Snowed in at the Practice

by Penny Parkes

  ‘Holly? Are you still there?’ Alice asked plaintively. ‘I’d be so grateful. And I know it’s short notice, but maybe it could count as one of those “Keeping in Touch” days that Patricia was banging on about. Hang on . . .’

  Holly flinched; there was obviously nothing bogus about Alice’s illness. She gave herself a mental shake: wasn’t a day of normality what she’d been dreaming of lately? A day to be Dr Holly Graham and actually talk to her patients in an official capacity rather than tiptoeing around the issue in the park, playground, or deli? Not to mention ticking another one of Patricia’s tiresome boxes?

  Plum poked her head around the door. ‘I make pancakes for the little ones. You would like?’

  ‘Oh, I really would like,’ said Holly with feeling, unconsciously adopting Plum’s slightly pidgin English. She paused, one hand over the mouthpiece of the phone. ‘I may need to pop into work for a while today. Will you be okay with quite so many children in the house?’

  ‘Of course,’ Plum said, looking almost affronted by the question. ‘It’s like with a puppy, yes. First we feed, then we walk, then we rest and repeat.’

  Holly smiled, Plum’s innocent competence rather beguiling. ‘Sounds perfect,’ she said. Whether Elsie would be quite so easy to manage, once she finally surfaced with another hangover from hell would be another story. Perhaps it would be kinder anyway, to let her recover before peppering her with the multitude of questions that Holly was simply dying to ask? Starting with the house, or Connor, or the house . . .

  Holly returned to her phone call with a lighter sense of purpose. First her kids, then her patients. Breathe and repeat, she thought to herself with a smile.

  *

  Holly felt her shoulders lift just a little as she walked through the Market Place, her feet squashed into heeled boots and her favourite work dress gripping rather more tightly than she’d remembered. The snow clouds had blown through overnight and a gradual thaw had already begun, Larkford literally sparkling in her early morning beauty, but it was the way Taffy’s hand had automatically sought hers as they left the house that had made her spirits soar.

  ‘I’ve missed this,’ he said easily, swinging her hand, and conveniently forgetting that he was the main culprit for putting up barriers and delaying this very moment. In a funny way, it was almost better to have a spontaneous return like this – no time for Holly to worry about the kids or stress about compliance. No time for Taffy to overthink the whole situation and start listing obstacles.

  It was certainly a side to him that she could never have foreseen. Since becoming a dad, he’d seemingly shed his laissez-faire approach to life and spent more time worrying and planning than was surely healthy. Even with the arrival of Plum, the most conscientious and solicitous nanny that Holly had ever encountered, Taffy’s grip on the tiller of their household was still white-knuckled and tense. It would be interesting to see if that extended to his professional demeanour too these days.

  She gave his hand a loving squeeze. ‘I’ve missed this too, just taking a breath together before the next part of the day.’ She leaned into his side affectionately. ‘I’m quite excited about seeing everyone again.’

  Taffy turned to her, bemused. ‘But you see everyone all the time?’

  Holly shrugged. ‘It’s not the same though, is it? I’ve been a civilian for months. Now I’m part of the team again.’ She paused. ‘If you’ll have me?’

  Taffy shot her a queer look. ‘Is that what this whole back-and-forth with the Rugby Club has been about then? Were you trying to make a point? Of course, we want you back. Just, there’s no rush, is there? And anyway, the timing is yours to choose now, you know that, once the twelve-month mark ticked over.’ He paused, frowning, as though worried he was putting ideas into her head by quoting the partnership agreement, as though prioritising anything other than their children would be a mistake. ‘But we’re managing fine if you need longer.’

  He was trying to be considerate, her logical brain could understand that much. It was just that, in the process, she came away feeling, well, a bit disposable. At some point, the boundary between considerate and patronising had apparently become impossibly blurry.

  *

  If she’d had any concern about being welcomed back with open arms, the effusive greeting she received from Grace and Lucy should really have put her mind at rest.

  ‘Holly! Now, are you a sight for sore eyes!’ said Grace, pulling her into a rib-crushing hug as though they hadn’t seen each other only last night. ‘God we’ve missed you. And you’re ready to come back? Not being strong-armed by puking Alice?’ Grace shot a worried glance in Taffy’s direction that was obviously not meant to be spotted.

  Holly took a moment, wanting to start as she meant to go on. ‘Oh yes, poor Alice. But hopefully a few quiet days and she’ll be right as rain, and it’s the perfect excuse for me to get back to work.’ She too glanced at Taffy. ‘I’ve been poised for the off for ages, but it’s good to make a staggered return, don’t you think? And, honestly, finding a decent nanny has made it so much easier.’

  Taffy hesitated, seemingly braced for his beloved to throw him under the proverbial bus, smiling at Holly weakly when she said nothing.

  ‘Speaking of nannies, though, Holls, if I pop home mid-morning, can you go home for lunch?’ Taffy said, obviously not sharing her confidence in Plum’s abilities. ‘We’re not checking up on her if we happen to swing by unannounced, are we?’

  Holly shook her head. ‘She’s really capable, Taffs. I was going home for lunch, anyway, but really? Mid-morning drive-by?’

  ‘I’ll go,’ volunteered Tilly, wandering through reception with a vast takeaway coffee in her hand. ‘Plum’s a sweetie and I’d love an excuse for a coffee break. Plus, you know, it’s less obvious than Dithery Dad here turning up.’

  ‘Dithery Dad?’ Taffy turned and scowled at her.

  Tilly just shrugged with a laugh. ‘Ah, but the truth hurts. Besides, Lulu’s on my list of follow-ups for today. So, there you go, problem solved.’

  The two of them left the room, still bickering, and Holly breathed out slowly. ‘Maybe I’m not the one who’s been most worried about finding the perfect nanny, but I have to tell you, Plum is a wonder.’

  Grace smiled. ‘Well, whatever it takes, it’s truly lovely to see you. It really hasn’t been the same around here.’ She gave a nervous laugh. ‘I have to confess I was a bit worried when Dan said you might be considering a move to private practice.’

  Holly shook her head. ‘I like it here,’ she said simply, seeing no reason to share her convoluted reasoning process. Besides, as far as she was concerned, the timing of being back here couldn’t be better – the perfect way to discreetly dip a tentative toe in the practical waters with her thus-far, theoretical plans.

  ‘How’s little Lulu settling in?’ Grace asked, following her lead. ‘I’ve a call booked in with Keira’s consultant later this morning, if you’d like to take it?’

  ‘That would be really good actually. I need to know whether she’s up to a visit, or whether it would just be too distressing for them both. I gather they haven’t actually seen each other in weeks and I can’t help thinking . . .’ She paused. ‘Well, obviously it’s not my decision to make. She really is a very sweet little girl though; Dan was amazing with her, by the way. So patient.’

  Grace nodded with a smile of recognition. ‘He’s just a pussycat really.’ Another phone line began ringing out on her desk, Lucy still welded to the first, juggling call after call. ‘Now, spit spot, you’ve patients back to back I’m afraid. A few sledging injuries and chesty coughs fitted in for good measure. I hope that’s okay.’

  It was more than okay, as far as Holly was concerned. It was ideal.

  Any opportunity for hesitation or doubt would be eclipsed by the steady ebb and flow of patients. Ten-minute slots, constantly changing personalities and parameters: it was the perfect way to ease herself back into medicine, she decided.

  In at the de
ep end.

  She pushed open the door to the waiting room, hurriedly annotated list in hand. She looked up and the sense of serendipity that had flickered in her periphery all morning announced its presence with a flourish. ‘Daphne? Hannah? Why don’t you both come on through?’

  She hesitated for a moment, unsure for a second where she should actually be this morning. Was her consulting room still actually hers, or was that where Tilly had set up shop?

  ‘Coffee’s on your desk, lovely to see you, Holly,’ called Maggie as she let herself into the pharmacy with the thumb scanner clicking open the lock.

  ‘Come on in then,’ said Holly, taking a breath and pushing open her door, memories assailing her as she took in the all-too-familiar smells, groaning radiator and morning sunlight. ‘How great to see you both today. You’re my very first post-baby patients,’ she said with a smile, determined to put Hannah at ease.

  The teenager was almost a caricature of angst and discomfort, long sleeves tugged down over her hands and hair hanging over her face. A face, Holly couldn’t help but notice, that was visibly less acned than usual, but at what price?

  ‘So,’ she said, ‘what can I do for you?’ She saw no need to let on that Daphne had already given her a pretty good insight into how things were going when they’d spoken at The Deli.

  Hannah refused to look up, her shoulders hunched and abject misery in her every movement.

  There was an awkward pause before Daphne could restrain herself no longer. ‘Oh, Dr Graham, I’m so glad it’s you. I know you’ll understand.’ She reached over and gently pulled back one of Hannah’s sleeves.

  ‘Oh my darling,’ said Holly automatically, struggling to reclaim her professional vocabulary. She took Hannah’s hand and held it gently, waiting for the young girl to look up, taking her time; ten minutes be damned.

  ‘Tell me,’ she said quietly after a moment, when Hannah’s troubled gaze had drifted up to Holly’s face, even through the heavy filter of her fringe.

  Hannah shook her head, tears welling. ‘I just feel so . . .’ Words failed her, but it wasn’t the first time that Holly had seen this look of total, utter desolation on a patient’s face. It was the first time that she’d seen it on a seventeen-year-old girl however, and she felt her newly vulnerable heart break a little.

  ‘You are not alone, Hannah. This is a temporary feeling that will pass. I promise you. This is not for ever.’ It seemed urgently vital that, if Hannah left here today understanding only one thing, it was this.

  Hannah nodded. ‘Mum said the same. But that doesn’t mean I can live like this.’ She dropped her head into her hands and the bleak keening that came from her cut through Holly as surely as the razor this poor girl had taken to her own arms.

  It was as close to a cry for help as Holly had ever heard. She rested one hand on Hannah’s shoulder as she scrolled through her notes on the computer, trying not to completely lose her temper when she saw that Hannah had already been in a few days ago, just after she and Daphne had spoken, and yet her acne medication remained unchanged. Whatever might be the underlying cause of her depression, continuing to give her a drug that listed suicidal ideation as a possible side-effect was nothing short of negligent.

  ‘Hannah?’ Holly said gently, blatantly ignoring the flashing red light on her phone that was no doubt Grace chivvying her along. ‘Hannah? Will you let me help you? I want you to listen if you can, okay? Daphne, it’s important that you hear this too. I need you to stop taking your acne medication. It’s important. And it will take a couple of days to clear your system, so we need to make sure that you feel safe and supported during that time.’

  Hannah looked up, aghast. ‘But my skin?’

  The poor girl didn’t seem able to compute that her skin was actually the least of her worries at the moment, the depression clouding her judgement on almost every level. In so much pain, she was cutting herself to find relief, but terrified of her complexion returning to its previously blighted state. Holly watched Hannah rip at her dry and flaking lips with her teeth, unable to see that this could hardly be considered a preferable outcome.

  ‘Hannah, I think it would be a really good idea for you to talk to a lovely team in Bath, who see this all the time, and hopefully you can stay a few days with them, just while your thoughts settle down. They can help you feel better and there are people there who are specially trained to guide you through your feelings.’ She glanced across at Daphne, hoping that she understood, hoping there was no need to articulate the words ‘suicide watch’.

  All she had to do now was persuade the already overburdened system that Hannah Porter was worthy of a bed. Daphne was a single mum and was already fraying at the edges; in Holly’s opinion sending them home with the emergency phone number for when feelings turned to plans was just too big a risk to take.

  ‘Daphne, can you and Hannah take a seat in the waiting room for a moment while I make a few calls? Don’t go home, just wait for me, okay? Hannah, okay?’

  They left the room, hands clasped together, and Holly breathed out slowly. Talk about a baptism of fire!

  She picked up the phone, trying to arrange her thoughts into the most persuasive argument for a hospital bed that she could muster. The number for the Crisis Resolution Team was embedded in her memory and this time she wouldn’t be so easily fobbed off. This time, there would be no wait and see. She swallowed hard and dialled the number.

  Chapter 26

  By lunchtime, Holly was reeling and she was fully prepared to admit that pedantic Patricia, her return-to-work liaison, may have made a valid point or two. This wasn’t just about finding the perfect childcare, or fitting back into her work clothes; there had been a fundamental shift in how she viewed the world, how emotionally invested she became, and how vulnerable she herself felt trying to tackle her patients’ problems.

  She’d been kidding herself, she realised, if she thought that car park consultations and coffee shop ‘off the record’ chats had kept her eye in. One appointment after another, after another, was like a deluge of suffering and she was like a giant sponge soaking it all in.

  ‘Teflon not Velcro, Teflon not Velcro,’ she murmured to herself as she showed her final patient of the morning to the door. She’d been delicate after having Ben and Tom, but something about the financial necessity of that situation had toughened up her exposed vulnerabilities quickly. This time, with Olivia and Lottie being a little bit older, and with so much more support in place, she had assumed the transition would be painless.

  She’d been wrong.

  She pressed her hand over her mouth to stifle the sob that was building in her chest, shutting herself in her room so that none of her colleagues could bear witness to her losing the plot quite so comprehensively. Was it possible that Taffy, unburdened as he was by hormones and working-mother’s-guilt, actually had a more realistic take on their situation than she did, she wondered, ready to forgive all his overprotectiveness in the light of this new information.

  She pushed her shoulders back, ignoring the hollow ache in her chest. All she had to manage was the short walk through the building and then she was heading home. She’d never been more grateful to Taffy for insisting that half a day was enough to start with, however much she had resented his patriarchal bossiness at the time.

  She walked out of the door and straight into Dan.

  ‘Whoa,’ he said laughing, ‘someone’s in a hurry to get home. Are you sick of us already?’

  Holly shook her head. ‘Of course not,’ she lied.

  Dan shrugged. ‘I find it hard getting back into the swing of things after a fortnight on the beach. I can’t imagine what it’s like for you.’

  The feminist in Holly wanted to stamp her feet in protest at his assumptions, but in reality there was more than a grain of truth in his words. She settled for the middle ground, a half-truth. ‘I guess I’d just got used to having all the time in the world to chat to people, you know, out in the wild. Being their friend as well as their doct
or. Ten-minute-medicine requires a different bandwidth, maybe?’

  Dan’s expression tightened. ‘Well, you wouldn’t need that in private practice. I didn’t realise you were still in discussions with Mike Urquhart?’

  Holly frowned. ‘I didn’t approach him, Dan. And yes, we’re talking, but mainly because the club has disposable funds and I’m keen to help him spend them.’ She paused, not wanting to show her hand too soon. ‘Their sponsorship of Matthew Giles’s Young Carers Group has been invaluable,’ she reminded him.

  ‘So you’re not taking the job?’ Dan pushed.

  Holly shrugged, a little thrown by the intensity of his questioning. ‘Are you asking because you’re worried about losing me, or because you fancy being a Rugby Club GP yourself?’ she teased, unwilling to let him off the hook too soon after his arsey questioning, laughing a little to alleviate the tension.

  Dan just shook his head. ‘Let’s not fall out over this,’ he said ambiguously.

  ‘Deal,’ said Holly. It was easy to agree, with no personal agenda of her own to accommodate. ‘Well, I need to head home, although I was hoping to see Tilly. She popped in to give Lulu her check-up earlier.’

  Dan’s entire demeanour changed at the mention of Lulu’s name and Holly couldn’t suppress her smile. ‘Maybe you could swing by again later? Lulu really seemed to relax around you. Maybe she can recognise the big kid in you? It had to come in useful at some point.’

  Dan gave her a nudge. ‘Oi. Less of the mocking please.’ He paused. ‘She is an absolute sweetheart, isn’t she? I can’t get over the difference in her already. You’d hardly recognise that poor neglected little tyke we found at May’s flat now, would you?’

  Holly found herself conflicted: to her mind, neglect had an element of intent. May had just been overwhelmed and incapable. Was that really the same thing? Thinking about the hungry, dirty child that had been carried into her kitchen barely three days ago, she was aggrieved to find that her own assumptions might be in need of reassessment.