‘I’m sure Martin is more concerned about you than anything else,’ Helen assured her. She certainly didn’t want to add to the poor woman’s woes by encouraging her to worry about how her husband was feeling. ‘When did this all start?’
‘It’s been going on for a while now,’ Diane admitted. ‘I just kept telling myself to stop being so silly but it’s got to the point now where I don’t know what to do. I can’t keep on feeling this awful all the time, Dr Daniels. Life isn’t worth living.’
‘Then we need to do something about it,’ Helen said firmly, standing up. ‘I’m going to examine you to get an idea of how your health is generally and we’ll take it from there.’
She examined Diane and found nothing to alarm her. Putting her stethoscope away, she went to one of the cupboards. ‘I’d like to take a blood sample, if you wouldn’t mind. We need to find out if there’s a physical cause for the way you’re feeling.’
‘Of course I don’t mind!’ Diane sounded so relieved that Helen looked at her in surprise. Diane blushed. ‘I thought I was having some sort of mental breakdown. There’s a lot of pressure in my job and I assumed it was that which was causing the problem.’
‘It could very well be a factor,’ Helen agreed. ‘However, these feelings you’ve been experiencing could also be the result of physical changes in your body. Have you noticed anything else unusual happening recently?’
‘Well, yes, now that you mention it, I’ve been having these terrible hot spells. I wake up at night because I’m dripping wet. And my periods have become very irregular, too. I’ve always been like clockwork but I never know when I’m going to come on nowadays. Do you think they might be linked to how miserable I’ve been feeling lately?’
Helen chose her words with care. There could be a common factor linking all those symptoms and one that Diane might not be happy about, either. ‘It’s possible, if your oestrogen levels have dropped.’
‘My oestrogen levels…’ Diane repeated, then gasped. ‘You don’t think I could be going through the menopause, do you? I mean, I’m only thirty-six so surely it’s far too early for that to happen?’
‘I don’t intend to make any snap judgements today. However, you told me last year that you and Martin were trying for a baby so it’s possible that you haven’t conceived because your fertility levels have fallen. The blood test will confirm that, one way or the other.’
‘But does that mean I won’t be able to have a baby now?’ Diane asked in dismay.
‘I really can’t say what will happen until I know exactly what’s going on, Diane,’ Helen replied gently, uncapping a syringe and taking an alcohol swab out of its foil packet.
‘How long will it take to find out?’ Diane demanded, wincing as the needle slid into her arm.
‘Just a couple of days.’ Helen carefully withdrew the small amount of blood she needed for the tests and smiled reassuringly. ‘I’ll give it top priority so we should have the results back by the end of the week. And I’ll phone you immediately once I get them.’
‘And if it is the onset of the menopause, then what happens? Is there anything you can do to stop it?’
‘If it is that, I shall refer you to a fertility specialist. There’s a very good clinic near Blackpool which has achieved some excellent results. But it’s all speculation at this stage. We need to see those results before we know what we’re dealing with.’
Diane sighed as she stood up. ‘I don’t know what I’m hoping for now. If the tests show that I’m going through an early menopause, it will explain why I’ve been feeling so dreadful, but it could also mean that Martin and I might never have a family.’
‘I know how difficult it must be for you but at least we’re doing something positive and that’s the main thing.’
Helen made herself sound as upbeat as possible as she saw Diane out. However, she couldn’t helping drawing a comparison with her own situation. She was thirty-eight and her own fertility levels must be dropping, too. Ian had never wanted them to have a child because he’d had the twins. His first wife had died soon after Helen had started her GP training at The Beeches and it had seemed the most natural thing in the world to offer her help when Ian had found it difficult to manage with two small children to look after on top of doing his job.
Tom and Katie had been six when she had married Ian, and by that time she had loved them as much as she would have loved her own children. However, she couldn’t deny that it had been a blow when she’d found out that Ian hadn’t wanted to add to their family. She’d kept hoping that he would change his mind, but it hadn’t happened. Now it seemed unlikely that she would ever give birth to her own son or daughter, and she couldn’t help feeling sad at the thought of what she was missing.
No wonder Lewis was so determined to do all he could for his daughter, she thought, then sighed in exasperation. Why did every single thought lead back to Lewis?
Lewis was late for the meeting, mainly because he still hadn’t got used to judging the length of time he could spend with each patient. Six minutes were allotted for each consultation and it was far too little in his opinion. Harry and Amy were already sitting at the staffroom table with an open tin of biscuits in front of them when he arrived. Helen was pouring coffee and she glanced round when he appeared.
‘Black or white?’
‘Black, please, with plenty of sugar.’
‘Sounds like you had a hard morning,’ Amy said, grinning as he sat down. A pretty girl in her twenties, she was engaged to a policeman and in the throes of planning a summer wedding.
‘I haven’t adjusted to the conveyor-belt system you operate here so I find it difficult to keep up.’ He rolled his eyes. ‘Switching my brain from what analgesic to prescribe for a teething toddler to how to treat Mr Parsons’s gout all in the space of a couple of minutes takes some doing!’
‘It must be your age,’ Amy retorted. ‘That’s why you can’t keep up.’
‘Cheeky monkey!’ Lewis laughed out loud. It was refreshing to be treated as just another member of the team after the awe he’d inspired in his previous post. ‘I’ll remind you of that in a few years’ time when you’re having problems keeping up the pace.’
‘Ah, but I’ll still be younger than you so I’ll still fare better,’ Amy countered.
‘Touché!’ He shook his head in defeat because he obviously wasn’t going to win this argument. He glanced round when Helen brought over the coffee, feeling his heart leap when her hand accidentally brushed against his as she placed it in front of him.
‘Thanks.’ Picking up the mug, he took a gulp of the coffee in the hope that it would steady him, but his hand was still tingling from the contact and it worried him that he should be so aware of her. He’d had his share of relationships and didn’t intend to have any more until Kristy was all grown up and no longer needed him. And by that time he’d be too old to bother!
‘Is Mr Parsons’s gout getting worse?’
Helen sat down opposite him and he hastily returned his thoughts to the reason for the meeting. He was supposed to be discussing his patients’ problems, not thinking about his own.
‘It’s spread to his ankle now and he’s in a lot of pain. The joint is very red and swollen, and obviously tender. Unfortunately, he forgot to renew his prescription after the last bout so he didn’t have any medication to stave it off. I gave him an injection of corticosteroids and another script. I also took some blood to check his levels of uric acid. He might need a new drug and diet regime to reduce the levels of uric acid in his body and help his kidneys excrete it more quickly. I noticed from his file that it’s two years since his last review so he must be due for one.’
‘He is. Let me know when the test results come back and we can discuss it then.’ She put her mug down and reached for the biscuit tin at the same moment as he went to get it. Once again their hands touched and he jerked his back when he felt the current of electricity that arced between them.
‘Of course, if you’re inte
rested,’ he replied thickly, struggling to get a grip on himself.
‘Tom Parsons is one of our oldest patients. He was the first person to sign on when the practice opened so naturally I’m interested,’ Helen replied neutrally, so neutrally, in fact, that he couldn’t help wondering if she’d felt the electricity, too.
He shot her a wary glance but it was impossible to tell what she was thinking, and maybe it was better that he couldn’t. There was no room in his life for Helen or any other woman when he had Kristy to consider. The thought steadied him and he looked calmly at her. ‘I can’t imagine having patients for that length of time. Most of the people I treated at St Leona’s I saw just a couple of times—once before their surgery and once after it was over.’
‘It’s totally different here,’ Harry put in, helping himself to a biscuit. ‘Most of the folk we see have been on our books for years. Talk about from the cradle to the grave isn’t in it!’
Lewis smiled at the wry note in the younger man’s voice. ‘Don’t you approve?’
‘Oh, it’s great if you like that sort of thing.’ Harry grimaced. ‘It’s just not for me. I want a bit of excitement in my life before I settle for the old pipe and slippers routine. To be honest, I can’t imagine why you decided to swop an interesting job in London for working here…no offence intended, Helen,’ he added as an obvious afterthought.
‘And none taken,’ she replied smoothly. ‘I know this is just a stopgap for you, Harry, before you move on to bigger and better things.’
‘I didn’t mean it that way,’ the younger man said uncomfortably. ‘I enjoy working here but I wouldn’t want to spend the rest of my days doing the same job. The Beeches is great the way it looks after all its patients so wonderfully, but it’s a bit of a throwback to another era. Very few general practices offer the kind of all-encompassing service we provide.’
‘Maybe they don’t but The Beeches was founded on the principle of commitment and caring, and that’s something I’m proud of and intend to continue,’ Helen said firmly. She turned and Lewis stiffened when he saw the challenge in her eyes. ‘How do you feel, Lewis? Do you think we’re out of date in the way we do things here?’
‘I think you could cut out a lot of the unnecessary work,’ he said carefully, not wanting to offend her.
‘Really? Would you care to elaborate?’
She stared back at him and he sighed when he saw the glint in her beautiful eyes. He really and truly didn’t want to start an argument but, now that she’d asked for his opinion, he felt duty bound to give it.
‘A lot of patients we see don’t actually need to be seen by a doctor. They could visit the local pharmacy and buy something over the counter for their cough or their cold. If we could be more selective when making appointments then we could spend extra time on the people who really do need our help.’
‘And how do you propose we sort out who does and who doesn’t need an appointment?’ she shot back.
He shrugged. ‘Most general practices use their reception staff to separate the wheat from the chaff, so to speak.’
‘I’m sure they do. However, the reception staff aren’t medically qualified so how can they assess if a patient really needs to see one of us? If we ask them to make decisions like that, there is the risk of someone who is really sick not getting an appointment.’
‘That’s a valid point. However, the reception staff could be trained to ask a few simple questions when people phone for an appointment,’ he pointed out, although he suspected there was little hope of persuading her to adopt a different policy. However, it seemed wrong to him that their lists should be cluttered up with people who really didn’t need to see a doctor when it put added pressure on everyone.
Helen, for instance, could spare herself a lot of work if she would make a few simple changes to the way the practice was run. In the week he’d been there, he’d discovered that she was the first to arrive each morning and the last to leave each night. She didn’t even take an afternoon off like the rest of them did. She worked far too hard and it seemed wrong to him that she felt that she had to devote her every waking minute to the job.
‘I’m afraid I wouldn’t be at all happy with that idea.’ She pushed back her chair, making it clear that she didn’t intend to discuss the matter further. However, now that he’d got this far, Lewis wasn’t prepared to let it drop without a fight.
‘If it’s change that worries you then it’s always the first step that’s the most difficult.’ He shrugged when she looked sharply at him. ‘It gets easier after that.’
‘Thank you for that sage advice, Dr Cole. However, I’m the senior partner in this practice and I shall decide how best to run it.’
‘But Lewis has made a legitimate point,’ Harry interjected. ‘Take this morning, for instance. I saw three people who had colds and nothing else wrong with them. It’s a waste of our time to have to deal with things like that when folk would be better off at home in bed.’
‘Thank you for your contribution, Harry, but I think I’ve made my feelings on the matter perfectly clear. The Beeches has been run on an open-house basis ever since it was opened and I can see no reason to change the system at this point in time.’
She marched to the door, pausing to shoot an icy look over her shoulder. Lewis winced when he received the full brunt of her displeasure. ‘I’ll see you in the car park in ten minutes’ time. We have a full list of calls to get through so I’d appreciate it if you didn’t keep me waiting.’
With that she swept out of the door, leaving behind her a small but potent silence, broken when Harry cleared his throat.
‘Ahem! That went down rather well, don’t you think?’
‘Like a lead balloon.’ Lewis downed the rest of his coffee then got up to leave, knowing it would be unwise to keep Helen waiting. It had been her idea to accompany him to any home visits during his first week. She’d offered to introduce him to the patients and make sure that he knew where he was going. However, he couldn’t help wishing that she’d left him to his own devices. The thought of spending an afternoon with her after what had happened was less than appealing.
‘I still think you were right to say what you did.’ Harry gathered up their cups and took them to the sink. ‘Don’t you, Amy?’
‘I do. We need to cut down the amount of work we do otherwise we’re going to sink under the sheer number of patients we’re expected to see each day. I was hoping things might improve when Helen took over, but she’s not changed a thing. She runs this place along exactly the same lines as Ian and his father always did.’
‘Why is she so reluctant to alter the routine?’ Lewis asked curiously.
‘I’m not sure.’ Amy shrugged. ‘Maybe it’s her way of keeping Ian’s memory alive. If she changes things then it might seem that she’s trying to get rid of everything he held dear. But something needs to be done otherwise she’s going to run herself into the ground. Since the twins took off for Australia on their gap year trip before university, Helen has been working harder than ever. I think she’s lonely, although she’d never admit it.’
‘Her children are old enough to go to university?’ he exclaimed in amazement.
‘Oh, they’re not actually her kids, not biologically anyway,’ Amy explained hurriedly. ‘Ian was married before and when his wife died, Helen helped him look after the twins. They were only toddlers at the time and a real handful from what my mum has told me. She used to be the practice nurse before she retired and she was here when it happened. Helen was doing her GP training at the time but she stayed on after Ian’s first wife died and married Ian a couple of years later.’
‘I see. So does Helen have any children of her own, as well as the twins, I mean?’ he asked, wanting to form a clearer picture of the situation because it seemed important for some reason.
‘No. From what Mum has said, I don’t think Ian wanted any more children so he and Helen never had any.’ Amy sighed. ‘I think it was a bit mean of him, actually. I get the im
pression that she would have loved a baby of her own. She’s wonderful with the little ones—they all adore her.’
Very mean indeed, he thought grimly as he left the staffroom, although he took care not to say so. Helen’s reluctance to make any changes to the way things were done in the surgery was worrying, especially if it was bound up with loyalty to her dead husband. However, what really upset him was the thought of her disappointment at not being allowed to have a child of her own.
It seemed wrong to him that a woman who was as caring and as committed as Helen should be denied the one thing she wanted most of all. It also made him feel incredibly helpless to know there was nothing he could do to help her.
CHAPTER THREE
‘THE next case is an interesting one. The patient’s name is Ben Harmon. He’s a farmer and two months ago he had a serious accident while he was ploughing one of his fields.’
Helen withdrew Ben Harmon’s file from her case and handed it to Lewis then started the car. They were onto their fifth call of the day and the anger she’d felt in the surgery still hadn’t abated. She could scarcely believe that he’d had the temerity to tell her how she should run the practice after he’d been there for just one week. Why on earth did he think that he knew more about running the place than she did?
‘I’m sorry. I shouldn’t have said what I did at the surgery. You have every right to be annoyed with me.’
The apology caught her unawares so that the car swerved towards the ditch. Helen’s mouth compressed as she quickly righted it. She hated to feel so vulnerable. Lewis was the new partner in the practice—an incomer, as the people of Summerfield would have called him—and he shouldn’t have this effect on her. She had to nip these foolish feelings in the bud.
‘I’m not annoyed. You’re entitled to voice your opinion, just as I am entitled to veto any ideas I feel aren’t appropriate.’
In His Loving Care Page 3
