Читать книгу Saving Dr Gregory - Caroline Anderson - Страница 6

THEY met up again at three for the ante-natal clinic, and Polly had an opportunity to see Matt Gregory in action. She found it a real eye-opener.

Far too young to assume a paternalistic attitude, with his warm, open smile and solid bulk he just became everyone’s favourite brother. He asked searching personal questions with gentle understanding, said nothing trite or patronising, and managed to refrain from avuncular pats or the worse alternative, chilling professional distance.

He treated the women in his care with respect, interest and a touching tenderness, as if what they were doing was somehow special—which of course it was.

Polly was impressed. She didn’t think she had ever seen anyone so human before.

Ms Harding, the liberated elderly primip, was dealt with without any faux pas on Polly’s behalf and with humorous efficiency by Matt, and she was pleased to meet Sarah Goddard, the woman who was going for a home delivery.

When she showed Mrs Goddard in to Matt after weighing her and checking her BP and urine, he asked Polly to stay. As she watched his strong, sensitive hands moving deftly and with infinite care over Mrs Goddard’s swollen abdomen, Polly felt some strange emotion rise up and clog her throat.

The baby, resenting Matt’s interference, squirmed and kicked, and Matt and Mrs Goddard both laughed, a warm, intimate laugh that made Polly feel left out. The thing, whatever it was, that had come to life inside Polly when Matt had kissed her turned into full-blown jealousy for a brief instant—so brief that Polly didn’t even have time to recognise it, but she was aware of a tiny flash of pain which she attributed to a frustrated maternal urge.

Sighing, she turned away and busied herself laying up the instrument trolley with swabs, gloves, KY jelly, speculum, cervical spatulas and the like.

Polly wanted children. She had no particular image of herself, either as a nurse or as a woman, but she knew that men—not all, certainly, but enough—found her reasonably attractive. With her nut-brown hair curling in unruly tangles around her head, and her warm brown eyes in what she saw as an honest but unremarkable face, Polly was as far removed as she could be from her ideal of the Nordic blonde which she imagined was what turned men on. Her breasts were too full, her hips too rounded, although her waist was neat and her stomach flat and firm. She was too short, too squat, and altogether too homespun for perfection, but she knew she had a warm heart and a loving nature, and her one affair had been filled with affection and humour.

Martin had emigrated to Australia, and the choice for Polly had been simple—go with him, as his mistress, or stay. He had never asked her to be his wife, and Polly felt he probably never would unless he was pushed—but she didn’t want to push him. Somewhere inside the practical, cheerful and warmhearted woman everybody loved to know was a passionate, romantic girl who wanted to be swept off her feet.

No matter that it was unrealistic. Polly knew that in the end she would settle for a kind man and set up a loving home based on mutual affection and respect. She didn’t ask for fireworks. She had learned long ago that they were a figment of romantic fiction. All she asked was that some time, before she was too old, she should find a good man to settle down with and raise a brood of chicks. And the young and attractive Mrs Goddard, with her mother-earth good looks and the smooth mound of her burgeoning pregnancy, was a reminder that time was ticking by.

Squashing the thing she now recognised as jealousy, she helped the woman off the couch and back into her dress, before excusing herself and returning to her room where she set about rearranging her shelves.

A few minutes later Matt limped in with two cups of tea, and propped himself on the edge of her desk.

‘Are you OK?’ he asked, a slight frown creasing his brow.

Polly nodded. ’Of course. Why shouldn’t I be?’

‘Just wondered. You looked a bit strained while you were fiddling with the trolley, rearranging things over and over again. I just wondered if I’d upset you that much this morning.’

With a sigh, Polly picked up her tea and sank down on to the chair, propping her feet on the desk.

‘No. I just felt the pressure of years, that’s all. I was jealous of her—isn’t that silly? I think it’s all these pregnant bumps around the place this afternoon. You’re good with them, aren’t you? I get the feeling you really care about those mums and their babies.’

‘I do. They’re very important to me.’

‘You were good with Mrs Major this morning, too. She is pregnant, by the way.’

‘I thought she was. She had the look.’

Polly smiled. ‘I’m glad you agree that there’s a look. Most men dismiss it.’

He gave a curiously bleak smile. ‘Oh, no, I believe in the look. My wife had it when she was pregnant.’

Polly felt a strange little lurch of pain. Of course he was married—he had ‘HUSBAND MATERIAL’ written all over him in letters ten inches high. She should have guessed.

Misinterpreting her sigh, Matt smiled. ‘There’s plenty of time for you, Polly. How old are you?’

‘Twenty-six.’

‘Are you? You don’t look it.’

Her smile was wry. ‘Is that supposed to be a compliment?’

‘Just a comment, neither one way or the other. Thinking about it, you must be that old to have enough experience to do this job. But going back to pregnant bumps, you’ve got years before you need to worry.’

Polly dropped her feet to the floor. ‘I wasn’t worried, Matt. I just had a surge of maternal feeling—it caught me by surprise, that’s all.’

‘I know the feeling,’ he said quietly. ‘Every time I do an ante-natal clinic, I long to have a child of my own. One day, maybe—but I doubt it.’

‘But I thought you said—what happened?’

‘She had a water-skiing accident. The baby died.’

‘Oh, Matt!’ Polly’s warm heart ached for him, and she covered his hand with hers. ‘I’m sorry. But there’ll be other chances——’

‘No.’

His bitterness showed briefly in his eyes before he straightened and moved away from Polly.

‘Evening surgery,’ he said abruptly, and left, limping awkwardly down the corridor towards his room. His tea on her desk was still untouched, and Polly went via the kitchen and took him in a fresh one before his first patient.

He flashed her a distracted smile and busied himself on the computer. He had evidently said much more than he had intended, and now he regretted it. Her dismissal was obvious—and painful.

He found her in the morning, after surgery, when she was clearing up her room and remaking the couch with a clean sheet.

‘Morning,’ she said, sparing him a quick smile as she bustled round.

‘Have you got a minute? There’s a patient I’d like to discuss with you, Polly.’

‘Sure.’ She stopped bustling, and pulled up a chair. Go ahead.’

‘Her name’s Helen Robinson, and I’ve suggested she comes to see you at the well-person clinic. She’s got nothing wrong with her, but she’s a real problem.’

Polly’s heart sank.

‘I’ve got a letter from her old GP. He describes her as one of his “heartsink” patients.’

Polly suppressed a smile. That had been her immediate reaction, too. She could imagine why. There were patients like that in every walk of medicine—physically apparently fit, but with a morbid fear of their own health or an unrealistic expectation of their bodies. Every last palpitation, twinge or hiccup would send them flying to the surgery in a panic. Perhaps Mrs Robinson was just a good old-fashioned hypochondriac?

‘She’s in her late forties, not yet in the menopause. She’s an attractive woman, slim and apparently healthy. They moved here six months ago, and she’s been to see me four times—each time with something unrelated and insignificant. But there’s something wrong—some pain inside that shows in her eyes. I don’t think she’s so much a heartsink as heartsick, and I think she just doesn’t know how to start to explain.’

Polly frowned. She trusted Matt’s instincts, and if he felt there was something wrong, then there probably was. Not a hypochondriac, then, but was her problem medical or social?

‘What makes you think she doesn’t need to talk to a social worker or priest, Matt? Why does she need us?’

Matt sighed and ran his hand through his hair, then pulled off his glasses and rubbed his eyes wearily. ‘She had a lumpectomy seven years ago for breast cancer, and she was cleared by the oncologist a year ago. I asked her if she had any worries about it returning, and she said no, but she was cagey. Polly, I think something about it is troubling her. She hasn’t had a smear done for eight years, and when I asked her she said she didn’t think it was necessary. That’s when I suggested she should come to see you. I think a well-person clinic is sufficiently routine and unthreatening that you could check all sorts of things without planting any seeds of doubt in her mind. Will you look at her for me?’

‘Of course. When’s she coming?’

‘This evening. I’d like to talk to you after you see her—can you come round to my house? We can have something to eat while we chat.’

Polly’s heart hiccuped, and then she remembered the unknown Mrs Gregory. ‘Is there any reason why we can’t do it here?’

He shook his head. ‘No, not really, if coming to my house gives you a problem. The only reason was that I’m off duty this afternoon and I wanted to get my weight off this leg as soon as I could, but it doesn’t matter. I can come back quite easily.’

‘Oh!’ Polly had forgotten his leg. ‘Let me do the dressing now and have a look at it—have you got time?’

‘I thought you’d never ask,’ he teased, but instead of lowering his trousers, he pulled up the left leg to his knee. Polly was relieved. Her feelings about Dr Matthew Gregory were becoming distinctly confused and unprofessional, and that troubled her. If he hadn’t been married, well then, fair enough, but as it was—she eased off the dressing, cleaned the wound and redressed it with swift but sympathetic fingers.

Thanks,’ he murmured, sliding off the couch, and Polly, to avoid a repetition of yesterday’s kiss, busied herself at the sink.

‘I’ll come to your house, if you like. What time?’

‘When you’re ready. I’ll be in all evening. Thanks, Pollyanna. I’ll see you later.’

She thought about Mrs Heartsink—or was it Heartsick?—for the rest of that busy day, and when she went into the waiting-room to call for her she was able to pick out the woman quite easily, because she had focused her thoughts on her so exclusively.

She was fairly tall, elegantly dressed, with dark hair greying slightly and swept up into a neat bun. She looked like a businesswoman, and Polly wondered if she had been forced to give up her career to move here with her husband, and she wondered why they had moved. Then she remembered that the woman’s previous GP and not Matt had described her as a heartsink patient, and she dismissed that idea. Her problem, whatever it was, was longer-standing than that. And Matt was right—it showed in her eyes.

‘Come on through, Mrs Robinson,’ Polly said with a smile, and seating the woman, she picked up a blank well person card to fill in the details. First, after the name, was marital status.

‘I just have to ask a few routine questions, Mrs Robinson. Have you ever been to a well-person clinic before?’

At the woman’s headshake, Polly said, ‘Well, it’s all quite simple and routine. We establish your history, and test all the usual things like blood pressure, cholesterol and so on. Right. What’s your marital status?’

‘Married,’ she answered shortly. Polly thought she detected a twinge of bitterness.

‘Occupation?’

‘I used to be manager in a travel agency until we moved.’

‘Oh!’ Polly said. ‘How lovely! Did you go anywhere exciting?’

‘Once or twice. Nowhere that special. My husband runs his own business, and getting time off is difficult.’

‘Oh, yes,’ Polly agreed. ‘I know several people like that, and they work harder for themselves than they ever would for anyone else. Perhaps we ought to have a look at him too, just to make sure that he isn’t overdoing things and doesn’t have any problems with blood pressure. This isn’t just a clinic for women, you know.’

‘He won’t come,’ Mrs Robinson told her. ‘He says doctors are a waste of time.’

‘But that’s rubbish,’ Polly said briskly. ‘Without doctors you probably wouldn’t be alive now, so he can’t say that.’

‘He can,’ Mrs Robinson assured her, and sighed heavily. ‘Sometimes I wonder why they bothered with me.’

Polly frowned. Mrs Robinson was her last patient, and she felt they needed a cup of tea, to break the ice, but she didn’t want to do anything which might seem unusual and put Mrs Robinson on her guard. She pressed on.

‘Any current medical problems? I gather you saw Dr Gregory yesterday.’

She shook her head. ‘I thought I had a chest infection, but he said I was clear. Must have been a bit of a wheeze.’

‘Any drugs or allergic reactions?’

‘No.’

‘What about your parents? Any history of heart disease, diabetes, stroke, that sort of thing?’

Again she shook her head.

‘What about you? Do you smoke or drink?’

‘Drink, occasionally; I haven’t smoked since—well, since my op. I always watch my weight. Glamour is very important in the travel business, and I kept a close eye on myself when I was working.’

‘Do you miss your job?’

Mrs Robinson shook her head again. ‘No, not really. I miss my friends. It’s a bit lonely.’

Polly agreed. ‘I’ve only been here a week and a bit, and it takes a little getting used to. There must be something you could join—perhaps you’d tell me if you find anything!’

They laughed together, for the first time, and Polly felt the ice creak, if not break. She went over the immunisations, recommended a series of tetanus injections, and then reached the tricky bit.

‘Do you do regular breast examinations, Mrs Robinson?’ Polly asked, and waited while the silence stretched out.

‘Sometimes.’ The reply was strained, quiet. Polly watched her unobtrusively.

‘You’re cleared now, aren’t you?’

‘So they said.’

‘What about contraception? You aren’t on the Pill, are you?’

‘No.’ The reply this time came quickly and was abrupt. Polly glanced through the notes.

‘Have you still got an IUCD?’

‘A coil? Yes.’

Polly made a note on the card. It was like getting blood out of a stone, she thought.

‘Periods still regular? No change in flow, or longer gaps, anything like that?’

She seemed to relax a little, as if they had got off a difficult subject. Not for long, Polly thought grimly.

‘No changes,’ Mrs Robinson said. ‘I just tick on, as regularly as clockwork. It’s quite reassuring.’

Polly thought she must mean that she was relieved not to be pregnant, and at forty-eight that was understandable.

‘When did you have your last cervical smear, Mrs Robinson?’

Immediately she stiffened up again. ‘Eight years ago, but I don’t need one.’

Polly frowned. ‘Eight years is a long time, you know. It’s a very simple procedure, and it doesn’t hurt at all. I can do it for you, so there’s no need for Dr Gregory to be involved unless you would rather he did it?’

‘I don’t want it done.’

She was emphatic. Polly pressed on. ‘Really, you know, it’s quite routine. All women from puberty to late old age are at risk to a certain extent, but certainly anyone who is sexually active should have it done—and by sexually active, I don’t mean carrying on like rabbits! Anyone with a partner is included, however much their sex lives may have slowed down, or even stopped.’

She didn’t reply, but something in her stance alerted Polly. She reached out and took the woman’s hand.

‘Do you want to talk about it?’

‘He hasn’t touched me, you know,’ she blurted. ‘Not since I had the operation.’

Ah! Polly thought. Here we go. ‘Why? Is he afraid to hurt you?’

Her high, thin laugh cut Polly to the quick. ‘He doesn’t care about that. He just doesn’t want to touch me any more—he calls me—an udderless cow.’

‘Oh, dear God,’ Polly whispered, her soft heart torn apart by the pain and anguish in those simple words. Reaching out, she wrapped her arms around the woman and rocked her against her shoulder as the tears fell, released at last after all this time.

‘He hates me,’ she sobbed, ‘he said it would have been better if I’d died. What use am I? All those models lolling about on the brochures, bursting out of their bikini tops, and him going on about going to topless beaches and getting a bit on the side—he hates me, and I wish I were dead!’

Polly had never felt so hopelessly, overwhelmingly useless in her life. She knew that Mrs Robinson had to grieve for her loss, but the way ahead wasn’t clear to her, and there were many things she wanted to check up on—like the existence of a local mastectomy support group, or the possibility of reconstructive surgery. In the meantime, she wondered if Mrs Robinson didn’t need more than emotional support.

Once the worst of her tears were shed, Polly handed the woman some tissues and slipped out of the door to phone Matt at home and ask his advice. To her surprise and relief, he was coming out of his room, and she grabbed him by the sleeve and hustled him back through his door, pulling it shut behind her and leaning on it gratefully.

She became aware that her knees were trembling and Matt took one look at her and led her to a chair.

‘What’s up?’ he asked gently, and she told him all that Mrs Robinson had revealed.

His face went taut with anger, and he stood up and paced around the room, waves of rage pouring off him almost visibly.

‘How could he do that to her? How could anyone say that to another human being? God, Polly, I wouldn’t treat my dog like that!’

‘Do you think she needs anti-depressants?’

He stopped pacing and turned to face her. ‘Could be. I’ll prescribe some for her if I think she does, just to take the edge off, and only for a few days, and then I think we need to talk about reconstructive surgery—I can think of some surgery I’d like to do to him!’

Polly smiled, and then her smile faded as she remembered Mrs Robinson. ‘Do you think he needs help too? Perhaps no one has given his feelings any consideration, or given him an opportunity to grieve. If they didn’t have any professional counselling during the time of her illness, then it’s not surprising that they can’t cope with it.’

‘I would have thought all that had been done at the time,’ Matt said, surprised, and shook his head. ‘We are much more aware now than we used to be about the emotional effects of radical surgery, I think. Polly, see if you can get them to go along for counselling. I’ve got the address somewhere of the Breast Care and Mastectomy Association—it’s a charity, but the work they do is excellent. The head office is in London, but I think there’s a branch in Cambridge. They’re very good with this sort of thing, and if the Robinsons’s marriage is salvageable, they’ll probably find a way.’

She nodded. ‘Are you going to come and have a chat to her?’

‘Yes. Would you mind making some coffee, and then come and join us? I think I’ll make more progress if you’re there, somehow.’

By the time Polly had made the coffee and gone back to her room, Matt was in there with Mrs Robinson, holding her hand and smoothing the skin on the back with an age-old gesture of sympathy.

‘But how would you feel if it were your wife?’ Mrs Robinson asked, pulling her hand away.

Matt straightened up. ‘I can’t tell you, Mrs Robinson, and that isn’t really the issue here. How your husband feels is what’s affecting you, and I think, and Polly agrees, that he’s probably very distressed and unable to cope with his feelings. I think counselling could help you, if you want help. You don’t both have to go, but of course it would help if you did.’

She lifted her head. ‘What about reconstructive surgery?’

‘Mammoplasty? It’s usually done sooner. What they would do in your case, I suspect, is make a small incision in the skin and insert a silicone implant to help to balance the other breast, and they can create a nipple if necessary using pigmented tissue from elsewhere. Results are variable; usually physically very successful, but it isn’t going to cure your marriage problems or make you the way you were before. It’s become quite common to do it at the time of the first operation, to reduce the kind of emotional stress that you’ve been through. In fact, I’m surprised you weren’t offered it at the time. Results after this length of time, though, may not be so successful.’

‘What do you think are the chances of it working?’

‘Depends on the level of residual scarring, shrinkage of the skin and so on due to radiotherapy, and how much was removed. Also the size of the other breast—it’s much harder to get a satisfactory result with women who are more well-endowed. I can’t really tell you much more without examining you.’

She seemed to shrink into herself, but Polly wasn’t about to allow it. Squatting down beside her, she took her other hand and squeezed it. ‘I’ll be here with you. If Dr Gregory thinks you would be a suitable candidate for surgery, then if you decide that’s what you want, he can refer you and get the process under way. Don’t give up now.’

There was a long, painful silence, and then she took a deep breath and nodded.

Matt let out his breath in a silent sigh of relief, and stood up.

‘Polly, perhaps you could help Mrs Robinson undress?’ he said, moving over to the sink to wash his hands under the hot tap.

Polly watched him out of the corner of her eye, and saw him pick up gloves, look at them and then replace them on the shelf.

‘OK, let’s have a look,’ he said, returning to the couch with a smile. Mrs Robinson turned her head to the side, but Matt ignored her indrawn breath as he folded down the blanket and laid his hands gently on her chest above the breast, working slowly and steadily across it with a gentle, even pressure. When he had finished, he pulled the blanket up over her and tucked it round her shoulders, to restore her dignity.

The skin seems fairly elastic, and because of the amount of tissue that’s been removed it’s obviously much smaller than the other one, but luckily your nipple wasn’t removed. I think you might get away with it, especially if the surgeon reduced the size of the other breast as well. It could be worth a try, if you want. OK, Polly, would you help Mrs Robinson dress?’

He turned away and busied himself with the notes, as much to give her privacy as anything, and Polly smiled reassuringly at the woman.

‘What would you do, Polly?’ she asked.

Polly shot Matt a quick look, and gave a small shrug. ‘I don’t know. Get counselling first, I think. You really don’t look that bad to me. There are plenty of women who are naturally that lop-sided without surgical intervention.’

‘But I’m mutilated——’

‘No!’ Polly and Matt both spoke at once, and Matt continued, ‘You are far from mutilated. There’s nothing off-putting about your appearance. Believe me, I’ve seen far, far worse. I don’t think you need reconstructive surgery, and if you were my wife I’d move heaven and earth to prevent you going through any more suffering. What you need is help to come to terms with who you are now, both inside and out. Surgery will change the outside, but the inside is far more badly hurt, Helen. You need to learn to love yourself again. Of course I’ll refer you if that’s what you want, but please try the counselling.’

She nodded, tears welling in her eyes. Polly laid a hand on her shoulder and squeezed gently.

Matt continued, ‘I’d like to see your husband, as well, if you can talk him into coming to see me.’

‘He won’t come. He doesn’t care.’

Matt smiled at her, tenderly and with great sympathy. ‘Are you sure? Please ask him. If he really didn’t care about you, why is he still with you after seven years?’

Matt patted her hand and stood up. ‘Polly, have you done a smear?’

She shook her head. ‘Perhaps Mrs Robinson would like to come back later in the week and we’ll finish off the tests and things? I think you’ve probably had enough for now, haven’t you?’

She nodded. ‘I think I’d like to go home and have a bath and an early night. My husband’s away until tomorrow, so there’s no need for me to stay up. I’ve got a lot to think about.’

She took Polly’s hand. ‘Thank you for being so kind to me.’

‘Oh, Mrs Robinson,’ Polly said with a slight smile, ‘you’re welcome. I’m always here—come and have a chat if you need to. Don’t bottle things up—if you need an answer, come and ask one of us. That’s what we’re for.’

Polly showed her to the door, and turned to find Matt watching her from the doorway of her surgery.

‘Well done,’ he said quietly, and Polly burst into tears.

‘Oh, Matt,’ she whispered, ‘why are we so horrible to each other?’

He handed her a tissue and stood patiently beside her while she blew her nose and pulled herself together, then he waited while she found her bag and put on her coat, and locked the surgery behind them.

‘Supper,’ he said, and with a wink, he hobbled over to his car and climbed in. ‘Can you remember the way?’

Polly nodded. ‘I’ll see you back there.’

As she followed his Volvo estate out of the car park, she thought it was typical that he would have a car like that—big, solid, reliable, safe—just like him. Husband material, she thought again, with a heavy sigh. She wondered what his wife was like.

‘She’d better damn well deserve him,’ Polly thought with a protective urge, and then laughed, a little weakly. She realised that her laugh was just a short step from tears.