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  ‘No, of course there is that,’ her mother allowed patiently, oblivious to Philippa’s sarcasm; so oblivious in fact that she made Philippa feel both childishly petty and furiously angry. ‘But he was your husband and in the circumstances Daddy feels that it might be a good idea if you didn’t come over to see us for a while. Poor, dear Robert is terribly upset about the whole thing, you know. I mean, you do live almost on his doorstep and he’s held in such high esteem… Have you made any arrangements yet for the…?’ Delicately her mother let the sentence hang in the air.

  ‘For the cremation, you mean?’ Philippa asked her grimly. ‘Yes. It will be on Friday, but don’t worry, Mother; I shall quite understand if you don’t feel you want to be there.’

  ‘It isn’t a question of wanting…’ her mother told her, obviously shocked. ‘One has a duty, and Andrew was after all our son-in-law, although I must say, Philippa, I could never really understand why you married him, nor could Daddy. We did try to warn you…’

  Did you… did you really, Mother? Philippa wanted to demand. And when was that… when did you warn me? Was it after you told me what a good husband Andrew would make me, or before you pointed out that I would be lucky to find another man so suited to me… or rather so suited to the kind of wife you had raised me to be? If you really didn’t want me to marry him, why wouldn’t you allow me to go on to university; why did you insist on keeping me at home, as dependent on you as a pet dog and just as carefully leashed?

  ‘But then you always were such a very impetuous and stubborn girl,’ her mother sighed. ‘Robert was saying only this morning how much both Daddy and I spoiled you and I’m afraid he was right.

  ‘Have you made any plans yet for after… ?’

  ‘Not yet,’ Philippa told her brusquely. ‘But don’t worry, Mummy; whatever plans I do make I shall make sure that they don’t cause either you or Daddy any problems.’

  Philippa replaced the receiver before her mother could make any response.

  Her palms felt damp and sticky, her body perspiring with the heat of her suppressed anger, but what, after all, was the point in blaming her parents for what they were, or what they had tried to make her? Hadn’t they, after all, been victims of their upbringing just as much as she was of hers? This was the way she had taught herself to think over the years. It was a panacea, an anaesthetic to all the pain she could not allow herself to feel.

  CHAPTER FOUR

  ‘THE trouble with long weekends is that they just don’t last long enough,’ Richard grumbled as he drained his teacup and reached for the pot to refill it. Elizabeth laughed.

  ‘Fraud,’ she teased him affectionately. ‘You know as well as I do that you can’t wait to get back to your patients. I heard you on the phone to Jenny earlier.’

  Jenny Wisden was Richard’s junior registrar and as dedicated to her work as Richard was to his. She had married the previous year, a fellow medic working in a busy local practice.

  ‘Poor Jenny,’ Elizabeth had commented at the time.

  Richard had raised his eyebrows as he’d asked her, ‘Why poor? The girl’s deliriously in love; anyone can see that.’

  ‘Yes, she is, and so is he. She’s also a young woman on the bottom rungs of a notoriously demanding career ladder. What’s going to happen when she and Tony decide they want children?’

  ‘She’ll take maternity leave,’ Richard had informed her, plainly not following the drift of her argument.

  ‘Yes, and then what? Spend the next eighteen years constantly torn between conflicting demands and loyalties, knowing that she’s got to sacrifice either her feelings as a mother or her desire to reach the top of her profession.’

  Richard had frowned then.

  ‘What are you trying to say? I thought you were all for female equality… women fulfilling their professional potential. You’ve lectured me about it often enough…’

  ‘I am all for it, but, once a woman has children, biologically and materially the scales are weighted against her. You know it’s true, Rick: once Jenny has children she won’t be able to go as far in her career as she would if she were a man. She’ll be the one who has to take time off to attend the school concert and the children’s sports day. She’ll be the one who takes them to the dentist and who worries about them when they’re ill, feeling guilty because she can’t be with them.

  ‘No amount of paid substitute care, no matter how professional or good it is, can ever assuage a woman’s in-built biological guilt on that score.’

  ‘Mmm—damn waste it will be too. Jenny is one of the best, if not the best junior registrar I’ve ever had.’

  ‘Well, perhaps in future you should remember that and when you’re lecturing your students you should remind them all, but especially the male students, what sexual equality really should mean—and I’m not referring to a token filling up and emptying of the dishwasher now and then.

  ‘Do you realise, Rick, that, despite all this media hoo-ha about the “New Man”, women are still responsible for the major part of all domestic chores? Sorry,’ she’d apologised, with a wry smile. ‘I didn’t mean to start lecturing you, but…’

  ‘I know.’ Richard had smiled, standing up and leaning towards her to kiss her.

  ‘I saw Sir Arthur yesterday,’ Elizabeth told him now.

  Sir Arthur Lawrence was the chairman of the hospital board, an ex-army major, rigidly old-fashioned in his views and outlook, with whom Richard had had so many clashes over the years.

  ‘Oh, did you? What did he have to say for himself? More complaints about overspending on budgets, I suppose,’ Richard grunted.

  Elizabeth laughed. ‘No, as a matter of fact he was very complimentary, praising you for all the work you’ve done to help raise money for the new Fast Response Accident Unit.’

  Richard grunted again. ‘You should have told him not to count his chickens. We need government funding if we’re to go ahead with it, and we haven’t heard that we’re going to get it yet. The Northern is putting up a pretty good counter-claim to ours. They maintain that they’re closer to a wider range of motorway systems than we are…’

  ‘And we’re closer to the centre of the region and we have better access to the motorway,’ Elizabeth reminded him. ‘And you’ve got a much better recovery record.’

  ‘Mmm… well, that’s no thanks to Sir Arthur; you should have heard the objections he raised when we opened our recovery ward…’

  ‘Admit it, you enjoy fighting with him.’ Elizabeth laughed.

  Richard pulled a face. ‘He’s twenty years behind the times… more… Hell, is that the time? I’ve got to go. You’re at home today, aren’t you?’

  ‘Yes. I thought I might drive over and see Sara. She sounded a bit down when I spoke to her yesterday.’

  ‘Yes, it’s no picnic being a GP’s wife—nor being a GP, either.’ Richard kissed her, smiling at her as he suggested, ‘Why don’t we go out for dinner together tonight… Mario’s? Just the two of us,’ he added.

  ‘Just the two of us,’ Elizabeth responded, emphasising the ‘just’. ‘Mmm… that would be lovely.’

  ‘I’ll get Kelly to book us a table,’ he promised her as he picked up his briefcase and headed for the door.

  After he had gone, Elizabeth made herself a fresh cup of coffee and picked up a buff folder from the dresser. The dresser had been an antiques fair find, which she and Richard had stripped of its old paint, a long and laborious job which she suspected had cost far more in terms of their time and paint-stripper than had she bought the ready-stripped, polished version from an antique shop.

  There was a sense of satisfaction in having done the work themselves, though, and she had enjoyed those hours in Richard’s company. They had reminded her of the early days of their marriage, when it hadn’t seemed so unusual to see him wearing old clothes and getting dirty. ‘You’re so lucky, you and Richard,’ her friends often told her enviously. But their marriage had suffered its ups and downs just like any other. Where they had been l
ucky perhaps had been in that both of them shared the same deep commitment to their relationship, so that, at times when both of them might have viewed their individual roles within it from opposing and conflicting viewpoints, their joint desire to keep their marriage alive and functioning had continued to survive.

  She had not always experienced the same contentment in their relationship, the same pleasure in being herself as she did now, Elizabeth admitted. There had been times, when Sara was young, when she had felt Richard growing away from her… when she had felt threatened by and resentful of not just the claims of his work but his evident involvement with it.

  It had been an article in the local newspaper absently flicked through in the hairdressers which had initially sparked off her interest in community work. With a twenty-year-old degree and no professional skills whatsoever, she had humbly approached the local community liaison officer, explaining that she would like to give her services and that she had time on her hands with her daughter living away from home, but that she had no skills she could put to use.

  ‘No skills?’ the other woman had queried. ‘You run a home, you’ve brought up a family, you drive a car. Don’t worry, we’ll soon find something for you to do!’ And so they had.

  Elizabeth smiled to herself now, remembering how terrified she had been that first day, manning the reception desk at the Citizens Advice Bureau, and then six months later when she had been asked if she would like to train as a counsellor. She had protested that she was not experienced enough to give advice to others, that her life, her relationships were very far from perfect, and certainly did not justify her handing out advice to others.

  ‘The more problems our counsellors have faced in their own lives, the better they are at listening compassionately to the problems of others,’ she had been told crisply.

  She sat down and opened the folder.

  She had recently attended a national conference on the effects of long-term unemployment and redundancy on people. She frowned as she read through the notes she had made. They were certainly getting an increased number of people coming to them for advice on how to cope with their unemployment—women in the main, anxious not just about the loss of income but the effects of their husband’s redundancy and consequent loss of self-esteem on the men emotionally, and on the family as well.

  If the gossip going round following Andrew Ryecart’s suicide was correct in suggesting that it had been caused by financial problems with Kilcoyne’s, it seemed likely that the town would soon have more men out of work. The company was one of the town’s main employers, one of the last light engineering companies left in the area. There would be no alternative jobs for people to go to.

  Elizabeth nibbled the end of her pen. She had suggested at last week’s general staff meeting that it might be an idea to put together a special package formulated specifically to help such cases. People were individuals, of course, with individual problems, but…

  ‘It’s a good idea,’ her boss had agreed. ‘But we simply can’t spare anyone to work on it at the moment, unless…’

  ‘Unless I do it at home in my spare time,’ Elizabeth had offered wryly.

  ‘I’m sorry, Elizabeth,’ her boss had apologised. ‘But you know how things are: we’re all suffering cutbacks and underfunding, just like everyone else.’

  That was true enough. Richard had been complaining that the hospital now seemed to employ more accountants to watch over its budgets than they did nurses to watch over its patients.

  * * *

  ‘Richard, have you got a minute?’

  Richard paused, frowning as he glanced at his watch.

  ‘Barely,’ he told the hospital’s chief executive. ‘My clinic starts in half an hour and I’ve got a couple of phone calls I need to make first.’

  ‘I really do need to talk to you, Richard,’ the other man insisted. ‘We’ve got a committee meeting coming up soon and we still have to go through your budgets.’

  Richard grimaced, suppressing his instinctive response, which was to say that he was a surgeon, not an accountant. It was pointless losing his temper with Brian; he was just as much a victim of the financial cuts being imposed on them as he himself was.

  ‘Look, let’s go into my office,’ Brian suggested, taking advantage of his silence.

  Irritably Richard followed him, shaking his head when Brian offered him coffee. ‘No, I forgot for a moment—you’re a tea man, aren’t you?’

  ‘I drank too much coffee when I was a student and a young intern,’ Richard told him. ‘They talk about working long hours now, but when I first qualified… Still, we didn’t have the same pressures on us then that they do now, nor the huge diversity of skills and facts to learn. These days there seems to be a new drug on the market every day and a new set of complications to go with it, never mind all the new operating techniques, and then of course there’s the paperwork…’

  Brian Simmonds watched him sympathetically. He had remarked at last month’s meeting to the new area health chief administrator that it was perhaps unfair to expect some of their senior and older medical staff to be able to absorb the intricacies of the new technology and the tighter control of finances as speedily as the younger ones.

  ‘If that’s the case, then perhaps you ought to be thinking about pensioning a few of them off,’ had been David Howarth’s cold response. ‘It appals me to see how much money we’re wasting paying top salaries to people who could quite easily be replaced by someone younger—and cheaper.

  ‘The whole area health system needs reorganising and rationalising. We’ve got far too many small specialist units competing with one another. It would make much more sense to nominate specific hospitals to deal with specific areas of expertise. Out of the eighteen hospitals in this area, a good number of them have specialist heart units, and both your hospital and the Northern have specialised microsurgery units. Older surgeons like Richard Humphries…’

  ‘Richard Humphries was the first local surgeon to specialise in his field,’ Brian had protested defensively. ‘He really pioneered the treatment in his area…’

  ‘But Richard Humphries is a man not far off sixty who, no matter how excellent a surgeon he might be, has made it plain that he just isn’t equipped to deal with the financial implications of working in an independent hospital. Christopher Jeffries at the Northern, in contrast, has already shown that he has an excellent grasp of the way we’re going to need to operate in future to make sure we’re financially viable, and he’s twenty years younger than Richard.’

  Brian hadn’t repeated their conversation to Richard. Richard and David had taken a dislike to one another virtually at first sight, and Brian already knew from past experience that Richard was simply not a man to compromise on what he believed were the best interests of his patients for any mere financial reasons.

  Richard epitomised all that was best in the Health Service, its principles and its goals, while David on the other hand represented the new financial cutting edge that was being imposed on it to try to counteract the burden of a growing population and the rapid advances made in medical technology.

  He sighed to himself, knowing that the problem was one thing, but finding the answers to it was something else again, and while David and his like believed that the answer was a far more hard-nosed response to the provision of health services, and while publicly Brian might feel it was politic to agree with him, privately he couldn’t help but sympathise with Richard’s totally opposite point of view.

  Sympathising with him was one thing, failing to get across to him the message that if financial restraints were not self imposed then they would be imposed from outside was another matter, and one that could potentially prejudice the whole hospital’s future.

  ‘Our accountant was on the phone yesterday,’ he told Richard now. ‘It seems that she still hasn’t received your budget forecasts for the next quarter…’

  ‘What exactly is the hospital paying me for?’ Richard countered irritably. ‘Filling
in forms or operating on patients?’

  Brian sighed again. ‘Richard, I know how you feel, but try not to make too much of an enemy of people like David.’ He moved uncomfortably in his seat. ‘There are areas where savings can be made. The Northern——’

  ‘The Northern has a far lower post-operation recovery-rate than we do here,’ Richard interrupted, and added bluntly, ‘And you already know my opinion on the reasons for that…’

  ‘You’re getting too old and too idealistic, Richard,’ his GP son-in-law had told him drily the last time they had met. ‘And if you think you’ve got problems you should sit at my desk for a couple of days.’ Too idealistic he might be, but too old… Richard frowned, wondering why the thought should make him feel so edgy and defensive. He wasn’t even sixty yet. No age for a surgeon. Heavens, he could remember when he’d got his first internship: the senior surgeon had been close to seventy and everyone apart from the matron had gone in awe of him. It hadn’t mattered that you had to shout to make yourself heard because he was going deaf; watching him operate had been a privilege. In those days age and experience had been things to honour and respect—not like today, when the moment you got past forty-five you were considered to be past your best.

  Back in his office, he found that his secretary, Kelly, had already sorted his mail into urgent and non-urgent piles. On the top of the urgent pile was a GP’s report on one of her female patients. As he studied it he pushed aside his conversation with Brian, frowning as he read the doctor’s findings.

  A lump had been detected in the patient’s breast and an immediate operation would be necessary to perform a biopsy and removal if the lump was found to be malignant. She was a relatively young woman, only in her mid-thirties, and he knew from experience the trauma she would experience over the potential loss of a breast, but given the choice between that and losing her life…

 

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