Chapter 23
When you walk through a storm
Hold your head up high
And don't be afraid of the dark
At the end of a storm
There's a golden sky
And the sweet silver song of a lark
Walk on through the wind
Walk on through the rain
Though your dreams be tossed and blown
Walk on, walk on
With hope in your heart
And you'll never walk alone
"You'll Never Walk Alone" by Gerry and the Pacemakers
We Made It
The afternoon was quite peaceful as we walk Phillip out of the farmhouse, but I just didn't feel quite myself. Looking back over my day's activities I feel there is something I haven't done, but it escapes my mind. We had a wonderful morning in the village shopping, and I spent part of the afternoon on the computer looking for nursery items. The realization that we need two of everything makes this pregnancy more portentous. Phillip isn't old enough to transition to a bed so we need two additional cribs; in fact, we need two more of everything. I spent hours studying different designs and discovered that they have special cribs for twins. By the time I finish for the day my notebook is full of ideas Martin and I can discuss later.
Martin is down the hall in Phillip's room collecting items for his bag for our trip to the farm while I finished my business in our bedroom.
Phillip pulls out extra books and discovers that there isn't enough room for them in the bag and decides that the extra nappies aren't important and pulls them out. I watch from the hallway as my son pulls them out and picks up the books he wants in the bag without his daddy noticing. I notice Martin as he turns from the dresser to discover everything he just put in the bag is now spread out on the floor.
"Phillip, what are you doing?" he asks softly, in that beautiful voice he uses with his son.
I have never seen or heard Martin get angry with his inquisitive son.
"Bouks," Phillip replies pointing to his stash of books in the bag.
I smile as I watch Portwenn's tall doctor squat down and settle onto the floor of his son's room, collecting the nappies and other items Phillip removed from the bag but he doesn't remove the books from the bag. Father and son converse together, with fingers pointing at different items and both of my Ellingham men shaking heads in agreement and disagreement. Finally, all but two books are pulled from the bag, and all the nappies and other items are placed back in. Phillip looks proud of the outcome of their conversation, and tries to pick up the bag while loudly voicing out his thrilled voice, "Gram."
Martin is finally cognizant of me standing in the doorframe, as usual, he observes my body looking for trouble or maybe that glint is lust. I nervously rub my hand along my side down towards my hip trying to ease the discomfort I have felt recently.
"Louisa is anything wrong?" he asks.
"No, just the usual aches and pains," I reply.
That look of concern crosses his features and I know that encyclopedic brain of his is searching for answers.
Dinner was wonderful with Ruth and Phillip entertaining us throughout the meal. I could sense Martin watching me as I spoke to the aunts about my research on baby wares. It is not the look of interest in the conversation but that of concern of a loving husband that is also a doctor.
While Joan and Ruth cleared the dishes Martin and I took Phillip for a walk in the tall grassy field. Phillip walked between us with his little hands clasped in ours slowly wearing himself out in the fresh sea air. He suddenly squeals, pulling his hands away from us, leans over excitingly points at a redness on the tall grass. To his delight, he has discovered a ladybird and immediately is trying to grasp it.
"Phillip, wait don't hurt it," I say. I slowly bend to take hold of his hand as I explain this strange bug to him. But as usual, everything new to him is going to go into his mouth.
"Phillip it won't taste very good," his father says as he squats down next to him. "Yuck," my husband says again as Phillip once again reaches for the bug.
He looks at his father and then back at the bug trying to decide if his daddy is correct about how it will taste, before finally deciding his daddy knows all, announcing loudly, "Uck."
My lower back is bothering me more than usual and I have this weird sensation in my hips. I thought at first of Braxton Hicks but that wasn't it. Martin as usual notices my discomfort and suggests we go sit down.
Joan and Ruth meet us at the gazebo pouring the tea as we arrive. Ruth notices Martin's thoughtful expression but can't figure it out. It isn't long before Martin is issuing orders to his aunts and lifting me into his arms moving quickly to our car. I can hear Phillip's little voice far off as Martin's long legs outpace his aunts, then suddenly everything speeds up and everyone is moving around the car, with the clicking of safety belts, the engine starting, and the sound of tires on gravel as the car storms off down the drive.
Martin is throwing question, after question at me as he drives like a maniac towards Portwenn. I register him talking to someone else as my mind deals with this new discomfort. My thoughts all point towards the twins, something is wrong and Martin, the doctor, has observed.
"Martin, what is wrong with me," I ask.
"Not sure but it could be early labor. I am waiting for Doctor Rawle to return my call." I can hear the anxiety in his voice, I tell myself to relax and just breathe, and Martin will take care of me.
We pull into the surgery parking area, Martin quickly comes around the car and lifts me out intent on carrying me again, "Martin, you don't need to…" I start to say before he hushes me.
"Louisa, we don't have time for you to walk. Just let me carry you so I can start my examination as fast as possible."
With my head nestled onto his chest, I hear him mumble a few times as he pushes open the surgery door and finally sets me down on his examination table. He pulls his cart over, searches through his lower cabinet, and pulls out a machine that I've seen before. He places the monitoring device strap around my ever-expanding belly, he is in full doctor mode now but I can see fear in his eyes of the uncertainty of what we are dealing with. I watch as he pulls out more instruments of his trade, and see how anxious he is in those oh so expressive slate-green eyes of his as he listens to the sounds of the machine. He is reaching for his sphygmomanometer when his mobile buzzes.
ME/LE
I reach for my mobile, "Ellingham."
"Doctor Ellingham, you left a message to call you. What is the problem?"
"Louisa is complaining of pain, spreading out across her lumbar region, hip to hip. Tiredness came upon her very quickly. The manual examination shows no sign of fetuses in distress. The tocodynamometer is currently recording, with a full measurement in a few minutes. Fetal heartbeats register within normal range."
I look at Louisa, laying there with her eyes closed but I can see the stress on her face.
"I was about to examine her when you called."
While I talk providing my observations I castigate myself for my lack of medical knowledge concerning obstetrics. I continue setting up for my examination. The cuff for the sphygmomanometer is in my hand as I hear Rawle ask his questions.
"The pain is lumbar or posterior?"
"Posterior," I answer as I squeeze the bulb and listen to Louisa's blood pressure. "BP is 132 over 80, her color is paler than normal, and she is confused and suffering from dizziness earlier."
I hear the beep of the tocodynamometer, "Contractions register at three mm Hg*." I sign with some relief that Louisa is not in labor. Doctor Rawle's voice pulls me from my thoughts,
"Are you ready to do the exam?" he asks.
"No, give me a moment." I turn towards Louisa noticing a fearful confused questioning look on her face. I smile as I try to show my relief, "Louisa, currently you are not in labor but I need to perform an exam to provide Doctor Rawle with useful information." I help her into the examination position and remove her clothing from the waist down.
Over the speaker of my phone Doctor Rawle explains what to look for during the exam. I note the following to him, "No discharge or blood." I palpate the uterus for manual contractions, "No contraction noted with manual palpitation." My face relaxes, even more, when I finish my final assessment, "No, dilatation of the cervix noted."
I now take the position next to Louisa's abdomen so I can observe any changes in her skin, fetal movement, or distension. I warm my hands together, looking at Louisa, I notice concern still evident in her eyes, clearing my throat I continue with my abdominal examination. I check the fundal height, presentation, and lie of the uterus. "My manual examination is normal for a woman of twenty weeks gestation."
"Martin at this time I am not concerned with early labor. Is Louisa keeping herself hydrated?"
"Yes, she…" I don't finish my sentence as Louisa gasps.
"I haven't drunk my usual amount of water. I was engrossed in my research this afternoon that I didn't drink my required amount Martin, I only had my morning glass."
I close my eyes, running the different scenarios through and knowing dehydration can bring on every symptom Louisa displayed today. On one hand, I am happy but with this knowledge, I know the complications it could lead to pregnancy and early labor. I walk over to the sink and fill a glass with water and hand it to her to drink. I pull from my rolling cabinet everything I will need along with a bag of saline solution to start an IV to start fluids.
"Doctor Rawle, I am starting an IV to counter the dehydration," I announce.
"I agree," he replies. "I think this is not the whole problem. Louisa's injury, the pain she is feeling can be attributed to her growing uterus and loosening ligaments in her pelvis and spine. She is in the mid-point of the second trimester; she is at a higher risk for back pain. You mentioned hip to hip pain, her abdominal muscles, and her altered center of gravity is the main cause and likely placing more stress on her back injury. We knew this was going to happen but I was hoping not for a few more weeks. I will talk to Doctor Gee in the morning, for now, get her hydrated, and both of you relax. I currently don't believe Louisa and the fetuses are in danger."
I end the call and look over to Louisa, who is biting her lower lip as she waits for me to explode. I pull my rolling stool over and sit down with a groan, raising my eyes to meet hers as I try to keep the frustration out of my voice. "Louisa, we spoke about this…" I can't finish my thought when I see the tears roll down her cheeks. She knows as well as I do that we dodged a medical consequence with her pregnancy. Getting up I take hold of her shoulders and wrap my arms around her, consoling her but I know we will need to discuss this later.
My mobile buzzes and I hear Ruth's voice when I answer. I can hear the concern in her voice and the background of Joan's insistent words to tell her what I've said. I turn to look at Louisa as I explain Louisa's medical condition, noticing her eyes closed, her tears continue to slide down her cheeks, and my anger continues to dissipate. "Tell Joan, Louisa, and I will be home soon.
I pick up Louisa's knickers and put them in my pocket, slide her shoes onto her feet, and roll the bottom of her dress down over the lower part of her body readying her for our departure to our home. "Louisa, let's get you home comfortably lying in your own bed now. The IV will take some time and you would be more comfortable in our bed than on this hard exam table."
I move away from her and open the wooden cadenza where I store the blankets and sheets for emergencies, pulling my favorite purple blanket out. Her eyes catch sight of it, a small smile crosses her lips as she remembers our multiple wine bottle night together. Sadly it is one night I wish I could have enjoyed Louisa's companionship instead of that dog.
"I will be right back I want to move the car closer to the door. I return and wrap Louisa in the blanket, lay the IV bag on her pregnant belly, and pick her up taking her to her waiting chariot. I close and lock up the surgery and drive us to our house.
ME/LE
I get Louisa tucked into bed, with plenty of pillows for support before I finally breathe a sigh of relief.
"Louisa, I am empty without you. Today brought forth all my worries. Doctor Hayes would call them my insecurities from my upbringing. I just know that I would be lost. Phillip and I would be lost without you in our lives."
I wrap myself around her with my head firmly in the well of her neck where the shoulder meets, pulling myself closer… as close as I can.
Louisa realizes that her husband's emotional state is on the brink of crashing.
"Martin, my body was alerting me that all was not well. My stupidity for not following your important guidelines didn't help. We knew my injury would be an issue. I haven't had pain for a while, so my body needed to remind me of everything my husband and the doctors told me to do to carry these two wonderful babies to term. Nothing like this will happen ever again, Martin, I promise you."
"Get some sleep, I will be right here if you need me."
I splay my hand across her expanding abdomen, grazing slowly across in slow circles, as I feel the stress-free itself from Louisa, I can sense the twins settling down under my hand one slow circle after another.
After what seemed like hours Joan poked her head around the half-open door, I notice the movement and brought a hand up to stop her from making any noise. Silently sliding away from Louisa I motion Joan out of the room so we can talk.
"Ruth and I are leaving but I wanted to make sure you knew," she said.
"Let me tell you everything first over a cup of tea."
I check one more time on Louisa and then Phillip before heading to the kitchen to speak with my aunts. They have brewed a pot of tea for our discussion, with Joan fussing over me like a mother should and Ruth watching me with a clinical eye.
"Louisa will be fine then; No future problem as you see it," Ruth states.
"Yes, she and the babies are fine. We see Doctor Rawle on Friday for her twenty-week check-up. We will be halfway through the pregnancy with sixteen to twenty weeks till the birth."
"Will her pain get worse?"
"Yes, the added weight, stretching ligaments are putting a terrible strain on her injury. We see Doctor Gee on Friday also. Maybe he has some ideas for us."
"We need to make sure she stays hydrated," Joan adds. "I will make a nuisance of myself to make sure when I'm here each day, and I will make sure Melanie does too."
"Martin, I planned on staying just for the weekend but in light of everything I changed my mind and will stay till mid-month if that is alright with you Joan?" Ruth states.
"Yes, stay as long as you wish Ruth. Believe it or not, I do enjoy our time together," she says with a raised eyebrow.
I catch little of the conversation as my mind is on Louisa.
"Martin, we will talk about the London properties tomorrow. We'll go and you go back upstairs and take care of that wife of yours."
I nod my head, agreeing quickly so they will leave and I can check on Louisa's IV. I walk them both to the front door, receiving a kiss and a bear hug from Joan, and a touch on my arm from Ruth. After locking up and clearing the tea items up, I head upstairs stopping first to check on Phillip. He brings a smile to my lips when I notice his sleeping position with the knowledge that my mother would be furious. His legs were tucked under him with his derriere in the air and his arms wrapped around his stuffed animal. I turn and partially close his door, heading for my bedroom to check on Louisa. I checked her pulse, lightly pinched her skin to ensure she is rehydrated and started the process to remove the IV. She slept through the removal. I took the medical waste down to my study and returned to the en-suite to get ready for bed. Crawling into bed and slide up behind Louisa, wrapping my arm over her, and was reminded of my recent vision of my son. I touch Louisa in different places on her abdomen sensing where each of my children is located, wished them goodnight, and fell quickly asleep.
ME/LE
I wake to the sound of Phillip jabbering with his dinosaur from his bedroom, I quickly check on Louisa before I pull myself out of bed, pulling on my dressing gown as I walk towards his room. Phillip notices me immediately when I open his door, reaching for me to pick him up.
"Good morning Phillip. What were you discussing with your purple dinosaur?"
"Baff, Illip wants baff."
I laugh as he points out of his room towards my bedroom. "Your dinosaur doesn't need a bath, leave it here."
Phillip looks at his stuffed friend and back at me.
"Phillip you may take your duck but not both."
He looks at his stuffed friend again and makes his decision by dropping the toy in his cot.
"Good choice," I say. "Now let me remove your pajamas."
I lay him on his changing table and begin to unsnap his clothes. Picking him up and together I walk towards his bathroom when he suddenly screams out, "No, Illip baff," he yells while he points towards my room down the hall.
"Martin, what is wrong with Phillip?" I hear Louisa's voice coming from our bedroom.
I turn and walk towards my room causing Phillip to start dancing in my arms. I walk in to see Louisa rolling herself off our bed to find out what is wrong with her son.
"Stop, Louisa, stay put. Phillip is fine. He wants his special bath instead of his tub bath," I say with a groan.
Louisa smiles and says, "Martin, you're such a good daddy, but let me go in there first."
While we wait for Louisa to finish I pull an extra towel and flannel from the cupboard. The door opens and Louisa looks at us,
"I got the water started."
I walk in setting Phillip on the mat; I remove my dressing gown and hang it on the peg behind the door. I turn to the toilet, lifting the cover in preparation for our daily experiment with Phillip. I stand him up, pull the tabs on the nappy allowing the open wet nappy to fall to the floor, pick him up placing him backward on the toilet, while I carefully hold him.
"Phillip time to urinate, you can't have your bath until you show daddy you can sink the tissue."
The first time we did the toilet experiment I had to pour warm water over his genitals so he would relate to the water feeling of the shower. From there I needed a target for him to aim for and placed a square of toilet paper in the water and urge him to sink it. Now, over a month later Phillip happily sinks the toilet paper and giggles at the game. Louisa walks in carrying his soaps and proudly says,
"Phillip is such a big boy."
I lift him and replace him on the mat, judging the water temperature with my foot as I make sure Phillip stays put. When I am satisfied I pull my pants off, pick Phillip up, and we enter the shower stall together. When we are both clean and the water drains away Louisa hands me his towel to wrap around his small body, I set him on the mat as I take my towel and quickly dry myself, finally wrapping it around my waist. Phillip and I go to his room to dress in the clothes Louisa laid out. I grab a book and a few toys and place him in his cot with his dinosaur to entertain him.
"Phillip, play with your toys while I dress, and then we will go downstairs and make mommy her breakfast."
He happily plays with his toys and I quickly shave occasionally glancing at the reflection of Louisa's naked body in the shower; her uterus is pulling her hips forward on her slender body. She looks larger than when she knocked on my door that fateful night. She notices me watching in the reflection in the mirror, she smiles and wriggles her finger for me to come over to the shower door. I am touching the handle to the door when I hear Phillip squeal. I cross the room as fast as my long legs can move me, my shocked face of my son standing up in his cot pointing to the little white dog rolling around on the floor, but my temporary shock on my face disappears when I realize there is a filthy animal in my house.
"Louisa do you know anything about this?" I yell.
Louisa waddles in tying her dressing gown closed, "What are you talking about?" she asks.
I point to the offending creature, "This is what I am talking about."
"Martin, it's a dog. Do you remember we talked to Joan about Buddy and his owner dying? Then I mentioned that little boys need a dog."
"Yes, I remember, but I also remember replying 'NO' to filthy animals in my house."
"Your house Martin, is that what this is, 'YOUR HOUSE'?"
I knew I said the wrong thing as soon as it left my mouth. "I didn't mean 'MY' when I said it. I meant our home."
"Nice try Martin, but that is not what you yelled. Buddy is here for the morning until Joan is finished helping Joe Penhale out at the McIntyre farm. I told Joan to drop him off, so calm down, and she bathed him yesterday. The vet said he is in perfect health."
I look at my wife, those green eyes flashing angry golden sparks, and can hear my son giggles and ramble of conversation with the dog and I know I have lost this battle.
"Take Phillip downstairs, Buddy will follow and you can feed both of them," she states in a voice I know I won't be able to argue with.
"What do I feed the dog?"
"Joan should have left a bag of food in the kitchen. I'll be down in a few minutes."
I take Phillip into my arms and sure enough, that mutt follows us downstairs. I place Phillip in his chair, pull a bowl out, and slice a banana, placing the bowl in front of Phillip all while those biddy eyes of that mutt watch. Buddy sits down next to Phillip's chair watching and waiting for him to drop food onto the floor. I act quickly, run to my study and pull gloves from my medical bag and return to the kitchen, snapping the gloves on before the mangy mutt can move I scoop him up and put him in the pantry, closing the door before he escapes.
Louisa joins us in the kitchen a few minutes later, she looks around but doesn't see what she is looking for. I am busy at the hob preparing our cereal when she asks,
"Where's Buddy?"
"I put him in the pantry with his bowl of food and water. He doesn't need to be in our kitchen while we eat."
I pour her brewed tea into her cup and place the bowls of sliced fruit next to our place settings. Spooning the cereal into our bowls, I wave to her to catch her attention to sit down and eat. Phillip puts another mushed piece of banana into his mouth as he watches his mother stand behind her chair with a scowl on her face.
"Martin, why did you put him in there?"
"You know how Phillip drops food onto the floor, I didn't want the dog eating it and getting sick in the house."
"Oh, all right," she says as I move to help her sit.
I take my place and start feeding Phillip his cereal ignoring the whining sound coming from our pantry, but Phillip is distracted and is ignoring the spoon of food as he tries to turn in his chair towards the sound. My frustration is rising, I look at the clock knowing it is getting late and I need to finish feeding him and clean up the kitchen before heading to the surgery for early appointments, I push my chair back, and walk over to the pantry door and release the mutt. He trots over to Phillip's chair and sits up on its hind legs to start his begging. Before I can voice my outrage…
"Buddy down, no begging," Louisa announces.
Of course, that mangy hairy mutt listens and lies down.
"See Martin, he can behave."
I spoon more cereal into my son's mouth and keep my opinions to myself.
ME/LE
My day improved even with the multitude of medical complaints throughout the day, I just finished my last of the patient notes when I hear a knock on the door.
"Come," I announce as I place the cap on my fountain pen.
My aunt pushes the door open, looking around before stating, "I'm not interrupting am I, Martin?"
"Ruth no, come in. What can I do for you?"
"I asked Joan to drop me off here on her way to your house with the groceries. I thought we could talk a bit before we return to your home."
"What are your concerns, Ruth?"
"How this pregnancy is affecting you. I have never seen you this emotional before."
This is the last thing I want to discuss with my aunt. She sits across from me and her demeanor is professional but I sense concern for me personally.
"Not sure what you want to hear. I'm happy with Louisa's pregnancy. I want what she has given me, I need what she gives me."
Ruth smirks, her eyes digging deeper into me, and I feel like one of the feeble-minded patients in the sanatorium.
"Not sure what Joan has told you about my marriage. Louisa and I were engaged almost two years ago, but the engagement only lasted a few weeks. I was an emotional wreck of self-doubt. Why would a beautiful woman like her want with me, a person his parents hated, a surgeon afraid of blood that chose a backward fishing village to hide in. I sat in the lounge in this cottage on our wedding day in self-doubt while everyone waited in the church. Louisa had doubts also, but she said 'she loved me and always would'. I thought we had time together in the village to start again but she left, went to London, leaving her home, friends, and job because it was too hard to be near me without being with me. I made the decision a month after she left that I couldn't stay here and began work to go back to surgery, but first I needed to cure myself of the haemophobia. I was introduced to Doctor Hayes during a PCT meeting, he worked with me, and he continues to work with me on many issues. Louisa returned to the village six months pregnant, we talked that evening, and I fell in love all over again."
"Martin, what was her reason to return to her village, was it for you?"
"She discovered she was pregnant a month or so after leaving the village. Louisa is not fond of London and the school wasn't happy to have a single pregnant teacher. She said she missed the village and her old job. Our talks the first week opened old wounds and renewed a need for me. She is my life. I can't live without her and don't want to. Even though we were together she kept the pregnancy, she gave me my son. Nobody has ever loved me enough to do that. And now she gives me two more children, and once again this pregnancy will be hard for her."
"That's all I needed to know Martin, and I am happy for you."
Ruth is an Ellingham through and through so I am shocked when this frail-looking woman squeezes me tightly, just like Joan. After what seems too long I clear my throat a few times, my aunt finally looks me in the eye, gives me that smirked grin, and pats my shoulder trying to relieve my tension.
"I have something else I need to discuss with you," she says.
I groan as if the last thirty minutes wasn't enough nosing around in my business.
"What else do you need to know?" I ask.
"Not sure if you remember my association with several board members at Imperial Hospital. I understand that John Rasmussen introduced a certain name to the board for the Head of Vascular. It is not your name, and I was wondering why."
"John and I spoke when he was in Truro last month. He asked me to take the position. I turned him down, and gave him another name to be considered."
"Martin, why would you turn it down? It is everything you ever wanted."
"You don't understand anything I just said. I want to be with Louisa, and being Head of Vascular would put a burden on my marriage. I want to spend time with my children and my wife. Not seeing them around a schedule where I miss every precious moment in their lives. Louisa does not like London; her job is here at her school. I like the life I have forged here in Portwenn."
I get up and fill a glass with water and slowly drink it down allowing my anger to dissipate.
"I gave John a good replacement, William Shaw."
"Your father's illegitimate son?" she asks.
"He is a good choice for the position. I told John of my relationship with him."
"But Mr. Shaw is a nobody in the medical community; the board won't accept him because I know they want you, Martin."
"He is talented and improved on many of my groundbreaking surgical techniques. William just needs a powerful influence like John behind him. John called me last week about the board dragging their feet; he didn't want to use the relationship with dad and William to influence their decision. We wanted William to stand on his own merit so I sent a letter fully endorsing him to the board highlighting William's credentials and new techniques he has developed over the last couple of years. The hospital will benefit William and I will be happy living in Portwenn with my wife and children."
I look at my aunt and see that she isn't completely happy with my decision but can understand it.
"Is there anything else you want to discuss or can we go home so I can check on my wife?"
"Let's go, Martin. Maybe Phillip wants to explain another medical article to me," she replies.
End of chapter
*During labor, uterine contractions are usually monitored along with the fetal heart rate. A pressure-sensitive device called a tocodynamometer is placed on the mother's abdomen over the area of the strongest contractions to measure the length, frequency, and strength of uterine contractions.
