A Second Psychologist

On the last Thursday of February, Martin Ellingham walks from his London flat to a small townhouse tucked in a square filled with medical offices. A placard at the entry identifies the office of Teodora Varga-Nagy, the Hungarian psychologist tasked by Imperial Hospital "to fix Ellingham's problem."

Her patient list is extensive but a carefully-guarded secret: royals who fear death, renowned actors whose voices are silenced by stage fright, corporate executives who are unable to board an airplane. All have responded well to her mental ministrations and, some would say, her unorthodox methods. She did not write the book on phobic disorders, but rather dictated it to a series of Oxford graduate students who translated her fractured English into the seminal work on the treatment of phobias.

A few months from her 66th birthday, she remains energetic, uncompromising and intensely committed to her patients. Teodora, as most patients eventually call her, is very successful at healing disturbed psyches.

Since January, she has met with Martin Ellingham at 10 am each Monday and Thursday for 50 minute sessions. It is Dr. Varga-Nagy's policy to serve tea to her patients as this simple courtesy provides many insights. At his first appointment, Dr. Ellingham asked for coffee rather than tea. The assistant declined his request, and Dr. Ellingham refused tea for his next four sessions. At the direction of Teodora, the assistant brought him a cup of tea on his sixth appointment. Then the doctor carefully observed the minutes needed for Dr. Ellingham to drink from the cup. Usually, patients would have the first sip of tea after 10 minutes, indicating they were becoming comfortable with Teodora and lowering their guard a bit.

Dr. Ellingham did not drink tea during that meeting or for the subsequent five sessions. In the 34th minute of this, his eleventh appointment, he lifts the tea cup but does not drink until the 35th minute. This is after telling Teodora about his Aunt Joan and Uncle Phil.

In the previous session, Teodora prised from Dr. Ellingham information about his parents. It was a battle of wills with him initially refusing to tell her more than: "My father was a surgeon, my mother had lunch with the wives of other surgeons. I had a nanny for five years and was then sent to boarding school. They divorced recently. My mother lives in Portugal and my father in London. I've seen them only once in the last ten years."

After more prodding, Teodora found he had no siblings, no cousins, no other relatives except a paternal aunt who lives on a farm in Cornwall. Her husband's death several years ago precipitated another falling out with his parents. Dr. Ellingham spent childhood summers and several school holidays at his aunt's farm. While a GP in Cornwall, he did see his aunt and tried to provide financial assistance to her.

He has one goddaughter but is not close to her. When he and the girl's parents lived in London, he would see them at Christmas and on birthdays. Now, he sees the goddaughter on her birthday and her siblings on theirs. Only after the girl's mother assured him that the godmother would be solely responsible for the child did he agree to act as the godfather. This is more of an honorary title than an expectation that he would have any parental role should something happen to the goddaughter's parents.

Why did he agree to become the girl's godfather, Teodora wanted to know. It was only then that Martin revealed that the girl is the daughter of Chris Parsons. He had discussed his relationship with Chris in earlier meetings. However, it was done within the context of how haemophobia affected his career and his re-training as a GP. In those discussions, Martin did not mention the length and depth of his relationship with Chris and Susan Parsons. To Teodora, he characterized Chris as a med school acquaintance who, as head of a PCT, was able to help him find a new career path and GP posting.

Teodora gently chided Martin for not providing these details, and he tried to defend himself by saying they were not important. "Oh but they are, Dr. Ellingham. Very important, indeed. If you were asked to be a godfather and spent birthdays and holidays with these people, they were providing friendship and something of a family life for you."

"No, they weren't," he insisted.

In this current session, Dr. Ellingham gives a hint of caring about, if not loving, his Aunt Joan. He is embarrassed when he talks of his aunt's affair and how he tried to comfort her when she saw her lover leave for the last time. He admits that his aunt provided sage advice for dealing with the denizens of the village where he served as GP and other aspects of his life. Their session is ending, but next time Teodora will explore the "other aspects of his life" where advice from his aunt was needed.

She stands to signal an end to the meeting. They will work on sensitization techniques on Monday and talk more about his life on Thursday. As he always does, Dr. Ellingham curtly thanks her and leaves.

Hurrying to his office at Imperial Hospital, Martin redoubles his determination to conquer the haemophobia solely through the sensitization methods which have proven to be somewhat successful. The sooner he can end this so-called "talking therapy" with Dr. Varga-Nagy, the better. He longs to return to the order of surgery rather than the chaos awaiting him in the research department. Robert Southwood has imposed this penance of managing a clinical trial in return for his admittance to the surgical theatres of Imperial.

By God, he will do it as he always has: through hard work and determination. He will manage the clinical trial no matter how much he hates it. He will conquer his haemophobia and return to surgery. He must do it soon, as Dr. Varga-Nagy is coming uncomfortably close to making him talk about relationships he does not want to discuss. Edith Montgomery can be easily dismissed. Noelle Giffen perhaps not as easily, as he recognizes the somewhat aberrant aspects of their purely sexual encounters. Louisa Glasson he will never mention. Never! There is no need. It is over, resolved, ended. He has left Portwenn and will never see nor hear from her again.

By seven that evening, Martin is exhausted. He observed two intense operations mid-day and then spent another two hours on a teleconference with the staff in Basel discussing preliminary data. He has just asked the Imperial statistician to run yet another regression analysis, and she sighed in her usual manner assuring him that the results would not be different. Post-op rounds await him, and he does not relish explaining to patients why he is following them rather than the surgeon who performed their procedures. Without the espresso he sips throughout the day, he could not continue. He is simply that tired - perhaps more fed up than tired - but he will soldier on.

As he is walking through the areaway between the research facility and hospital, his mobile rings. He pulls it impatiently from his pocket and nearly bellows: "Ellingham."

"Martin, good evening. This is Louisa, Louisa Glasson. Could we talk for just a moment, please?"

He cannot speak and has stopped walking. He presses his hand against a wall to steady himself, and he can feel his pulse quicken and his blood pressure rise. Nearly staggering to a bench, he recovers enough to utter: "Yes."

She then asks it she could see him in London this weekend - just for a short time, perhaps 15 minutes. Could they meet for coffee, possibly near Paddington Station or any other place he might suggest?

First surprised by her call and then confused as to why she wants to see him, he can only say: "No, I'm much too busy. Why is it that you are calling me? I've left Portwenn and am no longer treating patients there."

"Yes, Martin, I realize that you've left Portwenn. However, I need to discuss a matter with you. It is quite complicated, and I thought it better if we met in person rather than telling you by phone."

"I've no time to discuss anything with you. Telephone will have to to. Now what is it?"

"Martin, I'm pregnant."

It is fortunate that he is sitting on the bench, as the breath is taken from his lungs by this announcement. He says nothing because he really cannot speak or perhaps even move.

After a minute or so, she asks: "Martin, are you there?" Another minute passes and she repeats: "Martin, Martin, you seem to be on the line. Can you let me know if you are there."

Finally, he says: "That's impossible. We used condoms. When is the baby due?"

She then tells him that the condoms must have failed as she is pregnant and the baby is due the second week of July. She will not hold him responsible for the baby in any way. She only wanted to tell him before villagers started to gossip about it. Should she call his Aunt Joan to let her know?

His Aunt Joan, God no! It is one thing for the cretins of Portwenn to know what he has done but Aunt Joan. "No, that's not necessary. I will talk to my aunt."

"Martin, I know this is difficult but if you want any information about the baby - as the pregnancy progresses, I could send it to you. You may be interested from a medical standpoint."

"No. That's not necessary."

"I will, of course, let you know when the baby is born. If you want to see the baby or know anything more that would be good. It would be good for the baby as well as you, Martin."

"No. None of this is necessry."

"Well, then Martin, please call me if you later want to know about the child. Thank you, Martin."

"Yes."

After taking deep breaths to normalize his pulse rate and blood pressure, Martin Ellingham stands and continues to the surgical wing. He tries to think about the phone call from her and what she said, but it is so surreal that he is not certain it actually happened. She is pregnant. They used condoms, but she is pregnant. He remembers once telling her that she would make a lovely mother. She will. Then he wipes his cheeks before he steps into the vascular surgical ward for post-op rounds.

continued...