‘You mentioned that your wife was a doctor?’ she says, then inwardly chides herself. Of all the questions she could ask why on earth has she chosen one about his late wife, for God’s sake? Partly nerves, partly curiosity.
‘Madeleine. Yes. She was an immunologist.’
‘How did you meet?’
‘We were students together at Cambridge. I was studying Maths. We went our separate ways for a while after graduation. Bizarrely we met up again by chance in Hong Kong. I’d gone over for a friend’s wedding and she was presenting a paper at a congress, on stem cell transplantation.’ His features soften. ‘We bumped into each other at a function in the Hong Kong Jockey Club.’ He turns to look at her. ‘Strange thing, fate, isn’t it?’
Ruth digs her hands deeper into her pockets. She can’t help but feel sorry for Dominic. The sound of a cycle bell interrupts her train of thought. She’s strayed on to the cycle path. As the bicycle flashes past she sidesteps it and brushes Dominic’s arm. She grasps it to steady herself.
‘Woah,’ he says, grabbing hold of her. ‘These guys think they have right of way regardless.’ He juts his elbow towards her and she links his arm. Neither look at each other. It’s an instinctive gesture and it feels right.
10
Bella
April 2005
There’s a little table in the waiting room. On it are lots of red and blue whirly wires with coloured beads. Bella tries to make the yellow beads go round the wires from one end to the other but then there’s a loud buzz above her head.
‘That’s us,’ says her daddy, taking her hand, as they go down the passage. He knocks on one of the doors.
‘Come in,’ says a voice behind the door.
There’s a lady sitting at a table, in front of a big computer. She smiles and asks them to sit down.
‘Hello, Isabella,’ she says, her eyes flicking between Bella and her daddy. ‘How can I help today?’
Bella’s daddy puts his hand on her knee. ‘Stop swinging your legs when the doctor is talking to us,’ he says. He takes a little book out of his pocket and he flicks the pages while he talks to the lady.
Under the lady’s table is a box. Bella climbs off the chair and crawls under the table to see what’s in it. No-one stops her. It has some books in it and a big cube with holes to post shapes through. Bella thinks that’s for babies. She sits on the floor and has a look round. There are lots of drawers with shiny handles. There’s a tall bed with a pillow. She wonders if that’s where the lady sleeps. There’s an orange bin, and a black one, and a yellow one. The room has a lemony smell.
The nice lady’s face appears under the table.
‘Time to come out now, Isabella,’ she says. Bella wonders if she’s been naughty. Her daddy calls her Isabella when she’s been naughty. And that’s a lot.
The lady lifts her onto the bed, then shines the torch. In her ears. In her throat. Prods her belly.
‘Everything seems hunky dory,’ she says, ‘but I think it’s worth doing a few tests just to be on the safe side.’
She gives her daddy a little pot. He takes Bella to the loo and tells her to wee in it. Her daddy gets wee on his hand. He goes to the sink to wash it off but now his thumb is bleeding. He knocked it on the jaggedy edge of the sink.
‘Silly me,’ he says, as he sticks his thumb under the tap. It’s an accident.
When they go back in the room the lady puts a stick in the wee then waves the stick round like a little wand.
‘Ta-da!’ she says, ‘A speckle of blood. I think we have the answer. Daddy is going to give you some nice medicine which will make you feel better.’
In the car, on the way home, Daddy tells Bella about when she was a little baby.
‘When you were born, Bella, you were such a tiny baby you had to live in a little plastic bubble till you grew stronger. You were just like a little chick waiting to hatch.’
‘Did I tap on the shell when I was ready to come out?’
Her daddy laughs.
‘Not quite, Bella, but you’ve always been a little fighter. We need to make sure you stay that way.’
11
Dominic
‘Sorry to keep you waiting, just putting you through now…..’
A hum on the line, like an annoying bluebottle. Dominic stares out the window. The bird feeder, crammed with seed, sways on its cast iron support by the low garden wall. A finch perches on the wires and pecks at the sunflower hearts and peanuts.
‘Hello, is that Mr. Peterson? Yes? It’s Dr. Crofton here.’
‘Hello, Doctor. Thanks for your time.’
‘Not at all. Sorry I wasn’t able to speak to you earlier. I have the result of Bella’s blood test. It shows she has a mild anaemia. Nothing to worry about. Actually anaemia is fairly common in young children. That could explain why she’s had her recent urine infections. I’ll do a prescription for iron for you to collect. Is that okay?’
Next door’s tortoiseshell cat appears on an adjoining high stone wall. It pads along the top, its fluid musculature supple, precise. It stops. Rigid.
‘Yes, of course, Doctor. I understand. I’m glad we’ve found out why she’s been unwell.’
‘Well that’s not quite the whole picture. Bella should get better with the iron, but because of her recent infections she’s going to need a kidney scan. We need to make sure we’re not missing anything.’
Dominic watches as the cat bounds down off the wall. The bird takes flight.
‘Oh, really? When will that happen?’
‘The ultrasound should be sometime in the next four to six weeks. Then there’s another scan she’ll need within the next six months.’
Undeterred the cat crouches low, its head static, frozen, camouflaged in the brown flecked bushes.
‘I wasn’t expecting this, Dr. Crofton. Thank you for being so thorough.’
The cat waits patiently, in the shadows. It stands still, totally focussed.
‘No problem. Is there anything else I can help with?’
A bull finch alights on the feeder.
‘Mr. Peterson?’
Dominic wonders whether he should tap on the window but the cat launches itself, its supple spine straight as an arrow, and catches the bird mid-air. Not a drop of blood spilt, just feathered carnage.
‘Oh, sorry, no, I don’t think so… except, well, yes, there is one thing that’s been worrying me.’
‘Yes?’
‘Well. I worry about family history. My wife had multiple sclerosis and she had lots of problems with her kidneys. Is that hereditary? Could there be a connection? Sorry if I sound like a hypochondriac, but I’ve been so worried about her.’
‘Well, don’t worry. I really don’t think there’s a connection. Let’s see how things progress once we have the results from the tests. How is she, by the way?’
‘She hasn’t got much of an appetite. Complains of tummy aches and feeling tired, but I think we’re managing okay, for the time being.’
Dominic stands up and peers outside. No sign of the cat. Just a bird feeder swinging in the breeze.
‘Okay, well do get back in touch if you have any further concerns.’
‘Thanks again, Doctor. I will.’
You bet I will, he thinks, as he puts down the phone.
12
Ruth
May 2005
Wednesday. Her half day. But the morning’s workload always bullies the afternoon’s respite into submission. At lunchtime it’s the weekly practice meeting. Her mind flashes back to the agenda. Margaret’s case tops the list. It’s vital she puts forward her defence. Trepidation lassoes her like a choke lead.
As she enters her consulting room, there’s an envelope propped up on her computer keyboard. Her heart lurches wondering if it’s from Dom. The spidery handwriting isn’t instantly recognisable. She
slides a flowery card out of its envelope.
‘Dear Dr. Cooper,
Just a wee note to say thank you very much for looking after Dad in his final days. Mum and I appreciate your care and support. It means a lot to us as a family.
Thank you and God Bless,
Anna Jones.’
She casts her mind back to the end-of-terrace house on Bramwell Estate. They had brought Cyril’s bed down to the front room, where he was the centre of attention to the constant stream of visitors: grandchildren, district nurses, former colleagues from the Post Office. Whenever Ruth visited, the house was always full, but everyone melted away when she appeared, save for the constant presence of Mabel and Anna at his bedside. Cyril always had a story to tell, and a great sense of humour. ‘Promise me, doc,’ he said, transfixing her with his watery grey eyes, ‘promise me, that you won’t send me into hospital. I’m comfortable here. I don’t want no body pumping me chest or trying to keep me going with those jump leads.’ She would draw her chair up to the cot sides of the bed and take his waxy hand in hers. They both laughed at his jokes, but their mutual expressions and locked handshake were an acknowledgement that they were both on the same wavelength. Ruth smiles to herself. He achieved his final wish of dying at home, surrounded by his family. She’ll miss him.
She logs on to the computer and notes that she’s supervising the trainee doctor this morning. Hastening along the corridor, she pops her head round Emma’s door.
‘Morning, Emma. How are you this morning?’
A young girl, exuding calm efficiency looks up. A smile dimples her cheeks.
‘Hi, Ruth,’ she says. ‘I’m okay now, thanks. Although I had a panic earlier this morning. Jessica was grisly all night. Thought she might have a fever but she was all right when I dropped her off at nursery. Probably teething. Doesn’t stop you feeling guilty though, does it?’
Ruth bites her lip and lets that remark pass. ‘Better let you crack on. We can catch up over coffee at the end of surgery. I’m in Room 10 if you need me.’
The morning passes quickly. Just time for a mini tutorial afterwards, though sometimes she struggles to teach Emma things she doesn’t already know. Today it’s the new European guidelines on urinary tract infections in children. Ruth makes a mental note to add it to her educational log as she makes her way to the coffee room.
She lifts the post out of her pigeon hole and sifts through it. The usual pieces of medical junk mail, pharmaceutical advertising, course invitations. Her fingers linger over the last envelope. It’s franked with three words that cast fear through her whole being. General Medical Board. General. Medical. Board. She knows it can’t be a subscription reminder. The coffee room is empty. She sits down and, as her fingers slide open the envelope, her stomach reels as if she’s in a lift that’s ascending too quickly.
Dear Dr. Cooper,
We write with regard to two recent referrals to the General Medical Board, namely:
Case 2651 Filed 17/2/2005 by Mr. A Tremayne.
Case 2652 Filed 26/3/2005 by Abbey Pharmacy.
These cases have been considered by our Board. In the first instance referral will be made back to your local Professional Standards Committee, who will be in contact with you shortly.
On completion of their investigations the Committee will make one of three recommendations to the GMB:
Closure of the cases
The issue of a warning
Referral back to the GMB for consideration of possible negligence proceedings.
Please note that it may take up to eighteen months for the Professional Standards Committee to report on their findings. We recommend that you inform your medical defence organisation.
We are aware that referrals to the GMB can cause stress for medical practitioners and offer a free confidential helpline (see below) should you wish further support. The enclosed booklet provides more details on the GMB investigation process.
Please acknowledge receipt of this letter.
Yours faithfully,
Her fingers trace over the words, the brushstrokes getting harder in the vain hope it might erase them. Eighteen months? Surely it shouldn’t take that long. They should be able to tell, unequivocally, that it was genuine human error. Shouldn’t they? Nobody died. It could have been worse. Much worse. Why that length of time? Swallowing hard she tries to suppress the lump in her throat. She tries stuffing the letter back in the envelope but her hands are shaking too much.
She’ll ring Dom. He would put things into perspective for her. She hesitates. Would he? It might expose her as incompetent. She’s frightened. Ashamed. Embarrassed. And this isn’t going to go away in a hurry.
What would her parents have thought? About the complaints. About Dom. Her mother would have enveloped her in a cocoon of floral scent, wool and hairspray and would have told her that everything was going to be okay, as she squeezed her tight. Eleven years since her death from breast cancer and she still thinks of her every day. Would she approve of Dominic? Good looking, educated, well mannered. She probably would. Much older, widowed, with a young child. Why torment herself with hypothetical questions? Her father would have been less sympathetic. Stress? The word ‘stress’ didn’t exist in his dictionary. Even when he accompanied her to the clinic all those years ago he wasn’t convinced it was stress. No, as far as he was concerned you met life’s obstacles head on and just got on with it. He didn’t understand that minds could fracture as easily as bones. Ironic that the pressures of redundancy and unemployment may have forced him into an early grave when he died of a stroke, aged sixty.
She pushes the letter down the side of her bulging equipment bag, forces the zips and picks up the printed computer summaries for her two allocated home visits. As she makes her way out to the car park, one of the receptionists stops her in her tracks.
‘Ruth, I’m glad I’ve caught you,’ she says.
Foreboding envelopes her.
‘The duty doctor has gone out to an emergency and there’s another visit request come through. Orchards Care Home. Expected death. Do you think you could do it, please?’
‘Of course, no problem.’
Taking the print-out from the receptionist, the bundle of notes slips from Ruth’s hand and it falls to the floor, like her mood.
Ruth places her thumb over the old man’s eyelids and gently strokes them closed. His skin is cold now, and yellow as tallow. She takes a step back and bows her head for a second, then looks up at Matron.
‘Are the family still here? Shall I have a word with them?’
‘No, they left about half an hour ago, but if you come into my office we can complete the paperwork.’
Ruth nods and unclips the stethoscope from around her neck. Collecting her ophthalmoscope case from the dressing table, her eyes are drawn to the cards which clutter its surface. A vintage car proclaims ‘Happy Birthday, Dad’, and another, ‘To Grandad’, is handmade in crayon. On the wall is a black and white photo of a smiling couple on their wedding day, the bride, with crimped hair and a buttoned crepe suit, next to her groom in Army uniform. Adjacent is a framed certificate recognising thirty years’ service with the Electricity Board. A life well-lived has been condensed into the microcosm of a care home bedroom.
Back in the car she switches on the radio just as the one o’clock news is finishing. She wonders what Dom is doing. Thoughts of him constantly distract her. That day by the boating lake. His touch as he pulled her out of the way of the cyclist. No, she must remain focussed. Sifting through her papers she looks at her remaining requests. A review following hospital discharge after a stroke, and a note from the district nurse to look at a wound. They’ll have to wait until after the practice meeting, she thinks, as she turns back towards Parkside Surgery.
One forty five. Ruth rushes into the meeting room, breathless and apologetic. Priya is there, plus Tony and Lesley, two of th
e doctors.
‘Don’t worry, you’re not late,’ says Lesley, pouring orange juice into a plastic cup and handing it to Ruth. ‘We can’t start till the others get here. Must be finishing their visits. Help yourself to a sandwich. Plenty to choose from.’ She glances at Tony and leans over towards Ruth. ‘Tony and I were just talking about the Tremayne case. That could have been any one of us. Sorry I’ve not had a chance to come and talk to you about it but we’re here to support you anyway we can.’
‘Absolutely,’ agrees Tony, nodding his head vigorously.
‘Thanks.’
It’s a wonder they can’t hear the pulsing in her ears, thinks Ruth, as she sinks into the seat. She takes a few long breaths, then takes a sip of orange juice. The hammering in her chest subsides and she reaches over the table for a paper plate and sandwich. Soon Emma enters, followed by Paul and Sally, and the meeting starts.
‘Just three case reviews today,’ announces Sally, the Practice Manager. ‘Who’d like to kick off first?’
Ruth locks eyes with Sally. She can’t be last today. She needs to get this over as quickly as possible.
‘Do you mind if we discuss Mrs. Tremayne first?’ She coughs, attempting to clear her throat.
‘Fire away,’ says Paul.
Ruth takes a deep breath and launches into a well-rehearsed script about the day she was on emergency duty and was inundated with requests for urgent advice, emergency appointments, immediate visits. It’s a scene she’s played out countless times in her mind. A scenario which makes her feel nervous every time she thinks about it, whether at three in the morning, or now after reading this morning’s letter from the General Medical Board. At times her voice wavers and cracks. At one stage tears well, but she blinks them away. She stops and, for what seems like minutes, there is silence round the room, punctuated solely by the crinkling of crisp packets.
Love Until It Hurts Page 6
