One Step At A Time

by Caroline Anderson

  She set the photo frame down carefully on the desk and turned back to Jeremy. ‘I think I can manage to work in here,’ she said with a grin. Did it look forced? She hoped not. ‘Does he have a computer?’

  Jeremy chuckled. ‘Oh, yes—here, and over in Garden Cottage. He’s well up on technology. It’s behind the door, on a proper desk. The ergonomist wouldn’t let him use it stuck sideways on the end of this monstrosity because the height was all wrong, and he told Dominic that he couldn’t expect people to take advice about workstations if he didn’t set a good example. So he moved the computer to a proper desk and now he stands up and bends over it instead!’

  Kate laughed. That was so like Dominic. A little pang twisted deep inside her, and she straightened up and smiled at Jeremy. ‘Shall we move on?’ she said brightly.

  She followed him out, without a second glance at the photo.

  She didn’t need to look at it again. She had one in her purse, old and battered, but infinitely precious. She just hadn’t imagined that it would be precious to Dominic, too. After all, he had left her.

  So why, twelve years later, did he have a wedding photo on his desk?

  Unless it was to fool the patients with the image of a stable, clean-living family man?

  She laughed under her breath. Rumour had whipped round the hospital after he’d left her. His prowess had not gone unremarked, and if the whispers were to be believed he had had an affair with almost every available woman in the place. By all accounts they had been queuing up for his favours.

  Bile rose in her throat, forced up by the tight band of tension and jealousy that assaulted her every time she thought about it. She had loved him so desperately, so blindly. In her innocence she had thought the white-hot passion that had gripped them both was evidence of his love. Instead it had simply been evidence of a young man’s hyperactive libido.

  So he was attractive. So what? He was also a womanising bastard through and through, and she would do well to remember it.

  She followed Jeremy on through the clinic and past the physiotherapy room where Angela, one of the physiotherapists, was working with a patient on the parallel bars in front of mirrors.

  ‘Hi—how are you doing?’ Jeremy called.

  The patient turned and smiled at him. ‘She’s bullying me!’

  Jeremy laughed. ‘Jolly good. That’s what she’s here for.’

  They both grinned and went back to their work. ‘That’s Susie Elmswell,’ Jeremy told Kate as they moved away. ‘She was injured in an accident at work that left her paralysed. She’s getting sensation back gradually, and Angela’s trying to keep her moving so she doesn’t backslide. She’s got masses of grit, that girl. She’s getting married in September, and she says she’s going to walk down the aisle unaided. I believe her, too.’

  It was July, just. Kate wondered if they were all being blindly optimistic, or if Heywood Hall offered miracle cures as well. Perhaps Dominic’s charm and wit was the secret?

  The next room they didn’t enter, because the aromatherapist was working with a patient and she didn’t like being disturbed.

  Jeremy explained the reason. ‘We encourage people to relax and let go, and sometimes if they’re harbouring a lot of pain and anger after an accident they can have quite an emotional response to treatment.’

  ‘I’ve seen that with amputees,’ Kate said. ‘They have to grieve for the limb, and it’s quite difficult to get them to let go.’

  ‘Absolutely, but the atmosphere here is so supportive they feel safe enough to acknowledge their feelings. We try and make it possible for them to do that in private, and if they start to cry sometimes we just let them get on with it for a few minutes and talk it through later, when they’re calmer. It’s harrowing for everyone, but it can be a critical part of their rehabilitation and recovery.’

  ‘A sort of catharsis,’ Kate offered.

  ‘Exactly,’ Jeremy agreed. ‘Even if they aren’t upset, they’re trying to relax and let their body energies flow more positively, and having people buzzing in and out isn’t conducive to relaxation.’

  That Kate understood absolutely. Try relaxing with a teenager in the house, she almost said, but he was off again, continuing her tour, filling her in with invaluable information.

  He was a mine of facts and figures—how many patients they had at any one time, the average length of stay, the funding—and he had the names of all the patients and their problems at his fingertips, together with the treatment plans and progress.

  She realised that Dominic had been lucky to find him, and knew that she would safely be able to rely on him to maintain the continuity of the clinic. As they passed the treatment rooms he reeled off the various disciplines, and Kate was amazed to find so many diverse therapies all working together under one roof. They were all heavily dependent on one another, and such teamwork would require a degree of professional trust and respect that Kate knew was rare.

  She wondered how long the status quo would exist without Dominic. Hopefully long enough to see out her short spell here. She didn’t fancy overseeing an inter-disciplinary wrangle over whose treatment was the most effective!

  A thought occured to her, and she voiced it to Jeremy. ‘Who decides what treatment is right for each patient?’ she asked him.

  ‘Dominic,’ he said promptly. ‘Well, we have a case conference, where everybody listens to the case history and offers their opinion, and Dominic weighs up the information, adds his own experience and prepares a treatment plan accordingly.’

  ‘And you all agree?’

  Jeremy gave a wry grin. ‘Nobody bothers to disagree with Dominic. It’s his clinic, and if you want to work here, you co-operate. Quite apart from which, he’s always right.’

  ‘Always?’

  ‘Almost without fail. Anyway, someone has to make the decisions, and Dominic ultimately carries the can. If a given treatment plan fails to work to expectations in an allotted time, it’s modified. However, he usually has pretty good results.’

  And that, Kate knew for a fact, was putting it mildly. ‘What sort of patients do you have?’ Kate asked curiously. ‘Is there any pattern?’

  ‘All sorts. A lot of amputees—because we’ve got a regular limb-fitter as well as occupational therapy, physio and hydrotherapy—and they tend to come for some time and stay in the stables. They’re little individual semi-dependent units, where they can practise being self-sufficient and build up until they’re cooking for themselves and managing all their daily care routines without help.’

  ‘How long are they here for?’ Kate asked.

  Jeremy shrugged. ‘How long is a piece of string? As long as necessary, if they can afford it. Their partners can come and stay with them at weekends, and for many of them it’s the first time they’ve been together since their operations. It’s a vital step—just one of many. Ultimately we want to send them home completely independent, but of course that isn’t always possible.’

  ‘No, of course not. Bilateral amputees have much more trouble.’

  ‘We’ve got one in now—he’s just arrived today. His name’s John Whitelaw, he’s thirty-two, married, lost both legs in a car accident three months ago. He’s had other injuries as well, which have taken time to heal, and now he’s here for rehabilitation. He’s young, of course, but it remains to be seen if he’ll have the grit to get back on his new feet and make a real go of it. Some simply can’t cope, and resign themselves to being in a wheelchair for life.’

  ‘How come he’s arrived on a Saturday?’ Kate asked. ‘It seems an odd day to start treatment.’

  Jeremy shrugged slightly. ‘Dominic likes them to have time to settle in and get to know the place a little before they start the intensive treatment. He normally assesses them on arrival, talks to them extensively about how they feel, their expectations and so on, and then we’re ready with a treatment plan by Monday morning.’

  ‘So who’s done it this time?’ she asked.

  Jeremy grinned. ‘No one, yet. He�
�s just settling in and one of the nurses has taken a history. We’ll talk to him after lunch—I thought you could join in, see what we do.’

  He stopped outside a set of doors. ‘This is the orangery—it’s like a conservatory, really, and patients can relax here after hydrotherapy or swimming, or after they’ve done a session in the gym. We’ve got a fitness club attached to the hall, which is open to the public on a membership basis and the patients use it as well. Some of them have a programme worked out there with the physio. It helps them to get back into mainstream life a bit if their equipment is standard fitness gear. They don’t feel so different, and they’re working alongside “normal” people as well, which also helps.’

  She followed him into the orangery. It was warm and slightly humid, and there were massive palms and jungle plants, which added to the tropical feel. Rattan furniture was grouped around the columns which supported the magnificent vaulted roof, and Kate marvelled at the attention to detail that must have gone into the restoration of this building alone.

  ‘He’s done a fantastic job, hasn’t he?’ Jeremy said with a smile. ‘He really has worked so hard to make it right, but it wasn’t easy satisfying the planners and the health and safety boffins. It’s a listed building, of course, so everything has been inspected with a microscope.’

  She could imagine Dominic’s frustration at that, but the end result certainly justified it. They went through a door in the far wall into a huge room with a vaulted timber ceiling that arched over the swimming pool and the hydrotherapy pool. At the end was the access to the fitness club, which also had doors back to the corridor behind the stable flats and treatment rooms.

  They wandered through the fitness club and Kate saw the steady bustle of a successful commercial enterprise.

  ‘Are they usually this busy?’ she asked.

  ‘Often, at the weekend. It’s better early and late. Dominic often comes in here about six-thirty, before the enthusiasts get here, or at the other end of the day to wind down about nine o’clock. He works long hours—but you have to, to run a place like this.’

  It was, Kate realised with awe, a vast and most impressive set-up. They walked along the corridor behind the stable flats, where patients like John Whitelaw battled to regain their independence, and then went through into the walled garden behind.

  It was a huge area, about an acre, with glasshouses against the far wall, a fountain, and a rose arbour leading to Garden Cottage, which sat squarely in the centre of the left-hand end, facing down the garden. At the other end was a small area given over to vegetables.

  ‘Patients can come in here during the day and stroll around, and some of the long-term patients like to grow a few veg for recreation, but we close the gates at six so that Dominic has some privacy at home. His bedroom opens directly onto the garden. Unfortunately, though, shutting the gates doesn’t keep the cats out of his house!’

  Kate laughed. ‘Does he mind the cats?’

  ‘No. Only when they have kittens in his bed, like Moggy did last year. He had her done after that. So-and-So comes and goes, but Moggy’s nearly always around here somewhere—here she is.’

  He bent and stroked the little grey cat, who had trotted towards them over the grass, and she arched under his hand and purred copiously.

  ‘Soppy animal,’ Jeremy said indulgently. ‘The kitchen staff spoil her. We don’t let them into the clinic in case anyone is allergic, but every now and again we have to turf them out because they sneak in.’

  ‘I’m sure. Hello, Moggy,’ Kate murmured, crouching to indulge the cat. She rolled to her back, exposing her tummy in a gesture of trust which Kate found remarkable. How like a female to be so trusting, she thought. She tickled the soft expanse, drawing a frenzy of purring from the cat. ‘Hussy,’ she scolded gently, and then stood up, looking round at the beautiful garden.

  ‘It’s gorgeous, isn’t it?’ Jeremy sighed. ‘I wish mine looked a tenth as good.’

  ‘Me, too. Still, I suppose that’s what comes of having a fleet of staff.’

  Jeremy smiled, but he looked guarded. Did her bitterness show? She didn’t mean it to. She had genuine admiration for Dominic and what he had achieved here. ‘I wouldn’t like the overheads, though,’ she added, and Jeremy’s smile widened.

  ‘No. They are a bit of a drawback. Come and have some lunch, and then we’ll find John Whitelaw and you can start getting involved in the patients. I think you’ll enjoy it.’

  Kate hoped that he was right. The more she saw, the more daunted she felt. As they walked back across the courtyard that was surrounded by the stable flats, the treatment areas and the U-shaped hall itself, Kate again mentally assessed the sheer organisation involved in keeping it all running smoothly. It was a mammoth undertaking, and she didn’t want to be held responsible for bringing it to its knees.

  Suddenly, instead of hoping that Dominic would stay out of the way, she hoped that he would come home as quickly as possible, if only so that he was there to ask if Jeremy wasn’t around and she came unstuck.

  Except, of course, that he’d stick his oar in whether she asked or not. Why had she let him talk her into it?

  She sighed, and followed Jeremy back into the house.

  CHAPTER THREE

  HAVING introduced himself and Kate to their patient, Jeremy started the consultation with a full history of the events leading up to John Whitelaw’s admission to the clinics—from the accident itself, through subsequent decisions that had led to the amputations, and to his post-surgical recovery and physiotherapy.

  Because he had had internal injuries and a fractured pelvis, as well as the damage to his lower legs, his recovery had been slower than if, for example, he had simply crushed one foot and had it removed in a clean and relatively straightforward operation. That very timescale had its own implications, of course.

  Being off his feet for some time had led to muscle-wasting, loss of the natural balancing mechanism and a general loss of fitness that could take hard work to recover, Jeremy explained to him. He had been having physiotherapy as an in-patient, of course, but they had as yet failed to get him on his feet in new legs.

  ‘The first step is to make sure your stumps are well enough to start weight-bearing training, so we can get you upright again as soon as we can,’ Jeremy told him. The other problem is upper-body strength, and so we’re going to get you working in our fitness club under the guidance of a physio and a fitness instructor. Have you ever worked out in a gym?’

  John nodded. ‘Yes—there’s one at work, in the sports club. I use it often—or I did,’ he said with a disparaging snort. ‘Don’t suppose I shall now.’

  ‘I expect you will—in fact, you’ll have greater need of it.’

  ‘If they keep me on.’

  ‘Is it a desk job?’

  John raised an eyebrow. To Kate it looked sceptical, and clearly John’s outlook was deeply pessimistic. ‘My job?’ he said. ‘I suppose it is—part of it. But there’s a lot of running around from one office to another fetching things, meetings out at other firms, entertaining clients. . .I have to be able to drive, as well.’

  ‘Well, that’s OK. We can achieve all that—including driving a car. You can easily drive an automatic with a below-knee amputation, and you won’t even have to have it modified.’

  Kate saw the first flicker of hope in John’s eyes, but then it died at Jeremy’s next words. ‘Your wife could use it then, too—just like any other car,’ Jeremy said, and John withdrew again.

  ‘If she’s still around,’ he said quietly.

  Jeremy and Kate exchanged glances over John’s bent head.

  ‘Is it likely that she won’t be?’ Jeremy probed carefully.

  A shrug was their only answer. The silence was heavy with John’s tension.

  Kate broke it, her voice quiet, the question nonthreatening. ‘How long have you been married?’

  There was a sigh. ‘Almost a year. Nine months at the time of the accident.’

  ‘Happily?’


  ‘I thought so.’

  ‘But now?’ Jeremy pushed. ‘Since the accident?’

  He shrugged again. ‘I have no idea. We hardly talk. How are you? I’m fine. The cat was sick—you know how it is at hospital visiting.’

  Jeremy leant back in his chair and steepled his fingers, studying them intently. ‘Does she talk about the accident, or about your legs?’

  He shoot his head. ‘Never. Not to me, anyway.’

  ‘How do you think she feels?’

  ‘She was driving,’ John said flatly, and the featureless words spoke volumes. Her guilt, his anger, their joint grief over all he had lost—so much was contained in those few short words.

  ‘Has she seen a physchologist yet?’ Jeremy asked matter-of-factly.

  This time the snort was derisory. ‘Andrea? You’re joking. She won’t. I had no choice in the hospital—not that it did any good. All this rubbish about facing anger and grief—I’ve lost my legs, not my life.’

  ‘But you have lost your life—your old life, the part you used to take for granted, like getting up in the middle of the night for a drink of water without having to spend half an hour putting your legs on, or going to the beach and running in the sand, or playing football with your kids—you’ve lost a great deal. Don’t underestimate what you’ve lost, both of you.

  ‘Your wife, too—she needs to grieve. You’re a different man, and she sees it as her fault. Maybe she doesn’t like the man you are now. That will make her feel guilty, and that guilt will make her resentful. Maybe you’re angry with her—maybe that makes you feel guilty, so you feel resentful. There are all sorts of ways in which you could be short-circuiting your lines of communication, both of you, and one of the most important things we can do for you both is get you talking again.’

  If John had looked sceptical before, he now looked downright disbelieving. ‘Forget it,’ he said flatly. ‘You’re wasting your time, and, anyway, I don’t need a shrink.’

  ‘Time spent on our patients is never wasted,’ Jeremy corrected him, his voice firm but infinitely kind.