Taken For Granted

by Caroline Anderson

  Instead she just had time to stroll round it and weep with exasperation in between calls. If only Sam could be trusted, she thought, and then remembered her pansies.

  Perhaps everything could wait. It was only another week, after all.

  She found herself looking forward to the end of that next week more and more as the weekend went on. Most of the calls were spectacularly insignificant—but she knew Sam almost never refused to visit a patient, and so she felt she should do the same, just to gauge how irksome it could be.

  She found out, in spades.

  By Sunday afternoon she was ready to tell the next caller to drop dead, but when the call came in she was very much afraid that he might.

  ‘Man of forty, severe chest pain—a Mr Turner,’ she told Sam as she ran for the car. ‘I’ll see you later.’

  She arrived at the house to find a boy in his midteens waiting anxiously at the side of the road.

  ‘Are you the doctor?’ he asked, and when she confirmed it he all but dragged her through the house into the garden.

  ‘Dad’s here,’ he told her, and led her to the shade under an apple-tree. A man was lying there, his skin grey and clammy, his lips bluish, and a woman, obviously his wife, was smoothing his brow and talking calmingly to him.

  ‘Oh, thank God you’re here,’ she said fervently to Sally.

  She knelt down beside the man. ‘What’s his name?’ she asked.

  ‘Brian.’

  ‘Brian,’ Sally said, ‘it’s Dr Alexander. Can you hear me?’

  He grunted affirmation.

  ‘Can you tell me where the pain is?’

  ‘Chest,’ he mumbled. ‘Weight—and my arm.’

  ‘When did it start?’

  ‘Digging. Rested for a bit—better—did some more. Bad now…’ He broke off and licked his lips, obviously in great pain.

  ‘Brian, I’m going to sit you up a bit, see if that eases it. Don’t move, I’ll get something to lean you on.’

  She looked round the garden and saw a solid wooden chair.

  ‘That’ll do. Turn it upside down and he can lean on the back. He’ll need cushions,’ she told his family, and they rushed to follow her instructions, clearly only too glad to do something useful.

  She asked his wife to help sit him up, and the son pushed the chair up behind him and arranged the heap of cushions so that he could lean comfortably back on it.

  ‘Better?’

  He nodded. His speech was still slurred, but clearer than before. ‘I can breathe better—as if some of the weight’s gone.’

  ‘Good. I’ll give you something for the pain while we wait for the ambulance. OK?’

  She put a cannula in his hand ready for drugs at the hospital, and gave him diamorphine for the pain.

  Because of its importance in reducing risk of a further attack if given within six hours of the pain, he was likely to be given a thrombolytic drug on arrival at the hospital. The sooner it was given, the better, but just for good measure she gave him half an aspirin tablet to start the process.

  She had a defibrillator in the car, but she was hoping she wouldn’t need it. He looked reasonably stable, and his colour had improved slightly since they had sat him up. Happy that he was in good shape for the ambulance transfer, she sent the son out to the front of the house to wait for the ambulance.

  ‘He will be all right?’ Mrs Turner asked softly.

  ‘I hope so,’ Sally said, unwilling to reassure blindly when things could still go wrong. She was also very conscious of the fact that Brian was probably listening, even though the diamorphine had made him very drowsy. ‘I think he’s had a bit of a heart attack,’ she said simply. ‘They’ll be able to tell you more at the hospital when they’ve done some tests.’

  ‘Oh, dear. Oh, I feel so guilty. I nagged and nagged him about that digging…’ She started to cry, and Sally squeezed her shoulder and thought of how much pressure Sam was under. He and Brian were about the same age, she reflected uncomfortably, and suddenly she couldn’t wait to get home to him and just tell him how glad she was that he was alive.

  The ambulance came, and Brian Turner and his wife and son were loaded into it, then Sally made her way home.

  The house was empty, with no sign of Sam or the children. Puzzled, she decided they must have gone out for a walk, and so she made herself a cup of tea and settled down in the garden. It was still just about warm enough in the sun to sit there without a coat, and she wrapped her hands round her mug and wondered where they were.

  At last she heard the Mercedes pull into the drive, and Sam and the children trooped into the kitchen.

  Sam waved to her, and she got up and went in.

  There were three children in the kitchen: Ben and Molly and another boy of about Molly’s age. Sally thought she recognised him, but what he was doing there on a Sunday afternoon Sally couldn’t imagine.

  They looked upset, she realised, as she took a closer look.

  ‘What’s up?’ she asked Sam.

  ‘Toby’s brother’s had an accident with a lawnmower. He’s gone to hospital, and we’ve got Toby until his parents come back.’

  ‘Oh, dear, Toby, I am sorry,’ she said softly. He began to cry, big fat tears rolling silently down his grubby cheeks, and Sally went over to him and put an arm comfortingly round his shoulders.

  ‘Tell you what, why don’t we see if we can find a packet of chocolate biscuits and a nice video, eh?’

  She led him through to the sitting-room, noticing as she did so that Sam’s jeans were liberally splattered with blood. She would ask for more details once they were alone, she decided.

  A few minutes later Toby, still a bit wide-eyed, was tucking into chocolate animals with Molly and Ben in front of Superman Two and Sally was able to corner Sam in the bedroom where he was changing.

  ‘What happened?’ she asked.

  He rolled his eyes. ‘It was awful. The call came just after you’d left, and I knew I couldn’t leave it till you’d finished, so I bundled the kids in the car and went round. Talk about carnage.’

  ‘What had he done?’

  ‘Tried to help his father with the lawn. He’d got the Flymo, started it and was walking backwards and tripped. I think he’s going to lose his left foot.’

  ‘Oh, no!’

  ‘Oh, yes. It was a dreadful mess. I just wrapped it up in clean gauze and got the ambulance immediately. They were very good with him, but he was obviously in tremendous pain, poor lad. I said we’d keep Toby till later—I guess we may have him for the night.’

  Sally nodded. ‘That’s not a problem, he can sleep in Ben’s room. Poor boy. He must have been very shocked.’

  ‘Not as shocked as Liam.’

  ‘Liam? I thought I recognised Toby. Liam’s a friend of Ben’s, I think.’

  Sam nodded. ‘Yes, he is. He’s been here once or twice, I recognised him. Poor kid. Of course he only had light shoes on.’

  ‘Always the way, isn’t it? Nothing like that ever happens when you stand a decent chance.’

  Sam tugged clean jeans up his long legs and fastened the waist, waggling it up and down. ‘Look—I’m thinner.’

  She smiled. ‘So am I, but not because I’ve been working out. I feel sluggish and disgusting. I just haven’t had time to eat anything proper recently.’

  ‘How was your Mr Turner, by the way?’

  She sighed. ‘Your age, reasonably slim and fitlooking—you wouldn’t pick him out in a crowd as the one most likely to have an MI, anyway.’

  ‘So why did he?’

  ‘He’d been digging. Got a bit of chest pain, stopped for a while and it went away, so he carried on. I expect he thought it was indigestion at first.’

  ‘Easy mistake to make.’ He glanced at his watch. ‘What about supper? I was going to make spaghetti bolognese, but I’m not sure I feel up to another culinary defeat. Shall I get a take-away?’

  She tried hard not to smile. ‘Good idea. Patients can always get me on the mobile phone—we’ll s
et it to transfer automatically.’

  Nothing was ever as straightforward as it sounded, she thought half an hour later when the children were still unable to decide what they wanted.

  In the end Sam ordered three Chinese meals, one lot of fish and chips and a curry for himself.

  As the phone rang yet again, Sally wondered if she would actually have time to sit down and eat it while it was still hot.

  Oh, well, there was always the microwave…

  Monday morning didn’t come anything like soon enough for Sally. She was in and out all night, and it seemed each time she got home there was another call just as she got into bed.

  In the end she stayed in her clothes and just lay down on top of the bed, which typically ended the stream of calls.

  Toby was still with them, as Liam had had to have surgery on his foot on Sunday evening and his parents had wanted to stay with him.

  His father had been back with a change of clothes and his school uniform, and spent some time reassuring him about his brother, promising to collect him after school and take him to the hospital to see Liam.

  Sally wondered if she would disturb him in the night, but it seemed he was exhausted by the course of events and slept like a log.

  She left Sam dealing with the three of them and went into the surgery to make up the computer notes of the patients she had seen that weekend, before her surgery started at eight-thirty.

  Martin Goody came and found her, took one look at her and disappeared, returning with a cup of coffee.

  ‘Oh, life-saver,’ she murmured.

  ‘Busy weekend?’

  ‘Like you wouldn’t believe,’ she told him. ‘I think I had over forty calls.’

  He whistled softly. ‘Wow. I think my record is forty-two.’

  ‘Mmm. Sam said something like that. Trust me to have a mega-weekend the only one I have to do!’

  Martin laughed. ‘That’s the way it goes, Sally. At least you can hand back to Sam at the end of the week.’

  Five more days.

  Suddenly it seemed terribly close—too close, almost.

  ‘Did you want anything?’

  He shrugged. ‘Just to know how you’d got on. Make sure you were coping and all that. I wouldn’t trust Sam to swap back in a hurry—he must be living the life of Riley at the moment.’

  Sally laughed. ‘Actually he’s reduced to cheating. He got Dustbusters in to sort the house out, and he keeps buying take-aways!’

  Martin chuckled and pushed himself up off the desk with a sigh. ‘Oh, well, I suppose I’d better go and get stuck in. See you.’

  He waggled his fingers and left her, and she watched him go and thought how kind he was. Sam was very lucky to have a senior partner who was so easy to get on with. Not everyone was so lucky.

  Jackie came in with the stack of notes for the morning surgery, and she flicked through them, noting with interest that old Mrs Wright was coming back to see her. She wondered if her giddiness was worse, and once again was assailed by doubts. Perhaps she should have sent her to a neurologist for a check.

  She was the third patient, and Sally found herself dreading the woman’s entrance into the room.

  She needn’t have worried. She came round the door head first, beaming, and bustled over to the chair.

  ‘I won’t keep you, dear,’ she said, ‘but I just wanted you to know I’m completely better!’

  Sally was actually delighted, but pointed out to Mrs Wright that a phone call would have done, and even that wasn’t strictly necessary.

  ‘Oh, dear—I hope you didn’t mind me coming in, only I wanted to thank you personally.’

  Sally smiled at her tolerantly. ‘Of course I don’t mind—I’m really glad you’re better. Thank you for letting me know.’

  She watched her go, thinking as she went that it was a shame all consultations weren’t so positive and brief. Still, if they were, there’d be little point in her presence, so it was probably just as well!

  In her break at ten-thirty she phoned the hospital to ask after Brian Turner and Liam O’Connor, and was told that Mr Turner had suffered a massive MI and was on heparin, and was still not out of the woods. Such a major heart attack at his age was not good news, of course, and Sally wondered how his wife was taking the news.

  Liam O’Connor, on the other hand, was doing better than Sam had expected. His foot had required very long and tricky microsurgery, but they had managed to save it and they were hoping he would recover almost normally. It had required a team effort of neurology and orthopaedics to reconstruct the foot, but they were confident that, apart from the loss of one toe, he would be back to normal within a few months.

  Toby would be relieved, Sally knew. He had looked quite troubled earlier that morning, and had asked if there was any news. Poor little lad. It must have been a horrendous shock for him. He had apparently been standing right beside Liam when it happened, and had grabbed the mower and pulled it off him, thus probably saving the foot.

  She went back to her surgery and called the next patient. He was a lad of about seventeen, and one look at him was enough to tell her why he was there.

  He had possibly the worst case of acne she had ever seen, and she had a feeling that under the very sore rash he was blushing.

  ‘Hi, there,’ she said with a friendly smile. ‘I don’t think we’ve met—I’m Sally Alexander. You must be Rob Saunders.’

  ‘That’s right,’ he mumbled.

  ‘Rob, have a seat and tell me about your problem.’

  He perched awkwardly on the edge of the chair. ‘Its my acne.’

  ‘It is looking very angry and sore. Have you had any treatment?’

  He shook his head. ‘My dad says zits are zits, and he had ‘em as a kid, so why am I making such a fuss, but it hurts.’

  ‘I’m sure it must. Anyway, acne isn’t just about spots, it’s about infected spots, and you need a long course of antibiotics to deal with acne like that. May I have a look?’

  She stood beside him and very gently ran her fingers over the affected areas, feeling to see how deep the cysts were. They were, as she’d thought, very deepseated.

  ‘Is it on your back as well?’ she asked, and he nodded miserably.

  ‘Summer’s coming too, and how can I take my shirt off when I look like this?’

  ‘May I see?’ Sally asked gently, aware of the depth of his embarrassment.

  He stripped off his shirt and revealed a mass of red swollen pustules all over his back. There was some scarring already, she noted, but not much. With any luck he could be treated and much of the inevitable scarring could be prevented.

  ‘Fine—put your shirt back on, Rob. Right, I think you need to be referred to the hospital for treatment with a new drug called isotretinoin. It’s a very drastic treatment, and it needs hospital supervision, but it can have marvellous results with severe acne.’

  ‘Hospital? For zits? Dad’ll die laughing.’

  ‘Only an outpatient clinic—and whatever your father says about zits, what you have is very sore and infected skin and you need appropriate treatment.’

  He looked relieved, as if someone for the first time had actually taken his suffering seriously.

  ‘Mum says it because I eat so much junk food, like chips and stuff.’

  ‘There is actually no evidence that junk food or greasy food or chocolate can make any difference at all,’ she assured him. ‘However, a healthy diet wouldn’t do you any harm at all, so your mother’s advice isn’t entirely wrong.’

  He grinned weakly. ‘I hate boiled cabbage.’

  ‘So have salad. Do you like salad?’

  He nodded.

  ‘Fruit? Eat lots of fruit and salads, and try and spend some time in the sun. It’s very good for the skin, unless you have too much. But for heaven’s sake make sure you don’t burn! The last thing you need on top of that lot is sunburn!’

  His smile widened. ‘That would really be the pits,’ he agreed.

  ‘Right,’ she said
, getting down to basics. ‘I need to take some blood from you so we can run various tests on you, and you’ll need the results for the hospital clinic. At the moment the wait to see someone is about two months, but there’s a lot we can do to start with. I’m going to put you on antibiotics, and you’ll need a topical antibiotic cream to put on the affected areas.

  ‘You also need to watch for things like athlete’s foot, and eat live natural yoghurt every day to make sure the yeast in your gut doesn’t go mad while you’re on the antibiotics, but don’t take it at the same time or the antibiotic won’t work.’

  After giving him a list of seemingly endless instructions and a card to fill in with his progress as the days went by, she let him go, armed with a ray of hope and the knowledge that someone, at least, was taking his suffering seriously.

  The father was half his problem, of course. How any caring parent could make fun of a boy so miserably afflicted with acne was beyond her, and she found it made her very angry.

  Presumably he’d be upset if the boy was burned and thus scarred for life, so what about acne, which could be just as damaging to the skin?

  Some people, she mused as she called in her next patient, didn’t deserve to be parents.

  One woman who did deserve to be a parent came home from hospital with her baby that day, and Sally went to visit her in the afternoon, even though she was off duty.

  Sue Palmer was looking very well—much better than when Sally had last seen her—and lying beside her chair in a carry-cot was a tiny little doll.

  ‘Oh, she’s minute!’

  Sue smiled tenderly. ‘Yes, she is, but she’s a real little fighter. I love her to bits.’

  ‘I’m so glad. How are you—how’s the tum?’

  ‘Much better now. They didn’t give me a bikini cut, of course, because of the hurry, but I don’t care. So what if I have a scar? Look at her—don’t you think she’s worth it?’

  Sally ran a finger gently over the downy cheek and sighed. ‘You nearly lost her—I’m sorry I didn’t admit you earlier.’

  ‘What for?’ Sue asked in surprise. ‘I wasn’t that bad—really, if you’d tried to send me in earlier I might have refused to go! I was still waiting for the contractions to start rhythmically, instead of one long ache, when the placenta came away. What is it they call it?’