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‘How long has he been like this?’ he asked, observing the neck movements keenly.
‘He had a really bad sore throat last week,’ Linda Giles said uncomfortably, ‘and then he started twitching. His brothers and sisters keep laughing at him. But I thought I’d better bring him in to be looked at.’
‘It is a good job you did,’ he told her as he gently examined her son. ‘Why didn’t you bring him into the surgery when he had the inflamed throat?’
She shrugged. ‘I gave him some Friar’s balsam on a spoon with some sugar and it didn’t seem as bad after that.’
Daniel frowned. ‘Friar’s balsam is a very old remedy, and in some cases is sufficient to clear up a sore throat, but what your son had would have been much worse than that,’ he explained. ‘He should have been seen by a doctor.’
The Giles family lived in an old tumbledown house at the top of the road that led to the circle of peaks that surrounded the village. There were five children in all and though Linda Giles did her best she never seemed to be on top of things.
‘Why? Is it the sore throat that’s making him twitch?’ she wanted to know.
Daniel nodded. ‘It could be.’ Turning to Billy, he said, ‘Can you hold your hands out in front of you for me, Billy, like this?’ He showed him, with palms facing downward.
The child, who seemed to have a better idea of what was going on than his mother, obeyed, and Daniel saw what he didn’t want to see. The fingers were curling backwards, and he knew he was seeing a case of Sydenham’s chorea.
‘Have you ever heard of St Vitus’dance?’ he asked Mrs Giles. ‘That’s the common name of the illness that I think your son might be suffering from, which is rheumatism of the central nervous system. It’s hardly heard of in this day and age but it can occur very rarely. I’m going to get Billy seen by a neurologist as soon as possible to see if I am right. In the meantime, take him home, put him to bed, keep him warm and give him the antibiotics that I’m going to prescribe for his throat.’
‘I can’t take him home. I’m on school dinners,’ Linda protested. ‘I’ve been taking him with me while he’s been poorly.’
‘Forget school dinners until he has been seen by the neurologist,’ he told her firmly. ‘The only thing that will stop the body movements getting worse is bed rest and sedation and I am not going to prescribe anything like that until a firm diagnosis has been made. So please do as I say.’
At last Mrs Giles seemed to realise the seriousness of the situation and she took Billy’s hand in hers and led him out of the surgery. Daniel sighed and hoped that she would do as he had said.
He rang her later in the morning and told her he’d arranged an appointment with a neurologist for the following day. ‘It will be a home visit,’ he told her. ‘He will be coming to the house so don’t let Billy out of bed until he’s seen him.’
‘Oh!’ she wailed. ‘Does he have to come here? I haven’t had the chance to put the vac round for days what with one thing and another.’
‘Don’t worry. He’s not coming to look at the house. He’s coming to see Billy,’ he said. And I’m pretty sure I know what he will say, he thought as he said goodbye and put the phone down.
He’d told Billy’s mother that the neurologist wasn’t going to be looking at the house, but damp living conditions and poor nourishment would be noted.
When they were getting ready to leave at the end of the day he said to Miriam, ‘What experience do you have of Sydenham’s chorea in a patient?’
She was reaching for her coat and collecting her belongings, anxious to be gone, and she replied, ‘So far, none. I’ve heard of it, of course.’ And before he could explain that he would like to discuss little Billy’s case with her, she was off.
When he arrived back at Jasmine Cottage, Kate was ironing the clothes that she’d laundered earlier in the day and he said with a frown, ‘You don’t have to do mine. I’m quite capable of ironing my own things.’
‘Yes. I’m sure you are,’ she told him, ‘but you are not going to tell me that my mum doesn’t do your ironing. I know her too well for that.’
‘Yes. Ruth does do my washing and ironing. It was part of the deal when I moved in.’
‘And so I’m taking her place.’
‘So it would seem,’ he commented dryly.
This sort of domestic scene was the very thing he wanted to avoid, he thought as he went upstairs to change out of the suit he’d worn at the surgery.
He didn’t want this forced intimacy to become too cosy.
To begin with, Kate was too forthright and pushy. The absolute opposite of how Lucy had been. She had been gentle and amenable, with long silky hair and a piquant face. Life without her was an empty thing. Yet the woman downstairs ironing his shirts wasn’t to blame for that. It was just that he didn’t want any more complications in his life than he had already.
There was the business of her mentioning the vacancy at the surgery. The more they were thrown together the more she might see it as a reason for him to offer it to her, and he wasn’t going to be manipulated.
They had a meal of sorts. Eating together at the kitchen table, pizza and a fruit flan that Ruth had put in the freezer. Short of being downright rude there was no way he could have avoided it. But once they’d cleared away he said, ‘I’m going upstairs for a while to unwind. If I don’t see you later, sleep well.’
Once in his room he lay down on top of the bed and picked up a book that he’d half read, but he couldn’t settle into it. He felt restless and it was all because of Kate downstairs, who, if she had something to say, came out with it.
She had barged into his life just a short time ago and ever since he’d felt as if his organised existence was being threatened. Yet Kate was vulnerable too in her own way. Trying to cope with being surplus to requirements for some low-life who had strung her along. She didn’t deserve that.
She’d got the message, Kate thought when he’d gone. In a roundabout sort of way he was telling her to keep her distance. That enough was enough, and she couldn’t blame him.
If she needed employment it was up to her to look for it instead of expecting it to be handed to her on a plate. But she was going to have to move out of the area if Daniel didn’t want her in the practice.
She glanced through a magazine, watched some television half-heartedly, and finally decided to go to bed for lack of anything else to do. The days were stretching ahead emptily and she wished that Gran was better and her mother was home.
Ruth had never liked Craig. She’d thought he had a wandering eye and sadly she hadn’t been wrong.
They’d drifted into a relationship, working long hours together, snatching quick meals. Talking shop sometimes, and at others letting the close environment they worked in shut out everyone else, so that it had been as if there had only been the two of them.
The odd thing was at this troubled time in her life the fates had sent another man into it, and the more she saw of Daniel the more Craig was becoming a shadowy figure. Yet she knew nothing about the GP who had taken Peter Swain’s place in the village’s health centre.
He was far too attractive for the women he met to overlook deep hazel eyes and hair as dark as ebony curling neatly above his ears, yet he was alone and seemingly un-attached.
Surely he must have someone, somewhere who cared for him. A wife or a partner, a mother, or a sister. Or was the house he was having built by the river just for himself?
One thing was sure. She wasn’t going to ask him. She’d already floored him twice in one day by her determination to give away the wedding dress and almost in the same breath asking him about the vacancy at the practice. It was more than likely that he thought she wasn’t exactly broken-hearted if she was job-hunting two days after her arrival and disposing of the dress that must have meant a lot to her at the same time.
She kept her tears for when she was alone in the dark hours of the night. The feeling of not being wanted hurt so much that she had to push it to the back of her mind when she was with Daniel in case she made a fool of herself. The last thing she wanted was for him to feel that she was looking for a shoulder to cry on.
Getting up off the sofa, she began to walk slowly upstairs, having given up on seeing him again before morning, but as she reached the landing the door of his bedroom opened and he was framed there, dressed in a thick sweater and jeans with a sheepskin jacket over the top.
‘Hi,’ he said warily. ‘You aren’t going to bed, are you?’
‘Yes,’ she told him flatly. ‘There doesn’t seem much else to do.’
‘It’s only half past nine.’
‘So?’
She looked pale and lost and he weakened, saying, ‘I’m going down to the pub for an hour. Do you want to come?’
He couldn’t believe he’d said it when the words were out. This wasn’t keeping Kate at a distance. Her expression had brightened but she was hesitating.
‘That would be nice,’ she said, ‘but I hope that everyone doesn’t start asking questions about why I’ve come back to live. I presume my mother will have told some people that I’m engaged and they’ll be curious because it wasn’t someone local, but I don’t want to suddenly be the focus of attention.’ Kate sighed. ‘It hurt a lot to have my trust betrayed. The fact that I won’t be wearing the wedding dress or honeymooning abroad is disappointing, but delightful as those things are, they’re just the trappings of a wedding. It’s knowing that the person you’re marrying can be trusted to love and cherish you that matters. With Craig that was never going to happen, so I suppose I should consider myself to have had a lucky escape, but it doesn’t make the pain go away.’
‘I can believe that,’ Daniel said gravely, finding himself wishing that he knew her well enough to offer comfort. ‘But, Kate, you will have to face the people around here some time, so why not get it over and done with?’
She smiled for the first time since they’d met on the landing. ‘Yes. Why not? At least I’ll have you for moral support.’
‘You will indeed,’ he promised, and thought that it was a long time since he’d felt so protective over anyone, but he wasn’t sure if he wanted it to be like that.
A diversion was called for and, remembering little Billy Giles, he asked her, ‘Have you ever seen or treated anyone with Sydenham’s chorea, rheumatism of the central nervous system?’
She frowned thoughtfully. ‘I know what it is, but I’ve never treated anyone with it. Although I do believe I once saw someone whose life had been blighted by it.’
‘So go and get your coat and make sure that you wrap up warm. It isn’t long since you were ill, so don’t take any chances, and you can tell me about it while we’re walking to the pub.’
Kate nodded and went into her room to quickly get ready while Daniel waited downstairs. Then they stepped out of the house and began the pleasant walk towards the pub.
‘So why are you asking about Sydenham’s chorea?’ Kate asked immediately. ‘You haven’t got a patient with it, have you?’
‘I might have, and it’s very much on my mind. A young boy who from the sound of it has had a severe throat infection, came to see me this morning with his mother. He was making uncontrollable neck movements all the time and I suspect that it is the jolly old St Vitus’ dance as it used to be called way back.’
‘What makes you think so? The twitching of the neck?’
‘Yes, that, and also what happened when I tested him in the same way that a neurologist once did on a patient that I’d sent to him with the same kind of problem.’
‘What sort of test?’ she asked, and he thought at that moment she wasn’t his landlady’s daughter or the jilted bride, she was the doctor first and foremost, tuned in, keen to know. Miriam could take a lesson from Kate.
‘When the boy stretched his hands out in front of him palms down, his fingers curled backwards. I’ve tried it with my hands, and if you try it with yours you’ll find that it is almost impossible to make them do that. So simple, but so illuminating, though I never found out what it actually revealed. But it will be interesting to see what happens tomorrow.’
‘That’s interesting,’ she commented. ‘That someone could be diagnosed in such a way.’
‘I know, but that is how it was then. They may have other ways of making a diagnosis now. So tell me about this person that you saw.’
‘It was a man in a big department store. His whole body was on the go all the time, making exhausting sweeping movements. Some people were laughing at him, but I just felt so sorry for him I could have wept. I thought at the time that it might have been Sydenham’s chorea, but had no way of knowing if it was, short of asking him, and he was having enough to cope with without that. It comes from a streptococcal throat infection, doesn’t it, and poor living conditions?’
‘Yes, and Billy Giles lives in a damp old house. They are a big family and I don’t somehow think they live off the fat of the land, even though the father works on a farm. Immediate and prolonged bed rest is essential to prevent the damage to the nervous system progressing, so I bundled him off home to bed and have arranged for a home visit from a neurologist tomorrow.’
‘I’ll be very interested to know what happens,’ she said. ‘Would it be possible for me to see Billy, so that if ever I do come up against it I will be better informed than I am now?’
‘Yes, of course,’ he said immediately. ‘I’ll be visiting him regularly once it is sorted and I’ll take you with me if you like.’
He was weakening, Daniel was thinking. He knew it. But her kind of enthusiasm was what he was looking for in the practice. Miriam was a good doctor, but he’d never found her prepared to go the extra mile.
‘Maybe you could come down for an interview,’ he said as the pub came into sight, and as her expression brightened he thought that Kate was going to be renewing her acquaintance with the villagers inside The Poacher’s Rest with a bit more sparkle than when they’d left the house.
‘Hello, there, Daniel,’ Michael Grimshaw, the landlord, said when they appeared, and, on seeing who was with him, ‘Kate! Nice to see you. Are you just visiting, or back for good?’
Before she had the chance to answer someone called from across the room, ‘So when’s the wedding, Kate? We’re always ready for a chance to dress up in the village, especially when it’s for one of our own.’
Daniel cast a quick glance at his companion. Was he ever going to be free of the feeling of responsibility he’d had for her from the very moment of their meeting? he wondered. What was Kate going to say to that?
The sparkle had gone as quickly as it had come, but she was totally composed as she announced for the benefit of anyone listening, ‘The wedding preparations are on hold at the moment. We’re spending some time apart, but I will bear in mind that you would like me to be married here when the occasion arises.’
As they sat down with their drinks he murmured. ‘Well done and very subtle. I’m proud of you. That took some pluck. It should give you some breathing space and delay any surmises about the wedding dress for the time being.’
She flashed him a watery smile. ‘Thanks for being with me. It did make it easier. At least I’ve been able to give a hint of things to come.’
‘You have indeed, and now relax for a while, Kate. What shall we talk about?’
The smile was still there. “Sydenham’s chorea?’
‘No. We’ve given that enough of an airing until I have some results on young Billy.’ He sighed. ‘It’s been a week of coming into contact with some very unfortunate people, but of course that’s the doctor’s lot.
‘I had an anxious young woman consult me who is fighting breast cancer and is facing a mastectomy. She’s considering having both breasts removed to give herself a better chance and wanted my opinion.’
‘What did you advise?’
‘That she see the oncologist and get an opinion from her. She is under the hospital and I don’t know enough about her case to tell her what to do, but I could see sense in what she was contemplating.’
‘It makes one’s own troubles seem small compared to that kind of problem, doesn’t it?’ Kate said sombrely.
‘Hmm. But they don’t go away because of it, do they?’
She glanced at him curiously. ‘You don’t come over as having problems Although I do sense that you are alone. Do you not have any family?’
‘If you mean am I married, or in any other kind of relationship, the answer is no.’
‘Amazing,’ said Kate, wondering why such an attractive man was on his own.
‘What do you mean?’ asked Daniel levelly, as he sipped his drink.
‘Just that lots of women would see you as their dream man.’
He laughed, but there was no mirth in it. ‘Really? Well, I’m sure that you won’t get any of those sorts of ideas. Though saying that, I know how the minds of people on the rebound can work.’
As she was about to voice an indignant protest he went on, ‘I’m afraid that my life is not an open book, like yours. Some of its pages will stay closed for ever. Both my parents are dead. I had a fantastic childhood and would have wanted the same for any children I might have. But we don’t always get what we want, do we?’
‘So are the closed pages about your parents?’ Kate asked, rather annoyed about his assumption that she could be some sort of desperate woman on the rebound.
‘No,’ he said abruptly. ‘They are not, and I think we should be making a move. If you can lie in bed in the morning, I can’t.’
‘What about my interview?’ Kate asked nervously.
‘Leave it with me. After the house calls and before the late surgery would be a good time, but I’ll have to check with Miriam so that she will be available to join us. I don’t want to go over her head in this.’
As they walked home in the quiet night beneath a sky full of stars Daniel said, ‘Do you think you might find working at the practice a bit tame after a busy A and E department?’
‘I didn’t before,’ she told him. ‘General practice might move at a slower pace, yet it’s just as challenging in its own way.’
Kate couldn’t help but feel hopeful. But she told herself she wasn’t there yet. There was nothing to say that she was the only person he had in mind for the position, and what about Miriam? Would she want her on the staff?
That night she dreamt about the wedding dress. That she’d gone to the wardrobe and it was hanging there unused and unwanted. In the dream she’d cried out in dismay and Daniel had come dashing in to see what was wrong.
‘You said you’d taken it to the charity shop!’ she’d sobbed.
