by Julie Corbin
‘Warming up their instruments,’ Agnes says, looking up at me, her neck held at an awkward angle.
I hold out a hand and she takes it. Her fingers are gnarled, cold and dry as paper. She is crippled with arthritis but carries on, undaunted, her sense of humour and interest in the world around her what keeps her going. I propel her into a standing position and she holds my arm, scuttling along beside me. ‘Unto the breach,’ she says cheerfully, and we go to my room to begin the consult. I quickly ascertain that her pain medications have stopped giving her the relief she needs and I up them to the maximum dose.
‘Don’t be taking them with alcohol, now,’ I tell her.
‘Not me, no. Although my lovely grandson brought me some whisky back from the Black Isle, Doctor. It’s peaty and sharp. Wonderful stuff ! I’m making it last, measuring it out in a tot glass, and only on a Friday. It should last me until Christmas.’
‘Your restraint is enviable,’ I tell her as I help her back to the waiting room. ‘If only all my patients were as disciplined as you.’
I see the two elderly ladies to the front door and call on my next patient, sixteen-year-old Tess Williamson. She is small and plump with unbrushed hair and tired eyes.
‘So what can I do for you, Tess?’ Her details are up on the screen in front of me and I notice she usually sees Leila, who prescribed her the contraceptive pill last month. ‘I don’t think we’ve met before, have we?’
‘I normally see Dr Campbell.’
I know Leila’s list isn’t full this morning and wonder why she’s chosen to see me instead. Sometimes teenagers have to be persuaded into telling me what’s wrong and I give her a few seconds to speak before I begin to question her. There’s a glass ornament on my desk, a freebie from a pharmaceutical rep, and she picks it up then turns it over so that purple teardrop-shaped globules slide through the hole and reform on the other side. She watches this process as if mesmerised, and then flips it over to begin again.
‘How can I help you, Tess?’ I say, a bit more firmly this time.
‘Well.’ She puts the glass down and tells me she has pain on urination. I ask her a few more questions and she answers with a textbook precision that always makes me slightly suspicious. Since information became so freely available, patients often check their symptoms online and add to the list, as the information draws their attention to symptoms they hadn’t even noticed.
I reach into the drawer close by my feet, bring out a plastic bottle and write her name on it. ‘Do you think you could give me a sample?’
‘A sample?’
‘Of urine.’
‘Okay.’ She takes the bottle from me. ‘Is there a toilet?’
‘End of the corridor. Last door on the right.’
While she’s gone I read back over her notes, looking for signs of past medical or social history that might indicate difficulties. I can’t see anything of interest and her family aren’t known to me. She returns with the sample and I fill out a form and put it and the sample in a bag for microbiology. ‘Results should be back within five days,’ I tell her. ‘But I can prescribe you a broad-spectrum antibiotic now if you want me to.’
She shakes her head. ‘It’s okay. I can wait.’
I’m growing more sure that there’s something she’s not telling me. Sufferers of cystitis are not inclined to refuse treatment when each time they pee feels as though they’re passing cut glass.
I swivel my seat round towards her. It’s meant to help her relax, to indicate I’ve got all the time in the world, but I watch her hands stiffen into fists on her lap. ‘Is everything okay with you otherwise?’
‘What?’ She looks at me warily.
‘I’m wondering whether there’s something else you want to tell me?’
‘Like what?’
‘Well . . .’ I look back at the screen. ‘I see that last month you were prescribed the contraceptive pill.’
‘Yes.’ She’s blushing. ‘Is a problem with peeing a side effect?’
‘Not from the pill, no. It is a side effect of sex, though. It used to be called honeymoon cystitis, back in the day when women were virgins until they married.’ I smile at her to let her see I’m not judging her. Many girls are sexually active at sixteen and I respect that choice. As long as it is a choice and not a decision that’s been foisted on them. ‘And you’re using contraception, aren’t you?’
‘Yes.’
‘Is it working okay for you?’
‘Yes.’
‘No unpleasant side effects?’
‘No.’
‘You remember to take it every day?’
She nods.
‘Unplanned pregnancies are best avoided.’
‘I know.’
‘And your boyfriend. Is everything going well with him?’
She shifts with discomfort, the blush spreading to her neck. ‘I suppose.’
‘Are you also using condoms?’
‘No.’
‘Have you heard of chlamydia?’ No answer. ‘It’s a sexually transmitted infection and one of the signs can be cystitis.’ I talk some more about it then hand her a leaflet from my desk drawer. ‘A smear test is all it takes to establish whether or not you’re infected.’
I’m about to say more but I stop talking because I can see she’s not listening. There are half a dozen photographs on my walls and she’s staring at the one of us as a family. It was taken about five years ago on the top of Arthur’s Seat. Fat clouds billow like candyfloss across the blue sky behind us and the wind is blowing our hair into wayward shapes around our heads. Our body language is easy. Both Phil and I have our outside arms around the children and our inside ones around each other. I haven’t taken it off the wall because it’s such a happy photograph and, despite what’s happened since, it brings back good memories.
‘Aren’t you divorced now?’
I jerk back in my seat. ‘I’m sorry?’
‘It said in the papers you were divorced.’
‘Yes, I am, but I wasn’t when the photograph was taken. Now,’ I give her my most doctorly smile, ‘is there anything else I can help you with?’
‘How’s Robbie?’ She says it in a rush and then immediately bites her lip.
‘You know Robbie?’ I smile. ‘How come?’
Her cheeks are redder than a ripe strawberry. ‘From school.’
‘Robbie’s well,’ I say evenly. ‘He’s completely fine now.’
She nods as if this is what she needs to hear and then she takes a shaky breath. ‘Have the police worked out who did it yet?’
A cold wind blows up my spine. ‘What makes you say that?’
‘It’s just that . . .’ She frowns and shakes her head. ‘I know they’re trying to find the person who did it and I thought that maybe they had.’
I hold her wary eyes in mine, keep them there and lean forward until we are less than a foot away from each other. ‘Tess, do you know something?’ I say quietly. ‘Is that why you’ve come to see me?’
‘No, no.’ Strawberry drains from her face. ‘It’s just that I like him and I wanted to be sure he was okay.’
‘He’s been back at school for a week. You must have seen him there.’
‘I’ve been on holiday and I didn’t go in today and . . .’ She trails off. ‘Thank you.’ She’s on her feet and I stand up beside her.
‘If you know something, please tell me,’ I say, placing a gentle hand on her upper arm. ‘It’s important we find out what happened that night.’
‘I don’t!’ Her voice rises with hysteria and her head shakes from side to side as if she’s watching a fast playing tennis match. ‘I don’t know anything! I don’t! Leave me alone!’ She hauls herself away from me, opens the door and all but flees through it.
‘Wait, Tess!’ I follow her along the corridor but am slowed down by a young mother coming out of one of the other consulting rooms, her buggy pushing into the corridor in front of me, and by the time she’s turned it sideways, and I’m able to pass
, Tess has gone. I run out on to the street and look both ways along the pavement, but it’s a busy Friday morning and she’s already merged with the crowd.
Bugger.
Back in my room I sit for a few seconds trying to absorb the significance of what’s just happened. I don’t think Tess has cystitis at all. I think she knows the symptoms from discussions with friends or Internet research. She made an appointment with me so that she could ask about Robbie. It’s the first proper lead we’ve had since the incident happened and I call O’Reilly at once, waiting for almost ten minutes as the person on the other end tries to find him. Twice she asks me to leave a message – ‘DI O’Reilly will get back to you,’ she says – but I’m not about to be fobbed off. Finally, he comes to the phone.
‘Is this an okay time to talk?’ I say.
‘I have a meeting in one minute.’
‘It won’t take long.’ Without breaking medical confidentiality, I tell him about Tess’s appointment with me, that she was asking after Robbie and that I felt as though she was hiding something. He tells me he’ll get on to it this afternoon and will be in touch again later. ‘You can’t go round now?’ I say. ‘While she’s still agitated. She might have composed herself by this afternoon.’
He tells me he’s working on another case and that’s just as crucial. I protest some more and he stops me short. ‘You need to trust us, Dr Somers.’ He sounds impatient. ‘We want to find out what happened just as much as you do.’
I doubt that, but I can hardly say as much because I already feel as if I’m pushing his cooperation to breaking point. Up till now, he’s allocated a good number of police hours to solving this. I know I’ve had more than my taxpayer’s worth of attention and I’m treading a thin line between asking politely and hassling him for more time than he has. I liken it to behaving the way a handful of my regular patients do; patients who are convinced there’s something wrong with them and, no matter how many investigations we do that turn up negative, they keep coming back.
But the thing is, I remind myself, sometimes their intuition is right – they do have something wrong with them – but the disease presentation is atypical and it takes us a while to work it out.
I sit for almost a minute, agitating in my seat, worrying about what Tess’s strange behaviour might mean, but I have no further time to dwell on it as the receptionist buzzes through to ask me whether I’m ready for my next patient. I answer yes and spend the rest of the morning working through my appointment list.
At lunchtime I remember I need to register for some annual leave to care for my mother and do it quickly before I forget.
‘You’ll never last two weeks,’ Leila says, reading my email to the practice manager over my shoulder. ‘Why don’t you arrange for the community nurses to come in?’
‘And then it’ll be “my daughter couldn’t even bring herself to come over and help me”,’ I sigh. ‘You’re right, though, I’ll make sure proper care is set up before I leave. It’s only fair on Declan and Aisling.’ I press send and take my plastic lunchbox out of my bag. ‘It won’t be so bad. We can all stay at the farm. The kids will be on summer holiday by then and they love hanging out with their cousins, so at least they’ll be there to keep me cheerful.’ My mobile buzzes on the desk next to me – ‘Phil’ is flashing up on the screen.
‘You not getting that?’ Leila says, sitting down opposite me and starting on her own lunch.
‘It’s only Phil. His latest idea is that Robbie, and possibly Lauren, should have counselling. He’s decided that Robbie wouldn’t have got himself into this sort of trouble if he was able to talk through his feelings on the divorce.’
Leila gives a derisive roll of her eyes.
‘My thoughts exactly. Robbie is refusing to go, insisting that if his dad doesn’t trust him to tell the truth then he doesn’t trust his dad to have his best interests at heart.’
‘So Phil still thinks Robbie is lying about taking the drugs?’
‘More than ever. And apparently I’m a fool for believing my own son. But anyway,’ I take a forkful of salad, ‘I need to tell you about this morning. Does the name Tess Williamson ring any bells?’
‘I see a fair bit of her mother Audrey. She’s insulin dependent and her glucose levels are often all over the place so she’s been hospitalised a couple of times recently. But I don’t see much of Tess.’
‘She came to you last month and you put her on the pill.’
‘What’s the problem? Side effects?’
‘No.’ I fill Leila in on what was said and she listens without interrupting until I get to the part where Tess said she went to the same school as the boys.
‘I’m almost a hundred per cent sure she doesn’t go to their school,’ Leila says. ‘She goes to a boarding school somewhere.’ She takes a bite of samosa. ‘She was always getting head lice and her mother was obsessed with getting rid of them.’
‘Strange she would lie about the school she goes to,’ I say, making a mental note to share this with O’Reilly. ‘And then she said to me – have the police worked out who did it yet?’
Leila pauses mid-chew. ‘It’s a reasonable question, isn’t it?’
‘Except that most people would say “Have the police found the person who did it?” Asking whether they’ve worked it out yet implies that she knows something. Don’t you think?’
‘I see what you’re getting at.’ She wipes her hands on a paper napkin. ‘You should have a word with your friendly detective.’
‘I already have. He’s going to follow it up this afternoon. I think I’m beginning to get on his nerves.’
‘How come?’
‘I was pushing quite hard for him to go and see Tess immediately and he was a bit short with me.’
‘I expect he’s juggling several cases at once.’
‘I’m sure you’re right.’
‘Archie was saying you’ll have had more police time because of the award you’re getting.’
‘Might be getting.’
‘The police always give more attention to victims who have clout or have the education to get involved in the inquiry.’
‘Cynical.’
‘Realistic.’
‘I suppose.’ I sigh. ‘Power and money do the talking.’
‘You’re telling me.’ Leila launches into one of her favourite topics – reorganisation of the NHS – and we spend a couple of minutes mulling over changes we would make if we held any power before she comes back to the subject of Tess. ‘Don’t get your hopes up.’ She touches my arm. ‘It might be nothing.’
‘It can’t be nothing.’
‘Teenage girls can be very odd though, Liv, can’t they?’ Leila says. ‘Maybe she just fancies him and she came to see you because she was desperate for information.’
‘Or perhaps she was the person who spiked his drink. Maybe he inadvertently hurt her feelings and she’s become obsessed with him and wanted to get back at him but is feeling guilty about it now.’ I fork some more salad into my mouth. ‘I’ll be interested to see whether the urine sample has anything in it.’
‘What’s that you’re eating?’ Leila asks, her nose wrinkling at the sight of what’s on my fork. She peers down into the plastic box. ‘Honestly, Liv, that looks revolting!’
‘It’s not. The beetroot has stained everything but it tastes okay.’
‘Have some of mine.’
She holds out a samosa but I shake my head. ‘I’m going dress shopping when I’ve finished lunch. I need to go easy on the carbs.’
‘Is it for this evening?’
I nod and take another quick forkful.
‘Talk about last minute! You’ll hardly have any time to browse.’
‘You’re right. I’d better get going.’ I put the lid back on my lunchbox and stand up. ‘I said I’d collect the kids from school and I don’t want to be late.’
‘Where will you shop?’
‘I’m thinking I’ll start with the shops in George Street and then go o
n to John Lewis.’ I take my jacket from the hanger on the back of the door and slide it on. ‘Saving Harvey Nicks as a last resort because they’ll probably have something gorgeous but it’ll cost an arm and a leg.’
‘Choose something that matches your eyes and shows off your assets.’ She looks at her watch. ‘I’d come with you but I have the asthma clinic at two.’
‘I think I’ll manage.’
‘Don’t chicken out,’ she reminds me, pulling the collar of my jacket out and straightening the lapel. ‘Get something spectacular.’
‘From love police –’ I grab my bag and open the door – ‘to style police.’
‘I mean it, Liv.’
‘Your voice is in my head!’ I shout back as I run along the corridor.
For once the parking gods are with me. I find a space immediately and it doesn’t take me long to find a dress either. The assistant in the second shop I go into takes a proactive approach and has me trying on four different styles. The one I end up buying is a halter neck in charcoal-coloured silk. ‘It’s a very fashionable colour this season and it goes so well with your skin tone,’ she says. ‘And the waterfall sash falling from just below the bust is very flattering on you.’
‘I feel like I’m showing too much skin,’ I say, trying to pull the material in to hide my cleavage. ‘Don’t you think?’
‘Not at all,’ she tells me, standing back and appraising me from head to foot. ‘Walk tall and confident. You’ll be a knockout.’
With no time to dither, I buy the dress, a matching bolero cardigan and then some spectacular shoes, and make it to school just in time to collect Lauren and Robbie. Lauren is beaming with excitement. ‘I can’t wait to put on my dress,’ she tells me as she climbs into the car. ‘I’ve wanted this day to come for ages and ages and now it’s here, and Mum, did you find a dress?’