White death

THREE

Edinburgh

March 2007

‘I don’t want to go to school.’

Virginia Lyons glanced at the kitchen clock on the wall. ‘Look, Trish, you have to go. There’s nothing wrong with you. Why have you started doing this to me? You’ve always liked school, you know you have.’

‘Don’t want to go,’ mumbled her daughter, looking down at the floor.

‘Forget the “don’t want to go” nonsense. There has to be a reason. Tell me.’

‘Just don’t want to, all right?’

Virginia stayed silent for a moment to let the spark of anger in her daughter die down. ‘Are you being bullied?’ she asked. ‘Is that it? Just tell me if you are because I’m not having that. I’ll go straight to the head teacher about it. We’ll nip this in the bud.’

Trish shook her head silently, still staring studiously down at the floor.

‘Then what?’

Silence.

Virginia looked at the clock again and felt her stomach tighten. She was going to be late for work again and, as a divorced single mother, she needed the job even if it was only as a filing clerk in an estate agent’s office. It was a busy office. ‘Please Trish, tell me.’ She tried to make eye contact by taking Trish’s hands in hers and pulling her to her feet.

‘They’ve started calling me Patch in the gym class.’

‘Patch? And this is what this is all about?’ exclaimed Virginia. ‘Some silly children calling you some silly nickname?’

‘I don’t like it. I want it to go away.’

Virginia back-pedalled on derision when she saw the tears start to run down her daughter’s face. In recent months Trish had developed a patch of white skin on her right shoulder which ran nearly all the way down her right arm. Since she was dark haired and sallow skinned, it was very noticeable. The doctor had said it was really nothing to worry about and probably the result of hormonal changes in her body — she had just turned thirteen. He was confident that, given time, the discolouration would disappear of its own accord but it had been three months now without much change if any.

‘Look, if it will make you any happier, we’ll go back to the doctor and tell him there’s been no improvement.’

Trish nodded. ‘Yes please, Mum.’

‘You go off to school now and ignore these ignorant people. I’ll call the doctor before I leave for work and try for an evening appointment. Okay?’

Trish nodded and kissed her mother goodbye.

‘I’m not sure what you want me to do,’ said Dr James Gault when Trish and her mother told him the rash wasn’t getting any better. He sounded irritable. ‘It’s not technically a rash,’ he corrected. ‘It’s just an area of skin discolouration and most probably psychological in origin.’

‘Whatever it is, it’s showing no signs of going away and some of her class-mates have started calling her names and it’s very upsetting.’

Gault shrugged. ‘It’s absolutely harmless and what’s a little name calling. Sticks and stones, eh Trish?’

Trish stared resolutely at the floor.

Virginia felt a wave of exasperation sweep over her at what she felt was Gault’s lack of sensitivity. ‘It’s not harmless if it’s making her so unhappy,’ she pointed out. ‘It’s only a matter of time before it begins to affect her school work. School kids can be very cruel.’

‘I’m reluctant to refer her to a skin clinic when it’s clearly just a harmless and almost certainly temporary loss of pigment. Frankly it would be a waste of time and resources.’

‘Then I’d like a second opinion,’ said Virginia.

Gault looked as if he might be thinking about arguing but then he changed his mind and conceded. ‘Very well,’ he sighed. ‘I’ll see if one of my colleagues will take a look at her but I’m sure they’ll tell you the exact same thing. It’s impossible to predict how long these things will take to go away. The more you make of them the more likely they are to persist.’

‘Tell that to her class-mates,’ countered Virginia.

Gault excused himself, leaving Virginia and Trish alone in his surgery. Although he was probably gone for less than two minutes, Virginia found the seconds passing like hours as she and Trish sat in silence. Both were unhappy, Virginia because she hated coming into any kind of conflict with authority and Trish because it seemed that nothing could be done to help her.

Gault returned and said, ‘Our Dr Haldane will see you after his next patient… if you’d care to wait in the waiting room…’

Virginia found Gault’s manner was now even more curt and decidedly distant but this was not unexpected. He was clearly taking her request as a personal slur. Gault held the door while she ushered Trish out first. She neither made eye contact with him nor said anything.

Scott Haldane beamed broadly when Virginia and Trish entered and Trish took to him immediately. He was young, broad-shouldered and wearing a smile that suggested openness. ‘Hi, how are you doing?’ he asked Trish.

‘All right,’ she mumbled.

‘All right apart from the patch on your arm, eh? Let’s have a look at it, shall we?’

Trish managed a nod and the suggestion of a smile. She took off her blazer and cardigan before slipping off one sleeve of her blouse and holding out her arm for inspection.

‘How long have you had this, Trish?’ asked Haldane, closely examining the area of white skin running up Trish’s arm.

‘Just over three months,’ said Virginia.

‘Thirteen weeks,’ said Trish.

Haldane smiled. ‘You’re the one counting the days,’ he said to Trish as if it was a secret between them. ‘Any pain or tenderness?’

Trish shook her head.

‘Good. How about itching, scaliness?’

Another shake of the head.

‘Good show. So it’s just that it’s a bit of a nuisance that’s a bit slow to go away eh?’

‘A bit?’ exclaimed Trish with such vehemence that both Haldane and Virginia smiled.

‘Have you been abroad in the last year, Trish?’

‘I’ve never been abroad,’ said Trish.

‘That’s not strictly true,’ said Virginia. ‘Although you were too young to remember, your dad and I took you with us to Greece when you were two.’

‘Before you broke up,’ said Trish.

‘And when was that?’ asked Haldane cautiously.

‘The break-up or the holiday?’

‘The break-up.’

‘Three years ago.’

‘And three months,’ added Trish.

Haldane looked thoughtful.

‘She still sees her dad regularly,’ said Virginia, figuring out which road the doctor was about to travel down. ‘We all get on.’

Haldane nodded.

‘Why did you ask if Trish had been abroad?’

‘Just a routine question.’

Virginia seemed unconvinced and didn’t hide the fact. The question lingered in her eyes. Haldane, however, diverted his gaze and got up from his seat. He brought out a sterile stylet from a small chest of shallow drawers sitting by the wash-hand basin and removed its wrapping. ‘Trish, I’m going to give your skin a little prick here and there. I want you to tell me what you feel.’

‘Dr Gault didn’t do this,’ said Virginia, a comment that Haldane ignored as he moved the sharp point around the area of discolouration on Trish’s arm.

‘Not sore,’ said Trish. ‘Not sore… not sore… not sore.’

‘Good. Let’s try your other arm.’

Trish removed her blouse completely and placed her other arm on the table while Haldane fetched a new stylet. ‘Here we go again. Tell me what you feel.’

‘A bit sore… Ouch!.. Ouch!’

‘Sorry, Trish,’ said Haldane, ‘I was a bit too heavy handed there. Sorry. Okay, you can put your blouse back on. I think maybe we should refer you to a specialist skin clinic, just to see what they say.’

‘What do you think it is?’ asked Virginia anxiously.

‘In all probability the chances are that it’s exactly what Dr Gault thinks it is — just one of these unfortunate reactions we see now and then resulting from some kind of emotional stress — but there’s no harm in being absolutely sure and, as it’s clearly causing Trish some anxiety, the clinic may be able to suggest some treatment to speed up things — UV light or something like that. I’ll have a chat with Dr Gault after surgery’s over and we’ll get things moving on the referral front.’

‘Thank you so much, Doctor,’ said Virginia. ‘I didn’t mean to cause trouble. I just want the best for Trish.’

‘Nothing wrong with that, Mrs Lyons.’

‘How did you get on with the over-protective mother?’ asked James Gault, putting his head round the door of Haldane’s office when the last patient from evening surgery had gone.

Haldane smiled. ‘She’s not so bad,’ he said. ‘Her kid’s having a hard time at school and she feels helpless. Perfectly understandable.’

‘Fine, but you have to remember we’re not social workers,’ said Gault. ‘What did you think of the child’s skin problem?’

‘I think you’re probably right but all the same I’d like to refer her to the skin clinic just to be on the safe side. There were certain unusual aspects that I’d like checked out.’

‘What aspects?’

‘It’s probably just an over-active imagination on my part,’ smiled Haldane, getting up from his chair and giving his colleague a reassuring touch on his upper arm.

‘Well, if you really feel you must,’ said Gault, sounding slightly miffed. ‘Perhaps in the circumstances you’d care to do the paperwork?’

‘Of course. Remind me, who’s the main man at the skin clinic?’

‘Ray McFarlane. He’s the kind of chap who won’t thank you for wasting his time.’

April 2007

‘Look, I’m sorry, Trish, I just don’t know what more we can do,’ said Virginia Lyons as they came out from morning surgery after getting the results from the skin clinic. ‘The specialist agrees with the other doctors. He says it’s something called vitiligo. It’s nothing serious and it’ll go away in its own good time. Unfortunately, there’s nothing they can do to speed it up so you’ll just have to persevere until it does. I know you hate it, sweetie, but hang on in there, huh? Let’s just be grateful it isn’t something more serious.’

‘You don’t know what it’s like,’ mumbled Trish.

Virginia looked at her daughter with a lump in her throat. She hated seeing her so unhappy. ‘I could write and ask Miss Neilson if you could be excused gym classes until it clears up?’

Trish nodded.

‘When’s your next class?’

‘Tomorrow.’

‘I’ll do it tonight. You can take the letter with you in the morning.’

Virginia came home next evening to find Trish sitting at the kitchen table in tears. Her shoulders were heaving, her head resting on folded arms. Wrapping her arms round her made matters worse for a few moments until cuddles and soothing words finally did their job and she was able to get some sense from her daughter.

‘They made me do gym.’

‘What?’ exclaimed Virginia. ‘But what about the letter I gave you?’

‘Miss Neilson said there was nothing physically wrong with me so I’d need a letter from a doctor before I could be excused. Everyone was laughing at me.’

‘Give me strength,’ murmured Virginia, entertaining notions of flattening Miss Neilson with a hockey stick. ‘All right,’ she said. ‘If it’s a letter from a doctor they want, a letter from a doctor is what they’ll get. I’ll go round to the surgery first thing in the morning. When’s your next gym class?’

‘Friday.’

‘Plenty of time.’

‘Frankly, Mrs Lyons, I’m inclined to agree with the school. There is no physical reason why your daughter shouldn’t take part in gym classes,’ said James Gault in response to Virginia’s request. ‘I’m very reluctant to take sides in this sort of thing.’

Virginia took a deep breath. ‘It’s not really a physical reason we’re discussing here, Doctor.’

‘Ah, we’re moving into the realms of popular psychiatry, are we? Underlying psychological issues and all that?’

‘No, we are bloody not,’ replied Virginia, her patience coming to an abrupt end. ‘We are attempting to move into the realms of common sense but obviously failing. Kids don’t see things the way adults do.’

Gault seemed shaken at the outburst. He paled and swallowed before digging in and saying, ‘I have no intention of referring your daughter to a child psychiatrist over a little bit of skin discolouration.’

‘But that’s the whole point. Trish doesn’t see it as a little bit of skin discolouration. It’s making her whole life a misery. I’m not asking you to refer her anywhere. I’m asking you to write a simple bloody letter which anyone with a modicum of imagination would understand the need for… but not, apparently, you.’

Gault swallowed again. ‘I think we may have come to the point where a change of doctor…’

‘Would be most welcome,’ completed Virginia.

‘I’ll get the forms,’ said Gault, getting up.

‘That’s going to take time. Trish needs help now. I’d like to transfer within the practice to Dr Haldane; Trish seemed to like him.’

Gault looked as if he had just encountered a nasty smell under his nose. He took his time replying and Virginia surmised he was weighing up the pros and cons of full-scale confrontation as the alternative to giving in to her request. She decided to push him. ‘Then we could call this just a clash of personalities and there would be no need for me to write a letter of complaint to the relevant authorities about what I see as your complete lack of sensitivity towards my daughter.’

‘I’d have to sound out Dr Haldane about such a change.’

‘Then please do.’

Virginia remained seated in Gault’s surgery. She could feel a nervous tremor in her fingers. She stared out the window behind his empty swivel chair, watching birds come and go in the branches of a tree in the garden — the one she could see above the frosted lower pane. A group of children passed by on the pavement and, in the silence of the room, she could hear their laughter. She wanted Trish to be like that, carefree and happy, but it was getting to the point where she couldn’t remember the last time she’d heard her laugh and it was all very reminiscent of the trauma she’d undergone at the time of the divorce. She and Andrew had done their best to shield her from unpleasantness but a split was a split whatever way you looked at it from a child’s angle. There had to come a point where it seemed logical for the child to ask, ‘If you still like each other so much, why are you breaking up?’

Gault returned and stood holding the door for her. ‘Dr Haldane will speak to you when he can. Perhaps you’d care to wait in the waiting room?’

Virginia had thumbed her way through three long out-of-date copies of Scottish Field before Haldane was free to see her. He welcomed her with the same broad smile she’d remembered from the time before. ‘I’m so sorry about this,’ she began. ‘I know this must be causing you all sorts of problems but I’m so worried about Trish and Dr Gault doesn’t seem to take me seriously. I’m at my wits’ end.’ She told Haldane about the school forcing Trish to take gym classes when she was so self-conscious about her skin disorder. ‘They call her names like “Patch” and I know it seems trivial but it’s not to her and it’s what goes on in her head that really matters, don’t you think?’

Haldane smiled and said, ‘It’s all right, you don’t have to make out the case to me. People like to pretend that kids are just mini adults but they’re not. They follow the rules of the jungle until they’re taught differently. I take it you’d like some kind of official letter for the school?’

‘Yes please,’ said Virginia with real gratitude in her voice.

‘Do you think that will be enough or do you think Trish might need some sort of counselling or…’

‘No, really, I think the letter will be enough. If she doesn’t have to expose her “difference” in public, I think she’ll soon start to be seen as one of the herd again and when that happens, who knows, the damn thing might start to fade and we can all get back to normal.’

‘Has Trish noticed any change in the rash since I last saw her?’

‘Dr Gault said it wasn’t a rash,’ said Virginia.

‘And technically it isn’t,’ said Haldane with a smile that conveyed to Virginia some sympathy with her views on James Gault.

‘She hasn’t mentioned anything. Fading, you mean?’

‘No… just anything.’

Virginia shook her head.

‘If she does, let me know, will you?’

Virginia waited again in the waiting room while Haldane wrote the letter and finally delivered it to her in a sealed envelope marked, ‘To Whom It May Concern’. She left the surgery with a lightness in her step. She was going to be late for work again but she had the letter and Trish would be pleased. They could have an evening free of fretting and angst. She started planning a surprise trip to the Dominion, their local cinema. They might even have a burger afterwards — if only to spite the medical profession.

May 2007

‘What’s up?’ Virginia asked Trish in response to her silence.

‘It’s not getting better,’ said Trish.

‘The doctors did say it might take some time.’

‘Mum, they’ve no idea what it is let alone how long it’s going to take to clear up.’

‘But they said it was vitiligo.’

‘I looked it up on the net. They’ve given it a name but they’ve no idea what it is or what causes it.’

‘You don’t want to believe everything you read on the net, love. It’s full of half truths and downright lies.’

Virginia could see that she was not getting through to Trish who seemed to be on a worrying downward spiral.

‘I think it’s getting worse…’

Virginia was alarmed. ‘You mean it’s spreading?’

‘Spreading… and changing… my skin feels funny…’

‘Let me see.’

Virginia examined Trish’s arm but couldn’t see anything different. She didn’t want to say this to Trish so she said, ‘Dr Haldane said we should get back in touch if you noticed any changes. I’ll make an appointment first thing in the morning.’

Virginia couldn’t get an appointment for Trish until the evening surgery session. She hoped to get away sharp from work but it was ten past five before she was finished and she was out of breath from the run home from the bus stop when she opened the front door. ‘Trish, I’m home. Did you think I’d got lost?’

There was no answer. ‘Trish? Are you in?’

Virginia was puzzled. She had expected to find Trish ready and waiting to go round to the surgery. She looked in the living room and then Trish’s bedroom before realising that she could hear a gas burner on in the kitchen. ‘Trish?’ she said, pushing open the door.

Trish was on the floor. She was sitting at a strange angle with her back propped up against one of the cupboards. Her arm was bare and livid flesh was peeling off it from where she had obviously suffered severe burns. The gas flames from a front burner on the hob and the pot lying on its side on the floor beside her told a horrifying tale of boiling water.

Virginia’s throat went into spasm and for a moment she couldn’t speak as she fell to her knees beside Trish, her mind a whirlpool of shock and terror. ‘Oh my God, Trish… oh my God…Trish, speak to me…’

Trish appeared to be in shock. She was staring unseeingly into the middle distance with glazed eyes. She seemed frighteningly calm when Virginia expected her to be writhing in pain. ‘I didn’t feel…’

Virginia completed the sentence in her head… I didn’t feel I could stand it any more… Her daughter had tried to burn the rash off with boiling water… She got up and punched three nines into the kitchen phone on the wall with a shaking forefinger and without taking her eyes off her daughter. She almost screamed her request for an ambulance but the calm voice of the operator talked her into giving all relevant information.

Virginia was only vaguely aware of well-meaning neighbours asking what was wrong as she followed the stretcher bearing her daughter downstairs to the ambulance. ‘An accident…’ she murmured. ‘Trish has had an accident…’

Virginia was an hour into her vigil at Trish’s bedside when she became aware of someone appearing at her shoulder. She glanced up and saw that it was Scott Haldane.

‘How is she?’ he asked.

‘Sleeping. They sedated her. They’re not sure yet about her arm… how did you know?’

‘When you didn’t turn up at the surgery I popped round to see what was wrong. The neighbours told me about the accident.’

‘Accident?’ murmured Virginia bitterly.

Haldane felt his blood run cold. ‘What are you saying?’ he whispered hoarsely.

Virginia didn’t take her eyes from her sleeping daughter. ‘Trish decided to treat the rash in her own way…’

Haldane shook his head in horror. ‘No,’ he protested. ‘Trish is a perfectly level-headed girl. She was upset but she wouldn’t do anything like that…’

‘It’s what she said,’ interrupted Virginia.

Haldane shook his head. ‘Tell me exactly what she said.’

‘She said she didn’t feel she could go on.’

Haldane shook his head again as if unwilling to believe what he was hearing and then a thought seemed to occur to him. ‘Tell me again,’ he said. ‘Her precise words, nothing else.’

Virginia looked at him as if he were making some kind of a mountain out of a molehill but rather than argue she took the easiest course of action and said, ‘She said, “I didn’t feel…” She didn’t have to say any more. I knew what she meant. I’m her mother.’ She looked up at Haldane and saw the questioning look on his face. ‘What is it?’

Haldane behaved as if he hadn’t heard her. He gave her a preoccupied look and mumbled something about having to go.