by Nancy Peach
“Oh, good grief! You are utterly impossible. Look, I’ll call Mum later today. Maybe you should leave things for a bit?”
“Let me guess, you’re worried I’m going to make things worse?”
“Don’t be ridiculous. I just know how upset you are, and I expect she does too. I’ll talk to her and we’ll go from there? And how about you see if you can avoid further alienating any of her doctors, particularly her favourite one? Sounds like it might be better to have this Dr Carter onside?”
“Too late for that. Sorry. She’s going to hate my guts now. I mean, I probably was just a little overbearing, but she needed to hear it. I’m certainly not going to apologise to her.”
“Okay, whatever. Tell Mummy I’ll call her later, okay? I love you, Eddie. Take care.”
Tess meanwhile, had been called in to have a conversation with her boss. Dr Fielding made them both a cup of tea and sought to reassure her that she was not in any trouble. He had a calm voice that soothed Tess’s frayed nerves as he outlined the conversation he had already had with Edward Russell.
“He’s very distressed, Tess, but he’s an eloquent and articulate man,” Dr Fielding said, peering over his wire-rimmed spectacles. “I wonder if you caught the sharp end of his tongue somewhat. Hmm?” He leaned forward and steepled his fingers together on a desk piled high with old journals.
The gentleness of his tone and the level of understatement about exactly how sharp Edward Russell’s punishing tongue had been overwhelmed Tess and she began, in spite of her best efforts, to cry. She still couldn’t reconcile the man she thought she knew with the one who had accused her of those awful things.
“He’s horrible,” she spluttered through her tears. “He’s horrible to me; he’s horrible to his mother. He’s forcing her to undergo treatment that she doesn’t want and his response to anything other than total obedience is to bully people into submission. He’s rude,” she continued. “He’s arrogant. He’s obnoxious.”
“And he’s clearly upset you a great deal. Yes?”
She nodded miserably, wiping her tears away with the back of her hand.
“He may indeed be all those things you describe,” said Dr Fielding. “I have to say that I found him to be polite and quite considerate, but I know that people behave in different ways according to audience and scenario.” He paused. “But – and here is the crux of the matter – he is grieving. He is going through the angry phase of his bereavement process a little prematurely, and he is lashing out.”
“Yes, but I know all that,” Tess blurted out before she could stop herself. “Sorry, with the greatest respect and all, I know that. And if it were just me he was being vile to, I could absolutely take it on the chin. My concern is for my patient, his mother. His behaviour is having a negative impact on her and he is bullying her into decisions about treatment.” She leant forward in her chair. “I think this is potentially a safeguarding issue. Mary is vulnerable and he is coercing her. It’s simple. And it’s not on!”
Dr Fielding strove to avoid a patronising tone. “Tess. This is your first job in palliative care, yes? And you enjoy it, you like the patient contact, the holistic nature of the role?”
“Yes. I really do.”
“The thing is, palliative care is not the pink and fluffy creature that our surgical and medical colleagues like to suggest. You need balls of steel for this job, forgive the euphemism. I suspect there is a gender-neutral alternative but I can’t pluck it out of the air at the moment.”
She smiled, this time a genuine, although shaky, one.
“You need to be tough. Really tough. These are not insignificant decisions; they are literally life-and-death decisions. These are not minor feelings we are encountering; they are right out of the top drawer of high-intensity emotions, the strongest, most basic of instincts we are dealing with here: grief, anger, hurt, loss, pain.” His fingers relaxed out of the steeple and he placed his hands flat on the desktop. “I can’t tell you how much it irritates me when people assume that end-of-life care is all about aromatherapy and mood lighting,” he said, and Tess laughed. “That’s better. Now, I know that you are coming from a good place on this. And I applaud your dedication to your advocacy role, I really do. But you are too invested in this particular case and it will be more destructive for you than you realise if you don’t detach yourself a little. Does that make sense?”
“Yes. Of course. I understand.” She continued to look troubled. “He said that if she died, he would blame me and suggested I shouldn’t be a doctor anymore. Could I be accused of negligence or I don’t know…?”
“What is it you’re worried about?”
“It wouldn’t be my fault if she died, would it?” she asked in a small voice.
“Tess,” he peered over his glasses again. “You know that you’re not responsible for the death of this patient. She’s already dying.”
She nodded.
“However, I cannot promise that her son will see it in the same light. He may well hold you personally accountable for his mother’s death, however unreasonable that may seem. There is very little you can do about it. Grief is not reasonable.”
There was a brief silence as they both mulled this over and Tess shifted in her chair. “Thank you, that really helps. And you’re right, of course. I need some distance from this entire case.”
“Another thought, Tess.” Dr Fielding gestured back at the chair. “Mr Russell does not strike me as a man who enjoys having his vulnerabilities exposed.”
She gave a snort of agreement as she sat back down.
“No. Indeed,” he said, “it occurs to me that the reason you may have been on the receiving end of the majority of his animosity is because perhaps you have witnessed him in moments of what he would perceive to be weakness? Yes?”
“I suppose so.”
“And that’s not your fault. But when someone has opened up to you, there’s often a bit of fallout if they subsequently regret lowering their guard.”
He leant back with an air of conclusion and gestured towards the door. “Now, you go and enjoy your bank holiday weekend. Next week, a fresh start, and I would suggest that whilst you attend to all of Mrs Russell’s medical needs, you perhaps avoid lengthy existential conversations for the time being. I think I can persuade her son that intervention on a purely clinical level, as provided by yourself, will be entirely suitable and appropriate.”
Tess had her hand on the door before she spoke: “Dr Fielding, thank you. You’re really very… wise.”
He smiled broadly. “Thank you, Tess, but rest assured, we all doubt ourselves from time to time, and whenever I’m feeling too smug about my own staggering genius, my wife, who is a professor of astrophysics, disabuses me of the notion fairly rapidly. Now off you go.”
Chapter Thirteen
Tess made the journey home to Sheffield the next morning and brought Morris, who was happy stretched out across the parcel shelf in the sun. She was really looking forward to seeing her mum and felt that it could not have come at a better time, given recent events. She felt completely wrung-out and Kath, who had known something was amiss, approached the topic with her usual candour.
“Tess, babe,” she’d said. “It’s pretty clear there’s something kicking off at work. At least, I’m assuming it’s work because let’s face it, there isn’t exactly a whole heap of other stuff going on in your life at the moment.”
Tess pointed out that being alerted to the shoddy state of her work–life balance was not the most helpful in terms of cheery reminders but Kath remained unabashed.
“It must get a bit draining, is all. You’re there all the bleedin’ time and it’s a pretty intense job anyways. You need to get yourself home, bit of quality time with your mam and that gorgeous brother of yours – well, I mean, he is, you can’t deny it – anyways, you’ll be grand.”
Tess had to admit Kath was probably right. The strain of attending to other people’s needs was starting to take its toll, and as she left the mo
torway and joined the meandering A-roads, she opened the windows to let in the bracing air, taking a couple of deep breaths and feeling the tension in her neck and shoulders ease. Even her forehead relaxed and she realised that she had grown accustomed to a perpetual frown for the past few days, which was most unlike her. Every time she came back to Yorkshire she enjoyed the freedom of vast open space; even when in the centre of the city, you could often see glimpses of dramatic natural landscapes if you raised your eyes to the skyline and took in the surrounding hills. It seemed that on this occasion the further north she went the less constrained and suffocated she felt, a sensation that was odd given the fact that the reverse had been true when she initially left home at eighteen and headed south for the broad horizons of university life. She supposed she had been escaping in a different way at that time, and perhaps the geography was immaterial; what mattered was the getting away, the putting of physical distance between herself and a problem. Either way, although her family home was neither grand nor picturesque, the faded ex-council house set in a terrace of identical stone-clad properties looked so welcoming as she pulled up outside that she almost wept.
Jane Austen sighed contentedly. “The comforts of home are truly a restorative salve for the troubled soul,” she said as Tess dropped her bags in the cluttered porch and released Morris who was wriggling under her arm. He padded off to rediscover his favourite haunts and Tess found him in the kitchen, purring loudly as he rubbed up against her mother’s ankles.
“Mam.” They hugged and Tess breathed in the scent of hairspray and clean washing.
“Perfect timing, pet.” Her mum reached up to take two mugs off the shelf. “I’ve just put the kettle on. You’ll be needing a brew after that journey.”
“Yeah. Ta.” Tess sank into one of the kitchen chairs and propped her elbows up on the table, exhaling loudly.
“You sound a bit tired.” She looked more closely at her daughter, this time noticing the groove at the top of her nose where a worry line was forming.
“Are you all right, love?” She pulled up a chair opposite. “You’re not quite yourself? Is it Scott?”
“God no! It’s nothing to do with him. I haven’t given him a second thought.” As Tess said this the truth of the statement hit home. She really hadn’t thought about Scott and Luke for ages. “It’s difficult to explain. I guess work has been getting me down a bit.”
Her mum paused in stirring her tea for a moment, the spoon held in mid-air. She had never heard Tess complain about her job before. “Do you want to talk about it?”
“Actually, no. Just being home makes it better. It’s nothing specific anyway.” Tess picked up her mug, blowing across the surface and staring into the distance. “Can I do anything? Help with lunch or something?”
Her mother went to the breadbin and brought her over a pack of rolls. “You could butter those bread buns while I get the soup on,” she said, seeing that her daughter needed an activity to occupy her before she would start talking. She opened up a tin of soup from the cupboard and poured it into a saucepan. “I’ll do us something nice for tea,” she said. “Viv and Gina are coming over later, your Aunty Gee’s looking forward to seeing you, and Jake’ll be here too. He’s bringing that new lass with him – nice girl, sounds like. Another trainee teacher. Met her at college.” She paused again. There was silence and then, as predicted, Tess began to unburden herself.
“It’s just… this guy,” she said.
“Go on…” Her mum raised her eyebrows in a question.
“No! It’s nothing like that. Really, it isn’t. There might have been a time in the past, I mean, I sort of knew him before and I thought… But it was a long time ago, and people change, and if anything, it’s the complete opposite now.” She continued to butter the rolls, aware that she wasn’t making much sense. “He’s not a patient, but his mother is, and she’s dying – obviously – it’s a hospice, so no surprise there, but he’s not accepting it.”
Her mum started to open the cutlery drawer, removing items with as little noise as possible, like a middle-aged cat burglar with a penchant for teaspoons.
“I guess he blames me for not doing more,” said Tess. “She’s had enough of all the treatments and she wants to stop. I told him that and he got angry, said some stuff about me having a chip on my shoulder and being a crap doctor. He’s making out like I don’t care, or I’ve got my priorities wrong, and really, it’s him, he’s the one who’s in the wrong.” She looked down at the rolls. “Mum, this butter’s way too hard to spread. Has it been in the fridge? You got any marge?”
Her mother silently handed her a tub.
“But then of course he’s grieving, and I spoke to my consultant and he said he’s bound to be confused and lashing out, but he… Oh, I don’t know… It was just so horrible.” She raised the back of her hand to her eye.
Tess’s mum was not one to offer unsolicited opinions, particularly where the world of medicine was concerned. She weighed up her words carefully. “Right. So, this lad… he really loves his mum and he’s proper cut up about her dying.”
Tess nodded.
“He’s furious with everybody. Including you, yeah?”
“Particularly me.”
“But you’re doing your job properly, like, and presumably this happens all the time in the hospice. So… why the bother? Why are you hauling yourself over the coals about it, pet?” She sat back down in front of her daughter and took her hands in her own. “He obviously had a right go at you, but people say all kinds of daft stuff when they’re grieving, love. D’you remember that earful I gave the nurse looking after your gran? I were a proper cow to her.” She smiled. “I did go back and apologise afterwards, mind. You never know, this lad may do the same?”
“I think that’s pretty unlikely. He’s not really the type to admit he was wrong.”
“So… why d’you care? He don’t sound like someone whose opinion would matter to you.” There was a pause while she regarded her daughter, a curious expression on her face.
Tess shrugged. “I don’t honestly know, Mum. I agree, it doesn’t make any sense. I guess, to start off with, I actually did sort of value his opinion?”
“I see.”
“God knows why. I mean he clearly has no regard for me or my professional judgement. But… we’d chatted a bit over the weeks and kind of got to know each other better, and I thought perhaps… As I said, I knew him before, sort of, but he doesn’t remember me and that in itself kind of hurt my feelings a bit. I don’t know. I’m being stupid letting it get to me like this.”
Her mother gave her a shrewd look, sensing a lot of what had been left unsaid. She poured the soup into two bowls and brought them to the table with a tiny frown. “Right, love, let’s get this down you and then how about you go have a nice bath and a kip upstairs?” She put her arm back round her daughter. “Sounds like you just needed a bit of time back at home with your mam, and Jake of course, whenever he gets here – we’ll be like three amigos again! Oh, I’ve missed you both!” She gave Tess a squeeze. “After you’ve had a snooze maybe we’ll head over to Meadowhall for some shopping, buy yourself something nice?”
“That sounds good.” Tess started ripping up her bread roll with a decisive action and dropping sections of it into her bowl. “I’ll be fine, honestly. This bloke… it’s nothing I haven’t had to deal with before. I’ve just got to be professional about it, you’re absolutely right.”
After lunch. Tess took her bags upstairs whilst her mum ran her a bath. Once wrapped in her towel she entered the bathroom, followed by Morris who seemed to have no natural feline aversion to water and often chose to sit in the sink drinking from the tap. Crossing the floor, she stubbed her toe on the set of scales poking out from beneath the cabinet and swore under her breath, thinking back to the times she had stood poised above them, half looking at the dial and hoping they were broken.
She avoided the temptation to get on the scales now, taking the stubbed toe as fair warning.
The last thing she needed was tangible evidence of weight gain to whittle away at her fragile self-esteem. The television host had been more vocal these past couple of days, capitalising on her insecurities around work, and she had already decided to allow herself one more binge when she returned to Bristol. The thought calmed her.
She forced herself to drop her shoulders and relax into the bath, to enjoy the sensation of being back on home territory, because whilst there were reminders of youthful angst here, there was also comfort and familiarity. The tiny room was filled with the perfumed steam of her mum’s favourite bubble bath, the water was hot and soothing, and a cup of tea had been left next to the splayed toothbrush and soap fragments along with a rolled-up copy of Marie Claire magazine wedged behind the tap. It was as close to a spa as her mother could make it, and Tess felt suitably pampered by her little gestures. She made a conscious effort to drown out the voice of the television host and clear her mind of negative teenage memories, along with all traces of Edward Russell and his cruel words, as she closed her eyes and sank beneath the soapy suds.
Later they went shopping, Tess buying herself a new top and treating her mum to a pair of shoes. There was the usual wrangle over payment, her mother predictably embarrassed to have her daughter feel it necessary to fund her wardrobe, but Tess could see as soon as her mum tried on the shoes that she was hopelessly smitten with them. She had even responded with a flirtatious giggle to the sales assistant who insisted that of course she wasn’t too old for them. “After all,” he said, “it’s not everyone who has a fine pair of legs like that, miss. It’d be a crime not to show them off to their full advantage and those shoes look right classy. See, even your sister thinks so.”
Tess rolled her eyes at this blatant sales patter, but her mum, usually so vigilant against flattery, blushed and told the young man that, actually, this wasn’t her sister but her daughter, a comment that was predictably greeted with disbelief. It was evident from this point on that she had to have the shoes and eventually Tess managed to persuade her to accept them as an extra birthday present. She felt a glow of happiness in her stomach to see her mum so overjoyed with her new heels. She knew how much she loved a little touch of glamour; it was just that she could so rarely afford it.