Questions Of Trust: A Medical Romance

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by Archer, Sam


  ‘No, Daddy,’ she scoffed. ‘I hate monkeys.’

  ‘Thought so,’ he said.

  ‘Whose is it?’

  ‘I don’t know. I found it in my bag this morning.’

  He’d assumed it was Kelly’s, but it must belong to one of his child patients who’d dropped it into his open attaché case in his consulting room by mistake, or as a prank. Well, he’d drop it off with the receptionists later that evening and they could hand it back when its owner came looking for it.

  The mild depression that clung to him after every conversation he had with Rebecca these days lifted as he and Kelly made pasta and Bolognese sauce for lunch, inexpertly and messily. By the time their laughter had started to ebb and they’d finished tidying up, it was gone two o’clock. Less than three hours of precious afternoon time left together. And they still had to go shopping.

  There was a large supermarket fifteen minutes’ drive out of town, but for convenience Tom preferred the smaller one in Pemberham’s central shopping area. He procured a trolley and hoisted Kelly up into the child seat in the front, resisting the childish urge to race around the aisles at top speed with her. It wouldn’t do for the local doctor to be seen behaving like a buffoon.

  Several people smiled, nodded and said hello as he strolled the aisles. Thankfully none started telling him about their medical problems, a hazard most doctors faced outside the work environment. The pile of groceries in the trolley grew into a small mountain, and as luck would have it Tom had picked a trolley with a stiff wheel so that it kept listing to one side. He struggled to steer it round one particularly troublesome corner when he crashed it side-on into a stationary trolley at the end of the aisle.

  ‘Sorry,’ he muttered to the woman who’d turned sharply at the sound of the impact.

  Then: ‘Hi.’

  It was the new patient from yesterday, Chloe Edwards. Her little boy, Jake, was like Kelly ensconced in the seat at the front of the trolley. Mrs Edwards’s eyes widened. Then her expression softened in recognition.

  ‘Dr Carlyle. Hello.’

  ‘Sorry about the collision. Wonky wheel.’ He shrugged apologetically. ‘Hey, Jake. How’s Wolf?’

  ‘Fine.’ The little boy grinned in recognition. His mother smiled, a little tightly, Tom thought. She was in trousers, a jeans jacket and a white T-shirt. Tom tried not to look at her figure, at the swell of her breasts through the cotton.

  ‘This is Kelly,’ he said. Never a shy child, Kelly stared openly at the new boy and his mother. Tom nudged his daughter and stage-whispered from the corner of his mouth: ‘Hey, you. Some manners, if you don’t mind.’

  There were greetings all round, and Tom thought the ice was cracked a little, if not quite broken. He was smiling his goodbyes when a thought struck him.

  ‘Jake, did you bring anyone else when you came to see me yesterday? Any other animal as well as Wolf?’

  He saw Chloe’s eyes widen again and her glance dart to her son. ‘Jake? What about George?’

  Tom squinted at the boy. ‘George wouldn’t happen to be a monkey, now would he? A purple one?’

  ‘Yes!’ the boy shouted.

  Chloe whispered, ‘You’ve found him?’

  Tom nodded. ‘In my bag. Must have dropped in there.’

  She pinched the bridge of her nose between thumb and forefinger. ‘Thank goodness.’ She expelled a long breath, and gave him a smile of such relieved radiance he felt his stomach do a slow flip-flop. ‘We only noticed it was missing this afternoon, before we came out. You wouldn’t believe the tantrum.’

  ‘Oh, I can believe it. Been there.’ He tipped his head at Kelly. ‘The monkey’s in the car. If you can guard my trolley, and my daughter, I’ll go and fetch it.’

  ‘Don’t worry about that,’ said Chloe. She seemed embarrassed by her earlier stand-offishness. ‘Finish your shopping and we’ll wait for you in front.’

  He was almost done anyway, as it happened. As he joined the short queue at the checkout, Kelly said, ‘Who are they? That lady and that boy?’

  ‘Mrs Edwards and Jake.’

  ‘I know that.’ She didn’t quite roll her eyes. ‘But who are they? Are they your friends?’

  Kelly hadn’t quite grasped the notion of “patients” yet. Tom said, ‘They’re people from Daddy’s work.’

  Chloe was already outside, whirling Jake in the air so that he squealed. Tom raised a hand and ambled over, Kelly at his side. The little group made their way to his Ford and he retrieved the monkey, which Jake pounced on with a yelp.

  Chloe put out her hand. ‘Thanks again.’

  He smiled. ‘All part of the service.’

  Had that come out wrong? She retrieved her hand, her own smile fading a degree or two. With a small wave she turned and made her way with son and laden trolley towards her own car.

  Not wanting to stare, Tom began to load daughter and shopping into the Ford. Had he come across as lecherous? He didn’t think he tended to, and nobody had ever accused him of it. Had she read some innuendo in the word “service”? Or was he just being oversensitive, seeing hostility in someone whose approval, if he was honest with himself, he thought he’d rather like?

  Shaking his head not for the first time at the mysteries of the human species, he set off for home.

  ***

  After a final check of her email to see if the editor at the Pemberham Gazette had responded to the article she’d submitted – he hadn’t, apart from an nitial acknowledgement of receipt, but then again it had been less than twelve hours since she’d sent it, for goodness’ sake – Chloe closed her laptop and took her cup of tea over to the small sofa. Jake had been in bed for an hour, and wasn’t likely to wake until morning if past experience was anything to go by. She settled herself into the comfort of the sofa and drew her legs up under her. From where she was sitting she could see distant hills, dark against the twilight sky. A red sky at night... She supposed around these parts, there were indeed shepherds who took such sayings to heart.

  It was times like these that Chloe found the most difficult. The evening stillness, when there was no Jake to distract her, no work deadline to engross her attention. At these times it was hardest to keep the brooding at bay.

  She picked up a copy of the local newspaper, both for its content and from a professional point of view, to familiarise herself with its style; but she’d bought it when they had arrived, two evenings ago, and had already read it from cover to cover. Chloe tried her novel, one she’d been meaning to get round to reading for months now, but found herself going over the same page time and again, the sentences failing to take hold. At last, giving in to the inevitable, she cast the book aside and allowed herself the indulgence of memory. It was the only way she’d get any sleep later on.

  It had all happened almost a year earlier, in June. Mark had come home from work one evening – he was a partner in a City legal firm, dealing mainly with tax law – in an uncharacteristically bad temper. After he’d snapped at her and Jake for the third time, she’d frowned her puzzlement and he’d stopped short and apologised.

  Once Jake was in bed he said, ‘Sorry about tonight. It’s this headache. Woke up with it and it’s been there all day.’

  She asked if he’d tried various anti-inflammatories, and he said he had, without success. Moving behind him, Chloe massaged his neck, but felt none of the usual knots of tension there.

  It turned out that the headaches hadn’t started that morning, but had been present for a few weeks now, on and off. Never a complainer, Mark hadn’t mentioned them to Chloe. But while they normally passed after a few minutes, the initial sharp stabbing fading to a dull ache which gradually disappeared, that morning Mark had woken with a lance of agony behind his eyes and very little relief through the day.

  ‘It’s been getting in the way of work today,’ he admitted. ‘I haven’t been concentrating, I’ve let things slip.’

  Chloe picked up the phone handset from a nearby coffee table. ‘I’m calling the doctor.’<
br />
  ‘I’ll make an appointment first thing tomorrow –’

  ‘You need attending to now.’

  ‘No.’ He made a grab for the phone.

  Mark was a strong-willed man, as solicitors tended to be. Chloe too was stubborn, which was one of the things that made her an effective journalist. When the two of them disagreed over something, it was like two bison bashing their heads together. This time, whether because his resistance was weakened by the pain he was in or whether he conceded deep down that Chloe was right, Mark gave in. Chloe dialled.

  After an interminable wait she was put through to an operator, who put her on hold. Mark, Chloe and Jake lived in a townhouse in the north London suburb of Belsize Park. The local doctors’ surgery was a short walk away down the hill, but it was closed now, at nine p.m., and there was an emergency out-of-hours service operating.

  At last a voice answered. It wasn’t the doctor but a clerk of some sort who asked Chloe to describe the symptoms her husband was experiencing. Chloe did so, as patiently as she could. Again she was put on hold.

  Chloe glanced at Mark. He was sitting with the heel of his hand pressed to his forehead, his eyes closed.

  Finally the doctor came on the line. Chloe didn’t recognise his voice and realised he must be a locum, a temporary doctor filling in on night duty. His manner was abrupt from the outset. When Chloe reported her husband’s main complaint as a headache, she could almost see the look of incredulity on the doctor’s face at the other end of the phone.

  ‘He needs to take paracetamol.’

  ‘He’s done that,’ she said.

  ‘Ibuprofen, then.’

  ‘That hasn’t worked, either. Plus, this isn’t a one-off. He’s had these headaches for weeks now, and this particular one all day.’

  Chloe pushed and pushed, as if she were pinning down a politician she was interviewing and who was evading her questions. Eventually, out of resignation, it seemed, the doctor agreed to come out and visit Mark.

  He arrived ninety minutes later, a fussy, irritable man in his fifties. After asking Mark a series of brusque questions – did he have high blood pressure, did he smoke or drink, had he been under a lot of emotional pressure lately – he conducted a physical examination that looked cursory even to Chloe’s untrained eye.

  Straightening at the end and putting his instruments away in his bag, he said, ‘You have a migraine.’

  ‘Migraine?’ Chloe spoke up. ‘He’s never had them before.’

  The doctor turned to peer at her over his glasses. ‘They can come on at any age.’

  Chloe thought she’d read somewhere that it was unusual for a man of Mark’s age, thirty-three, to develop migraines for the first time, but didn’t say so. ‘Isn’t the pain normally pulsating?’ she asked. ‘Mark’s described a sharp stabbing.’

  ‘My dear lady,’ the doctor said, an edge sharpening his voice, ‘I can assure you I have had years of experience as a general practitioner. I recognise a migraine when I see one. It’s painful, it’s highly unpleasant… but it’s not life threatening.’ He scribbled something on a prescription pad and plucked the sheet off. ‘A codeine-based painkiller. It’ll take the worst of the discomfort away until the headache disappears of its own accord. They’ll come back, most likely. Speak to your regular doctor about possible preventative treatments.’

  And with that he left.

  Chloe sat beside him on the sofa, her palm smoothing his hair, her brow furrowed with concern. Mark’s face was pale, sweat springing in tiny beads on his forehead.

  ‘Is it still bad?’

  ‘Yes.’

  ‘Will you be all right to stay here with Jake for a few minutes? While I go to the chemist?’

  He nodded.

  There was an all-night pharmacy fifteen minutes’ walk from the house. Chloe returned to find Mark’s features contorted in a grimace of agony, an expression he tried to suppress as she walked in.

  Mark took the pills, pronounced the pain a little easier after ten minutes, and went to bed.

  He never woke up.

  As the summer morning light slanted through a crack in the curtains, Chloe, lying beside her husband, stretched an arm across his chest, felt him cold and unresponsive. She sat up in panic, saw his eyes closed, his lips slightly parted.

  No rise and fall of his chest.

  She called his name, slapped her fingers against his cheeks, shook him increasingly frantically. Then she backed across the bed, groping behind her for the phone on the bedside table, her stare fixed on her motionless husband, her knuckles crammed into her mouth to stifle the scream that was building in her chest.

  The coroner’s report was straightforward. The immediate cause of death was a cerebral haemorrhage resulting from a ruptured berry aneurysm. Unbeknown to Mark, he’d had a tiny swelling in one of the vessels in his brain where the wall was weakened. The piercing headaches he’d been getting were caused by minute leaks of blood as the vessel wall was breached, a fraction of a millimetre at a time. The tipping point came on the day the headaches had become constant. At some time in the night, the vessel had burst completely.

  Could the damaged vessel have been repaired in time to save his life? Possibly, decided the coroner. But while the misdiagnosis of migraine was unfortunate, it didn’t, in the coroner’s view, represent medical negligence. A regrettable but forgivable error had been made.

  Forgivable. Well, not to Chloe. In the white heat of grief and fury she’d lived through for the first few weeks after Mark’s death, she’d explored legal action against the doctor who’d attended Mark. Her lawyer, a friend and colleague of her late husband’s, had in the end persuaded her not to go through with it.

  ‘He’s a rotten doctor, Chloe. You know it, and I know it. And he probably knows it, too. But I’ve looked into this. The signs and symptoms of migraine are diverse enough that he’ll just about get away with saying he made a not unreasonable error. Plus, there’s the coroner’s ruling. You won’t win this, Chloe. I’d take on the case for free if I thought we had a chance. But we don’t. You’ll just prolong the pain you’re already going through, and be faced with the added burden of disappointment at the end.’

  So she’d dropped it, and concentrated her energy on Jake, who despite being only a year old was clearly bewildered by what was going on, and by the sudden absence of his daddy. She’d gone back to work after a reasonable absence, but couldn’t pick up the threads again, couldn’t return in the evenings to the townhouse without a feeling not just of sadness and regret but of profound horror at how utterly wrong a turn their lives had taken. Her decision to move, to start a new life with Jake outside the city, had followed quickly.

  Sitting alone in the stillness of the cottage, Chloe became aware her neck was wet, and realised the tears had been coursing down her face, as fresh and as stinging as if they were the first ones. When? she wondered. When does it start to get easier?

  On her way to bed, she caught sight of George, the toy monkey, which after all the drama earlier had now been left on the dining room table. Dr Carlyle’s image came into her mind. It had been good of him to return the toy.

  He was a likeable man, and clearly great with kids. And he was a charmer, there was no doubt about that. Charming to women.

  But underneath it all, he was one of them. One of the arrogant, self-righteous clique who’d allowed her husband, her Mark, the man to whom she’d pledged her life, to die. However unfair it was to him as an individual, while she could tolerate Dr Carlyle, she could never bring herself to trust him.

  Chloe drew up the covers and hoped sleep would come soon. Her hopes were in vain.

  Chapter Three

  Chloe heard it through the open kitchen window, the awful harsh grinding of metal on tarmac. She’d just finished doing the breakfast dishes and was going to spend an hour reading to Jake before catching up with her emails and settling down to work.

  It was Saturday morning, five days after she and Jake had arrived in the town and t
hree days since she’d sent her article to the Pemberham Gazette. The editor-in-chief had replied the next day, the tone of his email brimming with enthusiasm. He’d loved the piece, thought she struck just the right balance between self-deprecating wit and shrewd observations of the differences in country versus city outlooks, and wanted to run the article in next Monday’s edition. Best of all, if it was received well by the paper’s readers, he’d give serious consideration to commissioning a regular series of columns from her.

  Her own column! Chloe couldn’t help smiling in delight at the thought of it. Granted, it was a small-town weekly, not one of the big national papers. But it would be quite a feather in her cap, considering she’d been in town less than a week. And it would be a stepping stone to greater things. Already she was soaking in the details around her as she and Jake went about their daily lives in their new home, noting with a forensic eye the minutiae of Pemberham’s architecture, its rhythms, even the subtle quirks of its residents’ accents. All were potential raw material for her writing.

  The noise grated through her thoughts again. She craned to look out the window but the sound seemed to be coming from somewhere round the front of the cottage.

  Chloe swept Jake up from the floor and went to the front door. On the lane outside, a car Chloe recognised as Margaret McFarland’s, a somewhat clapped-out Volkswagen Beetle, was parked half-protruding from her neighbour’s driveway. Mrs McFarland stood beside it, staring down at it and muttering.

  Chloe joined her. The Beetle’s front passenger tyre was flat. More than that, the rim had eaten through the rubber and was naked against the tarmac. It explained the noise Chloe had heard.

  ‘Och,’ growled the older woman. ‘All I need. I was just reversing out to go and do the shopping when it happened. No warning.’

  Chloe thought the tyre must have been in a pretty threadbare state to begin with for the wheel to have broken through, but she didn’t say so. She asked, ‘Have you got a spare?’

  ‘No idea, pet,’ said Mrs McFarland without embarrassment.

 

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