The Doctor’s Proposal Read online

  ‘I work fast when I see rewards in front of me. Pretty good, huh?’

  ‘Pretty fantastic,’ she whispered. From the dark and gloomy castle of last night, there was now life and laughter and the chaos of a family. Even if it lasted only a day, this was worth it. Susie had been so bemused this morning she’d laughed at least half a dozen times, and that was six times more than she’d laughed since Rory had been killed. She thought the twins were great. They’d all sat at the kitchen table and eaten cold meat and salad for lunch, and Susie had hardly seemed to notice that she was eating.

  The twins, two chirpy imps with their daddy’s gorgeous brown curls and eyes that were wide with innocence and mischief, hadn’t permitted a moment’s silence, and who could be desolate when they were around?

  ‘It’s excellent,’ Jake said, and she grinned her agreement. But…

  ‘There’s no need to get too smug. If we come home and Boris has dug up the pumpkin patch…’

  ‘Boris is a dog of intelligence,’ Jake said solidly. ‘Besides, it’s a pumpkin patch. Now, if it was lamb shanks or even strawberries, I’d worry.’

  There was a long contented silence. It wasn’t just Susie and Angus who were benefiting from this, Kirsty thought. Her own mood had lightened about a thousand per cent.

  And maybe some of that was to do with sitting beside Jake Cameron?

  ‘Tell me about the patient you’re taking me to see,’ she said hurriedly, in an attempt to distract herself from thoughts she had no right to think. But she was thinking anyway.

  For a moment she didn’t think he’d answer. Maybe he was distracted too, she thought hopefully. Maybe he was thinking…

  Cut it out!

  ‘Mavis Hipton is a sweetheart,’ he said softly, and she knew she’d been misjudging him. His face said all his attention was on his patient, and he was worried. ‘She’s eighty and has terminal cancer. Uterine cancer with bone metastases. Like Angus, she refuses to go into hospital. She’s better off than Angus, though, in that she has her daughter caring for her. Barbara is looking after her mother really well.’

  ‘So why do you need me to see her?’

  ‘She has breakthrough pain. I can’t keep it under control without making her so drowsy she can’t read to her grandchildren. I saw her when I left you last night. I upped her morphine, but I was hoping you might be able to give me a more imaginative solution to the problem. I can ring a physician in Sydney to get advice, but without seeing her he’s not much use. And…’ He hesitated.

  ‘And?’

  ‘And he seems to think sleeping into death is the way to go,’ Jake said bleakly. ‘I’m hoping you disagree. Mavis may have a few months left, and if I can give her some quality time with her family…well, I’m damned if I’ll deprive her of it unless I have to.’

  Their destination was as far from Kirsty’s Manhattan hospice as she could imagine. It was a tiny weatherboard shack, ramshackle around the edges but with bright gingham curtains in the window, hens clucking around what was obviously a well-tended garden and a toddler making mud pies on the front step. The lady who greeted them was wearing jeans, an oversized shirt and big workman’s boots. She was wiping her hands on a dishcloth as she opened the door, and she tossed the cloth aside to seize Jake’s hands in welcome.

  ‘Jake. I didn’t think you’d make it back today.’

  ‘I told you I would, Barbara.’

  ‘Yeah, but you squeezed us in last night and we know how busy you are.’

  ‘How did she sleep?’

  ‘Like a baby,’ Barbara told him. ‘It was great that you did come. She was in so much pain.’

  ‘And today?’

  Barbara’s eyes clouded. ‘It’s probably worse than it ought to be. She won’t take any more of the morphine. She’ll take it tonight, she says, but not now. It makes her drowsy and she says if she’s going to sleep all the time then she may as well die right now.’

  Jake grimaced. ‘Maybe we can do better than that. Barbara, this is Dr McMahon. Kirsty’s a pain specialist from the US. I wondered if your mum would mind seeing her.’

  ‘Mum’s delighted to see anyone,’ Barbara said. She motioned to a bigger house along the track. ‘That’s where my hubby and I live,’ she told Kirsty. ‘But Mum gets lonely and her oven’s better than mine. I’ve got scones in the oven right now. You go in and see her and by the time you finish I’ll have the scones ready.’

  ‘Who needs payment when we have scones?’ Jake said lightly, bending down to admire the toddler’s mud pies.

  Kirsty’s astonishment grew. Jake Cameron was a doctor with heart, she decided. Real heart. Most of the doctors she knew cared about their patients, but they’d not spare the time to stoop to admire a small child’s mud pie-or to give their patient’s daughter a swift hug, as Jake did as he passed Barbara to enter the house. Barbara sounded cheerful but her eyes were strained and bleak. Kirsty knew from experience that there was often little sleep for the primary caregiver. Not much sleep and too much heartache.

  Mavis’s bedroom was lovely. It was simply furnished, with an old double bed on a plain wooden floor, a worn rug and a vast patchwork eiderdown that was the centrepiece of the room. But it was the window that made it. From where the diminutive old lady lay, Mavis could see out over the veranda. She could see her granddaughter making her mud pies. She could see the hens scratching among the rose bushes, and in the distance she’d see the cows ambling lazily up toward the dairy from the clifftops further away.

  Who would choose to be ill in hospital when you could be ill here? Kirsty thought, stunned. No one.

  But the lady herself was in trouble. The look in Mavis’s eyes suggested fear and pain. Relentless pain, Kirsty thought. She’d seen that look so many times. Acceptance that pain would be with her until the end.

  A bottle of morphine mixture stood on the bedside table. Any time she wanted she could use this, Kirsty thought, appreciating that Jake had ensured Mavis could ease her pain whenever she wanted and drift into painless sleep. But she was obviously choosing not to.

  Sleeping into oblivion had a distinct downside when there was so much life just through this window.

  ‘So you’re a pain specialist,’ Mavis said as she walked in, and Kirsty realised she must be tuned in to everything that was said in the outer rooms. She’d be aching to be a part of the world again.

  ‘Hello, Mrs Hipton,’ she said, taking the lady’s proffered hand. It was dry to touch-was she dehydrated? ‘I’m Dr McMahon.’ She hesitated, then added, ‘Call me Kirsty.’ That was something she’d never do back home. The use of first names in her Manhattan hospice was frowned on by the powers that be, but here it felt right.

  ‘Where do you fit in?’ Mavis whispered, and Kirsty saw it was an effort to talk. ‘Don’t tell me you flew in all the way from the States just to give me a consultation.’

  ‘Kirsty’s sister was married to Rory Douglas,’ Jake told her, and the lady’s eyes lit up with interest.

  ‘Married to Rory. Angus’s Rory?’

  ‘My sister’s visiting Angus,’ Kirsty told her. ‘So I thought I’d make myself useful while they get to know each other.’

  ‘So Angus has family again,’ Mavis breathed. ‘Well, well. Isn’t that lovely?’ She managed a tight, pain-filled smile. ‘Everyone should have family,’ she whispered. Her sharp, intelligent eyes moved from Kirsty to Jake and back again. Questioning without words. ‘Even Dr Cameron.’

  ‘I think twins are enough family for anyone,’ Kirsty said lightly, ignoring the innuendo. ‘Mrs Hipton-’

  ‘Call me Mavis.’

  ‘Mavis, then.’ Kirsty smiled. ‘Could you bear it if you and Dr-if you and Jake gave me a complete history of your pain?’

  Kirsty listened. For a while she didn’t comment. She waited while Jake completed his normal examination. She sat while Jake talked, while he checked a pressure sore on Mavis’s back, while he listened while Mavis told him about her granddaughter’s attempt to conquer a tricycle. Jake was d
eliberately giving her space to think.

  So she thought.

  ‘I think I may be able to help a little,’ she said at last, tentatively. ‘That is, if you trust me.’

  ‘I’ve checked Dr McMahon’s credentials,’ Jake told Mavis before the old lady could respond. ‘She’s the best.’

  She shot him a surprised but gratified look. That was a compliment that must have come via her boss back home, but hearing it from Jake felt good.

  ‘When did you last have morphine?’ she asked.

  ‘About four this morning.’

  ‘Why not since?’

  ‘I didn’t need it.’

  ‘You’re hurting now. A lot.’

  ‘I can bear it,’ Mavis said. ‘I thought… You get used to it. You get addicted to that stuff so it’s not effective. If it gets really bad…’

  ‘It’s bad now,’ Jake said gently, and Mavis flashed him a look of fear.

  ‘I’m not dying yet.’

  That was always the unspoken terror, Kirsty thought. That the pain would get worse and worse, and then when you needed it most the drugs wouldn’t work.

  ‘No,’ Kirsty said softly, and she lifted Mavis’s hand and held. ‘You’re not dying yet. But you are in pain. You know, morphine is an odd drug. If you take it to forget your troubles, as many addicts do, then, yes, you’ll become addicted. It’ll lose effectiveness and you’ll need increasing doses. But if you have real pain-as you have-then it never loses its effect. I promise you. Mavis, I’m thinking you’re suffering a lot of unnecessary pain because you’re frightened of becoming addicted and because it’s making you drowsy. Because of your fears, you’re not taking the morphine regularly, which means you’re getting a lot of pain before you take the next dose. You reach the stage where the pain’s unbearable and then you finally take it. That’s right, isn’t it?’

  ‘I… Yes,’ she muttered, and Jake said nothing.

  ‘Mavis, I promise you that morphine is not addictive if we use it in the right dose for the pain you’re having. I promise you also that it will stay being effective for as long as you need it. What we need to do is to find the right dose. The dose is different for everybody, because everybody’s pain is different. You need to start off by taking a prescribed dose of this mixture regularly every four hours. Slightly less than you’re taking now-but regularly. I want you to promise me that you’ll take this dose regardless. After a day or so the sleepiness will ease. The dose I’m prescribing will leave you free to enjoy life. It’ll be regular and it’ll keep the pain level tolerable. If, despite this, you have breakthrough pain, then I want you to take more, but I want the background dose to stay constant. I want you to call me every day, and we’ll gradually increase the background dose until the pain is completely gone. Completely. And it will happen, Mavis. I promise. Then I’ll change you over to a really convenient long-acting tablet that you can take just twice a day. That way we’ll stay one step ahead of the pain, and you should rarely need to take the mixture. We’re aiming to get rid of the pain completely-not just aim for good enough. We’re aiming to get you out on the veranda, back into the kitchen when you’re feeling well enough-not just watching life through a window.’

  ‘But the morphine makes me so drowsy,’ Mavis whispered. ‘I don’t want that. I have so little time. I can’t just sleep…’

  ‘Drowsiness often happens if you take a little too much occasionally,’ Kirsty told her. ‘You’re waiting so long that you need a big dose to fight the pain and so you’ll go to sleep. What we need to do is give you a little and often. Drowsiness is much less likely to happen then.’ She smiled. ‘And this is only step one. If morphine still makes you sleepy, we’ll ditch it and try another drug. No excuses, Mavis. We need to get rid of this pain completely. Will you work with me to do that?’

  Mavis glanced at Jake. Jake was smiling.

  She looked back at Kirsty.

  ‘You’re staying for a while?’

  ‘My sister’s expecting a baby in a month. I’m not going anywhere.’

  ‘So our Dr Jake has a partner for a month.’

  ‘I guess he does,’ Kirsty said. ‘And you have a very bossy palliative-care physician. If you’ll have me.’

  ‘Jake doesn’t mind?’

  ‘Jake doesn’t mind,’ Jake said solidly from behind them. ‘Kirsty looks like being a gift horse, Mavis, and I’m not one for looking gift horses in the mouth.

  ‘Me either,’ Mavis said soundly. ‘Welcome to Dolphin Bay, love. I’d very much appreciate it if you could make me more comfortable.’

  ‘Good,’ Kirsty said cheerfully. ‘Great.’ She beamed at her patient. This sort of case was the reason she’d decided on her specialty. She’d missed her work so much, and to be useful again was wonderful. ‘I’ll have you bouncing in no time,’ she told Mavis. ‘But meanwhile you need to answer the question that every palliative-care physician worth her salt asks every patient.’

  ‘Which is?’

  ‘What’s happening with your bowels?’

  ‘That was fantastic.’ Jake turned the car homewards and shot Kirsty a look of appraisal that was more than tinged with approval. ‘Really great.’

  ‘We don’t know yet whether she’ll follow instructions.’

  ‘She’ll follow instructions,’ he said bluntly. ‘Why wouldn’t she? She’s been in so much trouble that she wanted to die as soon as she could-and what I was doing wasn’t helping.’

  ‘You were keeping her pain-free. Or giving her the choice to be pain-free.’

  ‘By doping her to the eyeballs.’ His fingers clenched round the steering-wheel, so hard they showed white. ‘There’s so much I don’t know in this job,’ he said grimly. ‘I barely touch the surface, and there’s so much more. You have this information at your fingertips.’

  ‘Caring for terminally ill patients is what I do every day of my working life. Of course I know my stuff. But I’d imagine my general medicine is a whole lot more limited than yours. Give me a good dose of chickenpox, and I’ll run a mile.’

  He grinned at that. ‘Anyone in their senses would run a mile from a good dose of chickenpox.’

  She chuckled. This felt good, she thought. More. It felt great. She could work with this man. She could even enjoy herself. For the next month…

  ‘Would you be prepared to give an anaesthetic for minor surgery?’ he asked, almost as if he was echoing her thoughts about them working together.

  She nodded. ‘Sure. Um…what needs doing?’

  ‘I have a middle-aged farmer with a hernia who’s desperate for an operation,’ he told her. ‘Francis is almost totally incapacitated by a hernia in his groin, but he’s scared silly of city hospitals. He has it in his head that if he leaves here he won’t come back. So he puts up with a hernia that makes him an invalid. For nothing. With a competent anaesthetist I could fix it in my sleep. If you’re here…’

  ‘You may as well make use of me, huh?’

  ‘That’s what I intend.’

  Silence. Contented silence. Jake flicked the radio on, and something soft and happy drifted over the airways. On Kirsty’s left was the sea, glistening sapphire, broken only by a battered blue fishing boat chugging ponderously back to harbour.

  ‘This is heaven,’ she whispered, and Jake glanced at her with a strange look.

  ‘As you say.’

  ‘It really would be a fantastic place to bring up kids.’

  ‘That’s why I’m here.’

  She hesitated. They were nearing the castle now, and the car was slowing. ‘What do you intend doing now?’

  ‘This afternoon?’

  ‘Yes.’

  ‘Dropping you at the castle, collecting the Boyces, the twins and Boris and taking them all home,’ he said promptly.

  ‘But you have more work to do.’

  ‘Yes, but you’ll be back at the castle to take care of Angus and Susie, so there’ll be no need for Margie to stay. Margie will take care of everyone back at the hospital residence.’


  ‘You live in the hospital residence?’

  ‘Yes.’

  ‘Would you like to leave everyone at the castle for the rest of the afternoon?’ she said impulsively, thinking of the pile of food she’d seen in Angus’s freezer. ‘Come back when you’ve finished work for the day and I’ll cook you all dinner.’

  His face stilled.

  ‘No,’ he said brusquely. ‘Thank you.’

  She stared. His tone had changed so dramatically that she was reminded of their first conversation, when he’d thought she and Susie were here after money.

  ‘What have I said wrong?’

  ‘Nothing.’

  ‘Wouldn’t you like to have dinner with m-with us?’

  There was a moment’s hesitation. ‘Kirsty, I may as well say this straight out,’ he said bluntly. ‘It might sound dumb to state this so early, but I don’t want you getting the wrong idea. I don’t have relationships with women. My twins need all my attention and I can’t mess them around.’

  Silence.

  More silence.

  Her jaw seemed to hit her ankles. Lower. As a statement it was as effective as a wash of cold water, seemingly just as shocking.

  ‘You don’t have relationships with women?’ Kirsty said at last, carefully, as if not trusting her voice. She didn’t trust her voice.

  ‘The twins and I manage very well by ourselves,’ he told her. ‘I’ve made a resolution not to mess with their lives by getting involved. I’m a dad first and foremost. Then I’m doctor to this district. My sex life comes a sad last.’

  Her jaw dropped a bit more. Count to ten, she told herself fiercely. One, two…

  She didn’t make it.

  ‘You don’t have relationships with women,’ she repeated, and he’d be a dope if he hadn’t heard the anger surging in her voice. They’d arrived at the castle gates. He’d drawn to a halt and hit the remote that had the gates swing open. But he had to stop while they opened. ‘What exactly do you mean by relationships?’ she asked.

  ‘You know.’

  ‘I don’t know,’ she snarled. ‘I’ve been working with you for the last hour. Does that define a relationship?’