Questions of Trust A Medical Romance

chapter Two



The email was waiting for Chloe when she logged on.

Dear Ms Edwards, it ran. Thanks for your submitted articles, which we enjoyed very much. I particularly liked the one from the Camden Express about the plight of the homeless population in the area – very insightful, and dare I say it, quite moving. You’re clearly a writer of considerable talent.

I’m afraid you might find Pemberham a little parochial for your liking, but I’m intrigued by the proposal that you made for a one-off article, about a journalist from the city who relocates to a country town. It’s the kind of human interest story that would go down well with our readers, and I’ve no doubt your style would be popular. How about a 2,000-word piece on this theme? If you’re still interested, email me back for our terms and conditions of service.

Look forward to hearing from you.

Best wishes,

Mike Sellers, Editor-In-Chief, Pemberham Gazette

Chloe felt a small fist of triumph raise itself in her chest. It was a start. A 2,000-word article didn’t give her much breathing space to be creative, but that was the essence of good journalism: brevity with style. She’d been in town for a day and a half, and already she had paying work. That was what mattered.

An early riser, by habit but also by necessity since Jake had learned to walk, Chloe had got up at six, just like on any normal working day, and after breakfasting with Jake she’d sat at the tiny dining room table with a mug of coffee and opened her laptop. Yesterday had been spent unpacking and neatening the cottage up, and although it needed a touch of finesse and a lick of paint here and there, those were details that could wait.

She began to outline her article while Jake played happily on his own on the rug where she could see him. Already she’d decided on a mildly self-deprecating tone, portraying herself as a big city girl haplessly out of her depth. It certainly wouldn’t do to come across as brash or cocksure; that would put readers off from the word go. The trouble was, she hadn’t been in town long enough for any amusing episodes to have occurred that might illustrate the culture clash between city and country at which she was aiming. And she didn’t want to make anything up.

Chloe took a sip of coffee and stared at the floral print wallpaper, thinking vaguely that that would most likely have to go at some point in the future. A thought drifted unbidden into her awareness.

Why not use the encounter at the doctor’s surgery?

As always when an idea occurred to her, she began typing notes before her analytical thought processes had a chance to get to work and possibly ruin the concept. GP surgery – expecting conveyor-belt treatment – instead, personal greeting by name from one of the doctors and invitation to drop into his office.

She looked at what she’d written. No, it wouldn’t do. The readers might get the impression she was suggesting doctors in Pemberham were at best underworked, at worst lazy. Plus, it was a small town, with only two GP practices. Many readers would work out, or guess, who the doctor was that she was referring to. That would be too personal an element for an article like this, and Dr Carlyle himself might hear about it and take offence.

So, over the next couple of hours, with occasional interruptions to attend to Jake when he needed to use the potty or simply wanted a hug, Chloe concocted a wry tale of a rather naïve professional woman rediscovering the simple pleasures of everyday life, of interactions with a community that existed quite successfully and happily outside the hurly burly of city life. She took pains all the while to avoid sounding patronising or sardonic, except when referring to her own mild ineptitude.

She wrote, and rewrote, and polished the article until it gleamed. Then, conscious as all experienced writers learn to become that too much revision could rub the life out of a piece of writing, she pronounced it finished.

Rereading it, this time with a potential reader’s eye rather than an editor’s, she felt a glow of pride. The style, the lively, quirky prose, were undoubtedly her. And the details of the story, while carefully selected and often embellished, were true to life.

But the narrator of the piece, the woman relating the tale, most emphatically wasn’t her.

The woman gave no indication that she was weighed down by a grief like a set of medieval chains. Or that the future, in truth, terrified her, because she was going to have to provide for her infant son, and was going to have to do it alone.

Or that her every emotion, every action, was being acted out on a bedrock of that most corrosive of all human afflictions: a profound bitterness which nobody, not her parents or her closest friends, could possibly guess she harboured.

Chloe shut her eyes for a moment. She was aware she had let herself down. Long ago, she’d vowed that part of her new life with Jake would involve her never brooding, never dwelling on what had happened, and what might have been. Brooding created fertile ground for the weeds of apathy and despair to take root. And she couldn’t allow that to happen. She owed it to Jake, even more than to herself, not to permit it.

She drained the last dregs of her third mug of coffee and fired back an email to the editor of the Pemberham Gazette with her article attached, then opened a blank document and began to jot down ideas for further pieces.



***



Tom stepped out of the surgery door into brilliant sunshine, the kind of fresh golden light you only really saw for a brief period at the beginning of the spring before the haze of summer set in. For a moment he stopped, savouring the prickle of the blossoms in his nostrils, the gentle intermittent breeze on his face.

It was 12.30 in the afternoon. He’d finished his morning surgery on time, and had a leisurely half hour to wend his way across town to pick Kelly up from the nursery. There were a few errands to be done this afternoon, including a visit to the supermarket, but he enjoyed even mundane tasks such as these when he had his daughter as company. Four precious hours with her, and then the sitter would take over and he’d be back at work for the evening shift.

He’d turned the key in the Ford’s ignition when the phone rang on the seat beside him.

Tom glanced down, saw the name that came up on the screen. He hesitated through one ring. Two. The vibrating phone shuddered in a slow circle on the seat.

He could ignore it, let it go to voicemail. Pick Kelly up, have a nice afternoon with her. Then, when it was time for him to go back to work, listen to the message. But he knew it wouldn’t be as straightforward as that, knew there’d be another call, and another, until he relented.

Sighing, he killed the engine and picked up the handset, thumbed the green button.

‘Hello, Rebecca,’ he said.

‘Tom.’

The sound of her voice made him close his eyes, a complex mix of emotions flooding through him as always.

‘I’m just on my way to pick Kelly up from nursery,’ he said.

‘I’m fine, Tom, and thank you for asking,’ she said. He closed his eyes again. ‘Don’t worry, I won’t keep you long. I just wanted to remind you about the twenty-fifth.’

She fell silent. Tom said, ‘The twenty-fifth?’ It was next week Friday. ‘What’s –’

‘You have forgotten. I thought so. Just as well I’m ringing, then, isn’t it?’

‘Hang on. Give me a minute.’ He racked his brains. Down the line he seemed to sense her enjoying his discomfort.

After thirty seconds he gave up. ‘Sorry. Remind me.’

‘Andrew and I are going away to Paris for the weekend, and we’re taking Kelly with us. Remember?’

It hit him like a spotlight being turned on full beam. ‘Oh, God. Is that next week?’

‘Yes.’

‘But you said it was months ahead.’

‘It was. When we discussed it. Before Christmas.’

‘Before Christmas? Surely not.’ But he dimly recalled the conversation, the sleet falling outside as he struggled to get Kelly ready for some outing or other, desperate for his ex-wife to finish her phone call to him so that he could get on. And she was absolutely right. He’d agreed to send Kelly away with Rebecca and the other man. Now, with the prospect looming of being separated from his daughter for a full two and a half days, he felt sick with anguish.

‘Andrew will come and pick her up on Friday afternoon –’

‘No.’ He spoke more forcefully than he’d intended. ‘Where are you flying from?’

‘Stansted, but –’

‘I’ll bring her there. Let me know the time.’ He hadn’t planned for this, so he’d have to find some way of taking next Friday afternoon off. It wouldn’t be easy. But he didn’t want that other man spending any longer with Kelly than was strictly necessary.

‘All right.’ She sighed heavily. Theatrically, Tom thought.

‘One more thing, while you’re on the line,’ said Tom.

She waited.

‘You haven’t given Kelly a toy monkey at all, have you?’

‘She hates monkeys,’ Rebecca said, an unmistakeable edge of scorn in her voice. ‘You should know that. Why do you ask?’

‘No reason. Bye.’

He dropped the phone on the seat once more and set off.

Kelly was as thrilled to see him as ever. Tom knew he should bring up the subject of her trip away with her mother and Andrew next week, but he couldn’t bear to on this glorious spring afternoon. He couldn’t face the excitement she’d display.

On the way home he fumbled in his attaché case which he’d propped in the passenger footwell and held up the soft toy monkey for her to see.

‘Is this yours?’

‘No, Daddy,’ she scoffed. ‘I hate monkeys.’

‘Thought so,’ he said.

‘Whose is it?’

‘I don’t know. I found it in my bag this morning.’

He’d assumed it was Kelly’s, but it must belong to one of his child patients who’d dropped it into his open attaché case in his consulting room by mistake, or as a prank. Well, he’d drop it off with the receptionists later that evening and they could hand it back when its owner came looking for it.

The mild depression that clung to him after every conversation he had with Rebecca these days lifted as he and Kelly made pasta and Bolognese sauce for lunch, inexpertly and messily. By the time their laughter had started to ebb and they’d finished tidying up, it was gone two o’clock. Less than three hours of precious afternoon time left together. And they still had to go shopping.

There was a large supermarket fifteen minutes’ drive out of town, but for convenience Tom preferred the smaller one in Pemberham’s central shopping area. He procured a trolley and hoisted Kelly up into the child seat in the front, resisting the childish urge to race around the aisles at top speed with her. It wouldn’t do for the local doctor to be seen behaving like a buffoon.

Several people smiled, nodded and said hello as he strolled the aisles. Thankfully none started telling him about their medical problems, a hazard most doctors faced outside the work environment. The pile of groceries in the trolley grew into a small mountain, and as luck would have it Tom had picked a trolley with a stiff wheel so that it kept listing to one side. He struggled to steer it round one particularly troublesome corner when he crashed it side-on into a stationary trolley at the end of the aisle.

‘Sorry,’ he muttered to the woman who’d turned sharply at the sound of the impact.

Then: ‘Hi.’

It was the new patient from yesterday, Chloe Edwards. Her little boy, Jake, was like Kelly ensconced in the seat at the front of the trolley. Mrs Edwards’s eyes widened. Then her expression softened in recognition.

‘Dr Carlyle. Hello.’

‘Sorry about the collision. Wonky wheel.’ He shrugged apologetically. ‘Hey, Jake. How’s Wolf?’

‘Fine.’ The little boy grinned in recognition. His mother smiled, a little tightly, Tom thought. She was in trousers, a jeans jacket and a white T-shirt. Tom tried not to look at her figure, at the swell of her breasts through the cotton.

‘This is Kelly,’ he said. Never a shy child, Kelly stared openly at the new boy and his mother. Tom nudged his daughter and stage-whispered from the corner of his mouth: ‘Hey, you. Some manners, if you don’t mind.’

There were greetings all round, and Tom thought the ice was cracked a little, if not quite broken. He was smiling his goodbyes when a thought struck him.

‘Jake, did you bring anyone else when you came to see me yesterday? Any other animal as well as Wolf?’

He saw Chloe’s eyes widen again and her glance dart to her son. ‘Jake? What about George?’

Tom squinted at the boy. ‘George wouldn’t happen to be a monkey, now would he? A purple one?’

‘Yes!’ the boy shouted.

Chloe whispered, ‘You’ve found him?’

Tom nodded. ‘In my bag. Must have dropped in there.’

She pinched the bridge of her nose between thumb and forefinger. ‘Thank goodness.’ She expelled a long breath, and gave him a smile of such relieved radiance he felt his stomach do a slow flip-flop. ‘We only noticed it was missing this afternoon, before we came out. You wouldn’t believe the tantrum.’

‘Oh, I can believe it. Been there.’ He tipped his head at Kelly. ‘The monkey’s in the car. If you can guard my trolley, and my daughter, I’ll go and fetch it.’

‘Don’t worry about that,’ said Chloe. She seemed embarrassed by her earlier stand-offishness. ‘Finish your shopping and we’ll wait for you in front.’

He was almost done anyway, as it happened. As he joined the short queue at the checkout, Kelly said, ‘Who are they? That lady and that boy?’

‘Mrs Edwards and Jake.’

‘I know that.’ She didn’t quite roll her eyes. ‘But who are they? Are they your friends?’

Kelly hadn’t quite grasped the notion of “patients” yet. Tom said, ‘They’re people from Daddy’s work.’

Chloe was already outside, whirling Jake in the air so that he squealed. Tom raised a hand and ambled over, Kelly at his side. The little group made their way to his Ford and he retrieved the monkey, which Jake pounced on with a yelp.

Chloe put out her hand. ‘Thanks again.’

He smiled. ‘All part of the service.’

Had that come out wrong? She retrieved her hand, her own smile fading a degree or two. With a small wave she turned and made her way with son and laden trolley towards her own car.

Not wanting to stare, Tom began to load daughter and shopping into the Ford. Had he come across as lecherous? He didn’t think he tended to, and nobody had ever accused him of it. Had she read some innuendo in the word “service”? Or was he just being oversensitive, seeing hostility in someone whose approval, if he was honest with himself, he thought he’d rather like?

Shaking his head not for the first time at the mysteries of the human species, he set off for home.



***



After a final check of her email to see if the editor at the Pemberham Gazette had responded to the article she’d submitted – he hadn’t, apart from an nitial acknowledgement of receipt, but then again it had been less than twelve hours since she’d sent it, for goodness’ sake – Chloe closed her laptop and took her cup of tea over to the small sofa. Jake had been in bed for an hour, and wasn’t likely to wake until morning if past experience was anything to go by. She settled herself into the comfort of the sofa and drew her legs up under her. From where she was sitting she could see distant hills, dark against the twilight sky. A red sky at night... She supposed around these parts, there were indeed shepherds who took such sayings to heart.

It was times like these that Chloe found the most difficult. The evening stillness, when there was no Jake to distract her, no work deadline to engross her attention. At these times it was hardest to keep the brooding at bay.

She picked up a copy of the local newspaper, both for its content and from a professional point of view, to familiarise herself with its style; but she’d bought it when they had arrived, two evenings ago, and had already read it from cover to cover. Chloe tried her novel, one she’d been meaning to get round to reading for months now, but found herself going over the same page time and again, the sentences failing to take hold. At last, giving in to the inevitable, she cast the book aside and allowed herself the indulgence of memory. It was the only way she’d get any sleep later on.

It had all happened almost a year earlier, in June. Mark had come home from work one evening – he was a partner in a City legal firm, dealing mainly with tax law – in an uncharacteristically bad temper. After he’d snapped at her and Jake for the third time, she’d frowned her puzzlement and he’d stopped short and apologised.

Once Jake was in bed he said, ‘Sorry about tonight. It’s this headache. Woke up with it and it’s been there all day.’

She asked if he’d tried various anti-inflammatories, and he said he had, without success. Moving behind him, Chloe massaged his neck, but felt none of the usual knots of tension there.

It turned out that the headaches hadn’t started that morning, but had been present for a few weeks now, on and off. Never a complainer, Mark hadn’t mentioned them to Chloe. But while they normally passed after a few minutes, the initial sharp stabbing fading to a dull ache which gradually disappeared, that morning Mark had woken with a lance of agony behind his eyes and very little relief through the day.

‘It’s been getting in the way of work today,’ he admitted. ‘I haven’t been concentrating, I’ve let things slip.’

Chloe picked up the phone handset from a nearby coffee table. ‘I’m calling the doctor.’

‘I’ll make an appointment first thing tomorrow –’

‘You need attending to now.’

‘No.’ He made a grab for the phone.

Mark was a strong-willed man, as solicitors tended to be. Chloe too was stubborn, which was one of the things that made her an effective journalist. When the two of them disagreed over something, it was like two bison bashing their heads together. This time, whether because his resistance was weakened by the pain he was in or whether he conceded deep down that Chloe was right, Mark gave in. Chloe dialled.

After an interminable wait she was put through to an operator, who put her on hold. Mark, Chloe and Jake lived in a townhouse in the north London suburb of Belsize Park. The local doctors’ surgery was a short walk away down the hill, but it was closed now, at nine p.m., and there was an emergency out-of-hours service operating.

At last a voice answered. It wasn’t the doctor but a clerk of some sort who asked Chloe to describe the symptoms her husband was experiencing. Chloe did so, as patiently as she could. Again she was put on hold.

Chloe glanced at Mark. He was sitting with the heel of his hand pressed to his forehead, his eyes closed.

Finally the doctor came on the line. Chloe didn’t recognise his voice and realised he must be a locum, a temporary doctor filling in on night duty. His manner was abrupt from the outset. When Chloe reported her husband’s main complaint as a headache, she could almost see the look of incredulity on the doctor’s face at the other end of the phone.

‘He needs to take paracetamol.’

‘He’s done that,’ she said.

‘Ibuprofen, then.’

‘That hasn’t worked, either. Plus, this isn’t a one-off. He’s had these headaches for weeks now, and this particular one all day.’

Chloe pushed and pushed, as if she were pinning down a politician she was interviewing and who was evading her questions. Eventually, out of resignation, it seemed, the doctor agreed to come out and visit Mark.

He arrived ninety minutes later, a fussy, irritable man in his fifties. After asking Mark a series of brusque questions – did he have high blood pressure, did he smoke or drink, had he been under a lot of emotional pressure lately – he conducted a physical examination that looked cursory even to Chloe’s untrained eye.

Straightening at the end and putting his instruments away in his bag, he said, ‘You have a migraine.’

‘Migraine?’ Chloe spoke up. ‘He’s never had them before.’

The doctor turned to peer at her over his glasses. ‘They can come on at any age.’

Chloe thought she’d read somewhere that it was unusual for a man of Mark’s age, thirty-three, to develop migraines for the first time, but didn’t say so. ‘Isn’t the pain normally pulsating?’ she asked. ‘Mark’s described a sharp stabbing.’

‘My dear lady,’ the doctor said, an edge sharpening his voice, ‘I can assure you I have had years of experience as a general practitioner. I recognise a migraine when I see one. It’s painful, it’s highly unpleasant… but it’s not life threatening.’ He scribbled something on a prescription pad and plucked the sheet off. ‘A codeine-based painkiller. It’ll take the worst of the discomfort away until the headache disappears of its own accord. They’ll come back, most likely. Speak to your regular doctor about possible preventative treatments.’

And with that he left.

Chloe sat beside him on the sofa, her palm smoothing his hair, her brow furrowed with concern. Mark’s face was pale, sweat springing in tiny beads on his forehead.

‘Is it still bad?’

‘Yes.’

‘Will you be all right to stay here with Jake for a few minutes? While I go to the chemist?’

He nodded.

There was an all-night pharmacy fifteen minutes’ walk from the house. Chloe returned to find Mark’s features contorted in a grimace of agony, an expression he tried to suppress as she walked in.

Mark took the pills, pronounced the pain a little easier after ten minutes, and went to bed.

He never woke up.

As the summer morning light slanted through a crack in the curtains, Chloe, lying beside her husband, stretched an arm across his chest, felt him cold and unresponsive. She sat up in panic, saw his eyes closed, his lips slightly parted.

No rise and fall of his chest.

She called his name, slapped her fingers against his cheeks, shook him increasingly frantically. Then she backed across the bed, groping behind her for the phone on the bedside table, her stare fixed on her motionless husband, her knuckles crammed into her mouth to stifle the scream that was building in her chest.

The coroner’s report was straightforward. The immediate cause of death was a cerebral haemorrhage resulting from a ruptured berry aneurysm. Unbeknown to Mark, he’d had a tiny swelling in one of the vessels in his brain where the wall was weakened. The piercing headaches he’d been getting were caused by minute leaks of blood as the vessel wall was breached, a fraction of a millimetre at a time. The tipping point came on the day the headaches had become constant. At some time in the night, the vessel had burst completely.

Could the damaged vessel have been repaired in time to save his life? Possibly, decided the coroner. But while the misdiagnosis of migraine was unfortunate, it didn’t, in the coroner’s view, represent medical negligence. A regrettable but forgivable error had been made.

Forgivable. Well, not to Chloe. In the white heat of grief and fury she’d lived through for the first few weeks after Mark’s death, she’d explored legal action against the doctor who’d attended Mark. Her lawyer, a friend and colleague of her late husband’s, had in the end persuaded her not to go through with it.

‘He’s a rotten doctor, Chloe. You know it, and I know it. And he probably knows it, too. But I’ve looked into this. The signs and symptoms of migraine are diverse enough that he’ll just about get away with saying he made a not unreasonable error. Plus, there’s the coroner’s ruling. You won’t win this, Chloe. I’d take on the case for free if I thought we had a chance. But we don’t. You’ll just prolong the pain you’re already going through, and be faced with the added burden of disappointment at the end.’

So she’d dropped it, and concentrated her energy on Jake, who despite being only a year old was clearly bewildered by what was going on, and by the sudden absence of his daddy. She’d gone back to work after a reasonable absence, but couldn’t pick up the threads again, couldn’t return in the evenings to the townhouse without a feeling not just of sadness and regret but of profound horror at how utterly wrong a turn their lives had taken. Her decision to move, to start a new life with Jake outside the city, had followed quickly.

Sitting alone in the stillness of the cottage, Chloe became aware her neck was wet, and realised the tears had been coursing down her face, as fresh and as stinging as if they were the first ones. When? she wondered. When does it start to get easier?

On her way to bed, she caught sight of George, the toy monkey, which after all the drama earlier had now been left on the dining room table. Dr Carlyle’s image came into her mind. It had been good of him to return the toy.

He was a likeable man, and clearly great with kids. And he was a charmer, there was no doubt about that. Charming to women.

But underneath it all, he was one of them. One of the arrogant, self-righteous clique who’d allowed her husband, her Mark, the man to whom she’d pledged her life, to die. However unfair it was to him as an individual, while she could tolerate Dr Carlyle, she could never bring herself to trust him.

Chloe drew up the covers and hoped sleep would come soon. Her hopes were in vain.