by Cathy Glass
She nodded but didn’t seem any less anxious, so I began to make light conversation to try to take her mind off it, and asked her if she’d had a good day at school. She said she had; she liked Tuesdays as she had science all morning – one of her favourite subjects. Then she suddenly turned to me and said: ‘I won’t be seeing that boy again. It’s over, so there is no need for you to worry or tell anyone.’
‘I think Tara should know,’ I said. ‘If you have boyfriend problems she or I might be able to advise you. We were both young once.’
‘There’s nothing to advise me about,’ she said. ‘It’s finished and I’ll make sure my phone is off in future.’
‘I wasn’t prying, love,’ I said, for it had sounded as though she thought I had been. ‘Adrian heard your phone ringing and I went to check as I wondered if it was urgent. That’s all.’
‘Can we just forget about it, please?’ she said, a little agitated.
‘Sure. Don’t worry.’ I changed the subject and said what a lovely afternoon it was and how much I liked the summer, but Zeena didn’t reply.
We walked the rest of the way to the surgery in silence. A couple of times I glanced at her, but there was nothing to be read in her downcast profile beyond anxiety. If she didn’t want to confide her worries in me there was little I could do to help. We entered the surgery and went to the reception desk, where Zeena gave her name and date of birth to the receptionist, who typed this information into her computer. She gave Zeena a card to complete so that she could register her as a temporary patient. We went into the waiting room and I sat beside her as she filled in the card: her name, date of birth and our address. I told her the postcode, which she hadn’t memorized yet. The last section asked for details of her previous doctor. Her pen stopped and she looked at me.
‘Why do they want to know that?’ she asked, anxiously.
‘So they can get your medical records,’ I said.
‘Will my old doctor know who my new doctor is?’ she asked.
‘I’m not sure. I suppose they might,’ I said.
‘I can’t fill it in,’ Zeena said. ‘My old doctor is a family friend and he’ll tell my parents where I am.’
I knew there was no point in trying to reassure her that confidentiality should have prevented this; she was petrified of any link that might trace her.
‘I can’t remember his details,’ she added, leaving the box blank.
‘All right, let me tell the receptionist,’ I said.
I took the card to the receptionist and explained that Zeena couldn’t remember the details of her previous doctor.
‘Just the name and the area will do,’ she said helpfully.
I went over to Zeena and repeated this. ‘I can’t remember any of it,’ she said, shaking her head.
The receptionist must have heard this, for as I returned to the desk she said, ‘All right, don’t worry. Leave it blank for now and let us know when you have the information.’
‘Thank you,’ I said.
I left the card at the reception desk and returned to sit next to Zeena. A couple of minutes later her name was called and she stood and went down the short corridor to where the doctor’s consulting rooms were. A minute later she reappeared, very distressed. Rushing over, she sat down beside me. ‘It’s a man,’ she said. ‘I can’t see him.’
Dr Graham also appeared and came over. ‘Don’t worry,’ he said to me. ‘I’ll see if my wife can see her. Tell Zeena not to worry.’
‘Thank you so much,’ I said. ‘I am sorry.’
He smiled and went over to the receptionist and looked at her computer screen. I’d told Zeena the practice consisted of a husband and wife, and that I’d taken the first available evening appointment, but it hadn’t crossed my mind to tell her it was the male doctor who would be seeing her. My family and I saw either Dr Graham or his wife Dr Alice Graham. They were both excellent doctors.
Dr Graham returned and said quietly, ‘If you don’t mind waiting half an hour, my wife has a cancellation.’
‘Thank you so much,’ I said. ‘I am grateful.’
‘You’re welcome,’ he said kindly, and called the next patient.
‘Sorry,’ I said to Zeena. ‘I should have asked you if you wanted to see a woman doctor. They’re both nice people and very good doctors.’
‘It’s not that,’ she said. ‘I just can’t see him.’
‘All right. Don’t worry, we’re waiting to see his wife.’
She nodded, but I could see she was still anxious and her anxiety grew. Her hands trembled in her lap and she kept chewing her bottom lip.
‘Is there anything I can say that will make you feel less worried?’ I asked her.
‘No,’ she said.
I placed my hands on hers. ‘Try not to worry,’ I said, I didn’t know what else to say.
I then stood and went over to the small table in the corner of the waiting room where there were some magazines. I took a few and returned, offering some to Zeena, but she didn’t want one. I opened the top magazine and began flipping through it, but I couldn’t concentrate; it just occupied my hands. Zeena was clearly very worried and her refusal to see a male doctor, coupled with her not being able to tell Tara (or me) why she needed to see a doctor, led me to the conclusion that whatever she was suffering from was a personal female condition. With a sinking heart I thought she was probably pregnant. It seemed the most likely outcome, given the existence of the secret boyfriend.
That half an hour was one of the longest of my life as Zeena’s anxiety grew and I couldn’t offer her any words of comfort or support. When her name was finally called she visibly jumped.
‘Are you sure you don’t want me to come in with you?’ I asked.
‘No,’ she said quietly. Keeping her head lowered she left the waiting room, this time to go to Dr Alice Graham’s consulting room.
I returned the magazines to the table and watched the clock. The minutes ticked by very slowly and the longer Zeena was with the doctor the more convinced I became that she was pregnant. It all fitted: her secretiveness, the boyfriend’s urgent phone calls, their relationship ending when she’d told him she was pregnant; rejected by her parents and called a slut by her mother. Pregnant at fourteen, and having to shoulder the worry alone. No wonder she was in a state. I wished she could have told me.
Twenty minutes later Dr Alice Graham appeared and came over to me. ‘Could you come in, please?’ she asked quietly so none of the patients waiting could hear. ‘Zeena’s very upset.’
‘Yes, of course,’ I said, going with her.
I followed Dr Alice down the corridor into her consulting room. Zeena was sitting on one of the chairs in front of the doctor’s desk with her head in her hands, crying.
‘Oh, love,’ I said, going over and sitting in the chair next to her. I put my arm around her. Dr Alice closed the door. There was a box of tissues on the doctor’s desk and I took a couple and passed them to Zeena. ‘Come on, pet,’ I said. ‘Nothing is that bad. Whatever the problem is, we can sort it out.’
Dr Alice sat on the other side of her desk. I could tell from her expression how concerned she was, and although there were other patients in the waiting room and she was running late, I felt there was no rush and Zeena could take all the time she needed.
‘Come on, dry your eyes, love,’ I encouraged.
Zeena blew her nose and wiped her eyes and then sat hunched forward with a tissue pressed to her cheek. She looked absolutely wretched. I slipped my hand from around her shoulder and placed it reassuringly on her arm.
‘Zeena, do I have your permission to share your condition with Cathy, your foster carer?’ Dr Alice asked her.
Zeena nodded, but didn’t look up.
Dr Alice looked at me. ‘I understand Zeena has only been with you a short while?’
‘Yes. Nearly a week.’
Dr Alice made a note. ‘Zeena should have seen a doctor sooner,’ she said, ‘when her symptoms first appeared and were at their wor
st, although I can appreciate why she didn’t. She tells me her family are very strict?’
‘Yes,’ I said, not understanding where this was leading.
‘I’ve examined Zeena,’ Dr Alice said. ‘She has a severe case of genital herpes. She must have been in pain for some considerable time.’
‘Oh,’ I said, and hid my shock.
‘I’ve talked to Zeena about treatment options,’ Dr Alice said. ‘With a first outbreak of herpes an antiviral drug can be prescribed, but it’s most effective in the early stages. Zeena is over the worst now, although some of the sores are still open. I don’t think it will be very effective. It’s more about managing her symptoms now. Warm salt baths give the best relief. I’ll give you a leaflet that explains the condition. I’ve explained to Zeena that while any of the sores are still open they are highly infectious and she mustn’t have sexual intercourse – not that she’s likely to want to; she’ll be too sore.’
Zeena gave a small sob and I patted her arm reassuringly. I could have done with someone patting my arm, for I was struggling with what I was hearing, although I hid it. Foster carers can’t afford to be squeamish.
‘I’d like Zeena to go to the sexual health clinic first thing in the morning,’ Dr Alice continued. ‘They have better facilities for treating STIs – sexually transmitted infections – than we do here. It is important Zeena is tested to see if she has contracted any other STIs that may need treating with antibiotics. They can also give advice on protection. It’s a “walk-in” clinic at St Mary’s Hospital, so you won’t need to make an appointment. Will you be able to take her tomorrow? It’s important she goes and it’s best if she has someone with her for support.’
‘Yes, of course,’ I said, my outwardly calm manner hiding my inner turmoil.
‘The first outbreak of herpes is always the worst,’ Dr Alice continued in her professional, non-condemnatory manner. ‘But the virus stays in the body, so other outbreaks may occur in the future. This leaflet explains it in more detail. It also gives the opening times of the clinic.’ She swivelled round in her chair, took a leaflet from the shelf behind her and pushed it across her desk towards us.
Zeena didn’t take the leaflet, so I did. ‘Thank you,’ I said.
Dr Alice paused and looked directly at me. ‘Zeena is fourteen and under the legal age of consent,’ she said solemnly. ‘So there are safeguarding issues. I understand she has a social worker?’
‘Yes, Tara B—.’
‘Is she based at county hall?’
‘Yes.’
She made a note and then looked up at Zeena. I could see the pain in her eyes. I knew she had teenage children, and no one wants to see a child in this position. ‘Is there anything you want to ask me?’ she said gently to Zeena.
Zeena shook her head and stifled another sob, but didn’t look up.
‘Well, if you do think of anything, you or Cathy can phone me,’ she said kindly. ‘You’ll also be able to ask questions tomorrow at the clinic. Don’t feel embarrassed; the staff are very friendly and they’re used to counselling young people with this type of condition.’
They may be used to it, I thought, but I wasn’t. Zeena was fourteen and looked more like twelve. She was a child!
‘Zeena’s boyfriend will need to be contacted so he can be tested, and treated if necessary,’ Dr Alice continued, looking at me. ‘Zeena doesn’t feel up to telling him yet, so perhaps you can have a chat with her? It is important he is tested.’
‘Yes,’ I said.
‘I can see Zeena here for a follow-up appointment, or she can go to the clinic. Whichever she prefers. You don’t have to decide now.’
Numb from shock, it took me a moment to realize Dr Alice had finished and we should leave. ‘Thank you for everything,’ I said, and touched Zeena’s arm to go. She was clearly more shocked than I was. ‘Come on, love,’ I said gently. ‘Time to go.’
She gradually rose to her feet and, with her head lowered and unable to meet Dr Alice’s eyes, she walked with me to the door. I thanked the doctor again as we left, and closed the door behind us. In the corridor I tucked the leaflet into my bag. We went through reception and I opened the door that led onto the street. As we stepped out, Zeena looped her scarf over her head as she always did when going outside, only now it was further forwards, as though she were trying to hide her face. The evening was still warm and the air alive with birdsong and flower perfume, but I took no pleasure from it. Zeena’s distress was raw.
We walked up the high road, close and in silence. I was thinking carefully about what I should say. Zeena didn’t need me telling her she’d acted irresponsibly; she knew that already, and was probably feeling she’d been punished for having a relationship. I’m sure I would have felt the same in her position. What she needed was support and understanding, and while on a personal level I thought she was far too young to be having sex, there was no point in lecturing her now. I would talk to her about that when she wasn’t so upset. And it occurred to me that if her parents hadn’t been so strict and prohibitive, they could have talked to her about boyfriends and safe sex in the context of a loving and committed relationship, hopefully avoiding this. However, the damage was done, and I needed to concentrate on the future.
‘Zeena,’ I said gently as we walked, ‘it is important you tell your boyfriend – or rather ex-boyfriend – what’s happened so he can be tested and treated.’
She didn’t reply.
‘These types of diseases – STIs – are more common than you may think,’ I said, trying to offer her some comfort. ‘That’s why most towns have a special clinic. Thousands of young people unfortunately find themselves in this position. Did you understand that Dr Alice felt it was too late for the antiviral drug to be effective, and the best remedy now was for you to have warm, salty baths? Salt is a good antiseptic and is used for many things. We can run a bath for you when we get home.’
I glanced at her. Her head was lowered and her gaze was down as she concentrated on the pavement. She looked desperate.
‘I know this must have come as a huge shock to you,’ I said. ‘But you will get over this, I promise, and be wiser in future.’
‘I don’t want a future,’ she said quietly, without looking up. ‘I want to die.’
Chapter Eight
Lost Innocence
‘No, you don’t. You’re upset,’ I said. ‘And I can understand why. But life’s very precious and you will get over this in time. Trust me, Zeena, you will.’
She didn’t reply, and we continued walking along the high road towards home. I talked to her on and off all the way, trying to give some perspective to what had happened: that while it was distressing, there were worse things in life and she would recover and move on – although at the back of my mind was the horrendous possibility that it could get worse. Supposing she tested positive for HIV at the clinic? I recoiled from the thought.
I opened the front door and Paula, the only one in, came from the kitchen into the hall to greet us. ‘I’m making dinner,’ she said. ‘Risotto and garlic bread.’ Then, seeing Zeena’s face, she asked her: ‘Are you OK?’
Zeena fled upstairs to her room.
‘What’s the matter?’ Paula asked me, concerned. ‘Is she ill?’ Paula knew I’d gone to the doctor’s with Zeena – I’d left a note saying we’d be back at about half past five.
‘She’ll be better soon,’ I said vaguely, and Paula knew not to ask more. Confidentiality stopped me from giving her or any members of my family details of a looked-after child’s medical history. If Zeena wanted to tell them that was all right, but I couldn’t.
‘I hope she feels better soon,’ Paula said. ‘I’ll finish making dinner.’
‘Thanks, love,’ I said, and kissed her cheek.
As Paula returned to the kitchen I went upstairs. Zeena’s bedroom door was closed so I knocked on it. ‘Can I come in?’
She didn’t answer so I knocked again. When she still didn’t answer I slowly opened the door and
went in. She was sitting on the bed with her head in her hands, not crying but looking so wretched that it was as if she hadn’t a hope in the world. I went quietly over and sat next to her.
‘I know how much of a shock this has been for you,’ I said gently, easing one hand away from her face so I could see her better. ‘But I’m here to help you and support you in any way I can. I appreciate how difficult this is – even to talk about it. If it was a sore on your hand it would be easier, but the doctor was very nice, wasn’t she? And the nurses at the clinic tomorrow will be too.’
Zeena turned her head slightly to look at me, her eyes showing nothing but despair and fear. ‘You won’t tell anyone, will you?’ she asked.
‘We need to tell your social worker,’ I said. ‘But I won’t tell anyone else, it’s confidential.’
‘Does Tara have to know?’ she asked.
‘Yes. If we don’t tell her, Dr Alice will. It’s important she knows. You are still a minor and children need protecting.’
‘Do you think I’m a slut?’ Zeena asked pitifully.
I took her hand in mine. ‘No, of course not. You made the wrong decision and you’ve learned from your mistake. Life is full of wrong decisions. And you weren’t the only one involved. That ex-boyfriend of yours has to take his share of the responsibility as well.’
Zeena went quiet for a moment. ‘I can’t tell him,’ she said. ‘It’s impossible.’
‘You don’t have to see him to tell him,’ I said. ‘You could send him a text, but he does have to know so he can be tested, and treated if necessary.’
‘I can’t,’ she said, and looked close to tears again.
I let the subject go. I thought that tomorrow, after a night’s sleep, when she was starting to get over the shock, she might feel differently, and doubtless the nurse at the clinic would talk to her about this too. ‘We’ll go to the clinic first thing in the morning,’ I said. ‘I’ll phone your school and tell them you’ll be going in late. Or if you prefer it you can have the day off. I’ll just say you’re ill.’