* * *
When Rachel had dropped Sophie at nursery and Robin at school, she drove to the surgery. Her first patient, Teresa Lord, was already waiting for her.
‘What can I do for you, Teresa?’ she asked with a smile.
‘It’s...’ Teresa sighed. ‘I know this is going to sound stupid. But I’ve been so miserable, and my sister’s taking Prozac. She says it makes you feel so much brighter. And I wondered...’
Rachel’s heart sank. She hated it when patients thought antidepressants were the answer to everything. ‘It’s one of several options, yes,’ Rachel said carefully. ‘So how have you been feeling?’
‘Low.’
‘How are you sleeping?’ Waking early—often two or three hours earlier than usual—was a common symptom of depression.
‘OK. It’s just it’s a bit hard to get to sleep.’ Teresa bit her lip. ‘I lie there and think.’
‘Is anything particular bothering you?’ Rachel asked gently.
‘No.’ Teresa sighed and her shoulders sagged. ‘Yes.’
‘Tell me about it. Maybe I can help,’ Rachel offered.
Teresa looked torn between wanting to confide and afraid that it would make things worse. Rachel had a fair idea why her patient was worried. ‘Remember, whatever you tell me is confidential. I’m your doctor. I’m not going to gossip about you in the playground. Nobody in the village will hear a word from me,’ she said quietly. Teresa’s face cleared, and Rachel knew she’d guessed correctly. She waited, knowing that it was best to let the patient set the pace.
‘It’s my husband,’ Teresa blurted out. ‘I think he’s having an affair.’
Ouch. Just what Rachel had half been thinking about Oliver. ‘What makes you think that?’
‘He’s been distant with me lately. And he’s working late every night. And he snaps at me and the kids. Then he can be so loving... I thought maybe he was worried about something at work. But then I read this article, and I recognised the signs.’
You and me both, Rachel thought grimly. I bet you read the same article I did. ‘Just because you did a quiz in a magazine and the results weren’t very nice, it doesn’t mean Dick’s definitely having an affair,’ she reassured Teresa, though she was sure her words sounded hollow. ‘You’d be much better off talking to him about your worries. The longer you leave it, the more anxious you’re going to get, the worse you’ll feel and the more likely you are to end up having a hell of a row instead of discussing it calmly.’
‘So you’re not going to give me antidepressants?’
‘Antidepressants can be useful in cases of clinical depression—they change the chemicals in your brain,’ Rachel said. ‘But I think in your case, Teresa, they’re not going to help. You’re upset for a reason—a good reason—and the way to help yourself feel better again is to tackle the cause of what you’re worrying about. If you don’t want to talk to Dick about it on your own, talking to a counsellor’s a good start. It’ll help you find some common ground with him.’
‘I don’t know if he’ll agree to go.’
Mmm. Rachel could dish out the advice, but she couldn’t take it herself. If she asked Oliver to go to marriage counselling with her, he’d probably look at her as if she’d grown three heads. ‘Then why don’t you get your mum to have the kids for the night, sit down with Dick and talk things through with him? If you tell him how you’re feeling and listen to how he’s feeling, too, you might be able to see a way through it together. It might be that he’s got problems at work, he doesn’t want to worry you about them, and he doesn’t realise how he’s being at home.’
‘Or he might be having an affair,’ Teresa said glumly.
‘If he is, then taking antidepressants isn’t going to change anything. You need to talk to each other,’ Rachel said gently. She looked up the numbers for the nearest counsellors on her computer, wrote three of them down and handed the paper to Teresa. ‘Before you talk to him, you could have a word with one of these. They can give you some tips to help you discuss things without making it a confrontation.’
‘I suppose.’
Rachel reached over and squeezed Teresa’s hand. ‘You might be getting yourself worked up about nothing. Give it a try. You can always come back and see me again if it doesn’t help and you’re still feeling low.’
‘What about St John’s wort? My cousin takes that.’
‘Some studies show it’s effective with depression,’ Rachel said. ‘But it reacts with some medications—it makes the drugs go through the body too quickly so they don’t work properly. The Pill’s one of the drugs it reacts with, so if you’re going to take St John’s wort you’ll need to use an extra method of contraception.’
‘I never thought of that,’ Teresa said, blinking in surprise. ‘It’s a natural remedy. I just assumed it’d be safe to take.’
‘It can be, if you’re not taking any other medications,’ Rachel said. ‘But if you do go into the chemist for a complementary remedy, it’s always worth having a chat with the pharmacist before you buy it, just to check it’s going to suit you and won’t interfere with anything else you’re taking—and also how long you should take it for.’
Teresa nodded. ‘Thanks, Rachel.’
Rachel smiled back. ‘That’s what I’m here for.’
When Teresa left, Rachel waited a while before buzzing her next patient in. Teresa’s worries had made her own doubts resurface. Supposing Oliver was having an affair? Would he agree to see a relationship counsellor? Or would the suggestion be the thing to push him over the edge and make him leave her?
She shook herself. Ridiculous. They had a strong marriage. They’d been together for fourteen years, despite the initial opposition of his family. Two gorgeous children. Oliver wouldn’t walk out on them...would he?
* * *
Oliver buzzed his first patient in. ‘Good morning, Mrs Porter. How are you?’
‘Fine. Well, um, look, I don’t want to waste your time, Dr Bedingfield. It’s a bit silly.’
‘That’s what I’m here for,’ Oliver said with a smile. ‘What’s the problem?’
‘I keep getting pins and needles in my hand. I’ve been waking up in the night and my hand’s just numb until I shake it or rub it.’
‘Do you get it during the day as well?’
‘Not really. It’s a lot worse at night,’ Hayley said.
‘It sounds as if it might be carpal tunnel syndrome,’ Oliver said. ‘The bones in your wrist form a tunnel, called the carpal tunnel, and the main nerve in your hand—the median nerve—goes through it, together with other tendons and ligaments. When the tendons get swollen for any reason, they squash the median nerve and that’s what causes the pain and tingling. May I take a look at your hand?’
‘It’s the left one.’ She held it out for inspection.
‘Does it affect your fingers at all?’
‘My thumb, first finger and middle finger,’ she said.
A textbook case—but he needed to check a couple of things. ‘OK. I’m going to ask you to do a couple of things which will tell me where the problem is.’ He started with Tinel’s test—tapping over the carpal tunnel in the wrist to see if he could reproduce the tingling. ‘How does that feel?’
‘My