I was a doctor in my village, and had been for four years. It was my home and I barely left it. Even during my studies, I usually brought my work home with me. It was a half an hour drive to the nearest village, and an hours drive to the nearest supermarket. The only way in and out was through the same old battered road; one road in, the same road out. I loved it, but maybe that was because it was all I knew. Most people lived and died in the village of Staylittle.
My father had worked in the village surgery before his death, and so did his father. You could say it was becoming something of a family tradition to care for the people of Staylittle; how many generations makes a family tradition? Anyway, even the surgery was named after us. Well a room was. You might say it was my destiny, but I didn’t see it that way, I just knew I wanted to help people, I don’t think my family influenced this. Aside from the kids, I was youngest person in the place. Everyone else their age rushed to get out as soon as they could; there was no work, no clubs and only one pub, two miles out, let alone the awful telephone and WiFi reception; all of the MPs promised to fix this, but they never did. What was the point, we meant nothing and we were nowhere. Little old Staylittle had its name for a reason. But in any case, it was a good job, and I enjoyed it. I wanted a simple life and, for a while, I had it.
It was my first day back after a rare Sunday off, which was naturally spent in the pub, and I was regretting the night’s pints with my early Monday morning start. It was chilly, like a typical British summer’s morning, the air heavy and damp. The sun had only just started to rise, giving the horizon that warming red glow. I remember stepping out on to the pavement, closing my garden gate behind me before having to quickly tuck in against the wood to avoid two kids cycling on the pavement. I yelled after them in annoyance, and, while they did look back to me over their shoulders, it was not out of concern. Instead, they laughed at my reaction as they turned the corner out of sight. I didn’t recognise them at the time, and if I did I would have called their parents, but they were noticeably muddy with long hair. When I see them again, I thought, I’ll give them a talking to.
It was a short walk to my surgery so I was there in less than five minutes. It was a small brick building with a single, ground floor. Only one other doctor worked at the surgery. He and I had a good relation, covering one another when we needed to. This week Doctor Jameson was away on holiday, leaving me with his patients to deal with as well. This was fine though, I hardly expected to be rushed off my feet.
I had pulled out my keys to open the surgery’s door on the way down, only to find the lights already on. Opening its distinctive wooden, green door, I stepped through the entrance while taking off my coat to place on the communal rack. I had a brief, disinterested look to my left towards the open waiting room. A teenage boy that I recognised sat on one of the chairs, near. the corner. He was hunched over. I ignored him for now as I needed to sign in. I showed my back to him when I sauntered toward the reception.
“Morning, doctor,” the receptionist said, chewing gum that had long since lost its scent. I fully suspected she used it instead of toothpaste. She placed an apple on the counter; my breakfast.
“Morning, Dot,” I said, not looking up as I signed my name in on the sign-in sheet.
“Looking forward to another busy, busy day, doctor?” she continued, with a drawl. I’m certain that she thought it was sexy, but it came across as more gutteral than anything else. This woman was twice my age and I couldn’t be any less interested in her advancements, but this never really stopped her. I didn’t mind, we got on fairly well.
“Yeah, sure,” I scrawled my name and answered her disinterestedly. Propping my elbows on the counter, I leaned close. I pointed the pen over my shoulder behind me.
“Do you know what the boy’s up to, how long’s he been there?” I said, not in a whisper but quiet enough that the boy couldn’t hear me from across the waiting room.
“Oh him?” Dot sighed, having previously leaned in probably in hope for a bout of dirty talk, finally. She leaned back in her chair and tapped her long nails on the counter. “He was waiting at the entrance before I got here, said it was something urgent.”
“Urgent?” I raised an eyebrow. I lackadaisically looked over my shoulder to get a better look at the boy. He was looking over at us with a frightened look on his pale face. He nervously pushed his ill-fitted glasses up onto his nose with a sweaty hand. He wore a knitted sweater and straight blue jeans. He was bouncing his knees anxiously.
“You did say that he has to book an appointment, right?”
“Yes,” Dot said, “I told him but he said that it couldn’t wait, I just told him to sit down, if that’s all alright with you?” Judging by her tone, I believe Dot thought I was patronising her. I wasn’t trying to, I could just be curt at times.
“Alright, yes, that is fine. I’ll have a word.” I rose, taking the apple, and turned to face the boy across the room.
“Come on then” I waved my arm towards the boy in a lazy come-hither motion. I heard the boy’s hurried footsteps behind me as I strode past the reception and down the corridor to my office. I opened the door, turned and held it open for the boy. He didn’t meet my gaze, instead ducking in without prompt into the small room while I switched on the light.
The room was unremarkable, with lime green walls and a strong smell of anti-bacterial steriliser. There was a desk on one wall, opposite which was a sink and a hospital bed. There were two chairs against the wall for patients and a swivel one for me. The boy stood awkwardly near the centre of the room, facing me for direction. I pulled a chair from against the wall and placed it in front of him.
“Please, sit,” I motioned with my hand towards the chair, and he sat quickly, as if by order.
I pulled up my chair at my desk and opposite the boy. His pockmarked face seemed even whiter than in the waiting room. He breathed heavily from cracked lips that he licked often. I recognised him. He was a farmer’s kid who was a bit of a loner. He wasn’t very good at sports and I think he got picked on a lot for just being a bit odd. He was Dr Jameson’s patient who I think had asthma, but I had never seen him with an inhaler, He was always asking Dr Jameson for sick notes to get out of PE, which he was usually given. Dr Jameson was soft like that, and didn’t realise he was making a hypochondriac out of the boy. I took a quick glance over his head towards the clock face above the door. 8:43AM. I suppressed a combination of both a yawn and sigh, half-heartedly covering my mouth. Was a sick note really so important? I didn’t think so, so I went straight to the point.
“I know Dr Jameson likes you and will give you a sick note without a blink, but for me you have to actually be si-“
“No, s-sorry that’s not it, that’s not… I’m not here because of that,” the boy interrupted me but trailed off mid-sentence. I did not fill the silence and instead waited for him to continue. The boy seemed to be waiting for me to encourage him onward. I didn’t.
“I… It’s kind of embarrassing,” he continued after a short silence.
“Go on,” I replied; the boy was trying my patience.
“I…I have a rash… down… there…,” he said, looking down, either to provide direction or out of embarrassment, but likely both. Again, I looked over the boy’s shoulder to the clockface. 8:44am. This is going to be a long day, I thought. I reached over to my desk to and picked up a pair of plastic gloves.
“Alright, let’s have a look then,” I said, putting on my gloves. I stood, turning away from the boy in order to make him comfortable. I didn’t hear any movement from him.
“I’m going to have to look at some point, so sooner the better”.
I could sense the boy’s hesitation. But after a moment, I heard him stand before he unzipped his jeans and they dropped to the floor. I turned, and knelt down, avoiding eye contact with the boy, and inspected his genitals.
Sure enough, there was something wrong with them. A red rash covered a large area of his penis and patches of his testicles. To me, it looked like chlamydia, maybe gonorrhoea.
“Okay, you can get dressed,” I rolled my eyes as I turned away.
He didn’t need to be asked twice, hurriedly pulling up his jeans as I stood back up before reclining into my chair. It was time for, in unprofessional terms, “the talk”.
“Joe… it’s Joe, isn’t it? Son of the Tynesdales?” I rubbed a temple with one hand.
“Y-yes,”
“How long have you been having sex, Joe?”
“What? No, no, I haven’t had sex,” Joe genuinely looked shocked, like he wasn’t prepared for the assumption. As much as I could believe that he was a virgin, I didn’t appreciate being lied to.
“Joe, I’m not kidding around here, this looks like an STD, a sexually transmitted disease,” tears welled in Joe’s eyes, “I can treat this but I really need you to be honest with me, I’m going to need to treat the girl too.”
“No, please, I promise you,” Joe wiped his tears away, now looking as stern as his bloodshot eyes and boyish face could, “I PROMISE you, I haven’t had sex with anyone”.
I looked him in the eyes. He matched my stare, as much as he could anyway, his eyes fleeting occasionally from mine. He did not look like he was lying but that was definitely an STD.
“Fine,” I leaned back, averting my gaze and facing my computer instead, “I’m going to give you a course of antibiotics.” I tapped through a summary of the appointment. I tore the prescription from the printer.
“Take this to the pharmacy. You know the one opposite the chippy, take one tablet a day for 30 days, if the symptoms get any worse then let me know”. I paused. “And I won’t tell your parents if you don’t want me to.”
He stood and took the prescription from my hand gingerly. I did not stand to walk him to the door. I pretended to work at the computer.
“Thank you,” he said, quietly.
“Remember to book an appointment next time, please,” I responded, uninterested.
“I will.” He left the room, shutting the door gently behind him. I took a bite out of the apple. It wasn’t as crunchy as yesterday’s.
Throughout the rest of the day, I treated the patients that came through my door. I noticed a handful of them came in with rashes of varying sizes, underneath armpits and joints. I didn’t think much of it.
- - - - - - - -
“Same again?”
“Same again.”
The barman poured me my second pint, pulling the lever repeatedly until the golden ale was close to overflowing. Of course it didn’t overflow, the man had been doing this his whole adult life. Like how I was the doctor, he was the barman, it was just how it was.
“4.80.”
I already had my wallet open and handed him the cash in a five pound note while taking my pint. I had a tenner and a handful of change, which would get me three more pints. I knew I shouldn’t stay that long, but after all I had a busy day. It wasn’t hard work but it was busy, as it always was when covering for another doctor’s patients. In any case, I thought, I helped them today as I will tomorrow and as tired as it made me, I just thanked God that there were no emergencies; the closest hospital was three hours away, but we were lucky to get an ambulance in four. I was very aware of that when Jameson was out of town.
The bar was quiet. I was the only patron sat on a stool. At the tables behind me, there was a spattering of elderly men, nursing pints. A roar went up around the corner, along with spontaneous, sporadic clapping. The rugby was being streamed from a projector onto the wall at the far end of the pub. I couldn’t see the result and it didn’t particularly interest me. For a Monday night, this place was heaving, but there couldn’t have been more than twenty people there.
“Mind the bar, will you, I need a piss,” the barman said to me. He didn’t wait for an answer, already moving his potbellied and stout body out from the bar. He was one of my patients. He had problems with kidney stones due to complications with alcoholism, and I guess that’s why he felt that he didn’t have to explain himself to me. But the issue seemed to be his eye which he was rubbing red raw as he left. I didn’t mind, and I would probably get a free pint out of it.
I soon noticed the sound of a couple of kids near the tables behind me. I didn’t hear them come in and this wasn’t the place to take kids; it wasn’t particularly rough, but it was definitely a drinkers pub. I swivelled on the torn, leather stool, interest somewhat piqued. A couple of young, grimy looking boys were heading from table to table, hands outstretched in a begging motion. I could hear their whining over the background chatter and low music playing. They were being waved away by the nicer patrons, and told to fuck off by the less patient. It didn’t take me long to realise that they were the two boys that rode past me that morning. I watched as they reached the last table which sat a man in his fifties. He wore a farmers jacket, a flat-cap and rested his walking stick between his leg. He simply ignored them, didn’t take his eye off his Guinness the whole time. They pestered him for around 30 seconds, even going as far as poking him, but still they ignored him. They eventually got bored and went to head down towards the rugby fans, bypassing the bar in order to avoid the barman I’m sure they assumed was still there.
“Oi, you two,” I called. They startled, like rabbits caught in headlights.
“Come here, come,” I waved them over. They looked at each other for reassurance, before stepping over nervously, unsure of my motive. One was taller than the other, one looked about ten, the other six or seven. As they came closer, I noticed how dirty their clothes and faces were but, more than that, I noticed that they looked aged before their time. Their eyes were a faded blue in sunken sockets over heavy bags. They each had crows feet and some noticeable lines on their forehead. I felt immediately saddened. The boys have had tough lives, I thought.
“What are you doing here, lads?” I said, softly. I leaned down slowly, resting my elbows on my knees, fiddling with the pint glass in my hands. I looked them both in their faces, now noticing the sores on their lips and at the signs of their mouths.
“We need food, sir, that’s all,” the bigger of the two said, “we just need some money to buy some, for old John”.
“Old John?” I raised an eyebrow.
“Yes, he’s our-” started replying the smaller one, before getting stopped with a light nudge of the elbow by the taller one.
“We live with him,” the taller one said, gaining confidence.
“I see… you’re not from around here, are you boys?”
“No,” they replied in unison.
“When was the last time you saw a doctor?”
They paused, and looked at each other nervously.
“That’s fine, that’s fine, no need to say. But I’m the doctor here and I feel like I can help you with your sores, okay? Would you like that?”
The smaller one looked towards the taller boy for reassurance of how to act. The taller boy shrugged. The smaller boy looked back towards me, and shrugged. I smiled lightly.
“You see, my surgery, my mini hospital, is just around the corner, yeah? If you come in tomorrow, I’m sure I can help you, okay?”
“OI, YOU TWO, WHAT YOU DOIN’ IN ‘ERE,” boomed the barman, coming out of the toilet, pulling up his jeans in the process. The kids went to dart.
“No wait,” I said to the boys, putting a hand out to stop them dashing out the door. “They’re with me, mate.”
“Well you’ll ‘ave to leave with ‘em,” he snarled, pointing to the door with one hand. His other held a tissue to his weeping eye. I was taken aback by his aggression. I drained my pint and stood from my stool.
“So be it,” I replied, putting on my coat. I left, the boys following close behind. I think one of them stuck his tongue out at the barman. As the bell dinged when I opened the door, I swore I heard one of the regulars say “fucking gypsies”. I tensed, but ignored it.
When outside, we walked a few steps and stopped near the pub’s outside bin. The smell hit my nostrils and I noticed the bin was overflowing with rotting food. I stepped to the right away from it and the kids followed my move. The kids wore only shorts and t-shirts, but the air was cold and there was a light breeze. I was, once again, concerned for their well-being.
“You two do have a warm place to stay tonight?” I said.
“Yeah, yeah we do, we’re just hungry,” the tall boy replied with emphasis. I took the hint, and opened up my wallet.
“Alright, I have a tenner, go get you, yourself and, Old John was it? Get you all some food,” I handed them the tenner. Their eyes lit up as they held the cash between them.
“Just promise me to head round the surgery tomo-,” I stopped. They had already started walking away and I was soon talking to air. Not so much as a thank you, but I’m not sure what I expected. I sighed and headed back in. That fun little escapade of being a good person cost me a tenner, and I’m unsure if it was worth it. I sighed, turned and went to enter back into the pub, realised that I had work in the morning, and instead took the long walk home. I noticed that wet, brown leaves covered the pavements which I walked on, despite it still being summer. I ignored it.
- - - - - - - -
The next morning, I rose exactly like the last; hungover. I remembered the events from the night before and pushed my palm against my aching forehead in frustration; don’t piss off the barman! Why would you piss off the barman? And I lost a tenner!
It wasn’t the end of the world though, I’d apologise to him, buy him a pint. And, with all hope, the kids would actually come into the surgery and weren’t going to spend my money on street drugs. Not that there was a way to get street drugs in my village, as much as I sometimes wished there was.
I got out of bed, lethargically dressed myself, and downed the pint of water I left by my bed the night before. I made crumpets, holding one in my mouth as I opened my garden gate, being careful this time to look left and right before exiting. I made the walk down to the surgery eating my breakfast, a crumpet. It tasted off. Leaves covered the ground, with few left in the trees along my walk.
Once again, I pulled out my keys to open the surgery’s door, but the lights were already on. I didn’t anything untoward, I just thought I was late this day. I opened the door, and took off my coat to place on the communal rack, and took a routine brief look around the empty waiting room. No unwanted visitors this morning, I thought, only my appointments.
I turned to my right towards the reception and wrote my name on the sign-in sheet. Dot was sat there but hadn’t said a word.
“Morning, Dot,” I said, not looking up from the paper.
“Morning, doctor,” she said, in a much softer tone than usual, causing me to look up from the page sharply. The fact that this startled me should tell you all you need to know about her character. She was the same old Dot, sat there with the same old mole on her face and peach dyed grey and brittle hair, but she looked different; she looked worried.
“You okay, Dot, you don’t seem yourself,” I said, genuinely concerned. She looked like she could burst into tears at any moment.
“No.. it’s… it’s fine doctor, I’ll set an appointment,” she replied, unable to keep my eye contact.
“Oh, then I can help, I think I have a patient in about,” I checked my watch, “ten minutes, but after that I’m free, is that all okay, Dot?”
She didn’t reply.
“Dot?” I repeated, with inflection.
“Yes, doctor, I’ll see you after,” she replied with a slight waiver from her otherwise flat response, at the same time using her swivel chair to turn her back to me and find something across the reception area. Her hands searched pen pots and upturned papers strewn across the unkept desk. I believe she was just pretending to look for something, and this was confirmed as I stood, waiting for her to pick something up. She didn’t, but didn’t turn round to look at me, knowing I was still there. For Dot, this was very, very odd behaviour. As much as the borderline sexual harassment kind of creeped me out, Dot was one of the old guard, a relic of the past, a dying breed. I liked her, and wanted to help.
“Okay Dot, well… well I’ll see you then,” I said, placing the pen down on the desk as I did so. I picked up the apple with the same hand and started to walk to my office, but after a couple of steps I turned back around.
“Dot, just take it easy okay? just tell the patient to come right in, no more hassle needed,” She didn’t reply, instead nodding slightly once, before finding the pen she was supposedly looking for. Clicking it, she turned slightly and gave me a half smile over her shoulder. I smiled slightly back and nodded my head. I turned on my heel and headed to my office.
Lime green walls once again greeted me as I pulled back my chair, sat on it and pulled myself in to the desk. I booted up my computer and placed the apple on my desk. As Windows Vista greeted me on the screen, I leant on my elbows, folding my hands together and resting the side of my face on them in order to get a good look at the clock face above the door. 9:07am. My patient was late, but then again I was too that morning.
I rested like this until 9:15am, glazing over watching the seconds tick-by, before lifting my head off my hands, motivating myself enough to get the patients details up on my computer. I fully expected that the patient wouldn’t be coming in at this point and the normal process in this occasion was to get Dot to call the patient at home, but I decided to save her the job, as she was definitely not herself. I didn’t actually know who I was scheduled to see, as I usually waited until the last minute to pull up my patient’s medical records as people cancelled, or just didn’t turn up, often. The details popped up on my screen and I put my head in my hands.
“This bloody kid,” I rubbed my forehead with my thumb and index finger, leaning back in my chair.
“When I said “book an appointment next time”, I didn’t mean the next bloody day,” I said to myself, picking up the corded landline with my free hand, continuing to rub my forehead.
I dialled the landline on the screen, his parent’s number, and scanned his medical record as it rang. There had been a new entry input this morning by Pat, probably from our answerphone last night. One word stood out to me. “Holes”.
“This is Judy Tynsedale,” I snapped back to attention and was in the process of crafting a reply before the voice continued: “I’m sorry but I can’t get to the phone right now, please leave a message after the beep.”
I sighed and put the phone down. I couldn’t really leave a message on his Mum’s answer phone, if she called back and asked why I called, I didn’t want to put the kid in a position where he’d have to tell his Mum that he had chlamydia. Instead, I returned to my natural position of leaning back in my chair and looking up at the clock above the door. Twenty minutes past nine. There was a quick knock which caused me to straighten with a start and the door slighted opened hesitantly. I cleared my throat.
“Come in,” I said now sitting upright pretending to look at my screen with intensity. I heard the click clack of someone walking in on the laminate floor, before the door closed slowly with a gentle click. I fully expected it to be the boy that walked into the room considering how meek the entrance had been, but peeling my eyes away from the nothing that was on my screen, I instead saw Dot standing in front of the doorway.
“Oh Dot, my patient hasn’t arrived, I was just going to get y-,” I started, stopping when Dot started unbuttoning her blouse.
“Dot, Jesus Christ, what are you doing,” I stood up immediately and took a step back, covering my eyes with one hand and held the other, palm out, in her direction.
“You have to see, you have to see, I don’t know what to do, I don’t know,” she was crying, and the words were pronounced with a painful wheeze, as if she had a lump in her throat. Without me knowing, had moved around my extended arm, clasping two strong hands onto my other, pulling it down in a swift motion and exposing my eyes to her chest.
Her bare breast sagged upon her gut, dangling towards her waist. At the centre of her left breast was a cluster of open white cysts, leaking a clear liquid slowly, but constantly, with each heart beat. This mass seemed to act like a nucleus for an angry red rash which covered her whole chest and breasts, small blotches of those same white cysts speckled throughout. Her veins were pressed to the skin’s surface and looked to be throbbing.
“Oh my God, Dot, how long have you had this? How long have you been sitting with this?” My immediate thought was cancer, and at this stage this looked fatal, it looked like it had spread through her blood stream and, even if it hadn’t, large portions of her chest and both breasts would have to be removed if she didn’t respond well to chemo. You could say I was almost captivated for a few seconds, but I then drew my eyes away from her chest and to her face. Poor Dot was inconsolable, her heavily applied rouge ran down her face. A congealed mess of mucus and foundation formed under her nose and dribbled down her lips.
“Please help me, please, please,” she fell to her knees and hung her head, arms to her side. She was not wiping her face and a trail of drool and mucus hanged from her chin.While I was momentarily taken aback by the wound, I snapped myself out of it quickly; I was a doctor, I had seen much worse. Or had I? This wound was different… it just wasn’t anything I had seen before. It truly was awful. I knelt down opposite Dot, her face not visible when bowed. I fumbled in my pockets to find a crumpled up napkin I had taken from the pub the night before. I reached my hand out to give it to her but she didn’t take it. I dropped it in her lap. She wasn’t crying so much any more.
“This is what we’re going to do, Dot, okay?” I wasn’t sure if she was listening.
“Pick up the tissue if you’re listening, Dot, I need to tell you what we’re going to do to get you all safe and better,” I continued to kneel but her face was still not visible. After a few seconds, she reached and took the napkin from her lap with a trembling hand. She began to wipe her face slowly. I nodded in acknowledgement and continued.
“I’m going to call you an ambulance and get you checked out but it’ll probably be a couple of hours until it gets here. Until then I’ll get you bandaged up and we will do a few tests, okay?” she wasn’t responding but I carried on anyway. “I have other patients today so you’ll have to wait in Dr Jameson’s room, but we’ll lay you down and you can have a rest. Like I said, Dot, only a couple of hours and we’ll get you completely looked over and then no more worry, we will know, you will know.” I already knew but my rambling seemed to comfort he. She looked up at me and smiled slightly. Her make-up was still smudged on her face but what I fully noticed was how old Dot looked.
“Thanks, doll,” she took my hands in hers. We stayed like that for a few seconds before I gave her palms a squeeze and stood.
“Now come on, this is a respectable establishment, put that top back on,” I winked and turned my back to her. She laughed dryly, so dry it was almost a cough.
“You perv,” she replied and I laughed too. The air felt a whole lot lighter. She put her blouse back on and I turned back around. To see a dishevelled looking Dot, but still Dot. I guided her to a chair and sat her down, then I took a seat and looked instinctively towards the clock. I stopped myself almost immediately and I don’t think Dot noticed; she was not wasting my time and I didn’t want her to think that she was. I refocused and picked up the landline to call the ambulance. It rang and I was put through to the operator. I described the situation and gave the address for the surgery.
“We will have an ambulance dispatched shortly,” said the operator placidly.
“Could you give me a ballpark figure on how long it’ll be until it gets here, please,” I replied.
“I shouldn’t really say-.”
“I know you shouldn’t say but I’m asking you if you could,”
“I… okay…” I could hear the keyboard being tapped rapidly over the phone. A few seconds past. “Oh… there seem to be a number of ambulances already heading to Staylittle, are you sure that this hasn’t already been called in?”
“What? No it hasn’t.”
“Okay…” I could tell she doubted me. “An ambulance will be with you within three hours.” She paused. “If not sooner.”
I ignored the dig.
“Thank you.”
I put the phone down and suppressed a sigh. Three hours. I didn’t know what to do with my hands; I went to rub my temples but I didn’t want to seemed stressed in front of Dot. I forced both hands flat on the table instead and turned to Dot, straining a smile.
“Not long now, girl.”
- - - - - - - -