The Doctors of Downlands

by Claire Rayner

  Then, I interrupted him, in mid sentence.

  “Charles! This is a business proposition you’re making?”

  “What else, my dear? What do you think of it?”

  “But all this would be private practice? Wouldn’t you work any more for the National Health Service?”

  I couldn’t really have cared less about the details of his plans, but I had to say something, anything, to hide from myself and from him the way I was feeling. I had been confidently expecting a proposal of marriage, and what I’d been offered was a sordid business transaction, designed to milk as much money as possible from gullible patients, money that Charles would keep to himself and not even offer in the form of a decent salary to his assistant.

  “- life’s too short for philanthropy,” Charles was saying. “I for one am sick and tired of caring for grubby specimens of National Health humanity - I prefer the pleasanter types who use Harley Street, and I’d confidently hoped that you’d join me - you’d be an asset to such a practice, both medically and decoratively!”

  He laughed suddenly, “My dear, I can imagine the more elderly gentlemen of the practice taking a positive delight in bringing their skin problems to so charming a practitioner! As much delight as the elderly ladies will take in me -” and he laughed fatly and drank some of his brandy.

  I stood up, and stood swaying slightly as he peered up at me in surprise.

  “I regret I won’t be able to accept your invitation, Charles.”

  I spoke very clearly, the wine, and the Benedictine giving me a spurious courage I was far from feeling.

  “On several grounds. I cannot leave my young brother to fend for himself, in order to look after rich old people in Harley Street. I certainly can’t afford to work the way you propose for even less than I am earning now. And above all, you make me sick.”

  I took a deep breath, and looked at him through the tears that were gathering in my eyes, in spite of myself.

  “I thought you - you liked me a little, as I - cared for you. As a person. Well, obviously you don’t. You just see me as a potential ally in a money-making set-up. Well, no thank you. There’s nothing more we can possibly have to say to each other.”

  And gathering the rags of my pride about me, I turned and fled for the ladies’ room, blinded by my tears.

  There was a small hubbub going on in there, and the women involved were standing with their backs to me, which gave me time to pull myself together and dry my eyes.

  Then someone turned and saw me, and gasped, “It’s - it is, isn’t it? The doctor?”

  “Yes,” I said dully. “What’s the matter?”

  “I don’t know -” the woman said. “Oh, I’m that glad you’re here - and to think I recognized you - well, it was meant, wasn’t it? It’s this lass here. I think she’s had too much to drink myself, but there’s some that say she’s ill. Now you’re here we’ll know for sure.”

  I shook my head to clear the muzziness in it, caused by the excellence of the meal I’d just had, and the way Charles had made me feel, and knelt on the floor beside the girl I could now see lying there, as the women who had been clustered round her made room for me.

  It was Jennifer, and as I looked down at her, at her partly closed eyes, listened to her deep sighing breathing, and noticed the smell of her breath - it was like acetone, a pungent familiar odour - I remembered. I remembered what it was about Jennifer that was bothering me, had been bothering me ever since I’d seen her at the hotel.

  “What happened?” I asked sharply. “Did she come in and say she had a pain in her middle? And was she sick?”

  “Why, yes!” the cloakroom attendant said, pushing forwards.

  “That’s just what happened! I reckoned she’d made a pig of herself, had too much to eat and drink, especially drink so I didn’t worry too much. These girls! But then she keeled over like this, and it don’t seem like an ordinary faint, that it don’t -”

  “It isn’t,” I said crisply. “This is a diabetic coma.”

  For what I had remembered was that Jennifer had come to me with a list of symptoms that made me suspect diabetes. I had sent her to Fenbridge hospital for a blood test, and then waited for results. And now I recalled that the results had come in a few days earlier, and I’d asked Barbara Moon to write to Jennifer telling her to come and see me about the results of the tests - which showed conclusively that she had got diabetes. And she hadn’t kept the appointment. That was why Jennifer had looked so guilty when she saw me this evening -

  “We’ve got to get her to hospital fast,” I said. “Can someone phone for an ambulance?”

  There was a scuffing sound and one of the women disappeared, but then I had a better idea.

  “No - quick - there’s another doctor here tonight - in the bar. A tall - good-looking man -” It hurt even to say that much. “Tell him there’s been an emergency, and - and Dr Fenwick wants him to take a patient into Fenbridge for her.”

  Another woman nodded and ran off, while I turned back to Jennifer to loosen her clothes and make her more comfortable. There was nothing more I could do, for what she needed was urgent hospital treatment.

  The second of the women who had obeyed my instructions came back, and her face was white and stormy.

  “Dr Fenwick!” she said. “Dr Fenwick! Did you say that man was a doctor?”

  I nodded, surprised.

  “Well, thank God he isn’t mine. Because when I gave him your message he just said ‘Tell Dr Fenwick that I haven’t time to waste on her wretched country bumpkins, and to look after her own patients. I’m going back to London.’ What do you think of that!”

  “It doesn’t matter,” I said, flatly. “It doesn’t matter.” Charles had gone out of my life for ever, and all I could say was “It doesn’t matter. It doesn’t matter -” I felt dead inside.

  And then there was a small hubbub at the door, and the other woman came back, bustling importantly.

  “I couldn’t get an ambulance, Doctor,” she reported. “Seeing they’re all out, on calls right now - we’ve only the three in Tetherdown, after all -”

  “Oh, good lord!” I said, anxiously. “This girl’s got to get to hospital fast -”

  “Don’t you fret!” the woman said. “I phoned Downlands, and explained, and that Dr Lester, he said he’d come with his car and take the girl to hospital. He says to hold on here - he’s on his way.”

  On his way - Max Lester. He’d know that Charles and I had quarrelled, for he knew I’d gone out with him tonight - and my pride shrivelled as I thought about it. I wouldn’t have minded so much if it were Peter who knew, friendly, easy going Peter, but the short-tempered Max - that was something else again.

  I crouched by my patient, now breathing even more deeply, and in a deeper than ever state of coma, and wished I were dead. Everything was going wrong for me. If I’d remembered about Jennifer’s blood tests as soon as I saw her, I could have warned her to go easy on food and especially on drink, for an excess of both had undoubtedly contributed to her condition now. If I hadn’t been so light-headed about Charles, so bedazzled by his London elegance, I’d have seen through him long ago for what he was - a self-seeking piece of conceit - and not let myself be hurt by him.

  And now Max was on his way, to see me in trouble yet again. Indeed and indeed the world seemed a miserable place at that moment.

  CHAPTER NINE

  I sat in the back of the car with Jennifer’s head cradled in my lap, staring at Max’s uncompromising back in the darkness. He’d said very little since arriving at the Black Swan and Cygnet. He’d come quietly into the ladies’ room, looked briefly at Jennifer, and then with a curt nod at me had scooped the girl up into his arms and led the way out to the car. I had followed meekly, and since he had started the drive into Fenbridge he hadn’t spoken at all.

  “Do you know this girl?” I asked, somehow needing to break the silence.

  “No. Should I?”

  As briefly as I could, I explained what had h
appened, making no effort to slur over my own part in her collapse. I couldn’t forget that it had been my own lapse of memory that had contributed to it. If only I had remembered those tests and the broken appointment -

  “That’s silly,” Max broke in brusquely. “We’re doctors, not little tin gods. People come to us with their symptoms, and we do our best to diagnose the illness and recommend treatment. After that, it’s up to the patient. If they haven’t the sense to do as they’re advised to do for their own good, then we can’t be blamed. To wallow in guilt the way you’re doing is stupid.”

  “From your point of view, I’m always stupid!” I snapped, stung into childishness. “I can’t put a foot right as far as you’re concerned -”

  “Not at all,” he said coolly. “You’ve done rather well tonight, on balance. You remembered what was necessary when it was necessary and made a fast diagnosis. If you’d treated this as a simple case of drunkenness - which it could have seemed - you wouldn’t have been the first doctor to have made that mistake. You recognized dangerous illness when you saw it, and took the right steps to deal with it. What more do you want? A medal?”

  And crushed, I sat silent for the rest of the journey. There seemed nothing else to say.

  In the silence thoughts of Charles and what he had said came crowding back to torment me, stinging my eyes with unshed tears of - what?

  Almost to my surprise I realized it wasn’t rejected love that hurt me, but shattered pride. Oddly, the realization made me feel better. Pride recovers much more rapidly than a lacerated heart, I thought. Maybe I didn’t care that much for Charles after all?

  And then I thought of his tall elegant body and his handsome face, and my heart gave the old familiar lurch. Clearly, I wasn’t going to recover overnight.

  The small fuss at the hospital when we arrived drove all thoughts of my own problems away, and gratefully I turned all my attention to Jennifer and her treatment.

  Preliminary blood tests confirmed my diagnosis, and within minutes, Jennifer was settled in the intensive care ward with a special nurse to care for her, and intravenous drips running. Max and I saw her once more when she was finally settled and then went to talk to the consultant in charge before leaving.

  “I’ll ring you in the morning to let you know how she gets on,” he promised. “With a bit of luck we’ll get her on an even keel by then, and we can set about stabilizing her diabetes properly. She’ll clearly need insulin, and I suspect some fairly heroic dieting. She’s plump - and that almost certainly contributed to her condition.” He turned to me, then.

  “You did very well, Dr Fenwick, to spot the diagnosis so quickly, and to have the good sense not to try any treatment before bringing her in. Too often less experienced practitioners in this condition go off half-cocked and pump insulin into these patients before they come to hospital - and when that happens it’s much harder to evaluate the situation. Well done.”

  And I blushed absurdly and stole a look at Max. But he showed no response at all.

  We drove back to Tetherdown in silence, but it was a different sort of silence now. I was exhausted. It was now two in the morning, and I’d had a long day both from the work point of view, and the emotional one. Two men had kissed me unexpectedly, and the one I had wanted to kiss me had, metaphorically speaking, kicked me in the teeth. And the thought was so absurd that I giggled aloud a little hysterically.

  Max looked at me briefly, and raised his eyebrows.

  “I’m sorry,” I said. “I was just - thinking about the day. And it struck me as funny. Not that I could explain why -”

  “Jeremy? Is he the joke?”

  “No!” I flashed, hot with embarrassment. “Certainly not! He - he’s a sweet boy who let his imagination run away with him. Lots of boys his age get the notion they - they care for a woman older than themselves. There’s no more to it than that. It’s only calf love, and he’ll get over it - but I wouldn’t dream of laughing at him! That would be cruel - and I sincerely hope you’ll have the - the courtesy to forget what you saw this afternoon! I can cope with your nasty sneers, but I don’t see why Jeremy should have to put up with them.”

  “Nasty sneers? Me?” He sounded genuinely surprised. “Surely I never sneer?

  “It looks very like it from where I’m sitting,” I retorted, and relapsed into a sulky silence that lasted all the way to Downlands.

  After that night, life at Downlands slipped back into its quiet ways, as spring drifted into a warm sunlit summer, and the days stretched themselves and yawned through the long tranquil days of June and July.

  Judith was ecstatically happy, and her happiness illuminated her, shearing years off her looks. She put on a little weight and that suited her enormously, and the softness of her looks was only matched by the softness of her mood. As far as I could tell she hadn’t taken a drink since the night Emma was born.

  Judith’s new happiness in the baby seemed to communicate itself to the rest of us. Peter became much more relaxed and exchanged his previous hail-fellow-well-met ways for more mellow behaviour as Judith’s own relaxation made his life so much more easy. He was still easy-going, helpful Peter, but so much nicer a person than he had been.

  Jeremy, too, found new happiness that summer. The first time we met after that day when he had kissed me and blurted out his feelings was a little embarrassing, I can’t deny. He had flushed a patchy brick red, and stammered a little, but I had smoothed things over with talk about his father, and the awkwardness passed.

  Dr Redmond made superb progress, and left hospital for good a couple of weeks after Jeremy had proposed to me. He was all for coming back to work, but none of us would hear of such a thing, and Peter and Max together arranged for him to spend a long lazy summer, recuperating properly, at the house of a friend of theirs in Cornwall.

  But what really made the difference to Jeremy was Barbara Moon. Quite how it happened, I don’t know, though I suspected that Max had had something to do with it. According to Peter he had, one evening, presented Barbara with a pair of tickets to Fenbridge repertory theatre with the gruff suggestion that she get Jeremy to use the other one. Quite how Barbara felt about this I never knew, for I was quite sure at the time that she was in love with Max. But, obediently, she asked Jeremy.

  And as the weeks pleated into months, the friendship between the two deepened and ripened, until we were all used to thinking of Jeremy and Barbara as a pair. We were all happy for them, for Barbara especially, for now she too seemed to relax, to become softer and happier, just as Peter and Judith were.

  So, everyone at Downlands was happier - even Max, I think, for with Dr Redmond away he had to work harder than ever, both at running the practice and caring for patients, and he thrived on work. Everyone but me.

  I tried to be rational and sensible about Charles, about the way my romantic dreams of him had been shattered and left in shards about my feet, but it was difficult. All I succeeded in doing was becoming harder, somehow, as I wrapped a protective veneer of not-caring around my hurt pride.

  But at the same time, there was one area in which my pride in myself was enhanced rather than damaged - and that was my work. As surgeries followed visiting rounds and clinic sessions at Fenbridge hospital followed surgeries I learned more and more about the intricacies of general practice, learned more and more about the art of diagnosis and the management of disease, and I positively revelled in it.

  Sometimes when I looked back on my hospital days at the Royal, when I’d thought I knew so much, I marvelled at the naïve creature I’d been. Hospital work is all very well, I thought, but for real medicine, you can’t beat general practice.

  I said as much one evening to Max, at the end of surgery. I’d gone into his room to report on Jennifer who had come to see me. She had made an excellent recovery and was now very well stabilized, her diabetes under complete control, on daily insulin injections. She’d lost the weight that was so dangerous to her condition, and looked a much happier healthier girl than she h
ad.

  “She’s to go to Fenbridge at three-monthly intervals,” I told Max. “For the rest, I’ve got the consultant’s letter here, and he’s very happy to leave her in our care otherwise. That’s one of the best things about general practice, isn’t it? The way you get the chance to follow your patients through - really look after them properly, as whole people, instead of just medical cases.”

  Max looked up at me, his head framed in the nimbus of light from his desk lamp. It had darkened early this evening, for high summer, but there was thunder in the air, muttering away in the distance, and the sky was heavy and dark with unshed rain.

  “Do you really feel that?”

  “I wouldn’t say it if I didn’t.”

  “I thought you regarded general practice as an also-ran sort of occupation - the backwater of medicine.”

  “I did, once,” I said honestly, wandering across the room to sit on the window seat, my back to the glowering sky outside. Thundery weather always makes me uneasy. “But I’ve learned better. I owe an apology for my original narrowmindedness. All right?”

  He leaned back in his chair, and only his hands were left in the light. His face was shadowed, but I was aware of his eyes on me.

  “Well, if apologies are the order of the day, I must be honest and admit I owe you one. So - I apologize.”

  The thunder growled softly, and I shivered a little, hunching my shoulders against the gloom outside.

  “What for? I mean - I’m only too delighted to accept an apology, any time, as long as I know what it’s in aid of!”

  I kept my voice as light as possible, trying not to show the childish fear that was building up in me. It’s shaming to admit it, as a grown woman and a doctor to boot, but thunderstorms terrify me.

  “For misjudging you.” His voice sounded gruff, but this time I recognized the genuine feeling in it, not assuming, as I usually did with him, that it was due to bad temper.

  “I thought you were just a flibbertigibbet,” he went on after a pause. “A silly empty-headed girl who’d got herself qualified by a fluke, and was going to kill time here at our expense. Most of the women doctors I’ve ever known have been - that sort. Self-centred. Well, I was wrong. You’re a good doctor. A damn good doctor. The children in this practice - and their mothers - get much better care now than they did, because you really understand them and care about them as people. We - Peter and I - haven’t got your touch in this area, and we’re delighted you have -”