An Apple a Day was the very first story I had published for remuneration: not quite money, but enough of a start to keep me banging away at this for another 20 years and counting. Published in Quantum Muse, an online who’s long time slogan has been: Posting the finest in science fiction, fantasy and alternative writing and artwork. For free. In our sober moments… and is still going strong today, AAaD got me a natty t-shirt, one I still wear occasionally when writing even though it’s pretty much faded away to nothing.
In today’s climate, and celebrating the NHS’ 70th year I think this story still has some relevance in thinking about health care and the pressure we put on all medical staff.
An Apple a Day
“Another day, another headache.” He thought as he woke. A strange line that had stayed with him since childhood. It had been from a kid’s programme on TV. The Muppets, he remembered, as he took his shower. A set of drums which were actually little creatures, and the guy who played them hit them with his drumstick to evoke an “Oww” at different pitches. One of the creature things had muttered at the start of the sketch, before the punch line of the whacking began.
Out of the shower he saw Jenny had woken up and left their bed. He walked down for breakfast; adjusting his tie, and trying to get the cowlicks out of his hair. He’d had them since he was a kid, and even though his hair was now turning grey and even receding, the cowlicks had stayed. He looked older than his 34 years. There weren’t many in his line of work that didn’t.
It was the stress and the physical endurance.
He took the glass of orange juice Jenny had left on the breakfast counter and drank it thirstily. As he drained the glass he smacked his lips with satisfaction. He sat down to savour the moment’s peace, but the newspaper headlines spoilt it for him. The virus numbers still on the increase. New strain discovered. He turned to page two as his wife came in the room, bulky dressing gown tied around her.
She gave him a kiss on the cheek, complaining he hadn’t shaved. He shrugged.
“Joe says he’s not feeling well.” She said, casually.
He raised an eyebrow, “Big test today, huh?”
“Will you have a look at him? I think he may be running a bit of a temperature.”
“Sure, I’ll pop up in just a minute.”
“Hmm?” he asked, looking through the paper. The page 2 headline told of a high court judge who had committed suicide, and he turned to page 4 before she saw it.
“Look at him as a father, not as a doctor, please?”
He laughed, “You let that kid get away with too much. You’re going to let him stay off school just because he doesn’t want to do a test?”
She busied herself putting dishes away; “He’s only ten. It doesn’t do any harm to play on your parents once in a while. Don’t tell me you never did it.”
He couldn’t deny that one, but his parents had been a civil servant and a teacher. He was a doctor. And it felt like a long long time since he’d been a kid.
But he said that it was fine, and when he went up there he just felt the boy’s forehead and made gentle comments that he did seem a bit hot, and did he think he should have the day off school.
The boy had agreed enthusiastically before catching himself and meekly saying that maybe it would be best if he had the day in bed.
David smiled and gave him a kiss on the same spot where he’d just tested for temperature.
The boy had hugged him and told him to be careful at work.
He went downstairs and sat back down at the table, taking a piece of the toast that had appeared during his upstairs visit. Jenny looked at him, smiling slightly.
“Possibly a temperature- more likely he’s been putting hot flannels on his head. I said he should have the day off. So you’re stuck with him. He’ll probably be fine by ten o’clock, and then you’ll have him running around the place all day.”
“I don’t mind.”
He looked at her closely, “Is he still worried?”
She didn’t meet his eyes for a moment, but then gave in. “Yes, he still talks about it a bit. Keeps looking for reassurance that nothing is going to happen to you.”
He’d been upset when the news report had come on last week. The doctor who had a massive heart attack in front of his patient. He’d died instantly. It happened from time to time.
“Are you still worried about it?” he asked her, reaching out to touch her fingers.
She tried to smile but it was paper thin, “You know me, I’ll worry about anything.”
“That’s not an answer.”
She took a deep breath, “Yes, I worry. There are so many dangers. I worry every day when you go to the surgery. I think about the other doctors we’ve seen over the years. I think of Gus…”
He was silent. He and Gus had been at medical school together. They still saw his wife Lorraine occasionally, but since Gus had died it had been less and less. He could understand why she would want to break the contact. Every time she saw him she’d be wondering why it had been Gus who’d had to be on duty when that drug addict had come in. Why Gus had had to be the one to examine him, unaware that he’d just taken a lethal dose of heroin. Why Gus had been alone in the room with him.
He could understand Lorraine’s feelings, and he could understand his wife’s worry.
“It’s a one in a million chance, hon, you know that. What can I do?”
“Nothing. It’s me being selfish. You do a wonderful job, and you save lives. What could I say that would make any difference? You’re in it for the long run. The government have made sure of that.”
“What can I say? Doctors are born…”he started, and she finished the line with him.
“…not made. I know, I know. I saw the Government statements as well.”
He looked at his watch, “I gotta go, or I’ll have a waiting room full of people. Give the tiger a hug from me if he comes out of his ‘fever’ before I’m home.”
They kissed again, a longer, lingering kiss before he finally, reluctantly broke away.
“That’s not fair. I’m late as it is.”
She let him go and waved to him as he left, saying a silent little prayer as she always did, telling herself it was only six years until he retired. But six years seemed a very long time on mornings like this.
He listened to the news reports on the way in. The high court judge had been the top story on the radio, and there were calls for better screening. He made a ‘pff’ sound as he listened. There’d apparently been a note; “I can’t go on, I’ve seen too much.”
Simple but to the point.
He could of course imagine it better than most. He could have been a high court judge, or a policeman, or a social worker, or a psychologist. He couldn’t picture himself in any of the roles, but he could have gone down any of those paths so easily. He parked the car in his personal space and went into reception. Half an hour before his first appointment. He took the swipe cards for the first four cases, thanked Yvonne for the mug of coffee she had ready for him and went into his office.
He swiped the first card through the computer. John Harris. 28. His work thought he was suffering from stress and he was getting severe headaches. Loss of appetite. David pulled a face as he looked at the details. He hated stress cases.
Next up after that was Julie Newton with severe cramping. Could be pre-menstrual but there was a history of cancer in the family and her mother wanted it checked out.
It was looking like it was going to turn into some morning.
“Give me a young couple who are hoping for a baby and are here to find out that the wife really is pregnant,” he thought. Not that they needed doctors for that any more.
Third appointment was a young boy of about Joe’s age. Here for a check up on his broken fibula. It would be fairly straight forward, as long as there hadn’t been any complications. He’d had to admonish the boy’s mother at the last appointment about letting him do too much.
He looked at the fourth appointment. He didn’t like the look of it. Possible alcoholic coming in about a problem with his stomach. He could guess what the problem was. He put an order in for security back up on that one. No one messed with Big Al: what he lacked in brains he more than made up for in strength and loyalty to the doctor.
He wished Gus had had a Big Al.
He put the cards down. The morning cases would take him about half an hour to get through and then he had two hours off. He thought about going home but knew it was against the rules. Complete rest for doctors after every four cases. One of the few concessions the government had made over the last couple of years. That and reducing the retirement age. He remembered the days when it had been ten patients before a rest. Tell the new doctors that today and they wouldn’t believe it.
He remembered his days as a junior doctor and the killer hours. He’d been in practice for a couple of years before it came to light about the dangers. Junior doctors doing ridiculous hours. A couple of deaths and a few more suicides had made the press sit up and take notice. It had taken a long time, but the government had eventually come around…as much as they ever did.
He finished his coffee and got the machine out and placed it on the desk in front of him. He switched it on and it hummed quietly, running through its internal diagnostic test.
He pressed the button on the underside of his desk that switched the green light on outside the door.
The doctor is in.
John Harris came in. 28 but looking about ten years older. His face was gaunt. He looked as if he’d been crying recently and he had virtually no nails left on his hands. When he sat down he was shaking slightly. His leg trembled and he seemed either unaware or incapable of stopping it.
David smiled and asked him to hold out his arm. When he did David slipped the band around the lower bicep, as thought it was a junkie’s tourniquet. He took the other end and held the pressure pads in his hands.
He remembered when it had taken half an hour to get the various wires hooked up between doctor and patient. Now it could be done in ten seconds.
“Ok, John. You know what happens next. I’ll turn the machine on; you’ll not feel anything. It’ll take about thirty seconds. If there’s any problem I’ll let go of the pads and the connection will be broken instantly.”
John Harris nodded. This was all standard practice. As automatic as an Air Steward’s instructions.
David turned on the machine and went into the misery of John Harris’ mind. The usual rush, the first of the day, and not a great one to start with.
Fear, distrust, loneliness, paranoid, tired, I’m so tired, I can’t do this, I can’t do my work, my boss hates me, my wife keeps asking me what’s wrong, I can’t tell her, I’m tired, What’s the point of carrying…
He cut beneath it and felt the physical. The watery bowels. Hadn’t been able to eat this morning. A headache. Tired. Wired. Weak.
He dropped the pads and smiled as best he could, “Ok, John. You’ve got clinical depression and you’re not in any state to go to work. I’m going to prescribe some anti-depressants for you and I want to set up a time for you to see the Psyche- transfer worker. She’ll help you get some bad feelings out and some good ones back in there.”
John Harris left, not looking any better.
But he would be within a week.
Patient two. An ovarian cyst. She’d been right to come. The pain was a bit like PMT, but much worse. She’d left it a little bit too late he thought after she’d left, rubbing his stomach tenderly, but she was young- twelve, and not sure what her periods should be like. He’d sent her off to hospital. They could take it out this afternoon.
The young boy’s leg was coming along nicely. Still a dull pain and he ordered a course of physio for after the cast came off.
The fourth was as he’d expected. Refusal to wear the band at first. Distrust of him. Court order to come along today. The initial wave hit him like a long hard pull of Scotch. A dull sick pain in the head. But nothing compared to the stomach. He felt himself. Swollen, pain in the kidneys and liver. Sclerosis. No doubt. He noticed Al standing close by, ready to take the man out if he tried anything, but he didn’t. Sat there, trance like, like they were supposed to. Blank.
It had been bad scheduling he reflected as he started the break.
Three stomach problems in one morning. Of course, when he’d started out he could have done five or six without really thinking about it. But it was different now. He was older for a start. He’d had the virus two hundred and thirty six times (and how many more times to come with a new strain now he wondered), Cancer more than five hundred, two thousand breaks, countless tumours: both malignant and benign, cataracts, clots, more minor heart attacks than he could remember, and the strokes…
It would be quicker to get a list together of what he hadn’t had.
He remembered the doctors of his youth. They’d talked to patients. It seemed a strange concept now. That was probably why the waiting rooms had always been so busy. He wondered how they found the time. He wondered how they got things right so much of the time.
A good education mainly.
Of course, his own education had been impeccable. Ever since the telepathic ability had revealed itself when he was seven he’d been destined for a career in medicine. God knew he didn’t want to go into the forces.
Ten years of telepathic and medical training in government camp. Him and the other 0.01% they found. How to use the machines, how to diagnose. The machines weren’t essential, but they speeded up the process. Get more bodies through.
He’d made some good friends but Gus had been the best of them. As he drifted off to sleep, knowing he’d wake in exactly one hour, he thought of poor Gus: he could imagine all too well what it would feel like to have your heart mentally explode from such a massive overdose.
He thought about his cases this afternoon.
The worst of the worst.
A scan on an unborn strongly suspected of having brain damage.
Another day, another headache.