The Country Doctor's Choice

Dr Shelagh Hammond looked at her watch: three-fifteen. Councillor Ben Maynard’s funeral was over, and the congregation was streaming out of St Matthew’s church and crossing the road to the church hall where a substantial buffet was laid out on long tables.

‘A good turnout,’ commented Paul Sykes at her side, ‘and quite a few from the hospital – look, there’s that mousey little Sister Oates from Outpatients. What’s
she
doing here?’

‘Iris Oates sings in the choir at St Matthew’s – and she’s here for the same reason as we are. Ben was chairman of the hospital’s League of Friends, and did a lot for us. I see Mr Fielding who operated on Ben is here.’

‘Too bad it was unsuccessful. So, are we going over to the bunfight, darling?’

‘I’m not, because I want to pop home and see Mother before going back to Maternity. But don’t let that stop you from going, Paul. Actually, I’d better say a word or two to Phyllis Maynard first. Coming?’

‘Righto, but I don’t know the lady. I’ll stand beside you looking suitably grave.’

Outside in the mellow October sunlight, Ben Maynard’s widow was pale but composed, unlike her younger daughter, Marion, who was weeping silently while her husband kept an eye on their little boy and girl; the elder daughter, Jennifer, stood beside her mother, her husband at a discreet distance. As Shelagh opened her mouth to offer sympathy, the organist came forward, kissed Phyllis and offered his condolences.

‘We’ll
all
miss him, Phyllis, he was a remarkable man. Everham won’t be the same without him. We’re all thinking and praying for you and – Mrs Gifford and Mrs – er—’ He nodded towards the daughters; he knew Jenny Gifford as a teacher at Everham Primary.

‘Thank you, Mr North, and for taking time off to play the organ for us,’ Phyllis responded with automatic politeness. ‘Will you have to go back to school now?’

‘No rush, I’ve left my deputy head in charge.’ He caught sight of Shelagh waiting to speak. ‘Good
afternoon, Dr Hammond – I’m sorry for barging in. Ah, I see his reverence Mr Bolt over there, and I need a word with him, so I’ll catch him now.’

He kissed Mrs Maynard again, and moved away.

‘I can only echo what Mr North has just said, Phyllis, and – and so does Dr Sykes,’ she said rather awkwardly, beckoning to Paul who came forward to shake the lady’s hand. She nodded in acknowledgement.

‘I remember seeing you at the hospital, doctor, when my Ben was in Male Surgical.’

‘Yes, I’m Mr Fielding’s registrar, Mrs Maynard.’

‘Thank you for coming this afternoon. I know you all did what you could for him.’

‘There must be many here who want to offer their condolences, Phyllis, so we’ll make room for them,’ said Shelagh, tactfully moving away.

‘Shall I see you at the weekend, darling?’ Paul asked in a low tone.

‘I’m not sure, Paul, I’m rather worried about Mother. I may need to stay with her over the weekend.’

‘Well, do try, because we’ll soon have to close the caravan – it’s getting chillier.’

‘I’ll let you know, Paul. I want to be with you just as much as ever, but – well, it depends. Bye for now.’ She held up her face for his brief kiss – which did not go unnoticed by some eyes in the crowd – and made her way to the car park.

Shelagh and her mother lived in a neat mid-terrace house on Alexandra Road in the older part of Everham. Shelagh had grown up there, leaving to go to London University, from where she had returned, a qualified doctor, and had not left again. At Everham Park Hospital, greatly enlarged since its foundation as a war memorial after the First World War, and now a teaching hospital for nurses and midwives, she had completed six months as a house officer on both the surgical and medical wards, and had by now completed six months as houseman on the obstetrics and gynaecology team, which she enjoyed.

‘Is that yeself, Shelagh?’

‘Hallo, Mother!’ She no longer used the name of Mum or Mummy. ‘I’m on call tonight, so thought I’d pop in to see you. Shall I put the kettle on? No, don’t get up, I’ll do it, and you sit down!’

‘Can ye not stay for half an hour, girl?’

‘’Fraid not. I went to Ben Maynard’s funeral this afternoon, and can’t take any more time off today.’ In fact Shelagh’s real reason for the quick visit was to check on her mother, who had been looking tired and pale lately.

Bridget Hammond crossed herself automatically at the mention of a funeral. She was an Irish immigrant who had come over to Liverpool before the war to train as a nurse, but having given birth to Shelagh, she had never gone back to her family in Donegal. Deserted by Jim Hammond, she
had remained a strict Roman Catholic, and had supported herself and her daughter by working as a hospital domestic during the war and later as an auxiliary nurse at Everham Park. Arthritis had forced her to give up work early, and now at fifty she looked older, and treated Shelagh as if she were a schoolgirl instead of a professional woman of twenty-six, refusing to take any medical advice from her, on the grounds that she was in charge of her own health, and when necessary consulted old Dr McGuinness, the semi-retired senior partner of four general practitioners, her only authority on medical matters. He prescribed iron tablets and painkillers, and Bridget said that she needed no other treatment. Shelagh had tried and failed to get her mother to see an orthopaedic surgeon.

‘So did they give Mr Maynard a good send-off, girl?’

‘Yes, St Matthew’s was packed. His wife looked strained, and the two daughters took part in the service, one reading the lesson and the other giving the eulogy.’

‘God help the poor woman,’ Bridget sighed. ‘If it had been at Our Lady of Pity, now, I’d have asked ye to take me.’

Shelagh did not reply. It was an unresolved issue between them, that Shelagh no longer attended church regularly, and would only drive her mother the six miles to the Convent if she happened to be
free on a Sunday – and for most of her free weekends during the summer, she had stayed with friends in the caravan at Netheredge on the other side of the Blackwater river. Bridget did not know that there was in fact only one friend, Paul Sykes, to whom Shelagh had been unofficially engaged since the spring. It plagued Shelagh’s conscience from time to time, this telling of a downright lie to her mother, but she considered it the lesser of two evils; if she ever told Bridget the truth, there would be endless trouble, and their relationship perhaps permanently harmed. When she and Paul were free to announce their engagement and name a wedding day, that would be time enough to introduce him to her mother; meanwhile, she reasoned, she spared Bridget deep distress, and was immensely grateful to a kind Catholic couple who were willing to drive her mother to the 10 a.m. Mass every Sunday.

‘You still look pale, Mother,’ she said, pouring out tea for them both. ‘I hope you’re remembering to take your iron tablets.’

‘I’ll take anything Dr McGuinness orders for me, though they don’t agree wid me, I’ll take ’em for sure.’

‘How do they disagree with you?’

‘Nothin’ you need know about, girl.’

‘No, please, Mother, I’ve a right to know. Are you getting any sort of discharge? There was a bloodstain on the side of the toilet seat the other day.’

‘I didn’t mention anythin’ to yeself, Shelagh, and I’ll be seein’ Dr McGuinness next week.’ Her voice rose indignantly. ‘And if ye think I’m goin’ to take down my drawers for
you
to interfere wid me, ye can think again, me girl.’

Shelagh did not answer, but her heart gave a sudden lurch. She cursed herself for not being more alert to her mother’s pallor and loss of weight – and the bloodstain in the lavatory. She would have to get her mother to attend Mr Kydd’s gynae clinic as soon as possible. But
how
?

The insistent peep-peep-peep of Shelagh’s bleeper could not be ignored, and she picked up the receiver of the nearest phone to dial the switchboard.

‘Dr Hammond here.’

‘Oh, Dr Hammond, there’s a call for you from Antenatal,’ said the switchboard operator. ‘They sound urgent. I’ll say you’re on your way, shall I?’

‘Thanks.’ In less than a minute she had climbed the stairs two at a time rather than wait for the lift, and hurried along the upper corridor to the antenatal ward of the maternity department. Her eyes swept the twelve-bedded unit: a few patients were sitting in their beds or in armchairs. There was no sign of any emergency.

‘They’re down in the day room, doctor,’ they chorused. ‘We’ve been chucked out!’

She turned and sped along the corridor, past
the office, treatment room and kitchen, making for the day room where the new black-and-white television set was now switched off. A woman lay on the carpeted floor, and Shelagh recognised Mrs Jane Blake, a known epileptic. She appeared to be unconscious, and the rigidity of her face and staring eyes, plus the convulsive jerking of her limbs indicated that she was having an epileptic fit of the grand mal severity. Sister Dickenson and Staff Midwife Moffatt were kneeling on each side of her, and looked up when Shelagh hurried in.

‘We’ve been bleeping you for ages, Dr Hammond,’ said Tanya Dickenson. ‘I’ve bleeped Dr McDowall.’

Shelagh’s heart sank. Jane Blake’s epilepsy was usually controlled by daily medication, but the complex hormonal changes of pregnancy had disrupted her equilibrium, and she had been brought into hospital where she could be closely observed. Brief petit mal fits were occurring almost daily, lasting only a few seconds; but this was a full-blown grand mal, a threat to both mother and unborn child.

‘When did this one start, Sister?’ asked Shelagh.

‘Five or six minutes ago, she was watching the news and the other patients called out to us,’ answered the efficient, newly appointed Sister Dickenson. ‘I’ve managed to get a padded metal spatula between her teeth.’

‘Can we get her over on to her side?’ ventured Shelagh, and kneeling beside the patient’s head,
she placed her fingers firmly behind Jane’s jaws in an attempt to open her mouth wider, but there was no response, and Jane’s face and lips were turning unpleasantly blue.

‘Be careful, Dr Hammond!’ cried Staff Nurse Laurie Moffatt as the patient ground her teeth, and Shelagh involuntarily withdrew her hand in a moment of panic.

At that moment a firm, hurrying step was heard in the corridor, and into the room swept the tall figure of the medical registrar, Dr Leigh McDowall, his white coat flapping. Shelagh had met him on other occasions when pregnant mothers had medical conditions such as epilepsy, diabetes or asthma. She respected his skill, though his over-familiar manner was irritating.

‘Hey, buck up, girls, don’t just kneel there saying your prayers! What she needs is oxygen – send somebody to lug a cylinder up here
now
!’

‘I’ve already sent for one,’ said Tanya, and he nodded.

‘Good girl.’

‘Ought we to use tongue forceps?’ asked Shelagh.

‘No, we oughtn’t, barbarous things. Let’s get an airway in.’ He produced a rubber airway from his pocket, and manoeuvring the metal spatula between Jane’s teeth, he inserted it into her mouth and throat, then removed the spatula. As soon as the oxygen cylinder arrived, he placed a black rubber mask over
her nose and mouth, sending a stream of pure oxygen into her lungs and thence to her blood vessels. Within thirty seconds the convulsions began to subside, her body relaxed, her eyelids fluttered and her skin began to turn a healthy pink. They all looked at each other with sighs of relief, and McDowall listened to the baby’s heartbeat with his stethoscope.

‘Hi, Jane,’ he murmured softly as her eyes opened, though with no sign of awareness of her surroundings. ‘Don’t worry, m’dear, you’re all right. We’re going to take you back to your bed for a nice long sleep, OK?’

The auxiliary nurse who had brought the oxygen cylinder now appeared with a stretcher trolley, and McDowall lifted Jane bodily on to it, while Tanya and Laurie held her legs. She smiled at them in a bemused way, like someone waking up from a deep sleep, and when she was gently laid on her bed, Tanya put up the cot sides, clicking them into position.

McDowall turned to the midwives. ‘Always keep the O
₂
at hand, girls, wherever she goes – to the bathroom, the TV lounge or kissing her husband behind a screen, she needs to have it at hand, and the nipper needs it even more.’

Back in the ward office he picked up Jane’s treatment chart. ‘Give her a stat dose of phenytoin, a hundred milligrams, and up the daily dose to four hundred milligrams in all. We can’t go any higher than that because of junior – and carry on with the
phenobarbitone at night. I’ll write it all up. Heigh-ho! Time for a reviving cup of tea all round, I’d say, don’t you agree, Tanya?’

The auxiliary was sent to the kitchen to prepare a tray of tea, while McDowall continued, ‘You know, girls, the old man had better get that girl delivered sooner rather than later.’

‘That’s just what we’ve been saying,’ said Tanya, a slim ash-blonde, and Shelagh saw her cool, light-blue eyes appraising McDowall who returned her look, also taking in the attractions of Laurie Moffatt, plump and giggly. Nobody had addressed her, the doctor, and she stood a little way apart from them, her heart still thudding after the incident, and annoyed at herself for not showing as much initiative as Sister Dickenson in dealing with a serious epileptic fit, and being late to answer her bleep. Thankful as she was that McDowall had been summoned, and for his prompt action, she felt that she had appeared to be incompetent; she also disliked hearing the consultant obstetrician and gynaecologist, Mr Kydd, referred to as ‘the old man’, though she silently agreed that an early delivery for Mrs Blake was indicated.

McDowall suddenly turned round in his chair and addressed her over a mug of tea.

‘Don’t you agree, Dr Hammond? The poor little nipper won’t take kindly to his mum flaking out and cutting off his oxygen supply – no fun for either of them.’

‘Mr Kydd will take everything into consideration,’ she said coolly, ‘though the baby’s not very big, even for thirty-six weeks.’

‘And won’t get any bigger if he’s going to have
this
caper day after day, plus all this dope we’re pumping into her – the little chap’ll be stoned out of his mind.’