The Doctor's Engagement

‘And you suddenly discovered that you were more than friends.’ Ian sat back in his chair and put down his knife and fork. ‘That’s lovely. They always say that the very best relationships start with friendship. My wife would love your story. I’m afraid she couldn’t join us tonight because she’s babysitting our grandchild, but you’ll meet her soon.’

Holly blushed and felt horribly uncomfortable. Could she keep this up?

‘Why don’t we fill Holly in on the different clinics?’ Mark suggested smoothly, clearly aware of her discomfort.

Holly glanced at him gratefully. ‘That would be very helpful.’

‘The clinics?’ Ian watched the waiter clear their plates. ‘Well, the main one is our coronary heart disease clinic. We have a surprisingly high rate of coronary heart disease in this area. I say surprisingly, because one wouldn’t expect it of a fishing port, but there you go!’

‘So you run a clinic?’ Holly shook her head when the waiter offered her the dessert menu. ‘What sort of clinic? Screening?’

‘Actually, more of a lifestyle clinic, although there is some screening involved.’ Ian ordered coffees and smiled at Holly. ‘As you well know, a myocardial infarction—or heart attack as the layman calls it—is part of a chronic disease process. There is some evidence that behaviour modification counselling increases healthy lifestyles.’

Holly nodded. ‘I know that patients who have already had a heart attack seem to benefit from secondary prevention clinics.’

‘Absolutely.’ Ian murmured his thanks as the waiter poured the coffee. ‘Which was how our lifestyle clinic started. We run it as a team—dieticians, GPs, health visitors, practice nurse—and we give each patient their own personalised lifestyle plan. It works brilliantly.’

‘In fact, it works so brilliantly,’ Mark interjected, ‘that nearly all the other neighbouring practices have started to do the same thing.’

Holly sipped her coffee. ‘So if someone needs dietary advice they see the dietician and if they’re smoking—’

‘Then we give them counselling directed at behavioural and attitudinal change,’ Ian finished. ‘And, of course, we use nicotine replacement if it’s appropriate. Have you had any training in behavioural counselling?’

‘Oh, yes.’ Holly played idly with a teaspoon. ‘The course I did trained us to assess whether a patient was ready to change and to use things like goal-setting and specific behavioural advice.’

‘I knew you were going to be an asset.’ Ian smiled and continued, ‘As well as diet and smoking, we also look at their levels of physical activity. In fact, we even joined forces with the leisure centre and were offering different grades of exercise classes at one point, but unfortunately the instructor had a nasty car accident a few months ago so that’s fizzled out.’

Holly tipped her head on one side as she listened. ‘I could do that,’ she said impulsively, glancing shyly at Mark. ‘I’m a trained aerobics and keep-fit instructor, remember?’

‘So you are.’ He looked at her thoughtfully. ‘I’d totally forgotten that. She’s right, Ian, she could take some of the classes.’

Ian was delighted. ‘Lots of the women in particular have been quite upset at missing their exercise sessions, so that would be fantastic.’

Holly blushed. ‘Well, that’s fine, then. When does it all happen?’

‘We do the lifestyle clinics one evening a week and we all help out so it’s pretty busy, but it seems to work.’

‘Presumably there’s a group discussion element, too?’ Holly asked. ‘Allowing people to talk about any problems they’ve been having or any worries?’

‘We haven’t done that to date...’ Ian frowned thoughtfully. ‘But it would be a great idea. I’d never thought of it, to be honest. We’ve always just seen people as individuals, but I think it would be very popular. The patients already meet up and chat informally while they’re waiting to be seen. It would need someone to chair it, of course. I don’t suppose I could tempt you?’

‘You probably could.’ Holly smiled, pleased to help. ‘Perhaps with one of the dieticians because I’m sure some of the problems will be around weight control.’

‘That would be excellent.’ Ian beamed at Mark. ‘I can see why you love this woman. Not only stunningly beautiful but clever and enthusiastic as well.’

Stunningly beautiful? Not by any stretch of the imagination, Holly thought, catching Mark’s eye and trying not to laugh.

‘Tell me about the other clinics,’ she prompted, draining her coffee cup. ‘Immunisation obviously. What’s the uptake like around here?’

‘Well, like most practices, we were affected by the MMR scare. We put quite a bit of work into educating the mums and our uptake has gone up again. How did you handle it in your last practice?’

‘Much the same way,’ Holly told him. ‘We held a few open evenings, with the immunisation officer and the public health director answering questions.’

‘And Mark tells me

you used to work in A and E together.’

‘That’s right.’ Holly smiled and exchanged a warm look with Mark. They’d had a lot of fun working in A and E.