‘Louise, you are a human being, a lovely young lady, and we are here to help you.’
Tears shimmered in her eyes. ‘I don’t like to waste your time.’
‘You are not wasting my time. I can see from your notes that you aren’t someone who makes a fuss and you don’t seek the help you are entitled to. But you’re back today. That’s good. It must have been hard for you to come,’ she said, working to set the anxious girl at her ease and gain some trust. ‘Let’s try and make a new start. Begin at the beginning. All right?’
Louise nodded and bit her lip, tears spiking her lashes. As Kate encouraged her to talk, years of bullying, shame and fear poured out along with the health problems, and Kate struggled to keep an upwelling of emotion in check.
‘I’ve tried every diet imaginable, tried exercising, but I’m laughed at if I go to the gym and nothing works long term, more just goes back on again if I lose any weight. It’s like a vicious circle. And the more problems I have with my health, the more people taunt me, the less motivation there is.’
‘OK.’ Kate blew out a breath, her mind sorting out all the issues here. ‘Let’s deal with one thing at a time. You have problems with your periods?’
Blushing, Louise lowered her gaze and nodded. ‘They are irregular but when I do have one it’s very heavy and lasts ages. And the breaks between are getting shorter and shorter. I never know what is going to happen or when, but when it starts, it’s just awful. It’s got so bad I can’t hold down a job and I can’t leave the house for days sometimes.’
‘Do you have any pain with them?’
‘I have pelvic pain most of the time,’ Louise admitted, her voice a little stronger as she talked. ‘It’s hard to describe but I feel it deep inside, all around the pelvis and through my lower back.’
Kate nodded, making notes. ‘And is that the pain you mentioned earlier, the pain that has become so bad you were brave enough to come here today?’
‘No,’ Louise admitted, lowering her gaze.
‘Tell me about this other pain, Louise.’
As she ran through the symptoms, her eating patterns and the times of pain, the more Kate suspected gallstones. Louise was very young but all the signs were there. There was so much going on she wasn’t sure where to begin.
‘Is it all right if I do a few checks, Louise? I’d like to test your blood pressure,’ she explained, taking things one step at a time so as not to alarm her, careful not to cause embarrassment as she substituted a larger cuff to fit Louise’s arm. There were no previous readings to compare with but Kate was concerned that the level was on the high side and made a note to keep a regular watch on Louise’s BP over the coming months. She checked the girl’s eyes, unsurprised to find the conjunctivae pale. ‘Is it all right if I take a blood sample?’
‘Why do you need to do that?’
‘Losing so much blood could make you anaemic and that would make you feel low and tired. A simple test will confirm it and a course of iron tablets will help. I want to check your hormone levels, see if something there is adding to the problems with your periods,’ she explained, preparing what she needed, making a mental note to check thyroid function, too.
‘All right,’ Louise agreed.
‘Thank you.’ She set about taking the blood sample and smiled as she finished up. ‘All done. You are doing really well, Louise. I’d also like you to provide a urine sample for me. No hurry right now, but I’ll give you a sample bottle and you can drop it in when you can. I need that because I want to ensure there is nothing there that we don’t know about,’ she explained, thinking about any signs of diabetes.
‘OK.’
Knowing this was going to be difficult, she tackled the next problem. ‘I don’t want to rush you, but I would like to examine you, Louise, so I can help find out what’s making you so uncomfortable. Will you let me do that?’
‘I don’t know if I can.’ The words were whispered, the grey eyes filling with tears once more. ‘Do I h-have to?’
‘I would never make you do anything against your will, Louise, but we need to sort out this pain. I’m not going to think anything and I’m definitely not judging you. I just want to help. Please?’
When Louise finally agreed, Kate kept things as businesslike and dignified as she could so as not to cause more stress than necessary, leaving any question of an internal exam for when Louise was more trusting and relaxed. Keeping a blanket drawn up to Louise’s waist, Kate felt her abdomen, finding tenderness in the upper-right quadrant. It was true that Louise’s shape made it hard to feel but, combined with the other reported symptoms, she was pretty certain of her diagnosis.
‘OK, Louise, you’ve been great. You can straighten your clothes now and sit down when you are ready.’ Kate gave her some space and returned to her desk, jotting notes as she waited for Louise to rejoin her. ‘Now, then, one thing at a time. We’ll test for the anaemia and hormone levels, plus monitor your thyroid activity, and I’ll check the urine sample as soon as you provide it,’ she said, handing over the sample pack which the young woman slipped into her bag. ‘While we wait for the test results I’m going to start you on a course of iron tablets and I’ll write you a prescription for a low-dose contraceptive pill and we’ll use it temporarily to begin to get your periods under control.’
‘What could be making them bad?’
‘I’m not sure yet.’ Kate smiled in reassurance, anxious not to worry Louise until they knew more but considering the possibility of endometriosis or fibroids. ‘When we have a clearer idea what’s going on, we’ll probably change you to a different medication but we’ll wait for the results and see how the Pill helps you in the short term.’
‘Gosh,’ Louise murmured, tucking the prescription into her bag to join the sample pack.
‘I know, it’s a lot to take in.’ Kate gave her a moment to absorb what she had heard. ‘Now, about your upper abdominal pain, nausea and so on. I think you might have gallstones, Louise. It’s a horrible pain, but we can do something about it. I do need to refer you to the hospital, though, to have a scan.’
Grey eyes widened in alarm. ‘Oh, I can’t do that!’
‘It’s painless, Louise. They just put some gel on your skin and the ultrasound can look inside and see if you have the stones or not.’
‘It’s not that. I—’
As the young woman broke off, Kate nodded, understanding her fear of being examined. ‘I’ll contact them myself and explain the situation, I promise.’
‘And if I do have these stones?’ she said after several moments.
‘We’ll cross that bridge if and when we come to it. The important thing now is to know what we are dealing with.’
Louise nodded, her fingers twisting together in agitation. ‘I’ll try.’
‘Good girl. In the meantime, there are things you can do about the attacks of pain. With gallstones, it helps if you cut out fatty foods because they aggravates the condition. I’ll give you a leaflet about it. Anything you can do to remove trigger foods will make a difference to the pain.’
‘Really?’
Kate smiled at Louise’s surprise. ‘Really. I want you to take one iron tablet three times a day—they might make you a bit constipated so make sure you eat plenty of fibre while you are taking them and lots of vitamin C, which helps your body absorb the iron. Eat plenty of fruit and vegetables, whole grains, white meat, fish, and cut back all you can on dairy products and fatty foods,’ she advised, handing over the leaflet.
‘I’ll do that.’
‘Is there anything you want to ask me, Louise?’
Frowning in consideration, she shook her head. ‘No. I don’t think so.’
‘OK, we’ll leave it there today. You’ve done really well, Louise, I’m so glad you came to see me. Things will get better, I promise.’
‘I don’t know what to say,’ the young woman whispered. ‘You’ve been so kind, I never expected…’
‘You have every right to expect. I want you to come
and see me again in a week, but if you have any concerns in the meantime or any pain that worries you, just call me. And you’ll drop that sample in for me?’ Kate stressed, walking with Louise to the deserted reception area.
‘I will. Thank you so much.’
Kate gave her shoulder a gentle squeeze. ‘It’s no problem, honestly.’
Surprised how late it was and discovering everyone had gone to lunch, Kate unlocked the front door, seeing Conor approaching from the car park.
‘Hi, Louise,’ he said. ‘We haven’t seen you for a while. Everything all right?’
Kate noticed Louise blush scarlet at Conor’s attention and warm smile.
‘Yes, thank you. Kate’s been lovely.’
‘That’s good.’
She almost flushed herself at the approval and slow burn of heat in Conor’s green eyes as his gaze met hers before he walked on into the building. Pulling herself together, she held the door open for Louise. ‘I’ll see you soon.’
She watched the young woman walk away, head down, shoulders hunched. There would be a lot of work ahead on all kinds of issues and she wanted to ensure that Louise would be able to seek help from one of the other doctors when she herself was no longer there. Frowning at the welter of emotions churning inside her at the thought of leaving Glentown-on-Firth, she locked the door and returned to her consulting room, staring down at her notes, her chin resting in her hands. She was seething with fury at the treatment Louise had experienced in the past, shocked at the lack of care and understanding demonstrated by Dr Myers.
A brief tap on the door was the only warning she received before Conor came in. She was amazed when he handed her a pack of sandwiches and a fresh fruit smoothie.
Disconcerted, she met his gaze. ‘What’s this for?’
‘You missed lunch.’
‘I can’t stop now,’ she said, unsettled by his thoughtfulness. ‘I have a couple of house calls to catch up on before afternoon surgery.’
‘I’ve done them.’
To her chagrin, he sat himself on her desk, far too close, far too familiar. ‘You have?’
‘Mmm.’ Feeling him assessing her, she concentrated on the refreshing tangy drink. ‘It was clear you needed time—Louise was here over an hour—so I did the calls.’
‘I’m sorry,’ she responded, unable to keep the stiffness from her voice.
‘There’s nothing to apologise for, it wasn’t a criticism,’ he said, his voice warm and concerned. ‘You gave Louise what she needed.’ He paused and she couldn’t stop herself looking up at him, his nearness making her pulse race. ‘So, what’s the story? Everything all right with Louise?’
‘Yes,’ she lied. Green eyes studied her as he waited and she sighed. ‘Sort of. Why?’
‘What’s wrong?’
Did the wretched man always have to read her so easily, know what she was thinking? She shook her head in denial but he wasn’t buying it.
‘Kate, talk to me.’
‘What was Dr Myers like?’
Conor let out an exclamation of surprise. ‘I’ve not heard her name mentioned in a while.’
‘And?’
‘She was hopeless,’ he admitted, frustration evident in his tone as he folded his arms across his chest. ‘Well qualified on paper but she hadn’t a clue about community medicine or interacting with people. She didn’t last more than a couple of weeks.’
‘Well, she left her mark,’ Kate informed him, thinking of the time it had taken poor Louise to find the courage to come back for help.
‘What do you mean?’
Kate told him the bare bones of what had happened, seeing the thunderous look on his face, listening to the angry tirade against Dr Myers as he slid off the desk and paced her room. ‘I had no idea.’
‘It’s not your fault, Conor. How could you have known?’
‘Poor Louise.’ Swearing under his breath, he dragged the fingers of one hand through his wayward hair and she looked away, dismayed how much her own fingers itched to follow the path of his. ‘Why didn’t she come to me or Fred?’
Reining in her inappropriate thoughts, Kate frowned, unsure how much to tell him because she guessed Louise wouldn’t want Conor to know about her crush on him. ‘It’s been hard for her, Conor. I think she finds it easier talking to a woman.’
‘I’m glad you were here for her.’ His voice husky, he closed the gap between them again. ‘Thank you.’
Staring into mesmerising green eyes, she feared she was in danger of losing something of herself. ‘Just doing my job,’ she replied, unable to look away.
‘No. It’s more than that. And I appreciate it. Louise and your other patients are very lucky.’
She felt herself flushing at his compliment. ‘Thank you. Um, do you know who would be likely to do the ultrasound when I refer Louise?’ she asked, trying to restore order to her thoughts and banish the unwanted awareness of Conor as a man.
‘Dee Miller would be your best bet,’ he advised, making her nervous as he perched himself back on her desk, far too close for comfort.
‘When we have an appointment confirmed I thought I would ring and have a chat to explain Louise’s genuine anxiety. I hope they’ll be a bit gentle with her.’
‘Good idea.’ His approval and understanding warmed some of the chill spots deep inside her, places she’d never expected to feel anything again. ‘I’m sure they’ll do all they can to put her at ease. Maybe you could persuade Louise to have an ultrasound to check for fibroids at the same time and save her the anxiety of two visits.’
Kate wasn’t sure if Louise could handle more than one thing at a time. ‘I’ll think about it.’
‘There’s an excellent female gynae consultant at the county hospital. Let me know if you want me to introduce you.’
‘I’ll remember that, thanks.’
Kate was amazing. Conor couldn’t stop looking at her, wishing he could linger there all day, talking with her. It was true he’d had reservations about her appointment—was still concerned on a personal level about her secrets and inner pain—but she was an incredible doctor, the best locum they had ever had. He was livid about Dr Myers, concerned what else the woman had done in the short time she had been with them, and he planned to review as many of the cases she had handled as possible to ensure no one else had been suffering in silence, as Louise Kerr had done. Kate was the complete opposite of Dr Myers—caring, thoughtful, dedicated. What she had done for Louise today had been important, special. He planned to do everything he could to make Kate a permanent fixture, not just at the practice but in his life…his perfect partner.
‘May I cook you dinner tonight?’ he asked, watching as she picked at her sandwich.
‘I don’t think so.’
A pout of dissatisfaction shaped his mouth. ‘Why not?’
‘I have things to do.’
‘What things?’ he pressed, unwilling to be fobbed off.
Her nervous glance flicked over him and away again. ‘Private things.’
‘Right.’ He folded his arms, amused at her feeble excuse, noting the tinge of colour wash her cheeks. ‘I’d really like to cook for you.’
‘It wouldn’t be a good idea, Conor,’ she insisted, her voice flat and guarded.
He raised an eyebrow, teasing her. ‘I’m not going to poison you.’
‘I didn’t mean that.’
‘Kate, am I paying for someone else’s sins?’
She looked shocked and wary as she glanced up in response to his softly voiced question. ‘What you mean?’
‘You labelled me from day one. I don’t know why. But the image you have of me is wrong.’ Shifting, he slid his hands under his legs, heat flooding his veins as he caught the way her gaze lingered on his thigh before she swallowed and closed her eyes. He might be as frustrated as hell but it gave him a measure of satisfaction to know Kate was not as unaffected as she pretended to be. ‘You thought something was going on between me and Jenny, didn’t you?’ he continued, seeing her flush.
‘And that wasn’t the first time. So why do you always think the worst of me?’
He thought she wasn’t going to answer, she was silent for so long, then she sighed and pushed the remains of her sandwich aside. ‘Let’s just say I knew someone who cut a swathe through the medical and clerical staff.’
‘He hurt you.’
‘At the time. I learned the lesson, though.’
‘What lesson?’ He wished she would look at him so he could gauge her expression. ‘That all men are the same?’
She shook her head, one hand moving to flick a fall of hair back behind her shoulder. ‘Not to get involved with colleagues.’
‘Doesn’t that rather depend on the circumstances and the person?’ he challenged softly.
‘Conor…’
As her voice trailed off, he reached out and caught her chin, tipping her face up so he could look into her eyes. Clearly her past experience was making her wary about trusting him now but he could see that this issue was not the main cause of her inner pain and the loss of professional confidence. Unfortunately they were pressed for time now and, hearing staff moving along the corridor, he reluctantly released his hold on Kate’s silky-smooth skin and slid off her desk. He’d made some headway today—at least he knew why she was wary of embarking on a relationship—but there was still a long way to go if he was ever going to get beneath the surface and discover the secrets Kate kept hidden.
CHAPTER EIGHT
BEFORE dusk fell on the Saturday after Easter, Kate strolled along the sandy beach that edged the curve of the bay to where the ground rose up to a craggy headland. After a wet, grey week today had been sunny, but the April air was chilly and she drew her coat around her, sinking her hands deep into her pockets. Apart from the couple of days her father had been there, she had not yet explored this beautiful and varied landscape. Her gaze strayed out over the Solway Firth. On a clear day, she could see the Cambrian mountains on the English side to the south. Aside from a couple of people walking their dogs, the beach was deserted. She welcomed the solitude after the hectic week, although time alone with her troubled thoughts was not always a good thing. What had possessed her to reveal anything to Conor? Far from putting him off, her explanation had intrigued him further. Stopping for a moment, she breathed in the clear fresh air.
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