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My head throbs. Flashes of training videos and textbook paragraphs loop and knit together.

Parents can hurt their children in so many ways. One of those ways is making them sick on purpose.

I think of Tom, ill and vulnerable in his hospital bed. The strength it must have taken him to write this note. The risk he took to trust me.

The note drops into my lap and I see my hands pressed together in prayer.

Dear God … I never doubted her … I never doubted …

Lizzie.

How could she have fooled us?

We studied abusive parent profiles in training. Learned about the classic signs: drug addiction, neglect, secrecy and chaos.

I pictured abusers as stoned, angry Leanne Neilsons. But Lizzie … she seemed completely normal. Nice. Doing her very best. Yet the whole time …

Tessa was right. It’s Lizzie. It’s all Lizzie. She’s the one hurting him.

I put my hands on the steering wheel, but I don’t trust myself to drive. Not just yet. For the first time since I opened Tom Kinnock’s case notes, everything makes sense.

Medical child abuse. It’s not common. Most social workers will never see it. But it happens.

A switch has flicked and the world has turned dark. I see someone posing as an angelic, caring mother and fooling everybody.

With shaking fingers, I take out Tom’s note and read it again.

Mum

Then I call Tessa.

‘Hello?’ she barks. ‘Are you going to tell me what on earth is going on? Where have you been?’

‘We need an emergency protection order,’ I say. ‘For Tom Kinnock.’

‘Anemergency protectionorder? At this stage of the game? We’re already looking to move Tom out of her care.’

‘Lizzie is hurting Tom,’ I say. ‘Medical child abuse. She’s causing the seizures. It all makes sense. The odd pattern to them. The injection marks. The head injury – she probably knocked him out to inject him with something.’

‘Good lord.’

‘We need to get Tom out of harm’s way.’

‘Steady on. He’s in hospital at the minute. That gives us a bit of breathing space.’

‘Assuming she doesn’t take himoutof hospital.’ I’m in my car now.

‘Get yourself back to the office. We’ll get the papers sorted out and see what can be arranged.’

It’s way past office working hours, but for once, I don’t feel tired. I have way too much adrenalin.

Lizzie fooled me so perfectly. Blaming the school. Blaming the father. Such a loving mother. And she’s been hurting Tom the whole time …

Ruth

When Elizabeth leaves, I get to work on her kitchen. Try and fail to make it look half decent. I give up in the end. It’s a job that will take days and anyway, there are no cleaning products. Or teabags.

No clean cups. Not even fresh milk. The food cupboards are empty and piles of dirty laundry are strewn around the place.