The Shipbuilder’s Daughter

by Emma Fraser

  ‘Diabetes,’ Effie murmured. ‘Poor thing.’

  It was just as Margaret had suspected. It explained how thin Caroline was and that faint sweet smell she’d noticed on her breath. Until recently, a diagnosis of diabetes, especially in the young, had been pretty much a death sentence. Happily, a way of treating the illness with insulin from the livers of cows and pig had been discovered. However, pregnancy for diabetics was still dangerous – very much so – indeed, often fatal.

  She hoped for Caroline’s sake that she wasn’t pregnant.

  ‘We do have insulin?’ Margaret asked.

  ‘I’m not sure. I’ll have to have a look. If needs be we can get some from Stornoway.’

  Margaret returned to the consulting room. Caroline was sitting in the chair, hands calmly folded in her lap, waiting.

  ‘I’m afraid, Caroline, that you have diabetes. That’s probably why you’ve been tired and feeling thirsty and getting up in the night to pass water. It also explains why the cut on your leg is slow to heal.’

  ‘Oh I know that! The doctor in Lochboisdale told me that a while ago.’

  ‘So you’re on insulin already? You should have said. We might need to fiddle around with your dosage.’

  ‘Oh, I’m not on that stuff. Dr Sinclair did give it to me but I swelled up like a balloon and came out in spots. Had to go to my bed for a few days. Soon as he stopped it I was fine.’

  ‘He stopped it?’

  ‘Said it would kill me. So he put me on a strict diet – not to lose weight, obviously. Donald says there’s nothing of me as it is. Wasn’t much of a diet really. No sugar – that was about it – not that that was a problem. There’s no’ much of it to be had here and when there is, it’s much too expensive.’

  Margaret had heard of people being allergic to insulin. It was rare, but happened enough to cause problems. The only way to manage diabetes without it was by diet. However, this was a poor way of treating the illness. Sooner or later most of the patients developed severe health problems which, in turn, eventually led to an early death. And as for getting pregnant! Surely Dr Sinclair must have warned Caroline of the implications for her and the baby? Caroline was certain to lose the baby and likely her own life.

  ‘Did the doctor say anything about not getting pregnant?’ Margaret asked gently.

  Caroline laughed. ‘Imagine anyone telling a Catholic she shouldn’t have children! It’s like telling the tide it can’t come in.’

  ‘Caroline, he should have warned you about getting pregnant because it’s very dangerous for someone with your condition.’

  ‘Me a married woman without children? No.’ She clutched Margaret’s hand. ‘You’ve no idea what having a baby means to me.’ Her eyes were shining. ‘Don’t you see? It will be the best thing that’s ever happened to me.’ She smiled shyly. ‘Except for marrying Donald, that is.’

  Margaret kept her expression non-committal. She wasn’t sure what the options for Caroline were. She needed to speak to Dr Alan before she alarmed Caroline any more. Perhaps there were innovations that had been made since she last practised although, as she’d told Dr Alan, she had kept up with the medical journals. However, it was entirely possible she’d missed something. In the meantime, should she arrange for Caroline to go to Glasgow? Or admit her to the hospital in Stornoway? She couldn’t do either without consulting with Dr Alan first.

  She realised Caroline was still looking at her, waiting for her reply. There was little point in continuing the conversation until Margaret knew for sure that Caroline was pregnant.

  ‘I’ll need to have a word with Dr Alan. You get off home and either he or I will come and see you.’

  ‘Come and see me? Why?’

  ‘Because we’ll need to keep a close eye on your wound to check that it’s started to heal. And then, once we find out for definite if you are pregnant, we’ll have to decide what to do about that too.’

  Caroline frowned. ‘I don’t know what you mean.’

  Margaret leaned forward. ‘Caroline, if you are expecting, you, and very likely your baby, will be at risk. Very serious risk.’

  ‘But you’ll see us all right, Doctor? You and Dr Alan?’ Caroline fingered the cross around her neck.

  If Caroline was pregnant as well as being allergic to insulin, then Margaret very much doubted she would be all right.

  ‘We’ll do our very best. In the meantime, try and rest as much as you can.’

  The clinic went on longer than she anticipated but eventually Margaret finished writing up her notes whilst Effie tidied away. She wasn’t expecting to see Dr Alan but to her surprise and relief she found him sitting in the kitchen, sipping tea from a delicate china cup and looking contented and relaxed. Most of the time he was in too much of a hurry, standing to drink his tea and draining his cup in three mouthfuls.

  ‘More in the pot.’ He gestured to the stove. ‘Help yourself.’ He sighed with pleasure. ‘Can’t remember the last time I enjoyed a cup of tea without being interrupted.’

  ‘Oh, sorry. I’ll leave you in peace then.’

  ‘Sit, girl, sit. I can see you have something on your mind. Spit it out. Let’s see if I can help, eh?’

  She pulled out a chair opposite him and told him about Caroline.

  ‘So what do you think?’ Margaret leaned forward, anxious to hear his view. ‘Should we send her to Glasgow?’

  Dr Alan pushed back his chair and stretched his legs out. He looked up at the ceiling as if seeking inspiration. ‘No, there’s no point in doing that. If she’s allergic to insulin there’s not much the doctors there can do except treat her diabetes by diet which, from what you say, the young woman is already doing.’

  ‘At least I should send a telegram to her doctor in South Uist, confirm her allergic reaction to insulin.’

  ‘You could. Aye, you could do that.’ He shook his head. ‘But I suspect he’ll just confirm what this Caroline told you.’ He drained his cup and reached over to the stove for the teapot. ‘All you can really do, Margaret, is arrange to have one of the nurses dress the patient’s wound every other day and report on any significant changes.’

  ‘And if she is pregnant?’

  ‘Then it is in God’s hands.’

  There was something they could do that, if Caroline was pregnant, might save her life. But Margaret didn’t want to mention it to Dr Alan. Not yet. And she hoped she would never have to.

  She rubbed her face, suddenly feeling drained. ‘I’ll go back and see her in a week or two. I’ll probably be able to tell for sure whether she is pregnant by then. In the meantime, I’m going to get in touch with her doctor in South Uist. Perhaps Caroline is confused about the insulin? Maybe she had an allergic reaction to something else and misunderstood her doctor. Either way I need to be clear what we’re dealing with.’

  ‘Of course you do. Once you know for certain, we’ll talk again.’

  Before she set out on her visits, Margaret walked over to the post office to send the telegram to the doctor in South Uist. She would have much preferred to have spoken to him in person, but that wasn’t an option. Although South Uist was one of the islands that made up the Uists, coming after Benbecula which came after Grimsay in the long string that made up the Outer Hebrides, it might as well have been the other side of the world. She thought carefully about what to say. She trusted the postmistress would be discreet, but just in case she wasn’t, Margaret didn’t want to use Caroline’s name. She’d already discovered that what Mairi had told her was true, the islanders knew who everyone was on the island and liked nothing better than to discuss every snippet of each other’s lives with one another.

  In the end she’d decided upon: Need information on a young woman seen by you – perhaps last year – with a diagnosis of diabetes. The patient in question apparently suffered severe allergic reaction to insulin. Need to confirm soonest. She signed it with her assumed name and qualification and hoped that Dr Sinclair would get back to her by return.

  Chapter 30
r />   Margaret was reading a Somerset Maugham novel by the light of an oil lamp a few evenings later, trying not to worry about the children and Alasdair but failing, when there was a loud rap at the door. She put her book aside. If Dr Alan was out on a call, she was next in line for any emergencies.

  A man in tweed had raised his hand to knock again just as she opened the door.

  ‘Dr Murdoch?’

  He didn’t look like a local. A spider of dread crawled up her spine. Was he someone her father had hired to find her? Had she finally been discovered? Her heart gave a sickening thump.

  ‘Yes. Does someone need a doctor?’ Her mouth was dry.

  He laughed. ‘They might do. But hopefully not me.’ He stuck out a hand. ‘I’m Dr Sinclair. I was in the vicinity so I thought I’d call on you.’ He peered over her shoulder. ‘May I come in, or do you keep all your guests standing on the doorstep?’

  She stepped back and held the door open. ‘I beg your pardon. Do come in.’ So this was Caroline’s previous doctor. He was a little older than Margaret, with short, sandy-coloured hair. He was wearing plus-fours, a waistcoat and a tweed jacket. He would have fitted in perfectly with the men who had come over on the ferry with her.

  He looked around her kitchen. ‘They don’t exactly spoil you in terms of accommodation, do they?’

  Despite her relief that he wasn’t someone her father had sent to find her, the look of amused contempt in his eyes made her bristle. Her accommodation was none of his business. ‘Please sit down, Dr Sinclair. I’m assuming you’re here because of the telegram?’

  To her chagrin he flicked his handkerchief over the already spotless chair before taking a seat. ‘I gathered you need more information about a previous patient of mine. You could have been clearer in your message.’

  ‘As you must know, very little on this island is secret. I had no wish to broadcast my patient’s medical history. There is little enough privacy for patients as it is.’

  ‘You’ll get over your mainland sensibilities soon enough. Things are done differently around these parts and the sooner you accept that the better.’

  She stiffened. ‘I’m assuming you didn’t come here to lecture me, Dr Sinclair.’ She’d rarely taken such an immediate dislike to someone before. She tried to put her feelings aside and concentrate on getting the information she needed from him. ‘You could easily have telegraphed me with the information I requested.’

  ‘I thought I would save us both the tedious business of cryptic messages going back and forth.’

  ‘That’s very kind of you. I’m sure you must be as busy in the south as we are here.’

  He grinned. ‘Don’t paint me with a saintly brush, Dr Murdoch. I have a weekend’s fishing planned down here with some pals from the mainland.’ So she was partly right in one respect. ‘I’ve left my assistant in charge for the weekend and when I heard Dr MacLean’s winter assistant was prettier than mine, I thought I’d come and see for myself.’

  Although she didn’t care for his manner, or his remarks, she decided the best way to deal with Dr Sinclair was not to react. She’d come across many like him before both as a medical student and as a House Officer – the type of male doctor who either liked to show off to the women medical students and doctors or patronise them. Which essentially was the same thing.

  ‘The patient I wanted to know about is Caroline MacIntosh. I understand you diagnosed her diabetes.’

  ‘Did I?’

  ‘Perhaps you will check her notes? I presume you’ve not discarded record-keeping along with your manners?’

  ‘Ouch.’ He leaned back in his chair and locked his arms behind his neck.

  Although she was damned if she was going to kowtow to him, she really had to try and keep the sarcasm from her voice. Right now he had information she needed and she wouldn’t put it past him to withhold it just to make a point. ‘I apologise,’ she said stiffly. ‘I’m sure you keep records. Would you mind having a look when you get back to your surgery?’

  ‘As a matter of fact I looked through my records yesterday. Happened to find one that I thought fitted the bill. A Caroline McKinnon? Address Yellowpoint, Daliburgh. Diabetic. Allergic to insulin.’

  ‘That sounds like her. But she’s Caroline MacIntosh now.’

  ‘I take it she got married then. I have noted all the details down.’ He reached inside his jacket pocket and brought out a folded piece of paper. ‘Now, are you going to tell me what this is about?’ He took out a packet of cigarettes from his pocket, offered them to her, and when she shook her head, lit one for himself.

  ‘Caroline came to see me with a non-healing sore. I tested her urine and discovered she has diabetes – which you correctly diagnosed when exactly?’

  He consulted his note. ‘Just over six months ago.’

  ‘I gather you tried her on insulin?’

  ‘Most certainly. Whatever you think of us in this backwater, Dr Murdoch,’ she bristled again, ‘most of us do keep up with latest developments – at least we try.’

  ‘I’m sure you do. And she reacted badly to the insulin?’

  ‘Yes. She suffered a severe anaphylactic reaction. It’s rare, but it happens. Happily, she survived, down to the quick thinking of my nurse who was with her at the time.’ He flicked the ash from his cigarette into the pail by the stove. ‘The new wonder treatment has kept a lot of people alive, or at least given them a few more years than they might have had without it, but it doesn’t suit everyone.’

  ‘I understand they’re working on a synthetic substitute which may mean it is less expensive as well as less likely to cause an allergic reaction.’

  He looked surprised. However, after his recent assertion that he kept up to date with medical developments, he clearly wasn’t going to mention that he hadn’t known.

  ‘They’re a bit away from having it ready for the general public,’ she continued after a pause. At least he knew she kept up. Perhaps he’d pay more attention now.

  ‘What else would you like to know?’

  ‘As I’m sure you’re aware, becoming pregnant when one has diabetes is very dangerous. Yet you didn’t warn Caroline.’

  He narrowed his eyes and surveyed her through a cloud of smoke ‘My dear woman, of course I did.’ He ground out his cigarette and threw the extinguished butt into the fire. ‘I’m not sure I care for the conclusion you’ve clearly come to that I don’t know my medicine well enough to warn patients against doing something that may well kill them.’

  ‘You did warn her against getting pregnant, then?’

  He leaned back in his chair and crossed his legs. ‘Naturally. I’m assuming since she lived in South Uist originally that she’s Catholic?’

  ‘Yes.’

  ‘Well, there’s your answer then.’

  Margaret was mortified. She’d charged in with both feet. It hadn’t occurred to her that Caroline would have lied to her, but then come to think of it, she hadn’t actually said that Dr Sinclair hadn’t told her not to get pregnant.

  ‘I apologise. Of course you told her.’

  ‘I gather she’s pregnant then.’

  ‘I’m not certain, but I think she is.’

  ‘The fool! I couldn’t have been clearer. She does know that if she is, it’s likely she and the baby will both die?’

  ‘I didn’t want to spell it out quite so badly until I confirmed she was pregnant.’

  Dr Sinclair shook his head. ‘What a waste. Foolish, foolish woman. But there’s always those who won’t listen to reason. She’s made her bed, so to speak, now she’ll have to lie on it.’

  ‘I haven’t given up on her. If she’s pregnant there is still something I could do —’

  His eyebrows shot up. ‘You’re not thinking of terminating the pregnancy, are you? If so, you’re just as foolish as her. It’s against the law as I’m sure you’re aware. You could get struck off – never mind what the priests and their congregations would have to say if they ever found out.’

  She realised
she’d made a mistake by telling him what had been on her mind, but it was too late to take her words back now.

  ‘It’s immaterial. I suspect she won’t even consider it.’

  He studied the glowing tip of his cigarette. ‘There is a chance if she is pregnant the baby won’t survive until term. You might yet be able to save the mother, though I doubt it. Anyway why does it matter so much? She’s just another woman producing another baby. These people breed like rabbits as it is! Some might say one less mouth to feed is a blessing.’

  ‘That’s a disgusting thing to say!’

  ‘It’s only the truth. Why do you care so much, anyway?’