A Nurse In Crisis

She hadn’t expected him to take her up on that overenthusiastic offer to keep a secret from her own husband, but he really didn’t want it gossiped about for the moment, not even between husband and wife, and if that didn’t convince her that he was being appropriately cautious, what would?

Everyone in the practice knew that they had been away for the weekend recently, of course, but he’d presented the event as what it essentially had been—a group of friends enjoying two days of winter sports, not a romantic interlude.

‘You know I’m only saying this because I care about you, Dad,’ Rebecca said, her voice suddenly husky with tenderness.

And he did know it, too. As well, he was guiltily aware that he’d once interfered in her relationship with Harry for exactly the same reason, and the result might have been disastrous on that occasion if Harry hadn’t completely ignored his sage advice.

‘Shall we change the subject?’ he offered, and she greeted the suggestion with relief.

Marshall wondered later, as they returned to the surgery together, if she realised how relentlessly her words were laying siege to his inner equilibrium. In many ways he was as wary as his daughter about this new thing that had so unexpectedly entered his life. Rebecca had no reason to accuse him of not being careful.

If dwelling on things, and replaying conversations—and silences—over and over in one’s mind were signs of being careful, then he was being positively obsessive. That stupid business of Aimee’s wineglass the other night, for example. He could have kicked himself for that unforgivable moment of hesitation.

He could tell she was afraid he suspected her of being a secret drinker, and he didn’t. She’d given him no reason to. Not at the snowfields or at work here in Sydney. Not during the three times they’d been out together. So why that moment of suspicion, flashing through his mind, that he hadn’t managed to hide?

‘Because I’m a doctor, I suppose,’ he concluded, muttering to himself. ‘I’ve had patients who did drink, when sometimes it was the last thing you’d suspect.’

Like fifty-eight-year-old Joan Allyson, who was first on his list this afternoon.

‘How are you, Joan?’ he greeted her, as she sat down in the chair opposite his desk.

‘Fighting fit, I hope,’ she answered, and she looked it. Short grey hair, trim, energetic figure, dangling earrings of a pretty red to match her red trouser suit. She had come straight from work, and was due back there after her appointment. ‘I’m just here for my annual check-up.’

She’d been very good about such things for the past seven years, but it hadn’t always been that way. She’d started drinking heavily about fifteen years ago, after a painful divorce, but she’d hidden it so carefully at first that no one had suspected. Not her grown-up children. Not her colleagues at the insurance company where she’d worked. Not even her family doctor!

Until she’d turned up one day with gout, indicated by her symptoms of pain and confirmed by the test Marshall had done, revealing high uric acid levels. At that point he’d suspected very strongly, but his questions on the issue had brought only flat denial.

After that, it had got worse and everyone knew. Her two children had each come to see him in turn to ask if there was anything they or he could do. Without her willingness to admit to a problem, of course, there hadn’t been. Her health had deteriorated. There had been more severe episodes of gout, and treatment for venereal disease. She’d lost her job.

Finally, and he still wasn’t sure what the trigger had been, although he suspected another one-night stand which had turned bad, she’d come to him of her own volition and had asked for help. She’d heard of a drug called Antabuse, which caused any alcohol intake to create strong feelings of nausea, and she’d been keen to try it. He’d prescribed it for her, but had also urged her to join Alcoholics Anonymous.

Since then, she hadn’t looked back. Now, seven years since her last drink, she had a well-paid and satisfying job in the administration of the Sydney Opera House, her health was good and on this visit she had some news as well.

‘I’m particularly hoping everything’s all right today,’ she said, ‘because I’m getting married in six weeks.’

‘Oh, Joan, that’s marvellous!’ Marshall said, and meant it. ‘Congratulations!’

She beamed, and the warmth in the room was palpable. Marshall was honest enough to admit to himself that if it hadn’t been for the advent of Aimee in his life, he wouldn’t be basking quite so strongly in the reflected glow of Joan’s obvious happiness. But, to be truthful, he did find it very encouraging that love could run smoothly on the far side of fifty!

‘He’s a violinist with the Sydney Symphony Orchestra,’ Joan went on. ‘And he’s got an adventurous spirit. We’re going to East Africa for our honeymoon. Will we need any vaccinations?’

‘Yes, I’m sure you will, but I’ll have to check the most up-to-date information,’ he told her. ‘Why don’t you make an appointment for next week? I’ll make sure I have what you need in stock. Meanwhile…’

He gave her a thorough check-up, including a pap smear and a good listen to her chest and heart. In a minute, Aimee would take some blood to be tested for lipids, and he finished his own part of the check-up with, ‘How long since you had a mammogram—do you remember?’

She made a face. ‘I was afraid you’d say that.’

‘I can easily check it in your file.’

‘No, I know perfectly well I’m due for one.’

‘The mammography screening unit at Southshore Health Centre would be the easiest place to go.’

‘Will I have to wait? I’d really like to have it over with before the wedding.’

‘That shouldn’t be a problem. But do you really hate it so much? It doesn’t hurt very badly, does it?’

‘Spoken like a man,’ she teased. ‘Yes, it does hurt a fair bit, especially if you have largish breasts, on top of which it’s not remotely dignified. Oh, I’ll be glad I’ve done it, but it’s not exactly something to look forward to.’

‘I suppose not,’ he agreed on a laugh. ‘Rest assured, though, we males of the species have our own unique and painful medical indignities to endure!’

‘True,’ she conceded.

The rest of the afternoon’s patients were routine, with some more interesting than others. After over twenty years in general practice, Marshall was used to the rhythm and flow of the work. If he’d been a composer, he could have written a piece of music to express it.

Intertwining pastoral melodies for all those rather benign things like children’s ear infections, annual flu shots, blood-pressure measurements. The interest lay in the way he got to know his patients year by year as he watched the wheels of their lives slowly turn. Patients he’d known as children were now grown up and married with families of their own. Patients he’d first seen in their fifties were now making decisions about retirement homes.

Then there would be plodding underbeat for the cases that few doctors could find interesting. Patients who came once to have a cut stitched or an ear syringed and were never seen again. People who needed a medical examination for work or insurance purposes and had phoned this practice purely because it was on a list of approved ones in the area.

There would be a burst of joyful song for wanted pregnancies, good test results, serious illnesses cured. And, finally, there’d be the keening of violins for the patients that broke your heart.

Like Hilde Deutschkron. He’d spoken to her surgeon on Tuesday morning. Today was Thursday, and she’d been discharged from the hospital this morning as planned.

After his last office appointment for the day, Marshall drove to her small house several streets back from the beach at Bondi and knocked at the front door.

Mrs Deutschkron’s daughter, Marianne, answered. She was an attractive dark-haired woman of about thirty-eight, and Marshall had seen her a few times years ago for minor illnesses when she’d still been living at home. Since then, she’d led an interesting life as a journalist, with several stints of living and working overseas. She wasn’t married, and he was pleased to find that she’d taken time off work to help her mother convalesce. Mrs Deutschkron’s two sons lived in Melbourne and he knew she got lonely at times.

‘How are you, Marianne?’ he said. ‘I don’t suppose you remember me…’

‘Of course I do, Dr Irwin!’ she said with a confident smile. ‘How could I forget the man who came at me with a cauterising thingy that time I had that strange lump on my little finger that kept bleeding if I bumped it?’

‘That’s right,’ he said. ‘I’d forgotten all about that. We never really decided what it was, did we? The cauterising didn’t work, I remember, and it came back. You had to have it cut out under local anaesthetic at Southshore Hospital.’

‘I’m amazed you remember!’

‘Only because it stumped me, and the doctors at Southshore, too. Did it ever come back after the surgery?’

‘No, but I still have the scar.’ She stuck her little finger up in the air, then lowered her voice and said, ‘Come through. Mum’s on the couch, though I think she should really be in bed. She’s not feeling very good, and she’s anxious to hear your report. Do you have all the results or whatever everyone was waiting for?’

‘Yes, I do,’ he said, following her down the rather dark corridor. ‘Uh, would it be too much trouble to ask for some tea?’

‘Of course not. Straight away?’

‘If you don’t mind.’

Marianne nodded, and he saw that she understood. There was a brief flare of well-schooled alarm in her eyes. Marshall didn’t really need tea, but he wanted to break the news to Mrs Deutschkron alone. He had no doubt she’d need her daughter later, but for those first few moments…

‘Hello, Mrs Deutschkron!’ he said, coming into the thickly decorated sitting-room. There was a floral lounge suite, photos and knick-knacks everywhere, two shelves of books, vases of silk flowers, and all of it immaculately dust-free. ‘Marianne says you’re not feeling too good?’