by Annie O'Neil
Glenn Davidson, their octogenarian patient, was not in a good way. He had a fever, was dehydrated, had low concentration and was very weak. They’d ruled out flu, as he didn’t have any congestion or a sore throat. The fatigue and fever he was feeling was something he’d felt creeping up on him rather than something that had hit him in a blast, as flu symptoms often did. Besides, he’d assured them, he’d had a flu inoculation back in September.
‘Had it right before your grandmother, I did,’ Glenn had said weakly, rocking back and forth on the edge of the bed as if the movement was literally jogging his memory. ‘We’d made the appointments together so we could swap magazines.’
Audrey’s eyes shot to Cooper.
He looked away.
He’d not mentioned the glaring scarlet letter on his chest to her. A for abandonment. Perhaps he should have. But there was a part of him that was grateful that a new colleague meant a clean slate. She had no idea who he was and vice versa. Yet another chance to try and be the man he’d always hoped to be. Honourable. Loyal. Kind.
Moments like these were pointed reminders that he had quite a journey ahead of him before hitting any of those milestones. He’d known about Gran’s flu shot, so hadn’t been worried—but, like Mr Davidson here—his gran had been elderly, making her more vulnerable to chest infections.
Pneumonia didn’t care whether or not you’d had a flu inoculation.
He should’ve been more like Mhairi, moving his world around to be there for her. His gran had been the woman who’d protected him all his life, and what had he done? Spread his wings, as she’d taught him, then flown too far from the nest to be of any use.
‘Any history of Alzheimer’s?’ Audrey asked in a low voice.
Ah. A simple question, not an accusatory glance. He’d have to start checking his guilty conscience at the door if he was going to get through the day with his focus where it needed to be: on his patients.
Cooper shook his head in the negative, then busied himself with jotting down a few notes on Mr Davidson’s chart. He would tell Audrey what had happened when they were done here. It would put all the little asides everyone was bound to make in context. Besides, there’d been something in Audrey’s eyes that had given him reason to believe she had her own set of troubles. Who knew? Maybe she’d understand and he’d have an ally.
And maybe a kangaroo would bounce into the room and wish them all a happy Christmas.
‘Is that too snug?’ Audrey looked into Glenn’s watery blue eyes as she adjusted the blood pressure cuff.
‘No, it’s fine,’ Glenn said, not sounding entirely convinced—or focused, to be honest. His attention had dipped in and out ever since they’d entered his bedroom. Although in fairness, Cooper’s had, too.
He’d suggested Audrey take the lead, so he could get a feel for how she worked, but she seemed a bit edgy. As if his decision was less a vote of confidence and more an opportunity for him to loom over her, judging her every move.
She popped her stethoscope ear-tips into place, gave the instrument’s metal head a bit of a rub between her hands, so it wasn’t cold, then gave the inflation bulb a quick pump to see whether or not Glenn’s blood pressure was as low as they suspected.
As she put the stethoscope bell to his forearm he began to droop forward. Cooper was there in an instant, helping her right him. ‘Easy there, Mr Davidson. I’ve got you.’
The poor man was finding it hard to sit upright, and started muttering something about finding the dog...the dog would help. So far as he knew, Glenn hadn’t had a dog for some years. Maybe that Alzheimer’s diagnosis should be reconsidered.
‘Shall we rearrange your pillows there, Glenn? Let you lie back in bed? Is it dizziness you’re feeling or fatigue?’
‘Both. I don’t understand what’s happening,’ Glenn said, for about the tenth time since they’d propped him up in his bed and begun the examination. ‘Can’t wrap my head round it.’
‘Is this normal for him?’ Audrey whispered to Cooper.
That increasingly familiar blaze of defensiveness charged through him. He didn’t know the ins and outs of every single human on Bourtree. No one did. Except, perhaps, his gran and Dr Anstruther, who’d been here over forty years. And Mhairi. And the neighbours. And, and, and...
But this wasn’t about him. This was about Glenn.
He knelt down on one knee so that he could look directly into Mr Davidson’s eyes. ‘Glenn. We weren’t able to have much of a talk with Mhairi when we arrived as she was late picking up the children. Are you able to explain exactly what’s bothering you?’
‘Hurts,’ he said.
Cooper’s eyes darted from the blood pressure cuff to Audrey, then back to Glenn.
‘The cuff? Glenn, you’ve got to say if it pinches, all right? No prizes for bravery today.’
‘No, it’s more...’ Glenn drew his knees up towards his chest.
‘Glenn?’ Audrey asked as she swiftly released the cuff from his arm. ‘Are you eating at all?’
He shook his head. ‘Nah. Not hungry.’
‘Have you been sick?’
‘Nah. Nah. I just want to sleep. Or die.’ He fell back into the mound of pillows they’d built behind him and closed his eyes against whatever invisible pain he was enduring.
‘Have you been drinking plenty of water?’
Glenn gave a soft moan and muttered something about a wee nip being all he could manage and it had only been to try and stop the pain.
Cooper winced. Alcohol wasn’t a brilliant solution to anything. In fact, it wasn’t a solution at all.
Cooper’s heart went out to him as his brain whizzed through all the possibilities and prayed to whatever gods were out there that his grandmother had never felt this low. Doc Anstruther had said she’d gone in her sleep. It had been little comfort to him, but seeing Glenn like this, in agony, he was grateful for the small mercy she’d been shown.
Audrey’s eyes locked on Cooper’s and the wheels were obviously turning behind those brown eyes of hers. The expression on her face made it clear she knew very well that this was definitely not the psychological terrain you wanted any patient to be treading.
Audrey gave her forehead a little scratch, then asked, ‘How often are you going to the toilet, Glenn?’
Glenn looked at her, his eyes lucid for the first time since they’d entered the room. ‘All the time. I stopped drinking water yesterday, because it was getting to be too much, and I didn’t want to wear...you know...nappies for men.’
Audrey gave his hand a gentle squeeze. Cooper appreciated the gesture. Getting an older man to talk about intimate things such as hygiene and incontinence was tough. Particularly when he was a Scottish Islander. He’d been told once that each male bairn born to the island received the same welcome upon their first cry. ‘A good hearty voice you have, laddie, now that’ll be enough of that.’
Glenn’s voice lowered to a whisper. ‘I barely made it back to bed the last time, before I had to turn round and go back.’
As one, Cooper and Audrey figured it out. UTI.
He gave her a nod that said, You go ahead.
‘I think you’ve got yourself a bad urinary tract infection, Glenn,’ Audrey said, catching eyes again with Cooper.
He gave a little Of course it is thunk to his forehead, out of Glenn’s line of vision. He should’ve added up the symptoms. Discomfort. Fever. Distractedness. Pain.
‘What does that mean?’ Glenn asked.
‘It means we can get you feeling much more like yourself with some antibiotics,’ Audrey said with a gentle smile.
Cooper nodded. That was a great way to deal with a patient. Let them know the prognosis was good first, then let them know how it would happen.
‘Will it be instant?’
‘No,’ Cooper said when Audrey threw him a Help, please look. ‘But if we get some f
luids into you and ask your daughter to pick up the prescription on her way over, after picking up your grandkids, you should be feeling better by morning and better still in a few days’ time.’
‘Don’t you need to take samples or anything?’
‘Aye, we will, Glenn—if you’re up to it. But, as Audrey pointed out, all your symptoms add up to a classic UTI. They can drive men mad. You should be proud you’ve made it this far without hallucinating.’
Glenn barked out a laugh. ‘I thought I was when you walked through the door, Coop.’
‘Eh?’
Glenn waved a trembling finger in his direction. ‘This get-up you’re wearing. I thought Santa had come to take me away to my maker.’
Audrey tried and failed to squelch a smile.
‘Thought I’d spread some Christmas cheer a bit early this year. Looks like I brought some Christmas fear instead.’
Glenn’s clear-eyed look softened. ‘I’d like to make it to Christmas.’
‘Eh, well.’ He gave the man’s thin shoulder a gentle pat. ‘You’ll make it well past Christmas and Hogmanay, if Audrey and I have anything to do with it.’
‘But you’ll not be here for any follow-up,’ Glenn said, the lift in his mood instantly plummeting. ‘If I make it through to the New Year, that is. And of course Dr Anstruther will be off in the tropics somewhere...’
* * *
Audrey looked up at Cooper. This was his question to answer. Her contract lasted through until New Year’s Day. He didn’t have a contract. Not yet.
‘Noreen’ll be back, Glenn. She’ll keep her watchful eye on you. Don’t you worry. You’ll be skipping through the spring heather before you know it.’
‘Aye...’ Glenn cracked a smile, then closed his eyes. ‘That’ll be right.’
‘Right, Glenn,’ Audrey said, adroitly sensing the older man’s need for some rest. ‘Let me pull this lovely blanket up around you.’
* * *
As Audrey pulled a brightly coloured blanket up around him Cooper’s heart skipped a beat. There was only one person on the whole of Bourtree who would’ve put together a blanket with that colour scheme. Gertie MacAskill. His gran.
Luckily, Audrey missed the hit of recognition as she was too busy tucking it into place.
‘Why don’t we get you some water to have by your bed, Glenn? Is there any particular glass you like?’
He muttered something indecipherable as she moved away from his bedside and she and Cooper left the room.
‘Good call on the UTI,’ Cooper said as he popped his medical bag on the kitchen table and put everything back in order. ‘You got there before I did.’
‘I’m sure that’s not true,’ Audrey said, then added, ‘I used to see them all the time amongst my older patients and he has pretty classic symptoms.’
‘Used to?’
Audrey looked away, busying herself with opening cupboards to find a glass. ‘I took a job at a children’s hospital a couple of months back. It was great, of course, but there’s a different sort of job satisfaction from district nursing.’
There was something in that admission, he thought. Guilt? Loss? Hard to put his finger on it. Maybe something had happened on one of her calls that had made her switch to a hospital. Some people found the intimacy of being in a patient’s home too much. He was one of them.
‘I don’t know. Diagnosing UTIs isn’t as exciting as a bustling hospital.’
‘All my patients receive the same treatment,’ Audrey bit out as she filled the glass with water over a pile of unwashed dishes in the kitchen sink. ‘Whether they’re at home or anaesthetised and about to go into surgery.’
Okay. Cool your jets.
‘I wasn’t suggesting otherwise.’
She set the glass down on the counter, then pulled on a pair of washing up gloves that hung over the tap.
‘What are you doing?’
‘What does it look like I’m doing?’ She put the tap on full and gave the dishes beneath a big squirt of washing up liquid.
‘Doing dishes isn’t the normal remit of a district nurse.’
She looked at him as if his heart was made of stone. ‘Cooper, the poor man’s unwell. His daughter sounds like she has less time than either of us do and—’ she held up three coffee mugs, then dropped them back into the soapy water ‘—these might offer some insight as to why Glenn’s suffering. It looks like he’s had nothing but coffee, whisky and...from the looks of this plate...a curry ready-meal. None of which are any good for a UTI. Offering him advice on what is and isn’t going to help him feel better is very much the remit of a district nurse.’
Well, that was him told. And fair enough, too.
Cooper scrubbed a hand over his stubbly chin, hoping the conciliatory sound he’d just made would make up for the fact that he was wrong and she was right.
The truth was, he was only a handful of days into this house doctor gig and he was still trying to find the job’s heartbeat. When he’d come back to Bourtree, Dr Anstruther had met him at the docks to drive him up to his gran’s. He’d ever so casually mentioned that he was retiring on Christmas Eve and that he had the budget for another doctor up until then. It was intended to go to the doctor who’d be replacing him, but as there weren’t any takers so far...
He’d refused at first. Said this was a one-doctor island. But Doc Anstruther had said there were a few cases he might find interesting. So far they’d yet to surface. And if anything truly disastrous happened, an air ambulance and doctors from the mainland would be flown in. They’d flown in for his parents. Too late, as it happened, but they’d been part of the inspiration for Cooper to become a doctor. Helping when people needed help most. Commanding instant trust. Respect.
Two things he didn’t know if he would ever earn here.
He gave the back of his head a rub. What was done was done. Enough introspective soul destruction for one day. Luckily he had a perfect distraction in the form of an anti-elf-suit, pixie-haired district nurse, who’d left the bright lights of London to come here to Bourtree. Maybe she could throw some light on what made this type of medical practice more desirable than working in a hospital.
He pulled the top over his run-bag and began to zip it shut. ‘I’m curious,’ he said. ‘Why didn’t you try another discipline after paediatric nursing rather than take a professional move backwards?’
Her eyes widened. ‘Who says district nursing is going backwards?’
Oh, hell. Talk about open mouth and insert foot.
Cooper backtracked. ‘Sorry. I’m not dissing it. Not at all. It’s a valuable service. But c’mon... Now that you’ve had a taste of it, you have to admit that life in a hospital is...’
He was about to say the ultimate buzz but he stopped himself. Getting an adrenaline hit out of other people’s misfortunes wasn’t what he meant. An ideal emergency department would be an empty one, but being a busy doctor with a non-stop flow of anonymous patients demanded full focus. Consumed more hours of the week than any other job he could think of. Hours spent improving people’s lives, not destroying them, as his parents used to tell him over and over.
‘If it hadn’t been for you and your sister...’
The lives they would’ve led...
He cleared his throat and chose a simpler, less emotionally toxic tack. ‘I’m just curious as to why you took this locum post rather than one at a London hospital. They pay better. There must be scores of jobs over Christmas if that’s the goal. And yet you chose to come here. Why?’
From the look on Audrey’s face, Cooper had done an out of the frying pan into the fire manoeuvre. So much for trying to steer clear of emotional toxicity.
‘Not everything’s about money and status, Dr Claus.’
She gave him a proper glare that tugged at an impulse to pull her into his arms and comfort her. Then, as quickly as her temper had flared
, her lips curved into a weak but apologetic smile.
‘Sorry. Touchy subject.’
‘Money or status?’
‘Neither.’
‘A boyfriend obsessed with one or both?’ he parried.
She chewed on the inside of her cheek. Whether she was fighting tears or conjuring up an acidic response to a question that was none of his business was difficult to tell. When she released it, he realised her lips were shaped like a perfect bow. A crimson bow that, if he were looking for a pair of lips to kiss, would be very inviting indeed.
‘Something like that,’ she said finally.
His eyes were still glued to her lips as she asked, ‘Should we wrap up here and get to the next patient?’
There was a challenge in her tone. A dare for him to try and press her for more information. Fair enough. Calling his own love-life chequered would be putting it nicely.
He dragged his eyes away from her lips and took the glass of water to give to Glenn, doing his best to ignore the spark of connection when their hands brushed. He took the glass through to Glenn, made sure he was tucked up in bed, and gave him a reminder that they or his daughter would be back within an hour or so with his prescription, but to call if he needed anything.
When he got back to the kitchen Audrey was already heading to the car.
Fair enough.
He didn’t like being pushed for answers to uncomfortable questions either. Why didn’t he have a girlfriend? Why wasn’t he married? Why didn’t he have a family of his own when so many of his peers were already looking forward to their second or third child?
Questions people on Bourtree had never bothered asking him because they already knew the answers.
CHAPTER THREE
FOUR HOURS, ONE huge serving of takeaway fish and chips and seven patients later, Audrey and Cooper finally wrapped up the last of the calls. It was almost eight o’clock and, despite her cosy winter coat—now stained with mud, a streak of spilt tea and some errant ketchup from a friendly toddler—she was feeling the cold. The car’s heating system had packed up after their second visit.