‘Thanks, Ruth,’ interjects Paul. ‘Any learning points you’d like to highlight?’
Her sandwich lies untouched on its paper plate.
‘Just that I’ve only got myself to blame,’ replies Ruth. Her nails dig white crescents into the palms of her hands, but she’s not allowed to go any further.
‘Whoa, hold on’ interrupts Paul. ‘I think it’s important to state something to everyone in this room. This is not a blame game. We’re only human, sometimes we all do things that, maybe with hindsight, we would have done differently.’ No-one speaks, but heads nod.
Ruth stares at her sandwich.
‘So,’ he continues, ‘with that in mind, are there any points that you’d like to share with the team?’
Ruth gives a weak smile and looks at her plate. A dry cough causes her to look up. Five pairs of eyes are looking at her. Paul’s words about learning points echo in her head. ‘Yes,’ she continues, ‘It’s impossible to diagnose the cause of pain over the phone, even when you think you know the patient well. When giving telephone advice always think about red flag signs. Sudden onset of worsening upper abdominal pain may mean a heart attack. Mrs. Tremayne was known by me to have gallstones and, with hindsight, that threw me off track.’ Her voice wobbles. It hurts to admit this. ‘Always offer safety-netting advice-that is, advise the patient to ring back or call an ambulance if the symptoms get much worse.’ She hesitates. ‘Oh and make sure you document carefully in the notes what has been said to the patient.’ She bites her lip.
‘Thank you, Ruth,’ says Sally. ‘If you could write up a case review and circulate it by e mail that would be great. Now, moving on, Case Number Two.’
There’s a shuffling of notes, as everyone turns to the next case on the list. A tear rolls down Ruth’s cheek. She feels a soft kick under the table and looks across the table to see Lesley nodding gently, her mouth upturned in a gesture of solidarity.
At the end of the meeting everyone, apart from Paul, files out of the room but Ruth holds back. She doesn’t want to be accosted in the corridor again. Her morning’s work isn’t yet complete. The table is strewn with used plastic cups and crumbed paper plates. Paul opens a packet, studies its contents and turns out a coronation chicken sandwich onto a napkin.
‘Uncertainty,’ he says, without looking up. ‘It’s what we deal with all the time.’ The lines round his eyes soften. ‘Don’t you think that’s enough for one day, Ruth? Isn’t this supposed to be your half day? You better get going while there’s still some of it left.’
‘I will.’ She pushes the chair back. ‘Thanks for your support.’
‘That’s okay. We’re a team, remember? If ever there’s anything worrying you, you can come to me and have a chat about it, okay?’
She sways a little. Should she tell him about the letter from the GMB? Maybe he already knows about it. ‘Well, I was wondering how to proceed with Margaret,’ she says. ‘I’d like to visit her when the time is right.’
‘Plenty of time for that, once the complaint is resolved. Trust me.’
‘Thanks, Paul.’ She slinks out of the room.
The waiting room is eerily quiet as Ruth walks past reception.
‘Still here?’
Ruth gives the receptionist a weary smile.
‘The meeting’s just finished. Oh, do me a favour please, Ginny. I’ve still got two visits. I’m not going to have time to come back and print out the prescriptions. Would you pass me a prescription pad for my bag, so I can handwrite them?’
‘Sure.’
Ginny slides open a drawer and passes over a pad of green paper. ‘See you tomorrow. Don’t work too hard.’
‘Ta. You too.’
13
Ruth
Val must have seen her walking up the path because she’s at the front door before Ruth rings the doorbell. Val puts a finger to her lips.
‘Sshh,’ she warns, ‘I’ve just got him off to sleep.’ She gives her friend a hug. ‘Hey, good to see you.’ They retreat indoors and Val runs her eyes over the linen suit, the smart sandals. ‘Just come from work? I thought Wednesday was your half day?’
‘Well, it’s supposed to be. Been another bummer of a day, actually. Six extras on top of morning surgery, three visits and a practice meeting. I’m shattered.’
‘God, I’ve got all this to look forward to when I go back in September,’ Val says, wiping her hands on her T shirt. ‘Don’t know how I’m going to manage.’ She feels in her pockets, then pats the top of her head and looks satisfied when she locates her spectacles. ‘Sounds like you could do with a glass of wine. I know I could.’ She laughs. ‘But four thirty’s probably a bit too early. Tea?’
They walk through to the back of the house. Ruth loves Val’s kitchen. It’s open plan with a large pine table on one side and a sofa and play area on the other. Large patio doors lead out to the garden. Today the low afternoon sun casts its warm rays over a rug where two little girls are playing. They’ve set out a miniature tea set, and each is absorbed in her own individual chatter.
‘Hello, Alice,’ Ruth says, to the dark-haired toddler who is stacking cups. Both little girls look up. Ruth finds herself drawn to her blonde-haired companion. The sharp angles of her shoulder blades and the pinched cheekbones are instantly recognisable.
‘Bella! Hello, you! What a lovely surprise.’
The fair-haired girl looks up through her fringe. She gets up and runs over to Ruth, knocking her legs.
‘Look what I’ve got,’ says Bella, holding up a pink plastic cup.
As Ruth bends down to grasp the toy she can’t help noticing Bella’s pallid cheeks, the purplish semi-circles under her eyes and how skinny she looks compared with her three-year-old playmate.
‘Are you having a tea party?’ Ruth laughs. ‘That looks fun.’
Bella runs back to the table and carries on with her task.
Ruth turns to Val. ‘How come?’ she whispers.
‘Mike arranged a meeting with Dom this afternoon,’ says Val, filling the kettle. She lowers her voice a fraction. ‘He said I should offer to look after Bella.’ She turns so that her back is to Bella. ‘I’m a bit nervous to be honest. He’s very protective of his daughter.’ Her forehead appears creased in curiosity. ‘Anyway, how’s it going?’
Ruth smiles. She edges in closer to Val, and angles an eyebrow. ‘That’s a loaded question if ever I heard one.’
‘Is it now? You always were a dark horse, Dr. Cooper.’
Val walks over to the patio doors and opens them outwards. The air smells fresh and Ruth detects the faint fragrance of honeysuckle.
‘Girls,’ Val says, addressing the playmates, ‘as it’s such a nice sunny day Ruth and I are going to sit outside in the garden.’ Neither of the little girls look up. She loads up a tray and hands it to Ruth, who follows her friend out into the bright sunlight.
Val opens out the parasol above the glass-topped rattan table. The teapot and mugs are placed on the table and both women slide onto the plump cushions.
‘You and I have a lot of catching up to do’ says Val, before Ruth can get a word in. ‘You need to bring me up to date with events since the Ball.’ She pushes a mug in Ruth’s direction.
Ruth sits back in her chair and takes a long gulp of her drink. She takes stock of her friend, who leans forward on the edge of her seat. It amuses Ruth to see her interest.
‘Actually, there’s not very much to say.’
Val’s shoulders drop. She looks disappointed. ‘Oh, come on. I know that’s not true. How many times have you seen him?’
Ruth lowers her voice. ‘I’ve been pre-occupied with work, and I guess he’s been busy dealing with his own situation.’ She kicks off her shoes and tucks her legs under her on the cushion. ‘You don’t mind, do you?’ she asks, pointing to her feet. Val shakes her head and gestures to her to continue. Her fru
stration is palpable, and Ruth intends to spin this out for as long as possible. ‘We agreed to meet up one evening,’ Ruth continues, ‘but that fell through at the last minute. I was really looking forward to a nice leisurely evening but he couldn’t get a babysitter, and I had an emergency at work. My last patient came in at six thirty and needed a referral to the Crisis Team.’
Val inches forward with every sentence. ‘And?’
‘You know what it’s like.’
‘I’m not interested in work. What happened with Dominic?’
‘I didn’t get home till gone eight. So that date was a disaster.’ A robin hops on the bird bath and Ruth watches it bob its head in the water before flying away.
‘Go on. And then what?’
‘Well, after the Ball we went out for lunch. That’s when I met Bella.’
‘And?’
‘And what?’ Ruth’s cheeks colour.
‘Oh, give me a break. There’s got to be more to it than that.’ Val picks up a chocolate wafer and snaps it in two.
Ruth regards her with shy amusement. ‘He’s really nice. I kind of feel sorry for him, all the stuff he’s had to deal with. He needs time. And she’s a sweet little girl.’ She sweeps her hair back off her face, twists it into a knot and pushes it under her collar. ‘Anyway, it’s me that should be asking you. You probably know him a lot better than I do.’
Val is about to take a bite of her second biscuit but pauses and returns it to the plate. She looks thoughtful. ‘Ha,’ she says, ‘where do I begin? Well I first met Dominic through Mike’s work then found out that his wife was a doctor. I guess, as couples, that meant we both had a lot in common. You must have been off doing your GP rotation, at the time.’ She stops, and stares ahead for a few seconds, as if weighing up what she is going to say next. ‘Actually I’ve been feeling very guilty.’ She fiddles with the back of her earring.
‘Guilty? Why?’
Val doesn’t reply but untucks her legs from under her, stretches them, then pats the cushions on either side.
Ruth tries to dampen the trill of anxiety unleashing in her stomach.
Val studies her closely and her words seem measured. ‘Madeleine and I used to be good friends. We fell out over … over a disagreement about six years ago. It was petty, but you know how these things can fester. Then she became ill and Dominic and Madeleine kept us at arm’s length. I always got the impression they preferred it that way.’ She pauses and readjusts the cushions for the second time. ‘When Alice and Ollie came along I guess our priorities changed,’ Val continues, ‘and Mike and I kind of lost contact with them. Which, of course, I regret.’ She waves away a wasp. ‘Mike went to Madeleine’s funeral, but I couldn’t go at the last minute because Ollie was ill. I feel guilty about that too.’ She sighs. ‘Anyway that’s all water under the bridge now.’
‘What do you mean?
‘Christ knows, we all do things we regret.’
‘I don’t understand.’
Val closes her eyes and taps the fingers of each hand together as if she’s meditating. After what feels like many seconds she opens her eyes and turns to Ruth. ‘I mean I could have been a better friend to Madeleine but it’s too late now. Maybe I can make amends by helping Dominic out with Bella.’
The tension in Ruth’s shoulders lifts and she rests back. They sit in companionable silence for a few seconds. The sound of a strimmer strikes up from a neighbouring garden. ‘But d’you know, I was wrong about Dominic.’
‘Wrong about what?’
‘Well Mike was keen for you to meet him but I warned him off. Said he was too much of a control freak. But with Bella he’s a changed person. It’s remarkable.’ A wasp hovers near her wrist and she waves it away. ‘From what I can gather she’s been quite a sickly child. Poor little soul. He left me a bag of medicines: Calpol, Piriton, Trimethoprim. Complete with instructions, bless him. He forgets I’m a doctor. He’s so attentive and caring. It breaks my heart to see them together, especially when I think of Alice having a mummy and a daddy.’
The bumblebees move in and out of the lavender bushes, as Ruth considers this information. It was true Dominic appeared arrogant at times but if you knew how to handle him he was a softie.
‘Don’t get me wrong,’ Val continues, ‘I really like him. I have a lot of sympathy for him.’ She leans forward and says in a whisper, ‘and he’s very good looking.’
They both laugh.
‘Here,’ says Val, lifting the teapot, ‘would you like a top-up before this gets cold?’ She refills Ruth’s mug, then leans back. Suddenly her posture stiffens. She looks at her watch. ‘That didn’t last long,’ she says, as a baby’s cry becomes audible from the window above their head. ‘Probably all that noise coming from next door. Make yourself at home while I go and fetch Ollie.’
While she’s gone Ruth glances round the garden, then looks up at the windows of the neighbouring houses. Satisfied she is sheltered from prying eyes, she lifts up her skirt, then rolls her sweaty tights down her legs. She sculpts them into a little ball and stretches her legs. The low afternoon sun warms her face. Should she tell Val about the replies she’s had on alikemind.com? What would Val say? Probably that men are like buses. You wait ages then three come along at once. The smell of freshly mown grass drifts over the fence. Ruth readjusts the cushions at her back then closes her eyes again. The company director looked hot, not so the university lecturer. But why is she even thinking this, now that she’s met Dominic? Although did she really want to rush into a relationship with someone who has a child and was so recently bereaved? Maybe that additional responsibility was why he came across as controlling. She could understand that. And now she understands why Bella looks so pallid.
A gurgling sounds brings her out of her daydream and she opens her eyes to find Val standing over her, cradling a fractious baby. She plonks a bottle of milk on the garden table and hands over the mewling bundle to Ruth.
‘Here we are, Ollie,’ she says, depositing the baby in Ruth’s lap, ‘Auntie Ruth can give you your bottle, whilst Mummy gets the girls’ tea ready.’ She gives Ruth a broad smile, accompanied by a shrug of the shoulders. ‘You don’t mind, do you? I won’t be long. Give me a shout if you need to. Besides, it’s a lovely day for sitting in the garden.’
She must have been sitting in the garden for about twenty minutes. There’s still not a cloud in the sky and the strimming from next door has stopped. Adjusting her seat under the parasol, so that Ollie is out of direct sunlight, she cradles him in her lap, breathing in his yeasty smell. His chubby fingers grasp the sides of his bottle and his face is a picture of dreamy contentment. He hasn’t a care in the world and she feels envious. A butterfly alights on the table and for a second its tortoiseshell wings glint in the sunshine before it flies away. Bliss. But in her mind there is an alternative narrative, and it runs through her like sandpaper over splintered wood. Loss is an indeterminate emotion which stabs you when you’re least prepared. She dandles Ollie on her knee and he obliges her with a one tooth smile which dints his face.
14
Ruth
Mike strides across the lawn, smartly-suited, a bottle of wine and some glasses in his hands. He beams at her. ‘What a lovely surprise!’ She readjusts her hold on the baby and wriggles to the edge of the seat. ‘It’s okay,’ says Mike, ‘don’t get up. You’re doing a great job there,’ and he leans forward to plant a kiss on her cheek and stroke the top of the baby’s downy head. Ollie babbles in delight.
‘Ollie’s been keeping me company in the sunshine,’ says Ruth. ‘How are you? Busy day?’
‘Productive day, thanks.’
Ruth feels a bristle of panic. She knows she doesn’t look her best. Is Dominic about to emerge into the hazy sunshine? She smooths her hair and brushes crumbs off her blouse.
‘Yes, Val said you’ve been with Dominic. Is he still here? Shall I go in and say hello?’
‘Oh, I’d leave them to it if I were you,’ says Mike, as he twists the cap on the bottle of wine. ‘They’re sorting the kids out. Plenty of time to say hello later. Val’s persuaded him to stay for supper, and we’re hoping you will too.’
Their eyes meet, as she considers her plans for the evening. She’s got nothing to lose, has she? She wonders if Dominic has said anything about her to Mike.
‘Save you having to cook tonight,’ he adds, in case she needs any encouragement.
Ruth shrugs her shoulders and smiles. ‘Why not?’ she says. ‘Sounds like a good plan.’
‘Excellent,’ he says. ‘Now let me pour you a glass of wine.’
‘Will you two quit taking about motor-racing,’ Val remonstrates. ‘Not all of us are interested in Formula One.’
‘Maybe you should be, darling,’ says Mike. ‘One of these days you might be grateful.’ Dominic reciprocates with a smirk and continues twisting noodles round his fork.
Val shrugs her shoulders. ‘Meaning what, exactly?’
‘You know Lucky Pagoda, the mobile phone company?’ continues Mike. ‘It looks like they’re going to buy and manage one of the teams. We had an interesting conversation about it this afternoon.’
Val looks up and feigns a yawn. ‘Tell me more. If you must.’
‘We met Gary Sharp, today,’ says Mike. ‘Remember him?’
Val seems to be smothering a laugh. ‘Not ‘‘Steel Bollocks Sharp?’’ What the hell was he doing there?’
Ruth bites her lip, trying her best to keep a straight face.
‘He moved over from LIFFE too. He’s an independent broker now. Reckons Lucky Pagoda’s one to watch.’
Val frowns. ‘I’d be a bit wary of him to be honest. All mouth and no trousers. Which reminds me, you both scrubbed up well for your meeting today, if you don’t mind me saying.’ She blows Mike a kiss across the table.
Love Until It Hurts Page 7
