Rain Check
by Portwenn Hydra
Doc Martin and all of its characters, themes and plotlines are the property of Buffalo Pictures. This work of fiction is written for purely entertainment purposes and no infringement of any legal rights is intended or implied.
Chapter 7
As predicted, the storm had taken a turn for the worse. Rain was blowing in every direction and land and sky had coalesced into a shifting wall of gray mist. I turned to Louisa and ordered her back into the village hall, but my words were swept away by the gale force winds gusting off the harbor. The tide was due to peak in a few minutes, causing the Platt and surrounding areas to flood from the high seas. It would be difficult going, even with the Bedford, and I couldn't risk having Louisa placed in harm's way.
Once again, I yelled for Louisa to head back into the hall, but she firmly shook her head. I knew that look all too well, and also knew it would be useless to argue. Cursing under my breath, I grabbed her hand before making a run for it. Time was of the essence – if Penhale was telling it right, the fisherman being cared for by Alec Harrison was in serious trouble.
The cold rain trickled down the inside of my waterproof, soaking my clothes in seconds. Penhale had fired up the Bedford, and was gesturing for us to hurry. A torrent of water whipped in front of my eyes, and I blinked a few times before I saw a flash of light coming from the road leading into the village. Louisa had seen it too, and we both turned as the Lexus skidded to a stop a few feet from where we stood. I groaned at the state of my car- the front bumper was hanging by a thread and one of the headlamps was smashed to pieces. There were tendrils of smoke coming from under the bonnet, and I could only imagine the condition of the undercarriage. I wanted to give the blighter who had done this a good bollocking, but I quickly curbed my anger when Harrison jump out, followed by Al Large and the two burly boat hands that had helped transport the wounded fisherman up to the school.
Harrison frantically motioned for us to come over, and I started to run with Louisa close at my heels. We got to the car as Harrison flung open the front passenger door; the fisherman was laid out on the seat, his leg elevated on the dashboard. He was quietly moaning, but didn't appear to be fully conscious. I turned to Harrison and yelled above the deafening wind, "What's his condition?"
"Piss poor. Swelling's worse and now he's got no blood flow to his foot. Risk losing it if something's not done soon. Didn't trust your village constable to get you there in time, so here we are. Anyhow, we barely made it through the incoming tide. You wouldn't have stood a chance."
Louisa, Penhale and Al were pressed behind me and the two boat hands were hovering anxiously behind them. I quickly assessed the man's leg, noting the pallor of his foot and the taunt swelling of his calf and ankle. Harrison had done a good job stabilizing the fracture, and I expected some swelling. But this wasn't just any swelling.
"Compartment syndrome," I yelled over the howling wind. Massive oedema to an extremity resulting in the loss of blood flow, considered one of the most urgent of surgical emergencies.
"You got it," answered Harrison. "I can do the cut down, but suspect he's got a nicked artery. That falls in your court, mate."
Unfettered anxiety rushed through me like a shock wave. I hadn't performed anything close to this kind surgery in over five years, and now I was being asked to repair this man's artery in a hall devoid of heat and light and without proper equipment and sanitation. My heart pounded in my chest, and the world swerved dangerously in front of my eyes. Bloody hell, could this get any worse?
I was preoccupied with calming my rattled nerves when Harrison started giving orders to the boat hands and Penhale.
"Callum, Dickie, go find something flat and sturdy to carry Jacob into the hall. You" he pointed to Penhale, "go help them."
"Right on it Doc," said Penhale. He scrambled off after the two men, and Harrison watched him go with a bemused look on his face.
"Your constable's got a few screws loose," he said.
I ignored him, instead forcing my attention on the patient lying in front of me; better to dwell on the facts in the hopes of preventing a full blown panic attack. Louisa was still at my side, and placed a hand on my arm before saying, "I know you can do this." She smiled and I gently pushed aside a strand of wet hair clinging to her face. Her presence went a long way in bolstering my resolve to see this through, and I felt my heart slow to a near normal pace.
"What can I do to help?" she asked.
"Tell Morwenna to take out the surgical packs and find us a table to operate on," I said before turning to Al, who had been patiently waiting for instructions. "We'll need hot water, and lots of it. Ask Bert to boil as much water as possible. And any kind of light you can find."
They both nodded, and Louisa squeezed my hand before she and Al ran towards the hall's entrance. They disappeared inside as the two boat hands came trotting out with a folding table. We laid it on the ground, and with some difficulty, transferred the ailing fisherman on the makeshift stretcher. He moaned and groaned as we gingerly made our way into the hall; the ground was slick with icing rain and the afternoon light was quickly turning to dusk. By the time we made it inside, I was soaked to my vest and pants, and wondered if I'd ever feel warm and dry again.
After my eyes adjusted to dim light in the hall, I saw Louisa giving orders for the trestle tables to be cleared of food and brought next to one of the floor to ceiling windows. The electrics were still out, and the meager light filtering through the grimy glass would be better than nothing. The boy scouts were scurrying about, collecting all the lanterns they could find, and Al was rigging a clothes line on which to hang them. Morwenna hurried over with the surgical packs and my medical case, the ubiquitous iPad tucked under her arm.
"Got everything you asked for, Doc. And you have a few patients waiting. Peter says it's nothing urgent by the looks of it. One of the boy scouts has a stomach ache, but I think he's had too much of Bert's cooking," she sniffed. "Oh, and there's little Sammy Lewis with a sore throat. Doesn't look like much, just a virus I'd say. And mom and babies are doing fine. Maureen's with them now. Thought it would be a good idea to have her help, considering she's had twins and all."
I let her prattle on, wondering what the PCT would say if they found out a thirteen year old boy was triaging patients and my so called practice manager was dishing out random diagnoses. The only saving grace was that Peter was smarter than the average teenager, and I hoped he would know enough to call for me if anything was amiss.
"Ask Peter to take the temperatures of the stomach ache and sore throat and report back to me," I grunted, as we edged the makeshift stretcher against the trestle table. Morwenna ran off, and after some doing, we were able to safely transfer the patient with the help of the two boat hands.
"Not a bad set up," said Harrison, surveying the improvised surgical theater. "I've operated in worse during my stint in the army."
I was about to sneer he could get away with operating under dismal conditions, considering orthopaedic surgery was more like carpentry while vascular work was all about finesse and precision. But I thought it best to keep my mouth shut. After all, I might need him to assist, or worse take over, if I found myself incapacitated by the haemophobia.
Harrison said he was going to wash up, and I started my examination of the patient. His foot continued to be pale, and not surprisingly, cold to the touch. There was no pulse to be found except for behind the knee, telling me that Harrison had been right in suspecting an arterial tear. I was carefully removing the splint, when Jacob let out a low moan and muttered, "My leg's killing me! What's wrong with it? Where the hell am I?"
"Portwenn Village Hall," I answered tersely. "The blood flow to your foot has been cut off by swelling and possibly a severed artery. You need surgery now or your foot will become necrotic and you might then need an amputation."
He shrieked and started thrashing about on the narrow table. "I ain't having no operation. Dickie, Callum, get me out of here!"
Callum was close by and hurried over to help.
"It's okay Jacob. You have two doctors here to help you." This did nothing to calm the ship's captain, and Dickie arrived to lend a hand. He was now trying to get up from the table, and it took everything we had to restrain him.
Louisa had heard the commotion and quickly came to stand at my side.
"Draw up a vial of midazolam. In my case, second drawer down," I yelled over Jacob's screams. She bit her lower lip, possibly remembering her fumbled attempt at drawing up the narcotic antidote before her horrid little friend went into cardiac arrest.
I gave her a reassuring nod and she scrambled over to my medical case. I watched as she carefully drew up the sedative and handed it to me. Harrison returned just as I had finished administering the drug through the patient's intravenous line.
"Found this," he said, holding up a torch. "Thought it might come in handy." He flicked it on, and the strong beam illuminated the drowsing man's leg. It was even more swollen than before, and his foot was now glassy white in the torch's glare.
I swallowed hard as Harrison said, "See you got him under pretty good. We might need more sedatives before this is over. I hope you've got more from where that came from?"
"A few more vials and limited antibiotics," I answered. "I hope we can get rescue in here sooner than later. He'll need more care than we can give him, considering the setup and limited supplies."
Harrison had started laying out the contents of one of the surgical packs on the trolley commandeered from the kitchen. "Don't know about that mate. I listened to the Met's latest forecast before we left the school and it said the storm would continue into tomorrow."
I glanced at the man lying prostrate on the table, and silently hoped we could keep him alive until we could get him to hospital. The risk of complications was very real and included septicemia, blood clots and shock, none of which we were equipped to treat.
"Right then, let's get started," said Harrison briskly. He turned to Louisa, "I bet you're not rattled by a little gore. You can be my assistant while Ellingham goes and scrubs up."
Morwenna had just returned from giving my message to Peter. "Hey, what about me?" she exclaimed. "I've had more experience assisting Doc Martin than she has."
Morwenna glared at Louisa and I was about to tell her to stop making a nuisance of herself when Harrison stepped in. "I'll need someone to take notes during surgery. Maybe you could continue on as you've done for the other patients." He smiled at her, and she visibly became putty in his hands.
"That's exactly what I'll do! Good thing I've got my iPad." She dragged a chair next to the table, and climbed on it in order to get a better view of the proceedings.
"Louisa, you keep an eye Jacob's breathing. I just need a word with Ellingham before we get started," said Harrison, quietly pulling me aside.
"I'll open up his leg and you can jump in once the artery's exposed." He gave me a searching look before continuing, "You know it's going to be very bloody. I assume you're up for it or you wouldn't have accepted the post at Imperial."
I looked away before answering, "Yeah, it's not a problem."
"It's like riding a bike, mate. You never forget, once you know how," said Harrison.
I had never learned to ride a bike – no one had ever bothered to teach me. Nonetheless, I knew what he meant. This was a procedure I had done hundreds of times at Imperial. It was simple really; find the damaged artery and repair it. In this case, I suspected a jagged piece of bone had sliced the popliteal artery, causing swelling and loss of blood flow to the foot.
"I'll go wash up while you get started," I said, turning on my heel and hurrying towards the lavatory.
I suddenly felt like an animal cornered and the urge to run overtook me. But instead I pushed my way through the mass of villagers, ignoring the furtive glances and whispers following in my wake. To hell with the lot of them, I thought, shutting the door of the lavatory firmly behind me.
I stripped off the moth ridden jumper that had been part of my attire for the past few hours, and was about to start scrubbing up in my vest when the door swung open. Bert entered, struggling with the weight of a large cast iron kettle.
"Brought more hot water, just in case. Can never have enough, under the circumstances." He poured the water in the sink, and bellows of steam rose to the ceiling. "We're all rooting for you and best of luck. Not that you need it," he added hastily.
I grunted a response and plunged my hands into the steamy water, washing the best I could with the sliver of soap sitting on the edge of the sink. Bert offered me the less than clean towel that had been tucked inside the waist band of his trousers, but I opted for a paper towel instead. Cleanliness was at the bottom these idiots priority list, along with healthy eating and exercise. It still amazed me the village hadn't yet been decimated by a virulent strain of salmonella or E. coli, or that the rate of coronary artery disease wasn't any higher than it was. But this was the lot of the village GP, struggling against the tide of ignorance until one retired or just died of plain exhaustion.
I wormed my way past Bert, careful not to touch anything; best to keep the surgical field as sterile as possible. A chorus of "Good luck, Doc," followed me as I walked to where surgery was already in progress. Harrison was masked and gowned, while Louisa stood next to him, ready to hand over the instruments lined up on the trolley. Al Large stood on the broad window sill, and was shining the torch over the surgical field.
There was blood everywhere; spurting from the wound, soaking the patient's clothes, dripping from the table, pooling on the floor.
The scene held all the hallmarks of a macabre dream, but I knew to be wide awake when the smell of fresh blood hit me like a ton of bricks. I faltered, a cold sweat breaking out on my brow and the pasty I had eaten earlier had started to uncomfortably churn inside my stomach.
"There you are," said Harrison, glancing my way. "Gown up. I'm almost done here."
Louisa gave me an encouraging smile, and I pulled myself together. This was my chance to redeem myself and prove I was no longer crippled by the blasted phobia.
I did as I was told, slipping on a gown, mask and gloves. After taking a deep breath, I took over from Harrison, who had just finished making a wide excision on the side of the patient's calf. His work was neat and precise, and I grudgingly admired the orthopaedic surgeon's workmanship before examining the wound bed.
I asked Al to angle the torch to the right, and that's when I saw the blood seeping from the damaged artery. By then, my sole focus was on the surgical site in front of me to the exclusion of everything else; I could have been standing in the middle of busy Trafalgar Square and not taken any notice.
Harrison handed me a small clamp before I had the chance to ask for it. And so it went - Harrison supplying me with what was needed while I isolated the leak and sutured the tear. It seemed to take hours, but I was done in less than twenty minutes, remarkable considering the conditions under which we were operating. Actually it was remarkable that I had been able to do this at all, and I stepped back, relieved that I had been to finish the surgery without vomiting on Harrison or the patient.
I didn't close up as the wound needed to remain open to prevent a recurrence of the swelling. Harrison took a set of vital signs while I administered pain medication through the intravenous port. The patient was heavily sedated and wouldn't awake for a few hours yet, a good thing considering he needed to remain still to avoid hemorrhaging from the surgical site.
Now that the rush of adrenaline was over, my mouth was dry and my stomach felt a touch queasy. A delayed reaction to a stressful situation, I thought, binning my gloves and gown. Louisa had gone in search of a blanket for Jacob, and Harrison was updating Callum and Dickie on their shipmate's condition. After telling Morwenna I'd be right back, I walked across the hall and towards the kitchen for a drink of water.
The wind was still howling, and it was now pitch black outside the windows. It was also rather dark inside the hall, with just a few lanterns and torches casting long shadows against the walls. There were clusters of villagers assembled here and there, playing cards or Chinese checkers while others held sleeping children.
I suddenly remembered James Henry and wondered how he was faring at High Trees. My aunt wasn't accustomed to caring for infants, or children for that matter, and I hoped she knew enough to ask for help if she ran into trouble. Someone at the convalescent home must have experience with babies, I told myself, trying to quell my disquiet. There was nothing I could do from here, so I tried pushing this latest worry aside and stopped in to check on the newly delivered mother and her babies.
Maureen was holding one of the newborns while other was asleep on his mother's chest. Satisfied that all was in order, I quickly went through to the kitchen, relieved that the pesky Carrie Wilson was nowhere to be seen. That woman was a vamp and troublemaker, and the less I saw of her, the better. I smirked at the treatment she had received at Louisa's hand, and hoped she would give me a wide berth from now on.
The kitchen was empty, except for a pot of soup simmering on the cooker. I helped myself to a bottle of water, drinking most of it in one gulp.
"There you are."
I turned to find Louisa standing behind me, a warm smile on her face.
"I brought your grip from the car. Thought you might like to freshen up and have a change of clothes," she said, holding up my bag. It seemed like days had gone by since I had packed it, but it had really been just a few hours.
I looked down at my sweat stained vest and trousers splattered with blood. "Thank you. I look a sight, don't I?"
Her expression suddenly changed from playful to serious. "You were brilliant out there. I'm so proud of you, Martin."
She dropped the grip and walked up to me, slipping her arms around my waist. I felt some of the tension ease from my shoulders and neck at her touch, and I kissed the top of her head before saying gruffly, "I'm glad you were there."
She tilted her head towards mine and kissed me. "I love you, Martin Ellingham," she whispered and kissed me again. I pulled her closer, and our embrace deepened until I worried we might get carried away. After all, half the village was within ear shot, and it wouldn't do for them to find the head mistress and the local medic going at it on the kitchen table.
But I shouldn't have worried – as usual, the villagers where hell bent on making my life a living misery.
Bert bustled in and let out a low whistle before we had the chance to step apart. I glared at him, and was about to tell him to mind his own business when we heard a series of screams coming from the main hall.
Louisa and I looked at each other before running out to investigate. The screams had now turned into a torrent of abuses coming from behind the privacy screen where mom and babies had been resting just minutes before.
"You bloody bastard! Look what you've done to me!"
We came upon Claire Tyler, the newly delivered mom of two, sobbing hysterically while Alec Harrison stood next to her, his face ashen and eyes widened in shock.
