by Mairi Chong
Deadly Diagnosis
Mairi Chong
Copyright © 2020 by Mairi Chong
All rights reserved.
No part of this book may be reproduced in any form or by any electronic or mechanical means, including information storage and retrieval systems, without written permission from the author, except for the use of brief quotations in a book review.
All the characters in this book are fictitious, and any resemblance to actual persons living or dead, is purely coincidental.
IBSN: 978-1-913463-02-1 (print edition)
IBSN: 978-1-913463-03-8 (ebook edition)
For W - forever and forever
1
The man glided evenly across the polished floor, his white coat offering no resistance. Hands beneath his armpits dragged him slowly, purposefully.
A metallic click sounded, like the cock of a pistol, as the door behind them shut. He stirred, but his assailant was now busy by the wall. Although he did not know it, he was in the centre of the room. A window in the ceiling offered only bruised moonlight and even this was not much. The skylight itself was distorted with cobwebs and many years of grime.
He was barely conscious. Some awareness allowed him to shuffle his legs. He attempted to manoeuvre his limbs into position so that he might try to sit up. His arms were heavy, like sodden cloth. Useless. His fingers clawed and scratched at the linoleum. Exhausted, he lay back once more, panting. His breath came in heaves. Summoning his energy, he tried to speak. His dry lips twitched. He heard a mumbling noise that he didn’t recognise, and then a snort. His assailant came across and stood above him. The man tried to look up, but his head would only lift as far as his attacker’s ankles. His vision was blurred. He blinked uncomprehendingly. His mouth moved again, but this time, no noise came. The feet retreated once more.
A shiver ran through him. The movement made his body ache. His head pounded. It was easier with his eyes closed. The effort to open them again was too great anyway.
A hissing sound came from across the room. He had heard the sound before but could not place it. His eyelids fluttered and he forced them apart. Frowning hurt. His face relaxed into hopeless passivity once more.
Hands were now on his head. He wanted to pull away but couldn’t. He managed to grunt, but the hands were relentless. Something sticky was placed on his temples. He tried to think. Stupid. Then came a moment of recollection. A blinding flash of realisation. He wished he had not remembered.
As the footsteps moved to the door, the hiss continued. He inhaled cool air for the last time. Thankfully, he did not hear the flick of the switch, nor was he aware of the sudden flame that engulfed the room after his attacker had closed the door.
His body lay shuddering and convulsing long into the night. Finally, the flames burnt through the wires to his forehead and allowed his charred remains to rest.
2
For a woman in her mid-thirties, Dr Cathy Moreland looked, if anything, far younger than her years. Her hair, recently cut, was glossy but, still not used to the length, she found herself tucking the ends behind her ear in a distracted manner. The thick jumper that she wore seemed to engulf her small frame, but it was necessary given the time of year.
The radiator by the window clunked twice. Cathy, without looking, stretched out her left leg and tapped the side of it with the heel of her shoe. It silenced almost immediately. She smiled and looking up from her notes, glanced sideways out of the window. Her last patient had been complicated and often, even when a person left her room, she found herself considering them and hoping that she had done the right thing. She would mentally carry their problems home with her at night often, and lie awake, wondering. She leant back in her chair and rubbed her forehead, as was her habit.
Before her illness, she had been more blasé. She had always followed up her consultations with the caveat that they should return if their symptoms worsened. This, she documented in the notes. As far as insurance purposes were concerned, she was covered. But these days, she regularly thought about the diagnoses she might have missed back in the early days. The patients whose lives, through her nonchalance, even conceit, might have suffered. But it was impossible to think like that. You could only do your utmost to help people at the time, and then let it go. Everyone in the profession knew that.
Her reflection in the window, cut at regular intervals by the hanging blinds, looked back, gaunt and weary. It had been a long week.
Outside, the street lights had already come on. It was only four o’clock but the sky had darkened and the rainclouds that had been gathering all late-afternoon were ready to release their offering. The patients who had been in to see her that day had said it was going to snow come the weekend, but so far, the menacing clouds had only given rise to a cold, damp drizzle.
Cathy sighed. She had a full surgery of patients to attend to that afternoon. She turned back from the window and looked once more at her computer screen. The receptionists had just added a message for her attention. She quickly scanned the contents. It wasn’t unusual to have late requests for appointments on a Friday afternoon. Usually, however, the girls would field them, and if necessary, punt them in the direction of the duty doctor. That afternoon, Linda was on-call. As far as she knew, her colleague had had a fairly quiet day of it, with only a couple of emergency visits. Cathy couldn’t understand why it wasn’t Linda who had been sent the appointment request instead of herself. She re-read the message and typed a quick reply: ‘Explain that I’m chock-a-block. If urgent, ask Linda. If not, book for next week.’
She rose from her chair, seeing on the screen that her next patient was in. The man hadn’t been in since his daughter had died the previous year and she wondered what he might have come for. She walked to the door of her consulting room and opened it, ready to call his name.
‘Oh, I’m sorry,’ she said, coming face-to-face with an elderly lady in the corridor right outside. ‘Whose room are you looking for?’
The white-haired lady smiled. ‘It’s your room I’m after, Dr Moreland. I’m from the charity shop in town. A fundraiser, that was what it was. The girls at the desk said I couldn’t get an appointment until next Thursday and they wouldn’t listen when I told them it was only a quick word.’
Cathy smiled. ‘They were right. I’m afraid I have a full surgery this afternoon. I’m very sorry, Mrs …’
‘Oh, you don’t know my name, it’s Scott. Elizabeth Scott. I’ve not been in to see you before, but I had heard about your interest in …’
‘I’m so sorry Mrs Scott. If you just come to the front desk with me, we’ll sort out an appointment.’
She guided the woman back through the waiting area, ignoring her protestations that it would only take a couple of minutes, five at the most.
‘Michelle,’ Cathy said, coming to the desk and giving her receptionist a stern look. ‘Next week, please. And find out what on earth Linda’s doing.’
The tone of irritation was impossible to miss and the elderly lady, still fussing and remonstrating, was finally silenced. Cathy moved back through the waiting room. She called her next legitimate patient’s name and stood by her door waiting. The girls were meant to be gate-keepers to the GPs. Michelle should have dealt with the whole situation far better. Cathy was breaking her back trying to field calls and requests. It was hardly fair to start allowing members of the public access to her at all hours of the day, and without even an appointment. And what was Linda doing anyway? She had no one booked-in, couldn’t she have seen the old woman if it was that urgent?
Sitting down and trying to compose herself, Cathy sighed. ‘Mr Stonley, it’s been a while since we last saw you. What can I do for you today?’
Barely a week later, Cathy looked at the patient before he
r and tried to gauge how much she knew. She was halfway through her morning surgery and had, up until then, seen a fairly predictable list.
‘Oh, I know of course,’ the woman said in answer to the unvoiced question. Her face, creased and Cathy was reminded of an old novel. The elderly lady’s pallor was almost the same as the pages of one. The woman’s eyes had an odd expression of almost pity, which was strange given the fact that she was the one dying. Elizabeth Scott was lying on Cathy’s examination couch. She had pulled the curtain around for modesty and had been somewhat shocked by what her patient had initially described as ‘a little matter.’
Cathy nodded. ‘Why did you leave it?’ she asked, withdrawing her hands.
The old woman pulled her blouse across her bare flesh again, screening the firm, irregular outline to her left breast. She shrugged. ‘I know you’re busy and, well, I suppose I didn’t want to admit it to myself. I’ve had a good run at things really.’
‘There are things we can do,’ Cathy said. ‘Please take your time.’ She drew the curtain around the woman, having indicated that she should get dressed once more. She washed her hands absent-mindedly, dropping the paper towel in the pedal bin by the sink. The lid fell with a clang. From her desk now, she continued to speak. ‘Can I ask how long it’s been there – the lump?’
She heard the old woman sigh from behind the curtain as she paused getting dressed. ‘Too long to remember. Months, maybe. I know I’m the very worst kind of patient. I should know better.’
‘You used to be a nurse, you said?’ Cathy asked as she typed in the lady’s notes. ‘Left lateral upper quadrant breast lump. Hard, craggy, irregular. 4cm approx. Skin dimpling, Erythema. No nipple discharge. Unilateral lymphadenopathy. URGENT BREAST CLINIC REFERRAL.’
‘Oh, many moons ago,’ the woman said, now coming around the curtain. Mrs Scott slowly fussed with the curtain, setting it against the wall and then turned, and moving back to the bed, tore off the sheet of thin paper that had covered it, and drew another from the roll at the end of the bed.
‘Oh, please, don’t bother,’ Cathy said, but it was clear that the woman wanted to.
She then settled herself in the chair beside the doctor’s desk, fiddling with the handle of her handbag. ‘Make the worst patients, so they say,’ the old lady repeated.
Cathy nodded but didn’t smile. ‘I’ll refer you up to the breast clinic as a matter of urgency. You’ll be seen in the next day or so I expect. They’ll do scans and see what’s what. I assume you agree to that, so we can judge what we’re dealing with?’
The woman raised her hands in acceptance. ‘If you say so. I won’t have treatment though. I’ve decided.’
‘Let’s see what they say first,’ she said. ‘Then we can talk about the pros and cons of treatments and all of the options. Many people initially feel the way you do but you’d be surprised how much things have changed over the years. The treatments now …’
The woman nodded but Cathy felt that her words were falling on deaf ears.
‘You came in last week and tried to see me on Friday,’ she said, looking up having finished typing. ‘Was it about this? I feel dreadful if you’d wanted to be seen but were too uncomfortable to say why. I’d have made the time to see you, or one of the other doctors …’
But the old woman was shaking her head and smiling. ‘No, I needed to see you. And in truth, the lump was just an excuse, I’d have left it longer really,’ she said.
Cathy raised her eyebrows.
‘No, my real reason for coming in today was to talk to you about a little issue at the charity shop.’
Cathy, now quite incredulous, smiled, and the elderly woman, with a twinkle in her eye, smiled back through her white halo of fringe.
3
‘Well darling, what do you think? We’d go as a threesome obviously. I know you hate walking into things on your own. After a few drinks, it’d be fine though.’
Cathy had arrived home an hour later than she should have. She moved the mobile phone to her other ear as she opened the fridge door. Milk, eggs, margarine, and a rather out-of-date-smelling block of cheese. There was always omelette but perhaps she’d just have cereal and save herself the hassle. Her kitchen was rarely utilised. She could barely remember when she last had anything in the oven other than frozen pizza. It was the result of living alone for too long, she mused. Her last boyfriend had gone not long after her initial diagnosis of bipolar, unable to take any more of the rows and mood swings. She couldn’t blame him. Since he’d gone, she had found, if not comfort in being alone, then acceptance of it. Now her social calendar only had in it meetings with insistent and stubborn friends who refused to be blocked-out. Suzalinna, her closest, and the only one who dared had been harping on about her getting back on the dating scene again, but Cathy felt that this was so far removed from where she was emotionally, it was almost laughable.
‘Well?’
Cathy groaned. ‘Oh, God, but why do we have to do it at all?’ she asked. ‘You know I hate these bloody things, Suz. Can’t we just be happy to have kept in touch with the important friends from our year, in other words, each other, and go out for a meal ourselves without all the rest of them? Medic reunions are a well-known pain in the backside. Everyone will get pissed and talk about themselves and how many lives they’ve managed to save since we last saw one another. Then, there’ll be the nerds who never intended on doing the degree to see patients. They’ll huddle together and bore everyone with their vital research projects. Honestly, it’ll be torture.’
Cathy heard her friend snort. ‘You’re awful,’ Suzalinna said. ‘Why not come? It’s always funny to see what everyone’s been up to. Last time they organised a reunion, it was only five years after qualifying, and we were all still boasting about our bloody exam results. It’ll be different this time. People have moved past that. I want to see what everyone’s ended up doing. Don’t you want to know where they all are? Remember Orange Clarissa?’
‘Oh yes. I wonder if she’s found a better match for her skin tone yet. Well, she’s one I’ll be avoiding. Odds on, she’ll be a consultant by now, but only having slept her way to the top.’
‘There you go, see? I knew you were interested. There were other nice people in our year if you care to remember, or has it been such a bad day at the office that you can only recall your medical school days through blood-tinted spectacles?’
It was Cathy’s turn to snort. ‘You know my spectacles are more likely to be snot-tinted. I’m not elbow-deep in gore like you and your A and E buddies.’
Suzalinna laughed, but she wasn’t letting it drop. ‘It’s not even as if we’d need to travel far,’ she continued. ‘It’s at The Georges just outside town. Everyone else moved away. Only you, me and a handful of others stayed put. The least you could do is come and talk to poor, old Saj. You know he hates these big, social gatherings. The two of you can support one another while I find out all the gossip. Oh, please darling. Do it for me. I’m booking our tickets now.’
Cathy, knowing full-well that she was being bulldozed, made a few more reluctant noises. Suzalinna was used to getting her way. It had always been so. Now, as a well-respected, but unquestionably arrogant A and E consultant, it had only escalated.
In many ways, Cathy found herself envying her friend’s situation. Suzalinna and her husband, a pathology consultant, were undoubtedly a perfect match. They had supported Cathy through the last turbulent year. It was Suzalinna who had taken her for an initial appointment to see a psychiatrist. Cathy’s practice partners had become increasingly concerned about her behaviour at work; her irritability and her rash judgements in dealing with people. There had been complaints about her language and then she had been caught self-medicating. That was the last straw.
But it was all in the past now. Since then, she had been established on an antipsychotic regime which, after the first few months of teething troubles, was helping a good deal. Her life, the psychiatrist said, was going to be very different post-di
agnosis. It would have to be. Suzalinna and Saj had encouraged her to find a routine. She had been advised to avoid excitement but even this, along with the medication, might not stave off future relapses. Cathy knew that herself. She also knew how fortunate she was to be able to practise medicine at all now, albeit under the watchful eye of her senior practice partner James, and occupational health.
Cathy sighed. ‘I’m too tired,’ and she must have sounded it. In the end, it was agreed that she would sleep on it. Promising to talk again soon, Cathy hung up. That was the issue really if she was honest. Everyone else at the reunion would be boasting about their great careers, but the illness had curtailed hers. She was no longer allowed to train registrars. The stress was going to be too much. Her supervisor, who now met with her at three-monthly intervals, had recommended that she consider dropping a session. So far, Cathy had ignored the suggestion. Sometimes she felt trapped by the disease. Part of her yearned for the old, manic days, the thrill of the euphoria. Since starting the medication, this had been blunted considerably. A bit of excitement was what she craved. Perhaps Suzalinna was right, after all. She looked around her empty kitchen. The slog of the daily grind was enough to depress anyone. Impulsively, she snatched up her mobile.
‘Go on then. Get me a ticket too.’
‘I had an interesting one the other day, James,’ Cathy said at coffee time the following day.
Dr Longmuir, Cathy’s practice partner, now edging reluctantly closer to retirement, glanced sideways.
‘Well?’ he said, settling himself on one of the low, cushioned chairs along the edge of the upstairs room. In front of him, was a large pile of prescriptions waiting to be signed. Michelle had brought them up having printed them out at the front reception desk that morning, hoping that the GPs might get the opportunity to attend to them during their break. James moved the pink papers to the side and placed his mug of coffee on the table. ‘Where’s Linda anyway?’ he asked. ‘Shouldn’t she be finished by now? I checked before coming up and there weren’t any calls.’
