Out of Practice (21 page)

‘You looked like you were having fun last night,’ said Taffy, as he hung up his jacket and found his schedule for the morning. ‘How’s the head?’

Holly groaned. ‘Don’t ask. Just kill me now. Preferably quietly.’ She refilled her coffee mug and turned away from his sympathetic gaze. There was altogether too much affection
in his eyes and it sent little shivers down Holly’s spine that had absolutely no place being there. On the other hand, perhaps she had picked up a nasty bug and was destined to spend the next
few days tucked up in bed with a fever and a Lemsip, she thought hopefully.

Holly shook her head at her own stupidity, instantly regretting the sudden movement. How ridiculous was her conscience to try and project an actual, physical illness, rather than admitting the
simple truths?

She was sleep deprived, hung-over and unnerved.

It was that simple.

The reasons she was feeling unnerved however, were a little more complicated.

She sat back against the worktop in the doctors’ lounge and watched Taffy assemble his coffee – three sugars, two spoonfuls of Nescafé and a huge slug of cream from the
fridge. He was basically a teenager . . .

‘What? I’m hungry,’ Taffy protested, as he noticed the expression on her face. ‘And don’t judge until you’ve tried it.’ He held out the mug to Holly.
‘Go on. It’s my patented hangover cure, so I wouldn’t be so quick to dismiss it, if I were you.’

Holly took a tentative sip, half expecting the Mini Eggs to make an encore appearance, but to her surprise, Taffy’s sickly concoction was like a hug in a mug. ‘Well,’ she
prevaricated, unwilling to succumb so easily, ‘it’s no bacon sandwich . . .’

Taffy just grinned, pulled out another mug and began to cook up a second batch. ‘Drink it, it’s yours. Now, by way of thanks, you can tell me what you and Lizzie were gossiping about
last night? You can be honest. I’m not shy. It was my new jeans, wasn’t it?’ he said, his face completely dead-pan.

Holly couldn’t help but laugh, having noted with some amusement last night, the entirely shredded and shabby appearance of what was clearly a very well-loved bit of denim.
‘You’ve got me,’ she said. ‘In fact, Lizzie will probably be calling you later to set up a photo shoot for the magazine.’ Holly tried not to think about how the soft,
worn denim had sculpted Taffy’s thighs so perfectly that Lizzie had even tried to get a snapshot on her iPhone.

‘Don’t mock the afflicted,’ he said, trying to look offended and failing. ‘We can’t all roll out of bed looking gorgeous, Dr Graham.’ He gave her a cheeky
grin and left the room, leaving Holly floundering for a witty response. He couldn’t possibly mean her, could he?

Perhaps he was due for his annual sight test, Holly decided in the end. It made a lot more sense than the alternative.

After a few hours of ministering to the sick, the malingering and the generally deranged, Holly was beginning to question the idea that General Practice would be an easier
proposition than her shifts at the hospital. True, the atmosphere was more conducive to intimate revelations, but the stories were not so different. It seemed to Holly as though maybe she was
actually seeing the same patients, just earlier on in their stories, before ‘Doctor’ wasn’t enough and an upgrade to ‘Hospital’ was required.

Taffy’s Tincture had worked wonders and Holly couldn’t deny that having him around was making her new job that bit more fun. It was the one thing she’d been worried about when
going into General Practice – the dark and wonderful sense of humour at the hospital had kept them all going through some tricky times. It had built up their sense of camaraderie and
Blitz-spirit and Holly had adored it.

She’d already seen that Dan and Taffy approached medicine in much the same way. Thankfully the rest of the team seemed to follow their lead – with the notable exception of Julia
Channing and Henry Bruce.

Even George Kingsley had turned out to be a bit of a hoot. Although, to be fair, Holly wasn’t entirely sure that it was intentional. Only this morning, she’d popped through to his
consulting rooms to find him playing duck with some cervical dilators. He seemed to be even clumsier than she was – in his embarrassment, he’d knocked a huge pot of tongue depressors
flying.

According to Grace, in the last week alone, he’d broken an anatomical model of a knee joint and nearly injected himself with insulin by mistake – apparently he fiddled when he was
nervous or distracted.

By all the evidence then, Holly reckoned he must be pretty nervous and distracted about his retirement plans.

Holly poked her head around the waiting room door. ‘Martin Lane? If you’d like to follow me?’ Holly held open the door to her consulting room and guided him
through. He looked fragile and emaciated and Holly pulled a chair around so it was closer for him.

Even so, pale and struggling, Martin looked defeated by the distance to the chair.

‘So, Martin, what’s been going on with you? I gather you’ve lost about a stone in the last few weeks?’ Holly leaned in closer, guiltily thinking that, after a morning of
ear infections and thrush, it was quite nice to have a more challenging case.

Martin nodded. ‘I’ve been really under the weather, Dr Graham. At first we thought we’d got the flu from the grandkids, but they all got better and I didn’t.’

‘When you say the flu,’ said Holly sympathetically, her eyes ranging over him, searching for visual clues, ‘what symptoms did you have?’

Martin rubbed at his forehead. ‘Well, the little ones were all coughing and sneezing, but I just had really aching joints, splitting headache, exhausted . . .’ His words trailed off
as if the effort of talking alone had indeed exhausted him. ‘I’ve been off work, off my food, off my game generally really.’

Holly quietly made notes as Martin spoke. ‘Okay, but you did get your flu jab this year, didn’t you?’

‘Just goes to show it’s a waste of time, doesn’t it?’

‘Obviously there are different kinds of flu, Martin, but what you’re describing is so generalised, we could be looking at almost anything. Has there been anything else unusual? Any
other illness in the family? Any change in routine?’

Martin shrugged, reluctant to admit the extent of his illness. He blinked hard to get the tears from his eyes. ‘Sorry to be a bit weepy about all this, Doctor. It’s been a miserable
couple of weeks, with no sleep and feeling so wretched and now I daren’t even cuddle the new grandson in case I’m contagious . . .’ His voice petered out and Holly discreetly
handed him a tissue.

It seemed that most of Holly’s time here had been spent dispensing tissues to crying patients. Most people seemed to wait until they were at their wits’ end before booking themselves
in for an appointment. With so many concoctions available over the counter, Holly realised that it was inevitable really. Most people, after all, weren’t in a desperate hurry to spend ages
sitting in a germ-filled waiting room. Except, ironically, the Worried Well. The WW, as Taffy would say, were terribly suggestible and one bad episode of Horizon or Panorama could have the waiting
room packed to the gills.

Holly let Martin chat on as she methodically checked his temperature, ears, throat and blood pressure. She felt around for swollen glands and tried her best not to show her shock at the extent
of the swelling around Martin’s lymph glands in his armpit and at the side of his neck.

She could see from his file that Martin’s father had recently passed away from leukaemia and he’d been in a couple of times, asking for something to help him sleep. She offered up a
silent prayer that this was not going to be a case of history repeating itself. He obviously wasn’t a young man, but he’d apparently been in reasonable health and Holly hoped that he
might dodge ticking the statistical boxes for a little while yet.

Holly leaned forward in her chair, elbows on her knees, brain crunching data. ‘Think for me, Martin. Have you had a sore throat? An earache?’

Martin shook his head. ‘I was absolutely fine, helping out the youngest with her new business and then bam – I was knocked for six. Thought it might be the early starts, you know?
I’ve got out of the habit of getting up early.’

Holly stood up and pulled a roll of paper over the treatment bed and helped Martin to his feet. ‘Well, let’s get you comfortable lying down and we can discuss what happens next. You
know, one of us could have visited you at home, Martin. You only had to ask.’

‘I didn’t want to be a bother,’ Martin replied.

Holly quickly and expertly drew enough blood to send off to the lab, hoping that Grace wouldn’t give her stick for doing what was technically a job for the nursing team. But she
couldn’t see the point in making Martin wander around the building when he was clearly struggling. As Holly held down a ball of cotton wool on the inside of Martin’s arm, Martin himself
was chattering away about his Fiona’s wonderful new enterprise and how proud he was that she was so dedicated.

Holly turned Martin’s arm to and fro in the light, leaning in to examine his skin amongst the dense black hair that seemingly covered him from head to foot. ‘Martin?’ she said
slowly. ‘When did these lumps appear?’

Martin looked down at his arm. ‘Oh about a month ago, the first one. It was like a little ganglion, you know. I had to stop the wife from bashing it with a bible! And then, the others,
slowly since then. Fiona made me stop picking up the heavy boxes after that. Obviously not as fit as I used to be.’

Holly pulled the overhead light down and examined the lumps that ran from Martin’s wrist to elbow, some pearly pink, some purple, others openly weeping. She racked her brains as a germ of
an idea stayed stubbornly out of reach. ‘We’ll send all the blood off, Martin and I think I’ll give you something topical for these too, in the meantime. Can you really think for
me, Martin, did anything happen before the lumps began?’

‘Only helping Fiona out, like I said.’

Holly printed out a prescription for some topical ointment and shook her head with frustration, knowing that the answer was in there somewhere. ‘I’ll call you when the results come
in and if anything changes, I want you to come straight back in, okay?’

Martin nodded and stepped down from the bed. ‘And if you want a few flowers to brighten up the waiting room, I’m sure Fiona would love to help. She’s a wonder with a floral
arrangement, my girl. She’ll be the best florist for miles around soon.’

Holly felt all the cogs of her brain click into place. ‘Martin, sit down. You’ve got sporotrichosis. You pricked yourself on a rose thorn, didn’t you? When you were helping
your daughter?’

Martin looked perplexed. ‘You know, you’re right. I did. But what’s that got to do with this? It was weeks ago.’ He looked down at his arm and ran his fingers over the
lump on his thumb, which was now a deep purple.

Holly breathed a sigh of relief and then tore up Martin’s earlier prescription. ‘There’s mould spores on rose thorns that can cause some really nasty infections if they get
under your skin. If you don’t catch them early, it can actually get pretty serious, Martin. So, we’ll still get the bloods checked and I’m going to speak to a colleague about
whether we need to refer you, but in the meantime I want you to use this potassium iodide and I think an anti-fungal wouldn’t go astray here either.’

Holly talked Martin through his proposed course of treatment and other developments to keep an eye out for. The last thing they needed was for this to develop into a nasty cellulitis. All the
while, in her head, Holly kept thanking the gods that Martin was a chatty fellow, or she may have missed this one completely.

Score one for General Practice, thought Holly, as she saw Martin through to the Pharmacy. A little squiggle of excitement in her stomach reminded Holly how much she loved her work – the
challenge, the puzzle, knowing she’d made a difference. Knowing now, more than ever, that she’d made the right decision.

‘You look like the cat that’s got the cream,’ said Grace, as Holly perched on her desk after a long morning surgery.

Holly shrugged. ‘A lucky catch, that’s all.’

Grace nodded. ‘Some days you win . . . I have to say Holly, George and I are thrilled at how well you’re settling in. Seems like you’ve been here for ages. I know he’s
worried about how his little team are going to cope when he’s gone. Let’s his heart rule his head, that one. But between you and me, with this partnership fandango, I rather hoped he
would stay true to form. But, he’s got a bee in his bonnet about being fair and open-minded.

‘He’s never been a big supporter of Big Business when it comes to medicine – rather likes the personal touch – so it’s obvious to anyone who knows him that
Dan’s his natural successor. But obviously Julia and Henry deserve their bite at the cherry too.’ Grace sighed. ‘If only Dan were on top form, then it wouldn’t even be an
issue.’

Holly sat quietly, wondering whether Grace was supposed to be letting any of this slip. Not that Holly didn’t want to know, she was practically on tenterhooks, but she didn’t want
Grace to regret confiding in her later.

But Grace carried on, seemingly relieved to be sharing her concerns. ‘There’s no doubt in my mind at all that Dan’s the superior GP, Holly. Henry would probably be happier in
private practice to be honest. He does love his perks that one. And Julia, well . . . I always get the feeling she misunderstood the meaning of “Critical Care”. Not the most empathetic
of souls, is she? She would have made the perfect surgeon, don’t you think?’

Holly laughed, as Grace’s comment was unerringly accurate. Julia
would
make the perfect surgeon. Clearly ridiculously intelligent and dedicated to finding solutions, Julia was
very black and white. Find problem. Fix problem. Go home. Avoid talking to your patient in any depth at all wherever possible. It was so bloody obvious, now that Grace had articulated the thought,
that Holly wondered how she’d missed it before. ‘Grace, you’re so right. She’s clearly missed her calling.’

Grace shrugged. ‘Missed, bodged, flunked . . .’

Holly leaned in, intrigued. ‘And?’