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Best Practice by Penny Parkes (7)

Chapter 7

The Practice always felt strangely adrift on the days that Dan and Grace were away at HQ, sharing their pearls of wisdom. Harry Grant from their Primary Care Trust had been true to his word and the clock on these time-consuming seminars was winding down, their commitments as a Model Surgery almost fulfilled. It seemed to Holly as though Grace in particular would actually miss these sessions when they were over, much as they all liked to moan about their inconvenience. She certainly seemed to make an effort to look her best when ‘on parade’.

At least with Alice on board, they still had a full complement of doctors on duty when Grace and Dan had their ‘away days’, even if occasionally that meant Holly got lumbered with one of Dan’s somewhat misogynistic frequent fliers.

She bumped into Taffy outside the waiting room. ‘Fancy taking my three o’clock?’ She pulled a face. ‘Rock, paper, scissors? I’ve got Gordon Lightly.’

Taffy laughed. ‘No chance.’ Gordon’s reputation for being a pain in the proverbial preceded him.

‘Go on,’ Holly said, switching on the charm. ‘There have to be some perks from sleeping with one of the partners.’ She grinned. ‘I’ll even cook supper—’

Taffy shook his head in defeat and held out his hand, reliably a pushover whenever it came to his girlfriend. ‘On the count of three then—’

Holly stared at their hands in disbelief. ‘Best of three?’ she offered.

Taffy leaned forward and kissed her with a smile. ‘He’s all yours, baby,’ he said as he retrieved his own patient and left her dithering in the doorway.

Gordon Lightly scowled at her as he unwillingly followed her from Reception to her consulting room. Holly really wanted to say that, since he’d arrived for his appointment with only seconds to spare, perhaps going on the immediate offensive wasn’t his brightest idea.

‘Perhaps it’s just better if I come back another day? Like I said, I do usually see Dr Carter and I think a man’s perspective on this might be better. No offence, miss, I’m sure you’re a lovely doctor, but . . . ’ His voice petered out, unable to articulate his reasons.

Holly could empathise, she really could. It wasn’t always easy discussing intimate issues with a doctor of the opposite sex, but they were already overbooked for the next few days, so it was her job to put him at ease, not turn him away.

She gestured to the seat beside her desk and sat down. ‘Well, why don’t we have a brief chat and you can outline the problem for me. And if you need any tests run, I can get those sorted and you can discuss the results with Dr Carter another day.’ She was already making a mental assessment of her patient, playing the probabilities of what he had come to discuss.

Fifty or so, clearly overweight, balding.

His forehead had a sheen of perspiration, whether from nerves or the effort of walking from the car park she couldn’t tell.

Sallow skin, heavy jowls, broken spider veins on his cheeks.

This was not a man in perfect health; equally, this was not a man to whom health was a priority. The nicotine stains on his teeth were a dead giveaway that he had not, in fact, quit smoking as his file suggested.

Gordon looked so uncomfortable, though, that Holly could only surmise that they were looking at a problem in the trouser department. She’d put money on erectile dysfunction or trouble peeing, she decided.

Gordon fidgeted. ‘Well, I suppose you are a doctor . . . ‘He sighed. ‘Look, it’s not me I’ve come about, it’s my wife. She refuses to come, you see. She says there’s nothing wrong and I should stop going on about it, but I worry, Dr Graham. She’s just not herself.’

Holly had to quickly recalibrate her perceptions. Far from being the misogynist she’d pegged him as, might he in fact be a loving husband, a concerned husband at that? ‘Okay,’ she said. ‘Well, first of all, I can’t tell you anything about your wife’s health without her consent, but I am only too happy to have a chat about what’s concerning you and maybe a bit more information might encourage her to seek advice herself?’

Gordon grunted his approval. ‘Dr Carter’s known me for years. And my wife. So he’d know what I’m saying is true.’

‘I’m not doubting you, Mr Lightly, but then you haven’t really told me anything yet. Let’s start with what’s worrying you the most.’

Gordon’s neck immediately flushed scarlet. ‘Well, you see, I don’t know how to put this but . . . ’ He coughed awkwardly. ‘She’s lost all interest in the bedroom. No sex drive at all. Almost flinches at the very idea.’ Having blurted this news out in staccato sentences, Gordon was now on a roll. ‘And she doesn’t want to cook, doesn’t even care if the house is a mess. I think she’s depressed, Dr Graham. She keeps taking long walks and watching those endless bloody box-sets in the evening. It’s been like living with a different person these last few months.’

‘And her health?’ prompted Holly, trying to steer this consultation in a useful direction. ‘Has she lost her appetite? Is she having trouble sleeping? Is she down all the time – teary, perhaps?’

He concentrated for a moment. ‘She’s been making lots of those vegetable smoothie things. And she’s always up before I’m awake.’ He frowned. ‘But she’s not crying all the time, Dr Graham, it’s more a distracted thing – as though she’s not really there.’

Holly clicked through a few screens on her computer and pulled up poor Mrs Lightly’s file, angling the screen slightly so it was for her eyes only. Amanda Lightly was one of their rare patients without repeat prescriptions, ongoing health issues or indeed the odd appointment for coughs and sniffles. In terms of considering depression, though, it told her precisely nothing.

She looked at Gordon, frankly considering him a much more likely candidate. ‘And how are you feeling about all this?’ she asked. ‘It must be difficult?’

‘It is difficult,’ he said, the surprise evident in his voice that she might appreciate that. ‘Since I’ve taken early retirement, I’m at home all the time, you see.’

For Holly, the picture he was painting wasn’t necessarily one of medical causality; in fact it seemed perfectly possible to her that poor Amanda Lightly was utterly resenting her husband’s omnipresent retirement and doing her very best to look after herself in light of all the stress.

‘Have you and your wife been arguing a lot, Mr Lightly?’ Holly asked tentatively.

‘Too right we have. She just doesn’t want to see things from my point of view. When I rearranged the kitchen so it was more efficient, she told me I could, well, I’m quoting directly here, Dr Graham – told me I could cook my own fucking dinner myself then.’

‘And it was about that time that she lost interest in cooking, was it?’ Holly ventured.

‘Are you saying that her depression is my fault?’ Gordon accused. ‘All these years of going out to work every day, and the minute I get some time at home, she’s out that front door every chance she gets.’

Holly said nothing, hoping against hope that the penny might finally drop without her having to spell it out. This wasn’t, after all, such an unusual situation. And, as Gordon dabbed at his sweaty upper lip and the rings of dark fabric under his armpits grew, she could actually empathise with the departure of Amanda’s libido as well.

‘I see from my screen that your wife is actually due her Well Woman check next year. Why don’t I bring that forward a little and invite her in for a chat? It might help put both of your minds at rest,’ she said obliquely. ‘And in the meantime, while you’re here—’

She had to swallow a smile at that one. Mostly it was her patients trying to cram several ailments into one tiny appointment. But the chance was just too good to miss.

‘Let’s get you in tip-top shape so you can enjoy your retirement – get you out on the golf course, or maybe a spot of fishing?’ She plugged in the blood pressure monitor and by the time she’d finished, poor Gordon had a lot more to think about than whether Mrs Lightly was fulfilling her wifely duties.

The process of becoming a wife again herself was something Holly chose not to think about too much. In all honesty, the engagement ring on her finger was all the commitment to Taffy that she actually needed. Perhaps they could just skip the whole wedding fandango and concentrate on what was important, Holly wondered – and not for the first time – as she waited for Elsie to answer the door later that day. Holly and Taffy had a future together and that was what mattered. Certainly not whether the napkins at their wedding breakfast were oyster or ecru, which in either case just looked cream to her own, undiscerning eye.

But try telling Elsie that.

On the one hand, Holly was beyond touched at Elsie’s almost maternal interest in her wedding and all its minor details; on the other, the whole thing was in danger of getting a little out of control. As evidenced by this latest get-together with The Wedding Folder.

Elsie pulled open the front door with gusto. ‘There you are!’ Her hot pink velour tracksuit and flushed complexion were a sure sign that her physio session had not long finished. But there was something else too; a skittish excitement that immediately had Holly on her toes.

Following Elsie through to her gorgeous kitchen, Holly noticed that the beautifully decorated binder, which had kept Elsie busy for weeks, if not months now, was open on the kitchen island, fluttering with Post-its and magazine clippings. Planning Holly and Taffy’s wedding had captured Elsie’s imagination and forced her to adhere to all the health advice she’d been given to try and avoid another stroke. With the launch of her book being constantly postponed, Holly couldn’t help be concerned that this binder represented the only thing keeping Elsie occupied and sane of late.

‘So,’ Elsie began, before Holly could even say anything, clapping her hands together excitedly, ‘I have news! Fabulous news! I’ve pulled in a few favours with Vivienne and they can squeeze you in for a fitting, if you’re happy to have ready-to-wear tailored to fit. I know you don’t want anything fancy – as you keep reminding me, it is your wedding, not mine – but short of going couture, this will be utterly wonderful. You, my darling, will look utterly wonderful.’

‘About that, actually—’ Holly attempted to rein Elsie in before she got even more carried away.

‘And I’ve just gone ahead and given some thoughts to the printer. If we waited any longer, then they couldn’t do the leitmotif on the invitations to match your theme.’

‘We have a theme?’ clarified Holly in surprise.

‘Dear gods,’ said Elsie, shaking her head with benevolent affection. ‘I do wonder how you manage to run a household, let alone putting people’s lives in your hands!’ Elsie had never been one to understand the way Holly prioritised her time, and the wedding planning – or lack of it – had rather brought that into focus.

Holly flicked through the endless pages of The Wedding Folder that Elsie had compiled, insisting it was essential. As always, she was blown away by the thought, care and attention that had been invested in it.

‘Let’s just get on and make some decisions, any decisions!’ Elsie chivvied her, thrown a little by Holly’s lack of enthusiasm.

‘Oh Elsie, you’re right of course, and thank you,’ said Holly, pulling her attention back to the list at the front of the folder, beautifully written in Elsie’s swirling calligraphy. ‘It all looks beautiful and incredibly stylish . . . You’ve put in so much effort to make this a day to remember, but maybe we could simplify everything a little bit, just to get the ball rolling? Think about the dress later? Yes?’ Sometimes when dealing with Elsie, subtlety was not an option. It was, in fact, an over-application of tact that had led them to where they were now, with Elsie pulling in favours from British fashion designers, cinematographers and who knew what else?

Holly picked up a pen and skimmed her eyes down the extensive and highly detailed list. She deftly drew a line through doves, choir and croquembouche, only acknowledging Elsie’s increasingly loud tsks of disapproval with a humorously raised eyebrow. ‘I thought we agreed we were going for small and intimate?’ Holly queried, as she noted the seven-course tasting menu tucked underneath as a suggestion.

‘Well, you could always go all Kate Winslet and have bangers’n’mash at The Kingsley Arms, but I think that would be rather a shame. For Taffy,’ Elsie added pointedly, sipping at her post-workout power shake.

And this was where they hit the sticking point every time. For Holly, this was her second trip down the aisle and the big white wedding had done absolutely nothing to secure the future of that union. It was only Taffy’s feelings on the matter that kept her moving forward, rather than booking four tickets to Florence and eloping with the twins for a simple lo voglio, followed by pasta and Chianti.

Elsie was nothing if not astute and immediately backed off at the expression on Holly’s face, as though she were a young horse that might startle if she moved too quickly on this. It was a shame that Alice had recently introduced Elsie to Julia Roberts’ films; she’d been sleeping particularly badly since watching Runaway Bride.

‘So,’ Elsie said gently, changing tack. ‘What did you two decide on your weekend away? You and Taffy must have come up with a few certainties on your little treehouse escapade that we can go ahead and put into action?’

‘Ah,’ said Holly. ‘About that—’ She couldn’t help the adolescent smile that lit up her face, just remembering the unadulterated luxury of her night away with Taffy in that treehouse. Gorgeous bed linen and one of those claw-foot baths, not to mention their own little wood burner – she’d been gutted to leave actually. ‘We got a little distracted, I’m afraid.’

Distracted barely covered it, remembered Holly contentedly. And what’s more, she honestly didn’t give a fig that they hadn’t finalised the cars, or the flowers, or the wedding registry as instructed. The precious hours they’d spent hopping from bed to sofa, in front of the wood-burning stove, had done more for her well-being than ticking items off any arbitrary list ever could.

‘I’ll bet you did,’ said Elsie, shaking her head with a filthy laugh, unable to remain annoyed for long. Even she could appreciate that it was probably more important for the future bride and groom to be in love than to have a personalised choral accompaniment to their vows.

‘But the thing is, if you don’t commit to the venue today, then they do have another couple waiting, so . . .’ Elsie paused, waiting for a reaction – any reaction – to show that Holly would be devastated to learn that the swish country house hotel they had chosen was about to slip through their fingers. ‘Holly,’ Elsie said quietly, ‘you need to confirm the booking, or there won’t be a wedding. You need to tell me if you’re having second thoughts.’

Holly shook her head, swallowing the wave of queasiness that followed. Was that what this was, she wondered? It was easy to assume that the stress of these last few days had provoked this reaction, but what if it was actually cold feet? What if she didn’t want this wedding after all?

She blinked hard, relieved beyond measure that her subconscious was finally all but screaming in her head, tipped over the edge at the prospect of free-range doves. It wasn’t the marriage she didn’t want; it was this wedding. All her procrastination about flowers and menus and goblets and venues boiled down to one thing. She just didn’t want a big fancy wedding.

‘I want to marry Taffy,’ Holly said simply, taking Elsie’s hand affectionately. ‘But this, all this grandeur, it isn’t me. I’m so sorry, Elsie, but I need to talk to Taffy before we do anything else. I know this wedding is important to him, I do. And, before you say anything, I know that marriage is all about compromise. But last time around, I was the only one compromising and it made me miserable. And I’m not doing it that way again. Even for you.’ She offered Elsie an apologetic smile, half expecting her to be furious after all her hard work and research.

Instead, Elsie looked proud beyond measure. She reached forward and took the hotel’s booking form from Holly’s fingers and tore it decisively into quarters. ‘Well, okay then. Let’s go back to the drawing board.’ She gave a wicked smile. ‘But this time, we’re going to need gin.’

Holly gripped Elsie’s hand tightly across the table. ‘Thank you,’ she said with feeling, oddly emotional with the relief. ‘I really want to get it right this time – from the very beginning.’

‘Well, Holly, far be it from me to give marital advice,’ Elsie pulled a face, her own divorces testament to the fact that she was still learning too, ‘but I firmly believe that, if you only do one thing in this new marriage of yours, then choose to be true to yourself. And look – you’ve already started. Without me! I honestly couldn’t be more proud. Well, a little annoyed that you don’t want a fancy frock, but if we gloss over that for a moment . . . And we can still make it an occasion to remember, just a little more boho-rustic-chic, yes? A little more you?’

Holly smiled, basking in Elsie’s praise, whilst secretly noting away today’s mots justes to add to the beautiful leather notebook beside her bed. Practice Makes Perfect: the gift from Elsie was one of her most treasured possessions and Holly delighted in keeping it ‘up to date’. Its very pages were well thumbed and the entries all but memorised, Elsie’s beautiful lessons in living remaining Holly’s go-to bedtime reading any time she felt uncertain or in need of inspiration.

Elsie frowned for a moment. ‘Leave it with me. Either way, I shall still enjoy having a little project on the go. Now everyone half-decent I know has moved into Sarandon Hall, I find myself rather adrift.’

She had a point.

Holly was actually a little annoyed at how the advent of Sarandon Hall had changed the dynamic in Larkford as a whole. The converted Grade II residence on the outskirts of Larkford had been cleverly divided into beautiful, eye-wateringly expensive apartments and was now The Place To Be for the landed gentry passing on their homes early to try and dodge inheritance tax. It wasn’t enough that a particular cross-section of their own community had decamped, it was the number of ageing aristos and nouveau riche that had followed the promise of a little grandeur and delight for their retirement. The volume of red trousers and caviar being sold in Larkford had certainly doubled, just as the number of decent events and activities for their senior citizens had declined. It was one thing to be discerning and exclusive; it was quite another to be so discriminating as to cause waves of discontent.

‘What’s going on at Sarandon Hall that’s so very fabulous then?’ Holly asked, abandoning all talk of weddings and deciding to face the issue head on. It was obviously not going anywhere on its own, as Elsie had been griping about it for weeks now. First the bridge club had decamped, then the t’ai chi class. Holly couldn’t help but wonder what had happened now.

‘They’ve got a rosta of visiting professors coming in each week to talk to them about psychology, ecology, politics – there’s even rumours that Sir David Attenborough is going to pop by and do a slide show!’

‘Well,’ said Holly, ‘surely they could invite you along, if you’re feeling left out?’

‘I am not feeling left out,’ Elsie protested in direct contradiction of herself. ‘I just think it’s rather small-minded that they haven’t actually invited me along. That Cécile de Martin,’ she spat in a flawless French accent. ‘We all know she was plain old Sylvia Martin back in the day. A windfall inheritance and a few elocutions lessons don’t make her queen, you know.’

‘Elsie?’ Holly asked, unable to resist a handful of the salted almonds beside her. ‘Is it possible that Cécile is just stepping on your toes a little? I mean, before Sarandon Hall opened, you were rather the social centrifuge around here. But just because you haven’t upped sticks and thrown in your lot over there, doesn’t mean they should exclude you. Go along and join in. Be true to yourself,’ she offered back with a smile.

Elsie paused for a moment. ‘You are clever, Holly. I knew I should talk to you. I think I shall go and pay them all a visit. Invite myself along. Why wait? Let’s find out what all the fuss is about.’

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