Sail Upon the Land (28 page)

She looked into adoption and fostering and applied to go through the process of being examined by social services for her suitability. A lot of information arrived, but she soon found that she was beyond unlikely to get an actual baby to replace that little bud of a face topped by a tuft of dark hair. She should be able to get one back as she had put one in. It was only fair. Then she laughed at her craziness and completed the process, but without any intention of accepting an actual child.

She told herself that she was much better off without a baby. She was free to take off by herself on adventure holidays and swimming treks across the Hellespont without any worries about what to do with an inconvenient child.

She could be selfish while helping her patients. A perfect combination. And yet, in the hushed dark just before dawn, she knew she told herself lies. As she lay in bed too restless after a late call-out to sleep, she would think of the just-delivered women, saggy and soft, leaky and exhausted though they were, as they gazed delightedly at their new-borns. And she would hear her voice rise to a baby-friendly squeak and her own face would fall into a besotted crumple.

Thank God for the internet, at least she had the illusion of friends in the online medical community, where everyone forgave and offered support and love anonymously. Where you could grumble about or mourn your patients, or share triumphs and failures. For a shy, lonely, reticent Englishwoman, it took a bit of getting used to, but she persisted.

Now she had close friends among women physicians all over the world, who were thousands of miles away and whose faces she had never seen. There was no danger of meeting and it was all anonymous. Some even shared similar experiences of date rape and having a child adopted, of mothers dying young and difficult stepmothers. It was a relief not to be unique. All shared the simultaneously humdrum and dramatic daily life of a doctor.

With the online community’s support, she now knew without any doubt at all that she had been raped, and that it was not ‘her fault’. She also knew that women could love their babies, however they were conceived.

It was a comfort and an outlet for her. As time went on the online community soothed her and allowed her to heal and to forgive everyone concerned. Even Margaret.

Damson jolted her bike into the rack behind the surgery and locked it. Pulling off the cycling helmet that channelled rain so efficiently on to her scalp, she pushed open the glass door of the Sixties low-rise housing the Hillside practice. Patients stared down at a carpet stained beyond steam-cleaning by years of their predecessors ignoring the notice not to eat in the waiting room. She didn’t look at them, but hurried through to her consulting room, waving at Tina on reception as she went.

‘Can I have five, Tina?’ indicating her sopping hair and hoping to dash through into the loo to dry herself under the hand blower.

‘First patient here for you, Dr Hayes.’ Tina’s monotone could penetrate anything.

‘OK, right there.’ She knew her bright tone didn’t deceive Tina. Were all doctors slightly scared of their receptionists?

Knowing full well that damp did not give you pneumonia, she took off her yellow cycling cape and hung it on the back of the door. Her sludge-coloured men’s corduroy trousers were soaking. She ignored the squelch as she sat down on the plastic chair, and turned on the computer. Her appointments flashed up in front of her, and she blinked. A new patient, inherited from the recently retired Dr Bentley.

A faint knock, and Damson called, ‘Come in’.

The door opened and a very stout woman sidled in. Probably younger than she looked. As her bodily profile was about the same width as most people’s facing forwards, this required the door to be fully opened. Damson let herself for a moment rest in peaceful contemplation of her patient’s sweet smile and pleasing, round and fuzzy face.

Then she snapped back to professional mode, and opened the patient record for Ada Lindley. BMI 34.5, well into the obesity range, poor duck. She swung her chair around to face her patient, and leaned forward resting her hands on her knees, prepared to give Ada the attention she needed if she was ever to stop comfort eating.

‘Good morning, Miss Lindley. Now Dr Bentley has retired, I’ll be looking after you. Is that OK?’

‘Yes, Doctor. Thank you. I’ve just come for my tablets.’

Damson could see from the screen that Dr Bentley had some time ago prescribed antidepressants and some mild appetite suppressants, but these had long since been replaced with the next best thing to placebos. Not particularly ethical, she knew, but widely practised.

‘I have something much better for you than tablets, Miss Lindley.’

Ada looked crestfallen. So Damson hastily added, ‘Something new and exciting that’s much more effective and specially designed just for you. Now, your test results show you’re at risk of a metabolic disorder, and that means I can help you in a different way.’

‘Dr Bentley gave me tablets for my glands.’

‘Did they work?’

‘I think so. I’m not sure.’

Damson could see that Ada had been gradually gaining weight and that she was a perfect candidate for the new scheme. She took her blood pressure to check that it was still high. She fitted all the criteria, and at last the NHS had approved something properly preventative that might just work.

‘Perhaps if you gave me different ones?’ Ada added.

‘I think your tablets may have stopped working. So I have something else to prescribe for you. You’ll need to commit to a programme that’s run in the church hall every week. It’s called Fast Friends, and it’s all about helping you speed up your metabolism and get your glands really working hard.’

Did that sound patronising? Damson wanted to kick herself when things like that fell out of her mouth. Ada was unperturbed.

‘OK, what do I have to do?’

‘Well, you turn up and there will be a whole group of you with the same metabolic issues. You can gain points and win prizes every week. It sounds like great fun. There’s a health coach there, and she’ll explain the programme. You’ll need to eat special foods to help your glands, but it isn’t expensive and there’s some easy exercise to do as well. And the meetings are completely free. You’ll all be working together to make you healthier. And it’s a way to make new friends as well. There’s a website and you can chat to the others online between sessions,’ Damson finished with a smile.

‘OK,’ Ada replied uncertainly, taking the printout from Damson’s hand and clutching it with both of hers.

‘I’ll be there myself, I could do with some advice about healthier living as well.’ Damson knew her diet was appalling. Her body was slim and fit from cycling up hill and down dale, but she never cooked, just ate the nearest thing, standing up. That’s what being alone did to you. Why bother to cook for one? Ada perked up at the idea of a slim doctor also needing the same kind of help. Damson knew from her own bitter experience what it was like to be told you were fat. She remembered a plain dull man during her first of two Freshers’ Weeks at Cambridge who’d told her she would be quite pretty if only she were thin. She’d been pregnant at the time but hadn’t yet realised.

Damson could easily understand that Ada couldn’t bear to be told she was too fat, it just sent her home defeated to the fridge and the biscuit tin. And her colossal mother.

‘The health coach comes to your house as well,’ Damson added. ‘To teach you about food and help you get your cupboards and fridge ready for the new way of eating.’

‘What will Mum say? She doesn’t like strangers indoors.’

Damson resolved to call on Mrs Lindley and get her on board as well. She had called on her before and found her sitting, monumental and unmoving, as she did day and night, in an armchair in the front room. That was when she wasn’t in hospital having gangrenous toes removed and her ulcers treated. She had full-blown diabetes, and was managed by the specialist nurse.

‘Haven’t been upstairs since my Ada was born,’ she would say proudly. Her small and sad postman husband had retired at sixty-five, dwindling away and dying shortly afterwards. Being stuck indoors with his wife, at her beck and call all day long, had been too much for his heart, according to the retired Dr Bentley, who had old-fashioned views about what was what.

Ada heaved herself on to her spread feet clutching her prescription.

‘Thank you, Doctor. Mum’s in all the time, you can call when you want.’

The intercom squeaked, and Tina said: ‘Next patient has signed in as a visitor. Leeta Delapi.’

She pressed the buzzer on her desk. Seconds later, there was a knock on her door.

‘Come in.’

Fumbling for her glasses and peering at her computer screen, she tried to gauge her day’s workload as her patient sat down in the chair beside her desk and sighed. She glanced round and saw a slim Indian girl, clearly pregnant. Unusually coloured eyes looked at her from a pale rather blotchy face. The girl’s nose had an elegant curve, her mouth was small and well-shaped and she had a neat, determined chin from which had erupted a large angry spot.

‘Hello. What can I do to help?’ Damson looked back at her computer screen.

The girl looked down at her Ugg boots. Her slender legs were clad in skinny jeans. On top she wore a large soft grey jumper that failed to conceal a neat bump.

‘I filled in a form to be a visitor,’ the girl began. Her accent was much more private London girls’ school than Mumbai or Derbyshire. She seemed to be having trouble meeting Damson’s eye, although she looked confident and held herself well. Her head tilted forward on a long, delicate neck, glossy dark brown hair falling across her face. Her fingers came up to fidget with the spot.

‘Date of birth? I have your name.’ Damson had opened the relevant page on her computer, and started to fill in the form.

‘The twenty-fifth of April 1988.’

‘Occupation?’

‘Medical student.’

Damson’s eyebrows rose involuntarily. ‘What stage are you at?’

‘I’m pre-registration, but I’ve deferred the hospital internship because of this.’ She gestured at her belly.

‘Up here on holiday?’

‘Not exactly.’ She hesitated, opened her mouth to say something else and then stopped.

Damson paused to give her space, but then carried on as nothing seemed to be forthcoming.

‘OK, what can I do for you?’

‘As you can probably see, there’s this.’ She gestured at her belly with her long slender fingers. The nails were particularly beautiful, almond shaped, curved over and around the top of the finger with only a tiny edge of ivory but they weren’t very clean. Damson was aware of her own red and bitten fingertips. There was no wedding ring, but Indian brides didn’t always wear them, did they?

‘Where do you usually go for antenatal care?’

‘I haven’t had any. This is the first time I’ve been to a doctor for this.’ She nodded down at her tummy, unsmiling.

This was obviously a nicely brought-up Indian girl and a medical student. In trouble, as they used to say?

‘I see. Where do you usually live?’

‘In London.’ There was a touch of defiance, as the girl tossed her long hair over her shoulders and looked Damson in the eye. ‘But I don’t live there at the moment. I don’t live anywhere right now.’

Damson wanted to ask what she was doing so far from home, and what she meant, but it seemed intrusive. She wondered about mental health issues but continued with all the usual questions.

‘Date of the first day of your last period?’

‘I don’t remember.’

‘OK, approximately.’

‘I don’t remember, but I only had sex once. On Valentine’s day.’

‘Well that narrows it down, doesn’t it? We should be able to do a calculation. And I’ll be able to tell more by examining you.’

Damson was very used to her patients lying to her – particularly about sex, drugs and alcohol – but she wasn’t used to calculating due dates these days. All the young mums went online, working out exactly when the baby was due at the first secret hint of a suspicion. She sighed at the extremely detailed knowledge they had at their fingertips. Pre-internet it had been easier to allay their fears. Now most mothers could probably breeze through midwifery exams. Those that didn’t find their way into the more extreme US forums for free-birthing and other dangerous nonsense.

Damson got her tape measure out of the drawer in her desk.

‘We’d better have a quick look. Can you hop up on the table? Do you want a nurse to attend?’

The girl looked at her from almost lilac eyes. They had a darker ring around the iris.

‘No, I don’t need a nurse. You are a woman after all.’ There was something chilly and defensive in her tone, which Damson put down to embarrassment at her condition.

The girl hoisted herself on to the examining table and lay down, lifting her jumper and the T-shirt underneath. She was thin, and the bump stood out, round and proud, seamed with a brown stripe up the centre. Something did not compute. Even her clothes, very low-cut Seven for All Mankind jeans that conveniently fitted under the bump with a button undone. Damson’s fingers detected cashmere as she moved the jumper out of the way. Noonie-type clothes. Hardly what a medical student usually wore either.

She stretched the tape measure over the bump, which looked as if there was a beach ball stitched in under the creamy skin.

‘OK, about thirty-seven weeks. We’d better work it out on the computer. As you probably know, the centimetre measurement from the pubic bone to the top of the fundus is the same as the number of weeks. Converted me to metric.’

‘I do know,’ said Leeta. ‘I just didn’t want to do it myself. I was trying to ignore it I suppose.’

Damson hesitated. Then she said: ‘Would you like to hear the baby’s heartbeat?’ She took out her foetal Doppler.

‘No.’

Damson herself did, so she pressed the monitor gently against the bump and the sound of a healthy heartbeat of 130 bpm filled the consulting room. Damson saw the girl’s hand come up as if to push the instrument off her belly, but then drop back.