The London Doctor

by Joanna Neil

  ‘That’s all true, but his pain level is getting worse despite the medication he’s on, and I’m wondering if it’s possible that he has a liver abscess.’

  Adam looked sceptical. ‘An abscess would be a relatively rare diagnosis.’

  ‘Yes, I know.’ She had been doubtful about putting forward the suggestion, but she had come this far and it would be an admission of defeat if she turned back now. She pulled in a quick breath and forged ahead, saying, ‘Given the nature of the pain and the fact that there are signs of biliary disease, I want to at least rule it out. There could have been an obstruction that’s caused infection to flare up, resulting in an abscess. I’d hate to leave it alone and then find that it has erupted and caused septicaemia.’

  He studied her for a moment. ‘Then you should do a CT scan.’

  ‘Yes, that’s what I planned to do.’

  He nodded, and then moved away without commenting any further, and Hannah hesitated for a moment before going back to her patient. She hadn’t seen Adam around the department for a day or two, and she guessed he must have been off duty.

  Now that he was here, though, his manner towards her was coolly professional, nothing more, and that worried her. Was he still annoyed with her for the way she had turned on him the other day? She needed to put things right between them. It had been wrong of her to condemn him for his apparent dismissal of Ryan and his problems. He was at least entitled to express his opinion without having to fend off an attack from her about his way of life.

  When she brought her patient back from having the CT scan, Adam was by the reception desk, going through the patients’ charts, but he wasn’t alone. His older brother, Taylor, was there with him, along with a young woman who appeared to be heavily pregnant. She guessed that she was his brother’s wife.

  Hannah acknowledged them with a nod, and wheeled her patient back into the treatment room. ‘I’m going to leave you in the care of our nurse for a few minutes,’ she told him, ‘while I go and have a word with the registrar. I’ll try not to be too long. I know that you’re very uncomfortable.’

  Her step faltered as she approached Adam and his brother. She had not seen much of Taylor when she had lived with her adoptive mother. He had often been away on business, but she guessed that he must at last be getting ready to put down roots now that they had a baby on the way.

  Taylor was talking about the garden at his new property. ‘We want to landscape it so that there’s a child-friendly play area established by the time the baby is beginning to toddle around.’ He laughed. ‘Marianne has been busy buying every plant that catches her eye, but I keep telling her that we have to work out what’s going where, depending on the soil type and whether a particular area gets the sun or whether it’s in shade.’

  Marianne shook her head. ‘You have such a neat, tidy mind, don’t you? I just know whether I like something or not, and I tell myself I’ll decide where it’s going to go when I get it home.’ She smiled at him. ‘Anyway, a lot of the plants were going cheap after the Chelsea Flower show, and I couldn’t resist a bargain or two.’

  ‘Or three, or four,’ Taylor added, his mouth making a wry twist. He caught sight of Hannah and said, ‘I know you, don’t I? You’re the girl from the house on Calder Close, aren’t you? Hannah, isn’t it?’ He frowned, trying to recall the memories. ‘You used to come up to the estate sometimes.’

  ‘I’m surprised that you remember me,’ she said awkwardly. ‘You weren’t home very much, as I recall.’

  ‘That’s true, but I have a notion that I’ve seen you more than a few times over the years.’ He introduced her to his wife, and said, ‘We were just talking about getting the garden ready at our new house. Do you have a garden here in London, Hannah?’

  She shook her head. ‘I’m afraid I can’t even manage a window-box in my tiny flat.’ Her expression was wistful for a moment or two. ‘I loved the garden back home, though. I miss it.’

  Taylor nodded. ‘Now I remember how it was…you were the quiet, shy one, weren’t you? You loved being on the estate because it was so big and open, and you loved the fields and the stream. The last place you wanted to be was in the town or the city, with all the noise and the traffic. I remember you once said that you had travelled to London with your mother when you were a small child, and you didn’t like it very much.’

  He looked at her quizzically, in a way that reminded her very much of Adam’s way of watching her. ‘Do you still feel the same way, or are you planning to stay on in London? I’m assuming your post here is a temporary one, of course.’

  ‘That’s right, it is. I can’t see myself staying on,’ she admitted. ‘I still prefer to live near the countryside. I thought I might try for a general practitioner position in a rural community, once I’ve completed my training.’

  Adam’s eyes narrowed on her, and he cut in, saying, ‘Did you want something, Hannah? Is there a problem?’

  ‘No problem,’ she murmured, ‘but I wondered if you would take a look at the CT film of Mr Nichols in treatment room three. I need a second opinion so that I know whether I should go ahead with the treatment.’

  ‘Let’s go and have a look.’ He excused himself to his brother and Marianne, and went with her to look at the films.

  ‘It certainly looks like an abscess,’ he said a moment or two later. ‘Have you had the rest of the results back from the lab yet?’

  She nodded. ‘The blood cultures were positive.’

  ‘Hmm…then you should drain the abscess under ultrasound scanning and send a sample to the lab. The procedure should do something to relieve the pain, anyway. When you have the results, you might need to add another antibiotic to the metronidazole and ampicillin.’

  ‘I’ll go and prepare the patient for treatment now.’ She paused, and as he would have turned to go back to his brother, she said quickly, ‘I’ve been meaning to have a word with you all day. I wanted to say that I’m sorry for the way I let off steam the other day. I shouldn’t have gone on at you the way I did, especially after you took the trouble to come and help me out with the shower.’

  ‘You don’t have to apologise. You said what you thought, and that’s fine.’

  ‘No, it isn’t.’ She moistened her lower lip with her tongue. ‘I was out of order.’

  ‘Go and treat your patient, Hannah. He needs your attention.’

  She was crushed by his response. He wasn’t going to let her put things right, was he? And now she felt worse than ever.

  He was suddenly thoughtful. ‘Have you aspirated a liver abscess before?’ he asked.

  She shook her head.

  ‘Then I’ll come and supervise.’

  ‘Are you sure? What about your brother and his wife? You’re on a break, aren’t you?’

  ‘I’ll catch up with them later. They’re going to be in the area for a few days. Just give me a minute to have a word with them. In the meantime, you could start getting your patient ready for the procedure.’

  ‘I’ll do that.’ She didn’t know what had prompted his decision. After all, she could have asked Colin to supervise, but perhaps Adam wanted to see for himself that all was being done correctly.

  It was some time later when she was satisfied that she had done all she could for her patient. Adam had taken her through the process step by step, making sure that she accessed the abscess at the right angle and ensuring that all went smoothly.

  ‘You did well to pick up on that diagnosis,’ he said, when she had finished and was ready to move on.

  She glanced at him. ‘Thanks. I thought you were doubtful about it earlier on.’

  ‘I was, but you argued your point, and it just goes to show that you’re beginning to have more confidence in yourself. You carried through on your instinct, despite opposition, and that can only be good.’

  ‘Maybe.’

  ‘Definitely.’ He made a fleeting smile. ‘I think there’s still one other difficulty you have that we ought to address, though.’

  He
r eyes widened a fraction. ‘Really? What’s that?’

  ‘Your negative attitude towards the city. We need general practitioners here in the city just as much as we need them in rural areas, you know. Besides, if you find that your natural mother is living here, you might feel that you need to adjust your plans. I really think you need to get around and see the sights. You haven’t given the city a proper chance.’

  ‘I went on the river the other day,’ she pointed out.

  ‘That’s not enough, by a long way. You should see the rest of the city, the green areas, the parks, the places where you can relax and simply enjoy nature. It might give you a different perspective on city life.’

  ‘Perhaps I will, one day, when I have the time.’

  He raised a dark brow. ‘What’s that supposed to mean?’

  ‘It means that the only time I have to do any exploring is on my days off, and that’s when I catch up on my chores, usually. Quite apart from the fact that I’m looking after Ellie these days, and a lot of time is spent taking her to see her mother in hospital.’

  ‘Hmm…I can see that would be a problem. Then we’ll just have to make a start today.’ He sent her an oblique glance. ‘You haven’t had your lunch break yet, have you?’

  She shook her head. ‘Not yet.’ She forestalled him. ‘I have plans for my break. This afternoon is one of my study-break periods and I need to catch up on some of my paperwork.’

  ‘That’s even better,’ he said with marked satisfaction. ‘My shift finishes in a while, and I’m not on call until later in the afternoon, so we can both forget the paperwork for a time. Instead you can spend an hour or so in the city with me, studying the opportunities that are available for GPs who choose to work here.’

  ‘Adam, I can’t do that. You don’t understand…I’ve a mountain of work to wade through…’

  ‘I doubt that. You’ve always been an organised, conscientious woman, and you don’t allow yourself to become so swamped with work that you’re overwhelmed.’

  She opened her mouth to say something, but floundered, like a fish out of water. How was it that he knew her so well? She frowned, sending him a bewildered, blue gaze.

  ‘Today, the paperwork gets pushed to one side. We’ll go out and get a leisurely lunch, somewhere where we can enjoy looking out onto a pleasant, open scene. Perhaps we’ll take a walk in one of the parks.’ Just in case she came up with any argument to the contrary, he added, ‘You’re coming with me, and that’s final.’ He sent her a sideways look. ‘Anyway, you owe me…for the shower.’

  ‘That was a low blow.’ Her lips pursed.

  ‘Yes, it was, wasn’t it?’ He looked pleased with himself and laughed. ‘I’ll meet up with you in half an hour.’

  She thought about backing out at the last minute, but as she stood by the exit doors just a little later, she looked around her and saw that the sun was shining. It was inviting and she relaxed for a moment or two, pausing to drink in its warmth and let it bathe her in its golden glow.

  Adam caught up with her. ‘Hyde Park is probably the nearest,’ he said, ‘so perhaps we should head over there. His hand lightly rested on her elbow as he urged her towards the main thoroughfare and away from the hospital. ‘You weren’t thinking of skipping out on me, were you, by any chance?’

  ‘Would I do that?’ she asked, and was treated to a dubious stare. All at once, though, she was glad of the chance to spend some time with him, away from the hospital, away from the worries of looking after Ellie and all the demands that were being made of her. As he’d said, she owed him for the shower and perhaps this would make up for her ill-timed words afterwards.

  They walked through tree-lined squares until they reached the Bayswater Road and then they turned onto the leafy North Carriage Drive. ‘We’ll head towards the Serpentine,’ he said. ‘We can eat at a restaurant overlooking the lake and watch the people out on the boats. It’s warm enough for us to sit and have our meal outside if we can get a table.’

  He led the way to the restaurant where they found a place to sit on a large terrace overlooking a garden area, and Hannah gazed around her, taking in the gentle chatter of people feeding ducks on the lake and the shouts of children running across the grass. For the first time in days, she gradually began to relax.

  Their food was brought to their table, an appetising mix of meats and salad and sun-dried tomatoes. There was a dish of pasta, drizzled with a colourful, mouthwatering sauce, and a chilled wine to wash it all down.

  ‘Feeling better?’ Adam asked, as she laid down her fork and glanced around.

  ‘Much better, thanks,’ she murmured. She glanced up at him. ‘How did you know? I haven’t said that anything was wrong.’

  ‘You didn’t have to. I know you well enough to know that you’ve been feeling uptight these last few weeks. I thought perhaps it was because you were trying to adjust to life in the city, but I know there must be other things that are piling on the pressure…like worrying about Abby, not being able to find your mother, wondering what’s going on with Ryan.’

  ‘I hadn’t realised that you’d even given it a thought,’ Hannah said quietly. She took a sip of her wine, feeling its coolness slide down her throat and allay the heat of the day. The sky was a beautiful eggshell blue, and there was barely a cloud in sight. ‘Of course, you didn’t mention the difficulties of getting to grips with work in A and E.’

  ‘I took that as read. After seeing your reaction to the flight in the air ambulance, I guessed the worst was nearly over. I thought after that you’d be able to handle just about anything.’

  He chuckled, and speared a forkful of pasta, twisting it gently in the succulent vegetable sauce.

  ‘I suppose I am a little more confident in what I do. It’s been good, having you help me out and point me in the right direction, though you have been a bit exacting at times.’

  He lifted a dark brow. ‘You must have me confused with someone else.’

  She shook her head. ‘You thrive on all this, don’t you…the city life, the adrenaline punch of emergency work?’

  ‘It’s never going to be an easy job, I accept that, but, yes, I’m comfortable with what I do, and I like living in London.’

  The waitress came and cleared away their plates, and he gave her their order for dessert.

  After she had gone, he said, ‘When I was a young boy, my father used to bring me with him sometimes when he had to come to London on business, and I feel the same way about it as he does. The city can be an exciting place, full of opportunity. I don’t really miss my country roots as you do. I was happy living on the estate back home, but I enjoy being in the city.’

  ‘And this is where you plan to go on working as a consultant, isn’t it? I heard that Mr Tremayne was leaving.’

  She leaned back in her seat as the waitress brought their dessert, a confection of fresh fruit and ice cream laid out on a bed of melt-in-the-mouth pastry.

  ‘It’s a wonderful opportunity for me, to be offered promotion. It’s been a good experience, working in a large teaching hospital, and a job as consultant would be the icing on the cake. It could be a stepping stone to even greater things…a lecture consultancy perhaps, in years to come.’

  ‘I can see you doing that.’ Even now, he was thinking ahead, ambitious for what was still out there.

  She slid a spoon into her dessert and let the sweet, delicate flavours of the fruit burst on her tongue. It should have been a luscious, stimulating experience, but the taste turned to blandness in her mouth. Why was she forever looking for something more from Adam? He was going to stay here. He wasn’t ever going to be content to go back home to the Chilterns. She had known that, but at the back of her mind, despite all their troubled background, she had wondered…had dared to hope that he might change his plans.

  Ever since she had first known him, she had found him irresistible, and she had never quite managed to quell that unbidden, treacherous tug of desire. Nothing would come of it, though. It wouldn’t do to t
hink that way about him, would it?

  ‘I suppose Ryan will be hoping to find work when his exams are over…is he looking for work in a particular area?’

  ‘He hasn’t said much about it, but I imagine that since he wants to keep his accommodation, he must be thinking of finding something locally. I hope it works out for him. I know he’s been studying hard, despite all the setbacks he’s had lately.’

  If Adam thought that the setbacks were of Ryan’s own making, at least he kept quiet about it. He said, ‘Does he ever see his parents these days? I know he used to keep in touch with them from time to time.’

  ‘I think he does. They were very young when they got together, and I don’t think they were mature enough to cope with bringing up a child. Then there were problems with drugs and alcohol, and Ryan was eventually taken into care. Over the years, his mother has made an effort to get back on her feet, and Ryan goes to visit her from time to time. I think, like me, he needed to come to terms with his past.’

  ‘Have you made any headway doing that? You said you had posted something on the internet. Have you had any luck so far?’

  ‘Nothing, as yet. Someone contacted me to say that they used to live near my grandmother, but after she died the house was sold to pay off debts. Apparently, my mother only lived there for a short time. She moved on, and there was no forwarding address.’

  ‘I’m sorry. That must have been hard for you.’

  She pressed her lips together. ‘I’m getting used to it. I tend not to get my hopes up now. I know that these leads might not go anywhere, but my foster-mother said that my mother came to London, and that was when she lost touch with her. We relied on the adoption agency to keep the details up to date, but either they lost her address or my mother moved house and didn’t update them.’

  ‘Has it occurred to you that she might not want you to contact her?’

  ‘Yes, I’ve thought of that…but she had always tried to keep in touch before then, even though the contact was a bit hit and miss because she was unwell. I know my father didn’t have much that was good to say about her, but I have to cling to some kind of hope.’