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The young GP leaned back in his chair and sighed wearily. It was the same old story; the patient sitting anxiously before him had put off and off coming to see him, not wanting to make a fuss, and now she was going to pay heavily for it.

‘I’m afraid it’s rheumatoid arthritis all right, Mrs Langley,’ he told her.

The woman sitting on the opposite side of the desk sighed in her turn and shook her head. ‘I feared it was something like that. But it was easy to ignore until this past month or so, when it suddenly became much worse.’

‘It’ll be this wretched cold weather that’s brought it out,’ said the doctor, gesturing at the window, through which a heavy fog was all that could be seen. ‘Winter is always a bad time of year for rheumatic sufferers.’

‘What do you suggest for it, Dr Robertson? I suppose it is…chronic?’

‘I’m afraid so. There is no cure for it, and it will gradually gain a stronger hold as the years pass. Until recently there was little we could do beyond issuing painkillers, which were very ineffective anyway. However, there is now a new treatment available which tackles the inflammation itself, and I would highly recommend you try it.’

‘What is it?’ she asked curiously.

‘It’s a course of injections which brings all the swelling down,’ explained Dr Robertson. ‘It was first pioneered in America, and it was brought over to Britain two years ago by a friend of mine from Guy’s who specialises in rheumatism. It won’t cure you, but it will greatly relieve your symptoms and slow down any permanent damage. I believe come peacetime it will become a standard treatment for RA, and much more widely available. As it is now, though, my friend is the only one trained and able to offer it.’

‘It sounds promising,’ said Mrs Langley approvingly. ‘Where is he based, Doctor? Somewhere in the city?’

‘Oh no, though it’s not all that far from here,’ said Dr Robertson. ‘He’s attached to a Sanatorium near the Welsh border in Armishire, up in the mountains. It’s run by Sir James Russell, the TB specialist, you know.’

‘The Welsh mountains?’ exclaimed Mrs Langley. ‘But I can’t possibly go, then. There’s no one to take care of my little girl, Helen. I thought I could have attended as an outpatient, if he was in Birmingham.’

Dr Robertson shook his head. ‘This treatment is a full regime which requires a hospital stay. Rest, controlled exercises, diet, and so on. You must be prepared to go into hospital for at least three months. As for your daughter, is she of school age?’

‘Yes, she’s twelve.’

‘Well, if you have no relatives or friends with whom she could stay, might I suggest you send her to boarding school for the duration of your treatment? One term would probably be sufficient. Plus it would get her out of Birmingham and away from any danger of bombing. Armishire is a safe area, so if you sent her to somewhere there, she would be out of harm’s way, and near at hand if you want to see her, too.’

Mrs Langley sat frowning for a few moments. ‘I’d have to think it over, Doctor. I should certainly like to try this treatment you suggest, but finding something suitable for Helen is more difficult.’

‘If you’d care to wait outside for a minute or two, I will telephone Dr Peters and outline your case to him,’ said Dr Robertson, ‘and if he is able to take you on, I shall ask him about any schools in the area that he could recommend for Helen.’

‘Thank you,’ said Mrs Langley, allowing herself to be ushered from the consulting room. After seeing her seated in the little waiting room outside, Dr Robertson returned to his desk and put through a call to the Sanatorium in Armishire.

Frank was at his desk in his office, buried in some case notes, when the phone at his elbow rang. Muttering a most uncharitable remark under his breath at having his flow of thought interrupted, he picked up the receiver.

‘Yes?’

‘Dr Peters, there’s a Dr Robertson from Birmingham on the line for you,’ purred the efficient tones of Miss Hiles, one of the San receptionists.

Frank’s eyebrows shot up in astonishment. Robertson was an old acquaintance from Guy’s, of course, but they had never had any sort of formal dealings, only a friendly correspondence consisting mainly of medical discussions.

‘I see. Put him through, please.’

A few clicks and far off noises, and then he heard the polished tones of his old classmate.

‘Is that you, Peters? It’s Terry Robertson.’

‘To what do I owe this pleasure, Robertson?’ asked Frank. ‘It’s been some months since I last heard from you.’

‘I know, I know,’ groaned Robertson. ‘It’s this damn war, I haven’t a minute to call my own for letter-writing these days.’

‘Oh I know, believe me, I know. Are you still in general practice up in Birmingham?’

‘And how! Look here, Peters, I have a request for you, and I hope you’ll take it on. I’ve a patient on my books that I’ve just diagnosed with rheumatoid arthritis. She’s not particularly old – forty if even that – but it’s had a hold on her for some time now, though the silly woman held off coming to me as long as she could, not wanting to make a fuss. You know the type.’

‘Only too well,’ sighed Frank. ‘They only end up creating even more of a fuss than they were dreading by leaving it so long. I suppose you want me to take a look at her?’

‘Got it in one. Well, it’s your field, isn’t it? Give her a good dose of that American treatment you’ve been raving about. Can you take her on?’

‘I expect so, we ought to have a bed available in the next few weeks, but I’d have to give her a proper overhaul before I could say for sure whether that treatment would do anything for her. It will depend very much on how severe it is, how much joint damage she’s sustained, and so on. And if it is suitable for her, it will mean a stay in the San here for three or four months.’

‘I know, I’ve told her that, but there’s a snag in that she has a child to consider, a girl of twelve or so. She’s a widow, and seems to be devoid of relations she could send the girl to while she’s in hospital. I suggested boarding school, even if it’s just for a term or two, but she isn’t too keen on the idea.’

‘Suggest the Chalet School to her,’ said Frank at once. ‘It’s owned by Jem Russell’s wife, Madge, and it’s very much connected to our place. A lot of the girls who go there do so because they’ve got relatives here receiving treatment – as I expect I’ve told you, we specialise particularly in TB, so many of our patients are in for the long term and like to have their girls nearby. It’s a very decent place, and it’s a fairly easy matter for the girls to come here for visits and so on. It’s based at Plas Howell, a huge old manor house about three miles from Howells Village, which is only about fifteen miles from here.’

‘That sounds ideal,’ said Robertson approvingly. ‘I’ll mention it to Mrs Langley and see what she thinks. I’d certainly like to have her seen to quickly, before the rheumatism gets a stronger hold on her.’

‘Of course. Send her over for an initial appointment so that I can size her condition up, and if she’s suitable, I’ll see what I can do about getting her in quickly for treatment.’

‘Right.’



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