The Country Doctor's Choice

by Maggie Bennett

  Phyllis Maynard’s mouth set in a determined line. The ‘little princess’ was like a message of hope at a time of despair, and she resolved to do everything in her power to persuade Jenny and Tim that this was the answer to hitherto unanswered prayers.

  CHAPTER FOUR

  Trish Pendle’s IVP report came back with a red star, indicating that urgent action was needed. Shelagh stood in the antenatal ward office and read it with consternation.

  Left kidney small, poorly outlined, appears to be non-functioning, suggestive of congenital abnormality or chronic pyelonephritis. Right kidney shows moderate hydro-nephrosis due to reflux.

  So McDowall’s hunch had been right. The girl had a chronic kidney condition, possibly from before birth, and the ‘good’ kidney had to do the work of two. So far it had managed, but the additional strain of pregnancy, aggravated by a poor diet, was proving to be too great a burden, and it was beginning to show signs of pressure, and a backward flow of urine. The warning signs of rising blood-pressure, swollen legs and protein in the urine had been diagnosed as toxaemia of pregnancy, a fairly common condition, and not to be ruled out as additional to the kidney dysfunction. The newly begun fluid chart corresponded with the finding of the IVP, and Shelagh went straight to find Trish and ask her to get into bed for an examination.

  ‘Just sit up for me, Trish,’ she said, pressing the palm of her hand over the girl’s left loin, in the region of the faulty kidney. ‘Now, does it hurt here, my dear?’

  ‘Yeah, a bit. I been tellin’ ’em it aches round there, but they don’t take no notice, they just say it’s ’cos o’ the baby.’

  ‘And here, Trish?’ Shelagh placed her hand over the right kidney, and Trish shouted, ‘Yeah, that’s sore – ouch! – Bloody hell!’

  Shelagh was concerned. Tenderness over the right loin indicated that the back-pressure was causing some inflammation of the ‘good’ kidney, already overloaded with work.

  ‘’Ere, ’ave yer ’eard anything about that whatsit I ’ad yesterday?’ Trish demanded.

  ‘Yes, dear, and it does look as if you might have some kidney trouble,’ Shelagh answered with the calm, matter-of-fact manner she used when imparting unwelcome news.

  ‘What are they goin’ to do about it, then? Any chance o’ Dr Kydd startin’ me off early?’

  ‘I really couldn’t say right now, Trish. We’ll have to wait and see what Mr Kydd says on his ward round tomorrow,’ Shelagh temporised. ‘Meanwhile we’ll get some blood tests done. Don’t worry about it, dear, you’re in the best place – though I believe you’re having some problems with the food in here, so Sister says.’

  ‘Yeah, it’s muck – makes me feel sick.’

  By the time Shelagh had finished trying to advise Trish about the importance of a healthy diet, it was visiting time, and Trish’s scruffy girlfriend’s arrival cut her short, though it was interesting to overhear the girls’ comments to each other.

  ‘Who’s she, then Trish? Is she any better than the others?’

  ‘She’s not bad, at least she listens to yer, ’stead o’ dronin’ on about toxaemia an’ stuff, so’s yer can’t make out what they’re on about.’

  Over in the doctors’ mess, Shelagh found Paul Sykes drinking a solitary cup of coffee, so took a small cheese salad and went to join him.

  ‘You look whacked out, darling,’ he told her. ‘What we both need is a night in that cosy little place at Eastbourne. How soon d’you think you’ll be free?’

  ‘Mother’s being discharged on Thursday, and my Aunt Maura will be arriving tomorrow to stay with us – so perhaps next time we’re both off at a weekend … we’ll enjoy it all the more because of the wait, Paul!’

  ‘Seems like years,’ he said dolefully. ‘How long is Auntie staying?’

  ‘As long as she’s needed, and that means – until my – you know,’ she said bleakly, and he was immediately apologetic.

  ‘Oh, darling, what a stupid question, I’m so sorry.’ He put his hand over hers on the table. ‘That’ll mean over Christmas, I suppose.’

  ‘How do I know? How do any of us know, Paul?’

  As usual there was a pile of post on the hall table, and Derek Bolt’s quick glance went straight to the backward sloping handwriting on the blue envelope. He picked it up at once and put it in his pocket. Daphne was in the living room watching television, and heard him come in.

  ‘Derek, who is the person who keeps sending you these letters on posh paper? It looks like a female hand. Is it something to do with that Christmas choir of Jeremy North’s?’

  ‘No, just a poor soul I’ve been visiting, grieving for her mother and going through a phase of doubt. Let’s get this stuff out of the way,’ he said, sweeping up the rest of the post and taking it to his study, so that she would not notice the absence of the blue envelope. He went through to the kitchen and plugged in the kettle. ‘I’m ready for a cuppa, aren’t you?’

  ‘Doubt? What sort of doubt? Has she lost her faith, d’you mean?’

  ‘Oh, it’s quite understandable when somebody loses the person closest to them – they feel that either God has deserted them, or doesn’t exist at all. I try to give such reassurance as I can, but the words can sound a little hollow, even to me, when dealing with bereavement.’

  Hollow indeed, you lying cleric, he told himself, and changed the subject to the date of the boys’ homecoming. ‘Will they be here by the Sunday before Christmas? Or are they staying on for the usual dinners and parties and pantomimes at Uni, and dashing home on Christmas Eve?’

  ‘How should I know? I’ve written to say we’re expecting them by the twentieth at least.’

  Derek fervently hoped she would not be disappointed; her enjoyment of Christmas depended very much on the presence of Philip and Mark. Later, reading the unwelcome letter in the privacy of his study, heated by a one-bar electric fire, he experienced again the familiar mix of pity and exasperation.

  Dear Reverend Bolt, dearest Derek,

  My happiness, perhaps my sanity, waits upon your pity, your kindness to me. All I ask for is a note, however brief, a word of Christian friendship to show that you understand the plight I am in, longing for a drop of water in the desert, a crust of bread to one who is starving. Whatever your responsibilities to your family, you cannot deny your duty as a priest to one of your parishioners, a sheep of your flock. If this plea from my heart cannot touch yours, you condemn me to despair, and you will be answerable to God for your cruelty.

  Please, please, Derek, light of my life, send me a note to say that you care what becomes of me. Surely you cannot deny that much to a fellow human being …

  He could read no more. What in God’s name should he do? He had tried praying for guidance, but there had been no definite answer. Of course he could not possibly arrange to meet her anywhere – should he send a firm letter, suggesting that she should pray about it? Of course he pitied her as one of the flock entrusted to him by God, but he could not help her.

  ‘Blessed Lord Jesus, show me what thou wouldst have me do for this unhappy woman.’ He frequently found himself using the English of the Book of Common Prayer when dealing with a problem, and the words in themselves were consoling.

  ‘You were right about Trish Pendle,’ Shelagh admitted to Leigh McDowall when she met him in the corridor that connected the antenatal and post-natal wards.

  He shook his head gravely. ‘The poor kid will need to be thoroughly investigated after delivery, but we can do a full blood profile now for electrolytes, creatinine clearance and so on – and watch out for bugs in the urine.’

  She nodded. ‘I’ve sent the requests to the lab.’

  ‘Good. D’you think the old man will go for an early delivery?’

  ‘An early Caesarean section, I’d guess, to save her pushing,’ she said. ‘Her condition’s only going to worsen as long as she’s pregnant, isn’t it?’

  He sighed. ‘Oh, it just isn’t fair, Shelagh, that poor kid. Whatever kind of future has she got, if any? And t
he poor little beggar inside her, who’s going to take him on, or her? She hasn’t got a home for him, only a council flat with an alcoholic mother.’

  ‘It’ll be a case for the social workers to sort out,’ said Shelagh. ‘Foster care, most likely, while they wait to see how things go.’

  ‘Wish I could meet the father of that poor little bastard – he wouldn’t father any more!’

  ‘Then you’d be had up for grievous bodily harm! Nobody ever does find out who’s taken up one of these unlucky girls, get her drunk and then taken advantage of her. By the way, Dr McDowall, you’re on call tonight, aren’t you?’

  ‘Yes, but I can take a couple of hours off this afternoon – to keep an appointment with a very special lady!’ He gave a knowing wink, for they both knew that Tanya Dickenson had a half day.

  ‘Enjoy yourselves,’ she said coolly, putting away Trish Pendle’s case notes in the file.

  Miss Maura Carlin was scarcely able to hide her dismay when she saw her elder sister’s fragile appearance; the two of them clung together on their first meeting after nearly thirty years.

  ‘Sure, Bridie, none of us ever understood why ye upped and left us to marry that sailor feller, him that none of us ever saw,’ she said, smoothing back her sister’s white hair and looking reproachfully into the faded blue eyes. ‘Well, they’ll just have to manage widout me at home for a bit, so they will. I’m here to look after ye and little Shelagh until ye’re better!’

  The bustling Irish spinster was as good as her word, and Shelagh was filled with relief and gratitude towards an aunt she had never met. On her part Maura was open-mouthed when she saw that her little niece had become an efficient, attractive doctor.

  ‘But why didn’t ye write to me before, Shelagh?’ she asked. ‘How could ye let your mother face such an operation widout lettin’ her family know?’

  Bridget begged her not to blame Shelagh but herself, likewise for all the years without making contact.

  ‘But never mind, I’m here now, and here I’m goin’ to stay!’ declared Maura, before they were interrupted by the arrival of a visitor.

  ‘Bless yer, Dr Leigh!’ cried Bridget. ‘Meet me sister Maura!’

  ‘Hello, Maura, pleased to meet you. I just bobbed in to ask how you’re doing, Bridget, but I needn’t have worried, you’re looking fine! Let me explain, Maura. Bridget’s my sweetheart, or at least I thought she was, but she won’t give me any encouragement, says I’m too old for her – what a cruel world!’

  Amid the laughter, Maura brewed a pot of tea and found some biscuits in a tin.

  Shelagh felt a little awkward at such familiarity. ‘Good heavens, Dr McDowall, what are you doing here?’

  ‘Why, don’t you remember, Dr Hammond, I told you I had a rendezvous with a very special lady? Thanks, Auntie Maura, I’ll have another. Cheers!’

  Shelagh was both baffled and annoyed. What on earth was he up to, going behind her back to ingratiate himself with her mother?

  ‘I can’t stay long, Mother, I only wanted to see how you are, and Aunt Maura. It looks as if I needn’t have worried. Bye!’

  Mr Kydd’s decision to perform an elective Caesarean section of Trish Pendle resulted in the arrival of a small but healthy boy whom his young mother called Donovan. He was taken to the Special Care Baby Unit for assessment of his prematurity, and from there transferred to the care of a foster mother by the social worker under whose care Trish had been for several months. Trish herself was transferred two days later to Women’s Surgical for a battery of kidney tests, prior to possible removal of the non-functioning kidney.

  ‘My God, Shelagh, what a lump that Pendle girl is!’ groaned Paul Sykes over lunch in the doctors’ mess. ‘Overweight, unintelligent and adding to the housing problems by producing a kid that she can’t look after. I ask you, what can be done with creatures like that? There’s something to be said for compulsory sterilisation, and I know you won’t agree with that, but quite frankly it’s my gut reaction.’

  Shelagh was a little chilled by his words, though she knew that there were many who would agree with his argument. She paused before replying.

  ‘In her case there might be no need for sterilisation anyway, Paul. With her serious kidney condition, she’s not likely to become pregnant again, in fact she might not even survive. Let’s just hope that little Donovan finds somebody to love him.’

  ‘God, Shelagh, you make me feel such an ogre,’ he protested. ‘I’m just as concerned as you are for the little chap’s future.’

  The dark December days passed by, and Doctor Hammond was presiding at the last antenatal clinic before Christmas.

  ‘Morning, Iris. There’s quite a few here, so we’d better get started. Who’s first?’

  ‘A self referral. Her mother’s with her.’ Iris spoke a little breathlessly. ‘Denise North, the doctor will see you now.’

  ‘Good morning, Denise. I’m Dr Hammond. And – your mother?’

  ‘Yes, I’ve come to support her.’ Fiona waved a finger at the smiling little boy.

  ‘And this fine little fellow is your son?’

  ‘Yes, he’s my grandson. Come here, darling, don’t climb on the couch.’

  ‘And is there a daddy around, Denise?’ Shelagh asked quietly.

  ‘No, and we don’t need one. We’re all devoted to him,’ said Fiona North.

  ‘And have you been referred to a social worker?’

  ‘There’s no need, I’ll take care of my daughter, and see about maternity benefits.’

  Shelagh turned to Iris. ‘Sister, will you take this little chap out for a few minutes, I need to examine his mother.’

  ‘There’s nothing to feel yet, it’s only been a month!’ objected Mrs North. ‘And I’m not going to be sent out of the room – my place is with my daughter.’

  ‘Just hop up on to the couch, Denise, and let me feel your tummy.’ Shelagh gently pressed her hand against the pubic bone.

  ‘I think you’re about ten or twelve weeks’ pregnant, my dear.’

  ‘But that’s impossible!’ cried Mrs North. ‘Her last period was in November.’ Shelagh continued to speak to the daughter. ‘I think your last true period would have been around mid-October. Anyway, we’ll take a couple of blood samples today, and see you again after Christmas.’

  ‘What’s the blood test for?’ demanded Mrs North.

  ‘Oh, a whole raft of tests we do on our expectant mums, to check for anaemia and other conditions. A nurse will show you where to go, and make a further appointment. Good morning!’

  She grinned at Iris as they left. ‘I wonder what she’d have said if I’d told her we check them all for VD! What a woman – I can’t help feeling sorry for that poor girl. But Iris, are you all right? You’re as white as a sheet. You’d better sit down. I’ll get you a glass of water.’

  But Iris waved her aside. ‘I’m all right, Shelagh, honestly. I’ll call the next one in.’

  Christmas Eve brought a clear, cold night, full of twinkling stars, like silver lamps in a distant shrine, Jeremy North half remembered from some old carol. His heart beat a little faster as he looked upon his special choir assembled at the west door of the church with their music sheets. Rebecca Coulter was a stately presence in a fur coat, Phyllis Maynard and Mary Whittaker were well wrapped up in woollen fleeces, scarves, gloves and knee-high leather boots. Beryl Johnson was muffled in a long scarf wound twice round her neck and over her mouth, above which her eyes peered anxiously, and Daphne Bolt, who had not attended any rehearsals, now appeared smiling broadly, with her sons Philip and Mark, home from University and looking for some entertainment. Cyril Pritchard immediately went over to welcome them to the choir and hand them each a carol sheet.

  ‘I thought we might need a few extra copies, so I got these typed out by one of the ladies in the solicitors’ office,’ he said. ‘I’ll be leading you all in ‘Patapan’, that’s a French carol written primarily for children, but has a very nice refrain, so take a look at it.’

  T
he boys nodded and turned to grin at each other as soon as he turned away. ‘What a weirdo!’ muttered Philip behind his hand. ‘Wouldn’t care to meet him in the churchyard after dark, would you?’

  ‘Poor old bugger, I bet he’s as lonely as hell,’ his kinder brother replied.

  As always, Jeremy North experienced a tremor of mixed emotions at the mystery of Christmas: the medieval treasures of art and architecture to be found in this church that had stood here for over six hundred years, and where they were now celebrating the Nativity, the Incarnation of a holy child born in a stable. Memories of past Christmases when the children had been young came back to him, the feasting, the tree with its soft lights and wrapped presents at its base, the carols, the gifts given and received, the holly and the mistletoe – and the soft light in Fiona’s eyes as they’d looked at each other over the tops of the happy children’s heads, before it had all gone so wrong. As headmaster of a primary school he had the opportunity to see again the festival through the innocent eyes of a child; he enjoyed watching the parents’ pride – and sometimes surprise – at seeing their children taking part in the annual nativity play, listening to their praise and shrugging off their enquiries about his own family. Now he prayed that the success of his Christmas choir would renew his own faith which was burning low. There was too much suffering in the world and not enough answers to prayer.

  But now, surrounded by his singers, one face stood out from the rest: Iris Oates in her quilted red jacket with a fur-trimmed hood that framed her face smiled shyly at him, her eyes meeting his just for a moment, before she looked away.

  O, God, is there a man who can resist a woman’s adoration, especially when – but no, to encourage the girl in any way would be wrong. Wicked, in fact. And could lead nowhere. And yet, and yet … he longed to talk to her, tell her everything, for surely she would listen and understand.