by Sarah Morgan
‘We almost cancelled this particular clinic as it’s the week between Christmas and New Year, but there were so many patients that in the end I decided that we had to run it. Are you going to eat that sandwich in front of you or just look at it?’ Kate flicked the switch on the kettle and waited for it to boil.
‘I’m not really hungry.’ It was a shame they hadn’t cancelled the clinic.
‘You have a busy afternoon ahead of you. You should eat lunch.’ Kate made her coffee and added some milk. ‘Is it Marco that’s made you lose your appetite? What’s going on with the two of you?’
Amy hesitated. Kate was a friend, but she wasn’t used to confiding in people. All her life she’d made her own decisions and relied on herself. To begin with she’d had no choice, and then it had become a way of life. ‘We’re— Well, let’s just say our relationship is still over. We’re just working a few things out.’
‘That must be hard.’ Kate put her mug on the table and sat down. ‘You’re very pale, Amy. Are you ill? Or is it just the stress of seeing Marco again?’
Could she pretend she was ill?
It would get her out of doing the clinic and it wasn’t altogether a lie. The mere thought of spending an afternoon talking to pregnant women was enough to make her ill. But if she said she was ill, Marco would be on to her, trying to find out what was wrong.
‘I’m not ill.’
‘Then it must be stress. Do you honestly think the two of you are going to be able to work together?’ Kate slowly stirred sugar into her coffee. ‘I know that Nick’s worried about it. He thinks that the history between you is going to make things difficult.’
‘It will be fine. Nick has nothing to worry about. Marco and I are not planning to discuss the demise of our marriage at work.’
‘No—all the same, it was good of you to stay and help us. I’m guessing that you didn’t want to but Marco is very persuasive, as we both know. He has a way of getting a person to say yes to all sorts of things.’ Kate’s voice was gentle. ‘Whatever you say to the contrary, I know this can’t be easy for you, Amy. I never really under stood what went wrong between the two of you but if you want someone to talk to, you have a friend in me. I just wanted to remind you of that.’
‘Thanks. Thanks, Kate.’ Unbelievably touched, Amy rose to her feet quickly before she was tempted to blurt out the truth about the current situation. ‘Love is complicated, isn’t it? And painful.’ She had no doubt that Kate knew first hand how painful love could be. Hadn’t she lost her husband in a tragedy at sea that had left her to bring up a child alone?
‘Yes. It’s both those things.’
‘How are things with you? How is Jeremiah?’
‘Jem? He’s fine. Really good. He’s eight now. Unbelievable, really, how time passes.’ For a moment, Kate stared blankly into the distance and then she cleared her throat and reached for her coffee, suddenly brisk and efficient. ‘I envy you doing the antenatal clinic. At least pregnant women are healthy and cheerful.’
Amy’s smile froze. ‘Yes.’
‘There are days when I miss midwifery.’
‘I’d for got ten that you’re a trained midwife.’ This was a conversation she didn’t want to be having. ‘I’d better get on. I’ll see you later, Kate.’
She had a clinic to run. A clinic that she didn’t want to take.
And she needed to prepare herself.
Amy worked on automatic, barely registering the identity of each patient.
It was as if a part of her mind was shut off.
By four o’clock, she only had one pregnant woman left to go and she poured herself a glass of water and drank deeply, promising herself that she was going to go straight home after the clinic. She was going to go straight home and hide under the duvet.
The door opened and her last patient walked in, a blonde woman in her late twenties, carrying a baby in a car seat.
‘I know, I know, you’re thinking I’m in the wrong clinic.’ The woman laughed and sat down on the chair. ‘Can you believe it? This little one is only four months old and I’m pregnant again! It’s done wonders for my husband’s ego. He thinks he’s some sort of stallion. So much for the contraceptive effects of breastfeeding! I didn’t believe it at first but I’ve done the test three times so I don’t think there’s any doubt. I rang for an appointment and they told me to come along this afternoon. They like you to get checked out as soon as possible these days, don’t they?’
‘That’s right. You did the right thing to come.’ Amy’s mouth dried. ‘Congratulations. Are you pleased?’
‘Oh, yes. Well, Geoff, that’s my husband, always wanted a large family so it’s not a problem. We hadn’t quite planned on having them so close together but it’s quite good when they’re close in age, isn’t it?’ The baby started to cry and she bent down, undid the straps and gently lifted the baby from the car seat. ‘Oh, now I’ve woken him up with my loud voice. Are you ready for your milk? Ridiculous, isn’t it? Breastfeeding while you’re pregnant. I mean, that’s one of the things I wanted to talk to you about. Is it OK? I don’t want to deprive the new baby of nutrients or anything.’
Amy watched as the woman lifted her jumper and skilfully attached the baby to her breast. The baby greedily clamped its jaws around her nipple and then closed his eyes and started to suck, a blissful expression on his face.
What did it feel like?
‘Are you all right, Dr Avanti?’ The woman frowned at her. ‘You look a bit pale, yourself.’
‘I’m fine,’ Amy said tonelessly.
‘And you’re married to the other Dr Avanti. Lucky you. Now, that’s a man any woman would want to make babies with.’
The pain inside her was so vicious that it took Amy a moment to find the breath to speak. ‘It shouldn’t be a problem to continue breast feeding.’ Somehow she forced herself to deliver the facts. ‘Your biggest problem is likely to be that you’ll feel very tired. Make sure you get plenty of rest and eat well. The taste of the milk might change and the baby might object to that for a while…’ With difficulty she got through the consultation, saying what needed to be said and carrying out the tests that needed to be done.
By the time she finally closed the door on her consulting room at the end of clinic she felt emotionally drained. Sliding back into her chair, she felt the hot sting of tears behind her eyes.
Appalled at herself, she took a huge gulping breath and tried to control her emotions, but her misery was just too great to be contained and the tears spilled down her cheeks as the dam broke.
Sobs tore through her body and she put her head in her arms and gave in to it, crying like a child, consumed by the emotion that had been building inside her for so long.
She didn’t hear the door open—wasn’t aware of anything apart from her own misery until she felt a gentle hand on her shoulder and the sound of her name.
She gave a start and lifted her head to find Nick standing there, a look of concern on his face. ‘Amy? What’s happened?’
‘Nothing.’ Mortified, she sat up instantly and rubbed her palms over her cheeks, trying to compose herself. ‘Well, this is embarrassing. I’m so sorry. Really sorry. I’m just tired or something. It’s been a bit of a long week.’ Her voice was thickened by crying and she knew that she must look a mess.
‘Tired?’ He studied her for a moment and then pulled up a chair and sat down next to her. ‘No one cries like that just because they’re tired. Are you depressed?’
Depressed?
Sodden with misery, Amy just stared at him. Clearly he wasn’t going to leave her alone without an explanation and she was worn out with searching for new explanations that would keep people satisfied. ‘Honestly, I’m not depressed. I’m sorry, Nick.’ She yanked a tissue out of the box on her desk and blew her nose hard. ‘That was very unprofessional of me. I can assure you that I was fine in front of the patients. I didn’t—’
‘Amy.’ His tone was gruff as he interrupted her anxious apology. ‘At this preci
se moment I don’t give a damn about the patients. I’m not thinking about the patients. It’s you that I’m worried about.’
‘That’s kind of you.’ She blew her nose again and then gave him a smile. ‘But there’s no need to worry. I’m fine. Really.’
‘Fine doesn’t make you sob your heart out on the desk. Does this have something to do with the antenatal clinic? You really didn’t want to run it, did you? And we didn’t listen.’
‘It’s not the antenatal clinic.’
Nick watched her. ‘Did you lose a baby, Amy?’
‘No!’ She shot him an anguished look, the pain twisting inside her. ‘No, I didn’t.’
‘Then what’s this about? Tell me.’
Amy teetered on the edge of confession and then suddenly remembered just who Nick was. ‘I can’t.’ The tears threatened to start again and she gritted her teeth. ‘I— It wouldn’t be fair to you.’
‘So it’s something to do with your relationship with Marco and you’re afraid that telling me would put me in a difficult position. You’re also not sure that you trust me not to tell him. He mentioned that you’d changed your mind about having a family. Is this related?’
‘Don’t ask me. I can’t talk to you, Nick.’
‘I’m your doctor. You can talk to me and it’s confidential.’
She blew her nose again and gave a watery smile. ‘You’re not my doctor. I’ve only been back in the country for five minutes. I don’t have a doctor.’
‘Well, you clearly need one, so from now on I’m officially your doctor. Kate will take care of the paperwork.’ There was a faint trace of humour in his eyes. ‘I need new patients. In case you hadn’t noticed, we’re nowhere near busy enough around here. I want to know why you were crying, Amy.’
She looked at him, her reluctance dissolving under the kindness she saw in his eyes. ‘I find the antenatal clinic difficult.’
‘Yes. I gathered that.’ His voice was soft. ‘Tell me why, Amy. Tell me why you find it difficult.’
She waited a heartbeat. ‘Because I can’t have children. I’m infertile.’
Nick was silent for a moment and then he sat back in his chair and gave a slow nod. ‘All right. Now things are starting to make more sense. And this, presumably, is why you ended a relationship with a man you love?’
‘I had no choice.’
‘What about Marco? Didn’t you think he deserved to know?’
‘Don’t judge me, Nick!’ Her voice sharp, she rose to her feet and paced across the consulting room. Then she turned and wrapped her arms around her body, rubbing her hands up her arms to try and warm herself. ‘I did what had to be done.’
‘Can we take this a step at a time? When the two of you first arrived in Penhally, you were planning to start a family, I know. That’s why you didn’t bother finding a job. You were chasing around looking for suitable houses. You’d only been together for a few months. Given that you were in your early thirties, I wouldn’t have expected you to become pregnant absolutely. It often doesn’t work like that, as you well know.’
‘I know.’ Should she tell him the truth? ‘I went for tests.’
‘After three months?’
‘It was longer than that. By the time I had the tests, we’d been together for six months. No contraception. No pregnancy.’ She started to pace again. ‘To begin with I thought what you thought. I said all those things women always say to themselves when they’re trying to get pregnant. Six months is nothing. I’m over thirty, it might take a while. And then I bumped into an old friend I was in med school with and she turned out to be an infertility specialist at a clinic in Exeter. I decided I may as well have some tests.’
‘You didn’t tell Marco?’
‘No.’ She stopped pacing. ‘I wanted to find out for myself.’
‘So what did the tests show?’
‘Scarring.’ Such a simple word for something that had had such a massive impact on her life. ‘Mild endometriosis. Not enough to need treatment but quite enough to interfere with my fertility. The doctor said that my Fallopian tubes are completely gummed up.’
Nick listened carefully and then he stirred. ‘Well, the first thing to say is that infertility is a particularly inexact science. No doctor would ever be able to be one hundred percent sure that you were infertile.’
‘She said that if an egg ever made it along my Fallopian tube, she’d be surprised.’
‘Well, we’ve just had snow in Cornwall.’ He gave a wry smile. ‘So life is full of surprises, Amy.’
‘I know that miracles happen. I know all that, Nick.’ She was touched by his kindness. Often with his colleagues Nick was brusque and some times even sharp-tongued. But there was no doubting his concern for her at that moment. ‘But I couldn’t risk our marriage and Marco’s happiness on a hope. The chances are that I will never be able to get pregnant.’
‘And that was enough for you to decide to end your marriage?’
‘It was enough for me.’ More than enough.
‘Let’s assume for the sake of argument that your Fallopian tubes are blocked—there are still other options. IVF? Adoption?’
Amy stilled. ‘Those aren’t options for me.’
‘Why not?’
‘I have my reasons.’ And she wasn’t going to share those reasons with anyone. She’d already said more than enough. ‘So now you see why I had to leave.’
‘Well, not really, no. I see why you think you had to leave. You managed to convince yourself that Marco would be better off without you. So you spun a story about choosing a career over a family and about not loving him enough.’
‘I had to give him a reason.’
‘Why not give him the truth?’
‘Because then he would have felt an obligation towards me. I was already his wife. I decided that the easiest way was just to end the relationship. It would have ended at some point anyway, so I didn’t do anything except bring forward the inevitable.’
‘That’s a very negative attitude. Why would it have ended anyway?’
‘Because infertility wrecks marriages. It tears them apart.’ She stared out of the window, her expression bleak. ‘Even strong marriages, and ours wasn’t that strong. We hadn’t known each other long. He didn’t love me enough.’
‘Didn’t he? That’s interesting,’ Nick said calmly. ‘So why did he go completely off the rails when you left?’
Startled, Amy turned to him. ‘What do you mean, “off the rails”?’
‘I’ll spare you the details but let’s just say that he wasn’t a happy man.’ Nick’s eyes narrowed. ‘I’ve known Marco for years, as you know. I can honestly say that you were the first woman he ever really loved.’
‘He didn’t love me. He couldn’t have done.’
‘Why not?’
‘Because we were together such a short time.’
‘But you loved him in that same short time,’ Nick pointed out calmly, and she gave a reluctant nod.
‘Yes, but…he didn’t love me.’ Amy frowned and shook her head. ‘He never said.’
‘Ah. Didn’t he?’ Nick gave a wry smile. ‘Well, we men are terrible at saying what women want to hear, you should know that. But just because the words aren’t there doesn’t mean that the emotions aren’t.’
‘He didn’t love me, Nick.’ She clasped her hands in front of her. ‘He didn’t try and stop me going.’
‘He was in shock. You’d just bought a house to move into together and then suddenly you changed overnight. He assumed you’d met someone else and were just throwing excuses at him.’
Amy felt the colour drain from her face. ‘There was no one else. There’s never been anyone else.’
‘I’m just telling you what he assumed. He couldn’t think of anything else that would explain the sudden shift in your behaviour.’
‘Is that why he didn’t come after me?’
‘He’s a proud man, Amy. He assumed that you wanted to get away from him so he wasn’t about to follow you. And
after he calmed down—well, that was when things fell apart here.’ Nick’s face was expressionless as he referred obliquely to the death of his wife. ‘I expect he felt he couldn’t leave.’
‘Of course he couldn’t. I understand. It must have been a horrendous time for you. And I didn’t want, or expect, Marco to follow me.’ She closed her eyes for a moment. ‘I’m so, so sorry about your wife, Nick.’
‘We’re talking about you, not me.’
‘I think we’ve said all there is to say. I can’t have a child, Nick. I can’t give Marco the family he wants so badly. And he does want it badly—you of all people should know that. He’s Italian. He wants a big, noisy, busy family with at least four children as beautiful as he is, fighting over the large bowl of spaghetti in the middle of the table.’
‘I don’t understand why you’re so black and white about this.’ Nick stood up and rubbed his forehead with the tips of his fingers. ‘There are other options, Amy. If it’s so important to you both, you could look for a solution.’
The past clawed at her and she gave a little shake of her head, trying to dispel the memories. It was always there in the background.
‘I’m not interested in any of those options. I’ve seen what—’ She broke off but Nick’s questioning gaze was enough to tell her that she’d already said too much.
‘What have you seen, Amy?’
‘Nothing.’ Her voice was hoarse. ‘Nothing. I just know that those aren’t options.’
Nick studied her face for a moment but he didn’t push her for more information. ‘Well, at least now I understand why you didn’t want to do the antenatal clinic.’
‘It was difficult,’ she said honestly, ‘but you don’t come to terms with something by ignoring it, so I’m sure that taking that clinic will do me good in the long term.’
‘Some things are more difficult to come to terms with than others. Marco can do that clinic from now on, Amy. Or I will. You can do child health or minor surgery.’
‘If we swap things around then he’ll ask questions that I don’t want to answer, and anyway he should do child health— he’s a paediatrician. I’ll be fine, Nick. I can do the clinic.’ Amy walked back to her desk and picked up her coat and bag. ‘I’m sorry to dump all over you like this. I can’t think what came over me.’