‘Ivan will be up later. Perhaps he can move it,’ Hilary said, obligingly. To spite Yvonne, she was being Joyce’s best friend. ‘I’d love to help myself, but I daren’t. Ivan won’t let me lift a thing. I’m pregnant, you see.’
‘Oh,
congratulations
,’ said Sara. The two patients murmured their approval.
Hilary preened. ‘Ivan won’t hardly let me do
anything
actually, he’s spoiling me rotten. Cups of tea, day and night, you name it.’
‘My sister couldn’t look at tea when she was carrying,’ the Welshman said. ‘Couldn’t touch it, and she used to get through fifty teabags a week.’
‘Oh, it’s not ordinary tea, it’s herbal. Ivan mixes it himself, it’s got all the things you should have when you’re pregnant. Tastes quite nice.’
‘Er, may we discuss the piano?’ Yvonne ventured, with insincere sweetness. She had overheard enough simpering accounts of Ivan’s devotion to feel she need not acknowledge another. ‘It belongs in the dining room. It’s a baby grand.’
‘But nobody plays it. Anyway,’ Hilary said, turning to Sara but still, disconcertingly, talking to Yvonne, ‘Miss Selkirk isn’t here to listen to our arrangements, is she?’ This was true. Sara had been seen into the house by Hilary and, walking ahead, had followed the sound of Joyce’s voice through the open door. It was the sight of Joyce, watched by two patients, standing sourly with her hands on her hips over the instruments on the floor that had made Sara fear that she was about to become unbearably grand about the whole thing, and that had started her babbling about fun and recorders.
‘It’ll need tuning, I suppose,’ Joyce was saying now. She looked sternly at them all.
‘You’re here to see Dr Golightly, aren’t you?’ Hilary said, this time actually to Sara. ‘He was telling me. I expect he’ll get you to sign a CD! I’ll take you along.’
Sara smiled and turned to follow her. Just before she closed the door she heard the Welshman asking, ‘Sign a CD? She famous, is she?’ and Joyce replying. ‘Och, no. She’s just a wee lassie.’
* * *
S
TEPHEN
G
OLIGHTLY’S
concerns seemed to be worrying him rather beautifully. He rose to meet Sara and showed her to a chair in his consulting room, and Sara noticed again that he and Andrew had the same sort of strong, long-legged, broad-shouldered body. The sort she could barely take her eyes off, she was now finding. Her two meetings with Stephen Golightly had been brief, and last time most of her energies had been concentrated on getting him to agree to try Joyce out as music therapist. It seemed like a careless oversight not to have noticed then how attractive he was, and it felt like an irrelevance now that he was at least twenty years older than she was.
As she sat down, he remained standing. She observed that where he and Andrew differed most was in the face. Andrew’s deep brown eyes could chill or burn at twenty paces, but at times, like now, when he was in one of his patches of miserable inarticulacy over some difficult case or an emotional question concerning his children or both (or, Sara thought guiltily, the problem of where he and Sara wanted to live) his eyes became unreadable, seeming to absorb all available light and defy interpretation. Stephen Golightly’s blue eyes were gentler. They invited if not instant trust (because she was not, either on principle or by inclination, as gullible as that) then at least the assurance that one could look for longer and further into them
without too much danger, risking at most a pleasurable loss of peace of mind. So she did.
‘I’m going to show you something,’ he said. He turned to unlock his filing cabinet, allowing Sara to confirm to herself that his rear view was every bit as rewarding as the front. He returned to the armchair opposite hers with two files. ‘I do have James’s blessing to do this, of course.’ He took his seat and opened one of the folders. ‘It’s rather more serious than we thought. He wants you to be completely in the picture, since Tom is away and can’t be here.’
Sara instantly dropped her recreational appreciation of Stephen Golightly’s bottom. Her mind seemed suddenly, true to all the clichés, to be simultaneously numb and racing ahead to hear the worst news she would ever hear in her life. She wondered if she was going to choke, or faint, and thought she could feel the colour leaving her face. Dr Golightly, without smiling, leaned towards her. ‘I’m sorry I have to give you bad news,’ he said. ‘It’s a shock. Try to breathe deeply, and you’ll be all right in a few minutes. Lean back and breathe as deeply as you can.’
Sara obeyed, and in the silence he rose noiselessly, poured a glass of water from a carafe on his desk and returned. Sara took the glass and sipped. It seemed that Dr Golightly had, in the few seconds that her eyes had been closed, filled the room with quiet reassurance. After a moment he removed a piece of paper from the bottom of the pile in the folder. It had
Avon & District-Health Authority Screening Services
in turquoise at the top.
‘It’s not IBS after all. It’s ulcers. I’ve had James’s test results back and it’s conclusively not IBS, which we were all hoping it was, since it’s easily treatable, although distressing,
of course. But I’m afraid there’s quite severe ulceration of the duodenum.’
Sara’s numbness began to give way to gratitude, perverse though she knew it to be, as if Dr Golightly himself had somehow personally intervened to prevent James’s diagnosis from being cancer. She looked up at him and was absurdly comforted by the look in his eyes. Her own had filled with tears of relief.
‘Oh. Oh, thank God. You’re sure—it’s an ulcer? Not—not, I mean, it’s not worse, is it? It’s just an ulcer? I mean, that’s bad, I know, but you’re sure that’s what it is? Because he’s going to be all right, isn’t he? I mean—’
Dr Golightly said, ‘Would you like me to explain?’
Sara closed her mouth and nodded. The eyes were telling her that everything was going to be just fine, so it was unthinkable that the mouth could be about to spout words which would contradict them.
‘The duodenum is ulcerated, that’s just where the stomach contents empty into the small intestine. James’s stomach is producing too much acid which, added to his mucus production being somewhat compromised and probably abnormally high levels of
Helicobacter pylori
, added to psychological and emotional factors, is the cause of the problem.’ Dr Golightly paused to make sure that Sara was following him. ‘If conventionally treated, he would be stuffed with painkillers, antibiotics and antacids, plus pills to reduce acid secretion, plus pills to help coat the surface of the ulcers, and probably tranquillizers as well. And do you know what would happen then?’
‘Um … he’d get better?’
‘No! No. That’s the point! Well, of course he’d get better in one sense. His symptoms would be alleviated. But
the body would have been bombarded with chemical treatments to deal with the symptoms, while the underlying cause of the illness would not have been addressed. That would go unchecked. Do you see? But
that’s
what we’ll help him do here. Understand the reasons he got ill, and help him rebalance mentally and physically—spiritually, too, in a sense—so that he gets better
naturally
. And stays better.’
‘So you mean he’s agreed to this?’
‘He has, yes. I’ve explained to him what we can do here, and what we can’t. He doesn’t smoke so that’s a bonus, he’s got to chuck the aspirin and the alcohol, also meat, salt and dairy foods. He understands all that. Then we have to work on mind and body awareness. Staying here and working on posture, breathing, nutrition, massage and relaxation is his best chance of avoiding deterioration, and surgery. And peritonitis, of course.’
‘Peritonitis, of
course?
What do you mean?’
Dr Golightly’s face grew grave. ‘Sometimes, if an ulcer persists, it perforates. When that happens, the contents of the bowel can escape into the peritoneal cavity, causing peritonitis. Very serious. Sometimes fatal. Thankfully rare, though. With proper management, there’s no reason not to expect that that can be avoided.’
He picked up one of the folders from the table and returned it to the filing cabinet. Sara rather mechanically drained the water in her glass and Stephen, noticing how shocked she still looked, returned to the chair carrying the carafe.
More gently he said, ‘I am sorry to be landing you with this. James isn’t feeling too well today, not surprisingly, and asked me to tell you myself how things stand.’
Sara nodded. ‘Thank you. Now I must go. Can I see him?’
Dr Golightly filled her glass again. ‘I really do think better not, just for today,’ he said. ‘He’s very weary, and he’s just making a gentle start on his treatments. He still has quite a lot to go through. Treatment can be quite demanding on a patient, that’s why we advocate lots of rest. We wouldn’t want to exhaust him, would we? And there’s Joyce,’ he added rather quickly, ‘who I hoped to have a word with you about, too.’
Here it comes, Sara thought. In the interests of other users, please take your rubbish home. Do not leave your baggage unattended. Get her out of here. Bus station, here we come. But Stephen was opening the folder still on the table. ‘She’s had a full medical questionnaire and examination, of course,’ he said, ‘and she’s put you down as next of kin.’
‘But I’m not! We’re not related at all,’ Sara exclaimed.
Dr Golightly looked at her intently. ‘Nevertheless, you are the person she wishes to have contacted in the event of any medical or other emergency. Wouldn’t you wish to be contacted if anything serious should develop? Are you saying you’re not willing to stand in that capacity, should there be any sort of crisis?’
A vision of an irate, thin-lipped ghost in a pink wool suit and a whining Pretzel scratching at the soil over an unmarked grave rose in Sara’s mind. ‘No, no, I’m not saying that,’ she said, defeated. ‘Of course I would want to be contacted. So, when do you want me to collect her things?’
‘Collect her things? Oh, I do assure you, it’s not as bad
as all that. Nothing we can’t address, certainly. Of course I
am
only a doctor.’ His lips were twitching.
He’s practically laughing at me, Sara thought, and set her mind firmly against blushing. Or smiling back.
‘No need to look so solemn,’ Stephen went on, consulting the notes. ‘Her nutritional status is poor. There’s generally poor organ condition. Some spontaneous bruising, fortunately mild, but probably due to poor diet, mainly vitamin C deficiency.’ He pulled an X-ray from an envelope in Joyce’s folder and held it up for Sara to look at. ‘Just got these back. Look here, do you see?’ He tapped the larger and darker of two patches. ‘The main problem is underlying kidney stress. If she continues to abuse alcohol, it’ll be the liver next and she won’t be long for this world.’
‘Why,’ Sara suddenly asked, ‘are you telling me all this? About James, and now Joyce? I don’t see what I can do.’
Dr Golightly replaced the X-ray in its envelope, raised his eyes and looked at her for a time without speaking. In his faintly surprised expression Sara saw not only that she had been judged, but that she had disappointed.
‘Forgive me, of course you needn’t involve yourself at all.’
‘It’s just that I’m very busy. I’ve got to go to Salzburg very soon, and I’ve got things I have to see to—at home, you see. Things.’ She tailed off hopelessly. How could the current unresolved mess with Dvořák, the problem of Andrew (was that what he now was?) be explained to this stranger, except by some such inadequate phrase? She looked at him with defiance. Let Dvořák and Andrew be reduced to things to see to at home, then. It was still true.
Dr Golightly said gently, ‘Joyce is possibly on the cusp, as it were. The body is a wonderful thing.’ With you there,
Sara thought. ‘Even after such neglect, the body will regenerate to a remarkable degree if it gets the right fuel. Everything here is home-made and organic, you know. If we can’t source it easily we grow it ourselves, even some of our own cereals. Joyce could expect several more good years if she starts to look after herself now. Conversely, her body won’t take much more if she doesn’t.’
Sara bit her lip. ‘But someone I know, who’s seen a lot of this, says nobody can help an alcoholic who doesn’t want help.’ Andrew’s point of view sounded like heresy in this humane, optimistic atmosphere and Sara knew she did not believe it, anyway.
‘I haven’t seen any evidence yet that she doesn’t want it. And I was assuming that you would wish to help. The regime here is not always an easy one, and a supportive, loving friend can make all the difference.’ He smiled. ‘I’m only the doctor, I can only advise. The real healing is done by the patient, and patients who are supported by love do best of all. In that sense, you and I would be partners in helping Joyce and James heal themselves.’
Sara felt every bit as guilty as this was designed to make her feel. ‘Of course I want to help them. I just don’t see how I can. Much, I mean.’
‘Oh, a little support goes a long way. Just be here, talk to them, encourage them? Help them feel they’re getting better. Could you do that, Sara?’
He got up to replace the folders in the filing cabinet and Sara, watching him move across the room, supposed that Dvořák and Andrew notwithstanding, perhaps she could.
J
AMES SAW
S
ARA
go, aching inwardly because he had agreed to not having visitors today. Looking up from his lump of clay he gazed out through the window of the art studio across to the fountain and watched her stroll with Dr Golightly around it. Both heads, inclined downwards in apparent contemplation of the formal planting that surrounded it, were being raised from time to time, perhaps to respond to whatever the other might be saying but more likely simply to look at the other, a thing that each of them seemed to find pleasurable, judging by the amount of smiling that was going on. They were walking much more slowly than was necessary and by the most indirect route to the car park. James watched their polite orbit of each other, observing how mutual attraction sometimes made people quite delectably uncomfortable. Stephen Golightly and Sara were behaving like a man and woman who had already undressed each other, at least mentally, but were painfully conscious of having been too recently introduced to have done so with any propriety.