Chapter 2
He wandered down to the canteen for lunch and looked disparagingly at the "healthy" options on display. None appeared to be edible to him so he picked up an apple and tangerine, together with a cup of tea and went to sit down at the rear of the canteen. He preferred solitude rather than the meaningless chitchat which appeared to be going on all around him. He was unexpectedly hailed by a new voice
"Marty! Marty, how are you?" and looking up saw an old friend, Chris Parsons rapidly approaching. Getting to his feet he held out his hand to greet his friend. "What brings you up to town, Chris?" Martin asked.
"Conference on the new NHS Administration procedures" grumbled Chris. "They're always mucking about with something. Gives the penpushers something to do, I suppose, but it's us poor sods on the coalface who have to implement their dozy directives!" He expounded a few more choice words on the subject and then reverted to his question of Martin.
Martin acknowledged Chris' rant and went on to say he was well in both health and temper! He said "Rounds went well this morning with none of the usual daft questions, or inattention to details."
Chris looked at him and smiled. "That's because your underlings are all terrified of you" he joked.
"So, they should be," Martin said. "If they won't buckle down by themselves someone has to ensure they do!" They went on to talk quietly about their relative lives before Martin said he had to get back to his office. "Good to see you Chris, tell Carole I said hello."
"Thanks Marty, take care" answered Chris as he watched his tall friend leave the canteen.
His first consultation at 3:00p.m. was on time and was ushered in by Mrs Jarvis. "This is Mrs. Manners, Mr. Ellingham".
"Please take a seat Mrs. Manners" directed Martin. "I see from your notes that your arterial/venous malformation repair was done 6 weeks ago. Can you tell me if you've had any problems at all? Any headaches, nausea when you turn your head?" he enquired.
"I had headaches for the first week or so" replied Mrs. Manners "but nothing in this last month and no nausea at all." "I've not noticed anything out of the ordinary and I feel well in myself." she volunteered.
Martin thanked her and told her that he would send her for a CT scan to check for any bleeds, but didn't think there would be a problem. "After your scan you can go home and when I've reviewed them, I'll be in touch with you to let you know the outcome. After that I will refer you back to your own GP. See Mrs Jarvis on your way out for directions from here to the CT section. Goodbye Mrs Manners."
She thanked him profusely, which even after all this time and many operations on numerous patients, still left him faintly embarrassed.
Mr Roberts was next in. He was a new referral with a heart problem. Martin checked the scans and informed Mr Roberts that one of his coronary arteries was blocked and would require an operation to fix it. Mr Roberts blanched and asked how bad the condition was. Martin said that if he'd not consulted his GP so quickly then the consequences would have been serious. "Do you smoke, Mr Roberts? What about alcohol consumption?" Martin asked.
"Yes Mr. Ellingham, I do both."
"How many cigarettes per day, and how many units of alcohol per week?" Martin enquired.
Mr Roberts replied "Not that many cigarettes, about 20 a day and only 6 or so pints at the weekend."
"I see you are only 52, so how long have you been smoking?" asked Martin.
Roberts looked down and said shamefacedly, "Since I were 16."
Martin sighed. "Well, I think we now know why you've developed this condition, don't we? I'll book you in for the operation, but it won't be until a few months' time, at the earliest, he informed Mr Roberts. In the meantime, do only gentle exercise, stop smoking and drinking."
"I can't give up me fags," blustered Mr Roberts.
"Well, if you don't, then this problem will recur and you will be dead not long after!" explained Martin. He saw Mr Roberts gulp as he took in what Martin had said. Martin didn't really expect Roberts to follow his recommendations, but he hoped he would. "Right, I'll be in touch, Mr Roberts. Goodbye".
His third patient was David Hardcastle who had been diagnosed with a potential atrial septum defect (hole in the heart) by his GP. David was 5 years old and accompanied by his parents.
"Good afternoon Mr Ellingham, we're here to discuss David's problem with you," said the boy's father, Paul Hardcastle. Martin gestured to the seats, inviting them to sit down.
"When did you notice that David had a problem?"
"Must have been when he was just about 4", replied Mrs Hardcastle. "He didn't seem able to run around as our other children had done. He tired very easily."
"Did you go to your GP straight away?" asked Martin.
"At first we put it down to a cold, or just sort of lack of sleep" Mr Hardcastle explained. "When he wasn't any better after a month, then we took him to see Dr Gupta. He said, after he'd examined David, that he couldn't see anything immediately wrong but for us to bring him back for blood tests and a more thorough examination." We did that and then Dr Gupta said that David's blood didn't have enough oxygen in it. He could also see some swelling in his legs and a bluish tinge on his face." Mrs Hardcastle told Martin that they hadn't noticed this blue colour until it was pointed out to them. "Dr Gupta said he wanted to refer David to a consultant and then gave us your name, Dr Ellingham."
Martin corrected Mrs Hardcastle "It's Mr Ellingham. Surgeons are called Mr."
Martin informed them "The ECG results have come through from the test and they confirm that David does have an atrial septum defect, or "hole-in-the-heart". Judging from the result I would say it was not very big and should be relatively easy to repair."
Paul Hardcastle swallowed convulsively and asked whether it was a big operation and would David have to spend a long time in hospital?
"Fortunately, techniques have improved enormously, even in the last 10 years or so. We would sedate David, make an incision in his groin and feed a catheter through his arteries/veins until we reached the site of the hole. The catheter is fitted with tools which help us repair the hole." Martin explained. "The amount of sedation is relatively small and I would expect that he would only be in hospital for 2 days, barring any unforeseen complications."
"That quickly?" enquired Mrs Hardcastle. "We expected it to be at least a week or more!"
"As I said, Mrs Hardcastle, techniques have come on in leaps and bounds." Martin told them that his schedule for the next month was fully booked, but that he would try and get David in for the following month. Obviously, any emergencies could delay the operation but he was hopeful that is would be done. "My secretary will send you the proposed dates of the operation. Please pick the best date and confirm with her, your choice. If anything arises in the meantime such as David becoming ill then contact Dr Gupta and ask him to advise me of the symptoms or diagnosis of the illness. Are there any more questions you'd like to ask me?"
"No, no Mr Ellingham, that seems very clear." replied Paul Hardcastle. They all got up to leave when Mrs Hardcastle turned around and asked "Do you have any leaflets explaining the operation in a little more detail? Only I don't fully understand exactly what you will be doing."
Martin acknowledged that for lay people it was a lot to comprehend and he would ensure that more details would be included with the appointment letter. Mrs Hardcastle smiled at that and said "Thank you."
"No problem" replied Martin.
