers over her computer's keyboard.
"Douglas, my boy!"
"Hi Rose, how are you this Monday?" Douglas asked in his laid back drawl.
"Good. How was your weekend?"
"It was great. I'm looking forward to Friday when the weekend can start all over again!"
"Have you been notified of a Sophia Thomas? She's a suspected rubella."
"Date of birth?"
"19th June 2001. Her GP is Dr Moore and date of onset was 3 days ago."
"Nope, she's not on flare. I'll put her on the system now. What I do have on flare is an outbreak in a nursing home. The lab phoned in an I-log number this morning. Thirty people ill, ten of whom are staff. Stephen is annoyed. There has been a delay in bringing this to our attention. It could be big!"
Rose quickly touch-typed the details onto her computer and forwarded it to the attention of Gillian. Gillian swiftly spun round in her chair. "Has Stephen done his inspection yet?"
"Has Stephen inspected the premises?" Rose asked Douglas.
"He's going this afternoon," Douglas responded. "He had a follow up visit to do this morning at a school".
"This afternoon", Rose reported back to Gillian.
"He should take Cynthia," Gillian pointed out. "It would be a great opportunity for her".
"But she's new", Rose retorted.
"She'll be involved in the investigation from the onset. It would be a good learning experience for her. Besides, Stephen will be doing the investigation. Tell her to run it by Mike."
Knock! Knock! Cynthia marched into Mike's office to the sound of Mike's "come in".
"I contacted Chemicals and Hazards Division", Cynthia began. "It all seems to be under control. The lorry was carrying 45 gallon drum of chemical UN 1992 when it crashed into a car. Two of the drums leaked on impact. The police got hold of the division really quickly so there was little time delayed in containing the drums in sand. None of the chemical evaporated. The drains on the road were covered and the specialist cleaner has arrived. They don't think that there has been any environmental damage."
"And the public? Was anyone exposed?"
"The car had been overtaking the lorry on the right when the lorry pulled out without indicating. The collision was side on and caused the car to spin backwards and this blocked any further traffic from getting near the lorry."
"What about people approaching the accident? Was there spillage from the lorry?"
"It seems that everyone on the scene obeyed the Highway Code and kept their distance from the lorry's displayed hazardous sign."
Mike smirked somewhat cynically. "How did people know that the drums had leaked? Did anyone look inside the lorry?"
"The lorry driver phoned in a suspicion that he might have a leak".
"He did?"
"I know but I guess shock can make people to think irrationally. Maybe he was too scared to see what happened to the people in the car and instead focused on the dangerous load he was carrying".
"Or maybe he didn't know that they were there. He might have thought the bang was one of the drums exploding. Anyway, you're sure no one was exposed".
"According to those on the scene, no one has."
"And the people travelling in the car?"
Cynthia shook her head. "They didn't survive".
"What none of them? Wasn't there five travelling?"
"According to the news report on the web, the driver and front seat passenger died on impact with the lorry. Those in the back weren't wearing safety belts and were thrown through the windows, when the car smashed into the metal barrier."
Mike straightened his tie. "We win one and lose one".
Rhonda parked in front of a derelict corner shop on Silver Street. The smog faded lettering above the boarded window indicated it had once been a butcher's shop. The street was littered with chip cartons, cans and plastic bags. A smell of unwashed skin hung in the humid air. Rhonda rang the doorbell to the flat about the corner shop. While she waited for an answer, Rhonda looked down the hill where row upon row of terraced housing acted as remnants of Castel's industrial past. There was a shuffle of slippered feet as a thin hunched woman opened the door.
"Miss Sandra Thomas? Hello, I'm Rhonda Oloo, health protection nurse. I believe we spoke earlier on the phone".
The woman nodded and opened back the door with her twig like arm. Rhonda couldn't help but notice the lank blonde hair, the greasy dark roots and the acne on her chin. Sandra Thomas did not look well. Rhonda followed Sandra up the bare stairs and into a floral carpeted sitting room cluttered with children's toys.
"Are you from around here", Sandra asked in a tinny voice.
"No, no". Rhonda answered, "I'm from Clapham".
"Is that in Jamaica?"
"No, it's in London".
A wave of confusion passed over Sandra's haggard face.
"My parents are from Kenya", Rhonda offered as explanation. "So where is little Sophia?"
"Sophia! Sophia!" Sandra screamed. "Get in here right now!"
There was a sound of running feet like a pack of dogs on a hunt. How many Sophias has she got? Rhonda thought to herself.
Six children scuttled into the room. They were all under the age of eight but were of differing heights, hair colour and features.
"Are these your children?" Rhonda asked in her plumy pronounced tones.
"Yeah," Sandra answered. "Sophia, come 'ere".
A freckle faced child shyly stepped forward.
"Hello Sophia", Rhonda beamed at the little girl. "My name is Rhonda and I heard that you've not been feeling well".
Sophia nodded.
"Are you feeling better?"
Sophia nodded again.
"That's good. When was the last time you were at school?"
"Thursday"
"Thursday? That's a long time ago. You must be missing all your friends. I bet they're missing you".
Sophia nodded.
"When should she go back", Sandra butted in. "Doctor don't know. He said to check with you."
"Well, I usually say a week after onset of symptoms. Now, I can assure you that it's probably not Rubella because we haven't had a case in Castel in five years. But I will take a saliva sample and send it to the lab just to make sure."
"Yeah, you said on the phone".
"So Sophia," Rhonda said as she pulled the swab out of its kit, "can you tell me what you do with a lollypop?"
"I put it in my mouth", Sophia whispered.
"This is just like a lollypop and I'm going to put it in your mouth for a quick twirl. It won't hurt you, see". Rhonda gently twirled the swab on the back of Sophia's hand before getting her sample of Sophia's saliva. She sealed the swab and placed it into a plastic bag. "See it was easy".
Sophia ran back giggling to her brothers and sisters.
"When will I know?" Sandra said pulling the sleeves of her baggy jumper over her hands.
"In about two days. Like I said, chances are it's not Rubella but that's not to say that your children may never be exposed to it. Rubella, measles and mumps are serious diseases and your children need to be protected. They should have the MMR."
"Yeah, I know", Sandra replied. "Me eldest had it alright and I think one of the others had one MMR but it's hard when I have so many and it's just me. It's hard to get them to the doctor's. They won't sit still on the bus for me. They just go in all directions".
Rhonda smiled sympathetically at Sandra and looked over at the children who were still staring at her curiously. It was only then that she noticed that two of the children had red cheeks like they had been slapped.
"Have any of your other children been ill?" Rhonda enquired.
"Yeah, Joe and Jacinta came down with a rash today and Robbie was ill last week. I took him to the doctor and he said that Robbie had 5th syndrome. That'll be right, he's the 5th child!" Sandra cackled.
"Fifth disease is also called Parvovirus or slapped cheek syndrome. It looks like the face has been slapped".
"I know. I couldn't let them to school today in case the other mothers thought I was hitting them again".
Rhonda's face held its expression despite the mental note to check with social services. "Parvovirus is often mistaken for Rubella. It's likely that this is what Sophia has".
"Should we test for that?"
"There's no need, "Rhonda continued. "Parvovirus is a very common mild childhood illness. Usually there is a fever for 2 to 3 days before the rash appears but it is a short lived infection. You've nothing to worry about, unless", Rhonda paused. "Are you pregnant?"
Sandra laughed hoarsely. "I'd need a man for that!"
"Have the children been in contact with anyone who could be pregnant?"
Sandra shook her head. "No one's been here in weeks, no wait, there was that nurse. A district nurse called here over a week ago. That's right. It was a few days before Robbie got ill".
Rhonda's eyes widened. "Can you tell me more about this nurse?"
"Yeah, she came in asking me all sorts of strange questions. I had never seen her before. I'm sure it was me neighbours interfering again, sending folk to check up on me. I soon sent her packing. I think I may still have her card".
Minutes later Rhonda got into her car, flipped open her mobile phone and rapidly dialled a number.
"Gillian, we've got a problem".
Back at her desk, Cynthia leisurely checked her emails. She nibbled a biscuit when a male whistling on the stairs stopped her in her tracks. It couldn't be him, could it?"
"Who's the environmental health officer who's taking me out?" Cynthia croaked.
"Stephen Walker", Rose replied.
Cynthia abruptly dropped to her knees and crawled under her desk.
"Cynthia, what is it?" Rose wandered over to Cynthia's desk.
"He's my ex. Tell him I'm not here. No, tell him that you've never heard of me. He's got the wrong HPU".
"Surely, it's not that bad". Rose looked perplexed.
"Not that bad? He hates me!"
The door buzzed open and heavy set footsteps crossed the carpet towards Rose. Cynthia's heart was pounding. Please go away, please go away but the footsteps kept coming in her direction. A pair of brown timberland boots stopped next to Rose's feet.
"This is bad", Rose blurted out as Stephen coolly bent down to meet Cynthia's horrified gaze.
"Hello pixie! Nice to see you on your knees!"