One Step At A Time

by Caroline Anderson

  Kate thought again what a nice man he was, and how lucky the clinic was to have him.

  ‘Besides,’ he went on, ‘a clinical psychologist isn’t the same as a shrink. Psychiatrists deal with mental illness. Psychologists help their patients understand and come to terms with events that have had a major effect on their lives. It’s nothing to do with mental health, more to do with stress-management and adjustment.

  John still seemed unconvinced. ‘It’s the same thing. They all talk gobbledegook.’

  ‘Martin Gray doesn’t. He’s very funny and very down to earth. You’ll like him.’

  John snorted. ‘Don’t bet on it.’

  ‘I’d stake my life on it.’

  ‘That might be rather foolish.’

  ‘I’d risk it. He’s good.’

  And he’d need to be, Kate thought. John’s body language was very negative. She wondered why he was here at Heywood Hall, and whose idea it had been.

  ‘How did you hear about the clinic?’ she asked.

  ‘It was my father-in-law’s idea. He’s paying off his daughter’s guilt.’

  The words were angry, bitter and full of resentment. Martin Gray had better be very, very good, Kate thought with an inward sigh. He had a lot here to work with.

  ‘You need to be positive about it yourself, John,’ Jeremy said gently. ‘It doesn’t matter why you’re here. The fact is you are, and you’re much more fortunate than many people in your situation. You’ll get intensive therapy, massive back-up and support, and I think you’ll find you have a lot of fun, too—and I don’t think you’ve had too much of that recently.’

  John’s smile was a twisted parody, and Kate found her usual distancing mechanisms failing. She was going to get involved with the patients here, she knew she was, and no amount of professional lecturing to herself would stop it. There was so much at stake for them, and so much that could be done. It was a massive undertaking, though, and she found her admiration for Dominic and the work he was doing here expanding until her chest felt tight and there was a lump in her throat.

  Had he really turned into so caring and unselfish a man that he had sunk his personal fortune into this clinic without hesitation, devoting his life to the patients and staff and giving everything he had to their welfare?

  She knew the fees at the private clinic were high, but now that she had a better understanding of what was on offer, she was amazed they could do it for so little. The upkeep of the house and grounds alone must be phenomenal.

  She turned her attention back to John and Jeremy.

  ‘Fun?’ John was saying. ‘All this and fun too? I can hardly wait.’

  Jeremy smiled. ‘You’ll see.’

  ‘So, what form does this miracle cure take?’ John asked with undisguised bitterness.

  ‘It’s no miracle. It’s hard work—for everybody—but it’s worth it. The first thing we want you to do, though, is relax—forget about hospital and concentrate on getting refreshed and fitter. The rest of the weekend is a holiday, OK? You can swim, spend time in the gym, take your chair out into the garden and sit in the sun, or just lie around and read and soak up the quiet. There’s a TV in your room, or you can watch the one in the main house. There’s a quiet sitting room, a library, and then the grounds, which are quite beautiful. I’ll get a nurse to take you on a guided tour after we finish here, and you can plan your weekend.’

  John still looked unconvinced. ‘I’ve done nothing but lie around and “relax” for weeks.’

  ‘So work out in the gym. Push your wheelchair round the grounds, and explore the outside. There are lots of hard paths you can use that run through the pleasure grounds, and up near the house it’s substantially flat. If you get out onto the park it gets a bit more hilly, so I should leave that until you’re fitter.’

  ‘The gardens are old, aren’t they? I saw a yew scroll somewhere as we came in.’

  Jeremy nodded. ‘That’s right. If you’re interested in gardens and history, Humphrey Repton did a Red Book on the garden, and there’s a copy in Reception you can look at. It’s fascinating, and Linda, the head gardener, would be delighted to show you round, I’m sure. Otherwise just help yourself to it. If you get tired, all you have to do is holler, and someone will come and retrieve you.’

  John snorted. ‘Bale me out, you mean.’

  Jeremy’s voice was comforting. ‘Don’t knock yourself. You’ve had a major physical trauma, and your body will get very tired quite quickly. That’s no disgrace.’

  ‘I used to be fit,’ he said disgustedly.

  ‘And that will help you now, because you understand the principles of fitness and you’ll have a residual strength in your muscles that will help you recover more quickly.’

  John nodded. That much he seemed to be able to take on board, but he was obviously very depressed and unable to see a normal life at the end of the tunnel. Kate wondered how on earth they would convince him and turn him round.

  So, obviously, did John. ‘You didn’t tell me how your miracle cure works,’ he said now.

  Jeremy laughed. ‘We bully you,’ he told the man frankly. ‘Come Monday morning you’ll have your first session with the physio. She’ll work on your stiff muscles and get them moving smoothly again, and the first and most important step in that direction is getting you on your feet.’

  ‘Whose feet?’ John interjected with bitterness.

  ‘Well, initially not yours. She and the prosthetist will sort out new legs for you and get them under way, and until they come you’ll have adjustable temporary ones for your physio sessions. If the physio thinks you need it, the osteopath will do some work on your back and neck, because lying and sitting all the time can play havoc with the spinal mechanics, and then the occupational therapist will do things with you—initially working on coping in a wheelchair, and later learning how to deal with the difficulties of dressing, personal care and so on.’

  He grinned at John. ‘You’re going to be busy, you’re going to be tired, but at the end of it you’ll be fit and raring to go. First things first, though. I need to do a thorough medical examination, take some blood and urine for analysis, and make sure these stumps are fit for the next stage. Then, if everything looks basically good, I’ll get someone to give you a guided tour and you can start your programme of relaxation with an aromatherapy massage and a sleep in your room before supper. Think you can manage that?’

  John responded to the teasing tone with a crooked smile. ‘I’ll force myself,’ he said drily. ‘Just so long as I don’t end up smelling like a rosebed.’

  The physical examination was conducted in the same cajoling, friendly atmosphere. Kate wondered if he might feel inhibited about having his stumps examined in front of her, but clearly by now it was totally routine, and he had lost so much of his pride that he no longer cared.

  Kate found that the saddest part. He was a good-looking young man, his body well-made, and she could quite imagine that his wife had found him very attractive. How did she feel now? Kate wondered. Apart from her guilt, of course, which would keep them apart anyway.

  His left leg had been amputated at mid-thigh in a classic trans-femoral amputation, because the knee joint had been smashed beyond repair and the nerve supply to his lower leg destroyed.

  His right leg had been taken off below the knee a little higher than was desirable, but artificial limbs were now so good that a satisfactory stump was less critical than with earlier models.

  Both stumps had healed well and were healthy, without obvious oedema, and Jeremy was confident that the physio would be able to get him up and walking straight away.

  ‘How tall are you?’ Jeremy asked him.

  ‘I was about six foot,’ John replied. ‘Why, does it matter?’

  Jeremy grinned. ‘Of course. Your new legs need to be the right length, otherwise all your trousers will need altering. Think of all the sewing you’d have to do.’

  John laughed. He actually laughed, a real smile on his face, and Kate felt quite
choked.

  ‘That’s ridiculous,’ he said, but the smile stayed there, and for the first time Kate thought that the psychologist might stand a chance.

  ‘Right, Kate, could you take some blood while I ask a few more questions? And then we’ll send Jeremy off for his guided tour and rub-down with a rosebed.’

  ‘Thornless, I hope.’

  A joke? Kate blinked.

  ‘Maybe, if you’re good,’ Jeremy quipped back. ‘Otherwise it’ll be a bramble. Right, date of birth.’

  Minutes late John was gone, wheeled off by Samson, the big porter with a huge smile and a constant stream of awful jokes, Jeremy told her.

  As they watched their patient disappear down the corridor Kate sat back in her chair with an exaggerated sigh. ‘Wow. He is screwed up.’

  Jeremy nodded. They usually are. Martin will get him sorted.’

  ‘What about his wife?’

  ‘Her too. He’ll insist, and when Martin wants something, he has a way of getting it.’

  ‘So, what programme of treatment will he have?’

  Jeremy glanced down at the notes. ‘Physio, of course—probably swimming and hydrotherapy—to get his legs moving straight at the hip and to help avoid contractures, upper body work in the gym, to give him the strength to drag himself around the bed, get in and out of the bath and that sort of thing-because although he’ll have legs for walking, there’s still a lot he can’t do with them on, and he needs to be able to cope both with and without. We’ll see how he gets on with the aromatherapy. I’m going to ask Lindsay to use something to relax and stimulate, so he feels refreshed and mentally able to cope with the rigours of his treatment.’

  ‘It must be hard work, the physio and so on.’

  ‘It is. Very hard. He’ll probably hate the physiotherapist after a few days, but then he’ll make some progress and she’ll be flavour of the month again.’

  Kate laughed, then her sympathy rose to the surface again. ‘Poor man. He really has lucked out.’

  ‘Especially if his wife leaves him. That sort of blow is always hard to take, but if they can’t cope with the amputation the patients often think they’re better off without their other halves. The trouble is it’s just another amputation of a sort, and that’s where Martin comes in. He almost always sees the spouse first.’

  ‘To assess what the patient has to deal with?’

  ‘Yes—but ostensibly to explain his role in the patient’s treatment plan and discuss how the wife or husband feels the patient will cope with it. It gives him great insight into how the spouse feels, and he can then use that to help them both. Then he has to see them again, of course, to report, and without them realising it it turns into a course of treatment.’

  ‘Sneaky.’

  ‘Not really. Often they don’t realise they need help, and afterwards they say how much he’s helped them understand their other half and what they’ve gone through. And that, of course, is what it’s all about.’

  Kate eyed Jeremy thoughtfully. ‘Do you get very involved with the patients?’

  He laughed. ‘Me? Of course not. Pieces of meat.’

  ‘Liar.’

  His smile was understanding. ‘It isn’t possible to keep a distance. You have to be able to see them clearly, yes, but without fail we all end up as a very close team. They’re like members of the same family by the time they leave, and you wouldn’t believe how many of them send us Christmas cards to tell us how they’re getting on and postcards when they go on holiday. Some even come back for a refresher, if they feel they’re backsliding or losing fitness, and it’s wonderful to see them again.’

  Kate asked a question that had been burning at the back of her mind since she had realised how depressed John Whitelaw was. ‘How often do you fail?’

  Jeremy sighed. ‘Not often. Every now and again someone comes here who’s left it too late, and they’ll never walk again. Usually they’re elderly, or they’ve had massive trauma and there’s too little to work with. They all go home fitter, though, and usually happier. We try and improve people’s self-image and mental attitude to their disability even if we can’t rehabilitate them with total success.’

  ‘How do you think John will do?’

  Jeremy grinned. ‘He’ll be fine. He can still smile. He’ll make it.’

  ‘And his wife?’

  Jeremy shrugged. ‘Who knows? I spoke to her briefly this morning when she dropped him off. She seemed in a hurry to get away. I think she can’t cope with the situation at all, probably because of her guilt. There’s a court case pending—she’s being done for driving without due care.’

  ‘Oops.’

  ‘Yes, quite. There’s a lot of baggage there. I think we’ll let Martin see him on Monday, too. I’d better contact Andrea Whitelaw and make sure she’ll be around.’ He glanced at his watch. ‘Are you going to see Dominic?’

  She blinked in surprise. ‘I wasn’t.’

  ‘Oh. It’s just that he’s asked for some acupuncture needles and some essential oils to be taken in if anyone’s going.’

  Kate chewed her lip. ‘I could go, but what about Stephie? I haven’t got a due where she is.’

  ‘Leave her. She’s fine. She’s used to entertaining herself when she’s here. She’s not a problem.’

  ‘She’ll want to see her father.’

  ‘Let her want. There’s always tomorrow. I don’t suppose he’ll want to see her—I understand he’s in a lot of pain at the moment.’

  Kate stood up. ‘I’ll go, then. Can you get the things together while I go and get ready?’

  Jeremy nodded. ‘I’ll leave everything at Reception.’

  She went over to the cottage, left a note for Stephie to say she’d slipped out for a little while and would be back soon, and then went up to the little spare bedroom she had commandeered and eyed her clothes critically. She was wearing a fine cotton lawn skirt in an all-over floral print with a sleeveless cotton T-shirt tucked in, and it was cool and comfortable.

  Hardly the stuff of fantasy.

  She caught herself up before her thoughts could run away with her. She should be wearing sackcloth, not dressing up for a man-hunt! What was she thinking about?

  She turned away from the mirror in disgust, picked up her handbag and car keys and ran down the stairs. He was in pain. He needed the acupuncture needles and the essential oils. He didn’t need her tarted up to the nines and flirting with him.

  Stop it. You’re his ex-wife. That’s ex, E-X, finished, over, done with, she reminded herself. He doesn’t even like you.

  She picked up the parcel from Reception, left another message for Stephie and drove to the hospital. It was the middle of visiting and the car park was crowded. It would be, of course, on a Saturday.

  She found a space eventually, miles from the hospital, and had to walk right across the site to Dominic’s ward. There wasn’t a member of the nursing staff on whom she recognised, but she found Dominic without difficulty and dredged up a smile.

  His mouth lifted in recognition. ‘Hi,’ he murmured. ‘Did you get the message?’

  ‘Yes—I’ve brought the things.’ He looked better, she thought. He was propped up a little, and he was wearing a T-shirt that covered his battered chest. Maybe that was why he looked better. He also had both eyes open, which made an enormous difference, although his face was still very colourful. She didn’t kiss him today, just handed him the parcel and sat on the chair. ‘How are you?’

  ‘Sore. I’m off the pethidine pump and I hurt. Are the needles in here?’

  ‘Yes. Do they mind you doing it?’

  He snorted. ‘I don’t give a monkey’s armpit whether they mind or not. It’s harmless, relatively non-invasive and brings relief. Shut the door.’

  She did, reluctantly, and then sat back down again. ‘I think you ought to ask for their anaesthetist to do this,’ she cautioned.

  ‘The pain chap’s off for the weekend. It’s me or me.’

  ‘Fine.’ She sat back. He was an adult,
a qualified professional at the top of his field of pain relief. If he couldn’t bung a few needles in his leg, who could? She watched as he got on with it.

  The needles were long, very fine and made of stainless steel wire. There were no preparations, no wiping of the skin or other sterilising techniques, he just threw back the bedclothes, picked up the needles one at a time and slid them into his right thigh just below the level of the break, twirling them between thumb and forefinger as he pushed then home. Then he directed her.

  ‘Find the edge of my tibia, just below my knee, and come round about two inches towards the top of the fibula—go on, put one finger on it. That’s right. Now move round—right, now down—stop. Good. Put one in there.’

  ‘Me?’ she exclaimed. ‘I can’t do that!’

  ‘Why?’

  She was appalled. ‘I might hurt you.’

  He snorted. ‘You won’t hurt me half as much as I’ll hurt myself trying to reach to do it on my own. Just put the end of the needle on the skin, hold it with your thumb and third finger and tap with your index finger.’

  She picked up a needle and put the point against his skin. ‘Here?’ she said tentatively.

  ‘Yes. Now, tap it firmly—harder than that! That’s better. Good. Now twiddle it and push it in a little way—oh, fantastic. You’ve got it. Just twiddle there for a moment.’ He lay back with a sign of relief. ‘Thank God for that,’ he murmured after a moment.

  ‘Better?’

  ‘Much. Keep twiddling.’

  She did, very cautiously. ‘Are you all right?’ she asked as his eyes slid shut.

  ‘Fine,’ he mumbled. ‘You can stop twiddling now. Did Lindsay sort out any oils?’

  Kate rummaged in the parcel and came up with a little bottle. ‘It says “Lavender, geranium and chamomile in sweet almond oil” on the label.’

  ‘Wonderful. I’ll put some on my chest in a minute.’ He lay back and closed his eyes, and Kate saw the lines of strain around his mouth. She ached for him.

  ‘Would you like me to do it?’ she offered quietly.

  He opened his eyes. ‘Could you?’