Author's notes:
This story is set toward the end of Series 2. It is rated PG (for language only).
The story and characters of Doc Martin belong to Buffalo Pictures. This work of fanfiction is for amusement only and no infringement of any legal rights is intended.
Thanks to robspace54 for the beta as well as words of encouragement. Any errors (especially in converting to British English and conventions) are mine alone.
It started halfway through my examination of Mrs. Wentworth. Suddenly, and without warning, I felt the familiar signs of bile rising rapidly from my stomach toward my throat, followed by the overwhelming urge to retch. The sensation was all too familiar, and I instinctively pulled away from my patient, looking for something – anything – to cover my mouth. I grabbed a paper towel and heaved into it, the stench of my own vomit nearly causing me to retch yet again.
"Sorry," I mumbled, taking a few steps backwards.
Mrs. Wentworth, bank manager and also the patient currently sitting on my examination table, stared at me strangely. My occasional need to vomit at the sight of blood was well known in Portwenn and generally tolerated among my regular patients. Thus, they were no longer surprised to see me look away or fight to control my stomach when tending to a bloody wound or taking blood or even seeing blood. What they didn't expect – and what had obviously startled Mrs. Wentworth – was to see me heaving when there was not a drop of blood anywhere in sight.
"Are you all right, Doctor?" she asked judiciously, frowning at me.
I ignored her concerned gaze and moved quickly to the sink to clean off my mouth and rewash my hands. "Fine," I replied without turning around.
"I must say that you don't look at all fine."
"That's why I'm the doctor and you're the patient."
Despite my bravado and repartee, I actually didn't feel all that well. My malaise in the form of a vague gastrointestinal distress had started several days ago but had turned suddenly worse this morning, which had in turn made the day's surgery and patients more intolerable than usual.
"You look a little peaked," she added. "Did you have breakfast? Maybe you need to eat something to settle your stomach. I've always found that-"
Why did my patients always feel the need to ply me with medical advice? "Mrs. Wentworth!" I turned around and favored her with a stern gaze. "You're in my surgery for me to diagnose and treat your medical condition. Now shall we get on with that? I do have other patients waiting."
Mrs. Wentworth frowned again but let me proceed. She'd presented with a cough accompanied by shortness of breath and, based on my careful questioning, the most likely culprit was bronchitis. The illness was more common in smokers, and Mrs. Wentworth's nasty habit had undoubtedly intensified the effects of the disease. I needed only to listen to her chest and lungs to confirm my diagnosis.
"Deep breath in," I recited automatically. "And out." I moved the stethoscope across her back hearing the pronounced bilateral rales. "Again. And out."
Finished, I pulled the stethoscope from my ears and nodded at her. "Close up." She buttoned up her blouse as I washed and dried my hands for the third time in the last five minutes. At this rate, my fingers would be raw by day's end.
"Still smoking, I see." It was obvious from the odor on her clothes and breath.
Mrs. Wentworth looked a bit sheepish. "I've done what you suggested, Doctor, cutting back that is. I'm down to only a half-pack a day."
It was a number that I immediately doubled to get the likely real total, before reconsidering. Mrs. Wentworth was one of my more compliant – and honest – patients. And she was a banker. If she said a half-pack, she likely counted out the cigarettes each morning. Half a pack was a definite improvement over the two pack-a-day habit she'd had when she first came to me. Nonetheless, as her doctor, I couldn't allow her to think any amount of smoking was acceptable.
"I told you to stop smoking altogether."
"And I'm getting there," she insisted.
"Well, you have acute bronchitis, which is aggravated by your smoking. You need to stop smoking, rest, drink plenty of fluids and, if you're feeling feverish, take paracetemol."
"No antibiotics, Doctor?" she asked, standing up from the exam table and giving me the indignant stare I received from most patients when I refused to give them whatever medication they were expecting but didn't actually need.
"No. Bronchitis is a viral infection and antibiotics are ineffective against viruses."
"My sister had bronchitis last summer and her GP prescribed antibiotics."
"I can't help that your sister's doctor is an idiot," I replied, with somewhat less vehemence than usual. I was starting to feel lightheaded and had an urgent need to use the lavatory. I started to move toward the door, hoping that she would follow. Thankfully, she did, as I wasn't sure I could resist the lavatory more than another minute.
"Rest, fluids, acetaminophen," I reminded her, speaking even more quickly than usual. "And you must stop smoking altogether if you want to get well. If you're not better in a week, come back and see me."
I opened the door to my waiting room and cringed inwardly at the sight of a full complement of patients. Pauline must have squeezed some self-proclaimed emergencies in between an already fully afternoon schedule. As always, she had an impeccable sense of timing.
My receptionist looked at me expectantly, no doubt awaiting my usual bellow of, "Next patient."
Trying to avoid eye contact with her or my patients, I called, "Back in a minute," and made my way to the lavatory.
Two hours and eight patients later was probably not the best time to be dealing with young Johnny Pope and his worried parents. Unlike most parents, who were invariably insufferably overwrought about their hypochondriacal and ill-behaved children, Edward and Melissa Pope had good reason for their concern given that they'd just been informed that the test results showed that their ten-year-old son was suffering from Type 1 diabetes.
"Diabetes? I've heard of it but I'm not sure exactly what it means," Melissa replied, nervously twisting her hands.
Not surprisingly, the Popes had no experience with the disease, which meant that I was in for a lengthy consultation.
I swallowed a sigh. "It means that his pancreas is not producing sufficient insulin to control his blood sugar levels."
"That's bad, isn't it?"
"It's . . . manageable," I replied, mindful that the boy was still in the room.
"And that's why he's been feeling so tired?"
"Yes, and why he's been thirsty and urinating frequently." I squirmed in my seat, once again plagued with an urgent need to use the lavatory, where I'd already spent most of the afternoon and, in the process, earned some very odd looks from Pauline.
"But you can cure it?" the mother asked.
"Diabetes isn't curable."
It was a good thing Louisa wasn't here, as she'd no doubt chastise me for not being sufficiently sympathetic. In truth, I did feel somewhat badly for the family. Diabetes was a diagnosis I never liked handing out, especially when it involved young children. Nonetheless, my job as the GP was to convey the information; coddling and handholding wouldn't change the facts.
At the shellshocked expression on the faces of both parents, I tried to soften my approach. "We manage the disease by monitoring his blood sugar and controlling his insulin levels."
"That sounds complicated," Melissa said.
"You'll learn."
"How long do we have to do this monitoring?"
"His entire life."
"His entire life?" Melissa's tone was almost a wail.
"Yes. Once you and the boy learn what to do, in time it will become almost . . . routine."
The father sat up straight in the chair, seemingly determined to take charge of the situation. "All right then, tell us what we have to do."
Oh, God. It was all I could do to sit at my desk for a few minutes without either throwing up or running to the lavatory. How was I ever going to make it through a lengthy tutorial on blood testing and insulin injection? Although the visiting nurse would drop in to help the family with testing and injections, as their GP, the initial instructions were my responsibility.
I took a deep breath and pulled the testing kit from my drawer. "There are two steps. First, you must test his blood. You'll need to do this several times a day." I pulled the lancet and glucose test meter out of the kit and turned to the boy, standing next to his mother.
"Johnny, come closer."
The boy's eyes widened in fear at the sight of the lancet and, instead of stepping forward, he backed away. Whatever tiny bit of patience I might normally have exerted was overcome by the fact that I was exhausted, my stomach ached, and I still needed to use the lavatory. The last suddenly became my first priority.
"Excuse me a minute." I stood up and, feeling the blood rush from my head, immediately grabbed for my desk to keep myself steady. I was more weak than dizzy but, even so, my knees started to buckle and I was finding it hard to stay on my feet.
"Doc?" The voice sounded far away. "You okay?"
"I think," I cleared my throat. "I think I need to sit down." Strong arms helped me back into my chair and I sat there gratefully sucking in air.
"Maybe we should come back tomorrow," Edward said. "When you're feeling better."
"Yes, that might be best."
Out of the corner of my eye, I observed the family scrambling out of my consulting room. Any other time, it would have annoyed the hell out of me. Right now, I felt only relief – a relief I knew would be fleeting.
