A Nurse and a Pup to Heal Him
Auteur
Kate Hardy
Lezers
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Hoofdstukken
11
CHAPTER ONE
GREAT CROWMELL SURGERY. More than a hundred miles away from his old life in London. Right on the Norfolk coast, a place of wide sands and big skies. Peace. Quiet. No complications. No lies. Just him and his new job.
A fresh start.
Ben Mitchell took a deep breath, then pushed the door open.
The receptionist looked up. ‘Good morning, Dr Mitchell.’
‘Ben, please,’ he said with a smile.
‘Ben. Welcome to the surgery. The kettle’s hot and I made choc-chip cookies yesterday. They’re in the staff kitchen. Do help yourself.’
‘Thank you, Mrs Hartley.’
‘Do call me Moira.’ She smiled at him. ‘You look like a schoolboy on your first day. Just remember, Ranjit gave you the job because he thought you were the right one for it. You’ll be fine.’
Did his nerves really show that much? ‘Thank you.’ It was ridiculous to feel this nervous. For pity’s sake, he’d worked as a GP trainer in London. He was thirty-five. Experienced. He’d done this job for years and years and he knew he was good with patients.
But the first day in a new place would make adrenalin pump through everyone’s veins. Having to fit in with an established team; getting to know new people and learn their quirks, their strengths and their weaknesses. Getting to know your patients and working out what they weren’t telling you during the consultation so you could help them with their real problem.
Of course he’d be fine. He’d do the job he’d trained to do. The job he loved. Only this time he’d be coming home to a house with no memories and no misery, which made everything a lot easier.
He opened the door with his name on it—Dr B Mitchell, in neat capitals—dropped his bag next to his desk and went in search of the staff kitchen to grab a cup of tea and maybe one of Moira’s cookies.
But as he turned round the corner he stumbled over a brown and white dog, who yelped and looked sorrowfully up at him with huge amber eyes calculated to extract as much guilt as possible.
‘Archie?’ The kitchen door opened abruptly. From the dark blue uniform she wore, Ben realised that this must be one of the practice nurses, probably the one the senior partner had mentioned being on leave when Ben had come for his interview and met the rest of the team. What was her name? Terry?
She frowned at him and bent down to stroke the dog, who whined softly. ‘What happened?’
‘I didn’t see the dog and I tripped over it.’
‘Him,’ she corrected, her eyes narrowing. Beautiful grey eyes, like the sky in November. It shocked him that he’d actually noticed.
‘I’m sorry,’ he said, knowing that he was in the wrong for hurting the dog, albeit completely unintentionally. But at the same time nobody would expect to find a dog in the corridor in a family doctor’s surgery. ‘I didn’t mean to hurt the dog. But it shouldn’t be here. What if it bit a patient?’
‘He,’ she corrected again, ‘barely even nipped when he was a puppy. He’s incredibly gentle.’
‘There’s always a first time,’ he said crisply, ‘and our patients’ health and safety have to come first.’
The look she gave him said very clearly, You’re throwing your weight around this much on your first day here? ‘It does indeed,’ she said, surprising him, as he’d expected her to make some kind of protest.
She wasn’t smiling when she added, ‘Though our patients happen to like having Archie around on Mondays. As do the rest of the staff. And there’s an infection control policy in the surgery.’
On Mondays? Why was the dog specifically here on Mondays? But, before he could ask her, she clicked her fingers and the dog got up and trotted behind her to the door next to his, which she closed a little too loudly behind them.
Nurse Practitioner Toni Butler.
Toni. He’d remembered a masculine-sounding name. Short for Antonia? Not that it mattered.
He’d just got off to a really bad start with one of his new colleagues.
But he stood by his view that a dog had no place in a family doctor’s surgery, regardless of an infection control policy being in place. Some patients were frightened of dogs; others were allergic and the dander from the dog’s fur could trigger an asthma attack in a vulnerable patient.
Nobody said a word about the little spat when he walked into the kitchen, but he was pretty sure from the awkwardness in everyone’s faces that they’d all overheard the conversation. He felt embarrassed enough to do nothing more than mumble a brief hello and go straight into his consulting room without bothering to make himself a mug of tea.
At least his patients all seemed pleased to see him during the morning’s surgery, welcoming him to the village. He settled into the routine of talking to his patients and suggesting self-help measures as well as medication.
At lunchtime, Toni and the dog were nowhere to be seen.
‘How was your first morning?’ Moira asked.
Apart from having a fight with the nurse practitioner over her dog? ‘Fine, thanks,’ he said.
‘Good. If you haven’t brought anything with you for lunch, there are a few cafés plus the deli and the fish and chip shop along the harbour front—and of course Scott’s do the best ice cream in the area. Abby Scott—well, Powell, since she got remarried to Brad—has even developed a special ice cream for dogs. Toni’s one of her most loyal customers.’
‘Ice cream for dogs?’ He’d never heard of such a thing.
‘Archie loves it.’ Moira smiled. ‘Everyone loves Archie.’
Pretty much what Toni had said to him. In his view, the dog still had no place in a doctor’s surgery; though Ben rather thought he’d be on a losing wicket if he protested any further.
‘Hello, Ginny.’ Toni kissed the elderly woman’s papery cheek and sat down next to her. ‘How are you today?’
Ginny didn’t answer. She hadn’t said a word in three months, now. Given that her dementia was advanced, she’d either forgotten what to say or she couldn’t quite piece together what Toni was saying enough to answer her. But she smiled, and her smile brightened even more when she saw Archie.
This was exactly why Toni had trained her spaniel as a therapy dog. A dog could sometimes get through to someone when a human couldn’t, and could bring a spot of brightness into a sick person’s day. Residents at a nursing home had often had to leave a much-loved pet behind, and the chance to relive happy memories was so good for them. When Toni’s grandmother had been in the nursing home, a visitor with a dog had really helped brighten her mood. Toni desperately wanted to give something back—to help someone the way her grandmother had been helped. And Ginny had been one of her grandmother’s best friends and who’d been like a second grandmother to Toni and Stacey when they’d been growing up; Toni desperately wanted to make a difference to Ginny’s last days.
Archie, once his fluorescent coat was on, went into work mode, being gentle and sweet and sitting perfectly still to let an elderly patient or a young child pet him, suppressing his natural instinct to bounce everywhere. At the nursing home, Toni came to the lounge so all the residents could spend a few minutes with the dog in turn, and it also meant that one of the staff would be present at all times, in accordance with therapy dog visiting rules.
‘Hey, Toni. Hello, Archie, you gorgeous boy.’ Julia, the nursing home manager, came over to them and scratched behind the dog’s ears. ‘Look, Ginny, it’s your favourite visitor.’
Ginny didn’t reply, but she smiled.
‘Catch me in my office on the way out, Toni?’ Julia asked quietly.
‘Sure.’ Toni knew it was Julia’s way of saying that she wanted to talk to her privately about a couple of potential health complications among the residents.
‘Thanks.’ Julia patted her shoulder.
Toni spent a few more minutes with Ginny, letting her stroke the dog and hopefully latch on to happy memories of dogs in her past, then said gently, ‘Ginny, Archie needs to go and visit Ella now. We’ll come back and see you next week. Say “bye”, Arch.’
The dog gave a quiet ‘woof’.
Toni did her usual round in the lounge, chatting with the residents in turn and letting them make a fuss of the dog. At the end of her allotted two hours—the maximum length of time for a therapy dog session—she made a fuss of Archie, said goodbye to the residents and headed for Julia’s office.
The nursing home manager nodded at her drawer, where Toni knew she kept a box of dog treats especially for Archie. ‘May I?’
‘Sure. He’s earned it—plus we’re going for a run on the beach when we leave here, so we’ll burn it off,’ she said with a smile.
Archie, knowing from long experience what was coming, sat beautifully and offered a paw.
Julia grinned, rubbed the top of his head and gave him a treat. ‘I love the fact you visit us on Mondays. It really sets our residents up for the week, not to mention the staff.’
‘He loves it, too,’ Toni said. ‘I assume you wanted to talk to me about a couple of residents?’
‘Yes.’ Julia took three files out of her drawer. ‘I think Liza is brewing a UTI. I did a dipstick test this morning, and although it wasn’t conclusive I’d like to nip any infection in the bud before it becomes full-blown.’
Toni knew that urinary tract infections could cause additional confusion in elderly patients, making dementia worse; and they were more frequent in elderly patients who sometimes refused to drink enough and weren’t that mobile. ‘OK. Do another dipstick test in the morning and let me know the results. I’ll flag it up at the team meeting tomorrow and see what everyone’s schedule looks like. Either I’ll come out tomorrow myself and see them, or I’ll get one of the doctors to come out; we won’t wait until our scheduled weekly visit on Thursday.’ Toni checked the notes. ‘This is potentially her fourth UTI in three months, so I’d like to look at giving her a lower dose of antibiotics long-term as prophylaxis.’ As a nurse practitioner, Toni was able to prescribe antibiotics rather than having to consult one of the GPs, which made life a lot easier.
‘Agreed.’ Julia, as the nursing home manager, was also a qualified geriatric nurse and Toni knew she was good at picking up early signs. ‘And I’m also a bit concerned about Renée. I’ve noticed she has a bit of a tremor when she holds a mug, and she’s been a little bit off with everyone for the last couple of days.’
‘You think her lithium levels might need rebalancing?’ Toni asked, knowing that Renée was bipolar; lithium levels in Renée’s blood needed to be checked regularly, to make sure they weren’t too high and the drug was doing its job properly. A tremor was often one of the first signs of a problem, along with a change in mood.
Julia nodded. ‘Again, I’d like to catch it early if we can.’
‘I’ll take a blood sample now and drop it in to the surgery on my way back,’ Toni said. ‘We’ve missed the bloods pick-up for today, but I’ll pop the sample in the fridge overnight and it’ll go in tomorrow’s batch. We’ll ring you as soon as the results are through.’
‘Thank you.’
She washed her hands, and went to see the charge nurse to pick up a syringe, a plaster, a phial and a label. Renée was a little more scattered than usual and kept wringing her hands. ‘They don’t like me in here, you know,’ she confided. ‘They’re going to tell me to leave.’
Toni knew from experience that when Renée was worried, she’d keep circling back to the same fears and no reassurance would work for longer than a couple of minutes; it just needed a couple of days for her lithium levels to get back in balance and her mood would change and her worries would disappear. So instead Toni gently asked if Renée would mind her taking a blood sample, then after her agreement changed the subject to the weather and how pretty the sunset had been last night.
Thankfully, the distraction worked and she was able to take the sample, then reassured Renée a little more before going to see Julia again to collect Archie.
‘Even before we get the test results, from her behaviour I’m pretty sure you’re right and her lithium levels are out of balance,’ she said. ‘But we need the numbers to fine-tune the dosage, and although I can prescribe a few things this is a medication I’ll have to talk to one of the GPs about.’
‘OK. Until we get the results back, we’ll keep reassuring her and changing the subject so she doesn’t get too anxious,’ Julia said. ‘Thanks, Toni. It’s appreciated.’
‘No problem. One of us will come out to see you tomorrow,’ Toni said, ‘and Archie and I will see you next Monday afternoon.’
‘She’s a smashing girl, Toni,’ Mr Fellowes said. ‘She used to work in a big London hospital. We’re lucky to have her.’
The nurse practitioner had come here from London, too? And it was unusual to move from a hospital to a general practice. Had she been burned out, in London? Ben wondered. Or had there been some other reason why she’d come here? Even though they’d clashed, Ben had been very aware of her—and, despite his intentions never to get involved with anyone again, he found that she intrigued him.
Mr Fellowes went on to answer the unspoken question. ‘She came home to help her sister look after their grandmother when she became ill. Lovely woman, Betty Butler. Her girls did her proud.’
Which sounded as if Toni and her sister had been brought up by their grandmother. Which was none of his business, Ben reminded himself. He wasn’t going to ask what had happened to her parents, or why her grandmother had needed looking after, or if her grandmother was still around. It was nothing to do with him.
‘She’d do anything to help anyone, our Toni.’
Which told him that the nurse practitioner was kind as well as being popular. He felt another twinge of guilt. Maybe he’d overreacted a bit about the dog. Or maybe he’d overreacted because he’d noticed the colour of her eyes and his awareness of her had spooked him slightly because he hadn’t noticed small details like that about anyone for the last two years.
‘That’s good to know,’ he said neutrally, and guided the conversation back to the ulcer on Mr Fellowes’ lower leg that refused to heal.
Toni dropped the blood sample into the surgery. She wasn’t sure if she was more relieved or disappointed not to see the new GP again, which unsettled her slightly. If he was a hotshot London doctor like Sean had been, he was the last person she wanted to spend time around. And yet there was something about him that drew her.
She shook herself, and drove to the car park by the beach. She changed into her running shoes, slung a bag over her shoulder with two bottles of water and a bowl for the dog, then clipped his lead on and took him to the dog-friendly side of the beach before letting him off the lead again so he could bound along the sand.
The tide was halfway out; she followed the dog down to the shoreline, enjoying the freshness of the slight breeze coming off the sea and the swishing sound of the waves against the sand. Running produced the usual endorphins; by the time they’d run along the shore and then back to the car park, she was feeling much less grumpy than she had after her run-in with Ben Mitchell.
She picked up a home-made apple pie at the beach café and a sausage for Archie, then clipped the dog into his harness on the back seat and drove to her sister’s house.
Stacey greeted her with a hug. ‘Perfect timing. The kettle’s hot.’
‘Lovely. I’m dying for a mug of tea. And I brought pudding.’ Toni kissed her sister and handed over the apple pie. ‘How’s my best niece?’ she asked, lifting Scarlett out of her bouncy chair and giving her a cuddle.
Scarlett giggled and plastered a mushy kiss to Toni’s cheek. ‘Tee-to!’
Scarlett-speak for Auntie Toni; Toni was so glad she’d stayed in Norfolk and had the chance to watch her niece grow up instead of going back to London, when maybe she would only have seen her sister once a month and missed all the important milestones in her niece’s development.
‘How’s your day been, Stace?’ Toni asked.
‘Good. We had toddler group this morning, and Mary brought her guitar in. Then we went for a picnic in the park. How about you?’
‘My usual Monday afternoon at The Beeches,’ Toni said. ‘Archie brought a smile to a few faces.’
‘That’s good. Though it must be bittersweet for you, going back and knowing Gran isn’t there any more,’ Stacey said softly.
Toni nodded. ‘It is. And I know you miss her, too.’ There was a lump in her throat. ‘She would’ve adored Scarlett.’ Except Betty Butler had died from pneumonia, the month before Scarlett was born. In some ways Toni had been relieved, because at last her grandmother was out of pain and confusion; but in others she’d been devastated. Another link to the past severed. If only Betty hadn’t developed dementia. If only their parents hadn’t died. They would all have loved Scarlett so much. And it must be even harder for her sister with all the might-have-beens.
‘Yes.’
Hearing the slight crack in her sister’s voice and knowing they were sharing the same regrets, Toni changed the subject. ‘The new doctor started at the practice today.’
‘What’s he like?’
Toni wrinkled her nose. ‘Your age, I’d say. Tall, dark and grumpy.’
‘Not handsome?’
‘I didn’t notice.’ It was a slight fib. Ben Mitchell was very nice-looking. Or he would be if he actually smiled. And his eyes were the same green as the sea on a spring day. Not that she should be focusing on that.
‘But grumpy?’ Stacey shook her head. ‘I can’t imagine Ranjit offering a place to someone grumpy. Someone like that just wouldn’t fit in at the practice.’
Ranjit Sidana, the head of the practice at Great Crowmell, was one of the nicest-natured men either of them had ever met, always full of smiles.
‘We clashed a bit.’ Toni rolled her eyes. ‘Over Archie. He didn’t approve of the dog being at the surgery.’
‘Maybe it was first-day nerves,’ Stacey suggested. ‘You know what Gran would’ve said. Give him time to settle in before you judge him.’
‘I guess.’
‘So what do you know about him? Is he married? Single? Any children?’
Toni heard the hopeful note in her sister’s voice and sighed inwardly. ‘I have absolutely no idea. All Ranjit told us about him was that he’s moved here from London.’
‘Like you did.’
‘From another practice, rather than a hospital.’ And the reason why he’d moved from the capital to a quiet country practice was none of her business. ‘Even if he isn’t involved with someone, I’m really not interested, Stacey. You don’t have to hope that he’s a potential date for me. I don’t want to date anyone.’
Stacey squeezed her shoulder. ‘You know I worry about you being alone.’
‘I’m not alone. I live in the same village as the best sister and brother-in-law and niece in the world, I have plenty of friends locally, and I have Archie to keep me company at home.’
Stacey raised an eyebrow. ‘Thank you for the compliment, but you know what I meant. Surely you’d like to share your life with someone who says more than just “woof”?’
Toni laughed. ‘There’s an awful lot to be said for talking to someone who doesn’t answer back.’
As if to emphasise her point, Archie wagged his tail and licked Stacey’s hand and then Scarlett’s foot, making the little girl giggle.
‘I swear you trained him to do that on purpose.’ But Stacey was smiling. ‘Just don’t let Sean the Smug put you off finding happiness with someone else. Not all men are like him.’
‘I know they’re not.’ But she hadn’t managed to pick anyone who felt right before him, either. ‘I’m doing just fine on my own, Stacey. I live in my favourite place in the world, I love my job, and I have my family and friends nearby. I don’t need anything else.’
‘Hint taken, and I’ll stop nagging,’ Stacey said.
For now, Toni thought. She knew her sister’s motives were good, but her life really was just fine as it was. Toni felt very much part of the village where she’d grown up and she had absolutely no regrets about coming here from London. She had a great life; she didn’t need to date someone.
She didn’t need to prove her judgement to herself, either. Of course she knew that not all men were as selfish and demanding as her ex. But if she was honest with herself she knew that the two men she’d dated before him had been just as single-minded and just as selfish as Sean. Sometimes she wondered if she subconsciously picked men who just couldn’t give her love and security so it wouldn’t break her heart when things went wrong. She’d already lost too many people who really mattered at too young an age. Sean had given her an ultimatum: dump her grandmother, or be dumped. That one had been very easy, and she was done with ultimatums.
Single and happy. That was her. And that was the way she intended to stay.
‘Let’s get you back down in your chair, Miss Beautiful,’ she said to her niece, ‘and I’m going to help your mummy cook dinner.’
‘Din-dins,’ Scarlett said, and beamed.
