by Kate Hardy
‘So I’m not breathing out enough air,’ Sam said.
‘Instead of you blowing most of the air out of your lungs in the first second, there’s a shallower curve,’ Oliver said. ‘It’s what we call an obstructive pattern, meaning that you’ve got a lung condition which narrows your airways, so the air is flowing out more slowly than it should.’
‘I was hoping that the medication would open up your airways a lot more, so your pattern would match that of someone who doesn’t have a lung condition, and that would’ve meant I’d diagnose you with asthma,’ Gemma said, ‘but unfortunately it hasn’t. There are some other conditions that can cause breathlessness, so I’m going to send you for a chest X-ray and do some blood tests to check if you’re anaemic, or if there’s a higher than average concentration of red blood cells in your blood.’
‘Chest X-ray?’ Sam went white. ‘Oh, no. Are you telling me you think I’ve got lung cancer?’
‘I’m just being thorough and ruling things out,’ Gemma said. ‘From the look of this graph, I think you have something called chronic obstructive pulmonary disease—COPD for short.’
‘I agree with Nurse Practitioner Baxter. Chronic means it’s long-term and won’t go away, obstructive means your airways are narrowed so it’s harder for you to breathe out quickly and air gets trapped in your chest, and pulmonary means it affects your lungs,’ Oliver added.
Sam grimaced. ‘And I’ve got it because I’m a smoker?’
‘We’re not judging you, but yes. Nine out of ten cases of COPD are caused by smoking,’ Gemma said.
‘Though COPD can also run in families,’ Oliver said. ‘And if you work in a place where you’re exposed to a lot of dust, fumes or chemicals, that can contribute.’
‘Nobody else in my family gets breathless, and I work in a garden centre. So it has to be the smoking,’ Sam said with a sigh. ‘I know I shouldn’t do it. But I started smoking when I was fifteen, because all my friends were doing it and I didn’t want to be left out. And then it got to be a habit. It calms me down when things get tough.
‘I’ve tried to give up a couple of times, and I managed it when I was pregnant because I didn’t want it to affect the baby, but Louisa’s toddler tantrums sent me right back to having a quick cigarette in the garden to help calm me down, and I never managed to stop again.’ She shook her head and grimaced. ‘It’s just too hard.’
‘COPD isn’t a condition we can cure, or even reverse,’ Gemma said. ‘But the best way to stop it getting any worse is for you to stop smoking.’
‘We can support you,’ Oliver said. ‘There are lots of things that can help you—patches and gums and sprays. And you’re three times more likely to be able to give up with our support than if you’re struggling on your own.’
‘We can also refer you for a pulmonary rehabilitation programme,’ Gemma said. ‘It’s a six-week course with other people who have the same condition as you do. Some of the sessions will teach you exercises to help your breathing, but the trainer will also be able to teach you breathing techniques, how to manage stress, and how to manage your condition better.’
‘That sounds good,’ Sam said.
‘We ask all our patients who have asthma or COPD to have a flu jab every year,’ Gemma said, ‘because when you have a lung condition you’re more vulnerable to catching the flu in the first place, and developing complications.’
‘And there’s a one-off pneumococcal vaccine, which will help protect you against pneumonia,’ Oliver added. ‘I know it’s a lot to take in, and it sounds scary, but we can help you.’
‘You’ll get a letter so you can book onto the pulmonary rehab course at a time that works for you,’ Gemma said, ‘and I’ll refer you to a counsellor who can help you stop smoking. Plus you’ll have regular appointments with me to see how you’re doing, and to check that your symptoms are under control and you’re not getting any side effects from the medication.’
‘Thank you,’ Sam said. ‘And I’ll try really hard to stop smoking. Really, I will.’
‘You’re not on your own,’ Oliver said. ‘That’s the main thing. We’re here to help.’
Once Sam and Oliver had left her consulting room, Gemma took a sip of water. Now she’d seen Oliver Langley with a patient, she could see exactly why the head of the practice had offered him the job. He was kind, supportive and clear without being patronising; he hadn’t judged Sam for smoking; and he was a world away from the cold, slightly haughty man she’d first met on Monday morning. The way he’d worked with Gemma, backing her up, had made her feel as if she’d worked with him for years, rather than today being only his third day on the team.
But Oliver was still practically a stranger. And she needed to be sensible instead of noticing how her heart skipped a beat every time he smiled.
She sent him a note across the practice messaging system after she’d written up the notes and before seeing her next patient.
Thanks for your help with Sam’s COPD. Appreciated.
You’re welcome, he replied.
Gemma liked the fact that he had nice manners. The more she got to know Oliver Langley, the more she liked him.
Strictly as a colleague, she reminded herself, and saw her next patient.
Just when she’d seen her last appointment of morning surgery, her computer pinged with a message.
Are you busy for lunch, or can I buy you a sandwich and we can maybe sit on the cliffs again?
Which sounded as if they were about to start becoming friends.
She messaged back.
A sandwich would be nice. Thank you. Just writing up my last set of notes and I’ll be with you.
* * *
Crazy.
Ollie knew he shouldn’t be looking forward to lunch with Gemma.
But he was. He’d liked the way she’d been with her patient this morning, all calm and kind and reassuring. And the fact that she’d checked with him on a case she wasn’t sure about: her patients’ welfare came before her professional pride, which was exactly how it should be.
Gemma Baxter was nothing like the man-eater he’d assumed she was when he’d first set foot in the reception area on Monday morning and overheard that comment.
She was nice. Genuine.
And if Rob was here right now he’d grin and say that Gemma was just Ollie’s type, with those huge eyes and all that fair hair.
He didn’t need a type. This was a burgeoning friendship, that was all—and that was fine by him.
Once they’d chosen sandwiches and headed up to the cliffs, he helped her spread out the picnic blanket. Again, his fingers accidentally touched hers and it felt as if lightning zinged through him. His lower lip tingled, and he couldn’t help moistening it with the tip of his tongue.
Oh, for pity’s sake. He really needed to get a grip. Work, he thought. That was a safe subject. ‘How was your morning?’ he asked.
‘Pretty good. Thanks for your help with Sam—I’ve only just taken over the practice asthma clinic, so I’m still finding my feet a bit.’
‘No problem. That’s what I’m here for,’ he said.
‘How was your morning?’ she asked.
‘Pretty good.’ He smiled at her. ‘I’ve been thinking. I’d like to sponsor you for your skydive. You said it was next month?’
‘Two weeks on Friday,’ she said. ‘I have to admit, I’m feeling a bit nervous about it now. It’s a tandem skydive, so I know I’m going to be perfectly safe with an instructor, but even the idea of stepping out of that plane makes my palms go sweaty.’
‘You’re clearly not scared of heights, though, or you wouldn’t be here on the cliff.’
‘No, but I wouldn’t choose to go rock-climbing.’ She looked at him. ‘Though, actually, I guess that could be a potential challenge for the future. Maybe next year.’
He frowned. ‘So why are you doing the
skydive? I know you said it was for charity, but is it because you’re challenging yourself to overcome your fears as well?’
‘No, but people get bored of sponsoring the same thing. A skydive’s good for raising the profile of the cause, too. There’s a good chance it’ll go on the local newspaper’s website, along with my fundraising page details, so maybe people who don’t know me but want to support the cause will donate something.’
‘You said you were raising funds for the local hospital’s cardiac unit. Is that because you did some of your training there?’ he asked.
‘No.’ She took a deep breath, as if psyching herself up to say something. ‘My little sister spent a while there. I’m fundraising in her memory.’
In her memory... Gemma’s little sister had died?
Before he could process that, she said, ‘It was a long time ago now. I caught a bug at school, and Sarah caught it from me. I got better, but she didn’t—she was still breathless and struggling. The next thing we knew, she was in the cardiac unit, being diagnosed with myocarditis.’
He’d noticed exactly what she’d said. ‘It wasn’t your fault. If the bug was going round at school, she could’ve caught it from one of her friends, not just from you.’
‘Uh-huh.’
It sounded as if she still blamed herself, even though as a medic she’d know that wasn’t fair. ‘Was she on the list for a transplant?’ he asked.
‘Yes, but we were waiting for months. The right donor just didn’t come along.’ She looked away. ‘Sarah died when I was seventeen and she was thirteen.’
He reached over and squeezed her hand. ‘I’m sorry. That must have been devastating for you and your family.’
‘It was,’ she admitted. ‘I’ve had twelve years to get used to it, but I still miss my little sister. And I really didn’t cope very well at the time.’ She shrugged. ‘This is why I do the fundraising. It won’t bring my little sister back and it won’t do anything for the donor lists, but the hospital is doing research into permanent artificial hearts. And if that works out, it means another family might not have to lose someone they love dearly.’
‘I’m sorry I’ve brought back bad memories for you.’
‘I have a lot of good memories of Sarah.’ She smiled, though her eyes were suspiciously shiny and he rather thought she was holding back tears. ‘Doing her hair and make-up for a school disco, painting her nails, making cakes with her, playing in the garden.’
Obviously her memories were what carried her through the tough times. ‘I’ll definitely sponsor you,’ he said.
She shook her head. ‘I don’t want you to feel obliged. It’s fine.’
He knew the way to persuade her to accept his offer. ‘It’s not that I feel obliged,’ he said. ‘I was very nearly in your shoes, earlier this year.’
* * *
Apart from the people in the support group she’d gone to—and that hadn’t lasted for long—Gemma had never met anyone else who’d had someone close who needed a heart transplant. ‘Someone in your family needed a heart transplant?’
‘No. My brother needed a kidney transplant.’
She winced. ‘That must’ve been hard for you all.’
He nodded. ‘Rob’s a bit of a thrill-seeker. He’s an A and E doctor in Manchester. He spends all his free time climbing, and he’s on the local mountain rescue team. He took a six-month sabbatical to work with a humanitarian aid agency; he’d gone out to help with a region that had just been hit by an earthquake. He had stomach pains when he’d been there for a couple of days, but he just assumed it was an ordinary tummy upset because he wasn’t used to the food and water. And then, when he collapsed, they realised he had acute appendicitis.’
‘Poor man—that’s really tough.’
‘It was. He was airlifted to a hospital, but his appendix burst on the way and he ended up with severe blood poisoning.’ Oliver looked grim. ‘It wiped out his kidneys, and he was on dialysis for a while.’
‘But you got a donor?’
Oliver inclined his head. ‘That’s the main reason why I came back to Northumbria. We’ve been recuperating at our parents’ house since the transplant.’
She blinked. ‘We—you mean, you were a living donor?’
‘It was the obvious solution,’ Oliver said. ‘Rob’s my twin.’
She hadn’t expected that. ‘Identical?’
‘Apparently you can look identical but not actually be identical, so we had to do gene sequencing to check,’ Oliver said. ‘We’re not quite identical. But, even so, getting a kidney from me meant his body was much less likely to reject it, and he’s on a lower dose of immunosuppressant drugs than he’d need if anyone else had donated the kidney.’
‘So that’s why you’re working up here now?’
‘I was getting a bit stir-crazy,’ he said. ‘Mum’s overdoing the cotton wool treatment.’
Gemma’s parents had been too hurt to wrap her in cotton wool. Instead, they’d let their grief build a wall between them and never let her back in. She pushed the thought away.
‘I’m the sensible one and it’s been driving me crazy, so poor Rob is really having to learn to be patient.’ He grinned. ‘Which will probably do him good.’
‘You’re both so lucky,’ she said. ‘Your twin, because he has you; and you, because you could actually do something practical to help.’
‘Yes. If it had been a different organ that failed, we would’ve had to wait for one to become available.’ He wrinkled his nose. ‘You know yourself, it’s not very nice, waiting for someone else to die.’
‘No. It’d feel horrible, knowing your loved one’s only still with you because someone else lost someone they loved,’ Gemma said. ‘Though Sarah thought about that, even when we knew it was too late and she was too ill for a transplant to work. She said she’d rather help someone else, even though she couldn’t be helped, so she made our parents sign to donate everything that she could.’
‘Brave kid,’ Oliver said.
‘She was. I wish...’ Her breath hitched, and he could guess what she was thinking. She wished her sister hadn’t died. Wished she’d been the one to be ill, to save her sibling. All the thoughts that had scrambled through his own brain in the early hours of the morning, when he couldn’t sleep for thinking of what might have been.
‘I often wonder what she would’ve been doing now,’ Gemma said. ‘She would’ve been twenty-five. I think she would’ve done something with art—she was really good.’
Oliver reached over and squeezed her hand. ‘I’m sorry. I know how bad I felt when I thought I was going to lose Rob, earlier this year. It must’ve been so hard for you.’
‘It was,’ she agreed. ‘And my parents have never recovered from it. They moved from the village, the year after Sarah died, because they couldn’t handle all the memories.’
‘You said you were seventeen at the time, so I assume they waited for you to finish your A levels before they moved?’ he asked.
She shook her head. ‘I made a complete mess of my exams and ended up having to resit them. But I didn’t have to change schools; my best friend’s mum let me stay with them and redo the year.’ Yvonne had got her back on the straight and narrow. She’d cared. Been the stand-in mum Gemma had desperately needed.
‘That’s an amazing thing to do for someone,’ he said.
‘It is, and I’ll always be grateful to her. Actually, I’ve been thinking lately that maybe I could offer a place for a teenager needing support—kind of pay forward what Claire’s parents did for me. I live alone, but my working hours are regular so I could be there for someone who needed it.’
* * *
Gemma lived alone, and it sounded as if she didn’t have a partner.
That really shouldn’t make Ollie feel as pleased as it did. He wasn’t looking for a relationship and, since Tabby had broken their engagement, h
e wasn’t sure he’d be enough for anyone in any case.
But there was something about Gemma Baxter that drew him. A brightness, a warmth.
She’d come through the kind of nightmare that he’d dreaded happening to Rob and had kept him awake at night for months, and she was doing her best to try to stop other people having to go through it.
No partner.
He really needed to stop this. Yes, he liked Gemma and he was drawn to her. But he wasn’t ready to move on with his life. He needed to be fair to her; all he could offer her right now was friendship.
‘It’d be a good thing to do,’ he agreed. ‘Rewarding. You’d know you were really making a difference to someone’s life.’
‘So how’s your brother doing now?’ she asked.
‘He’s recovering well, but it’s driving him a bit crazy not being at work. He knows there’s no way he can go back out to do the humanitarian aid stuff or the mountain rescue—with only one working kidney, he’s too much of a risk to be on a team. And he’s not fit enough to go climbing again, either. He needs to be patient for a bit longer. And, for Rob, “rest” is most definitely a four-letter word.’
‘So when did it all happen?’ she asked.
‘He collapsed at the beginning of March. We did the transplant at the beginning of June, and I got the green light from the surgical team a couple of weeks ago to go back to work.’
‘So you’re still healing from donating the kidney, really.’
‘I’m fine. It means no heavy lifting,’ Ollie said, ‘but that’s about all. Luckily there weren’t any complications for either of us, though Rob’s not pleased that they’ve told him to wait a few more weeks before he goes back.’
‘That’s such an amazing thing to do, being a live donor and giving your brother a kidney.’
‘I’m guessing you would’ve done the same for your sister.’
‘Of course I would,’ she said. ‘Any live donation—a whole kidney, a piece of liver or a bit of pancreas. If I could’ve saved her...’ Her eyes were suspiciously glittery.
