Just a Family Doctor

‘What?’

‘What’s the matter?’

Was she so easy to read? She shrugged. ‘I just thought—I don’t know. I always knew you were going to be a surgeon.’

He grinned. ‘Well, I’m not. Believe me, I was shocked as well. You’ll get over it. The scampi’s good. Do you want some tartare sauce?’

‘Mmm.’ She tore the corner off the packet and squeezed it out mechanically, then stuck the little wooden fork into a piece of scampi and bit into it. He was right, it was good. She put thoughts of his career out of her mind and concentrated on eating and enjoying his company, but something had gone, like a light being switched off inside her.

It was only later, after he’d taken her home and given her another of those sizzling kisses on the doorstep, that she realised why.

They had no future, because there was no way she could spend her life with anyone who was going into general practice. There was no way she’d marry him if things went that far. She couldn’t bring children into the world knowing their father might not last the course. She’d seen at first hand the havoc it could cause in a woman’s life, and she had no intention of letting it happen to her.

Then she chided herself for being ridiculous.

You’re getting a bit ahead of yourself, Allie Baker. You’ve had two dates—and one of them didn’t even really count. Stop acting like he’s asked you to marry him!

She got ready for bed, climbed under the chilly duvet and snuggled down, and waited fruitlessly for sleep to come.

They had a new admission the next day, a little girl of seven from the cystic fibrosis clinic. Claudia Hall had been diagnosed with CF at birth, and was currently struggling with yet another deep-seated chest infection.

She was coming in for intravenous antibiotics to combat it, and Allie greeted her and her very pregnant mother affectionately. It was the second time she’d been in in the few months Allie had been on the ward, the last time to insert a gastrostomy tube in her stomach so she could have special feeds delivered by pump overnight to boost the amount she was able to eat, because her appetite was dreadful and she wasn’t able to take in enough to sustain herself.

Everybody thought CF was just a chest condition, Allie mused, and yet it affected the intestines just as much, causing havoc with the assimilation of food and secretion of enzymes. In fact if Claudia ate anything with fat in it, she took handfuls of enzyme pills to enable her to digest it properly. Between the enzymes and the tube feeds, Claudia had been gaining weight, but now she’d lost it again with this infection. Allie had hoped they wouldn’t have to see her again so soon, and it was a shame. She’d had more than enough to deal with already in her short life.

‘Where am I this time?’ the little girl asked as she looked round the all too familiar ward.

‘Nice bed by the window—that do you?’ Allie said with a smile.

Claudia nodded. ‘Yes, please. I don’t want to be in the Winnie the Pooh room again.’

Allie laughed. ‘Well, you won’t have to this time because you’re MRSA free, so we won’t have to isolate you. How’s Piglet?’

Claudia pulled up her jumper and showed Allie her gastrostomy tube, nicknamed Piglet because of the Winnie the Pooh room she’d been put in when she’d gone down with the MRSA infection in the gastrostomy site. ‘He’s fine. Still eating all night.’

‘Good. Right, we need to admit you and do all the paperwork, then you can go and find out who’s in the playroom.’

‘Is Katie still here?’ she asked.

Allie shook her head. ‘No, sorry. She went home a few weeks ago. There are a couple of girls of your age, though. I’m sure you’ll get on with them.’

Claudia nodded and scrambled up onto the bed, triggering a coughing fit that ended in her vomiting. Allie was prepared. It was a frequent occurrence with CF children, and she was ready with a paper bowl.

‘She’s really gone downhill the last few days,’ her mother Jayne explained. ‘She’s been coughing more and more—Dr Barrett thought she should come in and get it sorted. She’s got pneumonia this time—I suppose it makes a change from Pseudomonas.’

Allie nodded. ‘Yes, she’s down for gentamycin. That should clobber it. Can’t have you feeling this poorly, can we?’ she said with a smile for Claudia, who was flopped against the backrest looking exhausted.

‘She hasn’t been sleeping all that much,’ Jayne said, and Allie could tell by the bags under her eyes that Jayne hadn’t, either.

‘When’s the new baby due?’ she asked.

‘Three weeks, but I may not make it that long. I’ve got dodgy ligaments in my pelvis and it’s so painful. I have to wear a belt round my hips to support it, and it’s getting really tiresome, not to mention difficult to move around, so they might induce me early.’

As if the poor woman didn’t have enough on her plate. ‘It’ll soon be over,’ Allie said comfortingly, and then turned back to Claudia. ‘All right, poppet? Feeling a bit better?’

She nodded, but it was only politeness. She looked awful, poor kid, and Allie wanted to hug her.

‘Dr Jarvis’ll be here in a minute, I expect, and he’ll check you over and get your IV line in. Then we can get some bug-zapper into you and you should start to feel a bit better.’

Claudia nodded again, and Allie flipped open her file and took out the sheet at the front with all the labels on. They were printed with name, address, next of kin, hospital number and so forth, and were stuck on anything to do with the patient. It saved hours of copying and potential inaccuracy—when they were right.

Allie checked, on the principle that one could never be too sure. ‘Are all your details still the same? Address, phone number and so on?’

Jayne nodded. ‘Yes, nothing’s changed.’

‘Good.’ She stuck Claudia’s labels on the charts, clipped them to the end of the bed and took her temperature and blood pressure. The respirations she’d already done surreptitiously while Jayne had been talking, and they were up, as she’d expected.

‘Fancy a cup of tea?’ she asked Jayne when she’d finished.

‘Oh, I’d love one. Can I make it?’

Allie shook her head. ‘You sit there, I’ll find someone to do it for you. Weak, black, no sugar—is that right?’

‘How did you remember that?’ Jayne asked softly, and looked near to tears. Allie guessed that this pregnancy had been very difficult for her. She had a horrendous obstetric history, by all accounts, and it was touch and go whether this one would be all right. Still, at least she was almost there. That was a huge improvement.

‘I have a very retentive memory for useless information,’ she told Jayne now, and with a smile, she left them alone and found Pearl, the Jamaican ward orderly. ‘You couldn’t take a cuppa to Jayne Hall, could you? She’s over there. Weak, black, no sugar.’

‘I remember, darlin’, don’t worry. I know Jayne very well. Sometimes I think she lives here. Sure, I’ll take her a cup of tea. I was just goin’ to ask her myself.’

Allie left Jayne in Pearl’s capable hands, and thought not for the first time what a gift to the ward the matronly woman was. She was possessed of infinite kindness and patience, and seemed to be able to keep order with the bored and naughty children absolutely effortlessly. They all adored her, and it was mutual. She would have made a wonderful nurse, but perhaps she was more useful as an orderly, because she never had to do anything unpleasant to the children and that made her easier to trust.

Allie checked on Amy Fulcher who had come back from Theatre yesterday after she’d gone off duty. She was looking better already, much more comfortable, and her mother was slumped in the big vinyl armchair beside her, sleeping.

It seemed a shame to wake either of them, so Allie left them to it for a little while. Sleep was probably more useful than anything to the baby at the moment, and the mother was exhausted.

She looked across at Claudia’s bed and saw Mark had arrived and was chatting to them. He had one hip hitched up on the edge of the bed, and he was smiling and teasing Claudia into smiling back. He was good with children, she realised, and wondered why he didn’t go into paediatric surgery.

He’d been so keen, so certain of his choice—

She shook her head. She was still stunned by his revelation, and was trying to reconcile herself to the bitter fact that there could be no future for them beyond the immediate one of a few dates—except maybe, because he was the only man she’d ever felt like this about, a brief affair.

Nothing lasting. Nothing permanent. No happy ever after. Just something to remember him by when he moved on.

She swallowed hard and found herself something to do at the other end of the ward, away from him and his laughing eyes and wide, ready smile that made the sun come out.

Her reprieve was short-lived, though, because he asked her to assist him with Claudia’s intravenous line. He was putting in a long line, not as long as a Hickman line that went all the way to the heart, but one that went into the arm in the crook of the elbow and up into the top of the chest.

‘As you know it lasts longer than a needle cannula,’ he explained to Jayne and Claudia, ‘and this treatment’s going to take a couple of weeks. We don’t want to have to keep putting in another line and messing you about, do we, Claudia?’

Claudia shook her head, and they moved her into the treatment room where they undertook the more sterile procedures. Allie was the ‘clean’ nurse, and a younger staff nurse was the ‘dirty’ nurse, the one who handled the outside of the packets and opened them for Allie, who was scrubbed and gowned and ready to assist.

Mark scrubbed as well, and then they settled down with Claudia to insert the line into her little arm. It was splinted straight, and would stay like that until the line came out, which was a bit restricting but one of the penalties for not having to have the line changed constantly.

Her mother was there, of course, supportive as ever, and Allie wondered how Mark would deal with Claudia and her independent attitude. Her mother had brought her up as far as possible with input and control over her illness, and her quiet courage and calm dignity were terrifying.

As for Mark, it was the first time Allie had seen him doing any procedure, and she was impressed. Claudia cried, of course, but only a little, and he was very kind and gentle with her, and it was over in no time. Allie secured the end of the line with tape and made sure the splint that kept her elbow straight was comfortable, and then she was given the first dose of antibiotic through it.

It seemed such a shame to have to put her through it, Allie thought sadly, but it was a small price to pay to combat the germs in her chest which were playing havoc with her breathing and damaging the already fragile structure of her lungs.

‘All right now?’ Mark asked, checking his handiwork and smiling at Claudia.

She nodded, looking wan and exhausted against the white pillows. Allie wanted to cry for her. She wanted to cry for all of them, but she couldn’t, of course, so she smiled and hugged and dished out sensible advice and struggled on.

Just like Jayne, she thought with sympathy, struggling on with her softened pelvic ligaments so that every movement made the two ends of her pubic bones scrape together at the synthesis, the join in the middle at the front. It wasn’t a joint anyone was ever aware of, unless something like this happened.

It must be horribly painful and difficult, Allie thought with another surge of sympathy as she pushed the bed back to its place in the ward. Still, not for much longer. It would soon recover once the pregnancy hormones disappeared from her system.

‘Can I go and see who’s in the playroom?’ Claudia asked her, and Allie nodded.

‘If you want to. Take a paper hat with you, just in case you’re sick. Want me to introduce you to the others?’

She shook her head. “S OK,’ she said pragmatically. ‘I’ll do it.’

‘She’s so independent,’ Jayne said in admiration, sinking into the big armchair by the bed. ‘You’d think she’d be clingy, but she’s not. She just gets on with it, no matter how awful. She’s got such guts—’

Jayne broke off, her lips pressed together in a firm line, and Allie wondered what it must be like to have a child with CF and know there was a one-in-four chance that the baby she carried would have inherited the same dreadful and debilitating disease.

She patted her shoulder, giving quiet comfort and support, and then left her to grab a few precious moments alone to rest in the comfy chair. Allie reckoned she’d earned it.

She managed to slip up to the canteen for lunch, by a miracle, and was sitting propped up in an easy chair in the corner nursing a cup of tea when Beth strolled over.

‘He’s gorgeous,’ she said without preamble. ‘I saw him today in Outpatients. I had to cover. He is just luscious.’

Allie didn’t pretend not to understand. ‘I know,’ she said glumly.

Beth dropped into the chair opposite and gave her a curious look. ‘What’s the matter?’ she asked. ‘I’m the one that should have the long face. At least he’s interested in you—he wouldn’t have noticed if I’d got six legs!’

Allie laughed. ‘Beth, you’re silly. He’s going to be a GP,’ she added after a pause.

‘How wonderful. There are far too few of them out there.’

‘I don’t want him to be a GP. It’s so stressful.’

‘Isn’t that rather for him to decide?’ Beth said pointedly. ‘And anyway, what does it matter? He’s here now, he’s giving out all the right messages—you’d have to be mad to ignore it. Well, mad or dead or totally sexless.’

Beth was right—and Allie wasn’t any of those things, at least not where Mark was concerned. Well—mad, maybe, but that was different.

She finished her tepid tea and set the cup down. Happy ever after was probably a figment of the imagination, anyway, but there was no time like the present. Who said every relationship worth having had to end in marriage?

She gave the bemused Beth a dazzling smile. ‘You’re a love. See you later.’

And feeling much brighter than she had all day, she went back to work.

CHAPTER THREE

HE DIDN’T ask her out again until the weekend, and she was beginning to wonder if her imagination had read more into their relationship than was warranted.

If you could call it a relationship.

Maybe she’d presumed too much from their slight acquaintance. Maybe Anna was more appealing to him than he’d let on—although there was no sign of anything blossoming there either, she thought, and told herself that the only reason Mark had shown so much interest in her was because he was lonely in Audley and didn’t know anyone else!

So she put it out of her mind, and carried on with her work and tried not to notice when he was around, but it was pointless. Her radar wouldn’t switch off, and she was constantly aware of every breath he took when he was on the ward.

Still, her patients were a good distraction, and she tried to concentrate on them.

Little Claudia Hall was doing all right on her antibiotics, despite feeling sick, and her mother and father had taken over her antibiotic therapy and were giving her the injections through the catheter in her arm. It saved the nursing staff a job, and her parents were already so involved with their daughter’s care that they were utterly reliable.

In any case they were probably more knowledgeable about her condition than many of the staff on the ward, and like so many parents these days, wanted to know everything and not be kept in the dark. Furthermore they explained everything to Claudia, so that she could be in control of her treatment.

As Jayne said, ‘She’s Claudia first, and CF second. All this treatment isn’t for the CF, it’s for Claudia. She has to understand it and condone it and accept it. It’s her body, not yours, not mine. She has to make the choices, and if she’s given some control, it helps her to deal with it.’

However their philosophy could only help so much. One of the hardest things was also one of the simplest, in comparison to the other things she had to endure. Every third day of her gentamycin therapy, she had to have pre- and post-gentamycin blood tests to make sure that her fragile little system was able to cope with the drug.

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