by Penny Parkes
‘No problem,’ said Holly, clicking save on the referral letter she was typing. It didn’t matter how many times Grace told her she could just dictate them, Holly was still more comfortable thinking on paper. These letters didn’t need to be eloquently crafted, but having been at the hospital end of this very equation, Holly knew that the right personal information, phrased in the right way, could often make a significant difference to waiting times.
From that perspective, what was five minutes more of her time, compared to weeks of additional worry for her patients?
‘Still typing your own referrals, I see,’ said Dan.
‘I know you all think I’m mad, but it’s important to me,’ Holly replied. ‘Don’t start telling me all about GP time ratios again.’
‘I wasn’t going to,’ Dan said. ‘In fact, I’m beginning to wonder whether we should all be following your lead. You’re the one with hospital background, after all. And anyway, it’s actually your fluffy-bunny sensibilities I need this afternoon.’
He opened the buff folder and pulled out a print-out sheet from the MRI scanning department in Bath. He passed it to Holly without comment.
Holly didn’t need any. The tumour was unmistakable, showing white hot against the hazier outlines. ‘Well, that’s not good,’ she said, mentally calculating scale. ‘That has to be an inch across. Any secondaries?’
Dan silently passed her a second page.
Holly took a moment to check she was seeing everything; it was so easy for the eye to be drawn to the bigger growths, but sometimes it was the smaller, more aggressively mutating ones that would prove more devastating.
‘So,’ she said eventually, ‘are we providing familial support, or Macmillan referrals . . . I presume they’ll get the news from the consultant direct.’
‘Normally, yes,’ said Dan, ‘but we need to be a little bit careful with this one. Kid gloves so to speak, so the consultant has asked if we can break the initial news and then he’ll see them in the morning. Shirley, our lovely Macmillan nurse was going to come and hold my hand, but Mr Jeffries is on his last legs and she’s needed there really.’
The request was unspoken and Holly felt quite panicked. This bit of her job never got any easier. At least, by leaving the hospital, she never had to break the news of a fatality any more – that was guaranteed to give her sleepless nights for ages.
‘And the kid gloves?’
Dan shook his head. ‘It’s Lance. From the deli?’
‘Oh no,’ cried Holly, involuntarily. ‘How bloody cruel.’
Lance was all of thirty-two years old and he ran the deli with his gorgeous wife, Hattie. After four rounds of IVF, Hattie was finally, ecstatically pregnant. But Holly had seen her only the other day for a blood pressure check, so she knew from her file that the IVF had been necessary after years of unexplained miscarriages. The last thing they wanted to do was to trigger another one.
‘I need a bit of help on this one,’ said Dan apologetically. ‘I hope you don’t mind, but Julia is not known for her sensitivity when it comes to pregnancy. She claims that pregnancy isn’t an illness and therefore shouldn’t be something we deal with, but I think the whole thing kind of freaks her out. I know it sounds weird for a doctor, but she’s actually kind of squeamish. That’s why we needed you.’
‘Okay then,’ said Holly, Julia edging ever closer to human on the spectrum in Holly’s mind. ‘I’m not saying I’ll be any good at this one, but at least I know Hattie. She was one of the first people to welcome us here actually.’ Holly felt herself getting a little choked up. She tried to pull herself together, but when she looked up, Dan’s eyes were decidedly moist too.
‘Are you sure we’re the best people to be handling this? Surely, the distance and anonymity of an oncologist might make it all feel a bit less real?’ Holly wondered out loud.
Dan shrugged. ‘We’ve been through hell and back with them here, trying to get Hattie through each pregnancy. Not to mention the fact that Lance and I have known each other for ever. Let’s just stick to the basics, tell them the news and I’ll go to Bath with them tomorrow. Just in case they have any questions.’
‘Do you normally do that?’ asked Holly, pressing her hand to her chest, beyond impressed.
‘Sometimes. Not all the time obviously, but this isn’t just anyone, is it?’
Holly pushed back her chair, handing Dan the print-outs. ‘So you do the talking, I’ll do the hand-holding?’
‘I suspect that we’ll both be doing a little of each.’ He took Holly’s hand in his, squeezed it and then let go. ‘Thanks for this, Holly.’
Holly was about to say ‘my pleasure’ but the words fell to sawdust in her mouth. ‘No one should do this alone,’ she said instead and she meant it.
Holly pulled open the door to Dan’s room, where Grace had already escorted Hattie and Lance and organised a jug of water.
The news at this point felt like a mere formality. The stricken look on Hattie’s face said it all. They weren’t stupid and the minute glasses of water and two doctors arrived, their worst fears began to be realised.
Holly felt clumsy and ill-informed as Dan outlined the diagnosis. She held Hattie’s hand in her own, rubbing her thumb in circles, as she might to soothe one of her boys after a nightmare. But Hattie’s nightmare was only just beginning.
After a few minutes, both Lance and Hattie were beginning to look overwhelmed. ‘There’s just so much to take in,’ said Hattie bewildered.
Lance had yet to say a word, he just listened with an intensity that suggested his life depended on it.
Holly pulled a piece of paper from Dan’s desk and scribbled her phone number on it. ‘I know Dan will answer all your questions and guide you through your options tomorrow, but, Hattie, please do phone me if there’s anything you want to talk through, anything that’s not making sense.’
Hattie choked up further then. ‘You can’t go round giving out your home number, Holly, you’ll have all the nutters on the phone.’
Holly rubbed her shoulder. ‘Well, you don’t seem that nutty to me. Keep it. If you need me, I’m there.’
Dan hung back, talking quietly with Lance, as Holly made sure that Hattie was feeling alright. ‘Let’s just check your BP to be on the safe side. And if you can get some sleep tonight, then you and the baby will both be better for it.’
‘I knew, you know, Holly. As soon as we found that lump. I knew it would come to this. I tried keeping busy, sticking my head in the sand, but there was just this feeling that wouldn’t go away. How could we get so lucky as to have this little bean on the way . . .’
Holly wrote down the BP readings and looked Hattie in the eye. ‘We’ll get you both the best care in the county. You won’t be on your own through this, Hattie. And Shirley will be around tomorrow, from Macmillan, and she’s wonderful.’
‘You’re not bad yourself, Holly. Thank you for telling us here. I hate those impersonal doctors that make you feel like a number not a person. And you giving me your number . . .’
‘Use it,’ said Holly. ‘I wasn’t just being polite. I know you don’t know me very well yet, but I very rarely make offers, or threats, that I don’t carry through on.’
‘That’s why your boys are so good,’ said Hattie, hiccupping through her tears. ‘They know their boundaries.’
‘Doesn’t work so well on husbands, though,’ said Holly with a wry smile, as she gave Hattie a gentle hug.
Why did it always work like this, thought Holly, and not for the first time. Bad things did happen to good people and yet some of the worst old reprobates she knew were still in the running for a telegram from the Queen. It was almost enough to make her question her every belief.
Chapter 17
‘Dan? Have you got a minute?’ Jason appeared in the doorway the next morning, in his off-duty ensemble of tracksuit and trainers. His face was flushed and he was walking rather strangely. The front door had barely been unlocked ten minutes, but already the waiting room was fi
lling up and the phones were ringing off the hook. There seemed to be a couple of viruses doing the rounds and the patients would insist on coming in and sharing their lurgies around, rather than simply taking it easy at home for twenty-four hours.
Taffy was perched on the end of Dan’s desk, making short work of a bacon sandwich.
‘Literally a minute though, and then you can both sod off. I’ve got a roomful of malingerers awaiting my undivided attention in ooh, about 15 minutes. I didn’t think you were in this morning, Jason.’
‘Not ’til later, really, but I’ve got myself in a bit of trouble and I need your help.’ Jason sat down gingerly. ‘You guys have to promise not to tell anyone though – it’s kind of embarrassing.’
Taffy grinned, wondering what (or possibly who), Jason had been up to. ‘My lips are sealed, but I could do with a laugh. Come on – out with it. What have you done?’
Jason gingerly rolled down his tracksuit trousers, wincing as the fabric caught on the strips of wax covering one leg to the thigh. He shrugged, embarrassed. ‘I’ve got a big triathlon at the weekend and I read somewhere that professional cyclists always have smooth legs – you know, less drag. So I was thinking that if I used one of those leg waxing kits . . .’
Taffy gave the reddened skin a gleeful poke. ‘And how many did you manage to get off before you panicked and came in here?’
‘One,’ admitted Jason rather pathetically. ‘It really hurt!’
Dan took in the sorry sight and squashed the urge to slip out his camera, delighted to have a reprieve from his morning of pointing out that 90 per cent of sore throats go away on their own without antibiotics.
‘Are you supposed to put them all on in one go?’ he asked, intrigued.
‘Dunno,’ Jason shrugged sulkily. ‘It was a spur of the moment kind of thing.’
Dan grabbed one corner of a wax strip and pulled. The strip snagged slightly, so Dan pulled harder, making Jason’s eyes bulge. It clearly wasn’t the right technique.
‘Against the grain,’ Jason groaned, ‘I think you’re supposed to pull against the grain.’
‘Come on, let me have a go. It’s not rocket science,’ Taffy interrupted. He grabbed the other end of the strip, changing direction and pulled even harder. The wax strip came away, along with a forest of leg hair and what remained of Jason’s dignity as he yowled like a little girl.
‘Can’t I have an injection or something? There’s eight more to go! You could give me some lidocaine or something? Surely?’
‘Nah – don’t be a baby. The girls do this all the time. How bad can it be?’ Taffy laughed.
‘Yeah,’ said Jason grumpily, rubbing the scarlet patch on his leg, ‘but they also manage to have babies, which I gather is like pushing a watermelon through your nostril. They have to be wired differently, mate.’
Dan stepped in with the element of surprise as he ripped off the second strip and Jason swore loudly.
Moments later, a gentle knock at the door and Holly’s voice from the hallway, ‘Erm . . . Morning. Is everything okay in there?’
Jason looked at Dan and Taffy beseechingly, ‘Don’t let her in . . .’
Dan patted his leg. ‘I think it’s time we called in the experts now, Jase. And Holly’s a good sort – she won’t tell.’ He got up and let Holly in with the warning, ‘Not a word to anyone, okay?’
Holly shook her head and clapped her hand over her mouth, as she took in the view. Jason’s leg was now erupting into angry weals where the two strips of wax had been removed and two very hairy caterpillars of wax were lying discarded on the treatment bed.
‘Honestly, guys! How long have these strips been on?’
Jason checked his watch. ‘About two hours now.’ His voice got a little higher. ‘The little fuckers just won’t come off!’
Holly bent double at this, clutching at her sides as she tried and failed to stop laughing. ‘But why?’
Jason tried to explain about his cycling race but Holly only shook her head. ‘They shave them, Jase. With a razor.’ She ran a hand gently over the reddened skin. ‘We need to get these off.’
‘I can’t do it,’ said Jason. ‘I take one look and lose my nerve. And look what a bloody mess Dan and Taffy have made of it.’
‘I’m a doctor, Jason, not a sodding beautician,’ remonstrated Taffy huffily.
‘Okay then,’ said Holly, grinning. ‘It looks like it’s my turn.’ She rolled up her sleeves and cracked her knuckles, watching Jason flinch. ‘Or, you know, you could just go home and sit in a hot bath until they fall right off?’
The three men looked at each other in sheer disbelief. ‘A bath? That’s all it takes?’ managed Jason.
‘That’s all it takes,’ she confirmed.
‘But how did you . . . ?’
‘This is not my first time,’ said Holly, attempting to waggle her eyebrows but giving in to the laughter instead.
Dan watched as Holly took pity on Jason and sponged down his legs with a warm flannel, easing the wax strips away.
‘He says it’s for a triathlon, but I reckon he’s getting all spruced up for the Spring Swim,’ Taffy said to Holly, holding out the bowl of warm water for another dip. ‘You are coming, aren’t you?’
Holly bit her lip as she eased off another wax strip with concentration. ‘I don’t know, maybe?’
‘Sorry, Holly, but maybe’s not good enough,’ said Dan, distractedly opening up his files for the morning. ‘I should have said, it’s a three-line whip. Everyone on parade I’m afraid.’
Taffy swotted at him with the other damp flannel. ‘Well, don’t make it sound so tempting will you? Jesus!’
Dan looked sheepish. ‘Sorry. Taff’s right though, actually. We all go every year and it’s brilliant.’
‘Properly good fun,’ interjected Jason, who was beginning to recover from his dented pride.
‘Bring Milo and the kids and some hot chocolate – lots of towels. You can’t go wrong. George is even Master of Ceremonies this year,’ Dan said.
‘Seriously though,’ Taffy carried on, ‘it’s such a laugh. All the grannies and the little ones, all in together. It’s my favourite Larkford event of the year.’
Jason sniggered, ‘You mean compared to the fête, the Hallowe’en parade and the WI cake sale? It’s hardly a riot a minute around here, is it?’
Taffy shook his head. ‘Now you’re just making me feel old. So be quiet and concentrate on your lovely smooth bits.’
Holly’s smirk did not go un-noticed.
Dan gave her a nudge. ‘Do come, Holly. If nothing else, it’s really good for the partners to see you getting involved in the community.’
Holly nodded. ‘I’ll crank up the water wings and we’ll be there.’
‘You need water wings?’ said Jason, slow on the uptake as ever.
Taffy cuffed him round the back of the head, prompting Jason to immediately try to rescue his ’do. ‘For her kids, you wally.’
Jason shrugged, pouting a little about his ruffled hair. ‘Well, I didn’t know, did I? Some grown-ups can’t swim.’
‘And some have no common sense,’ cut in Dan with a wry grin, ‘but we gave you a job anyway. Now, if you’ve all quite finished turning my room into a beauty parlour, I’ve a delightful morning ahead of me . . .’
He stood up to shoo them out. ‘Oh Taffs, looks like I’ve got one of yours on my list this morning, Karen Dobbs?’
Taffy let out a belly laugh. ‘Well good luck with that then, mate. You’re very welcome to work your magic there. I’ve all but given up. She’s a heart-sink patient that one.’
Dan knew immediately what he meant. There were a handful of ‘regulars’ at The Practice that literally made your heart sink the minute they walked in the room. Often, they seemed to have spent far too long on WebMD and were only too quick to tell you if they felt their proposed course of treatment was too lenient, too aggressive, or flat out wrong.
‘There’s not a lot you can do to help that one, until she decides to
help herself, to be honest,’ said Taffy.
‘We’ll get out of your way and leave you to it,’ said Holly, helping Jason to his feet. ‘Have a fun morning,’ she said with a grin as she walked out of the room, several pencils seemingly holding up her hairdo and tripping slightly as she went.
Dan turned to Taffy, smiling. ‘For such a clumsy person, she does a remarkably good job of staying upright, don’t you think?’
Taffy said nothing for a moment, just watching her go. ‘For such a clumsy person, she does a remarkably good job at most things.’ He wandered back to his office, thoughts clearly elsewhere. He didn’t even crack a smile about the patient that came out of the loo with her skirt tucked in her knickers and that worried Dan most of all.
‘So, Karen? What can I do for you this morning?’ Dan asked moments later, as his patient attempted to settle herself into the chair in front him. Politely put, she was Rubenesque, but Dan had a feeling that the British Medical Council might be a bit blunter.
‘Well, Dr Carter, my kinesiology lady says my candida levels are very high again. And I have been having a few issues down there, so I wanted your thoughts really.’ Karen pulled a print-out from her vast patent handbag and Dan tried to keep an open expression on his face, even though as promised, his heart was sinking. ‘This says that a one-off course of flucka . . . floocka . . .’
‘Fluconazole?’ suggested Dan slowly.
‘Yes, that’s right! Fancy you knowing that. Well, this fluconazole works wonders apparently.’
‘Well, yes it does and it is very powerful medication too. Had you given any more thought to what you discussed with Dr Jones last time? Trying to lose some weight? Avoiding sugary foods, alcohol, yeast and mushrooms?’
Karen folded her rather pudgy hands in her lap and looked a bit put out. ‘I know you doctors like to blame everything on my weight, Dr Carter. But not everything is down to that, you know. I have very heavy bones and a rather slow metabolism, as I mentioned before.’
