Go Not Gently - [12]

The receptionist clicked us off on the computer and directed us to the waiting room. Three women were already there. No one spoke to anyone else or made eye contact.

Agnes leant over to whisper to me. ‘When we go in,’ she said, ‘I’ll explain what we want.’

I agreed. ‘You do the talking.’

We were another tedious twenty minutes waiting. I leafed through Marie Claire and Vogue. Gradually each of the three women was summoned by the buzzer and the illuminated sign inviting ‘Next patient please’, and disappeared. Then it was our turn.

Dr Goulden welcomed us with a bright smile.

‘Mrs Palmer.’ He shook Agnes by the hand and gestured to the seat at the side of his desk.

‘I’m Miss Donlan,’ said Agnes. ‘We’ve come about-’

‘I’m sorry,’ he interrupted, the smile replaced by a puzzled look, ‘but I seem to have the wrong notes here.’

‘No, they’re right,’ said Agnes, sitting down. ‘We’ve come about Mrs Palmer.’

‘Aah.’ He regained his composure and fetched an extra chair over from the far corner of the room for me.

‘So,’ he held his hands open to Agnes, ‘how can I help?’

While she explained the situation and her worries I studied Dr Goulden. He was probably in his early thirties, with a square face, thick blond hair, pale blue eyes, sandy freckles. Tall, big-boned. He was impeccably dressed in blue striped shirt, dark blue suit and tie. He probably had to shop at Long and Tall or whatever that specialist shop is called. He sounded solid middle class, no trace of a regional accent. He listened attentively, his head cocked to one side just so you’d know he was listening attentively.

When Agnes had finished he said, ‘I’d just like to clarify a few points. You are a friend of Mrs Palmer’s and this is…’ He looked at me.

‘A friend of the family,’ said Agnes, ‘Sal, Sally.’

I winced visibly. People have a habit of softening my name. But I’ve never been a Sally. Sal was a pet name my dad used. My real name’s Sarah but I’ve been Sal as long as I can remember. Sally makes me feel like a six-year-old.

‘Mmm,’ Dr Goulden didn’t sound all that keen, ‘Mrs Palmer’s son is actually listed as next of kin.’

‘But he’s in Exeter,’ said Agnes. ‘I talked to him on Friday, he’d no objection to me making the appointment. He knows I visit Lily two or three times a week.’ Agnes began to sound defensive.

‘I don’t discuss my patients with other people. Confidentiality is paramount. I’m sure you understand. Mrs Palmer is getting the very best care, Homelea has an excellent reputation-’

‘We could go to the trouble of arranging for Mr Palmer to travel up from Devon to put these questions to you,’ I said, ‘but it seems rather an extreme measure, a waste of time for everyone concerned. We’ve already spoken to Mrs Knight and I’m not aware that there has been any problem about patient confidentiality. If you could answer some of Miss Donlan’s queries we wouldn’t need to trouble you any further.’

There was an uncomfortable pause. We sat it out.

He decided to play ball. ‘Your concern is that Mrs Palmer may be suffering from an acute confusion rather than chronic decline?’

Agnes nodded.

Dr Goulden smiled sympathetically. ‘I’m ninety-nine per cent certain that’s not the case but if you’ll bear with me I’ll scan the notes and see if we could have missed anything.’ He leafed through the papers humming tunelessly. ‘Tum-ti-tum-ti-tum-tum-tum’, a gesture intended to show us that all was well, to demonstrate how competent and relaxed he was.

He patted the papers back into the manila folder. ‘No,’ he said, ‘nothing. I’d have been very surprised if there had been. In the sort of case you’re asking about,’ he explained, ‘we’d look for a certain sort of physical problem, an untreated infection, perhaps, from which we could date the development of the confusion. Now we’ve nothing like that here, absolutely nothing.’ He stressed the words. ‘She had a full medical on arrival at Homelea, sort of MOT,’ he smiled insincerely and waved the folder, ‘and everything I’ve seen of Mrs Palmer makes me certain that she has chronic dementia, Alzheimer’s. I’m sorry. I can assure you we are doing our best for her.’

Agnes suddenly looked much older, the brilliance of her dark eyes dulled. ‘But it’s all been so quick,’ she said. ‘She doesn’t know who I am any more.’ The last words came out in a whisper as she fought to stay in control.

‘There are peaks and troughs,’ said Dr Goulden, ‘as with any chronic disease. The situation may well improve. Often adjusting the medication can help things considerably. With some patients the situation can stabilise and remain so for many months.’

‘What medicine is she getting?’ I asked.

He looked at me. That smile again. ‘She’s currently receiving a controlled-dose tranquilliser, what we call an antipsychotic drug, and she’s given something to help her sleep if Mrs Knight judges it to be necessary. Drugs have a very useful role in Mrs Palmer’s therapy but we use them with caution. The tranquilliser, for example, wouldn’t be given on a long-term basis.’

‘Is it one of the phenothiazines?’ I asked, remembering what I’d read in Moira’s books and hoping I’d got the pronunciation right. ‘What dosage is she on?’