by Debra Oswald
She would finish by running along the beach, welcoming the burn up her ankles and calves from the strain of jogging on loose sand. This was probably some pathetic and futile act of self-punishment.
The medical centre was down the road from the town’s tiny eight-bed hospital which mostly functioned as a respite place for elderly people and a first aid/transfer point to city hospitals for people injured in car crashes on the highway. Because it was winter now, there were few tourists around to swell the patient numbers.
The general practice was run by an old-fashioned but competent bloke, close to retirement, and a young guy in his first GP placement. Paula was employed to fill in for the other regular senior GP, Tanya, who was on an Alaskan cruise. Paula had quickly got the impression Tanya was a trusted and beloved doctor in the district.
Saturday was Paula’s last day in the place. The doctoring required of her during the afternoon session was pretty straightforward stuff—three vaccinations, two medical certificates for days off work and one small laceration to be sutured.
Patients with anything complicated or delicate were unlikely to confide in the locum. They would hang on to their problem until Tanya returned to work and that suited Paula just fine. The last thing she wanted right now was to be drawn into the personal dramas of people in crisis.
There had been days when Paula couldn’t avoid seeing the bruises on a woman’s body or wondering how a woman’s arm had been broken or noticing that a woman flinched at a sudden noise. Paula would feel the rage flare inside her, as if the pilot light was always on and any small sign would spark it up. When that happened, she worked hard to stay calm, regulate her breathing, to run through the standard guidelines in her mind and ask the patient the appropriate questions. Some of those women were most likely being abused at home but they were unlikely to trust a temporary doctor. And Paula wasn’t going to push. She didn’t trust herself.
She couldn’t rely on her own perception anymore. When one woman sat up on the examination table and took off her shirt, Paula saw bruising on her ribcage. Bruises shaped like handprints from a large man. It turned out to be the blotchy shadows cast by the tree outside the window. When a woman made a few cracks about her husband being ‘a difficult customer’, Paula couldn’t stop herself wondering if the jokes were covering real fear of the man. But maybe it was only a joke. Another female patient had a rasping voice, and Paula immediately pictured a man’s hands around this woman’s neck, crushing her vocal cords. But in this case, it was just laryngitis.
If there were enough worrying signs, enough red flags, Paula would speak to one of the permanent doctors in the practice about following up with the woman, making sure the mandatory reporting was done. Dr Kaczmarek was only temporary so it wasn’t up to her. She couldn’t be responsible. She tried not to let her mind follow those patients any further than the door.
This Saturday ended with another straightforward run: sinus infection, sprained ankle and a blood test for a gent at risk of developing type 2 diabetes. Paula put on a reassuring performance as a thorough and caring doctor, even though, in truth, she was keeping real human feelings in frozen suspension. It helped that this was her last day at the practice. On Monday, she would move on to some other anonymous locum job and she would have no idea what happened to anyone in this town.
After work, Paula planned to go for a last walk, filling her head with an audiobook rather than think about bruises or broken bones or strangulation injuries. She was untangling her earbuds as she passed the front office. Fiona, the receptionist, was on the phone, so Paula mouthed ‘I’m off now’ as she headed for the door. But Fiona signalled wait and beckoned Paula over.
‘Hang on a sec, sweetie,’ Fiona said into the phone and then turned to Paula. ‘This kid says her little brother’s got a temperature and a sore ear.’
‘Well, I’ll stick around if she wants to bring him in.’
‘They live ten k’s out of town and got no transport at the moment. I mean, if it was something more serious, we could send an ambulance, but not for this.’
‘No. I understand. Okay. What would Tanya normally do in a situation like this?’
‘She’d drive out there, take a bunch of antibiotics and whatever. But doesn’t mean you have to.’
‘Of course, yeah. A sick kid with no transport. Can I speak to her?’ Paula asked.
Fiona handed the receiver across the desk.
‘Hi, this is Paula. I’m one of the doctors here. What’s your name?’
‘Ruby. Jye’s my brother. He’s five.’
Paula immediately pictured the spiky whippety teenage girl and the little boy she’d seen in the supermarket on her first night in town.
‘And Jye’s got a sore ear, has he?’ Paula asked.
‘Yep. He had an ear infection last year and it’s same as then. Forehead’s really hot and he reckons the inside of his ear really hurts. He loses his balance if he stands up and that. He’s just, like, quiet and doesn’t want to eat, which for Jye is a big deal.’
Paula could hear the sturdiness in Ruby’s voice—this girl was used to handling whatever shit was thrown at her—but there was a tiny quiver in the voice too. She was only a kid herself, anxious about her brother and scared to be handling this on her own.
‘Okay, Ruby—that’s a really good description you’ve given me. And there’s no one at your house who can drive him in to see a doctor?’
‘Nuh. His dad, my stepdad, he took the car. I mean, should I bring Jye in on my dirt bike?’
‘No, don’t do that if he’s feeling wobbly. I’ll come out to your house and see him. Hang tight, Ruby.’
While Paula chucked a few antibiotics and other supplies into her medical bag, Fiona took back the phone to write down directions to the house.
Paula looked at the names and address on the slip of paper Fiona handed her. ‘Do you know this family?’
‘Nope. Don’t think they come to this practice.’
According to the GPS map in Paula’s car, Lower Pinch Road branched off the highway, then ran almost parallel to it behind a wall of trees before winding back to join the highway again. Upper Pinch Road looped off Lower Pinch, travelling up a heavily wooded slope, passing a small number of houses. The dirt surface was rough but Paula was able to zigzag to avoid the big potholes if she took it slowly.
Finding herself back near the highway, she realised she’d overshot the house and had to do a precarious U-turn on the crumbly edges of the road. Approaching from this direction, she could see it—the roadside mailbox for 8 Upper Pinch Road.
She had to rev her car to coax it up the rutted driveway, until the forest opened into a clearing where the house sat. A small clapboard house perched on the hillside, with a front verandah built on tall wooden posts and ramshackle lattice covering the dark mouth of the underfloor area. The house was in poor shape, with paintwork flaking off so the exposed timber was rotting away in places.
The dirt bike Paula had seen Ruby riding away from the town supermarket was now tucked in the space under the steps. Next to it was a kid’s tricycle. The carcass of an old truck was sprouting weeds beside the concrete water tank and other bits of rusty debris were strewn over the cleared ground. A corrugated-iron awning had been built against one side of the house to form a kind of open shed which housed a stack of engine parts and sections of car bodies.
There was no farmland nearby so this wasn’t a farmhouse; Paula guessed it must have been a timber worker’s cottage back when the logging industry still existed here. Now it was home for Ruby and her family.
The setting, nestled in the forest, was pretty, and with imagination and a bit of squinting to keep details out of focus, you could picture it as idyllic for kids. There was a blow-up swimming pool, deflated since the summer months, now with plastic toys floating among a few dead leaves. There was a tyre swing hanging off one of the big gum trees.
Paula remembered Cameron, when he was still little, hanging upside down on the tyre swing in the home
paddock of the Maryvale property, grinning like a happy monkey. It was the first time she and Remy had driven up there to visit Stacey in the new place. With that move to Maryvale, Stacey had given up a teaching job she loved so she could support Matt in his new scheme to become a cattle farmer. They’d thrown a modest inheritance and all their savings into buying the small farm. Stacey had been fizzy like a little kid to have their first proper visitors, and she swept Paula and Remy through a tour of the weatherboard house they had started to renovate. ‘This is what Matt needs,’ she said, as if talking about treatment for a difficult patient. ‘We’re away from all the stresses in the city. It’s just the four of us, loving each other.’ Paula and Remy had smiled and made supportive noises. In private, they whispered about the precarious finances, Matt’s changeable moods, the foolishness of the whole enterprise. Then again, the kids seemed happy and Stacey’s chatter about their new adventure had functioned as a bright wall designed to deflect questions or concerns.
‘You the doctor?’ Ruby called out. The fourteen-year-old girl peered down at Paula from the verandah.
‘Yes. Hello, Ruby.’
Paula fetched her medical bag from the passenger seat and picked her way up the wooden steps, avoiding the splintered boards, while Ruby held the front door open for her. Paula smiled but Ruby just squinted back, watchful and defensive, trying to read Paula’s face, anticipating judgement.
The interior of the house was in better shape than you might expect from the outside. The furniture was shabby and mismatched but the place was clean and organised.
Jye was wearing clean pyjamas and lying on the nubbly mustard-coloured couch, rugged up in a mauve cotton blanket, watching Bluey, an animated series with dog characters, on a chunky old laptop. On the coffee table next to the laptop was a glass of water, a plate of half-eaten Vegemite toast, a bowl of green jelly and a bottle of children’s paracetamol with a measuring glass sitting on top of the lid. It was obvious Ruby had constructed this little Sick Boy nest for him. Paula had an urge to spin around and grab the girl in a tight hug for being such a gorgeous big sister, but she assumed that wouldn’t be welcomed.
‘Hello, Jye. My name’s Paula. I’m a doctor.’
‘Hi,’ replied the boy, an enfeebled version of the kid Paula had seen in the supermarket. It never ceased to amaze her how normally sparky children could so suddenly become wan and limp and knocked around by sickness and then so quickly bounce back.
While Paula examined the boy and took his temperature, Ruby dashed over to pause the Bluey video, then hovered close by like an anxious parent.
‘I gave him some of that,’ she said, indicating the paracetamol. ‘That was the stuff they gave us last time he had the ear thing. I gave him the amount it says for five years old. Two hours ago.’
Ruby was earnest, as if she were doing a hospital handover, so Paula responded with a serious, respectful nod. ‘That was exactly the right thing to do, Ruby.’
As Paula looked in Jye’s ears with the otoscope, she asked, ‘Are you guys home on your own?’
‘No. Well, Jye’s dad is out. He took the ute. But our mum’s here. She’s having a lie-down.’
Paula followed Ruby’s gaze towards the closed bedroom door. The girl then took a step to plant her body between Paula and the view of the door. A protective impulse. She didn’t want this stranger even to think about her mother, let alone go snooping. She didn’t want some stickybeak middle-class doctor lady judging her family.
‘You know what, Jye?’ Paula said. ‘I reckon your sister would be a very good doctor. She’s exactly right about what’s wrong. You’ve got an ear infection. The good news is I have some medicine here that’s going to fix you up.’
Paula turned to Ruby. ‘I see your bottle of paracetamol is almost finished. How about I give you this little one to last you until your mum can get to the chemist?’
‘Oh. Yeah. Ta. I mean, if that’s okay.’
‘Definitely okay. And here’s the antibiotic I want Jye to take.’ Paula handed Ruby a bottle of liquid amoxicillin. ‘If I write things down for you, you can measure out the right amount to give him, can’t you?’
‘Yeah. Yeah. No problem. I mean, I think so.’
‘I’m sure so. You’re doing a good job looking after your brother.’
Just as Paula was writing a list of instructions for Ruby, the bedroom door swung open.
A woman padded out of the dark bedroom in bare feet, wearing loose drawstring pants and an oversized man’s shirt. She was probably in her mid-thirties but it was difficult to be sure. The physical resemblance to Ruby was clear—this woman had the same slight, lean build, the same sharp but attractive features, the same big brown eyes—but if she’d ever had the same fierce spirit and self-possession as her daughter, that was long gone. This woman was worn down, a defeated human being.
The mother was startled to see a stranger in the living room and she hugged her arms defensively across her chest.
Ruby jumped in. ‘This is the doctor, Mum. Because of Jye’s earache.’
‘Oh right. Sorry … I didn’t realise—uh, hi. I’m Nicole. Jye and Ruby’s mum.’
‘Hi, Nicole. Paula Kaczmarek. Good to meet you.’
‘Thanks for coming. Sorry I wasn’t up when you got here. I’m feeling a bit crook.’
‘No worries,’ Paula assured her.
‘Do you want a cup of tea, Mum?’ Ruby asked.
‘No, honey, thank you. Oh, unless the doctor wants one?’
‘I’m fine, thanks.’
Nicole went over to kiss Jye on the top of the head, asking him how he was feeling, making a fuss of him. Then she raised her arms to smooth down her bed-matted hair and the sleeves of the shirt fell back.
Paula could see bruises on the pale skin of Nicole’s arms. Nicole quickly tugged the sleeves back down, realising the bruises had been seen. Paula froze for a moment—not wanting to jump to conclusions, not wanting to interfere and cause problems for these people, not wanting to overstep the new boundaries she’d established for herself.
‘Nicole, would it be possible for you to bring Jye into the medical practice in town on Monday?’ Paula asked.
‘Oh, um, yeah. I’m sure I can get the car or, y’know, I could get my—’
‘He’s back,’ Ruby interrupted, going to the front window. ‘Earlier than he said.’
The girl had heard the sound of the gears grinding down on her stepfather’s ute as it laboured up the driveway towards the house. Paula saw Nicole instantly shrink into herself, folding her arms around her torso again, as she listened to her husband slam the door of his ute and stomp up the steps.
Before he even reached the door, he demanded, ‘Whose car is that?’
Seeing Paula standing in the living room, he flicked his chin up, belligerent. ‘Hello?’
The guy was in his mid-forties, short but powerful-looking, with a solid chest like a keg of beer, shaved head, a tattoo of a fist emerging from flames that spread across his chunky neck.
His clothes were smeared with black grease, which made the fresh gash on his forehead stand out, bright red and glistening.
‘That’s my car,’ Paula said, stepping forward with an instinct to place herself between this man and Nicole and her kids. ‘I’m Paula Kaczmarek. Doctor from town. I’m here to see Jye, Mr … ?’
‘Curtis Wigney.’ Then he aimed his bullety head at Nicole. ‘Rang for a doctor to come up here, did ya?’
‘No,’ responded Nicole, barely audible.
Ruby jumped in quickly. ‘Me. I did. For Jye’s ear. All good now.’
‘Yeah? You all good now, little mate?’
Jye didn’t answer.
‘Beg yours? I asked you a question, Jye.’
Seeing the irritated way Curtis was glaring at his son, Ruby jumped in again. ‘He’ll be okay now he’s got the medicine and that.’
‘Just an ear infection,’ Paula added. ‘But Ruby did the right thing to call. With the antibiotic, he should be fine in
a couple of days.’
‘Doctor fixed you up, has she?’
Jye nodded, which seemed to be enough to appease his father. Curtis then scanned the other faces in the room—Paula, Nicole and Ruby—and he must’ve decided that no one was out to get him right at the moment.
‘Quite a bad gash on your forehead, Mr Wigney,’ Paula ventured.
‘Oh yeah … fucking thing.’ He poked his grease-black finger around the edges of the wound. ‘The dropkick at the wrecker’s yard doesn’t know how to store shit properly. Huge fucking piece of junk fell on my head.’
‘It’d be better with a few stitches,’ said Paula. ‘I mean, I’m here and I’ve got everything I need in the bag. I could stitch it for you.’
Curtis looked at Paula for several seconds, assessing if she was causing him grief or taking the piss or pulling some other scam he didn’t quite understand. Eventually he said, ‘Why the fuck not? Where do you want me?’
Paula swung one of the straight-backed dining chairs into a clear space and indicated he should sit there.
Curtis guffawed. ‘How about this, Nicole? A doctor doing house calls! Pretty good, eh?’
‘Yeah,’ said Nicole with a weak smile.
‘What about you, Ruby?’ Curtis asked. ‘Is there something wrong with you the doc can fix while she’s here?’
‘Nuh. I’m okay.’
Curtis’s tone suddenly turned ugly. ‘Sure about that? Maybe the doctor can give you a fucking pill to wipe that nasty bitch look off your face.’
Paula felt the air in the room tighten up like a held breath. She feared she’d made a mistake by offering to stay and treat his wound.
‘Where can I wash my hands, Ruby?’ Paula asked. ‘Oh, and could you find me a clean towel, please?’
‘No worries,’ said the girl, leading the way to the kitchen.
While Paula rinsed her hands at the kitchen sink, Ruby brought soap and a small towel. Paula gestured for Ruby to stay a moment.