She picked up the latest BMJ from the top of the small pile of medical journals that served as a constant reminder of how much and how often she should attempt to catch up with the ever-advancing world of medicine. She put it down again. ‘You wouldn’t believe how late I ran today. I could have spent all morning with the first three patients alone.’ A GP who prided herself on her ability and commitment, she was often frustrated by the necessary time restrictions put on her work. ‘I kicked off with a guy who claimed he’d collected enough anti-depressants to kill himself, so that was a suicide risk assessment. Then, as he was leaving, he happened to mention that he had a jock itch so I had to look at that, which took ages.’
Paul’s full attention was on the window of the oven as he watched and waited for his soufflé to rise, so Kate just carried on, assuming he was listening. ‘After him, I had a dear eighty-three-year-old who had nothing wrong with her but who wanted to tell me about everything that was going on in her life. And then I had to refer a woman for a termination, which took ages because she couldn’t decide which hospital she wanted me to refer her to. How was I supposed to deal with any of them in ten minutes flat? Paul! Am I boring you?’
He turned in her direction for a second, making a sterling effort to appear interested. ‘No, no, darling. Not at all.’ His attempt to disguise a yawn was futile. ‘Keep going.’
She wasn’t fooled. ‘No, it’s all right. I’ll spare you. Just one of those days. How was yours?’
‘Same old, same old. Aaah.’ Said with the satisfaction of a job successfully executed. ‘I think we’re ready.’
Triumphant, he made his way to the table by the wide glass door to the garden carrying the perfectly risen soufflé, its smell filling the room. ‘Come and sit down.’
Kate dragged herself across the room while Paul examined the interior of the main course as if it was a biological specimen before serving it, then passed her the salad. He was uncharacteristically silent as they ate so she filled the vacuum with more gossip from the surgery while he nodded or shook his head, making the occasional sympathetic sound at the right moments. She could tell by the way his eyes occasionally drifted towards the kitchen that his mind wasn’t entirely on what she was saying but she forgave him. Her professional problems must sometimes seem so petty and tedious to him, but she wanted him to understand her irritation when one of the other partners had to go out for a chunk of the morning leaving her and the on-call doctor to share his patients, as well as her impatience with the practice manager who seemed to be having an awful lot of days sick in the run-up to her daughter’s wedding. Never mind the frustrations of an appointment system that rationed only ten minutes to everyone, when many needed more time – much more time.
*
Her day had begun to go wrong at 8.15 a.m. when she had turned up at the practice and asked Mrs Yilmaz to come inside before the doors officially opened.
The old woman was leaning against the wall, her stick not enough to support her for the wait until the surgery opened, a warm smell of urine and old age drifting off her. A patterned headscarf covered most of her head and face while an old patched coat hid most of what she was wearing, except for the bottom of a long, shapeless dark skirt, thick stockings and sensible black shoes. Her entire body shook with a guttural graveyard cough as she took Kate’s arm, then shuffled beside her to the glass door, coughing again as she waited for her to open it. Kate dug out her keys, aware that she was about to incur the wrath of Sonia, their draconian receptionist, who liked the practice to run the way she thought best. And that meant not having the doctors bringing in the patients to the waiting room, however needy they might be, until the clock struck half past eight on the dot. Not only was Kate about to annoy Sonia but, sensing the pent-up irritation behind her, she’d already alienated most of the remaining queue of patients. Some of them were probably on their way to work, already displeased at being late, while others always felt they had first call on the doctor’s attention. Just another Friday morning.
Having settled Mrs Yilmaz into one of the comfier chairs in the waiting room, she greeted Sonia with the cheeriest ‘Good morning’ she could muster, only to be met with a scowl and a grunt. Their chief receptionist had made herself indispensable to the practice but, all the same, a little compassion wouldn’t go amiss, thought Kate, as she walked down the corridor to her room. She was the first of the partners to be in, as usual. She liked it that way, having a bit of time to make the transfer from her life at home to her role at work, to gather herself for the day ahead. She let herself in. The pale blue of the walls at least had a soothing quality as did the view over the small haphazard garden at the back of the building.
She hung her bag on the back of her chair and sat behind her desk, where her computer was already on and a cup of coffee steaming beside it. Thank God for Evangelina, the junior receptionist, who suffered under Sonia’s large thumb but remembered the little things that made the partners’ lives bearable – a regular supply of hot drinks and occasional biscuits being two of them. Kate flicked to her appointments’ screen, her heart sinking as she registered in whose company she would be spending her morning.
With one or two exceptions, it was a question of the same old patients with the same old insoluble problems: people suffering from all manner of aches and pains that were usually merely symptomatic of their circumstances. Unloved, unhappy, lonely, unemployed: the conditions that bred so many minor complaints. All those patients wanted was a reassuring chat or a token prescription and to be sent away feeling someone was taking notice and cared about them. No one else did. She sighed. At least she had the post-natal clinic to look forward to in the afternoon. That was one of the bright spots in her week, where her examinations gave her the perfect excuse to cuddle and play with one cute, unquestioning, doted-upon baby after another.
She glanced at her watch. She had five minutes. Just enough time to check her emails and not enough to do anything else. Having negotiated the rigmarole that got her through to her NHS inbox, she ran her eye down the entries, hoping to see one from her middle son, Sam, who had recently arrived in Ghana on a school-building project. She was disappointed to find nothing.
Dear Sam, the most adventurous of their children, the one who dared to go higher, further and faster than either of his siblings, up for any kind of physical challenge. Always the dreamiest of the three, he had left school and, to her and Paul’s dismay, chosen not to follow his friends to university. With no idea what he wanted from life, he had travelled alone to New Zealand where he had found a job in the timber industry. Just when she’d thought he had settled, he was off again, this time to work towards preserving the Canadian wilderness. And now he was building a school in Ghana. She knew rationally that each of their children had to leave home and follow their own path in life. But if only his didn’t have to take him quite so far away. They couldn’t even pick up the phone for a chat when they felt like it. She missed him terribly.
On her desk, she had a calendar that Sam had given her as a farewell present. Each day displayed a photograph from a different part of the world and each day she tore one off and tossed it into the bin. Today she was saying goodbye to a yellow-and-black-shrouded Japanese monk, his legs in white stockings, his face hidden under the upside-down bowl of a straw hat, begging outside a temple in Kyoto. Taking his place, a small plane flew high through the spray that erupted into the air from a rushing Victoria Falls. In the background, the sky was a cloudless periwinkle blue. Sitting in her purpose-built medical centre off a busy arterial road that took traffic roaring through London, she couldn’t have felt more remote from either of them. She stopped herself turning up the corner of Victoria Falls to see what was underneath.