Twice as Good

‘They’ll send someone else. When or if they can find someone. There’s a heavy demand for locums at present. Apparently we’re in the middle of conference season.’

Luckily, Miss Little had decided to dress herself again without waiting for clearance. Janet despatched her towards Oliver’s room. There was an unusual silence in the waiting area as she headed back to the front office. All conversation had stopped. Sandy was staring over the counter, looking slightly pale. Janet’s nose provided the first clue to the new development to the day. Young Katy Prendergast had vomited, dousing both the carpet and the contents of the toy basket. Eighteen-month-old Toby Dawson was openly fascinated. Katy’s mother was appalled.

‘Oh, I’m so sorry! Can I find something to clean up with?’

‘I’ll do that,’ Janet told her. ‘Don’t worry. These things happen.’ She nudged Sandy. ‘Take Katy and her mum down to the side room. Get one of the cardboard containers out of my dressings cupboard in case Katy feels sick again.’

Joshua Young’s mother emerged from Sophie Bennett’s room. Joshua was still howling and his mother looked weary. Her expression changed and her nose wrinkled with distaste as she moved towards the counter. Sophie followed her patient out. Her eyes widened in dismay as she neared the waiting room, then she clapped her hand over her mouth and nose and ran for the toilet, slamming the door hurriedly shut behind her.

Janet donned gloves and quickly gathered a bucket of hot water and disinfectant, tucking a supply of floor cloths under her arm. Toby’s mother was trying to keep the active toddler away from the toy basket.

‘Take him into the treatment room, Margaret,’ Janet suggested. ‘I won’t be long. Sorry to have kept you waiting.’

‘No problem.’ Toby’s mother smiled. ‘You look like you’re having a bad morning.’

Janet nodded wearily. There were still three people left in the waiting room after Margaret and Toby left. One was waiting to see Sophie who had still not emerged from the toilet. May Little was in Oliver’s room and Katy was next in line for his attention. The elderly Mr Beaumont and his wife would have to wait a while longer for their appointment to see Dr Spencer.

Sandy Smith looked ready to cry. ‘I wish Toni was here,’ she told Janet mournfully. ‘I don’t think I’m ready to cope with this job on my own. I’m only a receptionist, not a practice manager.’

‘You’re not on your own,’ Janet told her. ‘I’m here. And this is as bad as it gets around here. Honestly! If you can cope with this, you can cope with anything.’

Sandy sniffed dubiously and Janet patted her arm. ‘Open the windows in here for a while. As soon as I’ve finished with wee Toby I’ll come back and look after the desk and you can have half an hour for lunch. Take a walk by the river and get some sunshine and fresh air.’

Sandy brightened. ‘I could go down to the shops. Outboard’s getting low on cat food and kitty litter.’

Janet eyed the still firmly closed door of the toilet. ‘Get some water crackers as well. They’re supposed to be good for morning sickness.’

Not that there was much of the morning left. Toby and his mother had been waiting for over an hour for their appointment.

‘I’m so sorry,’ Janet apologised again. ‘It’s been chaos this morning. I don’t think we had any idea how disruptive it was going to be, having both Josh and Toni away at the same time. And our locum didn’t show up.’

‘I’m not bothered,’ Margaret assured her. ‘It’s not often I get the chance to sit and read magazines. Where did Josh and Toni go for their honeymoon?’

‘They’re cruising the Caribbean,’ Janet said with mock bitterness. ‘If they send a postcard of some tropical paradise with ‘‘wish you were here’’ scribbled on the back, it will definitely be the last straw.’

Both women laughed, and Toby beamed at the sound. Janet held out her hand.

‘Come and stand by the giraffe, sweetheart. Let’s see how tall you’ve got.’

She recorded the measurement on Toby’s file. ‘He’s shot up,’ she told Margaret. ‘That’s a huge increase since his fifteen-month check.’

‘Goodness knows where he’s getting the energy to grow from. I can’t get him to eat a thing.’

‘Tell me about it,’ Janet said with a grin. ‘The fight I had this morning, trying to get my boys to eat breakfast!’

‘You mean they haven’t grown out of it yet?’

‘It gets worse when they start watching TV,’ Janet warned. ‘All the ads for the new high-sugar, high-fat, junk cereal they keep coming up with. It’s a constant battle.’

‘So what do you give the twins for breakfast?’

‘Porridge,’ Janet said defensively. ‘It was good enough for me when I was growing up and I wasn’t even allowed brown sugar and milk on it.’ She lifted Toby onto the scales.

‘Toby likes porridge.’ Margaret sighed. ‘It’s the meat and vegetables I can’t get into him.’

‘You’re obviously doing quite well enough.’ Janet steadied the toddler before checking the reading. ‘He’s right up the charts for both weight and height.’ She lifted Toby onto the bed and tickled a smile out of her small patient. ‘Do you like porridge, then, Toby?’

Toby nodded happily.

‘I wish my boys did. They say it’s got too many toenails in it.’

Toby looked nonplussed. So did Margaret. ‘Toe-nails?’

‘They’re just the oat husks,’ Janet explained. ‘I make the real stuff that you have to soak overnight. It’s healthier, not to mention a lot cheaper.’ She unbuttoned the fastening on the shoulder of Toby’s bright blue jersey. ‘We’ll take this off, shall we, darling? Dr Sophie is going to come and listen to your chest in a minute and look in your ears and down your throat. Do you think she’ll be able to see the porridge you had for breakfast?’

Toby nodded gleefully. He stuck his arms up helpfully as Janet pulled the sleeves of his jersey clear. She excused herself to fetch Sophie but was waylaid by Sandy, who spoke in a whisper.

‘That funny little man that looks like a garden gnome just came in.’

‘Mr Collins?’

Sandy nodded. ‘He hasn’t got an appointment but he says the doctors will want to see him urgently. What shall I say?’

Janet sighed. Mr Collins was a regular patient. Too regular. ‘What are his symptoms today?’

‘He says he’s got a crushing central chest pain radiating to his jaw and left arm. He’s sweating and nauseated and he’s having palpy something or other.’

‘Palpitations.’ Janet chuckled. ‘You’ll have to borrow Mr Collins’s textbook some time. He doesn’t need it any more. I think he’s learned off every symptom by heart.’ Janet pondered the situation briefly. ‘Tell him to have a seat. Maybe I can keep him happy by taking his blood pressure and doing an ECG. He hasn’t picked a very good day to come looking for a bit of attention, has he?’

Sophie hadn’t quite finished with her patient. She still looked wan as she came into the treatment room ten minutes later.

‘I like powwidge,’ Toby informed Sophie. ‘Wiv toenails.’

Sophie gave Janet a despairing glance and rushed out of the room. Janet had to laugh. ‘I don’t believe this. Let me see if Oliver can come and see Toby. Sophie might be held up for a while. She’s in a rather delicate state.’

It was another fifteen minutes before Margaret was able to take Toby home for his lunch. Sandy took the opportunity to escape for her break and Janet tidied up the treatment room, before moving back to the main office to man the telephones. It was only then that she remembered Mr Collins. He was sitting quietly in the corner of the waiting room. Too quietly.

‘Oliver!’ Janet shouted. ‘Sophie! Come quickly!’

Janet Muir’s strength was out of proportion to her slim build. She had no real difficulty transferring Mr Collins to the floor. She had tilted his head back to open his airway and was feeling his neck for the carotid pulse as both doctors rushed in.

‘No pulse, no respirations,’ she reported. Pinching the elderly man’s nose, Janet covered his mouth with her own and inflated his lungs with two deep, full breaths.

Oliver positioned his hands on Mr Collins’s chest to begin cardiac compressions. ‘Grab the life pack,’ he directed Sophie. ‘And a bag mask unit.’

Sophie was back within seconds. She stuck the electrodes in place and Oliver stopped compressions while they looked at the screen.

‘Ventricular fibrillation,’ Oliver muttered. Sophie had the large sticky pads ready as Oliver cut through Mr Collins’s clothing. He positioned the paddles. ‘Everybody clear,’ he instructed.