Unperfect

by Susie Tate

  Anything but Easy

  Susie Tate

  Chapter 1

  Are you even a bloody doctor?

  Kira

  “Kira, you maniac!” Mark grunted, finally dropping the remote after I elbowed him in the stomach. My face split into a wide grin as I scrambled away, remote in hand.

  “Man up, Marky Mark,” I said, pressing some buttons to change over to BBC HD. “You know I gotta get my news on in high-def these days. And you were about to turn over to Say Yes to the Dress, you big queen.”

  “I’m a queen and proud Ki-Ki. And since when don’t you like Yes to the Dress?”

  “I think we could all do with a bit of current affairs, don’t you, Mark?” I used my best haughty tone as I flung my arm out to the rest of the genitourinary department coffee room. Apart from me and Mark, there was only a locum GU consultant who was trying his best to ignore us, and Sandra, a staff nurse so used to me that she barely even looked up from her tuna salad. “Some of us care about the world at large.”

  I paused the telly and took a deep breath in. Mark held up both his hands and shook his head.

  “Kira, don’t you dare si–”

  I leapt off the sofa, got right in Mark’s face and went into my version of Fight the Power by Public Enemy, complete with my pop and lock rap moves.

  I was cut off by him dragging me up from a slut drop and clamping his hand over my mouth. Just as I was getting into it, the fun sponge. Sandra’s shoulders were shaking with laughter.

  “No. Rapping.” Mark looked at me sternly. “You are a small white English girl with hippy tendencies, not an African-American freedom fighter from the ghettos of New York.”

  “We can all fight the powers that be, Mark.” I grabbed the remote and started up the News again. “But it starts with us being well informed.”

  The headlines came to an end and I sat back with a dreamy sigh as He filled the screen. Mark rolled his eyes.

  “Well informed, my arse. You’re obsessed . . . with a fucking Tory.”

  I shushed him, my gaze intent on the glorious sight in front of me as I leaned forward over my knees to get a better look.

  “Yeah,” I breathed. “Yeah, you dirty little politician, you. Wear that suit, you naughty man. Own it. Work it.”

  You’d be forgiven for thinking I was watching a Magic Mike routine rather than the current Minister of State for Business, Energy and Clean Growth walk out of Number 10 Downing street and get into a waiting car. He was tall, taller even than the close protection officers that flanked him, and he filled that immaculate suit out nicely. His hair was dark but his eyes were light blue and piercing. Every time he looked into the camera during a speech, he gave me shivers up my spine.

  “I love the way he ignores the press. He’s always got this stern, serious thing going on.” I flopped back with a loud groan as the image of Barclay Lucas was replaced by Fiona Bruce. I fanned myself for a minute. “Holy cockwombles. I’m so turned on I’m not sure I can cope with my clinic this afternoon.”

  “This obsession is getting weird, Ki Ki,” Mark said. “I mean he’s hot, but honestly. A politician?”

  “But I love his commanding presence. The way he doesn’t take any crap. He’s just like taking global warming and giving it a good spanking. He cares about stuff. And, well, he’s got a nice arse. I think. Under the suits. At least, I imagine it’s nice.”

  I would agree with Mark that Barclay Lucas was not the most logical subject of a Kira Crush – there was a gaping chasm between him and my normal type (think dreadlocks, eyelids half-mast after smoking too much weed, questionable personal hygiene). But the thing about Barclay was that even if his party did support cuts to legal aid, housing benefit and didn’t fully support unions, the times I’d heard him speak on Question Time or in the Houses of Parliament (yes I might be a bit of a flake, but that doesn’t mean I don’t like to get my politics on of an evening) he had this fire in his eyes, this passion for change. Despite being a Tory, he still seemed to be bent on improving social inequality. And he was the driving force behind the Energy Revolution, which he believed would benefit the most disadvantaged in society and the environment. After nuclear fusion producing clean energy for the national grid became a real possibility two years ago, some politicians had been dragging their feet. Barclay was certainly not. And the way he spoke about it – the intense focus and absolute clarity of his words – it was impossible not to believe him. It was impossible not to believe that yes, Barclay Lucas could save this country. In fact, forget the country: Barclay Lucas could save the world.

  “Well, he’s gone now so can you please . . .” Mark made another lunge for the remote, but when he was within reaching distance I smirked, leaned forward and licked his face. He had this weird thing about germs. He wouldn’t eat a pasty after it had fallen onto the canteen floor, not even when it was within the five-second rule – fussy, wasteful weirdo.

  “Ugh!” he said, recoiling in horror. “You are so gross. I do not want girl cooties, thank you very much.”

  “Plenty of peeps would pay good money to have me lick their faces,” I told him, before catching the locum consultant looking over at us in horror and giving him a cheeky one-eyebrow raise. He abruptly abandoned his cheese sandwich and made a dash for the nearest exit.

  “Try not to scare off the locums, Kira,” Sandra said in a patient tone, shaking her head. “You know it’s hard enough to get them in the first place and he’s one of the good ones.”

  “He’s a pussy is what he is,” I muttered under my breath, snatching up the uneaten half of the cheese sandwich he’d left and shoving it in my mouth. “Come on, losers. Those willies and foofs out there aren’t going to save themselves.”

  “Actually Kira, you’re not doing the walk-in today,” she said. “Prof’s had to go to some type of emergency meeting. You’re covering his HIV clinic.”

  I smiled. It wasn’t that I minded the bread-and-butter genitourinary medicine stuff, but once in a while it was good to actually get stuck into some difficult cases, and Prof’s clinics were full of those.

  *****

  I sighed and sat back in my chair to look at the gaunt, scruffy, but surprisingly still handsome, man in front of me. Surprisingly because the skin of his face was red and flaky with seborrhoeic dermatitis, his cheeks were hollow and he wore a sullen, pissed-off expression. Why had I thought that tackling tricky cases would be a nice change of pace? This guy was just depressing. When I’d seen that his second name was Lucas, I’d felt like it was a cosmic sign of how well my day was going to go. I was very into cosmic signs. For me, daydreaming about a guy called Lucas and then seeing that same name on a set of notes in front of me was a good one. I was now realising that my theory had some holes.

  “Mr Lucas . . . Henry,” I said, noticing a flinch at the use of his first name, but still no attempt at actual eye contact. “Since your hospital admission with PCP you’ve been on antiretrovirals for a good few months.”

  Henry had had a dry cough for long time which he had ignored until it became difficult for him to breathe. He was admitted to hospital a year ago and his chest x-ray showed diffuse shadowing, suggesting Pneumocystis Carinii Pneumonia, or PCP – a marker of the immunosuppression associated with AIDS. An HIV test was requested in his first set of blood tests and the result had been positive. The pneumonia was treated with antibiotics and he was discharged with antiretroviral medication, but he’d missed two follow-ups in clinic since then. The one time he had actually attended, Prof had described him as having a ‘flat affect’, meaning he’d appeared emotionless. Prof had been concerned, but his attempts to contact Henry after his subsequent missed appointments had been unsuccessful.

  “Your CD4 counts and viral load aren’t improving. I . . . there doesn’t really seem to be a reason why they’re not getting any better. We’d expect at this stage for there to be a drastic change in the numbers.”

  Henry shrugged and scuffed his feet on the floor. His hair looked greasy an
d he had a good few days of beard growth on his face – not in the nice, trimmed and trendy beard way, more like the homeless person way.

  I cleared my throat and tried again. “Do you . . . Henry, do you actually take the meds?”

  I waited and watched as he shrugged his thin shoulders, before giving a short nod: not altogether convincing.

  “I mean, if you were taking the antiretrovirals your CD4 count should be almost undetectable and I just –”

  “You done?” he cut in, scraping his chair back and pushing up as if to leave.

  “Uh, I –”

  “Because this was supposed to be Professor Patel’s clinic.” He flashed me a brief unimpressed look. “Not sure I’m up for a lecture from one of his minions, to be honest.”

  I took a deep breath in through my nose and let it out again slowly. It wouldn’t do to punch one of the HIV patients in the face.

  “For fuck’s sake,” I muttered under my breath.

  “What did you say?” he asked, eyes wide and no longer looking down at his feet.

  “I said . . .” I paused to reflect on the consequences of expressing my real opinion. All too often I’d landed in hot water for just that. But nothing was getting through to this guy. Prof had been trying to contact him for weeks and he’d only gone downhill. I decided to take a chance. “I said, for fuck’s sake.”

  Henry’s mouth dropped open. At least I had his attention. “You can’t speak to patients like that! Who the hell do you think you are?”

  “Er, well the swearing police haven’t exactly broken down the door so, I’m gonna take a guess and say yes, yes I can. Or rather yes, if the patient in question is a misogynistic dickhead.”

  “Excuse me?”

  “Listen, I am trying to help you here. Do you think I sit around in clinic waiting to talk lying wankpuffins into taking their life-saving medication that the NHS is providing for them for shits and giggles? Do you have any idea what someone in Sub-Saharan Africa would do to get their hands on these meds? Well? Do you?”

  I had full eye contact from Henry now.

  “You-you called me a wankpuffin . . .” he spluttered, looking a mixture of shocked and bizarrely ever so slightly respectful. “What does that even mean?”

  “I’m sure that in other areas of your life, Henry, you’re a perfectly reasonable human being,” I told him. “But as far as this clinic goes and this treatment, you are being a wankpuffin. Now, do you want to tell me why you’re not taking the medication?”

  “You can’t speak to me like that.” His tone was angry now and he was leaning forwards in his chair towards me. “Are you even a bloody doctor? You don’t look like a doctor.”

  That, I thought, was a fair comment. I was wearing a pair of loose sarong trousers I’d bought at the Full Moon Party in Thailand, and a gypsy top complete with tiny mini mirrors around the hem. My earrings were long and contained the odd feather. I also had flip-flops on.

  “Henry, I assure you I am a qualified doctor. I–”

  “So what are you? First year or something?”

  “I’m a registrar.”

  He looked genuinely shocked and swiped his hand through the air in dismissal. “No way. No way in hell.”

  “When I was applying for training, I would not have got away with wearing this. Not much they can do about it now though. As you can see, we’re not exactly overstaffed. The first thing I did after the interview for my training scheme was give away all my stud earrings. So, now that we’ve established my credentials, let’s get back to the task at hand. Why aren’t you taking your meds? No bullshit this time.”

  “Ugh!” Henry flung his hands up and slouched back in the chair. “What’s the fucking point? They won’t cure me, will they? There’s no goddamn cure for this bloody disease.”

  I shifted forward in my chair and waited until I had full eye contact with Henry before I spoke.

  “You are probably always going to be HIV positive, yes. But that doesn’t mean you have to die from it. The medications now can control it so that it becomes just another chronic disease, like diabetes.”

  “Don’t you get it?” he exploded, suddenly jumping out of the chair and pacing up and down the room. “I don’t want to live. Who wants a life where they can’t do anything meaningful? I used to be the big man – did you know that?” He laughed, but there was no real humour there. “At least I thought I was. Living the high life, fast women, fast cars. I thought I was the dog’s bollocks, and then . . . bam! All of that goes away.” I watched as the angry energy drained out of him and he sunk back into his chair. After a minute of silence he spoke again, but his voice was much quieter than before. “The worst thing is . . .” He swallowed and cleared his throat before carrying on in a husky, low voice. “The worst thing is that I brought it on myself. I’m not one of those innocent people who picked up HIV ‘through no fault of their own’, I shot it into my arm along with the drugs I was taking at the time . . . for a laugh. Because I was bloody bored.” He looked back down at the floor and heaved a sigh as his shoulder slumped in defeat. “I deserve to die,” he whispered to his feet.

  I closed my eyes slowly and felt my chest tighten. When I opened them, I saw a tear tracking down one of his hollow cheeks.

  “You don’t deserve to die, Henry,” I said, softly now, but all I got was a sniff in response. “Do you think that just because you lived large and had a good time you deserved to contract a disease and die from it? Nobody deserves to contract HIV. It’s not like you were injecting heroine into small children’s eyeballs and the needle slipped. You were using it as a recreational drug for yourself. You made a poor choice. That doesn’t mean you deserve to die.”

  “I should go,” he muttered, his hands going to the arms of his chair as if to push up to standing again.

  I acted on instinct and my hand shot out to cover his thin forearm. “And who says you can’t have a meaningful life? Lots of people with HIV live very full lives.”

  Henry shrugged, but did settle back into the chair. “You know what I mean,” he whispered.

  “Ah,” I said. “Intercourse!”

  Henry blinked once before staring at me. “You are not normal.”

  I waved a hand dismissively in front of myself. “Of course I’m not, but that’s beside the point. You want some punani, yes? I mean, I’m guessing you’re not gay. My gaydar is better than a Grindr app at an Elton John concert, and you, my friend, are straight. Also, I hate to generalize but gay men tend to cope way better with a diagnosis of HIV and are always super organized about their meds – something I suspect you are very much not.”

  Henry rolled his eyes but I caught his lips twitching. I was getting somewhere.

  “I’m hardly in a fit bloody state to go looking for ‘punani’, as you so eloquently put it. I thought you were a sexual health doctor. Shouldn’t you be referring to genitals in the correct way?”

  “Oh, I’m so sorry,” I said, leaning forward and propping my chin on my hand on the desk. “I’ll start again: You would like to seek out some receptive vaginas for sexual intercourse. Am I right?” He sighed, but the lip twitch was back again. “We-e-e-ll,” I drew out the word. “If you want to get into a ‘fit state’, you have to start taking your medication.”

  The lip twitch faded rapidly and a scowl took its place. “What the fuck would the point be of that?” he asked. “Who is going to want to have sex with a bloke who’s HIV positive?”

  I sat back in my chair and softened my expression. “I don’t know, Henry,” I said. “Maybe someone who finds him attractive, likes his (admittedly at the moment less than sparkling, but I assume circumstances have contributed to that) personality – maybe even falls in love with him. That’s who.”

  Henry huffed and looked down at his feet again. “Nobody, however much they love me, is going to risk their health to have a relationship with me. And nor should they.”

  “Henry, antiretroviral therapy can reduce a person’s viral load to the point where it is
so low that it cannot be detected by measurements in the lab. You must have been told this when you were first diagnosed? If you have an undetectable viral load in your blood for at least six months, you cannot transmit HIV through sex. Undetectable equals Untransmittable. We call it U=U. I’m not saying you wouldn’t continue to wear condoms in those circumstances but–”

  “Wh–what?” His eyes had snapped up to mine and I saw something flash through them, something that looked a little like hope.

  “If you take your meds as prescribed (just one tablet a day), not only will your health improve, but you can start thinking about punani again. And, do you think they’re not working on a cure right now? HIV treatment has come so far in such a short space of time. Do you think in ten years time it won’t have progressed even further? You can’t just give up. The researchers working on it aren’t giving up, so there’s no reason for you to pussy out up the stairway to heaven just because you might have to have a few awkward convos with potential lady friends before you do the dirty with them.”

  Henry started rubbing the back of his neck as his head dropped forward and he let out a puff of air.

  “You’ve got to try, Henry,” I whispered. “Shit happens, life isn’t perfect. But you can’t just give up.”

  His hand dropped from his neck and he sat up straighter in his chair. He squared his jaw and his eyes lit with a new determination. Yes, I thought, this guy could definitely be hot if his skin improved, he gained a fair few kilos, and he changed his attitude.

  “Okay,” he said, his tone stronger than before. “Take me through the med schedule again.”

  Chapter 2

  Anything but easy

  Kira

  “Dr Murphy?” Nigel Derwent, the hospital director, was looking at me with a pained expression. The last time I’d really spoken to him was at my ARCP (Annual Review of Competence and Progression) a year ago. The suit I’d worn to that was a world away from the purple leggings and paisley tunic I was wearing now. “Great, just great,” he muttered to himself, and I suppressed an eye roll as he started looking up and down the corridor as if to try and find another, more suitably dressed, Dr Murphy.