by Jan Carson
The lady receptionist is shaking her head apologetically. There are problems. Sammy is feeling increasingly uncomfortable. He can’t be sure he won’t throw up all over the counter. She says, ‘I’m sorry, sir, Dr Owens isn’t in today. Because of the fires, you know. I can give you Dr Murray or Dr Bell. Which would you like?’
‘Is either of them a woman?’ asks Sammy.
‘Not the last time I looked,’ replies the lady receptionist, and winks.
The wink is wasted on Sammy. He is a big man, but he looks like he might cry. Instinctively she reaches over and nudges the box of Kleenex closer to the edge of the counter, where Sammy’s hands are curling into the wood, like a kind of knuckly vice.
‘Which one’s nicer?’ he asks.
‘Dr Bell,’ she replies, then clamps a hand over her mouth. ‘I mean, they’re both great, but Dr Murray’s just a wee bit more … serious.’
‘I’ll take him.’
‘Are you sure?’
‘I don’t want nice, love,’ he says. ‘I want somebody who’ll get me sorted out.’
Sammy doesn’t know why he is saying this. He wants nice. He has come here specifically to be treated nicely by the doctor with the lamby face. Now his mouth is telling him that he wants serious and blunt, possibly even cruel. His mouth knows that he does not deserve nice. He deserves somebody coming at him with a sawn-off shotgun.
‘Right you be, sir. Dr Murray it is. Take a wee seat in the waiting room and he’ll be right with you.’
Sammy unfastens himself from the reception desk and lumbers off in the direction of the waiting room. The lady receptionist watches him leave. He is like a sad gorilla, hanging over his own weariness. He takes a seat in the furthest corner of the waiting room, positioning himself between the wall and Barry, who comes in every day, with drink on him, just to get out of the weather. He lifts an out-of-date car magazine from the coffee-table and flicks through it, front to back, his eye never for a moment focusing on any page. When it is his turn to meet the doctor he remains in his seat for a further thirty seconds, staring at the toes of his shoes as if willing himself to stand up and walk down the long, carpeted corridor to Dr Murray’s door.
He stops outside the doctor’s room. He knocks on the door, though it’s already partially open. He can see a slim slice of the young doctor sitting at his desk. Damn it, he thinks. It’s the posh fella from Reception. He feels judged, and he hasn’t even opened his mouth yet. He deserves to be judged for what he’s done. He opens the door and slides into the room. Next to the doctor’s desk there is a plastic chair of the variety often found in healthcare facilities. Sammy sinks into it. It is a relief to be finally sitting down.
He doesn’t even take the time to introduce himself. ‘I’m a bad man, Doctor,’ he says, ‘a very bad man.’
This strikes Jonathan as somewhat ludicrous, a phrase you’d hear in a movie and never actually say in real life. He stifles the urge to laugh as he looks up from the script he’s filling in for yet another course of antibiotics. (Antibiotics have replaced religion as the opiate of the East. Seemingly there’s no illness, real or imagined, that cannot be cured by a prescription for penicillin or one of its sister drugs.) Jonathan pushes the script aside. He can finish it later. He gives the patient his full attention. The man in front of him is about fifty. He is wearing very white trainers, blue jeans and a V-neck sweater of pale coral lambswool. He does not look like a very bad man. He looks like a retired geography teacher. Then again, Jonathan reminds himself, looks can be deceiving. Hitler’s face on a different man might have been homely, reassuring even, like that of a retired butler.
Jonathan smiles at the very bad man. ‘Dr Murray,’ he says, extending his hand to the man. He glances down at his notes. ‘And you’re … Samuel Agnew. What can I do for you?’
‘It’s Sammy,’ says the man. He looks furtively round the room. His eyes go left and right, all over the floor, like prison searchlights.
Jonathan takes him in, head to foot, the way his eyes are going. He decides to use his softly-softly mental-health voice. He smiles, careful not to show any tooth. Sammy shifts his weight in the chair. He lifts a leg and hooks it over his thigh so he’s sitting there, like a right-angled triangle, all edge and sharpish nerves. He leans forwards. Jonathan leans forwards to meet him. He uncrosses his arms. He has learnt this from Melanie: open body language means you are open to your patient’s needs. Jonathan is not open to his patient’s needs. He is already elsewhere in his head, wondering what he will think about while this man tells him his own particular sob story. He can tell that Sammy’s going to be a talker. Maybe the next ten minutes will give him an opportunity to think about Christine and how to nip their non-romance in the bud.
‘You know that thing where you can’t tell anyone what I say?’ asks Sammy.
‘Patient confidentiality,’ replies Jonathan.
‘Aye, patient confidentiality. Does it still work if I tell you something illegal?’
This is not the first time Jonathan has been asked this question. It is surprisingly common in doctors’ surgeries. It usually prefaces an admission of drug use. He holds his smile by the edges. It’s beginning to feel stiff on his face.
‘Illegal how?’ he asks. ‘Like you’ve killed somebody or like you’ve taken drugs?’
This seems to throw the older man. ‘Well, I’ve done both,’ he replies. ‘Not for years now and it’s not like the peelers don’t know. But that’s not what I’m in for. It’s something else. Something worse.’
In the East there is only one thing worse than killing someone.
‘Did you touch a child?’ Jonathan asks.
Sammy neither admits this nor denies it, so Jonathan assumes it must be child abuse. He is no longer miles away, thinking about Christine. He is sharp, like needles, running through the protocol in his head. He’ll have to write a report and inform Marty, who is their designated child protection officer. He’ll probably have to talk to the police. He is thinking, Shit, shit, shit, mostly because child abuse is a vile sort of thing to encounter on a Tuesday morning, but also because he is, at heart, a selfish man and there is an enormous amount of paperwork associated with processing this sort of allegation.
Sammy doesn’t notice his consternation. ‘Look,’ he continues, leaning even further forwards, ‘you need to tell me now. If I tell you something will you go to the police or not?’
Jonathan snaps back into the moment. ‘If you tell me you’ve done something illegal and the police aren’t aware of it, or I suspect that another person is at risk because of your behaviour, I’m duty-bound to inform the police.’ This is a phrase he has learnt by heart and rarely had opportunity to use. It has been partially inspired by years of watching the BBC medical drama Casualty. Saying it now, Jonathan is not even sure it’s factually accurate.
‘Right,’ Sammy says. ‘There’s little point in my being here, then.’
‘I think a priest’s what you’re after, Mr Agnew.’
This does not go down well. Sammy leans back in his chair. Jonathan can see the ghost of an old paramilitary tattoo emerging from the cuff of his sweater. It’s not the sort of tattoo you’d see in a chapel. It’s the other sort.
‘Look,’ says Jonathan, trying to reel the conversation back in, ‘is there anything I can do for you … medically?’
Sammy sits quietly for a moment, turning this offer over in his mind. His jaws circle slowly while he thinks, round and round in loose loops, as if he is sucking a boiled sweet. Twice he goes to stand up and Jonathan thinks he’s going to leave, but he remains in his seat, breathing in, breathing out, struggling to keep each hoarse breath under control.
‘I’m feeling a bit down, Doctor,’ he says at last.
To Jonathan’s great surprise, a little tear, no bigger than a lemon pip, sneaks out of the side of his eye and trails down his cheek. Without thinking he plucks a tissue from the box and hands it to the older man. Sammy stares at the tissue. At first he looks confused, then h
orrified, as if the doctor has placed a steaming lump of dog shit in his hand. He hasn’t realized that he’s crying. He’s not the sort of man who ever cries in public. He reaches a hand to his cheek and it comes away wet. His cheeks immediately blood up. He is mortified. This crying business is almost as bad as letting a doctor see you naked.
‘Sorry,’ he says.
‘Nothing to apologize for,’ says Jonathan. ‘You wouldn’t believe how many people come in here for the same thing.’
‘Even men?’
‘Lots of men.’
‘Pack of fruits,’ says Sammy, his voice thick with self-deprecation.
Jonathan starts to run through the checklist for depression: loss of appetite, broken sleep, weight loss, weight gain, anxiety. Sammy nods after most of these symptoms, patting his ample belly and muttering, ‘Does it look like I’m fading away?’ when the doctor mentions weight loss.
He’s been in the surgery for almost eight minutes already. Jonathan needs to keep the consultation moving or the next patient will be in on their heels. It’s clearly depression. He’s already thinking about prescribing anti-depressants. He could write a script for something that will take the edge off his sadness and have him out of the room in ninety seconds flat. He could say, ‘Come back next week and talk to Dr Owens about counselling.’ He could do both of these things and it wouldn’t even be particularly bad practice. But he doesn’t.
Something has shifted in Jonathan recently. Since Sophie. He has always kept to the rules – like a sort of recipe – one action naturally leading to the next. He has chosen the easiest route through every situation. He has thought, What would most people do when faced with this decision? and, regardless of desire or intent, always gone with the most popular option: general practice medicine instead of consultancy, carnivore not vegetarian, short-back-and-sides, blue jeans, brown brogues, four-door estate with a generous boot, Tesco instead of Sainsbury’s, and U2 over other, more interesting, bands. This has nothing to do with laziness, though fear, as always, has been a factor. With Jonathan it is always about the desire to fit in or, perhaps more specifically, the fear – the loud, loud horror – of sticking out. Things are different now. He can’t stop himself. He has opinions, tastes, likes and dislikes, which refuse to sit quietly below the surface of his reserve. He feels like a moving thing, a car or train, something capable of tremendous speed, something that could cause damage.
Jonathan does not say, ‘Would you like a prescription for anti-depressants, Mr Agnew?’
He does not say, ‘Come back next week and Dr Owens will get you sorted with a counsellor.’
He doesn’t even say, ‘Anything you tell me could be held against you, Sammy.’
Instead he opens his mouth and a thing like kindness comes rushing out of him: ‘Is something making you feel down, Sammy?’ he asks. ‘Is it the thing you can’t tell me about?’
‘Aye,’ he replies, and Jonathan can tell from the way his shoulders have risen a little, that a weight has lifted from him with the admission. He wonders what it must feel like to confess a thing, then leave it be and not return to it, over and over, like a picked scab. He thinks about Sophie and the secret she is every time he leaves the house. Maybe his own shoulders would go up like wings if he could – even for a minute – talk with another person about all the ways she makes him afraid.
‘Oh, what the hell?’ he says, which is a terribly unprofessional thing for a doctor to say. ‘I won’t tell anyone what you say. Your secrets won’t leave this room.’
‘Do I have your word on that, Doctor?’ Sammy asks.
‘You have my word. Go on now, tell me this terrible bad thing you’ve done. It’ll help, getting it off your chest.’
Sammy straightens in his chair. He folds his arms, left over right, like a pair of coat-hangers catching on each other. ‘I done bad things when I was younger, Doctor,’ he starts. ‘I’ll not go into what I done but I’m sure you can use your imagination. It was during the Troubles. You know the sort of thing I’m talking about. I thought that was all behind me. I wanted to be different. I said I wasn’t for hurting anyone ever again.’
‘Did you hurt someone?’
Sammy nods. The tears start again. He rubs at his eyes roughly with the cuff of his pullover.
‘Who did you hurt?’
‘I hurt my son, Doctor.’
‘Is he dead?’
‘Naw, he’s not dead. Might be better off if he was, though.’
‘Did you touch him, Sammy?’
‘Of course I didn’t touch him, Doctor. I’m not a pervert.’ His face curls up at the edges, like he’s sucking hard on a bitter lemon.
‘Did you hit him, then? Do you beat him? You have to tell me what you’ve done if you want me to help you, Samuel.’
‘I never lifted a hand against the boy. But I’ve hurt him all the same.’
Jonathan is beginning to lose patience. He imagines the other patients piling up in the waiting room, like rush-hour traffic tailed around the Westlink. He tugs at the soft part of his ear, pinching it between thumb and finger till the pain pulls him back into the moment. He’s starting to wonder if Agnew is one of those old men who just like moaning. If it’s too late to stop his confession and prescribe a short run of Prozac instead. He reaches across the desk, drawing his prescription pad towards himself.
Sammy is still talking. ‘I’m so worried about my son, Doctor,’ he continues. ‘He’s turned into me. Not me now, me the way I was before. He’s actually worse than me. He’s going to hurt somebody properly. He’s going to hurt a lot of people and it’ll all be my fault.’
Jonathan’s hand hovers over the prescription pad. ‘What do you mean, he’s going to hurt somebody?’
‘It’s all getting out of hand. The fires. There’s so many of them now. I don’t know where it’s going to end,’ replies Sammy, beginning to ramble. ‘I have to do something, stop him before it gets worse. It’s my fault he’s like this.’
The softness goes suddenly out of his face. There is an urgency in him now, curling into the cut of his fists. Then he is up, out of the plastic chair, through the door and off down the corridor. He doesn’t even say goodbye. Neither does Jonathan. He rises from his desk and shuts the door. He’s not surprised by Agnew’s behaviour. Most likely there are mental-health issues at play and it’s impossible to predict how an appointment with a crazy person will proceed. Once, an elderly lady tried to kiss him on the lips, in the middle of having her blood-pressure check. He’s also been slapped, shoved, sworn at and, on several occasions, spat upon. Leaving without saying goodbye seems almost normal in comparison.
Jonathan glances down at his hand and the prescription pad resting beneath it. He has, without thinking, doodled ‘SORRY’, in capital letters, as if regret is something that can be prescribed on the NHS. He wonders if he is sorry, or Sammy is sorry, or one of them is sorry for the other. All three options seem equally plausible.
He rips the top leaf off the pad, stuffs the paper into his pocket and tries to forget about Agnew. He moves on to the next patient and the next patient and the patient after that, who is a recently diagnosed diabetic. He can’t forget about Samuel Agnew or the sorry he is now carrying inside his trouser pocket. His fingers catch on it every time he goes searching for a tissue or a piece of chewing gum. He carries it home with him after work. When he steps through the door into the hall, the old fears are waiting for him and some new ones besides: the fear of loving people and the fear of hurting the people he loves. He drops his bag by the telephone table, takes the stairs three at a time and lifts Sophie from sleep to hold her, screaming, against his chest.
11
Little Wings
Ella Penney arrives in the health centre at exactly the right moment. Two days earlier and I’d probably have missed her. Any later may have been too late.
I’m not known for my rapport with small children. Once, while taking a toddler’s pulse, I made the mewing noise associated with attracting a cat. The
mother was not amused. She lodged a formal complaint and moved her entire family to a different practice. There have been other incidents since: I can never remember to warm the stethoscope’s ear before pressing it to a child’s chest; I forget to let the magic cream take effect; and sometimes address my younger patients formally as Master or Miss, adopting the austere demeanour of a Victorian dentist. The lady receptionists know all this. They know everything that happens in the health centre. They are, in this and other matters, comparable to God. That which they are not told explicitly they discern from snippets of overheard conversation and the particularly furious way certain patients will enter or exit the building. They tend to direct small children and sensitive types away from me, towards the other doctors, who do not make children cry or mothers fume. Even Marty, who is a relatively old man with fierce glasses and a Communist’s sunken face, is considered more child-friendly than I am. Maybe they will see me differently now I’m a father myself.
If the younger doctors hadn’t been stuck at home with the fires and Marty at the dentist for a filling, Ella Penney would never have found her way into my surgery. Two days later, she would have been too late to make any difference.
Two days from today, I will arrive home from work early. I’ll have a takeaway pizza with me: ham and pineapple with extra mushrooms on my side. Christine will meet me at the door, holding a hastily written sign that reads, ‘Sorry, can’t stay for pizza. I’ve got a date.’ This so-called ‘date’ will come as both a shock and a relief to me. I will still be trying to let the girl down gently. For a moment I’ll feel briefly, but utterly, mortified. I will stand on my own doorstep quickly flicking through all the occasions when I’ve been sure, absolutely certain, she was flirting with me: her hands lingering on my shoulder, her loose smiles, the red shirt she’s worn three times now, its neckline riding low across her little breasts. Eventually I will conclude, as I’ve often concluded in the past, that women are not to be trusted and never to be understood with any certainty. Then I’ll raise both thumbs and offer Christine the kind of blistering ear-to-ear grin that is our code for ‘absolutely delighted’. On this occasion it will also mean ‘No one deserves this more than you.’ The sentiment will be entirely genuine. Sophie aside, I like Christine as much as anyone I’ve ever met.
