‘Forgive me, Margaret, for I have sinned!’
She sits up in bed. Her shirt is damp with sweat. Her heartbeat pulses in her ears. Nausea swamps her. Why the convent? Why Sister Immaculata? She adjusts to the shadows taking shape around the room, the oak chest by the window, the dressing table cluttered with bottles, the illuminated alarm clock on the bedside table. Six thirty. Saturday. Another hour’s respite before getting up for work.
She’d wanted to visit Margaret as soon as she came home, to draw up a chair next to the chintz sofa, to take her hand and say, ‘I’m sorry,’ but Paul Franklin had advised against it.
‘We need to follow proper procedure,’ he said, ‘now that an official complaint has come through. Need to run your response letter through the medical defence organisation first. There’ll be time to apologise after.’
She curses Alan Tremayne for going straight to the Practice Manager the day after his mother’s hospital admission. Of course proper procedure had to be followed but taking the official route took time.
She closes her eyes. Poor Margaret lying in her Coronary Care bed, surrounded by bleeping machines and flashing monitors. Margaret, being wheeled into the ED room, as a clogged artery was rodded, under the harsh arc lights. Margaret, levitating between light and darkness. If only she’d had the chance to explain herself, Margaret would have forgiven her.
‘It could have happened to anyone.’ Isn’t that what Val had said to her? ‘There’s so much pressure to give telephone advice now,’ she said, ‘when there just isn’t enough time to see everybody.’
Time. Precious time. But complaints procedures take even more time, thinks Ruth as she sinks her feet into the Fair Isle boots by the side of the bed, and shuffles over to the window, tripping over a crimson evening dress which lies discarded on the floor. She lifts the curtain a fraction. A pale pink disc rises behind the office blocks in the distance, casting a large bruise across the sky. Across the neighbourhood, lights blink and curtains are drawn back. Ruth imagines scenarios all too familiar to her from her house calls: the octogenarian sitting in urine–soaked pyjamas, waiting for the sound of a key scraping in a frosted lock, the exhausted parent who has nursed a febrile child all night, the pregnant mother unable to settle after another false alarm.
Why did she agree to go in early today? Surely the lab results could wait till Monday? She picks up her dress and, clutching it like a comforter, climbs back into bed. Burying her face in the soft folds of material, she can smell him. And if she closes her eyes she can picture him too. His good looks, his impeccable manners. Even his aloofness had been appealing to a degree, but there was something else. Beneath that veneer of arrogance lay a vulnerability. She recognised it as soon as she asked him about his family. When he looked away she could see the hurt in his eyes.
With a dart of panic she realises he has her number but she doesn’t have his. What if she never hears from Dominic again? Casting aside her duvet she eases herself out of bed and hears the hot water pipes clank into action.
‘Just a couple of messages before you start,’ says Ginny, as Ruth arrives at the surgery. The receptionist has left her tea- ‘milk, no sugar’- on her desk, with two chocolate biscuits, no doubt by way of sweetener for the requests which follow. ‘The District Nurse needs a prescription for liquid morphine for one of her home visits. Oh, and can you ring Mr Hobbs with his INR result? It came through after the surgery closed yesterday and he wants to know how much warfarin to take. They’re on the computer. Thanks.’
Ruth flicks biscuit crumbs off her skirt, then a pinging noise alerts her to her phone. She extracts it from her pocket and studies the text message.
Morning. How’s the head? Are you free for coffee later? Dom. x
Dominic? Her pulse quickens. She hadn’t expected to hear from him so quickly. A brisk knock makes her jump and, before she has a chance to respond, the district nurse pokes her head round the door frame.
‘Just thought I’d catch you before you start surgery,’ she says. ‘I’m on my way to see Mrs. Phillips and I need that prescription for morphine.’
‘Yes. Of course. Just doing it now,’ Ruth replies, feeling piqued. ‘Can you give me two minutes? I’ll come down to reception with it.’
The nurse retreats and Ruth glances at her phone. Hastily she taps on it.
Sounds good. Could be in Byefield 2ish. Tell me where and I’ll be there. R.
She hesitates, re-reads her message several times, then adds a kiss before pressing ‘send.’
Clicking on the record of the palliative care patient she sees the District Nurse’s request. She scrolls down the drug formulary on the computer screen until she gets to morphine solution. Her phone goes again. God, he’s keen. She looks down and sees that the message is from Val.
Where did you get to last night? Couldn’t find you to say goodbye. Hope you’ve got a good excuse. Ring me later. xx
Quickly Ruth sends back a ‘thumbs up’ emoji. She switches off her phone. No more interruptions.
Turning back to the computer screen she prints off a prescription, signs it and runs down to reception to hand it over to the nurse. Tick. A quick phone call to Mr Hobbs next who is advised on his dose of warfarin. Great. Then just time to dictate three referrals from yesterday before the appointments start. Sorted.
Her first patient is a four-year-old boy. His anxious mother rolls up his sleeve to reveal a well-demarcated rash. He sits meekly, engulfed by the consulting room chair, his large brown eyes looking at Ruth from under a thick fringe.
‘Mrs. Choudhury,’ says Ruth, ‘would you mind if one of our junior doctors has a look at Sanjay’s rash? It’s certainly nothing to worry about but it’s an interesting presentation.’ She calls in the trainee from the adjoining room.
The young doctor takes Sanjay’s arm and inspects the dusky pink targets enveloping the little boy’s hands and arms. He turns to Ruth with a shake of his head.
‘Erythema multiforme,’ pronounces Ruth, stroking the little boy’s arm, ‘It’s a common skin disease and it’s not serious, but these little target lesions are a classic presentation. Most likely caused by a virus and should settle in time.’ The mother’s shoulders drop, as she nods her head and smiles at Ruth. The trainee looks suitably impressed.
Ruth is packing her equipment into her battered leather Gladstone bag when Ginny puts through a call from the pharmacist.
‘Dr. Cooper? Abbey Pharmacy here. We received your prescription for liquid morphine this morning and just wanted to check the dose with you. You’ve requested the concentrated solution. That’s twenty milligrams per ml. It’s usually two milligrams per ml.’
There is silence, measured only by the scudding of Ruth’s heartbeat. She hooks the phone under her chin as she scrolls down the formulary list. Usually the commonest items flash up first on the computer screen, but then Ruth realises the list has been changed to alphabetical order. Hadn’t there been an e mail about it recently? Morphine concentrated oral solution, hardly ever prescribed, comes before morphine oral solution. Fuck. Alphabetical. Simple as that. Fucking alphabetical, just as ‘jail’ comes before ‘jury.’
‘Yes, you’re right. Thanks for calling me,’ she says, her voice splintering. ‘It’s the two milligrams per ml solution that’s required. I’ll drop the new script round to you after surgery. Around one, if that’s okay? Yes? Well, thanks again, very grateful to you.’
She slumps over the desk, her head in her hands. Jesus. Ten times the required concentration? My God, how could she do that? Her skin constricts with goose bumps. Another stupid mistake. What’s wrong with her? And suddenly Sister Immaculata’s dream makes sense. Guilt. Threaded through every fibre of her body since her convent days. Guilt for taking time out of medical school as a student. Guilt that Margaret Tremayne had a heart attack. And now guilt that she’s allowed herself to be seduced by a man who’s recently bereaved.
&n
bsp; Contrition, my child, contrition, she thinks to herself, as she hurries out of the surgery.
9
Ruth
Steam rises from the unfurled umbrellas by the door, fogging the windows of the Cardamom Café. It’s packed and a mixed aroma of fried bacon and damp newsprint lingers. Ruth feels a trickle of sweat run down her back, as she spots Dominic signalling to her from a corner table. Taking a deep breath she squeezes through the packed tables. He rises and offers a stilted peck on each cheek.
‘Dominic, I’m so sorry I’m late,’ she says, brushing matted clumps of hair away from her face. ‘I got held up at work.’
‘No probs. Hope you managed to save a few lives,’ he says, his mouth creasing into a disarming smile.
‘Ha, yes,’ she says, peeling off her coat, twisting sideways to face the little girl who is sitting at the table.
‘Ruth,’ says Dominic, ‘I want you to meet Bella. Bella say hello.’
Bella has scattered coloured crayons over the table top and is engrossed in her drawing.
‘Hiya,’ says Ruth. She’s caught off guard. She hadn’t expected to meet Bella so soon. ‘That looks interesting.’
The child looks up through a curtain of blonde hair and stares at her. Her azure eyes are like saucers and remind Ruth of her cat. ‘It’s a hole,’ she says. ‘A big, blue hole.’
‘I’ve ordered some food as Bella was getting fidgety,’ says Dominic, sliding the pile of coats across the upholstery. ‘I hope you don’t mind.’
‘Of course not,’ says Ruth. Mind? It’s their first date and he’s brought along his four-year-old daughter? But then what was he supposed to do? Contrition, nags an inner voice. ‘Gosh, it’s warm in here’ she says, feeling her cheeks colour.
A waitress appears with a dish of ice cream, prompting Bella to drop one of her crayons. ‘Banana split?’ says the young woman, lowering the confection onto the table and stepping back to look at Dominic with a degree of expectation. ‘Can I get you anything else, sir?’ Dominic turns to Ruth.
‘Just a cappuccino for me, please,’ says Ruth.
‘Me too,’ says Dominic, ‘and maybe a jug of water.’
‘Daddy, look at that lady’s dragon,’ pipes up Bella, as the tattooed waitress disappears. ‘I’m going to draw a dragon,’ she says, picking up a red crayon.
‘Later, Bella,’ Dominic says, collecting Bella’s crayons and placing them to one side. ‘So how was this morning?’ he says, turning to Ruth. ‘Busy, I expect?’ He fixes a stray clip in Bella’s hair and strokes the top of her head. Something stirs in Ruth’s chest.
‘Oh, just the usual,’ she replies ‘Nothing that couldn’t be sorted.’ She smooths back her hair. She must block out the anxiety of her near-miss this morning. Plenty of time to ruminate over that when she gets home. ‘So, I hope the Ball was a success.’ They exchange glances and she thinks about their embrace by the cloakroom.
‘Yes, let’s hope they raised lots of money.’
Dominic leans over and carefully picks bits of banana off Bella’s sleeve, transferring them to a napkin, which he screws up into a tight ball. Ruth can’t help observing his right hand. Why didn’t she notice it last night? A mild deformity, the proximal finger joints hyperextended, the distal ones flexed. She remembers seeing a similar case as a student. Rheumatoid arthritis maybe? She can’t be sure but reminds herself to cast off her doctor’s hat. She’s off duty now. She looks away.
The waitress returns, balancing a tray of coffee cups and a water jug, and looks at the mess Bella is making. She removes some of the scrunched up paper from the table. ‘I’ll bring you some more napkins,’ she says with a smile.
They sit in silence, watching Bella, until both speak simultaneously. They laugh.
‘Go ahead, please,’ says Ruth.
‘Oh, well, actually, I was going to say is everything okay?’ offers Dominic. ‘You seem a little pre-occupied.’
His intuition catches her unexpectedly. ‘I’m fine. It’s just that … I had a busy morning and I…and I haven’t been sleeping well. I’ve just got a lot on my mind at the-’
‘Daddy.’ Ruth feels a sharp kick on her knee as Bella wriggles along the seat.
‘Not now, Bella, please. Ruth is talking.’
Ruth watches Bella making ice cream swirls with her spoon and silently chides herself for being so selfish. ‘Oh gosh, I’m sorry. That’s very self-indulgent of me to start talking about my problems. Enough about me. What about you?’
Dominic shifts in his seat. ‘Oh, we’re muddling along.’ He leans over to tuck a napkin into the collar of Bella’s dress, carefully lifting her hair out of the way. An endearing gesture. ‘Nothing much to say. I’m more interested in hearing about you. You were saying last night that you worked in Australia?’ he says, as he twists in his seat to face her.
‘Yes. I wanted to spread my wings.’ She laughs. ‘After I graduated from Leeds I did a year in Paediatrics, then a year in Obs and Gynae so I could get an Australian licence. Then off I went. I was in Melbourne for two years.’ She pauses and takes a sip of water.
‘What made you come back?’
‘Good question,’ says Ruth. She looks away. There is a man two tables away whose profile bears a close resemblance to Mark’s. Blonde hair, broad physique. He’s sitting with three kids, and a slim attractive woman, who is probably their mother. He turns to say something to one of the kids, bringing his narrow chin and small eyes into view. Of course it’s not him. Mark is in Australia. Ruth looks back at Dominic. ‘I guess I’d got tired of travelling. I missed my parents. And my friends.’
‘Fair enough,’ says Dom, ‘a case of the grass isn’t always greener.’
She smiles. ‘You could say that.’
Bella pushes her plate away.
‘Have a bit more, Bella,’ says her dad, putting his cup down.
‘No! Don’t want to!’
‘Come on, one more mouthful.’ He tries to coax her, but Bella is having none of it. He lifts the toy kangaroo, lying on the seat next to her. ‘Watch out, Roo, will finish it if you don’t.’ Her mouth is clamped shut, her face set in grim determination. ‘One more, then we can go to the park and feed the ducks.’ He reaches over for the little girl’s spoon just as Ruth lifts the water jug to re-fill her glass. The glass is knocked sideways.
‘Oh. I’m so sorry,’ says Dominic, grasping a paper napkin and dabbing Ruth’s soaked thigh. His hand lingers and their eyes meet. Beneath the table she rests her hand on his for a few seconds.
‘It’s okay it was my fault.’
‘Daddy, I need a wee.’ Bella’s voice pricks at Ruth’s conscience like a tack stuck to the sole of her shoe.
Dominic folds his lips. ‘Would you excuse us please, Ruth,’ he says, sliding Bella out of her seat.
Ruth stirs her coffee as father and daughter criss-cross the room. Blonde curls bounce on Bella’s collar as Bella pulls on her father’s arm. Poor Dominic. And poor Bella, having to grow up without her mother. She waits until they are out of sight then extracts her phone from her pocket and scrolls down to Val’s number.
Call u later. So much to catch up on.
By the time they leave the café it’s stopped raining, but a chill breeze feathers the water of the boating lake. The boathouse is padlocked, the ice cream kiosk is boarded, its metal sign creaking in the wind. A few people, muffled in thick scarves, walk the perimeter of the lake.
Ruth wishes she’d had time to go home and change instead of coming here straight from work. Her pencil skirt feels tight, her court shoes uncomfortable, as the wind whips round her legs, forcing her to march briskly. Dominic is smiling at her.
‘I didn’t exactly come dressed for the occasion, I know,’ she says, as if reading his thoughts. ‘I’d give anything to swap these for my trainers right now.’ She lifts her foot and points her shoe in the air.
‘Maybe next time,’ he replies, raising a quizzical eyebrow. He rummages in his rucksack for a pair of knitted gloves and a woolly hat. ‘Come here, Bella,’ he says, catching the tail end of Bella’s coat. ‘Let’s put your hat and gloves on. Let me have Roo. We can put him in Daddy’s bag so he doesn’t get lost.’ He squats down beside the little girl, and a gust of wind ruffles his thick locks. He pulls the hat down over her ears. Bella remains rooted to the spot and tight-lipped, but as soon as he’s finished she skips away. ‘You don’t mind if we walk to the other side of the lake, do you?’ asks Dominic, ‘Only I’d promised Bella we could feed the ducks.’
‘Of course, not,’ she replies, her breath curling away from her as she shivers in the crisp air. They fall into step together and, as they pick up a steady pace, she feels the blood rushing to her calves, elevating her stride. Bella stops to pick up a stick, then runs after a pigeon, her pink wellies slapping along the uneven tarmac. ‘You’re doing a great job with Bella, if you don’t mind me saying. She’s a lovely little girl.’
Dominic casts her a sideways glance. ‘She’s not been well recently. Something’s been bothering me. Tell me, you’ll know this as a doctor. Is multiple sclerosis hereditary?’
The question catches her unaware. It’s barely twenty four hours since they met and already he’s picking her brains as a doctor.
‘Why?’
‘Bella’s had a couple of bladder infections recently. I worry about these things.’
Bella stamps through a puddle and laughs as the muddy water sloshes up her wellies. She’s behaving like any normal four-year-old, but concern is mapped across her father’s face. Ruth castigates herself. He’s probably just anxious, he’s recently bereaved after all.
‘Urine infections are quite common in little girls,’ she says, as they pass an elderly lady walking her dog. ‘I’m sure it’s nothing to worry about. Maybe she’s a bit run down. I’m sure it’s not connected to multiple sclerosis.’ She lifts her collar, tucking in some stray hairs. They walk on in silence, content to watch Bella zig-zagging across the path. Minutes pass before Ruth feels the need to strike up conversation again.
Love Until It Hurts Page 5