Practice Makes Perfect

by Penny Parkes

  ‘We could have an in-house physio,’ interrupted Taffy, whose support for the scheme seemed to have increased considerably with the prospect of a little working capital. ‘And you know, this could be just the thing to re-launch the Health in the Community programme properly,’ he wondered aloud, as Dan nodded encouragingly.

  Julia nodded. ‘It might even mean that you two could stop with all the bonkers fund-raising schemes and concentrate on the job in hand?’

  Taffy looked pointedly at Dan’s shaven scalp. ‘The lady does make an excellent point there, Dan – you could even let your hair grow back and then you can have a normal-sized head again.’

  Dan had been doing his best to ignore all the one-liners about the fact that he had a teeny-tiny head – in proportion to his gym-honed body anyway – and he tried not to let his irritation show. Trust Julia to be all about the optics, he thought tiredly.

  ‘But, if you think about it,’ Julia carried on, ‘whilst a Physio would be nice, wouldn’t we be better off expanding the nurses’ clinics? They’ve been getting slammed recently, with all the chronic care patients. Our ratios are really skewed in that direction – everybody round here lives too damn long. They could really use the help.’

  Dan sat back in his chair, a little ashamed of himself for having doubted her. He knew Julia was difficult. He knew her social skills were a little wide of the mark sometimes and she certainly came with baggage. But he should never have doubted that she also came with a good heart and the best of intentions.

  He listened to the debate around the table, each doctor considering a different angle and Harry answering their quick-fire questions with patient attention.

  Traditionally, Dan liked to steer well clear of bureaucracy – the regulations always seemed to have a rather loose affiliation with the reality of medicine – but in this case, he couldn’t help feel that this nomination might actually be a blessing in disguise.

  There remained so much latent tension bubbling quietly under the surface at The Practice about the decision not to nominate a Senior Partner, even if nobody was prepared to admit it. At the time they’d all been so relieved to rescue The Practice from closure that it hadn’t seemed like a big deal to any of them. As the months had passed, it had become apparent that Dan was not the only one feeling that their career ambitions had been thwarted and secretly wanting to be in charge. Some days, it felt like a glass ceiling on any progression or promotion.

  But now this – endorsement from on high – and it looked as though doing the right thing might not have been the wrong thing after all. For any of them.

  Chapter 4

  The next morning, as her clinic dragged on, Julia took another calming breath and made sure that her tone belied none of her impatience. ‘So, as I was saying last time you came in Mr Phillips, if you have a double espresso and a cigarette before you come in for your blood pressure review, it does make it terribly hard to get a sensible reading.’ She dutifully made a note of the terrifying numbers on a piece of paper, but didn’t enter them into the computer for fear of triggering an emergency response.

  Much as Julia was loath to admit it, Dan Carter had a point when he said that having the TV camera crew following her every move would change how she behaved around her patients. From his perspective, the main concern had been that there would be some error caught on film and therefore The Practice would end up indisputably liable. Or even that Julia’s split focus between her patient and how she appeared on film might make her patients feel irrelevant, unheard or simply resentful of having their privacy invaded.

  What neither Dan nor Julia could have foreseen is that the patients that opted to be included – and everybody was given the choice – were loving their five minutes of fame, and that Julia’s bedside manner had never before been so empathetic, patient or compassionate.

  Admittedly, it had been a bit of a shock that first week when she and Quentin, her producer, had watched the rushes together. Catching sight of each sigh, tap of her biro and the occasional look of utter disdain had been a complete eye opener. They’d binned the lot and started again. She wouldn’t tell a soul this, of course, but now when the little light on the camera turned red, she would simply ask herself, ‘What would Holly say?’ and go from there.

  Her patients were delighted. Her producer was delighted. Only Dan was getting the short end of the straw, because after a long day of being personable and caring, it was incredibly hard for Julia to go home and not pick a fight with the next person that moved.

  It was fair to say that, if being ‘nice’ was this much effort, then maybe it was time to accept that it wasn’t her natural state. Pithy and judgemental made life so much easier to bear, apparently.

  ‘So I think it would be a really good idea if you sat down quietly in the waiting room for a little while and then we’ll check those numbers again,’ Julia said as she leaned forward in her chair, the epitome of caring compassion. ‘I just wouldn’t feel right about sending you home, Mr Phillips. Just in case.’

  He shook his head, even as he agreed, ‘I suppose you’re right, Dr Channing. Better safe than sorry, eh?’ He pulled himself to his feet and sighed, playing to the camera as he shuffled out of the room in his tweed suit.

  It was probably lucky that the camera panned to follow him out and missed the look of utter disbelief on Julia’s face. Seriously, how hard could it be to follow the instructions in the letter she now issued as a matter of course?

  ‘Are we nearly done for the morning, then?’ asked Quentin from his position tucked behind the camera. ‘Only I think we should have a strategy meeting about this Model Surgery business. Could be a little goldmine, that one.’

  Julia bristled slightly. Somehow, it was okay for her to think about the commercial implications of the nomination, but it felt prurient and opportunistic when the self-same sentiments came from her erstwhile producer.

  She shrugged. ‘Let’s talk in a couple of days when we’ve a clearer picture of what’s involved. At the moment it’s just a concept, really.’ A concept she couldn’t quite get her head around.

  Quentin blinked slowly, his scrutiny of her face making her feel even more uncomfortable than the high definition cameras that emphasised every individual flaw. ‘Okay,’ he said eventually. ‘We’ll make an evening of it.’

  Julia was never really sure of Quentin’s intentions. She knew that Dan had taken an almost instant dislike to him, but she had never been able to pinpoint the source of her boyfriend’s unease. Was it simply because he didn’t appreciate Quentin and his film crew disrupting life at The Practice, or could Dan see something that Julia herself had missed? Sometimes, when she caught a lascivious glance at her thighs or a lingering kiss on her cheek, she wondered what exactly Quentin’s real agenda was. Certainly right now, the notion of an evening out was not something that seemed terribly advisable, given how incredibly attractive he was and how vulnerable she had been feeling of late.

  By way of distraction, she clicked on the appointment screen and, without prompting, turned to do a piece to camera.

  ‘So, Mrs Jennings will be here in a moment and she is actually one of our Frequent Fliers,’ she smiled charmingly as the little red camera light blinked, having been told by a focus group that they loved it when she was a little humorous. ‘She has a condition called Trigeminal Neuralgia, which presents as extreme facial pain and it’s been getting gradually worse over the last few months.’

  Quentin’s slightly pompous voice interrupted her, clearly annoyed by her taking the initiative, ‘And will she be getting a referral to a Neurologist, or is she stuck on yet another lengthy waiting list?’

  The original idea of the voice off-screen had been for Quentin to guide Julia’s pieces, but when he was rattled he would also take the opportunity to pose those questions that he claimed the viewers at home would be dying to ask. Julia felt that it was often a case of being contentious for the sake of it, but was rarely in a position to deflect his line of questioning, for when sh
e did, he simply called ‘cut’ and started over.

  Julia paused for a moment, marshalling her thoughts. ‘Mrs Jennings has already been reviewed at the hospital and her scans have all come back NAD. That’s the acronym we use for No Abnormality Detected. So really at this point, it’s a case of working together with her consultant to manage the pain as best we can.’

  ‘So there’s nothing to see? And there’s no way of knowing what triggers the pain?’ Quentin asked, his voice now laden with faux-concern for this woman he had never met.

  ‘I’m afraid at this point, we’ll probably call it Idiopathic Neuropathy, but that doesn’t mean that we can’t make Mrs Jennings more comfortable with a combination of pain relief and other medication.’ She didn’t go on to explain that in medical terms, the use of the word idiopathic was roughly the same as throwing up your hands and saying ‘fuck knows!’.

  Luckily, Quentin didn’t pursue it, but his alternative agenda soon had Julia on her toes. ‘And aren’t you worried that in fact there is no facial pain and that, what was she called? – Mrs Jennings, that’s right – might actually be exhibiting drug-seeking behaviour?’

  This was nothing short of sensationalising and Julia struggled to keep her face in neutral whilst swallowing the urge to strangle him. Pain was such a slippery beast to deal with: everyone’s opinion subjective and often with nothing visual to go on. It could be devastating for her patients and frustrating for her, as their doctor, to try and find them some level of comfort. Ignorant comments like that didn’t exactly help.

  As the purported drug-seeker inched her way into Julia’s consulting room, hunched over a walking stick and looking every one of her eighty-seven years, Julia was pleased to see that Quentin at least had the decency to blush – perhaps not quite the stereotype he had in mind.

  Julia took great pleasure in standing up to help Mrs Jennings into her seat, trying not to be irritated by the look of surprise on the old lady’s face. She’d surprised herself recently too. It seemed that half her patients came into The Practice with the simple requirement of a willing ear and a sensible, calming opinion. All these years, she’d felt as though they had come to her demanding miracles she could rarely produce. It had been a highly unsatisfactory arrangement, whereby both parties had gone away disappointed. And all she’d had to do to change gear professionally was to put herself in Holly’s (slightly dated, rather unfashionable) shoes.

  If only it was so easy from a personal perspective, too.

  After Mrs Jennings had departed, she could only feel grateful that Quentin had chosen that moment to step outside too, as her mobile phone began to trill. She noted the three missed calls earlier, all from the same number and tried not to let her agitation show. There were no voicemails – all part of the control game that her mother liked to play – ‘if you want to know what I called for, you’ll have to call me back, or perhaps you’d like to sit on the worry that it was something important?’ Of course, it never was, and Julia’s mum had become adept at manipulating her daughter into making contact at all hours, against all her better judgement and despite her jam-packed schedule.

  She answered the phone with the sick feeling of dread that appeared to have become her default setting whenever her mother’s caller ID flashed up on the screen. ‘Hi, Mum,’ she said, forcing a certain lightness into her voice. ‘It’s not the best time actually, can I call you back?’ She glanced out into the corridor where Quentin and the team were packing up for lunch and quietly pushed the door shut with her foot. The last thing she needed was him nosing around her family situation.

  Her mother’s sigh echoed down the airwaves. ‘Well, that’s a lovely way to start a phone call. I should be grateful you answered at all, I suppose. If you’re so busy.’ She imbued the word with as much doubt and disappointment as she could muster.

  Julia determinedly refused to rise. ‘Well, I’ve a waiting room full of patients and the TV crew are here too, so why don’t we chat this evening when we’ve got more time.’

  ‘And you can start the conversation with “I haven’t got long” like you always do?’ said her mother astutely.

  Julia felt the beginnings of the prickling heat on her neck, the one that warned that her tenuous grip on her patented ‘cool, calm and collected mode’ was in danger of letting go altogether.

  ‘I’ll make myself a cup of tea and we can chat for as long as you need,’ she said instead, squashing the voice in her head that angrily pointed out that she hardly had time for the bloody cup of tea, let alone seven verses of life’s-so-unfair and your-father-doesn’t-listen. Credit to Julia’s dad though, he seemed to have done nothing but listen for the last forty years – the opportunities for getting a word in edgewise around Candace in full flow were few and far between. But nevertheless, as an only child, Julia felt a cloak of obligation on her slight shoulders. There was certainly no point suggesting that Candace chat to her friends about her marriage – she’d managed to alienate almost every single one of them with her drunken bouts of ‘honesty’ over the years.

  ‘Hmmmm,’ said her mother, sounding suspiciously like Marge Simpson. ‘Well, make sure you do.’ She paused. ‘There are things we need to discuss.’

  Had the way her mother stressed the word ‘things’ carried an ominous ring to it, Julia wondered yet again, as the conversation still niggled at the back of her mind hours later. She tried to block out the raised voices from along the corridor – let someone else deal with it, she thought, she had enough on her mind – and forced herself to concentrate on the referral letter she was dictating.

  Dan pushed the door open abruptly. ‘So you are in here! Can you not hear what’s going on?’

  Snippets of conversation filtered through and Julia shook her head. ‘Seriously? Not this again? Somebody needs to have a word with the nurses.’

  ‘They do,’ agreed Dan. ‘And since it’s your TV programme, it probably should be you.’

  Julia scowled. It sounded as though Quentin had managed to rile the nurses for the umpteenth time, with his constant requests for B-roll footage and now apparently Dan had taken umbrage on their behalf.

  ‘Look, Julia,’ he said firmly, ‘you need to understand that they just don’t like it. It’s one thing to constantly interrupt their work and do tactless voice-over commentary whilst he’s filming them, but Jade in particular is getting very annoyed that he keeps referring to them as B-roll,’ he said.

  Julia shrugged helplessly. ‘But that’s what it’s called. It’s the little bits of film that fill in the gaps – it doesn’t make her B-list if that’s what she’s worrying about.’

  Dan stepped forward and held out his hand for her to take, almost giving her no option but to stand up and deal with the problem. ‘I’m only telling you, because you need to be aware – Quentin’s stepping on an awful lot of toes.’

  She nodded, knowing full well that Dan’s toes were firmly among them. ‘I’ll talk to him again,’ she said tiredly, a small part of her resentful at being repeatedly put on the spot to justify Quentin’s behaviour. For all his drive and charisma – and neither were in short supply – he did manage to ruffle an awful lot of feathers. The nurses, the admin team, Holly Graham – none of them succumbed to his charm in the way that he was used to and it only served to make Quentin ratchet everything up a gear. It didn’t matter how many times Julia tried to tell him that life in the countryside was very much a ‘less is more’ proposition. His own insecurities meant that he just pushed harder.

  She walked through to the doctors’ lounge, where Jade was standing with her hands on her hips, in full-on confrontation with Quentin. ‘You could try saying please occasionally, before you barge in on one of my clinics,’ she shouted, her eyes flashing in anger and her low-cut uniform barely coping. ‘And stop staring at my boobs every chance you get.’

  Jason may have been leaning against the table in a more casual stance but his words carried just as much fury, ‘And don’t think we didn’t hear that line about “wannabe doc
tors” in last week’s show. We don’t have to put up with this, and if you keep throwing your weight around, then you’ll have a chance to see how much we “wannabes” actually do around here!’ Jason belatedly noticed Julia’s arrival. ‘Sorry, Jules, but this arsehole just needs to know his place.’

  ‘I think we can probably have this conversation without the profanities,’ Julia said awkwardly, as Jason, Jade and Quentin all glared at her, each expecting her to take their side – there was no winning solution to being the jam in this sandwich. It was one thing to mediate between her parents, quite another to attempt it at work as well; she felt as though she were being pulled every which way, with no respite.

  ‘Look, guys,’ she said to Jason and Jade, ‘we can work this out, if you can give me and Quentin a few days to look at the filming schedules—’

  ‘I’m not changing my schedules to fit around them,’ protested Quentin. ‘They’re only nurses. The programme is Doctor In The House, in case you’d forgotten.’

  Julia gaped at him, his ignorance and lack of diplomacy only showing how little he really understood about the dynamics of The Practice. ‘Only nurses?’ she queried, her voice taut. ‘Only nurses? Quentin, you are way out of line. The support staff here are the backbone that holds the rest together!’

  ‘Actually,’ interrupted Jason, the self-nominated spokesperson apparently, ‘the film crew have upset Maggie, too. That’s what started all this.’

  Julia looked around to where Maggie was cowering in the corner of the room, unhappy at being made the focal point of the dispute. ‘I only wanted them to be a bit more considerate about the amount of dirt and mud they were dragging in, with all their kit bags.’