Lamplight in the Shadows (5 page)

‘Good morning, Dr Armstrong.'

The female voice was pleasant but matter-of-fact in its tone. James turned from hanging his coat on the back of the consulting room door to see one of the receptionists place a box of medical notes on the desk.

‘Dr McGarva would like to see you in his room after surgery this morning.'

‘Thank you. Did he say why?'

‘Not exactly.'

With that, the receptionist abruptly turned and left with barely a sideways glance at James. A frown appeared on his forehead as he watched the back of her departing blue cardigan, her long, wavy, fair hair gently bouncing as she walked. There was something about her that unsettled him, but try as he might, he had yet to put his finger on the reason.

Ever since starting as a locum within the practice, he had felt that he got on well with the staff; especially the receptionists with whom, with the possible exception of the secretaries, he had the most contact. Although his general attitude was one of professional detachment, he liked to think that he treated everyone fairly and politely. In return, they were always pleasant to him, looked after him when he wasn't sure where to go on his visits, made him cups of tea and often had a bit of a joke to help the day along. He knew most of them by their Christian names; though not through any particular diligence on his part, for he was dreadful at remembering names, but because they all wore a badge stating their first name for the benefit of the patients. None of them called him James, however; always a formal ‘Dr Armstrong', which he neither encouraged or discouraged. The situation was somewhat different with the particular receptionist who had this morning brought him the message from Dr McGarva. She was the one member of staff about whom he knew very little. He guessed that she was somewhere in her thirties, knew that she was married (only because her husband met her from the surgery in the evenings) and had overheard conversations about a house she was building. For some reason she made him feel uneasy. It wasn't that she was unattractive; indeed, on the contrary, she was in his view the most attractive of all the receptionists. However, the look in her eyes disquieted him and always gave him the impression that he had somehow done something intangibly wrong. When he did approach her for any reason, he lost his usual confidence, often finding himself dropping his gaze and ending up feeling awkward. As a result, he rarely spoke to her, preferring to make any requests to her colleagues whom he felt able to approach more freely. Because she habitually wore a blue cardigan over her uniform, thereby effectively hiding her badge, it was only recently that he had even learned that her name was Anna; Anna Baldwin, to be precise.

James shrugged and turned his attention to the box of medical notes Anna had left on his desk. They represented his forthcoming morning surgery. Casually, he flicked through the notes, finding many of the names familiar to him. It was interesting that, after only ten months in the practice, he was building up a list of patients who clearly gravitated to him rather than their registered doctor, despite the fact that he was only a locum.

Relieved to find that there were no exceptionally large sets of notes in the box that morning (implying that the cases were likely to be short and less complicated), he sat back in his chair. Absent-mindedly flicking through the pages of that month's copy of
Theology,
which he usually brought to the surgery in case there was some spare time in the day for him to study, he gazed across to the mirror on the opposite wall.

‘I wonder what Dr McGarva wants to see me about?' he asked his reflection, his mind scanning back over the past few weeks, alert to the possibility of a missed diagnosis or a patient he had inadvertently upset. With no reply immediately forthcoming, he shrugged at his image, picked up the top set of notes and walked to the door.

The waiting room was already filling with an assortment of the local population, some well known to him. A couple of elderly women were busy chatting in the corner, wheeled shopping trolleys parked in front of them. In the centre of the room a young mother stood trying to soothe the crying baby in her arms, whilst two more of her children diligently distributed the contents of the toy box over the remaining available floor space.

To one side sat a middle-aged man in a pinstriped suit, the
Financial Times
held up in front of him as though it was a shield against the illnesses around him. His psychological discomfort was quite clear as pieces of Lego and the odd toy car bounced off his polished black shoes to the background musical accompaniment of a Postman Pat pop-up picture book. James grinned as he took in the various dynamics at play. People-watching could be a most entertaining pastime.

Spotting a somewhat rotund little man perched in a chair by the window James called his name and waited whilst the local Methodist Minister negotiated the toy-strewn floor before holding out his hand in greeting.

‘Good morning, Mr Reynolds,' he said, gesturing for him to go first into the consulting room. ‘Please do have a seat. How can I help you this morning?' he continued, closing the door and resuming his own seat at the desk.

* * *

Patient by patient, the morning accordingly passed in a steady round of sore throats, chest infections, medication reviews and renewal of sickness certificates until James finally said a polite goodbye to the last patient on his list. Pausing only to place his stethoscope in the black bag at the side of the desk, he walked out into the waiting room and down past the reception area to the senior partner's consulting room. Finding the door ajar, he gave a perfunctory couple of taps on the frame and entered.

‘Ah, James, come in, come in,' said Dr McGarva, swivelling round on his antique oak chair, its well-worn leather upholstery splitting in several places to reveal a coarse stuffing of horsehair. His left arm gesticulated in a theatrical manner that James took to be an invitation to sit on the only other available chair in his room; small and upright, its hard wooden seat was devoid of any cushioning. Dr McGarva did not approve of making his patients feel too comfortable.

‘How was the morning? Manage to sort out a few ear infections in between saving lives?' he asked with a chuckle, sliding down in his seat until his head perched on the backrest and his brown corduroy-trousered legs stretched out in front of him, feet crossed. James smiled, knowing that this was simply a rueful joke at the expense of the type of work that was very much the routine in general medical practice.

‘I noticed that you haven't many visits today, James,' he continued. With his elbows just managing to perch themselves on the armrests, he reached across the desk for a pile of medical notes.

‘Well, actually I have got four new ones and a follow-up from yesterday,' James quickly corrected, not wishing to look as though he was failing to pull his weight.

‘Splendid, splendid,' came the reply, attaching no significance to what James had just said. ‘I wondered if you wouldn't mind dropping in on Constance Halliday. Her daughter rang to say that her mother is confused again. She saw you five months ago about a similar problem and I always think continuity is important in such matters, don't you, James? And whilst you're out that way,' he continued before James could reply, ‘could you call on old Bill Greenstone at Lower March Farm? He probably just has another chest infection, but no point in two of us going the same way, is there?'

James started to point out that Mrs Halliday and Mr Greenstone actually lived in villages situated in opposite directions from the town. However, any attempt at a protest was immediately over-ridden as Dr McGarva continued to speak.

‘I also have one wee favour to ask of you. The District Nurse wants someone to check Mrs Caistor's leg ulcer and I wondered if you could meet her at 2 p.m., when she will have the leg undressed. I would like to have gone myself. However, I promised to call on Jim Moorland following his recent operation and you know how difficult it is to get away from him.'

With that, James fully understood that the senior partner was expertly ridding himself of his own visits with the sole intention of enjoying a liquid lunch with a local pub landlord, the latter having recently undergone an inguinal hernia repair. Hardly the type of operation that would normally require a visit, but Dr McGarva was always willing to make professional exceptions where there was the expectation of an alcoholic reward.

Wondering just where the fine line of exploitation lay for a locum, but keen not to upset a steady position whilst no permanent prospects were in sight elsewhere, James reluctantly took the proffered notes and rose to leave. Dr McGarva, however, had not finished and beckoned him to resume his seat.

‘Charles seems to have responded quite well to his latest course of chemotherapy,' he said, referring to his absent partner, Dr Hawkins. ‘He is presently in remission and is rather hoping to be fit enough to return to work next month.'

Trying to show some enthusiasm for the recovery of his professional colleague, James could not help but feel a sense of disappointment. Although he had always known that the job was only a temporary one, he had also hoped that the position would continue to provide some stability until he was successful in finding a permanent partnership. However, there it was; he would have to go and find another locum position elsewhere.

‘…and, although it is not what you are looking for, you do seem to have become quite settled in Bishopsworth over the past eight months. The patients seem to like you and the staff want us to keep you, which is always a good sign. So what do you think?'

Dr McGarva's voice cut into James' thoughts, bringing him back to the present with a jolt. Confused about what he had just heard, he could only stutter a reply that he hoped was appropriate.

‘Sorry, what do I think about… I, eh, think it is wonderful that Dr Hawkins is recovering.'

‘Absolutely. I could not agree more. Nevertheless, what about my proposition? If, at the practice meeting on Thursday evening, we decide to expand the partnership to five doctors, would you be interested in the position?' Dr McGarva ran his hands through his tussled black hair until they rested on the back of his head. With one bushy eyebrow raised and his chin sunk into his chest, he waited for a reply.

‘I should be delighted to consider it,' came James' amazed response.

‘Good, that's settled then. Must get on.'

With that, Dr McGarva swung himself back to face his desk, picking up the telephone receiver in the process. James rose to leave.

‘Oh, and James…' The voice caused James to pause as he was halfway through the door. ‘I didn't manage to sign my repeat prescriptions this morning. I doubt I will have time before the afternoon surgery, what with the visit and such. Could you possibly oblige?'

This
, thought James,
is definitely stepping over the line of exploitation
. ‘Under the circumstances, how could I possibly refuse?' he replied with a grin.

Closing the door, he walked back to the reception area, picked up the large pile of unsigned prescriptions from Dr McGarva's tray and started to work through them.

‘Do you think you will take it?'

The soft female voice behind him sent a ripple across his shoulders and down his back as, involuntarily, his muscles went into contraction.

‘I thought you didn't know what he wanted to see me about?' he asked, somewhat perplexed.

‘Ah, there isn't much we don't know about here,' replied Anna, placing a cup of tea next to him. ‘We understand more about you than you know about yourself,' she continued, allowing her fingers to lightly brush against the back of his right hand as she moved away to attend to a patient standing at the counter.

An electric shock could not have induced a greater reaction in James than the touch of those fingers. For the second time that morning he found himself staring at the back of the blue cardigan half-covered with long, wavy, fair hair. Had that touch been deliberate or was he reading too much into it?

No longer able to concentrate on the prescriptions in front of him, he gathered the medical notes for his own visits and, deep in thought, walked out of the reception area. Passing the appointments desk, he could not help but glance towards it. As he did so, Anna looked up, her clear blue eyes meeting his own gaze, but her expression as neutral as ever.

With the waiting room a blur, he collected his medical bag from the consulting room and walked to the backdoor leading to the doctor's car park. Turning to close the door, he looked once more towards the reception desk. As he did so, the sight of the back of a blue cardigan, half-covered with long, wavy, fair hair, again met his eyes.

‘Everything alright, James?'

The voice was distant, as though heard through a long tunnel.

‘Eh, yes, fine, thanks,' replied James, standing aside to allow Dr Slater to enter.

‘Fine,' he echoed aloud to himself as, feeling very much to the contrary, he closed the door and walked across to his car.

* * *

Being mid-October, the clocks were yet to be put back by one hour, meaning that, on a cloudless afternoon, there was still just enough light filtering through the plain-glass windows to avoid the need to switch on the electric lights. Besides, it suited James better that way. There was something more ethereal about a dimly lit church.

Finding himself alone, he paused at the start of the nave and bowed towards the altar, crossing himself in the process. Walking down the aisle, he entered a pew on the south side, four rows from the front. The choice was a subconscious one, ingrained from years of following the same pattern in whichever church he entered. It all stemmed from his time as a medical student in London. There, his local parish church had a pillar halfway along the fourth pew. Its primary role was to support the roof trusses of the south transept. However, it served a secondary role for James, as it used to give him something to lean against whilst listening to the sermon delivered from the pulpit on the north side. Here in Bishopsworth, at the parish church dedicated to St Matthew, there was no column in the fourth row. However, it was still where he psychologically felt most comfortable.