Chapter 11
Assessment
Harriett Jaffe had spoken to Martin Ellingham from her father's study in Oxford. She had taken a leave from her London practise and family to see Stanley Jaffe through the cancer that inevitably took his life. The last few months and recent days had left her shattered. First was the burial one day after Dad's death, followed by six days of sitting shiva, and then yesterday's memorial service. Her husband had taken their three sons back to London this morning, and Harriett was left alone. Too exhausted to do anything more, she was reading condolence notes when she received a call from her service in London. During the last few months, she had treated only her most critical cases, but was not surprised to receive a call at this time of year. Psychiatric patients did not do well at Christmas.
The young woman apologised for phoning, but said that the gentlemen insisted he knew Dr. Jaffe. She need not ring him tonight, tomorrow would do. On hearing the caller was Martin Ellingham, Harriett sighed. Of course, he would never want to inconvenience anyone.
It was a bit after eight, but her curiosity won out; she must phone Martin tonight. Harriett had been among the many extending offers of help when his haemophobia occurred. Like Chris Parsons, she had not given up on Ellingham. But, unlike Chris, he never responded to her calls and notes. The stubborn Martin Ellingham ignored all of them, even her father and his other Oxford tutors.
Harriett had been with Ellingham and Parsons at St. Mary's and became a bit close to Martin their first year as junior house officers. Her boyfriend, Pradeep, had chosen an internship in the States after med school, and she was not certain where they stood when he left England. One night following too many hours on duty and her moaning over Pradeep, Ellingham told her about Edith Montgomery. She, too, had left him in England. But Martin knew where he stood with Edith - their relationship was over.
Through the rest of the year, Martin said little about Montgomery, but he became Harriett's reluctant confidant. As she tried to reconcile her relationship with a man living an ocean away, Ellingham simply let her talk. Harriett and Pradeep progressed to the point that she took a psychiatric residency in the States rather than continue training in London. They returned to England a few years later and were married. Harriet was delighted when the reclusive Martin Ellingham attended both their Jewish wedding and the Jain ceremony which followed.
Pleading time constraints, Ellingham never again appeared at a wedding or any gathering of St. Mary's colleagues. Pradeep, more than Harriett, would see him occasionally at professional conferences where Martin was pleasantly brusque.
Of course there was the gossip that swirled through London medical circles, but references to Ellingham were of a professional rather than personal nature. Harriett always regretted not urging him to address the issues arising from his bleak childhood. Martin's troubled psyche was quite apparent, but she respected their thin friendship too much to press him about it. She experienced a bit of guilt on learning of Martin's haemophobia, as the basis for his disorder was easily identified.
Bracing herself with a glass of wine, Harriett rang Ellingham. "Martin, how are you? Lovely to hear from you."
Before she could continue, he interrupted: "Harriett, I'm very sorry about your father. I just read of it. He was an extraordinary don. Obviously, he made an impression on many of his students, and I count myself among them."
"Thank you, Martin. Very kind of you. There was a small memorial gathering at Balliol yesterday, but something larger will be planned for the Hilary Term in the spring. Shall I let you know about it?"
"Um, no, I'm sure I'll hear of it. I'll try to be in Oxford, but I'm quite busy."
"Yes, I understand that you're a GP now in Cornwall. Chris Parsons rang me last week about Dad. We had a catch up about the St. Mary's group living outside London. Good that you two see each other. That must be nice for you."
"It's good. Right, good. Um, Chris may have mentioned my issue. The reason I left London and surgery."
Now Harriett interrupted him: "Yes, Martin. I am well aware of your haemophobia. That's why I rang you and sent those notes when it occurred. You understand that many of us, including my father, were very concerned about you and wanted to help. Have you done anything about it Martin?"
Silence greeted her somewhat harsh comments, but Harriett had suppressed her frustration with him for several years. Why would he not avail himself of the best minds in psychology and psychiatry to treat his illness?
What followed this silence was completely unexpected by Harriett. When Martin finally talked, it was in a torrent of words muddled together and nonsensical to her. He hated the Cornwall village; his patients were imbeciles; the chemist was daft; something about vomiting – a good deal of vomiting; then jibberish about a vicar and a pig; Chris Parsons was fed up with him, and on and on. He finally ended: "Harriett, you aren't the right person, but I need someone to treat my phobia. I must return to surgery. Work in London again."
What his old colleagues had waited years to hear was finally uttered by Martin Ellingham. He was ready to end his exile and re-enter their world. Of course, Harriett would try to help him. But it would be better if they met. She could sort out the extent of his problem and whether a psychiatrist or psychologist should minister to him. Could he come to Oxford in the next few days? Ellingham had a few patients in the morning, but he could be there by three or so, It would take but a few moments of her time. Only a brief assessment and referral was needed. Nothing more.
"Martin, please don't pretend this isn't serious," she chided. "Come prepared to tell me everything, so that I may help you. Thank you for calling on me Martin. Now rest before the trip."
Harriett then scrolled through her phone for Chris Parsons' number. By the desperate tone of his voice, Ellingham was experiencing some issue beyond his blood phobia. She knew it would be difficult to extract much of a personal nature from Ellingham, but some occurrence caused this additional anxiety. Perhaps Parsons could provide insights.
Much as he wanted to help, Chris knew Mart would have his head if he told Harriett anything of a personal nature. Ellingham was not his patient, so there was no issue of confidentiality. He only felt uneasy – more disloyal – in discussing with Harriett the little he knew of his friend's life.
"Chris, I know about his haemophobia, but there seems to be more than that. Has he had a recent accident, death in his family, some mishap with a patient?"
"Look, Harriett, Martin will likely not mention this – and you didn't hear it from me – but he was to be married in November. At the last minute, he and the bride decided not to go through with it. For the life of me, I can't work out what happened. Mart won't say a word, other than it was mutual, but clearly it had an effect. You know the sort of life he's led. To go from that level of detachment to a full relationship may have traumatized him enough that he had to stop it."
Trying not to leap ahead in her analysis, Harriett began to consider the colleagues who were best for treating Ellingham's phobia and his probable depression. It was a short but effective list. Now if she could only persuade him to consult one of them. Parsons warned it would be nearly impossible.
Harriett's psychiatric specialty was post traumatic stress disorder. Arising from the many horrors delivered by the world, she first treated patients who had served in Northern Ireland, Bosnia and Kosovo. Now it was survivors of terrorist attacks on English soil; Middle Eastern women who had escaped honour killings and –more recently - the British and Australian soldiers deployed to Iraq and Afghanistan. It was a grim but terribly necessary field of work.
When Martin Ellingham appeared in Oxford the next day, his physical demeanor was not unlike that of a PTSD patient. He was thin, pasty and held his face immobile, even as Harriett showed him photos of her children with their grandfather days before he died. Martin's fingers twitched and he had difficulty maintaining eye contact as he paced about the study. Pain was radiating from Martin, and she sensed a man in serious trouble. And so she returned his favour from their time as junior house officers: Harriett simply let him talk.
Continued . . .
