Best Practice

by Penny Parkes

  No such luck, she thought.

  Coco pressed her nose into Alice’s hand, her hot breath almost a kiss, and the affection clear in her deep brown eyes.

  ‘Do you think Coco gets bored, being with me every day?’ Alice asked, as Jamie signalled to overtake a carful of students with music blaring, carefree in the sunshine. ‘Do you think she’d find it more fulfilling doing the detection job?’

  Jamie frowned. ‘Stop giving that dog human emotions. She doesn’t know she’s sniffing for cancer – she can’t evaluate the consequences. And she has an amazing life with you.’ He fell silent, manoeuvring through the traffic as he quickly changed course and pulled into the motorway services, stopping abruptly before they even reached the cluster of shops.

  He unclipped his seat belt and swivelled in his seat. ‘That’s better. I can’t have a conversation like this without seeing your face. You’re a genius at hiding your emotions, Alice Walker, but I like to think I’m learning the signals.’

  Alice flushed. She wasn’t entirely sure that made her feel comfortable.

  ‘Look, I can’t deny that you’re in a spot here. And, to be honest, part of me wishes we’d never even pursued this. But I get it, Alice. I truly do. How anyone can expect you two to part ways is beyond me. And I genuinely feel that you need to think of yourself in all this. And, if that’s not enough, then your livelihood. Can you be your best self at work, if you’re constantly on edge about hypos?’ He shrugged. ‘It’s probably not for me to say, but please don’t get swept up in the guilt. There’s a lot of pressure on you to decide, to commit, to sacrifice for the greater good and God knows, Judith is a professional at laying it on with a shovel. But I don’t see it that way. Okay?’ He reached over and squeezed her hand, Coco instantly leaning in to lick him. ‘I’ve got your back,’ he said firmly.

  Alice could only nod, his empathy so genuine and insightful. If only it really were that easy. How many patients had she seen at The Practice this week alone, whose lives would have been fundamentally altered by early detection?

  ‘Thank you,’ she said simply. Their friendship allowed a certain shorthand these days, the hours spent together seemingly bringing them closer together, even as Alice’s decision time loomed inexorably on the horizon.

  Alice sank back into her seat as Jamie rejoined the steady flow of traffic and his beloved Eighties soundtrack filled the silence. Maybe Bucks Fizz had a point, she realised, as the lyrics of their song filtered into her subconscious – the time really had come for making her mind up. One way or the other.

  She closed her eyes and allowed her thoughts to drift. Maybe if she climbed the Three Peaks with Taffy, they could raise enough to train another dog, a different dog? And that was when Alice realised the extent of her problem – she didn’t want just any dog, she wanted Coco. And she wasn’t entirely sure that money could buy the skill in detecting cancer that Coco had so spontaneously acquired. So, even with funding on the table, somebody somewhere was going to be short-changed.

  As she swallowed hard and pretended to be asleep, Coco’s head heavy on her knees, she didn’t see the look of concern on Jamie’s face; his emotional investment in their project so obviously running far beyond the professional.

  It was probably just as well.

  Chapter 10

  Holly glanced at her watch impatiently, hoping that today would find Lizzie in a forgiving mood for her tardiness. She’d been hovering outside Taffy’s consulting room every chance she got all morning, trying to find a moment to talk, but their schedules seemed destined not to coincide. He’d come home so late last night that she’d been out for the count.

  ‘Dan!’ she called, as he strode purposefully from the front office like a caffeine-seeking missile. ‘Did you get my message about Rosemore?’ She jogged over to him, mentally changing gear as she did so – so many balls in the air at the moment, so little time.

  He frowned. ‘I can’t quite believe they moved so quickly on this. I checked with Chris Virtue, and a few days ago it was just vague rumours of an audit, apparently. That letter though—’ He shook his head. ‘It’s hardly patient-centred care, is it?’

  ‘Thank God we’d only got a handful of people booked in there. Emily Arden’s my biggest concern; she’s due any day now and talking about a home birth instead. I’m seeing her later to get the lie of the land.’

  ‘Okay,’ said Dan. ‘I’ll do a little more reconnaissance and we’ll compare notes later.’ He sighed. ‘I keep waiting for someone to shout April Fool,’ he confessed. ‘I’m so over the politics of medicine when the people making decisions have no idea what’s actually happening on the front line.’

  Holly nodded. ‘Information first, okay, then we’ll panic.’

  ‘Deal,’ Dan replied, walking away and immediately tapping into his iPhone, the very figure of despondency.

  Holly hovered a moment longer, but from the wisps of conversation on the other side of Taffy’s door, he wasn’t finishing up any time soon. She checked her watch again, as her own phone rang out loudly in the echoing hallway. She’d been waiting on tenterhooks all morning to hear the outcome of Charlotte Lansing’s surgery, and her priorities shifted once again.

  ‘Dr Graham?’ came the harried voice at the end of the phone. ‘Cally Lomax, the ward sister, here, returning your call. I’ve good news and bad news, I’m afraid. The good news is that we’ve got her on a targeted IV antibiotic and we’ve managed to halt the spread of the infection. The bad news unfortunately is the amount of tissue damage in her arm, especially the muscle. The consultant is coming back in later to assess whether we managed to achieve a clear margin with the excision of the damaged tissue or, well, whether we need to look at more dramatic intervention.’

  There was an awkward pause, as both women considered what that might mean. Holly couldn’t begin to imagine how the energetic horsewoman might react to even the possibility of an amputation.

  ‘Shall I come in?’ Holly offered, genuinely floored by the implications for Charlotte’s way of life. ‘Offer some support when you break the news? A familiar face at least?’

  Cally’s voice softened as she clearly recognised in Holly a caring soul and kindred spirit. The detachment in her voice disappeared and Holly half-wondered whether the ward sister had been expecting a bollocking for not having pulled off a medical miracle.

  ‘It might be a good idea, if it does come to that,’ Cally said. ‘She’s really awfully traumatised. She keeps muttering about it just being a little scratch.’

  Necrotising fasciitis was no joking matter and Holly had been hoping against hope that she had actually been wrong in her initial assessment. Sometimes there was just no way around it. When it was time to hit Code Red and rush a transfer to hospital, it had to be done, even if Holly knew it was traumatic for the patient. Coming here, to The Practice, sometimes lulled patients into a false sense of security about the severity of their condition.

  With promises to keep each other in the loop, Holly got off the phone and checked her watch; it was becoming a nervous tic. There was little point phoning Frenchay Hospital yet again for an update on Jessica Hearst. One might say that no news was good news – after all, the consultant had promised to phone immediately there was any change, but still . . . Holly sighed – she was counting the days since the accident and couldn’t pretend she hadn’t been hoping for a more positive update.

  She tucked her phone into her pocket and headed out to meet Lizzie, immediately reversing and taking the side exit when she saw old Mr Jarley in Reception. She wasn’t sure what it was about that man, but on some subliminal level he just gave her the creeps. Although to be fair, on a logical level, it might also be that he was a pervert of the first order and had been known to flash the local joggers when he got bored. Well, that and his ever-sweaty hands, his hugely dilated pupils and his not-so-very-secret history of dallying with pharmaceuticals.

  Lizzie was waiting in the Market Place in true Lizzie fashion, impatiently stylish: hip tilted,
sunglasses in hair, face in the sun. She really had spent too much time working on glossy magazines, thought Holly fondly. It was only as she got closer that she realised the entire pose was a case of style over substance.

  Knowing Lizzie so well was a mixed blessing at this point – with anybody else she would have just dived in and asked them how they were feeling, but Lizzie was skittish. Throughout all her issues with anxiety last year, when she’d abruptly quit her job and started to look for a career with more purpose and more flexible hours, she’d kept Holly at arm’s length. It was only recently, following a lengthy course of CBT, that Lizzie had begun to open up a little, and even then, it was mainly to joke about whatever latest fad she was following to try and find her balance again.

  ‘Sorry I’m so late. Let’s grab a coffee and then we can find somewhere sunny to set up camp, shall we?’ Holly held up a logoed hessian bag containing an earlier drive-by sweep of the counter at The Deli. Lizzie picked up a cardboard tray of takeout coffees from the wall behind her. ‘One step ahead of you. But do we have to have our lunch in a bag advertising thrush medication?’

  Holly looked down, so readily bombarded with promotional bits and bobs as to have become oblivious to their messages. ‘Could be worse,’ she said with a grin. ‘I was given one the other day with a floppy willy looking sad on the side. Now that would have been a downer over lunch!’

  They walked in easy silence for a moment, navigating their way around a swathe of yummy mummies and their practically platinum-plated pushchairs. Holly knew that she often harboured uncharitable thoughts about these women who seemed to have nothing but time and cold hard cash on their hands, but the reality was that some of them were really nice people who just happened to have won life’s lottery, or worked for it, or both.

  As Davina Davis ran over her foot without so much as an apology, Holly mentally corrected that statement: some of them also happened to be absolute bitches and, when she became aware of the appraising looks they were shooting at Lizzie, not to mention the whispered comments that followed, Holly was about to lose her rag.

  Except that Lizzie – always on parade, never knowingly underdressed – didn’t seem to have noticed a thing. ‘Do I smell like roast chicken?’ she asked instead, apropos of nothing, as they settled on a sunlit bench in the park.

  Holly leaned in and lifted the soft cashmere of her silver-grey wrap to tentatively sniff. ‘Maybe not chicken per se, but—’ She closed her eyes and inhaled. ‘Roast potatoes?’

  Lizzie shook her head. ‘Well that’s another idea down the pan. My masseuse reckons burning sage in the house will give me clarity and calm. But I think it’s now in the very fibre of my clothes.’

  ‘But did it work?’ asked Holly, walking the line as an intrigued cynic.

  ‘Kind of, but now I’m just anxious about smelling like a Sunday roast instead,’ Lizzie replied in an easy-come-easy-go spacey fashion that suggested she hadn’t quite given up on her traditional prescriptions either.

  ‘Although,’ she leaned in and gave an impish smile as she pressed a business card into Holly’s hand as though it were contraband, ‘you have to see my reflexology guy. I’m telling you, the things he can do with his fingers . . .’

  Holly blinked, thrown a little by Lizzie’s heartfelt endorsement. ‘To your feet?’ she clarified, unwrapping a packet of salami for grazing.

  Lizzie’s face lit up as she laughed and Holly couldn’t help feeling a small swell of relief – obviously she wanted to hear Lizzie’s news, but she also needed a little friendship herself today and, increasingly of late, that was only really on offer if Lizzie happened to be on good form.

  Lizzie took a swig of her coffee and looked from side to side as though imparting state secrets. ‘I have to tell you that it hasn’t helped with the panic attacks one tiny little bit, but I have discovered a new erogenous zone that I never knew existed. Seriously – I’m forty-one and I just found out that feet are sexy!’ She wiggled her beautifully pedicured toes in their fancy new sandals delightedly.

  ‘Is that?’ Holly bent down to look closer. ‘Lizzie, do you have Kermit the Frog tattooed on your ankle?’

  Lizzie looked smug. ‘I do. He reminds me to moisturise. If I forget, he starts looking a little bit, well, toady. And nobody wants that.’

  ‘Indeed,’ replied Holly drily. ‘I actually wanted to ask you something—’

  ‘Is it about Eric?’ Lizzie interrupted. ‘Because I have to tell you, he’s developed rather a fondness for joining in my yoga practice.’

  ‘Please tell me there are photos,’ Holly said, laughing at the expression on her face and the mental picture of their exuberant labradoodle striking a pose.

  Lizzie gave her a sideways look. ‘He has to have the snip, Holls, no matter how much Taffy defends his honour. The merest prospect of Downward-Facing Dog gets him all unnecessary.’ She grinned. ‘It took Elsie’s poor physio-chap quite unawares the other day when we had a joint session.’

  ‘Oh my God!’ exclaimed Holly, knowing only too well that they had both stuck their heads in the sand about Eric’s increasingly hormonal behaviour. ‘I’ll call Rupert and book him in. And maybe you and Elsie need a small chat about boundaries with your health professionals while we’re at it?’

  She reached for a slice of Brie, before hesitating with her hand in mid-air. ‘Actually, it wasn’t so much Eric’s fertility I wanted to talk to you about,’ Holly said tentatively after a moment.

  Lizzie looked up instantly. ‘Are you thinking of trying for a baby?’

  Holly shook her head, unable to disguise her excitement and apprehension a moment longer. ‘I think there’s a tiny chance that ship may have sailed.’ She held her breath slightly; Lizzie’s reaction to even the possibility was unpredictable at best and she wanted – no, strike that, she needed – her best friend to be on board before she even felt brave enough to pee on a stick.

  ‘Bloody hell!’ Lizzie cried, pulling Holly into a smothering hug. ‘Are you excited? Are you throwing up? What does Taffy think? Argh! You’re going to get SO fat.’ She stopped dead as the thought occurred to her, ‘Oh Holly, what if it’s twins again?’ She fell about laughing, apologising even as she did so, but seemingly unable to stop. When she eventually caught her breath, she clasped Holly’s hand tightly. ‘Well that would certainly put my issues into perspective!’

  Holly shook her head, relieved, if not a little startled, by Lizzie’s overdramatic reaction. ‘Nah, not this time. This time feels . . . Different.’ She laid her hand on the gentle swell of her stomach that she had previously ascribed to stress-eating Hobnobs, until the thought had leapt into her mind fully formed, in a moment of perfect serendipity the day before: the smell of coffee no longer alluring but nauseating; their spontaneous night in the treehouse; not to mention the little fat Bornean icon sitting on her bookshelf . . . ‘Besides,’ she clarified, ‘lightning doesn’t strike twice and I’m using a different recipe these days.’

  Lizzie shook her head. ‘I can’t believe it. Seriously, what did Taffy say?’

  ‘Well, I haven’t told him yet,’ Holly confessed guiltily. ‘I thought we should take the test together and I was already asleep when he got in late last night and I keep missing him this morning . . .’

  ‘You mean you haven’t even taken the test yet?’ Lizzie said, her whole demeanour dropping like a pebble. ‘You’re basing this solely on the fact that coffee tastes a bit funny at the moment?’

  ‘Pretty much,’ admitted Holly with a nervous laugh. ‘Mad, isn’t it?’

  ‘Er, yes.’

  ‘No, you daft muppet, I mean – once you know, you know, right?’ She stuck her shoulders back to illustrate her point. ‘Once you see—’

  ‘Oh my God,’ said Lizzie, ‘your boobs are enormous. Hobnobs can’t do that,’ she said firmly, as though that settled the matter once and for all, and peeing on a stick was now simply a formality.

  Holly grinned. ‘I wanted to tell you first,’ she said quietly, ‘just in cas
e it’s a false alarm. Boys don’t really understand.’

  Lizzie nodded, only too familiar with the exhilarating rollercoaster of excitements and disappointments that had accompanied the conception and birth of her own three children.

  ‘Ah, but then Taffy Jones is not your regular “boy”, now is he?’ She reached out for yet another hug. ‘Whatever the outcome, I’m so thrilled for you. Even if you’re not pregnant right now, I only need to look at your face to see that it’s something you really want. And I’m not convinced you knew that before.’

  Holly wiped away a little tear; Lizzie on a good day always knew exactly what to say. ‘I can’t put my finger on why this feels so different to last time.’

  ‘Oh that’s easy,’ Lizzie said flippantly. ‘This time you’re happy. This time, the father of your baby will be Taffy Jones. If not today, then one day, yes?’ She swallowed for a moment, as a flurry of emotion flitted across her face. ‘You two are going to have properly beautiful babies, one at a time, the way God intended, and I intend to spoil them rotten.’ She reached across and pinched the last of the Brie. ‘And by the way, you have no idea how much it means that you told me first.’ She discreetly wiped away a rogue tear. ‘Even if it was just-in-case.’

  Chapter 11

  Holly sat at the kitchen table, savouring a moment of silence and sipping peppermint tea. It was amazing how much Holly was prepared to let slide when she felt quite so excitable and distracted herself and the twins had finally worn themselves out after a particularly passionate pillow fight. All she wanted now was Taffy home. The need to share her suspicions was almost overwhelming and she’d had to bite her tongue not to blurt anything out at work all afternoon. The magnitude of her secret knowledge bubbled away inside her and she fidgeted impatiently.

  She looked up as Taffy came in, quietly for once, having spotted that all the lights were off upstairs. It had taken him a while to get used to the shadow hour, where the difference between a peaceful evening with Holly and an unruly chaos with the twins might be as simple as slamming the front door just as they were drifting off to sleep. She smiled. ‘Hello, stranger. Don’t jinx it, but I think they’re asleep.’