by Anne Fraser
She had been an exceptionally driven medical student and junior doctor. When she hadn’t been working the long hours demanded by her training, she had been studying hard for her exams. And that had left little time for her and Charlie. In the early years of their marriage he had often tried to arrange outings for them both: nights out to the theatre and restaurants—walking trips in the Scottish hills. Things that had initially drawn them together. But increasingly she had declined to go with him, pleading the pressures of work and study. And so eventually he had gone by himself and she guessed that that had been how he had eventually met and fallen in love with Catherine. And she had never even suspected. What was she? A trusting fool? Or too wrapped up in her own career? One thing was for sure, however, she may be attracted to Cameron and getting over Charlie, but that didn’t mean she was ready for a relationship. She smiled to herself. Wasn’t she getting a bit ahead of herself? There was nothing to indicate that Cameron wanted anything more from her than a professional relationship. Besides, he looked like a man who liked playing the field. And then there was Rachel. There was still something between them, that much was obvious.
She was still chewing over the problem when she arrived at the surgery. She was looking forward to getting started and hoped it would be a full day, the busier the better. Working hard left less time for brooding.
She found that most of the staff had arrived ahead of her. Cameron, dressed in a dark grey suit with a striped tie, welcomed her formally. If possible, he looked even more good-looking and her heart gave a traitorous flip.
‘I thought we’d start with a tour before morning surgery starts,’ he said. ‘You have a small number of patients to see. I thought we’d ease you in gently.’ He gave her a crooked smile.
Meagan had already seen the waiting area and the meeting room but Cameron showed her around the clinical areas. Apart from three examination rooms there was a separate treatment room for minor procedures.
‘We do all our own minor surgery here,’ Cameron explained. ‘As Colin said, anything complicated we either send to Stornoway or, if more serious, to Glasgow. There is an air ambulance for emergency transfers, but occasionally we have no choice but to operate at the small local hospital. It’s equipped for most emergencies. How are your surgical skills anyway?’
‘Fortunately or unfortunately, depending on which way you look at it, that was one area where I got a lot of experience while I was working abroad,’ Meagan replied with a smile.
‘I must impress on you, Meagan, that you should always seek to use the expert facilities whenever possible. If you have any doubt, please call me for advice. We do not want you thinking you are back in the field and able to perform inappropriate procedures on our patients.’
Stung by his remarks, Meagan felt her smile freeze and her temper rise. Where was the easygoing man from yesterday? It seemed he was keen to ensure that she knew that now they were working together, he was the boss.
‘I can assure you, Cameron, I have no intention of carrying out procedures for which I am neither as equipped nor as qualified as others close to hand. I was simply trying to reassure you that I can cope, if need be, in an emergency situation,’ she replied, her voice clipped with the effort of keeping it under control.
She couldn’t make head or tail of this man. One minute he was friendly, the next he was treating her as if she was a belligerent medical student.
‘Good,’ Cameron replied brusquely. ‘Just as long as you realise that top marks in examinations and a couple of years’ experience in a third-world situation is not enough to make a competent GP. Hands-on experience in the field of general practice is what counts.’
‘What exactly is bothering you about me being here?’ Meagan asked with an exasperated lift of her eyebrow. ‘The fact that I did very well in my exams or that I am not very experienced? May I remind you that I have completed several years of medical training and my full general practice rotation, and that neither the General Medical Council nor Dr MacDonald seem to have any reservations regarding my suitability to practise.’
‘I’m sure that you are eminently qualified Meagan.’ Cameron’s voice was soft. ‘Of your academic ability there can be no doubt. I am simply anxious that you don’t overreach yourself. Shall we leave it at that for the time being?’ He smiled his lovely smile which softened his face. ‘Come, I’ll show you the rest of the place. Then we’ll get going.’
As it turned out the day was as busy as Meagan had hoped. She had a large number of patients allocated to her, although she suspected that the more serious or complex cases had been sifted out by Cameron as all the patients were suffering from either minor viral illnesses or simply needed reassurance.
‘You will give me a shout if there is anything you’re not sure of?’ he had said at the start of the clinic. Meagan had bitten her tongue and had reassured him that she would. She would just have to let time take its course and he would eventually come to trust her medical skills.
After morning surgery, Cameron introduced her to the rest of the team. There was Sophie, a woman near retiring age, who was the practice nurse, and the health visitor, Dorothy, a kindly-looking woman in her early thirties. Both women welcomed Meagan warmly and she looked forward to working with them. Apart from the nursing staff there was a receptionist called Mary, who looked as if she had worked there for ever. Meagan suspected she ruled the place with a rod of iron.
They all had lunch together in the small staffroom at the back of the surgery. Dorothy told Meagan that they tried to have lunch together whenever possible. Dr MacDonald and Dr Stuart liked knowing that everyone was up to date with what was happening to their patients. Eventually the conversation turned to Meagan’s visit to Grimsay House.
‘So you met young Effie and her mum Jessie, then? And did you meet the glamorous Rachel?’ said Dorothy with a pointed glance at Cameron, which he studiously ignored. ‘Is everything OK with Effie? Would you like me to pop in and see them this afternoon?’
As well as being responsible, along with the medical staff, for the antenatal care of women on the island, Dorothy also had responsibility for the under fives as well as the elderly. Cameron had told her that small rural practices could rarely afford to employ more than one health visitor so, unlike their counterparts in the cities who tended to specialise in only one of these areas, health visitors like Dorothy had to combine the three roles.
‘That’s OK, but thanks anyway, Dorothy,’ said Meagan with a warm smile. ‘I’d prefer to go myself, as I promised Jessie that I would call. I’ll go after I finish visits with you, Cameron, if that suits you?’
Cameron nodded.
Dorothy looked a little relieved. ‘I’ve got a few other calls I want to make so one less would help. Actually, I got a call just before lunch from Katie White. She’s feeling a little anxious, Cameron. Thinks the baby hasn’t being moving as much as he has been. I said I would go and see her after lunch.’
Cameron looked thoughtful. ‘How many weeks pregnant is she?’ he asked Dorothy, holding his hand out for the notes that Dorothy held in her lap.
‘Thirty-six. Just. She’s due to be admitted to Stornoway in two weeks.’
Meagan looked enquiringly at Cameron.
‘Katie White is 33 and pregnant with her first child. Like almost all the mothers here, she’ll be sent either to Lewis or to Glasgow a couple of weeks in advance of delivery. Even earlier if it looks like there might be a problem. Obviously it’s not ideal, especially for women like Katie whose husband is a commercial diver and can’t afford to take time off work to stay with her in Stornoway, but it is believed to be safer for mother and child. We try to keep them at home as long as we safely can. Katie has had a normal pregnancy to date and I’m not anticipating any problems. It’s good that you’re going to see her, Dorothy. Meagan and I will be on visits ourselves but you can reach us on my mobile if you have any concerns. Speaking of which, we should be on our way. C’mon, Meagan. We’ll take my car. I’ll just get my bag and
the notes.’
As they headed off towards their first visit, Meagan bit her lip, trying to find the right words. She needed to ask him about Rachel.
Taking a breath to steady her voice, she turned to him. ‘Cameron, that night—back then—were you married?’
He kept on driving, concentrating on the road. A muscle twitched in his cheek.
‘No,’ he said. ‘I’m not the sort of man who would be with another woman if I was married. No matter how strong the temptation.’ He slid a look in Meagan’s direction and she was annoyed to find herself blushing.
‘But,’ he said, ‘I had been seeing Rachel before I met you. We had broken up a couple of weeks before. And then, the day I returned to London, she came to see me. She was pregnant and there was no doubt the child was mine. I thought…’ He broke off, shaking his head. ‘It doesn’t matter now what I thought. We got married. We had a son, and now we are divorced.’ His tone was clipped. A spasm of pain crossed his features.
Meagan wanted to know more, but something in his expression warned her not to probe. His marriage and subsequent divorce clearly caused him pain. No doubt he was still in love with his ex-wife. How could he not be? She was so beautiful. She decided to let the matter drop. Let the past stay there. She and Cameron were different people now, work colleagues and perhaps in the future friends. That was all she wanted. Wasn’t it?
The first patient lived fairly close to the surgery. He was an elderly man suffering from shortness of breath. No doubt he could have managed to come to the surgery, albeit with difficulty. He and his wife apologised for the trouble they were putting the doctors to. And not just one but two! They shook their heads in amazement. Cameron was quick to reassure them.
‘It’s no trouble. That’s what we’re here for. There’s two of us as it’s Dr Galbraith’s first day and I wanted to show her where everyone lives. You know it’s not easy to find some of the houses here. And as for us coming to see you, I’ll not have you coming to see us on a wet and miserable day such as this. Particularly when you’re feeling low. And especially when I know that there’s every chance of tea and home baking,’ he said casting a hopeful eye at Mr Morrison’s wife.
‘As if we’d let you leave this house without your strupack,’ Mrs Morrison admonished, wagging a gnarled finger. ‘I’ll just get it ready while you’re seeing to John.’
As she bustled out of the bedroom Cameron explained the patient’s history.
‘Mr Morrison here is 75 years old. He was fit and well up until a couple of days ago when he developed shortness of breath.’ He stood back to allow Meagan to examine the older man who was sitting up in bed, looking drawn and flushed.
‘There’s nothing wrong with me,’ he protested a little grumpily. ‘It’s that wife of mine. She just fusses. I’ve got work to do, but she won’t let me out of bed long enough to see to it.’
Meagan caught Cameron’s eye and smiled briefly.
‘We’ll just give you a quick look-over, if that’s all right? Better to be safe than sorry, eh?’
She listened to his chest and examined his ankles for swelling. Then she took his temperature, which was elevated.
‘It looks like a chest infection, Mr Morrison. It’s not serious, but I’m surprised you’re even considering getting out of bed and going out on the croft. You must be feeling pretty lousy.’
‘I suppose I’m not feeling that great, but someone has to see to the animals. Anyway, a bit of flu never killed anyone.’
‘I’m afraid a chest infection at your age can turn nasty,’ Meagan said gently. ‘I do think you need to take it easy for a while, take plenty of fluids, and I’ll prescribe you some antibiotics. If you follow my advice we should have you back to your usual self in no time.’
‘If it’s the animals you’re worried about I can ask Donald from the estate to check them for you,’ Cameron interjected.
Mr Morrison looked at Meagan then at Cameron.
‘I can see that you two have ganged up on me. All right, then,’ he conceded. ‘If you can ask Donald to check the animals in the top field, I’ll do as you say.’
Meagan had some cause to regret that she had bothered with lunch when, after leaving John tucked up in bed, Mrs Morrison ushered them into the sitting room and handed them a plate full of food. There were tiny sandwiches, scones stuffed with cheese and home-made shortbread piled in heaps on the plates. And it was clear that they were expected to eat every bite from the way Mrs Morrison sat herself down in front of them with her arms folded and a satisfied expression on her face.
‘Are you not having any yourself?’ said Meagan hopefully, holding her plate out to Mrs Morrison.
‘Oh, I’m not long after having my lunch,’ replied the old lady, rubbing her ample frame. ‘And, besides, I have to watch my figure—unlike some,’ she added, eyeing Meagan’s slim frame disapprovingly. ‘We’ll need to get some fat on these bones, won’t we, Dr Cameron?’
‘Well, you know what young women are like these days, May,’ Cameron replied.
Dismayed at the turn the conversation was taking, Meagan was about to make a sharp rejoinder when she noticed that Cameron was having difficulty containing his mirth at her discomfort and, sure enough, when at last, stuffed to the gills, they were able to leave and get on their way to see the next patient, he burst out laughing.
When at last he could eventually speak he said to Meagan, ‘I should have warned you about the patients here before you had lunch, but I’m afraid I just couldn’t help myself. The same thing happened to me when I first started doing visits, and I knew to refuse hospitality is considered extremely rude, especially by the elderly patients. So I’m afraid it doesn’t matter how full you are, you just have to do your best to get it down.’
‘I can hardly move,’ groaned Meagan
‘Well, now you know,’ he said, ‘Be careful in future who you visit and when. But as a rule we visit all our elderly sick patients even without a callout. We feel it’s an important part of the service here.’ He went on, ‘And it has practical advantages too. It means that we can keep an eye on things and often prevent minor ailments turning into something more serious. I just hope you don’t find it all a little boring for you,’ he teased.
‘I really like the way you look after the patients here,’ Meagan assured him. ‘Even going as far as sorting his worries about the croft out for him. Where would you see that in an urban practice?’ She smiled at Cameron. ‘I know GPs in busy inner-city practices who hardly ever get to see the same patient twice. I much prefer to get to know my patients. What makes them tick, what worries them. It’s one of the reasons I wanted to work in a rural practice.’
‘On the downside, it means that we get very involved with them,’ Cameron said. ‘Sometimes it’s harder when you know them, but on the whole it’s what I like best about living and working here. I’ve known most of these people all my life.’
They made two other house calls—one to an elderly man with pulmonary oedema and the other to a child with chickenpox. Although both cases were straightforward, Cameron was impressed with the thoroughness with which Meagan examined her patients. She had listened carefully and sympathetically as they outlined her symptoms and she had a relaxed and friendly manner, which put the patients immediately at their ease. It was clear to Cameron that she was going to prove a popular member of the team and he felt himself beginning to relax.
Having diplomatically escaped the offer of refeshments from the harassed young mother, Meagan asked, ‘Who is next on our list?’
‘Robert McLean. He lives close to the Benbecula side. He’s our furthest-away call. The last two we’ll see on the way back to the surgery.’ Suddenly he slowed the car down to a crawl.
‘Hello, what’s this? Dorothy’s car is still at Katie White’s house. I would have expected her to have been on her way by now.’ A small frown creased his brow. ‘Let’s just pop in while we are passing.’
As he swung the car into the driveway a very anxious-looking D
orothy came out of the house.
‘Thank goodness you’re here. I tried your mobile a couple of times but you must have been in a dead spot as I couldn’t get a response.’
‘What is it, Dorothy? What’s wrong?’
‘I thought I’d listen to the foetal heart to reassure Katie, but her instincts seem right. The baby’s heartbeat is very slow. Around 50. I’ve also done a brief examination and there’s worse. Her waters have broken and I can see the cord. I’m afraid we are dealing with a cord prolapse and a very distressed baby.’
Meagan felt a flutter of anxiety. She knew from her obstetric experience that this was bad news for mother and baby. Particularly as they were so far away from a hospital with the specialist obstetric and paediatric facilities such a situation required. Despite Cameron having qualified as a paediatrician, the baby, if it survived, would need admission to a high-dependency unit.
‘When I couldn’t reach you, I took the liberty of phoning the air ambulance. They are on standby, awaiting your call,’ Dorothy went on, calmer now that her colleagues had arrived.
Pretty certain that Dorothy would be correct in her diagnosis, Cameron knew they would have to act quickly if the baby was to have any chance of survival. Putting his own anxieties aside at the thought of dealing with a premature distressed baby, he said, ‘It’ll take at least two hours to get mother and baby to Glasgow. We won’t have that long if we are to save the mother. We’ll need to get her delivered. Meagan, have you performed an emergency section before?’
‘Yes, many times. But always in a proper theatre. Are you suggesting we perform one here?’
‘There is a proper theatre in the local hospital which is ten minutes from here. It’s normally reserved for minor procedures but, as I told you this morning, it is fully equipped for emergencies such as this. Dr Lake, one of the Benbecula GPs, is qualified to act as an anaesthetist if we need one.’
