He went out to the hall to take the call. As he’d expected, it was the practice receptionist, Ruth Hargreaves. He assured her that surgery would go ahead as scheduled and hung up. There was no sign of Emma when he went back to the kitchen but he heard a car starting up and looked out of the window in time to see her driving away. She hadn’t bothered saying goodbye but why should she? So far as Emma was concerned, she would do what had to be done and that was it. She wasn’t going to suddenly want to become his best friend and he didn’t blame her. He had hurt her badly and the worst thing was knowing that he could never atone for what he had done. Even if he told her the truth, and even if by some miracle she believed him, it was far too late to get back what they’d had.
The waiting room was packed when Emma got back shortly after five p.m. Aunt Margaret had decided to stay the night at the hospital so Emma had come back on her own. Ruth was on the phone when she went in, looking unusually harassed. Emma waited until the receptionist finished the call.
‘Problems?’
‘Oh, just the umpteenth person phoning to see if we’re open.’ Ruth rolled her eyes when the phone rang again the second she put down the receiver. ‘That’ll be another one. I’m sorely tempted to take the wretched thing off the hook!’
‘I don’t blame you.’ Emma smiled sympathetically. ‘I’m helping out tonight so you can send the next patient in to me when you get the chance.’
‘Will do.’
Ruth snatched up the receiver as Emma made her way along the corridor. There were two consulting rooms and she guessed that Daniel would be using the one her uncle normally used. She made her way to the other room and switched on the light. The room hadn’t been used very often since her uncle’s partner had retired some years ago. Although Uncle Jim had tried to find a replacement, few doctors had been keen to relocate to the area. The younger ones thought the town too quiet to consider living there permanently, while the older ones weren’t willing to cope with the difficulties of the job.
As well as caring for the townsfolk, the practice provided care for the people living on the outlying farms. Some home visits could be extremely difficult to reach, especially during the winter months. The few candidates who had applied for the post had soon lost interest when they’d discovered what the job had entailed, so in the end her uncle had given up advertising and run the surgery single-handed. However, if the number of patients in the waiting room was anything to go by, it really needed more than one doctor to run the practice.
It was something that needed thinking about in view of her uncle’s health, Emma decided. However, there was no time to worry about it right then. A knock on the door heralded the arrival of her first patient, a young woman who looked vaguely familiar. Emma smiled at her.
‘Please sit down. I’m Dr Roberts. I’m helping out while my uncle is in hospital.’
‘Oh, I remember you!’ the young woman exclaimed. ‘You were in the same class at school as my sister—Cathy Martindale. Remember her?’
‘Of course I do.’ Emma laughed. ‘No wonder you look so familiar. You’re very like Cathy. How is she, by the way?’
‘She’s fine. She lives in Leeds now with her husband and her two little boys.’
‘Tell her I was asking about her, will you?’ Emma picked up the folder of notes that the girl had brought in with her. ‘So, Judith, what can I do for you today?’
‘It’s my periods, Dr Roberts. They’re so heavy and irregular that they’re causing me a real problem. I also suffer the most awful pain in my tummy and lower back each time it happens.’
‘I see. How long has this been going on?’ Emma asked.
‘About a year now. I came off the Pill eighteen months ago because my husband and I want to start a family. My periods were very erratic after I stopped taking it, but I thought everything would settle down once the drugs were out of my system. Instead, it’s just got worse.’
‘Have you had any other symptoms? Pain on having intercourse, perhaps?’
‘Yes.’ Judith blushed. ‘I’ve never had a problem before, but recently I dread making love with David because it’s so uncomfortable.’
‘Which doesn’t help when you’re hoping to have a baby,’ Emma said sympathetically, standing up. ‘I’ll just check your blood pressure and then I’d like to examine you, if that’s all right?’
‘Oh, yes, of course it is.’ Judith sounded relieved as she slipped off her coat. ‘I’ve been putting off coming for weeks, to be honest. Dr Haynes is lovely, but I felt so embarrassed about having to explain it all to him. I couldn’t believe my luck when Ruth told me I’d be seeing you tonight!’
‘Good.’ Emma laughed, although she couldn’t help wondering how many other women were delaying making appointments because they felt uncomfortable about discussing their problems with an elderly male doctor.
She checked Judith’s BP, which was fine, then asked her to undress and lie on the couch while she examined her. She gently palpated her abdomen and then performed an internal examination but could find nothing to indicate what was causing the problem. Judith had had a smear test the previous month and that had come back clear.
‘And there’s been no other symptoms at all?’ she asked after Judith had got dressed again. ‘Not even something that is apparently unrelated?’
‘No … well, apart from the fact that I’ve had several bouts of diarrhoea. It’s not something I’ve ever suffered from before, but it’s happened a few times lately. Either that or I get constipated,’ Judith added, grimacing.
‘I see.’ Emma frowned thoughtfully as she considered what she’d heard. ‘It’s possible that you’re suffering from endometriosis, although I wouldn’t like to make a final diagnosis without sending you for some tests first. However, the symptoms you described could point towards it being that.’
‘Endometriosis?’ Judith repeated. ‘What’s that? I’ve never heard of it.’
‘It’s when tiny pieces of the lining of the womb, the endometrium, are shed during menstruation but don’t pass out of the body. Instead they travel up the Fallopian tubes into the pelvic cavity and attach themselves to the pelvic organs. They continue to respond to your menstrual cycle so each month they bleed, but because the blood can’t escape, it causes cysts to form. And they’re the cause of most of the pain and discomfort.’
‘How weird!’ Judith exclaimed. ‘And you think that’s what is wrong with me?’
‘I think it’s worth investigating further.’ Emma brought up the relevant document on the computer and filled in the patient’s details. She glanced at Judith. ‘You need to be seen by a gynaecologist so I’ll organise an appointment for you. Basically, what it means is that your pelvic cavity will need to be examined. It’s done by using a laparoscope, which is a special instrument that’s passed through the wall of the abdomen. There’s a tiny camera on the end of it so the gynaecologist can see what’s going on inside you.’
‘It sounds horrible,’ Judith said, shuddering.
‘It’ll be fine,’ Emma assured her. ‘And it will be worth having it done if it means we can sort out this problem you have.’
‘If I do have this endometriosis, how will you treat it?’
‘It depends how severe it is. Drugs can be very effective in some cases. In others, where the cysts are very large, surgery to remove them is the best option. Pregnancy can also suppress the condition.’
‘So I can still have a baby?’ Judith asked anxiously.
‘Yes, although it’s only fair to warn you that endometriosis can affect your fertility. However, let’s find out if my diagnosis