Dr Haynes is lovely, but I felt so embarrassed about having to explain it all to him. I couldn’t believe my luck when Ruth told me I’d be seeing you tonight!’
‘Good.’ Emma laughed, although she couldn’t help wondering how many other women were delaying making appointments because they felt uncomfortable about discussing their problems with an elderly male doctor.
She checked Judith’s BP, which was fine, then asked her to undress and lie on the couch while she examined her. She gently palpated her abdomen and then performed an internal examination but could find nothing to indicate what was causing the problem. Judith had had a smear test the previous month and that had come back clear.
‘And there’s been no other symptoms at all?’ she asked after Judith had got dressed again. ‘Not even something that is apparently unrelated?’
‘No … well, apart from the fact that I’ve had several bouts of diarrhoea. It’s not something I’ve ever suffered from before, but it’s happened a few times lately. Either that or I get constipated,’ Judith added, grimacing.
‘I see.’ Emma frowned thoughtfully as she considered what she’d heard. ‘It’s possible that you’re suffering from endometriosis, although I wouldn’t like to make a final diagnosis without sending you for some tests first. However, the symptoms you described could point towards it being that.’
‘Endometriosis?’ Judith repeated. ‘What’s that? I’ve never heard of it.’
‘It’s when tiny pieces of the lining of the womb, the endometrium, are shed during menstruation but don’t pass out of the body. Instead they travel up the Fallopian tubes into the pelvic cavity and attach themselves to the pelvic organs. They continue to respond to your menstrual cycle so each month they bleed, but because the blood can’t escape, it causes cysts to form. And they’re the cause of most of the pain and discomfort.’
‘How weird!’ Judith exclaimed. ‘And you think that’s what is wrong with me?’
‘I think it’s worth investigating further.’ Emma brought up the relevant document on the computer and filled in the patient’s details. She glanced at Judith. ‘You need to be seen by a gynaecologist so I’ll organise an appointment for you. Basically, what it means is that your pelvic cavity will need to be examined. It’s done by using a laparoscope, which is a special instrument that’s passed through the wall of the abdomen. There’s a tiny camera on the end of it so the gynaecologist can see what’s going on inside you.’
‘It sounds horrible,’ Judith said, shuddering.
‘It’ll be fine,’ Emma assured her. ‘And it will be worth having it done if it means we can sort out this problem you have.’
‘If I do have this endometriosis, how will you treat it?’
‘It depends how severe it is. Drugs can be very effective in some cases. In others, where the cysts are very large, surgery to remove them is the best option. Pregnancy can also suppress the condition.’
‘So I can still have a baby?’ Judith asked anxiously.
‘Yes, although it’s only fair to warn you that endometriosis can affect your fertility. However, let’s find out if my diagnosis is correct before we worry about that.’ Emma tried to sound as positive as she could but she could tell that Judith was upset by the thought that she might not have the baby she longed for.
Emma saw her out and buzzed for her next patient. The evening flew past and before she knew it, it was time to pack up for the night. She collected up the files she had used and took them into the office. Ruth looked up from the computer and smiled at her. She had worked at the practice for many years and had watched Emma growing up so there was no question of her standing on ceremony.
‘I bet you’re sorry you came home now, aren’t you, love?’
‘It did cross my mind,’ Emma replied, jokingly. She held up the files. ‘You’d think we should be able to do away with all this paperwork now that we have computers to help us.’
‘I wish!’ Ruth replied cheerfully. ‘The trouble is that computers have a nasty habit of breaking down, so we need the files as back-up.’
‘I suppose so.’
Emma looked round when she heard footsteps in the corridor, feeling her pulse surge when Daniel appeared in the doorway. She had been too stressed about seeing him again to take much notice earlier in the day, but all of a sudden she found herself taking stock of the changes the past few years had wrought. Although he was still extremely good looking with those craggy, very masculine features and that thick dark hair, there were lines on his face that hadn’t been there five years before, an underlying sadness in his hazel eyes that surprised her. Daniel looked as though he had suffered some kind of sorrow in his life and she couldn’t help wondering what had happened. Was it possible that he had fallen in love and been let down?
The thought sent a shaft of pain searing through her. Emma bit her lip to contain the cry that threatened to emerge. That Daniel might have experienced the same kind of unhappiness as she had done when they’d parted should have filled her with a certain satisfaction, but it didn’t. All she felt was an overwhelming sense of grief that he might have loved some other woman more than he had loved her.
‘I hope it isn’t always as busy as that?’ He grinned at Ruth. ‘Sure you didn’t ring round all the patients and ask them to call in tonight so you could put me through my paces?’
‘How did you guess?’ Ruth winked at Emma. ‘Drat! We’ve been found out.’
‘I … um … it looks like it.’ Emma did her best to respond to the teasing comment but it wasn’t easy. The thought of Daniel loving another woman was more painful than it had any right to be. She was over him and it shouldn’t matter, but it did. She took a quick breath to control the pain when she saw him look at her in surprise. ‘We’re only joking, Daniel.’
‘That’s good to hear.’ He smiled coolly. ‘I’d hate to think you had it in for me, Emma.’
Emma flushed when she heard the irony in his voice. She turned away, busying herself with placing the files she’d used in the tray. By the time Daniel added his, it was brimming over. ‘Do you want me to put these away so you can have a clear run in the morning?’ she offered.
‘There’s no need. Dr Haynes took on a part-time receptionist at Christmas,’ Ruth explained. ‘There was some sort of wretched tummy bug doing the rounds and I was snowed under with all the extra paperwork. Claire comes in three mornings a week and helps with the filing, et cetera. We’ll soon get everything sorted out between us.’
‘Oh, right. That’s fine.’ Emma placed the referral letter she’d printed in the tray for posting. ‘There’s just the one letter that needs sending as well.’
‘And I’ve got another one here.’
Daniel leant past her and dropped his letter on top of hers. Emma tried not to flinch when his shoulder brushed against her but he must have felt the small involuntary jerk she gave. He stepped back, his face betraying very little as he told Ruth that he would lock up and set the alarm.
Emma took it as her cue to leave. She murmured a general goodbye and hurriedly left. Although the surgery was attached to the house, it was completely self-contained and she had to walk round to the front door
