Chapter 11 – The Case

Louisa was saying, "And here today, as you can see, is our special guest Doctor Ellingham."

The kids in the classroom tittered and I believe I heard one distinct, "Tosser," uttered from the back.

I blew air through my nose, then stood up. Nineteen pairs of eyes looked at me: one half smirking and the other half with fear on their faces. "Thank you, Miss Glasson," I said to her.

She was dressed in a sort of white maternity top with a light brown cardi, and grey slacks. Suitable flat shoes graced her feet, so some of my advice about not wearing heeled shoes had taken root. Her long beautiful hair was pulled back with a brown fabric loop into one of her trademark ponytails.

Another titter from the back, near the window. I stared at the boy. It was Timothy… hm, Jones… no James… no, uhm…

"Doctor?" Louisa asked softly. "I believe you were about to address the class?"

"Right," I addressed her. "Now…" I rubbed my hand together. "Let's have a chat, shall we? Rather a little talk about medicine and other things."

The kid in the back stuck his tongue out at me, which was overly red in color. Tongue, yes, glossitis, caused by his iron-poor diet. I'd put him onto vitamins and iron rich foods, such as potatoes, spinach, certain nuts, and whole-grain breads. That gave me his name, which was Gloyne. Timothy, no, Thomas Gloyne. His mother and father were quite as irritating as the child was, never being on time for medical appointments and complaining mightily when they did show up.

I glanced at Louisa who stood near me, but she was looking at me, so she did not see the tongue.

"Medicine…" I began, and the classroom groaned.

I stopped and closed my eyes, in frustration. This would not go well.

"Watch out Miss Glasson, he's gonna faint!" came a cry from the other side of the room, so that snapped my eyes open.

I fixed that boy, John Bogan, I think was his name, with a hard stare and I distantly saw his Adam's apple move in a huge gulp. I'd had to lance a boil off his right buttock and he had screamed and cried through the entire procedure, although I had administered local anesthetic. He'd almost fainted during the procedure, which lasted all of sixty seconds. Humph. "Let's address that," I said to him.

Louisa said, "Martin, you don't have to…"

"No, Lou… yes, Miss Glasson, I do. Let's talk about fainting, and why? As you all know, I have done it… rarely."

A girl in the front row (Katy Holmes? Kathleen Holzer? No, Kaitlin Howard; that was her name) raised her hand. "Doc Martin, is it because your blood pressure goes low? That happened to my gran. She had to have an electric thing put in her."

I faced her. "No, Kaitlin, that would be because your grandmother, had a cardiac, or heart, arrhythmia. Her heartbeat was too slow at times. The electric thing, as you call it, is a pacemaker to regulate the beating of her heart." I tried to smile, as such. "And the last time I saw her she was fit."

The girl nodded. "She has to take pills as well, an avoid too much salt," she added brightly. "She's been tellin' her lady friends that you are such a good doctor."

Louisa interrupted, "Kaitlin, I am sure that Doctor Ellingham would have any number of people say that – that he is a very good doctor."

I stared at Louisa for a moment until she gave me a signal with an eyeroll to look back at the class. "Erh, yes. But as for fainting…" I gave the class an abbreviated and simplified three-minute-long speech on haemodynaics and the regulation of blood pressure and what can and cannot cause fainting.

"Oh," the girl answered. "I see."

"The blood thing, then?" some other girl asked, and her name totally escaped me. I thought hard. This girl had freckles and reddish hair, and her father had a large cafe-au-lait mark on his hand. Right. Got it.

"Miss Barrows," I said to her.

"Burrows," she corrected me. "Maggie."

I cleared my throat. "Yes… now you may have heard that sometimes, it has been said, that Doctor Ellingham – Doc Martin – faints; passes out. That much is true."

Some of the kids looked at one another sideways and the boy in the right rear stuck his tongue out again.

I ignored them, saying, "I was a surgeon. A physician who can cut you open, fix what is wrong and sew you up again."

Some of them gasped, but one boy replied, "You did it to Peter Cronk."

"Ah, yes. Peter Cronk suffered an injury in a fall to one of his internal organs. It was bleeding, and I…"

I saw Louisa turn pale, so I stuffed a chair up to her and she sat down. Then she was okay. Good. Not a great idea at all for her to keel over in her condition; nearly eight months along in her pregnancy.

I answered, "I performed emergency surgery to stop the bleeding."

"In the back of a speeding ambulance," Louisa added. "Saved his life."

"My dad said that squared you with him," someone said. "Says you wuz alright in his book after that."

I nodded. "Yes."

The kids went quiet.

A timid looking boy raised a trembling hand, so I called on him. "Yes?"

"So, why da'yah faint then?"

I put my hands behind me and interlaced my fingers. "It is a delayed reaction to things I was exposed to, as a surgeon."

"Like a nightmare?" the boy inquired. "Scary things?"

I drew a deep breath and thought of Frank Marrak. "Yes. Scary things. Even adults can be scared." Speaking of Frank, where was he? I did expect he'd be in class today, but there was one empty chair, and no Frank. Not well, perhaps. I'd contact his mother after this mess was ended.

The children stared at one another as if I had just told them a horrible truth. It was true. I was very scared when Peter Cronk almost bled out, for as I pushed my right hand inside the incision I had made in the left side of his abdomen, I had fumbled in the wet and slippery hole until I located the spurting splenic artery, and got it between two fingers. The thing tried to propel itself away from me, but I managed to clamp it, just barely.

Louisa had almost been yelling in despair moments before but when she saw I had things under control, and Peter's blood pressure started to rise, she had not screamed. Neither had I, but I did bark at the ambulance medic, partly to voice my alarm. Who in God's name would specify plastic Spencer-Wells forceps for emergency use?

I still seethed at the memory and made damn sure that all ambulances in Cornwall were suitably equipped. The Medical Board had tried to compliment me for my foresight. They were not pleased when I replied that if they had done their jobs properly, the correct instruments would have already been at hand.

"So, yes, I can get - startled - just like anyone. Nervous, say. Just like any of you,"

"Huh. Scared? And then you faint? Go down hard?" a boy asked.

"Something like that," I said slowly. They had no need to hear the details of why I had haemophobia.

I saw a side-glance from Louisa and her face showed concern. "Now, boys and girls," she said, "I don't think this is quite the reason that Doctor Ellingham has come today. So please pay attention to what he has to talk to you about."

I gave a nod and I started with my primary message. "Yes, good. Now everyone of us eats to get the needed food to sustain us. Our bodies digest that food and break it down so that we can get the needed energy for life. Intestines absorb the digested food into the bloodstream to nourish every cell in the body. Certain organs make chemicals that make it possible for us to use or breakdown that food material. In some cases, certain people - their internal organs that is – do not make the proper chemicals, called enzymes. Therefore, they can get sick, without them."

A boy raised his hand. "Oh! My uncle works in a chemical plant."

I tried to ignore his comment. "Yes. Now these chemicals…"

The boy added, "He says it sorta of a medical place too."

"What is this place? Do you know the name?"

He screwed up his face. "Falmouth Med Works, I think."

"Ah. That company produces insulin, which is needed by those with diabetes. Insulin is a hormone, another sort of chemical in our bodies. But I was speaking about enzymes."

"Mar-tin," Louisa whispered to me, "does it really matter which is an enzyme and which is a hormone?"

"Louisa, enzymes are proteins that act as biological catalysts to speed up chemical reactions. Hormones are regulatory chemicals, so yes it does matter," I told her.

She sighed.

I then turned back to the class. "Now, one of your classmates has a biological deficit. His body, due to a defective gene, is unable to make one of those enzymes. The syndrome, erh, condition, is not contagious. You can't catch it, and it's not his fault," I was saying when Sally Chadwick, Louisa's secretary, burst in all in a tizzy.

I had a rather dim view of the woman, considering she tried to scrub away a tattoo from her chest by herself. Silly woman.

"Miss Glasson!" the secretary shouted. "I called Mrs. Marrak about Frank's absence today. She just this minute phoned and said Frank did leave for school this morning. Now we tell her he's not in school. So, where is he? Where's he off to?"

Suddenly I felt very scared.