Vets in Love (2 page)

‘I feel like I’m an extra on
Casualty
and you’re about to start spouting medical terms at me.’ He can hardly force a smile any more. ‘It’s all mumble jumble to me.’

‘Don’t you mean mumbo-jumbo, Steve?’ Claire says, giving me a look of concern. ‘I’m going to get Janet at reception to call your wife,’ she goes on. ‘I think you
should have someone with you.’ Without waiting for his response she goes outside.

At the same time, Steve gasps and clutches his throat, his lips turning blue. I glance at the trace of the electrical activity of his heart – it’s all over the place.

‘On a scale of one to ten, where is the pain now?’ I ask calmly, although my heartbeat is all over the place too. This isn’t looking good.

‘Oh, about a five, no, make that a …’ He can’t speak, let alone decide on a number, confirming my suspicions from the evidence so far that he’s in the grip of a major heart attack. He’s trying to be brave, but I can sense his growing panic, and panicking will only make his condition worse.

Although I’m afraid that he’s about to go into cardiac arrest, I concentrate on keeping him as calm as possible, distracting him while we wait for his family and the ambulance, which is probably trying to make its way through the holiday traffic that jams the lanes into Talyton St George on hot summer days like today.

‘I don’t think I’ve met a panto dame before,’ I say, keeping my hand on his, partly to reassure myself that he does indeed still have a pulse, and partly to reassure him. He’s breathing more steadily now and his colour is returning.

‘I love it,’ he says. ‘I don’t act professionally any more, but I still tread the boards for the Am Dram group’s annual Christmas show. My wife is used to me borrowing her lippy and blusher, but my daughter hasn’t always appreciated me dressing up in women’s
clothing.’ His grin quickly turns into a grimace of pain. His breathing quickens again and to my relief I hear the sound of a siren.

‘The ambulance is here, Steve. I’m going to call ahead to let the right people know you’re on your way.’ He doesn’t argue with me – he’s exhausted and in too much pain. Within a short time, he’s on the way to hospital with his wife, and all I can do now is hand over to the consultant in A&E and hope that he makes it.

The next few patients sympathise when I explain that I’m running late because of an emergency, and two of them can tell me exactly what it was because they’ve already heard about Steve’s condition on the grapevine, but my last patient of the morning is not so forgiving.

‘Mr Warren,’ I say, calling him through from the waiting room where he’s sitting beside a striking young woman in her mid-twenties, with long, dark, glossy hair, full lips, brown eyes and lashings of mascara. I recognise her as one of my patients, a vet who came to see me with a horse-inflicted injury not very long ago, a needle-stick wound that became infected and required a course of antibiotics. She’s wearing a crisp white blouse and jeans that emphasise her curvaceous figure, the kind that makes other women jealous.

‘Do you want me to come in with you?’ she says, touching the man’s arm as he stands up.

‘No, Mel. I appreciate you giving me a lift, but I can walk and talk for myself, thank you very much.’ He
pauses before going on more gently, ‘Why don’t you book that appointment?’

‘I haven’t got my diary with me,’ she says. ‘Go on, Matt. Now you’re the one keeping everyone waiting.’

I watch my patient walk along the corridor towards me. He’s a man of about my age and of average height dressed in soft moleskin trousers, a check shirt and light sweater. He has one hand clenched around a set of keys and the other around his mobile, and he moves with a slight stoop, his right shoulder dropped and carried forward of the left – okay, I’m a doctor, I notice these things.

‘What time do you call this?’ he says curtly as I step back to let him pass. ‘My appointment was over an hour ago. I’m a busy man.’

‘I’m sorry for the delay, Mr Warren. You could have rearranged, instead of waiting,’ I say, finding it hard to apologise to someone who appears to lack both patience and common sense, and perhaps compassion too, or any powers of observation. Didn’t he notice the ambulance? I suppress a sigh of annoyance at his attitude, especially when he appears quite healthy. This is one of the occasions when I’d very definitely prefer to be up at the stables, kicking about in my jodhs and polo shirt. I glance down at my work attire – an embroidered white vest with a lacy cotton cardigan over the top, a straight skirt and turquoise heels – I like to think I’m quite a glamorous lady doctor, and tall at almost five foot eight.

‘How can I rebook when I don’t have a spare
moment?’ he goes on. ‘Unless you’d consider opening up the surgery late one evening, say ten-thirty?’

I assume he’s being flippant.

‘Take a seat,’ I say, returning to mine and checking the notes on the monitor.

Matt Warren, thirty-two years old – that’s one great advantage of being a GP, having all the basics on record – blood type O, height 177cm which is – I make a quick calculation – five foot ten inches, and weight eleven stone six. As for the rest, he’s rather … well … I appraise his figure and his face in an enquiring medical way, assessing him for signs of health, and I would have to declare, if pressed, that he is extremely fit, in more ways than one, being ruggedly handsome and lightly tanned, with short brown hair, hazel eyes and a determinedly square jawline.

It’s a pity he’s so prickly and off with me. I don’t take it personally though.

As he catches me staring at him and I catch him staring at me, his irritation seems to disappear. His mouth curves into a smile and dimples form in his cheeks, at which I’m completely disarmed and almost forget he’s one of my patients.

‘It’s a long time since I was sick,’ he says ruefully, something I can understand – I never have time to be ill. ‘I guess these things happen though. I’m a vet and I should know. I was operating on a horse until three this morning.’ He yawns as if to emphasise the point before looking up at the photos on the wall. ‘Is that you on the horse?’

‘It is. I do a bit of eventing.’

‘Professionally?’

‘I’m a keen amateur.’

‘Oh, I have lots of clients like you,’ he says somewhat dismissively. ‘Where do you keep the beast?’

‘I keep Willow—’ I resent him describing my baby as a beast ‘—at Delphi Letherington’s yard.’

‘I know it. My partner attends the equestrian centre. I spend most of my time at the hospital, Westleigh Equine. I’m more into sports medicine and surgery than the routine GP kind of stuff.’

I’m a little offended, but he doesn’t seem to realise it.

‘So what’s the problem, Mr Warren?’ I say rather sharply.

‘Ah, I’m sorry. I didn’t mean to—’

‘It’s all right. Let’s get on. You obviously have far more important places to be.’

‘It’s my shoulder,’ he says, tapping his right elbow.

‘Can you be more precise?’ I ask, wondering about his knowledge of human anatomy.

‘Of course I can.’ He gazes at me and starts giving me his opinion of what’s wrong. ‘I injured my shoulder in my early twenties, playing rugby, and since then it plays me up now and again.’

‘Is it very painful?’

‘It’s agony, particularly when I’m doing dentals,’ he says, flinching at the mere thought. Wuss, I think as he continues, ‘At the moment, I can hardly lift my arm, which is bloody inconvenient. That’s why Mel, our houseman, offered me a lift.’

‘Are you right- or left-handed?’

‘Right,’ he says regretfully. ‘Anyway, I’d like you to
confirm that it’s a rotator cuff impingement and refer me to a decent orthopaedic surgeon asap.’

‘It seems you don’t need me. Have you got private medical insurance?’

‘I haven’t. There was an oversight.’ He pauses and I find myself waiting to see who he’s going to blame for it, but he goes on, ‘To be honest, I was so busy I forgot to put the forms in.’

I’m relieved to hear that he isn’t so perfect after all.

‘Let me examine you and then we’ll decide what to do.’

‘Do you want me here or on the couch?’

‘On the couch.’ I smile to myself. I’m going to enjoy causing him some pain. I wash my hands and dry them on a paper towel while he settles on the couch. ‘You’ll have to take your shirt off.’ My mouth runs dry and the words seem to stick on my tongue and my teeth. I sense that he’s testing me.

I keep my eyes averted as he removes his shirt and hangs it over the trolley beside the couch.

‘I’m ready now, Doctor,’ he says, his voice bubbling with humour.

‘I’d prefer it if you called me Nicci.’ I move towards him, forcing myself to look at his torso, at the tan lines on his neck and upper arms, at the slab-like muscles of his pectorals, and the smattering of dark curly hairs across his chest that spill down towards his navel, which indents an admirably flat belly. I realise that although I see many bodies, embarrassing and otherwise, both male and female, it’s been a very long time since I saw the body of a fit man.

‘And you must call me Matt. None of this “Mr Warren” nonsense. I hope you haven’t got cold hands,’ he says as I reach out to touch him.

‘You’re lucky it’s a warm day.’ I palpate his shoulders and the surrounding areas, applying light and deep pressure, checking for symmetry in the swell and dips of the musculature. He has just the right amount of muscle, not so much that you would think he spent all his time working out, but more than enough to be manly. I check the shoulder joints, feeling for warmth and tenderness, but he’s guarded and tense.

‘Hey, you can relax,’ I say gently, trying to put him at ease.

‘I can’t. I’m not used to being the patient.’

‘I expect your patients are more co-operative than you are,’ I say with irony.

‘More?’ I notice how his brow furrows briefly before he breaks into a heart-stopping slow smile. If I were attached to the ECG right now, it would have gone haywire, which is ridiculous because I never allow myself to respond to my patients, but then Matt isn’t any old patient. He’s utterly gorgeous. ‘Okay, that was a joke, right. I hope you make a better doctor than a comedian.’

‘What made you go into horses?’ I ask him, changing the subject.

‘I thought about going into small animals, but I don’t like hamsters – or hamsters don’t like me, I’m not sure which way round it is. No, I find horses a challenge. They can be such delicate creatures. It’s very satisfying
when you get one coming round after injury, or after colic surgery. That’s my specialist subject – tummy ache in the horse. I’m running a series of evidence-based studies at the moment.’

‘I see.’ I don’t know what I was expecting – for him to say he loved horses, like I do? It’s clear he sees them as patients to bring back to health and as subjects to research.

Observing the pattern of moles on his skin, I ask him to place the palms of his hands at the base of his neck with his elbows pointing out to each side. I notice how he’s biting his lip as I inspect his upper body for muscle wasting or swelling, anything that will confirm his diagnosis or suggest an alternative.

‘I’m going to do a couple of tests to assess the state of your rotator cuff,’ I say. ‘The cuff is formed from four muscles—’

‘I know what it is,’ he cuts in. ‘You don’t have to explain.’

I decide that I don’t need to explain the tests either, both of which are positive, judging by his reactions.

‘Ouch!’ He winces each time. ‘Are you some kind of sadist?’

I ignore that comment.

‘Much as it pains me to admit it,’ I begin, ‘I can confirm your diagnosis.’

‘So you’ll refer me.’

‘My approach is to prescribe complete rest in a sling for a few days, followed by some physio. If that doesn’t work, we can try a shot of steroid.’

‘What if you’re missing something?’ he asks. ‘Not that I’m suggesting you don’t know what you’re talking about.’

‘I should hope not,’ I say, standing tall and straight. ‘If necessary, I’ll refer you for a scan or X-rays.’

‘What if I disagree?’

Undeterred, I flash him the flirtiest of smiles.

‘I’m sure you’ll let me twist your arm.’

‘No no—’ he holds his hands up, wincing again ‘— not that.’ He chuckles. ‘Anything but that, Nicci – what kind of doctor are you?’

‘Take some time off to rest that shoulder.’

‘That’s impossible. We’re always working at full stretch and this is the worst possible time for me to take time off. There’s only me and Mel to cover the hospital and all the visits. My partner is on leave.’

I don’t ask what kind of partner he’s referring to, although I admit I’m a little curious.

‘Can’t you arrange cover for a few days?’

‘You know how it is. Clients like to see the same vet each time, they like continuity.’ He tilts his head to one side. ‘And of course, when it comes to equine surgery, no one does it better than me.’ Having lured me into believing he’s arrogant and his ego is bloated with self-importance, like some of the consultants I met during my medical training, he breaks into another smile. ‘Not really. I just don’t like the idea of having to sit around doing nothing all day.’ He drums his fingers on the edge of the couch.

‘It’s up to you, but I’d strongly advise you to—’

‘Are you always this bossy?’

I ignore that remark. ‘I would at least avoid rasping teeth for the foreseeable future.’

‘Are you sure you won’t just refer me straight away?’

‘Quite sure. I don’t suppose you can help being a surgeon,’ I say. ‘They always think the only way to solve a problem is with a scalpel.’

‘You don’t like surgeons then? In general, I mean, not specifically,’ he says.

‘What kind of question is that?’ I ask, turning away from his intense stare. Is he trying to chat me up in a funny sort of way?

‘Are you finished with me?’ he asks.

‘Um, yes,’ I say, a warm flush creeping up my neck.

‘I’ll get dressed then.’

‘Please do,’ I say, before wishing I hadn’t said it with such emphasis. I shouldn’t care if he’s sitting there with his shirt off. I’ve seen it all before.

I start to type some notes as he pulls on his shirt, fastens the buttons and rolls up his sleeves.