'Can you tell me what medication you're on?' Gabi asked, and blue eyes, still bright though greyed by age, gave her a scornful look.
'Of course I can. Everyone should know what they're taking and why.'
'Good!' Gabi told her. 'Then fire away.'
And fire away the patient did, though, even with the oxygen she'd been given when she'd first come in, she had to pause from time to time to catch her breath. She knew her drugs right down to the dosages: ninety milligrams of Adalat, a drug to reduce blood pressure, thirty milligrams of Lasix, a diuretic to prevent fluid retention, and one Zantac, a ranitidine hydrochloride drug designed to prevent recurrence of a duodenal ulcer but which could also be used as a preventative for reflux.
And if the woman had had problems like that once before, then a bleeding ulcer, or even bleeding polyps in her stomach or intestine, could be causing blood loss and the consequent lowering of her haemoglobin count now.
'How long have you been on the Zantac?' Gabi asked.
Mrs Armstrong frowned at her.
'Ages. It seems like for ever, in fact. I had some problems in my stomach. Had to swallow one of those nasty camera things and the specialist found some little things that were bleeding.'
'Polyps?'
The frown changed to a smile.
'That's what they were. He burnt them off I think, but I certainly didn't feel it.'
'Well, it may be that they need burning off again,' Gabi told her. 'I think you should be admitted, so the specialists can do some tests.'
'I didn't have to stay in last time,' Mrs Armstrong argued. 'If I stay in, who'll get Alf his tea? And what about my toothbrush and nighties and things? I've got a hospital bag all packed, because that's sensible when you get older, and it's somewhere to put the nice nighties my daughter gives me every Christmas, but I didn't bring it with me because I wasn't going to the hospital. I was going to the doctor's.'
The flow of words stopped momentarily, then Mrs Armstrong sat up on the examination couch and added with an air of triumph, 'Anyway, I can't stay. The car's on a parking meter and it'll expire soon.'
Gabi checked the date of birth she'd seen on the file. If her calculations were correct, Mrs Armstrong was eighty-nine.
'The car's a problem,' she agreed. 'But because the low blood count could have any number of causes, you'd be better off in hospital where we can run a series of tests. And with your haemoglobin so low you must be feeling tired. Your GP suggested a blood transfusion, and that will certainly pick you up while we work out what's wrong.'
She paused, wondering if the woman was listening or ignoring her.
'Perhaps you could drive home, arrange for someone to give Alf his dinner—we could organise meals on wheels for him if he can't cope on his own—'
Mrs Armstrong gave a shout of laughter.
'Meals on wheels don't come for cats,' she said, chortling merrily at the ridiculous idea.
Gabi regrouped.
'Maybe a neighbour?'
'I guess the young woman next door might do it,' Mrs Armstrong conceded. 'After all, it's only a matter of checking he's got clean water and a bowl of dried food. He's got a cat door so he can go in and out of the house.'
'Do you feel up to driving home, arranging things, then coming back? Do you have any way of getting back or would you like me to organise an ambulance pick-up?'
'An ambulance driving up my street? To my house? No, thank you. I'd have all the neighbours gossiping for weeks. I'll get a bus.'
Gabi hesitated. Much as she admired the woman's independent spirit, she didn't like the idea of her coming back to the hospital on a bus. For a start, the bus stopped a couple of hundred metres down the road, and the climb from the stop to the hospital entrance would be hard for anyone with a depleted oxygen supply.
'There's no one who'd drive you?' she asked.
'I've got my daughter and two daughters-in-law, but I wouldn't ask them,' Mrs Armstrong said. 'They're all very good to me, and one of my sons does my lawn, but the girls all work and they'd have to take time off.'
Gabi's mental calculation put 'the girls' somewhere in the region of sixty, but she gave up arguing.
'Look,' she said, 'there's an organisation with volunteer drivers. I'll see if I can get one of them to pick you up. Do you mind waiting until I find out?'
Mrs Armstrong glanced at her watch.
'I'm on a two-hour meter and I've only got ten minutes left.'
Gabi had to smile.
'I'll be quick,' she promised, leaving the cubicle and enlisting Roz's help in contacting the transport people.
'They'll do it, but they can't get anyone to pick you up until two,' she told her patient minutes later. 'When they drop you off, come into A and E and ask whoever's on the desk if you can see me. If you want to phone your family, you'll be going into Ward Eight B to begin with, and after the doctors there have done tests you might be transferred to another ward—one the gastroenterologist visits every day. But that wouldn't be for a few days.'
Mrs Armstrong departed, but thoughts of her lingered in Gabi's head. There was a fearlessness about the older woman that suggested she'd never been afraid of heights, or planes, or anything man or God had put on earth.
Including infectious diseases !
'Gabi, there's a little boy in Four—could you take him?'
Something in Roz's voice suggested she'd been keeping this patient for Gabi, but then most of the permanent staff knew of Gabi's interest in children and directed them her way.
She read the information already collected as she made her way to the small consulting room.
Michael McKenna. His date of birth put him at four—a much easier age to work out than eighty-nine—but as soon as Gabi met him she realised he shared the same fearlessness as Mrs Armstrong.
'There's nothing wrong with me,' he said, shooting his harassed-looking mother a fierce glare, then meeting Gabi's eyes with defiance.
'He's just not well,' Mrs McKenna said softly. 'I know I might be fussing, but he hasn't been himself lately.'
Gabi knelt so she was on a level with the child.
'Even if there's nothing wrong, your mum will feel better if I can tell her that. But I can't tell her unless I check you out. Do you hurt anywhere?'
Michael shook his head, setting dark curls bouncing around his pale face.
'You said your leg hurt, that's why you didn't want to play outside over the weekend,' his mother reminded him, and got another glare for her trouble.
'It doesn't hurt now,' Michael told Gabi.
'Good,' she said. 'Now, see this, see where the numbers are? I'm going to put this just a little way into your ear and the numbers that come up will tell me if you're running a temperature. That's usually a sign that someone's a bit sick.'
Michael submitted, but only on condition he could see the numbers when she'd finished.
By then they were friends—or as close as she was likely to get in a quick consultation—so he allowed himself to be lifted onto the examination table where Gabi could listen to his chest—and he to hers—and take his blood pressure. They had a slight argument over the cuff pump, but in the end Gabi pronounced herself satisfied.
'I'd like to do a blood test,' she said to Mrs McKenna. 'The most likely diagnosis is a mild virus of some kind, but a blood test would show up anything more serious.'
The woman nodded, though the thought Of anything more serious had her looking grim.
'Now, I need to take some of your blood,' Gabi explained to Michael. She found a rather tattered bear, one of many kept in A and E to use as guinea pigs, and showed on the bear what she'd do.
'See how still he sits although the needle pricks through his skin? Can you sit as still as that?'
Michael not only claimed he could, but he was as good as his word and sat watching in fascination as his blood filled the syringe.
'Do you have a local GP? I can have the results sent through to him.'
Mrs McKenna shook her head.
'Well, if you phone the hospital tomorrow at about this time and ask for Pathology. Give them this number...' she wrote Michael's patient number in clear figures on a card, '...and they'll tell you the results. I'll let them know you'll be ringing.'
She hesitated, knowing she could make an outpatient appointment for Michael but not wanting to drag the child and his mother back to the hospital unnecessarily. Hopefully, it was just a virus, but that nebulous 'not well' description parents often gave could be symptomatic of so many things.
After bidding Michael and his mother farewell, she moved on to her next patient—-a worker with a gashed hand that required suturing.
'I'll give you a tetanus shot as well,' she told the bulky man.
His look of horror suggested she might have to use the bear to reassure him, but after her experience over the weekend she was sensitive to fears and phobias of any kind, so she teased him into submission, pointing out he'd already had one injection when she'd put a local anaesthetic into his hand before stitching it.
'I didn't notice that one,' he admitted, and as she kept him talking, discussing—of all things—his passion for growing orchids, she slid the needle into his well-muscled arm. He didn't notice that either.
'I think it's the variety I like about A and E,' she said later, when she and the young nurse who'd worked with her most of the morning stopped for a quick cup of coffee. 'Not only in the injuries and complaints but in the people. I know you don't get to follow through on cases, but you get a different kind of satisfaction.'
The nurse shook her head.
'Not for me,' she said. 'To me, it's like first aid. I want to end up on a ward and see people getting better. Or help them cope if they're not going to get better. 'I like that patient contact thing you can build up.'
'But can you these days,' Gabi queried, 'when so many stays are short term? Even most chemo is done on an outpatient basis these days.'
The nurse shook her head.
'But three days in hospital must seem like a long time to a patient and, outside visiting hours, the nurse is the person closest to him or her.'
They were still arguing over it in a desultory fashion when Alex and another member of his team walked in. Gabi's heart reacted in what was now a predictable manner and she had to remind herself of her determination to keep out of his way.
Which meant finishing her coffee, putting down her cup and standing up.
The nurse joined her, whispering to Gabi as they left the tearoom, 'Is it true you were once married to him?'
Though she should have expected it—after all, hospitals were notorious hotbeds of gossip—the question still struck deep.
'Yes,' she said, when she realised the young woman was waiting for an answer. She'd have liked to add, Do you want to make something of it? But she knew such aggression would be duly reported and repeated and she'd be feeding the very machinery she hated.
Unfortunately, the nurse was still by her side when they passed the desk where a huge arrangement of flowers, long-lasting Australian natives like waratahs and Geraldton wax and kangaroo paw, was standing.
'Someone's popular,' she said to the clerk behind the desk. He glanced up at her and smiled.
'Seems so,' he said. 'They're for you.'
'For me?'
Duh! How could she have sounded so naive? And with the nurse standing there as well!
'Is it your birthday?' the nurse asked, and Gabi, recovering slightly, muttered something that the nurse and clerk could both have taken as a yes, before seizing the arrangement and heading back towards the tearoom.
They must be from a grateful patient, she decided, then regretted not offering this explanation to her eager audience. But at the door of the tearoom she stopped dead. Alex was probably still in there, and walking in with an armful of flowers might call for some explanations.
Not that it was any of his business.
But she detoured to the washrooms anyway, pushing open the door and plonking the arrangement down on the long bench that held the washbasins so she could find a card and see who was embarrassing her at work.
The card was small, and fitted so snugly into its mini-envelope that she had trouble dragging it out.
And even then it wasn't much help. 'I mean,' Gabi muttered to herself, 'what can one possibly glean from "Dinner tonight" and a question mark? Who on earth might want to have dinner with me and how do I say yes or no?'
She turned the card over, but there was no explanatory note or phone number. The young intern—his name kept escaping her, she must be going senile—had moved on with the new rotation. Would he want to dine with a senile thirty-year-old anyway? And did he imagine that now he wasn't working with her he'd have a better chance of getting her to agree to go out with him?
She frowned at the flowers, and in the end decided they were too nice to hide away, so she obeyed the instructions to give them a drink, picked them up and marched back into A and E where she put them on the desk for all to see.
Roz, back behind the desk, raised her eyebrows but said nothing, while Alex, walking past shortly afterwards, glanced her way but didn't comment.
'So you see,' Gabi said to Jane some hours later, when she'd finished work and had popped up to see her favourite patient, 'I've no idea who wants me to have dinner with him. Or maybe it's a her.'
She knew she was avoiding going home, as presumably whoever had asked her out to dinner would phone for a reply. And if it wasn't Alex she didn't want to go and if it was Alex, though there was no earthly reason why it should be, she really couldn't go.
'A her? The Queen of England?' Jane suggested.
'No, a him—the US President,' Gabi countered, and they both vied with each other to offer ridiculous suggestions until laughter made it impossible to speak.
As Alex walked in it struck him that he'd never seen his mother laugh the way she did with Gabi. If he'd been a female, would he and she—or she and she as it would have been—have laughed the same way, or was it part of Gabi's uniqueness that she could make his mother laugh?
'You're frowning. Has something upset you?'
His mother broke off first, asking the question, and from the startled glance Gabi flung his way she hadn't expected him to be calling in at this time.
He gave his mother a reassuring smile and quite liked the feeling that he'd had some effect on Gabi. After all, the flowers, which were now decorating his mother's bedside table, had met with nothing but silence.
'I was thinking how things might have been if I'd been a girl.'
Now his mother was frowning.
'If you'd been a girl?' she said faintly, and because it sounded so bizarre he tried again.
'If you'd had a daughter, not a son. What our relationship would have been like.'
The frown faded and she shook her head.
'Just as good as yours and mine. Different, I suppose, in that I think women talk to each other more.' She grinned at him. 'Why? Were you thinking of a sex change? Is this something we should discuss?'
'As if!' he muttered, embarrassed his mother could even talk about such a thing—and in front of Gabi, who looked suspiciously as if she was laughing.
And why hadn't she mentioned the flowers? Said yes or no to his invitation?
'Well?' he said to Gabi, as his aggravation with what now seemed like a female conspiracy grew.
'Well, should you have a sex change? Why ask me?'
He scowled at her.
'You know very well that's not what I mean. I meant, well, what about dinner?'
'Are you asking if I'm going to eat it some time this evening? Yes,' she said, though there was no longer the light of laughter in her eyes. She glanced from him to the flowers, then back to him again. 'Did you send them?'
She sounded so disbelieving the aggravation swelled into righteous indignation.
'Why wouldn't it have been me? Were you expecting flowers from someone else? Josh Phillips, perhaps? But surely he'd sign a card with love and probably a "J" rather than an "A".'
Gabi stared at him as if he was mad, then slowly withdrew a tiny card out of her pocket and passed it to him.
He read it and shook his head.
'They didn't put the A. I told them A.'
He passed the card back but didn't like the look in Gabi's eyes.
'Whether they put the A or not isn't really the point, is it, Alex?'
Then she stood up, kissed his mother goodbye and left the room.
'Well, so much for your bright idea!' he fumed at his mother, but she took no notice, merely staring at the door through which Gabi had departed.
'There's something wrong with Gabi,' she said. 'I thought at first it was to do with you coming back, but that wouldn't make her so—so brittle somehow. Then late yesterday, when she was here, I felt she was distracted.'
Yesterday? Gabi had been visiting his mother yesterday—not out with Josh Phillips? His heart leapt, but before he could analyse that reaction his mother was speaking again.
'I suppose it could be you coming back. The timing's spot on, and if I'm right in thinking she's never stopped loving you, I suppose your sudden return could have thrown her into a spin.'
'If she's never stopped loving me, she's got a mighty funny way of showing it,' Alex growled, but he knew his mother was right. Brittle was exactly the word he'd use about Gabi at the moment. 'Damn it all, we can't keep guessing about this. I'm going to go and see her, have it out with her, find out what's going on in that stubborn head of hers.'
'Good luck,' his mother said, and it wasn't until he was nearly home he realised there'd been a wealth of irony in the way she'd said it.
But having anything out with Gabi proved impossible. There was no response to his ring at Alana's doorbell and though, when he reached the fourth floor, there were 'company' sounds coming from Kirsten's flat, he didn't feel he could knock on the door to ask if Gabi was there.
Dr Graham's Marriage Page 12
