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Standing so close to him, Lucy was suddenly very aware of the width of his shoulders. He was wearing one of the dark poloneck jumpers that he favoured, and his subtle male scent teased her nostrils.
Suddenly anxious to put some distance between them, she backed away and moved back behind the relative safety of his desk.
‘I wanted to talk to you about Margaret.’
‘Oh, yes?’ He sat back and looked at her expectantly. ‘What happened?’
‘She was coughing too badly to do the spirometry so she’s going to make another appointment for two weeks’ time.’
Joel nodded. ‘I thought that might happen, but it was worth a try. In the meantime, I’m sending her for a chest X-ray. She is a smoker, so I want to exclude lung cancer and heart failure and I sent off some bloods. She doesn’t look anaemic but it’s worth checking because it could be the cause of her breathlessness.’
Lucy nodded. ‘You’ll be pleased to hear that she’s going to try and stop smoking.’
Joel raised his eyebrows. ‘Pleased and surprised. I must admit I didn’t think there was any hope of that.’
‘I think the chest infection scared her.’
‘Did it now?’ Joel looked at her thoughtfully. ‘So we need to strike while the iron is hot. Did she make an appointment to see Janice?’
Lucy shook her head. ‘No, she wasn’t that committed. She wanted to go away and read the leaflets first. I think even considering giving up smoking is a big step for her.’
‘OK.’ Joel nodded slowly. ‘In that case, I’ll give her a call in a few days to check on her and to give her a little push.’
Joel caught up with Lucy a few days later. ‘I just wanted to tell you that I had the results of Margaret’s chest X-ray.’
Lucy looked at him. ‘And?’
‘It showed some evidence of pulmonary hyperinflation.’
‘Oh.’ Lucy pulled a face, ‘That’s caused by air trapping, isn’t it? It’s a typical feature of COPD, but it can occur in chronic asthma so I suppose we still don’t have a diagnosis. What about her other tests?’
‘Her heart size was normal and there was no evidence of any other pathology.’
‘I’ve asked her to do serial peak-flow readings so when she comes back we can look at those results,’ Lucy suggested.
Joel nodded approval. ‘Good idea.’
That afternoon Lucy worked with Kim, the health visitor, to develop the idea for the new child health clinic.
Ros had designed a poster which they all agreed was fantastic, and Kim spread the word among the mothers as she went about her calls.
‘Never suggest anything in this practice,’ Joel said cheerfully one morning when they met in the staffroom. ‘From having to be present while you jab babies, I’m now the one that’s lumbered with being the doctor for the child health clinic.’
Lucy looked at him guiltily. ‘Do you mind, really?’
‘Of course not. I think it’s a great idea, and I suppose it’s sensible to have some consistency. Have you arranged a speaker for the first meeting?’
‘Actually, yes.’ Lucy nodded. ‘One of Kim’s mothers is an image consultant and she’s agreed to come and talk about colours and things.’
Joel’s expression was comical. ‘Remind me to hide in my surgery. It all sounds terrifying.’
‘You’re certainly not going to hide in your surgery,’ said Kim briskly as she walked past and overheard the conversation. ‘We agreed that you’d mingle, remember? Be there to answer little questions that worry people.’
Joel groaned. ‘Why did I ever agree to this?’
But his smile was good-natured and Lucy knew that he was pleased to help.
‘If you’re good, we’ll let you have five minutes with the image consultant,’ Lucy teased, ‘just in case you’re wearing the wrong colours for your skin tone.’
