The Family Way

And Megan was sorry. She even sort of understood how Mrs Summer could be terrified at the prospect of another baby, and yet devastated when the baby was abruptly taken away from her. A fifth child would have been a disaster. But losing it was a tragedy, a death in the family that she wasn’t even really allowed to mourn properly, except for these shameful tears in a doctor’s surgery the size of a broom cupboard.

Megan talked quietly to Mrs Summer about chromosomal and genetic abnormalities, and how, hard as it was for us to accept, they were simply incompatible with life.

‘You and your partner have to decide if you want any more children or not,’ Megan told her. ‘And if you don’t, then you need to start practising safe sex.’

‘I do, doctor. But it’s him. It’s me…partner. He doesn’t believe in safe sex. He says it’s like taking a shower in a raincoat.’

‘Well, you’ll just have to discuss it with him. And condoms are far from the only possibility, if that’s what he’s referring to.’

Megan knew perfectly well that condoms were what he was referring to. But now and again she felt the need to adopt a magisterial tone, to reassert her authority, to keep her head above the sorry human mess that pressed its way into her surgery.

‘What about the pill?’

‘I blew up. Fat as a fat thing. Got thrombosis. Blood clots. Had to come off it.’

‘Coitus interruptus?’

‘Whipping it out?’

‘Precisely.’

‘Oh, I don’t think so. You haven’t met him. I’ve tried, doctor. Tried all the safe sex. What do you call it? The rhythm section.’

‘Rhythm method, yes.’

‘Tried that one when the doctor said it was the pill that was blowing me up. But it’s when I’m asleep. He just helps himself.’

‘Helps himself?’

‘Jumps on top of me and he’s away. Then snoring his head off the moment it’s over. You would never get a condom on him, doctor. I wouldn’t like to try. Honest I wouldn’t.’

It was another world out there. The sprawling estates that surrounded the surgery. Where a baby was still a bun in the oven and the men still helped themselves when some poor cow collapsed at the end of another busy day.

‘Well, you tell him he can’t help himself. It’s outrageous behaviour. I’ll talk to him if you want me to.’

‘You’re nice, you are,’ the woman told Megan, and grasped her in a soggy bear hug. Megan gently prised her away, and talked about the glories of an intrauterine device.

Women liked her. She was by far the youngest doctor at the surgery, a GP registrar only a month into her final year of vocational training, yet easily the most popular.

She had spent the last seven years preparing for this job – six of them at medical school, and the last year as a house officer in two London hospitals. Now, in a surgery where the other three doctors were all men, she was finally in a position where she could make a difference.

When women came in complaining of period pains that made them feel like throwing themselves under a train, Megan didn’t just tell them to take a painkiller and get a grip. When young mothers came in saying that they felt so depressed they cried themselves to sleep every night, she didn’t simply tell them that the baby blues were perfectly natural. When a nuchal scan said that the possibility of Down’s syndrome was high, Megan discussed all the options, aware that this was one of the hardest decisions that any woman would ever have to make.

When Mrs Summer was gone, Dr Lawford stuck his head around her door. In the confines of the tiny room, Megan could smell him – cigarettes and a cheese and pickle bap. He bared his teeth in what he imagined to be a winning smile.

‘Alone at last,’ he said.

Lawford was Megan’s GP trainer – the senior doctor meant to act as her guide, teacher and mentor during the year before she became fully registered. Some junior doctors worshipped their GP trainers, but after a month under his tutelage, Megan had concluded that Dr Lawford was a cynical, bullying bastard who hated everything about her.

‘Chop chop, Dr Jewell. Your last patient was here for a good thirty minutes.’

‘Surely not?’

‘Thirty minutes, Dr Jewell.’ Tapping his watch. ‘Do try to move them in and out in seven, there’s a good chap.’

She stared at him sullenly. Growing up with two older sisters had made Megan militant about standing up for herself.

‘That patient has just had a miscarriage. And we’re not working in McDonald’s.’

‘Indeed,’ laughed Dr Lawford. ‘Dear old Ronald McDonald can lavish a lot more time on his customers than we can. Here, let me show you something.’

Megan followed Lawford out into the cramped waiting room.

Patients sat around in various degrees of distress and decay. A large woman with a number of tattoos on her bare white arms was screaming at the receptionist. There were hacking coughs, children crying, furious sighs of exasperation. Megan recognised some of the faces, found that she could even put an ailment to them. She’s cystitis, she thought. He’s hypertension. The little girl is asthma – like so many of the children breathing the air of this city. My God, she thought, how many of these people are waiting to see me?

‘You’re going to have a busy morning, aren’t you?’ Dr Lawford said, answering her question. ‘A good half of these patients are waiting for you.’ Chastened, Megan followed Lawford back to her office.

‘It’s Hackney, not Harley Street,’ he said. ‘Seven minutes per patient, okay? And it doesn’t matter if they have got the black plague or a boil on the bum. Seven minutes, in and out. Until God gives us forty-eight hours a day, or we get jobs in the private sector, it’s the only way we can do it.’

‘Of course.’

Lawford gave her an exasperated look and left her alone.

To get to this little room, Megan had worked so hard, but she wondered if she could make it through this final year with Lawford watching her every move. She had heard the only reason that surgeries welcomed a junior registrar was because it meant they were getting a doctor for nothing. But none of the old quacks, no matter how penny-pinching or cynical, wanted a bolshy GP registrar who was going to make their lives even harder. They would be better off without her. Megan felt that Lawford was waiting for her to do something stupid, so he could cut his losses and get shot of her.

And that was ironic because Megan suspected that she already had done something stupid. Something so stupid that she could hardly believe it.

In the morning, during one of her regular breakfast meetings with Lawford – Megan was obliged to meet him twice a week so that they could discuss her progress, or lack of it – she had quickly excused herself and run off to throw up her almond croissant and cappuccino in a café lavatory smelling of lemon-scented Jif.

But it was on her way home to her tiny flat, her feet and back aching, that Megan really believed that she had done something stupid.

She knew it was impossible, she knew that it was far too soon. But it felt so real.

The kick inside.

Two (#ulink_b5137a86-40f2-501f-8215-0d0dbf5b0780)

‘Oh, you’re far too young to be having a baby, dear,’ Megan’s mother told her. ‘And I’m certainly too young to be a grandmother.’

Megan estimated that her mother must be sixty-two by now, although officially she had only been in her fifties for the last six years or so.

In Megan’s surgery she often saw grandmothers from the Sunny View Estate who were the same age as Cat and even Jessica – all those ‘nans’ in their middle and early thirties, who started child-bearing in what Mother Nature, if not the metropolitan middle class, would have considered their child-bearing years. But it was true – Olivia Jewell didn’t look like anyone’s idea of a grandmother. And Megan thought, why should she? She had never really got the hang of being a mother.

Olivia Jewell still turned heads. Not because of the modest fame that she had once enjoyed – that had evaporated more than twenty years ago – but because of the way she looked. The massed black curls, the Snow White pallor, those huge blue eyes. Like Elizabeth Taylor if she had won her fight against the fat, or Joan Collins if she had never made it to Hollywood. An elderly English rose, wilting now, it was true, but still with a certain lustre.

‘They take over your life,’ Olivia said, although her voice softened as she contemplated her youngest daughter. ‘Darling. You don’t want anyone taking over your life, do you?’

When their parents had met at RADA, it was Olivia who was the catch. Jack was a tall, serviceably handsome young actor, ramrod straight after two years’ National Service in the RAF and moonlighting as a male model (cigarettes, mostly – the young Jack looked good smirking in a blazer with a snout on the go).