Rescuing Dr Ryan

by Caroline Anderson

  Nor did her first patient on Friday morning. Mr Gregory's stomach was still proving a problem, pending the result of his blood test, but at least the ECG had proved normal, as she'd expected.

  'I think I ought to start him on the treatment,' Lucie said to Will thoughtfully, just before Mr Gregory came in. 'If he's back because it's worse, I have to do something.'

  'The treatment's very expensive, and might mask other symptoms,' he warned.

  'So what would you do?'

  He leant back in his chair, steepled his fingers and pressed them against his lips, peering at her thoughtfully. 'I don't know. Encourage him to wait and give the palliative treatment which was all we had until a short while ago.'

  'I've done that. He's coming back. There must be a reason.'

  Will shrugged. 'Reassure him. I think he's worried. We'll see.'

  Will was right, of course. He was just worried and wanted reassurance that it wasn't, in fact, his heart. Finally satisfied that he was in no danger, Mr Gregory left, and Lucie finished her surgery without any further complications. She was just about to leave on her calls when the receptionist took a call from an anxious mother whose seventeen-year-old daughter was vomiting and looking very peaky.

  'We'll call in—we have to go that way,' Will told the receptionist. 'I doubt if it's anything urgent— probably a hangover.'

  'Sceptic,' Lucie said with a chuckle, and his mouth cracked into a fleeting smile.

  'Absolutely. That's the modern youth for you. No restraint and no stamina.'

  Lucie shook her head, stifling the smile. 'Such a sweeping generalisation. I bet you were really wild at university.'

  A wry grin tilted his lips. 'I had my moments, I confess—although nothing like they get up to these days.'

  'Ah, poor old man,' she teased, and he snorted.

  'Can we get on, please? We've got another call to fit in now and, hangover or not, it'll take time.' He scooped up the notes in his right hand, and Lucie noticed that it seemed to be co-operating fairly well.

  He'd been using it much more in the last few days, and it was obviously less painful.

  Not good enough, though, that he could drive yet, and she could tell that was frustrating him. Will went out to the car park, went round to the driver's side, swore colourfully under his breath and went round to the passenger side instead.

  'When can you drive?' she asked him, and he glowered at her over the roof of the car.

  'Not until the cast is off. I always advise my patients not to drive until they've had the cast off and their arms are functioning normally without undue pain. It's for insurance reasons, really.'

  'So I suppose you ought to take your own advice.'

  He snorted. 'Very probably.'

  'Mmm,' she agreed, sucking in her cheeks and ducking behind the wheel before he could see the smile that was sure to show in her eyes.

  He appeared beside her, shooting her an unreadable look. 'In the meantime,' he continued, 'you're stuck with me, and vice versa, so we might as well both make the best of it.'

  He then proceeded to spend the entire journey telling her she was in the wrong lane or had missed a turning.

  'For God's sake, didn't you see that cyclist?' he yelled as they neared their destination, and she glowered at him and turned on the radio. Anything was preferable to listening to him ranting!

  'Do we have to have that on?'

  She pulled over, switched off the engine and turned to face him. 'Will, I am an adult,' she said with exaggerated patience. 'I have a current, valid, clean driving licence. I do not need you giving me a hard time just because you want to be able to drive and can't! I've been driving for ten years and I've never had an accident or been pulled up by the police.'

  'That's a miracle!'

  'And I don't need you telling me how to do everything all the time!' she finished. 'Now, either we're going to do this in my car, or you're going to shut up, because frankly I've had enough!'

  He turned away, letting out a short, harsh sigh and glaring hard enough to melt the glass. 'I'm sorry,' he said gruffly, and she nearly choked. An apology? From Will?

  'Thank you,' she replied, struggling for a humble tone. 'Now, where do you want me to go from here—apart from hell?'

  He turned and met her eyes, and gave a rueful grin. 'It's not personal,' he confessed. 'I just can't delegate—and I hate being driven. The only accident I've ever been in, someone else was driving. I find it hard not being in control.'

  'That's because you're a control freak,' Lucie told him drily. 'If it's any help, I passed first time and I've taken my advanced driving test as well.'

  'And passed?' he asked her, picking up on her careful phrasing.

  She grinned. 'Not exactly—but I didn't fail drastically.'

  He gave a soft snort and shook his head, but the tension was gone, and at least the atmosphere in the car was restored.

  'So, where to, boss?' she asked again, and he directed her, and for the rest of the journey he kept his mouth firmly shut.

  They arrived at the house of the girl with the 'hangover', and her mother opened the door.

  'Mrs Webb? I'm Dr Lucie Compton, and I'm covering for Dr Ryan at the moment. I've come to see Harriet.'

  'Oh, I am glad you're here. She's looking awful. Come on up.' She led them to a bedroom where a thin, pale girl lay under a quilt, looking extremely unwell. Her skin was waxy, her eyes were sunken and she looked exhausted. It was certainly more than a simple hangover.

  'This is Harriet,' her mother said. 'Harriet, darling, it's the doctor.'

  Lucie smiled at her gently and crouched down beside the bed. 'Hello, I'm Lucie Compton, and this is Dr Ryan,' she told the girl. 'I'm covering his patients at the moment. Can you tell me how you're feeling?'

  'Sick,' Harriet said weakly. 'So sick. I never feel very hungry, but just now I feel really ill if I eat.'

  'Are you being sick?' Lucie asked her.

  She nodded. 'A bit. Not enough. I feel I want to do more, but all I can do is retch.'

  'Any diarrhoea, or constipation? Any other tummy problems?'

  Harriet shook her head. 'Not really.'

  'Mind if I have a look at your tummy?' Lucie asked, and at a nod from Harriet she peeled back the quilt. 1

  In contrast to her thin face and arms, her abdomen seemed bloated, and Lucie lifted her nightshirt out of the way and examined the skin. There was no sign of abnormal colouration, no hot spots or rashes, but there was a definite mass in the midline, consistent with an aortic aneurysm or an intestinal obstruction.

  'Are you bringing up any blood?' Lucie asked, feeling round the margins of the mass.

  'A little—sort of streaks of it.'

  'Red, or brown?'

  'Oh—I don't know. Maybe both. Brown gritty bits sometimes.'

  Lucie shot a look over her shoulder at Will. 'How good are your hands? I'd like a second opinion.'

  'I'm sure I can manage,' he murmured, and, bending over Harriet, he worked his way over the mass, his fingers probing gently. A fleeting frown crossed his brow, and he quirked an eyebrow at Lucie.

  'It feels like a mass in the stomach,' he said, confirming her fears, and Lucie nodded.

  She scanned Harriet's hair, and, yes, it seemed thin and wispy.

  'Harriet, have you ever eaten your hair?' she asked gently.

  'Oh, no!' her mother said. 'She used to, when she was tiny, so she always had it short. Right up until two years ago, but we thought she'd outgrown it.'

  'I have!' Harriet protested feebly. 'I don't do it any more, I swear!'

  'You might be doing it in your sleep,' Will suggested. 'It happens, especially during times of stress, and I imagine you're doing the first year of your A-levels?'

  Harriet nodded. 'Yes—and I have been Worried. Do you think I've got a hairball or something?'

  'Very possibly,' Lucie confirmed. 'I think you need to go to hospital for investigation, and if we're right, you'll have to have it removed. They'll know the best way of d
oing it. I'll contact the hospital now and get you admitted. Is that all right, Mrs Webb?'

  Mrs Webb was sitting down on the end of the bed, looking shocked. 'A hairball?'

  'The correct term is a trichobezoar,' Will explained. 'It's very rare, but the fact that she used to eat her hair points to it being highly likely in the light of her other symptoms. We do need to get it checked out as a matter of urgency, though.'

  'So should I take her in now?'

  Will shook his head. 'I would suggest we call an ambulance and admit her direct to the surgical team on take, and they can decide what they want to do. If you take her in yourself, you'll have to queue through Accident and Emergency, which isn't a good idea with Harriet feeling so unwell.'

  'Mum,' Harriet said feebly, and Mrs Webb moved up the bed and put her arms round her distressed daughter.

  'It's all right, darling. It'll be all right.'

  'I thought I'd stopped!' she wept, and then started to retch again.

  Will looked at Lucie. 'I think we need to mobilise the ambulance,' he said in an undertone. 'She's very weak, and I don't like the feel of that mass. It's utterly rigid and very large. I think her stomach's within an inch of rupture.'

  'Me, too. Can I leave it to you to talk to them? You know who to refer to.'

  He nodded. 'Mrs Webb, may I use your phone, please?' he asked, and she looked up.

  'Oh. Yes, of course. There's one in the front bedroom, by the bed.'

  He went out, and Lucie stayed with them, telling them more about the tests that might be performed and getting a little more history. She made some notes for the receiving surgical team, and by the time the ambulance arrived Harriet's bag was packed and Mrs Webb had contacted her husband and explained what was going on.

  They all left together, Harriet and her mother in the ambulance, Lucie and Will to their next case, and as soon as they were out of earshot Lucie let out her breath in a rush.

  'Wow. I've never seen anything like it,' she confessed.

  'Nor have I. It's very rare, but there was a tragic case not all that long ago. I think it's all part and parcel of the pressure we put kids under. Look at Clare Reid, worrying because her father will be cross if she's sick and doesn't do well in her end-of-year exams. But this, I have to say, is much more serious. I wonder if she's got psychiatric history. Let me look in the notes.'

  He fumbled through them as Lucie drove, checking through the early correspondence, and then stabbed the paper with a triumphant finger. 'Yup. Here it is. Trichotillomania—hair pulling and eating. Age five. Psychiatric referral, discharged six months later—presumably after she was "cured" with a haircut. Poor kid.'

  'Do you think she'll make it?' Lucie asked, dwelling on the terrified mother's face. She, too, had probably seen the news a couple of years ago about the teenager who had died with the condition. It must have struck fear into her heart, and rightly so, given her daughter's history.

  'I hope so,' Will said heavily. 'She looks pretty grim, though, and she's obviously lost quite a bit of blood over recent weeks. She's as white as a sheet.

  Still, hopefully we were called in time and they'll be able to do something if the inside of her stomach isn't too raw and vulnerable to haemorrhage.'

  If.

  Their next few calls were much more routine—a case of tonsillitis which could easily have been brought to the surgery, a fall in an elderly lady which had resulted in stiffness and soreness, not surprisingly, a baby with diarrhoea and vomiting who was getting dehydrated but had actually started keeping some boiled water down by the time they arrived. Lucie gave the mother some sachets of electrolyte replacement, and instructions that if the baby didn't pick up by four, they were to be called out again and the baby might have to be admitted to hospital for rehydration.

  Then they went back, dealt with the correspondence and notes from the week, had a meeting about practice policy on drug offenders and then while Lucie did the evening surgery, Will called the hospital about Harriet Webb.

  He popped his head round the door between patients. 'Harriet's all right—they've removed a massive hairball but they think her stomach will heal. Amazingly it didn't look too bad. She's had a blood transfusion and she's holding well.'

  Lucie felt her shoulders drop a few inches, and laughed. 'Excellent. I really wasn't sure she'd make it.'

  'Nor was I. How many more have you got?'

  "Three—I won't be long.'

  'Take your time. I'll have a cup of tea—do you want one?'

  'I'll wait,' she said with a shake of her head. 'I'd rather get home.'

  He nodded and left her to it, and half an hour later they were on their way.

  'Any plans for the weekend?' Will asked her, and she had a sudden chill. Fergus had said he'd come down, but he hadn't contacted her, thank God. Maybe he'd taken the hint from her abrupt departure after lunch on Saturday.

  'Not really,' she said evasively. 'How about you?'

  He shrugged. 'What can I do? Sit about and fret because I can't get on? Walk the dog till his legs fall off? You tell me.'

  'What would you normally have been doing?' she asked.

  His laugh was short and wry. 'The house? In case you haven't noticed it's barely habitable. I've done the roof and the dampproofing and started with the kitchen and breakfast room and two bedrooms and some basic plumbing, but nothing's finished, and the rest of it is crying out for some progress. The only rooms that are virtually done are the two bedrooms, and they just need decorating.'

  'Why on earth,' she asked, negotiating the track carefully, 'did you take on something so challenging?'

  'Because I like a challenge? Because I wanted to live here and it was falling down, so there wasn't a lot of choice. The barn had planning permission for conversion to guest accommodation, so I lived in a caravan and did that first, then lived there while I made the house weathertight and sound and installed the basics.'

  'So why don't you still live in the cottage? Or let it?'

  'Well, I am letting it. I'm letting it to trainees at the moment.'

  'But not for as much as you'd get for holiday lets.'

  'No, but it's less hassle, and I'm too busy at the weekends to deal with change-overs and guests and their trivial problems and queries. That's the plan, in the end, but not until I've got the house knocked into shape—and with my arms out of action, DIY's taken a definite back seat.'

  Lucie chuckled. 'You amaze me. I would have thought you'd have a go anyway.'

  He looked rueful. 'I have to confess I did have a go, during the week. I thought I might be able to tackle some of the simple things upstairs, but I couldn't even hold the electric screwdriver with my right hand, and my left—well, let's just say I'm not ambidextrous. Anyway, it still hurts, so what the hell. I gave up.'

  And it didn't agree with him, Lucie realised, because he wasn't a quitter.

  And nor, she realised with a sinking heart, was Fergus.

  They pulled up on the drive beside his car, and Will arched a brow at her. 'Have you got a visitor?'

  'Apparently,' she said tightly, and got out of the car at the same time as Fergus emerged from his, a wide smile on his face.

  'Lucie, darling! I thought you'd never get here! The dog's been barking its head off—I stayed in the car just in case it got out.'

  'You should have rung,' she told him, unable to be more welcoming, and dredged up a smile. 'I'm sorry we're late. I had evening surgery.'

  She offered a cheek for his kiss, and turned to Will, who was coming round the front of the car with a look in his eye that she didn't want to analyse. 'Will, meet Fergus Daly, a friend of mine from London,' she said smoothly. 'Fergus, this is Will Ryan, my trainer.'

  'I won't shake hands,' Will said a little curtly, holding up his cast, and looked at Lucie. 'You're obviously busy. If I can have the keys, I'll leave you to it.'

  She dropped them in his outstretched hand, and he turned on his heel and strode away, leaving Fergus staring after him.

  'Wh
at an odd fellow. Not very welcoming.'

  Nor was Lucie, but Fergus hadn't noticed—or wasn't acknowledging it. 'So, is this your little pied-a-terre?'

  She nodded, unlocking the door and pushing it open. 'Come in. I haven't done anything today, it's a bit of a mess. Tea?'

  'Nothing stronger?' he said hopefully.

  'No, nothing stronger. You're driving.'

  'Am I? Where are we going?'

  She gave a short sigh. 'To your hotel?'

  He reached for her, his hands cupping her shoulders, drawing her towards him. 'I had rather hoped I might be allowed to stay with you,' he murmured, and bent to kiss her.

  She turned her head and moved out of his reach. 'I think not, Fergus. I told you that before I left London, and nothing's changed. It was no then, and it's no now.'

  'But I miss you, Lucie.'

  'I know you miss me—or you think you do—but I don't miss you, Fergus. I'm sorry, but that's the way it is.'

  He stood dumbstruck, staring at her with astonished eyes. 'Lucie?'

  'Oh, Fergus, come on, it's not as if it's the first time you've heard me say it! We're friends—nothing more. If you can't accept that, then I don't know how else to tell you to make you understand. There is nothing between us—nothing!'

  'Oh.' He suddenly seemed to find the carpet absolutely fascinating, and she felt a pang of guilt.

  'Fergus, I'm sorry.'

  'I was really looking forward to this weekend,' he murmured.

  'Only because you've failed to listen to me for weeks now. If you'd been paying attention, you would have realised it was a waste of time.' She moved closer, putting her hand on his arm. 'Have a cup of tea before you go.'

  He pulled his arm away and looked up, his eyes suspiciously moist. 'I won't, thank you. I'll get out of your way.' He moved to the door, then paused, looking back at her. 'It's Will, isn't it?'

  She sighed. 'No, it's not Will. This was over before I left London, Fergus. Will has nothing to do with it.'

  'He may not have been then, but he is now,' he said with unusual perception. 'I hope you find what you're looking for, Lucie. You deserve to, you're a lovely girl.'