by Penny Parkes
As had finding out her mother’s ulterior motive for wanting her home. Picking at the somewhat rustic-looking stollen she’d bought on their first lap of the stalls, Alice decided there was no time like the present to put her cards on the table.
‘Holly, you know you have all these plans for The Practice?’
‘Well, to be honest, I’d call them ideas or suggestions at this point,’ Holly corrected her gently. ‘I’m not naïve enough to think we can all get what we want, but I’m determined enough to try, if that helps?’
‘Works for me,’ said Alice. ‘Look, the thing is . . .’ She floundered then, unable to clearly articulate what ‘the thing’ was, because it was still unformed in her own mind.
‘Well, in a nutshell, I guess I’m asking whether you see me as a fixture here, and might consider me becoming a partner? I’d love to just get a sense of how you all think.’
‘Yes,’ said Holly simply. ‘You’re an integral part of the team and I, for one, can’t imagine moving forward with our plans for expansion without you. I mean, it’s going to take quite the leap of faith to put some of these ideas into practice, but you know you’re vital to that process, Alice. At least, I hope you know.’
‘Something for everyone, isn’t that what you said? Find out everyone’s aspirations and make sure their work fulfils them? I cannot tell you how much those words resonated with me, Holly. And now – with my cancer clinic with Coco, and overseeing the Assistance Animals pilot – well, you’re ticking so many of my boxes, that I almost feel awkward asking for more – but I think I’ve reached the age where I need to know where I stand, professionally. And with Mum in my ear all the time to up sticks back to Orkney – well, it’s focused my mind a little. I want to be a partner.’
‘Okay then,’ said Holly. ‘Do you want me to discuss this with Taffy and Dan – test the water?’
Alice nodded. ‘And in case it makes any difference. I can honour my buy-in with cash.’
Holly gaped for a moment, caught on the hoof. Nobody bought into a Partnership with cash. Loans were organised, mortgages repurposed . . . It just wasn’t . . . ‘Alice, have you been loaded all this time without telling us, or is your vintage clothing just worth a butt-load more than you realised?’
Alice twisted her mouth in embarrassment. ‘Well, it turns out that my mum hadn’t been entirely straight with me, when she said my dad hadn’t left me anything. There’s this trust, you see . . .’
‘You’re a Trustafarian?’ Holly blurted, pinking as she did so.
‘Only in this particular instance, as it turns out. He wanted me to follow in his footsteps; to be a GP. So, he left funds invested so that I could do that. Apparently. And you have to understand, Holly, that this is all fresh information to me. I only found out two days ago. Something my mum let slip about needing an income to fund a trip. Turns out she’s been sleeping with old Dr Sjorgen for the last ten years – they’re quite the couple on the Island. So, if I head home and buy out his practice, she kills two birds with one stone – her daughter home and under her watchful eye once more, and a lovely nest egg for her and her beau to retire on.’
‘You couldn’t make it up. It’s like Scotland Does Dynasty,’ gasped Holly.
‘It does feel a bit like that in my life at the moment, to be honest. First Tilly’s renaissance, then you offering me my dream job and then Mum. If I was wearing shoulder pads then I’d know the metamorphosis was complete.’
‘So do you have a plan?’ Holly asked, holding out her gift bag of Cotswold fudge by way of support, forgetting that Taffy’s dad was its intended recipient.
‘I do,’ said Alice. ‘And ironically, Mum’s made it so much easier to stay down south. I want to be a partner here, invested here – financially and emotionally.’ She blushed. ‘Jamie and I have already decided this is where we want to build our lives, maybe even have children, who knows? But at least now I can make my dad proud and myself happy with one decision. If you’ll have me?’
Alice swallowed hard. She wasn’t usually one for long speeches, but these words needed to be said, to be spoken out loud, if only to cement the notion in her own mind. Holly’s professional belief in her had boosted Alice’s self-esteem so much of late that she’d already been mulling over ways to make a commitment here, to prove to her mum that her life wasn’t on those rocky windy islands that claimed to be her home but held none of her affections or loyalties, only desperate memories of winter storms and losing her father.
This legacy from her father, for that is what it was, felt like a lifeline – not just words of support for what Holly was trying to achieve, but money and action. Holly’s concept of ‘family medicine’ was more in line with her own beliefs and ambitions than anyone she’d ever met, surely that was a better investment than becoming her mother’s boyfriend’s cash cow?
‘Holly,’ Alice said, as they neared The Practice and they both reached for their professional personas, ‘I wanted to say thank you for being Tilly’s mentor. It meant so much to her that you were prepared to take the time, make the effort. I’m sorry I was a bit jealous the other day.’
Holly grinned. ‘She’s a live wire that one. Reminds me of Elsie in a way – an unformed slip of a girl, just looking to find the shape she wants to be. Mark my words, she’ll be the boss of us all one day.’
‘I don’t doubt it,’ agreed Alice. ‘And in the meantime, maybe The Practice can be moulded into the shape we feel family medicine should be?’
‘I like that idea, Alice,’ Holly replied. ‘Any planning that involves Play-Doh automatically gets my vote. And Taffy’s.’
They pushed open the door and the bright winter sunlight flickered behind them in the doorway for a moment, as though they were stepping through into a future filled with possibilities.
‘Ah, Mrs Cavendish. You’re bang on time, and look, Coco’s so pleased to see you,’ said Alice. ‘Come on through and we’ll take a look at those test results.’
Chapter 44
‘Cassie, Cassie? Come on, my love. Don’t cry. You’re going to give yourself a blinding headache.’ Holly offered yet more tissues and couldn’t help the automatic glance at the clock as the minutes ticked by and her afternoon clinic ran more and more off piste.
It was fortunate in a way, that Holly had quietly started to trial the longer appointments. All very cloak and dagger actually, as she’d yet to clue the patients – or indeed some of the staff – in on the concept; instead, Lucy and Grace were making judgement calls as to which patients might benefit from a little extra time and booking them in with Holly accordingly. It was heartening to see that Holly’s diary was already fully booked with deserving candidates. Imagine, she thought – as she attempted to soothe the snot-bubbling fountain of emotions that was Cassie Holland that afternoon – if all the doctors’ diaries were opened up in that way? It would revolutionise their standard of care: she was convinced of it.
For every patient that was feeling frustrated for being rushed, she’d lay odds that their GP felt the same way. And really, what was the alternative? Just always to be running late, always running over? Booking in follow-up appointments that shouldn’t really be necessary if there had been sufficient time in the first one? How could that be called efficiency? She was waiting on Tilly for the numbers, but a small part of her was hoping that they would show an actual cost to benefit ratio in her favour. Then, and only then, could she begin to clarify her proposals. She couldn’t deny that an influx of new patients from the Rugby Club might have a positive impact, too, when it came to the bottom line.
Cassie looked up at her plaintively, her crying jag having burned itself out, and hiccuped her words. ‘Isn’t it bad enough that I’ve got cancer, Dr Graham? Cancer? Me? Do you know anyone else who lives as cleanly or holistically as I do? How can that be fair?’
‘I’m not sure cancer is interested in fairness, Cassie. And this melanoma has nothing to do with lifestyle choices. It’s awful, I know. But it’s simply one of those things. And s
omebody is looking out for you – I mean, if you hadn’t gone for that manicure?’
Cassie sniffed. ‘You know me, Dr Graham, I’ve always been ready to take on the world, seize the day, grasp the nettle with both hands? And I was always determined to make my mark before I die. But now suddenly, with this cancer, there’s not enough time,’ she confided, as though she were the first person ever to experience that particular rollercoaster of emotions. ‘Like the other week, when I went on the radio and I sorted that cocky Connor and his stupid festival. I made my mark then.’ She sniffed again and Holly’s stomach flipped disconcertingly at the sounds. ‘But now I’m dealing with all this and I find that everybody’s furious with me about it. Apparently,’ she spat, ‘they’d all been getting lots of new business off the back of it. All the B&Bs were booked solid and the pub was going to make lots of money from the extra people visiting Larkford. One minute, their scruples align with my own, and at the hint of some extra money, they all abandon their principles and I’m the bad guy?’
‘But surely—’ began Holly, wondering how Cassie could possibly be so blinkered, and whether she herself could reassure Cassie of the festival’s future without breaking any confidences.
‘Shunned. That’s what I am now. A pariah in my own town. A pariah with cancer!’ she wailed.
Holly discreetly pressed the button on her desk and breathed a sigh of relief when Jason knocked on the door. A male nurse at her beck and call would surely be enough for Cassie to take stock and pull herself together.
‘Cassie? I need to see my other patients now,’ Holly said gently, after all, there was no medical input required here. This was simply a hand-holding operation. Nevertheless she felt a lurch of guilt as she handed Cassie over into Jason’s capable hands.
Cassie blinked up at Jason, like a scene from a Disney movie, her eyes wide and trusting. ‘I’ll be okay,’ she said, standing up with disconcerting speed and taking Jason’s outstretched hand.
Cassie’s remorse would be of no consequence to Connor, of course, Holly thought, even despite their fruitful meeting last night. The untold ripples of damage Cassie had caused by running her mouth off on air were still making themselves felt, even with their new plans in place.
Holly took a breath and checked her screen, all thoughts of Cassie falling from her mind as she saw Hannah Porter’s name. If ever there was a patient deserving of a little extra time and attention it was Hannah.
‘Hello,’ Holly said, as Hannah walked nervously into her consulting room, for once without her mother hovering beside her.
‘Hi, Dr Graham,’ Hannah managed, sitting down and folding herself into the smallest space she possibly could. She’d lost weight in the last few weeks, anyone could see that, no matter how many jumpers she had clearly layered on top of each other. And that despite The Practice’s almost tropical central heating that was making Holly wilt.
‘How are you doing?’ Holly asked easily. She quietly noted the angry red stains on the poor girl’s skin, the pock marks mottling her cheeks and the fine down that appeared to have thickened since last they met. In Holly’s mind, alarm bells were ringing that they may yet have replaced one problem with another.
Hannah nodded, managing a twisted smile. ‘Well, I haven’t had the urge to top myself for a while, if that’s what you’re asking. So I think those horrible tablets are out of my system. And the people at the Nut House were terribly sweet with me.’
Holly shook her head. ‘It’s not a Nut House, Hannah. It was just to keep an eye on you while you found a little balance, yes?’
‘You weren’t there,’ said Hannah darkly. ‘But yeah, it got the job done. I guess I should be delighted that my skin is back to its hideous usual self.’
‘Hannah, I know Daphne’s not here, but if there’s ever anything you want to share, maybe that you don’t necessarily feel good about saying out loud, you know you can always come here, don’t you? No judgement, no drama. Just someone to talk to?’
‘I know.’ Hannah tugged her sleeves down over her hands and sighed. ‘I guess that’s what I was thinking when I made this appointment actually. Mum’s not been coping with me very well. She’s shadowing my every move and it’s so incredibly suffocating that, actually, it ends up having the opposite effect and I don’t tell her things. Important things.’
‘Like what?’ said Holly, as casually as she could muster. Softly, softly.
‘Well . . .’ Hannah paused. ‘I honestly don’t want to top myself anymore.’
‘Okay.’
‘But even I can tell that some of my thoughts aren’t real. Like they’re not accurate or true, but I still believe them?’ Hannah struggled to articulate what she’d clearly come here to ask. ‘Does that mean I really am going mad?’
‘Are you seeing things that aren’t really there?’ asked Holly, trying to get the measure of the situation. ‘Having conversations by yourself, abrupt surges of rage, anything like that?’
‘Not really. It’s more beliefs, you know? Like that I’m always going to be alone because I’m so ugly? That maybe if I’m smaller, people will notice me less? And then once I thought that, I couldn’t really manage my food – it got harder to swallow? So I’ve kind of stopped eating?’
There was a world of emotions and pain in the string of confidences formed as questions that told Holly so much about what Hannah was dealing with. She may have served her time at the Nut House, as she derisively called it, to deal with the drug-induced suicidal ideation, but Hannah’s mental health was clearly still a precarious situation. Anorexia seemed like a probable outcome, if Hannah’s jutting collarbones were any guideline – unless this disgust of food was actually a manifestation of sitophobia itself. Fear of food, rather than fear of nourishment.
It was the kind of diagnosis you might only ever find on the pages of a med school pop quiz, but nevertheless the word had long stuck with Holly. In some way it had offended her very sensibilities – after all, what was more intrinsic to life than the need to nourish our bodies, even our souls, by enjoying good food?
The look of revulsion on Hannah’s face as she talked about eating was telling in itself.
There was no doubt in Holly’s mind that Hannah needed some more professional counselling to get her back on track. But they’d been there before and Hannah had simply clammed up. Sure, it was progress that she’d come here today, sought out Holly for advice – even if Holly now found herself completely out of her depth, professionally.
Since she had absolutely no intention of playing fast and loose with Hannah’s well-being while she attempted to learn on the job, no matter how intriguing her patient, Holly could only rely on her basic human empathy and her skills of persuasion.
As Hannah shut her down time and time again, Holly found herself beginning to grasp at straws. How could she persuade this gorgeous young girl to seek help if she was so adamant that any talking therapy was just ‘a load of touchy feely bollocks’?
Holly frowned for a moment, as Hannah lapsed into silence. ‘Hannah, can you give me just a second?’ She angled her screen slightly so that her search of the NHS matrix was for her own eyes only. There was one avenue that she hadn’t explored and she was now kicking herself for not going there first. After all, wasn’t Hannah’s current eating disorder a symptom, rather than the primary problem?
She took a deep breath, as the screen loaded and she double-checked the wording of the Access Statement.
‘Look, Hannah, I’m going to talk to you like an adult, okay? So, I’m going to be blunt.’
Hannah managed the first smile since she’d walked in the door. ‘Blunt I can do.’
‘Look, we both know you need a little help right now. You need to talk to someone who is professionally trained to give you the best advice and a proper recovery programme. There is no doubt in my mind that taking the acne medication knocked you off balance, from a mental health perspective, and I know it must be distressing that your acne has flared up again so quickly and so badly.’<
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‘Fucked either way, really,’ offered Hannah, ‘– if we’re still being blunt.’
‘Quite,’ replied Holly, without missing a beat. Living with Elsie had almost inured her to any cursing and blinding. ‘So here’s the thing. We know that laser treatment for acne can work very well, but it’s not something the NHS covers—’
‘And I know Mum can’t afford it,’ Hannah interrupted.
‘Exactly. But what you may not know is that there are exemptions to that rule. There is – shall we say – a little leeway. And whether this is cheering to you or not, there is a caveat that it may be covered if the problem is causing the patient significant psychological distress.’
Holly paused, allowing Hannah to process what this might mean.
‘You’re saying that me going to the Nut House was actually a step in the right direction?’ Hannah said eventually, her brow furrowed in deliberation.
‘I’m saying that there are steps we need to take to make this happen. And the first one is to get a proper evaluation by a psychologist. And, in all likelihood, some ongoing therapy. But, Hannah, I can choose one for you who’s likely to look kindly on our cause – however you’d have to actually go to the sessions and you’d have to engage – you can’t just sit there and play on your phone for half an hour like last time. Whatever you do, please don’t confuse stubbornness with strength, Hannah.’ Holly’s tone was stern but gentle, hoping to guide her patient into choosing this path herself, rather than having ‘treatment’ inflicted upon her.
In Holly’s mind, that simple nuance could make all the difference to Hannah’s compliance. And, if she wanted to qualify for the treatment that might deal with the underlying trigger for all of this, and ultimately change her whole life for the better, then compliance was about to become her new watch word.
