Go Not Gently

by Cath Staincliffe

  He grinned and shook his head. ‘Only for the illness.’

  ‘What do you want me to do?’ I asked him.

  ‘Find out,’ he said. ‘Find out where she’s going, what she’s doing. Watch her, follow her, whatever you have to do.’ He waved his arm as he spoke, pushing the problem my way. ‘Shit, I hate this,’ he said.

  ‘OK. Let me suggest something. First of all try and talk to Tina about it again. Tell her you’re worried, that you don’t want secrets in the marriage, ask her straight out to tell you what’s going on. Now if she won’t or if you’re not happy with what she does tell you then you can come back to me. I charge a hundred pounds a day for surveillance, minimum. I might have to watch the house for several days.’

  He took a sharp breath in.

  ‘Think about it,’ I said. ‘It’s worth bearing in mind you may be paying for bad news. Tina’s keeping something from you, so there’s a danger it’ll be something you’ll find very difficult. I may find she’s having an affair – it could be something like that – but even if it’s completely innocent the fact of you using an investigator to spy on her could break up your marriage anyway.’

  ‘Don’t you think I haven’t thought about all that?’ he protested. ‘But knowing – at least I’d know.’ He rubbed his nose again. ‘If she was cheating on me I’d know where I stood. If it was something else,’ he shrugged, ‘maybe I’d not even tell her but I’d know. Now, it’s like I’m drowning.’ He frowned and looked away. I saw his Adam’s apple bob up and down.

  ‘OK,’ I said. ‘Think it over, try and talk to Tina again, then take it from there.’

  ‘Right, thanks.’

  We stood up. At the door Jimmy turned. ‘About the money – can I pay it in instalments, if it’s a fair bit? You don’t need it all at once?’

  ‘No problem. By the way, if you do want me to do the work I’ll need a photo of Tina.’

  ‘Yeah, right.’

  He’d lit the fag before he hit the pavement.

  I wrote up my notes so they’d make sense another day. Then I rang the number for Dr Goulden. An answerphone told me the surgery was closed, would open again at four o’clock and then gave me an emergency number to ring. That seemed a bit drastic so I hung fire.

  There was a heavy metallic sky and an unnerving pressure that made my eyeballs ache. The storm broke just as the kids emerged from school. Resounding cracks of thunder and great belching rumbles had half the playground in hysterics. The raindrops were the extra large variety that bounced as they hit the pavement. It kept it up for half an hour but even then didn’t have the decency to move on and dry up. Instead drizzle settled in. I closed the curtains and lit the lamps.

  I got through to Dr Goulden’s receptionist who arranged an appointment for the Monday afternoon. I explained we weren’t patients but needed to see the doctor about a member of the family at Homelea. (Not strictly true but I didn’t want to fail at the blood-relatives hurdle.) As it was, the computer couldn’t cope with information outside of its programme, it needed a patient, so in the end the appointment was made in Lily Palmer’s name.

  Dr Chattaway, Agnes’ GP and formerly Lily’s, didn’t have an appointment system. It was turn up and wait. I asked the receptionist when the quietest surgery was.

  ‘Oh, it’s always busy,’ she said, ‘but Monday’s by far the worst.’

  When I rang Agnes she suggested we try Tuesday morning. ‘We’d still have fresh in our minds what Dr Goulden said…and I wouldn’t want to leave it any longer than necessary. So, Tuesday, I think.’

  ‘Fine, I said. ‘When I see you on Monday we’ll fix up a time for the Tuesday morning. And once we’ve seen both doctors we can assess where we’re up to.’

  ‘Whether it’s all a waste of time.’

  ‘No, I didn’t mean…’

  ‘I’m sorry,’ she said, ‘it’s difficult to remain even-tempered sometimes. I do appreciate your help.’

  There wasn’t anything to do on the case until Monday. It was Thursday night. A three-day weekend then, one of the perks of part-time hours. And if I got some of the chores out of the way while the children were at school on the Friday there’d be more time for enjoying ourselves at the weekend proper. We’d go down to the park and gardens at Fletcher Moss. It often flooded in the winter but with wellies on, floods could be fun. I’d take Maddie and Tom swimming too or maybe to the pictures. My budget wouldn’t stretch to visits to the big plush cinemas but I could manage an occasional treat at the local picture house. I’d have to ring Cine City, find out what was on. Plenty to do, and more than enough to occupy my mind and stop me puzzling over Lily Palmer’s condition.

  CHAPTER SIX

  First thing Monday morning Jimmy Achebe rang. I hadn’t even opened the post. He spoke hurriedly. He wanted me to do the job, he’d drop off a photo later that day. I reminded him to include his address, his home phone number and a note of any regular appointments Tina had. There was no point in my trailing her to aqua-fit and back, then billing him for it. Were there any days in particular he wanted me to cover?

  ‘Maybe tomorrow and Wednesday – it’s usually mid-week.’

  ‘And you tried asking Tina about it?’

  ‘Yeah. She wasn’t having any of it. Told me I was imagining things, says she’s not hiding anything. Told me to stop harassing her.’ I heard him blow out in exasperation. ‘Look, about the money. I’ll get what I can today but the rest, well, like I said. .

  ‘Don’t worry, I’ll check back with you each time I’ve done a stint. That way, if it starts mounting up you can ask me to stop. How can I get in touch?’

  ‘I’ll have to ring you,’ he said, ‘but you can leave a message here at work. You’ve got the number, haven’t you?’

  ‘Yeah.’

  ‘Just say you want me to ring. They’ll pass it on. I hate this. I feel like I’m the one doing something wrong.’

  ‘Do you want to think it over a bit longer?’

  ‘No. It’s cracking me up. I just want it sorted.’

  There was a lull in my morning after I’d opened and binned the post. I went swimming. Thirty lengths of the local pool and a reasonably hot shower. I emerged into the blank February weather feeling loose-limbed and smug.

  Back home Ray had left a note on the kitchen table: ‘Harry knows someone looking for room. Sheila. May ring.’

  My heart dipped. In order to make ends meet we needed to let out the attic flat. We rented the house from an ex-lecturer of mine. He’d gone out to do a year in Australia and they kept renewing his contract. We had to cover the mortgage, bills and maintain the place.

  Our first lodgers, Joanne and Christine, had been great but they’d moved on once they’d saved enough for a deposit on a place of their own. Their successor, Clive, was the lodger from hell. Since we’d got him out we’d taken a succession of short-term lets: an actor appearing at the Royal Exchange, a teacher who needed a bolt hole while her damp-proof course was done and a German sociologist who was doing a term at the university. They were all a vast improvement on Clive but each time there was the disruption of getting used to a new face at the breakfast table, of negotiating use of the kitchen, the bath and the fridge. And in between we were short on income. We really needed a permanent person but I was still terrified we might end up with another complete wally. My old friend Harry wouldn’t deliberately send me a plonker but sometimes they could be hard to spot.

  Not long after lunch I collected Agnes and we drove over to Dr Goulden’s surgery. It was part of a large detached house. Brass plaques on the gatepost and front door showed it also housed Jason and Evers, Architects, and Mowbray Insurance Services. The front gardens had been tarmacked over for parking. Dr Goulden used the downstairs rooms. Reception and waiting room to the left, consulting room to the right.

  The receptionist clicked us off on the computer and directed us to the waiting room. Three women were already there. No one spoke to anyone else or made eye contact.

  Agnes lean
t over to whisper to me. ‘When we go in,’ she said, ‘I’ll explain what we want.’

  I agreed. ‘You do the talking.’

  We were another tedious twenty minutes waiting. I leafed through Marie Claire and Vogue. Gradually each of the three women was summoned by the buzzer and the illuminated sign inviting ‘Next patient please’, and disappeared. Then it was our turn.

  Dr Goulden welcomed us with a bright smile.

  ‘Mrs Palmer.’ He shook Agnes by the hand and gestured to the seat at the side of his desk.

  ‘I’m Miss Donlan,’ said Agnes. ‘We’ve come about–’

  ‘I’m sorry,’ he interrupted, the smile replaced by a puzzled look, ‘but I seem to have the wrong notes here.’

  ‘No, they’re right,’ said Agnes, sitting down. ‘We’ve come about Mrs Palmer.’

  ‘Aah.’ He regained his composure and fetched an extra chair over from the far corner of the room for me.

  ‘So,’ he held his hands open to Agnes, ‘how can I help?’

  While she explained the situation and her worries I studied Dr Goulden. He was probably in his early thirties, with a square face, thick blond hair, pale blue eyes, sandy freckles. Tall, big-boned. He was impeccably dressed in blue striped shirt, dark blue suit and tie. He probably had to shop at Long and Tall or whatever that specialist shop is called. He sounded solid middle class, no trace of a regional accent. He listened attentively, his head cocked to one side just so you’d know he was listening attentively.

  When Agnes had finished he said, ‘I’d just like to clarify a few points. You are a friend of Mrs Palmer’s and this is…’ He looked at me.

  ‘A friend of the family,’ said Agnes, ‘Sal, Sally.’

  I winced visibly. People have a habit of softening my name. But I’ve never been a Sally. Sal was a pet name my dad used. My real name’s Sarah but I’ve been Sal as long as I can remember. Sally makes me feel like a six-year-old.

  ‘Mmm,’ Dr Goulden didn’t sound all that keen, ‘Mrs Palmer’s son is actually listed as next of kin.’

  ‘But he’s in Exeter,’ said Agnes. ‘I talked to him on Friday, he’d no objection to me making the appointment. He knows I visit Lily two or three times a week.’ Agnes began to sound defensive.

  ‘I don’t discuss my patients with other people. Confidentiality is paramount. I’m sure you understand. Mrs Palmer is getting the very best care, Homelea has an excellent reputation—’

  ‘We could go to the trouble of arranging for Mr Palmer to travel up from Devon to put these questions to you,’ I said, ‘but it seems rather an extreme measure, a waste of time for everyone concerned. We’ve already spoken to Mrs Knight and I’m not aware that there has been any problem about patient confidentiality. If you could answer some of Miss Donlan’s queries we wouldn’t need to trouble you any further.’

  There was an uncomfortable pause. We sat it out.

  He decided to play ball. ‘Your concern is that Mrs Palmer may be suffering from an acute confusion rather than chronic decline?’

  Agnes nodded.

  Dr Goulden smiled sympathetically. ‘I’m ninety-nine per cent certain that’s not the case but if you’ll bear with me I’ll scan the notes and see if we could have missed anything.’ He leafed through the papers humming tunelessly. ‘Tum-ti-tum-ti-tum-tum-tum’, a gesture intended to show us that all was well, to demonstrate how competent and relaxed he was.

  He patted the papers back into the manila folder. ‘No,’ he said, ‘nothing. I’d have been very surprised if there had been. In the sort of case you’re asking about,’ he explained, ‘we’d look for a certain sort of physical problem, an untreated infection, perhaps, from which we could date the development of the confusion. Now we’ve nothing like that here, absolutely nothing.’ He stressed the words. ‘She had a full medical on arrival at Homelea, sort of MOT,’ he smiled insincerely and waved the folder, ‘and everything I’ve seen of Mrs Palmer makes me certain that she has chronic dementia, Alzheimer’s. I’m sorry. I can assure you we are doing our best for her.’

  Agnes suddenly looked much older, the brilliance of her dark eyes dulled. ‘But it’s all been so quick,’ she said. ‘She doesn’t know who I am any more.’ The last words came out in a whisper as she fought to stay in control.

  ‘There are peaks and troughs,’ said Dr Goulden, ‘as with any chronic disease. The situation may well improve. Often adjusting the medication can help things considerably. With some patients the situation can stabilise and remain so for many months.’

  ‘What medicine is she getting?’ I asked.

  He looked at me. That smile again. ‘She’s currently receiving a controlled-dose tranquilliser, what we call an antipsychotic drug, and she’s given something to help her sleep if Mrs Knight judges it to be necessary. Drugs have a very useful role in Mrs Palmer’s therapy but we use them with caution. The tranquilliser, for example, wouldn’t be given on a long-term basis.’

  ‘Is it one of the phenothiazines?’ I asked, remembering what I’d read in Moira’s books and hoping I’d got the pronunciation right. ‘What dosage is she on?’

  This time the smile was accompanied by a patronising tilt of the head. ‘I don’t see that such detail is of much help to the layperson in understanding our care plan.’

  ‘We’d like to know,’ I said. No explanation, no justification.

  He cleared his throat and rustled papers. ‘Thioridazine,’ he said. ‘Twenty-five milligrams twice daily. And nitrazepam for the insomnia as required.’

  ‘There can sometimes be side effects, can’t there?’ asked Agnes. ‘The drugs themselves can cause confusion in some people, make things worse.’

  ‘Yes, on occasion. All drugs carry some risk of minor side effects. But on the whole we feel the benefits far outweigh any risks. I can assure you I’ll be monitoring the response to the medication very carefully. There’s usually a settling-down period before the situation stabilises. If I see any indication of an adverse reaction I’ll reduce or withdraw the medication. I’d be hoping to gradually phase it out anyway. As I say, it’s not something I see Mrs Palmer requiring on a long-term basis.’

  ‘And you don’t think any of her symptoms are due to the drugs themselves?’ I asked.

  ‘No, definitely not. The confusion and agitation were what indicated the need for treatment in the first place. They’ve not arisen as a reaction to the medicines, they were present before the drug therapy started.’ He placed Lily’s notes on top of the neat stack on his desk. ‘Once the situation has stabilised, as I’m sure it will, I think we’ll see substantial improvement and we’ll have a much calmer and more relaxed patient.’

  He stood up and picked up Lily’s notes, batting them gently against his other hand as he waited for us to leave. Agnes went ahead of me. As she opened the door I glanced back into the room. Dr Goulden was standing at his filing cabinet putting the notes away. But it was his reflection in the mirror above the cabinet that caught my attention. His face was contorted with rage, lips drawn back, taut and white, teeth bared, eyes glaring. My stomach lurched. It was an astonishing sight. I slipped out before he noticed me looking.

  It was curiosity made me return to the building. I found it hard to credit what I’d seen and wanted to nose around a bit more. I settled Agnes in the car and then claimed to have left my gloves in the waiting room. The lobby was deserted – we must have been the last appointment.

  The words from the consulting room were a little muffled behind the closed door, but I could make out most of what Goulden said, particularly at such a loud volume. ‘I do not see friends and relatives. I’m a doctor, not a bloody support group. I see patients. You make appointments for patients.’ He was furious, spitting out the words, ladling on scorn and derision. ‘Next time you decide to offer appointments to Uncle Tom Cobleigh and all just use your bloody brains, woman.’

  I heard a murmur in reply.

  ‘Tell them you only make appointments for registered patients. Show some initiative, for Chris
t’s sake. Anything else, you check with me first. Got it?’

  Another murmur.

  ‘I’ve enough to do without being at the beck and call of every silly old bat who gets a bee in her bonnet. They read an article in some half-cocked magazine and next minute they’re God’s gift to medicine. Check next time and if they’re not patients…’

  I left. I’d heard enough and I didn’t want the receptionist to know I’d witnessed her humiliation.

  In the car Agnes was deflated. Goulden’s certainty about Lily’s illness had put paid to any hope she might have had about misdiagnosis. And he had given us the information we asked for even though we’d had to lean on him to get it. But she hadn’t seen what I had, nor heard him just now.

  ‘I think he’s hiding something,’ I said, ‘he hated having to see us, he didn’t want to talk to us about Lily.’

  I described to Agnes the expression I’d seen on Goulden’s face as I was leaving and the way he’d bawled out his receptionist.

  ‘He was beside himself,’ I said. ‘That makes me wonder, why did our visit upset him to such a degree?’

  ‘Perhaps he’s just a very angry man. Choleric they used to call it.’

  ‘I don’t like him,’ I said, ‘and I wouldn’t trust him as far as I can spit.’

  CHAPTER SEVEN

  Dr Chattaway used an end terraced house for his surgery. Plastic chairs were arranged around the walls of the room. On a table in the centre were copies of People’s Friend, National Geographic and Woman’s Own. The waiting room was full. No intercom here. The doctor stuck his head round the door every few minutes and asked for the next patient. People shuffled along each time.

  Gradually we moved around the room and finally we reached the inner sanctum. Dr Chattaway motioned to chairs and settled behind his highly polished desk. It was huge; they probably had to dismantle it to get it through the doorway. On the wall were framed diplomas and a photograph of Dr Chattaway in cap and gown.