The Patient

Jane Shemilt

• Publisher: HarperCollins
• Year: 2022
• Print ISBN:
  9780008517847
• eBook ISBN:
  9780008475925
• Topic: Literature
• Subtopic: Women in Fiction
• Index: Literature

She is his doctor. He will be her downfall.

The bestselling phenomenon returns…

'Beautifully paced' CARA HUNTER

'Beautifully written with an achingly real romance at its heart' SARAH HILARY

'A masterclass in upmarket thriller writing' CHARLOTTE PHILBY

'I raced through it!' EMMA CURTIS

When Rachel, a GP in Salisbury, meets Luc, the attraction between them is instant. But Rachel is married with a daughter – and Luc isn't well.

Despite themselves, a heady love affair begins – one that threatens to risk everything Rachel has worked for. And when someone in the town is found dead, the spotlight turns to Luc. Torn between her career, her marriage and her heart, Rachel finds herself in the middle of something much darker than she could have imagined…

A beautifully written domestic suspense story from the master of the what-if novel.

PRAISE FOR THE PATIENT:

'This elegant, multi-layered story has taken my breath away. Much more than a murder mystery, it explores mental health, middle age, marriage and love, while luring you to the edge of your seat' JANICE HALLETT

'A powerful obsession turns dark in this gripping tale of desire, betrayal and murder' T.M. LOGAN

'Constantly surprising' THE SUNDAY TIMES

'With plenty of tension and shocking moments, this atmospheric story is perfect for fans of Apple Tree Yard and Doctor Foster' CANDIS MAGAZINE

'A breath-taking dissection of a marriage' Woman & Home

'A compelling sense of place, good twists, and a tense, intense ending' Sarah Vaughan, bestselling author of Anatomy of a Scandal

'We absolutely loved this . . . It's difficult to believe that this accomplished book is a debut' Richard & Judy Book Club

'Utterly gripping. A tautly-coiled spring of suspicion and suspense which builds to a devastating ending' Mail on Sunday

'Gave me goosebumps' Claire Douglas, author of Then She Vanishes

'Jane Shemilt has a talent for taking you into her world – but be careful. It might not be what you think…' Jane Corry, Sunday Times bestselling author of I Made A Mistake

'Beautifully written and suffused with dread. A compelling literary thriller' Gilly Macmillan, bestselling author of The Nanny

Chapter 1

February 2017

My lawyer advised me to write everything down from the beginning, but it didn’t have a beginning, not like that. I’d been walking towards this for years. If I had to pick a time, I’d go back to the moment I parked my car in the almost-empty car park five months ago. I needn’t have done that. I could have gone straight home, I nearly did. Up to that point, the gods could have swerved me from my path, and I’d be at home with my husband now, instead of sitting in a brightly lit custody cell on my own.

The lights in the health centre reception were still on, which was strange at eight in the evening. Carol must be working late, waiting for me to return the medical notes after my weekly visit to Sarum Nursing Home. I had several bundles, lifetimes of problems and investigations, letters and results squashed untidily into pale brown cardboard envelopes. We kept those bundles for visits because they were portable and we were used to them. A link with the past when doctors had more time. Roger Morris, the senior partner, liked them. The writing itself was a clue for other doctors, he said, a scrawled exclamation mark spoke volumes.

I almost didn’t return them. Nathan would be at home; he might have started supper. We’d agreed to make an effort, I’d promised to play my part, but the notes belonged in the practice and if I took them home I’d be breaking a rule. Back then I was still a good girl, as Nathan would say, or at least I went by the rules. It would take just a few minutes to dump them in the tray. I indicated right into the car park and drove through the gates. I’d leave straight afterwards, drive home through Salisbury’s quiet streets and then the quieter ones of the Cathedral Close and still be back in time for supper. We’d watch the ten o’clock news and one of us would take the dog for a last walk. Nathan would check the doors were locked and then we’d go to bed.

We wouldn’t have sex. Sex was rare these days, Nathan was preoccupied and the truth was I didn’t want to make love. I couldn’t remember when we last had but I remembered the soreness, hormones or the lack of them, lack of desire too. Sweating could overtake me at night. Headaches as well, piercing sometimes. Tiredness, mine and Nathan’s. It was both our busy lives, and no one’s fault. We were close, close enough, or so I thought; sex didn’t really matter, it didn’t have to affect anything, though I see now that it did, it affected everything. Our bedside lights fell separately on the pillows; the room was quiet apart from the rustling as we turned the pages of our books. It was a measured life, safe, calm, enviable. After ten minutes Nathan would put his book down, switch off his light, turn away and fall asleep.

I’d lie awake, sometimes for hours as the cathedral bells tolled each quarter hour. I’d think about Lizzie and my patients and the lists of things I had to do the next day, results and visits, letters and meetings, patients to contact, until my heart was beating fast and the lists became muddled. I’d get up to make a cup of tea and then back to bed again. I’d listen to the cars that passed and watch the watery lozenges of light slide across the ceiling and disappear, soothing mysterious, companionable.

Carol’s Kia was in the surgery car park next to Debbie’s Ford, there was a red Mercedes too, parked across two spaces, the roof down, in February. Someone who had tickets to whatever was showing at Salisbury Playhouse probably, out to impress a date and too late to find parking.

Had there been another car, parked at the far corner where the overhanging trees make the tarmac slimy with rotten leaves? There might have been, I didn’t notice; it was dark by then, darker under the branches. I glanced at my reflection in the gleaming metal of the Mercedes, lit by the lights from the surgery, a small forward-slanting figure with wind-blown hair. It was lucky it was too late to encounter patients, my escape would be swift.

I was wrong. The tension was clear from the door. Carol was leaning over the reception counter, her fingers clutching a temporary resident’s card. Debbie was the other side, head bowed, listening. She was on call. One hand cupped her bump, her eyes were dark with fatigue, myself twenty-four years ago. I caught Carol’s sentence mid-hiss.

‘… suicide risk. I put him in Rachel’s room. I know it’s late, but I couldn’t say no.’

Nathan might be uncorking the wine in the kitchen, it would be Chardonnay, chilled, his favourite. I preferred red especially in the winter – after a day at work, I needed the warmth. He might be glancing at the clock, but the mention of suicide swung the balance. Liam’s face came to me, the rings under his eyes, the clenched fists, the despair that I’d missed.

‘I’ll get this, Debbie.’

She jolted and her hands tightened on her abdomen. I hadn’t meant to scare her, but the door opened silently and the carpet in the practice had been replaced last year. It was new and thick; you couldn’t hear footsteps.

‘It makes sense.’ I put my armful of notes in Carol’s in-tray. ‘Seeing he’s in my room already.’

‘You’d left it unlocked.’ Carol’s hand went to her glittering bob of hair. ‘He seemed upset.’

‘Don’t worry.’ I smiled at her. ‘I’m glad you chose it.’

Debbie’s room was as functional as the reception area. A pregnant mother with a toddler doesn’t have time to make her office a home, she doesn’t need to. Her life beyond the surgery teems with colour and noise, children, friends calling in, laughter and chat.

Our home life was very quiet nowadays. Nathan liked pastels for the walls, he found them restful. I chose the colours I wanted for my office instead: turquoise for the walls, a framed poster of the Mediterranean, red boats against the blue, and one of Victoria’s photographs, a volcano with lava erupting in a spray of gold and scarlet. There was a photo of Nathan with Lizzie on my desk, boxes of toys under the couch, and red bean bags for children to lie on. The room was scented with bunches of dried lavender from Victoria’s garden; things that provided comfort – well, they comforted me.

‘I’m on call.’ Debbie bent awkwardly to retrieve her bag. She didn’t want pity or allowances. I understood, I’d been the same; glancing down I could see her ankles were swollen, which happens in the third trimester when you’ve been on your feet all day.

‘Owe me if it makes you feel better.’ I was tired, but late-forties weariness is different from pregnancy. The fatigue has been present for a while, you get used to it, used to pushing on through.

Debbie straightened and stared at me, a complicated look: relief, guilt, resentment, pride, everything I recognized. I wanted to hug her, she was only twenty-six, just two years older than Lizzie though I couldn’t remember the last time I’d put my arms round my daughter. She evaded hugs. She needed her space, she was used to it, she said. I’d been busy in her childhood, she told me recently, it was too late to make up for that now. She had laughed but it wasn’t a joke.

Carol was talking to me, leaning forward earnestly.

‘… name is Luc Lefevre.’ She folded her lips between sentences, as neatly as sealing an envelope; it made her look disapproving. ‘Half French, I believe. He lives in London, he was going home but, as it turned out, he—’

‘Thanks Carol, I’ll get back to you if I need to.’ I preferred to have the story from the patient, unfiltered. It was often hidden in the silences or the way the patient was sitting, in the clenched hands or the quick sideways glance.

She handed me the temporary resident’s card the patient had filled in while waiting, and started to sort through the files I’d brought back, thumping them down in turn on the counter. The pretty white jersey with embroidered lambs round the neck was at odds with her flushed cheeks. I’d offended her, again. It was no secret she preferred Roger. I loved him too, everybody did. Tall, kindly, disorganized Roger, grey-haired and soft-spoken. He would have stopped in his tracks, bent his head attentively and listened to everything Carol told him. He might have nodded and smiled, apparently grateful. I was more impatient, not just with her but with friends and family. I’ve always been impatient but Nathan thought it was worse nowadays. Time of life, he’d said, but I hadn’t replied.

I should have listened to Carol as Roger would have done. She was quite right as it turned out. I needed a lot more information, though it’s too late now to ask about the things Luc Lefevre might have told her before I met him. Months and months too late.

I would have been kinder to Carol if only I’d known; much, much kinder. That’s one of the things that haunts me still. I should have tried harder. She sang in a choir, I’ve found out since, went ballroom dancing on Friday evenings and worked in the Oxfam shop on her afternoons off. I knew so little about her.

I sent a text to Nathan as I walked down the corridor towards my room. I’d be late, he should eat without waiting for me. Our health centre is large, it houses another practice as well as visiting physiotherapists and the nurses’ clinics. The corridors are lengthy. Carol had forgotten to switch on the lights down here, and, as I walked away from the reception and towards my room, I seemed to be progressing deeper and deeper into shadow.

I remember stumbling so I put my hand to the wall to steady myself as I groped my way forward.

Chapter 2

February 2017

‘Oh. I’m sorry. Are you all right? … I mean, I can see you’re not, but …’

I don’t usually apologize or trip over my words when I meet patients, but he’d been crying, and it felt as though I was intruding. Women sob openly but men often hide their grief. Luc was different, tears had soaked his stubble; even his collar was wet.

He began to get up when I came in, but that was breaking an unwritten rule. Patients don’t get up for doctors. I put my hand on his shoulder, another broken rule. Doctors don’t touch patients unless it’s part of an examination, in which case we ask their permission and, these days, offer a chaperone. He was upset, the excuse I gave myself at the time, but the truth was I was drawn to him despite myself, which was strange; good-looking men don’t usually interest me. I imagine arrogance or entitlement.

My husband’s looks were average, his face calm, the expression controlled. His smile was friendly enough. Luc Lefevre’s face was the opposite, handsome yes, but expressive and emotional. Open. I had the impression of wildness, not as in unkempt but undefended, as wild animals are. It was as if some veneer had gone and his soul was showing through his eyes.

I passed him the flowery box of tissues that Carol puts on my desk and he pulled out a handful, wiped his face and blew his nose. I eased my shoes off under the desk, he wouldn’t notice. My feet were swollen, like Debbie’s, a recent thing which was rapidly becoming a normal thing, along with the grey streaks in my hair, the arthritis in my thumb joints and having to wear glasses for reading.

I avoided his face for his sake, but clues were everywhere. His fingers were knotted together but his hands were tanned, the nails neatly trimmed. A Rolex watch, feet in expensive loafers. Whatever the problem, it wasn’t money. I waited, which is the very least you can do for someone who is suffering.

‘It’s okay,’ I told him. ‘There’s no hurry.’

The practice was quiet; the phones would have been switched over to the on-call centre by now. Carol wouldn’t be knocking at the door to request my signature on prescriptions, no one was waiting. I could listen for as long as he liked. I would give him the time that I hadn’t given Liam.

Liam Chambers had been slotted in at short notice during a busy morning surgery two weeks before. He was seventeen, with a blank gaze and bones in his wrists that protruded like marbles. He had a problem, he’d muttered, but wouldn’t answer my questions and we ran out of time. I asked him to make an appointment with me the next morning but that evening he was found in his room, hanging from a beam by his dressing gown cord. His mother didn’t let me in when I went round but agreed to see me in a fortnight on the 10th of February which was, I saw on the calendar, tomorrow.

The calendar hung on the corkboard above my desk, a gift from a drug company. Van Gogh’s sunflowers for February jammed between the on-call rota and the protocol for treatment of kidney disease. I’d never looked properly at that picture, one of those familiar images your glance slides past. Today I saw that the flowers weren’t young, I hadn’t noticed that before. It’s hard to see what’s in front of you when you’re busy – if you look again, you notice things you missed, obvious things. Some of the flowers had gone to seed, though the remaining petals flickered like little flames: saffron, ochre and burnt sienna, colours baked in the south of France. ‘Arles’ was scrawled at the bottom. I imagined how rich that name would sound when spoken in French, the ‘r’ warm in the mouth like something delicious to eat.

‘There was a tree on a bend along the road towards Stonehenge; it seemed to be waiting for me.’

His words gave me a jolt, a small one, easy to disguise. It was the French accent; it was as though he had seen into my very thoughts.

‘I decided to drive straight into it. I was going to call the police first, so they could clear up the mess before anyone else came by.’

I nodded, disguising shock. He was telling the truth and the matter-of-fact language made it worse. I said nothing; if you jump in too fast with words it can close someone up. It was quite possible I had closed Liam up. The silence stretched until he broke it again.

‘Everything is grey and quiet, it’s like I’m walking on ash. There’s ash in the air, as if the world’s gone up in flames.’

Ash. I’ve always loved the sound of that word, it feels soft in your mouth, which is fanciful – real ash would grate between the teeth, it would taste unbearably bitter.

‘I can’t remember a bloody thing. I don’t want to do things I normally like doing, I can’t be bothered.’ He sounded resentful, as if a stranger had come to his door in the night and shouldered his way in. ‘I don’t want sex any more.’

I glanced at his body, I couldn’t help it. He was muscled though I couldn’t see him in a gym somehow. His skin had a weathered look. I imagined him in some remote place with nothing but birds in the sky. The card in my hand put him at forty, the brown hair that reached to his collar was already going grey, dishevelled. He had large hands and wide shoulders, a long nose, dark brown eyes and a small scar by his mouth on the right side. It was the kind of face that would have caught my attention in a crowd. Doctors aren’t supposed to think of patients like that but it’s automatic; a way of gauging health, like registering weight or height. It’s surprising what you can take in at a glance, decisions being made before the conscious mind becomes aware of them. Given the age, the sex and the name you can guess with surprising accuracy what the problem will be before a word has been spoken.

‘Have you felt like this before?’

‘Not as bad.’

‘But you’ve been depressed?’

‘Yes.’

‘Enough to have had treatment?’

He nodded but his eyes clouded, some secret was being shifted to a deeper place. No one shares everything the first time. It’s a matter of waiting, Roger says, of walking in your patient’s shoes for as long as it takes. That’s all very well, if you have time.

‘Okay, helpful to know.’

The hands on his lap unfolded a little, he was wearing a thick gold wedding ring, gold cufflinks.

‘I’ve everything you’re supposed to want: a beautiful wife, an adorable son, well, stepson. No money troubles, not yet anyway. Work’s fine.’ He sounded angry, which was good, you can work with anger. Apathy is the danger.

‘What work is that?’

‘Architecture.’ He looked down then and his voice became quieter as though admitting something private. ‘I much prefer painting. I paint when I can.’

Some jobs make you more susceptible to suicide; anaesthe...

Table of contents

• Cover
• Title Page
• Copyright
• Dedication
• Contents
• Prologue
• Chapter 1
• Chapter 2
• Chapter 3
• Chapter 4
• Chapter 5
• Chapter 6
• Chapter 7
• Chapter 8
• Chapter 9
• Chapter 10
• Chapter 11
• Chapter 12
• Chapter 13
• Chapter 14
• Chapter 15
• Chapter 16
• Chapter 17
• Chapter 18
• Chapter 19
• Chapter 20
• Chapter 21
• Chapter 22
• Chapter 23
• Chapter 24
• Chapter 25
• Chapter 26
• Chapter 27
• Chapter 28
• Chapter 29
• Chapter 30
• Chapter 31
• Chapter 32
• Chapter 33
• Chapter 34
• Chapter 35
• Chapter 36
• Chapter 37
• Chapter 38
• Epilogue
• Acknowledgements
• Keep Reading …
• About the Author
• About the Publisher