Questions of Trust A Medical Romance

Chapter One



‘Mrs Edwards? And this must be Jake.’

Chloe glanced up in surprise. She was bent over the receptionist’s desk, filling out the form as neatly as she could in the tiny spaces, resisting the instinct to use shorthand. Her son toddled around her feet, worrying some sort of soft toy he’d found in the corner.

Doctor Carlyle – it could only have been him, as the only other doctor at the practice was Dr Okoro, an older Nigerian man – stood in the open doorway of a consulting room, a grin on his face. He was casually dressed in a pale blue shirt with the sleeves rolled halfway up his forearms in deference to the April warmth. The inevitable stethoscope was slung across his shoulders.

Chloe straightened and attempted a smile, aware that her face had been creased in harassment and had probably been that way for the last few hours. They’d arrived in town the previous evening, herself and two-year-old Jake, too late to get much done. This morning, though, she’d been up at dawn, doing most of the unpacking before setting off with Jake in tow to do the essentials: a shop, a visit to the local nursery to put Jake’s name down for two mornings a week, and now a trip to the local GP practice to register them both. She was an organised person and liked to get things done as quickly as possible.

‘Yes.’ She reached out a hand. ‘Chloe Edwards.’

‘Tom Carlyle.’ His grip was warm, firm, but not bone-crushing. Involuntarily, Chloe’s journalist’s eye took in the details: he was a few years older than her, but not many, perhaps thirty-three or -four. Tall, not excessively so; six foot, or a shade under. Dark brown, slightly shaggy hair. Eyes that were blue and amused, their expression matching the wryness of his grin. The faintest trace of fine creases at the corners of the eyes suggested he was a man who smiled, even laughed, a lot.

The receptionist, a cheery, blowsy girl with constantly dancing earrings, said: ‘Your eleven-thirty’s cancelled, doc.’

‘In that case,’ said the doctor to Chloe, ‘why don’t you and Jake step in for a moment? It’ll give me a chance to get to know him, so that if I ever do need to see him for anything we won’t be strangers.’

Chloe opened her mouth to protest, to say that they really needed to be off and that she hadn’t expected an impromptu doctor’s appointment for her son, but she thought, Why not? Hoisting the little boy on to one arm, she nodded as the doctor stepped aside for her and preceded him into his small, brightly sunlit room.

The doctor followed Jake’s rapt stare around the walls. ‘Not bad, is it?’ Two of the walls were decorated with elaborately colourful murals of cartoon characters. Carlyle smiled again and dropped into his swivel chair, tapping at the computer keyboard before him.

‘New to Pemberham?’ he said.

‘Yes. We arrived just yesterday.’

‘Nice town. Though I’ve been here only six months myself.’

He said it casually. It struck Chloe as an odd remark. Was he trying to empathise with her in some way? It didn’t exactly inspire confidence, suggesting as it did that he was a relative newcomer too and perhaps didn’t know the area or the people as well as he might. She said nothing.

He was right in one respect, though. Pemberham did seem a nice town. Chloe had researched the place extensively over the last year. She was looking for somewhere to move to that wasn’t so tiny that it would feel stifling, but at the same time wasn’t another metropolis like London, which was suffocating in a different way. Pemberham, nestled in the Gloucestershire countryside west of the capital, looked like a chocolate-box painting in all the online pictures, and when she’d visited it with Jake for the first time last summer, she’d been delighted to see that the photos hadn’t exaggerated its charm. They had, if anything, understated its appeal. Set between two hills in a dip too gentle to be called a valley, it was an old market town that had done its best to retain the peacefulness of its original atmosphere in the modern world. Further enquiries had informed Chloe that the schools were good, the accommodation affordable, and the rail links to London excellent. It hadn’t taken her long to decide that this was the place she and Jake would in future call home.

The move had been less traumatic than she’d expected. They had relatively little in the way of material possessions, and relatively few ties in the city. Jake was too small to have made many friends yet. The money would last Chloe for a year, plenty of time for her to find another job; and she’d already had an expression of interest from the local paper in Pemberham. All in all, the relocation of her little family unit had been accomplished with a minimum of fuss so far.

Across the desk the doctor glanced at the registration form Chloe had filled out. ‘Immunisations are up to date.’

‘Of course.’ Obscurely, Chloe felt annoyed. She didn’t need to be patronised.

Get a grip, she thought, and drew a deep breath, Speaking less sharply, she hoped, Chloe said: ‘How did you know who we were? There, back in reception?’

He raised his eyebrows. He really did have a nice smile, she had to admit. ‘It’s a small town. Whenever somebody new registers at the practice it’s a bit of an event with the reception staff. They spread the word around as if a film star is coming to town.’

Chloe had telephoned a few days earlier to make sure there was room on the practice list for her and Jake to sign up, so as to avoid a potential wasted trip.

Dr Carlyle scanned the rest of the form and made some sort of entry on his computer. ‘Healthy chap, aren’t you?’ he beamed at Jake. On Chloe’s lap, the two-year-old squirmed shyly and buried his face in her shoulder, but peeped round to see if the doctor was still watching him.

Chloe loosened her grip on her son when his squirming threatened to spill him out of her arms. She watched him anxiously, ready to scoop him up again if he started running riot; but instead, he made his way round the desk and held up Wolf, his beloved and well-chewed soft dog toy, for Dr Carlyle to inspect. The doctor peered at it with great interest.

‘And what’s your name?’ he asked.

‘Woof,’ piped up Jake.

Chloe smiled. ‘Wolf.’ Immediately she wondered: why did I set him right? What does it matter?

‘I’ll bet Wolf likes lollipops.’ Dr Carlyle glanced across at Chloe, his eyes enquiring. For a moment she was tempted to shake her head. Then she thought, oh, why not, and nodded.

With a conjuror’s flourish the doctor produced a lollipop, holding it out of the squealing boy’s reach and trying instead to hand it to the toy. In no time Jake was chuckling in that uninhibited, heartfelt way that always seemed to be the preserve of young children alone.

Chloe watched in silence. Jake was normally a cautious, quiet little boy, wary of strangers. In less than five minutes the doctor had won his friendship, his trust.

His, maybe, she thought. Not mine.

A tap on the door interrupted the merriment. The dangly-earringed receptionist put her head in.

‘Next patient’s here, doc. Mrs Watts.’

He raised a hand in acknowledgement, turned to Chloe. ‘Nice meeting you both. You’re registered to Dr Okoro and Jake is to me. That all right?’

‘Fine. Thanks.’ Chloe stood. Jake, seeing they were about to leave, began to pout, a tell-tale quiver starting in his lower lip. He clutched Wolf to his chest and lowered his head in a frown of defiance.

‘Whoops,’ said Dr Carlyle. ‘You nearly forgot this.’ He held out the lollipop.

Jake seized it with a whoop. Chloe took the opportunity to grasp his other hand.

‘What do you say?’

‘Thank you,’ the little boy announced solemnly. Dr Carlyle grinned, ruffled his hair.

‘Remember to brush, or I’ll get in trouble with the dentist down the road.’

The tantrum aborted, Jake allowed Chloe to steer him to the door.

‘Thank you, doctor,’ she said.

He smiled. ‘Tom.’

In the car park outside, as she strapped Jake into his seat in the back of her Astra, Chloe thought: Tom? Isn’t that a bit overfamiliar for a first meeting, especially with a doctor?

He’d been great with Jake, she had to give him that. He was friendly, and she imagined he had a good bedside manner. And, of course, his looks no doubt made him popular with the ladies attending the surgery, who probably made up ailments just so they could consult him.

But he was who he was, and represented what he did, and Chloe couldn’t forget that.



***



‘Oh, no, no, dear. Let me get those.’

The woman had appeared out of nowhere, a short figure with a busy walk and a wild nest of grey hair that looked as if it had resisted all attempts at taming. Deftly she grabbed the bottom of one of the bulging shopping bags Chloe was hauling out of the boot of the Astra an instant before the thin plastic gave way and the contents spilled and smashed on the ground. As it was, only a single can bounced off the pavement.

‘Close shave,’ the woman clucked. Her eyes peered up at Chloe, beady and amused.

‘Thank you.’ Chloe breathed out in relief and got a more secure grip on the remaining bags now that her load was lightened. ‘If you just put it down, I’ll take everything into the house.’

‘Nonsense. You’ve got your wee boy to sort out.’ Her brogue was thick and Scottish.

Chloe had been unloading the shopping from the boot while Jake remained strapped into the kiddie’s seat in the back. She didn’t want him running off into the road while she was otherwise occupied, even though there wasn’t much traffic about. As she released him from the confines of the seat and hefted him, she wondered vaguely how the woman had known she had a small child.

‘I’m Margaret McFarland,’ the small woman said, sticking out her hand. ‘Your neighbour.’

So that was it; she’d seen Chloe and Jake arrive the night before, or perhaps set off on their errands this morning. Chloe shook, introduced herself and Jake. The toddler had reverted to shyness and turned his head away.

Margaret McFarland chuckled. ‘Scary old lady. Never mind. We’ll get on fine, lad.’

Gratefully, Chloe accepted Mrs McFarland’s help in carrying the shopping to the cottage. Despite the less-than-relaxed circumstances she couldn’t help being struck by how picturesque their new home was. Set at the end of a cul de sac lane, it was a perfect little mock-Tudor building with a riot of roses and wisteria around the front door and windows and a border of honeysuckle and daffodils framing the small patch of lawn. The interior was all low beams and country styling, and from the kitchen window the view was one of a pretty patchwork of fields dotted with sheep. It was the kind of idyllic setting that she would once have considered ideal for retiring to. Certainly she wouldn’t have dreamed a few years ago of actually living in such a place yet, and neither would Mark.

But things were different now.

As she loaded the bags on to the kitchen counter she heard Mrs McFarland bustling behind her. She turned and saw the other woman opening cabinet doors until she found what she was looking for: mugs, and a box of teabags.

‘I’ll do that –’ Chloe began, but Mrs McFarland waved her quiet.

‘You’ve had yourself a busy morning. Sit down. Milk, sugar?’

Too tired suddenly to get annoyed at the way the other woman was taking over in her own home, Chloe thanked her and set about putting away some of the perishables she’d bought, then getting a drink and a snack for Jake, who was exploring the still-unfamiliar surroundings of the cottage like an adventurer.

Settling thankfully across the kitchen table from Mrs McFarland, and sipping her tea, Chloe began to get to know the older woman. Margaret – she insisted Chloe call her that, though she reminded Chloe too much of an eccentric old schoolmistress of hers for Chloe to be fully comfortable addressing her by her first name – had lived all her life in Pemberham, and had occupied the cottage next door ever since she’d got married forty years earlier.

‘And after my Reginald passed on twelve years ago, I couldn’t bear the thought of moving,’ she said matter-of-factly. She had a son in Oxford and a daughter in London, a brood of grandchildren – ‘So I’m well trained when it comes to babysitting duties, if you ever need me for your little one,’ she added as an aside – and a horde of cats.

And, it turned out, an encyclopaedic knowledge of the details of the lives of almost every resident of the town, young or old. Mrs McFarland knew who got on with whom, which family was feuding with which. She was a member of the Women’s Institute, the local Neighbourhood Watch, the church committee, the horticultural society. She took in laundry and ironing for a small fee, baked for various fetes, delivered pamphlets door to door for any number of causes, and was a regular letter writer to the local newspaper. Margaret McFarland was, in short, a pillar of the community.

As well as a busybody and a gossip, Chloe thought, hiding a smile behind her mug. She’d taken to this bossy, fussy lady immediately, sensing a deep kindness beneath the bluster.

Chloe was a good listener. It was a quality that came naturally to her, and she’d cultivated it further in her career as a journalist. So for what seemed like half an hour she was content to let Mrs McFarland ramble on about herself, town life, and even the state of the wider world. Eventually even Mrs McFarland seemed to run out of steam, and perhaps become aware that she was truly monopolising the conversation.

‘There I go again, blethering on about me, me, me,’ she said, helping them both to more tea from the pot despite Chloe’s half-hearted protests. ‘Where are my manners? What about you, dear? What’s your story?’

In other circumstances such a blatant question would have rubbed Chloe up the wrong way, but by now she’d got used to the older woman and her manner so she didn’t mind. ‘Jake and I have moved up from north London. We needed a change of scene, and Pemberham looked ideal.’ Before the obvious question could be asked – why did you need a change of scene? – Chloe went on: ‘I’m a journalist by training. I’ve had an expression of interest from the Pemberham Gazette, so I’m hoping that’ll bear fruit.’

‘A fine paper.’ Mrs McFarland nodded her approval. ‘But I didn’t know they were looking for a new reporter. They’ve four already.’

Is there anything that goes on in this town you don’t know? Chloe wondered wryly. ‘I do mostly freelance work, and the Gazette’s editor has read some of the stuff I’ve submitted and liked it. He says he might have a couple of commissions for me.’

‘Splendid.’ For the first time, Mrs McFarland seemed lost for words. Chloe knew she was burning to ask a particular question, and decided that it would be best to bring it out into the open from the start, rather than allow speculation and gossip to take on a life of their own.

Quietly Chloe said, ‘It’s just Jake and I, by the way. I lost my husband a year ago.’

‘Ah.’ Mrs McFarland nodded sadly. ‘He must have been mad.’

Chloe frowned. ‘I’m sorry?’

‘To have left a pretty girl like you. Some men…’

‘Oh.’ Chloe understood, and felt her anger seeping away. ‘No. It’s not like that. He didn’t leave me, not in that sense. Mark died.’

Mrs McFarland put her hand over her mouth and stared at Chloe. Then she covered her eyes and peeped out between splayed fingers.

‘Oh, my… I’m so, so sorry. Forgive me. How could I have…?’

‘It’s all right.’ Chloe managed to smile. But the memory stabbed at her, hard and cold as if the past year hadn’t dulled it, and suddenly she didn’t want to talk about it any more, and hoped the other woman wouldn’t ask her for details because she’d have to ask her to leave.

To Chloe’s relief, Mrs McFarland changed the subject, not abruptly as people often did when embarrassed by another person’s grief, but smoothly and naturally. She began to enumerate practicalities: waste collection days, useful contacts in the town council, local hospital facilities. Chloe reached for a notebook and paper but Mrs McFarland said, ‘Don’t worry. I’ll print it all out for you.’

Jake was getting fractious and was clearly in need of a nap. Mrs McFarland took the hint. At the door Chloe said, ‘Goodbye, Margaret. And thank you for the welcome. I really appreciate it.’

‘If there’s anything you need, I mean anything at all, you know where I am.’

Chloe watched the small woman make her way back towards her own cottage.

Anything I need? she thought. I need for the last year not to have happened. I need to have Mark back.

The blackness began to crowd down on her, even in the brightness of the early spring afternoon, and she stepped back inside and closed the door.



***



Normally, Dr Tom Carlyle’s schedule was straightforward on a Tuesday. See his last patient at 4.45 pm, finish up by 5.30 at the latest, then beat the rush-hour traffic across town to get to the nursery a couple of minutes before it closed at six. Over the last year Tom had got used to the rhythm of the day and had all the manoeuvres down like clockwork.

The problem was, today his last patient was Mr Biswas.

Mr Biswas was a seventy-five-year-old man with diabetes. He’d had the illness since his twenties and it wasn’t ever going to go away, but for the last few years it had been reasonably well managed with a carefully fine-tuned regime of insulin injections, oral hypoglycaemic medications, and diet, to which Mr Biswas stuck more or less religiously depending on his frame of mind. More recently, however, the elderly man had begun to succumb to the long-term complications of the disease, and as a result his vision was deteriorating, his kidneys were functioning at a fraction of their optimal capacity, and the nerve fibres in his feet were failing to provide adequate information to his brain about sensations such as pressure and pain.

It was this last complication that was of most concern to Tom. His patient had come in for a routine check, and his cheery manner and ready smile was at first reassuring to Tom, suggesting that all was well. But when he unwrapped the dressing from around Mr Biswas’s left foot towards the end of the consultation, his heart sank. The ulcer on the man’s heel, previously mending well, had now reverted to an ugly crater.

‘Everything all right, doc?’ Mr Biswas asked.

Tom glanced up at him ruefully. ‘Afraid not.’

‘Not the ulcer again?’

‘Yep.’

There was nothing for it. The wound needed immediate swabbing, cleaning, dressing and covering with oral antibiotics, at least until the culture from the swab came back in a few days to reveal the nature of the infection. Tom knew for a fact that the practice’s nurse had left early for the day, and his fellow doctor, Ben Okoro, was busy with other patients.

Tom moved swiftly through the building, gathering the materials he needed, glancing as discreetly as he could at his watch. Five twenty-five. He’d need to finish sorting the wound out in ten minutes, tops, if he was going to make it to the nursery before it closed. Those ten minutes included getting the notoriously talkative Mr Biswas out the door without being rude to the poor man.

As Tom worked briskly, he was struck by his patient’s complete lack of reaction when he prodded and poked the wound. Most people would have hit the roof with the pain, but it was an indication of just how advanced the peripheral neuropathy was in the elderly man’s foot that he seemed not to feel a thing.

‘All done,’ said Tom, as measuredly as he could, dropping the various bits of waste into their particular containers. He scribbled a prescription – like many doctors, he’d started his career with impeccably neat handwriting which had over the years degenerated into a childish and almost illegible scrawl – and surreptitiously checked his watch again.

Five forty. He wasn’t going to make it.

A thought struck him. ‘Who brought you here, Mr Biswas?’

‘My son,’ said the old man. ‘He’s driving round the block. He couldn’t find parking.’

Tom tried not to let his dismay show. He’d have to wait with his patient until the son arrived, because he needed to talk to him about the importance of dressing his father’s wound regularly in a certain way.

Tom helped Mr Biswas with the crutches he’d supplied him – fortunately the man had used them before – and guided him slowly out into the waiting room. A couple of patients looked up from their magazines, smiled and nodded at him. Dr Okoro’s patients, whom under other circumstances Tom might offer to see on his colleague’s behalf. But not today.

At five forty-seven by the clock on the wall, the door to the surgery opened and a young Asian man came in, out of breath as if he’d been running. He stopped when he saw Tom and his father.

‘I’m so sorry I’m late. Had to park down the hill in the end.’

Tom had a quick word with him about the dressings, then hesitated. ‘If you’re parked down the hill... Mr Biswas, I’ll give you both a lift to your car.’

The elderly man shook his head.

‘Doctor, you are in a hurry. You have been very patient with me. Please, go. My son can bring the car up and keep it running while I come out.’

‘Mr Biswas, it’s really no problem –’

‘Thank you, we will be fine.’

Burning with guilt, Tom thanked him, pulled on his coat, said goodbye to Davina the receptionist and hurried out. Had it really been so obvious that he was in a rush? Had he appeared impatient? It wasn’t Mr Biswas’s fault, after all, that Tom was on a tight schedule.

As he dashed to his car, a three-year-old Ford station wagon, he speed-dialled the nursery on his mobile phone. It was answered before the first ring finished.

‘Megan? Tom Carlyle here, Kelly’s dad. Look, I’m really sorry. I’m running a bit late.’

He pictured rather than heard her sigh.

‘Tom... how late?’

‘Just leaving now. I should be ten minutes. Fifteen max.’

‘Since when did it take you ten minutes to get across town in this traffic?’

‘I’ll get there by magic carpet if I have to.’

‘This is, what? The fourth time now?’

‘Hello... hello?’ Tom rubbed his cuff across the mouthpiece to simulate static. ‘You’re breaking up.’

He put the phone away, dropped into the front seat of his car and took off.

In the event, he pulled up outside the nursery at six twenty-two. The place was deserted apart from two figures in the front garden: Megan, the nursery manager, and a little girl of four. As always, Tom felt his heart leap, doubly so as he climbed out and she caught sight of him and yelled, ‘Daddy!’ in a voice of unfeigned delight. She ran to him, a tall child for her age with her fair hair in a plait – one of the staff must have done that during the day, as Tom certainly hadn’t when he’d got her dressed that morning – and collided with him like a missile meeting its target.

As his daughter babbled excitedly in his ear, cramming one anecdote about her day into another so that they made little sense, Tom winced an apology at Megan. The nursery manager looked exasperated rather than angry.

‘The last time,’ Tom said, having to raise his voice to make himself heard. ‘Promise.’

‘You said that before,’ chided Megan, fishing her own car keys out of her pocket.

Embarking on the journey home, with Kelly strapped into her seat in the back but still chattering unstoppably, Tom drew deep breaths, trying to force himself to relax. Megan was right. He’d promised before, and he couldn’t guarantee he’d always be on time in the future. Two days a week he collected Kelly from nursery in the afternoon, and left her with a babysitter later when he went to do his evening surgery. Those days weren’t a problem. It was the three days on which he had to be there before the nursery closed at six that were becoming increasingly difficult to manage. He could, he supposed, ask somebody to pick his daughter up from nursery on those days, but Tom had an aversion to the idea, and felt he couldn’t trust anyone to fetch her and bring her home safely. It was irrational, he knew, but it was there nonetheless.

Single parenthood. He’d heard it was difficult, had sympathised with those of his patients who found themselves in a similar position… but his understanding of it had been merely theoretical before. Now, living the life, he had a new appreciation for those who coped with it for years on end. Did it get easier as one became more accustomed? Well, he supposed he’d find out in time.

Tom found himself thinking about the new patients at the practice today, Chloe Edwards and her son Jake. Mrs Edwards herself was a lone parent, Tom assumed, otherwise her husband or partner would have registered at the same time as the rest of the family. She’d seemed distracted, harassed even. Had she too found herself recently left to raise her family single-handedly? Or was her unsettled air simply the result of the upheaval of moving house and the numerous hassles, minor and major, that inevitably came with such a big life event?

Tom didn’t think he was a particularly self-deluding man, and he recognised immediately that his thoughts had drifted to Chloe Edwards not just because of what they perhaps had in common. He had to admit she was an intensely attractive woman, even with her slightly offhand air. Thirty years old (he felt a twinge of guilt that he didn’t need to guess her age because her date of birth was on the registration form she’d filled out), there’d been an elegance about her despite the casualness of her clothes, a thin black sweater and jeans. Long, straight dark hair, a deep black, framed her pale, unlined face, and her eyelashes appeared naturally thick and highlighted the hazel of her eyes.

‘Now, now, Dr Carlyle,’ he murmured to himself. ‘Behave.’

He pulled in to the short driveway at the front of his house and, freeing Kelly from her seat and helping her down, he started rummaging in his mind for ideas about supper for them both.