Doctor...to Duchess? (11 page)

“I should be kicking myself, really. It’s a good idea.”

“You think?” It took a lot of willpower to keep her tone light.

“I do.” His tone turned serious. “I’ll put it into the mix.”

“Right. In with the rest of the hoi polloi.”

“For heaven’s sake, Julia! I’m not going to just up and give away part of the estate without considering all of the ramifications, am I? Don’t go all pouty on me—you’re bigger than that.”

“You, of all people, should know I didn’t mean it that way.” Julia pouted then pulled her lips into a thin line.

Oliver stopped running, hands on hips, and stared at her. “Why me ‘of all people’?”

Blimey! What do you want? My heart on a platter?
“I’m just saying I care! And there’s no one else I can talk to who understands what it is to believe so strongly in something. I care!”

“About the clinic?”

Oh, so very much more than the clinic.

“Yes, about the clinic...”

“And?”

What did he want? A confession of her true feelings? To know that having him around made a perfect place to live and work even better than she ever could have imagined?

“It’s just nice to have—you know—” She faltered. This was tough. She hadn’t found someone to be her sounding board since she’d moved here. And everyone needed someone to have a good rant with who would dole out some solid advice, right? She looked up into Oliver’s eyes—steady, unwavering. “To have a someone...to talk to,” she finished softly.

“So, I’m your ‘someone’?”

“You’ll do ’til I find someone proper...” Julia affected a teasing tone, pressing her lips forward into a cheeky pout, then thought better of it and pressed them together. How on earth she’d gone from bickering to flirting in a matter of a millisecond was beyond her.

“Shall we?” Oliver nodded toward the path, indicating they should carry on running. “You’re actually right, you know.” He flashed her a smile. “I don’t admit that very often, so you should take this moment to bask in the limelight.”

“Ha! I think I’ll take a rain check on that one. What am I right about, anyway?”

“I was a bit rash in thinking I could just fly in, sort out my future and fly back out without leaving a mark.”

You got that right!

“I need a proper sit down with my father and the ledgers.” He gave her a sidelong glance. “The truth?”

“Uh—yes, please.”

“I haven’t really got the foggiest about what to do with the estate. Up until now, it’s mostly been a case of out of sight, out of mind.”

“Up until now?”

“Julia, don’t be coy. You know more than most the estate hasn’t been the only thing that’s been on my mind.”

“He doesn’t seem to mind.”

“I suppose he wants you to be happy.”
You dodged it!
Why, you ninny?

“And what about you?” Oliver refused to be distracted.

“Do
I
want you to be happy?”

“No, silly. I mean, that’d be nice, but do you want a look at the books?”

Yes. Of course. The books. What else would we be talking about? Not beating my heart to a pulp or anything.

“You want me to look at your family’s accounts?”

“Well, it’s hardly akin to opening up the vaults of MI5.”

“I know, but it’s your private business.”

“I’d like you to see them.”

“Really? Why?”

“Let’s just say it’d be nice, on this occasion, to have a someone.”

His someone?
The telltale swirl of warmth began to ribbon through her. Was this his way of showing her he would take a serious look at staying? She grinned. So did Oliver. And then he play-kicked her on the bum again for good measure.

CHAPTER SEVEN

“
T
HERE
’
S
A
BIT
of improvement, but not much.” Julia gave Margaret Simms’s arm a quick squeeze as she took off the blood-pressure cuff. “Have you made any of those lifestyle changes we discussed?”

The sixty-seven-year-old woman sent a sharp look over her shoulder as if someone might overhear them in the private consultation room.

“Oh, yes!
Diligently
, Dr. MacKenzie, but let me tell you I’m struggling to fit it all in. On top of which, it all makes me so hungry!”

“Really? What exactly have you been doing?” Julia asked. She had previously diagnosed Margaret’s high blood pressure as a classic “lose a bit of weight, do a bit of exercise and things should improve” scenario. A bit less salt and sugar and a splash of exercise should have made an impact by now. Had Margaret initially presented with a sudden rise in her blood pressure and her lifestyle been a bit more active, she would’ve had more concern. Blocked arteries were often to blame and they generally required stents to be fitted. Margaret hadn’t complained of any chest pain—so she had ruled out that option.

“The list...” Margaret began to dig through her handbag. “The list you gave me when I wasn’t feeling right.”

“You mean the list of ways to lower your blood pressure?” Julia kept the smile twitching at her lips at bay. Margaret was a regular visitor, but it was rare for her actually to listen to any of her advice. Her husband had passed away about a year ago and Julia was fairly certain the visits were more for a bit of company than any true ailment.

“That’s right. That’s the one.” Margaret triumphantly held up a folded pink printout. “Here, look. It took me all of Sunday to get through them! I’d no time to sit and take my afternoon sherry. My knitting needles didn’t know what to do with themselves, but I couldn’t half have murdered a shepherd’s pie!”

Julia took a moment to scan the pamphlet. “Hang on, Margaret. Have you been doing
all
of these exercise suggestions in one day?”

“Well, of course. Twenty minutes each. I was inspired by watching the fun run and you said very clearly to try these suggestions. I take everything you say very seriously, Doctor.” Margaret gave her an appropriately pious expression.

Julia laughed good-naturedly. “I didn’t mean all at once! When you take on exercise, you want to do it gradually. Particularly if you haven’t been doing very much. No wonder you’re tired.” She sat back in her chair and thought for a moment. “Did you say you haven’t been taking your sherry any longer?”

“Yes, that’s right. Well, just the once, really.”

“And do you do your knitting when you take your sherry?”

“Yes, that’s right. To make a hat is three glasses, a scarf is four...” She petered off as Julia’s eyes widened.

“And is this an everyday thing, your knitting?”

“Oh, yes. Although, with Harold gone,” she reluctantly admitted, “there might be a bit more sherry than knitting. I made all of his sweaters, you see. Always getting holes in the elbows, he was. The man kept me ever so busy.”

Julia considered Margaret’s chart for a moment before continuing. Moving from the physical to the personal was always a delicate trick—particularly with the older, more private generation. “Margaret, since your husband passed, have you been getting out much? To see your friends?”

“No, not so much. It’s hard to get back into action after these winter months, isn’t it? They keep you in.”

“Mmm, yes.” She nodded. “I’ve got an idea for you, Margaret. I bet there are a few women round the village who might be suffering from a bit of cabin fever. Rather than working your way through this exercise list, why don’t you walk into town a couple of times a week—what’s that, a fifteen minute walk?—and start a knitting club down at Elsie’s tea shop? Send your hats and scarves to—” Julia stopped as she heard Oliver greeting Dr. Carney in the room across from them. “You could send them to Africa.”

Margaret cackled delightedly. “Africa? Dr. MacKenzie, have you gone mad?”

Very, very possibly.

“Not at all.” Julia covered with what she hoped was calm bravura. Could Oliver’s presence really have made such an impression on her subconscious or was the answer to that blaringly obvious? “There are all sorts of things you could knit for charities down there. Blankets for the orphans, little infant caps—that sort of thing.” She slipped her hand under the desk, crossing her fingers that such a charity existed. If not, maybe she could get her computer whiz of a son to start one up on the internet. “I think you’d be helping a lot of the ladies to get out for a bit of fresh air and a cup of tea if you were to start a knitting club.”

Margaret stifled her laughter then visibly considered the suggestion. “Perhaps Elsie’s shop could do with a bit more local business. I would be helping St. Bryar by doing that, wouldn’t I? And, of course,” she continued, giving Julia’s knee a pat, “Lord Oliver would most likely appreciate it, what with all of the work he does for those poor orphans.”

“Good thinking.”
Whatever it takes.

“You know, Dr. MacKenzie...” Margaret leaned in as if to share a secret. “Most of the girls call me Peggy. I could call the club ‘Knit & Purl with Peggy’!”

Julia clapped her hands in delight. “That sounds great.”

“I could also teach some of the younger girls!” Margaret enthused. “I hear on the television knitting has become trendy again!”

There was a quick knock on the door, and Oliver’s head popped round the corner. “So sorry to interrupt. Dr. MacKenzie, could I borrow you?”

“Yes, of course, we’re just wrapping up here.” Julia rose quickly to her feet. She wouldn’t normally rush a patient out the door, but she trusted Oliver enough to know he wouldn’t interrupt a consultation if it wasn’t urgent. “Margaret—Peggy—I think we’re onto a winner here. You’ll keep me updated?”

“Of course, dear. Of course.”

Julia gave the woman’s shoulder a quick squeeze and nipped across the corridor to Dr. Carney’s room. Oliver had already disappeared behind the curtain masking the bed from the door.

“Dr. Carney, how is everything?” Julia stopped in her tracks. Initial but obvious signs of jaundice were evident in his eyes and skin tone.

“Not looking my best today, I’m afraid, my dear.”

“I wouldn’t say yellow is your color.” Julia made a feeble stab at humor before glancing across the room at Oliver.

“Most likely a bile blockage. We were discussing surgery and
someone
—” Oliver pointedly looked at Dr. Carney “—claims he isn’t keen. I was hoping another doctor’s viewpoint might help this stubborn old bugger to see sense.”

Julia felt as though someone was physically reaching in and constricting her heart into a taut rope. Oliver was obviously struggling with his mentor’s illness and it was going to be tough to be as blunt with him as her predecessor had been with her.

Dr. Carney didn’t want surgery. He had a “do not resuscitate” request on his medical file, and she knew better than to fight him. The prognosis had never been good and the best she could get him to agree to was to let her keep his pain in check.

“I think the old bugger knows as well as we do what lack of treatment will lead to.” Julia tried to lighten the mood in the room, hoping Oliver would take the hint and discuss the situation with her outside.

Dr. Carney tried to push himself up and failed, but managed a weak smile. “Of course I do, dear boy! It’s not as if this cancer nonsense has gone to my brain.” He rattled off an impressive definition of bile duct blockage, possible treatments and prognoses. When he went on to clarify the fact that long-term blockages could lead to cancer, he gave the pair a wry smile. “I think I’ve already got the cancer part covered.”

Oliver signaled to Julia they should pull Dr. Carney’s sheets up a bit to make him more comfortable. As they did, he gently pressed, “I’m not going to teach you to suck eggs, Dr. Carney, but you know an infection from this can lead to a dangerous build-up of bilirubin. You hardly want to add sepsis to your symptoms.”

“No. That’s fair.” Dr. Carney patted Oliver’s hand. “But I wouldn’t have really put pancreatic cancer on my list of life ambitions, either. Come now, Oliver. Didn’t I teach you anything about bedside manner? Looking horrified is hardly in the best interest of the patient.”

“I have an idea that might appeal to you,” Julia interjected. “I just read about this in an article from a German medical study.” She knew she was taking a stab in the dark here but one thing she was sure of—Dr. Carney would refuse any sort of invasive treatment. “Artichoke tablets or milk thistle can help stimulate bile flow, which could decrease the blockage.” She continued quickly as Oliver made a move to interrupt. “The downside to the treatment is, if the blockage is really bad, the increase of flow could make the condition worse.”

“Which is precisely why a percutaneous biliary drainage is the best option,” Oliver countered.

Wow. So much for homeopathic remedies helping those in poor clinics
. Julia had to stop her jaw from dropping as Oliver continued.

“Dr. Carney, it’s hardly surgery. We just place a fine needle through your skin, after numbing it, then guide it to the correct location and inject some removal fluid. Easy-peasy.”

Julia had to turn away from Oliver.
What was wrong with him?
How could he offer procedures they didn’t have the equipment to perform? X-ray cameras, ultrasound machines, X-ray contrast dye... All easy to come by in the trauma ward of a state-funded hospital—not so much out here in St. Bryar’s humble country clinic. Apart from which, if the removal fluid didn’t work, inserting a balloon catheter would be the follow-on option—precisely the type of invasive procedure they didn’t have the wherewithal to perform. And exactly the type of procedure Dr. Carney would refuse. The patient had to come first. Biting her tongue was no longer an option.

“A PBD could lead to a bile leak causing peritonitis. I doubt we want to risk an abdominal infection.”

“An antibiotic drip is the easy solution to that,” Oliver parried.

Julia felt her sympathy flick into frustration.

“I think you’ve both given me plenty to think about.” Dr. Carney waved his hands weakly at the pair of them. “It’s not as if I haven’t done my own research. One of the lads down the village loaned me his tablet thingy and I feel quite
au fait
with what my choices are.” He made a shooing gesture. “Give me a few moments to think and I’ll press this nice buzzer Julia’s rigged up here when I’ve made my decision.”

Barely containing her anger at Oliver, and embarrassed that Dr. Carney had been caught in the middle of a pair of bickering doctors, Julia strode to the clinic’s back door, desperate for a calming breath, or a hundred, of spring air.

“What was that all about?” Oliver pressed, following her into the garden.

“I could ask you the same thing!” Julia whirled around, not caring that her cheeks were flaming with emotion.

“I’m trying to do best by the patient.”

“And I’m trying to do best by the patient’s
wishes
!”

“By offering him artichoke tablets? Are you kidding me?” Oliver’s eyes widened to the point she doubted his eyebrows could’ve gone much higher.

Slow breath, Julia. He’s upset. No one likes to see a loved one dying.

“I’m in a tricky place here, Oliver. Of course I want to do everything I can to prolong Dr. Carney’s life, but he’s fully aware we don’t have most of the equipment required for these treatments. On top of which, the future owner doesn’t really know where he stands as regards the clinic, so I hardly think putting in an order for an X-ray camera is going to meet with any success.”

Oliver scanned the garden as if it would give him answers. A shocked expression played across his features. Had she been too direct?

“You could’ve asked me for the equipment.” His eyes settled on hers.

“Really? While you were out there in South Sudan, saving the masses, you would’ve been sympathetic to the cause of one?”

No answer. Just one pair of angry green eyes and a very set jaw.

“If I’d told you it was for Dr. Carney I don’t doubt for a moment you would’ve helped, that we would’ve been able to buy the equipment in. You obviously love him and want the best for him. But if I’d kept the patient anonymous I’m not so sure you would’ve pushed as hard for treatment, Oliver.”

“How coldhearted do you think I am? ‘Hippocratic Oath’ mean anything to you, Dr. MacKenzie?”

Julia had to stop herself from feeling the effects of verbal whiplash. She’d struck a nerve. A deep one.

“I don’t think you’re coldhearted at all. But I think you’re confused about what you want in this particular case.”

“I’m a surgeon. I fix things. This is an easy procedure and I am trying to do what is best for the patient.”

“Against his wishes?”

It was all Oliver could do not to physically vent his frustration—kick a fence, punch a wall. Something to relieve the pressure. Everything Julia said was hitting home. Up until now he’d avoided situations like this by simply not being around. So much easier not to get involved if you couldn’t see it happening in front of you.

“This place is a shambles.”

“I’m sorry?” Julia looked as if he’d slapped her and he hated himself for it. He was heading for a dark place. The one he’d been hoping to rid himself of forever by putting the past behind him. He pulled a hand through his hair, willing the gesture to give him some clarity. Hurting Julia wasn’t part of the plan. Hell,
Julia
wasn’t part of the plan, yet here she was, well and truly under his skin.

“You’ve got to understand, this place has been a noose around my neck from the moment my brother died. He is dead because I didn’t tell anyone about his rash and by the time I did this so-called hospital lacked the resources to help.” He couldn’t believe he was saying these things. They’d always been his silent torture. But for the first time he needed someone to understand.
No. Quit avoiding the truth.
He needed
her
to understand.