Chapter 10
In another ten minutes Alice would have finished her very first day of consultations in her new post. She was already dreaming of a bubble bath, steaming and full to the brim, even if it would be taken in the little white tub back at her new temporary accommodation along that windy high street.
Even with the white plastic shower curtain, yellowing grout and the fan that didn’t work properly.
She’d learned not to wish for more, not with her student debts to pay off.
There was still this one consult left and already the room was charged with strong emotions.
‘You say Jolyon doesn’t speak at all?’ Alice enquired, looking at the little boy playing on the consulting room rug.
‘Jolyon laughs and makes sounds. He can make his feelings known,’ the boy’s mother, Mhairi Sears, began, ‘and he screams too.’
The circles under the woman’s eyes told Alice that, lately, there’d been rather a lot more screaming than laughing.
Alice looked again at the boy, not a toddler at all, but a big boy of reception class age, busy with a toy car clasped in his sweet, if a little sticky-looking, fist.
Like she’d told all her other patients today, Alice had also explained to Mhairi Sears that this was her first day and that although she’d completed her medical training at uni and on placement in hospitals, today was her very first day of specialist GP training.
She’d even asked whether Mrs Sears wanted her to call in Dr Millen, currently hunched over admin in his messy office next door.
The woman had said no. In fact, she was ‘glad to be seen by a young woman doctor, after everything…’ Then she’d tailed off and left Alice to guess what the ‘everything’ was that this woman had gone through.
Alice had only ten minutes and a long list of questions to ask; partly following the diagnostic guide on her screen, partly intuiting her way.
All she had to do was recall her training and hope she didn’t miss anything major.
Not so easy after what had been a long day, especially not now her head was full of conditions she wanted to revise and referrals she needed to make and patient queries that needed following up.
Concentrate, Alice. Concentrate.
‘And Jolyon sleeps all right?’ she asked.
‘Uh-huh,’ the mum answered. ‘Mostly during the day in cat naps. You love to stay awake at night, don’t you, Jolly?’
The boy looked up at this but quickly returned to driving his car along the floor.
‘We’ve had a lot of late-night Bluey marathons in the living room while Dan sleeps.’ Mhairi’s lips twitched ever so slightly and her eyes narrowed in a way that suggested she was picturing her husband snoring, oblivious, in a big comfy bed.
Alice didn’t know what to do with this sign of parental discord. Nor did she know what Bluey might be. She focused on the list on her screen, taking notes, hoping she was doing this right. For now, she wasn’t sure which of the two was actually unwell or what she was expected to do.
‘Would you like me to check on Jolyon’s referral to the Speech and Language team?’ she said, searching for the correct system on her computer.
‘If you can, please. We had one session with a lady at the Repair Shop Café. You know how they do drop-ins with experts now and again?’
Alice had to admit she didn’t know anything about that.
‘She was great. I’d hoped we’d be getting to the top of her referrals list by now though.’
Alice’s computer screen didn’t have much in the way of good news in that regard. ‘Tell you what, I’ll send them a note letting them know we’ve seen you both again, see if we can hurry them along,’ she said, not feeling hopeful.
‘All right, so I noticed Jolyon arrived in a pushchair today,’ Alice continued when she finished typing. ‘Is that typical?’
‘He doesn’t tend to walk far,’ the woman explained. ‘He often just drops to the ground and cries. Life’s easier with the buggy.’
Alice typed this into the little boy’s notes while the woman talked on.
‘It’s not as though there’s some kind of discipline issue, if that’s what you’re typing.’
Alice let her hands fall from the keys. ‘I wasn’t…’
‘“Mum gives in to tantrums too easily”,’ Mhairi said in air quotes, turning red-faced. ‘I’ve heard that one before, sometimes from my own sisters-in-law, to make it worse.’
‘No, no… I’m just recording our consultation.’
The mum sat back, hands clasped between her knees, giving her the same look she’d seen many times on the wards. Was she thinking how young Alice seemed? How inexperienced? Unready for this kind of responsibility, and certainly way too unworldly to know much about parenting?
Alice reached for her water bottle and took a swig to hide the lump in her throat.
No, there was something kind about Mrs Sears, and even though she was married with a kid, she was only a little older than Alice.
Plus, she seemed too weary to go interrogating Alice like some of the patients had back in Manchester as she followed the consultants on their rounds.
‘How old are you then?’ they’d ask while she nervously changed catheters and fitted cannulas and the nurses tried not to roll their eyes (the nurses were always a million times better at those things and not afraid of anything at all).
She needed to focus. ‘Where is your head, Alice in Wonderland?’ she heard Bastian saying.
‘And… he likes to eat?’ Alice said. ‘Is he putting on weight?’
‘I’ve tried him with different solids for years now. Spag bol, steamed veg, fish fingers…’
Alice tapped softly at the keys, hoping not to spook the woman again.
‘…but he only really eats plain pasta, breadsticks and Greek yoghurt. The occasional iced biscuit.’ Mhairi’s shoulders slumped in defeat.
‘Doesn’t like fish fingers?’ Alice repeated, still typing.
Her nephews adored them. She thought all kids did.
Though, looking at Jolyon now, he wasn’t all that much like her boisterous, chatterbox nephews; boys who, if anything, could do with a lesson in self-contained peacefulness from Jolyon Sears.
‘I know what you’re thinking,’ Mhairi said, the words tumbling out in self-defence. ‘I’ve seen that look before.’
Alice wiped her face blank.
‘I’ve seen it over and over, since he was about six months old and that Baby Tambourine Jamboree leader mentioned Jolly wasn’t meeting expected milestones.’ The mother’s eyes stayed fixed on the boy, who was very busy straightening out a paperclip he’d found on the floor.
Alice tried a sympathetic smile. If she could only read minds, she thought – and not for the first time.
If Alice could have dug inside Mhairi Sears’s brain at that moment, she’d have been confronted with a big angry, messy knot of memories and indignation She’d uncover how the young mum had stopped going to the stupid Baby Tambourine Jamboree classes after that.
She’d know what it felt like when the nursery assistants had said the exact same things about Jolly’s milestones and how it had become increasingly hard to dismiss their concerns the older he got.
She’d feel the burning anxiety when half the mums at the Health Visitor’s weigh-in mornings had made similar remarks.
She’d hear the endless crowing chorus of, ‘Has he not moved on to baby rice yet?’ ‘Not even crawling? Goodness!’ ‘My Skye was on the move at nine months, she was into everything!’ ‘Of course, my Henry’s taking swimming classes now! ’
‘Have you tried introducing a multivitamin?’ Alice tried, shut out on the other side of the wall.
‘He gets liquid vitamins added to his bottle,’ Mhairi said.
‘His… bottle?’
There they were. The big round eyes of a patient feeling judged. Alice quailed. She’d have said something consoling if Mhairi wasn’t now hurriedly defending herself.
‘He doesn’t get his mouth round a cup, somehow.
It spills everywhere… I tried giving him cups, hundreds of pounds worth of fancy toddler cups off the internet, all shapes and sizes, he didn’t get to grips with any of them.
It’s not as easy as just giving him a cup and making him drink…
and I can’t let him go thirsty, can I? What mum would do that? So he still has his bottle…’
‘That’s OK,’ Alice put in quickly, typing up a referral for the paediatric occupational therapist as well. This had been a prickly issue, clearly. ‘Adding some ice lollies would be fine too,’ Alice added. ‘If he likes those?’
This stopped Mhairi. ‘He likes some of them, actually.’
‘And those sucky frozen yoghurt sticks, and there’s jelly sweets you can buy with fruit juice centres.’ Alice remembered those from the palliative care ward and all those shifts when she’d followed the bedside rounds at the hospice.
‘What about the sugar? His teeth?’ Mhairi asked, like she’d been warned about this before.
Does it really matter right now? Alice wanted to say, remembering the parched lips of some of her patients. ‘You can buy low or zero sugar ones, and so long as he’s hydrated, it doesn’t matter too much. I’m sure you do your best with teeth-brushing.’
Mhairi’s face suggested teeth-brushing wasn’t entirely successful either but she wasn’t about to admit it here.
There was only one minute left on the clock. That’s when she saw the tears welling in the mother’s eyes and the fight to hold them back.
‘Would you… describe yourself as depressed at all?’ Alice said tentatively, reaching for the sheet with the tick boxes that she’d learned to give out in situations like this. ‘How many of these would you say apply to you?’
Cautiously, Mhairi took the sheet.
Alice knew the symptom check boxes by heart. Tearful? Low mood? Low libido? Intrusive thoughts? Difficulty sleeping? Loss of appetite?
‘I’m not here to talk about me,’ Mhairi said. ‘I’m here for Jolly. And I’m not depressed depressed,’ she said.