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treatment plan with Lizzy’s GP and the specialist.

      A choice would need to be made but Ryan had no intention of rushing into a decision that didn’t sit well with his daughter. He had removed his own GP hat and had worn his father hat during the conversation. There were a number of considerations moving forward. How his daughter felt about each and every one of them was paramount to Ryan. With the options clearly explained, Ryan wanted to sit and talk more with Lizzy before making their joint decision and visiting her doctor.

      Finally, a driver arrived to collect her. Ryan waved goodbye and walked his next patient into his consulting room and closed the door. He sat down opposite the older woman and leaned in towards her slightly.

      ‘Tell me, Dorothy, how are you and how is the adjusted medication level coming along?’

      ‘Not too bad, Doctor.’

      The elderly lady’s reply didn’t convince Ryan as he watched as her softly wrinkled hands fidgeted with her handkerchief. She was twisting the delicate lace-edged linen nervously.

      ‘Not too bad?’ he replied. ‘That’s not what I was hoping to hear and it’s not the same as good. I would like to hear that you’re feeling very well, Dorothy. You’re the most energetic and engaging octogenarian I know. What’s bothering you?’

      He didn’t take his eyes away from hers. Ryan was not going to let her leave without an explanation.

      ‘Well.’ She paused for a moment then took a considered breath and continued. ‘My sugar readings are all around six or seven, which you told me is fine, but the headaches are still there. Every day I have one. Some days I even wake up with one and, on those days, they are particularly bad. I don’t like taking painkillers but George says I must take them or I’m like a grumpy bear. He makes sure I do every four hours and gets quite cross if I don’t want to take them. I don’t want to upset him and I would hate to be a grumpy bear but I’m taking twelve of those tablets a day and that can’t be good.’

      Ryan’s displeasure with George’s behaviour towards his wife, insisting that she take the tablets rather than solving the problem, showed in his frown. ‘George is not qualified, Dorothy. And you should not need that level of medication, so let’s get to the reason for the headaches.’

      He did not further push his annoyance that George was encouraging the painkillers without consultation with a professional. Dorothy Dunstan, in Ryan’s opinion, was as far from a grumpy bear as one could get. Even in pain. The eighty-one-year-old was a slightly built woman, with a mass of white curls, stunning blue eyes and the sweetest smile. He had no doubt she would have been very beautiful as a younger woman and her prettiness would more than likely still turn heads in the upmarket retirement village where the couple lived.

      Her husband, George, on the other hand, also a patient of Ryan’s practice, was a solidly built man with a gruff demeanour and very much closer to a bear’s disposition on the best of days, particularly when his diverticulosis flared up and he blamed everyone around him. Ryan was upset that the man would force his wife to take medication just to keep her happy around him.

      ‘Let’s trial a break of your current medication. That may help with the headaches. No guarantee but it’s worth trying that route.’

      ‘Really, Doctor? But what about my diabetes?’

      ‘The surgery to remove your gall bladder last November also removed the chronic infection. That would have been stressing your body and as a result a number of organs were not functioning properly and your blood sugar level became elevated. I have been lowering your dose each month, as you know, but now I would like you to stop taking your medication completely for one week.’ Ryan paused and looked Dorothy in the eyes with a serious expression dressing his face. ‘But, Dorothy, you must maintain a diet without any added sugar as the dietician advised. None. No chocolates or other sugary treats. That means no cakes or biscuits with your cup of tea...and no scones, jam and cream either.’

      ‘I promise, Dr McFetridge, but I do love Devonshire teas and it has been very hard to say no to my friends when they make scones. And George buys us both cake with our coffee after lawn bowls and I don’t like to say no to him.’

      George’s selfish and ignorant attitude was testing Ryan’s patience but he controlled his desire to tell Dorothy what he thought of her husband. ‘I know, but you also want to stay healthy and drug free so it’s worth the sacrifice and I’m sure that your friends and George love you enough to understand. But you must tell them and you must be firm.’

      Dorothy nodded in response.

      ‘And I want you to call through your blood sugar reading every day to my nurse. Any raised levels and I need to see you straight away. Don’t try to persevere if the levels change. I can’t reiterate this enough. Diabetes is a serious condition, but as it only occurred after your illness we may be able to control it with a sensible diet from here on in. But it will mean ongoing monitoring and food restrictions.’

      ‘Really? You mean I may not need to take the medication again, ever?’

      ‘Let’s hope so. In some cases, an adjusted diet is all the treatment a patient needs and I hope you are one of the fortunate ones. Would you like me to tell George that he should refrain from buying the cake and the painkillers?’

      ‘Oh, Lord, no. He would have a fit if he thought I’d told you that.’ Dorothy’s disposition was suddenly flustered.

      ‘You can rest assured that I won’t say anything, then, Dorothy, but you need to be firm with him. And I do mean firm. You can’t eat the cakes just because your husband has bought one for each of you.’

      ‘I’ll just tell him I’m not hungry.’

      ‘You can tell George whatever you like, that is not my business, although I would have thought telling him the truth about your condition would be better, but again that’s not my place to advise you how best to manage George. However...’ He paused and his voice became increasingly deep and more serious in tone. ‘Whatever you tell him, you must not waver under pressure. It’s your long-term health that we are talking about here. And George would most definitely want a healthy wife.’

      She nodded her agreement to Ryan’s terms then continued. ‘If I stop the medication and avoid the temptation of the sweets, do you think my headache will finally go away?’

      ‘That’s what I’m hoping,’ Ryan told her as he stood.

      ‘Then that’s wonderful news and worth the sacrifice of a few cakes...’

      ‘All cakes, not a few cakes.’

      ‘That’s what I meant.’

      Ryan smiled as he reached for Dorothy’s arm and lifted her to her feet and walked her out to the reception area, asking Molly to make an appointment for the following week.

      He left Dorothy with Molly, then turned and smiled in her husband’s direction. ‘How are you today, George? Keeping dry and out of the cold as much as you can, I hope.’

      George grunted and made a dismissive gesture with his hand. ‘Damned appointments all day. After this I have to go home, pick up Dorothy’s darned cat and get her to the vet. Fur-balls again. If it’s not one thing it’s another. So much for retirement. I never get a day at home in peace. And the cat doesn’t like me anyway. It either hisses at me or ignores me. Typical woman.’

      Ryan wasn’t sure quite what to say. The elderly man was healthy for his age, with relatively few ailments, but his demeanour was another story. He behaved as if he had the weight of the world on his shoulders, and nothing appeared to make him happy. Ryan had initially suspected a level of depression but that was quickly ruled out by a referral to a clinical psychologist. George had retired from his successful fishing charter business in the lower Eyre Peninsula town of Port Lincoln a very wealthy man. He had a very sweet wife, the two of them had taken numerous extended overseas holidays and were active for their age, and their four daughters had provided them with half a dozen healthy, happy grandchildren. If only, Ryan thought, there were a

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